In military training, when the physiological heat stress load is excessive and cannot be corrected in time, heat illness may occur, and in severe cases, exertional heat stroke may occur, which will seriously affect the combat effectiveness. Rapid, effective and uninterrupted cooling is the key measure to relieve excessive heat stress reaction and prevent heat illness/stroke. Based on nearly 10 years of clinical practice experience, the scientific research achievements in heatstroke prevention areas, as well as domestic and foreign latest evidence, Expert Group of Heat Stroke Prevention and Treatment of the Chinese PLA summarized the temperature monitoring, preventive and therapeutic cooling strategies in the whole process of military training, and widely consulted the opinions of emergency and critical care experts in the military, and finally formed the consensus, thus being intended to provide guidance for the implementation of effective temperature management in military training.

Objective To investigate the effects of stem cells from human deciduous teeth (SHED) on temporomandibular joint osteoarthritis (TMJOA) in rats. Methods Sixty 8-week-old male SD rats were randomly divided into control group, sodium iodoacetate (MIA)-induced TMJOA group (MIA group) and SHED treatment TMJOA group (SHED group), 20 rats in each group, and 10 animals were sacrificed in each group 2 and 4 weeks after treatment and were collected. Temporomandibular joint (TMJ) on the left was used for morphological detection, and right TMJ condylar cartilage for molecular biology detection. The degree of cartilage degeneration was evaluated by HE and Saffron O-solid green staining, the expression of type collagen Ⅱ in condylar cartilage was detected by immunohistochemical staining, and the expression changes of cleaved-CASP3, the key molecule of apoptosis, and the pro-inflammatory factor tumor necrosis factor-α (TNF-α), were detected by Western blotting. Results Compared with control group, the arrangement of cells in each layer of condylar cartilage in MIA group was disordered, a large number of cell-free areas were visible, and the fibrous layer was significantly thickened (P<0.001). After SHED treatment, the morphology of SHED group basically returned to normal, and there was no significant difference between SHED group and control group. The histological score of Mankin's osteoarthritis of condylar cartilage in MIA group was significantly higher than that in control group (P<0.001). After treatment, the score decreased significantly in SHED group (P<0.001). The positive area ratio of Saffron-O staining and the percentage of positive area of collagen Ⅱ. Of condylar cartilage in MIA group were significantly lower than those in control group (P<0.001). After treatment, the value increased significantly in SHED group (P<0.01) and there was no significant difference compared with control group. The number of TUNEL-positive cells in the condylar cartilage in MIA group was significantly higher than that in control group (P<0.001). After treatment, this value decreased significantly in SHED group (P<0.001). Western blotting results showed that the protein expression levels of cleaved-CASP3 and TNF-α in the condylar cartilage of MIA group were significantly higher than those in control group (P<0.001). After treatment, this value decreased significantly in SHED group (P<0.001) and there was no significant difference compared with control group. Conclusion Intra-articular injection of SHED can reverse condylar cartilage degeneration induced by MIA.

Objective To investigate the effect of carbamazepine (CBZ) on Kv7.4 channels of dopaminergic (DA) neurons in the ventral tegmental area (VTA) of the midbrain of epileptic rats. Methods 50 male Wistar rats were randomly divided into 5 groups: control group, epilepsy group, and low, medium, high concentration CBZ group, 10 in each group. Except control group, rats in other groups were induced epilepsy with lithium chloride and pilocarpine to establish epilepsy rat model. After the model was successfully constructed, the rats in low, medium, and high concentration CBZ groups were given CBZ (10, 30, and 50 mg/kg) by gavage respectively, while rats in control group and epilepsy group were given the same amount of normal saline by gavage once a day for 7 days. The behavior changes of rats were observed. The malondialdehyde (MDA), glutathione (GSH) content and superoxide dismutase (SOD) activity in VTA were determinate by spectrophotometric. The protein expression of tyrosine hydroxylase (TH) and kv7.4 in VTA were detected by immunofluorescence and laser confocal microscopy. Western blotting was used to detecte the TH and Kv7.4 expression. Results No abnormal behavior showed with rats in control group. After pilocarpine injection, rats in epilepsy group experienced symptoms such as convulsions, chewing, and salivation, and the symptoms in low, medium, and high concentration CBZ group were alleviated. Compared with rats in control group, the MDA content of the rats in epilepsy group was significantly increased (P<0.05), the GSH content, SOD activity, number of DA neurons in the VTA region, and the expression of TH and Kv7.4 protein were significantly reduced (P<0.05). Compared with rats in epilepsy group, the seizure latency, GSH content, SOD activity, number of DA neurons in VTA area, and TH and Kv7.4 protein expression levels significantly increased in the low, medium and high concentration CBZ group (P<0.05); seizure rate and MDA content significantly decreased in the medium and high concentration CBZ group (P<0.05). Conclusions CBZ could alleviate oxidative stress response in brain of epileptic rats, promote DA neuron activity at VTA, activate Kv7.4 channels, and relieve epileptic seizures.

Objective To examine the differences between mouse models of classic heat stroke (CHS) with multiple organ dysfunction via two different rising strategies. Methods A total of 66 male C57BL/6J mice were divided into direct heat stroke (DHS) group (n=28), a stepwise heat stroke (SHS) group (n=28), and control group (n=10) using the random number table method. In the first two groups, animals received direct warming at 41 ℃ and stepwise warming from 25.0 ℃ to 39.5 ℃, using a simulated climate chamber, respectively. While the animals were in the climate chamber before reaching the endpoint, we constantly monitored the animal activity, animal consciousness, and rectal temperature. We randomly selected 4 animals from each group and collected the blood samples and organ tissues (liver, kidney, intestine, lung, and spleen) after 24 hours of recovery since the end of heat exposure. We used the automatic biochemical analyzer to measure the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (CREA), blood urea nitrogen (BUN), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and creatine kinase isoenzyme MB (CK-MB). We employed multifactorial test kits to detect the levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1 and transforming growth factor (TGF)-β. We analyzed the histological sections from each organ and then calculated the pathological injury scores. We saved the remaining mice for the 72 h survival analysis. Results Both heat stroke strategies can establish a stable CHS model of the mouse. In contrast with mice in DHS group, mice in SHS group exposed to heat for a longer time [(181.61±41.88) min vs. (104.72±18.68) min, P<0.001], had a higher percentage of dehydration [(11.59±1.52)% vs. (7.07±1.84)%, P<0.001] and higher 72 h mortality (73.68% vs. 22.22%, P<0.05). After 24 hours' recovery, biochemical indicators (ALT, AST, CREA, BUN) of SHS group were higher than those of DHS group [(875.63±241.24) U/L vs. (139.38±188.22) U/L, P<0.01; (2406.75±1008.69) U/L vs. (208.13±149.23) U/L, P<0.01; (79.88±41.39) U/L vs. (18.75±10.51) U/L, P<0.05; (134.33±52.54) U/L vs. (17.75±7.31) U/L, P<0.01]. The pathological injury scores of each organ tissue of the SHS group were higher than those of the DHS group (P<0.05). The levels of MCP-1 of the SHS group were higher than that of the DHS group [(22.89±1.97) pg/ml vs. (15.97±3.91) pg/ml, P<0.05], and TGF-β of SHS group was lower than that of DHS group [(936.46±30.17) pg/ml vs. (1453.50±129.81) pg/ml, P<0.001]. Conclusions The stepwise warming method had a higher success rate in developing the model, a higher mortality rate within 72 h, and more severe organ damage than the direct warming method. Thus it was a more stable and reliable modeling method that was more consistent with the pathophysiological state of CHS patients at the actual onset of illness.

Objective To investigate the protective function and mechanism of rapamycin on the hypothalamus injury of rats with exertional heat stroke. Methods Eighty male Wistar rats were randomly divided into four groups: control group, rapamycin group (Rapa group), exertional heat stroke group (EHS group), and exertional heat stroke + rapamycin group (EHS+Rapa group), with 20 rats in each group. The rats in Rapa group and EHS+Rapa group were injected intraperitoneally with Rapa (1 mg/kg, once a day) for four consecutive days before modeling. The rats in control and EHS groups were treated with the same dose of 0.9% normal saline. In EHS group and EHS+Rapa group, the rats ran in a climate chamber with a temperature range of (39.5±0.3) ℃ and a humidity range of (55%±5%). After successful modeling, the rats were removed from the climate chamber for cooling at room temperature. The animals in control and Rapa groups ran at the same intensity and room temperature as EHS group. During the establishment of the model, we monitored the general state, measured core temperature, and profiled the survival curve of the rats in each group (11 rats randomly selected from each group). The rats in EHS group and EHS+Rapa group were removed from the chamber after modeling of 80 min, and after 300 min observation, each group of rats was anesthetized. Then we collected the abdominal aorta blood and hypothalamus. The histopathological changes in the hypothalamus were analyzed by HE and Nissl staining. Immunofluorescence was used to determine the apoptosis of hypothalamus. Western blotting was used to detect the expression of mammalian target of rapamycin (mTOR) and phosphorylated mTOR (pmTOR), autophagy effector protein (Beclin-1), ubiquitin-binding protein (p62) and autophagy marker microtubule-associated protein 1 light chain 3(LC3) in the hypothalamus of rats. We calculated the ratios of pmTOR/mTOR and LC3-Ⅱ/LC3-Ⅰ. We measured the expression levels of neuron-specific enolase (NSE), brain active peptide 100β protein (S100β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in arterial serum by ELISA. Results When rats were entered into the climate chamber at 80 min, compared with control group, the core temperature of EHS group was significantly increased (P<0.001); compared with Rapa group, the core temperature of EHS+Rapa group was significantly increased (P<0.001). Compared with the EHS group, the survival rate of EHS+Rapa group was increased (P<0.01). HE and Nissl staining showed severe pathological damage in hypothalamic nerve cells in EHS group. We observed significantly less pathological damage in hypothalamic nerve cells in EHS+Rapa group than EHS group (P<0.001). Immunofluorescence analysis showed substantial cell apoptosis in the hypothalamus of EHS rats compared with control group (P<0.05). EHS+Rapa group had significantly less apoptosis in the hypothalamus than EHS group (P<0.05). Western blotting results showed that compared with control group, the ratio of pmTOR/mTOR, Beclin-1 expression, LC3-Ⅱ/LC3-Ⅰ ratio in the hypothalamus tissue of EHS group increased and p62 expression decreased (P<0.01); compared with EHS group, the ratio of pmTOR/mTOR in the hypothalamus of EHS+Rapa group decreased, Beclin-1 expression increased, LC3-Ⅱ/LC3-Ⅰ ratio increased and p62 expression decreased (P<0.05). ELISA results showed that the expression levels of NSE, S100β protein, and TNF-α in the serum of EHS group were significantly increased (P<0.05), while the expression of IL-6 in EHS group showed no significant difference (P>0.05). Compared with EHS group, the expression levels of NSE, S100β protein, IL-6, and TNF-α in the serum of EHS+Rapa group were significantly decreased (P<0.05). Conclusion Rapa can alleviate the hypothalamus tissue damage caused by exertional heat stroke, improve the function of brain cells, reduce the levels of inflammatory factors and the apoptosis of tissue cells, which is related to the inhibition of mTOR signaling pathway and the enhancement of hypothalamus autophagy level.

Objective To evaluate the hemostatic efficacy and safety of a new type of pushable compressed cellulose hemostatic device in emergency treatment of deep tissue massive hemorrhage. Methods The internal compressed cellulose hemostatic granules were placed in excess normal saline to test their saline absorption and volume expansion properties. Femoral artery blood was taken from 3 big-eared white rabbits for measuring the in vitro clotting time of the compressed cellulose hemostatic granules, and equal quality CELOX-A® hemostatic powder was set as the positive control group, and the blank plasma as negative control group. Ten rats were divided into the compressed cellulose hemostatic granule dressing group, CELOX-A® hemostatic powder group and negative control group, and plasma was taken to test the coagulation activity by using a thromboelastometer. The swine models of massive hemorrhage were established by complete transection of the femoral artery and vein, and divided into the model group of medical defatted gauze block, the pushable compressed cellulose hemostatic device group, and the positive control group of CELOX-A®. The three groups used parallel operation for hemostasis. The number of pushable compressed cellulose hemostatic device used in the hemostasis process, the number of presses, the hemostasis time, the total blood loss during the hemostasis process were recorded, the routine blood tests before and after hemostasis, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured and HE staining was used to observe the pathological changes of the tissue vessels. After DMEM medium was used to extract the pushable compressed cellulose hemostatic device, and the extract was added to L929 cells with vigorous growth to test the cytotoxicity. At the same time, the complete DMEM medium with phenol was set as the positive control group and the complete DMEM medium as the negative control group. After pushable compressed cellulose hemostatic device was extracted with normal saline, the normal saline extract was injected into the mice to test its acute toxicity, and equal volume of the normal saline into the mice in the same way as the negative control group. The normal saline was set as the negative control group and the deionized water was set as the positive control group, the hemolysis test was used to detect the hemolysis rate of pushable compressed cellulose hemostatic device. Results The compressed cellulose hemostatic granules inside the device rapidly absorbed and expanded in normal saline buffer, the maximum absorption ratio was more than 7.3 times, and the swelling rate reached about (9.0±0.3) times after 3 s in normal saline buffer. The in vitro clotting time of the compressed cellulose hemostatic granules was (451.7±26.6) s, significantly shorter than that of the negative control group (703.7±32.1) s (P<0.01), and was also shorter than that of the CELOX-A® hemostatic powder about (521.7±18.1) s (P<0.05). The result of thromboelastography showed that compared with negative control group, both the compressed cellulose hemostatic granules and CELOX-A® hemostatic powder significantly shortened the clot formation time (P<0.01), and the compressed cellulose hemostatic granules had shorter coagulation time than CELOX-A® hemostatic powder (P<0.05). The evaluation results of hemostatic efficacy study on the model of massive groin hemorrhage by complete transaction of the femoral artery and vein in the swine showed the pushable compressed cellulose hemostatic device group used (1.2±0.4) devices to achieve hemostasis, while CELOX-A® group needed (2.2±0.4) devices (P<0.05), and the total hemostatic time needed for the pushable compressed cellulose hemostatic device and CELOX-A® was (185.5±2.4) s and (268.5±83.4) s, respectively, and the difference between them was statistically significant (P<0.05). The APTT, PT and pathological changes of tissue and blood vessels were not obvious after the experiment in the pushable compressed cellulose hemostatic device group. The results of in vitro cytotoxicity test, acute toxicity test and hemolysis test were all within the standard range. Conclusions Pushable compressed cellulose hemostatic device has favourable hemostatic efficacy and biological safety. The compressed cellulose hemostatic granule can rapidly block the injured vessel and effectively fill the wound cavity based on its strong absorption and swelling property. To summarize, the pushable compressed cellulose hemostatic device is a promising candidate to be used for controlling junctional hemorrhage and evacuation of the wounded, especially for the hemorrhage caused by gunshot or penetrating injuries in battlefield, thus saving valuable time for the further evacuation and treatment.

Objective To explore the effect of versican (VCAN) gene on immunocyte infiltration and prognosis of bladder urothelial carcinoma (BUC). Methods The high-throughput sequencing data and clinical data of BUC were downloaded from TCGA database. The correlation between the expression level of VCAN and clinical characteristics of BUC patients was analyzed using the Limma R package; univariate and multivariate Cox regression analysis were performed to analyze the effect of VCAN expression and clinical characteristics (including gender, age, tumor grade, tumor stage, lymph node metastasis and distant metastasis) on the prognosis of BUC patients; TIMER database was used to analyze the correlation between VCAN expression level and immunocyte infiltration. T24 cells were divided into three groups: control group (cells transfected without any siRNA), NC siRNA group (cells transfected with negative control siRNA), and VCAN siRNA group (cells transfected with VCAN siRNA). After transfection, the proliferation, invasion and cell cycle proportion of T24 cells were determined by MTT assay, Transwell assay and flow cytometry, respectively. The protein expression levels of Cyclin E, Cyclin D1, E-cadherin and matrix metalloproteinase-9 (MMP-9) were determined by Western blotting. Results Compared with normal bladder tissues, the expression level of VCAN mRNA in BUC tissues was significantly up-regulated, and was positively correlated with tumor grade, tumor stage and distant metastasis (P<0.01). High VCAN expression was an independent risk factor for poor prognosis in BUC patients (P<0.05). The results of TIMER database analysis showed that the expression level of VCAN was significantly positively correlated with the infiltration degree of macrophages and regulatory T cells in BUC (P<0.001). Compared with control group, the proliferation and invasion ability of T24 cells in VCAN siRNA group decreased significantly and the cell proportion of G₀/G₁ phase increased significantly (P<0.05), the protein expression levels of Cyclin E, Cyclin D1 and MMP-9 were down-regulated significantly, and of E-cadherin was up-regulated significantly (P<0.05). Conclusions VCAN is highly expressed in BUC and correlated with immune infiltration and prognosis of BUC. Silencing the expression of VCAN may significantly inhibit the proliferation and invasion of T24 cells by regulating the protein expression levels of Cyclin E, Cyclin D1, E-cadherin and MMP-9.

Objective To evaluate the therapeutic effect of everolimus on tuberous sclerosis related renal angiomyolipoma (TSC-RAML) based on tumor components, and identify the types of main components in reducing RAML by everolimus. Methods To retrospectiely analyze the clinical data of 47 patients with TSC-RAML who were treated in the Urology Department of the First Affiliated Hospital of the Air Force Medical University and met the diagnostic criteria of ITSCCC from September 2017 to September 2022. According to the attenuation range of CT tissue specific threshold, patients were divided into fat rich group (HU ≤-10, n=26) and fat deficient group (HU ≥30, n=21). Collect patients' baseline CT data and 6 months after treatment, record the average CT value of RAML before and after treatment. Three-dimensional reconstruction of RAML was performed using Mimics software, and record the volume of RAML before and after treatment. The volume of RAML and mean CT value were compared between the two groups before and after treatment. Results No statistical difference existed in baseline characteristics between the two groups (P>0.05). The median reduction of tumor volume in fat rich group and fat deficient group of patients were 4.94 (3.12, 27.23) cm³ and 27.31 (10.83, 40.38) cm³, respectively, and the volume response rates were 11.52%±0.96% and 62.09%±12.60% respectively, the differences were statistically significant (P<0.05). The differences of average CT values between the fat rich group and fat deficient group were (4.23±3.01) HU and (14.52±3.61) HU respectively, and the reduction rates of CT values were 14.25%±11.94% and 29.23%±0.53% respectively, all were statistically significant (P<0.05). After treatment, the average CT value of tumors in fat deficient group decreased significantly compared to that in fat rich group with statistically significant difference (P<0.05). Six months after treatment with everolimus, the composition of high-density cord like vascular tissue in RAML tumors reduced significantly and fat conversion occurred. Conclusions The effect of everolimus on reducing tumor volume and average CT value of tumor in fat deficient RAML is better and significant, which confirmed that the reduction is the high-density component of TSC-RAML mainly composed of vascular components.

Objective To analyze the level of reactive oxygen species (ROS) produced by neutrophils and to explore its clinical significance in patients with chronic hepatitis B virus (HBV) infection. Methods Eighty-eight chronic HBV infected patients who admitted to the Fifth Medical Center of Chinese PLA General Hospital from April 2022 to September 2022 were enrolled in this study. Thirty patients who received nucleoside (acid) analogues (NAs) treatment were classified as the treated group, and fifty-eight did not receive treatment were classified as the untreated group. Simultaneously, twenty healthy individuals were classified as control group. The differences in clinical and virological parameters were compared between the three groups. The spontaneous ROS production by neutrophils after incubation with DHR 123 fluorescent dye were detected by flow cytometry. And the correlation between the spontaneous ROS and HBV DNA viral load, hepatitis B surface antigen (HBsAg), white blood cell (WBC), C-reactive protein (CRP), alanine transaminase (ALT) and aspartate transaminase (AST) were further analyzed. Culture medium, HepG2 cell supernatant and HepG2.2.15 cell supernatant were used to co-culture with neutrophils from healthy controls, respectively, to verify the effect of HBV virus particles and proteins on neutrophil spontaneous ROS in vitro. The secondary ROS production by neutrophils after lipopolysaccharide (LPS) stimulation was compared between the three groups. Results The spontaneous ROS production by neutrophils in the untreated group was higher than control group (P<0.05). The spontaneous ROS production by neutrophils in untreated patients was positively correlated with HBV DNA viral load and HBsAg quantification (r=0.315, P=0.016; r=0.326, P=0.013), but had no significant correlation with WBC, CRP, ALT and AST. HepG2.2.15 cell supernatant could induce the spontaneous ROS production by neutrophils in a dose-dependent manner (P<0.05). After LPS stimulation, the secondary ROS production by neutrophils in the untreated group and the treated group were lower than the control group (P<0.05). Conclusion Reducing the viral load by antiviral treatment contributes to reduction of spontaneous ROS production by neutrophils but not to restore the secondary ROS production by neutrophils after stimulated by LPS.

Objective To discuss the correlation between triglyceride-glucose index (TYG) and the major ischemic events in the past year in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary interventions (PCI). Methods The present study is a retrospective analysis based on a single-center registration database. From March 2016 to March 2019, the clinical data of 2203 eligible patients with AMI undergoing primary PCI were collected from the General Hospital of Northern Theater Command, and divided into two groups according to the median TYG index at admission [TYG <9.1047 group (n=1101) and TYG ≥9.1047 group (n=1102)]. The demographic characteristics, risk factors and complication, laboratory test, operation characteristics and medication after discharge were compared between the two groups. Meanwhile, the one-year ischemic events (cardiac death, myocardial infarction and/or ischemic stroke) and all-cause death were compared between the two groups. The Cox regression models were used to analyze the correlation between TYG and main outcomes. To evaluate the predictive value of TYG for one-year ischemic events using the ROC curve. Results Compared with TYG <9.1047 group, patients in TYG ≥9.1047 group were younger, less male, and had a higher proportion of hypertension and diabetes (P<0.05), and higher incidence with significant differences (P<0.05) in the frequency of one-year ischemic events, cardiac death and all-cause death. The TYG showed acceptable performance in prediction of one-year ischemic events and all-cause death with areas under the curve (AUC) of 0.62(95%CI 0.55-0.68) for ischemic events and 0.61(95%CI 0.55-0.68) for all-cause death. The best cut-off point for distinguishing the main end point from one-year ischemic events was 9.5948, the sensitivity was 47.3%, and the specificity was 76.5%. Conclusion Excessive TYG at admission of AMI patients is significantly related to the incidence of one-year ischemic events after PCI.

Objective To explore the clinical application value of transvaginal ultrasound combined with the micro-vascular flow (MV-Flow) imaging in analyzing the ultrasound characteristics of endometrium during ovulation in women of childbearing age. Methods A total of 74 women of childbearing age who underwent transvaginal gynecological ultrasound examination in the First Medical Center of Chinese PLA General Hospital from May 2022 to July 2022 were selected. Among them, aged 22-48 (34.4±5.0) years, including 35 women ≥35 years old in the elderly group and 39 women <35 years old in the younger group. All patients with clinically diagnosed of infertility were divided into infertility group (27 cases) and healthy control group (47 cases). On the day of ovulation, the endometrial thickness, peristalsis score, volume of endometrium, pulsatility index (PI) and resistance index (RI) of uterine spiral artery, PI and RI of bilateral uterine arteries, three-dimensional energy doppler flow parameters [blood flow index (FI), vascularization index (VI), vascular blood flow index (VFI)] and endometrial microvascular bleeding vascularization index (VI_MV) were measured by the transvaginal ultrasound. The above ultrasonic indexes were compared and analyzed between the two groups. Results There was no significant difference in the history of infertility between the younger group and the older group (P>0.05). The RI of uterine spiral artery in the younger group was lower than that in the older group, while the three-dimensional energy doppler flow parameters (VI, FI, VFI) and the VI_MV of endometrium in the younger group were significantly higher than those in the older group. There was no significant difference in age stratification between infertility group and healthy control group (P>0.05). The endometrial thickness, endometrial peristalsis score, endometrial volume, endometrial three-dimensional energy doppler flow parameters (VI, FI, VFI) and the VI_MV in inferbility group were significantly lower than those in healthy control group (P<0.05). Conclusion Transvaginal ultrasound indicators can evaluate the endometrium characteristics of women of childbearing age during ovulation to some extent, especially, VI_MV can quantitatively analyze the microblood perfusion of endometrium.

Diabetic cardiomyopathy (DCM) is a specific cardiomyopathy, independent of hypertension, coronary heart disease, valvular disease, congenital heart disease or other cardiovascular diseases. The pathogenesis of DCM is one of the current research hot spots in recent years. Due to the imbalance of glucose and lipid metabolism, the increase of oxidative stress and the activation of various inflammatory reactions, further mediating the myocardial cell and extracellular damage, resulting in pathological myocardial remodeling, diastolic and systolic dysfunction and eventually evolving into heart failure. At present, the effective methods for early screening and treatment of DCM are still limited. In order to better understand the specific mechanism of the occurrence and development of DCM, the latest research progress on pathophysiological mechanism, clinical manifestation and therapeutic prospect of DCM were reviewed for providing reference for the early clinical prevention and treatment of DCM.

Military traumatic brain injury (TBI) belongs to military psychiatry, which is a new subcategory of psychiatry. Military TBI has become a landmark injury in modern military conflicts, which not only has a high incidence and death rate, but also has many sequelae, bringing heavy burden to patients and society. There have been frequent reports on TBI, but the pathophysiological mechanism of trauma to human brain tissue caused by military action and war has not been extensively studied. In this paper, epidemiological data, pathogenesis, molecular biological diagnosis and research achievements of existing therapeutic techniques related to TBI were reviewed, especially in terms of pathophysiological mechanism, and the pathogenesis, pathophysiological changes, blood-brain barrier injury, neuroinflammation and immune response of military TBI induced concussion and impact brain injury were summarized. It will provide useful reference for further study of military TBI.

Sepsis-associated encephalopathy (SAE) is a complex disease with high mortality, an urgent clinical problem to be solved. The mechanism of SAE has not been fully elucidated and there is no effective treatment. Recent study found that high mobility group box 1 (HMGB1) is a late-stage pro-inflammatory mediator with the effect of activating inflammation, besides, HMGB1 plays important role in tissue repair, as well as in sepsis-induced brain injury. Therefore, In-depth research on the relationship between HMGB1 and SAE is expected to provide a new direction for the diagnosis and treatment of SAE. This review focuses on current status of SAE, HMGB1 and the four aspects of HMGB1, including impairment of blood-brain barrier, dysregulation of immune response, oxidative stress and neuronal apoptosis that involved in brain function impairment and SAE.

Virtual reality (VR) technology is a comprehensive multimedia technology. Since its development from the 1950s, VR technology has been widely applied in the field of military medicine. Armed forces around the world utilize VR technology to conduct psychological adjustment and skill training for front-line combat personnel and to educate health service personnel. Meanwhile, the high simulation of the real environment by VR enables rear medical personnel to carry out exposure therapy for patients suffering from post-traumatic stress disorder (PTSD) or other psychological trauma, in a reconstructed virtual environment which is extremely similar to battlefield but with far higher safety. It can also carry out rehabilitation training, health education or combat capability assessment for the wounded with brain injury or disability with higher efficiency. This paper reviews the origin and development of VR, expounds the development and application of VR technology in the field of military medicine, and prospects its possible development in near future.

Parkinson's disease (PD) is a common chronic inflammatory disease of the nervous system in the middle-aged and elderly. The main pathological basis of PD is the decrease of dopaminergic neurons in the substantia nigra and the formation of Louie bodies. The clinical manifestations of PD are usually quiescent tremor, bradykinesia, enhanced muscle tone and abnormal posture and gait. The pathogenesis of PD is very complex, which may be related to age, environment, heredity, oxidative stress and mitochondrial dysfunction. In this review, we summarized research progress on the mechanisms and treatment methods of α-synuclein, oxidative stress, mitochondrial dysfunction, LRRK2 gene mutation and other factors leading to the degeneration of dopaminergic neurons in PD, in order to provide a reference for basic and clinical research of PD.