BACKGROUND: Lung cancer is the leading malignancy in China in terms of both incidence and mortality. With increased health awareness and the widespread use of low-dose computed tomography (CT), early diagnosis rates have been steadily improving. Surgical intervention remains the primary treatment option for early-stage lung cancer, and video-assisted thoracoscopic surgery (VATS) has become a common approach due to its minimal invasiveness and rapid recovery. However, post-discharge recovery remains incomplete, underscoring the importance of postoperative care. Traditional follow-up methods, lack standardization, consume significant medical resources, and increase the burden of the patients. Artificial intelligence (AI)-driven disease management platforms offer a novel solution to optimize postoperative follow-up. This study followed 463 lung cancer surgery patients using an AI-based platform, aiming to identify common postoperative issues, propose solutions, improve quality of life, reduce recurrence-related costs, and promote AI integration in healthcare. METHODS: Using the AI disease management platform, this study integrated educational videos, collaboration between healthcare teams and AI assistants, daily health logs, health assessment forms, and personalized interventions to monitor postoperative recovery. The postoperative rehabilitation status of the patients was assessed by the Leicester Cough Questionnaire (LCQ-MC). Two independent t-test and one-way ANOVA were used to analyze the causes of postoperative cough in lung cancer. RESULTS: Most issues occurred within 7 d post-discharge, significantly declined on 14 d post-discharge. Factors such as gender, smoking history, and surgical approaches were found to influence cough recovery. The incidence of cough on 7 d post-discharge in females was higher than that in males (P<0.01), while the incidence of cough on 14 d post-discharge in elderly patients was lower than that in young patients (P=0.03). The AI-based platform effectively addressed cough, pain, and sleep disturbances through phased interventions. CONCLUSIONS The AI-based platform significantly enhanced postoperative management efficiency and the self-care capabilities of the patients, particularly in phased cough management. Future integration with wearable devices could enable more precise and personalized postoperative care, further advancing the application of AI technology across multidisciplinary healthcare domains.
Humans ; Lung Neoplasms/rehabilitation* ; Male ; Female ; Middle Aged ; Aged ; Patient Discharge ; Artificial Intelligence ; Adult ; Postoperative Care ; Postoperative Period ; Disease Management ; Quality of Life

Objective To explore the prognostic value of combined serum oxidized low-density lipoprotein(ox-LDL),remnant cholesterol(RC)and neutrophil-to-lymphocyte ratio(NLR)tests for clinical prognosis in patients with intracranial atherosclerotic stenosis(ICAS).Methods Patients with acute cerebral infarction were admitted to Cangzhou Central Hospital from June 2022 to December 2023 and diagnosed with ICAS by head MRI.A clinical diagnosis was selected(observation group,n=160).According to the modified Rankin scale(mRS)score,they were separated into a good prognosis group(mRS 0～2 points,n=52)and a poor prognosis group(mRS≥3 points,n=108).160 healthy volunteers who underwent physical examinations were used as a reference group.Magnetic particle immunochromatography was applied to detect serum ox-LDL levels.Clinical data of patients were collected,and the levels of RC and NLR were calculated.The Spearman method was used to analyze the correlation between serum ox-LDL,RC,NLR levels and mRS scores.Logistic regression was applied to analyze the factors influencing prognosis in ICAS patients.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of serum ox-LDL,RC and NLR levels for the prognosis of ICAS patients.Results Compared with reference group,the serum levels of ox-LDL(53.65±8.35 U/L vs 33.23±6.42 U/L),RC(0.82±0.15 mmol/L vs 0.52±0.13 mmol/L)and NLR(2.84±0.38 vs 1.95±0.26)in observation group were obviously increased,and the differences were statistically significant(t=24.523,65.079,62.911,all P<0.05).The serum levels of ox-LDL(57.52±8.72 U/L),RC(0.84±0.14 mmol/L)and NLR(3.02±0.45)in the poor prognosis group were higher than those in the good prognosis group(45.62±6.63 U/L,0.79±0.12 mmol/L,2.48±0.36),and the differences were statistically significant(t=8.699,8.507,7.562,all P＜0.05),and there were differences in TC,LDL-C,HDL-C levels and mRS scores between the two groups,and the differences were statistically significant(t=15.755～27.072,all P<0.05).The serum levels of ox-LDL,RC,NLR were positively correlated with mRS scores(r=0.612,0.623,0.653,all P<0.05).The levels of TC,LDL-C,HDL-C,ox-LDL,RC and NLR were all factors that affected the prognosis of ICAS(all P<0.05).The AUC of serum ox-LDL,RC and NLR for predicting prognosis in ICAS patients were 0.894(0.835～0.937),0.860(0.797～0.910)and 0.817(0.748～0.874),respectively.The combined AUC(95%CI)of the three was 0.965(0.923～0.987),the combination of the three was more valuable than predicting serum ox-LDL,RC and NLR alone(Z=3.030,3.969,4.839,all P<0.05).Conclusion The serum levels of ox-LDL,RC and NLR in ICAS patients have all increased and are positively correlated with mRs scores.The three have predictive value for the prognosis of ICAS patients,and the combined detection of the three has higher clinical value.

Objective To investigate the changes of serum levels of soluble scavenger receptor 163 (sCD163),angiopoietin-like protein 3 (ANGPTL3) before and after intravenous thrombolysis in patients with acute cerebral infarction (ACI) and their correlation with prognosis. Methods A total of 60 ACI patients accepted by Cangzhou Central Hospital from June 2021 to June 2022 were collected as the ACI group,and another 60 healthy individuals were regarded as the control group. According to the National Institutes of Health Stroke Scale (NIHSS) score after admission,60 patients were divided into mild group (n=10),moderate group (n=38) and severe group (n=12).According to the scores on the modified Rankin scale 90 days after thrombolysis,patients were separated into a good prognosis group (n=42) and a poor prognosis group (n=18). The serum levels of sCD163 and ANGPTL3 were detected using enzyme linked immunosorbent assay (ELISA),and receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sCD163 and ANGPTL3 levels for the prognosis of ACI patients after intravenous thrombolysis therapy. Results Compared with the control group,the levels of serum sCD163 (687.55±86.43 ng/ml vs 411.07±58.24 ng/ml) and ANGPTL3 (60.28±10.55 mg/L vs 25.34±5.93 mg/L) in ACI group were significantly increased,and the differences were significant (t=20.549,22.363,all P<0.05). The levels of serum sCD163 (551.65±69.66 ng/ml,668.92±81.12 ng/ml,859.79±117.24 ng/ml) and ANGPTL3 (44.52±8.12 mg/L,58.67±10.37 mg/L,75.34±13.12 mg/L) in mild,moderate and severe groups were gradually increased,and the differences were significant (F=36.011,23.007,all P<0.05). Compared with the good prognosis group,the proportion of time from onset to thrombolysis≥ 3 h,the proportion of NIHSS score>10 at admission,and the serum sCD163 and ANGPTL3 levels before and after thrombolysis were significantly increased in the poor prognosis group,and the differences were statistically significant (t/x2=5.644,4.775,8.982,10.866,10.293,9.702,all P<0.05). ROC results showed that the area under the curves(95％ confidence intervals)[AUC(95％CI)]of serum sCD163 and ANGPTL3 level alone in predicting the prognosis of ACI patients were 0.830 (0.711～0.915) and 0.783 (0.658～0.879),and their sensitivity and specificity were 72.22％ and 85.71％,77.78％ and 85.71％,respectively. The AUC(95％CI)of combined prediction of serum sCD163 and ANGPTL3 in predicting the prognosis of ACI patients[0.950(0.861～0.990)]was obviously greater than the AUC predicted by sCD163 and ANGPTL3 alone (Z=2.378,2.109,P=0.017,0.035). Conclusion sCD163 and ANGPTL3 levels are elevated in the serum of ACI patients,and are related to their severity and prognosis.

Objective To explore the effect and possible mechanism of rapamycin inhibiting mammalian target of rapamycin(mTOR)activation autophagy and regulating iron death on proliferation,invasion and migration of cervical cancer cells.Methods Normal cervical epithelial cells H8 and cervical cancer cells Caski were cultured and divided into H8 and Caski.Caski cells were further cultured and divided into cervical cancer,rapamycin and Erastin groups.Western blotting detected the protein levels of mTOR,Beclin1,microtubule-associated protein light chain 3 II(LC3Ⅱ),recombinant solute carrier family 7,member 11(SLC7A11)and glutathione peroxidase 4(GPX4)in the cells.The mRNA levels of mTOR,Beclin1,LC3Ⅱ,SLC7A11 and GPX4 were detected by RT-qPCR.The kit detected reactive oxygen species(ROS),glutathione(GSH)and Fe2+levels in cells.Plate cloning was used to detect the cloning ability of cells.Cell migration ability was detected by scratch test.Transwell assay was used to detect cell invasion ability.Results Compared with H8 cells,the protein expressions of mTOR,SLC7A11,GPX4 were increased in Caski cells(t=10.58,36.66,14.68).Beclin1,LC3 Ⅱ decreased protein expression(t=23.00,9.50),and the differences were statistically significant(all P<0.05).Compared with the cervical cancer group,the expressions of mTOR protein and mRNA in the rapamycin group were decreased(t=25.00,12.50),the expressions of Beclin1,LC3Ⅱ protein and mRNA were increased(t=6.84～30.31),and the differences were statistically significant(all P<0.05).The levels of GSH were decreased(t=9.15),ROS and Fe2+were increased(t=7.64,6.81),and the cell proliferation,migration and invasion ability were decreased(t=19.03,8.69,23.00),and the differences were statistically significant(all P<0.05).The proliferation ability,migration ability,and invasion ability of Caski cells in the Erastin group were decreased,and the differences were statistically significant(t=25.34,4.72,6.43,all P<0.05).Conclusion Rapamycin can reduce the proliferation,invasion and migration of cervical cancer cells by inhibiting mTOR activation of autophagy and regulating ferroptosis mediated by SLC7A11/GPX4 pathway.

OBJECTIVE: To observe the effects of electroacupuncture (EA) on improving motor function and regulating microglial activation based on Notch receptor 1 (Notch1)/Hes family bHLH transcription factor 1 (Hes1) pathway in mice with Parkinson's disease (PD). METHODS: Thirty-six male C57BL/6 mice were randomly divided into a control group, a model group and an EA group, 12 mice in each group. PD model was established by intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) for 7 consecutive days in the model group and the EA group. From the 1st day of modeling, EA was applied at "Baihui" (GV20) and bilateral "Shenshu" (BL23) in the EA group, with continuous wave, in frequency of 2 Hz and current of 2 mA, 15 min a time, once a day for 14 days continuously. The behavioral performance was evaluated by gait test, pole climbing test and hanging test, the number of positive cells of tyrosine hydroxylase (TH) and the co-expression positive cells of Notch1/ionized calcium binding adaptor molecule 1 (Iba-1) in the substantia nigra of midbrain was assessed by immunofluorescence, the protein expression of TH, α-synuclein (α-syn), Notch1, Hes1, Iba-1, inducible nitric oxide synthase (iNOS), Arginase-1 (ARG1), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and IL-10 was detected by Western blot, the mRNA expression of Notch1 and Hes1 was detected by real-time PCR. RESULTS: Compared with the control group, in the model group, the stride frequency was accelerated (P<0.001) and the stride length was shortened (P<0.001) for the four limbs, the pole climbing test time was prolonged (P<0.01) and the grip level was reduced (P<0.01); in the substantia nigra of midbrain, the number of positive cells of TH was decreased (P<0.001), the number of co-expression positive cells of Notch1/Iba-1 was increased (P<0.001), the protein expression of α-syn, Notch1, Hes1, Iba-1, iNOS, TNF-α, IL-1βand IL-6 was increased (P<0.01, P<0.05, P<0.001), the protein expression of TH, ARG1 and IL-10 was decreased (P<0.01, P<0.001), the mRNA expression of Notch1 and Hes1 was increased (P<0.01). Compared with the model group, in the EA group, the stride frequency was decelerated (P<0.001) and the stride length was increased (P<0.05, P<0.01, P<0.001) for the four limbs, the pole climbing test time was shortened (P<0.05) and the grip level was increased (P<0.05); in the substantia nigra of midbrain, the number of positive cells of TH was increased (P<0.01), the number of co-expression positive cells of Notch1/Iba-1 was decreased (P<0.001), the protein expression of α-syn, Notch1, Hes1, Iba-1, iNOS, TNF-α, IL-6 and IL-1β was decreased (P<0.05, P<0.01), the protein expression of TH, ARG1 and IL-10 was increased (P<0.05, P<0.001, P<0.01), the mRNA expression of Notch1 and Hes1 was decreased (P<0.05). CONCLUSION EA can improve the behavioral performance and protect the dopaminergic neurons in PD mice, its mechanism may relate to the inhibition of Notch1/Hes1-mediated neuroinflammation, thus inhibiting the microglial activation.
Animals ; Electroacupuncture ; Microglia/metabolism* ; Male ; Receptor, Notch1/metabolism* ; Parkinson Disease/physiopathology* ; Transcription Factor HES-1/metabolism* ; Mice ; Mice, Inbred C57BL ; Humans ; Signal Transduction

Objective To explore the effect and possible mechanism of rapamycin inhibiting mammalian target of rapamycin(mTOR)activation autophagy and regulating iron death on proliferation,invasion and migration of cervical cancer cells.Methods Normal cervical epithelial cells H8 and cervical cancer cells Caski were cultured and divided into H8 and Caski.Caski cells were further cultured and divided into cervical cancer,rapamycin and Erastin groups.Western blotting detected the protein levels of mTOR,Beclin1,microtubule-associated protein light chain 3 II(LC3Ⅱ),recombinant solute carrier family 7,member 11(SLC7A11)and glutathione peroxidase 4(GPX4)in the cells.The mRNA levels of mTOR,Beclin1,LC3Ⅱ,SLC7A11 and GPX4 were detected by RT-qPCR.The kit detected reactive oxygen species(ROS),glutathione(GSH)and Fe2+levels in cells.Plate cloning was used to detect the cloning ability of cells.Cell migration ability was detected by scratch test.Transwell assay was used to detect cell invasion ability.Results Compared with H8 cells,the protein expressions of mTOR,SLC7A11,GPX4 were increased in Caski cells(t=10.58,36.66,14.68).Beclin1,LC3 Ⅱ decreased protein expression(t=23.00,9.50),and the differences were statistically significant(all P<0.05).Compared with the cervical cancer group,the expressions of mTOR protein and mRNA in the rapamycin group were decreased(t=25.00,12.50),the expressions of Beclin1,LC3Ⅱ protein and mRNA were increased(t=6.84～30.31),and the differences were statistically significant(all P<0.05).The levels of GSH were decreased(t=9.15),ROS and Fe2+were increased(t=7.64,6.81),and the cell proliferation,migration and invasion ability were decreased(t=19.03,8.69,23.00),and the differences were statistically significant(all P<0.05).The proliferation ability,migration ability,and invasion ability of Caski cells in the Erastin group were decreased,and the differences were statistically significant(t=25.34,4.72,6.43,all P<0.05).Conclusion Rapamycin can reduce the proliferation,invasion and migration of cervical cancer cells by inhibiting mTOR activation of autophagy and regulating ferroptosis mediated by SLC7A11/GPX4 pathway.

Objective To explore the prognostic value of combined serum oxidized low-density lipoprotein(ox-LDL),remnant cholesterol(RC)and neutrophil-to-lymphocyte ratio(NLR)tests for clinical prognosis in patients with intracranial atherosclerotic stenosis(ICAS).Methods Patients with acute cerebral infarction were admitted to Cangzhou Central Hospital from June 2022 to December 2023 and diagnosed with ICAS by head MRI.A clinical diagnosis was selected(observation group,n=160).According to the modified Rankin scale(mRS)score,they were separated into a good prognosis group(mRS 0～2 points,n=52)and a poor prognosis group(mRS≥3 points,n=108).160 healthy volunteers who underwent physical examinations were used as a reference group.Magnetic particle immunochromatography was applied to detect serum ox-LDL levels.Clinical data of patients were collected,and the levels of RC and NLR were calculated.The Spearman method was used to analyze the correlation between serum ox-LDL,RC,NLR levels and mRS scores.Logistic regression was applied to analyze the factors influencing prognosis in ICAS patients.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of serum ox-LDL,RC and NLR levels for the prognosis of ICAS patients.Results Compared with reference group,the serum levels of ox-LDL(53.65±8.35 U/L vs 33.23±6.42 U/L),RC(0.82±0.15 mmol/L vs 0.52±0.13 mmol/L)and NLR(2.84±0.38 vs 1.95±0.26)in observation group were obviously increased,and the differences were statistically significant(t=24.523,65.079,62.911,all P<0.05).The serum levels of ox-LDL(57.52±8.72 U/L),RC(0.84±0.14 mmol/L)and NLR(3.02±0.45)in the poor prognosis group were higher than those in the good prognosis group(45.62±6.63 U/L,0.79±0.12 mmol/L,2.48±0.36),and the differences were statistically significant(t=8.699,8.507,7.562,all P＜0.05),and there were differences in TC,LDL-C,HDL-C levels and mRS scores between the two groups,and the differences were statistically significant(t=15.755～27.072,all P<0.05).The serum levels of ox-LDL,RC,NLR were positively correlated with mRS scores(r=0.612,0.623,0.653,all P<0.05).The levels of TC,LDL-C,HDL-C,ox-LDL,RC and NLR were all factors that affected the prognosis of ICAS(all P<0.05).The AUC of serum ox-LDL,RC and NLR for predicting prognosis in ICAS patients were 0.894(0.835～0.937),0.860(0.797～0.910)and 0.817(0.748～0.874),respectively.The combined AUC(95%CI)of the three was 0.965(0.923～0.987),the combination of the three was more valuable than predicting serum ox-LDL,RC and NLR alone(Z=3.030,3.969,4.839,all P<0.05).Conclusion The serum levels of ox-LDL,RC and NLR in ICAS patients have all increased and are positively correlated with mRs scores.The three have predictive value for the prognosis of ICAS patients,and the combined detection of the three has higher clinical value.

Objective To investigate the changes of serum levels of soluble scavenger receptor 163 (sCD163),angiopoietin-like protein 3 (ANGPTL3) before and after intravenous thrombolysis in patients with acute cerebral infarction (ACI) and their correlation with prognosis. Methods A total of 60 ACI patients accepted by Cangzhou Central Hospital from June 2021 to June 2022 were collected as the ACI group,and another 60 healthy individuals were regarded as the control group. According to the National Institutes of Health Stroke Scale (NIHSS) score after admission,60 patients were divided into mild group (n=10),moderate group (n=38) and severe group (n=12).According to the scores on the modified Rankin scale 90 days after thrombolysis,patients were separated into a good prognosis group (n=42) and a poor prognosis group (n=18). The serum levels of sCD163 and ANGPTL3 were detected using enzyme linked immunosorbent assay (ELISA),and receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sCD163 and ANGPTL3 levels for the prognosis of ACI patients after intravenous thrombolysis therapy. Results Compared with the control group,the levels of serum sCD163 (687.55±86.43 ng/ml vs 411.07±58.24 ng/ml) and ANGPTL3 (60.28±10.55 mg/L vs 25.34±5.93 mg/L) in ACI group were significantly increased,and the differences were significant (t=20.549,22.363,all P<0.05). The levels of serum sCD163 (551.65±69.66 ng/ml,668.92±81.12 ng/ml,859.79±117.24 ng/ml) and ANGPTL3 (44.52±8.12 mg/L,58.67±10.37 mg/L,75.34±13.12 mg/L) in mild,moderate and severe groups were gradually increased,and the differences were significant (F=36.011,23.007,all P<0.05). Compared with the good prognosis group,the proportion of time from onset to thrombolysis≥ 3 h,the proportion of NIHSS score>10 at admission,and the serum sCD163 and ANGPTL3 levels before and after thrombolysis were significantly increased in the poor prognosis group,and the differences were statistically significant (t/x2=5.644,4.775,8.982,10.866,10.293,9.702,all P<0.05). ROC results showed that the area under the curves(95％ confidence intervals)[AUC(95％CI)]of serum sCD163 and ANGPTL3 level alone in predicting the prognosis of ACI patients were 0.830 (0.711～0.915) and 0.783 (0.658～0.879),and their sensitivity and specificity were 72.22％ and 85.71％,77.78％ and 85.71％,respectively. The AUC(95％CI)of combined prediction of serum sCD163 and ANGPTL3 in predicting the prognosis of ACI patients[0.950(0.861～0.990)]was obviously greater than the AUC predicted by sCD163 and ANGPTL3 alone (Z=2.378,2.109,P=0.017,0.035). Conclusion sCD163 and ANGPTL3 levels are elevated in the serum of ACI patients,and are related to their severity and prognosis.

Objective To establish a clinical prediction model for preeclampsia by monitoring risk rating of MP gestation and levels of placental growth factor(PLGF)combined with uterine artery pulsatility index(PI)measured during examination of fetal nuchal translucency(NT).Methods Twenty-four patients with preeclampsia who met the inclusion criteria were selected as the case group,and 95 healthy pregnant women during the same period were randomly selected as the control group.Serum concentrations of PLGF,uterine artery PI values measured by quantitative immunofluorescence assay at 11-14 weeks of gestation,risk ratings for MP hypertension monitoring at 11-20 weeks of gestation,and other relevant data,BMI,age,gestation,mode of delivery,neonatal birth weight and Apgar score were collected in the two groups.Results Results of univariate regression analysis showed that BMI,age,high risk of PI,MP and PLGF<12 were influencing factors for adverse outcomes.Results of multivariate regression analysis showed that high PI,medium high risk in MP and PLGF<12 were independent risk factors for adverse outcomes.The prediction model of PE established was logit(P)=-15.767 + 0.020×PI + 0.072×MP risk(medium-high risk = 1,low risk = 0)+ 0.181×PLGF classification(＜12 = 1,≥12 = 0),with an AUC area of 0.883,specificity of 0.816 and sensitivity of 0.846.Conclusion The combination of PI,MP risk and PLGF to establish a clinical predictive model for preeclampsia has certain value,and its combined predictive value is higher than that of single application.

Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.