Military Medical Research最新文献

{"title":"Prioritizing human-AI collaboration in healthcare: the TRIAD framework for trustworthy governance, real-world, and integrated adaptive deployment.","authors":"Jia Li, Zi-Chun Zhou, Zhen-Chang Wang, Han Lv","doi":"10.1186/s40779-026-00684-w","DOIUrl":"10.1186/s40779-026-00684-w","url":null,"abstract":"<p><p>Artificial intelligence (AI) and big data are reshaping the healthcare landscape. However, clinical value depends on how well systems augment clinicians and fit into routine workflows. To this end, we introduce the TRIAD framework: trustworthy governance, real-world clinical value, and integrated adaptive deployment, to guide the development, validation, and deployment of clinical AI. TRIAD requires explicit data provenance and intended use, fairness auditing, and calibrated uncertainty. This framework evaluates the human-AI team in real workflows using team-level metrics, including accuracy, safety, workload, and patterns of acceptance, editing, and overriding. Deployment proceeds via staged rollouts with preregistered guardrails and continuous monitoring of performance and subgroup impact. TRIAD views intelligence as a property of the human-AI team rather than the AI model alone. Aligning governance, evaluation, and deployment around clinicians and patients enables durable gains in safety, equity, efficiency, and experience, thereby elevating clinical value.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"12 ","pages":"97"},"PeriodicalIF":29.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RNA as a genome architect: G-loops in G-quadruplex regulation.","authors":"Jie Wang, Zhao-Jie Lyu, Qi Zhang, William C Cho, De-Chao Feng","doi":"10.1186/s40779-025-00683-3","DOIUrl":"10.1186/s40779-025-00683-3","url":null,"abstract":"","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"12 1","pages":"96"},"PeriodicalIF":29.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"cytokine storm\" in infection and sepsis: win the battle but lose the war.","authors":"Jiang-Bo Fan, Qin-Yuan Li, Xi-Feng Feng, Si-Yuan Huang, Rui Wang, Feng-Ying Liao, Di Liu, Wen-Yi Liu, Jian-Hui Sun, Hua-Cai Zhang, Hui-Ting Zhou, Jian-Xin Jiang, Zhen Wang, Ling Zeng","doi":"10.1186/s40779-025-00678-0","DOIUrl":"10.1186/s40779-025-00678-0","url":null,"abstract":"<p><p>The cytokine storm, a life-threatening systemic inflammatory syndrome, is the primary driver of multiorgan failure in different clinical situations, including severe infections, autoimmune diseases, chimeric antigen receptor (CAR) T cell immunotherapy for cancer, and genetic syndromes. This review focuses primarily on cytokine storms triggered by severe infections such as viral pneumonia and bacterial sepsis, and explores the underlying mechanisms of cytokine storms and potential therapeutic interventions. Cytokine storms are characterized primarily by the excessive release of proinflammatory cytokines, which are triggered by pathogen-associated molecular patterns (PAMPs), damage-associated molecular patterns (DAMPs), and PANoptosis, all of which activate immune signaling cascades. Amplification mechanisms involve positive feedback loops and the failure of negative feedback mechanisms, leading to uncontrolled inflammation. Like a pyrrhic victory, the excessive activation of the immune system eliminated invading pathogens but caused catastrophic damage due to multiple organ dysfunction syndrome (MODS), turning the life-saving response into a life-threatening war. Therapeutic strategies, including cytokine antagonists, Janus kinase (JAK) inhibitors, caspase inhibitors, glucocorticoids, and blood purification therapies, aim to interrupt the self-amplifying cycle of inflammation that propagates organ injury, thereby reducing MODS and mortality. Challenges include optimizing the treatment timing and patient stratification. Future research should focus on combination therapies and personalized medicine based on the heterogeneity of infections and sepsis. Advances in multiomics and targeted therapies provide new hope for managing infections and sepsis.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"12 1","pages":"95"},"PeriodicalIF":29.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRIME: an interpretable artificial intelligence model based on liquid biopsy improves prediction of progression risk in non-small cell lung cancer.","authors":"Yu Wang, Yong-Bo Xiang, Xiao-Wei Chen, Tao Zhang, Jian-Yang Wang, Wen-Yang Liu, Lei Deng, Lu-Hua Wang, Shu-Geng Gao, Nan Bi","doi":"10.1186/s40779-025-00679-z","DOIUrl":"10.1186/s40779-025-00679-z","url":null,"abstract":"<p><strong>Background: </strong>Despite the predictive impact of circulating tumor DNA (ctDNA) minimal residual disease (MRD), accurate prediction of failure risk after curative-intent treatments for early-stage or localized non-small cell lung cancer (NSCLC) patients to guide personalized therapy remains challenging. This study aimed to develop and validate an interpretable artificial intelligence-assisted model using global data resources.</p><p><strong>Methods: </strong>Liquid biopsy data, blood-based genomic alterations, clinicopathological features, and survival outcomes of stage I-III NSCLC patients who underwent surgery or definitive chemoradiotherapy were collected from 6 cohorts. PRIME (Progression Risk prediction by Interpretable Machine learning on ctDNA-MRD, Mutations, and clinical-therapeutic features) was trained by 6 machine learning algorithms across 4 cohorts and validated in 2 independent cohorts. Model performance was evaluated by the area under the curve (AUC) and interpreted by SHapley Additive exPlanations (SHAP). Whole-exome sequencing (WES) or whole-genome sequencing (WGS) of tumor tissue from 430 stage II-III NSCLC patients and RNA-sequencing (RNA-seq) data from 1149 subjects, sourced from The Cancer Genome Atlas, were used to validate the prognostic effect of mutations identified in peripheral blood and investigate the underlying mechanisms.</p><p><strong>Results: </strong>A global dataset encompassing 781 blood samples from 493 patients was analyzed. Clinical stage, pre-treatment ctDNA, post-treatment MRD, blood-based Kelch-like ECH-associated protein 1 (KEAP1), serine/threonine kinase 11 (STK11), and cyclin-dependent kinase inhibitor 2A (CDKN2A) mutations, and treatment modality were significantly associated with the risk of disease progression and were thereby included in the model training. WES/WGS and RNA-seq confirmed the poor prognostic effect of KEAP1, STK11, and CDKN2A mutations, which were characterized by the suppressive tumor microenvironment and attenuated humoral immunity. The neural network (NN) model exhibited optimal prediction of treatment failure risk in the training (AUC = 0.85, 95% CI 0.81-0.89) and validation sets (AUC = 0.82, 95% CI 0.74-0.89). SHAP analysis indicated that MRD (+0.306), treatment modality (+0.128), and pre-treatment ctDNA (+0.043) ranked in the top 3 contributions. NN-PRIME outperformed single liquid biopsy biomarkers and clinical-therapeutic signatures, and demonstrated consistent robustness across different clinical scenarios. High-risk patients identified by NN-PRIME had poorer prognoses but derived significant benefits from adjuvant therapy after surgery.</p><p><strong>Conclusions: </strong>As an interpretable model integrating readily-accessible and crucial clinical-genomic predictors, PRIME achieves enhanced performance, allowing for early outcome prediction, refined risk stratification, and personalized clinical decision-making.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"12 1","pages":"94"},"PeriodicalIF":29.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in digital pathology diagnosis and analysis: technologies, challenges, and future prospects.","authors":"Xiu-Ming Zhang, Tian-Hong Gao, Qiu-Yu Cai, Jia-Bin Xia, Yu-Ning Sun, Jian Yang, Wei-Han Li, Sheng-Xu-Ming Zhang, Heng-Rui Lou, Xiao-Tian Yu, Kai-Wen Hu, Jing-Wen Ye, Jin-Xing Zhang, Jie Lei, Le-Chao Cheng, Lin-Jie Xu, Qing Chen, He-Xiang Wang, Mei-Fu Gan, Cheng Lu, Nan Pu, Ming-Li Song, Xin Chen, Wen-Jie Liang, Han Lv, Chao-Qing Xu, Zai-Yi Liu, Jing Zhang, Kai Yan, Zun-Lei Feng","doi":"10.1186/s40779-025-00680-6","DOIUrl":"10.1186/s40779-025-00680-6","url":null,"abstract":"<p><p>Artificial intelligence (AI) offers transformative potential in pathology, where histopathological images remain the diagnostic gold standard due to their rich morphological and molecular information. While the rapid development of AI-driven computational pathology tools is revolutionizing disease interpretation, these technologies have not yet been systematically evaluated. Therefore, this review systematically evaluates AI applications across the diagnostic continuum, from image preprocessing and tumor classification to prognostic stratification and the discovery of predictive biomarkers. It presents a technical taxonomy of the algorithms and foundation models powering these applications, benchmarking their performance across diverse diagnostic tasks through rigorous comparative analyses. It also identifies critical challenges in clinical translation, including computational scaling, noisy annotations, interpretability gaps, and domain shifts. Finally, it proposes a roadmap for advancing AI applications in precision oncology and pathological research. By bridging technological innovation with clinical needs, this review aims to accelerate the integration of robust, unified, scalable AI solutions into diagnostic workflows.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"12 1","pages":"93"},"PeriodicalIF":29.0,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The disease burden attributable to tobacco use in China and its provinces from 1990-2023: an analysis from the Global Burden of Disease Study 2023.","authors":"Ling-Ling Yu, Fan-Shu Yan, Jin-Lei Qi, Li-Jun Wang, Mai-Geng Zhou, Peng Yin","doi":"10.1016/j.mmr.2026.100041","DOIUrl":"10.1016/j.mmr.2026.100041","url":null,"abstract":"<p><strong>Background: </strong>As the world's leading producer and consumer of tobacco, China bears a significant health burden attributable to tobacco. This study aims to provide a precise, updated analysis of the demographic, temporal, and spatial dimensions of the tobacco-attributable disease burden across China.</p><p><strong>Methods: </strong>Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 comparative risk assessment framework and its hierarchical taxonomy, we analyzed tobacco use as a Level 2 (behavioral) risk. We estimated the national and provincial burdens of tobacco use in China from 1990 to 2023, quantifying deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) stratified by sex, age, cause, and the three Level 3 tobacco sub-categories: smoking, secondhand smoke (SHS), and chewing tobacco. Temporal trends were assessed via average annual percentage change (AAPC).</p><p><strong>Results: </strong>In 2023, tobacco use caused 2.38 million [95% uncertainty interval (UI) 2.02-2.83] deaths and 57.27 million (95% UI 48.28-60.82) DALYs, predominantly premature mortality [YLLs 49.45 million (95% UI 42.23-59.25)]. Direct smoking was the primary driver (2.01 million deaths), followed by SHS and chewing tobacco. A profound sex disparity existed in smoking burden, with the male age-standardized mortality rate (ASMR; 167.78/100,000) being 9.5-time higher than that of females, although females bore a greater SHS-attributable burden. From 1990 to 2023, absolute deaths and DALYs increased, but their age-standardized rates (ASRs) significantly declined (AAPC for mortality: -2.34%). The burden is concentrated in older adults, with the disease spectrum shifting from respiratory infections in youth to chronic diseases such as heart disease and lung cancer later in life. Geographically, northern provinces had the highest burden, whereas coastal areas had the lowest burden.</p><p><strong>Conclusions: </strong>Despite declining ASRs, China's tobacco attributable burden is concentrated among males, older adults, and northern provinces. In the context of rapid aging and the long-term harmful effects of tobacco smoking, more stringent and targeted policies should be implemented to address the challenges associated with tobacco use in China.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"13 1","pages":"100041"},"PeriodicalIF":29.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 diabetes does not inevitably shorten life expectancy.","authors":"Huai-Dong Du","doi":"10.1016/j.mmr.2026.100029","DOIUrl":"10.1016/j.mmr.2026.100029","url":null,"abstract":"","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"13 1","pages":"100029"},"PeriodicalIF":29.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the tumor microenvironment in mediating radiopharmaceutical therapy: bridging nuclear medicine and cancer immunotherapy.","authors":"Zhi-Peng Wang, Ai-Qing Li, Dilinaer Wusiman, Rui-Cheng Wu, Ji-Min Zhu, Xin-Rui Li, Yuan-Ning Guo, Premkamon Chaipanichkul, Uzoamaka Adaobi Okoli, Siang Boon Koh, Jie Wang, Deng-Xiong Li, Xiao-Dong Jin, Da-Hong Zhang, Cheema Umber, Qi Zhang, De-Chao Feng","doi":"10.1016/j.mmr.2026.100038","DOIUrl":"10.1016/j.mmr.2026.100038","url":null,"abstract":"<p><p>Radiopharmaceutical therapy (RPT) is a pivotal modality in cancer treatment, with its efficacy substantially modulated by the tumor microenvironment (TME). The TME regulates RPT penetration and influences therapeutic outcomes. Concurrently, RPT actively reconfigures the TME by enhancing immune activation and partially reversing immunosuppression. Specifically, RPT induces tumor cell senescence and immunogenic cell death, and catalyzes immune activation. RPT diminishes immunosuppressive elements, including regulatory T cells and tumor-associated macrophages, and augments populations of CD8⁺ T cells and natural killer cells, thereby fostering a more immunostimulatory TME. Additionally, RPT modulates critical cytokines and upregulates immune checkpoint molecules, bolstering anti-tumor immunity. Nevertheless, pathological features like hypoxia and extracellular matrix stiffness within the TME can hinder RPT biodistribution and therapeutic efficacy. Strategically targeting the TME through approaches, such as fibroblast depletion, hypoxia mitigation, metabolic reprogramming, nerve-immune-cancer interactions, or nanocarrier drug delivery, can amplify RPT effectiveness. Combination immunotherapies that integrate RPT with immune checkpoint inhibitors, chimeric antigen receptor (CAR)-T cells, or cancer vaccines have demonstrated enhanced anti-tumor responses and survival advantages in malignancies such as prostate cancer and neuroendocrine tumors. Given the complexity and heterogeneity of the TME, emerging strategies, including radiation-responsive nanocarriers, CAR-T cells engineered to secrete radiosensitizers, senolytic therapies, and artificial intelligence-driven multimodal data integration, are promising in addressing the challenges and refining precision cancer therapy. In summary, the TME serves as a critical bridge between RPT and immunotherapy; elucidating the interplay among these three elements is essential for advancing combination strategies.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"13 1","pages":"100038"},"PeriodicalIF":29.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>GastroAlert</i>: a multimodal epigenetic blood test for early detection of gastric cancer using cell-free DNA.","authors":"Yong-Jie Xu, Jian-Feng Xu, Chang-Fa Xia, Yu-Jie Wu, Dian-Ge Li, Tie-Yan Liu, Huai-Ping Cui, Jin Zhang, Liang Shang, Wan-Qing Chen","doi":"10.1016/j.mmr.2026.100066","DOIUrl":"10.1016/j.mmr.2026.100066","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains a leading cause of cancer-related mortality worldwide, frequently diagnosed at advanced stages due to the limitations of current diagnostic approaches. While cell-free DNA (cfDNA)-based epigenetic profiling has emerged as a promising avenue for early cancer detection, comprehensive investigations into the epigenetic landscape of cfDNA in gastric cancer remain scarce. To address this gap, we aimed to develop and validate a multimodal epigenetic blood test for the non-invasive detection of gastric cancer.</p><p><strong>Methods: </strong>We developed <i>GastroAlert</i>, a multimodal epigenetic blood test that integrates cfDNA methylation, nucleosome footprinting, and fragmentation features into a single diagnostic approach for gastric cancer detection. A custom-designed capture probe panel was utilized to target gastric cancer-associated differentially methylated CpG sites and functionally relevant genes. Targeted enzymatic methylation sequencing was then performed on a discovery dataset consisting of 136 participants, including 53 gastric cancer patients, 55 individuals with benign gastric conditions, and 28 healthy controls. Subsequently, the diagnostic performance of <i>GastroAlert</i> was rigorously validated in an independent external dataset of 149 participants, comprising 79 gastric cancer cases and 70 non-cancer controls.</p><p><strong>Results: </strong>In cross-validation of the discovery dataset, <i>GastroAlert</i> achieved an area under the receiver operating characteristic curve (AUC) of 0.950 [95% confidence interval (CI) 0.874-0.995], with observed AUCs for conventional protein biomarkers ranging from 0.507 to 0.687. Notably, the locked <i>GastroAlert</i> model exhibited robust and reproducible performance in the independent validation dataset, yielding an AUC of 0.965 (95% CI 0.940-0.989) for distinguishing gastric cancer patients from non-cancer controls. For the clinically critical subset of early-stage gastric cancer cases, the model still maintained high diagnostic efficacy with an AUC of 0.921 (95% CI 0.862-0.980) in the discovery dataset and 0.948 (95% CI 0.910-0.985) in the validation dataset. Among all 79 gastric cancer cases in the validation dataset, the model attained an overall sensitivity of 0.898 (95% CI 0.813-0.948) at a specificity of 0.900 in the validation dataset.</p><p><strong>Conclusions: </strong>The findings demonstrate that multimodal epigenetic analysis of cfDNA provides a robust, non-invasive strategy for early gastric cancer detection, with potential clinical utility to improve patient outcomes.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"13 1","pages":"100066"},"PeriodicalIF":29.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic hypoxia to protect and revive ischemic heart and brain.","authors":"Johannes Burtscher, Robert T Mallet, Lei Xi, Katharina Hüfner, Martin Burtscher","doi":"10.1016/j.mmr.2026.100064","DOIUrl":"10.1016/j.mmr.2026.100064","url":null,"abstract":"<p><p>Although hypoxia plays a central role in the pathobiology of cardiovascular and cerebrovascular diseases, controlled hypoxic stimuli, such as intermittent hypoxia conditioning (IHC), can trigger beneficial adaptations that counteract those diseases. IHC has been studied as a readily administered, non-pharmacological intervention for almost a century, it has not yet been widely adopted in clinical practice. Growing evidence demonstrates the beneficial preventive and therapeutic effects of IHC on the cardiovascular system, and although less conclusively established, on the brain. Moreover, IHC is highly feasible and raises few safety concerns. A notable limitation, similar to that of remote ischemic conditioning, is the lack of refined IHC protocols for personalized, disease-specific applications in the individual patient. Significant progress has been achieved in addressing this limitation. For example, increasingly sophisticated modern hypoxia equipment permits customization of IHC parameters according to each individual's responses to and tolerance of hypoxia. Still to be evaluated are the persistence of IHC's effects and the capacity of IHC booster protocols to renew its benefits. Comparative analyses of the mechanisms and efficacy of IHC and remote ischemic conditioning could aid in defining their respective applications and possible synergistic effects. This perspective article summarizes the historical development of IHC, presents a selection of preclinical and clinical studies exemplifying recent research progress, and discusses strategies to address the lingering concerns limiting clinical IHC applications.</p>","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":"13 1","pages":"100064"},"PeriodicalIF":29.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}