1.Application advances, ethical dilemmas, and future directions of large language models in lung cancer diagnosis and treatment
Zhizhen REN ; Yufan XI ; Xu ZHU ; Yijie LUO ; Geting HUANG ; Junqiao SONG ; Xiuyuan XU ; Nan CHEN ; Qiang PU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(03):353-362
Lung cancer is a leading cause of cancer-related morbidity and mortality worldwide. Coupled with the substantial workload, the clinical management of lung cancer is challenged by the critical need to efficiently and accurately process increasingly complex medical information. In recent years, large language models (LLMs) technology has undergone explosive development, demonstrating unique advantages in handling complex medical data by leveraging its powerful natural language processing capabilities, and its application value in the field of lung cancer diagnosis and treatment is continuously increasing. The paper systematically analyzes that the exceptional potential of LLMs in lung cancer auxiliary diagnosis, tumor feature extraction, automatic staging, progression/outcome analysis, treatment recommendations, medical documentation generation, and patient education. However, they face critical technical and ethical challenges including inconsistent performance in complex integrated decision-making (e.g., TNM staging, personalized treatment suggestions) and "black box" opacity issues, along with dilemmas such as training data biases, model hallucinations, data privacy concerns, and cross-lingual adaptation challenges ("data colonization"). Future directions should prioritize constructing high-quality multimodal corpora specific to lung cancer, developing interpretable and compliant specialized models, and achieving seamless integration with existing clinical workflows. Through dual drivers of technological innovation and ethical standardization, LLMs should be prudently advanced for holistic lung cancer management processes, ultimately promoting efficient, standardized, and personalized diagnosis and treatment practices.
2.Epidemiological characteristics of scrub typhus in Huai'an, Jiangsu Province in 2006 - 2024
Lei XU ; Zhizhen CUI ; Qiang GAO ; Hao JU ; Chuanyu WAN ; Ranfeng HANG ; Shiyao WU ; Ben CAI ; Zheng ZHANG ; Haiyan GE
Journal of Public Health and Preventive Medicine 2025;36(6):39-42
Objective To describe and analyze the epidemiological characteristics of scrub typhus in Huai'an, Jiangsu Province from 2006 to 2024 and explore the long-term incidence trend and distribution of high-risk areas, and to formulate targeted prevention and control strategies. Methods The scrub typhus case report data of Huai'an from 2006 to 2024 in the Chinese Disease Prevention and Control Information System were extracted for descriptive analysis. Results A total of 898 cases of scrub typhus were reported in Huai'an, with an average annual incidence rate of 0.96 per 100 000 from 2006 to 2024. There was a turning point in the incidence trend of scrub typhus in 2011. From 2006 to 2011, the annual percentage change (APC) was 47.09% (95% CI: 7.53 - 859.39), and the upward trend was statistically significant (P < 0.05). From 2012 to 2024, the APC was -2.12% (95% CI: -29.09 - 3.75), and the downward trend was not statistically significant. October and November were the high-incidence months, and the total concentration from 2006 to 2024 was 0.93, indicating that scrub typhus had strict seasonality. The circular distribution method estimated that the peak period of the epidemic was from October 11th to November 25th, and the peak day of incidence was November 3rd. Jinhu County was a high-incidence area. The ratio of male to female cases was 1.03. The age group with the highest reported incidence was 40 to < 80 years old. The occupation with the highest proportion was farmers, accounting for 78.03%. Conclusion From 2006 to 2024, scrub typhus in Huai'an shows a peak every 3 - 4 years. Middle-aged and elderly farmers are the key population at risk, and Jinhu County is a key area. In the future, targeted health education should be carried out to effectively control the prevalence of scrub typhus.
3.Preparation and Quality Standard Formulation of Compound Bupleurum Suppository
Zhizhen YU ; Zegan LIU ; Libo WANG ; Liangyong HUANG ; Fang YE ; Haitao ZHU ; Ziyan XU ; Shiming DU
Herald of Medicine 2025;44(9):1482-1489
Objective To explore the prescription and preparation technology of compound Bupleurum suppository and draft its quality standard.Methods The volatile oil of Bupleurum was extracted by steam distillation,and the compound Bupleurum-based suppository was prepared by mixing the volatile oil with taurine using the melting method.The quality standard of the preparation was formulated according to the quality inspection items of the general rule 0107 of the Pharmacopoeia of the People's Republic of China(2020 Edition,Volume IV);The contents of n-hexanoic acid and n-heptanoic acid in the preparation were determined by gas chromatography-mass spectrometry(GC-MS).The content of taurine in the preparation was determined by high-performance liquid chromatography(HPLC).Results The optimized distillation time of the volatile oil was 1.5 h,The linear ranges of n-hexanoic acid,n-heptanoic acid and taurine are 23.175 0-115.875 0 μg·mL-1(R2=0.999 4),4.590 0-68.850 0 μg·mL-1(R2=0.998 9)and 15-125 μg·mL-1(R2=0.999 6),respectively.The average recoveries are 99.83%,101.96%,98.89%with RSDs of 2.84%,1.36%,2.88%,respectively.The RSDs of precision,stability,and repeatability tests are less than 5%.The properties,mass difference,melting time,microbial limit,and stability assessment of the preparationwere all in accordance with the Pharmacopoeia of the People's Republic of China.Conclusion Compound Bupleurum suppository preparation technology is reasonable and feasible,which meets the quality standard.
4.Drug resistance genes and efflux pump phenotypes in clinically isolated Acinetobacter baumannii
Li LI ; Zhizhen ZHANG ; Xiaoling ZOU ; Xu WANG ; Jiao DAI
Chinese Journal of Nosocomiology 2025;35(11):1707-1710
OBJECTIVE To investigate the epidemiological characteristics of Acinetobacter baumannii,detect the distribution of its β-lactamase genes and efflux pump genes,and analyze the relationship between β-lactamase genes and efflux pump genes and the drug resistance of the strains.METHODS Acinetobacter baumannii strains clinically isolated from Jun.2021 to Jun.2022 in Dujiangyan People's Hospital were collected and tested for anti-microbial resistance.Polymerase chain reaction(PCR)technology was used to amplify the β-lactamase genes as well as the efflux pump genes of Acinetobacter baumannii.PaβN was performed to test the efflux pump pheno-type.RESULTS The drug resistance rates of imipenem-resistant Acinetobacter baumannii(IRAB)to cefopera-zone,ceftazidime,cefepime,imipenem,and meropenem were 14.29%,85.71%,91.43%,100.00%and 100.00%,respectively,significantly higher than those of imipenem-sensitive Acinetobacter baumannii(ISAB)(P<0.05).The detection rates of OXA-23,OXA-51,and IMP-1 in IRAB strains were 45.71%,62.86%and 65.71%,respectively,higher than those in ISAB strains(P<0.05).The detection rates of the efflux pump genes adeB,adeS,and adeG in IRAB strains were 60.00%,71.43%and 68.57%,respectively,higher than those in ISAB strains(P<0.05).In addition,the positive rate of the efflux pump phenotype in the IRAB group was 54.29%,significantly higher than 7.69%in the ISAB group(P<0.001).CONCLUSION The detection rates of β-lactamase genes(such as OXA-23,OXA-51 and IMP-1 etc.)and efflux pump genes(adeB,adeS and adeG)in IRAB are significantly higher than those in the ISAB,and the positive rate of the efflux pump phenotype in IRAB is higher,which confirms that β-lactamase genes and efflux pump genes are important mechanisms of drug resistance in the bacterium.
5.Preparation and Quality Standard Formulation of Compound Bupleurum Suppository
Zhizhen YU ; Zegan LIU ; Libo WANG ; Liangyong HUANG ; Fang YE ; Haitao ZHU ; Ziyan XU ; Shiming DU
Herald of Medicine 2025;44(9):1482-1489
Objective To explore the prescription and preparation technology of compound Bupleurum suppository and draft its quality standard.Methods The volatile oil of Bupleurum was extracted by steam distillation,and the compound Bupleurum-based suppository was prepared by mixing the volatile oil with taurine using the melting method.The quality standard of the preparation was formulated according to the quality inspection items of the general rule 0107 of the Pharmacopoeia of the People's Republic of China(2020 Edition,Volume IV);The contents of n-hexanoic acid and n-heptanoic acid in the preparation were determined by gas chromatography-mass spectrometry(GC-MS).The content of taurine in the preparation was determined by high-performance liquid chromatography(HPLC).Results The optimized distillation time of the volatile oil was 1.5 h,The linear ranges of n-hexanoic acid,n-heptanoic acid and taurine are 23.175 0-115.875 0 μg·mL-1(R2=0.999 4),4.590 0-68.850 0 μg·mL-1(R2=0.998 9)and 15-125 μg·mL-1(R2=0.999 6),respectively.The average recoveries are 99.83%,101.96%,98.89%with RSDs of 2.84%,1.36%,2.88%,respectively.The RSDs of precision,stability,and repeatability tests are less than 5%.The properties,mass difference,melting time,microbial limit,and stability assessment of the preparationwere all in accordance with the Pharmacopoeia of the People's Republic of China.Conclusion Compound Bupleurum suppository preparation technology is reasonable and feasible,which meets the quality standard.
6.Drug resistance genes and efflux pump phenotypes in clinically isolated Acinetobacter baumannii
Li LI ; Zhizhen ZHANG ; Xiaoling ZOU ; Xu WANG ; Jiao DAI
Chinese Journal of Nosocomiology 2025;35(11):1707-1710
OBJECTIVE To investigate the epidemiological characteristics of Acinetobacter baumannii,detect the distribution of its β-lactamase genes and efflux pump genes,and analyze the relationship between β-lactamase genes and efflux pump genes and the drug resistance of the strains.METHODS Acinetobacter baumannii strains clinically isolated from Jun.2021 to Jun.2022 in Dujiangyan People's Hospital were collected and tested for anti-microbial resistance.Polymerase chain reaction(PCR)technology was used to amplify the β-lactamase genes as well as the efflux pump genes of Acinetobacter baumannii.PaβN was performed to test the efflux pump pheno-type.RESULTS The drug resistance rates of imipenem-resistant Acinetobacter baumannii(IRAB)to cefopera-zone,ceftazidime,cefepime,imipenem,and meropenem were 14.29%,85.71%,91.43%,100.00%and 100.00%,respectively,significantly higher than those of imipenem-sensitive Acinetobacter baumannii(ISAB)(P<0.05).The detection rates of OXA-23,OXA-51,and IMP-1 in IRAB strains were 45.71%,62.86%and 65.71%,respectively,higher than those in ISAB strains(P<0.05).The detection rates of the efflux pump genes adeB,adeS,and adeG in IRAB strains were 60.00%,71.43%and 68.57%,respectively,higher than those in ISAB strains(P<0.05).In addition,the positive rate of the efflux pump phenotype in the IRAB group was 54.29%,significantly higher than 7.69%in the ISAB group(P<0.001).CONCLUSION The detection rates of β-lactamase genes(such as OXA-23,OXA-51 and IMP-1 etc.)and efflux pump genes(adeB,adeS and adeG)in IRAB are significantly higher than those in the ISAB,and the positive rate of the efflux pump phenotype in IRAB is higher,which confirms that β-lactamase genes and efflux pump genes are important mechanisms of drug resistance in the bacterium.
7.A meta-analysis of menstrual abnormalities in workers exposed to benzene series
Ming XU ; Zong’ang LI ; Zhizhen XU ; Zhaohui FU ; Changyan YU ; Xuefei LI ; Meibian ZHANG
Journal of Environmental and Occupational Medicine 2024;41(10):1156-1161
Background A large body of cross-sectional studies have indicated a correlation between exposure to benzene series and increased rates of menstrual abnormalities in female workers, but these findings are confusing as evidence in the field of preventive medicine. Objective To provide a more rigorous scientific basis for early prevention of reproductive function impairment through systematic review of independent studies. Methods A comprehensive search was conducted for scientific articles published between January 1987 and July 2022, encompassing databases such as PubMed, Medline, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and CQVIP. A meta-analysis was conducted on literature that met the stringent criteria for case-control studies, featuring well-defined and consistent datasets. A meticulous investigation was executed to ascertain the collective odds ratio (OR) linked to menstrual abnormalities, encompassing diverse categories such as component, dosage, cumulative exposure dosage, and age groups. The prevalence and corresponding risk fractions were estimated by calculating frequency distributions and attributing risk percentages (AR). Results A total of 53 papers of case-control studies were included in the meta-analysis, involving
8.Correlation between hyperuricemia and outcome in patients with acute ischemic stroke
Zhaohui XU ; Jiwei CHENG ; Zhizhen SHI ; Yuqing HOU ; Qian XIAO ; Biao LIANG ; Lishan CHENG ; Guoyi LI ; Qing ZHAO
International Journal of Cerebrovascular Diseases 2021;29(6):432-436
Objective:To investigate the relationship between hyperuricemia and outcome in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to Department of Neurology, Putuo Hospital, Shanghai University of Tranditional Chinese Medicine between January 2020 and September 2020 were enrolled retrospectively. The modified Rankin Scale (mRS) score was used to evaluate the clinical outcome 3 months after the onset. ≤2 was considered as good outcome, and >2 was considered as poor outcome. The demography and baseline characteristics were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome. Results:A total of 210 patients were included, their age was 69.87±62.62 years. There were 125 males (59.52%) and 85 females (40.48%). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 4. The serum uric acid level in 169 patients (80.48%) was normal and 41 (19.52%) had hyperuricemia; 120 patients (57.14%) had a good outcome, and 90 (42.86%) had a poor outcome. Blood glucose level, serum uric acid level, baseline NIHSS score and the proportions of diabetes mellitus, history of stroke or transient ischemic attack, hyperuricemia in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [ OR] 2.735, 95% confidence interval [ CI] 1.461-5.121; P=0.002), hyperuricemia ( OR 2.400, 95% CI 1.102-5.228; P=0.027), and higher baseline NIHSS score ( OR 1.233, 95% CI 1.118-1.360; P<0.001) were the independent risk factors for poor outcome in patient with acute ischemic stroke. Conclusion:Hyperuricemia is an independent risk factor for poor outcome in patients with acute ischemic stroke.
9.Primary exploration on the experimental teaching reform of biochemistry and molecular biology
Xiaohong FU ; Zhizhen XU ; Xiaojing YAN ; Li ZHAO ; Gang HUANG
Chinese Journal of Medical Education Research 2019;18(2):131-134
In order to improve the teaching of biochemistry and molecular biology experiment course and improving students' mastery of theoretical knowledge and comprehensive quality,we made a series of reform in the teaching of biochemistry and molecular biology experiment course,including enriching of teaching content (for example,updating content,setting up experiments,adding design/comprehensive experiments),reforming teaching mode (for example,increasing teaching methods and demonstration teaching),perfecting the system of teaching evaluation (matching laboratory report and experiment assessment).Through the questionnaire after the teaching reform,it was found that the students are more enthusiastic about the experiment course than before,and their experiment technology is more proficient.In addition to that,the teaching effect of biochemistry and molecular biology experiment course has been obviously improved.The methods and effects of the above reforms in recent years are summarized in order to provide useful reference for the experimental teaching of Biochemistry and molecular biology in medical colleges.
10.A survey on sun protection behavior among middle-aged and elderly women in two districts in Beijing
Fen PENG ; Shuai XU ; Man LI ; Chenhong XUE ; Zhizhen HUANG ; Jingyi HUANG ; Xiaojing YANG ; Zhou CHEN ; Jianzhong ZHANG
Chinese Journal of Dermatology 2019;52(7):491-494
Objective To investigate sun protection behavior among middle-aged and elderly women in Beijing.Methods The central (Xuanwumen district) and peripheral areas (Yanqing district) of Beijing city were selected for investigation from May to June in 2016.By random sampling and field investigation,interviewees completed questionnaires with the help of dermatologists.Results A total of 400 females aged 40-90 years were investigated,including 190 in the Xuanwumen district and 210 in the Yanqing district.Among all the subjects,the average duration of outdoor activities was 2 hours.Moreover,117 (29.2%) of the 400 interviewees had the active sun exposure habit,including 38 (18.1%) in the Yanqing district and 79 (41.6%) in the Xuanwumen district,and the proportion of subjects with the active sun exposure habit significantly differed between the two districts (x2 =26.582,P < 0.001).In addition,67 (16.8%) interviewees had a sunburn history,and 130 (32.5%) were used to applying sunscreen.The proportion of sunscreen users was significantly higher in moderately or highly educated women (103 [45.2%]) than in lowly educated women (28/172 [16.3%],P < 0.001).The proportion of sunscreen users in women with skin type Ⅲ (41.2% [70/170]) was significantly higher than that in those with skin type Ⅳ (26.5% [61/230],P =0.002).The scores for facial skin aging and dorsal hand skin aging were both significantly lower in sunscreen users than in non-users (Z =18.536,10.731,P =0.002,0.026,respectively).Conclusion The active sun exposure habit in the middle-aged and elderly women differs between the central and peripheral areas of Beijing,and the use of sunscreen is associated with education level.


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