Objective To observe the effects of total saponins of Trillium tschonoskii Maxim (TST) on vascular cognitive impairment (VCI), neurovascular units (NVUs), and neural circuit integrity in rats. Methods Forty-eight male Sprague-Dawley (SD) rats were randomly divided into sham-operated group, model group, TST group (intragastric administration, 100 mg/kg), and donepezil group (intragastric administration, 0.45 mg/kg), and then subjected to ischemic stroke by 2-VO method (bilateral common carotid artery ligation) or sham surgery. After 28 days of intragastric administration, Mirros water maze test was performed to evaluate the spatial learning and memory abilities of rats in each group. HE and Nissl staining were used to observe the pathological changes of brain tissue in rats. The expression of synuclein (SYN) in rat hippocampus was observed by immunohistochemical staining. Changes in dendritic spines in rat's hippocampal neurons were observed by Golgi staining. Western blotting was used to detect the expression levels of IL-1β, IL-10, vascular endothelial growth factor A (VEGFA), postsynaptic density protein 95 (PSD95), and growth associated protein 43 (GAP43) in rat's hippocampus in each group. Results In Mirros water maze test, rats in model group showed significant prolonged escape latency (P<0.05), and a significant reduction in the number of crossing platforms and the percentage of activity time in the target quadrant (P<0.05) than those in sham-operated group; while rats in TST group and donepezil group showed significant shortened escape latency (P<0.01), and significant increase of the number of times of crossing platforms and the percentage of activity time in the target quadrant (P<0.05) than those in model group. Compared of sham-operated group, model group showed a decrease in the expression of SYN and the number of neurons, Nissl bodies, and dendritic spines in the CA1 region of the hippocampus (P<0.05). Compared with model group, TST group and donepezil group showed an increase in the expression of SYN and the number of neurons, Nissl bodies, and dendritic spines in the CA1 region of the hippocampus (P<0.05). Western blotting showed a significant increase in the expression of IL-1β and VEGF (P<0.05), and a decrease in the expression of IL-10, PSD95, and GAP43 (P<0.01) in rat's hippocampus of model group than those in sham-operated group. Compared with model group, TST group and donepezil group showed a significant decrease in the expression of IL-1β (P<0.05), and an increase in the expression of VEGFA, IL-10, and GAP43 (P<0.05). Conclusions TST could alleviate cognitive impairment through promoting synaptic plasticity and neurovascular unit remodeling in 2-VO model rats, suggesting its significance as a potential drug for apoplexy.

Objective To investigate the effect of rats' injuries and its mechanism caused by specific dose of radiation combined with decompression exposure. Methods 81 male SD rats were randomly divided into control group (n=9), radiation group (n=18), radiation+low-load decompression group (n=18), radiation+medium-load decompression group (n=18), and radiation+high-load decompression group (n=18). In addition to control group, the rats were irradiated with ⁶⁰Co γ rays at 4 Gy and then underwent rapid escape experiments. The high-pressure exposure schemes were to stay underwater 57 m for 30 min, 45 min or 60 min and reduce to normal pressure within (30±5) s, respectively. The high-pressure exposure was not carried out in radiation group. The behavior and death of rats in each group were observed 0.5 h after leaving the cabin. Blood (abdominal aorta) and lung tissues were collected at 3 h and 72 h, respectively. The changes of lung wet-dry weight ratio (W/D), lung pathology and serum levels of interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), intercellular adhesion molecule-1 (ICAM-1) and thromboxane B2 (TXB2) were analyzed. Results Compared with control group and radiation group, radiation+low-load decompression group showed no significant difference in the injury and death rate of rats (P>0.05), while radiation+medium-load decompression group and radiation+high-load decompression group showed significantly increase of the injury and death rate of rats (P<0.05). Compared with control group, other groups showed no significant change in pulmonary W/D at 3 h (P>0.05), and increased at 72 h (P<0.05). HE staining showed that compared with control group, radiation group showed mild lung interstitial edema, while radiation+low-load decompression group showed obvious pulmonary tissue edema and a small number of red blood cells exudated in the alveolar cavity. The edema, congestion and inflammatory cell infiltration of lung tissue were more serious in radiation+medium-load decompression group and radiation+high-load decompression group. Compared with control group and radiation group, all radiation+decompression groups showed an increase in serum levels of IL-1β, IL-6, TNF-α, MDA, NO, ICAM-1 and TXB2 (P<0.05), and a decrease in SOD activity (P<0.05). Compared with radiation+low-load decompression group, radiation+medium-load decompression group and radiation+high-load decompression group showed increase in serum levels of IL-1β, IL-6, MDA, ICAM-1 and TXB2 (P<0.05), and decrease in activity of SOD (P<0.05). Except for control group, serum levels of IL-1β, IL-6, TNF-α, MDA, NO, ICAM-1 and TXB2 were decreased at 72 h compared with 3 h (P<0.05), and SOD activity was increased at 72 h in all groups (P<0.05). Conclusions High-load decompression can increase the injury and death rate of rats exposed to radiation and high pressure. The potential mechanism of the combined injury effect of radiation and decompression was related to inflammation, immune stress, oxidative damage, vasomotor activity and coagulation mechanism.

The progress and clinical application of troponin detection technology have continuously improved the diagnosis rate of acute myocardial infarction (AMI), which effectively shortens the time of necrotic myocardial reperfusion. Earlier studies have found that high-sensitivity troponin (hs-cTn) is elevated to varying degrees in patients with chronic kidney disease (CKD). Therefore, when patients with CKD have AMI, the application of hs-cTn is limited to a certain extent, and with the lack of chest pain symptoms and the non-specificity of electrocardiogram performance in patients with CKD, it is particularly difficult to make a quick and accurate diagnosis of such patients. Based on this, this article will summarize the application of hs-cTn in AMI, the clinical characteristics of patients with CKD combined with AMI, how to improve the diagnostic accuracy of patients with CKD combined with AMI, and the value of hs-cTn in risk stratification and prognosis assessment of such patients to provide clinical medical staff with reference for early intervention or revascularization of patients.

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.

α7 nicotinic acetylcholine receptor (α7nAChR) is widely expressed in the central nervous system and immune system, and plays a neuro-immunoregulatory role. On the one hand, α7nAChR is involved in the transmission of neurotransmitters, the conduction of excitatory signals and the maintenance of synaptic plasticity, which is of great significance for maintaining the normal and stable neurocognitive function. On the other hand, as an important part of the cholinergic anti-inflammatory pathway, α7nAChR is involved in the regulation of physiological and pathological processes such as inflammatory response, oxidative stress, apoptosis and autophagy in the central system, and plays an immunomodulatory and neuroprotective role, thus being potential target for improving perioperative neurocognitive function. This article reviews the biological characteristics of α7nAChR and its effect on perioperative neurocognitive function, in order to provide ideas and methods for clinical improvement of perioperative neurocognitive function in surgical patients.

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.

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.

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 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.

Objective To explore the prognostic factor and its predictive value of patients with Wilson disease-related acute-on-chronic liver failure (WD-ACLF). Methods The clinical data of 70 patients diagnosed as WD-ACLF admitted to the Department of Encephalopathy of the First Affiliated Hospital of Anhui University of Chinese Medicine from January 1, 2017 to January 1, 2022 were retrospectively collected. According to the 12-week prognosis, patients were divided into survival group (n=36) and death group (n=34). The data of the two groups were analyzed by univariate and multivariate logistic analysis to screen the prognostic risk factors and evaluate their predictive value. The model coefficient is omnibus tested, and the model-fitting degree is evaluated by the Hosmer-Lemeshow test. ROC curve was used to analyze the prognostic value for WD-ACLF between the new model and chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score, model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) score. Results A total of 70 WD-ACLF patients were enrolled in present study, including 36 cases in survival group [22 males and 14 females with median age of 30.0 (17.3, 40.0)] and 34 cases in death group [25 males and 9 females with median age of 34.0 (28.8, 41.0)]. Univariate analysis showed that the course of disease, prothrombin time (PT), activated partial thromboplastin time (APTT) were shorter in survival group than that in death group, the white blood cells (WBC), international normalized ratio (INR), aspartate transaminase (AST), total bilirubin (TBIL), blood urea nitrogen (BUN), creatinine (Cre) and ceruloplasmin (CER) levels and the proportion of infection, ascites, and upper gastrointestinal bleeding were lower in survival group than those in death group, however, the proportion of infection, ascites and upper digestive bleeding in the survival group were lower than those in the death group. Meanwhile, the red blood cells (RBC), hemoglobin (Hb), Na⁺ and total cholesterol (TC) level in the survival group were higher than those in the death group (P<0.05 or P<0.01). The results of multivariate logistic regression analysis showed that disease course (OR=1.176, 95%CI 1.043-1.325), INR (OR=7.635, 95%CI 1.767-32.980), TBIL (OR=1.012, 95%CI 1.003-1.021), and upper gastrointestinal bleeding (OR=11.654, 95%CI 1.029-131.980) were independent risk factors affecting the prognosis of WD-ACLF (P<0.05). Based on the results of logistic regression analysis, a joint model for predicting the prognosis of WD-ACLF was established. The AUC of the model for evaluating the prognosis of WD-ACLF was 0.941, which was greater than the CLIF-SOFA score (AUC=0.802), MELD score (AUC=0.897), and CTP score (AUC=0.722). Conclusions The course of disease, TBIL, INR, and upper gastrointestinal bleeding are risk factors that affect the prognosis of WD-ACLF. The prognosis model established based on this can more accurately predict the prognosis of WD-ACLF patients, and its predictive value is superior to CLIF-SOFA score, MELD score, and CTP score.