Objective To investigate the differences in physical fitness and physiological indexes of male soldiers stationed at different altitudes and to analyze the determinants of physical fitness of these soldiers. Methods A total of 13 648 male soldiers at different altitudes were included, whose results of annual military physical assessment and physiological indexes in 2023 were collected and comparatively analyzed. Results The 3000-meter running performance, 30-meter × 2 serpentine running performance and resting blood oxygen saturation of high-altitude soldiers gradually declined with the increase of altitudes. The pull-up performance dropped significantly when the altitude >2000 m. Soldiers ≥30 years old demonstrated a marked decline in physical fitness across different training programs. Moderate altitude acclimatization was conduciveto the recovery of physical fitness of soldiers,while exposure to high-altitude environment ≥5 years led to overall deterioration. Conclusion The high-altitude environment significantly impacts the aerobic endurance, speed, agility, and strength of soldiers. Altitude ≥4000 m, age ≥30 years, and prolonged exposure ≥5 years may contribute to the decline in physical fitness of soldiers.

Objective To establish a stable in vitro model of CD8⁺ T cell exhaustion. Methods CD8⁺ T cells were isolated and purified from the spleens of ovalbumin-specific CD8⁺ T cell receptor （OT-I） transgenic mice and subjected to chronic antigen stimulation to induce exhaustion in vitro. Flow cytometry was employed to evaluate the expressions of exhaustion markers, secretion of effector cytokines, and transcription factor profiles in CD8⁺ T cells. Exhausted and effector （non-exhausted） CD8⁺ T cells were co-cultured with tumor cells before tumor cell viability was measured to assess the cytotoxic potential of CD8⁺ T cells. Additionally, N-acetyl-L-cysteine （N-AC） was used as a positive control during exhaustion induction to validate the model. Results Chronic stimulation resulted in a significant upregulation of inhibitory receptors, including programmed cell death protein 1 （PD-1）, T cell immunoglobulin and mucin domain-containing protein 3 （TIM-3）, T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motifdomain （TIGIT）, and lymphocyte activation gene 3 （LAG-3）. Concurrently, the secretion of key effector cytokines such as tumor necrosis factor-α （TNF-α） and interferon-γ （IFN-γ） was markedly reduced. Exhausted CD8⁺ T cells exhibited diminished cytotoxicity against tumor cells compared to effector CD8⁺ T cells. Notably, treatment with N-AC effectively restored the function of exhausted CD8⁺ T cells and enhanced their anti-tumor activity. Conclusion This study has established an effective in vitro model for CD8⁺ T cell exhaustion. The use of N-AC demonstrates its potential to restore functionality in exhausted CD8⁺ T cells, underscoring the reliability and utility of this model for investigating the anti-tumor potential of exhausted T cells.

Objective To establish a simulated model that can optimize strategies for medical evacuation in case of mass casualties,and to study the guidelines for centralized scheduling of evacuation vehicles. Methods A simulated model was constructed based on theories about discrete event simulation and on processes of medical evacuation. Evacuation processes under different scheduling strategies were simulated and quantitatively evaluated in terms of efficiency of evacuation and utilization of resources.The impact of key parameters on the medical evacuation system was analyzed. Results When the critically wounded were given priority,the rate of immediate treatment for the wounded was the highest（87.44%）,and the median waiting time for the wounded was 23.70 min. In terms of utilization of resources,the strategy of prioritizing the critically wounded delivered the best result,with an average of 2.94 persons evacuated per vehicle and an overall rate of vehicle utilization was 50.93%. The daily number of the wounded and the number of evacuation vehicles made a big difference in the performance of the rescue system. Command and scheduling had to be dynamically optimizedas required so as to strike a balance between the efficiency of treatment and utilizationof resources. Conclusion This simulated model for medical evacuation in case of mass casualties,which is based on theories about discrete event simulation,is flexible enough toback up the simulation of strategy optimization.

α 2-Macroglobulin （A2M） is a high-abundance plasma protein with a molecular weight of 720× 10³, containing 1451 residues and 11 domains, and was isolated and identified for the first time in 1946. The capture and inhibitory effect on proteases is the classical biological function of A2M. However, A2M can also interact with membrane receptors, cytokines, and growth factors, and act as a molecular chaperone to affect extracellular protein homeostasis so that it is involved in a wide range of physiological and pathological processes such as immunity, inflammation, and degeneration. This article reviews the structural characteristics of A2M, the reported molecular targets, the mechanism of action, and its biological effects in the hope of providing a new line of thought for the functional exploration and clinical applications of A2M.

Metabolic reprogramming in the tumor microenvironment is closely associated with tumor initiation and progression. Endogenous metabolites can not only regulate tumor formation and metastasis, but also impair antitumor immune efficacy by influencing immune cells. However, current research focuses on the effects of single metabolites on tumors rather than take into account the systemic nature of metabolic networks, the diversity of metabolic products, and their dynamic regulatory roles in the tumor immune microenvironment. An in-depth analysis of the key nodes in metabolic pathways related to endogenous metabolites and their regulatory mechanisms in tumor progression is crucial to the development of antitumor therapies based on metabolic intervention. This paper provides an overview of the molecular mechanisms by which endogenous metabolites, such as amino acids, lipids and nucleotides, contribute to tumor progression and regulate the immune microenvironment. By offering new theoretical insights into the complex network of the metabolism-immune axis in tumor development, this review aims to provide data for the development of metabolism-targeted antitumor immunotherapy strategies.

Objective To investigate the age-dependent modulatory effects of treadmill exercise on spatial learning and memory in mice and to elucidate the potential neurobiological mechanisms underlying these effects. Methods Male C57BL/6J mice at three distinct developmental stages were subjected to a controlled treadmill training protocol for a duration of four weeks. Cognitive performance was assessed in terms of spatial learning and memoryusing a series of behavioral tests. To examine exercise-induced neurogenesis,proliferating adult neural stem cells in the hippocampal region were labeled via intraperitoneal administration of BrdU. Meanwhile,physiological parameters,including body and muscle weight,were monitored throughout the experiment. Results The study revealed significant age-specific effects of treadmill training. In one-month-old mice,exercise intervention markedly enhanced spatial learning and memory,along with increased proliferation of hippocampal neural stem cells,but no significant alterations were observed in body or muscle weight. In six-month-old mice,treadmill training selectively improved spatial memory and led to increased muscle weight. Notably,three-month-old mice exhibited no significant exercise-induced changes in cognitive performance,hippocampal neurogenesis,or muscle weight. Conclusion These findings demonstrate that treadmill exercise exerts significant,age-dependent regulatory effects on spatial learning and memory,with the most pronounced and comprehensive improvements observed in one-month-old mice. The cognitive enhancements may be mediated,at least partially,through exercise-induced promotion of hippocampal neurogenesis. This study provides data for elucidation of the mechanistic basis of exercise-mediated cognitive enhancement and contributes to the potential applications of exercise interventions in cognitive optimization and neuroplasticity across different developmental stages.

Objective To identify potential drug target genes associated with idiopathic pulmonary fibrosis （IPF） and predict therapeutic candidates using a two-sample Mendelian randomization （MR） approach across the druggable genome. Methods Druggable genome data from the DGIdb database and Finan were integrated to identify overlapping genes. A two-sample MR analysis was performed to infer causal relationships between genes and IPF. Functional enrichment analyses,including Gene Ontology （GO） and Kyoto encyclopedia of genes and genomes （KEGG）,were conducted to explore biological pathways. Drug-target interactions were predicted via DSigDB database screening,followed by molecular docking simulations to evaluate binding affinities. Results Among the 2588 overlapping druggable genes,thirty exhibited significant causal associations with IPF （P< 0.05）. Four hub genes （NOD2,LATS2,LTA,and TCF7L2） were enriched in IPF-related pathways,notably Hippo and TNF signaling. Six potential therapeutics were identified： oxyphenbutazone,moexipril,α-galactosylceramide,GSK429286A,CGP74514A,and JW-7-24-1. Molecular docking confirmed strong binding affinities between these drugs and their targets. Conclusion This study has identified thirty druggable gene targets and six candidate drugs for IPF. The enrichment of hub genes in key pathways and validated drug-target interactions provide insights into IPF therapies.;

High intensity ultraviolet radiation exists in special military operation environments such as oceans, plateaus, polar regions and deserts, which is a leading contributor to eye damage and can lead to luminous keratitis, dry eyes, pterygium, cataract and macular degeneration. Ultraviolet radiation can cause acute and chronic injury to eyes by inducing DNA damage, oxidative stress and inflammatory reaction. The commonly used clinical drugs have played a role in relieving symptoms and promoting the repair of ocular tissues, but there are still limitations. The research on targeted therapeutic drugs, proteins and their derived peptides, vitamins and their coenzymes, as well as natural active ingredients of animals and plants has provided new ideas for the development of more effective drugs that can protect eyes from ultraviolet and for medical support to China’s army in special environments. Based on the literature currently available, this paper reviews the eye injury caused by ultraviolet radiation and therapeutic drugs in terms of types of eye diseases, injury mechanisms, treatment strategies and drug development.

Objective To explore the role of Schlafen4 （SLFN4） in acute pneumonia induced by hypervirulent Klebsiella pneumoniae （hvKp） via intratracheal aerosolization. Methods Differential expression gene Slfn4 was identified after infection with hvKp based on RNA sequencing （RNA-seq） and single-cell RNA sequencing （scRNA-seq） data before Slfn4^-/- mice were obtained via CRISPR/Cas gene editing technology. Slfn4^-/- mice and wild mice were challenged via intratracheal aerosolization. Mortality and weight changes were recorded for 14 d, while pathological changes and expression levels of interleukin-6 （IL-6）, IL-17A, IL-1β, and tumor necrosis factor-α （TNF-α） were detected at 48 h post-infection. Results SLFN4 expression was significantly increased in wild mice after infection with hvKp. Survival was significantly increased, and weight loss was mitigated before gradual recovery in Slfn4^-/- mice after infection. The knockout of SLFN4 attenuated alveolar wall thickening, diminished neutrophil infiltration, and suppressed pro-inflammatory cytokine production （IL-6, IL-17A, IL-1β, TNF-α） in the lung at 48 h post-infection. Conclusion The deletion of SLFN4 may suppress the expression of specific pro-inflammatory cytokines and attenuate neutrophil over-recruitment in the lung, thereby alleviating pneumonia in mice after hvKp infection.

In the Ukraine crisis since 2022, the Russian army has adopted a wide range of strategies for medical support as required by the battlefield, including adjusting the ways of medical evacuation, increasing the number of medical institutions and personnel, optimizing the mechanism for medical supplies, improving rehabilitation and sanatorium facilities, enhancing military medical education and training, developing new health care equipment and field rescue techniques. This paper analyzes the characteristics and effects of these new strategies implemented by the Russian army.

Objective To efficiently produce Clostridium perfringens alpha toxin （CPA） by using a prokaryotic expression system and systematically analyze its biological activity. Methods The CPA gene fragment fused with His-Tag sequence was cloned into a prokaryotic expression vector pTIG-Trx and transformed into E. coli TransB （DE3）. The IPTG was used to induce the expression of the target protein,and the protein was obtained by using Ni-column affinity purification. The cytotoxic effect of recombinant CPA protein on 293T,LS174T and SW480 cells,hemolytic effect on human and mouse red blood cells,and lethal effect on mice were further evaluated. Results The recombinant CPA protein with a relative molecular weight of about 45×103 and a purity of more than 90% was successfully obtained. It had significant toxicity to 293T,LS174T and SW480 cells and induced hemolytic reactions in human and mouse red blood cells at specific concentrations. Low dose of CPA protein could cause rapid death in mice in a short time. Conclusion This study successfully obtained the high purity CPA protein with good biological activity in vitro and in vivo,which laid a foundation for further study of the pathogenic mechanism of CPA and its potential application.

Pyroptosis is a programmed cell death accompanied by cell swelling, nuclear condensation, membrane rupture, and the release of intracellular inflammatory factors. Pyroptosis is closely related to the occurrence and development of multiple organ and system diseases, and can trigger a cascade of inflammatory responses. Studies have demonstrated that effective components of traditional Chinese medicine （TCM） exhibit significant effects on modulating pyroptosis and the subsequent inflammatory responses. Here we review the research progress in studies on how TCM effective components improve diseases via pyroptosis in order to provide data for the development of new TCMs.

Pain management is an important component of military medical support during wartime.Early pain management for wounded soldiers can effectively alleviate pain, which is critical to maintaining combat effectiveness, promoting physiological and psychological recovery of wounded soldiers, preventing chronic pain, and helping them return to the battle field. In recent years, the U.S. Armed Forces have increasingly emphasized prehospital pain management. They have been updating the relevant pain management guidelines to establish a practical system in order to ensure that the pain of wounded soldiers is effectively controlled. This paper reviews the current research on prehospital pain management in the U.S. Armed Forces and summarizes the advanced and practical technologies for prehospital pain management. It provides references for research on prehospital pain management,and optimization of prehospital pain management strategies suited to China’s operational context, and for the design of related training programs.;

Objective To investigate the clinical efficacy and safety of Quhan Tongluo Formula in treating knee osteoarthritis（KOA） of cold-dampness obstruction pattern. Methods A retrospective study was conducted on 231 patients with KOA of cold-dampness obstruction pattern admitted to Dongfang Hospital,Beijing University of Chinese Medicine from December 2022 to December 2023. The patients were divided into an exposed group （105 cases） and a non-exposed group （126 cases） based on whether Quhan Tongluo Formula was applied. The exposed group received Quhan Tongluo Formula combined with celecoxib,while the non-exposed group received only celecoxib. Using propensity score matching based on the baseline data of the medical records,76 pairs （a total of 152 cases） were matched. The changes in Visual Analog Scale （VAS） scores,Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） total scores,and traditional Chinese medicine （TCM） syndrome scores before treatment and at 2,4,and 6 weeks after treatment were compared between the two groups,and safety was evaluated. Results Before treatment,there were no significant differences in VAS scores or WOMAC pain scores between the two groups. After treatment,both groups exhibited significant reductions in VAS scores and WOMAC pain scores,with the exposed group demonstrating significantly greater reductions compared to the non-exposed group （P< 0.01）. The total clinical effective rate was significantly higher in the exposed group than in the non-exposed group （P< 0.01）. Conclusion The clinical application of Quhan Tongluo Formula combined with celecoxib demonstrated superior efficacy over celecoxib monotherapy in treating knee osteoarthritis of cold-dampness obstruction pattern. The combined regimen significantly reduced VAS scores,total WOMAC scores,and TCM syndrome scores,with marked improvements in long-term efficacy.

Objective To investigate the effects of music therapy on cognitive function and immunity of sleep-deprived mice and the potential underlying mechanisms. Methods A novel music therapy was developed by integrating elements from both Western and Chinese music. A sleep-deprived mouse model was established to explore the effects of the music combination on learning and memory of mice using Morris water maze experiments. ELISA was used to detect immune-endocrine indicators in the blood and saliva of mice and to study the effects of this music combination on IgA levels.Transcriptome high-throughput sequencing and B-cell receptor （BCR） repertoire sequencing were adopted to explore the potential mechanisms through which music therapy influenced IgA production. Results The Morris water maze test revealed that the novel music therapy could promote the recovery of cognition and memory of sleep-deprived mice. Additionally, it was found that the music combination could increase IgA levels in both blood and saliva. Transcriptome high-throughput sequencing and BCR sequencing analysis showed that the music combination enhanced the abundance of the IgA immunoglobulin light chain variable region （Igkv4-53） and heavy chain constant region （Igha）. Conclusion Music therapy can help restore cognitive function and increase IgA levels in sleep-deprived mice. The mechanism may be related to the enhanced abundance of immunoglobulin light chain variable region （Igkv4-53） and heavy chain constant region （Igha）.

With the growing complexity and higher risk of modern warfare, artificial intelligence （AI） technologies have been increasingly used in the field of military medicine. This study investigates the innovative applications of AI in military medicine, focusing on practices in such countries as the United States, Israel and the United Kingdom. The research reveals that AI technologies have been extensively applied in battlefield medical training, casualty status monitoring, medical decision support and unmanned rescue operations. Through virtual reality simulation, intelligent decision support and vital sign monitoring technologies, AI has significantly improved the efficiency and precision of battlefield medical care. Despite challenges related to technological implementation, environmental adaptability and ethical controversies, future battlefield medical care will increasingly rely on unmanned systems and intelligent equipment to deliver efficient medical treatment through human-machine collaboration.

High partial pressure oxygen is widely used in the treatment of ischemic and hypoxic diseases and in diving. However, chronic inhalation of gas with high oxygen partial pressure can have a toxic effect on the body, that is, oxygen toxicity. The lung is one of the target organs where injury is the most pronounced and direct after exposure to high partial pressure oxygen. This article reviews the research progress in pathogenesis and diagnosis of pulmonary oxygen toxicity in the hope of providing a reference for related prevention and treatment.

Objective To investigate mutations in OTU domain-containing protein 3（OTUD3） and their functional mechanisms in the initiation and progression of colorectal cancer（CRC）. Methods Gene expression profiling interactive analysis （GEPIA2） and the human protein atlas database （THPA） were used to analyze gene transcription and protein expressions. Samples from 32 patients with CRC were collected to identify OTUD3 mutants. Based on the information about mutation sitesof OTUD3 in an existing database, a plasmid vector containing the OTUD3 gene mutant was constructed. Plasmid vectors containing the phosphatase and tensin homolog deleted on chromosome 10 （PTEN） and the OTUD3 gene mutant were co-transfected into HCT116 cells. Western blotting, half-life, immunoprecipitation, ubiquitination, and hybrid algorithm molecular docking （H-DOCK） assays were employed to find out whether and why the OTUD3 mutants affected PTEN protein levels.Functional alterations in CRC cells after OTUD3 mutation were verified by CCK-8 cell proliferation, transwell cell invasion, scratch, and clonal formation assays. Results OTUD3 mutations were highly frequent in CRC. OTUD3 mutants R178W and N321S resulted in the loss of function of the stable PTEN protein, leading to enhanced proliferation, invasion, migration, and survival of CRC. Conclusion In CRC, OTUD3 mutation reduces the ability to stabilize PTEN and promotes the occurrence and development of CRC.

At present, global health governance is entering a new reforming stage on its rules. The adoption of Amendments to the International Health Regulations（2005） at the 77th World Health Assembly in 2024 and the adoption of the WHO Pandemic Agreement at the 78th World Health Assembly in 2025 have become important interim achievements of this round of reform. Developed countries have always played a dominant role in rule-making in global health governance. In this round of reform, competition between developed and developing countries is becoming increasingly fierce, and developing countries including China are faced with significant challenges in playing their due roles in global health governance system. The key issues under dispute lie in genetic sequence data sharing, medical products availability, and international cooperation in core capacity building. United with other developing countries, China should make more constructive suggestions on advocating “conditional” sharing of genetic sequence date, promoting benefit-sharing obligations to be more substantive, and enhancing core capacity building of developing countries in the following reform process, promoting the construction of a human health community through practical actions.

Objective To establish models for real-time dynamic monitoring of intracellular cytoplasmic adenosine triphosphate （ATP） and mitochondrial ATP levels in cells in order to study the changes in metabolic processes. Methods The lentiviral plasmids of the cytoplasmic chemogenetic green fluorescent protein （GFP）ATP probe （Chemo-G）and those of the mitochondrial-localized chemogenetic GFP ATP probe （mito-Chemo-G） were constructed before being transfected into HEK293T together with the helper plasmids, respectively. Chemo-G and mito-Chemo-G lentiviruses were obtained. HeLa cells were infected with the lentivirus. Puromycin resistance selection and flow cytometry cell sorting were employed to identify and isolate the infected HeLa cells. The growth and GFP expressions of HeLa cells were observed. A live-cell imaging system was used for continuous imaging of the cells, with stimuli added at specific time points to alter intracellular ATP levels to observe changes in the fluorescence intensity of the ATP probe. Results Lentiviral plasmids containing Chemo-G and mito-Chemo-G sequences were constructed. Two cell lines which could stably express Chemo-G and mito-Chemo-G were established that exhibited strong growth and accurate intracellular fluorescence localization. Live-cell imaging revealed that after the addition of 2-deoxy-D-glucose （2-DG） into HeLa-Chemo-G, the fluorescence resonance energy transfer （FRET）/GFP ratio showed a decrease that was partially reversed by the addition of glucose. The FRET/GFP ratio increased after histamine stimulation, but rapidly decreased after the addition of oligomycin. Conclusion The Chemo-G and mito-Chemo-G lentiviral vectors and stably transfected cell lines HeLa-Chemo-G and HeLa-mito-Chemo-G are constructed, which provides reliable experimental models for studying cellular metabolism and changes in intracellular ATP levels.

Transient receptor potential vanilloid 1 （TRPV1） ion channel, a non-selective cation channel, not only plays a key role in pain transmission but also serves as a bridge between the nervous system and immune system by regulating neuropeptide release, immune cell activation, and inflammatory signaling pathways. This article summarized its crucial role in inflammatory signal transduction, discussed the interaction mechanism between TRPV1 and the neuro-immune regulatory axis, and explored its potential as a therapeutic target for inflammatory diseases.

On plateaus,the low-oxygen and low-pressure environment is likely to lead to cognitive impairments,negatively impacting individuals newly exposed to high altitudes. This paper reviews how high-altitude environments impair cognitive functions and explores protective strategies in terms of oxygen-enriched and pressurization technologies,neuroregulation techniques,and approaches to endogenous protection. It is recommended that future research focus on personalized cognitive protection and training,the construction of integrated protection systems based on multi-technology convergence,and the investigation of long-term effectiveness and sustainability. These efforts are expected to result in more comprehensive strategies for cognitive protection and enhancement in high-altitude operations.

Objective To investigate the applicability of D-dimer levels combined with the Tei index in assessing the volume load in patients with acute decompensated heart failure （ADHF）. Methods Two hundred patients admitted to the Emergency Department of Taizhou TCM Hospital between 2022 and 2023 were selected as the subjects, who were divided into a low volume load group （n=121） and a high volume load group （n=79） based on plasma volume indices.The clinical indicators and parameters of cardiac function of these subjects were compared. Multivariate Logistic regression analysis was used for identification of potential risk factors for elevated volume loads.A model for prediction of elevated volume loads was developed via Chi-square automatic interaction detection, followed by internal validation via Bootstrapping. Logistic regression analysis was used to study the interactions between D-dimer levels and Tei indices in assessing the volume loads of patients with ADHF. Results Multivariate regression analysis showed that age, Tei index, D-dimer levels and B type natriuretic peptide（BNP） were risk factors for high volume loads in ADHF patients. The decision tree model established had 14 nodes and 8 terminal nodes. Four explanatory variables including age, Tei index, D-dimer levels and BNP were screened out. The area under curve（AUC）, sensitivity, specificity and prediction accuracy of the classification tree model were higher than those of the regression model. When D-dimer levels ≥1.16 and Tei index ≥0.65 interacted and co-existed, ADHF patients were at higher risk of developing high volume loads （OR=6.526, 95%CI： 2.439-7.183）. The results of restricted cubic spline analysis pointed to nonlinear dose response relationships in the correlation strength of D-dimer levels, Tei index and volume loads. Conclusion There are interactions between D-dimer levels and Tei index, and the risk of high volume loads in ADHF patients is significantly increased when D-dimer levels are 1.16 or above and Tei index is 0.65 or above.

Objective To explore the biological functions of pyroptosis-related genes in pneumonic plague using bioinformatics methods, and to evaluate their potential applicability as diagnostic markers. Methods The pneumonic plague-related dataset GSE220123 was retrieved from the Gene Expression Omnibus （GEO） database and screened for differentially expressed pyroptosis-related genes （DE-PRGs）. The functions of DE-PRGs were studied via Gene Ontology （GO）, Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses, and immune infiltration analysis. The hub genes were identified via protein-protein interaction （PPI） network analysis, and further screened for key genes with sustained high expression characteristics based on differential expression analysis.The relative expression levels of the key genes were verified using the reverse transcription real-time quantitative PCR （qPCR） method. Results A total of 17 DE-PRGs were screened, and PPI network analysis revealed 7 Hub genes. Among them, Casp4 continued to be up-regulated during the course of pneumonic plague. The results of reverse transcription qPCR were consistent with the those of bioinformatic analyses. Conclusion DE-PRGs play a crucial role in the immune response of pneumonic plague, especially Casp4, which has significant applications as a diagnostic biomarker and potential therapeutic target for pneumonic plague.

Objective To investigate the effect of T2-fluid attenuated inversion recovery（T2-FLAIR） sequence on the appearance of ivy sign in patients with moyamoya disease under different imaging conditions. Methods Coronal T2-FLAIR scans were performed in 51 consecutive adult patients with moyamoya disease who had not undergone surgery and had their first visit to this hospital between March and July of 2024. According to the scanning conditions, the patients were divided into 19 and 14 of the echo train length in two groups,and 103, 144, and 195 ms of the time of echo（TE） in three groups, respectively. The left and right cerebral hemispheres and whole brains were scored according to the cerebral vascular anatomy, and scores of the ivy sign of left and right cerebral hemispheres and whole brain were compared. Results There was no statistical significance in the ivy sign scores of right and left cerebral hemispheres and whole brain between the two groups with 19 and 14 of the echo train length （P>0.05）. Comparison of ivy sign scores in right and left cerebral hemispheres and whole brain was statistically significant among the three groups of TE at 144, 103 and 195 ms （P<0.05）. Conclusion The best appearance of ivy sign in patients with moyamoya disease is seen under the condition of TE at 195 ms,so appropriately extending the TE time is helpful for ivy sign display.

This paper provides a survey of the research progress in and applications of radio frequency identification（RFID） technology in the entire process management of blood supply. This paper makes an in-depth analysis of the scenarios and effectiveness of the technology,focusing on such key operational stagesas donor management, health screening, blood collection and testing, component preparation, storage and distribution, and patient transfusion. Based on a comprehensive evaluation of current achievements and bottlenecks, this study offers strategies for optimization of RFID technology in the management of blood supply and gives recommendations. The findings are intended to provide data for the establishment of an intelligent and traceable modern blood management system.

Objective To assess the comprehensive effects of transcranial direct current stimulation （tDCS） on physical fitness in healthy athletes and non-athletes. Methods Two researchers independently retrieved PubMed, Embase, Web of Science, Scopus, the Cochrane Library, CNKI, Wanfang, and VIP databases, and collected experimental literature on the effects of tDCS on physical fitness from the database establishment to March 6, 2025. Reviewer Manager 5.4 software and Stata 18.0 software were used for Meta-analysis. Results Data from 40 studies involving 778 subjects was included in the Meta-analysis that revealed that tDCS significantly improved the physical fitness of subjects （SMD=0.15）. Specifically, anodal tDCS targeting the M1 area （SMD=0.17）, at the current of 1.5 mA or 2 mA （SMD=0.64; SMD=0.13）, maintained for 20 minutes （SMD=0.19）, and with a 35 cm⊃2; electrode patch （SMD=0.31） resulted in significant improvements in maximum strength （SMD=0.32）, explosive force（SMD=0.27）, muscle endurance （SMD=0.40）, cardiopulmonary endurance （SMD=0.51）, and static balance （SMD=0.34） in athletes （SMD=0.25） and non-athletes alike （SMD=0.13）. However, there was no significant effect on the moving speed and dynamic balance. Conclusion tDCS can effectively improve maximum strength, explosive power, muscle endurance, cardiopulmonary endurance, and static balance in healthy athletes and non-athletes.

Objective To investigate the roles and mechanism of deoxycholic acid （DCA） in mediating the neuroinflammatory responses induced by hypobaric hypoxia. Methods C57BL/6J mice were randomly divided into thecontrol group （Con）, tauroursodeoxycholic acid （TUDCA） group, hypoxia group （Hyp） and hypoxia+TUDCA group （Hyp+TUDCA）. The mice were exposed in a hypoxic chamber for 48 h, which could mimic the high altitude environment. The levels of total bile acids （BA）, lithocholic acid （LCA） and deoxycholic acid （DCA） in the serum and colon of mice were detected using enzyme-linked immunosorbent assay （ELISA）, so were levels of DCA in the cortex, hippocampus and hypothalamus. The role of DCA in inducing neuroinflammation and IL-1β and TNF-α expressions was evaluated by knocking down the DCA receptor, farnesoid X receptor （FXR） in the N9 microglial cells and by administrating TUDCA to mice followed by hypoxia exposure. Real-time quantitative PCR （qPCR） and immunofluorescence staining were used to detect the activation of microglia and expression levels of interleukin-1β（IL-1β） and tumor necrosis factor-α （TNF-α） in the cortex of mice in each group. Results Hypoxia exposure increased DCA levels in the colon, serum and cortex. Under the same conditions, cortical microglia were activated, along with the elevation of IL-1β and TNF-α levels. DCA treatment increased the expression levels of FXR, IL-1β and TNF-α in N9 microglial cells. Knocking down the expression level of FXR inhibited DCA-induced IL-1β and TNF-α expressions in N9 cells. Furthermore, administration of TUDCA inhibited microglial activation and elevation of IL-1β in the cortex induced by hypoxia. Conclusion DCA can serve as a mediator in neuroinflammation by activating FXR in the cortex under hypoxia exposure. TUDCA administration can be used to mitigate neuroinflammation induced by hypoxia.

In the era of rational molecular design of fusion proteins, linker selection has garnered significant attention as a critical determinant of construct functionality. Suboptimal selection of linkers may result in such structural perturbations as protein misfolding, reduced expression yields, and compromised bioactivity. Consequently, the strategic selection of linkers tailored to specific objectives of molecular design by optimizing spatial orientation, maintaining domain autonomy or enabling post-translational modifications has emerged as a pivotal research frontier. Given these challenges, this review outlines the common properties of linkers, ways of classification, and the functional-structural interplay in current applications. Furthermore, we propose context-dependent selection frameworks for therapeutic proteins, biosensors, and enzyme cascades, which can serve as a systematic methodology to guide linker optimization in next-generation fusion protein engineering.

高原地区受低氧、低温、复杂地形及极端天气影响,传统血液运输依赖专用运血车与运血箱,存在运输时效性差、设备故障率高、极端天气通行困难等突出问题。该文探讨了国内外无人机血液运输模式在高原特殊环境下的应用现状及潜力,系统梳理了高原无人机血液运输的设计要点与解决方案,为突破“最后一公里”血液配送难点和构建高海拔地区应急血液保障体系提供参考。

Infectious pneumonia caused by bacteria,viruses,or other pathogenic microorganisms remains a huge threat to human health. Immunocyte-derived biomimetic nano-drug delivery systems can be used for drug delivery by taking advantage of the natural anti-inflammatory effect of immune cells and thus show great potential in lung-targeted therapy. This review begins by introducing different types of immune cells in the lung. The preparation methods of immunocyte-derived biomimetic nano-drug delivery systems and their applications in bacterial pneumonia,viral pneumonia,acute respiratory distress syndrome and cytokine storms are also reviewed. The review is expected to provide data for the targeted therapy of infectious pneumonia.

With the increasing abuse of antibiotics, the development of rapid, accurate and sensitive methods for antibiotic detection has become critical. Nucleic acid sensors as new biosensors have shown great potential in the field of antibiotic detection due to their high selectivity, high sensitivity and real-time monitoring ability. This paper reviews the research progress in antibiotic detection based on nucleic acid sensors,including colorimetric, optical and electrochemical nucleic acid sensors, in the hope of providing a reference for the research and development of new types of antibiotic detection technologies based on nucleic acid sensors.

目的 分析罗布泊戈壁驻训军事人员2024年5-9月发病特点和病因,为卫勤保障资源的合理配置提供数据支持。方法 收集有效病例536例,涵盖性别、年龄、抵驻地日期、就诊日期及疾病诊断等信息,回顾性分析2024年5-9月罗布泊戈壁驻训军事人员初驻前4个月发病情况及病因。结果 罗布泊戈壁驻训军事人员病例数从第1个月（129例）持续增加至第4个月（149例）。前7位系统疾病是运动系统（29.85%）、消化系统（16.79%）、皮肤及皮下组织疾病（16.42%）、眼疾病（14.18%）、呼吸系统（8.77%）、中暑（4.85%）和失眠（3.92%）,占总病例数94.78%。前7位单一疾病是腰肌劳损（13.62%）、急性胃肠炎（7.46%）、结膜炎（5.03%）、干眼症（4.48%）、湿疹（4.10%）、踝外伤（3.73%）、急性上呼吸道感染（3.36%）,占总病例数41.79%。运动系统、眼疾病、中暑、失眠系统疾病及腰肌劳损、急性胃肠炎、结膜炎、干眼症单一疾病的发病与驻训时长有关（P<0.05）。结论 根据罗布泊戈壁地区驻训军事人员发病特点及病因,实施精准有效防治,对提升该地区卫勤保障的针对性和降低非战斗减员具有现实意义。

Objective To establish a rat model of acclimatization to motion sickness （MS） induced by rotational stimulation. Methods To determine the stimulation conditions of MS, SD rats were divided into a static control group （SCG） and a single rotation stimulation group （SRG） before being subjected to the motion sickness index （MSI） measurement, open-field experiment and Morris water maze experiment after rotational stimulation to verify the feasibility of MS being induced in rats. Morris water maze experiments were performed to find out whether rotational stimulation could be used to induce MS in rats. During experiments on acclimatization, the SD rats were divided into the control group （Ctrl）, one day of rotational stimulation group （Day1）, three days of continuous rotational stimulation group （Day3）, and seven days of continuous rotational stimulation group （Day7） before the changes in the MSI and behavior of these rats were recorded so as to explore the relationship between continuous stimulation and MS acclimatization in rats. Results After rotational stimulation, the rats showed a significant increase in the number of fecal pellets （P<0.0001） and in the MSI （P<0.0001） compared with the SCG.In the open field experiment, the rats showed a significant decrease in the spontaneous activity time （AT） （P<0.0001）, total spontaneous activity distance （TD） （P<0.001） and distance moved by the center point per second （DMCPS） （P<0.001）. The time taken to climb onto the platform （latency to find the platform, LP） （P<0.0001） and the total distance to the platform （distance to the platform, DP） （P<0.001） were significantly increased during the Morris water maze experiment. Acclimatization experiments revealed a significant increase in MSI and in the number of fecal pellets in the Day1 and Day3 groups of rotational stimulation compared to the Ctrl group （P<0.0001）. AT （P<0.01）, TD （P<0.05） and DMCPS （P<0.01） were significantly decreased, while LP and DP were significantly increased （P<0.0001）, but there was no statistically significant difference in indices compared with the Day7 group（P>; 0.05）. Conclusion Sinusoidal stimulation can induce MS in rats, and twice-a-day, continuous rotational stimulation for seven days can lead to acclimatization. The rat MS model can be assessed via behavioral experiments.

Objective To investigate the feasibility of using the cell-free DNA （cfDNA） carrying tissue-specific mutations as biomarkers for assessing the severity of exercise-induced tissue injury. Methods Based on a public gene expression database, ten tissue-specific and highly-expressed genes were selected for each of ten different human tissues. A total of 34 young healthy volunteers were recruited, and their peripheral blood samples were collected after running 5 km per day for one week. Genomic DNA from leukocytes, plasma exosomal RNA, and plasma cfDNA were extracted and subjected to high-throughput sequencing respectively. Tissue-specific somatic mutations in plasma exosomal RNA were identified, and the relationship between cfDNA carrying these mutations and traditional protein biomarkers was analyzed. Results Tissue-specific cfDNA mutations related to five tissues （myocardium, skeletal muscle, intestine, stomach, and kidney） were detected in more than five volunteers. The correlation coefficients between total plasma cfDNA levels and the levels of tissue-specific protein biomarkers associated with these five tissues were less than 0.3 （n=34, r=-0.51-0.28, P=0.0022-0.65）. Notably, for each specific tissue, the levels of tissue-specific cfDNA mutations were positively correlated with the corresponding protein biomarker levels, and correlation coefficients were over 0.8 （n=7-13, r=0.81-0.92, P=9.0× 10^-4-0.020）. Conclusion Tissue-specific cfDNA mutations may serve as novel potential biomarkers for non-invasive evaluation of exercise-related tissue injury.

Objective To enhance the cyclic peptide compound's membrane permeability, structural stability, and neuroprotective activity, based on the amino acid sequence of peptides of Tat-GluA2-3Y, by designing and synthesizing a serial of cyclic peptides through strategies including polypeptide cyclization, replacement of the cell-penetrating peptide, substitution with D-amino acids, and incorporation of mini polyethylene glycol fragments. Methods The target peptides were synthesized based on standard Fmoc solid-phase method, followed by analysis and purification via reverse phase high-performance liguid chromatography （RP-HPLC）. The cytoprotective activity of the peptides was evaluated by using the HT-22 cell model. The transmembrane transport efficiency of the peptides was determined based on the Caco-2 monolayer intestinal epithelial cell model. Plasmatic plasma and metabolic stability of the peptides were measured by in vitro co-incubation experiments with rat plasma and human liver microsomes. Finally, the in vivo neuroprotective activity of the peptides was validated by using a mouse middle cerebral artery occlusion model. Results Seven cyclic peptides were successfully designed and synthesized by using the standard Fmoc solid-phase method, with purities exceeding 90% as confirmed by RP-HPLC. Cytoprotective activity assay demonstrated that both Tat-GluA2-3Y and CMT-C3Y exhibited activity at concentrations above 125 nmol/L, with CMT-C3Y showing superior activity as compared to Tat-GluA2-3Y. The results of the transmembrane assay demonstrated that, compared to Tat-GluA2-3Y, CMT-C3Y exhibited significant transmembrane capabilities at all tested concentrations （P<0.001）. CMT-C3Y was classified as a highly permeable compound, whereas Tat-GluA2-3Y was categorized as a moderately permeable compound. Plasma stability studies indicated that over 50% of Tat-GluA2-3Y was metabolized after 4 h of co-incubation with rat plasma. After 8 h of coincubation with CMT-C3Y, the remaining amount was 88.1%, and no obvious degradation phenomenon occurred. In human liver microsomal stability tests, the half-life of Tat-GluA2-3Y was 26.1 min, as compared to 103.8 min for CMT-C3Y, highlighting the enhanced stability of CMT-C3Y. Tat-GluA2-3Y and CMT-C3Y were classified as a fast-metabolizing drug and a moderate-metabolizing drug, respectively. Animal experiments further demonstrated that at a dose of 8 mg/kg the neuroprotective activity of CMT-C3Y was significantly superior to that of Tat-GluA2-3Y （P<0.001）. Conclusion The designed bicyclic peptide CMT-C3Y demonstrates significantly higher cell-penetrating efficiency and superior plasma stability as compared to Tat-GluA2-3Y, along with enhanced neuroprotective activity at both cellular and animal levels.

Objective To establish a rapid detection method for Clostridium botulinum in food. Methods A rapid detection method based on RPA-CRISPR/Cas12a was developed by integrating recombinase polymerase amplification （RPA） with the CRISPR-Cas12a system. After the reaction conditions were optimized,the method′s sensitivity,specificity,and usefulness were methodically confirmed. Results and Conclusion The optimized method achieved detection within 1 hour,with a limit of detection （LOD） of 1.91 copies/µL. No cross-reactivity was observed with non-target pathogens. The RPA-CRISPR/Cas12a-based detection method developed in this study exhibits high specificity,sensitivity,and operational simplicity and may provide a feasible solution for the rapid detection of foodborne pathogens.

Objective To investigate the biological function and potential mechanisms of long non-coding RNA （lncRNA） neurensin 2-antisense RNA 1 （NRSN2-AS1） in liver cancer cells. Methods The Encyclopedia of RNA Interactomes （ENCORI） database was used to analyze the expression levels of NRSN2-AS1 in liver cancer tissues and normal tissues as well as its association with the prognosis of patients. Stable lncRNA NRSN2-AS1 cell lines, overexpressed or knockdown, were constructed. The effects of NRSN2-AS1 on tumor cell proliferation were explored using CCK-8 and colony formation assays. Transwell and wound healing assays were employed to examine the role of NRSN2-AS1 in tumor cell migration and invasion. The impact of NRSN2-AS1 on tumor cell aerobic glycolysis was assessed by measuring hexokinase activity, glucose uptake, ATP and etracellular lactate levels. Quantitative real-time PCR （qPCR） and Western blotting were used to evaluate the effects of NRSN2-AS1 on the mRNA and protein expression levels of hexokinase 2 （HK2） in tumor cells. Results Analysis from the ENCORI database revealed that NRSN2-AS1 was upregulated in liver cancer tissues compared to normal tissues, and that high expressions of NRSN2-AS1 were closely associated with poor prognosis of patients. In vitro functional assays demonstrated that overexpression of NRSN2-AS1 promoted proliferation, migration, and invasion of liver cancer cells, and enhanced glycolysis levels while knockdown of NRSN2-AS1 inhibited these processes and suppressed glycolysis. Furthermore, overexpression of NRSN2-AS1 increased the mRNA and protein levels of HK2 while knockdown of NRSN2-AS1 decreased HK2 expression in liver cancer cells. Conclusion NRSN2-AS1 is highly expressed in liver cancer tissues, and it may promote liver cancer progression by enhancing HK2 expression and aerobic glycolysis.

Objective To investigate the clinical manifestations of traditional Chinese medicine （TCM） and their associations with TCM constitutions in individuals who have migrated to plateau areas,and to provide a scientific basis for plateau health management. Methods Migrants living in areas above 3000 m were selected as research subjects. Data were collected by using TCM symptom assessment scales and constitution assessment scales. Descriptive statistical analysis was conducted to determine the incidence and severity of symptoms among individuals with different migration durations,and core symptoms were identified. Factor analysis was performed by using SPSS software to extract symptom clusters and explore the correlation between core symptoms and TCM constitutions. Results Among individuals who migrated to plateau areas,the incidence of discomfort symptoms was 83.44%. The five most common symptoms were dry skin （67.94%）,forgetfulness （56.03%）,dry mouth （52.06%）,yellow urine （48.73%）,and insomnia （47.14%）. In the top 10 symptoms with the highest increase in incidence,yellow urine （33.51%） and forgetfulness （26.33%） were both present in the top 10 symptoms across different migration durations. Factor analysis extracted 5,2,4,and 6 symptom clusters from the overall population,individuals who migrated within 1 year,those who migrated for 1-2 years,and those who migrated over 2 years,respectively. Qi-deficiency constitution （QDC）,blood stasis constitution （BSC）,qi stagnation constitution （QSC）,phlegm-dampness constitution （PDC）,and dampness-heat constitution （DHC） were significantly positively correlated with forgetfulness. Conclusion Migrating to plateau areas can induce discomfort symptoms,and both the number and incidence of symptoms increase with longer migration durations. The number and incidence of high-frequency symptoms （incidence≥30%） increase with prolonged migration time. There are differences in the composition and severity of symptom clusters across different migration durations. QDC,BSC,QSC,PDC,and DHC are closely related to forgetfulness and can be considered risk constitutions for forgetfulness. Timely attention to changes in symptom clusters and constitutions can help prevent and mitigate the occurrence and development of symptoms.