Objective To develop an artificial intelligence (AI)-driven lung cancer database by structuring and standardizing clinical data, enabling advanced data mining for lung cancer research, and providing high-quality data for real-world studies. Methods Building on the extensive clinical data resources of the Department of Thoracic Surgery at Peking Union Medical College Hospital, this study utilized machine learning techniques, particularly natural language processing (NLP), to automatically process unstructured data from electronic medical records, examination reports, and pathology reports, converting them into structured formats. Data governance and automated cleaning methods were employed to ensure data integrity and consistency. Results As of September 2024, the database included comprehensive data from 18 811 patients, encompassing inpatient and outpatient records, examination and pathology reports, physician orders, and follow-up information, creating a well-structured, multi-dimensional dataset with rich variables. The database’s real-time querying and multi-layer filtering functions enabled researchers to efficiently retrieve study data that meet specific criteria, significantly enhancing data processing speed and advancing research progress. In a real-world application exploring the prognosis of non-small cell lung cancer, the database facilitated the rapid analysis of prognostic factors. Research findings indicated that factors such as tumor staging and comorbidities had a significant impact on patient survival rates, further demonstrating the database’s value in clinical big data mining. Conclusion The AI-driven lung cancer database enhances data management and analysis efficiency, providing strong support for large-scale clinical research, retrospective studies, and disease management. With the ongoing integration of large language models and multi-modal data, the database’s precision and analytical capabilities are expected to improve further, providing stronger support for big data mining and real-world research of lung cancer.

Objective:To explore the value of coagulation indicators and related critical scores in evaluating the severity and prognosis of elderly sepsis patients.Methods:Patients admitted to the intensive care unit (ICU) of General Hospital of Ningxia Medical University aged ≥60 years with a definite diagnosis of sepsis from May 2020 to May 2022 were retrospectively included. General epidemiological data, coagulation indices such as prothrombin time (PT), international normalized ratio (INR), prothrombin activity (PTA), activated partial thromboplastin time (APTT), prothrombin time (TT), fibrinogen (FIB), D-dimer, platelet count (PLT), and other laboratory indices within 24 hours of admission to the ICU, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA), sepsis-related complications, and 28-day prognosis were collected. Patients were divided into shock and non-shock groups according to whether septic shock occurred or not, and into death and survival groups according to 28 days outcomes, and the differences of each index between the groups were compared. Independent risk factors for septic shock and 28-day death were analyzed by using univariate and multivariate Logistic regression, and the receiver operator characteristic curve (ROC curve) were further plotted to assess the value of independent risk factors in predicting the occurrence of septic shock and 28-day death in elderly patients with sepsis.Results:A total of 295 elderly patients with sepsis were included, 192 (65.08%) developed septic shock, and 126 (42.71%) died at 28 days. Multivariate binary Logistic regression analysis showed that SOFA score and PT-INR were independent risk factors for septic shock and 28-day death in elderly patients with sepsis [septic shock: odds ratio ( OR) and 95% confidence interval (95% CI) were 1.340 (1.186-1.513) and 1.720 (1.235-2.396), respectively; 28-day death: OR and 95% CI were 1.188 (1.044-1.351) and 4.546 (2.613-7.910), respectively, all P < 0.01]. ROC curve analysis showed that SOFA score and PT-INR had certain predictive values for septic shock occurrence and 28-day death in elderly patients with sepsis, and the area under the curve (AUC) for septic shock occurrence were 0.743 and 0.564, respectively. The AUC of 28-day death was 0.711 and 0.651, respectively. The combined predicted AUC was 0.761 and 0.817, the sensitivity was 78.1% and 65.1%, and the specificity was 63.1% and 85.8%, respectively. Conclusion:PT-INR and SOFA score have potential predictive value in the assessment of the severity and prognosis of elderly patients with sepsis, and their combined prediction accuracy is higher.

Exhaled breath analysis technology is a non-invasive,painless,safe,convenient,and efficient detection method.It holds great promise in disease screening,clinical diagnosis,assessment of disease severity,formulation of treatment plans,and prediction of disease prognosis.In recent years,this technology has rapidly ad-vanced and has become an important tool in the management of respiratory system diseases.This article aims to pro-vide a brief overview of the clinical applications and research progress of common exhaled breath analysis technolo-gies in respiratory system diseases such as airway chronic inflammatory diseases and airway infectious diseases.

Objective:To investigate the effect of short-chain fatty acid (SCFA) sodium butyrate (NaB) on the polarization of lipopolysaccharide(LPS) induced M1 type alveolar macrophages and the mechanism of action.Methods:Mouse alveolar macrophages (MH-S) were randomly(random number) divided into control group (Control group), sodium butyrate group (NaB group), LPS group, LPS+NaB group (LB group), and LPS+NaB+adenylate activated protein kinase (AMPK) inhibitor (Compound C) group (LC group).The mRNA expression levels of interleukin 6 (IL-6), interleukin 1β(IL-1β), tumor necrosis factor α(TNF-α), cluster of differentiation 86 (CD86), inducible nitric oxide synthase(iNOS) in MH-S cells, and zonula occludens 1 (ZO-1), tight junction protein 4(Claudin-4), and closed protein(Occludin) in mouse lung epithelial cells (MLE-12) were detected by qRT-PCR;Protein levels of IL-6, IL-1β, and TNF-α in the supernatant of MH-S cell medium were measured by ELISA;Western blot determed the protein expression of AMPK, P-AMPK, nuclear factor E2-related factor 2 (Nrf2), and heme oxygenase 1 (HO-1) in MH-S cells;Expression of M1 type macrophage-associated markers CD86 and iNOS were determined by flow cytometry.Results:(1) qRT-PCR and ELISA results were consistent, M1 type macrophage-associated proinflammatory cytokines IL-6, IL-1β and TNF-α significantly reduced in the LB group after NaB addition compared with the LPS ground (all P <0.05); (2)The results of qRT-PCR and flow cytometry were consistent,compared with the LPS group, the LB group showed a significant decrease in M1 type macrophage-related polarization indicators CD86 and iNOS after NaB addition(all P<0.05); (3) Western blot was used to detect the expression of the AMPK/Nrf2/HO-1 signaling pathway,compared with LPS,the addition of NaB in the LB group enhanced the expression of P-AMPK/AMPK, Nrf2 (nucleus), and HO-1 (all P<0.05); compared with the LB group, the LC group decreased the expression of P-AMPK/AMPK, Nrf2 (nucleus), and HO-1 (all P<0.05);the results of flow cytometry showed that compared with the LPS group, the addition of NaB significantly decreased the expression level of iNOS + in the LB group ( P<0.05); compared with the LB group, the addition of Compound C in the LC group reversed the inhibitory effect of NaB on iNOS + ( P <0.05);(4) The qRT-PCR results of MLE-12 cells showed that compared with the LPS group, the LB group showed a significant increase in Z0-1, Claudin-4, and Occludin after the addition of NaB(all P<0.05). Conclusions:SCFA inhibits LPS-induced polarization of M1-type alveolar macrophages and ameliorates the inflammatory response by activating the AMPK/Nrf2/HO-1 signaling pathway.

Human still has limited understanding of respiratory infectious diseases, especially emerging acute respiratory infectious diseases. Once the pandemic of this kind of infectious disease occur, it would be a serious challenge to health, political security, the economic development, and social stability. People hope to detect the changes in infectious diseases in early phase through surveillance and give early warning in time. In the field of public health, more attention has been paid to syndrome surveillance as an effective supplement to traditional surveillance. This paper summarizes the current surveillance system of infectious diseases abroad, introduces the syndrome surveillance system of acute respiratory infectious disease and its application in China, and discusses the development of syndrome surveillance and early warning technology for acute respiratory infectious diseases in the future.

Lower respiratory tract infection poses a major threat to the population's health, which brings about severe health damage and disease burden, especially in infants and the elderly. The prevalence and pathogen spectrum of lower respiratory tract infections differ in countries and regions as influenced by various factors such as region, population, and pathogen detection methods. The prevalence and severity of this group of diseases are jointly affected by pathogens, host characteristics, and the external environment. Monitoring programs set for the local epidemic situation, pathogen spectrum, and influencing factors of lower respiratory tract infection helps develop comprehensive prevention and control strategies according to local conditions and allocate and utilize medical and health resources more reasonably.

Objective:To observe the clinical characteristics and guideline compliance of chronic obstructive pulmonary disease (COPD) patients with initial triple therapy in real-life world.Methods:This study is a cross-sectional study. The subjects of the study were COPD patients admitted to 13 hospitals in Hunan Province and Guangxi Zhuang Autonomous Region from December 2016 to December 2021. The initial treatment was triple inhaled drugs. The data collected included gender, age, diagnosis, body mass index (BMI), history of acute exacerbation (AE) in the past year, pulmonary function, COPD Assessment Test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC), inhaled drugs and other indicators. The characteristics and differences of COPD patients before and after 2020 were analyzed.Results:7 184 patients with COPD were enrolled in this study, including 2 409 COPD patients treated with initial triple therapy, accounting for 33.5%(2 409/7 184). Taking January 1st, 2020 as the cut-off point, 1 825 COPD patients (75.8%) received initial treatment with triple inhaled drugs before 2020 and 584 patients (24.2%) after 2020 were included in this study. Compared with COPD patients before 2020, the COPD patients after 2020 had higher FEV 1% [(40.9±15.5 )% vs (39.3±15.5)%, P=0.040], lower CAT [(15.8±6.5)point vs (17.5±6.2)point, P<0.001], less AE in the past year [1(0, 2)times vs 1(0, 2)times, P=0.001] and higher rate of non-AE [255(43.7%) vs 581(37.1%), P=0.006]. In addition, before 2020, patients with COPD were mainly treated with open triple drugs (1 825/1 825, 100%); after 2020, 306 patients (52.4%) received open triple inhaled drugs, and 278 patients (47.6%) received closed triple inhaled drugs. Conclusions:In real-life world, most of patients with COPD treated with triple therapy have severe lung function, obvious symptoms and high risk of acute exacerbation. The real-world prescribing of triple therapy in patients with COPD does not always reflect recommendations in guidelines and strategies, and overtreatment is common. After 2020, prescribing triple therapy for COPD patients is more positive and worse consistency with guideline.

To analyze the clinical characteristics, treatment and prognosis of mediastinal germ cell tumors (GCTs) with concurrent hematologic malignancy (HM). The clinical features, treatment and prognosis of 3 cases of HM associated with mediastinal GCTs treated in the Department of Medical Oncology, Beijing Children′s Hospital from November 2014 to September 2018 were retrospectively analyzed.Meanwhile, relevant cases were searched in the PubMed and Wanfang database from their establishment to December 2019.Three male cases of HM associated with mediastinal GCTs aged from 12 to 16 years.The pathogenesis of mediastinal masses suggested teratoma or yolk sac tumor.All of them were treated with surgery and chemotherapy.Acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) was diagnosed respectively at 5 months, 9 months and 31 months after initial GCTs in the 3 cases.Two patients died and 1 child survived at the last follow-up.A total of 135 cases of concurrent GCTs and HM (or leukemia) were reviewed in online databases, involving 127 cases (94.1%) with the mediastinal GCTs associated with HM and 8 cases(5.9%) with GCTs related HM from another original sites.One hundred and twenty-six cases (99.2%) were male and the median age of GCTs diagnosis was 22 (10-48) years.Fifty-three cases (41.7%) were teratoma and 94 cases (74.0%) were GCTs containing teratoma with or without yolk sac tumor.Among the types of HM, 72 cases (56.7%) were AML and 31 cases (24.4%) were AML-M7.The median interval between GCTs and HM was 3 (0-122) months.Forty-six cases (36.2%) presented 2 malignancies simultaneously.HM were diagnosed within 12 months of GCTs in 85 cases (66.9%). The survival data were known in 107 cases, involving 94 (87.9%) deaths and 13 (12.1%) survivors.The median survival time after diagnosis of HM was 2 (0-48) months.The tendency of HM must be highly concerned in adolescent male patients with primary mediastinal GCTs, especially those with yolk sac tumor or teratoma.Their prognoses are very poor.Allogeneic hematopoietic stem cell transplantation is an alternative treatment.

Objective:To summarize the clinical features of neuroblastoma (NB) with bone metastasis in infants and the prognostic factors.Methods:A retrospective analysis was performed on 32 patients aged ≤12 months who were enrolled in Beijing Children′s Hospital, Capital Medical University from January 2010 to December 2019 and had imaging findings suggesting signs of distant bone metastasis.The control group was included NB children, aged ≤12 months, who were admitted to Beijing Children′s Hospital, Capital Medical University during the same period, without signs of distant bone destruction.The clinical manifestations and auxiliary examinations of infants with bone metastasis were summarized, and the efficacy evaluation and survival analysis of infants with regular treatment and follow-up were conducted until December 31, 2020. Kaplan- Meier survival analysis was used for prognostic analysis, and Log Rank test was used for univariate prognostic analysis. Results:There were 32 NB infants with bone metastases, involving 12 males (37.5%) and 20 females (62.5%), accounting for 16.0% (32/200 cases) of infants diagnosed with NB du-ring the same period.The median age of onset was 9 (4.5-12.0) months.The main primary site included the retroperitoneal and adrenal region in 24 cases(75.0%) and mediastinum in 3 cases (9.4%). Among the 32 cases, 14 cases (43.8%) had simple bone metastasis, 19 cases (59.4%) had distant lymph nodes, 18 cases (56.3%) had bone marrow, and 3 cases (9.4%) had intracranial and meningeal metastasis.Bone metastasis mainly occurred in the skull, with 11 cases of single bone metastases and the remaining with 2 or more bone metastases.Compared with 168 NB infants without bone metastasis, the prognosis of those with bone metastasis was significantly worse [3-year overall survival(OS) rate 97.6% vs.82.7%, P=0.001]. Univariate analysis showed that the prognosis of NB children with bone marrow metastasis, meningeal and intracranial metastasis, MYCN gene amplification, and high-risk group was poor (all P<0.05). Two patients returned to the local hospital for treatment after diagnosis.A total of 30 children were recruited for efficacy evaluation and prognostic analysis.Twenty-nine children underwent surgery, of which 6 cases received surgery before chemotherapy and 23 cases received surgery after chemotherapy.One case received chemotherapy only.The mean course of chemotherapy was 6.2 (4-13) times.One case was treated with radiotherapy, 1 case was treated with Metaiodobenzylguanidine (MIBG) therapy, and 1 case was treated with stem cell transplantation.A total of 18 cases (62.1%) event-free survived, and 12 cases (40.0%) had a mean event at 7 (1.5-32.0) months.Among them, 7 cases survived and 5 cases died (16.7%). The expected 3-year event-free survival rate and OS rate were 57.1% and 82.7%, respectively. Conclusions:The most common sites of infant NB metastasis are bone and bone marrow, and the most common sites of bone metastasis are skull.Infants with bone metastasis had a worse prognosis than those without bone metastasis, and infants with bone and bone marrow metastasis had a worse prognosis than infants with single bone metastasis.

Objective:To rapidly evaluate the level of healthcare resource demand for laboratory testing and prevention and control of corona virus disease 2019 (COVID-19) in different epidemic situation, and prepare for the capacity planning, stockpile distribution, and funding raising for infectious disease epidemic response.Methods:An susceptible, exposed, infectious, removed infectious disease dynamics model with confirmed asymptomatic infection cases and symptomatic hospitalized patients was introduced to simulate different COVID-19 epidemic situation and predict the numbers of hospitalized or isolated patients, and based on the current COVID-19 prevention and control measures in China, the demands of resources for laboratory testing and prevention and control of COVID-19 were evaluated.Results:When community or local transmission or outbreaks occur and total population nucleic acid testing is implemented, the need for human resources is 3.3-89.1 times higher than the reserved, and the current resources of medical personal protective equipment and instruments can meet the need. The surge in asymptomatic infections can also increase the human resource demand for laboratory testing and pose challenge to the prevention and control of the disease. When vaccine protection coverage reach ≥50%, appropriate adjustment of the prevention and control measures can reduce the need for laboratory and human resources.Conclusions:There is a great need in our country to reserve the human resources for laboratory testing and disease prevention and control for the response of the possible epidemic of COVID-19. Challenges to human resources resulted from total population nucleic acid testing and its necessity need to be considered. Conducting non-pharmaceutical interventions and encouraging more people to be vaccinated can mitigate the shock on healthcare resource demand in COVID-19 prevention and control.