1.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.
2.A cross-sectional study on the screening-detected rate of scoliosis among primary and secondary school students in Jiangqiao Town in Jiading District of Shanghai in 2025
Zhen DAI ; Bingyang ZHANG ; Xiaolong WANG ; Hui PENG ; Shifeng KAN ; Yujie MO
Shanghai Journal of Preventive Medicine 2026;38(6):468-473
ObjectiveTo investigate the detection status of scoliosis and its influencing factors among primary and secondary school students in Jiangqiao Town in Jiading District of Shanghai, thereby providing evidence for the prevention and management of scoliosis in children and adolescents. MethodsA stratified cluster random sampling was conducted in March 2025. Three primary schools and two secondary schools in Jiangqiao Town were randomly selected; within each school, 3‒4 entire classes were randomly chosen. Screening was performed in accordance with the criteria specified in GB/T 16133‒2014 Screening for Abnormal Spinal Curvature in Children and Adolescents, and a self-designed structured questionnaire was administered to conduct face-to-face surveys (Cronbach’s α=0.730). ResultsA total of 772 valid questionnaires were collected on-site, representing a 100% response rate. The sample consisted of 413 males (53.50%) and 359 females (46.50%), including 385 primary school students (49.87%) and 387 secondary school students (50.13%). The detection rate of scoliosis in primary and secondary school students was 12.05%. The detection rates were 8.72% for males and 15.88% for females, with the female rate being significantly higher than the male rate (χ²=9.29, P=0.002). For primary and secondary school students, the detection rates were 6.75% and 17.31%, respectively, with the secondary school student rate being significantly higher (χ²=20.31, P<0.001). The results of univariate analysis revealed that students with sufficient sleep and standard sitting postures during reading/writing had a significantly lower scoliosis detection rate compared to those with insufficient sleep and non-standard sitting postures (χ²=5.90, P=0.015 and χ²=5.09, P=0.024). Multivariate logistic regression analyses revealed that the detection rate of scoliosis was significantly higher in females than in males (OR=1.846, 95%CI: 1.156‒2.984), and significantly higher in secondary school students than in primary school students (OR=2.722, 95%CI: 1.656‒4.472). ConclusionThe scoliosis detection rate among primary and secondary school students in Jiangqiao Town in Jiading District is relatively high. Females and secondary school students are key populations requiring targeted prevention and control efforts. It is imperative to strengthen health education on scoliosis, promote early screening and diagnosis, and implement timely targeted interventions.
3.Disrupting calcium homeostasis and glycometabolism in engineered lipid-based pharmaceuticals propel cancer immunogenic death.
Qiuxia PENG ; Xiaolong LI ; Chao FANG ; Chunyan ZHU ; Taixia WANG ; Binxu YIN ; Xiulin DONG ; Huaijuan GUO ; Yang LIU ; Kun ZHANG
Acta Pharmaceutica Sinica B 2025;15(3):1255-1267
Homeostasis and energy and substance metabolism reprogramming shape various tumor microenvironment to sustain cancer stemness, self-plasticity and treatment resistance. Aiming at them, a lipid-based pharmaceutical loaded with CaO2 and glucose oxidase (GOx) (LipoCaO2/GOx, LCG) has been obtained to disrupt calcium homeostasis and interfere with glycometabolism. The loaded GOx can decompose glucose into H2O2 and gluconic acid, thus competing with anaerobic glycolysis to hamper lactic acid (LA) secretion. The obtained gluconic acid further deprives CaO2 to produce H2O2 and release Ca2+, disrupting Ca2+ homeostasis, which synergizes with GOx-mediated glycometabolism interference to deplete glutathione (GSH) and yield reactive oxygen species (ROS). Systematical experiments reveal that these sequential multifaceted events unlocked by Ca2+ homeostasis disruption and glycometabolism interference, ROS production and LA inhibition, successfully enhance cancer immunogenic deaths of breast cancer cells, hamper regulatory T cells (Tregs) infiltration and promote CD8+ T recruitment, which receives a considerably-inhibited outcome against breast cancer progression. Collectively, this calcium homeostasis disruption glycometabolism interference strategy effectively combines ion interference therapy with starvation therapy to eventually evoke an effective anti-tumor immune environment, which represents in the field of biomedical research.
4.Establishment of a core competency evaluation indicator system for pediatric surgery operating room specialist nurses
Si CHEN ; Lihong PENG ; Xiaoyan LIU ; Xiaolong LI ; Sisi TENG
Chinese Journal of Medical Education Research 2025;24(5):697-703
Objective:To explore the construction of a core competency evaluation indicator system for pediatric surgery operating room specialist nurses.Methods:The evaluation indicator system was constructed by reviewing literature, analyzing semi-structured interview results, and examining the characteristics of training specialized nurses in pediatric surgery operating rooms, as well as combining the characteristics of pediatric surgery and multi-source data. The research group discussed and proposed a preliminary core competency evaluation indicator system for specialized nurses in pediatric surgery operating rooms. This study used the Delphi expert inquiry method to conduct two rounds of expert consultation and ultimately established the core competency evaluation indicator system for pediatric surgery operating room specialist nurses. The expert positivity coefficient was represented by the questionnaire response rate, and the expert authority coefficient was calculated using the judgment coefficient and familiarity degree. The coefficient of variation and Kendall's W coefficient were used to measure the degree of coordination of expert opinions. Results:The effective response rates for the two rounds of expert consultation were 100.00% and 95.24%, respectively. The authority coefficients of the two rounds of expert consultation were 0.92 and 0.90, respectively. The coefficients of variation of indicators at various levels were less than 0.25. The Kendall's W coefficients for the first-, second-, and third-level indicators in the first and second rounds of expert consultation were 0.516-0.664 and 0.652-0.711, respectively ( P<0.001). The final core competency evaluation indicator system for pediatric surgery operating room specialist nurses included 3 first-level indicators, 15 second-level indicators, and 52 third-level indicators. Conclusions:The core competency evaluation indicator system for pediatric surgery operating room specialist nurses constructed in this study provides a scientific and practical guidance for training pediatric surgery operating room specialist nurses in China.
5.Establishment of a core competency evaluation indicator system for pediatric surgery operating room specialist nurses
Si CHEN ; Lihong PENG ; Xiaoyan LIU ; Xiaolong LI ; Sisi TENG
Chinese Journal of Medical Education Research 2025;24(5):697-703
Objective:To explore the construction of a core competency evaluation indicator system for pediatric surgery operating room specialist nurses.Methods:The evaluation indicator system was constructed by reviewing literature, analyzing semi-structured interview results, and examining the characteristics of training specialized nurses in pediatric surgery operating rooms, as well as combining the characteristics of pediatric surgery and multi-source data. The research group discussed and proposed a preliminary core competency evaluation indicator system for specialized nurses in pediatric surgery operating rooms. This study used the Delphi expert inquiry method to conduct two rounds of expert consultation and ultimately established the core competency evaluation indicator system for pediatric surgery operating room specialist nurses. The expert positivity coefficient was represented by the questionnaire response rate, and the expert authority coefficient was calculated using the judgment coefficient and familiarity degree. The coefficient of variation and Kendall's W coefficient were used to measure the degree of coordination of expert opinions. Results:The effective response rates for the two rounds of expert consultation were 100.00% and 95.24%, respectively. The authority coefficients of the two rounds of expert consultation were 0.92 and 0.90, respectively. The coefficients of variation of indicators at various levels were less than 0.25. The Kendall's W coefficients for the first-, second-, and third-level indicators in the first and second rounds of expert consultation were 0.516-0.664 and 0.652-0.711, respectively ( P<0.001). The final core competency evaluation indicator system for pediatric surgery operating room specialist nurses included 3 first-level indicators, 15 second-level indicators, and 52 third-level indicators. Conclusions:The core competency evaluation indicator system for pediatric surgery operating room specialist nurses constructed in this study provides a scientific and practical guidance for training pediatric surgery operating room specialist nurses in China.
6.Innovation and practice in cultivating outstanding imaging talents in new medical sciences based on the "1+Medicine+X" model
Peng XU ; Xiaolong WANG ; Kai XU ; Chunfeng HU ; Yan ZHANG
Chinese Journal of Medical Education Research 2025;24(7):952-956
Objective:To investigate the training mode of outstanding talents in medical imaging in the context of "new medicine".Methods:Aiming at the 138 undergraduate students of medical imaging in the class of 2019, this study proposed a new model of "1+Medicine+X" based on "emphasis on ideology and politics", "strengthening practice", and "interdisciplinary training", which targeted the problems in the traditional teaching process, and the methods such as self-made course satisfaction questionnaires and achievements data collection were used to evaluate the effectiveness of teaching reform.Results:Through five years of reform practice, landmark accomplishments had been achieved in the construction of majors and courses (national and provincial first-class undergraduate majors), with significant improvements in the comprehensive ability and teaching satisfaction of students (process evaluation increased to 50.00%, teaching satisfaction increased to 96.20%), and the teaching reform had been widely recognized by the society.Conclusions:The "1+Medicine+X" model can effectively improve the training quality of medical imaging talents and thus provides a new paradigm for the disciplinary development of imaging and the cultivation of outstanding talents in the context of new medicine.
7.Innovation and practice in cultivating outstanding imaging talents in new medical sciences based on the "1+Medicine+X" model
Peng XU ; Xiaolong WANG ; Kai XU ; Chunfeng HU ; Yan ZHANG
Chinese Journal of Medical Education Research 2025;24(7):952-956
Objective:To investigate the training mode of outstanding talents in medical imaging in the context of "new medicine".Methods:Aiming at the 138 undergraduate students of medical imaging in the class of 2019, this study proposed a new model of "1+Medicine+X" based on "emphasis on ideology and politics", "strengthening practice", and "interdisciplinary training", which targeted the problems in the traditional teaching process, and the methods such as self-made course satisfaction questionnaires and achievements data collection were used to evaluate the effectiveness of teaching reform.Results:Through five years of reform practice, landmark accomplishments had been achieved in the construction of majors and courses (national and provincial first-class undergraduate majors), with significant improvements in the comprehensive ability and teaching satisfaction of students (process evaluation increased to 50.00%, teaching satisfaction increased to 96.20%), and the teaching reform had been widely recognized by the society.Conclusions:The "1+Medicine+X" model can effectively improve the training quality of medical imaging talents and thus provides a new paradigm for the disciplinary development of imaging and the cultivation of outstanding talents in the context of new medicine.
8.MicroRNA-145-5p Regulates the Epithelial-Mesenchymal Transition in Nasal Polyps by Targeting Smad3
Mengyu ZHANG ; Xiaole PENG ; Xiaolong LIANG ; Wentao WANG ; Yuqing YANG ; Fan XU ; Xiaomin LU ; Dechun GENG ; Manyi LI
Clinical and Experimental Otorhinolaryngology 2024;17(2):122-136
Objectives:
. The annual prevalence of chronic rhinosinusitis (CRS) is increasing, and the lack of effective treatments imposes a substantial burden on both patients and society. The formation of nasal polyps in patients with CRS is closely related to tissue remodeling, which is largely driven by the epithelial-mesenchymal transition (EMT). MicroRNA (miRNA) plays a pivotal role in the pathogenesis of numerous diseases through the miRNA-mRNA regulatory network; however, the specific mechanism of the miRNAs involved in the formation of nasal polyps remains unclear.
Methods:
. The expression of EMT markers and Smad3 were detected using western blots, quantitative real-time polymerase chain reaction, and immunohistochemical and immunofluorescence staining. Differentially expressed genes in nasal polyps and normal tissues were screened through the Gene Expression Omnibus database. To predict the target genes of miR-145-5p, three different miRNA target prediction databases were used. The migratory ability of cells was evaluated using cell migration assay and wound healing assays.
Results:
. miR-145-5p was associated with the EMT process and was significantly downregulated in nasal polyp tissues. In vitro experiments revealed that the downregulation of miR-145-5p promoted EMT. Conversely, increasing miR-145-5p levels reversed the EMT induced by transforming growth factor-β1. Bioinformatics analysis suggested that miR-145-5p targets Smad3. Subsequent experiments confirmed that miR-145-5p inhibits Smad3 expression.
Conclusion
. Overall, miR-145-5p is a promising target to inhibit nasal polyp formation, and the findings of this study provide a theoretical basis for nanoparticle-mediated miR-145-5p delivery for the treatment of nasal polyps.
9.Effect of molar distalization with clear aligners on occlusal vertical dimension in different vertical craniofacial patterns
Chinese Journal of Tissue Engineering Research 2024;28(28):4559-4564
BACKGROUND:Previous studies have shown that clear aligners can achieve molar distalization effectively,but it is not yet clear how the vertical dimensions change in patients with different vertical craniofacial patterns after molar distalization. OBJECTIVE:To evaluate the effect of molar distalization with clear aligners on occlusal vertical dimension in different vertical craniofacial patterns. METHODS:Forty patients(13 cases of Class Ⅰ malocclusion,20 cases of Class Ⅱ malocclusion,and 7 cases of Class Ⅲ malocclusion)were selected,including 13 cases in the high angle group,17 cases in the average angle group,and 10 cases in the low angle group.Among them,the age ranged from 10 to 53 years,with an average of 28.5 years.All patients were subjected to clear aligners for molar distalization.Lateral cephalometric films were taken before and after treatment.Cephalometric measurements,including the sagittal and vertical indicators of teeth and jaws,were measured by the same orthodontist,and each indicator was measured 3 times and averaged. RESULTS AND CONCLUSION:After orthodontic treatment,the crowded dentition was corrected,the overbite and overjet were back to normal and the lateral profile was improved significantly in all 40 patients.The GoGn-SN in the high angle group decreased by 0.4°,while the GoGn-SN in the average and low angle groups increased by less than 1°,the ANS-Me in the three groups increased by less than 1 mm.There was no statistically significant difference before and after treatment.There was a statistically significant decrease in the U6-PP in the low angle group by 0.47 mm(P<0.01).The L1-MP and the U1-SN in the average angle group significantly decreased by 0.83 mm(P<0.05)and by 6.46°(P<0.001),respectively.In conclusion,molar distalization with clear aligner treatment can control the vertical dimension effectively,prevent clockwise mandibular rotation,and maintain the lower face height.Patients with high angle can also undergo invisible orthodontics to distal molars.The realization rate of the anterior tooth intrusion movement by using clear aligners is insufficient,and the intrusion design should be increased to prevent the elongation phenomenon in anterior teeth.
10.Setup error analysis of image registration using various regions of interest after individualized nasopharyngeal carcinoma radiotherapy immobilization
Panpan CAO ; Weiqing WANG ; Yu CHENG ; Jinyan LEI ; Shi LI ; Xiaolong SHI ; Haiyan PENG ; Fu JIN
Chinese Journal of Medical Physics 2024;41(2):151-157
Objective To explore the effects of image registration using various regions of interest(ROI)on the setup error for nasopharyngeal carcinoma(NPC)patients who were immobilized individually.Methods Forty-three NPC patients who required radiotherapy were enrolled.The patients were immobilized with customized plastic foam and thermoplastic mask,and CBCT verification was performed once a week.In CBCT images,ROI was divided into the whole ROI(ROIPTV)and 7 local ROI containing different cervical structures(ROIsphenoid sinus,ROIatlantoaxial,ROIneck3,ROIneck4,ROIneck5,ROIneck6,and ROIneck7),which were then used for registrations with localized CT image.The setup errors in superior-inferior(SI),left-right(LR),anterior-posterior(AP),Pitch,Roll,and Yaw directions were recorded.Results In SI direction,the setup errors within 0.3 cm accounted for 89.74%for ROIneck7,and more than 90%for the other ROI.The proportion of setup errors within 0.3 cm gradually increased with the neck upward in LR direction,and they were 76.78%,81.70%,85.26%,and above 90%for ROIneck7,ROIneck6,ROIneck5,and the other ROI,respectively.In AP direction,the proportions of setup errors within 0.3 cm were less than 90%,except for ROIatlantoaxial and ROIneck3.The setup errors of ROIsphenoid sinus,ROIatlantoaxial,ROIneck3,and ROIneck4 were significantly positively correlated with ROIPTV in SI direction,and the correlation coefficients(R)were 0.94,0.95,0.90,and 0.83,respectively.In LR direction,there were positive correlations between the setup errors of ROIatlantoaxial and ROIsphenoid sinus(R=0.95),ROIneck3 and ROIsphenoid sinus(R=0.91),ROIPTV and ROIneck3(R=0.91).The setup errors of ROIPTV in AP direction were positively correlated with ROIatlantoaxial vertebrae and ROIneck3(R=0.88,0.90).The margins of all ROIs ranged from 0.38 cm to 1.01 cm.The extension of ROIneck6 and ROIneck7 in AP direction exceeded 0.9 cm,and the extension of ROIneck7 reached 0.95 cm in SI direction.Conclusion ROIPTV and ROIsphenoid sinus,ROIatlantoaxial,ROIneck3 are significantly correlated in SI,LR,and AP directions.The setup error of nasopharyngeal carcinoma patients gradually increases with the neck down.The nasopharyngeal and cervical regions need to be expanded in segments when patients are immobilized individually.

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