Objective The aim of this study was to investigate whether downregulation of FK506 binding protein 4(FKBP4)could inhibit the malignant progression of non-small cell lung cancer(NSCLC)by blocking the PI3K/Akt/mTOR signaling pathway.Methods NSCLC A549,H1975,H358 and PC-9 cell lines,as well as human bronchial epithelial cells(HBE)were routinely cul-tured.The expression of FKBP4 in these cells was detected by qRT-PCR,and NSCLC cell lines with the most significant different ex-pression of FKBP4 compared with HBE cells was screened.FKBP4 siRNA and NC siRNA were transfected into A549 cells,which were divided into the si-FKBP4 group and NC group.CCK-8 assay was used to detect the proliferative ability of si-FKBP4 group and NC group,flow cytometry was used to detect the apoptosis rate,scratch healing assay was used to detect the migration ability,Transwell assay was used to detect the invasion ability,and Western blot was used to detect the total and phosphorylation protein expression of PI3K and its downstream effectors Akt and mTOR.Results The expression of FKBP4 in A549 cells,H1975 cells,H358 cells and PC-9 cells were significantly higher than those in HBE cells(P<0.05),and its expression in A549 cells was the highest(P<0.001).Downregulation of FKBP4 could inhibit the proliferation,invasion and migration of A549 cells and promote the apoptosis of A549 cells(P<0.001).In addition,downregulation of FKBP4 also could inhibit the phosphorylation of PI3K,Akt and mTOR,resulting in bloc-king the PI3K/Akt/mTOR signaling pathway.Conclusion Downregulation of FKBP4 can inhibit the proliferation,invasion and mi-gration of NSCLC cells by blocking the PI3K/Akt/mTOR signaling pathway,and promote the apoptosis of NSCLC cells.

Objective The aim of this study was to investigate whether downregulation of FK506 binding protein 4(FKBP4)could inhibit the malignant progression of non-small cell lung cancer(NSCLC)by blocking the PI3K/Akt/mTOR signaling pathway.Methods NSCLC A549,H1975,H358 and PC-9 cell lines,as well as human bronchial epithelial cells(HBE)were routinely cul-tured.The expression of FKBP4 in these cells was detected by qRT-PCR,and NSCLC cell lines with the most significant different ex-pression of FKBP4 compared with HBE cells was screened.FKBP4 siRNA and NC siRNA were transfected into A549 cells,which were divided into the si-FKBP4 group and NC group.CCK-8 assay was used to detect the proliferative ability of si-FKBP4 group and NC group,flow cytometry was used to detect the apoptosis rate,scratch healing assay was used to detect the migration ability,Transwell assay was used to detect the invasion ability,and Western blot was used to detect the total and phosphorylation protein expression of PI3K and its downstream effectors Akt and mTOR.Results The expression of FKBP4 in A549 cells,H1975 cells,H358 cells and PC-9 cells were significantly higher than those in HBE cells(P<0.05),and its expression in A549 cells was the highest(P<0.001).Downregulation of FKBP4 could inhibit the proliferation,invasion and migration of A549 cells and promote the apoptosis of A549 cells(P<0.001).In addition,downregulation of FKBP4 also could inhibit the phosphorylation of PI3K,Akt and mTOR,resulting in bloc-king the PI3K/Akt/mTOR signaling pathway.Conclusion Downregulation of FKBP4 can inhibit the proliferation,invasion and mi-gration of NSCLC cells by blocking the PI3K/Akt/mTOR signaling pathway,and promote the apoptosis of NSCLC cells.

Objective:To evaluate changes in operational effectiveness after the implementation of ambulatory surgical management in pars plana vitrectomy (PPV).Methods:A retrospective clinical study. 17 528 surgeries in 10 895 eyes of 10 895 patients who underwent minimally invasive PPV on an ambulatory and/or inpatient basis at Tianjin Medical University Eye Hospital from August 2015 to June 2023 were included in this study. Among them, 5 346 eyes in 5 346 cases were male; 5 549 eyes in 5 549 cases were female. The age ranged from 0 to 95 years, with the mean age of (57.74±13.15) years. 6 381 surgeries in 3 615 eyes from August 2015 to December 2018 (the initial period of day surgery) were used as the control group; 11 147 surgeries in 7 280 eyes from January 2019 to June 2023 (the expanded period of day surgery) were used as the observation group. According to the management mode of ambulatory surgery, the observation group was subdivided into the decentralized management group (January 2019 to December 2020) and the centralized management group (January 2021 to June 2023), with 2 905 and 4 375 eyes and 4 646 and 6 501 surgeries, respectively. Changes in the percentage of day surgery, average hospitalization days, and average unplanned reoperation rate were compared. The Mann-Whitney U test was used to compare numerical variables between groups; the chi-square test or Fisher's exact test was used to compare categorical variables. Results:The number of cases of daytime PPV performed in the observation group and control group was 7 852 (70.44%, 7 852/11 147) and 24 (0.38%, 24/6 381) cases, respectively, and the average hospitalization days were 1 (1) and 5 (3) d. Compared with the control group, the observation group had a significantly higher percentage of day surgery ( χ2=8 051.01) and a considerably lower mean hospitalization day ( Z=4 536 844.50), and the differences were statistically significant ( P<0.000 1). The mean hospitalization days in the decentralized and centralized management groups were 2 (3) and 1 (0) d, respectively, and unplanned reoperations were 34 (0.73%, 34/4 646) and 171 (2.63%, 171/6 501) eyes, respectively. Compared with the decentralized management group, average hospitalization days was significantly lower ( Z=1 436.94) and unplanned reoperation rate was significantly higher ( χ2=54.10) were significantly lower in the centralized management group, both of which were statistically significant ( P<0.000 1). Conclusion:PPV ambulatory management model can significantly reduce the average hospitalization day, but also results in higher rates of unplanned reoperations.

Objective:To construct model of risk factors for follicular thyroid carcinoma.Methods:Clinical, ultrasound, and pathological data of 196 patients with single thyroid follicular neoplasm who underwent initial surgical treatment at the First Affiliated Hospital of Nanjing Medical University from Apr 2018 to Oct 2023 were collected as a training cohort. The clinical, ultrasound, and pathological data of 48 patients with the same condition at the Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine were used as a validation cohort.Results:Among the training cohort, 63 cases (32.1%) were diagnosed with follicular thyroid carcinoma. Univariate analysis showed that patients with higher preoperative thyroglobulin levels [390.1(106.7-500.0)ng/ml vs. 42.6(27.7-139.2)ng/ml, Z=-5.612, P<0.001], solid internal structure on ultrasound (81.0% vs. 54.1%, χ2=13.154, P<0.001), low internal echogenicity (68.3% vs.15.0%, χ2=55.507, P<0.001), irregular tumor morphology (39.7% vs.3.0%, χ2=45.612, P<0.001), uneven tumor margins (20.6% vs. 1.5%, χ2=19.515, P<0.001), internal tumor calcification (52.4% vs.16.5%, χ2=27.201, P<0.001), absence of acoustic halo or the acoustic halo is uneven in thickness (85.7% vs. 24.8%, χ2=64.235, P<0.001), and uneven echogenicity of solid tumor portions (74.6% vs. 19.5%, χ2=55.437, P<0.001) were characteristics of follicular thyroid carcinoma. Multivariate logistic analysis demonstrated that preoperative serum thyroglobulin levels ( OR=1.001, 95% CI: 1.000-1.002, P=0.046), solid internal echogenicity of the tumor ( OR=4.967, 95% CI: 1.602-15.405, P=0.006), tumor with calcification ( OR=4.238,95% CI:1.550-11.588, P=0.005), absence of halo around the tumor ( OR=4.225,95% CI:1.353-13.192, P=0.013), uneven thickness of the halo ( OR=21.240, 95% CI: 3.242-139.160, P=0.001), and uneven echogenicity of solid tumor portions ( OR=4.580, 95% CI: 1.678-12.505, P=0.003) were independent risk factors for follicular thyroid carcinoma . A nomogram model was constructed based on these variables, and the ROC curve showed AUC values of 0.931. Conclusion:Higher preoperative serum thyroglobulin levels, solid internal echogenicity of the tumor, tumor with calcification, absence of halo around the tumor, uneven thickness of the halo, and uneven echogenicity of solid tumor portions are independent risk factors for follicular thyroid carcinoma.

Objective:To construct model of risk factors for follicular thyroid carcinoma.Methods:Clinical, ultrasound, and pathological data of 196 patients with single thyroid follicular neoplasm who underwent initial surgical treatment at the First Affiliated Hospital of Nanjing Medical University from Apr 2018 to Oct 2023 were collected as a training cohort. The clinical, ultrasound, and pathological data of 48 patients with the same condition at the Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine were used as a validation cohort.Results:Among the training cohort, 63 cases (32.1%) were diagnosed with follicular thyroid carcinoma. Univariate analysis showed that patients with higher preoperative thyroglobulin levels [390.1(106.7-500.0)ng/ml vs. 42.6(27.7-139.2)ng/ml, Z=-5.612, P<0.001], solid internal structure on ultrasound (81.0% vs. 54.1%, χ2=13.154, P<0.001), low internal echogenicity (68.3% vs.15.0%, χ2=55.507, P<0.001), irregular tumor morphology (39.7% vs.3.0%, χ2=45.612, P<0.001), uneven tumor margins (20.6% vs. 1.5%, χ2=19.515, P<0.001), internal tumor calcification (52.4% vs.16.5%, χ2=27.201, P<0.001), absence of acoustic halo or the acoustic halo is uneven in thickness (85.7% vs. 24.8%, χ2=64.235, P<0.001), and uneven echogenicity of solid tumor portions (74.6% vs. 19.5%, χ2=55.437, P<0.001) were characteristics of follicular thyroid carcinoma. Multivariate logistic analysis demonstrated that preoperative serum thyroglobulin levels ( OR=1.001, 95% CI: 1.000-1.002, P=0.046), solid internal echogenicity of the tumor ( OR=4.967, 95% CI: 1.602-15.405, P=0.006), tumor with calcification ( OR=4.238,95% CI:1.550-11.588, P=0.005), absence of halo around the tumor ( OR=4.225,95% CI:1.353-13.192, P=0.013), uneven thickness of the halo ( OR=21.240, 95% CI: 3.242-139.160, P=0.001), and uneven echogenicity of solid tumor portions ( OR=4.580, 95% CI: 1.678-12.505, P=0.003) were independent risk factors for follicular thyroid carcinoma . A nomogram model was constructed based on these variables, and the ROC curve showed AUC values of 0.931. Conclusion:Higher preoperative serum thyroglobulin levels, solid internal echogenicity of the tumor, tumor with calcification, absence of halo around the tumor, uneven thickness of the halo, and uneven echogenicity of solid tumor portions are independent risk factors for follicular thyroid carcinoma.

Objective:To investigate the prevalence and risk factors of tessellation fundus (TF) among Tianjin Medical University students with different refractive statuses.Methods:A cross-sectional study. From September to December 2019, 346 students from Tianjin Medical University were randomly selected and underwent slit-lamp examination, non-cycloplegic auto-refraction, subjective refraction, best-corrected visual acuity, ocular biometric measurement, and non-dilation fundus photography. The differences in the prevalence of TF in basic characteristics and ocular biometric parameters were compared. Based on the equivalent spherical (SE), refractive status was divided into the non-myopia group (SE>-0.50 D) and the myopia group (SE≤-0.50 D). The myopia group was further divided into mild myopia group (-3.00 D26 mm group. The logistic regression was used to analyze the risk factors affecting TF. Trend tests were performed for each risk factor and TF.Results:Of the 346 subjects, 324 (93.6%, 324/346) were myopia, of whom 73 (21.1%, 73/346), 167 (48.3%, 167/346), and 84 (24.3%, 84/346) were mild myopia, moderate myopia, and high myopia, respectively; 22 (6.4%, 22/346) were non-myopia. There were 294 (85.0%, 294/346) students with TF in the macula, including 9 (40.91%, 9/22), 58 (79.45%, 58/73), 145 (86.83%, 145/167), and 82 (97.62%, 82/84) in non-myopia, low myopia, moderate myopia, and high myopia group, respectively; 52 (15.0%, 52/346) students were without TF in the macula. There were statistically significant gender differences ( χ2=4.47), SE ( t=6.29), AL ( t=-8.29), anterior chamber depth ( Z=-2.62), lens thickness ( Z=-2.23), and average corneal radius ( Z=-3.58) between students with and without TF in the macula ( P<0.05). Spherical equivalent and axial length were independent risk factors for TF and its severity ( P≤0.001). With an increasing degree of myopia, and increasing axial length, the risk of TF increased ( P for trend<0.001). Conclusions:The prevalence of TF is 85.0% among Tianjin Medical University students. TF is detected in the fundus of no myopia, mild myopia, moderate myopia and high myopia. The degree of myopia is higher, the AL is longer, the possibility of TF is higher.

Shennongjia is well known as the national treasure of traditional Chinese medicine resources at home and abroad. In order to provide Shennongjia with better protection of traditional Chinese medicine and promote the sustainable utilization of its resources, based on the specific analysis of She nnongj ia′s conservation status and
available resources, we put forward primary strategies and specific measures for the sustainable utilization framework of Shennongjia traditional Chinese medicine resources, in view of resources conservation, development, utilization, as well as the resources administration.

Objective To survey the prevalence, distribution of non-motor symptoms (NMS) in essential tremor (ET) and the relationship with disease severity and duration.Methods Fahn-Tolosa-Matin Tremor Rating Scale (TRS) was used to assess motor symptoms in 62 patients with ET.The Parkinson's disease (PD) NMS Questionnaire and T&T olfacmeter and Mini-mental State Examination (MMSE) were used to explore non-motor symptoms in ET patients.Results In ET, a range of NMS occurred across all disease stages.More than half patients (51.6%, 32/62) had olfactory dysfunction,significantly higher than the healthy control group (30.0%, 18/60, x~2=12.371, P<0.05).A third had hyposmia.16.1% had partial olfactory loss.Each ET patient had 5 different NMS on average.Seven NMS were more common in ET patients than in control, including remembering, olfactory dysfunction, intense vivid dreams, anhedonia, depression, anxiety, sleep disorders.The incidences of remembering, olfactory dysfunction,intense vivid dreams were 58.1% (36/62),51.6% (32/62),48.4% (30/62), ranked top 3 in ET patients.Olfaction had inverse correlation with age, while there was a negative correlation between NMS score and TRS score, gender, disease duration and weather to be treated.Conclusion Besides posture tremor and kinetic tremor,NMS occur in ET,and should be well recognized and treated.

Objective To study the incidence of depression in essential tremor (ET) and associated factors. Methods Depression in 62 ET patients and 60 healthy subjects as control was evaluated by means of Hamilton Depression Scale ( HAMD ) , as well as Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and Pittsburgh Sleep Quality Index (PSQI). Results Fifty-three point two percent(33/62) of ET patients and 11.7% (7/60) of healthy subjects were found to have at least mildly depression (HAMD score of 8 or higher), 35. 5% (22/62) of ET patients and 8. 3% (5/60) of healthy subjects fell into the mildly-to-mederately depression (HAMD score between 8 and 20 ), 17.7% (11/62) of ET patients and 3.3% (2/60) of healthy subjects were classified into moderately-to-severely depressed range (HAMD score between 21 and 35). There were statistical differences in ET group and healthy subjects group (X2= 23.898, 13.043, 6.649, all P <0.01). Additionally, there were statistical differences in anxiety/ somatization (t=-6.747, P<0.01), cognitive impairment (t=-2.017, P=0.05), block(t= -4.145, P<0.01), sleep disorders (t=-4.500, P<0.01) and despair (t=-3.591, P<0.01) between depression group and non-depression group. There were marked differences in PSQI total score ( t =-3.196, P=0.003 ), subjective sleep ( F1, t=-3.037, P=0.004), quality sleep latency (F2, t= -4.674, P<0.01) and sleep disturbances (F5, t=-2.594, P=0.013 ) between depression disorder group and non-depression disorder group. Meanwhile, the score of TRS, PSQI and sex were closely correlated with HAMD (β=0.589, P=0.000 ;β=0.469,P=0.000 ;β=0.256, P=0.027 ). Conclusions The incidence of depression is high in ET. Manifestation of depression are anxiety, reduced interest in work, sleep disorders, retardneas, inferiority complex, etc. The degree of symptoms relates to the severity of ET, sleep quality and gender.