Objective To evaluate the changes in levels of fatigue during 24-hour simulated flight tasks and the anti-fatigue effect of modafinil based on electroencephalogram（EEG）technology so as to provide data for research on the applicability of modafinil to the military. Methods Six male subjects who met the physical requirements of pilots were selected. Within-subjects-design was adopted. Each subject participated in two 24-hour continuous simulated flight tasks. During the task, modafenib and placebo were taken separately, with modafenib as the experimental group and placebo as the control group. The subjective evaluation score（including the subjective sleepiness score and fatigue score）, critical flash fusion frequency and EEG data were collected throughout the experiment. Subjective evaluation and critical flash fusion frequency evaluation were used as auxiliary means to define the level of fatigue. The changes of four EEG rhythm waves, proportional parameters and wavelet entropy with flight time and the differences between the two groups were analyzed. Results During the 24-hour continuous simulation flight task, the δ-wave activity and wavelet entropy in the prefrontal area of the subjects were significantly reduced（F=1.981, 0.643, P=0.030, 0.016）, the subjects became less vigilant, the degree of inhibition of brain activity was elevated, and fatigue was intensified. There was no significant difference between the two groups, that was, modafinil did not completely block the positive increase of fatigue, which was basically consistent with the results of subjective and critical flash fusion frequency evaluation. Conclusion The δ-wave of EEG in the prefrontal region and wavelet entropy can be used as a potential objective and effective indexes to assess the fatigue level of flight personnel and the anti-fatigue effect of modafinil.

Objective To find out about the role of occupational exposure such as electromagnetic radiation, acceleration load and mental stress in the pathogenesis of thyroid diseases in flight personnel so as to provide data for the research on aerospace medical care. Methods The physical examination and assessment data of 8 057 military pilots who rehabilitated between January 2022 and July 2024 was collected, the incidence rates of thyroid diseases were calculated, and the differences in incidence rates between groups of different ages, aircraft types, jobs and flight hours were analyzed. Results The total prevalence rate of thyroid diseases among these flight personnel was 46.54%, including thyroid nodules（41.16%）, Hashimoto's thyroiditis（4.22%）, thyroid cancer（1.96%）, and thyroid dysfunction（0.84%）. The incidence of the above thyroid diseases increased with age（Z=190.500, 6.433, 63.164, 15.979, 308.026, P<0.001, =0.011, <0.001, <0.001, <0.001）and flight hours（Z=109.791, 9.864, 60.778, 16.943, 209.829, P<0.001, =0.002, <0.001, <0.001, <0.001）. Thyroid diseases were more prevalent in flight personnel of airborne early warning aircraft than in those of other types of aircraft（all P<0.05）, and among service crews than among pilots（χ²=4.209, 12.489, 4.723, 6.009, 18.536, P=0.040, <0.001, 0.030, 0.014, <0.001）. Age（OR=1.028, 95%CI: 1.019~1.037）, accumulated hours of flight（OR=1.114, 95%CI: 1.088~1.142）, aircraft types（OR=2.195, 95%CI: 1.337~3.606）, and service jobs（OR=1.669, 95%CI: 1.109~2.239）were all contributors to thyroid diseases in pilots. Conclusion The incidence of thyroid diseases in flight personnel is high, and age, accumulated hours of flight, aircraft types, and service jobs can make a difference in the vulnerability to thyroid diseases in pilots. Occupational exposure during flight is an important cause of thyroid diseases.

Objective To explore the abnormal spectra detected during ophthalmic selections of students from teenager aviation schools in Northeast China. Methods A total 173 students in Northeast China who were eliminated during Air Force recruitment medical selections in 2015-2020 were selected to analyze the abnormal spectra of ophthalmic diseases. Results A comparison of the rates of elimination due to ophthalmic diseases over the six years suggested that the percentage was over 50%. The analysis of the proportion of various diseases eliminated in ophthalmology showed that the diseases eliminated in ophthalmology in each year were mainly concentrated in fundus lesions and refractive errors, accounting for 35.40%（40/113）and 46.02%（52/113）respectively, and there was no statistically significant difference between the years（χ²=4.372, 3.881, P=0.497, 0.567）. Peripheral retinal degeneration was the main cause of retinal diseases（P=0.137）while myopia that exceeded the permitted level was the chief contributor to refractive errors（P=0.623）. The changes of the spherical degree were the main manifestation in myopia that exceeded the permitted level（F=3.968, P=0.006）. Conclusion Peripheral retinal degeneration and refractive errors are the major reasons that candidate from teenager aviation schools are eliminated ophthalmologically, and refractive errors mostly manifest themselves as myopia that exceeds the permitted level.

Objective This study aims to investigate the therapeutic effects of Jingning Decoction（JND）in a rat model of Tourette Syndrome（TS）and to explore the potential mechanisms through which JND modulates gut microbiota, influences neuroinflammation, and alters neurotransmitter levels. Methods A total of 48 male Wistar rats were used to establish a TS model by administering intraperitoneal injections of 3,3-iminodipropionitrile（IDPN）at a dosage of 150 mg/kg/day for one week. A stereotyped behavior score greater than 1 indicated successful modeling. Using the random number table method, the patients were randomly divided into six groups: control group（Control group）, model group（TS group）, positive drug group（Hal group）, low-dose Jingning decoction group（JND-LD group）, medium dose Jingning decoction group（JND-MD group）, and high-dose Jingning decoction group（JND-HD group）. After 4 weeks of administration, the efficacy was evaluated through stereotype scoring, ELISA assay, and histopathological analysis; Extract fecal genome and perform 16S rRNA sequencing detection. Results After 4 weeks of administration, the stereotype scores of the JND-HD group, JND-MD group, and JND-LD group were lower than those of the TS group（P=0.032, <0.001, 0.160）; The ELISA analysis results showed that the IL-4 levels in the JND group were higher than those in the TS group（P=0.002, 0.015, <0.001）, while the IL-6 and DA levels in the Hal group, JND-MD group, and JND-LD group were lower than those in the TS group（P=0.016, 0.017, 0.006, <0.001, 0.016, 0.006）. The Glu levels in the Hal group and JND-MD group were lower than those in the TS group（P=0.040, 0.027）; The results of histopathological analysis showed that the protein levels of ZO-1, Occludin, and Claudin-1 in the TS group were lower than those in the Control group（P=0.014, 0.007, 0.009）, while the JND-MD group was higher than the TS group（P=0.004, 0.021, <0.001）. The protein levels of Occludin and Claudin-1 in the Hal group were higher than those in the TS group（P=0.040, 0.012）. The 16S rRNA sequencing analysis results showed that the Shannon index and thickness/pseudo ratio of the TS group were lower than those of the Control group（P=0.033, 0.006）, while the JND-MD group was higher than the TS group（P<0.001, =0.003）. Conclusion JND demonstrates significant therapeutic efficacy in the treatment of Tourette Syndrome model in rats, with its mechanism of action mediated through the regulation of gut microbiota, modulation of inflammatory cytokines, and expression of neurotransmitters.

Objective To investigate the effect of cannabidiol（CBD）on propofol（PPF）-induced sleep rhythm disturbances in rats. Methods Twenty-four SD rats were divided into the control（CON）group, model（MOD）group, melatonin（MLT）group, and CBD group, and each group was acclimatized to a 12 h/12 h light/dark rhythm environment for one week. The MLT and CBD groups were given 15 mg·kg^-1 melatonin and 10 mg·kg^-1 CBD, respectively, by gavage at CT12（circadian time, CT12 was set at 20:00）while the other groups were given an equal volume of solvent. On the same day, all these groups except the CON group were anaesthetized with propofol at CT16（CT16 was set at 22:00）. Blood was collected through the fundus sinus vein at 1 h and 24 h after anesthesia and circadian rhythm was monitored for one week. The endogenous melatonin level of rats was detected by ELISA before the CTX-TNA2 cell lines were divided into the negative control（NC）group, 6.25, 12.50, 50.00 and 100.00 μM PPF group, and 2.50, 5.00, 10.00, 20.00, 40.00, 60.00, 80.00 and 100.00 μM CBD group. The cell survival rate was detected using the CCK-8 method. The CTX-TNA2 cell lines were divided into the NC group, PPF group, PPF+2.5 μM CBD group, PPF+5.0 μM CBD group, and PPF+10.0 μM CBD group. The NC group was routinely cultured, the PPF group was cultured for 24 h in medium containing propofol, while the PPF+2.5 μM CBD group, PPF+5.0 μM CBD group and PPF+10.0 μM CBD group were pretreated with media containing different concentrations of CBD for 4 h before being treated with media containing propofol for 24 h. Cellular γ-aminobutyric acid levels were measured by ELISA. Results Compared with the CON group, the circadian rhythm of rats in the MOD group was phase-delayed by 1-3 hours（P<0.001 or <0.05）, and serum melatonin levels were significantly increased at 1 h after anesthesia（P<0.001）. Compared with the MOD group, serum melatonin levels in the CBD group rats remained at normal levels after anesthesia（P=0.997）. Compared with the NC group, the cell survival rate decreased in the 40.00, 60.00, 80.00 and 100.00 μM CBD group（P<0.001）, but there was no significant difference in cell survival rates between other doses in the PPF and CBD groups compared with the NC group（P>0.05）. Compared with the NC group, the GABA level in the PPF group increased（P=0.014）. Compared with the PPF group, the GABA levels in the PPF+2.5 μM CBD group and PPF+5.0 μM CBD group decreased（P=0.002, <0.001）. Conclusion Propofol anesthesia can significantly disrupt normal circadian rhythm and serum melatonin levels in rats. After CBD intervention, circadian rhythm disturbances can be improved and serum melatonin levels can return to normal. CBD can down-regulate GABA levels in PPF induced CTX-TNA2 cells.

Objective To explore the levels of serum albumin（ALB）, lactate dehydrogenase（LDH）, interleukin-17 （IL-17）, and tumor necrosis factor alpha（TNF-α）in patients with interstitial pneumonia（IP）who received targeted therapy and chemotherapy for recurrent drug-resistant ovarian cancer (RDROC), and to construct a nomogram prediction model for IP based on these levels. Methods A total of 80 patients with RDROC who had been treated for IP related to targeted therapy+chemotherapy in Zhangjiakou Xuangang Hospital between June 2020 and June 2022 were assigned to the study group while another 80 patients with RDROC who had not were selected as the control group. The clinical data and serum levels of ALB, LDH, IL-17, and TNF-α were compared between the two groups. A logistic regression model was used to analyze the contributors to IP. A nomogram prediction model was constructed according to these contributors, whose prediction efficiency and clinical applicability were evaluated. Results Age, percentages of patients in primary FIGO stage Ⅲ-Ⅳ, with preexisting lung diseases, or with a history of smoking, and serum levels of LDH, IL-17, and TNF-α in the study group were higher than those of the control group（t=4.006-21.973, all P<0.001）, while the ALB level was lower（t=7.118, P<0.001）. The serum level of ALB in patients with acute exacerbation was lower than that of patients in stable condition（t=5.311, P<0.001）, but levels of LDH, IL-17, and TNF-α were higher（t=3.712, 4.390, 14.132, all P<0.001）. Preexisting lung diseases（OR=6.152, 95%CI: 2.406-15.729）, smoking（OR=5.017, 95%CI: 1.965-12.810）, serum LDH（OR=3.642, 95%CI: 1.733-7.652）, IL-17（OR=4.889, 95%CI: 2.267-10.543）, and TNF-α（OR=8.064, 95%CI: 3.012-21.591）were all independent risk factors for the occurrence of IP in patients with RDROC undergoing targeted therapy+chemotherapy, while serum ALB（OR=0.426, 95%CI: 0.215-0.843）was an independent protective factor（all P< 0.001）. ROC analysis showed that the AUC of the nomogram prediction model was 0.887 for predicting the occurrence of IP, with a good predictive performance. Conclusion Preexisting lung diseases, smoking, serum LDH, IL-17, and TNF-α are all independent risk factors for IP in patients with RDROC undergoing targeted therapy+chemotherapy. Serum ALB is an independent protective factor. A nomogram prediction model has been constructed, which can help predict the occurrence of IP.

Objective To investigate the impact of steroid treatment on clinical outcomes and steroid-related complications in children with type Ⅲ biliary atresia after Kasai surgery. Methods A retrospective study was conducted on 112 children with type Ⅲ biliary atresia who had undergone Kasai surgery at the Children's Hospital Affiliated to Capital Institute of Pediatrics between July 2018 and July 2020. The children were divided into steroid and control groups, each with 56 cases. The two groups were compared in terms of the jaundice clearance rate, autologous liver survival rate, and the incidence of steroid-related adverse reactions at 6, 12, and 24 months postoperatively before statistical analyses were performed. Results The jaundice clearance rate in the steroid group was significantly higher than that of the control group at 6, 12, and 24 months postoperatively（χ²=4.390, 4.495, 4.568, P=0.036, 0.034, 0.033）. At 6 months postoperatively, there was no significant difference in autologous liver survival rates between the two groups（P>0.05）. However, at 12 and 24 months postoperatively, the autologous liver survival rate in the steroid group was significantly higher than that of the control group（χ²=5.735, 5.312, P=0.017, 0.021）. There were no significant differences between the two groups in the total complication rate, or the incidence of wound dehiscence and gastrointestinal bleeding（P>0.05）. Conclusion Adjuvant steroid therapy can effectively promote bile drainage and prolong the survival of the autologous liver in children with type Ⅲ biliary atresia after Kasai surgery, although its clinical value in improving short-term autologous liver survival rates is not significant.

Objective To explore the relationship between probiotic supplements and fatigue in servicemen/veterans and to provide data for the use of probiotics in overcoming fatigue in military personnel. Methods Servicemen/veteran who had participated in the National Health and Nutrition Examination Survey（NHANES）from 2009-2018 were selected. Levels of fatigue were assessed via item DPQ040 from the Patient Health Questionnaire-9（PHQ-9）based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition（DSM-IV）. The usage of probiotics from dietary supplements over a 30-day period was calculated. Latent class analysis（LCA）was used to determine the patterns of co-morbidity of common chronic diseases. Multifactor Logistic regression was used to analyze the correlations between probiotics and fatigue. Results A total of 1 536 servicemen/veterans were enrolled, 44.3% of whom manifested fatigue, and 7.6% habitually took probiotics. Consumption of probiotics was a protective factor against fatigue（OR=0.565, 95%CI: 0.561 to 0.569）. The LCA categorized the subjects into four distinct patterns by the incidence of common chronic diseases: the hypertension-dominated, diabetic hypertension, multimorbidity, and relative healthy. Multifactorial logistic regression analysis showed that probiotics were a protective factor against fatigue in the relative healthy group（OR=0.492, 95%CI: 0.488 to 0.497）and the diabetic hypertension group（OR=0.743, 95%CI: 0.736 to 0.751）. Conclusion Consumption of probiotics may be associated with a reduced risk of fatigue in servicemen/veterans, suggesting a potential anti-fatigue effect of probiotics, but differences in the effects of probiotics on different diseases need to be studied.

Objective To evaluate the efficacy and safety of classical prescriptions combined with conventional Western medicine in treating acute attack of bronchial asthma via network Meta-analysis. Methods Randomized controlled trials on the treatment of acute attack of bronchial asthma with classical prescriptions combined with conventional Western medicine were retrieved from such databases as CNKI, Wanfang, VIP, SinoMed, Pubmed, Cochrane Library and Embase as of February 20, 2023. Software Revman 5.4 and STATA 16 was used for data analysis. Results A total of 46 studies were included, and classical prescriptions involved Xiaoqinglong decoction, Shegan-mahuang decoction and Maxing-shigan decoction. The results of network Meta-analysis showed that in terms of FEV1, the most effective classical prescription was Shegan-mahuang decoction+conventional Western medicine, followed by Maxing-shigan decoction+conventional Western medicine, Xiaoqinglong decoction+conventional Western medicine, and conventional Western medicine. As for FEV1%, the best classical prescription was Shegan-mahuang decoction+conventional Western medicine, followed by Xiaoqinglong decoction+conventional Western medicine, Maxing-shigan decoction+conventional Western medicine, and conventional Western medicine. In terms of PEF, the first option was Shegan-mahuang decoction+conventional Western medicine, followed by Xiaoqinglong decoction+conventional Western medicine, and conventional Western medicine. Conclusion Based on the conventional treatment with Western medicine, Shegan-mahuang decoction has the best effect in the control of asthma among the three prescriptions.