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.

In order to further standardize the vaccination of kidney transplant candidates and recipients in China, the Branch of Organ Transplantation of Chinese Medical Association has organized experts in kidney transplantation and infectious diseases. Based on the "Vaccination of Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice", and in combination with the clinical reality of infectious diseases and vaccination after organ transplantation in China, as well as referring to relevant recommendations from home and abroad in recent years, these guidelines are formulated from aspects such as epidemiology, types of vaccines, vaccination principles, target population, and specific vaccine administration. The "Guidelines for Vaccination of Kidney Transplant Candidates and Recipients in China" aims to provide theoretical reference for medical workers in the field of kidney transplantation in China, regarding the vaccination of kidney transplant candidates and recipients. It is expected to better guide the vaccination of kidney transplant candidates and recipients, reduce the risk of postoperative infection, and improve survival outcomes.

Objective To explore the correlation between osteocalcin (OCN) and visceral fat area (VFA) in overweight/obese population. Methods The data of 297 overweight/obese people who underwent health examinations in Health Management Department of Second Affiliated Hospital of Xi';an Jiaotong University from August 2021 to August 2024 were analyzed. According to the VFA value measured by InBody, the subjects were divided into an excessive group (VFA ≥100 cm²) and a normal group (VFA<100 cm2). The baseline data, glucose metabolism indicators, lipid metabolism indicators and OCN were compared between the two groups. Binary logistic regression analysis was used to analyze the independent risk factors affecting visceral fat deposition in overweight/obese people. Results According to the VFA value, there were 193 cases (64.98%) in the excessive group and 104 cases (35.02%) in the normal group. There were no statistical differences in gender, age and comorbidities between the two groups (P>0.05). The BMI, FPG, HbA1c, TC, TG, and LDL-C in the excessive group were higher than those in the normal group, while the HDL-C and OCN were lower than those in the normal group (P<0.05). Binary logistic regression analysis revealed that BMI, FPG, HbA1c, TC, TG and LDL-C were independent risk factors for visceral fat deposition in overweight/obese people, while HDL-C and OCN were protective factors (P<0.05). Conclusion Visceral fat deposition in overweight/obese people is closely related to OCN content, and is affected by abnormal glucolipid metabolism, which provides new ideas for the prevention and treatment of obesity-related diseases.

The 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI) was held from January 23 to 25, 2025. Several significant studies on the treatment of esophageal and gastroesophageal junction (GEJ) cancer were presented at the symposium, highlighting notable advances, particularly in the perioperative and advanced settings. Immunotherapy has demonstrated significant promise in the neoadjuvant treatment of esophageal cancer, showing potential to become a standard treatment. Furthermore, the long-term survival benefits of combining immunotherapy with chemotherapy for advanced GEJ cancer were further validated. This article summarizes and interprets the researches presented at the symposium concerning perioperative and advanced treatments for esophageal and GEJ cancers.

Objective To evaluate the value of postoperative radiotherapy (PORT) in patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy. Methods Patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy were chosen from the SEER Research Plus Database [17 Registries, November 2012 Submission (2000-2019)]. The patients were divided into a PORT group and a non-PORT group according to whether the PORT was used. To balance baseline characteristics between non-PORT and PORT groups, R software was used to conduct a propensity score matching (PSM) with a ratio of 1 : 1 and a matching tolerance of 0.01. Both the Cox regression analysis and Kaplan-Meier survival analysis were conducted to evaluate the value of PORT in terms of overall survival (OS) and disease-specific survival (DSS). Results In total, 2468 patients with stage ⅢA-N2 non-small cell lung cancer were enrolled, including 1078 males and 1390 females with a median age of 65 (58-71) years. There were 1336 patients in the PORT group, and 1132 patients in the non-PORT group. Cox regression analysis showed that PORT was not significantly associated with OS (multivariate analysis: HR=1.051, 95%CI 0.949-1.164, P=0.338) and DSS (multivariate analysis: HR=1.094, 95%CI 0.976-1.225, P=0.123). No statistical difference was found in the OS or DSS between non-PORT group and PORT group after PSM analysis (P＞0.05). Conclusion PORT does not have a survival benefit for patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy.

Objective To study the relationship between serum visfatin, neutrophil-to-lymphocyte ratio (NLR) and disease severity of coronary heart disease (CHD) in elderly patients (≥90 years old). Methods One hundred and two elderly patients (≥90 years old) with CHD who received coronary CT angiography (CTA) were selected from January 2020 to June 2024. In addition, thirty-five elderly patients (≥90 years old) without CHD who underwent coronary CTA during the same period were included in the control group. The CHD patients were divided into mild group, moderate group and severe group by CT-SYNTAX score. The clinical data and levels of serum visfatin and NLR were compared, and the correlation and diagnostic value of the above levels with disease severity of CHD in elderly patients were analyzed. Results Serum visfatin and NLR were manifested as severe group>moderate group>mild group>control group (P<0.05). Pearson correlation analysis found that serum visfatin and NLR were moderately positively correlated with CT-SYNTAX score (r=0.574, 0.482, P<0.001). Receiver operating characteristics (ROC) curve indicated that the area under the curve (AUC) of combination of serum visfatin and NLR in diagnosing severe lesion in elderly patients (≥90 years old) with CHD was 0.882, which was higher than that of visfatin or NLR alone, and its 95%CI was 0.803-0.938. Conclusion There is a certain correlation between serum visfatin, NLR and disease severity of CHD in elderly patients. The combination of the above indicators has a higher predictive value on severe lesion.

Objective To explore and analyze the related factors of kinesiophobia in elderly patients with coronary heart disease (CHD) during cardiac rehabilitation exercise period, and to evaluate the effect of cognitive behavior therapy on improving kinesiophobia and promoting rehabilitation. Methods A total of 352 elderly patients with CHD admitted to the hospital were included from October 2023 to October 2024. Tampa Scale for Kinesiophobia-11 (TSK-11) was adopted to evaluate the kinesiophobia status. Patients with kinesiophobia were randomly grouped. Routine intervention (routine group, n=82) and cognitive behavior intervention (study group, n=82) were implemented respectively. The intervention effects were observed in both groups. Results Among the 352 patients, 46.59 % (164/352 ) of elderly patients with coronary heart disease had different degrees of kinesiophobia. The proportions of female, divorced/widowed, revascularization and family relationship disharmony and scores of Patient Health Questionnaire (PHQ9) and Generalized Anxiety Disorder Scale (GAD7) in patients with kinesiophobia were higher than those in patients without kinesiophobia (P<0.05) while the scores of General Self-Efficacy Scale (GSES) and Social Support Rating Scale (SSRS) were lower compared with those in patients without kinesiophobia (P<0.05). Logistic regression analysis found that female, divorced/widowed, family relationship disharmony, revascularization and scores of PHQ9, TSK-11, GAD7, GSES and SSRS were related to kinesiophobia (P<0.05). After intervention, the scores of TSK-11, PHQ9 and GAD7 in the study group were lower while the scores of GSES and SSRS, 6 min walking test distance, and cardiopulmonary exercise test peak oxygen uptake and anaerobic threshold were higher compared to the routine group (P<0.05). Conclusion The kinesiophobia in elderly patients with CHD during cardiac rehabilitation is related to gender, revascularization and psychosocial factors. Clinically, cognitive behavior intervention should be provided according to the situation and guided to carry out rehabilitation exercise regularly so as to promote improvement of cardiopulmonary function.

Objective To investigate the association between lifestyle and risk of heart disease and diabetes in the elderly population in Xi';an City. Methods From January 2021 to January 2024, a staged cluster sampling method was used to investigate the lifestyle and the occurrence of heart disease and diabetes in elderly population aged 60 years and above in the communities of Xi';an. Multivariate logistic regression was used to analyze the relationship between lifestyle and the risk of heart disease and diabetes. Results A total of 413 elderly people were investigated, of which 31.96% had heart disease, 27.12% had diabetes, and 10.90% had diabetes with heart disease. Multivariate logistic regression analysis revealed that age, BMI, family history, sweet food preference, smoking, and sitting and lying for a long time were risk factors for diabetes in the elderly population (P<0.05). Age, BMI, family history, history of diabetes, preference for salted products, smoking, drinking, and sitting and lying for a long time were risk factors for heart disease in the elderly population (P<0.05). Conclusion The incidence rates of heart disease and diabetes are high in the elderly population in Xi';an City. The risk of diabetes is related to unhealthy lifestyles such as sweet food preference, smoking, and sitting and lying for a long time, while heart disease is related to unhealthy lifestyles such as preference for salted products, smoking, drinking, and sitting and lying for a long time.

Objective To analyze the correlation between Helicobacter pylori infection and gastrointestinal hormone levels in elderly patients with chronic atrophic gastritis (CAG), and to provide a theoretical basis for clinical treatment. Methods From January 2024 to December 2024, 3000 elderly CAG patients with Helicobacter pylori infection admitted to four tertiary hospitals in Xi’ an City were selected as the study group, and 3000 elderly CAG patients without Helicobacter pylori infection were enrolled as the control group according to the ratio of 1:1. The risk factors of Helicobacter pylori infection in elderly patients with CAG were explored by logistic multivariate regression analysis, and the association between Helicobacter pylori infection and gastrointestinal hormones in elderly CAG patients was analyzed. Results There were statistically significant differences in smoking history, alcohol drinking history, overeating, spicy diet, bile reflux, abuse of antibiotics, and levels of vasoactive intestinal peptide (VIP), gastrin (GAS), cholecystokinin (CCK), and motilin (MTL) between the two groups (P<0.05). Logistic multivariate analysis indicated that smoking history, alcohol drinking history, overeating, spicy diet, bile reflux, and abuse of antibiotics were independent risk factors of Helicobacter pylori infection in elderly patients with CAG, and VIP, GAS, CCK and MTL levels were associated with Helicobacter pylori infection in elderly CAG patients (P<0.05). Conclusion Helicobacter pylori infection in elderly patients with CAG is closely associated with gastrointestinal hormone levels. It is necessary to take active prevention and treatment measures for this population in clinical practice.

[摘 要] 目的：探究抗程序性死亡受体1（PD-1）免疫治疗对非小细胞肺癌（NSCLC）恶病质患者预后的影响。方法：以2019年1月—2021年1月在西京医院治疗的80例恶病质NSCLC患者为研究对象，用随机数字表法将其分为对照组和观察组，对照组给予序贯放化疗等对症治疗及营养治疗，观察组给予抗PD-1抗体免疫治疗联合治疗。比较两组临床疗效及治疗后身体状况改善情况，并观察患者治疗前后肺功能及免疫功能情况，在患者治疗后对其生存情况进行随访，统计两组患者治疗后1年累计生存率。结果：治疗后两组NSCLC患者的疾病控制率（DCR）及客观缓解率（ORR）对比均无明显差异（均P > 0.05）；观察组食欲评分及Karnofsky评分（KPS）均高于对照组（均P < 0.05）；治疗后观察组CD3+及CD4+/CD8+淋巴细胞亚群比例明显高于对照组（均P < 0.05），第1秒用力呼气容积（FEV1）及FEV1/用力肺活量（FEV1/FVC）比值均大于对照组（均P < 0.05）；观察组治疗后1年生存率[62.50%（25/40）]明显高于对照组[40.00%（16/40）]（P < 0.05）。结论: 抗PD-1抗体免疫治疗可减轻NSCLC恶病质患者免疫功能及肺功能损害，并能提高其1年生存率。