As the emergency of the COVID-19 pandemic has come to an end, there have been changes in the global R&D of COVID-19 vaccines. In general, the demand for COVID-19 vaccines in many countries has been diminishing, related R&D is losing steam, the number of ongoing projects that have made no progress or have been terminated has increased, and the remaining projects are turning to innovative technologies such as mRNA vaccines and recombinant protein vaccines. Since 2023, more than ten COVID-19 vaccines have been approved globally, most of which are upgraded versions of the original vaccines developed by research institutions targeting different variants of Omicron. In terms of developments, the R&D of COVID-19 vaccinesis becoming more innovative.Positive progress has been made in some of the next-generation COVID-19 vaccines aimed at providing broad-spectrum and long-lasting protection and in respiratory infectious disease combination vaccine projects. China should formulate workable plans, promote sustainable research and development of COVID-19 vaccines, and make key technical reserves to prevent and addresspandemics and public health emergency risks in the future.

Cognitive dysfunction, predominantly a consequence of neurodegenerative disorders, is a burgeoning health issue. Odor molecules have the unique ability to circumvent the blood-brain barrier through the olfactory pathway, exerting a direct influence on cognitive-related brain regions including the entorhinal cortex, hippocampus, and amygdala, without transiting through the thalamus. These olfactory molecules, mostly sourced from natural plant essential oils, are characterized by significant volatility, minimal adverse reactions, and abundant availability. Hence, research into and applications of olfactory stimulation in improving cognitive dysfunction have raised widespread concerns. This article reviews the relationship between the olfactory pathway and cognitive brain regions, and explores the mechanism by which natural plant essential oils alleviate cognitive dysfunction through olfactory stimulation in order to provide a reference for improving cognitive function via olfactory stimulation.

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

Mesenchymal stem cells have emerged as a promising cell therapy for anti-tumor research due to their homing properties,low immunogenicity,anti-angiogenic activity,anti-inflammatory properties,and paracrine effects. Paclitaxel has been clinically used for over thirty years in the treatment of various tumors such as ovarian cancer,lung cancer,and breast cancer. However,the broad-spectrum anti-tumor properties of paclitaxel are not possessed by the aforementioned cell therapies. Moreover,its adverse reactions,including peripheral neuropathy,bone marrow suppression,and gastrointestinal reactions,have long plagued cancer patients. In recent years,many studies have focused on combining cell therapy with chemotherapy to achieve better treatment outcomes,giving rise to a new drug delivery system that utilizes mesenchymal stem cells as carriers for delivering chemotherapeutic drugs. This review summarizes the research progress in MSC-based drug delivery systems for paclitaxel.

Cognitive ability assessment and cognitive enhancement techniques play an important role in maintaining and improving human cognitive function, psychological and emotional stability, and in enhancing work efficiency.This paper begins by introducing the theory of cognitive ability, influencing factors and cognitive assessment methods before summarizing the latest progress in current cognitive enhancement strategies and technological paths and analyzing their prospects of applications in order to provide reference for the development and application of personnel cognitive assessment and cognitive enhancement technology in the future.

预防和降低战斗应激对战斗力的损伤一直是美军军事医学研究的重点领域之一。美军在战斗应激调控方面确定了防治基本原则,成立了专门组织和机构,编写了多类指导手册,明确了医疗后送体制,建立了系列评估工具,规范了相关数据采集,未来将更加重视战斗应激控制与管理,提高心理卫生服务利用,加强战斗应激控制实践。

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

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

Objective To discover 5-HT_2A receptor antagonist molecules with novel structures and explore their structure-activity relationship through structure- and mechanism-based drug design, synthesis and activity evaluation. Methods The way in which pimovanserin interacted with 5-HT_2A receptor was analyzed via molecular docking, molecular dynamics simulation and binding free energy calculations.Based on the results of this study, the 5-HT_2A receptor antagonist target compounds with novel structures were designed using pimovanserin as the lead molecule. According to the structures of target compounds, corresponding synthetic routes were designed. The heterocyclic methylamine intermediates were obtained by reductive amination or reduction reaction from heterocyclic formaldehyde or heterocyclic methanonitrile before being reacted with 4-（4-fluorobenzylamino）-1-methylpiperidine to obtain the target compounds using CDI urea synthesis method. The inhibitory activity of the target compounds against 5-HT_2A receptor was tested at the cellular level, and the anti-hallucinogenic effects of the target compounds were tested in the mouse head twitch response model. Results Twelvenovel compounds were synthesized and their structures were confirmed by HR-MS, ¹H-NMR and ¹³C-NMR. The results of the activity assay showed that compounds 6a, 6c and 6d exhibited better 5-HT2Areceptor inhibitoryactivity with IC₅₀ values of 120, 152 and 285 nmol/L, respectively while compounds 6c and 6d exhibited better anti-hallucinogenic activity in mice with inhibition rates of 97.0% and 82.9% （10 mg/kg）, respectively. Results The novel compound 6c and 6d have shown strong 5-HT_2A receptor inhibitoryactivity and anti-hallucinogenic activity and deserve more research. Structure-activity relationship analyses of target compounds indicate that the repulsion of the heterocyclic ring with basic N atoms and the accommodation of the heterocyclic ring without basic N atoms by the side extended pocket of the 5-HT2A receptor could significantly affect the ex vivo and in vivo effects of antagonists.

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

Objective To evaluate both the causal relationship between plasma metabolites and the risk of knee osteoarthritis （KOA） and the potential mediating or masking effect of immune cells using Mendelian randomization （MR） systems. Methods The GWAS data on 1400 plasma metabolites, 731 immune cell traits and KOA was retrieved from the genome-wide association study （GWAS） database. Two-way MR analysis was used to evaluate the causal relationship between plasma metabolism and KOA. Two-step mediation MR analysis was conducted to evaluate immune cell traits that might have mediating or masking effects. Results After sensitivity analysis and screening, 65 plasma metabolites and 35 immune cell traits were found to have causal relationships with KOA （P<; 0.05）. Mediation analysis found that CD45RA+ CD28- CD8br %CD8br had a mediating effect in the causal relationship between three metabolites （2-hydroxyhippurate, X-07765, X-23739） and the risk of KOA. 2-hydroxyhippurate （salicylic acid） exerted a masking effect, and the effect ratio was 0.0412. Results A variety of plasma metabolites and immune cell traits are causally related to KOA, which should not be regarded as a simple degenerative joint disease. The protective effect of salicylic acid against KOA may be weakened by its role in inducing the differentiation of Treg cells, which is worthy of more studies.

Objective To optimize the solid-phase synthesis process of phosphorodiamidate morpholino oligonucleotide （PMO） and determine the optimal reaction conditions. Methods The PMO tetramer PMO-TTTT was synthesized according to the reported reaction conditions, followed by purification through a semi-preparative high-performance liquid chromatography （HPLC） process. PMO-TTTT was structurally verified using nuclear magnetic resonance （NMR） and high-resolution mass spectrometry. With purified PMO-TTTT as a reference, a calibration curve was established, which subsequently guided the optimization of the reaction conditions for the solid-phase coupling reaction process, including the organic base, additives, duration of reaction and temperature. Under the optimized reaction condition, the anti-influenza A virus PMO sequence, PMO-flu, was synthesized and purified using a nucleic acid purification device. Results The optimal parameters for PMO solid-phase synthesis were determined. The organic base was N-ethylmorpholine, the additive was lithium iodide, the best temperature was 30 ℃, and the duration was 90 minutes. Conclusion The PMO solid-phase synthesis process has been established. LiI has been screened as a potent coupling reaction additive which could significantly boosts the efficiency of PMO solid-phase synthesis.

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

Objective To investigate the effects of 0.5 Gy ⁶⁰Co γ-ray irradiation on intestinal tissue injury and intestinal microflora in mice. Methods C57BL/6N mice were irradiated with 0.5 Gy ⁶⁰Co γ-ray at 1 d, 3 d, 7 d and 14 d after irradiation. Jejunum tissues were fixed and frozen, and feces were frozen. Hematoxylin-eosin staining was used to observe the pathological injury to jejunum after irradiation, ki67 immunohistochemical staining was adopted to detect the proliferation of jejunum crypt cells, and TdT-mediated dUTP nick end labeling was employed to detect the apoptosis of jejunum crypt cells. The expressions of TNF-α, IL-1β, IL-6 and IL-10 cytokines in small intestines were detected via radioimmunoassay. The changes of intestinal flora in mice after irradiation were analyzed by metagenomic sequencing, and LEfSe analysis and ROC analysis were used to screen the bacteria with significant differences. Results After 0.5 Gy ⁶⁰Co γ-ray irradiation, the proliferative cells of the jejunal crypt were significantly decreased at 1 d after irradiation（P<0.05）, while the apoptotic cells were significantly increased at 1 and 3 d after irradiation （P<0.01）. The expression of TNF-α at 7 and 14 d after irradiation, that of IL-1β at 1,3,7 and 14 d after irradiation and that of IL-6 at 3,7 and 14 d after irradiation were significantly increased （P<0.05）, while the expression of IL-10 at 7 and 14 d after irradiation was significantly decreased （P<0.05）. After 0.5 Gy ⁶⁰Co γ-ray irradiation, intestinal flora composition changed significantly at phylum, genus and species levels, and Lactobacillus murinus, Lactobacillus johnsonii, Alistipes-unclassified, Mucispirillum schaedleri underwent the most significant changes and had higher LDA scores. Conclusion The whole body irradiation of 0.5 Gy ⁶⁰Co γ-ray can cause intestinal tissue damage and change the composition of intestinal flora in mice.

Objective To determine the infectiousness of the respiratory syncytial virus （RSV） 18537 strain of subtype B in different host cell lines and evaluate its pathogenicity and pathological damage in various animal models. Methods The cytopathic features, viral plaque morphology, viral protein expression, and in vitro proliferation efficiency were assessed to determine the basic biological characteristics of such infections. Nasal drops were used to infect 10-month-old BALB/c mice and 6-week-old cotton mice. The viral load in lung tissue after infection was detected, and the pathological injury was analyzed to assess the pathogenicity. Results The RSV 18537 strain of subtype B strain induced polynuclear fusion in Hep-2 cells, and typical viral plaques were formed in BHK-21 cells. In addition, viral proteins could be detected in Hep-2 and A549 cells. In BALB/c and cotton mice infected with nasal drops, viral nucleic acids were detectable in lung tissue on day 5 post-infection. This dose caused mild thickening of alveolar walls with scattered lymphocytes and neutrophil infiltration. Results The RSV 18537 strain of subtype B can be effectively proliferated in Hep-2 and A549 cells while infecting BALB/c mice and cotton mice, resulting in pathological injury to lung tissue. The 18537 strain of RSV subtype B is less contagious than the A2 strain of subtype A both in cells and animals.

A high-altitude environment is characterized by low oxygen levels, low pressure, and low temperatures. Exposure to the plateau environment often causes damage to the body, leading to the occurrence of acute mountain sickness/chronic mountain sickness（AMS/CMS）. Research indicates that acute or chronic exposure to the special environment can result in overall organ dysfunctions, such as those in the heart and gastrointestinal tract. The damage to the body caused by exposure to the plateau environment is closely related to acute and chronic hypoxia. Physiological maladjustment or disease is usually accompanied by changes in the structure of the gut microbiota. There have been reports on the correlations between the gut microbiota and bodily harm caused by high-altitude exposure. However, the specific types of bacteria involved and the mechanisms of action are still under investigation. This article reviews the intestinal tissue damage caused by low oxygen levels, immune activation, changes in microbial community structure, and differential metabolic products. The association and underlying mechanisms between bodily harm due to high-altitude exposure and the intestinal microbiota are also explored in hopes of stimulating new lines of thought related to the prevention and treatment of bodily harm caused by exposure to the plateau environment.

Objective To investigate the genetic characteristics and recombination of human-infected sapoviruses （SaVs） worldwide using bioinformatics. Methods The complete genome sequences of SaVs were downloaded from the National Center for Biotechnology Information （NCBI） while high-quality complete genomes were retained for analysis. Molecular phylogenetic trees of SaVs were constructed to analyze their genetic characteristics, followed by recombination analysis of human-infected SaV strains genetype Ⅰ,Ⅱ,Ⅳ, andⅤ （GⅠ, GⅡ, GⅣ, and GⅤ） with recombination analysis software. Results SaVs exhibited substantial genetic diversity worldwide and infected a wide range of hosts. Human-associated SaVs included GⅠ, GⅡ, GⅣ, and GⅤ, with GⅤ shared between human and swine hosts. Genetype recombination analysis of SaVs revealed a high frequency of recombination in SaV GⅡ strains that involved diverse hosts in the field of SaV GⅤstrains. Recombination breakpoints of the virus were concentrated in the major viral proteins 1 （VP1） and minor viral proteins 2 （VP2）. Results Based on systematic analysis of the genetic characteristics of human-infected SaVs, the genotype distribution and prevalence of SaVs are investigated, the recombination patterns of SaV revealed, and its genetic dynamics highlighted. These findings can offer insights into epidemiological trends of viruses and help devise effective prevention and control strategies.

Objective To offer a detailed review of developments in research on noise-induced hearing loss by constructing a knowledge map in order to provide data for related studies in China. Methods The literature related to research on noise-induced hearing loss was retrieved from the Web of Science and used as the subject. Such software for visualization analysis as VOSviewer, CiteSpace and Bibliometrix was used to construct the knowledge map. The way in which research on noise-induced hearing loss evolved was explored in terms of trends of publication, co-occurrence networks and co-occurrence of key words. Results Research on noise-induced hearing loss was fast-developing. The United States ranked first in this field in terms of the total number of articles published and citations. China took the second place in the number of articles published. The top institutions in the number of articles published included the University of Michigan, University at Buffalo SUNY, Harvard, Karolinska Institute and National Institute for Occupational Safety and Health. Conclusion Research in this sphere started with cochlear hair cells. Cochlear implant,hidden hearing loss and cochlear synaptopathy have come to be the hot spots for related research. Research on hair cell regeneration and sex difference has provided a new line of thought for the gene therapy and hormone therapy of noise-induced hearing loss.

Objective To determine the optimal conditions for CXCR4 upregulation by comparing the expression levels of chemokine （C-X-C motif） receptor 4 （CXCR4） in MSCs cultured with varying concentrations of oxygen and hydrogen peroxide （H₂O₂）. Methods MSCs were cultured with 0.1%, 1%, or 3% O₂ and 50 μmol/L H₂O₂ for different lengths of time （3, 6, 12, and 24 h）. The mRNA and protein expressions of CXCR4 in MSCs were measured by real-time quantitative PCR （qPCR）, Western blotting, and immunofluorescence staining. The viability and chemotactic ability of MSCs were measured using CCK-8, wound-healing and Transwell migration assays. Results Both hypoxia and H₂O₂ treatment were found to upregulate MSC expressions of CXCR4 to some extent. The mRNA and protein levels of CXCR4 were higher after 6-12 h of culture of MSCs with 3% O₂, and significantly higher when treated with H₂O₂ for 6 h. Cell viability was significantly increased after culture with 3% O₂ compared with the control group and both 3% O₂ and H₂O₂ pretreatment could enhance chemotactic migration in MSCs. Conclusion Culture with 3% O₂ and H₂O₂ pretreatment can upregulate CXCR4 expressions in MSCs and enhance migration in cells, with superior effects observed with 3% O₂. Therefore, treatment with 3% O₂ represents the best choice for upregulating the chemotactic ability of MSCs.

Sleep disorders are characterized by difficulty falling asleep or maintaining sleep, excessive sleepiness, abnormalities of respiration during sleep, disturbances of the sleep-wake cycle and abnormal movements that disturb sleep. The incidence is increasing year by year, which causes a wide range of mental diseases and metabolic disorders, and impacts the health of soldiers. Sleep scales, regarded as one of the main methods for screening and diagnosing sleep disorders, are currently in the spotlight. This review describes the characteristics of different sleep scales in the hopes of providing data for proper selection of sleep scales in the assessments and diagnosis of different sleep disorders, and improving the sleep quality of soldiers.

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

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

Objective To establish a mouse model of liver aging induced by irradiation combined with hepatectomy. Methods A model was established via single irradiation combined with hepatectomy. The survival rate, body weight, liver index and liver function of the mice were detected. The expressions of senescence-associated secretory phenotype factors in serum were detected with enzyme-linked immunosorbent assay （ELISA） and flow cytometry. The mRNA levels of senescence-associated secretory phenotype factors and telomerase in liver tissue were detected by real-time quantitative PCR （qPCR）. The expressions of cyclin dependent kinase inhibitor 1A （CDKN1A） and cyclin dependent kinase inhibitor 2A （CDKN2A） were determined by Western blotting. ELISA was used to calculate senescence-associated β-galactosidase （SA-β-Gal） and lipofuscin levels. Tissue malondialdehyde levels were measured using the thiobarbituric acid （TBA） method. The size of hepatocyte nuclei and lipid accumulation were detected by hematoxylin-eosin （HE） stainingand oil-red-O while triglyceride levels in the liver were studied with the weighing method. Results After irradiation combined with hepatectomy, the body weight of mice was significantly reduced, the liver index was not significantly affected, but the transaminase level was significantly increased. The levels of SA-β-Gal and lipofuscin increased while telomerase activity decreased significantly, and the nucleus size increased. The expressions of cyclin dependent protein kinase inhibitors CDKN1A and CDKN2A increased. The levels of senescence-associated secretory phenotype factors were significantly increased. Hepatic lipid deposition and oxidative damage were aggravated. Results A mouse model of liver aging induced by irradiation combined with hepatectomy has been established.

Military camps are characterized by compact space and high personnel density, which increases the risk of emerging respiratory infectious diseases and makes prevention and control difficult. One effective solution is to use a compartment model for early warning, prediction of epidemic outbreaks, and for optimization of precautions. Given the strong similarities in the transmission of emerging respiratory infectious diseases across military camps and communities, this article summarizes the cases where compartment models have been used both at home and abroad, constructs a susceptible-exposed-infectious-removed model and a susceptible-exposed-infectious-quarantined-removed model, and simulates the prediction of trends and selection of prevention and control measures in typical military camp scenarios after the outbreak of an epidemic in hopes of providing references for the prevention and control of emerging respiratory infectious diseases and for the construction of a regional intelligent early warning platform in military camps.

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

Objective To analyze the incidence of and risk factors for white matter hyperintensity （WMH） in pilots. Methods A retrospective case-control study was performed. The subjects were 1,415 pilots ages 19 to 58 who had undergone cranial MRI examination in a hospital between September 2020 and August 2023. They were divided into two groups： the WMH group and the control group （without WMH）. Univariate and multivariate logistic regression analysis were used to identify the risk factors for WMH. Results There were 219 cases in the WMH group and 1,196 cases in the control group. The total incidence of WMH was approximately 15.48%, with mild, moderate and severe cases of WMH accounting for 70.78%, 24.20%, and 0.47%, respectively. Regression analysis results showed that age （OR=1.625,95%CI：1.099-2.404） and flight time （OR=1.282, 95%CI： 1.033-1.592） were risk factors for WMH in pilots. Conclusion The incidence of WMH in pilots was approximately 15.48%. Most of WMH were mild according to Fazekas grading. Age increase and long flight time are risk factors for WMH in pilots.

Objective To study the influence of rosemary essential oil inhalation on the memory of mice experiencing sleep deprivation and to delineate the possible mechanisms involved. Methods C57BL/6J mice were randomly divided into four experimental groups in this study： a control group （Con）, a control group with rosemary essential oil inhalation （Con+REO）, a sleep deprivation group （SD） and a sleep deprivation group with rosemary essential oil inhalation （SD+REO）. A 72-hour sleep deprivation model was induced using the multiple platform water environment method, with the Con+REO and SD+REO groups exposed to rosemary essential oil inhalation. Cognitive function was evaluated through Y-maze and novel object recognition tests. The hippocampal tissue was analyzed for superoxide dismutase （SOD） activity and the concentrations of malondialdehyde （MDA） and glutathione （GSH）. ELISA was used to determine the levels of norepinephrine （NE）, dopamine （DA）, and serotonin 5-hydroxytryptamine（5-HT） in the hippocampus. The expression levels of postsynaptic density 95 （PSD95） and brain-derived neurotrophic factor （BDNF） in the hippocampus were determined using immunoblotting techniques. Results Compared with the Con and Con+REO groups, the SD group demonstrated a significant reduction in the spontaneous alternation percentage in the Y-maze as well as the novel object recognition index. Additionally, there was a pronounced decrease in hippocampal SOD activity and GSH content, a substantial elevation in MDA levels, and a decrease in the levels of DA, NE, and 5-HT. The expressions of PSD95 and BDNF proteins also decreased. In comparison with the SD group, the SD+REO group exhibited a significant increase in the spontaneous alternation percentage in the Y-maze and the novel object recognition index. There was also a marked increase in hippocampal SOD activity and GSH content, a reduction in MDA levels and elevated levels of NE and DA. Moreover, the expressions of PSD95 and BDNF proteins were upregulated. Results The inhalation of rosemary essential oil enhances the memory of sleep-deprived mice, and the underlying mechanism may involve the mitigation of oxidative stress within the hippocampal tissue, the modulation of neurotransmitter levels, and the facilitation of synaptic plasticity.

Objective To study the differences in features of event-related potentials （ERPs） and target detection accuracy between five brain regions （frontal,temporal,central,parietal,and occipital） in target detection tasks based on rapid serial visual presentation （RSVP） brain computer interface （BCI） under six target concealment conditions. Methods Twelve participants were selected for the study,whose scalp electroencephalogram （EEG） signals were collected under the six concealment conditions using a NeuroScan SynAmps2 EEG acquisition system.The ERP waveforms,P300 amplitudes and latencies,among other things,were compared across the five brain regions.The hierarchical discriminant component analysis （HDCA） algorithm was used to classify the EEG signals while the differences in classification accuracy were probed across the five brain regions. Results （1） Under the six concealment conditions,target images elicited distinct ERP waveforms in all the five brain regions; （2） For P300 amplitudes,the temporal region exhibited the smallest values; （3） Regarding P300 latencies,the parietal and central regions showed longer durations than other brain regions （except for small camouflage and small occlusion conditions）; （4） In terms of classification accuracy,the parietal and central regions outperformed other brain regions （except for the large camouflage condition）. Results The selection of parietal and central channels can offer a new perspective for enhancing the performance in concealed target detection based on RSVP-BCI,and is expected to spark new ideas for the design of miniaturized,simple and wearable BCI devices.

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

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

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

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

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

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

Objective To explore the impact of pH value of the reaction system on the properties of bovine hemoglobin modified with aldehydeated polyethylene glycol （PEG-bHb）. Methods PEG-bHb conjugates were synthesized under varying pH conditions（6.0, 6.5, 7.4 and 8.0 ） of the reaction system while consistent molar ratios, temperature, and reaction time were maintained. The structural and functional attributes of PEG-bHb were characterized. Results The proportion of methemoglobin decreased with an increase in pH. In a weakly acidic reaction environment, the PEG-bHb was found to be relatively highly modified. At pH 6.5, the average number of PEG chains attached to the bHb surface was 6.86±0.38. Selective PEG modification of the N-terminal α-NH2 groups was more pronounced under weakly acidic conditions. Specifically, at pH 6.5, the modification efficiency of the N-terminal α-NH2 groups of bHb by aldehyde-activated PEG reached 95.4% for the α-chains and 99.3% for the β-chains. The PEG modification influenced the heme region microenvironment of bHb, with minimal structural impact observed at pH 6.5. After modification, the oxygen affinity of PEG-bHb was enhanced, the Hill coefficient was reduced, and there were significant increases in colloid osmotic pressure, viscosity, and particle size, all of which differed markedly from the unmodified bHb group （P<0.001）. Results The synthesis of PEG-bHb under weakly acidic conditions can result in a high degree of selective modification of the N-terminal α-NH2 groups and an overall high degree of modification.

Objective To investigate the infectivity of hepatitis A virus （HAV） cell-adapted strain in a type I interferon receptor-deficient mouse model. Methods The biological charateristics of HM175/18f were identified, including the viral protein expression and viral proliferation by indirect immunofluorescence,Western blot and real-time quantitative RT-PCR in vitro. Then, type I interferon receptor-deficient A129 mice were infected with HM175/18f via intravenous injection. The viral RNA load in serum, feces and liver tissues of infected mice were detected to determine the replication of HAV in vivo. The level of serum alanine aminotransferase （ALT） and HE staining of liver tissues were used to evaluate liver injury. Additionally, the dynamic changes of HAV-specific IgG antibody was detected to assess the humoral immune response induced by HM175/18f. Results A129 mice infected with HM175/18f did not show obvious clinical symptoms, nor was the ALT level significantly elevated. However, viral RNA persisted in the liver tissue of infected mice until 42 days after infection. There was focal infiltration of lymphocytes and neutrophils in the liver tissue of infected mice, but no focal necrosis was observed. More importantly, HM175/18f infection caused significant viremia and sustained fecal virus shedding. In addition, HM175/18f induced a significant HAV-specific humoral immune response in A129 mice. Conclusion Our study has revealed the infectivity of HAV cell-adapted strain HM175/18f in type I interferon receptor-deficient mice, and identified the attenuated characteristics of HM175/18f, which not only contributes to our understanding of the pathogenesis of HAV, but also expand the applications of a type I interferon receptor-deficient mouse model in the study of hepatitis A.

Objective To investigate the applicability of simulation technology in the development of medical support plans and the evaluation of their effectiveness by focusing on the combat operations between Russian and Ukrainian forces over the Kherson region. Methods The casualties and medical evacuation routes of Russian military troops were conceptualized based on publicly available data from the Internet. Computer simulation methods were used to model the wartime medical evacuation by Russian troops and the results were quantitatively analyzed. Results Based on independent operations and combined operations of different medical evacuation routes, quantitative indicators such as treatment efficiency at three levels （field hospitals, evacuation hospitals, and base hospitals）,evacuation efficiency, and casualties were obtained. Conclusion By constructing multiple parallel and backup evacuation routes, the efficiency of medical evacuation can be improved, with casualties reduced, and the relative safety and stability of evacuation ensured.

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.

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

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