Latest Issue

    Volume 5 Issue 2 2018

      RESEARCH

    • Mental health among Iranian combat veterans with ankle-foot neuromusculoskeletal injuries

      Arsia Taghva, Mostafa Allami, Kamyab Alizadeh, Anahita Zandi, Elahe Faraji, Zohreh Ganjparvar
      Vol. 5, Issue 2, Pages: 95-102(2018) DOI: 10.1186/s40779-017-0138-1
      Abstract:Background:Veterans with purely physical disorders, such as ankle-foot neuromusculoskeletal disorders, are often neglected in psychological assessments because mental health evaluations are usually focused on those with a psychological disturbance or with a high percentage of injury. The purpose of this study was to evaluate the psychological condition of veterans with ankle-foot neuromusculoskeletal disorders.Methods:A cross-sectional study was performed between 2014 and 2016 on veterans with war-related ankle-foot injuries living in two provinces of Iran. An information form for demographic data and injury-related factors was used. Additionally, the previously validated Persian version of the Symptom Checklist-90-Revision (SCL-90-R) questionnaire was used for data collection.Results:The respondents were 215 male veterans with a mean age of 51.7±7.5 years. The most common mental health problems were observed for the somatization (24.7%), obsessions-compulsions (14.4%), and anxiety (12.6%). Based on the Global Severity Index (GSI), 48.6% of individuals had a possible psychiatric/psychological illness. According to the multivariate regression analysis, GSI scores were significantly higher among veterans who were older than 27 years at the time of injury (P=0.005), had an associated injury (P=0.002), and had a history of hospitalization within the past 12 months for reasons other than their injury (P=0.035).Conclusion:Approximately half of the combat veterans with ankle-foot neuromusculoskeletal disorders likely had psychological problems. The evaluation of the patterns and predicting factors of psychological conditions may inform strategic planning efforts and decision-making, which, in turn, may provide a better quality of life for veterans. Further studies that utilize longitudinal designs are needed to evaluate and compare the psychological status of different groups of veterans and other groups in the general population.  
      Keywords:Veterans’ health;Ankle;Foot;Mental health   
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      Updated:2026-03-12
    • Mostafa Allami, Amir Yavari, Amir Karimi, Mehdi Masoumi, Mohammadreza Soroush, Elahe Faraji
      Vol. 5, Issue 2, Pages: 103-110(2018) DOI: 10.1186/s40779-017-0146-1
      Abstract:Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime. This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.Methods:A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016. Demographic characteristics, including age, gender, marital status, disability percent, educational level, employment and additional injuries, were collected. The ability to perform daily activities was assessed using the Barthel activities of daily living (ADL) and Lawton instrumental activities of daily living (IADL) Indexes. Physical and mental health-related quality of life (HRQOL) data were measured via the SF-36 subscales. The data were compared with those of bilateral lower limb amputees (BLLAs) and of the general Iranian population. Statistical analyses, including Pearson’s correlation coefficient, one-sample t-test and analysis of variance (ANOVA), were performed using SPSS16.0. A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary (PCS) and Mental Component Summary (MCS).Results:The highest and lowest scores were observed for mental health (48.93±20.69) and bodily pain (28.16±21.74), respectively. The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees (P<0.001). The mean scores of ADLs and IADLs were 83.9±16.3 and 5.3±2.0, respectively. The higher dependency in ADLs (P<0.001) and IADLs (P<0.001), the higher disability rate (P<0.001) and additional injury (P<0.001) were significant determinants of the PCS. ADL (P<0.001) and IADL (P<0.001) limitations, additional injury (P<0.001), history of hospitalization in the year preceding the study (P=0.007) and employment (P=0.001) were reported as determinants of the MCS.Conclusion:The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor health-related quality of life. The main predicting factors of HRQOL were the disability to perform ADLs/IADLs, suffering two or more injuries, a history of hospitalization in the year preceding the study and unemployment.  
      Keywords:Activities of daily living;Instrumental activities of daily living;Quality of life;Ankle-foot injuries   
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      Updated:2026-03-12
    • Establishment and evaluation of a theater influenza monitoring platform

      Jian Wang, Hui-Suo Yang, Bing Deng, Meng-Jing Shi, Xiang-Da Li, Qing-Gong Nian, Wen-Jing Song, Feng Bing, Qing-Feng Li
      Vol. 5, Issue 2, Pages: 111-116(2018) DOI: 10.1186/s40779-017-0144-3
      Establishment and evaluation of a theater influenza monitoring platform
      Abstract:Background:Influenza is an acute respiratory infectious disease with a high incidence rate in the Chinese army, which directly disturbs military training and affects soldiers’ health. Influenza surveillance systems are widely used around the world and play an important role in influenza epidemic prevention and control.Methods:As a theater centers for disease prevention and control, we established an influenza monitoring platform (IMP) in 2014 to strengthen the monitoring of influenza-like illness and influenza virus infection. In this study, we introduced the constitution, influenza virus detection, and quality control for an IMP. The monitoring effect was also evaluated by comparing the monitoring data with data from national influenza surveillance systems. The experiences and problems associated with the platform also were summarized.Results:A theater IMP was established based on 3 levels of medical units, including monitoring sites, testing laboratories and a checking laboratory. A series of measures were taken to guarantee the quality of monitoring, such as technical training, a unified process, sufficient supervision and timely communication. The platform has run smoothly for 3 monitoring years to date. In the 2014–2015 and 2016–2017 monitoring years, sample amount coincided with that obtained from the National Influenza Surveillance program. In the 2015–2016 monitoring year, due to the strict prevention and control measures, an influenza epidemic peak was avoided in monitoring units, and the monitoring data did not coincide with that of the National Influenza Surveillance program. Several problems, including insufficient attention, unreasonable administrative intervention or subordination relationships, and the necessity of detection in monitoring sites were still observed.Conclusion:A theater IMP was established rationally and played a deserved role in the prevention and control of influenza. However, several problems remain to be solved.  
      Keywords:Influenza monitoring;Military;Establishment;Evaluation   
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      Updated:2026-03-12
    • Xian-Rong Shen, Xiu-Li Chen, Hai-Xia Xie, Ying He, Wei Chen, Qun Luo, Wei-Hong Yuan, Xue Tang, Deng-Yong Hou, Ding-Wen Jiang, Qing-Rong Wang
      Vol. 5, Issue 2, Pages: 117-128(2018) DOI: 10.1186/s40779-017-0143-4
      Beneficial effects of a novel shark-skin collagen dressing for the promotion of seawater immersion wound healing
      Abstract:Background:Wounded personnel who work at sea often encounter a plethora of difficulties. The most important of these difficulties is seawater immersion. Common medical dressings have little effect when the affected area is immersed in seawater, and only rarely dressings have been reported for the treatment of seawater-immersed wounds. The objective of this study is to develop a new dressing which should be suitable to prevent the wound from seawater immersion and to promote the wound healing.Methods:Shark skin collagen (SSC) was purified via ethanol de-sugaring and de-pigmentation and adjusted for pH. A shark skin collagen sponge (SSCS) was prepared by freeze-drying. SSCS was attached to an anti-seawater immersion polyurethane (PU) film (SSCS+PU) to compose a new dressing. The biochemical properties of SSC and physicochemical properties of SSCS were assessed by standard methods. The effects of SSCS and SSCS+PU on the healing of seawater-immersed wounds were studied using a seawater immersion rat model. For the detection of SSCS effects on seawater-immersed wounds, 12 SD rats, with four wounds created in each rat, were divided into four groups: the 3rd day group, 5th day group, 7th day group and 12th day group. In each group, six wounds were treated with SSCS, three wounds treated with chitosan served as the positive control, and three wounds treated with gauze served as the negative control. For the detection of the SSCS+PU effects on seawater-immersed wounds, 36 SD rats were divided into three groups: the gauze (GZ)+PU group, chitosan (CS)+PU group and SSCS+PU group, with 12 rats in each group, and two wounds in each rat. The wound sizes were measured to calculate the healing rate, and histomorphology and the immunohistochemistry of the CD31 and TGF-β expression levels in the wounded tissues were measured by standard methods.Results:The results of Ultraviolet-visible (UV-vis) spectrum, Fourier-transform infrared (FTIR) spectrum, circular dichroism (CD) spectra, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and amino acid composition analyses of SSC demonstrated that SSC is type I collagen. SSCS had a homogeneous porous structure of approximately 200μm, porosity rate of 83.57%±2.64%, water vapor transmission ratio (WVTR) of 4500g/m2, tensile strength of 1.79±0.41N/mm, and elongation at break of 4.52%±0.01%. SSCS had significant beneficial effects on seawater-immersed wound healing. On the 3rd day, the healing rates in the GZ negative control, CS positive control and SSCS rats were 13.94%±5.50%, 29.40%±1.10% and 47.24%±8.40%, respectively. SSCS also enhanced TGF-β and CD31 expression in the initial stage of the healing period. The SSCS+PU dressing effectively protected wounds from seawater immersion for at least 4h, and accelerated re-epithelialization, vascularization and granulation formation of seawater-immersed wounds in the earlier stages of wound healing, and as well as significantly promoted wound healing. The SSCS+PU dressing also enhanced expression of TGF-β and CD31. The effects of SSCS and SSCS+PU were superior to those of both the chitosan and gauze dressings.Conclusion:SSCS has significant positive effects on the promotion of seawater-immersed wound healing, and a SSCS+PU dressing effectively prevents seawater immersion, and significantly promotes seawater-immersed wound healing.  
      Keywords:Anti-seawater immersion dressing;Shark skin collagen;Seawater immersion wound;Wound healing   
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      Updated:2026-03-12
    • Xuan-ming Zhang, Xuan Zhang, Xu Luo, Hai-tao Guo, Li-qun Zhang, Ji-wei Guo
      Vol. 5, Issue 2, Pages: 129-139(2018) DOI: 10.1186/s40779-017-0131-8
      Knowledge mapping visualization analysis of the military health and medicine papers published in the Web of Science over the past 10 years
      Abstract:Background:Military medicine is a research field that seeks to solve the medical problems that occur in modern war conditions based on public medicine theory.Methods:We explore the main research topics of military health and medical research in the Web of Science™ core collection (WoSCC) from 2007 to 2016, and the goal of this work is to serve as a reference for orientation and development in military health and medicine. Based on CiteSpace III, a reference co-citation analysis is performed for 7921 papers published in the WoSCC from 2007 to 2016. In addition, a cluster analysis of research topics is performed with a comprehensive analysis of high-yield authors, outstanding research institutions and their cooperative networks.Results:Currently, the research topics in military health and medicine mainly focus on the following seven aspects: mental health diagnoses and interventions, an army study to assess risk and resilience in service members (STARRS), large-scale military action, brain science, veterans, soldier parents and children of wartime, and wound infection. We also observed that the annual publication rate increased with time. Wessely S, Greenberg N, Fear NT, Smith TC, Smith B, Jones N, Ryan MAK, Boyko EJ, Hull L, and Rona RJ were the top 10 authors in military health and medicine research. The top 10 institutes were the Uniformed Services University of the Health Sciences, the United States Army, the United States Navy, Kings College London, Walter Reed National Military Medical Center, Boston University, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Naval Health Research Center, and the VA Boston Healthcare System.Conclusion:We are able to perform a comprehensive analysis of studies in military health and medicine research and summarize the current research climate and the developmental trends in the WoSCC. However, further studies and collaborations are needed worldwide. Overall, our findings provide valuable information and new perspectives and shape future research directions for further research in the area of military health and medicine.  
      Keywords:Military health;Military medicine;Knowledge mapping;CiteSpace   
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      Updated:2026-03-12

      REVIEW

    • Application of stem cells in tissue engineering for defense medicine

      Chinedu Cletus Ude, Azizi Miskon, Ruszymah Bt Hj Idrus, Muhamad Bin Abu Bakar
      Vol. 5, Issue 2, Pages: 140-158(2018) DOI: 10.1186/s40779-018-0154-9
      Application of stem cells in tissue engineering for defense medicine
      Abstract:The dynamic nature of modern warfare, including threats and injuries faced by soldiers, necessitates the development of countermeasures that address a wide variety of injuries. Tissue engineering has emerged as a field with the potential to provide contemporary solutions. In this review, discussions focus on the applications of stem cells in tissue engineering to address health risks frequently faced by combatants at war. Human development depends intimately on stem cells, the mysterious precursor to every kind of cell in the body that, with proper instruction, can grow and differentiate into any new tissue or organ. Recent reports have suggested the greater therapeutic effects of the anti-inflammatory, trophic, paracrine and immune-modulatory functions associated with these cells, which induce them to restore normal healing and tissue regeneration by modulating immune reactions, regulating inflammation, and suppressing fibrosis. Therefore, the use of stem cells holds significant promise for the treatment of many battlefield injuries and their complications. These applications include the treatment of injuries to the skin, sensory organs, nervous system tissues, the musculoskeletal system, circulatory/pulmonary tissues and genitals/testicles and of acute radiation syndrome and the development of novel biosensors. The new research developments in these areas suggest that solutions are being developed to reduce critical consequences of wounds and exposures suffered in warfare. Current military applications of stem cell-based therapies are already saving the lives of soldiers who would have died in previous conflicts. Injuries that would have resulted in deaths previously now result in wounds today; similarly, today’s permanent wounds may be reduced to tomorrow’s bad memories with further advances in stem cell-based therapies.  
      Keywords:Tissue engineering;Defense medicine;Stem cells;War injuries   
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      Updated:2026-03-12
    • Assistive technologies for pain management in people with amputation: a literature review

      Kamiar Ghoseiri, Mostafa Allami, Mohammad Reza Soroush, Mohammad Yusuf Rastkhadiv
      Vol. 5, Issue 2, Pages: 159-164(2018) DOI: 10.1186/s40779-018-0151-z
      Assistive technologies for pain management in people with amputation: a literature review
      Abstract:The prevalence of limb amputation is increasing globally as a devastating experience that can physically and psychologically affect the lifestyle of a person. The residual limb pain and phantom limb pain are common disabling sequelae after amputation surgery. Assistive devices/technologies can be used to relieve pain in people with amputation. The existing assistive devices/technologies for pain management in people with amputation include electrical nerve block devices/technologies, TENS units, elastomeric pumps and catheters, residual limb covers, laser systems, myoelectric prostheses and virtual reality systems, etc. There is a great potential to design, fabricate, and manufacture some portable, wireless, smart, and thin devices/technologies to stimulate the spinal cord or peripheral nerves by electrical, thermal, mechanical, and pharmaceutical stimulus. Although some preliminary efforts have been done, more attention must be paid by researchers, clinicians, designers, engineers, and manufacturers to the post amputation pain and its treatment methods.  
      Keywords:Amputees;Amputation stumps;Self-help devices;Pain;Acute pain;Chronic pain;Pain management   
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      Updated:2026-03-12
    • Recent advances in the effects of microwave radiation on brains

      Wei-Jia Zhi, Li-Feng Wang, Xiang-Jun Hu
      Vol. 5, Issue 2, Pages: 165-177(2018) DOI: 10.1186/s40779-017-0139-0
      Abstract:This study concerns the effects of microwave on health because they pervade diverse fields of our lives. The brain has been recognized as one of the organs that is most vulnerable to microwave radiation. Therefore, in this article, we reviewed recent studies that have explored the effects of microwave radiation on the brain, especially the hippocampus, including analyses of epidemiology, morphology, electroencephalograms, learning and memory abilities and the mechanisms underlying brain dysfunction. However, the problem with these studies is that different parameters, such as the frequency, modulation, and power density of the radiation and the irradiation time, were used to evaluate microwave radiation between studies. As a result, the existing data exhibit poor reproducibility and comparability. To determine the specific dose-effect relationship between microwave radiation and its biological effects, more intensive studies must be performed.  
      Keywords:microwave;central nervous system;Dysfunction of learning and memory abilities   
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      Updated:2026-03-12

      HYPOTHESIS

    • A hypothesis study on bionic active noise reduction of auditory organs

      Qing-Qing Jiang, Ning Yu, Shi-Ming Yang
      Vol. 5, Issue 2, Pages: 178-182(2018) DOI: 10.1186/s40779-018-0155-8
      Abstract:Background:Noise exposure can lead to hearing loss and multiple system dysfunctions. As various forms of noise exist in our living environments, and our auditory organs are very sensitive to acoustic stimuli, it is a challenge to protect our hearing system in certain noisy environments.Presentation of the hypothesis:Herein, we propose that our hearing organ could serve as a noise eliminator for high intensity noise and enhance acoustic signal processing abilities by increasing the signal-noise ratio. For suprathreshold signals, the hearing system is capable of regulating the middle ear muscles and other structures to actively suppress the sound level to a safe range.Testing the hypothesis:To test our hypothesis, both mathematic model analyses and animal model studies are needed. Based on a digital 3D reconstructed model, every structure in the auditory system can be analyzed and tested for its contribution to the process of noise reduction. Products manufactured by this bionic method could be used and verified in animal models and volunteers.Implications:By mimicking the noise-reduction effect of the sophisticated structures in the hearing system, we may be able to provide a model that establishes a new active-sound-suppression mode. This innovative method may overcome the limited capabilities of current noise protection options and become a promising possibility for noise prevention.  
      Keywords:Active;Noise reduction;Bionic;Hearing loss   
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      Updated:2026-03-12
    • A hypothesis study on a four-period prevention model for high altitude disease

      Xian-Sheng Liu, Xiang-Rong Yang, Lu Liu, Xian-Kui Qin, Yu-Qi Gao
      Vol. 5, Issue 2, Pages: 183-188(2018) DOI: 10.1186/s40779-018-0150-0
      A hypothesis study on a four-period prevention model for high altitude disease
      Abstract:Background:High altitude disease (HAD) can reduce combat effectiveness and damage the health of soldiers at high altitudes. The objective of this hypothesis study is to build a four-period prevention model for high altitude disease that can be applied at high altitudes of over 3000m.Presentation of the hypothesis:We divided the time at high altitude into nine periods, with three stages from the ascent preparation to the descent to the plain, and applied a continuous dynamic and systematic four-period prevention model across the nine periods. Each period of three stages has its own different measures and targets high altitude health care services for the prevention of high altitude disease. A standard four-period prevention model for high altitude disease was constructed for the high altitude health services at the population level.Testing the hypothesis:Our hypothesized HAD prevention model represents a continuous dynamic and systematic four-period prevention model across the nine periods. This hypothesis can be tested from three aspects. The first one is assessment of soldiers' operating efficacies. The second is comparison of the long-term high altitude population health basic data and development and utilization of big data. The third is descent population health status comparative study and historical retrospective study on prevention.Implications:As we know, it is necessary to protect soldiers’ health through the ascent and descent. Through the standard four-period model, we can protect soldiers’ health by preventing high altitude diseases, screening the susceptible population, securely tracking their location and maintaining soldiers’ health statuses; we also maintain their operational capabilities, eliminate their psychological fears and ease their family troubles.  
      Keywords:High altitude disease;High altitude health service;Prevention model   
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      Updated:2026-03-12
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