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.

Objective To investigate the mechanism of Chonghe soft extract on ulcer wound healing in diabetic rats through protein kinase B(Akt)/mammalian Sirolimus target protein(mTOR)-mediated nucleotides binding oligomeric acid domain-like receptor protein 3(NLRP3)inflammasome inactivation.Methods Thirty six SD rats with diabetic ulcer,which were established by feeding with high glucose and high fat diet and injecting intraperitoneally with streptozocin(STZ)combined with skin defect,were randomly divided into model group,Chonghe soft extract group and growth factor group,with twelve rats in each group.Another twelve SD rats were injected an equal dose of citric acid-sodium citrate buffer solution and used as blank group.The blank group and the model group were not received drug intervention,but the Chonghe soft extract group and the growth factor group were externally applied Chonghe soft extract and growth factor gel,respectively.The wound healing of each group was observed and recorded.After 7 days and 14 days of treatment,the histopathology of wound were observed by HE staining and the number of fibroblasts were counted.The levels of IL-1β,IL-18 and TNF-α in serum were detected by ELISA.The expression of autophagy-related protein Beclin-1 and LC3Ⅱ in granulation tissue was detected by immunohistochemistry.The expression of NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),Caspase1,Pro-Caspase1 and Akt/mTOR autophagy pathway-related proteins Akt,p-Akt,mTOR and p-mTOR were detected by Western Blot.Results Compared with the blank control group,the pathological wound repair of the model group was delayed on the 7th day and 14th day,the number of fibroblasts per unit area was decreased(P<0.01).The levels of IL-1β,IL-18 and TNF-α were increased(P<0.01).The expression levels of ASC,Pro-Caspase1,Caspase1,and NLRP3 were increased in the wound tissues(P<0.01),while the expression levels of Beclin-1,LC3-Ⅱ,mTOR,p-mTOR,Akt and p-Akt were decreased in the wound tissues(P<0.01).Compared with the model group,the pathological injury in Chonghe soft extract group and growth factor group was significantly improved on the 7th day and 14th day.The number of fibroblasts per unit area was significantly increased(P<0.01).The levels of IL-1β,IL-18 and TNF-α were significantly decreased(P<0.01).The expression levels of ASC,Pro-Caspase1,Caspase1,and NLRP3 in the wound tissues were decreased(P<0.01),while the expression levels of Beclin-1,LC3-Ⅱ,mTOR,p-mTOR,Akt and p-Akt were increased(P<0.01,P<0.05).Conclusion Chonghe soft extract can reduce inflammatory reaction,promote the generation of fibro,regulate the Akt/mTOR-mediated NLRP3 inflammasome inactivation,improve the level of autophagy in wound,and promote ulcer wound healing in diabetic rats.

The Guarding field theory is a unique theoretical system of traditional Chinese medicine for the treatment of surgical diseases such as scabies, sores and gangrene. The hooping in place is the best performance of Guarding field theory. This paperreviews the research progress of Guarding field theory from the aspects of theoretical research, basic research, clinical research in recent years, which shows the connotation of this theory has been expanded. and the generalized concept of Guarding field theory refers to human's healthy Qi, and the field theory has been widely used in treating diseases likemalignant tumor, postoperative anorectal infection, refractory wound to guide clinical treatment.

Objective:To compare the marginal and internal fit of selective laser melting(SLM)titanium crowns with lost-wax cast (LW)titanium crowns.Methods:Titanium crowns of 10 subjects were fabricated by SLM and conventional LW respectively(n =10).The marginal and internal gaps of the crowns were recorded with silicon film using a replica technique.Each silicon film was cut into 2 parts and the thickness of silicon layer was measured at ×100 magnification using a stereomicroscope,the data of marginal gap (MG)and internal gap(IG)were statistically analysed by ANOVA and SPSS statistical package version 17.0.Results:The MG (μm)of the titanium crowns of SLMgroup and LMgroup were 90.67 ±14.7 and 94.77 ±21.9(P <0.05),IG were 213.73 ±90.4 and 217.00 ±97.7(P >0.05),respectively.Conclusion:The marginal fit of the SLMcrowns is better than that of the LW ones,and is significantly smaller than 120 μm of the clinical generally accepted standards.

Objective:To compare the adaption of cobalt-chromium prostheses fabricated by selective laser melting(SLM)and conven-tional lost wax technique(LW)method.Methods:Cobalt-chromium crowns and three-unit fixed dental prostheses(FDPs)were fabrica-ted by selective laser melting(SLM)or by conventional lost wax technique(LW)respectively(n =5).Marginal fit and internal fit were examined using a light-body silicone.After setting,each silicon film was cut into 2 parts and the thickness of silicon layer was measured at 1 00 ×magnification using a digital microscope,the data of marginal gap(MG)and internal gap(IG)were statistically analysed by ANOVA and SPSS statistical package version 1 7.0.Results:The MG and IG(μm)of cobalt-chromium alloy crowns in EOS M270 group were 42.28 ±1 1 .58 and 1 25.75 ±47.67,in EOS M280 group 46.54 ±8.4 and 1 28.22 ±54.1 8,in LW group 48.66 ±1 2.08 and 1 35.37 ±46.89.The MG and IG(μm)of three-unit FDPs in EOS M270 group were 40.55 ±1 0.04 and 1 33.09 ±39.80,in EOS M280 group 45.36 ±1 0 and 1 38.94 ±50.61 ,in LW group 54.24 ±1 2.04 and 1 51 .87 ±61 .94(P <0.05),respectively.Conclu-sion:The marginal fit of the SLMgroup is superior to that of the LW group and significantly smaller than 1 20 μm of clinical generally accepted standards.SLMsystem can satisfy the clinical requirements.