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Abstract Isolated rapid eye movement sleep behavior disorder is a prodrome of α-synucleinopathies. Using positron emission tomography, we assessed changes in Parkinson’s disease-related motor and cognitive metabolic networks and caudate/putamen dopaminergic input in a 4-year longitudinal imaging study of 13 male subjects with this disorder. We also correlated times to phenoconversion with baseline network expression in an independent validation sample. Expression values of both Parkinson’s disease-related networks increased over time while dopaminergic input gradually declined in the longitudinal cohort. While abnormal functional connections were identified at baseline in both networks, others bridging these networks appeared later. These changes resulted in compromised information flow through the networks years before phenoconversion. We noted an inverse correlation between baseline network expression and times to phenoconversion to Parkinson’s disease or dementia with Lewy bodies in the validation sample. Here, we show that the rate of network progression is a useful outcome measure in disease modification trials.

17–7 PH stainless steel is a highly versatile material with a multitude of applications in a diverse range of fields, including aerospace, chemistry and petrochemistry, and medicine. The material’s exceptional mechanical properties and corrosion resistance render it the optimal selection for numerous components and instruments. Nevertheless, the surface properties of 17–7 PH stainless steel are inadequate for applications requiring high hardness and wear resistance in certain extreme environments. Due to its excellent mechanical properties and corrosion resistance, it can be utilized in the manufacturing of pharmaceutical equipment components. However, certain specialized environments still require surface nitriding treatment. Considering the complex heat treatment process required for this material, this paper reports a detailed study of the surface performance changes of 17–7 PH steel before and after ion nitriding following aging heat treatment. The study employs rolled 17–7 PH stainless steel as the subject material. The impact of heat treatment on plasma nitriding of stainless steel is investigated by comparing and analyzing the influence of martensite content and dislocation density within the martensite of the material prior to and following heat treatment on the hardness, thickness, and corrosion resistance of the nitrided layer on the surface of the steel after nitriding. The results demonstrate that 17–7 PH stainless steel, which does not undergo heat treatment, exhibits a high internal dislocation density, a high nitriding efficiency, and consequently, a high surface hardness. Following the application of a heat treatment, there is an increase in the martensite content of 17–7 PH stainless steel, a decrease in the dislocation content, and an increase in the matrix hardness.

Abstract Background Vascular dysfunction, including cerebral hypoperfusion, plays an important role in the pathogenesis and progression of Alzheimer’s disease (AD), independent of amyloid and tau pathology. We established an AD-related perfusion pattern (ADRP) measured with arterial spin labeling (ASL) MRI using multivariate spatial covariance analysis. Methods We obtained multimodal MRI including pseudo-continuous ASL and neurocognitive testing in a total of 55 patients with a diagnosis of mild to moderate AD supported by amyloid PET and 46 normal controls (NCs). An ADRP was established from an identification cohort of 32 patients with AD and 32 NCs using a multivariate analysis method based on scaled subprofile model/principal component analysis, and pattern expression in individual subjects was quantified for both the identification cohort and a validation cohort (23 patients with AD and 14 NCs). Subject expression score of the ADRP was then used to assess diagnostic accuracy and cognitive correlations in AD patients and compared with global and regional cerebral blood flow (CBF) in specific areas identified from voxel-based univariate analysis. Results The ADRP featured negative loading in the bilateral middle and posterior cingulate and precuneus, inferior parietal lobule, and frontal areas, and positive loading in the right cerebellum and bilateral basal areas. Subject expression score of the ADRP was significantly elevated in AD patients compared with NCs (P

Abstract Aim The transjugular intrahepatic portosystemic shunt (TIPS) procedure has been performed in China for 30 years, but our understanding of the status and difficulties associated with the use of TIPS for portal hypertension is incomplete. This study aims to investigate the current situation of the use of TIPS for portal hypertension, which should aid the development of TIPS in China. Methods This study involved a questionnaire survey, initiated by the China Portal Hypertension Alliance (CHESS) to investigate the use of TIPS for portal hypertension in China. Questionnaires were released on the Internet between August 16, 2022 and September 16, 2022. Detailed information was collected from 545 hospitals contracted by the CHESS in China, which performed TIPS surgery in 2021. Results The 545 hospitals covers the majority of hospitals in China that conduct TIPS intervention. In the survey, a total of 13,527 TIPS interventions were carried out with 94.1% (498/545) of them had a system of routine follow‐up after TIPS. The majority (42.6% [232/545]) believed that the main indication of TIPS was the control of acute bleeding. Overall, 48.1% (262/545) carried out early or pre‐emptive TIPS, 53.0% (289/545) carried out TIPS for cavernous transformation of the portal vein, and 81.0% (441/545) chose routine embolization of collateral circulation during operation. Most used coils (97.0% [475/490]) and biological glue (72.0% [353/490]) as embolic materials, and 78.5% (428/545) routinely performed intraoperative portal pressure gradient measurements. When selecting TIPS stents, 57.1% (311/545) chose viator‐specific stents, and 57.2% (312/545) chose conventional anticoagulation after TIPS. Conventional anticoagulation after TIPS is over a time interval of 3–6 months (55.4% [173/312]). The limitation of TIPS surgery is mainly its cost (72.3% [394/545]) and insufficient understanding of the procedure by doctors in other related departments (77.4% [422/545]). Most of the hospital teams accept the use of domestic instruments in TIPS surgery (92.7% [505/545]). Conclusions This survey shows that TIPS is an essential part of the treatment of portal hypertension in China. TIPS is widely used in Chinese patients with portal hypertension, and this survey presents a more comprehensive picture of the options and difficulties encountered in the implementation of TIPS. In the future, it is necessary to promote TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Abstract Background Brain metabolic alterations and neuroinflammation have been reported in several peripheral inflammatory conditions and present significant potential for targeting with new diagnostic approaches and treatments. However, non-invasive evaluation of these alterations remains a challenge. Methods Here, we studied the utility of a micro positron emission tomography (microPET) dual tracer ([11C]PBR28 – for microglial activation and [18F]FDG for energy metabolism) approach to assess brain dysfunction, including neuroinflammation in murine endotoxemia. MicroPET imaging data were subjected to advanced conjunction and individual analyses, followed by post-hoc analysis. Results There were significant increases in [11C]PBR28 and [18F]FDG uptake in the hippocampus of C57BL/6 J mice 6 h following LPS (2 mg/kg) intraperitoneal (i.p.) administration compared with saline administration. These results confirmed previous postmortem observations. In addition, patterns of significant simultaneous activation were demonstrated in the hippocampus, the thalamus, and the hypothalamus in parallel with other tracer-specific and region-specific alterations. These changes were observed in the presence of robust systemic inflammatory responses manifested by significantly increased serum cytokine levels. Conclusions Together, these findings demonstrate the applicability of [11C]PBR28 - [18F]FDG dual tracer microPET imaging for assessing neuroinflammation and brain metabolic alterations in conditions “classically” characterized by peripheral inflammatory and metabolic pathogenesis.

Bread was prepared using wheat flour with grape seed proanthocyanidin (GSP) (0.4%). GSP improved the textural properties of bread including hardness, cohesiviness, gumminess and chewiness. At the last stage of fermentation, GSP reinforced the gluten microstructure with increased the disulfide bonds and hydrophobic interaction and α-helix in the secondary structures. Moreover, GSP addition could increase the total phenolics and antioxidative acitivity of the bread significantly. In addition, the degree of fermentation had a strong influence on the dough forces, and the reasonable control of bread fermentation time was beneficial to improve the bread quality, which provided a reference for the bread processing industry.

Abstract Brain stimulation technology has become a viable modality of reversible interventions in the effective treatment of many neurological and psychiatric disorders. It is aimed to restore brain dysfunction by the targeted delivery of specific electronic signal within or outside the brain to modulate neural activity on local and circuit levels. Development of therapeutic approaches with brain stimulation goes in tandem with the use of neuroimaging methodology in every step of the way. Indeed, multimodality neuroimaging tools have played important roles in target identification, neurosurgical planning, placement of stimulators and post-operative confirmation. They have also been indispensable in pre-treatment screen to identify potential responders and in post-treatment to assess the modulation of brain circuitry in relation to clinical outcome measures. Studies in patients to date have elucidated novel neurobiological mechanisms underlying the neuropathogenesis, action of stimulations, brain responses and therapeutic efficacy. In this article, we review some applications of deep brain stimulation for the treatment of several diseases in the field of neurology and psychiatry. We highlight how the synergistic combination of brain stimulation and neuroimaging technology is posed to accelerate the development of symptomatic therapies and bring revolutionary advances in the domain of bioelectronic medicine.

Abstract Background Alcohol abuse affects the brain regions responsible for memory, coordination and emotional processing. Binge alcohol drinking has shown reductions in brain activity, but the molecular targets have not been completely elucidated. We hypothesized that brain cells respond to excessive alcohol by releasing a novel inflammatory mediator, called cold inducible RNA-binding protein (CIRP), which is critical for the decreased brain metabolic activity and impaired cognition. Methods Male wild type (WT) mice and mice deficient in CIRP (CIRP−/−) were studied before and after exposure to binge alcohol level by assessment of relative brain glucose metabolism with fluorodeoxyglucose (18FDG) and positron emission tomography (PET). Mice were also examined for object-place memory (OPM) and open field (OF) tasks. Results Statistical Parametric Analysis (SPM) of 18FDG-PET uptake revealed marked decreases in relative glucose metabolism in distinct brain regions of WT mice after binge alcohol. Regional analysis (post hoc) revealed that while activity in the temporal (secondary visual) and limbic (entorhinal/perirhinal) cortices was decreased in WT mice, relative glucose metabolic activity was less suppressed in the CIRP−/− mice. Group and condition interaction analysis revealed differing responses in relative glucose metabolism (decrease in WT mice but increase in CIRP−/− mice) after alcohol in brain regions including the hippocampus and the cortical amygdala where the percent changes in metabolic activity correlated with changes in object discrimination performance. Behaviorally, alcohol-treated WT mice were impaired in exploring a repositioned object in the OPM task, and were more anxious in the OF task, whereas CIRP−/− mice were not impaired in these tasks. Conclusion CIRP released from brain cells could be responsible for regional brain metabolic hypoactivity leading to cognitive impairment under binge alcohol conditions.

In order to improve the properties of wood flour (WF)/poly(lactic acid) (PLA) 3D-printed composites, WF was treated with a silane coupling agent (KH550) and acetic anhydride (Ac2O), respectively. The effects of WF modification and the addition of acrylicester resin (ACR) as a toughening agent on the flowability of WF/PLA composite filament and the mechanical, thermal, dynamic mechanical thermal and water absorption properties of fused deposition modeling (FDM) 3D-printed WF/PLA specimens were investigated. The results indicated that the melt index (MI) of the specimens decreased after WF pretreatment or the addition of ACR, while the die swell ratio increased; KH550-modified WF/PLA had greater tensile strength, tensile modulus and impact strength, while Ac2O-modified WF/PLA had greater tensile modulus, flexural strength, flexural modulus and impact strength than unmodified WF/PLA; after the addition of ACR, all the strengths and moduli of WF/PLA could be improved; after WF pretreatment or the addition of ACR, the thermal decomposition temperature, storage modulus and glass transition temperature of WF/PLA were all increased, and water absorption was reduced.

In order to relieve the stress caused by the surge of flight flow, Closely Spaced Parallel Runways (CSPRs) have been built in many hub airports, and a paired approach mode has been applied to CSPRs in some countries. This paper proposes a method for optimizing the wake separation between aircrafts which utilizes a paired approach, aiming at reducing longitudinal separation by using computational fluid dynamics technology. Firstly, the model of the wake vortex field of the paired lead aircraft is constructed. Secondly, the numerical simulation preparation for the characteristics of the wake vortex field is completed through the computational pretreatment of the model. Thirdly, a calculation model of wake safety interval based on paired approach operation is established. Finally, the proposed method shows its superiority comparing with other methods. This method realized visual analysis of wake vortex through optimization modeling based on computational fluid dynamics, contributing to increasing the capacity of the runway and improving the operation efficiency of an aerodrome.

The aim of this study is to explore functional and structural properties of abnormal brain networks associated with Parkinson’s disease (PD). 18F-Fluorodeoxyglucose positron emission tomography (18F-FDG PET) and T1-weighted magnetic resonance imaging from 20 patients with moderate-stage PD and 20 age-matched healthy controls were acquired to identify disease-related patterns in functional and structural networks. Dual-modal images from another prospective subject of 15 PD patients were used as the validation group. Scaled Subprofile Modeling based on principal component analysis method was applied to determine disease-related patterns in both modalities, and brain connectome analysis based on graph theory was applied to verify these patterns. The results showed that the expressions of the metabolic and structural patterns in PD patients were significantly higher than healthy controls (PD1-HC, p = 0.0039, p = 0.0058; PD2-HC, p < 0.001, p = 0.044). The metabolic pattern was characterized by relative increased metabolic activity in pallidothalamic, pons, putamen, and cerebellum, associated with metabolic decreased in parietal–occipital areas. The structural pattern was characterized by relative decreased gray matter (GM) volume in pons, transverse temporal gyrus, left cuneus, right superior occipital gyrus, and right superior parietal lobule, associated with preservation in GM volume in pallidum and putamen. In addition, both patterns were verified in the connectome analysis. The findings suggest that significant overlaps between metabolic and structural patterns provide new evidence for elucidating the neuropathological mechanisms of PD.

Abstract Introduction The heterogeneity of behavioral variant frontotemporal dementia (bvFTD) calls for multivariate imaging biomarkers. Methods We studied a total of 148 dementia patients from the Feinstein Institute (Center‐A: 25 bvFTD and 10 Alzheimer's disease), Technical University of Munich (Center‐B: 44 bvFTD and 29 FTD language variants), and Alzheimer's Disease Neuroimaging Initiative (40 Alzheimer's disease subjects). To identify the covariance pattern of bvFTD (behavioral variant frontotemporal dementia–related pattern [bFDRP]), we applied principal component analysis to combined 18F‐fluorodeoxyglucose–positron emission tomography scans from bvFTD and healthy subjects. The phenotypic specificity and clinical correlates of bFDRP expression were assessed in independent testing sets. Results The bFDRP was identified in Center‐A data (24.1% of subject × voxel variance; P

Purpose: Multiple system atrophy (MSA) is an atypical parkinsonian syndrome and often difficult to discriminate clinically from progressive supranuclear palsy (PSP) and Parkinson's disease (PD) in early stages. Although a characteristic metabolic brain network has been reported for MSA, it is unknown whether this network can provide a clinically useful biomarker in different centers. This study was aimed to identify and cross-validate MSA-related brain network and assess its ability for differential diagnosis and clinical correlations in Chinese and American patient cohorts. Methods: We included 18F-FDG PET scans retrospectively from 128 clinically diagnosed parkinsonian patients (34 MSA, 34 PSP and 60 PD) and 40 normal subjects in China and in the USA. Using PET images from 20 moderate-stage MSA patients of parkinsonian subtype and 20 normal subjects in both centers, we reproduced MSA-related pattern (MSAPRP) of spatial covariance and estimated its reliability. MSAPRP scores were evaluated in assessing differential diagnosis among moderate- and early-stage MSA, PSP or PD patients and clinical correlations with disease severity. Regional metabolic differences were detected using statistical parameter mapping analysis. MSA-related network and regional topographies of metabolic abnormality were cross-validated between the Chinese and American cohorts. Results: We generated a highly reliable MSAPRP characterized by decreased loading in inferior frontal cortex, striatum and cerebellum, and increased loading in sensorimotor, parietal and occipital cortices. MSAPRP scores discriminated between normal, MSA, PSP and PD subjects and correlated with standardized ratings of clinical stages and motor symptoms in MSA. High similarities in MSAPRPs, network scores and corresponding maps of metabolic abnormality were observed between two different cohorts. Conclusion: We have demonstrated reproducible metabolic topographies associated with MSA at both network and regional levels in two independent patient cohorts. Moreover, MSAPRP scores are sensitive for evaluating disease discrimination and clinical correlates. This study supports differential diagnosis of MSA regardless of different patient populations, PET scanners and imaging protocols.

Parkinson’s disease (PD) is a highly heterogeneous clinical entity. Patients with young-onset PD (YOPD) show some characteristic manifestations to late-onset PD (LOPD). The current study aimed to investigate the cerebral dopaminergic and metabolic characteristics in YOPD with positron emission tomography (PET) imaging. In our study, 103 subjects (42 YOPD and 61 LOPD patients) accepted both 11 C-N-2-carbomethoxy-3-(4-fluorophenyl)-tropane ( 11 C-CFT) and 18 F-fluorodeoxyglucose ( 18 F-FDG) cerebral PET imaging. Sixty-two patients out of 103 patients in our study completed the cognition tests. In this limited subsection, YOPD patients performed better in cognitive functioning than LOPD patients of similar disease duration. In 11 C-CFT imaging, dopamine transporter binding in caudate was relatively spared in YOPD compared with lesions in putamen. In 18 F-FDG PET, YOPD patients showed increased metabolism in basal ganglia relative to the healthy controls. When compared with LOPD patients, YOPD patients exhibited hypermetabolism in caudate and hypometabolism in putamen. Furthermore, the regional metabolic values in caudate correlated positively and moderately with the dopaminergic binding deficiency in caudate. The findings of this imaging study might offer new perspectives in understanding the characteristic manifestations in YOPD in light of better-preserved cognition function.

Aim: To analyze age-related cerebral blood flow (CBF) using arterial spin labeling (ASL) MRI in healthy subjects with multivariate principal component analysis (PCA).Methods: 50 healthy subjects (mean age 45.8 ± 18.5 years, range 21–85) had 3D structural MRI and pseudo-continuous ASL MRI at resting state. The relationship between CBF and age was examined with voxel-based univariate analysis using multiple regression and two-sample t-test (median age 41.8 years as a cut-off). An age-related CBF pattern was identified using multivariate PCA.Results: Age correlated negatively with CBF especially anteriorly and in the cerebellum. After adjusting by global value, CBF was relatively decreased with aging in certain regions and relatively increased in others. The age-related CBF pattern showed relative reductions in frontal and parietal areas and cerebellum, and covarying increases in temporal and occipital areas. Subject scores of this pattern correlated negatively with age (R2 = 0.588; P < 0.001) and discriminated between the older and younger subgroups (P < 0.001).Conclusion: A distinct age-related CBF pattern can be identified with multivariate PCA using ASL MRI.

Scaled Subprofile Model of Principal Component Analysis (SSM-PCA) is a multivariate statistical method and has been widely used in Positron Emission Tomography (PET). Recently, SSM-PCA has been applied to discriminate patients with Parkinson's disease and healthy controls with Amplitude of Low Frequency Fluctuation (ALFF) from Resting-State Functional Magnetic Resonance Imaging (RS-fMRI). As RS-fMRI scans are more readily available than PET scans, it is important to investigate the intra- and inter-scanner reliability of SSM-PCA in RS-fMRI. A RS-fMRI dataset with Eyes Open (EO) and Eyes Closed (EC) conditions was obtained in 21 healthy subjects (21.8 ± 1.8 years old, 11 females) on 3 visits (V1, V2, and V3), with V1 and V2 (mean interval of 14 days apart) on one scanner and V3 (about 8 months from V2) on a different scanner. To simulate between-group analysis in conventional SSM-PCA studies, 21 subjects were randomly divided into two groups, i.e., EC-EO group (EC ALFF map minus EO ALFF map, n = 11) and EO-EC group (n = 10). A series of covariance patterns and their expressions were derived for each visit. Only the expression of the first pattern showed significant differences between the two groups for all the visits (p = 0.012, 0.0044, and 0.00062 for V1, V2, and V3, respectively). This pattern, referred to as EOEC-pattern, mainly involved the sensorimotor cortex, superior temporal gyrus, frontal pole, and visual cortex. EOEC-pattern's expression showed fair intra-scanner reliability (ICC = 0.49) and good inter-scanner reliability (ICC = 0.65 for V1 vs. V2 and ICC = 0.66 for V2 vs. V3). While the EOEC-pattern was similar with the pattern of conventional unpaired T-test map, the two patterns also showed method-specific regions, indicating that SSM-PCA and conventional T-test are complementary for neuroimaging studies.

Quasicrystal-strengthened Mg-Zn-RE (RE = rare-earth element) alloys have been investigated extensively due to their excellent mechanical properties. Here, we prepare quasicrystal-strengthened Mg-7.2Zn-2.4Gd (wt.%) alloy with different concentrations of Ca addition (0, 0.16, 0.32, and 0.64 wt.%) by traditional gravity casting, followed by extrusion at 573 K with the extrusion ratio of 9 : 1. The microstructure and room temperature tensile properties of as-cast and as-extruded alloys are characterized. With the addition of the trace amount of Ca, the I-phase tends to transfer into W-phase due to the appearance of Mg2Ca and Mg6Zn3Ca2. As a consequence, the mechanical properties of the as-cast Ca containing alloys are downgraded. After extrusion, in comparison to the as-cast alloys, microstructure of the four types of alloys is refined and mechanical property is enhanced greatly. With the increasing of Ca concentration, the grain size is decreased gradually. However, the yield strength of the alloys is decreased to about 230 MPa and then up to 269 MPa, while the elongation increases first from 12.9% to 13.6% yet then decreases to 9.9%.

We report magnetic properties and microstructure of high energy-product MnBi bulk magnets fabricated by low-temperature ball-milling and warm compaction technique. A maximum energy product (BH)max of 8.4 MGOe and a coercivity of 6.2 kOe were obtained in the bulk MnBi magnet at room temperature. Magnetic characterization at elevated temperatures showed an increase in coercivity to 16.2 kOe while (BH)max value decreased to 6.8 MGOe at 400 K. Microstructure characterization revealed that the bulk magnets consist of oriented uniform nanoscale grains with average size about 50 nm.

D-arginine oligomers have been widely used as intracellular delivery vectors both in in vitro and in vivo application. Nevertheless, their internalization pathway is obscure and conflicting results have been obtained concerning their intracellular distribution. In this study, we demonstrate that octa-D-arginine (r8) undergoes diffuse localization throughout the cytoplasm and nucleus even at low concentrations and that r8 (r: D-arginine) enters the cells via direct membrane translocation, unlike R8 (R: L-arginine), of which endocytosis is the major internalization pathway. The observation that R8 and r8 enter the cells through two clearly distinct internalization pathways suggests that the backbone stereochemistry affects the uptake mechanism of oligoarginines.

Multivariate analytical routines have become increasingly popular in the study of cerebral function in health and in disease states. Spatial covariance analysis of functional neuroimaging data has been used to identify and validate characteristic topographies associated with specific brain disorders. Voxel-wise correlations can be used to assess similarities and differences that exist between covariance topographies. While the magnitude of the resulting topographical correlations is critical, statistical significance can be difficult to determine in the setting of large data vectors (comprised of over 100,000 voxel weights) and substantial autocorrelation effects. Here, we propose a novel method to determine the p-value of such correlations using pseudo-random network simulations.

BACKGROUND:Baculoviral inhibitor of apoptosis repeat-containing 5 (BIRC5, also called as survivin) is a member of the inhibitor of apoptosis protein (IAP) family, which plays an important role in the occurrence and progression of cancer. Recently, a polymorphism in the promoter of BIRC5, -31C/G (rs9904341), was shown to influence BIRC5 expression. METHODS:We examined whether the -31C/G was related to the risk of developing nasopharyngeal carcinoma (NPC) in a case-control population from Guangxi province in southern China, which consists of 855 patients with NPC and 1036 controls. This polymorphism was genotyped by TaqMan assay. The genetic associations with the occurrence and progression of NPC were estimated by logistic regression. RESULTS:We observed a statistically significant increased occurrence of NPC associated with the CC genotype (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.13-1.73; P=0.0020) compared with the genotypes containing G allele (CG + GG genotype). However, no significant association was observed for the -31C/G with the severity of NPC (as measured by tumor-node-metastasis staging system). CONCLUSION:Our findings suggest that the functional polymorphism -31C/G in the promoter of BIRC5 gene may play a role in mediating the susceptibility to NPC among Chinese.

Non-small cell lung cancer (NSCLC) is still the disease with the highest incidence rate among malignant tumors, in which NSCLC under N2 stage has obvious survival differences among different patients due to its high heterogeneity. For NSCLC under this stage, the current treatment options are: preoperative neoadjuvant therapy, surgical treatment, postoperative adjuvant chemotherapy, postoperative adjuvant radiotherapy (PORT), Postoperative adjuvant targeted therapy and postoperative adjuvant immunotherapy. Whether postoperative adjuvant radiotherapy is routinely administered to patients with pN2 remains controversial in clinical application. Meanwhile, the booming development of adjuvant targeted therapy and adjuvant immunotherapy also provides newer therapeutic options for the prognosis of postoperative pN2 stage NSCLC, and some new markers will guide the adaptive application of immune drugs in the future. This article analyzes the current stage of therapeutic advances in operable stage N2 non-small cell lung cancer, and discusses in detail in this article the therapeutic controversy of postoperative adjuvant radiotherapy in pN2 stage non-small cell lung cancer, so as to explore a more reasonable treatment mode for future patients with stage N2 non-small cell lung cancer.