Advanced Medical Research

Botulinum Toxin Type A Combined with Fire Needling for Postherpetic Neuralgia: A Randomized Controlled Trial

Xu Chen — 2026-11-03

Objective: To compare the efficacy and safety of subcutaneous botulinum toxin type A (BTX-A) injection, fire needling, and their combination in patients with postherpetic neuralgia (PHN), with particular attention to whether the combined regimen sustains its benefit over six months. Methods: In this randomized controlled trial, 99 patients with PHN attending the outpatient and inpatient services of the Department of Rehabilitation Medicine, Gaoming District People’s Hospital of Foshan, between January 2024 and March 2025 were allocated 1:1:1 by a random number table to group A (subcutaneous BTX-A, n = 33), group B (fire needling, n = 33), or group C (BTX-A plus fire needling, n = 33). All patients received oral gabapentin 300 mg/d as background therapy. The primary outcome was pain intensity on the visual analogue scale (VAS) at 3 d, 15 d, 1 month, 3 months and 6 months. Secondary outcomes were the Self-Rating Scale of Sleep (SRSS), the proportion of patients achieving ≥50% reduction in VAS, the Patient Global Impression of Change (PGIC), the distribution of efficacy grades, and adverse events. Results: Ninety patients completed the study (30 per group). Mixed-effects models showed significant group × time interactions for both VAS and SRSS (both p < 0.001). VAS differed among groups at every post-treatment time point (all p < 0.001). From day 15 onward, VAS was lower in group C than in groups A and B (all p < 0.001), whereas groups A and B did not differ at any time point (all p > 0.05). At 6 months, VAS was 1.34 ± 0.64 in group C, 2.99 ± 1.13 in group A and 2.88 ± 0.98 in group B (both p < 0.001). The 6-month responder rate was 100.0% (30/30) in group C, 66.7% (20/30) in group A and 76.7% (23/30) in group B (p < 0.001). SRSS was lowest in group C at every time point, reaching 37.30 ± 4.94 at 6 months (p < 0.001). At 6 months, 30 patients (100.0%) in group C reported a PGIC of “improved” or better, compared with 21 (70.0%) in group A and 24 (80.0%) in group B (p = 0.006). Adverse events were mild in all three groups and no serious adverse event occurred. Conclusion: Subcutaneous BTX-A injection and fire needling each relieve pain and improve sleep in PHN, with comparable efficacy. The combined regimen acts faster and achieves a higher peak response, with no attenuation over six months of observation.

Exploration of Improving the Teaching Quality of off Campus Internship Bases: A Reform Path of “Five in One” Based on Medical Education Collaboration

Lan Ma — 2026-11-03

Clinical internship is a key link for medical education to move from theory to practice, and off campus internship bases are important platforms for cultivating medical students’ clinical abilities, professional qualities, and job competencies. At present, some off campus internship bases still suffer from structural shortages of teaching staff, emphasis on theory over practice in assessment and evaluation, loose control of internship processes, insufficient communication between doctors and patients, and inadequate cultivation of humanistic literacy, which hinders the further improvement of the quality of practical teaching. This article takes the internship base of a medical university affiliated hospital as the practical object, and constructs a “five in one” reform framework around five dimensions: teaching management, faculty team, teaching system, competition mechanism, and humanistic education. Through the construction of a student community that integrates teaching and life, the establishment of a student work department under the leadership of the Party committee, the improvement of teacher admission and incentive guarantee mechanisms, the establishment of a clinical case library and case discussion system, the construction of a teaching system that promotes learning, teaching, and improvement through competition, and the strengthening of medical humanities and psychological counseling, we aim to explore a systematic path for improving the teaching quality of off campus internship bases. Practice has shown that multi-dimensional collaborative promotion can help enhance students’ clinical practice ability, professional competence, and comprehensive competitiveness, but it still needs to be continuously deepened in areas such as real data accumulation, multi base collaboration, and long-term tracking and evaluation.

Research on a Monitoring System for Catheter-Associated Urinary Tract Infection Warning

Tsz Hei Li — 2026-11-02

Catheter associated urinary tract infection (CAUTI) is one of the most common hospital acquired infections in hospitalized patients, and a large number of patients face prolonged hospitalization or even life-threatening every year. The current clinical monitoring methods mainly include urine test paper detection, spectral analysis, inflammatory markers detection and so on. Each monitoring method has its obvious advantages and limitations. This paper systematically reviews the biological logic of urinary tract infection, and proposes a conceptual framework of CAUTI monitoring system that integrates the detection of bacterial biomarkers and host inflammatory biomarkers. This study can provide support for the early warning of clinical urinary tract infection, help medical staff to make reasonable judgment based on the patient’s symptoms, medical history and catheter indwelling time, select the appropriate antibiotics, and improve the efficiency of catheter care.

Research Progress of Internet Hospital Diagnosis and Treatment Service

Sha Meng — 2026-09-24

This study systematically reviews the current development, quality evaluation methods, and influencing factors of internet hospitals, aiming to provide a reference for improving internet diagnosis and treatment services and promoting the high-quality development of internet hospitals. Since 2014, China’s internet hospitals have gone through exploratory, standardization, and rapid development phases. As of September 2025, the national total reached 3756, with an annual diagnosis and treatment volume exceeding 100 million visits. Although technological applications continue to innovate, problems such as insufficient standardization, poor service continuity, medical safety hazards, difficulties in quality supervision, and obvious regional disparities have become increasingly prominent. Regarding quality evaluation, existing methods include subjective evaluations such as patient satisfaction surveys and the SERVQUAL scale, as well as objective evaluations such as guideline-based quality assessment and the standardized patient method (regarded as the “gold standard” for objective evaluation). Research indicates that diagnosis and treatment quality is comprehensively influenced by multi-level factors, including physicians’ professional competence, patients’ basic characteristics, platform technology, hospital management, and the policy environment. Moving forward, it is necessary to establish a scientific quality evaluation and supervision system, improve diagnosis and treatment norms and intelligent support, strengthen talent cultivation and platform optimization, innovate chronic disease management models and promote the downward allocation of resources, and refine standards and payment policies, thereby driving the sustained and healthy development of internet hospitals in the direction of intelligence, integration and standardization.

Electroacupuncture at the Auricular Concha Regulates the Hippocampal SIRT1/CREB/BDNF Axis and Promotes Neurogenesis in Rats with Post-Stroke Depression

Taohong Chen — 2026-09-16

Background and Objectives: Post-stroke depression (PSD) arises frequently after cerebral ischemia and worsens functional outcome, yet its pharmacological management remains suboptimal. Auricular-concha electroacupuncture (EA) activates afferents of the auricular branch of the vagus nerve and shows antidepressant promise; however, its effect on hippocampal neurogenesis and the underlying signaling cascade is incompletely characterized. This study examined whether EA at the auricular concha relieves depressive-like behavior and neurological deficits in PSD rats by stimulating hippocampal neurogenesis through the SIRT1/CREB/BDNF pathway. Methods: Male Sprague–Dawley rats were allocated into Control, Sham, PSD, and PSD + EA groups (n = 10). PSD was induced by permanent middle cerebral artery occlusion combined with chronic unpredictable mild stress and single housing. EA (square wave, 0.5 mA, 10/25 Hz, 30 s on/2 min off, 1 h/day, 28 days) was applied to the left auricular concha. Body weight, neurological severity (mNSS), sucrose preference, open-field, and forced-swim tests were evaluated at 24 h, 14 d, and 28 d. Neuronal morphology (HE), cell proliferation (Ki67), and the progenitor marker Nestin were assessed, and SIRT1, CREB, and BDNF expression was quantified by RT-PCR and Western blot. Results: PSD rats displayed higher mNSS, reduced body weight, lower sucrose preference and locomotion, and prolonged immobility (all p < 0.05 vs. Control). EA reversed each abnormality at 14 d and 28 d (p < 0.05 vs. PSD). Histology revealed neuronal loss and disarray in CA1, CA3, and the dentate gyrus, together with fewer Ki67-positive cells and diminished Nestin immunoreactivity; EA attenuated these changes. At the molecular level, PSD reduced SIRT1, p-CREB, and BDNF expression, which EA partially restored (p < 0.05 vs. PSD). Conclusion: Auricular-concha EA mitigates depressive-like and neurological deficits in PSD rats, an effect linked to enhanced hippocampal neurogenesis and re-activation of the SIRT1/CREB/BDNF cascade, supporting further translational evaluation.

Electroacupuncture of the Auricular Vagus Nerve Alleviates Glial Scar Formation in Astrocytes and Promotes Neuroprotection after Cerebral Ischemia–Reperfusion in Rats via the NF-κB Signaling Pathway

Jiaen Yang — 2026-09-16

Background: Ischemic stroke is a leading cause of death and long-term disability worldwide. Auricular vagus nerve stimulation (aVNS), delivered as electroacupuncture to the auricular concha, improves neurological outcome after cerebral ischemia–reperfusion (I/R), but the underlying molecular mechanism, particularly its effect on astrocytic reactive gliosis and glial scar formation, remains incompletely defined. Objectives: This study tested the hypothesis that aVNS alleviates astrocytic glial scar formation and promotes neuroprotection after I/R, and that the NF-κB signaling pathway is a key mediator of this effect. Methods: Male Sprague–Dawley rats were subjected to middle cerebral artery occlusion/reperfusion (MCAO/R) and randomly assigned to Sham, Model, PBS (vehicle), and aVNS groups. A separate cohort of IKKβ-knockout (IKKβ-KO) rats was used to dissect the role of NF-κB signaling. Neurological function was assessed by the modified neurological severity score (mNSS) and the adhesive-removal somatosensory test (ARST) at 7 and 14 days. Glial scar markers (GFAP, neurocan, phosphacan) and NF-κB pathway components (p-p65, p-IκBα) were quantified by qRT-PCR, Western blot, and immunofluorescence. Results: aVNS significantly improved mNSS and ARST and reduced cortical GFAP, neurocan, and phosphacan mRNA and protein expression compared with the Model group (all p < 0.05). aVNS also reduced phosphorylation of p65 and IκBα, indicating inhibition of NF-κB signaling. In IKKβ-KO rats, the aVNS-mediated suppression of glial scar markers and neuroprotection was largely abolished, confirming the involvement of NF-κB signaling. Conclusions: aVNS alleviates post-ischemic astrocytic glial scar formation and promotes neuroprotection through inhibition of the NF-κB signaling pathway. These findings identify NF-κB as a molecular target underlying the therapeutic effect of aVNS and support its clinical translation in post-stroke rehabilitation.

Tumor Metabolic Reprogramming: Mechanisms, Regulatory Networks, And Therapeutic Opportunities

Ang Gao — 2026-08-06

Metabolic reprogramming is one of the basic hallmarks of malignant tumors—that is, a whole set of adaptive responses by which tumor cells organize their metabolism in a way that suits fluctuating microenvironments, permits unchecked growth, and helps them withstand treatment pressures. Contrary to normal cells, which in general depend upon mitochondrial oxidative phosphorylation for energy generation under aerobic circumstances, tumor cells usually get their energy via glycolysis even if they are exposed to large amounts of oxygen (a situation called the Warburg effect).But now it is clear that tumor metabolic reprogramming is not just an exaggerated form of glycolysis, nor merely a localized change—rather, it entails an organized readjustment of several pathways (of glucose, of lipids, of amino acids, or of nucleotides). From the molecular standpoint, the basic regulatory factors HIF-1, MYC, p53, and mTORC1 are part of a complex signaling system which brings together nutrient sensing and signals for cancer as well as for transcriptional control. At the microenvironment level, interactions of all three kinds—tumor cells, immune cells, and fibroblasts linked to cancer—help to shape (often unfavorably) the local immunological situation. From the standpoint of clinical translational research, a number of approaches—lactate transporter inhibitors, fatty acid synthase inhibitors, and glutaminase inhibitors—related to metabolic vulnerability are now being tested clinically. The present work analyzes in detail the molecular bases, control circuits, interactions with the microenvironment, and treatment options for tumor metabolic reprogramming, as well as the main difficulties and likely developments connected with this area of study.

Virtual Reality in Non-Cancer Palliative Care: A Review of Current Applications and Future Directions

Shengli Huang — 2026-07-16

Palliative care has traditionally focused on cancer patients, yet non-cancer serious illnesses such as heart failure, chronic obstructive pulmonary disease (COPD), and dementia account for a substantial proportion of end-of-life care needs. Virtual reality (VR) technology is emerging as a promising non-pharmacological intervention that may address the complex physical, psychological, and spiritual dimensions of suffering in this population. This review synthesizes current evidence on VR applications in non-cancer palliative care. Key findings indicate that VR can effectively reduce pain, alleviate anxiety and depression, and improve quality of life across multiple non-cancer conditions. Specific applications include nature-based immersive experiences for symptom management in COPD, personalized VR distraction for pain relief in advanced heart failure, and synchronized dyadic interventions that simultaneously support both patients and caregivers. Meta-analytic evidence shows moderate-to-large effect sizes for pain reduction, though the evidence base remains limited by small sample sizes, heterogeneous protocols, and a lack of randomized controlled trials specifically targeting non-cancer populations. Distraction is frequently cited as the primary mechanism, but emerging evidence suggests that VR may facilitate deeper processes including restoration of autonomy, symbolic connection, and spiritual meaning-making. Safety and tolerability are generally favorable. Future research priorities include adequately powered randomized controlled trials targeting specific non-cancer conditions, elucidation of therapeutic mechanisms, and development of standardized implementation protocols.

A Cross-Sectional Study of Psychological and Academic Status among Medical Students

Yaxin Deng — 2026-07-07

This study investigated the current status of medical students’ psychological status (depression, anxiety) and academic adjustment (academic burnout, academic procrastination), analyzed their detection rates, demographic group differences and internal correlations, so as to provide empirical evidence for targeted mental health education and academic support in medical colleges. Using PHQ-9, GAD-7, SBI and BEPS scales, a cross-sectional questionnaire survey was conducted among 729 full-time undergraduates from freshmen to seniors in a clinical medical college. Descriptive statistics, Shapiro-Wilk normality test, one-way ANOVA, Pearson correlation analysis and multiple linear regression were adopted for data analysis. The results showed distinct detection rates of negative emotions and academic maladjustment: the detection rates of moderate and above depression, anxiety, academic burnout and academic procrastination were 11.66%, 8.78%, 41.84% and 50.62% respectively. Significant inter-group differences existed across symptom severity levels. Depression, anxiety, academic burnout and procrastination were significantly positively correlated pairwise (r = 0.470~0.854, p < 0.001). Depression and academic burnout positively predicted anxiety, while anxiety, burnout and procrastination jointly predicted depression. Only 26.9% of students reported clear distress and support demands, and merely 35% of high-risk students were willing to seek help actively, revealing a prominent mismatch between actual needs and help-seeking behaviors. Conclusion: Medical students suffer more severe academic maladjustment than emotional symptoms. Psychological distress and academic problems reinforce each other into a vicious cycle, and most students avoid seeking psychological help. Medical colleges should establish closed-loop mental health warning systems and hierarchical academic support services, deliver precise interventions for different student groups, and popularize mental health knowledge to reduce stigma.