The new synergistic education model integrating the “five arts” medical talent cultivation philosophy and the red doctor spirit could form a virtuous cycle of “spiritual guidance-technological breakthrough-spiritual reshaping” in the field of military medical education. Addressing the existing challenges in the process of military medical cadets’ training， such as mission awareness， humanistic care， battlefield rescue， and emergency response， this study proposed integrating the red doctor spirit， characterized by political steadfastness， healing the wounded and rescuing the dying， selfless devotion， relentless pursuit of excellence， and seeking truth and innovation， into the training system under the guidance of the “five arts” philosophy， including establishing a foundation through Daoist arts， forging the soul with benevolence， empowering through academia， tempering through technology， and nurturing the mind through artistry. A cultivation model was constructed featuring “moral education as the priority and cultivating through soul-forging； military spirit as the root and medical professionalism as the foundation and training for warfare； mastery in medicine for battlefield success and cultivating talent through rigorous scholarship.” Furthermore， through pathways including the optimization and implementation of the curriculum system， the enhancement and innovation of practical teaching， the development and training of the faculty team， and the improvement and innovation of the evaluation system， this model assisted in achieve the goal of cultivating compound talents with “the red medicine essence plus the five arts foundation.” These talents also built their foundation on the “five arts” philosophy， forge their spirit with the red doctor spirit， and was tempered with battlefield adaptability.

OBJECTIVE: Chromosome conformation-based karyotype analysis (C-MoKa) technology was used to test a couple who had experienced multiple adverse pregnancies in order to provide them with genetic counseling and reproductive guidance. METHODS: A couple presented at the Reproductive Medicine Center of the First Hospital of Lanzhou University in 2023 was selected as the study subject. Through C-MoKa testing, copy number variation sequencing (CNV-seq), and preimplantation genetic testing for aneuploidy (PGT-A), it was found that the couple's repeatedly miscarried fetuses and abnormal embryos exhibited highly similar chromosomal structural abnormalities. Using C-MoKa, the potential genetic abnormalities in both partners were traced, and reproductive guidance was provided based on the result. This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: LDYYSZLLKH2025-09). RESULTS: CNV-seq analysis of the couple's miscarriage fetal chorionic villi showed del(18)(q21.2q23)(28.90 Mb) and dup(13)(q31.2q34)(26.26 Mb). Chromosomal karyotyping analysis of both partners showed no abnormality. From 2024 to 2025, the couple underwent three rounds of PGT-A assisted reproduction. The first embryo test showed del(13)(q31.2q34)(26.77 Mb) and dup(18)(q21.2q23)(29.08 Mb). The second embryo test showed dup(13)(q31.2q34)(26.26 Mb) and del(18)(q21.2q23)(28.90 Mb). And the third embryo test results showed complex chromosomal abnormalities. In 2025, after genetic counseling, the couple had opted C-MoKa test, which has detected no abnormality in the wife, but a balanced 46,XY,t(13;18)(q31.2;q21.2) translocation in the husband. CONCLUSION As a high-throughput sequencing method based on the three-dimensional conformation of chromatin, C-MoKa has the advantages of high resolution and high accuracy, and can accurately detect balanced translocations with similar banding patterns. It has therefore offered a powerful new tool for chromosomal analysis.
Female ; Humans ; Male ; Pregnancy ; Abortion, Habitual/genetics* ; DNA Copy Number Variations ; Karyotyping/methods* ; Preimplantation Diagnosis ; Translocation, Genetic

OBJECTIVE To explore the antidepressant mechanism of Wenyang jieyu granules （WYJYG） via the NOD-like receptor thermal protein domain associated protein 3 （NLRP3）/apoptosis-associated speck-like protein containing a CARD （ASC）/Caspase-1 pathway. METHODS A rat model of depression was established by chronic unpredictable mild stress combined with single-housing for 42 consecutive days.The experiment set up blank group， model group， MCC950 （NLRP3 inflammasome inhibitor） group （10 mg/kg）， fluoxetine group （positive control，2.08 mg/kg），low-dose WYJYG（3.78 g/kg） and high-dose WYJYG group （7.56 g/kg），with 10 rats in each group. From the 22nd day of the experiment， rats in the fluoxetine group， low-dose and high-dose WYJYG groups were intragastrically administered with the corresponding drugs and intraperitoneally injected with an equal volume of normal saline. Rats in the MCC950 group were intraperitoneally injected with MCC950 at the corresponding concentration and intragastrically administered with an equal volume of distilled water. Rats in the blank group and model group were given an equal volume of distilled water by gavage and an equal volume of normal saline by intraperitoneal injection. All interventions were performed once a day for 21 consecutive days. Behavioral tests were conducted once a week. After the last administration， the contents of ASC， ionized calcium binding adaptor molecule 1 （Iba1）， interleukin-1β （IL-1β）， and IL-18 in hippocampal tissues were detected. The protein expressions of NLRP3， cluster of differentiation 68 （CD68）， Caspase-1， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein were determined， and neuronal apoptosis was observed. RESULTS After the last administration， compared with the model group， the open-field activity time was significantly prolonged （ P ＜0.05）， and the latency to feed in a novel environment was significantly shortened （ P ＜0.05） in rats of the high-dose WYJYG group. In hippocampal tissue， the contents of ASC， Iba1， IL-1β， and IL-18， as well as the protein expression levels of NLRP3， Caspase-1， and CD68， and the positive rate of neuronal apoptosis were all significantly decreased/downregulated （ P ＜0.05）. Bcl-2 protein expression was significantly upregulated （ P ＜0.05）， and the density of neuronal apoptosis-positive cells was significantly reduced （ P ＜0.05）. CONCLUSIONS WYJYG play on antidepressant role by inhibiting the NLRP3/ASC/Caspase-1 pathway， reducing microglia-mediated neuroinflammation， and inhibiting hippocampal neurons apoptosis.

In the challenging and specific military environment， medical activities are not only confined to traditional medical care but must also adapt to the special requirements of military operations. Meanwhile， when military operations employ medical interventions for treatment and research， they introduce complexities and ethical considerations inherent in the medical domain. Against this backdrop， the ethical conflicts and moral dilemmas confronted by the special identity of military doctors have become an inevitable and urgent issue requiring resolution. The identities of doctors and soldiers， typically distinct， overlap and intersect in the role of the military doctors on the battlefield， inevitably giving rise to intricate ethical predicaments that frequently place them in arduous moral choices. The special considerations in behavioral decision-making， contradictions in value judgments， and the reconciliation of moral injury among military doctors in battlefield scenarios should be comprehensively considered based on factors such as professional codes of conduct， values and emotions， international law， and humanitarian principles. Military doctors should regard respecting life as the supreme principle， while also taking into account the protection needs of special groups， and adhering to the core concept of fairness and reasonableness， all of which should serve as the fundamental guidance for their behavioral standards.

BACKGROUND:A large number of studies have confirmed that both amniotic extracellular matrix materials and bladder extracellular matrix materials can be used as stem cell carriers for the treatment of endometrial injury,but the difference in effect between the two materials is relatively rare.OBJECTIVE:To compare the difference of amniotic extracellular matrix materials and bladder extracellular matrix materials as stem cell carrier in the treatment of endometrial injury.METHODS:Whole bone marrow adhesion method was used to isolate and purify bone marrow mesenchymal stem cells from SD rats.SD-rat amniotic extracellular matrix materials and bladder extracellular matrix materials were prepared respectively,and then bone marrow mesenchymal stem cells were inoculated on the surface of the two materials to detect cell proliferation and adhesion.Forty SD rats were randomly divided into four groups(n=10 per group).Except the sham operation group,the endometrial injury group,the amniotic extracellular matrix group,and the bladder extracellular matrix group were all established by mechanical intervention.The amniotic extracellular matrix/bone marrow mesenchymal stem cell complex and bladder stromal extracellular matrix/bone marrow mesenchymal stem cell complex were transplanted into the injured endometrial site in the amniotic extracellular matrix group and the bladder extracellular matrix group.Samples were collected and detected 14 and 28 days after transplantation.The morphology of rat endometrial tissue was observed by hematoxylin-eosin staining.The levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor in endometrial tissues were analyzed by enzyme-linked immunosorbent assay.The expression levels of vimentin and CD34 in endometrial tissues were analyzed by immunohistochemical staining.RESULTS AND CONCLUSION:(1)Both kinds of extracellular matrix materials were beneficial to the proliferation of bone marrow mesenchymal stem cells.Compared with bladder extracellular matrix materials,amniotic extracellular matrix materials could promote the adhesion of bone marrow mesenchymal stem cells.(2)Compared with the sham operation group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were significantly decreased(P<0.01),endometrial tissue was dysplastic,endometrial thickness and number of glands were significantly decreased,and vimentin and CD34 positive expression levels were significantly decreased(P<0.01)in the endometrial injury group.Compared with the endometrial injury group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were increased(P<0.05 or P<0.01),the endometrial tissue morphology was significantly improved,and the endometrial thickness and the number of glands were significantly increased;the positive expressions of vimentin and CD34 were significantly increased(P<0.05 or P<0.01)in the amniotic extracellular matrix group and the bladder extracellular matrix group,and the improvement of amniotic extracellular matrix group was better than that of bladder extracellular matrix group(P<0.05).(3)The results show that compared with bladder extracellular matrix materials,amniotic extracellular matrix material as a carrier of bone marrow mesenchymal stem cells can further promote the repair of damaged endometrium.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

BACKGROUND:A large number of studies have confirmed that both amniotic extracellular matrix materials and bladder extracellular matrix materials can be used as stem cell carriers for the treatment of endometrial injury,but the difference in effect between the two materials is relatively rare.OBJECTIVE:To compare the difference of amniotic extracellular matrix materials and bladder extracellular matrix materials as stem cell carrier in the treatment of endometrial injury.METHODS:Whole bone marrow adhesion method was used to isolate and purify bone marrow mesenchymal stem cells from SD rats.SD-rat amniotic extracellular matrix materials and bladder extracellular matrix materials were prepared respectively,and then bone marrow mesenchymal stem cells were inoculated on the surface of the two materials to detect cell proliferation and adhesion.Forty SD rats were randomly divided into four groups(n=10 per group).Except the sham operation group,the endometrial injury group,the amniotic extracellular matrix group,and the bladder extracellular matrix group were all established by mechanical intervention.The amniotic extracellular matrix/bone marrow mesenchymal stem cell complex and bladder stromal extracellular matrix/bone marrow mesenchymal stem cell complex were transplanted into the injured endometrial site in the amniotic extracellular matrix group and the bladder extracellular matrix group.Samples were collected and detected 14 and 28 days after transplantation.The morphology of rat endometrial tissue was observed by hematoxylin-eosin staining.The levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor in endometrial tissues were analyzed by enzyme-linked immunosorbent assay.The expression levels of vimentin and CD34 in endometrial tissues were analyzed by immunohistochemical staining.RESULTS AND CONCLUSION:(1)Both kinds of extracellular matrix materials were beneficial to the proliferation of bone marrow mesenchymal stem cells.Compared with bladder extracellular matrix materials,amniotic extracellular matrix materials could promote the adhesion of bone marrow mesenchymal stem cells.(2)Compared with the sham operation group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were significantly decreased(P<0.01),endometrial tissue was dysplastic,endometrial thickness and number of glands were significantly decreased,and vimentin and CD34 positive expression levels were significantly decreased(P<0.01)in the endometrial injury group.Compared with the endometrial injury group,the levels of basic fibroblast growth factor,insulin-like growth factor 1,and vascular endothelial growth factor were increased(P<0.05 or P<0.01),the endometrial tissue morphology was significantly improved,and the endometrial thickness and the number of glands were significantly increased;the positive expressions of vimentin and CD34 were significantly increased(P<0.05 or P<0.01)in the amniotic extracellular matrix group and the bladder extracellular matrix group,and the improvement of amniotic extracellular matrix group was better than that of bladder extracellular matrix group(P<0.05).(3)The results show that compared with bladder extracellular matrix materials,amniotic extracellular matrix material as a carrier of bone marrow mesenchymal stem cells can further promote the repair of damaged endometrium.

Objective To explore the correlation between autoimmune diseases and adverse pregnancy outcomes and establish a pre-dictive model.Methods A retrospective analysis was conducted on 250 cases of pregnancy complicated with autoimmune diseases in the Obstetrics Department of the Second Affiliated Hospital of Kunming Medical University from September 2022 to September 2024.The pa-tients were grouped according to their pregnancy outcomes,including 117 cases in the good pregnancy outcome group and 133 cases in the poor pregnancy outcome group.The related factors of adverse pregnancy outcomes in patients with pregnancy complicated with autoimmune diseases were analyzed.And construct the nomogram prediction model.Results High body mass index,positive anti-Sjogren's syn-drome antigen B antibody,preeclampsia,high leukocyte and D-dimer were independent risk factors for adverse pregnancy outcomes.Based on the analysis results,the nomogram prediction model for the risk of adverse pregnancy outcomes in pregnant patients with autoim-mune diseases has a certain degree of differentiation.Conclusion There is a high probability of adverse pregnancy outcomes in pregnant patients with autoimmune diseases,among which BMI,positive anti-SSB,preeclampsia,white blood cell level and D-dimer level of patients are correlated.Based on the analysis results,the prediction model based on the histogram can evaluate the probability of adverse pregnancy outcomes to a certain extent.

Endothelial dysfunction is a pivotal contributor to atherosclerosis(As)pathogenesis.A comprehensive understanding of the mechanisms of endothelial dysfunction would provide novel insights into effective treatment of As.Recent advances in genome and transcripome technology have enabled researchers to further explore the molecular mecha-nisms of endothelial dysfunction.It has been found that the regulatory network of competitive endogenous RNA(ceRNA)mediated by long non-coding RNA(lncRNA)plays a key role in endothelial dysfunction.lncRNA acts as a"molecular sponge"for microRNA(miRNA)to block the post-transcriptional repression of miRNA on downstream target gene messen-ger RNA(mRNA)by binding to miRNA,thereby regulating the function and phenotypic conversion of endothelial cell(EC)lncRNA-miRNA-mRNA interactions are widely involved in play an essential role EC inflammatory responses,apopto-sis,autophagy,angiogenesis,and endothelial-mesenchymal transition(EndMT).Which suggests that it may be a poten-tial therapeutic targets for As.

Objective To explore the correlation between autoimmune diseases and adverse pregnancy outcomes and establish a pre-dictive model.Methods A retrospective analysis was conducted on 250 cases of pregnancy complicated with autoimmune diseases in the Obstetrics Department of the Second Affiliated Hospital of Kunming Medical University from September 2022 to September 2024.The pa-tients were grouped according to their pregnancy outcomes,including 117 cases in the good pregnancy outcome group and 133 cases in the poor pregnancy outcome group.The related factors of adverse pregnancy outcomes in patients with pregnancy complicated with autoimmune diseases were analyzed.And construct the nomogram prediction model.Results High body mass index,positive anti-Sjogren's syn-drome antigen B antibody,preeclampsia,high leukocyte and D-dimer were independent risk factors for adverse pregnancy outcomes.Based on the analysis results,the nomogram prediction model for the risk of adverse pregnancy outcomes in pregnant patients with autoim-mune diseases has a certain degree of differentiation.Conclusion There is a high probability of adverse pregnancy outcomes in pregnant patients with autoimmune diseases,among which BMI,positive anti-SSB,preeclampsia,white blood cell level and D-dimer level of patients are correlated.Based on the analysis results,the prediction model based on the histogram can evaluate the probability of adverse pregnancy outcomes to a certain extent.