Objective To construct a lung cancer surgery-oriented disease-specific database covering the entire perioperative care pathway, thereby improving the quality and usability of key surgical data elements. Methods Real-world clinical data were extracted from a single-center thoracic surgery department. A standardized data model was established based on the open electronic health record (openEHR) standard. Large language model (LLM), optical character recognition (OCR), and artificial intelligence (AI)-driven techniques were employed to extract, structure, and perform quality control on unstructured clinical narratives, imaging reports, and radiological data, with a focus on capturing surgically relevant perioperative indicator. Results A multimodal database comprising 19 917 patients was established, including 7 930 males and 11 987 females, with ages ranging from 15 to 97 (61.7±9.7) years. The database includes 582 structured data variables, textual report data corresponding to 69 clinical indicators, 13 000 pulmonary function test PDF reports, and chest CT imaging data from 16 884 patients. This database comprehensively covers major information relevant to surgical diagnosis and treatment of lung cancer, significantly improving the completeness and granularity of surgical detail data. Large language models (LLMs) and optical character recognition (OCR) technologies enhanced the efficiency of converting unstructured data into structured formats, while a multi-level manual verification process ensured data accuracy and traceability. The database supports real-world research including comparisons of surgical procedures, prediction of postoperative complications, prognosis assessment, and multimodal data association analyses.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

ObjectiveTo generate cynomolgus and rhesus monkey models carrying the Booroola fecundity (FecB) variant of bone morphogenetic protein receptor type 1B (BMPR1B) gene (designated BMPR1B^FecB) using adenine base edit technology and to explore genetic improvement strategies for enhancing the reproductive performance of laboratory macaques. MethodsFour single-guide RNAs (sgRNAs) were designed to target the BMPR1B c.746A>G locus in cynomolgus and rhesus monkeys. The sgRNAs were combined with the ABE8e-SpRY base editor, and the resulting editing complexes were microinjected into zygotes of both macaque species. Following in vitro culture of the injected embryos, nested PCR amplification was performed to detect the base-editing efficiency at the target site to screen for highly efficient sgRNAs. Subsequently, normally developing gene-edited embryos were transferred into the oviducts of surrogates. Seven days after birth, ear skin or peripheral blood samples were collected from the newborn monkeys for genotyping and mosaicism analysis, and the growth, development, and health status of the gene-edited monkeys were monitored. ResultsAmong the four candidate sgRNAs, sgRNA4 was identified as achieving 100% editing efficiency at the c.746A>G site. A total of 17 live monkey offspring were obtained via embryo transfer, including 8 cynomolgus monkeys and 9 rhesus monkeys. Genotyping results showed that all 8 newborn cynomolgus monkeys carried the c.746A>G point mutation, with an editing efficiency of 100% (8/8), of which 37.50% (3/8) were mosaics. Among the 9 newborn rhesus monkeys, 8 individuals carried the c.746A>G mutation, with an editing efficiency of 88.89% (8/9), of which 75.00% (6/8) were mosaics. ConclusionThe ABE8e-SpRY base-editing system enables precise editing at the c.746A>G (p.Q249R) locus of the BMPR1B gene in both cynomolgus and rhesus monkey embryos, resulting in the successful establishment of laboratory monkey models carrying the BMPR1B^FecB variant. These models provide a valuable foundation for future studies of the regulatory role of the BMPR1B^FecB variant in reproductive performance at the non‑human primate level, as well as for exploring genetic improvement strategies to enhance reproductive performance in laboratory monkeys.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective To analyze the relationship between serum angiopoietin-like protein 8(ANGPTL8)and semaphorin 3A(Sema 3A)levels and postoperative cerebral vasospasm(CVS)in patients with intracranial aneurysm(IA)rupture.Methods A total of 188 patients with IA rupture receiving surgical treatment in our hospital were prospectively selected during October 2021 and October 2023,and according to whether CVS occurred after surgery,they were classified into a spasm group(75 cases)and a non-spasm group(113 cases).Serum ANGPTL8 and Sema 3A levels were measured after admission.Spearman correlation analysis was performed to assess the correlation of the levels with CVS occurrence.Binary logistic regression analysis was applied to construct a prediction model with serum ANGPTL8 and Sema 3A as variables.ROC curve was plotted to evaluate the predictive value of the levels for postoperative CVS.Results The serum ANGPTL8 level was significantly higher while that of Sema 3A was obviously lower in the spasm group then the non-spasm group(P＜0.01).Binary logistic regression analysis showed that the levels of serum ANGPTL8 and Sema 3A were independent predictors of postoperative CVS in patients with ruptured IA(OR=1.021,95％CI:1.013-1.029,P=0.000;OR=0.980,95％CI:0.967-0.993,P=0.003).ROC curve analysis indicated that the AUC value,sensitivity and speci-ficity of the two indicators combined together in predicting postoperative CVS was 0.939(95％CI:0.894-0.969),89.33％and 89.38％,respectively,with better predictive efficiency than each indicator alone(P＜0.01).Conclusion Serum ANGPTL8 and Sema 3A levels are closely associat-ed with postoperative CVS in patients with IA rupture,and they can be used as effective indicators for early prediction of postoperative CVS.

Aim To reveal the mechanism of CIP4 homologs protein 1(RICH1)are involved in the regu-lation of myocardial fibrosis.Methods Mouse cardiac fibroblasts(MCFs)cells were treated with transforming growth factor-β(TGF-β1)to induce the formation of a myocardial fibrosis cell model;the level of the target protein was detected by Western blotting;and the RICH1 gene was detected by transfection of the cells with plasmid.The RICH1 gene was overexpressed(RICH 1 OE)using plasmid transfection;the RICH1 gene was silenced using siRNA fragment(siRICH1);and the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3 a1,and Acta2,were de-tected using RT-qPCR.Results RICH1 was signifi-cantly down-regulated in TGF-β1-treated MCFs;the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3a1,and Acta2,were down-regu-lated in the RICH1 OE+TGF-β1 group;and in the siRICH1+TGF-β1 group,myocardial fibrosis marker genes,such as Col1 a1,Col3a1 and Acta2 were up-regulated at the expression level;phosphorylated SMAD2(p-SMAD2)and phosphorylated SMAD3(p-SMAD3)levels were down-regulated in the siRICH1 OE+TGF-β1 group.p-SMAD2 and P-SMAD3 levels were upregulated in the siRICH1+TGF-β1 group.Conclusion RICH1 inhibits TGF-β1-induced myo-cardial fibrosis;RICH1 inhibits TGF-β1-induced myo-cardial fibrosis by negatively regulating the SMAD2/3 signaling pathway.

Aim To reveal the mechanism of CIP4 homologs protein 1(RICH1)are involved in the regu-lation of myocardial fibrosis.Methods Mouse cardiac fibroblasts(MCFs)cells were treated with transforming growth factor-β(TGF-β1)to induce the formation of a myocardial fibrosis cell model;the level of the target protein was detected by Western blotting;and the RICH1 gene was detected by transfection of the cells with plasmid.The RICH1 gene was overexpressed(RICH 1 OE)using plasmid transfection;the RICH1 gene was silenced using siRNA fragment(siRICH1);and the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3 a1,and Acta2,were de-tected using RT-qPCR.Results RICH1 was signifi-cantly down-regulated in TGF-β1-treated MCFs;the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3a1,and Acta2,were down-regu-lated in the RICH1 OE+TGF-β1 group;and in the siRICH1+TGF-β1 group,myocardial fibrosis marker genes,such as Col1 a1,Col3a1 and Acta2 were up-regulated at the expression level;phosphorylated SMAD2(p-SMAD2)and phosphorylated SMAD3(p-SMAD3)levels were down-regulated in the siRICH1 OE+TGF-β1 group.p-SMAD2 and P-SMAD3 levels were upregulated in the siRICH1+TGF-β1 group.Conclusion RICH1 inhibits TGF-β1-induced myo-cardial fibrosis;RICH1 inhibits TGF-β1-induced myo-cardial fibrosis by negatively regulating the SMAD2/3 signaling pathway.

The exoskeleton robot for lower limb medical rehabilitation in foreign countries and China was introduced in terms of the research status,structure and working principle,and analysis was carried out over its key technologies.It's pointed out the exoskeleton robot for lower limb medical rehabilitation would be enhanced in energy endurance,safety and comfort,individualized and intelligent control,modularity and lightweight design.[Chinese Medical Equipment Journal,2025,46(1):88-100]

OBJECTIVE To explore the influence of human cytomegalovirus(HCMV)infection on transforming growth factor β(TGF-β)/Smad signaling pathway and helper T cell(Th)1/Th2 cytokines of the patients with di-abetic retinopathy(DR)so as to provide guidance for clinical treatment of the DR patients with HCMV infection.METHODS Totally 100 DR patients complicated with HCMV infection who were treated in Xinyu People's Hospi-tal from Jan.2021 to Dec.2023 were assigned as the HCMV infection group and were divided into the non-prolif-erative DR group(NPDR group)and the proliferative DR group(the PDR group)according to the degree of path-ological change of retina.Meanwhile,100 DR patients without HCMV infection were chosen as the no HCMV in-fection group.The levels of serum TGF-β,interferon-γ(IFN-γ)and interleukin(IL)-4 as well as the relative ex-pression levels of Smad2 and Smad3 mRNA were observed.RESULTS The levels of serum TGF-β,IFN-γ and IL-4 of the HCMV infection group were respectively 1.41±0.43,(92.68±15.86)ng/L and(593.91±84.67)ng/L,higher than those of the no HCMV infection group;the relative expression levels of Smad2 mRNA and Smad3 mRNA of the HCMV infection group were respectively(1.54±0.44)and(1.68±0.50),higher than those of the no HCMV infection group(P＜0.05);the levels of the above indexes of the PDR group were higher than those of the NPDR group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the joint detection of TGF-β,IFN-γ,IL-4,Smad2 and Smad3 was 0.961 in prediction of HC-MV infection in the DR patients,with the sensitivity 90.70％,the specificity 85.10％.CONCLUSION The HC-MV infection may aggravate the degree of retinopathy,which may be associated with the regulation of TGF-β/Smad signaling pathways and imbalance of Th1/Th2 function.

Objective:To study the current status of transitional readiness from adolescence to adulthood of patients with inflammatory bowel disease（IBD）in China,analyze the factors affecting transitional readiness,and provide a basis for developing scientific and targeted transitional preparedness programmes.Methods:The IBD patients aged 12-24 years who were admitted to the Department of Gastroenterology,Beijing Children's Hospital Affiliated to Capital Medical University from January 1,2016 to January 15,2025 were enrolled.From November 1,2024 to January 15,2025,the survey was conducted through online distribution of the transition readiness assessment questionnaire (TRAQ)6.0 Chinese version scale to IBD patients by using the convenient sampling method.The scores of each dimension of TRAQ scale were calculated,and multiple linear regression analysis was used to analyze the factors influencing the scores of TRAQ during the transitional period.Results:A total of 184 patients were included and 184 questionnaires were collected.Male patients were slightly more than female(109:75),with an average age of (14.94±2.35) years.70.11% of patients had a disease duration of 1 to 5 years,with Crohn's disease accounting for the highest proportion(54.89%),and the severity of the disease was mostly mild to moderate.Family support was generally higher(84.24%).Parents were highly involved in patient disease management(94.02%).There were 52.72% of the patients received social support.The mean score of the TRAQ was 4.14 ± 0.89,and the mean scores of the four dimensions from high to low were following health problems(4.28±0.97),insisting on making an appointment and seeing a doctor on time(4.20±1.10),talking with medical staff(4.17±1.05) and drug management(4.14±0.99).Multiple linear regression analysis showed that family status,the encourage,supports and help from the family members,and the supports from the society were the independent influencing factors of IBD patients' readiness score for transition from adolescence to adulthood( P<0.05).Among them,family status had a positive effect on transition readiness score,and the degree of readiness score increased with the increase of harmony( P<0.05).Social support also had a positive effect on transition readiness score( P<0.05).Compared with no encouragement,support and help from family members,the situation of little encouragement had a certain improvement on the readiness score( P<0.05). Conclusion:Children with IBD have better overall performance during the transition from adolescence to adulthood.Family status,the encourage,supports and help from the family members,and the supports from the society are the important factors influencing transitional preparedness.