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.

To address the growing challenge of an increasing number of elderly lung cancer patients amidst China's aging population and to fill the gap in quality control standards for surgical treatment in this special population, this study aimed to develop a standardized surgical evaluation system for elderly lung cancer patients tailored to China's national conditions. The system was established through a literature review, integrated the pathophysiological characteristics of elderly patients, and was constructed following review, feedback, and revision by experts from multiple thoracic surgery centers. Employing a 100-point scoring system, it comprises three primary domains: physical infrastructure and geriatric adaptability foundational conditions (10 points); management level and perioperative care models (20 points); and technical proficiency and clinical outcomes (70 points). The system places a strong emphasis on geriatric adaptability, proposing specific, quantifiable indicators for age-friendly facility modifications, control of elderly-specific complications, multidisciplinary collaboration, and standardized perioperative management. It provides a convenient and measurable assessment tool for quality control in the surgical treatment of elderly lung cancer in China, which is expected to promote the standardization and homogenization of diagnosis and treatment.

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: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

Objective To modify YC-1,an inhibitor of hypoxia-inducible factor-1α(HIF-1α)into nanoparticles and explore its effect on reversing chemoresistance of colorectal cancer cells.Methods Nano-inhibitor mPEG350-YC-1(MYC-1)was prepared by the carboxyl condensation reaction of the active functional group hydroxyl(-OH)in the YC-1 molecule with methoxy polyethylene glycol carboxylic acid,and was verified by 1H nuclear magnetic resonance(1H-NMR).Its morphology was analyzed by transmission electron microscope(TEM),and its particle size distribution was analyzed by dynamic light scattering(DLS).By interacting FITC-labeled MYC-1(FYC-1)with HCT15 cells,the uptake ability of FYC-1 by the cells was observed using laser confocal microscopy.The cytotoxicity of MYC-1 was measured with CCK-8 assay.The sensitization effect of MYC-1 on the chemotherapy drug 5-Fu was detected through toxicity tests of resistant HCT15 cells(resistant HCT15,R-HCT15)and live/dead cell staining.The mechanism of MYC-1 reversing drug resistance was determined with immunofluorescence staining of HIF-1α and western blotting.Finally,a subcutaneous transplanted tumor model of R-HCT15 cells was constructed.The tumor bearing mice were randomly divided into PBS,5-Fu,MYC-1,and MYF groups,with 3 mice in each group.The tumor volume and weight were observed after treatment in each group to evaluate the ability of MYC-1 to reverse 5-Fu resistance in colorectal cancer.Results The nano-inhibitor MYC-1 was successfully prepared.TEM and DLS showed that MYC-1 could self-assemble into nanoparticles with a diameter of approximately 19.96±2.97 nm in aqueous solution.FYC-1 was also successfully prepared.When FYC-1 was interacted with HCT15 cells,FYC-1 could be better taken up by the cells,indicating that the amphiphilic MYC-1 could be better endocytosed into the cells to exert its function.When MYC-1 and 5-Fu acted in combination in colon cancer R-HCT15 cells,the resistance index(RI)was decreased from 7.99 to 1.55,and the relative reversal rate(RRR)of RI was 80.6%.Live(green)/dead(red)cell staining revealed that MYC-1 increased the toxicity of 5-Fu to R-HCT15 cells.Immunofluorescence staining(P<0.01)and Western blotting indicated that MYC-1 effectively inhibited the intracellular expression of HIF-1α.The combined action of MYC-1 and 5-Fu on mice with R-HCT15 subcutaneous transplanted tumors had the best therapeutic effect when compared with PBS(P<0.001),5-Fu(P<0.01),and MYC-1(P<0.01).Immunofluorescence staining of HIF-1α in tumor tissues displayed that the expression of HIF-1α was decreased in the MYC-1 and MYF groups.HE staining showed that there was no obvious damage to the important organs in each treatment group.Conclusion Nano-inhibitor MYC-1 can reverse the drug resistance of colorectal cancer to 5-Fu chemotherapy by reducing the expression of HIF-1α protein in colorectal cancer cells,thereby effectively improving the therapeutic effect of 5-Fu.

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.

Objective To investigate whether transcutaneous electrical acupoint stimulation(TEAS)can improve the muscle strength,endurance and work efficiency of calf muscles in healthy young men,aiming to explore a new method for preventing and combating microgravity-induced muscle atrophy in space environments.Methods 40 healthy young men aged 18-35 years were randomly divided into a Control group(Pseudo Transcutaneous Electrical Acupoint Stimulation)and a Experimental group(Transcutaneous Electrical Acupoint Stimulation)in a 1∶1 ratio,with 20 participants in each group.In the Control group,the indicator light of the stimulator was covered,and the device was turned on,but the electrodes did not contact the skin,The device automatically turned offafter 3 seconds.In the Experimental group,the TEAS device was connected to the current and TEAS intervention was performed.The electrical stimulation waveform was a sperse-dense wave with a frequency of 4/20 Hz,and the intensity was determined by patient tolerance.The acupoints selected for electrical stimulation in both groups were bilateral Zusanli(ST36)、Liangqiu(ST34),Taixi(KI3),and Fuliu(KI7).Zusanli and Liangqiu were paired,and Taixi and Fuliu were paired.The intervention frequency was 30 min/time,1 time/day,6 days/week,for 2 weeks.The relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral calf muscles were measured using an isokinetic dynamometer at 0th,7th,and 14d day of the experiment.Results After 1 week of TEAS,compared with Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,compared with Control group,the relative peak torque at 60°/s and the relative peak torque at 180°/s of the bilateral posterior calf muscles in the Experimental group were significantly increased(all P<0.05).After 2 weeks TEAS;compared with the Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,the relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral posterior calf muscles were significantly increased in the Experimental group(all P<0.05).Conclusion TEAS of Zusanli,Liangqiu,Fuliu and Taixi acupoints on the lower limbs for 2 weeks can effectively improve the maximum muscle strength,endurance and work efficiency of the posterior calf muscles in healthy young men.

Objective To clarify the prescription of acupoints for preventing and controlling insomnia problems of astronauts in orbit and to verify its effectiveness through ground-based experiments,so as to provide reference for space-based applications.Methods 60 patients with mild to moderate insomnia were randomly divided into 30 cases each in the experimental group and the control group.The experimental group was treated with TEAS,and the acupoints were Neiguan,Waiguan,Shenmen,Hegu,Shenmai,Zhaohai,Taixi,and Sanyinjiao for 30 min/times every other day for 4 weeks;the control group was treated with waiting.The TEAS treatment was evaluated using Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and indicators measured by the sleep monitor at pre-treatment,2-week,4-week,and 8-week follow-ups.Clinical efficacy for mild to moderate insomnia was assessed.Results The PSQI,ISI,and HAMD scores in the experimental group exhibited a decreasing trend during treatment and at follow-up,with significantly greater improvement compared to the control group(P<0.05).The experimental group demonstrated significantly greater improvement in HAMA scores than the control group at both the 4-week and 8-week follow-up assessments(P<0.05).Additionally,the experimental group demonstrated significantly greater improvements in reducing nighttime awakenings and enhancing sleep efficiency compared to the control group at the 4-week treatment mark(P<0.05).Conclusion TEAS Neiguan,Waiguan,Shenmen,Hegu,Shenmai,Zhaohai,Taixi and Sanyinjiao acupoints can significantly improve the sleep quality and anxiety and depression of patients with mild to moderate insomnia,and provide clinical data support for the prevention and treatment of insomnia in astronauts in orbit.

Objective To explore the methods of continuing education for advanced endoscope operations by diges-tive specialists through the establishment and teaching effect evaluation of the ERCP(endoscope retrograde cholan-giopancreatography)introductory training mode.Methods A total of 26 trainees from 3 sessions of the ERCP intro-ductory training courses at Peking Union Medical College Hospital from September 2023 to September 2024 were in-cluded.The teaching effects of the training courses and its 5 modules were subjectively and objectively evaluated by questionnaires,on-site tests and evaluations by senior ERCP operators.Results Through the ERCP introductory training courses,the trainees'self-evaluated proficiency in duodenoscope structure(pre-training:2.4±2.4,post-training:8.2±1.5,P＜0.001),duodenoscope operation(pre-training:1.2±2.2,post-training:6.6±1.8,P＜0.001),papillary cannulation(pre-training:0.5±1.3,post-training:5.4±1.8,P＜0.001),intra-bile duct operation(pre-training:0.2±0.6,post-training:4.9±2.1,P＜0.001),and identification of intra-bile duct lesions(pre-training:1.7±2.1,post-training:6.0±2.0,P＜0.001)was significantly improved.The accuracy rate of the trainees'theoretical tests and picture recognition before training was 37.2％and then increased up to 62.8％after training.Before training,all trainees were considered by senior operators as not ready to start ERCP training on real patients,while after training,69.2％(18/26)of the trainees were considered ready to start ERCP training on real patients.Conclusions The multi-module ERCP introductory training courses have a significant effect in terms of laying a foundation for trainees to start ERCP training on patients and of providing a reference for the con-tinuing education mode of advanced endoscope operations for digestive specialists in China.