BACKGROUND:Although previous studies have reported associations between lipids and the risk of osteoporotic pathological fractures,the specific causal relationships between lipid level and osteoporotic pathological fractures remain unclear.OBJECTIVE:To elucidate the causal relationship between lipids and osteoporotic pathological fractures using a two-sample bidirectional Mendelian randomization analysis.METHODS:The data for 178 lipid metabolites were obtained from the IEU-GWAS database(developed by the MRC Integrative Epidemiology Unit at the University of Bristol,UK,which provides extensive summary data from genome-wide association studies),while osteoporotic pathological fracture data(from 173 619 European participants)were acquired from the FinnGen database(constructed by the Finnish national gene research program,focusing on investigating relationships between genomics and health/disease in the Finnish population).Osteoporotic pathological fracture data were used as the outcome variable,with lipids serving as exposures,for the bidirectional Mendelian randomization study to evaluate the causal effects of different lipids on osteoporotic pathological fractures.The UK Biobank database was employed as a validation set by switching the outcome variable to verify the findings horizontally.RESULTS AND CONCLUSION:(1)The inverse variance weighted analysis indicated that each unit increase in sterol ester(27∶1/20∶2)levels was associated with a 25.55％increase in the risk of osteoporotic pathological fractures(odds ratio=1.256,95％confidence interval:1.001-1.575,P=0.049),suggesting a significant positive correlation between elevated sterol ester levels and increased fracture risk.Reverse Mendelian randomization analysis revealed a significant negative association between osteoporotic pathological fractures and three types of phosphatidylcholine.Horizontal validation yielded consistent results,confirming sterol ester as a risk factor for osteoporotic pathological fractures.(2)The results indicate that sterol ester is a risk factor for osteoporotic pathological fractures,while phosphatidylcholine serves as a protective factor.These findings strengthen the evidence supporting the effect of lipids on the risk of osteoporotic pathological fractures.Although the GWAS data used in this study were derived from European populations,given the broad commonality of human genetics,the results provide valuable reference significance for improving osteoporosis in Chinese populations through lipid regulation.

With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.

BACKGROUND:Although previous studies have reported associations between lipids and the risk of osteoporotic pathological fractures,the specific causal relationships between lipid level and osteoporotic pathological fractures remain unclear.OBJECTIVE:To elucidate the causal relationship between lipids and osteoporotic pathological fractures using a two-sample bidirectional Mendelian randomization analysis.METHODS:The data for 178 lipid metabolites were obtained from the IEU-GWAS database(developed by the MRC Integrative Epidemiology Unit at the University of Bristol,UK,which provides extensive summary data from genome-wide association studies),while osteoporotic pathological fracture data(from 173 619 European participants)were acquired from the FinnGen database(constructed by the Finnish national gene research program,focusing on investigating relationships between genomics and health/disease in the Finnish population).Osteoporotic pathological fracture data were used as the outcome variable,with lipids serving as exposures,for the bidirectional Mendelian randomization study to evaluate the causal effects of different lipids on osteoporotic pathological fractures.The UK Biobank database was employed as a validation set by switching the outcome variable to verify the findings horizontally.RESULTS AND CONCLUSION:(1)The inverse variance weighted analysis indicated that each unit increase in sterol ester(27∶1/20∶2)levels was associated with a 25.55％increase in the risk of osteoporotic pathological fractures(odds ratio=1.256,95％confidence interval:1.001-1.575,P=0.049),suggesting a significant positive correlation between elevated sterol ester levels and increased fracture risk.Reverse Mendelian randomization analysis revealed a significant negative association between osteoporotic pathological fractures and three types of phosphatidylcholine.Horizontal validation yielded consistent results,confirming sterol ester as a risk factor for osteoporotic pathological fractures.(2)The results indicate that sterol ester is a risk factor for osteoporotic pathological fractures,while phosphatidylcholine serves as a protective factor.These findings strengthen the evidence supporting the effect of lipids on the risk of osteoporotic pathological fractures.Although the GWAS data used in this study were derived from European populations,given the broad commonality of human genetics,the results provide valuable reference significance for improving osteoporosis in Chinese populations through lipid regulation.

Background As a traditional labor-intensive industry, the manufacturing sector is an important source of occupational exposure to hazards such as dust, toxic chemicals, and noise. Objective To analyze the current status and spatiotemporal patterns of occupational hazards including dust, toxic chemicals, and noise in manufacturing workplaces in Shanghai from 2020 to 2025, and to provided evidence for optimizing targeted prevention and control strategies. Methods Workplace monitoring data for manufacturing enterprises in Shanghai were obtained from the National Occupational Hazard Factor Monitoring System for Workplaces. Descriptive analyses were conducted to evaluate the exceedance rates of occupational hazard factors related to occupational exposure limits. GeoDa software was utilized to perform spatial autocorrelation analysis of hazard-specific exceedance rates to identify spatial clustering patterns. Results From 2020 to 2025, the number of monitored manufacturing enterprises in Shanghai increased from 374 to 504. The monitored enterprises were mainly small and micro enterprises located in suburban areas. Over the six-year period, the exceedance rate for dust-exposed work posts decreased from 21.05% to 10.03%, whereas the exceedance rate for chemical toxicant-exposed work posts remained below 3%. Noise showed the highest and most persistent exceedance rate remaining over 20% throughout the study period. Spatial autocorrelation analysis indicated that high-high clusters of dust hazards were consistently concentrated in suburban districts, including Qingpu, Jinshan, and Songjiang. The spatial pattern of chemical toxicant hazards changed over time, with high-low clusters later concentrated in Baoshan and Minhang. High-high clusters of noise hazards showed an expanding pattern, spreading from Qingpu and Songjiang to several other districts, including Jiading, Minhang, and Fengxian. Conclusion Occupational hazards in the manufacturing sector of Shanghai are mainly characterized by exceedances related to dust and noise, with noise emerging as the most persistent and spatially expanding monitored hazard. These hazards exhibit clear spatial heterogeneity: dust-related risks are concentrated in traditional industrial areas, chemical toxicant risks change dynamically with the spatial distribution of industries, and noise-related risks expand across multiple districts. Future occupational interventions should prioritize noise control and implement targeted prevention strategies based on spatial clustering characteristics.

Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.

Objective:To systematically review the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)on recurrence or metastasis of patients with ovarian cancer whose postoperative serum carbohydrate antigen 125(CA125)occurred abnormal elevation.Methods:A systematic search was conducted in foreign databases,including PubMed,Embase,Cochrane Library(Central)and Web of Science(SCI-Expanded),as well as Chinese databases,such as China National Knowledge Infrastructure(CNKI),VIP Network,Wanfang Database,and China Biology Medicine(CBM),for the studies that were published between January 2010 and January 2023 on the diagnostic value of 18F-FDG PET/CT on recurrence or metastasis of patients with ovarian cancer whose postoperative serum CA125 levels occurred abnormal elevation.The quality of the included studies was assessed by using the QUADAS-2 quality evaluation tool in Review Manager 5.4 software.The effective data were extracted,and effect quantities were merged,and heterogeneity test was conducted through Meta-Disc 1.4 software.Publication bias of the included studies was tested by using Stata 14.0 software.Results:A total of seven literatures were involved in this research,and 290 patients with ovarian cancer were included to conduct heterogeneity test,which revealed I2 values all were greater than 50%.Therefore,the a fixed-effect model was used to merge effect quantity.The results demonstrated that the diagnostic accuracy was higher,and the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio(DOR)of the mergement were respectively 0.95(95%CI:0.91-0.98),0.83(95%CI:0.70-0.92),4.84(95%CI:2.82-8.31),0.07(95%CI:0.04-0.13)and 73.53(95%CI:28.00-187.90).The area under curve(AUC)value of receiver operating characteristic curve(AUC)was 0.9527,and the diagnostic accuracy of 18F-FDG PET/CT for metastasis or recurrence in patients with ovarian cancer,whose postoperative serum CA125 levels occurred elevation,reached to 95.27%.Publication bias testing showed there was no evidence of publication bias.Conclusion:18F-FDG PET/CT exhibits higher accuracy in diagnosing recurrence or metastasis in patients with ovarian cancer whose postoperative serum CA125 levels occurred elevation,which can sensitively and accurately confirmed postoperative recurrence or metastasis of patients with ovarian cancer,and early find the lesions of metastasis or recurrence of ovarian cancer.

Objective To study the mandibular characteristics of the modern population in Beijing region.Methods In this study,we examined 22 measurements and their sexual dimorphism index(SDI)of 193 adult mandibles(126 males,67 females)collected from the Beijing region.In addition,eight mandibular indexes were calculated.These mandibular dimensions of the Beijing population were compared with those of other modern and contemporary populations in Asia,as well as Neolithic-historical populations in Northern China.Results The predominant mandibular index in the contemporary Beijing population was dolichostenomandibular.The SDI of mandibular size exhibited a wide range of variation.It was noteworthy the minimum height of mandibular ramus,height of mandibular ramus,height of coronoid process and minimum breadth of mandibular ramus demonstrate significant sexual dimorphism(SDI≥10％).The mandibular size aligned with the variation range of modern and contemporary Asian populations,with the cluster analysis indicating an affiliation with Northern Mongoloids.But the Beijing population was far away from other Northern populations in China.The mandibular size was more gracile compared to ancient populations in Northern China,whereas the height of mandibular ramus was greater than those of the latter.Conclusion This study provides valuable insights into the physical characteristics of modern populations in Beijing region.

Objective To investigate the size variation in the first metatarsal of extant primates.Methods In this study,we analyzed 135 first metatarsal specimens across 12 primate genera,quantifying eight linear measurements,articular surface areas,mid-shaft cross-sectional area,total surface area,volume,and derived indices.Multivariate patterns were assessed through mean-based correspondence analysis and principal component analysis(PCA).Results Eulemur,Otolemur,Cebus,and Perodicticus exhibited a relatively high metatarsal surface-area-to-volume ratio.Perodicticus additionally showed a low articular facet index.Propithecus,Colobus,and Macaca displayed lower values for metatarsal shaft robusticity,the ratio of shaft cross-sectional area to base articular surface area,and the proximal articular facet index.Nasalis possessed a relatively high articular facet index.Pongo,Pan,Gorilla,and Homo sapiens were characterized by higher metatarsal shaft robusticity and a lower metatarsal surface-area-to-volume ratio.Principal component analysis revealed that the 12 extant primate genera could be broadly divided into two groups.Group 1 comprised Pongo,Pan,Gorilla and H.sapiens,although H.sapiens formed a distinct cluster relative to the extant great apes.Group 2 included Eulemur,Otolemur,Perodicticus,Propithecus,Cebus,Colobus,Macaca and Nasalis.Conclusion The relative sizedistribution of the first metatarsal provides some reference value for classifying extant primates.However,it demonstrates no clear correlations with specific locomotor patterns or foot grasping ability.

To investigate the characteristics and differences of immune cell infiltration between different SDHx gene expression and pheochromocytoma/paraganglioma(PPGL).

Objective:To investigate lipid metabolism gene mutations and pathogenicity of hypertriglyceridemia acute pancreatitis (HTG-AP) patients.Methods:Clinical data of 495 HTG-AP patients admitted from June 2018 to June 2020 in the center for severe acute pancreatitis of Eastern Theater General Hospital were retrospectively analyzed. Whole-exome sequencing and mutation verification were performed by next-generation sequencing technology and Sanger sequencing. The pathogenicity of gene mutation was analyzed by population mutation ratio, pathogenicity prediction software, conservation scoring software, protein structure prediction, and in vitro experiments. Results:The mutation ratio of lipid metabolism-related genes, namely LPL, APOA5, LMF1, GPIHBP1, and APOC2, were 14.81%, 55.78%, 43.61%, 1.62%, and 0.61%, respectively. Among them, 44 heterozygous mutations in LPL gene were detected including 36 missense mutations, 5 nonsense mutations and 3 frameshift mutations, which were all rarely carried in single patient. Six HTG-AP patients carried the LPL gene heterozygous mutation c.835C>G (p.Leu279Val). The mean level of serum triglyceride at the onset of HTG-AP was 27.4 mmol/L. All of them had a history of recurrent HTG-AP, and most of them had severe acute pancreatitis. The serum LPL concentration and activity were lower than the normal level. The pathogenicity analysis results suggested that the LPL p.Leu279Val was a rare, highly possible pathogenic and highly conserved gene mutation. The in vitro results showed that the LPL p.Leu279Val could significantly reduce the synthesis and secretion ability of LPL as well as its enzymatic activity. Conclusions:The mutation ratio of lipid metabolism-related genes, including LPL, APOA5, LMF1, GPIHBP1, and APOC2, are relatively high in the HTG-AP patients. The LPL p.Leu279Val is a rare and highly possible pathogenic gene mutation, which may lead to recurrent episodes of HTG-AP.