ObjectiveTo analyze the research hotspots and development trends in the field of spinal cord stimulation (SCS) for spinal cord injury (SCI). MethodsLiterature about SCS for SCI was retrieve from the Web of Science (WOS) Core Collection database, with a time range from January, 1999 to July, 2025. VOSviewer 1.6.20 and CiteSpace 6.4.R2 were used to analyze the annual publication volume, countries, authors, institutions, journals and keywords. ResultsA total of 636 literatures were included. From 1999 to 2025, the overall publication trend in this field showed an upward trajectory, with recent years fluctuating but tending to stabilize. The country with the most publications was the United States (429 papers), followed by Russia (98 papers) and China (70 papers). The institution with the highest number of publications was the University of California, Los Angeles (76 papers), the author with the most publications was V. Reggie Edgerton (70 papers), and the journal with the most publications was Journal of Clinical Medicine (31 papers). The most frequently cited study focused on exploring the combination of epidural spinal cord stimulation with task-specific training to restore motor function in patients with complete SCI. Keyword analysis showed that the research hotspots in this field were mainly focused on neuroregulation mechanisms, recovery of motor and autonomic nervous dysfunction, artificial intelligence, closed-loop stimulation and brain-computer interface technology innovations. In recent years, the research focus gradually shifted from basic mechanisms to personalized and precise multifunctional rehabilitation strategies. ConclusionThe field of SCS for SCI has undergone phases of basic mechanism exploration and clinical application expansion. Current research hotspots and future trends focus primarily on the development of new stimulation paradigms and combined innovative technologies.

ObjectiveTo investigate the independent risk factors for decompensation in patients with liver cirrhosis， to construct a nomogram-based risk assessment model， and to assess its risk assessment performance and clinical value by comparing it with Model for End-Stage Liver Disease （MELD）， MELD combined with serum sodium concentration （MELD-Na）， and MELD 3.0 scoring system. MethodsA retrospective analysis was performed for 514 patients with liver cirrhosis who attended The First Hospital of Shanxi Medical University from January 2020 to May 2025， and related data were collected， including demographic data and laboratory markers. According to the presence or absence of decompensation， the patients were divided into compensation group with 275 patients and decompensation group with 239 patients. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. The least absolute shrinkage and selection operator regression analysis was used for screening of variables， and the multivariate logistic regression analysis was used to identify independent risk factors for decompensated liver cirrhosis and construct a nomogram model. The receiver operating characteristic （ROC） curve， calibration curve， and decision curve analysis were used to assess the discriminatory ability， calibration， and net clinical benefit of the model. ResultsThe multivariate logistic regression analysis showed that low hemoglobin （odds ratio ［OR］=0.984， 95% confidence interval ［CI］： 0.969　—　0.999， P<0.05）， low lymphocytes （OR=0.564， 95%CI： 0.383　—　0.830， P<0.05）， high international normalized ratio （OR=3.131， 95%CI： 1.242　—　7.891， P<0.05）， and low serum sodium （OR=0.922， 95%CI： 0.872　—　0.975， P<0.05） were independent risk factors for decompensation events in patients with liver cirrhosis. Construct the prediction model equation： Logit（P）=intercept value－0.016×hemoglobin－0.573×lymphocytes+1.141×INR－0.081×serum sodium. The nomogram constructed based on these factors had a good discriminatory ability， with an area under the ROC curve （AUC） of 0.787， a specificity of 77.8%， and a sensitivity of 67.4%， and it had significantly better predictive performance than MELD score （AUC=0.718）， MELD-Na score （AUC=0.719）， and MELD 3.0 score （AUC=0.725）. The calibration curve showed good consistency between the probability of risk assessed by the model and the observed probability. The decision curve analysis showed that compared with the MELD-based scores， this model provided higher net clinical benefit across a wide range of risk thresholds. ConclusionThis study successfully constructed and validated a nomogram risk assessment model incorporating hemoglobin， international normalized ratio， lymphocytes， and serum sodium. This model has good clinical practicability and can help to achieve early identification of high-risk patients with decompensated liver cirrhosis and optimize intervention strategies in clinical practice.

BACKGROUND:Wogonin is a flavonoid extracted from the root of Scutellaria baicalensis.Previous studies have shown that baicalein has protective effects against cerebral ischemia-reperfusion injury,and can also reduce blood sugar and complications in diabetic mice,but its role and mechanism in diabetic cerebral infarction remain unclear. OBJECTIVE:To explore the effect of wogonin on nerve injury in rats with diabetic cerebral infarction and its mechanism. METHODS:Sprague-Dawley rats were randomly divided into six groups:control group,model group,low-dose wogonin group,medium-dose wogonin group,high-dose wogonin group,and high-dose wogonin+Ras homolog gene family member A(RhoA)activator group.Except for the control group,the other rats were established with diabetes and cerebral ischemia models using intraperitoneal injection of streptozotocin and middle cerebral artery occlusion.Low,medium-and high-dose wogonin groups were intragastrically given 10,20,40 mg/kg wogonin,respectively;high-dose wogonin+RhoA activator group was intragastrically given 40 mg/kg wogonin and intraperitoneally injected 10 mg/kg lysophosphatidic acid;control group and model group were given the same amount of normal saline once a day for 7 consecutive days.Rats in each group were evaluated for neurological deficits and their blood glucose levels were measured after the last dose.TTC staining was applied to detect the volume of cerebral infarction.Hematoxylin-eosin staining was applied to observe pathological changes in brain tissue.ELISA kit was applied to detect tumor necrosis factor-α,interleukin-6,malondialdehyde,and superoxide dismutase levels in brain tissue.Western blot was applied to detect the protein expression of RhoA and Rho-associated protein kinase(ROCK)2 in brain tissue. RESULTS AND CONCLUSION:Compared with the control group,the neuronal structure of rats in the model group was severely damaged,with cell necrosis and degeneration,the neurological deficit score,blood glucose level,and infarct volume were significantly elevated(P<0.05),the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue were significantly increased(P<0.05),and the superoxide dismutase level was decreased(P<0.05).Compared with the model group,the low-,medium-,and high-dose wogonin groups showed improved neuronal damage,reduced cell degeneration and necrosis,a significant reduction in neurological deficit score,blood glucose level,infarct volume,and the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue,and an increase in the superoxide dismutase level(P<0.05).Compared with the high-dose wogonin group,the high-dose wogonin+RhoA activator group significantly weakened the improvement in the above indexes of rats with diabetic cerebral infarction(P<0.05).To conclude,wogonin can improve the blood glucose level in rats with diabetic cerebral infarction,reduce cerebral infarction and nerve injury,and its mechanism may be related to the inhibition of RhoA/ROCK signaling pathway.

ObjectiveTo investigate the awareness and clinical practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. MethodsFrom July 19 to December 31， 2024， a self-designed electronic questionnaire was distributed via the WeChat mini program to collect related data from 1 588 clinicians nationwide， including their awareness and practice based on 18 questions regarding testing and referral， diagnosis and treatment， and follow-up. ResultsAmong all respondents， only 350 clinicians correctly understood all the updated key points of antiviral indications and treatment for special populations in the 2022 edition of guidelines for the prevention and treatment of chronic hepatitis B， with an overall awareness rate of 22.0%. Only 20% ‍—‍ ‍40% of the patients with positive HBV DNA and an age of >30 years receive antiviral therapy， while 80% ‍—‍ ‍100% of the patients with positive HBV DNA and a family history of hepatitis B cirrhosis or hepatocellular carcinoma receive antiviral therapy. The median follow-up rates at 1 year， 3 years， and 5 years were 67.5% 57.5% and 47.5%，respectively， showing a trend of gradual reduction， which might be associated with the influencing factors such as insufficient time for follow-up management by clinicians， insufficient awareness of the disease among patients， and poor adherence to follow-up. ConclusionThere is a gap between the awareness and practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. It is recommended to further strengthen training and focus on the whole process of “detection， diagnosis， treatment， and management” for patients with chronic hepatitis B in healthcare institutions， in order to promote the implementation of the guidelines.

[This corrects the article DOI: 10.1016/j.apsb.2018.08.009.].

Objective To explore the value of deep learning(DL)model based on grayscale ultrasound for predicting asymptomatic advanced chronic liver disease(cACLD).Methods Totally 258 patients with asymptomatic compensatory chronic liver diseases were retrospectively included,among them 117 with F3 or F4 stage liver fibrosis were classified into cACLD group,while 141 with F1 or F2 stage liver fibrosis were taken as non-cACLD group.The patients were divided into training set(n=180,including 82 cases of cACLD and 98 cases of non-cACLD)and validation set(n=78,including 35 cases of cACLD and 43 cases of non-cACLD)at the ratio of 7∶3.Univariate and multivariate logistic regression were used to screen independent clinical predictors of cACLD and construct a clinical model.Based on liver grayscale ultrasound,optimal DL features were extracted and screened,and Resnet50 network was adopted as framework,na?ve Bayes classifier was used to construct DL model,and a combined model was constructed based on clinical model and DL model.The efficacy and clinical value of each model for predicting asymptomatic cACLD were evaluated.Results Age,gamma-glutamyl transferase and platelet count were all independent clinical predictors of cACLD,and a clinical model was constructed.Totally 38 optimal DL features were screened to build a DL model.The AUC of combined model in training set and validation set was 0.950 and 0.740,of DL model was 0.944 and 0.737,respectively,being not significantly different(both P＞0.05)but all higher than that of clinical model(0.667 and 0.573,all P＜0.05).Taken 0.59-0.90 as the threshold,the net benefits of combined model in both training and validation sets were higher than that of other models.Conclusion DL model based on grayscale ultrasound could be used to effectively predict asymptomatic cACLD.Combining with clinical characteristics might improve clinical net benefit of this model.

Objective To analyze the application effects of laryngeal mask airway(LMA)general anesthesia versus endotracheal intubation(ETI)general anesthesia in Parkinson's disease(PD)patients undergoing deep brain stimulation(DBS)implantable pulse generator(IPG)surgery.Methods A retrospective analysis was conducted on 164 PD patients who underwent IPG surgery at our hospital from August 2020 to February 2021.Patients were divided into two groups based on airway management:LMA group(n=61)and ETI group(n=103).Perioperative hemodynamic parameters,including mean arterial pressure(MAP)and heart rate(HR),were observed at five time points:pre-induction(T0),post-induction(T1),skin incision(T2),extubation(T3),and post-anesthesia care unit(PACU)admission(T4).Key outcomes,such as extubation time,intraoperative hypoxia events,LMA-to-ETI conversion rate,and postoperative complications(respiratory depression,pneumonia),were compared between the two groups.Results The LMA group had a significantly lower body mass index than the ETI group[(22.75±3.11)kg/m2 vs(23.85±3.49)kg/m2,P=0.039],while the other baseline characteristics were comparable.After induction,the LMA group exhibited a less decrease in MAP[(85.46±11.63)mmHg vs(74.13±11.78)mmHg in the ETI group,P<0.001].At extubation,the ETI group showed higher MAP[(98.27±13.78)mmHg vs(89.66±10.50)mmHg in the LMA group,P<0.001].The intraoperative use of vasoactive drugs was significantly lower in the LMA group(3.3%)than that in the ETI group(13.6%,P=0.032).The mean extubation time was shorter in the LMA group[(8.43±5.25)min vs(14.28±7.66)min in the ETI group,P<0.001].No intraoperative hypoxia or LMA-to-ETI conversion events occurred in either group.Postoperative respiratory depression and pneumonia rates showed no statistically significant differences between the groups.Conclusion LMA general anesthesia can be safely applied in PD patients undergoing DBS IPG implantation.It shortens extubation time,reduces the use of vasoactive drugs,and does not increase the risk of intubation-related complications.

Objective To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in the irradiation of chest wall and upper and lower clavicle regions after radical mastectomy for breast cancer.Methods A total of 100 patients who were scheduled to receive radiotherapy after radical mastectomy were included and selected as research subjects.Patients were divided into the VMAT group and the IMRT group by random number table method,with 50 cases in each group.The target dose parameters,exposure dose of organs at risk,monitor unit(MU)and treatment time were compared between the two groups.Results There were no statistical differences in V95 and V110 between the VMAT group and the IMRT group(P＞0.05).The D2%in the VMAT group was lower than that of the IMRT group,while D98%and D50%were higher in the VMAT group than those in the IMRT group(P＜0.05).Target area uniformity and target area conformity were better in the VMAT group than those in the IMRT group(P＜0.05).There were no significant differences in mean cardiac dose(Dmean)and ipsilateral lung V5 and V10 between the VMAT group and the IMRT group(P＞0.05).The heart V20 and V30,contralateral lung Dmean,maximum spinal cord dose(Dmax),contralateral breast Dmean,ipsilateral lung Dmean,V20,V30 and mean MU were lower in the VMAT group than those in the IMRT group,and the treatment time was shorter than that in the IMRT group(P＜0.05).Conclusion In the irradiation treatment of chest wall and upper and lower clavicle regions after radical mastectomy,VMAT demonstrates superior dosimetric characteristics and higher treatment efficiency compared with IMRT,particularly in terms of target area uniformity,target area conformity and exposure doses to organs at risk.

Objective To analyze the application effects of laryngeal mask airway(LMA)general anesthesia versus endotracheal intubation(ETI)general anesthesia in Parkinson's disease(PD)patients undergoing deep brain stimulation(DBS)implantable pulse generator(IPG)surgery.Methods A retrospective analysis was conducted on 164 PD patients who underwent IPG surgery at our hospital from August 2020 to February 2021.Patients were divided into two groups based on airway management:LMA group(n=61)and ETI group(n=103).Perioperative hemodynamic parameters,including mean arterial pressure(MAP)and heart rate(HR),were observed at five time points:pre-induction(T0),post-induction(T1),skin incision(T2),extubation(T3),and post-anesthesia care unit(PACU)admission(T4).Key outcomes,such as extubation time,intraoperative hypoxia events,LMA-to-ETI conversion rate,and postoperative complications(respiratory depression,pneumonia),were compared between the two groups.Results The LMA group had a significantly lower body mass index than the ETI group[(22.75±3.11)kg/m2 vs(23.85±3.49)kg/m2,P=0.039],while the other baseline characteristics were comparable.After induction,the LMA group exhibited a less decrease in MAP[(85.46±11.63)mmHg vs(74.13±11.78)mmHg in the ETI group,P<0.001].At extubation,the ETI group showed higher MAP[(98.27±13.78)mmHg vs(89.66±10.50)mmHg in the LMA group,P<0.001].The intraoperative use of vasoactive drugs was significantly lower in the LMA group(3.3%)than that in the ETI group(13.6%,P=0.032).The mean extubation time was shorter in the LMA group[(8.43±5.25)min vs(14.28±7.66)min in the ETI group,P<0.001].No intraoperative hypoxia or LMA-to-ETI conversion events occurred in either group.Postoperative respiratory depression and pneumonia rates showed no statistically significant differences between the groups.Conclusion LMA general anesthesia can be safely applied in PD patients undergoing DBS IPG implantation.It shortens extubation time,reduces the use of vasoactive drugs,and does not increase the risk of intubation-related complications.

Natural antimicrobial peptides (AMPs) are promising candidates for the development of a new generation of antimicrobials to combat antibiotic-resistant pathogens. They have found extensive applications in the fields of medicine, food, and agriculture. However, efficiently screening AMPs from natural sources poses several challenges, including low efficiency and high antibiotic resistance. This review focuses on the action mechanisms of AMPs, both through membrane and non-membrane routes. We thoroughly examine various highly efficient AMP screening methods, including whole-bacterial adsorption binding, cell membrane chromatography (CMC), phospholipid membrane chromatography binding, membrane-mediated capillary electrophoresis (CE), colorimetric assays, thin layer chromatography (TLC), fluorescence-based screening, genetic sequencing-based analysis, computational mining of AMP databases, and virtual screening methods. Additionally, we discuss potential developmental applications for enhancing the efficiency of AMP discovery. This review provides a comprehensive framework for identifying AMPs within complex natural product systems.