In military operational environments, soldiers are frequently exposed to the combined effects of multiple stressors, whether natural, physical or psychological, which combine to impact their physiological and psychological health. This paper elaborates stress among soldiers in military operational environments in terms of manifestations, underlying mechanisms and interventions. It has been found that the primary physiological mechanisms involve the activation of the hypothalamic-pituitary-adrenal （HPA） axis while psychological ones are related to cognitive appraisal and emotional regulation. Coping strategies for stress include stress assessment in soldiers, virtual reality（VR） simulation training and psychological interventions, such as cognitive-behavioral therapy, exposure therapy and mindfulness meditation. Subsequent research should focus on the psychophysiological interactiond under specific military stressors and development of personalized intervention programs, such as adaptive VR training protocols. These advancements are crucial to enhancing psychological resilience and preserving the overall combat effectiveness of military forces.

The increasing complexity of modern military operations has heightened research attention to the impacts of sleep restriction （SR） on soldiers’ combat effectiveness. This article analyzes SR-induced deficits in military performance, reviews global military countermeasures （spanning technical interventions to institutional safeguards）, and proposes actionable optimization frameworks for military sleep management.

Modern warfare poses a severe challenge to medical support so that portable, efficient, and real-time battlefield diagnostic technologies are needed desperately. This review focuses on wearable ultrasound devices by summarizing their applicability and developments in military medical support. This article analyzes the advantages unique to flexible transducers, portable acquisition of data, and wireless communication as well as ways in which such technologies revolutionize the immediate diagnosis of combat injuries （such as craniocerebral and thoracoabdominal trauma and fractures） and daily health monitoring （including musculoskeletal injuries and cardiovascular assessments）. The article also offers insights into the critical challenges facing imaging quality, data processing, and energy supply endurance in order to clarify the significant implications of this device for enhancing the timeliness of battlefield casualty care, optimizing the allocation of medical resources, and safeguarding soldiers’ health. Furthermore, this study points to the need for intensified research and development of hardware design and intelligent algorithms to accelerate the related applications in military medicine.

Objective To explore the neuroprotective effects of nicotinamide riboside against microwave radiation-induced brain injury in mice. Methods Mice were subjected to whole-body uniform microwave radiation （at a central frequency of 2.856 GHz,and average power density of 20 mW/cm⊃2; for 30 min）. After radiation,the mice received intraperitoneal injections of nicotinamide riboside chloride at doses of 250,500,or 1000 mg/（kg·d）. Behavioral performance was assessed using the open field test （OFT） and elevated plus maze （EPM）. Histopathological changes in the cortex （CTX）,hippocampus （HPC）,and hypothalamus （HT） were detected via hematoxylin-eosin （HE） staining. Levels of such pro-inflammatory cytokines as tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in the CTX,HPC,and HT were measured using enzyme-linked immunosorbent assay （ELISA）. Proteomic analysis was performed to assess changes in protein expressions in the CTX. Results After microwave exposure,the exploratory behavior of mice was reduced,and the entries into the central zone and open arms were decreased （P<0.05）. Neuronal injuries were increased,and the levels of TNF-α and IL-6 were elevated （P<0.05）. Proteomic analysis indicated that differentially expressed proteins were mostly enriched through oxidative phosphorylation related pathways. NR interventions significantly ameliorated these alterations,as evidenced by increased exploratory behavior,reduced neuronal injury,decreased inflammatory cytokine levels （P<0.05）,and the reversal of expressions of dysregulated proteins,including zinc finger AN1-type domain-containing protein 5 （Zfand5）. Conclusion NR can alleviate brain injury and associated behavioral and neuroinflammatory alterations in mice induced by microwave radiation,which might involve the zfands and other key molecules.

Objective To investigate the effects of intermittent microwave irradiation on pathological structure and cognitive function of Alzheimer’s disease （AD） mice. Methods Forty C57BL/6J mice and another forty 5×FAD mice were randomly divided into the sham irradiation （sham-WT）,irradiation （MW-WT）,AD sham irradiation （sham-AD）,and AD irradiation （MW-AD） groups,with 20 mice in each. Mice underwent daily 1-hour microwave irradiation （900 MHz,40 Hz repetition rate） on an intermittent schedule： 2 weeks on,2 weeks off,and 2 weeks on again. The cognitive function of mice was assessed via behavioral experiments conducted both immediately and six weeks after irradiation. The expressions of phosphorylated tau（p-Tau） and β amyloid protein （Aβ） plaques were detected via immunofluorescence. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of key enzymes involved in Aβ production and neuroinflammatory factors in the brain tissue. Results Compared with the sham-WT group,the novel object recognition index and the novel arm recognition index in the sham-AD group were significantly reduced（P<0.05）, but those were significantly increased in the MW-AD group compared to the sham-AD group （P<0.05）. In addition,the levels of p-Tau and Aβ proteins in the brain of the MW-AD group were significantly decreased （P<0.05） while the levels of β-secretase and γ-secretase in the cortex were significantly increased （P<0.05）. The levels of CD68,tumor necrosis factor-α （TNF-α）,and interleukin-10 （IL-10） were also increased to varying degrees （P<0.05）. Conclusion Intermittent microwave irradiation （900 MHz,40 Hz） can ameliorate cognitive deficits and attenuate Aβ and p-Tau pathology in AD mice rather than inhibit the key secretases involved in Aβ production or the occurrence of neuroinflammation.

Ricin is a plant protein toxin and is a type Ⅱ ribosome inactivating protein. Ricin contains two peptide chains, A and B. Chain B has a lectin function and is responsible for identifying cell surface sites while chain A has N-glycosidase activity, which can inactivate ribosomes and produce cytotoxicity. Ricin is simple to prepare and strongly toxic,so it can be used as a biological warfare agent to threaten human safety. So far, no specific antidote has been officially approved for marketing. In this paper, the in vivo transport process, mechanism of ricin and the research progress in antidotes are reviewed, which is expected to provide a reference for subsequent development of ricin-specific antidotes.

Amid increasing globalization, the risk of vector-borne diseases has risen significantly, posing a huge threat to public health in China. This situation is particularly pronounced in the military. Military personnel, who are highly concentrated and engaged in cross-regional operations, are exceedingly vulnerable to an epidemiconce exposed to vector organisms, thus impacting their combat effectiveness and health. Effective vaccines or preventive medications for vector-borne diseases are lacking, so vector control has become critical to curbing the spread. This paper not only analyzes the epidemiology of vector-borne diseases in China amid globalization and urbanization, but also summarizes the advancements in novel vector-control strategies that are compared and contrasted with traditional approaches. The prevention and control of vector organisms requires long-term, systematic, and collaborated efforts. China should comply with the basic principles concerning sustainable vector management （SVM）. By strengthening the monitoring system, fostering inter-regional collaboration, and promoting new technologies and equipment, we can safeguard public health and the safety of military personnel and civilians.

Objective To analyze the incidence of acute radiation dermatitis （ARD） induced by postoperative adjuvant radiotherapy in breast cancer patients during and after radiotherapy,and to explore the contributors to ARD so as to provide data for formulating phased and individualized prevention and management strategies. Methods A convenient sampling method was used to select 98 patients as subjects who had undergone postoperative intensity-modulated radiation therapy （IMRT） for breast cancer between June 2022 and June 2023. According to the grading criteria for Radiation Therapy Oncology Group （RTOG）,the occurrence and severity of ARD in patients during radiotherapy （once a week） and within 6 weeks of radiotherapy （once a week） were dynamically evaluated. The clinical data of the patients was collected. Chi-square test was used for univariate analysis,and Logistic regression analysis was conducted to screen independent contributors. Results Among the 98 patients,96 developed ARD above grade 0,with an overall incidence rate of 97.96%. The incidence rate was 74.5% （73/98） during radiotherapy and 23.5% （23/98） after radiotherapy. ARD was likely 3 to 5 weeks into radiotherapy and 2 weeks after radiotherapy. Univariate analysis showed that age and menopause were significantly correlated with the occurrence of ARD （P<0.05）. Multivariate Logistic regression analysis suggested that age <60 years old during radiotherapy was an independent risk factor for ARD （OR=0.272,95%CI 0.091-0.816,P=0.020）,so was menopause after radiotherapy （OR=3.057,95%CI 1.120-8.344,P=0.029）. Conclusion The overall incidence of ARD is high among breast cancer patients after postoperative radiotherapy,and varies by age. Young patients have a higher risk of ARD during radiotherapy while menopausal ones have an increased risk of ARD after radiotherapy. Clinically,phased prevention and control strategies should be implemented for high-risk groups in different periods to reduce the harm of ARD and improve the radiotherapy prognosis of patients.

Hemorrhagic shock （HS） is a state of acute circulatory failure caused by massive hemorrhage that results in a sharp decrease in effective circulating blood volume and tissue hypoperfusion. HS easily triggers a series of complex pathophysiological changes, among which mitochondrial dysfunction is regarded as a key link. Mitochondria are the center of cellular energy production, which are involved in the regulation of apoptosis, oxidative stress response and immune regulation. With in-depth studies on the pathophysiological mechanism of HS, the role of mitochondria in HS has received more attention, but the mechanism of action remains elusive. This article reviews the pathophysiological characteristics, molecular regulatory mechanisms and research progress related to therapeutic drugs for mitochondrial injury after HS in order to contribute to subsequent research in this area.

Objective To evaluate the detection rates of sleep disorders among Chinese soldiers stationed in plateau regions，providing evidence-based support to inform future research and preventive interventions. Methods A comprehensive search was conducted across CNKI，WanFang Data，VIP Chinese Journal Database，Web of Science，and PubMed. The search encompassed studies from the inception of these databases up to August 1st，2024. The quality of the literature was assessed using the Agency for Healthcare Research and Quality（AHRQ） methodological checklist recommended by the Agency for Healthcare Research and Quality. Data extracted from the included studies were analyzed using R software （version 4.3.2） for Meta-analysis. A random-effects model was used to calculate the overall detection rate of sleep disorders and generate a forest plot，while subgroup analysis was performed based on the duration of high-altitude deployment in Chinese soldiers. Results A total of 1498 publications were retrieved，with 20 studies meeting the inclusion criteria. These studies comprised 11 991 soldiers stationed in plateau regions，among whom 3586 cases of sleep disorders were identified. The detection rate of sleep disorders among Chinese soldiers stationed in plateau regions was 36.8% ［95%CI（32.0%，41.5%）］. Subgroup analysis revealed that the detection rate was higher among soldiers stationed for less than one year，at 40.3% ［95%CI（33.5%，47.0%）］，compared to those stationed for more than one year，who had a detection rate of 30.0% ［95%CI（16.1%，43.9%）］. Conclusion The detection rate of sleep disorders in the soldiers stationed in the plateau regions is notably high. Soldiers who have been stationed for less than one year are more likely to susceptible sleep disorders. These findings underscore the need for effective preventive measures to address this issue.

Objective To assess the potential causal association between baseline red blood cell （RBC） indices and high-altitude adaptation （HAA） among low-altitude residents by using the two-sample bidirectional Mendelian randomization （MR） analysis. Methods A total of 82 healthy volunteers from the plains were enrolled to find out whether baseline RBC indices measured under normoxia were correlated with the percent change in hemoglobin （HGB） after 4 hours of simulated hypobaric hypoxia exposure. Summary-level data from genome-wide association studies （GWAS） were collected for RBC indices among 162,255 residents on the plains of East Asia,and for HAA among a combined cohort of 10,295 Tibetans and non-Tibetan individuals of Eastern Asian ancestry. A two-sample bidirectional MR analysis was conducted to assess the potential causal association between baseline RBC indices and HAA. Results Significant negative correlations were observed between baseline RBC,HGB,and hematocrit （HCT） under normoxia on one hand and the percent change in HGB on the other hand after 4 hours of simulated hypobaric hypoxia exposure. Furthermore,when the subjects were dichotomized based on the percent change in HGB,baseline RBC indices could accurately predict the percent change in HGB post-hypoxia exposure （AUC=0.8491,95%CI=0.8178-0.8804）. Forward MR analysis suggested that an inverse-variance weighted random-effects model supported a significant positive correlation of genetically predicted higher baseline HCT （odds ratio [OR]=1.023;95%CI=1.009-1.036;P=8.94×10^-4） and HGB levels （OR=1.027; 95%CI=1.011-1.043; P=7.02×10^-4） with HAA. Reverse MR analysis indicated no significant reverse causation between HAA and baseline RBC indices. Conclusion Genetically predicted higher baseline levels of HCT and HGB may be helpful in the initial stage of HAA.

Organoids are three-dimensional tissue structures derived from stem cells. In recent years, significant progress has been made in the culture technology of human lung organoids. This technology can create three-dimensional tissue structures that can recapitulate the architecture and function of the human lung via stage-specific induction of directed differentiation among stem cells or specialized progenitor cells. As a powerful tool for research, this technology allows in-depth investigation into lung development, provides mechanistic insights into pulmonary diseases, and accelerates the discovery of drugs. This review summarizes the latest progress in the generation of human lung organoids from adult stem cells, embryonic stem cells, and induced pluripotent stem cells in general and what needs to be optimized in current culture systems in particular, such as the development of organoid models that can accurately reproduce the distal lung architecture. In addition, the article outlines the applications of human lung organoids in pulmonary disease research, cancer drug screening, and regenerative medicine while opportunities and future applications of this promising technology are also predicted.

The high incidence of exertional heat stroke （EHS） has posed a huge threat to the health and combat capability of military personnel.This paper reviews recent advancements in the prevention and management of EHS in general and three pivotal interventions—heat acclimatization,hydration strategies,and cooling interventions—in particular.An optimized framework for military medical support to EHS is recommended.In terms of heat acclimatization,it is recommended that China’s military learn from short-term training protocols employed inother countries, and that a hybrid model combining basic acclimatization with short-term intensive training be adopted.Moreover, intelligent monitoring technologies are to beused as an alternative to traditional laboratory-based heat tolerance tests. Hydration strategies call for individualized regimensand the adherence to the principle of “high-frequency and small-volumes” of fluid intake. Cooling interventions ought to revolve around the critical “golden 30 minutes” therapeutic window,with cold water immersion（CWI）designated as the first option.Additionally,research that aims to investigate the viability of seawater as a CWI alternative is proposed. Based on foreign experience and the realities in China,this paper recommends a comprehensive,integrated and tripartite strategy that involves acclimatization,hydration,and cooling for the whole-process prevention and control of EHS. This approach is expected to provide data for mitigating EHS during military operations in hot and humid environments and for enhancing the efficiency of military medical support.

Objective To develop a new hemostatic material that is both highly efficient and cost-effective using mica and agarose as raw materials. Methods A porous mica-agarose composite gel sponge was prepared via direct cross-linking, followed by freeze-drying. The microstructure was characterized by scanning electron microscopy （SEM）. The influence of the mica content on pore size, water absorption, and volumetric swelling ratio was investigated. Hemostatic performance was assessed by measuring the hemolysis rate and blood clotting index, along with a mouse tail-amputation model. Results The prepared sponge exhibited a uniformly porous structure. Both water absorption and the volumetric swelling ratio increased with the mica content. However, excessive mica led to reduced stability of the pore structure. Biological evaluations revealed a hemolysis rate below 5% and a coagulation index of approximately 30%, suggesting favorable biocompatibility and effective hemostatic performance. Conclusion A composite hemostatic gel sponge based on mica and agarose has been developed, which promises wide applications in clinical hemostasis.

Objective To optimize an oxygen dissociation analysis （ODA） technology in order to evaluate the oxygen release capacity of hemoglobin-based oxygen carriers （HBOCs） rapidly and accurately. Methods The ODA procedures and statistical approach were optimized. In the course of preparation,HBOCs samples were oxygenated with air for 10 cycles （5 min/cycle ） to reach oxygen saturation. During the testing,N₂ was used at a rate of 20 L/min with a duration of 50 cycles to ensure utter deoxygenation. For statistical analysis,the oxygen release ratio and oxygen release capacity of HBOCs were calculated by using natural hemoglobin （Hb） as the benchmark. After method optimization,the coefficient of variation （CV） decreased from 0.10 to 0.03. The calculation of the oxygen release rate was introduced,and results were positively correlated with P₅₀,which was often used to represent the oxygen-carrying/release ability. Additionally,a semi-quantitative method was adopted to evaluate the Bohr effect to distinguish between acid- and base-Bohr effects. Results After method optimization,the high-throughput ODA could quantify HBOCs’ oxygen release capacity more rapidly and more accurately by measuring the oxygen release ratio,oxygen release rate and semiquantitative Bohr effect.Conclusion The high-throughput ODA is optimized and is applicable to evaluating HBOC’s oxygen release capacity in vitro,which can facilitate HBOCs development.

Objective To compare brain region activation, hemodynamic responses, and functional connectivity between visual perception and visual imagery using functional near-infrared spectroscopy （fNIRS）, and to evaluate the performance of different methods of feature extraction and classification in recognizing visual cognitive states. Methods Hemodynamic signals were recorded from 34 healthy participants using the Shimadzu LIGHTNIRS system during tasks involving the visual perception and imagery of 340 images. Statistical analysis and machine learning approaches were employed to explore the neural representations underlying these processes. Results Analysis of changes inoxygenated hemoglobin （HbO） concentrations suggested that visual perception predominantly activated the occipital regions, with higher response amplitudes and a shorter rise latency. In contrast, visual imagery mainly involved prefrontal activation, with a longer rise latency. General linear model （GLM） analysis showed that the way prefrontal and occipital cortices were activated was considerably different between the two tasks. Functional connectivity analysis indicated enhanced prefrontal-occipital connections during imagery despite the lower overall network efficiency in imagination.Classification results indicated that the support vector machine（SVM）, adaptive boosting （AdaBoost）, and extreme gradient boosting （XGBoost） could all clearly distinguish the two tasks, with XGBoost showing the highest accuracy of 89.1%. Feature ablation analysis identified the skewness, peaklatency, and slope as the best discriminative features. Conclusion Visual perception and imagery show systematic differences in spatial activation, temporal response, and network connectivity. By integrating fNIRS with multidimensional feature modeling and machine learning approaches, the cognitive state can be recognized efficiently.

The term “prehospital” is increasingly used in military medicine and military medical service. This article is intended to explore the concept from both military-civilian and Chinese-foreign military perspectives before its range of applications within military medical service in China is summarized.Prehospital emergency care, which involves emergency treatment at the site and during evacuation, applies to peace-time emergency treatment by military medical institutions and hospitals at each level.However, in war time, its applications should be restricted to first aid and related medical treatment institutions. It is recommended that prehospital emergency care be distinguished from combat casualty care.

Objective To establish a quantum dot immunochromatographic test strip for simultaneous detection of central nervous system-specific protein （S100β） and neuron-specific enolase （NSE）, thereby achieving combined detection of both biomarkers. Methods A double-antibody sandwich immunochromatographic assay was developed using S100β and NSE capture antibodies as the test line and species-specific secondary antibodies as the control line coated on the nitrocellulose membrane. Quantum dot bead-conjugated antibodies targeting S100β and NSE served as fluorescent probes. The preparation parameters of the strip were optimized, and its performance was systematically evaluated to develop a rapid diagnostic strip for mild traumatic brain injury （mTBI）. The diagnostic efficacy of the strip was further validated using clinical samples. Results The total assay time for combined detection of S100β and NSE was 17 min, with a limit of detection （LOD） of 0.1 ng/mL for S100β and 2.67 ng/mL for NSE. The inter-batch reproducibility of the strips was excellent （coefficient of variation, CV<15%）. In clinical validation using 24 mTBI samples, the combined detection strip demonstrated a specificity of 90% and a sensitivity of 92.86%, outperforming single-marker detection. These results prove that the simultaneous quantification of S100β and NSE enhances diagnostic efficacy for mTBI patients. Conclusion A combined detection method for the biomarkers S100β and NSE in mTBI, based on quantum dot immunochromatography, has been preliminarily established. This method demonstrates promising clinical application prospects in the auxiliary diagnosis of mTBI.

Objective To develop an intelligent compression hemostatic device based on micro-pressure sensing technology for limb bleeding and compare its performance with that of manual inflatable tourniquets. Methods An intelligent inflatable compression hemostatic device was designed using micro-pressure sensors, an automatic pressure inflatable pump, and a pressure fixation belt. The device's inflation performance, material safety, and air tightness were tested through physical property experiments, while its hemostatic efficacy was evaluated using a simulated human limb model and compared with that of manual inflatable tourniquets. Results Compared with the manual inflatable tourniquet, the intelligent inflatable hemostatic device demonstrated significantly shorter inflation time （P<0.05） and better air tightness （P<0.05）. In simulation experiments, the hemostasis time for both small artery bleeding and venous bleeding was significantly shorter with the intelligent inflatable hemostatic device than with the manual inflatable tourniquet （P<0.05）. Conclusion The intelligent compression hemostatic device outperforms manual inflatable tourniquets in terms of inflation performance, air tightness, and hemostatic efficacy. It enables precise, dynamic, and adaptive pressure management, providing a safer and more effective intelligent solution for combat trauma first aid.

Objective To elucidate the spatiotemporal dynamics of Kupffer cells （KCs） in acetaminophen （APAP）-induced acute drug-induced liver injury and their regulatory mechanisms governing regional hepatocyte regeneration. Methods A Clec4f-iCre & Rosa26-tdTomato lineage-tracing mouse model was established to specifically label KCs. Acute liver injury was induced via intraperitoneal injection of acetaminophen （APAP, 400 mg/kg）. Liver tissues and blood samples were collected at 0,1,2,3 and 7 days post-APAP administration. Histopathological examinations （H&E staining, TUNEL assay for apoptosis detection）, serum biochemical analyses （ALT and AST）, and immunofluorescence staining were employed to find out about the spatiotemporal migration patterns of KCs, their phenotypic transition, and spatiotemporal correlations between KC dynamics and hepatocyte regeneration. Results On day 1 （D1） post-APAP injury, extensive hepatocyte necrosis and apoptosis were observed in the pericentral （PC） zone, accompanied by a reduction in KCs count and their migration from the periphery toward the necrotic core. From D2 onward, repair started, with the necrotic area progressively decreasing. By D3, inflammatory cell infiltration was pronounced in the PC zone, concurrent with a peak in hepatocyte proliferation （Ki67⁺ cells： approximately 22%, P<0.05）. During repair, monocytes （CD11b⁺ IBA-1^-） differentiated into monocyte-derived macrophages （CD11b⁺ IBA-1⁺）, which synergistically promoted the regeneration of cytochrome P450 2E1（CYP2E1⁺） hepatocytes in the pericentral zone. By D7, the hepatic lobular architecture was largely restored, indicating the completion of reconstruction of metabolic zonation. Conclusion KCs can regulate hepatocyte regeneration through spatiotemporal dynamics and phenotypic transitions of monocyte-derived macrophages. These findings underscore the pivotal role of macrophage spatiotemporal reprogramming in liver injury repair and may provide data for developing macrophage-targeted therapeutic interventions in hepatic injury.

Objective To investigate the effects and possible mechanisms of YL-0919 （a novel class 1.1 antidepressant drug with an original chemical structure, independently developed by our research institute）in the treatment of post-traumatic stress disorder （PTSD） and cognitive impairment in a mouse model of inescapable footshock （IFS）. Methods Highly selective sigma-1 receptor antagonist BD-1047 was intraperitoneally injected to verify the target of YL-0919： （1） Mice were randomly divided into the control group, IFS⁺vehiclegroup, IFS⁺YL-0919 （2.5 mg/kg）⁺vehicle group, and IFS⁺YL-0919⁺BD-1047 （2.0 or 4.0 mg/kg） groups. The plantar surface of the mice was subjected to two consecutive days of electric shockto establish an IFS model. Mice in the IFS⁺YL-0919⁺vehicle group and the IFS⁺YL-0919⁺BD-1047 group were orally administeredwith YL-0919 （2.5 mg/kg） twice daily while those in theBD-1047 group （2.0 or 4.0 mg/kg）were administered intraperitoneally once daily, starting two days before YL-0919 administration. One hour after drug administration on the seventh day, the rapid anti-PTSD effect of YL-0919 was evaluated via behavioral experiments. （2）Fluoxetine （Flx） was used as a positive control drug. Mice were randomly divided into the control group, IFS⁺vehicle group, IFS⁺YL-0919 （2.5 mg/kg）⁺vehicle group, IFS⁺YL-0919⁺BD-1047 （2.0 mg/kg） group, and IFS⁺Flx （10.0 mg/kg）⁺vehicle group. Twenty-four hours after drug administration on the fifth day, the rapid anti-PTSD effect of YL-0919 was assessed via behavioral experiments. （3） Western blot was used to detect the expression levels of synaptic plasticity protein PSD95, AMPA-type glutamate receptor subunit-1 （GluA1）, and brain-derived neurotrophic factor （BDNF） in the prefrontal cortex of mice. Results （1） Compared with the control group, there was an increase in freezing time and asignificant decrease in recognition indexes in the IFS model group （P<0.05）. Compared with the IFS group, these changes were significantly reversed by YL-0919 （2.5 mg/kg） （P<0.05）. In contrast, Flx （10.0 mg/kg） did not mitigate the behavior after 5 days of continuous administration, but14 days of administration of Flx （10.0 mg/kg） showed a significant anti-PTSD effect but failed to significantly improve cognitive deficits in the IFS model mice, suggesting that YL-0919 could exert rapid anti-PTSD effect and improve cognitive function compared to Flx. Compared with the IFS⁺YL-0919⁺vehicle group, the anti-PTSD and pro-cognitive effects of YL-0919 were blocked by BD-1047 （2.0 or 4.0 mg/kg）. （2） Compared with the control group, the expression levels of PSD95, BDNF, and GluA1 proteins in the prefrontal cortex of mice were significantly reduced in the IFS model group （P<0.05）, but were significantly increased in the IFS⁺YL-0919 （2.5 mg/kg, administration for 5 days） group compared with the IFS model group （P<0.05）. Compared with the IFS⁺YL-0919 ⁺vehicle group, the increased expression levels of PSD95, BDNF, and GluA1 proteins induced by YL-0919 were blocked after BD-1047 （2.0 mg/kg） administration. Compared with the IFS model group, the expression levels of PSD95, BDNF, and GluA1 proteins in the prefrontal cortex of mice in the IFS⁺Flx （10 mg/kg, administration for 5 days） group did not change significantly. Conclusion YL-0919 can exert rapid anti-PTSD effects and relieve cognitive impairment in the IFS model, and the mechanism of the action may be related to the activation of sigma-1 receptors to regulate synaptic plasticity and BDNF expression in the prefrontal cortex.

Objective To evaluate the protective effect of miR-486-5p modified umbilical cord mesenchymal stem cells （UCMSC^miR-486） against radiation-induced heart damage （RIHD） and explore the mechanism. Methods 20 Gy of ⁶⁰Co γ-ray was used to establish a model for radiation-induced cardiomyocytes and cardiac damage to mice before UCMSC^miR-486 （1×10⁶ cells per mouse） was treated after radiation. Cell proliferation was detected using CCK-8 kit 48 hours post-treatment. Apoptosis, changes of mitochondrial membrane potential, and the opening of the mitochondrial permeability transition pore of cardiomyocytes were detected by flow cytometry. Small animal ultrasound was used to detect and analyze the cardiac function of mice 42 days later. Changes of cardiac histopathology were detected via HE staining and Masson staining. The ultrastructure of myocardia was observed under a transmission electron microscope（TEM）. Real-time quantitative PCR （RT-qPCR） and Western blotting were performed to detect the expressions of ferroptosis-related genes and proteins. Results UCMSC^miR-486 markedly reduced radiation-induced apoptosis and especially reactive oxygen species（ROS） levels in AC16 cardiomyocytes and restored both mitochondrial membrane potential and membrane permeability. Intravenous administration of UCMSC^miR-486 via the tail vein significantly increased ejection fraction and shortening fraction in irradiated mouse hearts, decreased the area of myocardial fibrosis, and mitigated mitochondrial ultrastructural damage UCMSC^miR-486 could inhibit ferroptosis of radiated cardiomyocytes and cardiac tissues of mice by modulating the expressions of ferroptosis-related markers, especially acyl-CoA synthetase long chain family member 4（ACSL4） and glutathione peroxidase 4（GPX4）. Conclusion UCMSC^miR-486 can mitigate RIHD by inhibiting ferroptosis. This finding is expected to offer a new strategy for the clinical translation of mesenchymal stem cells.

Objective To study the ability of a decontaminant-a film-based chitosan （CS） and diethylenetriamine- pentaacetic acid （DTPA） conjugate-to remove radionuclides under waterless or low-water conditions. Methods DTPA was covalently conjugated to CS via amide bond formation to yield CS-DTPA, which was structurally characterized by Fourier-transform infrared spectroscopy （FTIR） and other analytical techniques. The tensile strength and elongation at break of the film were measured by a universal testing machine while the efficacy of the film in removing radionuclides was evaluated using inductively coupled plasma mass spectrometry. Results The successful grafting of DTPA onto CS was confirmed via FTIR, nuclear magnetic resonance hydrogen spectroscopy （¹H-NMR）, and X-Ray diffraction （XRD）. Glycerinum was added to obtain the flexible CS-DTPA film with a tensile strength of （14.51±5.83） MPa and an elongation at break of （326.06±38.06）%, suggesting adequate mechanical properties for skin applications. The clearance rate of uranyl acetoxide on the skin exceeded 90% after CS-DTPA treatment. Compared with DTPA aqueous solution, the film significantly reduced systemic absorption of uranyl acetate, as evidenced by lower blood concentrations. Conclusion The CS-DTPA film can effectively remove uranium contamination from the skin and inhibit transdermal absorption, making it applicable to water-restricted settings.

Objective To develop positively charged human ferritin nanoparticles capable of modulating the surface properties of adenovirus vectors via electrostatic interaction-mediated self-assembly in order to enhance the cellular delivery efficiency of adenovirus vectors. Methods Based on structure-guided rational design, combinatorial amino acid mutations were introduced into wild-type human ferritin heavy chain（hF-wt）to generate a panel of positively charged ferritin mutants [（+）hFm]. The particle size and electrostatic binding capacity of （+）hFm were characterized using dynamic light scattering （DLS） and agarose gel electrophoresis, respectively, to identify the optimal （+） hFm that could self-assemble into nanoparticles and exhibit a high affinity for negatively charged biomacromolecules. Furthermore, the properties of the complex formed by the adenovirus type 5 vector （Ad5） and （+）hFm [Ad5@（+）hFm] were determined. The efficacy with which target transgene expressions were enhanced and the potential cytotoxicity of Ad5@（+）hFm were subsequently evaluated in HeLa cells. Results The positively charged ferritins constructed by combinatorial amino acid mutations successfully self-assembled into nanoparticles with size distributions ranging from 10 to 70 nm. Among these mutants,（+）hFm-2 showed strong electrostatic binding to plasmid DNA at a migration retardation rate of up to 95.59%. At a molar ratio of 1∶1000 [Ad5 to（+）hFm-2], the two components formed a complex with modulated surface properties, which significantly improved Ad5-mediated transgene expressions in the cellular model without inducing detectable cytotoxicity. Conclusion The positively charged engineered ferritin variant（+）hFm-2 can efficiently bind to Ad5 via electrostatic interaction, enhance Ad5-mediated transgene expressions, and possess high biocompatibility.

Deep vein thrombosis caused by high altitudes has a high fatality and has become a health concern among military personnel at high altitudes. This review summarizes the research progress in the mechanism,prevention,diagnosis and treatment related to deep vein thrombosis at high altitudes in hopes of enhancing the awareness of frontline health care providers about this disease,providing tips for targeted prevention and treatment,and better safeguarding the health of military personnel at high altitudes.

As more peptide drugs are increasingly entering the market, cell-penetrating peptides（CPPs） have attracted much attention due to their low toxicity, high target specificity and tolerability. CPPs targeting the central nervous system are able to transport therapeutic cargoes across the blood-brain barrier （BBB）, offering novel strategies for treating the central nervous system （CNS） disorders, including Alzheimer's disease, Parkinson's disease, brain tumors, and neurotropic viral infections. This review summarizes the structural characteristics of blood-brain barrier-penetrating peptides, elucidates their mechanisms of cellular internalization, and outlines their applications in the treatment of CNS diseases.

Leptomeningeal metastases（LM）in breast cancer patients are rare,but are usually accompanied by severe symptoms and a very poor prognosis. So far,MRI of the brain and/or spinal cord and cytological examination of cerebrospinal fluid （CSF） are the two primary methods used to diagnose LM. However,the sensitivity of either technique is limited, leading to a long diagnostic process,and delaying treatment. Traditional chemotherapy and targeted therapies used to treat systemic diseases are hampered by the blood-brain barrier. Similarly,the efficacy of intrathecal therapy and radiotherapy is controversial. This review summarized advances in the diagnosis and therapies of LM in breast cancer,in the hopes of providing a reference for clinical practice.

该文回顾性分析了中国第14批赴南苏丹（瓦乌）维和二级医院2023年12月至2024年12月超声诊疗数据,总结了引入创伤超声重点评估技术、建立超声诊疗分级响应机制、制定疟疾超声预警评估方案、拓展超声应用领域、优化质量管控措施及细化感染防控举措等工作实践,梳理了存在的问题并提出了对策建议,旨在为维和医疗超声工作提供参考。

Objective To study the structural and genetic environment of the plasmid pNY1464-1, which co-carries tmexCD2-toprJ2 and bla_IMP-26 in Klebsiella aerogenes. Methods The bacterial strain was identified using 16S rDNA. After third-generation sequencing, the species was verified via average nucleotide identity （ANI） analysis of whole-genome sequences. Antimicrobial susceptibility testing was conducted using the VITEK 2 Compact system to determine the minimum inhibitory concentration （MIC）. By analyzing the whole-genome sequence data from such databases as the National Center for Biotechnology Information （NCBI） and the Comprehensive Antibiotic Resistance Database （CARD）, we conducted detailed annotation and comparative genomics analysis to determine the plasmid structure and the genetic environment of antibiotic resistance genes. Results This plasmid, pNY1464-1, co-carrying tmexCD2-toprJ2 and bla_IMP-26 in Klebsiella aerogenes, was identified as an IncHI5-type plasmid.Compared to the conserved region of the IncHI5-type plasmid, this plasmid had a complete tra1 region, but the tra2 region was interrupted by an IS5.pNY1464-1 contained a range of accessory module regions, including insertion sequences IS5, ISKpn21, and ISKpn37, transposons Tn6381 and Tn6778, a variant of Tn6855, and a novel transposon Tn7678.Among these, Tn6855 carried tmexCD2-toprJ2, while Tn7678 carried resistance genes including bla_IMP-26, arr3, dfrA27, and aadA16. Conclusion The plasmid pNY1464-1, which co-carries tmexCD2-toprJ2 and bla_IMP-26, is identified in Klebsiella aerogenes. This plasmid harbors multiple mobile genetic elements （MGE） containing antibiotic resistance genes （ARG）, which may facilitate the horizontal transfer of ARG across bacterial species.

目的 调查武警某直升机单位空勤人员膳食结构,了解膳食营养保障现状,为指导其营养健康管理提供理论与实践参考。方法 以该单位48例空勤人员为调查对象,采用称重法开展为期4 d的膳食调查,了解能量和营养素的摄入情况。同时采取问卷调查法,评估空勤人员伙食满意率和营养缺乏症的相关情况。结果 该单位空勤人员在食物种类与数量的摄入方面,仅水果达到标准要求,粮食、水产、奶及奶制品、豆类及其制品、坚果、植物油、蔬菜、菌藻、巧克力、复合维生素片均低于现行军标要求,畜肉、禽肉、蛋类的摄入量超过现行军标要求;在食物供给质量方面,瘦肉、牛羊肉、动物内脏、水果的摄入量符合军标规定,全谷类、海产品、深海鱼虾、山茶油或橄榄油、深色蔬菜的摄入量低于军标规定;在营养素摄入方面,矿物质钾、镁、锌、硒的摄入量符合军标要求,蛋白质、钠、磷、铁、烟酸、维生素C的摄入量高于军标要求,钙、碘、维生素A、维生素E、维生素B₁、维生素B₂的摄入量低于军标要求;能量摄入量超过军标规定范围;三大产能营养素供能比例存在一定程度失衡,蛋白质和脂肪的来源不合理。结论 该单位空勤人员膳食结构整体呈现营养缺乏与营养过剩并存的现象。建议增加粮食、全谷类、水产、海产品、深海鱼虾、奶及奶制品、豆类及其制品、坚果、蔬菜、深色蔬菜、菌藻类、山茶油或橄榄油、巧克力以及复合维生素片的供应比例,减少畜肉等富含脂肪的食物比例,减少盐的摄入量。

Depression is a common mental disorder, the pathogenesis of which involves such factors as the imbalance of the monoamine system, neuroinflammation, and oxidative stress. Depression has been found to be associated with dysfunction in the blood-brain barrier （BBB）. In recent years, cannabidiol （CBD） has attracted extensive attention due to its remarkable antidepressant activity and neuroprotective properties. Of particular interest is the possibility that CBD may combat depression by repairing BBB damage and thereby improving the homeostasis of the central nervous system. Based on recent research findings, this article explores the antidepressant mechanisms of CBD, the BBB damage in depression, and the protective effects of CBD on the BBB. It is expected to provide references for subsequent studies on the mechanisms of BBB damage in depression and the discovery of new antidepressant targets.

Autoimmune hepatitis （AIH） is an autoimmune liver disease that is getting increasingly prevalent. Notably, mesenchymal stem cells （MSCs） and MSC-based therapeutic strategies promise wide applications in the treatment of AIH. This paper reviews the treatments for AIH based on MSCs by outlining the definition, classification, pathogenesis and its current treatments of AIH, the role and mechanism of MSCs, their extracellular vesicles in treating AIH as well as other therapies based on MSCs. This study is intended to provide references for the development of AIH treatment strategies.

Diabetes mellitus （DM） is a metabolic disease caused by both genetic and environmental factors and characterized by a persistent increase in serum` glucose. As the most serious complication of DM，diabetic angiopathy （DA） damages the heart, kidney, retina and other important organs through the dual injury mechanism of microvessels （retina, kidney） and large blood vessels （cardiovascular）, and is the leading cause of death and disability of patients. Although the use of insulin and oral hypoglycemic drugs can effectively control glucose, their interventions in such pathological processes as vascular dysfunction, oxidative stress, and chronic inflammation are limited. In recent years, mesenchymal stem cell-derived exosomes （MSC-Exos） have attracted much attention due to their potential in regenerative medicine. MSC-Exos can regulate the function of target cells by carrying bioactive molecules such as non-coding RNAs（ncRNAs）, and proteins, and show advantages in promoting vascular repair, reducing inflammation and improving endothelial function in the treatment of DA. This article reviews the biological characteristics of MSC-Exos, their clinical applications and the mechanism of DA.

Recent studies have shown that long-term exposure to a particular intensity of electromagnetic radiation may pose a threat to human health. This paper outlines the characteristics and mechanisms of damage caused by electromagnetic radiation to the body’s central nervous system, reproductive and immune systems. It is believed that oxidative stress is an important mechanism of electromagnetic radiation-induced damage to the body and will be a priority of drug research. The research progress in anti-electromagnetic radiation drugs is also summarized.

The Russia-Ukraine conflict that broke out in 2022 has highlighted the distinct features of modern warfare. As a type of high-incidence injury on the battlefield, limb injuries are characterized by complexity, high risk of infection, delayed evacuation leading to aggravated conditions, increased rates of amputation, and high incidence of psychological trauma. During the treatment of limb injuries, both sides of the conflict accumulated practical experience in forward deployment of forces, application of concepts of damage control surgery, establishment of a three-dimensional evacuation system, and more effective rehabilitation. However, such problems were exposed as insufficient frontline treatment training, poor coordination in material support, and the lack of psychological treatment. This article reviews the characteristics of limb injuries, treatment regimens and takeaways from the Russia-Ukraine conflict, and conducts comparative analyses based on data on historical conflicts such as World War II and the U.S. wars in Afghanistan and Iraq in the hope of providing targeted references for the PLA to enhance its ability to manage limb injuries and improve its medical support system in high-intensity combat environments.

Objective To investigate the dynamic changes in cardiac structure and function at different time points within one week following high-power microwave exposure in rats in order to provide data for formulating protective strategies and elucidating the mechanisms of microwave-induced cardiac injury. Methods Male Wistar rats were exposed to high-power microwave radiation in the S-band （2.856 GHz） at an average power density of 50 mW/cm⊃2; for 30 min. At 1, 3, and 7 days post-radiation, cardiac electrophysiological function, macroscopic morphology, and microscopic structure were assessed using serum biochemical analysis （the cardiac enzyme profile, injury markers, and ion concentrations）, electrocardiography （ECG）, echocardiography, hematoxylin-eosin （HE） staining, and transmission electron microscopy. Results Rectal temperatures significantly increased in rats after microwave irradiation. Biochemical results of the serum showed significant increases in levels of aspartate aminotransferase, lactate dehydrogenase, and creatine kinase at 1 and 7 days post-microwave exposure. Peak changes in fatty acid-binding protein, cardiac troponin T, N-terminal pro-B-type natriuretic peptide, and serum calcium and potassium ion concentrations occurred at 3 days post-exposure, indicating maximal injury at this time point. ECG revealed decreased heart rate, prolonged R-R intervals, and shortened corrected QT intervals at 1 day post-irradiation. Three days after exposure, heart rate increased and P-wave amplitude was elevated, but all parameters largely returned to control levels by day 7. Echocardiography suggested significant thickening of the interventricular septum and left ventricular wall, along with increased left ventricular mass starting at 3 days post-irradiation. These structural alterations persisted until day 7. Histopathological and ultrastructural observations confirmed that myocardial injury peaked at 3 days post-radiation, characterized by inflammatory cell infiltration, myofibrillar disarray, mitochondrial swelling and vacuolation, and disruption of sarcomere structure. These lesions were mitigated by day 7, but complete recovery did not occur. Conclusion 2.856 GHz high-power microwave radiation induces acute cardiac injury in rats, manifested as myocardial enzyme leakage, ion homeostasis imbalance, abnormal electrical activity, and tissue structural remodeling. The effect of injury occurs in a time-dependent manner and peaks at 3 days post-radiation. By day 7, there is partial recovery, yet residual structural abnormalities persist.

Objective To establish a technology for rapid recognition of fear emotions in order to facilitate the monitoring and interventions of fear emotions among personnel doing unusual jobs based on the fNIRSNet model. Methods Functional near infrared spectroscopy （fNIRS） was used to record the changes of cerebral blood oxygen activities in 50 subjects watching non-thrilling and thrilling videos,whose emotions were assessed based on Self-Assessment Manikin （SAM）.Signals of blood oxygen in response to the two types of videos were labeled and preprocessed. Channels with significant differences were identified by calculating the Beta value.The features of data on fNIRS in the activated region of the brain where the channels were located were extracted. The fNIRSNet algorithm was used to establish a fear emotion recognition model, and the accuracy was evaluated using the 50-fold cross-validation method. Results The SAM showed that fear emotions were induced, and the brain region activated by fear emotions was located in the medial prefrontal cortex. The fNIRSNet algorithm could help classify fear emotions with high precision by analyzing the data on the 20 s short time series, with an accuracy of 82.36%. Conclusion This technology for emotion recognition based on the fNIRSNet model is capable of rapid and accurate assessment of fear emotions, which can be used for related monitoring and interventions.

目的 调查中国维和医疗分队空运后送对象分布特点,为促进维和空运医疗后送行动时效与安全提供参考。方法 回顾性调查2003—2018年刚果（金）、苏丹、马里、黎巴嫩等4个联合国维和任务区空运医疗后送情况,描述性统计分析空运伤病员的伤情分布与疾病种类特点。结果 在811例空运伤病员中,疾病占比66.3%,创伤占比33.7%。创伤病例中,脑损伤、骨折合计占比超50%。疾病病例中,非传染性疾病占比64.5%,传染性疾病占比35.5%。结论 维和空运后送对象具有多样化特点,既有常见脑损伤、骨折等创伤伤员,又有疟疾、肺结核、艾滋病等传染病病员。建议加强颅脑与骨创伤医护力量及卫生防疫,针对后送对象差异灵活调整机载药材物资编配,严格落实空运医疗后送业务操作规范,提升多元文化与冲突环境伤病员空运的时效与安全。

Objective To establish a field-deployable, rapid and highly sensitive detection method for Hendra virus nucleic acidusing clustered regularly interspaced short palindromic repeats （CRISPR） combined with the easy-readout and sensitive enhanced （ERASE） technique on lateral flow test strips. Methods Based on the conserved region of the Hendra virus N gene, specific primers for recombinase-aided amplification （RAA） and CRISPR RNA （crRNA） were designed and synthesized. The target sequence was amplified using RAA technology, followed by detection with the CRISPR/Cas13a system. The amplified products were subsequently analyzed using ERASE lateral flow test strips to interpret the results. Results This assay was able to reliably detect Hendra virus nucleic acid at as low a concentrationas 1 copy/μL within one hour withoutthe use of complex laboratory equipment. There was no cross-reactivity with nucleic acids from seven other RNA viruses that caused similar clinical manifestations.In simulated sample tests, the assay achieved 100% concordance with the expected results. Conclusion This study has established a field-deployable and highly sensitive detection method for Hendra virus nucleic acid based on isothermal amplification combined with the CRISPR-ERASE platform, which can contribute to rapid on-site detection of and control over Hendra virus transmission.

Animal models of intestinal diseases and two-dimensional intestinal tissue cell cultures have served as essential research tools for investigating intestinal diseases. Unlike conventional animal models for intestinal diseases, human intestinal organoids （HIOs） can lessen differences in species-specific backgrounds, costs of experiments and ethical concerns associated with animal experimentation. Human intestinal organoids have intestinal crypts and villus structures, which can simulate the structures of human intestinal tissues more realistically than simple cell culture systems. This review outlines the development of human intestinal organoids in general and methodological systems for inducing and differentiating human induced pluripotent stem cells （hiPSCs） into human intestinal organoids in particular. It also describes the latest advancements in applications of human intestinal organoids in terms of their roles in disease modeling, drug screening and evaluation, and tissue regeneration. An in-depth study on hiPSC-derived HIOs will not only facilitate innovative research into intestinal biology, but also offer a more biomimetic and ethically viable model platform for mechanistic studies on related diseases and clinical translation.