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.

ObjectiveTo explore the mechanism of Yishen Qubi Tongluo Formula （益肾祛痹通络方， YQTF） in the treatment of rheumatoid arthritis（RA）. MethodsNetwork pharmacology was employed to retrieve and screen the active components and potential targets of YQTF as well as RA-related targets using databases including TCMSP， BATMAN， ETCM and GEO. The intersection of targets related to active components and RA-related targets was identified， and a protein-protein interaction （PPI） network was constructed. Gene Ontology （GO） functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis were performed， and a drug-active component-common target network of YQTF in the treatment of RA was established. The core components of YQTF were molecularly docked with key targets. Human rheumatoid arthritis synovial fibroblast cell line MH7A was divided into blank group， model group， methotrexate group and YQTF group. The blank group was cultured with 10% fetal bovine serum， while the other three groups were stimulated with 10 μg/L of recombinant human tumor necrosis factor-α （TNF-α） for 24 h to establish the RA cell model. On this basis， the methotrexate group was treated with methotrexate suspension at a concentration of 20 μmol/L， and the YQTF group was treated with 10% YQTF-medicated serum. After 48 h of intervention， the levels of TNF-α and interleukin-17A（IL-17A）contents in cell supernatants were detected by enzyme-linked immunosorbent assay （ELISA）， and mRNA expressions of phosphatidylinositol 3-kinase（PI3K）， protein kinase B（AKT） and mammalian target of rapamycin（mTOR） were detected by real-time quantitative polymerase chain reaction （RT-qPCR）. ResultsNetwork pharmacological analysis identified 209 active components and 583 potential target genes of YQTF， as well as 818 RA-related targets. A total of 29 common targets were obtained from the intersection of drug-related targets and RA-related targets. Quercetin，β-sitosterol， kaempferol， stigmasterol and luteolin were the core active components of YQTF for the treatment of RA， while matrix metalloproteinase-9 （MMP9）， prostaglandin-endoperoxide synthase 2 （PTGS2）， Toll-like receptor 4 （TLR4）， tumor protein p53 （TP53） and transcription factor AP-1 subunit JUN were the key targets. The GO and KEGG pathway enrichment analysis showed that the involved biological processes and pathways were mainly associated with antioxidant responses， PI3K-AKT signaling pathway and Toll-like receptor （TLR） signaling pathway. Molecular docking results showed that MMP9 and PTGS2 exhibited high binding affinities with quercetin， β-sitosterol， kaempferol， stigmasterol and luteolin； TLR4 exhibited high binding activities with β-sitosterol， stigmasterol and luteolin； and TP53 showed high binding affinity with luteolin. The results of cell experiments showed that compared with the control group， the contents of TNF-α and IL-17A as well as the mRNA expressions of AKT and mTOR in the model group significantly increased （P＜0.05 or P＜0.01）. Compared with the model group， all the above indicators significantly decreased in the YQTF group， while the contents of TNF-α and the mRNA expression of AKT significantly decreased in the methotrexate group （P＜0.05 or P＜0.01）. ConclusionThe mechanism of YQTF in the treatment of RA may be associated with reducing inflammatory cytokine secretion and inhibiting the activation of the PI3K-AKT-mTOR signaling pathway.

Objective:To investigate the anatomical characteristics of the atlantoaxial joint associated with nonuniform settlement of the C 2 lateral mass (C 2LM-NUS) and its correlation with atlantoaxial osteoarthritis. Methods:A retrospective analysis was conducted on clinical and imaging data of 522 hospitalized patients (288 males, 234 females; mean age 60.8±11.2 years; range 18-83 years) who underwent CT scans of the head/neck or cervical spine at the Second Affiliated Hospital of Army Medical University between January 1, 2022 and December 31, 2022. Multiplanar reconstruction of CT data was performed to measure the settlement of the C 2 lateral mass (C 2LMS). Patients with a difference in bilateral C 2LMS (d-C 2LMS) >1.4 mm were classified into the C 2LM-NUS group (137 cases; 71 males, 66 females; mean age 63.3±11.6 years), while the normal group included 385 patients (217 males, 168 females; mean age 59.9±11.0 years). Imaging parameters of the atlantoaxial joint were measured, including the C 1, 2 coronal inclination angle (C 1, 2 CI), atlanto-dental interval (ADI), lateral atlanto-dental interval (LADI), coronal deviation angle of the odontoid (Od-CDA), and C 1, 2 relative rotation angle (C 1, 2 RRA). Osteoarthritis prevalence was recorded. A normal C 0-C 3 finite element (FE) model was constructed using CT data from a 48-year-old female in the normal group. A C 2LM-NUS FE model was developed based on anatomical differences between the C 2LM-NUS and normal groups, and stress distribution on the C 2 lateral mass articular surface was analyzed under flexion-extension, lateral bending, and axial rotation torques. Results:The C 2LM-NUS group exhibited asymmetric atlantoaxial joint morphology, with bilateral differences in C 1, 2CI and LADI of 8.5°(5.8°, 11.3°) and 0.8(0.1, 1.4) mm, respectively, significantly greater than those in the normal group [1.7°(0.8°, 2.7°) and 0.2(0.1, 0.5) mm, P<0.05]. Od-CDA and C 1, 2RRA were 3.9°(2.0°, 5.4°) and 7.2°(5.0°, 10.0°) in the C 2LM-NUS group, exceeding the normal group's values [0°(0°, 1.0°) and 0°(0°, 5.5°), P<0.05]. The prevalence of C 2LM-NUS was 37.8% in the atlantoaxial osteoarthritis group, significantly higher than in the non-osteoarthritis group (22.8%, P<0.05). Significant differences were observed in age (68.3±9.4 vs. 58.6±10.8 years), sex distribution (50/69 vs. 238/165), and C 1, 2RRA [5.6°(0°, 8.2°) vs. 3.8°(0°, 6.2°)] between the osteoarthritis and non-osteoarthritis groups ( P<0.05). After adjusting for age, sex, and C 1, 2RRA, binary logistic regression identified C 2LM-NUS as an independent risk factor for atlantoaxial osteoarthritis [ OR=2.024, 95% CI (1.300, 3.150), P<0.001]. FE analysis demonstrated a reduced C 1, 2 range of motion in the C 2LM-NUS model, with elevated stress concentrations on the settled side lateral mass during simulated flexion-extension, lateral bending, and rotation. Conclusions:The study indicated that C 2LM-NUS is associated with asymmetric anatomical changes in the atlantoaxial joint, increasing the risk of osteoarthritis. Stress concentration on the C 2 lateral mass articular surface, caused by C 2LM-NUS, is a biomechanical contributor to this heightened risk.

OBJECTIVES: To propose a single repetition time (TR) quantitative magnetic susceptibility imaging method for the lumbar spine using bipolar readout gradient, and compare the quantitative magnetic susceptibility measurement using single TR and dual TR methods for the lumbar spine with different bone densities. METHODS: A translation correction method was proposed to correct spatial misalignment along the frequency encoding direction between positive and negative gradient readout images, and the phase difference between the images was eliminated using a phase correction method. The data of lumbar vertebrae L1-L5 were collected using single TR and dual TR methods from 6 normal individuals, 2 patients with osteopenia, and 2 patients with osteoporosis. The magnetic susceptibility map was reconstructed, the quantitative results of single TR before and after correction were compared with those of the dual TR method. RESULTS: The linear regression result of the lumbar spine magnetic susceptibility values obtained by the single TR method before calibration and the dual TR method is Y=0.64*X-11.61. The linear regression result of the lumbar spine magnetic susceptibility values corrected by the single TR method and the dual TR method is Y=1.03*X+0.25. The results of the corrected single TR method were highly consistent with those of the dual TR method, and the calibrated single TR method could effectively distinguish osteopenia and osteoporosis patients from normal individuals. CONCLUSIONS The calibrated single TR bipolar readout gradient method can generate artifact-free lumbar spine quantitative magnetic susceptibility distribution maps and reduce data acquisition time by 50%.
Humans ; Lumbar Vertebrae/pathology* ; Magnetic Resonance Imaging/methods* ; Female ; Middle Aged ; Male ; Osteoporosis/diagnosis* ; Adult ; Bone Density ; Aged ; Bone Diseases, Metabolic/diagnosis*

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

OBJECTIVE: This study investigates the efficacy and mechanisms of Qingjie Fuzheng Granules (QFG) in inhibiting colitis-associated colorectal cancer (CAC) development via RNA sequencing (RNA-seq) and 16S ribosomal RNA (rRNA) correlation analysis. METHODS: CAC was induced in BALB/c mice using azoxymethane (AOM) and dextran sulfate sodium (DSS), and QFG was administered orally to the treatment group. The effects of QFG on CAC were evaluated using disease index, histology, and serum T-cell ratios. RNA-seq and 16S rRNA analysis assessed the transcriptome and microbiome change. Key pharmacodynamic pathways were identified by integrating these data and confirmed via Western blotting and immunofluorescence. The link between microbiota and CAC-related markers was explored using linear discriminant analysis effect size and Spearman correlation analysis. RESULTS: Long-term treatment with QFG prevented AOM/DSS-induced CAC formation, reduced levels of interleukin (IL)-1β, tumor necrosis factor-alpha (TNF-α), IL-6, and interferon γ (IFN-γ), and increased CD3⁺ and CD4⁺/CD8⁺ T cells ratio, without causing hepatic or renal toxicity. A 16S rRNA analysis revealed that QFG rebalanced the Firmicutes/Bacteroidetes ratio and mitigated AOM/DSS-induced microbiota disturbances. Transcriptomics and Western blotting analysis identified the nucleotide-binding oligomerization domain-containing protein 2 (NOD2)/nuclear factor kappa-B (NF-κB) pathway as key for QFG's treatment against CAC. Furthermore, QFG decreased the abundance of Bacilli, Bacillales, Staphylococcaceae, Staphylococcus, Lactobacillales, Aerococcus, Alloprevotella, and Akkermansia, while increasing Clostridiales, Lachnospiraceae, Lachnospiraceae_NK4A136_group, Ruminococcaceae, and Muribaculaceae, which were highly correlated with CAC-related markers or NOD2/NF-κB pathway. CONCLUSION By mapping the relationships between CAC, immune responses, microbiota, and key pathways, this study clarifies the mechanism of QFG in inhibiting CAC, highlighting its potential for clinical use as preventive therapy.

Objective: To investigate the distribution characteristics of CD36 antigen in healthy individuals in Xinjiang, China and analyze the molecular mechanisms underlying CD36 deficiency. Methods: Flow cytometry was used to assess CD36 antigen expression on platelets from 881 healthy individuals who underwent physical examinations between June and August 2023. Differences in CD36 antigen distribution among ethnic groups were compared, and genotyping and third-generation sequencing were conducted on samples with CD36 deficiency. Results: Among the 881 samples, 4 cases (0.5%) of CD36 type Ⅱ deficiency were identified. The deficiency frequency was 0.7% (3/430) in Han individuals and 0.3% (1/363) in Uygur individuals, with no statistically significant difference between the two groups (P>0.05). No mutations were detected in the coding regions of the deficient samples. Two samples exhibited a (TG)11 in intron 3. Among the 12 linked mutation sites, g. 55589 G>A was mutated to g. 55589G Del, while g. 55593 A del did not occur; however, g. 55591A>T was observed nearby. Additionally, 52742insGAAAA was present in 100% of the (TG)11 haplotypes, potentially representing a novel linked mutation. Conclusion: This study indicates that the positive frequency of CD36 antigen in Xinjiang is relatively high, suggesting a low risk of alloimmune diseases in clinical practice. The (TG)11 in intron 3 is not universally present in all CD36 type Ⅱ deficiency cases, and the number of linked mutation sites extends beyond the previously reported 12.

Objective:To investigate the anatomical characteristics of the atlantoaxial joint associated with nonuniform settlement of the C 2 lateral mass (C 2LM-NUS) and its correlation with atlantoaxial osteoarthritis. Methods:A retrospective analysis was conducted on clinical and imaging data of 522 hospitalized patients (288 males, 234 females; mean age 60.8±11.2 years; range 18-83 years) who underwent CT scans of the head/neck or cervical spine at the Second Affiliated Hospital of Army Medical University between January 1, 2022 and December 31, 2022. Multiplanar reconstruction of CT data was performed to measure the settlement of the C 2 lateral mass (C 2LMS). Patients with a difference in bilateral C 2LMS (d-C 2LMS) >1.4 mm were classified into the C 2LM-NUS group (137 cases; 71 males, 66 females; mean age 63.3±11.6 years), while the normal group included 385 patients (217 males, 168 females; mean age 59.9±11.0 years). Imaging parameters of the atlantoaxial joint were measured, including the C 1, 2 coronal inclination angle (C 1, 2 CI), atlanto-dental interval (ADI), lateral atlanto-dental interval (LADI), coronal deviation angle of the odontoid (Od-CDA), and C 1, 2 relative rotation angle (C 1, 2 RRA). Osteoarthritis prevalence was recorded. A normal C 0-C 3 finite element (FE) model was constructed using CT data from a 48-year-old female in the normal group. A C 2LM-NUS FE model was developed based on anatomical differences between the C 2LM-NUS and normal groups, and stress distribution on the C 2 lateral mass articular surface was analyzed under flexion-extension, lateral bending, and axial rotation torques. Results:The C 2LM-NUS group exhibited asymmetric atlantoaxial joint morphology, with bilateral differences in C 1, 2CI and LADI of 8.5°(5.8°, 11.3°) and 0.8(0.1, 1.4) mm, respectively, significantly greater than those in the normal group [1.7°(0.8°, 2.7°) and 0.2(0.1, 0.5) mm, P<0.05]. Od-CDA and C 1, 2RRA were 3.9°(2.0°, 5.4°) and 7.2°(5.0°, 10.0°) in the C 2LM-NUS group, exceeding the normal group's values [0°(0°, 1.0°) and 0°(0°, 5.5°), P<0.05]. The prevalence of C 2LM-NUS was 37.8% in the atlantoaxial osteoarthritis group, significantly higher than in the non-osteoarthritis group (22.8%, P<0.05). Significant differences were observed in age (68.3±9.4 vs. 58.6±10.8 years), sex distribution (50/69 vs. 238/165), and C 1, 2RRA [5.6°(0°, 8.2°) vs. 3.8°(0°, 6.2°)] between the osteoarthritis and non-osteoarthritis groups ( P<0.05). After adjusting for age, sex, and C 1, 2RRA, binary logistic regression identified C 2LM-NUS as an independent risk factor for atlantoaxial osteoarthritis [ OR=2.024, 95% CI (1.300, 3.150), P<0.001]. FE analysis demonstrated a reduced C 1, 2 range of motion in the C 2LM-NUS model, with elevated stress concentrations on the settled side lateral mass during simulated flexion-extension, lateral bending, and rotation. Conclusions:The study indicated that C 2LM-NUS is associated with asymmetric anatomical changes in the atlantoaxial joint, increasing the risk of osteoarthritis. Stress concentration on the C 2 lateral mass articular surface, caused by C 2LM-NUS, is a biomechanical contributor to this heightened risk.

Acute urinary retention(AUR)occurs frequently among astronauts on orbit.The current treatment is complex and easy to damage the urethra,which seriously affects the life and work of astronauts.In contrast,acupuncture,a traditional Chinese remedy,has shown promising results in managing urinary retention.However,the specific acupoints that could potentially prevent AUR remain uncertain due to the unique physiological conditions experienced by individuals in space compared to those on Earth.To address this gap,our research delved into the mechanisms of AUR and acupuncture within both traditional Chinese medicine and modern medical practices.We conducted a thorough literature review from Pubmed,Web of Science,CNKI,Wanfang database,VIP database and Chinese Medical Code database.A hierarchical evidence-scoring approach was utilized to analyze the included literatures,thus devised acupuncture protocols for the treatment of AUR.The outcomes of our study aim to establish a foundation for the application of acupuncture in managing AUR.

Under the influence of long-term space flights and the confined space environment,it is very easy to induce space depression syndrome,mainly manifested as decreased emotional stability,sleep disorders,mental fatigue,etc.,which seriously affect the living conditions and working abilities of astronauts.The current treatment methods mainly focus on psychological support and drug intervention.Acupuncture has a good effect in treating depression.Therefore,starting from the TCM pathogenesis and modern medical pathogenesis of aerospace depression syndrome,we conducted literature retrieval from databases such as the Chinese Medical Classic,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,PubMed,and Web of science.For the included literature,we adopted the stratified evidence scoring method and combined the TCM mechanism and modern medical mechanism of the effect of acupuncture.A prescription for acupuncture points was constructed to provide a basis for selecting acupuncture points for the prevention of aerospace depression syndrome through acupuncture.