Background: Irreversible electroporation (IRE) is an emerging tissue ablation technique that offers advantages over traditional catheter ablation, such as minimal thermal damage and reduced treatment time. However, as this technique also involves delivering energy through a catheter to target tissue, there are still challenges regarding the contact between the catheter and the targeted tissue, and there is a lack of relevant studies. In this study, we examined this issue using potato models with three groups of experiments. Methods: First, the relationship between the effect of biphasic and monophasic output modes and contact force (CF) was studied. Next, the effect of different voltages on biphasic output mode was examined. Finally, impedance analysis was conducted to test the contact impedance under different CFs. Results: The IRE ablation efficacy increased with the increase of CF in both monophasic and biphasic output modes, and there was a strong correlation between the ablation efficacy and the CF. In addition, at three voltage levels, the IRE ablation efficacy increased with increasing CF, and there was a strong correlation between the ablation efficacy and the CF. Conclusion: The results indicate that, under common IRE electrical parameter configuration, the effect of IRE on the tissue has a positive response to the CF of the electrode in the potato model. This finding has important implications for the design of electrodes used in IRE for the treatment of atrial fibrillation.

Objectives: This study aimed to identify acupoint selection patterns for breast cancer-related pain using the Knowledge Discovery in Databases (KDD) method, construct a data-informed candidate acupoint prescription, and preliminarily evaluate its clinical efficacy when combined with the World Health Organization three-step analgesic ladder. Methods: Databases including China National Knowledge Infrastructure, VIP Information, WanFang, PubMed, and Web of Science were searched from inception to May 2024. An Excel-based dataset was developed to analyze acupoint frequency and meridian attribution. Acupuncture prescriptions for cancer pain without specifying cancer type were retained as potentially informative references for breast cancer-related pain. Sixty eligible patients were randomized into two groups. The control group received standard three-step analgesics, including celecoxib, tramadol sustained-release, or oxycodone sustained-release according to pain severity. The intervention group received the same regimen plus a KDD-derived acupuncture prescription consisting of bilateral Hegu (LI4), Zusanli (ST36), Neiguan (PC6), Taichong (LR3), Sanyinjiao (SP6), and Ashi points. Needles were retained for 30 minutes using balanced stimulation, five sessions per week for three weeks. Outcomes included pain intensity, breakthrough pain frequency, duration of pain relief, Karnofsky Performance Status, sleep quality, depressive symptoms, analgesic efficacy, quality of life, and safety. Results: The KDD-derived candidate prescription was associated with a higher overall response rate than analgesics alone. Patients receiving adjunctive acupuncture showed greater reductions in pain intensity and breakthrough pain episodes, as well as improvements in functional status, sleep quality, and depressive symptoms. Fewer adverse events were reported in the acupuncture group. Conclusions: This study proposes a potential acupoint combination for relieving breast cancer-related pain based on distal meridian points and local tender points. Combined acupuncture and conventional pharmacotherapy may improve analgesic outcomes, quality of life, and psychological status, with a favorable safety profile.

In contrast to conventional oximeters, near-infrared spectroscopy-based brain tissue oximetry monitoring devices are capable of non-invasive, continuous, and real-time quantitative monitoring of cerebral oximetry parameters. Initially, these devices were utilized for intensive care or surgical monitoring of oxygen saturation. Due to the rapid advancement of optoelectronic sensing and measurement technologies over the past decade, the derived functional near-infrared brain imaging devices have been widely used in a variety of fields. This paper first introduces the basic principles of near-infrared spectroscopy-based cerebral oxygenation parameter detection, then focuses on the most recent developments in this field of study. Finally, a prospect on their future application in practical settings is also provided.

Sepsis is a systemic inflammatory response syndrome triggered by infection. It presents with simultaneous overactive immune activation and immune paralysis, leading to a cytokine storm, tissue injury, and multiple organ failure. The molecular mechanisms and pathological characteristics of the septic cytokine storm are comprehensively interpreted from multiple perspectives, including immune regulation, signaling pathways, cellular interactions, metabolic state reprogramming, and microcirculatory dysfunction. The cross-activation of signaling pathways, including NF-κB, JAK/STAT, mitogen-activated protein kinase (MAPK), and NLRP3 inflammasome, underlies the core mechanism for the enhancement of the inflammatory response via continued release of proinflammatory cytokines and also is involved in maintaining immune balance. In the latestage immunosuppressive phase, Treg cells, myeloid-derived suppressor cells (MDSCs) and regulatory macrophages play pivotal roles in reestablishing host homeostasis through negative feedback, and their dysfunction is closely associated with secondary infections and high mortality. This review consolidates the latest developments in precision medicine and multidimensional biomarkers, emphasizing the prospective value of several markers such as lactate and CD64, pentraxin 3 (PTX3), and BMP9 for early diagnosis and rognosis evaluation. Moreover, it reviews novel immunomodulators, for instance, bee venom peptides, GDF15, N-(1,3,4-oxadiazol-2-yl) guanidine (NWG), 4-octyl itaconate  (4-OI), and nanoparticle drug delivery systems that inhibit inflammatory signaling cascades, restore energy metabolism, and provide organ protection. Taken together, the pathogenic mechanisms of sepsis are non-linear and dynamic, which may render single-target therapy insufficient for successful management. Personalized interventions targeting multi-target network regulation based on omics and AI models may accomplish precision monitoring and stratified treatment of inflammatory responses, also providing new theoretical and clinical strategies to reduce sepsis-related mortality.

Ultrasound-guided nerve block is a safe and effective regional anesthesia technique; however, accurate identification of the brachial plexus remains challenging due to its small size and low contrast in ultrasound images. Recent advances in deep learning offer promising solutions to enhance brachial plexus segmentation and improve perioperative regional anesthesia precision and safety. This review systematically summarizes current deep learning approaches applied to ultrasound-based brachial plexus segmentation. We highlight key models, including Convolutional Neural Networks, the U-shaped Convolutional Neural Networks and their variants, Mask RegionBased Convolutional Neural Networks, and Generative Adversarial Network-based architectures, and compare their reported performances, with Dice Similarity Coefficients ranging from 0.5865 to 0.882 and Intersection over Union values up to 0.6957. Among them, U-Net remains the most frequently employed due to its balance of accuracy and computational efficiency. Moreover, novel models such as multi-objective brachial plexus segmentation network and BPMSegNet have demonstrated superior segmentation performance by incorporating attention mechanisms and spatial contrast features. Notwithstanding these advancements, challenges persist, particularly limited dataset availability and insufficient model generalization. This review provides a comprehensive overview of recent progress, evaluates comparative performance metrics, and outlines future directions to improve model robustness and clinical applicability and clinical applicability in the perioperative setting.

Objective: Skin is a complex tissue whose health is modulated by multiple factors. Exposure to the environment causes damage to skin cells and skin tissue. Identification of factors that can improve skin cell function potentially can prevent or reverse skin aging. Fibroblast growth factors (FGFs) induce growth of skin cells and regulate multiple genes important for skin function. However, FGFs cannot penetrate skin and thus cannot be used as therapeutic factors. Methods: Here we tested three proline-containing tripeptides for their ability to induce skin cell growth, change gene expression within these cells, and protect cells from harmful agents. We also tested the ability of one peptide to penetrate skin, a prerequisite to influence skin cells in vivo. Results: We identified three short proline-containing tripeptides that increase both fibroblast and keratinocyte cell growth, increase the abundance of COL1A1 (collagen type 1) and AQP3 (aquaporin 3) mRNA transcripts and decrease IL6 (interleukin-6) transcripts, all features of improved skin health. These tripeptides, when used as a pretreatment, prevent an increase in the abundance of MMP1 (matrix metalloprotease 1), a biomarker of skin damage when these cells are treated with an aging compound. Finally, we show that one of these tripeptides can penetrate skin. Conclusions: Proline-containing tripeptides have properties that indicate they can be used to reduce or reverse skin damage.

Objective: To compare the efficacy and adverse reactions between 0.15% ropivacaine combined with sufentanil and 0.1% ropivacaine combined with sufentanil for labor analgesia in primiparous women with severe pain. Method: 195 full-term singleton primiparous women with severe pain (visual pain assessment [VAS] ≥6) were randomly allocated to two epidural analgesia groups using different drug formulations. One group received 0.1%  ropivacaine + 0.3 μg/mL sufentanil (control group, n=98). The other group was treated with 0.15% ropivacaine and 0.3 μg/mL sufentanil (experiment group, n=97). The following parameters were recorded: analgesia onset time; maximum VAS scores before analgesia, at 20 min after epidural administration, and during labor; number of analgesic pump presses; number of rescue analgesia events; total analgesic drug consumption; modified Bromage score; maternal satisfaction; duration of labor stages; mode of delivery; neonatal Apgar scores at 1 min and 5 min; and incidence of adverse reactions during labor analgesia, such as skin itching, nausea and vomiting, urinary retention, and fever. Result: The onset time of analgesia in the experimental group was significantly shorter than that in the control group (P<0.05). While the maximum VAS scores in both groups were significantly lower at 20 minutes post-epidural administration and during labor than before delivery analgesia (P<0.05), no statistically significant inter-group differences were observed in VAS scores or in the number of pump compressions, rescue analgesia events, dosage of anesthetic drugs, modified Bromage score, or satisfaction ratings. Similarly, no significant differences were found between the two groups in the duration of labor, mode of delivery, and Apgar scores of newborns at 1 and 5 minutes, or the incidence of pruritus, nausea/vomiting, urinary retention, or intrapartum fever. Conclusion: For primiparous women with severe labor pain, initial use of 0.15% ropivacaine combined with sufentanil significantly shortens the onset time, provides more comprehensive analgesic effects, achieves higher satisfaction, and does not increase short-term adverse reactions (including motor block) compared to the conventional 0.1% concentration regimen.