未来海战中，反舰导弹将作为交战双方的主要作战武器。掌握反舰导弹打击舰船后的伤亡情况及伤员伤情分布对卫勤保障建设有着重要意义。本文通过历史数据收集及文献查阅，对二战以来的有关资料进行了整理分析。统计结果显示反舰导弹造成的伤亡比例增高，受打击舰船沉没的几率减小；在未来的医疗救治中，要着重关注炸伤、烧伤、吸入伤、贯通伤的救治，同时，也应警惕海水浸泡伤对伤员的危害。

Objective To investigate the role of Kelch-like- epichlorohydrin-associated protein1/nuclear factor erythroid-derived factor-2-related factor 2 （Keap1-Nrf2） and nuclear factor-κB（NF-κB） signaling pathways in sepsis-associated encephalopathy（SAE）. Methods Male C57BL/6J mice of SPF were randomly divided into four groups （n=10）： the control group and LPS 6 h, 24 h and 48 h groups. The behavioral changes of the mice were assessed based on their general conditions and open field test（OFT）. ELISA was used to measure the levels of pro-inflammatory cytokines in mouse serum, and the antioxidant capacity assay kit to examine antioxidant activity in brain tissues of mice. Real-time quantitative PCR（qPCR） was adopted to detect the mRNA levels of toll-like receptor4 （Tlr4）, NF-κB, Keap1 and Nrf2 in the hippocampus, and to determine protein expressions of NF-κB、Nrf2、Keap1 and Tlr4 with Western blotting. Results Compared to the control group, the serum concentrations of interleukin 6 （IL-6） in lipopolysaccharide（LPS） groups increased at 6 h, and reached the peak at 24 h and 48 h （P<0.01）. The levels of serum interleukin 18 （IL-18） in the LPS groups increased significantly at 6 h and 24 h （P<0.01） but there was no statistically significant difference compared with the 48h group. The results indicated the activity of superoxide dismutase（SOD） and glutathione（GSH） in brain tissues in LPS groups increased（P<0.01）. OFT results showed the time spent in the center of the open field, the distance covered around the center, and total distance covered by mice in LPS groups were significantly reduced （P<0.01）,except for the time spent in the center of the open field in the LPS 24 h group. The mRNA expressions of Tlr4 and （LPS 6 h, 48 h） NF-κB in the hippocampus tissue of mice in LPS groups were elevated （P<0.05）, so were the mRNA expressions of Keap1 and Nrf2 in LPS 6 h group. Additionally, the protein expressions of NF-κB, Keap1 and Tlr4 increased in LPS groups, so did the protein expression of Nrf2 in LPS 24 h and 48 h groups（P<0.05）. Conclusion Keap1-Nrf2 and NF-κB signaling pathways may play a certain role in SAE.;

目的 从技术管理和情报研究角度评估经颅磁刺激技术的研究活跃度、技术成熟度以及发展现状，以期为该技术的研究与临床应用、技术评估实证研究提供参考和借鉴。方法 选取经颅磁刺激技术的文献和专利数据作为研究样本，综合采用统计分析、社会网络分析等方法，运用Bicomb、Loglet Lab和UCINET软件，进行数据统计分析、网络图谱绘制等。结果 经颅磁刺激技术当前具有较高的研究活跃度，技术发展处于第2阶段由成长期向成熟期的过渡时期。技术的研究方向分散、深度不足，核心主题仍然缺乏。现阶段研究热点将为经颅磁刺激技术的临床应用提供支持。结论 在下一发展阶段，经颅磁刺激技术机理机制的解析、神经生物效应研究等主题有望成为研究热点。技术评估实证研究中，应加强多维度数据的挖掘与分析，引入专家咨询法。

Objective To analyze the hotspots and developments in the field of language model-assisted artificial intelligence （AI） for antibody design and optimization in order to provide reference for research on development of antibodies. Methods By using CiteSpace software, hotspots of research were analyzed based on literature retrieved from the Web of Science, PubMed, and Scopus databases, focusing on three pivotal areas of research related to antibody design and optimization： the construction of pre-trained language models for antibodies, the generation of antibody sequences, and the prediction of three-dimensional structures of antibodies. In addition, this analysis reviewed the major advances in each of the specified research tasks, focusing on the delineation of similarities and differences across studies and dominating challenges in this field. Results From 2019 （10 publications） to 2023 （89 publications）, the scale of and interest in this field kept increasing. Hotspots involved leveraging language models to assist the design or optimization of humanized, high-affinity, and highly specific antibodies. Within each research, methods were characterized by the diversity of model architectures, consistency of training data, and variations in training strategies. Challenges to the field included sparse antigen data, computational power limitations, and insufficient integration of wet and dry lab experiments. Conclusion Research in language model-assisted AI antibody design and optimization is gaining momentum and proves fruitful. However, researchers should be alert to the inadequate attention to antigen-antibody interactions and insufficient integration of experimental and computational validation, conduct more in-depth research and expand applications.

Objective To identify stable reference genes for a comparison of the transcription levels of target host genes under viral infection in order to provide data for studies on interactions between the host and the influenza virus. Methods Reverse transcription quantitative real-time PCR （RT-qPCR） was performed to detect the relative expression levels of six candidate reference genes, including glyceraldehyde 3-phosphate dehydrogenase（GAPDH）, β-actin, 18S RNA, β; 2-microglobulin （B2M）, ubiquitin-conjugating enzyme E2D2（UBE2D2）, and ribosomal protein L37A（RPL37A） in classical cell models （A549 cells and THP-1 cells） under different conditions. The stability of the reference genes was evaluated using such methods as BestKeeper, GeNorm, NormFinder, and comparative ΔCt method. Results The stability of reference genes varied depending on conditions. When such experimental factors as influenza virus infection and immune activation were taken into consideration, β-actin and GAPDH were identified as the most stable reference genes in A549 cells and THP-1 cells, followed by UBE2D2 and B2M. Conclusion The optimal reference genes in A549 cells and THP-1 cells under influenza virus infection or after being treated with interferons or LPS have been identified, which is of referential value for studying the mechanisms of viral infections.;

血管生成是肿瘤生长、增殖和迁移必不可少的过程。肿瘤血管生成机制非常复杂，受到多种信号因子的调节。VEGFR作为影响血管生成的关键信号因子，在过去二十多年里成为了抗肿瘤药物研发的重要靶点。VEGFR已被证实是肾细胞癌、胃肠道间质瘤、肝细胞癌、白血病等多种类型肿瘤的治疗靶点。基于小分子药物与靶蛋白的构效关系能够使得新化合物结构的设计和优化更加高效，因此成为关注的重点。目前，已有14个VEGFR抑制剂上市，许多VEGFR抑制剂正处于临床试验阶段，还有大量的在研小分子化合物处于活性测试阶段。本文综述了已上市的14个VEGFR抑制剂及部分具有发展潜力的处于临床试验阶段和近期公开发表的VEGFR小分子抑制剂的研究进展，就其结构特征和临床适应症进行了总结，并阐述了未来VEGFR抑制剂的主要研究方向和面临的挑战。

Military training injuries are a common and frequently occurring disease in the army， which pose a serious risk to the health of soldiers and combat effectiveness. On the basis of the larger number of pilot projects for military training injury prevention and control and the "three tours" carried out by the whole army， the research group organized experts in related fields of military training injury prevention and control to compile the Expert Consensus on Principles of Diagnosis and Prevention of Military Training Injuries （hereinafter referred to as the "Consensus"） in line with the principles of putting prevention first， taking into account the reality， highlighting key points and proper rehabilitation by reference to the Regulations on Health Protection in Military Training. The "Consensus" has explicitly specified the definition， diagnostic basis， diagnostic criteria， classification criteria for injuries， diagnostic points， treatment principles and prevention principles of military training injuries. It aims to guide military surgeons at each level to effectively carry out early prevention， standardized diagnosis， treatment and rehabilitation intervention of military training injuries， which will play an important role in the prevention and treatment of military training injuries in the whole army.

Proteolysis-targeting chimeras （PROTAC） is a bifunctional molecule that targets protein of interest （POI） for degradation by co-opting the ubiquitin-proteasome system （UPS）. In recent years, PROTAC technology has been widely explored as a novel therapeutic strategy for cancer, autoimmune diseases, neurodegenerative diseases and viral infection, which has become a hot spot and priority for drug development. This review is intended to outline the important milestones and the key research progress in the field of PROTAC, offer recommendations on the design of PROTAC,and describe the challenges to and prospects of targeted degradation by PROTAC.

Objective To explore the role and possible mechanism of transforming growth factor-β3 （TGF-β3） in radiation-induced lung epithelial cell injury, and to provide data for the prevention and treatment of radiation-caused lung injury. Methods The type Ⅱ transforming growth factor -β receptor （TGFBR2） siRNA was designed, synthesized and screened for cell TGFBR2 interference. Human bronchial epithelial cells （Beas-2B cells） and their TGFBR2 interference cells were randomly divided into the control group, 5 ng/ml TGF-β3 acting group （TGF-β3 group）, 6 Gy ⁶⁰Co-γ-ray irradiation group （6 Gy group）, and 6 Gy ⁶⁰Co-γ-ray irradiation+5 ng/ml TGF-β3 action group （6 Gy+TGF-β3 group）. The expressions of collagens and TGFBR2 in each group were detected by real-time fluorescence quantitative PCR（RT-qPCR）, and the expression of smooth muscle actin （α-SMA）, a marker of epithelial-mesenchymal transition（EMT）, was detected by RT-qPCR and Western blotting. Cell apoptosis and cell cycle were analyzed by flow cytometry. Results （1） TGF-β3 could significantly inhibit the expressions of collagens induced by radiation and reduce the abnormally high expressions of α-SMA gene and protein, which was a marker of EMT induced by radiation, suggesting that TGF-β3 could effectively protect against lung cell fibrosis induced by radiation. （2） TGF-β3 could inhibit abnormally high expressions of TGFBR2 induced by radiation, and had significant protective effect on cell apoptosis and G₂/M phase arrest induced by radiation.（3） The protective effect of TGF-β3 on radiation-induced apoptosis and G₂/M cell cycle arrest was lost after TGFBR2 interference, suggesting that TGF-β3 exerted its inhibitory effect on radiation-induced lung epithelial cell injury through TGFBR2. Conclusion TGF-β3 can protect radiation-damaged lung epithelial cells through TGFBR2.

Vaccines are considered a powerful weapon against major epidemics. As one of the most successful and cost-effective public health interventions, vaccination plays an important role in controlling widespread infections and maintaining military strength. The US military medical institutions have been committed to vaccine research and development （R&D） for many years. They have developed numerous effective vaccines against bacterial and viral infections, which play a crucial role in global deployment of the U.S. Armed Forces. The main spheres, priorities and characteristics of related research in these institutions are of significant referential value. This paper outlines the main research institutions engaged in vaccine research and the representative vaccines currently in preclinical and clinical trials, and summarizes the main strategies of the U.S military to promote R&D of vaccines, which is expected to provide data for R&D of vaccines in China′s armed forces.

The United States Bipartisan Biodefense Committee has issued the “ The Apollo Program for Biodefense-Winning the Race Against Biological Threats ” and the “ Athena Agenda： Advancing the Apollo Program for Biodefense”. This program conducted an exhaustive analysis of the scenario of biosecurity facing humans, proposed the objectives to be achieved, listed the priorities of research on core technologies and recommended specific measures for implementation. The program is an important tool for understanding the long-term U.S. response to biological threats. This paper outlines and analyzes the main contents of the program so as to provide reference for the construction of biosecurity defense in China.

In the future, all-domain operations will pose new challenges to Combat Casualty Care. To deal with these challenges, the U.S. military has continued to innovate the model and concept related to health services,impacting the new style of Combat Casualty Care. This article summarized the U.S. military's progress in Combat Casualty Care management and research in 2021, analyzed the measures taken by the U.S. military, including the continuous promotion of the health-information system reform, updating the new edition of Combat Casualty Care Guidelines, and organizing advanced training on Prolonged Casualty Care by focusing on the layout of a number of prospective projects as well as the new technologies and equipment for Combat Casualty Care in order to provide reference for the development of Combat Casualty Care here in China.

Objective To make an exhaustive study of the evolution, status quo and future developments of wearable technologies for monitoring of exercise across the world via knowledge graphs in order to provide reference for related research in China’s military. Methods Data on wearable technologies for monitoring of exercise collected from literature that was retrieved from Web of Science was used as the subject. Bibliometrix and other visual analysis softwares were used to construct knowledge graphs. The essential characteristics of developments of wearable technologies for monitoring of exercise were explored in terms of trends of publication, co-occurrence networks and co-occurrence of key words. Results The field of wearable technologies for monitoring of exercise was growing fast. Institutional cooperation was characterized by intraregional cooperation. The United States held an important position in the global innovation cooperation network. Conclusion As the leading author of co-occurrence network, Professor Zhonglin Wang has contributed greatly to the collaboration between research teams. Artificial intelligence, big data, cloud computing and other technologies have become hotspots in this field. The application and development of new materials has gone a long way towards making monitoring devices thin, skin-friendly and traceless.

This article reviews the research progress in military operational medicine of the U.S. Armed Forces in 2023 in terms of improved capabilities of health care in extreme natural environments, intervention strategies to improve nutrition and water security, assessment and monitoring of sleep quality, beeter hearing protection and optimization of physical fitness training. These measures are intended to improve the all-round and multifaceted level of operational performance of soldiers. This article is expected to provide useful reference for related research.

目的 观察高原某部驻守不同时间的驻训官兵血常规各个指标的差异，为维护保障高原驻训官兵健康提供科学依据。方法 对进驻海拔4200～4500米高原驻训1年、2年、5年的驻守官兵共153名，进行血常规检测，并进行统计学分析。结果 与驻训1年组相比，驻训2年组全血白细胞总数（WBC）、中性粒细胞总数（NEUT）、淋巴细胞比率（LYM%）、中间细胞比率（MID%）、中性粒细胞比率（NEUT%）、红细胞总数（RBC）、血红蛋白（HGB）、红细胞压积（HCT%）、血小板分布宽度（PDW）变化显著，同时NEUT%、RBC、HGB、HCT%、血小板压积（PCT%）的异常发生率变化显著；与驻训2年组相比，驻训5年组全血WBC、淋巴细胞总数（LYM）、中间细胞总数（MID）、NEUT、LYM%、MID%、NEUT%、RBC、HGB、HCT%、平均血红蛋白浓度（MCHC）、血小板平均体积（MPV）、PDW、大血小板总数、大血小板比率（P-LCR）变化显著，同时NEUT%、RBC、HGB、HCT%的异常发生率变化显著。结论 高原环境下不同驻训时间官兵的血常规指标发生明显的改变，应根据不同驻守时间对高原驻训人员有针对性的实施高原卫勤保障措施。

Objective To investigate the effect of classical neurotransmitter-serotonin-on innate immunity against DNA viruses and its potential molecular mechanism. Methods Blood samples of mice were collected at different time points after HSV-1 infection. Serotonin concentrations in serum were detected by enzyme-linked immunosorbent assay （ELISA）. At the cellular level, cells were pretreated with serotonin or a serotonin transporter inhibitor before being stimulated by HSV-1 or exogenous dsDNA to induce type Ⅰ interferon production. The mRNA levels of type Ⅰ interferon and viral replication were detected by real-time quantitative PCR, and the activation of cGAS-STING pathway was detected by Western blotting. Mice were pretreated with serotonin and then infected with HSV-1. Serum was collected and the levels of type Ⅰ interferon were detected by ELISA. Organs were collected to detect the amount of virus replication by real-time quantitative PCR. Results After HSV-1 infection, serotonin concentrations in serum of mice increased. Pretreatment with serotonin inhibited the production of type I interferon in immune cells during HSV-1 infection, and the viral replication increased. In mice, serotonin treatment suppressed the host type Ⅰ interferon response during HSV-1 infection, resulting in elevated viral infection. Studies on the mechanism showed that the effect of serotonin depended on serotonin transporters. Serotonin could inhibit both the phosphorylation of key proteins in the cGAS-STING pathway and the expression of the interferon, thus affecting the host antiviral innate immunity. Conclusion Serotonin can inhibit antiviral innate immunity mediated by cGAS-STING pathway, which is expected to provide a new target for research and development of antiviral drugs.

Synthetic biology not only has broad economic prospects and social benefits, but also has potential application value in the military field. In recent years, the U.S. Armed Forces has grasped the frontier hotspots of synthetic biology, carried out applied research of synthetic biology in the military field, and sought innovative breakthroughs in the fields of military materials, military energy, military medicine and military sensing. This paper analyzes the development of synthetic biology, the prospect of military application and the deployment of related science and technology of the U.S. Armed Forces for reference.

Organoid technology is a new frontier technology in the field of life sciences. An organoid is now defined as a 3D structure derived from either pluripotent stem cells （PSCs） or organ-restricted adult stem cells （ASCs） and critically dependent on the multi-lineage differentiation and self-organization potential of stem cells in culture. Most excitingly,many recent studies describe organoids as consisting of organ-specific cell types,exhibiting key structural and functional properties through cell sorting and spatially restricted lineage commitment. Human organoids can overcome the disadvantages of traditional biomedical models-2D cell lines and animal models,thus filling the gap of ex vivo human tissue accessibility and related ethical considerations. The rapid advancement of organoid technology revolutionizes biomedical research,promises exciting new insights into developmental biology and opens new routes for necessary clinical approaches to treating human diseases and regenerative medicine. In this review,we discuss the definition of organoids,origin of organoid technology,potential clinical translation applications and existing challenges.

Given the profound influence of cognitive ability of military pilots on the skills of information acquisition, situational awareness and decision making in battlefield environments, cognitive enhancement targeting military pilots has become a hot topic in cognitive neuroscience. This paper elaborates the principles and effects of three intervention methods for cognitive enhancement of military pilots： cognitive training intervention, non-invasive brain stimulation technology, and cognitive enhancement drugs and supplements. Furthermore, prospective interventions will involve by big data modeling, artificial intelligence, and biomedical engineering so that cognitive enhancement research can become multi-modal, adaptive, and personalized. In the increasingly complicated and competitive battlefield environments, the progress in cross-disciplinary research on cognitive enhancement should be accelerated, which will help military pilots gain a competitive/edge on the battlefield in the future.

Post-traumatic stress disorder （PTSD） is a complicated psychiatric disorder that results from exposure to a series of events, with anxiety or depression as the main manifestations, which is prevalent among veterans who used to be deployed. In recent years, the continuous military deployment has induced a persistent mental health crisis in U.S. service members as well as veterans. Such mental disorders as PTSD have kept the rate of suicide rising faster than the war has. The US military attaches great importance to research on PTSD in order to reduce its adverse effect on combat readiness while improving the ability of military personnel to cope with future conflicts. This article reviews the epidemiology and diagnostic criteria of PTSD in the US military. The medical countermeasures for and research progress of PTSD in the US Armed Forces are summarized from the perspective of pharmacologic prevention, cognitive behavioral therapies, other psychological interventions and potential innovative therapies. Some of the key training programs carried out by the US Armed Forces are listed and analyzed as well. This article is expected to provide useful reference for related research in China.

Sleep disorders are abnormalities in sleep duration or quality caused by factors that range from insomnia, circadian rhythm sleep disorders to abnormal behavioral disorders during sleep. Long-term sleep disorders may affect the emotions and physical strength of soldiers, impair their learning and cognitive ability, and even increase the prevalence of physical and mental diseases, which may be detrimental to their physical and mental health and combat effectiveness. This article is intended to review the current research progress in sleep disorders in military personal at home and abroad.

美国疾病预防控制中心为全世界所熟知，有关美军疾病预防控制机构建设经验方面的研究资料却较少。美军疾病预防控制机构是推动“部队全面健康保护”发展理念的主要卫勤力量，为了适应全球作战的现实需要，美军疾病预防控制领域的学科体系不断完善、组织机构不断优化、工作机制不断健全、技术能力不断提升、军民融合不断深化。本文主要对美军疾病预防控制机构的沿革和现状进行描述和分析，为我军疾病预防控制机构建设与发展提供参考。

Objective To find out about the current literacy level and awareness rate of health among recruits in a unit,and analyze the influencing factors so as to provide reference for formulating programs for health education and health promotion. Methods A total of 1846 recruits were surveyed via the China Citizen Health Literacy Questionnaire compiled by China Health Education Center in 2015,involving three dimensions--basic health knowledge and theory, healthy lifestyle and behavior, and fundamental skills and involving six types of problems--scientific health concepts,infectious disease prevention and treatment,chronic disease prevention and treatment,safety and first aid,basicmedical care, and health information. χ² test and multivariate unconditional logistic regression analysis were used. Results The overall level of health literacy among these new recruits was 8.88%,the score of health literacy was 37.07±12.45,and the health literacy awareness rate was 60.56%. Among the three dimensions,the level of life-styles and behavior was the lowest,which was 10.18%. Among the six types of problems,the literacy level of chronic disease prevention and control was the lowest（9.75%）. The awareness rate of health information was the lowest,which was 48.91%. There were 24 items（48% of the total） where the awareness rate was less than 60%. Among them,the awareness rate of the benefits of eating soybean was the lowest（9.53%）,followed by descriptions of the liver（only 10.78%）. Multiple Logistic regression analysis showed that the health literacy level of females was higher than that of males （OR=2.407,95%CI：1.430-4.054）. Compared with urban areas, the health literacy level in rural areas was lower（OR=0.613,95%CI：0.436-0.862）. The health literacy level of recruits with a college education and above was the highest （OR=1.799, 95%CI：1.216-2.664）.And the health literacy level of mothers who were farmers was the lowest （OR=0.491, 95%CI：0.303-0.797）. Conclusion The health literacy level of new recruits is low,especially regarding the prevention and treatment of diseases,suggesting that the military should make related knowledge more accessible to recruits and enforce health interventions.

Objective To establish a model of pulmonary fibrosis-prone and fibrosis-resistant mice and screen the differential genes in lung tissues before and after irradiation by telomere and telomerase real-time fluorescence quantitative PCR（RT-qPCR） microarray. Methods The chests of C57BL/6J and C3H/HeN mice were irradiated with 20 Gy ⁶⁰Co gamma rays. The differences in radiation-induced pulmonary fibrosis（RIPF） progression between them were studied via HE staining, sirius red staining, hydroxyproline content, TGF- β and CTGF detection. Telomere and telomerase RT-qPCR microarray was used to compare the expressions of telomere and telomerase related genes in their lung tissues before irradiation and 3 months after irradiation. The differential genes were verified by RT-qPCR. Results The fibrotic lesions of C57BL/6J mice were more obvious than those of C3H/HeN mice 3 months after irradiation. The content of hydroxyproline in lung tissues of C57BL/6J mice was significantly higher than before irradiation and in C3H/HeN mice（P<0.05）, and much more collagen typeⅠwas deposited in the alveolar wall of C57BL/6J mice than in that of C3H/HeN mice. The contents of TGF-β and CTGF in lung tissues of C57BL/6J mice were significantly higher than in those of C3H/HeN mice（P<0.05）. There were 48 differential genes in telomere and telomerase related pathways in lung tissues of control C57BL/6J and C3H/HeN mice and 32 differential genes were found in the lung tissues of the two types of mice 3 months after irradiation. Moreover, 8 differential genes were discovered in the lung tissues of C57BL/6J mice 3 months after irradiation and 4 discrepant genes were detected in the lung tissues of C3H/HeN mice after irradiation. The differential gene Tnks2 was verified. The expression of Tnks2 in lung tissues of C3H/HeN mice 3 months after irradiation was higher than that of C57BL/6J mice and before irradiation（P<0.05）. Conclusion Differential genes in telomere and telomerase related pathways in lung tissues of fibrosis-susceptible and fibrosis-resistant mice are found before and after ⁶⁰Co gamma rays irradiation.

Objective To investigate the protective effect and mechanism of glutathione peroxidase 3-（GPx3） modified mesenchymal stem cells （MSC） against radiation-induced lung injury （RILI）. Methods GPx3-modified MSCs were injected into the tail vein of mice whose lungs were irradiated with 20 Gy. Lung tissues were collected and sections were stained to observe pathological changes. The expression levels of inflammation-related factors were detected by real time quantitative PCR（qPCR）, while the levels of malondialdehyde （MDA）, H₂O₂, and 8-hydroxyguanine （8-OHG） were detected via biochemical experiments. Additionally, RNA damage was assessed by reverse transcription blocking combining with double primer PCR. Results GPx3-modified MSCs significantly improved the pathological damage in post-radiation lung tissues and inhibited the fibrosis process and inflammatory response. GPx3-modified MSCs were able to scavenge reactive oxygen species （ROS） more effectively, resulting in a reduction of lipid peroxidation products such as MDA and oxidative damage to RNA formation of 8-OHG. Conclusion By decreasing ROS accumulation, GPx3-modified MSCs can potentially reduce oxidative damage and attenuate RILI. GPx3-modified MSCs can improve the therapeutic efficacy against RILI.

Objective To evaluate the protective effect of dental pulp stem cells （DPSCs） against high-altitude pulmonary edema （HAPE） and explore the mechanism. Methods Twenty-one Sprague-Dawley rats were randomly divided into the normal control group （Control）, high altitude pulmonary edema group （HAPE） and DPSC prevention group （DPSC）. Three days and one day before the hypobaric and hypoxia environment was simulated, DPSCs were administrated via the tail vein in the DPSC group, and phosphate buffered saline（PBS） of the same volume was injected in the control group and HAPE group. After that, rats in the HAPE group and DPSC group were placed in a simulated hypobaric and hypoxic cabin to simulate the environment at an altitude of 6000 m before an HAPE model was established. The rats were sacrificed 3 days later, and the histopathological changes of lung tissue were observed via hematoxylin-eosine （HE） staining. The dry/wet weight of lung tissues was recorded. The concentrations of total protein in lung homogenate were detected using the BCA method. The expression of aquaporin 1 （APQ-1） in lung tissue was detected by real-time reverse transcription polymerase chain reaction （RT-PCR） and Western blotting. Colorimetry and enzyme linked immunosorbent assay （ELISA） were used to detect the concentrations of plasma vasoactive substances. The expression of inflammatory factors in serum and lung tissue was detected by ELISA and RT-PCR respectively. Results After three days of treatment in a simulated hypobaric and hypoxic environment, the lung tissue of the HAPE group showed infiltration of inflammatory cells, alveolar wall thickening, alveolar septum thickening and increases of exudation. DPSC prevention could significantly reduce the histopathological damage to the lung. Lung water content （LWC） and total protein content of lung homogenate were significantly increased in the HAPE group but obviously reduced in the DPSC prevention group, and the difference between the two groups was statistically significant （P<0.01）. The protein and mRNA expression levels of AQP-1 in lung tissue of the HAPE group were significantly decreased, but prevention via DPSCs could enhance the expression of AQP-1 in lung tissue. In the HAPE group, the concentrations of nitrous oxide （NO） and prostacyclin （PGI2） in plasma were significantly decreased, but prevention via DPSCs could significantly increase the expression of plasma vasoactive substances. The expressions of inflammatory factors interleukin-1α （IL-1α） and tumor necrosis factor-α（TNF-α） in serum and lung tissue of the HAPE group increased significantly, but decreased in the DPSC prevention group. Conclusion DPSCs can help prevent high-altitude pulmonary edema in rats by promoting the expression of aquaporin, increasing the content of vasodilators in plasma and reducing the expression of inflammatory factors in serum and lung tissue.;

The plateau refers to areas above 2500 m in altitude in medical terms, which can lead to intense stress in the body and bring about a variety of plateau diseases. Research on altitude acclimatization has identified a great number of factors associated with these diseases, and many genetic and non-genetic alterations have been identified inplateau populations, but the mechanisms involved have not yet been fully explored. This paper reviews the progress of research on altitude acclimatization by summarizing the levels of genomes, transcriptomes, proteomes and physiological changes in these populations.

The intestine-on-a-chip is a cutting-edge and in vitro research model of human intestines that has gained much attention in recent years. In comparison to traditional static culture models of intestinal epithelial cells, the intestine-on-a-chip offers numerous advantages. It accurately mimics the morphological structure of the intestine in vivo, allowing for the simulation of the microphysiological environment in intestinal tissues. Furthermore, it can be customized on a large scale and enables high-throughput drug screening. The intestine-on-a-chip has widespread applications in various areas, including the development of intestinal disease models, as well as drug screening and testing. The technology behind the intestine-on-a-chip is based on a co-culture system of intestinal epithelial cells and other cell types. Such chips can not only construct three-dimensional structures such as intestinal microvilli and folds in combination with microengineering techniques, but also replicate the intricacies of the intestine. Microfluidic devices are employed to simulate biomechanical parameters like blood flow and physiological peristalsis within the intestinal tissues, thus giving such chips microphysiological characteristics akin to those of natural intestinal tissues and subjecting it to biomechanical regulation. This review provided an overview of the advances in intestine-on-a-chip technology, focusing on cell co-culture techniques, microfluidic technology, and microengineering techniques. Furthermore, the application of this technology in intestinal disease modeling, and drug screening and testing were summarized.

The term “junshi yixue” has two meanings in Chinese. One is health care among the military troops and the other is military medical sciences. Another term “weisheng qinwu” also has two meanings in Chinese. One is the administration of military health care and the other is military medical services. Different meanings of these terms have left the Chinese military healthcare providers confused for many years. This article discusses in detail the different meanings of those two terms and draws three conclusions about their relationships.

Objective To identify the sensitive indexes for heat acclimatization by observing the changes of physiological and psychological indexes in the process of heat acclimatization training in order to recommend workable on-the-scene expertise. Methods One hundred and thirteen young male soldiers were enrolled for fourteen days of heat acclimatization training. 3000-meter running was chosen as the quantitative load exercise. The changes of physiological and psychological indexes before and after 3000-meter running at four time points in the process of thermal conditioning training were monitored. Such devices as the body activity meter with a heart rate belt, infrared thermometer and weight scale were used to monitor the heart rate during the plateau phase, body temperature （temperatures of the ear, forehead and palm skin）, amounts of perspiration during the 3000-meter running and the time taken by the 3000-meter running. Rating of perceived exertion（RPE）, thermal sensation（TSV） and sweat feeling index（SFI） were measured by means of questionnaires. Results With the prolongation of heat acclimatization training, the D-value of ear temperatures before and after 3000-meter running trended up （P<0.05） before trending down. The 3000-meter running was finished in a shorter time （P<0.01）, that is, the soldiers were improved athletically. The training-impulse（TRIMP） of 3000-meter running （heart rate × performance） was significantly decreased （P<0.01）, suggesting enhanced cardiovascular function. Conclusion The TRIMP of 3000-meter running and D-value of ear temperatures are easy to monitor and sensitive to changes, which can be used as the first-choice indexes for the evaluation of heat acclimatization at the site of training.

This paper is intended to analyze the driving force behind and main strategies for innovation and development of individual protective equipment in extreme environments by the U.S. Armed Forces,and outline the current developments and representative achievements of individual protective equipment by the U.S. Armed Forces for environments of high altitude, extreme cold and extreme heat. It is recommended that the top-level design be adopted, physiological modeling and analysis technologies for big data be given more attention, key technologies be innovated, and intelligent, information-based and lightweight new individual medical protective equipment be developed with more effort.

Sepsis is a global health issue that poses a serious threat to human health. The high incidence and complex pathogenic mechanism of sepsis are the main causes of death in critically ill patients. Cytokine storm is a phenomenon characterized by a tremendous amount of cytokine production,which is manifested as the uncontrolled systemic inflammatory response caused by the overactive immune system and plays an important role in sepsis. This article reviews the research progress in the mechanism and treatment of cytokine storm in sepsis in order to provide new ideas and strategies for clinical practice.

Objective To explore the effects of different types of fatigue and negative emotion factors on sleep quality and to analyze the correlations between sleep quality and alertness so as to provide data for improving sleep quality and cognitive ability of soldiers. Methods A total of 142 male soldiers were selected. Levels of fatigue, emotional state, sleep quality and alertness were measured using the Fatigue Symptom Questionnaire, Symptom Checklist?90 （SCL-90）, Pitts?burgh Sleep Quality Index （PSQI） and Psychomotor Vigilance Task （PVT） respectively. Results The PSQI score of these soldiers was 5.16±2.66, which was significantly higher than the norm for adults （P＜0.01） but lower than the norm for soldiers stationed on the plateau and along frontiers （P<0.05）. Soldiers with a PSQI≥7 were considered to suffer from sleep disorders, accounting for 31% of the soldiers tested. The total scores of fatigue， SCI?90 and PSQI were positively correlated （r=0.40, P<0.01;r=0.48, P＜0.01）, and psychosensory symptoms were positively correlated with daytime dysfunction （r=0.54, P＜0.01）. When the sleep disorder group was compared with the good sleep group， there were significant differences in each dimension of fatigue and sub?factor of emotion （P＜0.05）. The total score of fatigue （B=0.03， P=0.023） and that of SCL?90 （B=0.07， P=0.015） were the primary determinants of sleep quality. The total score of PSQl （B=0.01， P＜0.01）, which was an influencing factor of alertness, was positively correlated with the mean reaction time of PVT （r=0.55，P＜0.01）. Conclusion Compared with ordinary adults, the soldiers take a much longer time to fall asleep, which is likely to lead to serious sleep problems, such as a significant decline in subjective sleep quality, sleep time and sleep efficiency. The cumulative effect of various types of fatigue, negative emotions, and the synergy between fatigue and emotions can impact sleep quality. Targeted measures can be taken to improve sleep based on the cumulative effect and synergy among various factors. Regulation of sleep is critical to posts which require high alertness. Sleeping longer before tasks, naps between tasks, and active adjust after tasks can help maintain alertness.

Biological toxins are toxic molecules produced by specific microorganisms, plants or animals. Due to their wide range of sources and high toxicity, the availability of protein and non-protein toxins is becoming increasingly important, some of which are used for military purposes and developed as biotoxin warfare agents. In this paper, the classification and mechanism of action of biological toxins are discussed. In addition, the strategies for prevention and control of biological toxins as well as their therapeutic applications are reviewed.

目的：研究乳腺癌细胞转化为血管内皮细胞的功能和机制。方法：利用流式细胞分选术，从乳腺癌细胞中分选CD44+／CD24-/low乳腺癌干细胞；将分选后的乳腺癌干细胞经干细胞细胞培养基培养，检测其成球能力；通过蛋白质印迹法和流式细胞分析法检测在乳腺癌干细胞中内皮细胞Marker的表达；通过成管实验检测乳腺癌干细胞的体外成管功能。结果：分选获得CD44+／CD24-/low乳腺癌干细胞；CD44＋CD24－ ／low 乳腺癌干细胞具有更强的成球生长能力；在CD44+／CD24-/low乳腺癌干细胞中，Western Blot 检测发现CD31、CD105、VEGFR2表达升高，流式分析检测发现CD31含量增加；乳腺癌干细胞可以促进体外成管。结论：乳腺癌细胞可以转化为血管内皮细胞，促进体外成管。

目的 使用指示细菌、病毒代替有传染性的细菌、病毒，研究实验操作产生的微生物气溶胶风险，为相关的实验室活动的风险评估提供科学的数据。方法 负压实验室内用高浓度指示细菌和病毒（噬菌体）进行实验室中多种实验操作产生的气溶胶风险，包括高浓度吹吸混匀、高浓度培养瓶意外跌落、离心管破裂产生的气溶胶风险实验。安德森六级采样器主动采样和沉降平皿被动采样两种方法进行微生物气溶胶采样。根据采样结果得到各种实验操作产生的气溶胶风险。结果 在模拟的各种正常和意外事故的实验室操作中，在模拟的测试条件下高浓度气溶胶吹吸在局部环境中产生的细菌气溶胶风险最高浓度为1823CFU/m3、病毒气溶胶最高浓度为1852PFU/m3，高浓度培养瓶破碎产生的细菌气溶胶风险最高浓度为9326CFU/m3、病毒为9337PFU/m3，离心管破裂时产生的细菌气溶胶风险最高浓度为138CFU/m3、病毒为134PFU/m3。结论 病原微生物实验操作中存在着产生很高微生物气溶胶的风险。实验人员要遵守操作规程，选择合适的防护装备。

The emergence of stress medicine is based on the fact that humans are subjected to increasingly intense physical and psychological stress and stress-induced or exacerbated stress diseases. Stress medicine is a comprehensive interdisciplinary subject that studies the coping responses to stressors such as special environment, occupational factors and demands, as well as related medical problems. With the focus of stress research gradually shifting from physical stress to psychological stress and the increasingly close relationship between stress and diseases, stress medicine gradually emphasizes psychological stress, highlights special stress, improves operational ability, and highlights medical elements. By studying the biological mechanisms that trigger mental symptoms, developing new diagnostic criteria and treatment methods based on genetic, physiological, and cognitive data rather than just symptoms, is a trend in the prevention and treatment of stress diseases.

Objective To explore the in vivo pharmacokinetics of meloxicam nanocrystals of different particle sizes in animals. Methods Meloxicam nanocrystals of different particle sizes were prepared via wet media milling, and the stability of particle size was monitored. The changes of crystal shape before and after milling were investigated by X-ray powder diffraction analysis （XRPD）, and the pharmacokinetics of nanocrystals of different particle sizes in animals was studied. Results The prepared meloxicam nanocrystals maintained stable particle size at room temperature for 15 days, and there was no significant change in crystal shape before and after milling. The area under the plasma drug concentration curve （AUC_{0~24 h}） of meloxicam nanocrystals with a particle size of 76（76.60±1.00） nm in rats was 1.2 times larger than that of meloxicam nanocrystals with a particle size of 360（363.87±10.50）nm. Conclusion The prepared meloxicam nanocrystals are stable in nature and the particle size has a significant effect on the in vivo bioavailability of the nanocrystal drug.

Objective To construct a knowledge map based on the literature published in Military Medicine in 1995-2021 using 3 visual analysis methods so as to keep track of the development of U.S. military medicine. Methods From the Web of Science Core Collection, a total of 8328 articles published in Military Medicine between 1995 and 2021 were retrieved before Bibliometrix, VOSviewer and CiteSpace were used to create a knowledge map of the main areas of research, hotspots and evolution of these articles. Results The number of articles published in Military Medicine journals increased year by year, with a leapfrog increase in 2019-2021. The most prominent contributors were research institutions of military medicine such as Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, and Brooke Army Medical Center. The priorities of research included mental health, exercise physiology, trauma treatment and other directions closely related to military health maintenance and to the maintenance and improvement of military health and performance. Conclusion Construction of a knowledge map of Military Medicine can facilitate intuitive, efficient and comprehensive analysis of its developments, and provide reference for keeping track of the development of U.S. military medicine.

Objective To establish a novel primer design method to improve the specificity and sensitivity of primers for the detection of highly variable bacteria. Methods Genes in literature were annotated via the gene named entity recognition technology, and a knowledge base of highly variable bacterial conserved genes was constructed to guide primer design. MAFFT, Clustal Omega, Gblocks, Primer3 and MFEprimer3.0 were used to perform multiple sequence alignment, primer design, primer evaluation and iterative design of single repeat primers. The improved indexing algorithm and parallel computing were used to achieve high-performance specificity detection. Finally, multiple primers were obtained by combining single repeat primers using the greedy algorithm. Results Primers were designed for five highly variable bacteria, including Escherichia coli, Shigella, Listeria monocytogenes, Staphylococcus aureus, and Salmonella. In comparison, the single primers designed using our method were more specific and sensitive than primers in literature for detecting the same conserved gene. The multiple primers designed for each bacterium had strong specificity, and the coverage rate of Escherichia coli primers was 93.14% in terms of sensitivity, and the coverage rate of other bacterial primers was more than 99%. Conclusion This method can be applied to the design of PCR primers for the detection of highly variable bacteria.