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.Status and influencing factors of the application of informatization tools for antimicrobial stewardship in Chinese county hospitals
Yuqi FU ; Xin LI ; Ying LI ; Hongwei WU ; Zhixin FAN ; Jinru LIU ; Xi CHEN ; Yuxiang XIA ; Qiang SUN ; Yingbo ZHAO
China Pharmacy 2026;37(16):2084-2089
OBJECTIVE To investigate the current status of informatization tools applied to antimicrobial stewardship in county hospitals in China, and to provide a reference for promoting the informatization development of antimicrobial stewardship in county hospitals.METHODS From August to September 2025, an online questionnaire survey was conducted among 1 007 county hospitals across 31 provinces(autonomous regions, and municipalities) in China. The survey focused on the application of four types of informatization tools:the real-time monitoring system for antimicrobial use, the pre-prescription review system, the irrational use warning system, and the electronic prescription evaluation system(hereinafter referred to as the “monitoring system”“review system”“warning system”“evaluation system”,respectively). Correlation analysis and binary Logistic regression analysis were employed to explore the influencing factors.RESULTS Of the county hospitals, 80.83% were equipped with at least one type of informatization tool for antimicrobial stewardship, while 19.17% had no relevant tool. Only 18.87% of the hospitals were equipped with all four types of tools. The monitoring system exhibited the highest equipped rate (70.80%), whereas the warning system was equipped in only 33.96% of the hospitals. Four types of tools are evenly and adequately deployed in the eastern region, the central and western regions have far lower deployment rates of intervention tools including review system and warning system, accompanied by prominent intra-provincial gaps. The total number of the health technicians, hospital grade, and prescription review rate of outpatient antibacterial drug were significantly and positively correlated with the deployment rates of the four informatization tools ( P <0.05). The results of the Logistic regression model fitting indicated that the model of the review system was rated “excellent” [area under the receiver operating characteristic curve (AUC)=0.81], and the model of the warning system was rated “further improvement” (AUC=0.67). The total number of health technicians was significantly positively correlated with the deployment rates of all four types of informatization tools (all P <0.05).CONCLUSIONS The informatization of antimicrobial stewardship in county hospitals in China remains in the initial stage of transitioning from “passive statistics” to “active prevention and control”, with challenges such as structural imbalance and regional disparities. In the future, differentiated support strategies should be implemented, the allocation of resources should be optimized, to enhance the level of refined antimicrobial stewardship.
3.Principles, technical specifications, and clinical application of lung watershed topography map 2.0: A thoracic surgery expert consensus (2024 version)
Wenzhao ZHONG ; Fan YANG ; Jian HU ; Fengwei TAN ; Xuening YANG ; Qiang PU ; Wei JIANG ; Deping ZHAO ; Hecheng LI ; Xiaolong YAN ; Lijie TAN ; Junqiang FAN ; Guibin QIAO ; Qiang NIE ; Mingqiang KANG ; Weibing WU ; Hao ZHANG ; Zhigang LI ; Zihao CHEN ; Shugeng GAO ; Yilong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):141-152
With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.
4.Effect of early weight-bearing functional exercise on the postoperative function and satisfaction of patients with anterior talofibular ligament rupture
Hang WU ; Qiang LI ; Haitao YUAN ; Peng GU ; Shaoyong FAN ; Xiongwei DENG
China Modern Doctor 2025;63(28):5-8,57
Objective To explore the effect of early weight-bearing functional exercise on the postoperative function and satisfaction of patients with anterior talofibular ligament rupture.Methods Sixty patients with anterior talofibular ligament rupture admitted to Nanchang Hongdu Hospital of Traditional Chinese Medicine from June 2022 to June 2024 were included.According to the random number table method,the patients were divided into conventional group and early weight-bearing group,with 30 cases in each group.The American Orthopedic Foot and Ankle Society ankle-hindfoot scale(AOFAS-AHS)scores,Cumberland ankle instability tool(CAIT)scores,joint position sense active(JPSA)and joint position sense passive(JPSP)of ankle joint before and after the operation,and postoperative satisfaction of two groups of patients were compared.Results Six months after the operation,the AOFAS-AHS scores and CAIT scores of two groups were significantly higher than those before the operation,and the JPSA and JPSP were significantly lower than those before the operation(P<0.05).The AOFAS-AHS score and CAIT score of patients of early weight-bearing group were significantly higher than those of conventional group,while the JPSA and JPSP were significantly lower than those of conventional group(P<0.05).The satisfaction rate of patients of early weight-bearing group was significantly higher than that of conventional group(76.6%vs.66.6%,x2=6.205,P<0.001).Conclusion Early weight-bearing functional exercise can improve the postoperative function of patients with anterior talofibular ligament rupture and enhance their postoperative satisfaction.
5.Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic Contrast-Enhanced MRI
Xue-han WU ; Yu-tao QUE ; Xin-yue YANG ; Zi-qiang WEN ; Yu-ru MA ; Zhi-wen ZHANG ; Quan-meng LIU ; Wen-jie FAN ; Li DING ; Yue-jiao LANG ; Yun-zhu WU ; Jian-peng YUAN ; Shen-ping YU ; Yi-yan LIU ; Yan CHEN
Korean Journal of Radiology 2025;26(5):400-410
Objective:
To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.
Materials and Methods:
A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.
Results:
All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027).
Conclusion
The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.
6.Functional MRI study on the effects of different daily doses of methadone on the brain response of heroin addicts under drug cues
Hanyue WANG ; Ning WU ; Jiajie CHEN ; Fan WANG ; Qiang LI ; Wei WANG
Journal of Practical Radiology 2025;41(7):1081-1084
Objective To explore the effects of different daily doses of methadone maintenance treatment(MMT)on subjective craving and brain function under drug cues among heroin addicts,providing an objective basis for the formulation of methadone medi-cation plan in clinical practice.Methods Twenty-nine heroin addicts were included and grouped according to the daily dose of metha-done 40 mg,≤40 mg/d group 15 participants(group A),>40 mg/d group 14 participants(group B).The functional magnetic reso-nance imaging(fMRI)data of brain response induced by drug cues were collected using a 3.0T MR scanner,and the craving data induced by drug cues in the subjects were collected.Brain activity and behavioral data processing were analyzed using SPM8 and SPSS 20.0 software.Results There were no statistically significant differences in craving scores between the two groups of subjects exposed to drug cues(t=-0.69,P>0.05).The brain regions with differences in brain response included the left caudate nucleus(group A showed signifi-cantly enhanced response),and the strength of its response was negatively correlated with the daily dose of methadone(r=-0.465,P=0.025).Conclusion Higher doses of MMT may help control the value cognitive processing of drug cues in heroin addicts through the caudate nucleus,which can better prevent relapse.In the future,the degree of activation of the caudate nucleus under drug cues may serve as an indicator for evaluating the effectiveness of methadone treatment.
7.Association Between Abnormal Body Weight and Physical Fitness Levelsin Chinese Older Adults: Findings from the 5th National PhysicalFitness Surveillance in China
Chaoqun FAN ; Mei WANG ; Qiang FENG ; Jingjing WANG ; Dongming WU ; Zonghao SUN ; Jiarong ZHU ; Yini WU
Medical Journal of Peking Union Medical College Hospital 2025;16(3):617-626
Based on the data from the 5th National Physical Fitness Surveillance in China, this study aimed to explore the relationship between abnormal body weight and physical fitness levels in older adults. The study included adults aged 60-79 years from the 5th National Physical Fitness Surveillance database. Body weight was categorized into four groups—underweight, normal weight, overweight, and obesity—based on body mass index (BMI), with underweight, overweight, and obesity classified as abnormal weight. Physical fitness indicators such as cardiorespiratory endurance (number of 2-minute high-knee steps), lower limb muscle strength (number of 30-second chair stands), flexibility (sit-and-reach test), balance ability (eyes-closed single-leg stance time), and reaction ability (choice reaction time) were collected. Each physical fitness indicator was divided into four levels (excellent, good, pass, and fail) based on quartile cutoffs. After adjusting for demographic factors (including age, sex, urban/rural residence, education level, pre-retirement occupation, marital status, exercise habits, smoking, sleep quality, and self-rated fitness), binary Logistic regression was used to analyze the association between physical fitness indicators and abnormal weight. A total of 39 927 older adults aged 60-79 years were included, comprising 19 777 men (49.5%) and 20 150 women (50.5%), with a mean age of 69.2±5.6 years. The prevalence rates of underweight, overweight, and obesity were 2.3%, 41.8%, and 16.7%, respectively, with underweight prevalence significantly increasing with age ( Chinese older adults aged 60-79 years face a dual burden of underweight and overweight/obesity. Poor cardiorespiratory endurance and muscle strength (in women) are significantly associated with abnormal weight. Maintaining good cardiorespiratory endurance and muscle strength may help improve abnormal weight status in older adults.
8.Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic Contrast-Enhanced MRI
Xue-han WU ; Yu-tao QUE ; Xin-yue YANG ; Zi-qiang WEN ; Yu-ru MA ; Zhi-wen ZHANG ; Quan-meng LIU ; Wen-jie FAN ; Li DING ; Yue-jiao LANG ; Yun-zhu WU ; Jian-peng YUAN ; Shen-ping YU ; Yi-yan LIU ; Yan CHEN
Korean Journal of Radiology 2025;26(5):400-410
Objective:
To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.
Materials and Methods:
A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.
Results:
All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027).
Conclusion
The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.
9.Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic Contrast-Enhanced MRI
Xue-han WU ; Yu-tao QUE ; Xin-yue YANG ; Zi-qiang WEN ; Yu-ru MA ; Zhi-wen ZHANG ; Quan-meng LIU ; Wen-jie FAN ; Li DING ; Yue-jiao LANG ; Yun-zhu WU ; Jian-peng YUAN ; Shen-ping YU ; Yi-yan LIU ; Yan CHEN
Korean Journal of Radiology 2025;26(5):400-410
Objective:
To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.
Materials and Methods:
A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.
Results:
All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027).
Conclusion
The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.
10.Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic Contrast-Enhanced MRI
Xue-han WU ; Yu-tao QUE ; Xin-yue YANG ; Zi-qiang WEN ; Yu-ru MA ; Zhi-wen ZHANG ; Quan-meng LIU ; Wen-jie FAN ; Li DING ; Yue-jiao LANG ; Yun-zhu WU ; Jian-peng YUAN ; Shen-ping YU ; Yi-yan LIU ; Yan CHEN
Korean Journal of Radiology 2025;26(5):400-410
Objective:
To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.
Materials and Methods:
A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.
Results:
All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027).
Conclusion
The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

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