It has been over two years since the escalation of the Ukraine crisis. From the perspective of medical support, it not only continued the traditional pattern of combat casualties in mechanized warfare but also highlighted characteristics of modern warfare with precise strike on multi-domain battlefields. Specifically, it was manifested with masscasualties and severe and complex injury conditions, which reflected new changes in modern combat casualty treatment. This article summarized the basic situation of the organization and implementation of combat wound treatments,and analyzed the problems of treatments organization such as the efficiency of medical evacuation of the wounded, the allocation of first-line treatment forces, and combat wound treatment suppllies, as well as the technical application problems such as batch classification and assessment of the wounded, debridement and fixation, pain management, bacterial resistance, and the use of tourniquet. Then proposes the key contents that should be paid attention to in the treatments of combat wound in large-scale armed conflicts in the future.

The dengue virus, a member of the Flavivirus genus within the Flaviviridae family, is responsible for dengue fever, an acute mosquito-borne infectious disease that can progress to severe forms such as dengue hemorrhagic fever and dengue shock syndrome, taking a heavy toll on human health. Despite its impact on global public health, there are currently no specific drugs available that are both safe and effective for the treatment of dengue fever so that the research and development of related drugs are facing huge challenges. This paper not only pointed to the critical importance and urgency of developing antiviral medications, but also reviewed recent advancements in the development of dengue virus inhibitors of two categories： candidate drugs that directly target viral structural and non-structural proteins, and antiviral candidate agents that focus on host receptors. Additionally, this paper provided an overview of the progress in and the mechanisms of various inhibitors in the hope of providing a reference for antiviral drug development and the treatment of dengue fever.

Acute mountain sickness is a variety of pathological reactions that occur when people enter high altitude areas and are exposed to a hypobaric and hypoxic environment. China has vast high-altitude regions with complex terrains and of strategic importance. With the increase in large-scale combat training activities, more troops have entered high-altitude areas to carry out training. The hypobaric and hypoxic environment at high altitudes impacts the generation of combat effectiveness. The Wilderness Medical Society （WMS） has issued consensus guidelines for the prevention and treatment of acute mountain sickness in 2010, 2014, 2019 and 2024,respectively. The commonly used drugs for the prevention and treatment of acute mountain sickness include acetazolamide, dexamethasone, acetaminophen and nifedipine while non-pharmaceutical approaches include gradual ascendance, pre-acclimation, oxygen inhalation, descendance to a lower altitude, and portable hyperbaric oxygen chambers. This article was intended to trace the evolution of each means of prevention and treatment specified in the four editions of the guidelines, keep track of the latest approaches to acute mountain sickness, and provide a reference for military medical support for related training.

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.

With wide applications of radiation therapy in the treatment of cancer and other diseases and amid the increasing concerns about global nuclear safety, the research and development of drugs against radiation damage has become a hot spot. Thanks to its high energy properties, ionizing radiation can not only directly damage cell DNA through targeted effects, but also indirectly affect the cell environment through non-targeted effects, leading to cell dysfunction and even death. In this paper, the mechanism of ionizing radiation damage was analyzed, and the mechanisms of action and clinical applications of four types of anti-radiation drugs, namely, antioxidant, apoptosis inhibitor, cytokine and natural radiation protection agent were discussed. These drugs have huge implications for alleviating the targeted and non-targeted effects caused by ionizing radiation.

Objective To investigate the effects of syncytial formation induced by severe acute respiratory syndrome coronavirus 2（SARS-CoV-2）spike protein（SARS-2-S）on the proliferation and migration of human lung adenocarcinoma A549 cells and mouse melanoma B16 cells in vitro. Methods Plasmids expressing human angiotensin-converting enzyme 2 （hACE2） and SARS-2-S were constructed and respectively co-transfected with lentiviral packaging plasmids into HEK-293FT cells before the lentiviral supernatant was collected and infected with A549 cells which were screened by puromycin to obtain the A549 cells respectively that were stably transfected with hACE2（A549-A） and SARS-2-S （A549-S）. The protein expression of A549-A and A549-S cells was verified by Western blotting. A549-A and A549-S cells were co-cultured before their syncytia were observed by fluorescence microscopy. Conditioned media （syncytial supernatant and non-syncytial supernatant） was collected to culture A549 cells,ovalbumin （OVA）-gene-modified B16 cells （B16-OVA）,and B16-F10 cells in vitro.The CCK-8 assay and colony formation assay were used to assess the proliferation capacity of tumor cells,while the wound healing assay was employed to evaluate the migration capacity of tumor cells. Results Stable A549 cell lines expressing hACE2 and SARS-2-S were constructed. The SARS-2-S-induced syncytial formation system was established after co-culture of A549-A and A549-S cells. Both syncytial and non-syncytial supernatants significantly promoted the proliferation and migration of A549,B16-OVA,and B16-F10 cells in vitro,especially the syncytial supernatant. Conclusion SARS-2-S-induced syncytial formation promotes the proliferation and migration properties of A549 and B16 cells in vitro.

Zika virus （ZIKV） is a mosquito-borne flavivirus associated with neurological complications such as Limbari syndrome in adults and microcephaly in newborns. As there are no drugs or preventive vaccines available to specifically treat ZIKV infection, there is an urgent need to take comprehensive measures to prevent and control ZIKV infection and stop its spread. In this paper, we reviewed the structure and function of ZIKV gene and protein, and summarized the progress in the development of virus-targeting anti-ZIKV drug candidates through high-throughput screening and drug relocation, and summarized the mechanism of action of virus and host cell targeting drug candidates. The research and development trend of small molecule antiviral drugs in the future is prospected, which provides reference for promoting the research and development of new anti-ZIKV drugs.

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.

The hypobaric and hypoxic environment on the plateau impacts human neurocognitive functions. This paper summarizes cognitive assessment techniques currently available in general and the impact of high-altitude environmental exposure on human cognitive function in the past 10 years in particular. The development of emerging technologies in recent years has enabled multimodal physiological-psychological-behavioral detection to evaluate neurocognitive function more quickly and objectively. In line with the needs of brain science, this paper studies the construction model of a multimodal intelligent cognitive system that integrates monitoring, assessment and early warning before a comprehensive monitoring and evaluation platform for brain cognition is proposed, which can be applied to maintain and enhance brain cognitive function in military operations in the future.

Objective To comprehensively analyze the epidemiological characteristics and resistance mechanisms of New Delhi metallo-β-lactamase （NDM）-positive multidrug-resistant bacteria in China. Methods Relevant literatures on NDM-positive multidrug-resistant bacteria discovered in China were searched in the CNKI and PubMed databases （publications from January 1, 2017 to December 31, 2023）. The epidemiological analysis was conducted on the types of NDM-positive bacterial strains, their regional distribution, infection sources, resistance profiles, and transfer mechanisms. Results A total of 118 eligible articles were collected, reporting 1627 NDM-positive bacterial strains. The number of reports increased annually from 2011 to 2019, but began to decline annually from 2020 onwards. NDM-1 and NDM-5 were the most commonly reported variants. The highest number of reports came from Eastern China, followed by Central China and North China. The primary pathogens were Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae. The age distribution of patients with NDM-positive infections showed distinct patterns, with neonates and children accounting for 27.25% and patients over 50 years old accounting for 49.57%. The majority of positive bacterial infections came from sputum （38.28%）, urine （28.94%）, and blood （23.28%）. The main departments reporting NDM-positive bacteria were the ICU （39.93%） and pediatrics （20.14%）. These resistant bacteria exhibited resistance to more than 50.00% of antibiotics, with lower resistance to colistin and tigecycline （below 30.00%）. The predominant plasmid type carrying the bla_NDMwas IncX3, and the insertion sequences upstream and downstream of the bla_NDM showed diversity. Conclusion NDM-positive multidrug-resistant bacteria are widely prevalent across regions in China, exhibiting multidrug-resistance. This poses significant challenges to clinical antibiotic selection and necessitates the development of effective countermeasures.

Since emergence, the influenza virus has triggered numerous global pandemics and claimed more than ten million lives. This virus poses not only a severe threat to human life and health, but significant challenges to global economy and public health. The research on highly pathogenic influenza virus strains（such as H5 and H7）necessitates the use of biosafety level 3 laboratories, which significantly escalates the experimental risks and costs. The pseudovirus technology, as a relatively safe and effective research technique, has been applied in the studies of various high-risk viruses. Thanks to constant research and refinement, the pseudovirus technology for the influenza virus currently boasts such advantages as user-friendliness and good safety, and has been extensively used antibody neutralization and screening of antiviral drugs. This article reviews the research progress in the pseudovirus technology for the influenza virus.

Military training represents one of the most essential activities for troops during peacetime, of which the prevention and treatment of training-induced injuries are a very important part. Recent findings of research suggest that cold atmospheric plasma （CAP） exhibits a distinctive and multifaceted superiority in terms of broad-spectrum sterilization, rapid blood coagulation and healing promotion for wounds. Consequently, CAP has good prospects of applications in diverse fields such as clinical medicine, emergency rescue and military medicine. Based on a review of the research progress in plasma medicine, the applicability of CAP in the prevention and treatment of military training injuries was discussed in this paper by focusing on the urgent issues related to military training injury, including the typical application scenarios and methods for CAP, the safety and effectiveness of plasma trauma prevention and treatment, and the key issues facing the prevention and treatment of military training injuries.

Objective To investigate the protective effect of Gynostemma pentaphyllum on memory of individuals rapidly ascending to high altitudes. Methods Twenty-one healthy subjects were randomly divided into a G. pentaphyllum food group （n=12） and a control group （n=9）. The first group consumed G. pentaphyllum food for seven consecutive days while the control group received placebos. Both groups ascended from the plains to an altitude of 3600 m. Memory function was assessed using the matching memory and sequential memory tests of a cognitive evaluation system on day 1 and day 7 on the plains,and at 24 and 48 h after ascending to the high altitude. Scores of acute mountain sickness symptoms were also recorded. Results After 24 h of stay at the high altitude,the score of headache of the G. pentaphyllum food group was significantly lower than that of the control group（P<; 0.05）. Cognitive test results showed that the matching memory accuracy and sequential memory accuracy of the control group at 24 and 48 h were significantly lower than those on the plains（P<; 0.05）. In contrast,the G.pentaphyllum food group performed significantly better than the control group in these metrics（P<; 0.05）. Conclusion Regular consumption of G. pentaphyllum food can effectively alleviate headache symptoms in individuals rapidly ascending to high altitudes and mitigate the decline in working memory,short-term memory,and memory spans caused by acute hypoxic exposure.

In recent years, sudden public health events caused by group A streptococcus infections have been emerging, imposing a huge economic burden on society. The development of group A streptococcus vaccines has been an area of great interest to scientists. There is currently a wide range of vaccines in different stages of development. However, no mature and usable vaccines are available so far. This paper reviewed the current research on group A streptococcus vaccines in general and on M-protein recombinant protein vaccines, non-M-protein recombinant protein vaccines, and polysaccharide conjugate vaccines in particular.

Biometric recognition technology has developed rapidly and highly integrated with clinical diagnostics,phenotypic genomics,genomics,and big data analytics,facilitating not only precise personal identification but also demonstrating significant potential in health maintenance,particularly for military personnel. Global research has increasingly focused on uncovering the complex associations between biometric traits and key health determinants,such as disease susceptibility,psychological states,and physiological functions,to further harness biometrics in proactive health management. This paper provided a comprehensive overview of the latest progress and emerging applications of biometric technology in healthcare and military medicine,aiming to offer a scientific reference supporting the strategic development of biometrics research,its application promotion,and population-wide health management enhancement.

This article reviewed the progress in military operational medicine in the U.S. Armed Forces in 2024 in terms of improved capabilities of health care in extreme natural environments,protection from noise damage,sleep interventions, intelligence monitoring of operational efficiency and more academic exchanges in this field. These measures are intended to improve the operational performance of soldiers in every possible way. This article is expected to provide useful references for related research.

Objective To analyze the epidemiology and trends of measles,tuberculosis,pertussis,scarlet fever,influenza,mumps and rubella in Beijing between 2014 and 2023 in order to provide data for prevention and control of related diseases. Methods Data on the incidences of seven respiratory infectious diseases in Beijing between 2014 and 2023 was collected. Descriptive epidemiological methods were employed to analyze their demographic,temporal and spatial distribution. Joinpoint regression analysis was used to assess temporal trends in incidence. Results A total of 1 406 777 cases of seven respiratory infectious diseases were reported in Beijing between 2014 and 2023,which corresponded to an average crude rate of 649.76/100 000 reported annually. The crude rate of incidencewas higher among females than among males,with the most vulnerable age groups being 0-4 years and 5-19 years,and was higher in the six districts than on the outskirts.Most of the respiratory infectious diseases peaked in winter and spring. The annual increase in the incidence of respiratory infectious diseases in Beijing in this period averaged 27.27%,with no statistically significant differences in trends. The incidence rates of measles,tuberculosis,scarlet fever,mumps and rubella decreased significantly while those of pertussis and influenza increased,but with no statistically significant difference. Conclusion The overall incidence of major respiratory infectious diseases in Beijing is increasing. It is recommended that more people get vaccinated,surveillance of such diseases as pertussis and influenza be enhanced,and regional health resources be allocated more effectively,all of which will be critical to subsequent prevention and control of respiratory infectious diseases in Beijing.

Objective To design and develop an intelligent triage model for earthquake casualties that is intended for medical rescue teams based on reinforcement learning and the feasibility of this model is verified via computer simulation. Methods The process, difficulty, and requirements of the triage of the injured during an earthquake medical rescue were analyzed. The Markov decision process was used to formally describe the problem. Subsequently, a triage model was designed and developed based on reinforcement learning. Finally, the effectiveness of the model was verified through simulation experiments. Results Compared with conventional triage strategies, this intelligent triage model showed significant advantages in terms of mortality rates and waiting time.Under experimental conditions, casualties decreased by nearly 50%, and the waiting time for both nonoperative casualties（T-class） and operative casualties（S-class） casualties also decreased. Conclusion The intelligent triage model can autonomously learn triage strategies, reduce the casualty rate while lowering the waiting time for the injured, thereby effectively improving the efficiency of treatment of earthquake injuries.

Objective To study the mechanism by which acoustic wave stimulation improves cognitive function in sleep-deprived mice. Methods （1） Thirty-six male C57BL/6 mice were randomly divided into three groups： the control group,model group and acoustic wave group （n=12 per group）. A sleep deprivation model was established using the modified multiple platform method. After 21 days of sleep deprivation in a row,mice in the acoustic wave group were exposed to 30-minute acoustic wave stimulation at 40 dB. （2） During sleep deprivation, the health status of each group of mice was recorded, including the mental state and body weight. （3） After 21 days of sleep deprivation, behavioral tests （open field test, novel object recognition test, Y-maze and Morris water maze） were performed to assess the spontaneous activity, spatial exploration, and such cognitive functions as learning and memory in mice. Immunohistochemistry was conducted to analyze the expressions of neuronal nuclear antigen （NeuN）, glial fibrillary acidic protein （GFAP） and ionized calcium-binding adaptor molecule 1 （Iba-1）in the hippocampus. Quantitative real-time PCR （qPCR） was used to measure the expression levels of interleukin-6 （IL-6）, tumor necrosis factor-alpha （TNF-α） and inducible nitric oxide synthase （iNOS） in the hippocampus. （4） Transcriptome sequencing was employed to explore the mechanism underlying the improvement of cognitive impairment by acoustic wave stimulation. Results After 21 days of sleep deprivation, acoustic wave stimulation significantly alleviated weight loss in mice （P<0.01）. The accuracy of Y-maze spontaneous alternation, indexes of novel object discrimination, the time spent in the target quadrant and the number of times the mice crossed the platformin the Morris water maze were all significantly increased （P<0.05）, while the escape latency was significantly reduced （P<0.05）. The average optical density of NeuN in the hippocampal CA3 region significantly increased （P<0.05）, GFAP and Iba-1 immunopositive cell counts significantly decreased （P<0.01）, and the mRNA levels of IL-6, TNF-α, and iNOS in the hippocampal tissue were significantly reduced （P<0.05）. Conclusion Acoustic wave stimulation can repair neural damage, modulate hippocampal inflammatory responses, and improve cognitive deficits induced by sleep deprivation.

Cell-free biosensors are detection tools that involve cell-free protein synthesis and consist of recognition elements and reporting elements. These biosensors offer several advantages, such as the ease of construction, a significant specificity and a high sensitivity. By overcoming the limitations associated with cell survival and cell membrane barriers, cell-free biosensors can considerably reduce response times. This article reviewed the recognition and reporting components of cell-free biosensors, summarizes recent research advancements in their applications to such spheres of public health as environmental monitoring and disease diagnosis, and explores the programmability and logical analysis capabilities of these biosensors. Future developments in this field are also predicted.

In 2023, the U.S. Defense Advanced Research Projects Agency （DARPA） continued to advance the deployment of biotechnology projects. By translating cutting-edge biotechnological breakthroughs into practical applications, DARPA provided new methods to enhance the U.S. military capabilities in treating war wounds, improving the performance of facilities and equipment, and boosting soldier effectiveness. This paper offers an in-depth analysis of the progress of DARPA biotechnology projects in 2023, aiming to provide reference for related research endeavors in China.

Objective To study the effects of Shugan Jieyu capsules on the cardiac function and state of mind of chronic heart failure（CHF） patients with anxiety and depression. Methods Ninety-four CHF patients with anxiety and depression were randomly divided into the Shugan Jieyu capsule treatment group and mental therapy control group. Self-rating depression Scale（SDS）, self-rating anxiety scale（SAS）, left ventricular ejection fraction （LVEF）, N-terminal pro-B-type natriuretic peptide（NT-proBNP）, the 6-minute walking test（6MWT）, hemoglobin（Hb）, interleukin-6（IL-6）, albumin（ALB） and high-sensitivity c-reactive protein（hs-CRP） were compared between the two groups before and after treatment using t-tests and chi-square tests in order to find out about the efficacy of Shugan Jieyu capsules in CHF patients with anxiety and depression. Results After 8 weeks of treatment, SDS, SAS, NT-proBNP, hs-CRP and IL-6 were all significantly lower, especially in the treatment group, while LVEF, 6MWT,Hb and ALB were significantly higher or longer, particularly in the treatment group. Conclusion Shugan Jieyu capsules can effectively alleviate anxiety and depression in CHF patients, improve the cardiac function and nutritional status, and mitigate inflammation.

Triage has been critical to combat casualty care by determining the order in which wounded soldiers are treated in case of mass casualties and saving as many lives as possible. Changes in the operation mode unfolded in the future will make a huge difference to casualties and combat casualty care. Given the inadequacies of current methods of triage , this article focused on triage in large-scale combat operations in the future. It is recommended that such factors be taken into consideration as the situation on the battlefield： the number and severity of wounded soldiers, health care resources and supplies, and ways of evacuation.Meanwhile, multiple triage methods should be adopted and dynamic evaluations conducted in order to save more lives and enable some previously wounded soldiers to return to the battlefield soon.In this way, combat effectiveness can be maintained, the benefits to wounded soldiers maximized, and the level of combat casualty care improved.

目的 分析二战时期美军海战减员特点,并与现代海战进行比较。方法 运用文献调研、归纳总结、统计学分析等方法,对二战时期美军海战历史数据进行分类归纳,同时结合部分现代海战数据进行对比分析。结果 多种武器打击的单舰平均战伤减员数和阵亡数最多,分别为71.54人次和135.21人次。不同遭袭部位中,水线以上与水线以下混合的单舰平均战斗减员数最高,达到206.75人次。海战伤伤类以贯通伤和烧伤占比最大,分别为39.09%和21.73%。伤部位主要集中在头面和四肢,分别为12%和37%。对比二战与现代海战舰艇伤员致伤情况,现代海战单舰平均战斗减员率略高,平均卫生减员占战斗减员比例与二战时期接近。结论 现代海战中,战斗减员率与卫生减员率与二战时期没有显著差异,但由于舰艇被击伤和击沉的概率增加,人员伤亡增多,死亡率增高。

As a deubiquitinating enzyme with important biological functions,Mysm1 has become a significant regulatory factor affecting the functions of various stem cells, immune responses and occurrence and development of multiple diseases. Studies have found that the sequences of mouse and human Mysm1 are highly homologous,both Mysm1 knockout mice and patients with Mysm1 gene mutations exhibit developmental disorders in multiple tissues and organs. Therefore, in-depth analysis of Mysm1 function in mouse models is critical to the etiological study of human Mysm1-related syndromes. This article reviewed the various deubiquitinating functions of Mysm1 in the nucleus or cytoplasm, its impact on the proliferation and differentiation of various stem cells and immune cell functions, its role in the occurrence and development of diseases such as cancer,aging and depression in hopes of providing a reference for in-depth research on Mysm1 in the future.

Objective To establish a human intestinal organ-on-a-chip model using a multi-array chip array to simulate the microphysiological structure of the human intestine and to investigate the impact of ionizing radiation on radiation-induced damage to human intestinal cells. Methods Caco-2 and human umbilical vein endothelial cells （HUVECs） were co-cultured in an organ chip. The cells were subjected to fluid shear stress via a precision shaker. After 7 days of dynamic culture,the morphological structure of intestinal epithelial cells and venous endothelial cells within the intestinal organ chip was examined using phase contrast microscopy,immunofluorescence staining,and confocal microscopy for three-dimensional （3D） imaging. γ-H2AX and TUNEL immunofluorescence staining were employed to assess DNA damage and apoptosis in intestinal epithelial cells two days post-irradiation. Villin immunofluorescence staining was used to evaluate villus height three days post-irradiation. EdU incorporation assay and Ki67 immunofluorescence staining were conducted to observe the effects of ionizing radiation on the proliferation of intestinal epithelial cells. Results After 7 days of dynamic culture,phase contrast microscopy and immunofluorescence staining combined with confocal 3D imaging revealed that the upper intestinal epithelial cells in the middle compartment of the chip formed a 3D intestinal villus structure,while the vascular endothelial cells in the lower compartment developed a vascular network structure. The chip was subsequently irradiated by 10 Gy X-ray. Immunofluorescence staining results indicated that the mean fluorescence intensity of γ-H2AX and TUNEL in the irradiated group was significantly higher than in the non-irradiated group 2 days after irradiation （P<; 0.01）,and that the proportion of EDU+ and Ki67+ cells in the irradiated group was significantly lower than in the non-irradiated group three days after irradiation （P<; 0.05）. Conclusion Caco-2 cells and HUVECs co-culture on an organ chip can generate the biomimetic structure of human intestinal villus. Ionizing radiation has been found to shorten intestinal villus,increase DNA damage and apoptosis in intestinal epithelial cells,and inhibit the proliferation of these cells.

The special natural environment of the plateau brings about great difficulties and challenges to the field medical support. The serious injury treatment group of the field medical team is responsible for the early treatment of the critically injured, which is highly demanding and is more likely to be adversely affected by the plateau environment. Based on the real experiences and current reality, this paper outlines the priorities of work done by the serious injury treatment group on the plateau in terms of personnel selection, professional training, material preparation, site construction, treatment regimens and combat readiness in the hope of providing references for the medical support for China′s the military on the plateau.

Military training and operations usually lead to such skeletal injuries as fatigue fractures, acute bone fractures, osteochondral defects, and radiation-induced bone injury. Skeletal stem cells （SSCs） are newly-identified innate tissue specific stem cells in skeletons which are capable of differentiating into bone, cartilage and bone marrow stromal tissues, and are one of the seed cells critical to the development, homeostasis, and regeneration of skeletons. SSCs are highly heterogenous in cellular subpopulations and spatiotemporal distributions, which is why their cellular immunopheto type and regenerative capacity are different in different anatomical sites. Thus, there is considerable difference in the response of SSCs to military injuries and in the underlying mechanisms. This review discussed the sources of SSCs, underlying mechanisms of SSCs-mediated skeletal regeneration, and the potential applications of SSCs in military regenerative medicine.

目的 总结口服洁厕灵急性中毒患者的临床特征及治疗方法与效果,以提高对该病的认识和诊治水平。方法 选取2016年8月至2021年11月全军中毒救治中心收治的15例口服洁厕灵急性中毒住院患者为研究对象,对其一般情况、中毒时间、住院天数、服毒量、中毒原因、临床表现和血气分析、CT、胃镜等辅助检查,诊治及预后情况进行回顾性分析。结果 15例患者中,男性6例,女性9例,年龄19~90岁,M（P₂₅,P₇₅）为45.00（24.50,65.00）岁;中毒时间（接触毒物至就诊时间）2~144 h,M（P₂₅,P₇₅）为7.00（5.50,15.00）h;住院天数1~60 d,M（P₂₅,P₇₅）为11.8（2.5,14.5）d;服毒量为50~500 mL,M（P₂₅,P₇₅）为200（100,200）mL。15例患者均因心情不佳故意为之。并发低氧血症3例,代谢性酸中毒7例,合并高乳酸血症4例,消化道出血5例,消化道穿孔1例,凝血功能障碍4例,休克3例。低蛋白血症6例,肝损伤4例,心肌损伤3例。恶心、呕吐12例,腹痛4例,咽痛5例,胸骨后烧灼痛3例,咳嗽2例,声音嘶哑3例,意识不清2例。8例患者胸部CT示双肺渗出性改变,4例胸腔积液。胃镜示：腐蚀性食管炎2例;腐蚀性胃炎2例;食道狭窄1例,幽门狭窄1例。腹部CT示：1例出现气腹;腹盆腔积液;胃窦及十二指肠壁不均匀增厚。15例患者中,12例好转出院,死亡3例。结论 口服洁厕灵会对人体消化道、心肝肺等重要脏器产生不同程度的损伤,重者可出现消化道出血、穿孔、低氧血症、休克等,甚至危及生命,临床上应予以重视,治疗上以保护消化道黏膜,控制急性炎症反应,保护心、肝、肺等重要脏器功能等对症支持治疗为主。

Objective To explore the effects of lipoxygenase （LOX） on severe fever with thrombocytopenia syndrome virus （SFTSV） in human umbilical vein endothelial cells （HUVECs）. Methods The CCK-8 assay was used to assess the cytotoxicity of LOX in HUVECs. Real-time quantitative PCR （qPCR） was adopted to detect the replication of viral RNA in cells. The infection rate of SFTSV to HUVECs was observed via indirect immunofluorescence assay （IFA）. The expressions of intracellular viral NP protein and autophagy related proteins microtubule-associated protein 1 light chain 3 （LC3） and adenosine 5’-monophosphate-activated protein kinase（AMPK）/mammalian target of rapamycin（mTOR） were detected via Western blotting. Lipid metabolomics was used to analyze the differences in expressions of intracellular metabolites in the SFTSV-infected Huh 7 with or without LOX treatment. Results The results of CCK-8 showed no obvious cytotoxicity to HUVECs with LOX≤8 mg/mL. With the increase of LOX concentrations,the viral RNA level,viral infection rate,and expressions of SFTSV nucleoprotein （NP） protein were gradually decreased,respectively. The autophagy reaction was activated in SFTSV-infected HUVECs,evidenced by the increased expression level of LC3Ⅱprotein. Compared with the untreated group,LOX treatment resulted in decreased levels of LC3Ⅱand AMPK phosphorylation,and enhanced phosphorylation of mTOR in SFTSV-infected HUVEC. Conclusion LOX negatively regulates autophagy by inhibiting AMPK/mTOR signaling pathway,thereby inhibiting SFTSV replication.

Objective To develop nanobodies with broad-spectrum reactivity, specificity, and high sensitivity that can be used for detecting multiple subtypes of influenza A virus, and to establish a nanobody-based enzyme-linked immunosorbent assay（ELISA） method. Methods Gene sequences of twelve nanobodies against influenza A virus were retrieved from the National Center for Biotechnology Information （NCBI） and nanobody databases.The nanoantibodies were prepared using molecular biological techniques including gene synthesis and recombinant expression. The binding activity, specificity, sensitivity, and affinity of these nanobodies were determined by ELISA screening and Gator affinity analysis. A double-antibody sandwich ELISA assay was established by combining the selected nanobody with a traditional mouse monoclonal antibody. Results Twelve nanobodies were expressed and purified. Two nanobodies capable of binding to multiple subtypes of influenza virus including H1, H3, H5, H7, and H9 were obtained and designated as VHH54 and KV108. Both nanobodies showed no cross-reactivity with other respiratory virus antigens. Furthermore, the KV108 nanobody exhibited the highest binding affinity, with a dissociation constant of 5.94×; 10-9 mol/L for the influenza virus nucleoprotein （NP）, and the lowest detection concentration for the NP antigen reached 0.00064 μg/mL. The double-antibody sandwich ELISA,using a combination of KV108 and a mouse monoclonal antibody, could sensitively detect the five common subtypes of influenza A virus （H1N1, H3N2,H5N1, H7N9, and H9N2）. The lowest detection limit reached 110-403 PFU/mL, which was higher than that of the commercial colloidal gold kitfor influenza virus detection. Conclusion This study has identified a nanobody KV108, which is capable of binding to multiple subtypes of influenza virus, and established a nanobody-based ELISA method that can detect multiple subtypes of influenza A virus. This study can facilitate the development of nanobody-based influenza detection technologies.

Objective To analyze the characteristics of oral and maxillofacial injuries from military training and provide references for related prevention and treatment. Methods A retrospective analysis was conducted of the medical records of 111 patients with oral and maxillofacial military training injuries treated between 2014 and 2023. Results From 2014 to 2023, the number of hospitalized patients with maxillofacial military training injuries in the hospital trended upward. The top 3 training injuries in the spectrum of diseases were maxillofacial fractures （45.08%）, maxillofacial space infections （28.83%）, and temporomandibular joint injuries （18.92%）. The average number of hospitalizations for all maxillofacial military training injuries was 1.33 （1-4）, and the median length of hospital stay was 8 （5,12） days. The median hospitalization cost was 14 793.23 （5236.18, 24 255.25） yuan, and the improvement rate was 95.50%. Conclusion The number of patients hospitalized due to oral and maxillofacial military training injuries in this hospital is increasing year by year, and the injuries are mostly jaw fractures. Precautions should be taken to prevent maxillofacial training injuries.

Objective To investigate the protective effect and mechanism of CDK4/6 inhibitor palbociclib against radiation-induced injury in rats' small intestinal crypt epithelial cell line （IEC-6）. Methods （1） Using CCK-8 colorimetric assay,colony formation assay,the PI staining method,Annexin V-FITC/PI dual staining and Western blot,the impact of palbociclib on proliferation,cell cycle dynamics,apoptosis,DNA damage,as well as phosphorylation events at Rb-780 and 795 sites in irradiated IEC-6 cells was investigated. （2） An IEC-6 cell line overexpressing Rb was established,and the effects of Rb overexpression on proliferation,cell cycle,and apoptosis in the IEC-6 cell line were assessed using the CCK-8 colorimetric assay,PI staining method,Annexin V-PE/7-AAD dual staining and Western blot. Additionally,the impact of Rb overexpression on the protective effect of palbociclib against radiation damage was verified in the Rb-overexpressing IEC-6 cell line. Results （1） Administration of palbociclib was demonstrated to enhance the proliferative capacity of IEC-6 cells following exposure to 10 Gy X-ray irradiation,increase colony formation ability post 4-8 Gy X-ray exposure while concomitantly reducing the proportion of cells in the G2/M phase after 10 Gy irradiation and diminishing apoptosis in irradiated IEC-6 cells. Protein expression analysis revealed that palbociclib inhibited phosphorylation at Rb-780 and 795 sites and attenuated the production of γ-H2AX in IEC-6 cells following irradiation. （2） After transfection of IEC-6 cells with Rb overexpression lentivirus,there was a significant increase in the total protein expression of Rb. The phosphorylation levels at Rb-780 and 795 sites were markedly elevated. Consequently,cell proliferation was accelerated,the proportion of cells in the S phase of the cell cycle increased,and the apoptotic rate significantly rose after exposure to 10 Gy X-ray irradiation. （3） Treatment with a lower dose of palbociclib （0.05 μmol/L） was found to suppress the phosphorylation of Rb at 780 and 795 sites in IEC-6 cells overexpressing Rb. Additionally,it reduced apoptosis in IEC-6 cells overexpressing Rb following exposure to 10 Gy X-ray irradiation. However,this treatment did not inhibit the phosphorylation of Rb at 780 and 795 sites in IEC-6 cells transfected with the empty vector,nor did it exert a protective effect against radiation-induced damage in these cells. Conclusion The CDK4/6 inhibitor palbociclib demonstrates significant protective effects against radiation-induced damage in rats' intestinal crypt epithelial cell line （IEC-6）,with the Rb protein potentially playing a crucial role in mediating this radioprotective response.

Acute radiation sickness （ARS） is a systemic syndrome caused by exposure to large doses of radiation in a single or short period of time. Hematopoietic tissue injury is the basic injury in case of acute radiation sickness. Romiplostim （RP） is a thrombopoietin receptor agonist that promotes platelet production by stimulating bone marrow megakaryocytes. In recent years, studies have shown that RP has a significant effect on acute radiation sickness, and has been approved by the United States Food and Drug Administration （FDA） for the treatment of bone marrow acute radiation sickness. In this paper, the recent research progress in the treatment of acute radiation sickness with romiplostim is reviewed.

Objective To investigate the impact of O-linked β-N-acetylglucosamine （O-GlcNAc） modification levels in the amygdala on stress resilience. Methods A restraint stress model was established in male C57BL/6J mice by confining them for 24 hours,followed by by 7days of rest. Behavioral assays,including the tail suspension test,forced swimming test and fear conditioning test,were conducted. Subsequently,the mice were euthanized,and the hippocampus,cortex,and amygdala were isolated. O-GlcNAc modification levels in these brain regions were assessed using enzyme-linked immunosorbent assay （ELISA）. Using stereotaxic brain injection techniques,the O-GlcNAcase （OGA） inhibitor,O-GlcNAc transferase （OGT） inhibitor,and OGA and OGT adeno-associated viruses were administered to regulate O-GlcNAc levels in the amygdala before their effects on stress-related behavior were observed. Results The restraint stress group showed significantly increased anxiety,depressive-like behavior,and impaired memory. Concomitantly,O-GlcNAc levels in the amygdala were significantly decreased post-stress and were negatively correlated with behavioral performance.Mice with higher stress resilience exhibited significantly higher levels of O-GlcNAc in the amygdala than more sensitive ones. Upregulation of O-GlcNAc levels in the amygdala via Thiamet-G or adeno-associated virus-O-GlcNAc transferaseinjections increased O-GlcNAc levels,alleviated depressive-like behavior and enhanced stress resilience. In contrast,downregulation of O-GlcNAc levels through OSMI-1 or adeno-associated virus-O-GlcNAcase injections reduced the O-GlcNAc levels,exacerbated depressive-like behavior and reduced resilience to stress. Conclusion O-GlcNAc modification levels in the amygdala play a critical role in regulating stress resilience following restraint stress in mice.

Objective To establish a rapid and sensitive liquid chromatography-tandem mass spectrometry（LC-MS/MS）analysis method for determination of unsymmetrical dimethylhydrazine（UDMH）contents in rat plasma and investigate the toxicokinetic characteristics of UDMH in rats. Methods Twenty-two SD rats were divided into the intravenous injection of 10 mg/kg dose group（4 females）and intragastric administration groups（low, medium and high dose, with 6 rats in each group, half males and half females）. The rats were given 10mg/kg by intravenous administration and 10 mg/kg, 30 mg/kg, and 90 mg/kg single dose of UDMH by gavage. Blood samples were collected from the orbital venous plexus at 0 hour before administration and at different time points after administration. The plasma samples were extracted with protein precipitation and derivatization before being analyzed using the LC-MS/MS method. Separation was carried out on a ZORBAX column（4.6mm×75mm, 3.5 µm）, with a mobile phase composed of 0.3% acetonitrile/formic acid at a flow rate of 1 mL/min. Propranolol was used as the internal standard. An electrospray ionization（Turbo Ionspray）source was applied and the mass spectrometer was operated in a positive MRM mode. Quantitative analysis showed that the ionization source unsymmetrical dimethylhydrazine and propranolol was at m/z：192.0→148.1, m/z：260.2→116.1, respectively. The toxicokinetic parameters were analyzed with the DAS 2.1 software. Results Quantification of UDMH exhibited a good linearity within the concentration range of 50-50000 ng/mL, with a linear correlation coefficient greater than 0.9900 and a lower limit of quantification of 50 ng/mL. The average recovery rate of UDMH was 98.1%, compared with 100.5% for the internal standard propranolol hydrochloride. The inter batch precision of standard curve samples ranged from 0.7% to 6.3%, and the relative error was between -7.1% and 6.2%. The inter batch and intra batch precision of quality control samples ranged from1.8% to 19.8%, and the relative error from -9.8% to 0.2%. The main pharmacokinetic parameters of UDMH in rats exposed to 10 mg/kg,30 mg/kg, and 90 mg/kg gavage were UC_（0-t）：（7624.99±2569.31）,（34284.04±6657.15）,（84720.88±22354.80）µg/L·h,t_1/2：（0.07±0.15）,（2.24±1.45）,（3.04±0.90）h,T_max：（0.75±0.27）,（0.51±0.29）,（0.29±0.10）h,C_max：（4454.14±1329.45）,（19442.45±9121.07）,（32334.35±9882.41）µg/L, F：（77.34±26.06）%,（115.92±22.51）%,（95.48±25.19）%. Conclusion The LC-MS/MS method is highly accurate and specific, and is suitable for the toxicokinetic study of UDMH in rats. Single gavage administration of UDMH results in absorption and elimination saturation at a high dose. This study provides data for toxicological studies related to UDMH.

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.

Hypoxia inducible factors （HIFs） are core molecules that enable the body to adapt to hypoxia environments. By sensing changes in intracellular oxygen pressure,HIFs regulate gene expression related to hypoxia adaptation,thereby enhancing the body's hypoxia tolerance at cellular,tissue and organ levels. On the other hand,HIFs promote the generation of red blood cells,angiogenesis,and regulate the body's energy metabolism,thereby improving its hypoxia tolerance. The enhancement of hypoxia tolerance is of great significance for the prevention and treatment of hypoxia-related diseases,upgrading of athletes' performance,enhancement of workers' efficiency at high-altitudes,and the improvement of individuals' quality of life. This article reviews the relationships between HIFs and hypoxia tolerance as well as related mechanisms in order to provide strategies for enhancing hypoxia tolerance in the body.

Objective To develop a pressure swing adsorption oxygen generating device that is workable at altitudes of 0 to 7000 meters. Methods The three-bed molecular sieve oxygen production process was adopted. The switching time of air circuit solenoid valve and the rotation speed of the compression pump were taken as controllable variables. The performance of the oxygen generating device was tested in a normal atmospheric environment and a low-pressure environment corresponding to altitudes of 0 to 7000 meters. The optimal values of controllable oxygen generating parameters corresponding to 10 low-pressure environments（89.9,79.7,69.7,65.0,62.0,57.7,53.8,47.6,43.0,41.0 kPa）were obtained. Results The oxygen concentration could reach 94%,oxygen flow rate was 9 L/min and oxygen outlet pressure stood at 44 kPa in a normal atmospheric environment （altitude 416 meters）, compared with 94%, 6.3 L/min and 30 kPa in a low-pressure environment of 41 kPa（altitude 7000 meters）. Conclusion The oxygen generating device can meet the oxygen needs of two persons within the altitude range of 0 to 7000 meters.

Objective To assess the impact of freeze-drying and dry heat virus inactivation processes on the activity of α2-macroglobulin （A2M） derived from human plasma Cohn fraction Ⅳ. Methods A2M derived from human plasma Cohn fraction Ⅳ was prepared and subjected to programmed freeze-drying with dry heat virus inactivation. The lyophilized products were evaluated for their appearance, water content, and validation of the viral inactivation process. The bioactivity of the products before and after lyophilization as well as before and after dry heat inactivation was determined via trypsin inhibition, and the comparisons were studied. Results The appearance of the lyophilized product was fluffy, and the water content was （5.83±0.45）%. The specific activities of the samples before and after lyophilization were （10.199±0.137） and （10.033±0.201）μg/mg, respectively, with no statistically significantdifference between the two groups （P>0.05）. The viral inactivation of the samples was carried out by using dry heat inactivation conditions at 100 ℃ for 30 min. After inactivation, the reduction was ≥5.125 LgTCID₅₀/0.1 mL in Pseudorabies virus （PRV） titers,≥4.500 LgTCID₅₀/0.1 mL in Sindbis virus （SinV） titers, ≥6.375 LgTCID₅₀/0.1 mL in encephalomyocarditis virus （EMCV） titers, and ≥4.500 LgTCID₅₀/0.1 mL in porcine parvovirus （PPV） titers. The specific activities of the samples before and after dry heat were （9.921±0.292） and （10.091±0.278）μg/mg, respectively, with no statistically significant difference between the two groups. Conclusion A2M derived from human plasma Cohn fraction Ⅳ, when subjected to freeze-drying followed by dry heat inactivation at 100 ℃ for 30 minutes, can effectively inactivate viruses without altering the biological activity of the product.