1.Survey of post-discharge exercise behavior and analysis of factors influencing exercise intensity in patients undergoing lung surgery
Hongyu ZENG ; Xiang WANG ; Tian ZHANG ; Yaqin WANG ; Xing WEI ; Zhen DAI ; Liping ZHANG ; Xiaoqin LIU ; Qiang LI ; Qiuling SHI ; Wei DAI ; Jia LIAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(05):734-742
Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.
2.Optimized monovision Q-value-customized FS-LASIK for myopia, astigmatism, and presbyopia
Linjuan YANG ; Qiang SHI ; Zhao LIU ; Yu ZHANG ; Shengjian MI
International Eye Science 2026;26(5):772-779
AIM: To evaluate safety, efficacy, visual quality, and patient satisfaction after optimized monovision Q-value-customized femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for myopia, astigmatism, and presbyopia. METHODS: This prospective study enrolled patients suffering myopia, astigmatism, and presbyopia. At 1 y post operation, uncorrected distance, intermediate and near visual acuity(UDVA, UIVA, UNVA), refraction, corneal higher order aberrations(HOAs), Q value, objective visual quality, and near stereoacuity were evaluated. The impact of surgery on patients' living quality and their satisfaction were evaluated based on National Eye Institute Refractive Error Quality of Life Instrument(NEI RQL)scores at 1-year follow-up.RESULTS:The study enrolled 36 patients(72 eyes)including 12 males(33%)and 24 females(67%)with an average age of 46.03±3.60(range 40-53)y. One year postoperatively, 97% of patients achieved binocular UDVA of 1.0 or better, 89% achieved UIVA of 0.63 or better, and 97% achieved UNVA of 1.0 or better. The spherical equivalent refraction(SE)in dominant eye within ±1.00 D was 100%. SE in non-dominant eyes was uncorrected compared with the preoperative target correction, with a mean difference of -0.27±0.34 D before and after surgery(P<0.001). while in the non-dominant eyes, the anterior corneal Q-value within the 5 mm zone increased negatively compared with the preoperative value(-0.33±0.24 vs -0.21±0.09, P<0.001). In the non-dominant eye, spherical aberration and longitudinal spherical aberration were lower than preoperative values(both P<0.001). Besides, there were no significant changes in objective scatter index(OSI), modulation transfer function cutoff frequency(MTF cut off)and Strehl ratio(SR)in both dominant and non-dominant eyes(all P>0.05), and the near stereoacuity was better after surgery(P=0.007). Additionally, the patient satisfaction rate with the surgery was 94%, the satisfaction rates for UDVA and UNVA were both 98%. The 11% of patients required to wear low-diopter glasses when driving at night.CONCLUSION:Optimized monovision Q-value-customised FS-LASIK is a safe and effective procedure for correcting myopia, astigmatism, and presbyopia. It provides favorable subjective and objective visual quality and high patient satisfaction. The under correction in non-dominant eyes is observed, indicating the further optimization of nomogram is needed.
3.Expert consensus on the application of artificial intelligence in lung cancer screening, diagnosis, and treatment (2026 edition)
Wenzhao ZHONG ; Haibo WANG ; Yi HU ; Hao ZHANG ; Jigang DAI ; Junqiang FAN ; Guibin QIAO ; Fan YANG ; Jian HU ; Fengwei TAN ; Xuening YANG ; Qiang PU ; Zihao CHEN ; Hongxia TIAN ; Lunxu LIU ; Hecheng LI ; Xiaolong YAN ; Zongyang YU ; Zhenbin QIU ; Yihua SUN ; Jing HU ; Yuhang SHI ; Zhifei GUO ; Peng ZHANG ; Kezhong CHEN ; Shugeng GAO ; Yilong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):848-856
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.
4.Correlation between serum uric acid and incident chronic kidney disease in middle-aged and elderly Chinese population and gender differences
Qing MIN ; Han ZHANG ; Zi-yan SHEN ; Shi-qi LYU ; Cheng ZHU ; Xiao-yan ZHANG ; Xiao-qiang DING
Fudan University Journal of Medical Sciences 2025;52(3):317-325
Objective To investigate the correlation between serum uric acid(SUA)levels and incident chronic kidney disease(CKD)in middle-aged and elderly Chinese population and gender differences.Methods Based on the longitudinal survey data of China Health and Retirement Longitudinal Study from 2011 to 2015,the CKD-Epidemiology Collaboration cystatin C formula was used to estimate the glomerular filtration rate(eGFR),and 4 119 participants with normal renal function(eGFR≥60 mL·min-1·1.72 m-2)at baseline were included.Incident CKD was defined as eGFR<60 mL·min-1·1.72 m-2 at the follow-up in 2015.Logistic regression analysis was used to analysis the association of SUA levels at baseline and incident CKD among different genders.Restricted cubic spline analysis was used to analyze the dose-response relationship.Results After 4-year follow-up,127 participants developed incident CKD,including 57 males and 70 females.Multivariate Logistic regression analysis showed that elevated SUA levels were independently associated with the risk of incident CKD(OR=1.532,P<0.001).For each 1 mg/dL increase in SUA,the risk of incident CKD increased by 33.6%in males(OR=1.336,P=0.012)and 77.5%in females(OR=1.755,P<0.001).Restricted cubic spline analysis showed a linear positive correlation between SUA levels and incident CKD in both males and females.Participants were divided into four groups according to SUA quartiles(Q1-Q4).Multivariate Logistic regression analysis indicated a significant increase in the risk of incident CKD in Q3 group(3.75 mg/dL
5.Correlation between serum uric acid and incident chronic kidney disease in middle-aged and elderly Chinese population and gender differences
Qing MIN ; Han ZHANG ; Zi-yan SHEN ; Shi-qi LYU ; Cheng ZHU ; Xiao-yan ZHANG ; Xiao-qiang DING
Fudan University Journal of Medical Sciences 2025;52(3):317-325
Objective To investigate the correlation between serum uric acid(SUA)levels and incident chronic kidney disease(CKD)in middle-aged and elderly Chinese population and gender differences.Methods Based on the longitudinal survey data of China Health and Retirement Longitudinal Study from 2011 to 2015,the CKD-Epidemiology Collaboration cystatin C formula was used to estimate the glomerular filtration rate(eGFR),and 4 119 participants with normal renal function(eGFR≥60 mL·min-1·1.72 m-2)at baseline were included.Incident CKD was defined as eGFR<60 mL·min-1·1.72 m-2 at the follow-up in 2015.Logistic regression analysis was used to analysis the association of SUA levels at baseline and incident CKD among different genders.Restricted cubic spline analysis was used to analyze the dose-response relationship.Results After 4-year follow-up,127 participants developed incident CKD,including 57 males and 70 females.Multivariate Logistic regression analysis showed that elevated SUA levels were independently associated with the risk of incident CKD(OR=1.532,P<0.001).For each 1 mg/dL increase in SUA,the risk of incident CKD increased by 33.6%in males(OR=1.336,P=0.012)and 77.5%in females(OR=1.755,P<0.001).Restricted cubic spline analysis showed a linear positive correlation between SUA levels and incident CKD in both males and females.Participants were divided into four groups according to SUA quartiles(Q1-Q4).Multivariate Logistic regression analysis indicated a significant increase in the risk of incident CKD in Q3 group(3.75 mg/dL
6.Research on structural parameters of injection pump head flow channel based on energy dissipation analysis
Juan LIANG ; Jing WANG ; Qing-fu SHI ; Li-qiang ZHANG
Chinese Medical Equipment Journal 2025;46(9):28-32
Objective To study the influences of the structural parameters of the pump head flow channel on the energy dissipation of injection pumps and optimize the pump head flow channel structural parameters.Methods Firstly,three structural parameters of the injection pump head flow channel,namely the input chamber diameter,the connecting chamber diameter and the plunger rod chamber diameter,were selected as the experimental factors for orthogonal experimental design,and the total entropy production values of the injection pump head flow channels with different structures were obtained through entropy production analysis;secondly,the effects of the three structural parameters on the total entropy production values were explored with the range method;finally,the Kriging interpolation proxy model analysis and computational fluid dynamics(CFD)numerical analysis of the injection pump head flow channel were carried out to determine the effects of the combinations of the three structural parameters by pairs on the total entropy production values,and the structural parameters of the injection pump head flow channel were optimized with the objective of energy dissipation.Results The minimum total entropy production value was 2 783 970 mW/K,which was 29.8%lower than that in case of the initial structure(3 966 072 mW/K),when the input chamber diameter was 4.8 mm,the connecting chamber diameter was 0.32 mm and the plunger rod chamber diameter was 1.0 mm;the three structural parameters had significant differences in the effects on the total entropy production value,ordered as the plunger rod chamber diameter,the input chamber diameter and the connecting chamber diameter;considering the energy dissipation,the total entropy production value was minimized in case of the minimal input chamber diameter,the maximal connecting chamber diameter and the medium-sized plunger rod chamber diameter.Conclusion The input chamber diameter,the connecting chamber diameter and the plunger rod chamber diameter have differences in the sensitivity to the effects on the energy dissipation of the injection pump head flow channel,and the structural parameters of the head flow path can be optimized accordingly with the goal of minimizing energy dissipation.[Chinese Medical Equipment Journal,2025,46(9):28-32]
7.Research on structural parameters of injection pump head flow channel based on energy dissipation analysis
Juan LIANG ; Jing WANG ; Qing-fu SHI ; Li-qiang ZHANG
Chinese Medical Equipment Journal 2025;46(9):28-32
Objective To study the influences of the structural parameters of the pump head flow channel on the energy dissipation of injection pumps and optimize the pump head flow channel structural parameters.Methods Firstly,three structural parameters of the injection pump head flow channel,namely the input chamber diameter,the connecting chamber diameter and the plunger rod chamber diameter,were selected as the experimental factors for orthogonal experimental design,and the total entropy production values of the injection pump head flow channels with different structures were obtained through entropy production analysis;secondly,the effects of the three structural parameters on the total entropy production values were explored with the range method;finally,the Kriging interpolation proxy model analysis and computational fluid dynamics(CFD)numerical analysis of the injection pump head flow channel were carried out to determine the effects of the combinations of the three structural parameters by pairs on the total entropy production values,and the structural parameters of the injection pump head flow channel were optimized with the objective of energy dissipation.Results The minimum total entropy production value was 2 783 970 mW/K,which was 29.8%lower than that in case of the initial structure(3 966 072 mW/K),when the input chamber diameter was 4.8 mm,the connecting chamber diameter was 0.32 mm and the plunger rod chamber diameter was 1.0 mm;the three structural parameters had significant differences in the effects on the total entropy production value,ordered as the plunger rod chamber diameter,the input chamber diameter and the connecting chamber diameter;considering the energy dissipation,the total entropy production value was minimized in case of the minimal input chamber diameter,the maximal connecting chamber diameter and the medium-sized plunger rod chamber diameter.Conclusion The input chamber diameter,the connecting chamber diameter and the plunger rod chamber diameter have differences in the sensitivity to the effects on the energy dissipation of the injection pump head flow channel,and the structural parameters of the head flow path can be optimized accordingly with the goal of minimizing energy dissipation.[Chinese Medical Equipment Journal,2025,46(9):28-32]
8.Platelet-rich plasma intervenes in chondrocyte autophagy and apoptosis for treatment of osteoarthritis
Yaomin WANG ; Kefan ZHANG ; Dening WANG ; Qiang REN ; Jian LI ; Hui SHI
Chinese Journal of Tissue Engineering Research 2025;29(13):2802-2811
BACKGROUND:In the process of intervening in the development of osteoarthritis,platelet-rich plasma plays an important role by intervening in autophagy,apoptotic cytokines and signal transduction pathways.OBJECTIVE:To summarize the structure of cytokines and signaling pathways involved in the diagnosis of osteoarthritis by platelet-rich plasma in recent years,as well as its correlation with chondrocyte apoptosis and autophagy,in order to provide effective targets for the future treatment of osteoarthritis.METHODS:Literature search was conducted in CNKI,WanFang Data,VIP,PubMed,Web of Science,and Medline databases using "platelet-rich plasma,chondrocyte,apoptosis,autophagy,osteoarthritis,cytokines,signaling pathway" as Chinese and English search terms.A systematic summary and induction were made for the 66 included articles.RESULTS AND CONCLUSION:Current research has shown that platelet-rich plasma can promote cartilage repair and assist bone tissue healing through various pathways,mainly divided into three aspects:(1) Platelet-rich plasma regulates the extension,closure,and maturation of microautophagosomes,promotes chondrocyte megaautophagy and molecular chaperone-mediated cell autophagy under specific conditions,enhances the expression of autophagy-related factors such as LC3Ⅱ/Ⅰ and Beclin1,inhibits the expression of P62/SQSTM1.Currently,there is no clear research directly exploring the specific effect of platelet-rich plasma on heat shock proteins,and further research is needed in this field in the future.(2) The various growth factors released by platelet-rich plasma inhibit the expression of pro-apoptotic factors Caspase,interleukin-1β,and tumor necrosis factor alpha,promote the expression of anti-apoptotic factor Bcl-2,and prevent chondrocyte apoptosis and degeneration.(3) By activating the PI3K/AKT/mTOR signaling pathway,NF-κB signal transduction pathway,death receptor pathway,mitochondrial stress pathway and other pathways,platelet-rich plasma inhibits the expression of Bax and Caspase,and prevents the release of cytochrome c,thereby inhibiting the death and necrotic apoptosis of chondrocytes.In general,platelet-rich plasma promotes cartilage repair,supports cartilage regeneration,and plays an anti-inflammatory role,and its biological effect in chondrocytes usually depends on the regulation of autophagy and apoptosis-related cytokines and signaling pathways.
9.A qualitative study on digital-intelligent equipment empowering"generalized"development of traditional Chinese medicine inspection
Chen ZHAO ; Aomeng ZHANG ; Zehui YE ; Jiaying LUO ; Qiang SHI ; Ying YU ; Xiaoyu ZHANG ; Yin JIANG ; Zhicong ZENG ; Fengxia LIN ; Yinghui JIN ; Xue XU ; Xiaowei ZHANG ; Liangzhen YOU ; Yipin FAN ; Dameng YU ; Shaoyang MEN ; Jian DU ; Rui XU ; Ruijin QIU ; Yingjie ZHI ; Zhineng CHEN ; Xuan ZHANG ; Hongcai SHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(8):1052-1061
Objective This study investigated feasible cases and their significance in promoting the"generalized"development of inspection through digital-intelligent equipment.Methods A qualitative research approach was used,involving interviews conducted between February 2025 and March 2025 with experts in traditional Chinese medicine diagnostics,clinical research methodology,medical engineering integration,and related disciplines,using both online and offline methods.In accordance with the Consolidated Criteria for Reporting Qualitative Research,feasible cases involving the specific application of digital equipment in various parts of observation were collected through item enrichment.The significance of extending observation capabilities via these cases was analyzed,along with the overall implications of integrating digital technologies with traditional inspection method.Results Interviews were completed with 11 experts from domestic universities and research institutes in the fields of traditional Chinese medicine diagnosis,medical engineering integration,and related disciplines.A total of 78 feasible cases of digital-intelligent inspection were identified,along with 69 insights regarding the significance of enhancing the inspection capabilities.These insights were synthesized into two dimensions and 23 holistic meanings.The first dimension is to expand the scope of inspection,including obtaining internal environmental characteristics,observing external environmental characteristics,expanding thermodynamic characteristic data,and crossing time and space.The second dimension is to improve the quality of observation and diagnosis information collection and analysis,including 19 specific meanings,such as standardized collection environment,objective quantification,and refined observation.Conclusion Digital-intelligent equipment plays a significant role in expanding the scope of inspection content and achieving high-quality acquisition and analysis of extensive inspection information.These advancements extend and enrich the capabilities of traditional inspection method in traditional Chinese medicine.
10.Analysis of China's cross-regional medical insurance settlement policy based on policy tools
Shi-qiang WANG ; Hui WANG ; Shu ZHANG ; Zi-qi ZHANG ; Yi-jie LI ; Jia-yi LIU ; Guo-heng HU
Chinese Journal of Health Policy 2025;18(10):32-39
Objective:Systematically review the release status and characteristics of policies related to cross-regional medical insurance settlement policies in China,providing reference for promoting the convenience of medical insurance settlement services and improving management efficiency.Methods:Using content analysis,a two-dimensional framework of"policy objectives-policy tools"was constructed.A total of 127 policy documents were coded and analyzed.Results:Demand-based tools were applied most frequently(43.6%),followed by environmental and supply-based tools.Policy objectives mainly focused on improving service convenience,supported by expanding coverage and ensuring regulatory security.Conclusions:China's cross-regional medical insurance settlement policies have improved service accessibility and strengthened institutional supervision while gradually expanding coverage.However,deficiencies remain in assessment refinement and emergency mechanisms.Greater interdepartmental coordination is needed to enhance regulatory linkage and ensure the safe operation of medical insurance funds.

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