Non-small cell lung cancer ( NSCLC ) is one of the most prevalent and deadly malignant tumors in the world. In recent years, artificial intelligence (AI) in computed tomography (CT) has harnessed the power of big data to automatically extract and learn imaging features, thereby assisting radiologists in reducing the workload and missed diagnosis rate of pulmonary nodules. An ELISA kit for detecting seven lung cancer autoantibodies (p53, SOX2, PGP9.5, CAGE, MAGE-A1, GAGE7, and GBU4-5) has been clinically implemented in China, showing high specificity in the early screening of NSCLC. Additionally, other liquid biopsy techniques such as circulating tumor DNA (ctDNA) methylation markers are also continually being explored. However, existing methods for the early diagnosis of lung cancer all have their limitations, and optimizing their combination or establishing diagnostic models has become a trend. This review summarizes the research progress and value of the seven lung cancer autoantibodies and CT AI in the early diagnosis of NSCLC, with the aim of providing a reference for their combined use in the early diagnosis of lung cancer in Chinese population.

Objective To analyze the prevalence, disease burden, and trends of diabetes in China from 1999 to 2019, providing reference for diabetes prevention and control as well as health resource allocation to alleviate the disease burden. Methods Data on the disease burden of diabetes in China from 1999 to 2019 were collected from the Global Burden of Disease (GBD) 2019 database. Indicators such as incidence rate, prevalence rate, mortality rate, disability-adjusted life years (DALYs), years of life lost due to premature mortality (YLLs) and years lived with disability (YLDs) were used to analyze the diabetes burden in China by gender, age and year. The estimated annual percentage change (EAPC) was used to measure the temporal trend of standardized rates over a specified period, and the rank sum test was used to assess the gender differences in disease burden. Results In 2019, 3.78×10⁶ cases of diabetes and 1.73×10⁵ deaths were reported in China. Compared with 1999, the standardized rates of incidence and prevalence increased by 5.80% and 17.12%, respectively, while the standardized mortality rate decreased by 2.82%. Compared with 1999, the standardized rates of DALYs and YLDs increased by 2.86% and 16.06%, respectively, while the standardized YLL rate decreased by 14.39%. The EAPC for diabetes incidence, prevalence, YLDs, and DALYs in the 20-40 age group all exceed 0, indicating an annually upward trend in disease burden of diabetes. Additionally, the disease burden in males was significantly higher than that in females (P<0.05), and the gap is continuously widening. Conclusions The disease burden of diabetes in China is severe, particularly in term of life loss due to disability. The population with diabetes onset is becoming increasingly younger. Males constitute a high-risk population for diabetes-related morbidity and mortality. Diabetes prevention and control efforts should continue to enhance behavioral interventions, appropriately tilt health resource allocation towards high-risk population, and focus on improving the rehabilitation capabilities and promoting rehabilitation technology at grass-roots unit.

Objective To explore the efficacy and safety of modified meibomian gland massage combined with ultrasonic atomization and drug therapy for dry eye in high-altitude military personnel. Methods A total of 180 patients (360 eyes) with dry eye who were diagnosed and treated by the medical team of General Hospital of Central Theater Command of Chinese PLA from July to October 2022 in Linzhi, Tibet (average altitude of 3100 meters) were selected as the research subjects. Patients were divided into four block groups based on the course of the disease: <1 month, 1-3 months, 3-6 months, and ≥6 months, and each block group was randomly assigned to control group, traditional group and modified group by random number table method, with 60 cases in each group. Control group received routine treatment (artificial tear drops and atomization fumigation); on the basis of routine treatment, traditional group underwent traditional meibomian gland massage, and modified group underwent modified meibomian gland massage. After 3 months of treatment, the scores of symptoms and signs, total effective rate, duration of treatment and incidence of adverse events were compared among the 3 groups. Results In the intra-group comparison before and after treatment, except for control group's symptom scores difference which was not statistically significant (P>0.05), all other scores decreased significantly (P<0.05). In the inter-group comparison after treatment, the scores of both traditional group and modified group were significantly better than those of control group (P<0.05), but no significant difference was observed in symptom and sign scores between traditional and modified groups (P>0.05). Compared with control group, the total effective rates of traditional group and modified group both significantly increased (P<0.01), but there was no significant difference in total effective rate between traditional and modified groups (P>0.05). The treatment time in modified group was significantly longer than that in control group (P<0.05), but significantly shorter than that in traditional group (P<0.05). The incidence of adverse events was significantly lower in modified group than that in traditional group (P<0.001). Conclusion In high-altitude areas, modified meibomian gland massage combined with ultrasonic atomization and local drug therapy for dry eye is safe and effective, non-invasiveness and easy to perform, and suitable for promoting and application in military field training.

As a novel tumor treatment, photodynamic therapy (PDT) has been widely used in clinical treatment of a variety of tumors due to its advantages, such as fewer adverse reactions, precise targeting and repeatability of treatment. Unlike conventional treatments, such as surgery, chemotherapy and radiotherapy, PDT not only eliminates the primary tumor but also effectively inhibits metastatic tumors by activating the body's immune response. However, the PDT-activated immune response is influenced by multiple factors, including the localization and dose of photosensitizer in the cells, light parameters, oxygen concentration in the tumor, and the integrity of immune function. This review summarizes the mechanisms behind the PDT-activated anti-tumor immune response, systematically examines the key influencing factors on the immune effect of PDT, and discusses the future development direction of PDT in cancer treatment.

Objective To investigate the effect of vascular endothelial growth factor (VEGF) on the expression of genes related to ovarian steroid synthesis in mice and its underlying mechanism. Methods A transgenic mouse model with tetracycline -reversible regulation of VEGF expression was used, and the genotype of mice was identified by polymerase chain reaction (PCR). Twenty mice were divided into normal VEGF expression group (Dox⁺, n=10) and VEGF expression inhibition group (Dox^-, n=10) by feeding them doxycycline. Western blotting was used to detect the expression of VEGF protein in ovarian tissues. Fluorescence quantitative PCR was used to detect the mRNA expression of VEGF, KDR and genes known to play roles in follicle development, such as follicle-stimulating hormone (FSH) and inhibin B (INHBB). HE staining was used to observe changes in ovarian tissue. Total RNA was extracted from mouse ovarian tissues for transcriptome sequencing, and the relevant differential genes were analyzed by FPKM and log₂FC values. Results Compared with the Dox⁺ group, the mRNA and protein levels of VEGF in the Dox^- group significantly reduced, and the mRNA levels of KDR also significantly decreased (P<0.05). HE staining results showed that compared with the Dox⁺ group, follicular development was impaired and atresia follicles appeared in the Dox^- group. Sequencing analysis identified that significant differences in follicular development-related genes and steroid synthesis-related genes between the two groups (P<0.05). Enrichment analysis showed that VEGF in mouse ovaries mainly regulates ovarian steroidogenesis and other pathways. Fluorescence quantitative PCR results demonstrated that compared with the Dox⁺ group, the follicular development-related genes (INHBB and FSHR) in the ovarian tissues of the Dox^- group were significantly up-regulated (P<0.05), whereas the key genes of steroid synthesis (StAR, CYP11A1, 3β-HSD) were significantly down-regulated (P<0.05).The quantitative results were basically consistent with the sequencing results. Conclusion Mice with inhibited VEGF exhibited ovarian follicular dysplasia, potentially due to the mechanism whereby VEGF inhibition downregulated the expression of genes associated with steroid synthesis, such as FSH and INHBB, thereby obstructing cholesterol metabolism.

Objective To explore the application effect of opioid-free postoperative patient-controlled analgesia strategy in thoracic endoscopic resection of lung lesions. Methods This study is a single center, double-blind, prospective, open label, randomized controlled trial. Ninety patients with lung surgery under thoracic endoscope in the Second Affiliated Hospital of Chongqing Medical University were selected from November 2021 to April 2023, and divided into three groups, according to the random number table method including esketamine and dexmedetomidine (esKDex group, n=30), sufentanil and dexmedetomidine (sFDex group, n=30) and tramadol and dexmedetomidine (TraDex group, n=30). The incidence of postoperative nausea and vomiting (PONV), vital signs related indicators, visual analogue scale (VAS) score, Ramsay sedation (RSS) score, Bruggrmann comfort scale (BCS) score and mini-mental state examination (MMSE) score were compared among the 3 groups within 48 hours after surgery. Results Within 48 h after surgery, the incidence of PONV in esKDex group was lower than that in sFDex group and TraDex group [10.0%(3/30) vs. 20.0%(6/30) vs. 20.0%(6/30), P<0.001]. The VAS scores in esKDex group and sFDex group at 2 h and 4 h after surgery were lower than those in TraDex group (2 h after surgery: P=0.001, 0.001; 4 h after surgery: P=0.027, 0.024). The VAS scores at 24 h and 48 h after surgery were higher than those in TraDex group (24 h after surgery: P=0.008, 0.029; 48 h after surgery: P=0.005, 0.005). The BCS scores of esKDex group and sFDex group at 24 h and 48 h after surgery were lower than those in TraDex group (24 h after surgery: P=0.017, 0.007; 48 h after surgery: P=0.005, 0.007). There was no significant difference between Ramsay scores and MMSE scores among the three groups within 48 h after surgery (P>0.05). Conclusion The strategy of opioid-free postoperative patient-controlled analgesia (esketamine and dexmedetomidine) can reduce the incidence of PONV under the premise of satisfying the sedation and analgesia of patients after thoracic endoscopic surgery.

Objective To investigate the causal relationship between obstructive sleep apnea (OSA) and hypertension using bidirectional Mendelian randomization (MR). Methods Genetic data for OSA were obtained from the Genome-wide association study (GWAS) of FinnGen Biobank, including 16 761 cases and 201 194 controls, from which 5 single-nucleotide polymorphisms (SNPs) were screened as instrumental variables (IVs) for OSA. Genetic data for hypertension were obtained from GWAS of UK Biobank, including 124 227 cases and 337 653 controls from which 214 SNPs were selected as IVs for hypertension. Multiple MR methods, mainly Inverse variance weighted (IVW), were used for analysis. Sensitivity analysis of MR results was performed using MR-Egger regression et al, and IVs were evaluated using F values. Results OSA was associated with an increased risk of hypertension (OR=1.053, 95%CI 1.019-1.089, P<0.01), and hypertension was significantly associated with the risk of developing OSA (OR=1.812, 95%CI 1.354-2.425, P<0.001). Heterogeneity was observed in both two-way outcomes (OSA→ hypertension, P<0.001; hypertension→ OSA, P<0.001), but no evidence of horizontal pleiotropy was detected (OSA→ hypertension, P=0.666; hypertension→ OSA, P=0.556). The IVs selected in this study were strong instrumental variables for both OSA and hypertension (OSA-IVs F=14.695; hypertension-IVs F=39.624). Conclusions Our findings indicate a bidirectional causal relationship between OSA and hypertension, with a particularly significant effect of hypertension on the development of OSA.

Objective To investigate the effect of varying blood pressure stratification on renal function in the diabetic population. Methods A prospective cohort study was conducted, enrolling 9 489 diabetic patients from a total of 101 510 Kailuan Group employees who underwent health examinations between July 2006 and October 2007. The follow-up period was (8.6±4.0) years. Participants were categorized into four groups based on their baseline blood pressure levels: normal blood pressure (systolic blood pressure <120 mmHg and diastolic blood pressure <80 mmHg), elevated blood pressure (systolic blood pressure 120-130 mmHg and diastolic blood pressure <80 mmHg), stage 1 hypertension (systolic blood pressure 130-140 mmHg and/or diastolic blood pressure 80-90 mmHg), and stage 2 hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg). The incidence density of chronic kidney disease (CKD) was compared among these groups. A multivariate Cox proportional hazards regression model was employed to assess the effects of different blood pressure levels on renal function in diabetic patients, with the stability of the results confirmed using a multivariate time-dependent Cox proportional hazards model. Sensitivity analysis was conducted after excluding cases of cardiovascular disease (CVD) during follow-up, and cases using antihypertensive and antidiabetic medications at baseline. Results (1) At baseline, stage 1 hypertension patients demonstrated statistically significant higher differences with age and body mass index (BMI) compared to normal blood pressure group (P<0.05). (2) By the end of the follow-up, 2 294 cases of CKD were identified, including 1 117 cases of estimated glomerular filtration rate (eGFR) decline and 1 575 cases of urinary protein. The incidences density of CKD, eGFR decline and urinary protein for stage 1 hypertension group were 39.4, 16.3 and 25.5 per thousand person-years, respectively, all of which were statistically significant different from normal blood pressure group (log-rank test, P<0.01). (3) Multivariate Cox regression analysis revealed that, compared to the normal blood pressure group, stage 1 hypertension was associated with a 29% increased risk of CKD (HR=1.29, 95%CI 1.09-1.52) and a 40% increased risk of eGFR decline (HR=1.40, 95%CI 1.08-1.80) in diabetic individuals. Conclusion Stage 1 hypertension significantly increases the risk of CKD and eGFR decline in diabetic individuals, with a particularly notable effect on the risk of eGFR decline.

Objective To explore the effects of 1α,25-dihydroxyvitamin D₃ on airway inflammation in asthmatic mice and the potential mechanisms. Methods Twenty-four female BALB/c mice in SPF grade were randomly divided into three groups (n=8): control group, asthma group, and asthma+VD₃ group. On the 1st, 8th, and 15th day, asthma group and asthma+VD₃ group were given 0.2 ml ovalbumin (OVA) suspension for sensitization, while control group received 0.2 ml normal saline. On the 22-28th day, asthma group and asthma+VD₃ group were challenged with 1% OVA atomization inhalation, while control group received an equal amount of normal saline atomization, for 30 minutes each time, once a day, for a continuous 7 days. Asthma+VD₃ group was given intraperitoneal injection of 1α,25-dihydroxyvitamin D₃ injection (4 μg/kg) 30 minutes before each atomization, while control group and asthma group were given an equal dose of normal saline. After the last challenge, all mice were anesthetized, and serum, bronchoalveolar lavage fluid (BALF) and lung tissue samples were collected. HE staining and Periodic Acid Schiff (PAS) staining were used to observe the pathological changes in lung tissue and changes in airway mucus levels. ELISA was employed to detect serum IgE and inflammatory cytokines IL-4, IL-5 and IL-13 in BALF. Immunohistochemical technique and Western blotting were used to detect the expressions of SIRT1 and GATA-3 in mouse lung tissue. Results Compared with control group, asthma group had a significant increase in inflammatory cell infiltration around lung tissue, bronchia and accompanying perivascular, mainly characterized by eosinophils. Bronchial lumen stenosis, airway mucosal epithelial hyperplasia, and increased tracheal mucus secretion were also observed. The above changes in asthma+VD₃ group were reduced compared with asthma group. Compared with control group, serum levels of IgE, and IL-4, IL-5, IL-13 inflammatory factors in BALF and GATA-3 in lung tissue were increased in asthma group (P<0.05), and SIRT1 level in lung tissue was significant decreased (P<0.05). Compared with asthma group, IgE level in serum, inflammatory factors of IL-4, IL-5 and IL-13 in BALF, and GATA-3 in lung tissue in asthma+VD₃ group were decreased (P<0.05), and SIRT1 level in lung tissue was increased (P<0.05). Correlation analysis showed that the expression level of lung tissue SIRT1 was negatively correlated with the expression of GATA-3, serum IgG, and the levels of IL-4, IL-5, and IL-13 in BALF (P<0.05); the expression level of lung tissue GATA-3 was positively correlated with serum IgG and the levels of IL-4, IL-5, and IL-13 in BALF (P<0.05). Conclusion 1α,25-dihydroxyvitamin D₃ can alleviate airway inflammation in asthmatic mice, possibly by upregulating the expression of SIRT1 in lung tissue and inhibiting the expression of GATA-3, thereby inhibiting inflammatory factors (IL-4, IL-5, IL-13).

Objective To investigate the mechanism of nootkatone (NKT) in mitigating depression-like behavior caused by blast traumatic brain injury (TBI). Methods The rat bTBI depression-like model was established by simulating the shock wave parameters of blast overpressure (BOP of 60 kPa, 90 kPa, and 120 kPa) with a biological shock wave tube. After 14 days of exposure, we evaluated the depression-like behavior of rats using the tail suspension test and forced swimming test. We identified that the BOP (120 kPa) condition caused the most noticeable depressive behavior and used this condition for subsequent experiments. Thirty male SD rats were randomly divided into sham operation group, bTBI group (BOP of 120 kPa), and bTBI+NKT group [at 1 d after exposure to BOP of 120 kPa, giving NKT 10 mg/(kg·d) orally for 14 days], 10 in each group. After 14 days of exposure, the depression-like behavior of rats was evaluated by tail suspension test and forced swimming test. The expression levels of protein kinase A (PKA), phosphorylated cyclic adenosine monophosphate effector binding protein (pCREB), and brain-derived neurotrophic factor (BDNF) in the hippocampus of rat were determined by Western blotting. Immunohistochemistry was used to detect the generation of proliferating cell nuclear antigen (PCNA)-labeled neurons in the hippocampal dentate gyrus (DG). Results BOP of 90 kPa can cause depression-like in rats and BOP of 120 kPa can cause the most noticeable depressive behavior (P<0.05). Therefore, we selected the BOP exposure of 120 kPa for subsequent experiments. After 14 days of BOP exposure, compared with sham operation group, the immobility time of tad suspension test in bTBI group was prolonged (P<0.05), the latency of for ced swimming test was shortened, the immobility time was prolonged (P<0.05), the expression levels of PKA, pCREB and BDNF protein in hippocampus were lowered (P<0.05), and the number of PCNA-labeled neurons in hippocampal DG area was reduced (P<0.05); compared with the bTBI group, the immobility time of tail suspension test in bTBI+NKT group was shortened (P<0.05), the latency of forced swimming test was prolonged, the immobility time was shortened (P<0.05), the expression levels of PKA, pCREB and BDNF protein in hippocampus were increased (P<0.05), and the number of PCNA-labeled neurons in hippocampal DG area was increased (P<0.05). Conclusions Early treatment with NKT can improve depression-like behavior in mild bTBI rats. The mechanism may be related to the up-regulation of the PKA-CREB-BDNF signaling pathway and increased expression levels of pCREB and BDNF in the hippocampus, which results in increased neuron numbers in the DG region of the hippocampus.