OBJECTIVE:Disorders in iron metabolism increase the risk of type 2 diabetes mellitus.Hepcidin play an important role in maintaining iron homeostasis in the body,but its level increases with increased inflammation.Changes in hepcidin and iron homeostasis and the extent of their association with inflammation in people with and without type 2 diabetes mellitus are unknown.Meta-analysis was used to evaluate the effect of inflammation on serum hepcidin and iron metabolism related parameters in patients with type 2 diabetes mellitus.METHODS:CNKI,PubMed,Web of Science and EBSCOhost databases were searched by computer to collect observational studies related to inflammatory index and hepcidin in patients with type 2 diabetes mellitus.The search time was from September 1,2000 to September 30,2024.Three researchers independently screened the literature,extracted data and evaluated the quality of the included literature.Meta-analysis was performed by Review Manager 5.3,Stata 17.0 and GraphPad Prism 8.0.2 software.RESULTS:A total of 15 articles(17 studies)involving 3 159 participants,including 1 357 patients with type 2 diabetes mellitus,were included.Meta-analysis results showed that compared with the control group,patients with type 2 diabetes mellitus had higher levels of serum hepcidin[standardized mean difference(SMD)=0.35,95％confidence interval(CI)(0.05,0.65),P＜0.05],serum ferritin(SMD=0.49,95％CI(0.21,0.78),P＜0.01)and serum transferrin(SMD=0.19,95％CI(0.00,0.37),P＜0.05).Subgroup analysis results indicated that inflammation had a significant effect on serum hepcidin(SMD=0.76,95％CI(0.17,1.34),P＜0.05)and serum ferritin(SMD=0.77,95％CI(0.06,1.47),P＜0.05)in patients with type 2 diabetes mellitus.CONCLUSION:Hepcidin concentration is positively correlated with type 2 diabetes mellitus.Inflammation is one of the risk factors of type 2 diabetes mellitus.Early prevention of inflammation has certain significance in preventing iron metabolism disorder in patients with type 2 diabetes mellitus.

OBJECTIVE:Disorders in iron metabolism increase the risk of type 2 diabetes mellitus.Hepcidin play an important role in maintaining iron homeostasis in the body,but its level increases with increased inflammation.Changes in hepcidin and iron homeostasis and the extent of their association with inflammation in people with and without type 2 diabetes mellitus are unknown.Meta-analysis was used to evaluate the effect of inflammation on serum hepcidin and iron metabolism related parameters in patients with type 2 diabetes mellitus.METHODS:CNKI,PubMed,Web of Science and EBSCOhost databases were searched by computer to collect observational studies related to inflammatory index and hepcidin in patients with type 2 diabetes mellitus.The search time was from September 1,2000 to September 30,2024.Three researchers independently screened the literature,extracted data and evaluated the quality of the included literature.Meta-analysis was performed by Review Manager 5.3,Stata 17.0 and GraphPad Prism 8.0.2 software.RESULTS:A total of 15 articles(17 studies)involving 3 159 participants,including 1 357 patients with type 2 diabetes mellitus,were included.Meta-analysis results showed that compared with the control group,patients with type 2 diabetes mellitus had higher levels of serum hepcidin[standardized mean difference(SMD)=0.35,95％confidence interval(CI)(0.05,0.65),P＜0.05],serum ferritin(SMD=0.49,95％CI(0.21,0.78),P＜0.01)and serum transferrin(SMD=0.19,95％CI(0.00,0.37),P＜0.05).Subgroup analysis results indicated that inflammation had a significant effect on serum hepcidin(SMD=0.76,95％CI(0.17,1.34),P＜0.05)and serum ferritin(SMD=0.77,95％CI(0.06,1.47),P＜0.05)in patients with type 2 diabetes mellitus.CONCLUSION:Hepcidin concentration is positively correlated with type 2 diabetes mellitus.Inflammation is one of the risk factors of type 2 diabetes mellitus.Early prevention of inflammation has certain significance in preventing iron metabolism disorder in patients with type 2 diabetes mellitus.

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.

Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

The incidence of adenocarcinoma of the esophagogastric junction (AEG) continues to rise globally, with surgical resection representing the primary curative approach. Due to the complex anatomy and heterogeneous metastatic pathways of AEG, lymphadenectomy has become a critical focus in modern surgical oncology. However, traditional TNM staging and Siewert classification exhibit limitations in precisely guiding the optimal extent of lymphadenectomy. Consequently, this review integrated emerging evidence from membrane anatomy theory - a field experiencing breakthrough advances - to systematically explore lymphadenectomy strategies for AEG. Specifically, we analyzed the application of membrane anatomy principles to delineate lymphadenectomy strategies, dissection scope, and key surgical techniques tailored to each Siewert subtype (I, II, III) and varying degrees of esophageal involvement. Based on membrane anatomy, the review proposed specific, anatomically guided lymph node dissection strategies. Furthermore, we evaluated the feasibility, standardization, and clinical significance of membrane anatomy-guided dissection strategies considering recent advances, while also addressing current challenges and future directions for development and validation. Membrane anatomy is anticipated to serve as a novel and essential anatomical foundation for optimizing surgical approaches. Its application thus may hold significant promise for optimizing surgical pathways, enhancing the quality and precision of lymph node dissection, and ultimately improving oncological outcomes.

Objective To explore the efficacy and safety of side-to-side anastomosis(SS)and end-to-side anastomosis(ES)of the ileocolon in laparoscopic right hemicolectomy of colon cancer,so as to provide evidence-based evidence for surgical selection.Methods PubMed,Embase,Web of Science,Cochrane Library,China National Knowledge Infrastructure,Wanfang Data,VIP database,Chinese BioMedical Literature database were searched from inception to November 2024 to collect relevant clinical studies of SS versus ES.The Newcastle-Ottawa Scale(NOS)was used to evaluate the literature quality of retrospective studies,and the Cochrane system was used to evaluate the literature quality of randomized controlled trials(RCT).Rev Man 5.3 software was used for Meta-analysis,sensitivity analysis,and publication bias analysis.Results 9 retrospective studies and 4 RCTs with a total of 2 632 patients were included.The Meta-analysis results of the retrospective study show that:Compared with SS,ES has a shorter tolerance time for liquid diet(MD=-0.20,95%CI:-0.40～0.00,P<0.05),fewer daily episodes of diarrhea(MD=-1.06,95%CI:-1.79～0.23,P<0.05),but a higher pain score at 12 hours post-surgery(MD=0.95,95%CI:0.50～1.40,P<0.05).Comparison of the overall complication rates of the two anastomosis methods showed no statistically significant difference((OR)=1.05,95%CI:0.22～5.14,P>0.05).Sensitivity analysis of the retrospective study shows:the incidence of ES bowel obstruction was higher than that of SS,with a statistically significant difference((OR)=2.18,95%CI:1.15～4.14,P<0.05);The sensitivity analysis of the RCT shows:the overall incidence of complications at the anastomotic site of SS was significantly higher than that of ES,with a statistically significant difference((OR)=5.26,95%CI:1.91～14.48,P<0.05),and the results of other outcome indicators did not show reversal.The analysis of publication bias risk showed no significant publication bias.Conclusion Ileocolonic ES has a slight advantage over SS in laparoscopic right hemicolectomy of colon cancer,both anastomoses are safe and effective,and the surgeon can choose the appropriate anastomosis technique according to the patient's specific situation,in order to improve the postoperative recovery.

Objective:To examine the clinical effect of the enlarged anterior cervical intervertebral cone-shape decompression and fusion(EACDF) for treating degenerative cervical kyphosis (DCK).Methods:This study is a retrospective case series research. From September 2018 to September 2023, the data of 51 patients with DCK who underwent EACDF at Department of Orthopaedics, the Second Affiliated Hospital, Naval Medical University were analyzed retrospectively. Among the 51 patients, there were 28 males and 23 females, with an age of (61.6±9.8) years old (range:39 to 74 years), and an body mass index of (25.9±2.7) kg/m 2 (range:20.7 to 31.7 kg/m 2). Patients underwent EACDF with expanded decompression by distracted intervertebral space, partial resections of posterior edge of vertebral body and uncinate vertebral joint. The operation duration, blood loss and length of hospital stay were recorded. The visual analog scale (VAS) of neck pain and arm pain, cervical disability index (NDI), and modified Japanese Orthopaedic Association (mJOA) score were recorded in patients before and immediately after surgery, as well as at follow-up. Imaging parameters such as C 2-7 Cobb angle of cervical global curvature, Cobb angle at the operative segment, C 2-7 sagittal vertical axis (C 2-7 SVA), T 1 slope and the height of operative segment were measured. The fusion rate and surgical complications of two groups were recorded. Fourty-five patients who underwent anterior cervical corpectomy with fusion (ACCF) during the same period were included to compare the effectiveness of deformity correction between the two groups. Repeated measures ANOVA was used for intra group data comparison and Dunnett- t test was used for pairwise comparison, and mixed design ANOVA was used for inter group data comparison. Results:All patients were successfully completed the operation. The follow-up period after surgery was (40.4±13.4) months (range:12 to 72 months). The neck pain and arm pain VAS, NDI and JOA in the two groups immediately after surgery, at 2 months, 12 months after surgery, and the final follow-up were significantly improved compared with those before operation (all P<0.05). In both groups, postoperative the C 2-7 Cobb angle, Cobb angle at the operative segment, C 2-7 SVA, T 1 slope, and height of operative segment were significantly improved immediately after surgery, at 2 months, 12 months, and the final follow-up (all P<0.05). The C 2-7 Cobb angle, Cobb angle at the operative segment, and height of operative segment immediately after surgery, at 2 months, 12 months, and the final follow-up in the EACDF group were significantly higher than those in the ACCF group (all P<0.05). There were no significant differences in C 2-7 SVA and T 1 slope between the two groups(all P>0.05). At the final follow-up, the angle of every intervertebral space correction in the EACDF group was (9.3±1.6) °(range:6.5° to 12.3°), while in the ACCF group was (3.1±1.8) °(range:1.2° to 5.6°), with a significant difference between the two groups ( P<0.05). Patients at the both groups got bone graft fusion at the final follow-up. Conclusions:The clinical effect of EACDF for treating DCK is satisfactory. EACDF maybe superior to ACCF in restoring intervertebral height, correcting and maintaining cervical curvature.

Objective:To analyze the anatomical characteristics and surgical management measures of acute Stanford type A aortic dissection (AAD) involving coronary arteries, and to preliminarily explore the clinical efficacy of different coronary artery treatment techniques.Methods:A retrospective analysis was conducted on the clinical data of 42 patients who underwent surgery for AAD involving coronary arteries in Hunan Provincial People′s Hospital from January 2022 to May 2025. They were divided into the MI group (14 cases) and the nMI group (28 cases) according to whether they had acute myocardial infarction before surgery. The clinical data such as the actual surgical methods and mortality in the two groups were summarized.Results:Among 294 surgeries, 42 cases (14.3%) had definite coronary artery involvement, including 14 cases in the MI group and 28 cases in the nMI group; 1 case had bilateral coronary artery involvement and 41 cases had right coronary artery involvement. Regarding injury types: 16 cases were of the coronary trunk compression type, 12 cases were of the sinus intimal tear neal to ostium type, and 14 cases were of the coronary trunk intimal type. There was no statistically significant difference in the types of coronary artery involvement between the two groups ( P>0.05). There were 18 cases of Sun′s procedure with preserved aortic sinus and aortic valve, 7 cases of Bentall procedure without bypass, and 17 cases of Bentall procedure plus bypass. There was no statistically significant difference in the surgical plans between the two groups ( P>0.05). There were 4 deaths within 30 days (2 cases in each group). Conclusions:AAD involving coronary arteries is a critical condition, and accurate diagnosis is somewhat difficult. Myocardial ischemia is not significantly associated with the type of coronary artery involvement. The surgical plan depends on the type of coronary artery involvement. The classification method in this study is conducive to selecting appropriate surgical methods and improving surgical prognosis.

Objective To test the hypothesis that backward crawling and forward crawling share similar inter-joint coordination patterns,thus providing potential evidence for the application of backward crawling in rehabilitation training.Methods The acceleration signals in the X,Y,and Z directions for 9 joints(including bilateral wrists,elbows,shoulders,knees,and hips)in 9 volunteers during forward and backward crawling were collected using a custom signal acquisition system,and the pressure signals were also recorded when the palms contacted the ground.The collected acceleration signals were preprocessed,segmented into cycles,and vectorized.Based on the pressure signals,a single crawling cycle was divided into support phase and swing phase.In addition,principal component analysis was applied to extract inter-joint coordination in limbs at various scales(sagittal,coronal,and transverse planes).Pearson correlation coefficients of inter-joint coordination patterns were compared between forward and backward crawling in support period,swing period,and full cycle.Results The correlation coefficients for coordination patterns in the full cycle at the transverse plane scale were 0.813 5(PC1)and 0.837 5(PC2),and the correlation coefficient of the support period PC2 was 0.901 8.At the sagittal plane scale,the correlation coefficient of the support period PC1 was 0.948 5.Conclusion The study provides preliminary evidence that limb motion coordination patterns during backward crawling are similar to those observed during forward crawling.Future research will further explore the effects of backward crawling on functional rehabilitation in individuals with motor impairments.

Objective To explore a nomogram model based on clinical characteristics and immune indicators for predicting the efficacy of tyrosine kinase inhibitor(TKI)against chronic myeloid leukemia(CML).Methods Clinical data was retrospectively collected from 100 patients with CML treated with TKI between January 2021 and January 2023 in Tangshan Gongren Hospital.Patients were divided into the best response and warning/treatment failure groups according to therapeutic efficacy.Factors affecting therapeutic efficacy were analyzed using logistic regression analysis,and a nomogram model was constructed.Results The best response and warning/treatment failure groups showed significant differences in red blood cell distribution width(RDW),platelet count(PLT),ELTS score,Th 1/CD4+,Treg/CD4+ratio,white blood cell count,and absolute value of natural killer cells(P＜0.05).Logistic regression confirmed that the above indicators were influencing factors(P＜0.05),indicating that the model was meaningful,and had a high goodness of fit as well as high predictive value.Conclusion The nomogram model constructed based on RDW,PLT,and other factors can effectively predict the thera-peutic efficacy of AKI in treating CML.