Unilateral biportal endoscopic (UBE) technique is a minimally invasive spinal technique developed rapidly in recent years. Compared with traditional spinal endoscopy, the prominent feature of UBE is that it can open two channels on the same side of the spine, which can be used to provide visual field and insert operating instruments respectively, greatly expanding the operating space and reducing the difficulty of surgery. It has the advantages of less bleeding, little injury, quick recovery and mild pain, and has unique advantages in the treatment of lumbar spinal stenosis, lumbar disc herniation and other lumbar degenerative diseases. With the continuous in-depth exploration and development of the UBE technique, the field of diseases that can be treated by this technology has gradually expanded. It is not only limited to lumbar diseases, but also has made great progress in cervical and thoracic diseases, which has attracted the attention of many spinal surgeons. UBE technique has become one of the promising surgical methods for spinal-related diseases, but there are also complications such as incomplete decompression, nerve root and dural injury, epidural hematoma, relatively prolonged operation time, operation fatigue and other deficiencies. This paper summarizes the progress of the UBE technique, discusses its complications and deficiencies, proposes relevant solutions and possible future directions for its development, so as to provide reference for the clinical practice of UBE technique.

Objective To analyze the burden and changing trend of testicular cancer in China from 1990 to 2019. Methods Based on the 2019 Global Burden of Disease Database (GBD 2019), analyze the incidence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs) and their variation trend of testicular cancer in Chinese population from 1990 to 2019. Evaluating changes in age standardized rate (ASR) by calculating annual estimated percentage change (EAPC). According to the age grouping, analyze the age distribution characteristics of testicular cancer disease burden by age group. Results In 2019, the incident cases, deaths, age-standardized incidence rate, and age-standardized mortality rate of testicular cancer in China were 17.17×10³, 1.21×10³, 2.39/10⁵, and 0.16/10⁵, respectively. Compared to 1990, incident cases, deaths, and age-standardized incidence rate increased obviously in China, which was consistent with the global change trend, while the increase was higher than the global level. However, both Chinese and global age-standardized mortality rate showed a downward trend. From 1990 to 2019, DALYs, YLLs and YLDs of testicular cancer increased by 29.66%, 9.83% and 720.91% respectively in China. The two age groups, 0-15 years group and 30-35 years group, were with highest incidence of testicular cancer, while the highest disease burden of testicular cancer was 30-35 years. Conclusion From 1990 to 2019, the disease burden of testicular cancer in China showed an upward trend. Adolescents and young adults should be the priority population for screening and prevention due to their higher incidence and disease burden.

Objective To explore the role of pulmonary surfactant (PS) combined with budesonide in improving oxygenation and clinical outcomes of neonatal acute respiratory distress syndrome (ARDS). Methods The present study is a historically controlled trial. Infants with ARDS requiring mechanical ventilation and PS replacement therapy were collected from the neonatal unit of Southwest Medical University. Those from January 2022 to November 2022 were set as intervention group (PS+budesonid, n=35), treated with intratracheal instillation of a mixed suspension of budesonide (0.25 mg/kg) and PS (200 mg/kg), and continuous budesonide nebulization (0.25 mg/kg, twice per day) until withdrawal, then compared with a historical cohort, who just received intratracheal instillation of PS (200 mg/kg) (January 2020-December 2021, PS group, n=35). Baseline data such as gender, mode of delivery, 1 min and 5 min Apgar score, birth weight, gestational age, time of onset, and cause of onset were recorded in both groups. The oxygenation and clinical outcomes of infants were compared between the two groups, including: (1) Arterial blood gas analysis indicators, such as partial pressure of oxygen (PaO₂) and oxygenation index (OI) before treatment and at 6, 12 and 24 hours of treatment; (2) Clinical observation and evaluation indicators, such as the time to withdrawal, duration of oxygen supplementation, length of stay, improvement of the radiological images of the lungs at 72 h of treatment, and repeated PS use; (3) Blood chemistry indicators, such as white blood cell (WBC), neutrocyte (NEU), procalcitonin (PCT) before treatment and at 3 and 7 days of treatment; and (4) Observation indicators of complications, weight growth, and mortality outcomes, such as the incidences of intracranial hemorrhage, gastrointestinal hemorrhage, neonatal necrotizing enterocolitis (NEC), and hyperglycemia, weight growth, and fatality rate. Results The differences in baseline data between the two groups were not statistically different (P>0.05). The levels of PaO₂ of the two groups were increased after treatment for different time periods, while the levels of OI were decreased (P<0.001), and the levels of above indexes changed more significantly in PS+budesonide group than those in PS group (P<0.05). The time to withdrawal, duration of oxygen supplementation, and length of stay in PS+budesonide group were shorter than those in PS group; the radiological images of the lungs showed that the pulmonary inflammation absorption was significantly better in PS+budesonide group than that in PS group, while no significant difference between the two groups of infants with repeated PS use. The NEU was significantly higher in PS+budesonide group than in PS group at 3 d and 7 d of treatment (P<0.001); and at 3 days of treatment, the PCT levels were significantly lower in PS+budesonide group than that in PS group (P<0.05). The incidences of intracranial hemorrhage, gastrointestinal hemorrhage, NEC, hyperglycemia, weight growth, and fatality rate were not significantly different between the two groups (P>0.05). Conclusion The use of budesonide in addition to surfactant may improve the oxygenation of neonates with ARDS, improve the inflammatory infiltrates in lungs, shorten the duration of mechanical ventilation and oxygen supplementation, and without short-term complications associated with budesonide use.

In recent years, with the continuous innovation of modern war mode, weapons and protective equipment, the mechanism and mode of war trauma have also produced great changes. The widespread use of bulletproof vest and improvised explosive devices has led to increasing incidence of genitourinary trauma. The pattern of genitourinary trauma has also transformed from internal structures (kidney, ureters, bladder) to external structures (scrotum, testes, penis, urethra), suggesting that the research focus of genitourinary system war trauma should be gradually transformed to trauma research of lower urinary tract and external genitalia. This article reviews the incidence, treatment and prognosis of genitourinary trauma in several modern wars, and mainly describes the relevant conditions of lower urinary tract and external genitalia trauma and the relevant progress in the treatment in recent years.

According to the extracorporeal life support (ECLS) registry report, the use of extracorporeal membrane oxygenation (ECMO) in neonates with severe respiratory failure reached its peak in 1992. With the emergence of new respiratory support methods such as nitric oxide, pulmonary surfactant, and high-frequency ventilation, the number of neonates with ECMO for respiratory support decreased gradually, maintaining at about 1000 cases per year. However, it also means that the neonates who need ECMO support will be in a more severe condition, which requires higher requirements for clinicians. In order to further standardize the technique of neonatal extracorporeal life support, the Extracorporeal Life Support Organization (ELSO) published the guidelines for neonatal respiratory failure in 2020. The guidelines provide suggestions on the technology, patient management and complications during ECMO. This article mainly interprets the patient selection, support mode, technical considerations, management and complications during ECMO.

Sonogenetics is an emerging synthetic biology technique that uses sound waves to activate mechanosensitive ion channel proteins on the cell surface to regulate cell behavior and function. Due to the widespread presence of mechanically sensitive ion channel systems in cells and the advantages of non-invasion, strong penetrability, high safety and high accuracy of sonogenetics technology, it has great development potential in basic biomedical research and clinical applications, especially in neuronal regulation, tumor mechanism research, sonodynamic therapy and hearing impairment. This review discusses the basic principles of sonogenetics, the development status of sonogenetics and its application in the prevention and treatment of noise-induced hearing loss, summarizes and analyzes the current challenges and future development direction, thus providing a reference for further research and development of sonogenetics in the field of military medicine.

The essence of cirrhosis is the over-repairing reaction of liver tissue damage in the process of chronic liver disease. During repair, the liver parenchyma is gradually replaced by fibrosis tissue, resulting in changes in liver tissue morphology, followed by portal hypertension and other related manifestations. Liver failure are serious disorder of liver functions (synthesis, metabolism, transformation, regeneration, etc.) caused by various factors, often mainly manifested as jaundice, coagulation disfunction, hepatic encephalopathy, ascites, etc. The naming and typing of the two are different, and they can exist independently of each other or intersect with each other. In recent years, with the in-depth exploration of cirrhosis and liver failure, many new definitions and classification methods have been put forward in the research. However, due to the confusion of classification methods, there is still a lack of summary, so this article briefly reviews the current progress of clinical classification of liver cirrhosis and liver failure and their differences and intersections.

Objective To analyze the pathogenic characteristics and drug sensitivity of candidaemia, and construct a short-term mortality risk prediction scoring model. Methods The clinical data of patients with candidaemia admitted to the 909 Hospital of Joint Logistics Support Force from January 2011 to December 2020 were retrospectively analyzed, and the composition of pathogen composition, drug sensitivity test results and incidence of hospitalized patients were analyzed. 324 cases of candidaemia were randomly divided into modeling group (190 cases) and validation group (134 cases), and the risk factors were screened by binary logistic regression. According to the odds ratio (OR) score, the 30 day mortality risk prediction scoring model was constructed, and the predictive performance of the model was verified both in modeling and validation groups. Results 356 strains of Candida including 126 strains of C. albicans (35.39%), 79 strains of C. tropicalis (22.19%), 74 strains of C. parapsilosis (20.79%), 48 strains of C. glabrata (13.48%), 14 strains of C. guilliermondii (3.93%), 8 strains of C. krusei (2.25%), and 7 strains of other Candida (1.97%) were detected in 336 patients with candidemia. The incidence of candidaemia among hospitalized patients increased from 0.20 ‰ in 2011 to 0.48 ‰ in 2020. The resistance rate of candida to amphotericin B was significantly lower than that of fluconazole, voriconazole and itraconazole (P<0.05). Among the 324 cases included in the model, 95 patients died in 30 days after diagnosis, and the mortality rate was 29.32%. The proportion of males, fever, and parenteral nutrition in modeling group was significantly higher than that in validation group (P<0.05), while the proportion of chronic lung disease and surgical history within one month were lower than those in validation group (P<0.05). Logistic regression analysis showed that chronic renal failure, mechanical ventilation, severe neutropenia, failure to receive anti-fungal treatment within 72 hours, and APACHE Ⅱ ≥20 were risk factors for short-term death of candidaemia, the OR values were 3.179, 1.970, 2.979, 2.080, and 2.399, and the risk scores were 6, 4, 6, 4, and 5, respectively. The area under the curve (AUC) of the risk scoring model for modeling group was 0.792 (95%CI 0.721-0.862), and the result of Hosmer-Lemeshow (H-L) test was P=0.305; The AUC of validation group was 0.796 (95%CI 0.735-0.898), and the H-L test result was P=0.329. A risk score ≤8 indicated a low risk group for short-term mortality, a score of 9-15 indicated a medium risk group, and a score ≥16 indicated a high risk group. Conclusions The incidence of candidemia in hospitalized patients is increasing and the mortality is high. The risk prediction score model can effectively predict the short-term prognosis and facilitate the early identification of the prognosis.

The electroencephalography (EEG) is an important method to evaluate epileptic seizure and brain functions, and it is of great significance for screening aircrew with potential risks of seizure and thus reducing the incidence of airborne incapacitation events. There are cases of epileptic seizure and seizure attack during flight among military aircrew both at home and abroad. However, currently there is no detailed EEG standards for the selection of aircrew applicants and physical examination of military aircrew. This consensus of Chinese experts on electroencephalographic examination and identification criteria for military aircrew was compiled jointly by experts in the fields of aeromedicine, neurology, epilepsy, and neuro-electrophysiology, from Xijing Hospital of Air Force Military Medical University and PLA General Hospital. This consensus was formulated based on 287 relevant literatures from PubMed, CNKI, Wanfang Data and VIP, combined with guidelines in the fields of epilepsy and EEG and the clinical experiences of Chinese experts. The objectives of the consensus are to further clarify the definition of "normal EEG", "borderline EEG" and "abnormal EEG" for military aircrew, unify the criteria of EEG identification for military aircrew with high risk of incapacitation, and standardize the criteria of EEG examination for aeromedical identification for military aircrew. This consensus includes four sections: applicable population and quality requirements for EEG monitoring, standards for EEG interpretation, standards for medical decision based on EEG, and the treatment of "temporarily unqualified" aircrew, which aim to literature supports and practical expert opinions for the standardization and accuracy of aeromedical qualification of EEG in military aircrew.

Cholesterol metabolism is a hot topic in exploration of cancer treatment in recent years, and its complex mechanism of action potentially lays a molecular foundation related to lipid-cancer. However, most studies focus only on cholesterol as a product to understand and analyze the progress of cancer, ignoring the phased effects of related derivatives, regulatory proteins and immune cells in its metabolic process, so whether to find targets to regulate colorectal cancer (CRC) from the cholesterol metabolic pathway has become a research focus. This paper reviews the molecular mechanism and the role of signaling pathways in metabolic reprogramming of CRC starting from the abnormal intracellular cholesterol metabolic pathway in order to provide new ideas for the targeted cholesterol therapy of CRC.