Objective To investigate the efficacy of the inferior vena cava collapsibility index（IVC-CI）as a goal-directed parameter for fluid resuscitation in hemorrhagic shock beagle dogs under a hypobaric hypoxic environment. Methods A hemorrhagic shock model was established in 12 male beagle dogs by maintaining mean arterial pressure（MAP）at 45±5 mmHg for 30 minutes via controlled bleeding. The dogs were randomly divided into two groups: the IVC-CI-guided group（group I, n=6）and the MAP-guided group（group P, n=6）. Both groups underwent goal-directed fluid resuscitation in a simulated hypobaric hypoxic environment（2500-meter altitude）. The fluid intake/output, hemodynamic parameters, and blood gas indices were compared. At the end of resuscitation, total fluid infusion, urine outputs, blood loss, lactic acid（LAC）, buffer excess（BE）, and fluid balance difference were recorded. The IVC-CI, end-expiratory inferior vena cava diameter（IVCe）, end-inspiratory inferior vena cava diameter（IVCi）, MAP, and heart rate（HR）were measured at baseline（T0）, immediately after hemorrhagic shock（T1）, 10 minutes post-resuscitation（T2）, 20 minutes post-resuscitation（T3）, and at the end of resuscitation（T4）. Results Repeated measures ANOVA showed that there was no significant main effect of group on MAP or HR in either group of beagles（all P>0.05）, but a significant main effect of time was observed for both MAP and HR（F=799.113 and 691.913, respectively; all P<0.001）. No significant interaction was found between group and time for either variable（all P>0.05）. Post-hoc pairwise comparisons revealed that MAP at T1, T2, T3, and T4 was lower than that at T0（all P<0.001）, whereas HR was higher than that at T0 at each of these time points（all P≤0.001）. MAP at T2, T3, and T4 was higher than at T1（all P<0.001）, while HR was lower than at T1（all P<0.05）. MAP at T4 was higher than at both T2 and T3（all P<0.001）, whereas HR at T4 was lower than at T2 and T3（all P<0.001）. HR at T3 was lower than at T2（P<0.001）. The total infusion volume and fluid balance were lower in group I than in group P（t=7.888, 10.998, both P<0.001）. In group I, significant differences were observed across time points in IVCe, IVCi, and IVC-CI（F=20.239, 35.332, and 46.935, all P<0.001）. Post-hoc comparisons indicated that IVCe and IVCi at T1, T2, and T3 were lower than at T0（all P<0.05）, while IVC-CI was higher than at T0（all P<0.05）. IVCi at T2 was higher than at T1 while IVC-CI at T2 was lower than at T1（both P<0.05）. IVCe and IVCi at T3 and T4 were higher than at T1 and T2（all P<0.05）, whereas IVC-CI at T3 and T4 was lower than at T1 and T2（all P<0.05）. IVCi at T4 was higher than at T3 while IVC-CI at T4 was lower than at T3（both P<0.05）. Conclusion IVC-CI can reflect circulatory volume status under hypobaric hypoxic conditions, guide fluid resuscitation and provide a noninvasive, efficient monitoring tool for volume management in critically ill patients during aeromedical evacuation.
Objective To establish a safer and more intelligent objective hypoxia prediction and early warning model by investigating the physiological response and long-term stability of healthy adults under acute hypoxia stimulation. Methods Twenty-six healthy adult volunteers from the Air Force Medical Center were enrolled between May and June 2024, who were exposed to standardized 7 000 m hypoxia via a hypoxic simulator, followed by a repeat 7 000 m hypoxic trial six months later. Using Chatterjee's correlation coefficient analysis and paired t-tests, the consistency of subjects' saturation of peripheral oxygen（SpO2）and the dynamics of subjects' heart rate under hypoxic conditions were assessed while the average duration of hypoxia tolerance was compared across genders. while the average duration of hypoxia tolerance was compared across genders. Results Individual SpO2 trajectories varied, but the overall consistency was high in that 221 inter-individual pairs showed strong consistency（ξ=0.600-0.775, all P=0.001）while 101 pairs demonstrated moderate consistency（ξ=0.425-0.599, P=0.001-0.022）. In terms of longitudinal consistency results, consistency was strong in fifteen subjects（ξ=0.620-0.769, all P=0.001）, moderate in four（ξ=0.404-0.587, P=0.001-0.010）, and weak in one（ξ=0.347, P=0.002）. As for the consistency of group predicted mean values, consistency was strong in twenty-five subjects（ξ=0.605-0.795, P=0.001-0.002）, and moderate in one（ξ=0.486, P=0.012）. Heart rate consistently increased with the severity of hypoxia. In phase 1 trials, the mean maximum heart rate （105.15±9.96 beats per minute）（bpm）of the subjects was significantly higher than their mean baseline of 83.96±11.06 bpm（t=10.907, P=0.001）, with a mean heart rate increase of 21.04±9.05 bpm among all the subjects. In phase 2 trials, the mean maximum heart rate reached 105.82±10.65 bpm, which was markedly elevated compared with the baseline value of 83.95±8.39 bpm（t=13.771, P=0.001）, equivalent to an average heart rate rise of 21.86±7.28 bpm. Conclusion Acute hypoxia can induce SpO2 decline at different rates and in different patterns in healthy adults, yet the high consistency between the group-predicted mean value and the longitudinal stability over about 6 months supports the theoretical feasibility of a prediction model being established with the SpO2 of a population as baseline combined with individualized calibration parameters.
Objective To recommend a novel heart rate variability（HRV）based method to automatically and objectively categorize types of flight fatigue. Methods Between January 2020 and January 2024, 77 male pilots from an aviation unit of the Northern Theater Command were selected as the subjects. First, 11 HRV features are retrieved and computed. Subsequently, four supervised machine learning algorithms-decision tree, support vector machine（SVM）, k-nearest neighbors（KNN）, and light gradient boosting machine（LightGBM）-were independently used to classify flight fatigue into three ordinal levels: high energy, mild fatigue, and severe fatigue. Finally, the ten-fold cross validation method was used to calculate the average accuracy, precision, recall rate and F1 score to evaluate the effect of classification. Results Among the four machine-learning algorithms, LightGBM was the best-performing, with an accuracy of 0.851±0.039, precision of 0.768±0.036, recall of 0.814±0.049, and F1 score of 0.791±0.039. Conclusion The LightGBM model trained using the selected 11 HRV features can perform accurate three-class classification of flight fatigue, which can be used for real-time monitoring and early warning of flight fatigue.
Objective To explore the clinical effects of aromatherapy against emotional fatigue in flight personnel and its regulation of neuroendocrine. Methods A total of 120 male flight personnel from one Armed Police Corps were selected between March and May 2024 before being stratified by age and length of service. These subjects were randomly divided into an experimental group and a control group（60 each）via block randomization. The experimental group received 30 minutes of aromatherapy interventions using a compound essential oil（lavender, lemon and rosemary mixed at a ratio of 2∶1∶1）twice daily for 4 weeks while the control group rested in the same environment. Emotional fatigue was assessed using the Maslach Burnout Inventory-General Survey（MBI-GS）while salivary cortisol levels were measured to determine stress response levels. Indicators of heart rate variability（HRV）were used to evaluate changes in the function of the autonomic nervous system. Results After 2 weeks of intervention, after 4 weeks of intervention and follow-up, the score of the MBI-GS and cortisol levels in the experimental group were lower than in the control group（all P<0.05）. There was statistically significant difference between adjacent time points in the experimental group（all P<0.001）. After 2 weeks of intervention, there was statistically significant difference in cortisol levels between the two groups（P<0.05）. In the experimental group, the MBI-GS score and cortisol levels were significantly decreased at 2-week intervention, 4-week intervention and 4-week follow-up compared with the pre-intervention baseline（all P<0.001）; the indicators at 4-week intervention and 4-week follow-up were further reduced relative to those after 2-week intervention（all P<0.001）. In the experimental group, SDNN, RMSSD, and pNN50 increased after 4 weeks of intervention（t=14.026, 13.536, 11.643, all P<0.001）while the LF/HF ratio decreased （t=－11.386, P<0.001）. HRV indicators（SDNN, RMSSD, pNN50, LF/HF）improved more significantly in the experimental group than in the control group, with statistically significant differences between the two groups（t=9.847, 9.124, 8.632, －7.218, all P<0.001）. Improvement persisted after 4 weeks of follow-up, with an adherence rate of 98.33%（59/60）and no severe adverse reactions occurred. Conclusion Aromatherapy can effectively alleviate emotional fatigue in flight personnel by regulating the function of the hypothalamic-pituitary-adrenal axis and balancing the activity of the autonomic nervous system. This is a safe and effective non-pharmacological intervention strategy for management of occupational health of flight personnel.
Objective To investigate the clinical manifestations and aeromedical assessment of pilots with unilateral vestibular hypofunction, and to provide evidence and references for clinical applications of the guidelines in related assessments. Methods The clinical data of 41 pilots with unilateral vestibular hypofunction who were hospitalized in a medical institution were summarized. All the pilots underwent a comprehensive battery of vestibular function tests, including the video head impulse test（vHIT）, caloric test（CT）, rotary chair sinusoidal harmonic acceleration test（SHAT）, vestibular evoked myogenic potentials（VEMP）, subjective visual vertical/horizontal test（SVV/SVH）, and dynamic visual acuity（DVA）. According to the results of the caloric test, the pilots were divided into a high CP group（52%<CP≤100%）, low CP group（20%<CP≤52%）, normal DP group（DP≤30%, CP>20%）and abnormal DP group（DP>30%）. The detection rates of abnormal vestibular function were compared between these groups while the vestibular function of pilots with different results of aeromedical assessments was analyzed. Results Among the 41 pilots with unilateral vestibular hypofunction, the rate of abnormalities detected by SHAT was the highest（31.71%, 13/41）. The rate of abnormalities detected by vHIT was significantly higher in the high CP group than in the low CP group（χ2=4.230, P=0.040）. The rate of abnormalities detected by SHAT was significantly higher in the abnormal DP group than in the normal DP group（χ2=8.562, P=0.003）. There were statistically significant differences in the abnormality rates detected by vHIT, SHAT and DP between the group qualified for flight and the temporarily grounded group（χ2=6.720, 11.448, 13.437, P=0.010, <0.001, <0.001）. Conclusion During aeromedical assessment of pilots with unilateral vestibular hypofunction according to the guidelines, a systematic and comprehensive vestibular function examination is required, and the conclusion should be based on the results of examination. The guidelines should be used more widely in clinic.
Objective To explore the epidemiology of sleep disorders among personnel garrisoned in high-altitude environments and the key risk factors in order to contribute to targeted interventions. Methods Between June 2024 and July 2024, 835 troops from a unit stationed on the plateau were selected as the subjects. Data was collected using a Basic Information Questionnaire and the Pittsburgh Sleep Quality Index（PSQI）scale before being statistically analyzed. Results The PSQI total score of these subjects was 5.00（2.00, 8.00）points, with 27.78%（232/835）of them reporting poor sleep quality. Statistically significant differences in the incidence of sleep disorders were observed across such factors as gender, age, and marital status（χ2=4.337-193.809, all P<0.05）. Multivariate logistic regression analysis identified the following as factors influencing poor sleep quality: irregular patterns of sleep（OR=1.857, 95%CI: 1.025-3.364）, relatively poor air quality（OR=2.030, 95%CI: 1.162-3.546）, use of sleep supplements（OR=5.118, 95%CI: 2.363-11.082）, use of sleeping pills（OR=14.973, 95%CI: 2.915-76.910）, frequent shift（OR=2.468, 95%CI: 1.347-4.522）, and stresses from work or training（OR=2.580, 95%CI: 1.095-6.078）. Conclusion The sleep quality of personnel garrisoned on the plateau depends on multiple factors. It is critical to organize more medical tours of grassroots units, leave these troops better informed of health and care more about their sleep quality.
Objective To investigate the role of multi-component cognitive training in enhancing individuals' capacity to cope with high cognitive load. Methods A total of 50 male university students from Air Force Medical University were enrolled between March and April 2025 and randomly assigned to an experimental group（n=25）or a control group（n=25, 3 of them dropped out during the study）using a random number table method. The experimental group underwent a 4-week structured cognitive training program consisting of three sessions per week and involving spatial memory span, the Schulte grid task, and perceptual processing speed, while the control group received no interventions. The performance during high cognitive load tasks and Visual Analogue Scale（VAS）scores were compared between the two groups. Results After training, there were statistically significant improvements in spatial memory span, reaction time during the Schulte grid task, and reaction time during the perceptual processing speed task（Z/t=－3.590, 7.993, 11.861, all P<0.001）in the experimental group. The accuracy of the experimental group improved after training（P<0.001）, and was better than that of the control group during high cognitive load task（P=0.032）. The reaction time of both groups after training was shortened（both P<0.001）. The VAS scores suggested a statistically significant difference in task completion scores between the two groups before and after training（t=2.335, P=0.025）. Conclusion Systematic multi-component cognitive training can effectively enhance basic cognitive abilities such as working memory, attention, and perceptual speed, and can transfer the training benefits to complex high-load tasks so that both behavioral performance and subjective experience can be synchronously improved. This is an effective approach to boosting resistance to high cognitive load and offers data for cognitive training in related personnel.
Objective To construct an early screening model for mild cognitive impairment（MCI）based on multimodal speech features in order to provide an objective and user-friendly auxiliary diagnostic tool for early clinical identification and intervention. Methods A cross-sectional study design was adopted. A total of 286 patients suspected of cognitive decline who visited the departments of healthcare, geriatric diseases, health medicine, neurosurgery, and outpatient clinics in a tertiary hospital in Guangzhou between March 2024 and August 2025 were selected. They were divided into an MCI group（n=142）and a cognitively normal control group（n=144）based on clinical diagnosis. Speech samples were collected from these subjects via standardized speech tasks, including spontaneous speech, picture description, verbal fluency, and semantic memory tasks. Deep learning algorithms were employed to extract acoustic, linguistic, and prosodic features so as to construct a multidimensional speech feature vector. Machine learning algorithms such as the support vector machine, random forest, and deep neural network were used to establish classification models, the performance of which was evaluated using ten-fold cross-validation and externally validated on an independent test set. Results A total of 1 024-dimensional speech features were extracted, including 512-dimensional acoustic features, 256-dimensional linguistic ones, and 256-dimensional prosodic ones. The deep neural network model based on multimodal fusion performed the best, with an accuracy of 87.34%, sensitivity of 85.92%, specificity of 88.71%, and an area under curve（AUC）value of 0.923（95%CI: 0.884-0.961）on the training set. Validation results on the independent test set（n=86）showed the model achieved an accuracy of 84.88%, sensitivity of 83.72%, specificity of 86.05%, and an AUC value of 0.891（95%CI: 0.842-0.963）. The speech pause duration（weight coefficient 0.156）, semantic coherence score（weight coefficient 0.142）, and fundamental frequency variation coefficient（weight coefficient 0.138）were the three biggest contributors to the model. Compared with traditional neuropsychological scales, the diagnostic efficacy of this model was improved（P<0.001）. Conclusion The machine learning model based on multimodal speech features can effectively identify MCI, promise high diagnostic accuracy and wide clinical applications, and provide a new technological pathway for early screening of MCI.
Objective To explore the effects of multimodal breathing pattern training on morphological parameters of the diaphragm and core muscles, and to provide imaging evidence for the application of breathing training in rehabilitation medicine and physical fitness training. Methods A total of 40 healthy volunteers from a class of School of Aerospace Engineering, Tsinghua University, were enrolled and randomly divided into an intervention group（n=30）and a control group（n=10）using a random number table method. The intervention group received an 8-week multimodal breathing training program（30 minutes per day）, which consisted of four breathing patterns including diaphragmatic breathing, reverse diaphragmatic breathing, thoracoabdominal combined breathing and HP breathing as well as two core exercises: crunches and supine leg raises. The control group maintained daily activities without interventions. Ultrasonography was applied to measure both the thickness of the diaphragm at the end of quiet inspiration, quiet expiration and maximal deep inspiration and the morphological parameters of eight core muscles（quadratus lumborum, psoas major, rectus abdominis, internal oblique abdominis, external oblique abdominis, transversus abdominis, erector spinae and multifidus）before training and after 8 weeks of interventions. Results After 8 weeks of training, the thicknesses of the diaphragm, psoas major, rectus abdominis, external oblique, internal oblique, and transverse abdominis of the study group all increased（all P<0.001）and were greater than those of the diaphragm and core muscles in the control group（all P<0.001）. Conclusion Multimodal respiratory pattern training can effectively increase diaphragm thickness during inspiration and core muscle thickness in healthy adults. By enhancing core muscle function via morphological changes, such an approach is of great clinical value for improving respiratory function and core stability.
Objective To analyze the therapeutic effect of interlocking intramedullary nails（IMN）and limited contact dynamic compression plates（LC-DCP）in the fixation of patients with tibiofibular nonunion after limb trauma fractures. Methods A total of 87 patients with nonunion of the tibia and fibula after limb trauma fractures admitted to the 904th Hospital of the Joint Logistic Support Force between February 2022 and October 2024 were selected and divided into two groups according to fixation methods. The 43 cases in the control group were fixed with IMN, and 44 cases in the observation group with LC-DCP. Surgical effects were compared between the two groups. Results The excellent and good rate of surgeries in the observation group was significantly higher than that of the control group（χ2=4.623, P=0.032）. The intraoperative blood loss and the degree of pain at 2 weeks postoperatively were lower in the observation group than in the control group（t=3.477, 9.599, P=0.001, <0.001）, and the fracture healing time was shorter（t=9.961, P<0.001）. The Lane-Sandhu scores at three months postoperatively were significantly higher than at one month postoperatively in both groups（both P<0.001）. At one month postoperatively, the levels of alkaline phosphatase（ALP）, osteoprotegerin（OPG）and bone glaprotein（BGP）were higher in both groups（t=9.181-39.675, all P<0.001）, and the comparisons of the differences in ALP, OPG and BGP all showed statistically significant differences in both groups（t=19.711, 15.307, 15.819, all P<0.001）. especially in the observation group（all P<0.001）. Simple effect analysis suggested that both the Fugl-Meyer Assessment and Activities of Daily Living scores kept improving at three months postoperatively in both groups（all P<0.001）. There was no statistically significant difference in the incidence of complications within 3 months postoperatively between the two groups（χ2=0.001, P=0.979）. Conclusion LC-DCP fixation is more effective for patients with tibiofibular nonunion after limb trauma fractures, which can significantly improve bone metabolism indicators, enhance limb function and motor function of patients, and cause a lower degree of postoperative pain.
Objective To analyze the clinical efficacy and safety of 5-aminolevulinic acid photodynamic therapy against vaginal squamous intraepithelial lesion（VSIL）. Methods A total of 78 outpatients with VSILs admitted to the Gynecology and Obstetrics Department of Air Force Medical Center between June 2022 and August 2024 were enrolled as the subjects. These patients were divided into two groups according to treatment regimens. Thirty-eight of them received photodynamic therapy while the rest were treated with interferon. The clearance rate of HPV and efficacy were recorded and compared at 6 and 12 months after treatment. Patients with baseline positive HPV status in both groups were stratified by age（<50 years vs ≥50 years）. The clearance rate of HPV at 6 and 12 months after treatment was then compared across age subgroups. Results Among the patients with VaIN 1 and VaIN 2 in the photodynamic therapy group，the effective rates were 68.97%（20/29）and 66.67%（6/9）respectively at 6 months post-treatment and 86.21%（25/29）and 88.89%（8/9）respectively at 12 months post-treatment. The clearance rate of HPV at 6 months post-treatment was 46.43%（13/28）for VaIN 1 patients and 25.00%（2/8）for VaIN 2 patients, compared with67.86%（19/28）and 75.00%（6/8） respectively at 12 months post-treatment. Among patients diagnosed with VaIN 1, the clearance rate of HPV at 6 months post-treatment was 46.43%（13/28）in the photodynamic therapy group and 15.38%（6/39）in the interferon group, compared with 67.86%（19/28）and 38.46%（15/39）respectively at 12 months post-treatment. All the results were significantly different（χ2=6.279, 4.529, P=0.012, 0.033）. At 6 months post-treatment, the clearance rates of HPV among patients under 50 and those ages 50 and older who had received photodynamic therapy were 50.00%（10/20）and 31.25%（5/16）respectively, with no statistically significant difference（χ2=0.987, P=0.353）. For patients treated with interferon, the clearance rates of HPV were 26.32%（5/19）and 5.00%（1/20）respectively, and the difference was statistically significant（χ2=2.234, P=0.029）. At 12 months post-treatment, the clearance rates of HPV among patients under 50 and those ages 50 and older were 90.00%（18/20）and 43.75%（7/16）respectively in the photodynamic therapy group, compared with 57.89%（11/19）and 20.00%（4/20）in the interferon group, with statistically significant difference. In both groups, only a few patients experienced mild adverse reactions during treatment. In the photodynamic therapy group, 4 patients（10.53%, 4/38）experienced mild stinging or burning sensations at the irradiation site, 7 patients（18.42%, 7/38）presented with increased vaginal discharge, and 2 patients（5.26%, 2/38）reported mild lower abdominal distension. In the interferon group, 7 patients（17.50%, 7/40）suffered from vaginal stinging or burning, 5 patients（12.50%, 5/40）had increased vaginal discharge, and 1 patient（2.50%, 1/40）developed a small amount of bloody vaginal discharge. Conclusion 5-aminolevulinic acid photodynamic therapy can effectively improve the clearance rate of HPV and cervical cytological results among VaIN patients, especially in those under 50. This treatment is safe.
Objective To study the predisposing factors and outcomes of diabetic foot ulcer and to recommend ways of prevention. Methods Two hundred and four inpatients with diabetic foot ulcer were selected from the Endocrinology Department, Air Force Medical Center, between March 2023 and September 2024. The predisposing factors, clinical characteristics, locations of foot ulcers and outcomes of diabetic foot were analyzed. Results The main precipitating factors of 204 inpatients with diabetic foot ulcer included pedicures（21 cases, 10.29%）, scald injury（7 cases, 3.43%）, scratching（4 cases, 1.96%）, physiotherapy（10 cases, 4.90%）, foot bath（23 cases, 11.27%）, friction injury during walking（62 cases, 30.39%）, paronychia（9 cases, 4.41%）, callus rupture（31 cases, 15.20%）, skin rhagades（5 cases, 2.45%）, and spontaneous blister（12 cases, 5.88%）. The distribution of foot ulcer sites varied widely under different predisposing factors. Ulcers caused by pedicures mostly occurred in the simple toe region, accounting for 85.71%（18/21）. Ulcers induced by foot soaking and bathing mostly involved the toes or multiple foot sites simultaneously, with single toe involvement accounting for 56.52%（13/23）and combined involvement of the toe, dorsum, sole, and heel accounting for 39.13%（9/23）. Ulcers induced by friction injury from shoes or walking were predominantly located in the first and fifth toes, making up 35.48%（22/62）and 46.77%（29/62）, respectively. Ulcers caused by callus rupture primarily affected the plantar region（64.52%, 20/31）, followed by the fifth toe（35.48%, 11/31）. All ulcers induced by paronychia and ingrown toenails occurred in the first toe. Ulcers secondary to skin rhagades were mainly distributed in the heel, accounting for 80.00%（4/5）.The ulcer sites in amputated foot cases were mainly on the toes and toes accompanied by the dorsum pedis, vola, heel（93.89%, 123/131）. Conclusions The dominating predisposing factors of diabetic foot ulcer are pedicures, scald injury, scratching, physiotherapy, foot bath, friction injury during walking, paronychia, callus rupture, skin rhagades, spontaneous blister, which will lead to adverse outcomes. Keeping clear of predisposing factors can contribute to prevention of diabetic foot ulcers.
Objective To evaluate the clinical applicability of a self-developed automated packaging device in order to help address the problems of low efficiency, high rates of human errors, frequent label information loss, and fixative contamination in the process of packaging gastrointestinal endoscopic pathology specimens. Methods A prospective randomized controlled trial was conducted from July to September 2025 in the Endoscopy Center, Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University. A total of 1,860 patients undergoing gastroscopy were enrolled and randomly assigned（1:1）to the observation group（automated packaging device, n=930）or the control group（conventional manual packaging, n=930）. In the observation group, the entire process of specimen collection, sealing, label recognition and printing, fixative addition, and transport preparation was completed by the self-developed device, while the same procedures were performed manually by the medical staff in the control group. The two groups were compared in terms of total time taken by collection and packaging, label accuracy, fixative contamination rates, specimen integrity scores, staff satisfaction, and acceptance rates by the department of pathology. Results The median total time taken by specimen collection and packaging was significantly shorter in the observation group than in the control group（Z=－36.996, P<0.001）. As for indexes of quality, the scores of specimen integrity were significantly higher in the observation group（4.88±0.09）than in the control group（4.25±0.25）（t=72.254, P<0.001）, so were the labelling accuracy（99.03% vs 96.02%）, healthcare providers' levels of satisfaction（96.02% vs 88.06%）, and rate of acceptance by the pathology department（99.25% vs 93.66%）（χ2=17.476, 40.199, 42.477, all P<0.001）, while the contamination rate of fixative solution（1.83% vs 7.20%）was significantly lower（χ2=31.170, P<0.001）. Conclusion The automated packaging device can effectively enhance the standardization, accuracy, and overall efficiency of packaging gastrointestinal pathology specimens, significantly reduce errors, and improve the staff’s experience. It should be made more accessible in healthcare institutions at different levels.
Objective To explore the molecular mechanism by which heat acclimation training induces physiological heat acclimation at the proteomic level in order to provide data and molecular targets for early warning of and targeted interventions with heatstroke. Methods Seven healthy young males [（23.29±1.97）years] were recruited and subjected to 7 days of outdoor heat acclimation training. Standardized heat tolerance tests were performed and blood samples were collected before and after the training. Differentially expressed proteins were identified using data-independent acquisition based quantitative proteomics. The molecular adaptation mechanisms were analyzed by combining gene ontology/kyoto encyclopedia of genes and genomes（KEGG）enrichment analysis and STRING protein-protein interaction network analysis. Results After heat acclimation training, the heat tolerance test showed that the mean peak heart rate decreased（t=11.720, P<0.001）, so did the mean peak core temperature（t=8.832, P<0.001）and the physiological stress index（PSI）（t=11.714, P<0.001）. Proteomic analysis identified a total of 530 differentially expressed proteins, 63（11.89%，63/530）of which were upregulated and the rest were downregulated. Enrichment analysis found that: 1）Biological processes were significantly enriched in actin cytoskeleton organization, supramolecular fiber assembly, and regulation of protein metabolic processes; 2）Cellular components were primarily localized to the cytoplasm, vesicles, and membrane-bounded organelles; 3）Molecular functions were mainly associated with protein binding, enzyme activity regulation, and translational regulation; 4）KEGG pathways were highly enriched in cytoskeleton remodeling（e.g., regulation of actin cytoskeleton, focal adhesion）, immune-inflammatory responses（e.g., platelet activation, neutrophil extracellular trap formation）, and energy metabolism（e.g., glycolysis/gluconeogenesis, insulin signaling pathway）; 5）PPI network analysis identified key hub proteins such as RAC2（degree=34）, APP（degree=30）, and RHOG（degree=24）. Conclusion Heat acclimation training induces physiological remodeling at the proteomic level by regulating the cytoskeleton, immune-inflammatory responses, and energy metabolism. This mechanism provides molecular evidence for insights into the biological basis of heat acclimation and for developing personalized heat acclimation strategies based on molecular biomarkers.
Objective To investigate the dynamic changes of urinary biomarkers during heat acclimation training and their potential value for early warning of heat-related injuries. Methods A randomized controlled trial was conducted from May 15 to May 25, 2025 with 51 healthy male volunteers, who were randomly assigned to a running group（n=19）, a water immersion group（n=17）, and a control group（n=15）. The running group performed running training in a 30 ℃ environment, the water immersion group received 40 ℃ constant-temperature water immersion for 40 min while the control group maintained daily activities without interventions. The interventions lasted for 7 days. The correlations of changes in peak heart rate and peak core temperature before and after thermal adaptation training with changes in urine indicators before and after training in the three groups were analyzed. Results Correlation analysis of urinary indicators suggested positive correlations between amylase（AMY）and urinary creatinine（UCr）, heart-type fatty acid-binding protein（H-FABP）, urinary microalbumin（mALB）, myoglobin（MYO）, uric acid（UA）, and cortisol（Cor）（rs=0.137-0.424, all P<0.05）. UCr was positively correlated with H-FABP, mALB, Urea, and Cor（rs=0.171-0.631, all P<0.05）,but negatively with MYO（rs=－0.359, P<0.001）. H-FABP was positively correlated with mALB and Cor（rs=0.707, 0.247, both P<0.001）while mALB was negatively correlated with UA（rs=－0.212, P=0.001）. MYO was positively correlated with UA（rs=0.233, P<0.001）but negatively with Urea and Cor（rs=－0.373, －0.161, P<0.001, =0.014）. Urea was positively correlated with Cor（rs=0.490, P<0.001）, so was UA with Cor（rs=0.229, P<0.001）. After heat acclimation training, baseline heart rate, peak heart rate, and peak core temperature during the heat tolerance test significantly decreased in the experimental groups（t=4.524, 4.070, 4.517, all P<0.001）. The changes in H-FABP were positively correlated with the those in peak core temperature（rs=0.366, P=0.039）. Generalized estimating equation analysis pointed to a time main effect for MYO levels（Wald χ2=20.186, P<0.001）. Urea levels decreased after training in the water immersion group（P=0.030）while the post-training urea level was higher in the control group than in the running group（P=0.003）. A time main effect was observed for UA levels（Wald χ2=10.195, P=0.001）. Conclusion Urinary biomarkers undergo dynamic changes and are correlated during heat acclimation training, suggesting their potential application in evaluating training effectiveness and providing early warning of heat-related injury risks.
Objective To investigate the preventive effect of Huoxiang Zhengqi dripping pills against heat stroke. Methods A randomized controlled trial was conducted in 40 healthy young males from a military unit between March 19 and 25, 2025. These subjects were randomly divided into an experimental group and a control group by lottery, with 20 cases in each. The experimental group received daily oral administration of Huoxiang Zhengqi dripping pills plus routine water intake while the control group received routine water intake only. Both groups underwent 7 days of identical intensity training（running for 20 min at 32 ℃）under heat exposure. Urine samples were collected before and after the trial to measure urinary microalbumin（MAU）, urinary myoglobin（MYO）, and routine urinalysis parameters. Dynamic sweat monitoring was performed during exercise. Changes in various indicators were compared between the two groups before and after the trial. Results No significant main group effect was observed for urinary MAU between the two groups before and after heat exposure training（Wald χ2=1.701, P=0.192）, but a significant time effect was found, with post-training urinary MAU lower than the pre-training level（Wald χ2=15.003, P<0.001）. For urinary MYO, neither main effects nor interactions were of statistical significance（all P>0.05）. Before the training, the positive rate of urinary protein was 0 in the control group and 30%（6/20）in the experimental group, but decreased to 0 in the control group and 5%（1/20）in the experimental group after the training. Urine specific gravity in the experimental group was significantly lower after the training（P<0.001）. Real-time sweat monitoring during the 20-min running session suggested no significant differences in the sweat rate, sodium ion concentration, or potassium ion concentration between the two groups（all P>0.05）. Conclusion During high-temperature, high-humidity, and high-intensity training, administration of Huoxiang Zhengqi dripping pills cannot significantly improve early renal injury indicators related to heat stroke, but there is a potential regulatory effect on water and salt metabolism.
Objective To explore the real-time intervention effect of transcutaneous electrical acupoint stimulation（TEAS）at pericardium channel 6（PC6）during startle response so as to give tips for prevention of startle response among pilots under special circumstances. Methods Forty-eight males were enrolled and alternately assigned to a control group and an intervention group, with twenty-four in each group. An inter-subjects paradigm was adopted, with the intervention methods as the independent variable while the dependent variables were the changes of behavioral indexes（facial expression, reaction time）and physiological indexes（heart rate, respiratory rate, blood oxygen saturation, body temperature and heart rate variability）. Results Regarding the changes in physiological indicators, there were no statistically significant differences in the pre-post-test differences of physiological parameters between the control group and intervention group（all P>0.05）. Behavioral indicators showed that the degree of left eye squint and right eye squint in the control group was higher than that of the intervention group（t=3.241, 3.079, P=0.002, 0.004）. Conclusion The intervention effect of TEAS at PC6 on startle response is primarily reflected in changes of behavior, and TEAS at PC6 may potentially improve the startle response of pilots under special circumstances.
Objective To explore the clinical efficacy of acupuncture and moxibustion combined with exercise therapy against chronic insomnia disorder（CID）. Methods A total of 86 patients with CID who visited our hospital between January 2024 and April 2025 were selected and divided into an observation group（43 cases）and a control group（43 cases）using a random number table method. The control group received exercise therapy while the observation group was additionally treated with acupuncture and moxibustion. The Pittsburgh Sleep Quality Index（PSQI）, sleep efficiency（SE）, N3 sleep time, arousal index, and duration of rapid eye movement（REM）sleep were compared between the two groups before and after treatment. Results After treatment, improvements in the total PSQI score, sleep latency, habitual sleep efficiency, and daytime dysfunction were more pronounced in the observation group than in the control group（Z=－4.313, －3.185, －2.499, －4.593, P<0.001, <0.001, =0.012, <0.001）. As for sleep indicators, the observation group improved more significantly in terms of SE, N3 sleep time, arousal frequency, and durations of REM sleep than in the control group after treatment（Z=10.322, 6.973, －5.098, 5.175, all P<0.001）. Conclusion Acupuncture and moxibustion combined with exercise therapy have synergistic effects in the treatment of CID by effectively improving subjective sleep quality and optimizing objective sleep structure in patients with CID.
Objective To explore the applicability of auricular point sticking combined with Traditional Chinese Medicine（TCM）wet compress therapy in the treatment of enteral nutrition-related gastrointestinal intolerance in elderly critically ill patients. Methods A total of 80 elderly critically ill patients who received enteral nutrition（EN）support were selected from the Emergency Department between November 2023 and November 2024. According to intervention methods, these patients were divided into two groups. The control group（n=40）received routine nursing combined with auricular point sticking while the observation group（n=40）was additionally given TCM compress therapy. The incidence of gastrointestinal intolerance within 7 days of EN treatment, levels and dynamic changes of serum nutritional indicators in patients on the 1st, 4th, and 7th days of EN were compared between the two groups. Results The total incidence of gastrointestinal intolerance in the observation group was 42.50%（17/40）, which was significantly lower than 80.00%（32/40）in the control group（χ2=11.850, P<0.001）. Results of repeated measures analysis of variance showed that when different nutritional indicators were compared between the two groups, there were significant time effects（F=35.243, 12.832, 12.451, 28.166, all P<0.001）, group effects（F=6.575, 8.218, 5.121, 4.364, P=0.012, 0.005, 0.026, 0.040）and interaction effects（F=7.125, 6.347, 4.881, 5.243, P=0.002, 0.004, 0.024, 0.005）. Simple effect analysis revealed that, on the 4th and 7th days of EN, the albumin levels in the observation group were significantly higher than on the 1st day（P=0.008, <0.001）, and than those of the control group（P=0.018, <0.001）. On the 4th and 7th days of EN, the total protein（TP）levels in the observation group were significantly higher than those of the control group （P=0.048, P=0.033）. The TP level in the observation group on the 7th day of EN was significantly higher than on the 1st and 4th days（P=0.006, <0.001）.The prealbumin（PAB）level in the control group on the 4th day of EN was significantly lower than on the 1st day（P=0.019）,while the PAB level in the observation group on the 7th day of EN was significantly higher than on the 4th day（P=0.047）. The hemoglobin（Hb）level in the observation group on the 4th day of EN was significantly lower than on the 1st day（P=0.004）, the Hb level in the observation group on the 7th days of EN was significantly lower than on the 1st day（P=0.012）, but higher than on the 4th day（P=0.047）and than in the control group on the 7th day（P=0.012）. Conclusion On the basis of routine nursing care, the combined therapy of auricular point sticking and TCM wet compress therapy exerts a favorable synergistic effect by effectively reducing the incidence of enteral nutrition-related gastrointestinal intolerance in elderly critically ill patients, improving the absorption of nutrients, and optimizing the patients' nutritional status.
