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.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Objective:To investigate the effect of mast cell-derived chemokine C-C motif ligand 5 (CCL5) on the migration of CD8 + T cells from vitiligo patients under oxidative stress conditions. Methods:From January 2017 to January 2023, 10 patients with progressive segmental vitiligo, 10 patients with non-segmental vitiligo, and 10 healthy individuals were collected from the Department of Dermatology, Xijing Hospital. Skin tissue samples were obtained from the lesions of vitiligo patients and from the normal skin of healthy individuals, with sampling sites including the face, neck, and upper extremities, and toluidine blue staining was performed to analyze the characteristics of mast cells infiltrating the skin lesions. The effect of H 2O 2 treatment on mast cells was investigated in Transwell chambers. Peripheral blood mononuclear cells (PBMCs) from vitiligo patients were added to the upper chamber, while the human mast cell line LAD2 was added to the lower chamber and divided into 4 groups to receive different treatments: untreated group receiving no special treatment, H 2O 2 group pretreated with H 2O 2, H 2O 2 + neutralization antibody group pretreated with H 2O 2 followed by the treatment with CCL5/RANTES-neutralizing antibodies, and H 2O 2 + PF group pretreated with H 2O 2 followed by the treatment with a Janus kinase 3/non-receptor protein tyrosine kinase selective inhibitor PF-06651600. After 6 hours of co-incubation, cell suspensions were collected from the lower chamber. The number of CD8 + T cells was counted using flow cytometry, and the CCL5 level in the cell culture supernatant was detected using enzyme-linked immunosorbent assay. One-way analysis of variance was used to analyze differences among groups, and least significant difference- t test was used for multiple comparisons. Pearson correlation analysis was performed for correlation analysis. Results:In the 200 × magnification field, the numbers of infiltrating mast cells significantly differed among segmental vitiligo lesions, non-segmental vitiligo lesions, and normal skin tissues (15.7 ± 3.3, 20.9 ± 3.9, 7.2 ± 2.9, respectively; F = 8.07, P = 0.002) ; additionally, the number of infiltrating mast cells was significantly higher in the segmental or non-segmental vitiligo lesions than in the normal skin tissues (LSD- t = 3.50, 5.70, P = 0.047, 0.001, respectively), but there was no significant difference between the segmental and non-segmental vitiligo lesions (LSD- t = 2.20, P = 0.293). A significant positive correlation was observed between the number of infiltrating mast cells and that of CD8 + T cells in the vitiligo lesions ( r = 0.82, P = 0.004). The numbers of CD8 + T cells and CCL5 levels significantly differed among the untreated group, H 2O 2 group, H 2O 2 + neutralization antibody group, and H 2O 2 + PF group (CD8 + T cells: 197.0 ± 45.9, 580.4 ± 62.6, 296.0 ± 43.2, 398.6 ± 62.8, respectively; CCL5: 2.2 ± 0.6 pg/ml, 9.9 ± 1.3 pg/ml, 3.4 ± 0.4 pg/ml, 6.33 ± 0.7 pg/ml, respectively; F = 11.03, 17.77, respectively, both P < 0.001) ; additionally, the H 2O 2 group showed significantly increased numbers of CD8 + T cells and CCL5 levels compared with the untreated group, H 2O 2 + neutralization antibody group, and H 2O 2 + PF group (all P < 0.05) . Conclusion:Mast cells may be involved in the pathogenesis of vitiligo under oxidative stress, and mast cell-derived CCL5 appears to contribute to the occurrence and development of vitiligo by affecting CD8 + T cell migration.

OBJECTIVE To establish a core competency evaluation system for drug clinical trial quality management personnel in China and validate its application. METHODS Based on the scope of work， responsibilities， and role positioning of quality management personnel in drug clinical trials， a preliminary draft of the core competency evaluation system was constructed through literature analysis and expert consultation. The draft was refined through a Delphi method involving 17 experts who provided feedback and revisions， ultimately forming a complete evaluation system. The developed system was applied to conduct electronic surveys from March to May 2024 among 110 quality management personnel from 38 drug clinical trial institutions， comparing their scores on indicator importance and self-assessed capabilities. RESULTS The response rate of both rounds of questionnaire survey was 100%， with Kendall’s W coefficients of 0.256 and 0.277 （P＜0.001 for both）， and an expert authority coefficient of 0.946. The finalized evaluation system for core competencies of clinical trial quality management personnel comprised 9 primary indicators， covering individual professional competence， communication skills， implementation condition verification， informed consent process review， clinical trial execution monitoring， adverse event disposal， reporting and documentation， trial record examination， trial report auditing， and inspection of other tasks， and 107 secondary indicators. Empirical research revealed significant discrepancies between importance scores and self-assessed competency scores across 70 indicators among 110 respondents （P＜0.05）. Indicators with relatively notable gaps between importance scores and self-assessed competency scores included in-depth understanding of Good Clinical Practice （GCP） requirements （0.34-point gap）， familiarity with national and institutional clinical trial inspection priorities （0.24-point gap），etc. CONCLUSIONS The indicator system constructed in this study has good scientificity and reliability. Clinical trial quality management personnel demonstrate deficiencies in multiple critical competencies， highlighting the urgent need for targeted training programs to enhance their overall professional capabilities.

Objective:To investigate the effect of mast cell-derived chemokine C-C motif ligand 5 (CCL5) on the migration of CD8 + T cells from vitiligo patients under oxidative stress conditions. Methods:From January 2017 to January 2023, 10 patients with progressive segmental vitiligo, 10 patients with non-segmental vitiligo, and 10 healthy individuals were collected from the Department of Dermatology, Xijing Hospital. Skin tissue samples were obtained from the lesions of vitiligo patients and from the normal skin of healthy individuals, with sampling sites including the face, neck, and upper extremities, and toluidine blue staining was performed to analyze the characteristics of mast cells infiltrating the skin lesions. The effect of H 2O 2 treatment on mast cells was investigated in Transwell chambers. Peripheral blood mononuclear cells (PBMCs) from vitiligo patients were added to the upper chamber, while the human mast cell line LAD2 was added to the lower chamber and divided into 4 groups to receive different treatments: untreated group receiving no special treatment, H 2O 2 group pretreated with H 2O 2, H 2O 2 + neutralization antibody group pretreated with H 2O 2 followed by the treatment with CCL5/RANTES-neutralizing antibodies, and H 2O 2 + PF group pretreated with H 2O 2 followed by the treatment with a Janus kinase 3/non-receptor protein tyrosine kinase selective inhibitor PF-06651600. After 6 hours of co-incubation, cell suspensions were collected from the lower chamber. The number of CD8 + T cells was counted using flow cytometry, and the CCL5 level in the cell culture supernatant was detected using enzyme-linked immunosorbent assay. One-way analysis of variance was used to analyze differences among groups, and least significant difference- t test was used for multiple comparisons. Pearson correlation analysis was performed for correlation analysis. Results:In the 200 × magnification field, the numbers of infiltrating mast cells significantly differed among segmental vitiligo lesions, non-segmental vitiligo lesions, and normal skin tissues (15.7 ± 3.3, 20.9 ± 3.9, 7.2 ± 2.9, respectively; F = 8.07, P = 0.002) ; additionally, the number of infiltrating mast cells was significantly higher in the segmental or non-segmental vitiligo lesions than in the normal skin tissues (LSD- t = 3.50, 5.70, P = 0.047, 0.001, respectively), but there was no significant difference between the segmental and non-segmental vitiligo lesions (LSD- t = 2.20, P = 0.293). A significant positive correlation was observed between the number of infiltrating mast cells and that of CD8 + T cells in the vitiligo lesions ( r = 0.82, P = 0.004). The numbers of CD8 + T cells and CCL5 levels significantly differed among the untreated group, H 2O 2 group, H 2O 2 + neutralization antibody group, and H 2O 2 + PF group (CD8 + T cells: 197.0 ± 45.9, 580.4 ± 62.6, 296.0 ± 43.2, 398.6 ± 62.8, respectively; CCL5: 2.2 ± 0.6 pg/ml, 9.9 ± 1.3 pg/ml, 3.4 ± 0.4 pg/ml, 6.33 ± 0.7 pg/ml, respectively; F = 11.03, 17.77, respectively, both P < 0.001) ; additionally, the H 2O 2 group showed significantly increased numbers of CD8 + T cells and CCL5 levels compared with the untreated group, H 2O 2 + neutralization antibody group, and H 2O 2 + PF group (all P < 0.05) . Conclusion:Mast cells may be involved in the pathogenesis of vitiligo under oxidative stress, and mast cell-derived CCL5 appears to contribute to the occurrence and development of vitiligo by affecting CD8 + T cell migration.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

The adulteration and counterfeiting of herbal ingredients in medicinal and food homology (MFH) have a serious impact on the quality of herbal materials, thereby endangering human health. Compared to pharmaceutical drugs, health products derived from traditional Chinese medicine (TCM) are more easily accessible and closely integrated into consumers' daily life. However, the authentication of the authenticity of TCM ingredients in MFH has not received sufficient attention. The lack of clear standards emphasizes the necessity of conducting systematic research in this area. This study utilized DNA barcoding technology, combining ITS2, psbA-trnH, matK as universal barcode sequences, and DX, HH, JYH as specific barcode sequences, to identify the authenticity of commercial medicinal and food homology scented herbal teas. The aim was to investigate the authenticity of scented herbal tea products circulating in the market. The research results revealed that among 180 scented herbal tea samples, DNA barcodes were successfully obtained from 164 samples, while the remaining samples either lacked the target components or suffered severe DNA degradation, resulting in failed amplification. Combined with morphological identification studies, it was found that out of the 180 samples, 141 were authentic, accounting for 78.33% of the total samples, while 31 samples showed adulteration and 8 samples lacked the target components, accounting for 21.67% of the total samples. Additionally, water testing revealed that 5 samples of Carthamus tinctorius herbal tea exhibited the phenomenon of weight adulteration. This study exposed the presence of adulteration and weight adulteration in scented herbal tea products, highlighting the need for regulatory authorities to expedite the establishment of quality standards in scented herbal tea industry. These findings provide valuable insights for the rapid development of the scented herbal tea industry.

ObjectiveTo establish and evaluate a mouse model of heart failure with Qi deficiency syndrome. MethodForty-four KM mice were randomly divided into sham operation group， model group， and modified Si Junzitang group （12.89 g·kg^-1）. The model group and the modified Si Junzitang group underwent thoracic aortic constriction （TAC）， while the sham operation group only underwent suture without constriction. Echocardiography and pathological examination were used to assess the heart failure model and evaluate the pharmacological effects. Macroscopic characterization， microscopic biology， and formula identification were conducted to collect general signs， body weight， open-field behavior， grip strength， mitochondrial ultrastructure， and other macroscopic and microscopic characteristics of mice. Mitochondrial fission and fusion protein expression were measured to determine the syndrome type. ResultEight weeks after TAC， compared with the sham operation group， the model group showed a significant decrease in left ventricular ejection fraction （LVEF） （P<0.01）， and modified Si Junzitang improved LVEF in mice （P<0.05）. Hematoxylin-eosin （HE） staining of the heart showed inflammatory cell infiltration and thickening of blood vessel walls in the model group， which was significantly improved by modified Si Junzitang. After 6-8 weeks， compared with the sham operation group and the modified Si Junzitang group， the model group exhibited significant hair loss， hair yellowing， decreased activity， and depression. Moreover， compared with the sham operation group， the model group had a significantly lower increase in body weight （P<0.05）， while the modified Si Junzitang group showed a significant increase in body weight （P<0.05） compared with the model group. After 6-8 weeks， compared with the sham operation group， the model group showed a significant decrease in open-field distance and speed （P<0.05）， while the modified Si Junzitang group exhibited significantly improved open-field distance and speed in the 8^th week （P<0.05）. After 6-8 weeks， compared with the sham operation group， the model group exhibited a significant decrease in maximum grip strength （P<0.05）， while the modified Si Junzitang group showed a significant increase in maximum grip strength 8 weeks after TAC （P<0.05）. Transmission electron microscopy of the gastrocnemius muscle showed uneven muscle tissue matrix， mitochondrial swelling， increased volume， matrix dissolution， ridge loss， and vacuolization in the model group， while modified Si Junzitang improved mitochondrial swelling， ridge fracture， and matrix vacuolization. Western blot analysis showed that the expression of the kinetic associated protein 1 （DRP1） in the gastrocnemius muscle of the model group significantly increased （P<0.01）， and the expression of mitochondrial fusion hormone 1 （MFN1） significantly decreased （P<0.05） as compared with those in the sham operation group. Furthermore， compared with the model group， the modified Si Junzitang group exhibited a significant decrease in the expression of DRP1 （P<0.05） and a significant increase in MFN1 expression （P<0.01）. ConclusionMice exhibited significant manifestations of qi deficiency syndrome 6-8 weeks after TAC， accompanied by abnormal mitochondrial morphology and function in the gastrocnemius muscle， which were significantly improved by modified Si Junzitang.

This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.
Male ; Humans ; Prostate/pathology* ; Prostate-Specific Antigen/analysis* ; Prostatic Neoplasms/diagnostic imaging* ; Biopsy ; Nomograms ; Retrospective Studies