Heat stroke is a heat-related illness caused by an imbalance between the body's heat production and heat dissipation, which could lead to multiple organ dysfunction syndrome with a high mortality rate. Rapid and effective reduction of core body temperature is key to successful treatment. This article reviews recent progress in the treatment of heat stroke, including new understandings of organ injury mechanisms, the timing, velocity and goals of cooling treatment, evaluation and selection of traditional cooling techniques (such as cold water immersion), and scientific evaluation of new cooling technologies (such as blood purification technology and intravascular heat exchange cooling technology), aiming to promote understanding and treatment of heat stroke.

Alzheimer's disease (AD), a major cause of dementia, is a common neurodegenerative disease, beginning with memory loss and difficulties with thinking, language and problem-solving skills. Intensification of population aging and the increasing incidence of AD have imposed a heavy burden on healthcare systems. Currently, the main pathological explanation remains the excessive accumulation of β‑amyloid plaques, formation of neurofibrillary tangles and neuronal loss, but the true etiology and pathogenesis of AD remain unknown. The advances of research in AD, with respect to genetics, pathophysiological mechanism, imaging diagnosis and laboratory diagnosis, are reviewed in this article, aiming to provide references for relevant research and potential clinical applications.

White matter hyperintensities (WMH) are abnormal high-signal manifestations in white matter areas on magnetic resonance T₂-weighted or fluid-attenuated inversion recovery (FLAIR) sequences, with vasogenic WMH being the most common. Its pathological mechanism is related to cerebrovascular lesions and can lead to multi-dimensional brain functional impairments in cognition, movement, and emotions. Due to their unique working conditions, aircrews are more prone to vasogenic WMH than the general population. Moreover, with the widespread use of magnetic resonance imaging in cranial disease screening for aircrews, the detection rate of vasogenic WMH in aircrews has significantly increased. However, to date, no national or academic organization has issued standardized aviation medical assessment criteria for vasogenic WMH in aircrews. Therefore, led by Xijing Hospital of Air Force Medical University and the Chinese PLA General Hospital, a multi-disciplinary expert panel involved in aviation medicine, neurology, radiology, psychology, and related fields was assembled to formulate this consensus. The document integrates evidence from a systematic review of PubMed, CNKI, Wanfang Data, and VIP databases, incorporates existing WMH guidelines, and synthesizes clinical expertise from Chinese specialists. The consensus outlines three key domains: target population, neuroimaging protocols for vasogenic WMH screening, and clinical assessment and aeromedical identification for aircrews with vasogenic WMH. The aim is to provide evidence-based support and expert recommendations for standardizing and improving the accuracy of aviation medical evaluations of vasogenic WMH in aircrews.

Good endometrial receptivity is an essential factor for embryo implantation, and gene expression in endometrial tissue during the window of implantation (WOI) is closely related to receptivity. Transcriptome sequencing technology enables the identification of gene expression profiles of endometrium during different menstrual phases, as well as microRNAs and long-chain non-coding RNA sequences involved in regulating gene expression. Combining this technology with bioinformatics analysis provides a better understanding of specific gene expression during the receptive period and offers technical support for studying its regulatory mechanism. Moreover, gene expression profiles of the endometrium during different menstrual phases hold significant clinical application value for accurately assessing endometrium receptivity in infertility patients and those with repeated implantation failure, thereby guiding individualized embryo transfer strategies. This review summarizes the progress of transcriptome sequencing in evaluating human endometrial receptivity and discusses future research directions. This review aims to understand the complex molecular mechanisms of endometrial receptivity formation and regulation from the transcriptional level, in order to improve the implantation rate of embryos in assisted reproductive technology and reduce the abortion rate.

Objective To compare the disease burden and evolving trends of major malignant tumors in China and globally from 1990 to 2021, and conduct predictive analysis, so as to provide a reference for formulating prevention and treatment policies for malignant tumor in China. Methods Based on the Global Burden of Disease Database 2021 (GBD 2021), descriptive research methods were used to analyze the incidence and mortality of major malignant tumors in China and globally, as well as the changes in their rankings. The Joinpoint log-linear model was applied to analyze trends in age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASMR) of malignant tumors in China and globally from 1990-2021. A Bayesian age-period-cohort (BAPC) model was constructed using R 4.4.0 to predict the incidence trends of malignant tumor in China and globally from 2022 to 2035. Results In 2021, there were 17.2294 million new cases of malignant tumors (excluding non-melanoma skin cancer) and 9.7763 million deaths globally, with an ASIR of 201.06/100,000 and ASMR of 115.11/100,000. In China, 4.5375 million new cases and 2.7964 million deaths were reported, with ASIR and ASMR of 221.30/100,000 and 136.36/100,000, respectively. Lung cancer ranked first in both incidence and mortality of malignant tumors in China and globally. Female breast cancer had the second-highest ASIR in China. The number of incident cases and deaths from digestive system malignancies included in this study accounted for 42.0% of the total incident cases and 46.8% of the total deaths from all cancers in China, respectively. From 1990 to 2021, the average annual percentage change (AAPC) for overall ASIR of malignant tumors in China was 0.30, while ASMR declined (AAPC: -0.97). Globally, ASIR decreased slightly (AAPC: -0.10), and ASMR declined (AAPC: -0.78). The BAPC model predicted that by 2035, China's ASIR of malignant tumors may rise to 252.44/100,000, whereas the global ASIR is expected to decrease to 183.05/100,000. Conclusions China has achieved some success in cancer prevention and treatment, but still faces a heavy disease burden, with ASIR and ASMR exceeding global averages and ASIR persistently increasing. Cancer prevention and control work such as health education should be strengthened. Precise prevention and control measures should be taken for key cancer types, and preventive interventions should be focused on the elderly population.

Objective To systematically review and quantitatively analyze the safety of biologic agents for the clinical treatment of psoriasis during pregnancy and lactation. Methods The literature from start of database to June 27, 2023, was searched in MEDLINE (PubMed), Embase, Cochrane Library, and Web of Science by two researcher. Quality of included studies was assessed by the quality evaluation tool of case series from Australian JBI Evidence Based Healthcare Centre. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a systematic review and was conducted to assess pregnancy or breastfeeding outcomes in psoriasis patients exposed to biologics within 3 months prior to pregnancy, during pregnancy or breastfeeding. Data on pregnancy and exposure characteristics were pooled, and the prevalence of adverse pregnancy outcome was summarized using a random effects model. Results A total of 54 studies involving 1206 pregnancies in 1177 female patients with psoriasis exposed to biologic agents were included in the analysis. Systematic review results demonstrated that the majority of the exposures were limited to early pregnancy, with pooled spontaneous abortion rates, elective abortion rates, overall mortality, preterm birth rates, incidence of low birth weights, and congenital anomalies similar to those of general population (P>0.05). Furthermore, no serious adverse reactions were reported during lactation. Conclusions The use of biologic agents in pregnant and breastfeeding women with psoriasis does not significantly increase the risk of adverse pregnancy outcomes and does not affect neonatal health or growth. However, the limited available safety data underscores the necessity of further studies to establish the relationship between psoriasis, biologic agents, and pregnancy/lactation outcomes, thereby providing comprehensive guidance for clinical practice.

Objective To assess the effectiveness of the evaluation of military physical function (EMPF) system in predicting the occurrence of military training injuries among new recruits to provide scientific guidance and methodological choice for military training. Methods A total of 527 new recruits from 5 grassroots units from July 2016 to February 2018 were selected for the study. The recruits underwent EMPF testing, and their military training injuries were monitored over a 2-year follow-up period. Those who sustained injuries during training were divided into injury group (n=163), while the remaining recruits were placed in healthy group (n=364). The predictive ability of the total EMPF score for training injuries was assessed using the receiver operating characteristic curve (ROC), and the correlation between the total EMPF score, individual test scores, and military training injuries were analyzed using binary logistic regression. Results The total EMPF score of new recruits in injury group (19.52±1.97) was significantly lower than that of healthy group (24.31±1.54) (P<0.001), which also demonstrated a high diagnostic value in predicting the risk of military training injuries, with an area under the curve (AUC) of ROC of 0.971 (P<0.001). A cut-off value of 22 scores was found to have the highest accuracy in predicting future training injuries, with an odds ratio (OR) of 25.63, sensitivity of 0.939, specificity of 0.879, positive likelihood ratio of 7.76, and a post-test probability of 0.67. Binary logistic regression analysis revealed that 6 EMPF tests, including holding the ball over and leaning back, bending forward and touching the ground with the ball, lunge squat and twist, swallow balance with holding the ball afterward, vertical jump, and respiratory pattern assessment, were negatively associated with the risk of military training injuries (P<0.0001). Conclusion The EMPF system can effectively predict the risk of military training injuries, with military personnel whose total EMPF score is less than 22 being at higher risk of sustaining such injuries.

Objective To investigate the role of peptidyl prolyl cis-trans isomerase 1 (Pin1) in mediating stemness of tumor cells and the molecular mechanism of inducing epithelial-mesenchymal transition (EMT) in cervical cancer cells. Methods The Siha and Hele cells of Pin1 low-expression stable transfection uterine cervical neoplasm cell lines were constructed using lentivirus transfection technology and were divided into control group (shPin1-NON), knockdown group 1 (shPin1-1) and knockdown group 2 (shPin1-2). Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) were used to detect the expressions of Sex-determining region Y transcription factor 2 (SOX2), Aldehyde dehydrogenase 1A1 (ALDH1A1), and Cell adhesion molecule 44 (CD44). The serum-free spheroidization method was used to induce cervical cancer spheroids, with the adherent culture of cervical cancer cells as a control. Subsequently, Western blotting and qRT-PCR were employed to detect the expression of SOX2, ALDH1A1 and CD44 in both spheroid cells and adherent cells. Spheroid formation assay was used to detect the spheroid formation of cervical cancer cells after Pin1 knockdown. Transwell assay was used to detect the migration and invasion abilities of cervical cancer cells following down-regulation of Pin1. Western blotting and qRT-PCR were used to detect the expression of E-cadherin and N-cadherin attribute proteins in cervical cancer cells after transfection with pin1 low expression lentivirus. Western blotting and qRT-PCR were also used to assess the effects of Pin1 low expression on the expression levels of key proteins (c-Jun and c-Fos) of the transcriptional complex of Activator protein 1 (AP-1). Immunofluorescence combined with co-immunoprecipitation assays were conducted to detect the interaction and colocalization of Pin1 with c-Jun. Results In Siha and Hele cells, the mRNA and protein expression levels of Pin1, SOX2, ALDH1A1 and CD44 in shPin1-NON group were significantly higher than those in shPin1-1 group and shPin1-2 group (P<0.05). The expression levels of SOX2, ALDH1A1 and CD44 mRNA and protein in cervical cancer spheroid group were significantly higher than those in adherent cervical cancer cells (P<0.05). Compared with shPin1-NON group, the spheroidism and migration invasion abilities of shPin1-1 group and shPin1-2 group were significantly reduced (P<0.05). Compared with shPin1-NON group, the mRNA and protein expressions of E-cadherin in shPin1-1 and shPin1-2 groups were significantly increased (P<0.05), while the mRNA and protein expression levels of N-cadherin were significantly decreased (P<0.05). The mRNA and protein expression levels of c-Jun and c-Fos in shPin1-NON group were significantly higher than those in shPin1-1 group and shPin1-2 group (P<0.05). Conclusions Down-regulation of Pin1 can inhibit the stemness and migration invasion of cervical cancer cells, and Pin1 may mediate AP-1 to regulate the occurrence of stemness-induced epithelial-mesenchymal transition in cervical cancer cells.

Objective To investigate the predictive value of temperature gradients on the mortality of sepsis patients and their correlation with fluid input. Methods By means of a prospective observational method, 154 patients with sepsis or septic shock admitted to the Department of Critical Care Medicine at Nanfang Hospital, Southern Medical University from November 2019 to November 2021 were included as research subjects. They were divided into a survivor group (n=118) and a non-survivor group (n=36) according to whether they survived within 28 days. The core-to-toe temperature gradient (CTTG) and toe-to-room temperature gradient (TRTG) were monitored and calculated immediately upon admission to the intensive care unit (ICU) and 6 hours after admission. Receiver operating characteristic (ROC) curve was used to explore the predictive value of temperature gradients on mortality, and multivariate Cox regression analysis was performed to explore the risk factors of 28-day mortality in sepsis patients. The results were verified through survival analysis. Correlation analysis and multivariate analysis of variance were used to explore the correlation between temperature gradients and fluid input, as well as noradrenaline doses. Results Among the 154 patients, 118 survived within 28 days (survivor group), and 36 died (non-survivor group). ROC curve and multivariate Cox regression analysis showed that a toe-to-room temperature gradient of ≤5.35 ℃ within 6 hours after admission was a risk factor for 28-day mortality. Compared with patients with a high toe-to-room temperature gradient (>5.35 ℃), patients with a low toe-to-room temperature gradient (≤5.35 ℃) had a 2.74-fold increase in the risk of 28-day mortality (P=0.004, 95%CI 1.54, 9.12). The CTTG and TRTG upon admission to the ICU and 6 hours after admission were not significantly associated with fluid input or noradrenaline doses (P>0.05). Conclusions A toe-to-room temperature gradient of less than or equal to 5.35 ℃ within 6 hours after ICU admission is a risk factor for 28-day mortality in sepsis patients. The improvement of temperature gradients at different time points is not associated with fluid input.

Objective To analyze the relationship between the visceral adiposity index (VAI) and nocturia in the US adult population. Methods A cross-sectional study was performed. Data from subjects aged ≥20 years in the National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2020 were collected, including waist circumference, triglyceride, body mass index (BMI), high-density lipoprotein, age, gender, race, poverty income ratio, education level, marital status, smoking, alcohol consumption, sleep disorders, depression, occupation, hypertension, diabetes, congestive heart failure, cancer, and nocturnal urination frequency. Weighted analysis, multivariate logistic regression, generalized additive model (GAM), and curve fitting were employed to evaluate the association between VAI and nocturia, adjusting for age, gender, race, poverty income ratio, education level, marital status, smoking, alcohol consumption, sleep disorders, depression, occupation, hypertension, diabetes, congestive heart failure, and cancer. Subgroup analyses were conducted based on age, gender, race, hypertension and diabetes to further evaluate the relationship between VAI and the risk of nocturia. Results A total of 29,196 American adults were included. All subjects were divided into 4 groups based on VAI quartiles: Q₁ group (0.32≤VAI<1.01), Q₂ group (1.01≤VAI<1.70), Q₃ group (1.70≤VAI<2.95), and Q₄ group (2.95≤VAI<13.59), with nocturia prevalence rates of 28.5%, 31.4%, 33.3%, and 34.9%, respectively. In subgroup analyses, the risk of nocturia significantly increased with higher VAI in the 20-40 age group, females and other Hispanics (OR=1.04, 95%CI 1.01-1.08, P=0.006; OR=1.02, 95% CI 1.00-1.04, P=0.035; OR=1.05, 95%CI 1.01-1.09, P=0.026). GAM analysis results showed a nonlinear relationship between VAI and nocturia. Conclusion VAI is positively associated with the risk of nocturia, and may be an effective indicator for predicting the risk of nocturia occurrence.