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

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

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

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.

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.

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

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.

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

With the development of technology, humans are increasingly exposed to radio frequency electromagnetic fields. Previous studies have shown that radio frequency radiation could affect public health, but there was no consensus on whether radio frequency radiation affected human cognitive function, and most experimental results were not reproducible. Based on literature currently available, this paper reviews the measurement and control methods of public exposure and laboratory exposure to radio frequency electromagnetic fields, and the effects of long term and short term electromagnetic radiation on cognitive function and neural activity of the human brain. The existing problems are summarized, prospects are predicted, and recommendations are given as to how the influence of radio frequency electromagnetic fields on cognitive function should be studied in the future.

Anxiety and fear,as common symptoms of psychiatric disorders,remain inadequately understood in terms of their pathogenesis. Changes in immune inflammation are considered to play a significant role in both the pathological and physiological processes associated with these mental illnesses. In recent years,it has been demonstrated that stress can regulate immune inflammation through multiple pathways,including the regulation of the autonomic nervous system,the hypothalamic-pituitary-adrenal axis,indoleamine 2,3-dioxygenase and its metabolite kynurenine,and the gut-brain axis. These pathways are implicated in the onset and treatment of anxiety and fear-related mental illnesses. This article focuses on the relationships between anxiety and fear-related mental illnesses and immune inflammatory responses.

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

Objective To 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.

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

Objective To investigate the role of the piriformcortex in regulating attentional behavior in mice. Methods Adult male C57BL/6J mice were subjected to a 5-choice serial reaction time task （5-CSRTT）. Immunofluorescence staining was performed to detect expressions of cellular FBJ murine osteosarcoma viral oncogene homolog protein （c-Fos） in the piriform cortex. The changes of attentional behavior in the 5-CSRTT test were explored following either stereotactic injection of diphtheria toxin A virus to specifically damage piriform cortex neurons or chemogenetical inhibition of the neuronal activity inthe piriform cortex. Results It was found that the expression of c-Fos in the 5-CSRTT-tested mice was significantly increased compared to the control.Both lesion and chemogenetic inhibition of piriform cortex neuronsreduced the accuracy of attention,but omission rates and premature responses remained unaffected in the 5-CSRTT test. Conclusion Piriform cortex neuronsmay play a critical role in modulating attentional processes in mice.

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

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

Objective To develop a system for retrieving information from clinical records of Traditional Chinese Medicine （TCM） based on generative large language models（LLMs）. Methods Applicational needs of the system were analyzed, and entity types to be retrieved were identified. The functions, workflows, and architecture of the system were designed by combining the automatic retrieval capabilities of LLMs with human-in-the-loop （HITL）. The software was developed using such frameworks as vLLM and Node.js. Interaction of multiple commercial/open source LLMs was implemented using OpenAI-compatible interfaces. The quality of information retrieved from LLMs was enhanced by prompt engineering. Results This system supported task allocation, automatic retrieval of structured information, and manual review. To evaluate its performance, the moonshot-v1-8k model was used to retrieve clinical records of TCM before manual edition was performed. Combining large language model pre-annotation with meticulous annotator edits improved accuracy by 26.6% compared to the BERT-BiLSTM-CRF model, and enhanced extraction efficiency by 1.6-fold relative to purely manual methods. Conclusion General generative LLMs can retrieve a wide range of entity information from TCM records with high accuracy and scalability. The design and implementation of this system approach may provide a useful reference for developing other biomedical information retrieval systems.

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

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

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

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

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

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

Objective To develop a new model for predicting compound toxicity and exploring related toxicity mechanisms using transcriptomic data and gene ontology knowledge. Methods Using the TOXRIC database, two toxicity-related datasets were constructed and a Tox VNN model was established that incorporated gene ontology knowledge to evaluate compound toxicity and identify key biological processes. Results Tox VNN demonstrated good predictability.The identification of important biological processes related to CYP enzyme activity and p53 pathway stress response provided insights into the toxicity mechanisms. Conclusion The Tox VNN,which integrates data and knowledge,can not only ensure high predictability,but also effectively identify important biological processes related to toxicity. This model offers a new approach to predicting and understanding compound toxicity in drug safety evaluation.

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

Objective To explore an assessment model for multi-level integrated training in health service based on advanced intelligent trauma simulators in order to innovate health service training. Methods An assessment model for multi-level integrated training that involved advanced trauma simulators was adopted to assess chains of treatment and rescue that were composed of multi-hierarchy medical institutions. The assessment focused on trauma emergency response capabilities at each level and the overall therapeutic effect. Results In terms of capabilities for treatment and rescue, group B was the best one, followed by group C and group A. As for the overall therapeutic effect,group A was outstanding, followed by group B and group C. Based on the priorities of combat casualty care, the final results of assessment were as follows： group A was the best one, followed by group B and group C. Conclusion The analysis of processes and outcomes of assessment reveals the edge of this model, as evidenced by the continuity of treatment and rescue, integrity of overall effectiveness, and adaptability of this assessment model.

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

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

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

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

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

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

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

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

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

Objective To study the relationships between Helicobacter pylori （Hp） infection and the occurrence of osteoporosis via Meta-analysis. Methods Two researchers independently retrieved related literature related to the association between Hp infection and osteoporosis and published in such databases as PubMed, EMBASE and Cochrane Library, China Science and Technology Journal Database, China National Knowledge Infrastructure （CNKI）, and Wanfang Database as of February 2024. STATA 11.0 software was used for Meta-analysis before the combined OR value and its 95%CI were calculated. Results Twenty-four studies involving 24 936 participants were included in the study. Meta-analysis showed that Hp infection was significantly associated with the risk of osteoporosis （OR：1.52,95%CI：1.17-1.99）. Those infected with the CagA-positive Hp strain were more likely to develop osteoporosis （OR：2.42,95%CI：1.32-4.43）. Hp infection was significantly associated with decreased bone mass（OR=1.32,95%CI：1.08-1.62）,but the decrease of bone mineral density in Hp-positive patients was not significant compared with Hp negative controls. Conclusion Infection with Hp, particularly the CagA-positive strain, has been associated with an increased risk of osteoporosis. The bone health of Hp-positive patients deserves more attention.

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

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