1.Clinical application of an artificial intelligence system in predicting benign or malignant pulmonary nodules and pathological subtypes
Zhuowen YANG ; Zhizhong ZHENG ; Bin LI ; Yiming HUI ; Mingzhi LIN ; Jiying DANG ; Suiyang LI ; Chunjiao ZHANG ; Long YANG ; Liang SI ; Tieniu SONG ; Yuqi MENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(08):1086-1095
Objective To evaluate the predictive ability and clinical application value of artificial intelligence (AI) systems in the benign and malignant differentiation and pathological type of pulmonary nodules, and to summarize clinical application experience. Methods A retrospective analysis was conducted on the clinical data of patients with pulmonary nodules admitted to the Department of Thoracic Surgery, Second Hospital of Lanzhou University, from February 2016 to February 2025. Firstly, pulmonary nodules were divided into benign and non-benign groups, and the discriminative abilities of AI systems and clinicians were compared. Subsequently, lung nodules reported as precursor glandular lesions (PGL), microinvasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC) in postoperative pathological results were analyzed, comparing the efficacy of AI systems and clinicians in predicting the pathological type of pulmonary nodules. Results In the analysis of benign/non-benign pulmonary nodules, clinical data from a total of 638 patients with pulmonary nodules were included, of which there were 257 males (10 patients and 1 patient of double and triple primary lesions, respectively) and 381 females (18 patients and 1 patient of double and triple primary lesions, respectively), with a median age of 55.0 (47.0, 61.0) years. Different lesions in the same patient were analyzed as independent samples. Univariate analysis of the two groups of variables showed that, except for nodule location, the differences in the remaining variables were statistically significant (P<0.05). Multivariate logistic regression analysis showed that age, nodule type (subsolid pulmonary nodule), average density, spicule sign, and vascular convergence sign were independent influencing factors for non-benign pulmonary nodules, among which age, nodule type (subsolid pulmonary nodule), spicule sign, and vascular convergence sign were positively correlated with non-benign pulmonary nodules, while average density was negatively correlated with the occurrence of non-benign pulmonary nodules. The area under the receiver operating characteristic curve (AUC) of the malignancy risk value given by the AI system in predicting non-benign pulmonary nodules was 0.811, slightly lower than the 0.898 predicted by clinicians. In the PGL/MIA/IAC analysis, clinical data from a total of 411 patients with pulmonary nodules were included, of which there were 149 males (8 patients of double primary lesions) and 262 females (17 patients of double primary lesions), with a median age of 56.0 (50.0, 61.0) years. Different lesions in the same patient were analyzed as independent samples. Univariate analysis results showed that, except for gender, nodule location, and vascular convergence sign, the differences in the remaining variables among the three groups of PGL, MIA, and IAC patients were statistically significant (P<0.05). Multinomial multivariate logistic regression analysis showed that the differences between the parameters in the PGL group and the MIA group were not statistically significant (P>0.05), and the maximum diameter and average density of the nodules were statistically different between the PGL and IAC groups (P<0.05), and were positively correlated with the occurrence of IAC as independent risk factors. The average AUC value, accuracy, recall rate, and F1 score of the AI system in predicting lung nodule pathological type were 0.807, 74.3%, 73.2%, and 68.5%, respectively, all better than the clinical physicians’ prediction of lung nodule pathological type indicators (0.782, 70.9%, 66.2%, and 63.7% respectively). The AUC value of the AI system in predicting IAC was 0.853, and the sensitivity, specificity, and optimal cutoff value were 0.643, 0.943, and 50.0%, respectively. Conclusion This AI system has demonstrated high clinical value in predicting the benign and malignant nature and pathological type of lung nodules, especially in predicting lung nodule pathological type, its ability has surpassed that of clinical physicians. With the optimization of algorithms and the adequate integration of multimodal data, it can better assist clinical physicians in formulating individualized diagnostic and treatment plans for patients with lung nodules.
2.Effect of Xuanfei Zhisou Prescription on IL-17 Signaling Pathway in COPD Model Rats
Yanli SHI ; Yunchao WANG ; Zhen YANG ; Xinhua WANG ; Zhiyong JIA
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(9):28-39
ObjectiveTo investigate the effect of Xuanfei Zhisou prescription on the interleukin-17 (IL-17) signaling pathway in model rats with chronic obstructive pulmonary disease (COPD). MethodA total of 60 Wistar rats were randomly divided into a blank group (10 rats) and a model group (50 rats), and COPD model rats were established by tracheal infusion of lipopolysaccharide combined with passive fumigation. After modeling, the rats were divided into the model group, dexamethasone group, and high, medium, and low-dose Xuanfei Zhisou prescription groups (3.6, 1.8, 0.9 g·kg-1·d-1) according to the random number table. Rats in the blank group and model group were given normal saline of 10 mL·kg-1·d-1 by gavage administration, and the intervention groups of Xuanfei Zhisou prescription were given corresponding drugs. Rats in the dexamethasone group were given dexamethasone of 2.57×10-4 g·kg-1·d-1 for 28 days. The level of pulmonary function indexes in rats was measured by a pulmonary function detector. The contents of interleukin-6 (IL-6), interleukin-8 (IL-8), IL-17, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). The positive expressions of IL-17A, IL-17RA, nuclear factor-κB activator 1 (Act1), tumor necrosis factor-associated factor 6 (TRAF6), p-p38 mitogen-activated protein kinase (p-p38 MAPK), nuclear factor-κB p65 (NF-κB p65), and phosphorylation were detected by immunohistochemistry (IHC). The protein expression levels of IL-17A, IL-17RA, Act1, and TRAF6 in the lung tissue were detected by Western blot. The mRNA expressions of IL-17A, IL-17RA, Act1, and TRAF6 in the lung tissue were detected by Real-time polymerase chain reaction (Real-time PCR). ResultCompared with the blank group, the serum contents of IL-6, IL-8, IL-17, IL-1β, and TNF-α in the model group were significantly increased (P<0.05), and the flow rate and volume indexes of pulmonary function in the model group were significantly decreased (P<0.05), while the time indexes and other indexes were significantly increased (P<0.05). The mRNA and protein expression levels of IL-17A, IL-17RA, Act1, and TRAF6 in pulmonary tissue and the positive expressions of downstream NF-κB p65, p-NF-κB p65, and p-p38 MAPK were increased (P<0.05). Compared with the model group, the levels of IL-6, IL-8, IL-17, IL-1β, and TNF-α in the serum of all treatment groups were decreased to varying degrees (P<0.05), and the indexes of pulmonary function were improved to different degrees (P<0.05). The mRNA and protein levels of IL-17A, IL-17RA, Act1, and TRAF6 and the positive expression of downstream NF-κB p65, p-NF-κB p65, and p-p38 MAPK in high and medium-dose Xuanfei Zhisou prescription groups were significantly decreased (P<0.05). ConclusionXuanfei Zhisou prescription can effectively resist inflammation of COPD rats. The mechanism may be related to down-regulating the protein expression of IL-17A, IL-17RA, Act1, and TRAF6, inhibiting downstream NF-κB and p38 MAPK signaling pathways, and reducing the release of IL-6, IL-8, TNF-α, IL-17, and IL-1β, thus reducing the airway inflammation response.
3.Comprehensive evaluation and analysis of laboratory resource allocation in 14 blood stations based on entropy weight -TOPSIS method
Weiping FENG ; Zhifeng ZHANG ; Jianhua LI ; Feiyan ZHANG ; Xiaoqiang DONG ; Xiaogang LI ; Yin HAN ; Wenqing YUE ; Yue YANG ; Jun CUI ; Lixia FENG ; Qiang GAO ; Caifeng HAN ; Ran WANG ; Jia CHENG
Chinese Journal of Blood Transfusion 2023;36(8):720-723
【Objective】 To investigate the resource allocation status of blood testing laboratories in 14 blood stations in Gansu Province, explore the impact of differences in basic conditions on the comprehensive testing ability of laboratories, so as to promote the homogenization and standardization of blood screening capacity in blood stations in Gansu and improve blood safety and effectivenes. 【Methods】 An evaluation index system of laboratory resource allocation was constructed and a question-naire was designed. The data of human resources, infrastructure and key equipment of 14 blood stations were collected. The entropy weight -TOPSIS method was used to evaluate and rank the resource allocation of 14 blood stations. 【Results】 In the comprehensive evaluation of blood testing laboratory resource allocation in 14 blood stations in Gansu, the top three were laboratories A, B and I, and the last three were laboratories G, M and J. On the whole, the main issue was unreasonable structure of human resources: most laboratories had unreasonable age structure; except for Laboratory A, there was no personnel with bachelor's degree or above in laboratories; most laboratories had not established a team with intermediate professional titles. In terms of infrastructure, the size of seven laboratories could not meet the needs of modern laboratory testing, and all eight blood stations had no spare nucleic acid laboratories nor a mutual spare laboratory with other blood stations As for the key equipment, 5 laboratories had no automatic blood grouping diagnostic instrument, 5 laboratories only had one set of enzyme immunoassay detection system, 3 laboratories had no spare equipment for the key equipment, which means if the equipment failure could not be repaired in time, the release of results would be affected. 【Conclusion】 There were significant differences in human resources, infrastructure and key equipment of blood testing laboratories in 14 blood stations in Gansu, which had a great impact on laboratory testing capacity and subsequent development. It is suggested that governments at all levels and health administrative departments optimize the input of laboratory resource allocation according to the blood collection volume of blood stations to gradually narrow the differences in resource distribution between different regions, improve the degree of laboratory automation and optimize the personnel structure, so as to build high-quality and efficient blood testing laboratories and ensure the safety of clinical blood use.
4.Effectiveness of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022
Yuhua LI ; Peng ZHANG ; Chenqing SUN ; Ning XIAO ; Yuancheng YANG ; Baolin ZHONG ; Chun FANG ; Guoxiang KUI ; Zijing LIU ; Fan LI ; Shijie YANG ; Yu FENG
Chinese Journal of Schistosomiasis Control 2023;35(6):626-632
Objective To evaluate the effectiveness of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, so as to provide insights into echinococcosis control. Methods Administrative villages were sampled using a multi-stage cluster random sampling method from Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, and all residents at ages of 12 years and older in the sampled villages were screened for echinococcosis, and schools were sampled using a cluster sampling method, and all children at ages of 12 years and older in the sampled schools were screened for echinococcosis. Domestic dogs were sampled using a systematic random sampling method, and one domestic dog stool sample was collected from each household. Stray dog stool samples were collected outside the villages, and Echinococcus coproantigens were detected using enzyme-linked immunosorbent assay in domestic and stray dogs. In addition, echinococcosis was screened in sheep and cattle in designated slaughterhouses in Tianzhu Tibetan Autonomous County. The trends in the prevalence of echinococcosis in humans and livestock and the positive rate of Echinococcus coproantigens in dogs were examined with the Cochran-Armitage trend test. In addition, individuals screened for echinococcosis were randomly sampled from 2007 to 2022 for survey on the awareness of echinococcosis control knowledge. Results A total of 290 356 person-times were screened for echinococcosis among residents at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 094 residents detected with cystic echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ2 = 358.602, P < 0.001). A total of 32 931 person-times were screened for echinococcosis among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 296 children detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ2 = 267.673, P < 0.001). A total of 33 230 domestic dog stool samples were tested for Echinococcus coproantigens in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 777 Echinococcus coproantigens-positive samples tested, and the positive rate of Echinococcus coproantigens appeared a tendency towards a decline in domestic dogs over years (χ2 = 2 210.428, P < 0.001), while the positive rate of Echinococcus coproantigens showed a tendency towards a rise in domestic animals from 2016 to 2022 (χ2 = 37.745, P < 0.001). The positive rate of Echinococcus coproantigens remained relatively stable in stray dogs in Tianzhu Tibetan Autonomous County, Gansu Province from 2019 to 2022 (χ2 = 0.315, P = 0.575). A total of 10 973 sheep were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2007 to 2022, with 334 sheep detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a decline in sheep over years (χ2 = 53.579, P < 0.001); however, there was no significant change in the detection of echinococcosis during the period from 2015 through 2022 (χ2 = 1.520, P = 0.218). A total of 2 400 cattle were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2017 to 2022, with 231 cattle detected with echinococcosis, and the detection of echinococcosis showed a tendency towards a decline over years (χ2 = 5.579, P < 0.05). The awareness of echinococcosis control knowledge increased from 44.37% in 2007 to 94.00% in 2022 among residents at ages of 12 years and older and from 52.50% in 2007 to 92.50% in 2022 among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, respectively. Conclusions There has been a reduction in the detection of echinococcosis in humans and domestic animals and the positive rate of Echinococcus coproantigens in dogs and a rise in the awareness of the echinococcosis control knowledge following the implementation of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province; however, integrated echinococcosis control measures are still required for further control of the prevalence of echinococcosis.
5.Expert Consensus for Thermal Ablation of Pulmonary Subsolid Nodules (2021 Edition).
Xin YE ; Weijun FAN ; Zhongmin WANG ; Junjie WANG ; Hui WANG ; Jun WANG ; Chuntang WANG ; Lizhi NIU ; Yong FANG ; Shanzhi GU ; Hui TIAN ; Baodong LIU ; Lou ZHONG ; Yiping ZHUANG ; Jiachang CHI ; Xichao SUN ; Nuo YANG ; Zhigang WEI ; Xiao LI ; Xiaoguang LI ; Yuliang LI ; Chunhai LI ; Yan LI ; Xia YANG ; Wuwei YANG ; Po YANG ; Zhengqiang YANG ; Yueyong XIAO ; Xiaoming SONG ; Kaixian ZHANG ; Shilin CHEN ; Weisheng CHEN ; Zhengyu LIN ; Dianjie LIN ; Zhiqiang MENG ; Xiaojing ZHAO ; Kaiwen HU ; Chen LIU ; Cheng LIU ; Chundong GU ; Dong XU ; Yong HUANG ; Guanghui HUANG ; Zhongmin PENG ; Liang DONG ; Lei JIANG ; Yue HAN ; Qingshi ZENG ; Yong JIN ; Guangyan LEI ; Bo ZHAI ; Hailiang LI ; Jie PAN
Chinese Journal of Lung Cancer 2021;24(5):305-322
"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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6.Genetic diversity of protopine-6-hydroxylase in three medicinal Papaver plants.
Tian-Hua WU ; Jun-Hui ZHOU ; Yu-Yang ZHAO ; Yu-Jie WEI ; Fang CHEN ; Yong-Fu GONG ; Yuan YUAN ; Lu-Qi HUANG
China Journal of Chinese Materia Medica 2021;46(16):4111-4116
Sanguinarine is the main active component of the Papaver plants, and protopine-6-hydroxylase(P6 H), involved in the sanguinarine biosynthetic pathway, can oxidize protopine to 6-hydroxyprotopine. The investigation on the diversity of P6 H genes in the medicinal Papaver plants contributes to the acquirement of P6 H with high activity to increase the biosynthesis of sanguinarine. Five P6 H genes in P. somniferum, P. orientale, and P. rhoeas were discovered based on the re-sequencing data of the Papaver species, followed by bioinformatics analysis. With the elongation factor 1α(EF-1α), which exhibits stable expression in the root and stem, as the internal reference gene, the transcription levels of P6H genes in roots and stems of the Papaver plants were detected by real-time fluorescent quantitative PCR. As indicated by the re-sequencing results, there were two genotypes of P6H in P. somniferum and P. orientale, respectively, and only one in P. rhoeas. The bioinformatics analysis showed that the P6 H proteins of the three Papaver plants contained the conserved domain cl12078, which is the characteristic of p450 supergene family, and transmembrane regions. The existence of signal peptide remained verification. Real-time fluorescent quantitative PCR results revealed that the transcription level of P6 H in roots of P. somniferum was about 1.44 times of that in stems(α=0.05). The present study confirmed genetic diversity of P6 H in the three medicinal Papaver plants, which lays a basis for the research on the biosynthesis pathway and mechanism of sanguinarine in Papaver species.
Benzophenanthridines
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Berberine Alkaloids
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Cytochrome P-450 Enzyme System/genetics*
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Genetic Variation
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Papaver/genetics*
7.Isolation of Growth-Promoting Bacteria and Effect of Compound Bacteria on Yield of Fritillaria przewalskii
Jiang ZHAO ; Shi-jun LIANG ; Tao YANG ; Xiao-long WU ; Peng-nian QI ; Shi-wei WANG ; Zhi-ye WANG
Chinese Journal of Experimental Traditional Medical Formulae 2021;27(24):163-170
Objective:To explore the effects of anti-microbial compound (T1) from
8. Effect of Lumbricus Peptides on TLR4/NF-κB Signaling Pathway in Spontaneous Hypertensive Rat Kidney
Yi-yun YANG ; Lu-lu NIU ; Hui CHAI ; Bei-bei ZHU ; Kai LIU
Chinese Journal of Experimental Traditional Medical Formulae 2019;25(2):82-88
Objective:to observe the effect and mechanism of lumbricus peptides on early renal injury in spontaneous hypertensive rats (SHR) based on Toll-like receptors 4 (TLR4)/nuclear factor-κB(NF-κB) signaling pathway. Method:The 40 SHRs were randomly divided into model group (equal volume of distilled water by intragastric administration), lumbricus peptides low, middle and high dose groups (126, 252, 504 mg·kg-1), and Benazepril group (0.9 mg·kg-1), n=8 in each group. 8 male rats with normal blood pressure at the same age were set as the normal control group,with equal volume of distilled water. After treatment for 60 consecutive days, enzyme-linked immunosorbent assay (ELISA) was used to determine microalbumin (mAlb)and N-acetyl-β-D-glucosaminidase (NAG) content in 24 h urine as well as the level of serum angiotensinⅡ (AngⅡ). Ultrastructural changes of rat kidneys were observed by transmission electron microscope. Western blot was used to detect renal TLR4, NF-κB p65 protein levels. Immunohistochemical method was used to detect renal tumor necrosis factor-α (TNF-α) and interleukin 10 (IL-10) expression. Result:As compared with the normal control group, the levels of urine mAlb, NAG and serum Ang Ⅱ were increased in the model group (P<0.05); the expression of TLR4 and NF-κB p65 protein was increased (P<0.05); expression of TNF-α was increased (P<0.05), while IL-10 expression was decreased (P<0.05). Transmission electron microscopy of kidney tissues showed that most of the glomeruli of the model group had podocyte foot process fusion, mesangial cells and mesangial matrix hyperplasia. As compared with the model group, the levels of urine mAlb, NAG, and serum Ang Ⅱ were decreased in the rats in lumbricus peptides groups and benazepril group (P<0.05); the expression of TLR4 and NF-κB p65 protein was decreased (P<0.05); the positive expression of TNF-α in kidney was decreased to different extent (P<0.05), but the expression of IL-10 was increased (P<0.05). Transmission electron microscopy of kidney tissues showed that the damage of kidneys in rats after administration of high-dose lumbricus peptides and benazepril was improved in varying degrees. Conclusion:lumbricus peptides can reduce early renal damage in SHRs, and its mechanism may be achieved by regulating the AngⅡ-TLR4/NF-κB pathway.
9.Impact factors on ablation rate in cryoablation of soft tissue sarcomas
Long JIN ; Jing LI ; Xiao LI ; Wuwei YANG
Chinese Journal of Interventional Imaging and Therapy 2018;15(6):341-344
Objective To analyze the impact factors of the ablation rate after cryoablation treatment of soft tissue sarcomas.Methods Data of 60 patients with soft tissue sarcomas who underwent cryoablation treatment were analyzed.One month after cryoablation,CT or MR examination was performed to assess the ablation rate.Then statistical analysis was conducted to observe the impact factors on the ablation rate of cryoablation treatment.Results The univariate analysis showed that the largest diameter of tumor and tumor location were related to the ablation rate after cryoablation (x2 =10.408,P=0.015;x2 =36.778,P =0.006),while multivariate analysis showed that tumor location was the independent impact factor on ablation rate of cryoablation treatment for soft tissue sarcoma (P<0.05).Conclusion Cryoablation is safe and effective in the treatment of soft tissue sarcomas.Tumor location is an independent impact factor on ablation rate of cryoablation for soft tissue sarcomas.
10.Expert Consensus for Image-guided Radiofrequency Ablation of Pulmonary Tumors (2018 Version).
Baodong LIU ; Xin YE ; Weijun FAN ; Xiaoguang LI ; Weijian FENG ; Qiang LU ; Yu MAO ; Zhengyu LIN ; Lu LI ; Yiping ZHUANG ; Xudong NI ; Jialin SHEN ; Yili FU ; Jianjun HAN ; Chenrui LI ; Chen LIU ; Wuwei YANG ; Zhiyong SU ; Zhiyuan WU ; Lei LIU
Chinese Journal of Lung Cancer 2018;21(2):76-88

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