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.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Objectives:The aim of this study was to investigate the value of assessing Selvester QRS score in evaluating myocardial fibrosis in hypertrophic cardiomyopathy(HCM)patients.Methods:A total of consecutive 149 patients with HCM,who were admitted in Fuwai Hospital from October 2008 to September 2013,were enrolled in this study.Qualitative and quantitative analyses of myocardial fibrosis were conducted based on late gadolinium enhancement(LGE)derived from enhanced cardiac magnetic resonance imaging(CMR).According to the qualitative analysis of myocardial fibrosis by CMR-LGE,the patients were divided into the LGE-negative group(n=46)and the LGE-positive group(n=103).Standard 12-lead electrocardiogram examination was performed and the Selvester QRS score was calculated.Multivariate binary Logistic regression analysis was used to analyze the predictive factors of positive LGE,and the correlation analysis between the Selvester QRS score and the LGE score was also performed.Results:Compared with the LGE-negative group,the proportion of patients with a family history of HCM(12.8%vs.28.2%),the proportion of patients with a positive Selvester QRS score(65.2%vs.83.5%)and the Selvester QRS score([1.65±1.81]points vs.[5.71±3.80]points)were higher,the maximum thickness of the left ventricular wall([20.5±3.2]mm vs.[24.5±5.0]mm)and the percentage of left ventricular myocardial scar area([5.0±5.5]%vs.[17.1±11.4]%)were larger in the LGE-positive group(all P<0.05).Multivariate binary logistic regression analysis showed that the Selvester QRS score(OR=1.429,95%CI:1.128-1.802,P=0.003)and the maximum left ventricular wall thickness(OR=1.257,95%CI:1.029-1.537,P=0.025)were independent predictors of positive LGE.Pearson correlation analysis showed that in all HCM patients,the Selvester QRS score was positively correlated with the LGE score(r=0.682,P<0.001),and the percentage of left ventricular myocardial scar area was positively correlated with the percentage of enhanced area to the total mass of left ventricular myocardium(LGE%)(r=0.682,P<0.001);In the LGE positive group,the Selvester QRS score was positively correlated with the LGE score(r=0.569,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cut-off values of Selvester QRS score and maximum left ventricular wall thickness for predicting positive LGE were≥3.5 points and≥21 mm,respectively.Conclusions:In HCM patients,the Selvester QRS score is significantly associated with myocardial fibrosis,and the total score≥3.5 serves as a good predictive cutoffvalue for identifying the presence of LGE.

Objective To explore the application value of improving the operation method of the coaxial microcatheter system to increase the recanalization rate of long-segment occluded blood vessels in the lower extremity arteries.Methods Eleven patients with long-segment occlusion of the lower extremity arteries were selected.Firstly,the angiographic catheter was sent to about 3-4 cm proximal to the occluded segment to provide support and direction control of the coaxial microcatheter system.Then,the microcathe-ter was sent to about 1 cm proximal to the occluded segment through the angiographic catheter,and the microguide wire was sent to the occluded segment,making the tip of the guide wire closely adhere to the occluded segment.The guide wire was fixed by using the guide wire controller to ensure that the guide wire in the blood vessel was always about 1 cm exposed outside the microcatheter.Meanwhile,the microcatheter and the microguide wire were rotated to make the tip form a"spring"shape similar to that of a pipe-line dredging machine,so that the coaxial microcatheter system could pass through the occluded segment of the blood vessel in this shape.After confirmed that the microcatheter had entered the lumen of the distal outflow tract blood vessel,the subsequent interven-tional treatment was completed according to the conventional method.Results Eleven patients with long-segment occluded blood vessels in the lower extremity arteries were successfully treated with improving the operation method of the coaxial microcatheter system to dredge the occluded segment,and completed the interventional treatment of the affected limb blood vessels without vascu-lar rupture,vascular bleeding or arterial dissection.Conclusion Using the improved operation method of the coaxial microcatheter system to dredge the long-segment occluded blood vessels of the lower extremity arteries is simple,safe and has a high success rate,which is worthy of clinical promotion.

Neuronal intranuclear inclusion disease（NIID）is a rare hereditary neurodegenerative disorder that can affect multiple systems. However，it is uncommon for urinary dysfunction to be the initial symptom. This article reports five cases. The five patients began to experience voiding dysfunction such as frequent urination，weak urination，and incomplete urination at the mean ages of 55.4（47 - 65）years old. Four months to twelve years after urinary onset，neurological symptoms such as headache，memory decline，transient loss of consciousness，and unsteady gait began to appear. Four of the five cases had a family history. Brain MRI revealed the “ribbon sign” or “crest sign” in all cases. Skin biopsy revealed eosinophilic inclusions in the cell nuclei，and NOTCH2NLC gene testing identified abnormal GGC mutations. Three of the five patients underwent cystostomy due to secondary hydronephrosis，while the other two received no special treatment. After a follow-up of 18 to 35 months since diagnosis，the patients who underwent cystostomy had normal renal function. Neurological symptoms in all five patients worsened to varying degrees.

Objective:To investigate the effects of radiofrequency technology combined with electrical stimulation biofeedback training on stress urinary incontinence in female patients.Methods:This is a prospective study that included 360 female patients with stress urinary incontinence who visited the Department of Gynecology and Obstetrics at Lianyungang Maternal and Child Health Hospital from June 2021 to June 2023. The patients were divided into three groups using a random number table method: a radiofrequency treatment group ( n = 120, treated with radiofrequency technology), an electrical stimulation treatment group ( n = 120, treated with electrical stimulation biofeedback training), and a combined treatment group ( n = 120, treated with a combination of radiofrequency technology and electrical stimulation biofeedback training). The clinical efficacy of the three groups was evaluated. Before and after treatment, a 1-hour pad test and urine test were conducted. The Incontinence Questionnaire-Urinary Incontinence Short Form was used to assess the surface electromyography values of the pelvic floor muscles in patients across the three groups. Results:The effective treatment rate in the combined treatment group was 87.50% (105/120), which was significantly higher than the rates in the radiofrequency treatment group (69.17%, 83/120) and the electrical stimulation treatment group (71.67%, 86/120) ( χ2 = 13.05, P < 0.05). After treatment, the 1-hour pad test showed that the urine leakage amounts and the Incontinence Questionnaire-Urinary Incontinence Short Form scores for the combined treatment group were (1.14 ± 0.16) g and (4.15 ± 0.48), respectively. In comparison, the values in the radiofrequency treatment group were (3.04 ± 0.42) g and (8.66 ± 0.89), while in the electrical stimulation treatment group they were (3.01 ± 0.39) g and (8.78 ± 0.91). Differences among the three groups were statistically significant ( F = 1 024.37, 1 354.96, all P < 0.05). After treatment, the surface electromyography values during the rapid contraction, sustained contraction, and endurance contraction phases for the combined treatment group were (31.97 ± 3.24) μV, (27.01 ± 3.02) μV, and (20.05 ± 2.11) μV, respectively. For the radiofrequency treatment group, the values were (27.85 ± 2.72) μV, (21.63 ± 2.39) μV, and (15.14 ± 1.63) μV, while the electrical stimulation treatment group showed values of (27.93 ± 2.75) μV, (22.04 ± 2.41) μV, and (15.39 ± 1.67) μV. Differences among the three groups were also statistically significant ( F = 78.49, 156.43, 278.16, all P < 0.05). Conclusions:Radiofrequency technology combined with electrical stimulation biofeedback training can substantially improve pelvic floor muscle strength and reduce urinary incontinence symptoms in female patients with stress urinary incontinence.

Objective:To analyze the results of next generation sequencing (NGS) gene testing in liquid-based cytological specimens of lung adenocarcinoma cavity and evaluate the clinical efficacy of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment.Methods:Liquid based cytological specimens of 222 cases of lung adenocarcinoma with cavity effusion and 201 cases of metastatic lymph node biopsy were collected. Specimens were obtained from the Cytology Laboratory of the Cancer Hospital of the Chinese Academy of Medical Sciences. The collection period was from January 2018 to December 2022. The results of NGS gene detection were compared. The clinical efficacy of 91 patients treated with EGFR-TKI was evaluated, and the survival curve was analyzed by Kaplan-Meier and other statistical methods.Results:The mutation rates of cancer-related genes detected by NGS were 82.0% (182/222) vs 79.1% (159/201), ( P=0.455) in liquid-based cytological specimens and histological specimens of metastatic lymph node biopsy, respectively. However, the mutation rate of EGFR T790M was significantly higher in cavity effusion than in lymph node biopsy specimens [12.2%(27/222)＞3.5%(7/201), P=0.001]. The results of gene mutation were identical in 10 of the 13 cases with cavity effusion and metastatic lymph node biopsy, and the agreement rate of EGFR was 84.6%(11/13). In 3 inconsistent cases, EGFR mutations were detected in 2 cavity effusion cases that were not detected by lymph node biopsy. Results of genetic analysis of fluid-based cytological samples of 91 patients with cavity effusion were evaluated after drug treatment with EGFR-TKI. The mean progression-free survival (PFS) of the patients was 11.4 months (95% CI: 9.9-12.9). The mean PFS of patients harboring EGFR mutation was 12.3 months (95% CI: 10.8-13.9), and the mean PFS of EGFR wild type was 4.1 months (95% CI: 2.1-6.2). Conclusions:The results of NGS gene detection in liquid-based cytological specimens of lung adenocarcinoma patients with cavity effusion show that the PFS time is similar to that of histological specimens after clinical treatment with EGFR-TKI, which proves the reliability of NGS gene detection results in liquid cytological specimens. NGS gene testing appears higher sensitivity in cavity liquid-based samples than in metastatic lymph node samples.

Objectives:To explore whether short-course radiotherapy (SCRT)-based total neoadjuvant therapy (TNT) combined with PD-1 inhibitors could further promote tumor regression and improve the prognosis.Methods:This is a prospective, multicenter, two-arm randomized controlled, seamless phase Ⅱ/Ⅲ trial for proficient mismatch repair or microsatellite stable (pMMR/MSS) locally advanced rectal cancer (LARC). Eligible patients were randomly assigned to the iTNT (TNT+PD-1) group or the TNT group. Patients in the TNT group received SCRT (5 Gy×5) followed by 4 cycles of CAPOX or 6 cycles of mFOLFOX chemotherapy, with the iTNT group receiving SCRT followed by the same regime in combination with 4 cycles of Sintilimab. Total mesorectal excision (TME) surgery or watch and wait (W&W) was performed after neoadjuvant therapy and then 2 cycles of same regimen as before were recommended. The primary endpoints are the complete response (CR) rate for phase Ⅱ trial and 3-year disease-free survival (DFS) for phase Ⅲ trial. A total of 588 patients will be enrolled for the phase Ⅱ/Ⅲ trial. Short-term efficacy and safety data from the initial 100 treated patients were analyzed as planned.Results:From 2022-8-31 to 2023-5-24 the initial 100 patients were enrolled from 10 hospitals in China, 76.0%(76/100) patients were male, and the median age was 61 years (21-74 years). More patients had tumors located in the lower rectum (78.0%, 78/100), staged T3-4 (97.0%, 97/100) and N1-2 (93.0%, 93/100), and about half of the tumors invaded the mesorectal fascia (52.0%, 52/100) and with extramural vascular invasion (51.0%, 51/100). Analyses were performed according to the per-protocal (PP) set. All patients in the iTNT group ( n=52) and the TNT group ( n=48) completed SCRT; The 4-cycle chemotherapy±Sintilimab completion rates were 86.5% and 100.0% in the iTNT and TNT groups, respectively. In the iTNT group, 82.7% (43/52), 11.5% (6/52), and 5.8% (3/52) of the patients received 4, 3, and 2 cycles of PD-1 inhibitor. After TNT, 68 patients underwent radical surgery and 15 patients achieved cCR and adopted W&W. The pathological complete response (pCR) rates were 48.5% (16/33) and 17.1% (6/35) in the iTNT and TNT groups, with CR rates of 50.0% (25/50) and 26.1% (12/46), respectively. The incidence of treatment-related grade 3-4 adverse events was 26.9% (14/52, iTNT group) and 18.8% (9/48, TNT group), with thrombocytopenia and leukopenia being the most common. Among patients receiving immunotherapy, grade 3 immunotherapy-related adverse events occurred in 2 (3.8%, 2/52) patients: one case was pancreatitis, another case was hepatitis combined with myositis and myocarditis. Conclusion:The preliminary results show that SCRT-based TNT combined with PD-1 inhibitors could further improve the CR rate for LARC without unexpected serious adverse events.

Objective:To explore the application effects of improved case-based learning (CBL) combined with hierarchical and progressive teaching in the standardized training of nuclear medicine resident physicians.Methods:A total of 43 resident physicians who rotated in the nuclear medicine base of our hospital between 2018 and 2023 were selected as the research subjects and divided into an experimental group ( n=22) and a control group ( n=21) according to the order of enrollment. The control group received the traditional teacher-centered teaching model and was divided into junior and senior subgroups according to the training years. The experimental group received the improved CBL combined with hierarchical and progressive teaching. First, through multidimensional evaluation (theoretical testing + standardized case analysis), the students were scientifically divided into preliminary, intermediate, and advanced levels. Subsequently, progressive teaching objectives were set for different levels, and real clinical cases embedded with hierarchical learning tasks were published. During the teaching process, a dynamic discussion mode combining homogeneous and heterogeneous grouping was adopted, and personalized guidance was provided by the teachers. Finally, dynamic hierarchical adjustment was implemented through process evaluation. After the training, the two groups were compared in terms of exit assessment performance (including professional basic theory and practical skills) and teaching satisfaction. Results:The total score of the exit assessment of the experimental group was higher than that of the control group [(86.90±6.78) vs. (75.09±8.45)], and the difference was statistically significant. In terms of practical skill assessment, the experimental group scored higher than the control group in modules such as imaging symptom description [(22.34±2.56) vs. (19.85±3.12)], localization diagnosis [(23.01±2.11) vs. (20.12±2.98)], qualitative diagnosis [(22.89±2.67 vs. 18.67±3.45)], and differential diagnosis [(21.56±2.89) vs. (17.23±3.78)] ( P<0.01). The teaching satisfaction survey showed that the satisfaction scores of the experimental group were higher than those of the control group in nine domains, including theoretical knowledge mastery, clinical thinking, image interpretation, and learning initiative ( P<0.05). Conclusions:The improved CBL combined with hierarchical and progressive teaching can effectively improve the exit assessment performance, clinical practice skills, and teaching satisfaction of nuclear medicine resident trainees, and is worthy of promotion.