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 To investigate the effects of fractionated low-dose ionizing radiation (LDIR) on the ferroptosis in human bronchial epithelial (HBE) cells as well as the associated differentially expressed genes (DEGs), biological processes, and signaling pathways. Methods HBE cells were exposed to different single doses of X-ray irradiation (0, 25, 50, 75, and 100 mGy) for 24, 48, and 72 h, respectively. The change in cell viability was detected by MTT assay. Cells were irradiated with 0, 25, 50, and 100 mGy X-rays 5 times, with 48 h between each irradiation and a dose rate of 50 mGy/min. Cells were harvested 24 h after irradiation for the measurement of the expression of ferroptosis-related genes SLC7A11 and GPX4 at the mRNA and protein levels, cellular iron content, and the expression of FTH1 and FTL mRNAs. High-throughput sequencing was used to screen for the DEGs in each dose group, followed by Gene Ontology-Biological Process (GO-BP) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and Gene Set Enrichment Analysis (GSEA). Results Compared with the control group, single-dose LDIR significantly increased cell proliferation at 75 mGy after 24 h (P < 0.05), at 50, 75, and 100 mGy after 48 h (P < 0.05), and at 75 and 100 mGy after 72 h (P < 0.05). Compared with the control group, at the end of the fifth fractionated LDIR, SLC7A11 and GPX4 mRNAs decreased at all doses (P < 0.05), SLC7A11 protein decreased at all doses, GPX4 protein decreased at 25 and 100 mGy, iron content increased at all doses, and FTH1 and FTL mRNAs decreased at all doses (P< 0.05). Sequencing analysis identified 248, 30, and 291 DEGs and 10, 2, and 9 ferroptosis-associated genes at the three doses compared to the control. Gene Ontology-Biological Process analysis showed that DEGs were mainly enriched in biological processes such as response to lipids, cell death, and response to unfolded proteins. Kyoto Encyclopedia of Genes and Genomes analysis showed that DEGs were mainly enriched in the JAK-STAT signaling pathway, lipids and atherosclerosis, ferroptosis, protein processing in the endoplasmic reticulum, and FoxO signaling pathway. Gene set enrichment analysis showed that DEGs were mainly enriched in ferroptosis, fatty acid degradation, and glutathione metabolism. Conclusion Fractionated low-dose radiation induced ferroptosis in HBE cells, and DEGs were predominantly enriched in biological processes and signaling pathways related to inflammation, ferroptosis, and endoplasmic reticulum stress.

Background In recent years, the increasingly widespread application of nuclear and medical radiation technologies has resulted in a large number of occupational populations exposed to low-dose ionizing radiation (LDIR). At present, there is no consistent conclusion on the effects of long-term exposure to LDIR on the metabolic health of the occupational population. Objective To explore the association between long-term exposure to LDIR and metabolic syndrome (MetS) among medical radiologists. Methods A cross-sectional study was conducted to enroll 6431 medical radiologists who ordered occupational health checkups from January 2022 to December 2023, and basic information such as demographic characteristics, occupational characteristics, lifestyles, and dietary habits was collected through questionnaires. Physical examinations were conducted using a standardized protocol. Individual dose equivalents of occupational external exposure were monitored by dosimeters worn by medical radiologists. Logistic regression model was used for identifying influencing factors of MetS and sensitivity analysis, and restricted cubic spline model was used to explore the dose-response relationship between cumulative effective dose and MetS. Two-stage linear regression was used to evaluate threshold effect of association between cumulative effective dose and MetS. Results The positive rate of MetS was 13.6% (877/6431) among the enrolled 6431 study participants. The logistic regression showed that gender, age, monthly income, body mass index (BMI), cumulative effective dose, and smoking were influencing factors for MetS. The risk of MetS was higher in males (OR=1.511, 95%CI: 1.209, 1.888); using the < 30 years old group as reference, the risk of MetS was higher in the 30-39 years old (OR=1.509, 95%CI: 1.095, 2.079), 40-49 years old (OR=2.214, 95%CI: 1.551, 3.161), and ≥50 years old (OR=3.480, 95%CI: 2.338, 5.181) groups; using the <10000 yuan group as reference, the risk of MetS was lower in the group with a monthly income of 10000-14999 yuan (OR=0.715, 95%CI: 0.582, 0.878); the risk of MetS was higher in the BMI ≥ 24 kg·m⁻² group (OR=7.548, 95%CI: 6.223, 9.156); using the < 0.76 mSv group as reference, the risk of MetS was higher in the cumulative effective dose of 0.76-2.73 mSv group (OR=1.270, 95%CI: 1.017, 1.586); the risk of MetS was higher in the smoking group (OR=1.734, 95%CI: 1.428, 2.107). The results of restricted cubic spline showed that the cumulative effective dose was nonlinearly correlated with MetS (P _{non-linearity}=0.028), with an inflection point of 1.25 mSv. The risk of developing MetS increased by 34.1% for each unit increase in cumulative effective dose up to 1.25 mSv, whereas above 1.25 mSv, the statistical association was not significant. The sensitivity analysis results showed that after excluding the self-reported hypertensive and diabetic patients, the cumulative effective dose 0.76-2.73 mSv group still had an increased risk of developing MetS compared with the < 0.76 mSv group (P < 0.05), and the results were robust. Conclusion Among medical radiologists, male, age, BMI, and smoking are positively correlated with MetS, and monthly income is negatively correlated with MetS; cumulative effective dose is non-linearly correlated with MetS among medical radiologists.

Objective To investigate the role of the O-6-methylguanine-DNA methyltransferase (MGMT) gene-3′ untranslated region (UTR) microRNA-associated single nucleotide polymorphism (miRSNP) (rs7896488 G>A) in affecting miR-4297-targeted modulation of MGMT in senescence of lung cells with polymorphic genotypes induced by fractionated low dose ionizing radiation (LDIR). Methods i) MiRSNPs were predicted and screened using bioinformatics, and DNA from two types of lung cells, A549 cells and human bronchial epithelioid cells (HBE cells), was extracted for target gene sequencing. After co-transfection of pGL3c-MGMT-3′UTR-rs7896488 G>A reporter gene recombinant plasmid, pRL-TK Vector with micrON mimic NC #22 or micrON hsa-miR-4297 mimic (set up as the mimic NC group and the miR-4297 mimic group) in these two types of lung cells, dual luciferase reporter gene assay was performed. The relative expression of MGMT mRNA was detected by real-time fluorescence quantitative polymerase chain reaction, and the relative expression of MGMT protein was detected by Western blotting. ii) These two types of lung cells were randomly divided into the control group and irradiation group, which received either 0 or 100 mGy X-rays irradiation seven times. After irradiation, the cells were transfected with either micrON mimic NC #22 or micrON hsa-miR-4297 mimic, resulting in mimic NC + control group, miR-4297 mimic + control group, mimic NC + irradiation group, and miR-4297 mimic + irradiation group. Cells were collected for senescence-associated-β-galactosidase (SA-β-Gal) staining, and the relative expression of matrix metalloproteinase-9 (MMP-9) and chemokine (C-X-C motif) ligand-1 (CXCL-1) proteins was detected via Western blotting. Results i) The rs7896488 G>A was the miRSNP located in the conserved binding region targeted by miR-4297 in the MGMT gene 3′UTR. A549 cells were the rs7896488 GG wild-type homozygous genotype, while HBE cells were the rs7896488 GA heterozygous mutant genotype. In the miR-4297 mimic group, A549 and HBE cells carrying the rs7896488 G allele showed significantly lower dual-luciferase activity compared with that in the mimic NC group (both P<0.01). However, there was no significant difference in dual-luciferase activity between the two groups in both A549 and HBE cells carrying the rs7896488 A allele (both P>0.05). The relative expression levels of MGMT mRNA and MGMT protein of A549 cells in the miR-4297 mimic group were lower than those in the mimic NC group (both P<0.05). However, there was no significant difference in MGMT mRNA and MGMT protein of HBE cells between these two groups (both P>0.05). ii) The relative activity of SA-β-Gal and the relative expression of MMP-9 and CXCL-1 proteins of A549 cells in the miR-4297 mimic+irradiation group were higher than those in the mimic NC + control group, the miR-4297 mimic + control group, and the mimic NC + irradiation group (all P<0.05). The relative activity of SA-β-Gal and the relative expression of MMP-9 and CXCL-1 proteins of HBE cells in the miR-4297 mimic + irradiation group were higher than those in the mimic NC + control group and the miR-4297 mimic + control group (all P<0.05), while there was no significant difference compared with those in the mimic NC + irradiation group (all P>0.05). Conclusion MGMT-3′UTR-miRSNP rs7896488 G>A plays a role in LDIR-induced senescence of lung cells with different polymorphic genotypes by affecting miR-4297-targeted regulation of MGMT.

Checkpoint blockade immunotherapy has emerged as a transformative approach in cancer treatment by activating tumor-infiltrating T cells. However, the efficacy of PD-L1 blockade is restricted in "cold" tumors, which are characterized by low immunogenicity, presenting a challenge to immunotherapy. This study introduces an innovative strategy, utilizing cathepsin-cleavable N-(2-hydroxypropyl) methacrylamide (HPMA) polymer-assisted combined photodynamic therapy (PDT) and PD-L1 degradation for the first time, effectively treating T cell-deficient tumors. The degradable main-chain polymer, conjugated with photosensitizer porphyrin, facilitates the accumulation of reactive oxygen species (ROS), triggering immunogenic cell death (ICD) and promoting cytotoxic T lymphocytes (CTLs) infiltration into tumors. Multivalent peptide antagonists of PD-L1 promote PD-L1 degradation in lysosomes through receptor crosslinking, overcoming the adaptive cycling of PD-L1 to the tumor cell surface. These findings demonstrate that polymer-assisted PDT and PD-L1 crosslinking degradation represent a potential novel strategy for anti-tumor immunotherapy, providing valuable tools for expanding immunotherapy applications in immunosuppressive cancers.

As a third major discipline on par with internal medicine and surgery,interventional radiology is one of the key branches of modern medicine.The unique practicality and innovation of interventional radiology make it play an irreplaceable role in the diagnosis and treatment of diseases.In recent years,with the rapid development of technology and the updating of educational concepts,the teaching mode of interventional radiology is facing new challenges and opportunities.This article combines the clinical training methods adopted by interventional physicians in Europe and Germany,integrates imaging,anatomy and pathology teaching,strengthens the foundation,uses virtual reality(VR),augmented reality(AR)technology,and simulation training to enhance the practical ability of medical students.At the same time,with the help of online education platforms,the innovative methods and optimization strategies such as personalized learning program are implemented,which can greatly improve the teaching effectiveness of interventional radiology and provide useful references for teaching reform in this field.

Objective To explore the research status,hotspots and future development trends of traditional Chinese medicine in the field of multiple myeloma(MM)treatment in the past 20 years.Methods Retrieve the relevant literatures of traditional Chinese medicine in the field of MM treatment included in CNKI,Wanfang Data Knowledge Service Platform and VIP database from January 2004 to April 2024.The NoteExpress software was used for merging and deduplication,and the CiteSpace6.3.R1 software was used for visual analysis of the authors,research institutions and key words of the included literatures.Results A total of 420 literatures were included,and the overall number of published articles showed an upward trend.The author with the highest number of articles was Zhou Yuhong,with a total of 25 core authors.The institution with the highest number of published articles was the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.A total of 277 key words were obtained.Through the induction of high-frequency key words,it could be seen that the current research hotspots focus on aspects such as the pathogenesis,chemotherapy drugs,adverse reactions,and treatment based on syndrome differentiation in traditional Chinese medicine.Conclusion The research interest in the Chinese medicine treatment of MM is increasing.The research topics currently attracting the most attention are the single active ingredient of Chinese medicine,the experience of renowned medical practitioners,the treatment of associated complications,and the combined use of Chinese and Western medicines.The research focus in the future will be on the mechanism pathway and the Chinese medicine characteristic therapy to enhance the quality of life of patients.

Objective The aim of this study was to analyze the value of quantitative parameters of dynamic contrast en-hanced magnetic resonance imaging(DCE-MRI)combined with the detection of non-SMC condensing Ⅰ complex subunit H(NCAPH)in the diagnosis of early breast cancer.Methods Ninety-six patients with breast nodules who were treated in the depart-ment of Breast Surgery at Longgang District Maternity&Child Healthcare Hospital in Shenzhen from March 2020 to March 2022 were selected as the study objects.DCE-MRI examination was performed on all patients,and transport constant(Ktrans)and rate constant(Kep)were recorded.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression of serum NCAPH mRNA.Based on the results of pathological examination as the gold standard,the patients with breast nodules diag-nosed pathologically as the benign group and the patients with breast cancer as the breast cancer group,the differences of DCE-MRI quantitative parameters Ktrans,Kep and serum NCAPH mRNA between the benign group and the breast cancer group were compared.The accuracy,sensitivity and specificity of serum NCAPH mRNA and their combination in the diagnosis of early breast cancer were different.Kappa test was used to compare the consistency with the pathological results.Results The results of pathological examina-tion confirmed that there were 31 benign nodules and 65 breast cancer in 96 patients with breast nodules.Ktrans,Kep and NCAPH mRNA in the breast cancer group were significantly higher than those in the benign group(P<0.05);The AUC of Ktrans,Kep and NCAPH in the diagnosis of early breast cancer was 0.944,which was significantly higher than that of Ktrans and Kep alone,with the sensitivity and specificity of 96.92% and 77.42% ,respectively;Ktrans and Kep combined with NCAPH detected 7 false positives and 2 false negatives,with a Kappa value of 0.776(P<0.05),which was consistent with the pathological results;The sensitivity of DCE-MRI quantitative parameters combined with NCAPH in the diagnosis of early breast cancer was significantly higher than that of DCE-MRI quantitative parameters and serum NCAPH alone(P<0.05).Conclusion The expression of Ktrans,Kep and serum NCAPH mRNA in breast cancer patients with DCE-MRI quantitative parameters is high.Ktrans,Kep combined with serum NCAPH detection has certain clinical values in the diagnosis of early breast cancer.

Objective To investigate the effects and molecular mechanisms of ginsenoside Rg1(GSRG1)on the proliferation,mi-gration,and inflammatory cytokine expression of human gingival fibroblasts(HGFs)induced by lipopolysaccharide(LPS).Methods HGFs were isolated and cultured using the tissue block method.The effects of different concentrations of LPS(0,1,5,10,20μg/mL)on inflammatory cytokines in HGFs were detected by ELISA.Cells were divided into three groups:control group(no treat-ment),LPS group(20 μg/mL LPS),and LPS+GSRG1 group(20 μg/mL LPS and 100 mg/L GSRG1).Cell proliferation was detec-ted by cell counting kit-8(CCK-8);cell migration was assessed by Transwell assay;intracellular reactive oxygen species(ROS)lev-els were compared using flow cytometry;and the expression levels of TNF-α,IL-6,NLRP3,p-p38,and p38 proteins were detected by Western blot.Results LPS concentrations of 5,10,and 20 μg/mL significantly increased the expression of IL-6 and TNF-α in HGFs(P＜0.05),with 20 μg/mL showing the strongest pro-inflammatory effect.Compared with the control group,there was no notable difference in the proliferation of HGFs in the LPS group at Day 1 and 2.However,on Day 3,4 and 5,decreased cell proliferation,re-duced migration,significantly increased ROS levels(P＜0.001),elevated protein expression of TNF-α,IL-6,and NLRP3(P＜0.001),and reduced p-p38 protein expression(P＜0.001)were exhibited.Compared with the LPS group,the LPS+GSRG1 group showed significantly enhanced cell proliferation and migration(P＜0.05),reduced ROS levels,decreased protein expression of TNF-α,IL-6,and NLRP3,and increased p-p38 protein expression(P＜0.001).There was no significant change in p38 expression among the three groups.Conclusion GSRG1 can alleviate the inhibitory effects of LPS on the proliferation and migration of HGFs and inhibit the inflammatory response,potentially through mechanisms involving p-p38 protein regulation.

Objective The aim of this study was to analyze the value of quantitative parameters of dynamic contrast en-hanced magnetic resonance imaging(DCE-MRI)combined with the detection of non-SMC condensing Ⅰ complex subunit H(NCAPH)in the diagnosis of early breast cancer.Methods Ninety-six patients with breast nodules who were treated in the depart-ment of Breast Surgery at Longgang District Maternity&Child Healthcare Hospital in Shenzhen from March 2020 to March 2022 were selected as the study objects.DCE-MRI examination was performed on all patients,and transport constant(Ktrans)and rate constant(Kep)were recorded.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression of serum NCAPH mRNA.Based on the results of pathological examination as the gold standard,the patients with breast nodules diag-nosed pathologically as the benign group and the patients with breast cancer as the breast cancer group,the differences of DCE-MRI quantitative parameters Ktrans,Kep and serum NCAPH mRNA between the benign group and the breast cancer group were compared.The accuracy,sensitivity and specificity of serum NCAPH mRNA and their combination in the diagnosis of early breast cancer were different.Kappa test was used to compare the consistency with the pathological results.Results The results of pathological examina-tion confirmed that there were 31 benign nodules and 65 breast cancer in 96 patients with breast nodules.Ktrans,Kep and NCAPH mRNA in the breast cancer group were significantly higher than those in the benign group(P<0.05);The AUC of Ktrans,Kep and NCAPH in the diagnosis of early breast cancer was 0.944,which was significantly higher than that of Ktrans and Kep alone,with the sensitivity and specificity of 96.92% and 77.42% ,respectively;Ktrans and Kep combined with NCAPH detected 7 false positives and 2 false negatives,with a Kappa value of 0.776(P<0.05),which was consistent with the pathological results;The sensitivity of DCE-MRI quantitative parameters combined with NCAPH in the diagnosis of early breast cancer was significantly higher than that of DCE-MRI quantitative parameters and serum NCAPH alone(P<0.05).Conclusion The expression of Ktrans,Kep and serum NCAPH mRNA in breast cancer patients with DCE-MRI quantitative parameters is high.Ktrans,Kep combined with serum NCAPH detection has certain clinical values in the diagnosis of early breast cancer.