Comparative Analysis of Lennox-Gastaut Syndrome With Different Subtypes of Tonic Seizures: A Single-Center Retrospective Cohort Study.

BACKGROUND: Lennox-Gastaut syndrome (LGS) is one of the most severe childhood-onset epileptic encephalopathies, primarily characterized by tonic seizures. In clinical practice, we have identified various subtypes of tonic seizures in LGS. This study aimed to analyze the clinical characteristics, electrographic features, treatment responses, and prognosis across different subtypes of LGS. METHODS: This retrospective cohort study included 46 patients diagnosed with LGS at our center between January 2017 and January 2020. Patients were classified into four groups based on tonic seizure subtypes: Group A (tonic), Group B (spasm-tonic), Group C (myoclonic-tonic), and Group D (combination of spasm-tonic and myoclonic-tonic). Comprehensive clinical data were collected and analyzed. RESULTS: Of the 46 patients, 33 were male. The mean age of onset for Group B (12.38 ± 7.85 months) was significantly less than those of the other three groups (P = 0.02). No significant differences in etiology were found among the groups. Genetic analysis identified mutations in SCN8A, MCCC2, STXBP1, GABRB3, and CACNA1H. After a minimum follow-up of 24 months, the treatment outcomes were more favorable in Groups A and C, whereas psychomotor development was notably poorer in Groups B and D. CONCLUSIONS: The findings of this study suggest that LGS may present with distinct subtypes of tonic seizures, with spasm-tonic seizures presenting at an earlier age. Patients with LGS experiencing spasm-tonic seizures, with or without myoclonic-tonic seizures, exhibited poorer treatment responses and psychomotor development than those with other subtypes.

Dynamically Favorable Ion Channels Enabled by a Hybrid Ionic-Electronic Conducting Film toward Highly Reversible Zinc Metal Anodes.

Aqueous zinc ion batteries show great promise for future applications due to their high safety and ecofriendliness. However, nonuniform dendrite growth and parasitic reactions on the Zn anode have severely impeded their use. Herein, a hybrid ionic-electronic conducting ink composed of graphene-like carbon nitride (g-C3N4) and conductive polymers (CP) of poly(3,4ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) is introduced to Zn anode using a scalable spray-coating strategy. Notably, the g-C3N4 promotes a screening effect, disrupting the coulombic interaction between the PEDOT+ segments and PSS- chains within CP, thereby reducing interfacial resistance and homogenizing the surface electric field distribution of the Zn anode. Furthermore, the abundant N-containing species and ─SO3 - groups in g-C3N4/CP exhibit strong zincophilicity, which accelerates the diffusion of Zn2+ and disrupts the solvation structure of Zn(H2O)6 2+, thus improving the Zn2+ transfer capability. Consequently, the g-C3N4/CP can powerfully stabilize the Zn2+ flux and thus enable a high coulombic efficiency of 99.47% for 1500 cycles and smooth Zn plating/stripping behaviors more than 3000 h at a typical current density of 1 mA cm-2. These findings shed new light on the Zn electrodeposition process under the mediation of g-C3N4/CP and offer sustainability considerations in designing more stable Zn-metal anodes with enhanced reversibility.

Impact of injury mortality changes on life expectancy in Tianjin, 2003 and 2021.

OBJECTIVE: To analyze the impact of injury mortality changes on life expectancy (LE) in Tianjin in 2021 compared with 2003 by age, gender, urban-rural, and cause-specific differences. METHODS: The abridged life table and Arriaga's decomposition method were applied to analyze the cause of death surveillance data of Tianjin residents in 2003 and 2021, calculating the age-specific and subcategory-specific contribution of injury to the increase of LE. RESULTS: From 2003 to 2021, the injury mortality rate dropped from 30.33 to 21.57 per 100,000 in Tianjin. Over this period, LE varied from 77.70 to 82.03 years, with an increase of 4.33 years. The reduction in injury mortality contributed 0.3111 years (7.18 %) to the growth of LE. The positive impact on LE was notably observed in the age group of 1-49 years, contributing 0.4348 years (10.04 %) cumulatively. The major injuries that contributed significantly to the increase of LE were transport accidents excluding motor vehicles (0.2558 years, 5.91 %), accidental poisoning (0.0845 years, 1.95 %), motor vehicle traffic accidents (0.0474 years, 1.09 %), and drowning (0.0359 years, 0.83 %). However, the rise in intentional self-harm mortality rate from ages 10-24 and increased mortality rates due to other accidents and adverse effects, motor vehicle traffic accidents, and falls from ages 50+ had negative impacts on LE. CONCLUSION: During 2003-2021, the decline in injury mortality rates among children and young to middle-aged individuals in Tianjin played a crucial role in the increase of LE. It is essential to enhance primary prevention efforts, particularly focusing on key populations, to reduce the negative impact on LE growth from intentional self-harm, other accidents and adverse effects, motor vehicle traffic accidents, and falls.

Comparing Participation and Interim Effectiveness of Endoscopy and Biomarker-Based Screening for Gastric Cancer: A Cluster Randomized Controlled Trial.

Background: To improve compliance with endoscopic screening for gastric cancer (GC), we assessed five biomarkers-pepsinogen I (PG I), pepsinogen II (PG II), PG I/II ratio, helicobacter pylori antibody (HP-Ab), and gastrin 17 (G17) - for secondary GC screening by comparing participation and effectiveness of traditional endoscopy and biomarker-based screening in a randomized trial with baseline results. Methods: Seventy-four communities were randomly assigned to traditional endoscopy arm (TEA) or biomarker-based endoscopy arm (BEA). TEA uses a questionnaire for risk assessment, and BEA combines a questionnaire with biomarker detection. High-risk individuals in both arms underwent endoscopic screening. Participation and interim screening effectiveness in two arms were reported with baseline analysis. Results: In total, 5,798 participants in TEA and 5,158 in BEA were recruited, with a participation rate of 26.9%. BEA showed a significantly lower high-risk rate than TEA (15.2% vs. 38.9%) and a higher endoscopic participation rate for high-risk individuals (64.9% vs. 53.0%). The endoscopic screening results showed that there was no significant difference in detection rate of GC abnormalities between the two arms. Education level, frequent drinking, hot, rough and hard food consumption, family history of GC, and history of reflux esophagitis or gastropathy influenced participation rates in biomarker-based screening. Age group, sex and regular consumption of meat, eggs and milk products were associated with stomach abnormalities.Cumulative incidence and specific death rates did not significantly differ in intention-to-screen and per-protocol analyses. Conclusions: Biomarker-based screening effectively identifies high-risk individuals and increases endoscopic participation, providing value insights for improving screening efficiency as a secondary procedure.

Multi-platform analysis revealed the substance basis and mechanism of Wei-Tong-Xin in ameliorating ENS dysfunction for dyspepsia treatment.

ETHNOPHARMACOLOGICAL RELEVANCE: Duodenal motility disorder is a contributing factor to dyspepsia. The traditional Chinese medicine (TCM) formula Wei-Tong-Xin (WTX), originated from the famous ancient Chinese formula "Wan Ying Yuan", has been demonstrated efficacy in alleviating dyspepsia. AIM OF THE STUDY: The current study aims to elucidate the chemical composition of WTX to establish the pharmacodynamic material basis. On the basis of component, in depth to illuminate the mechanism by which WTX treats dyspepsia via constructing the comprehensive analysis of multi-platform. MATERIALS AND METHODS: The chemical constituents of WTX were systematically analyzed by UHPLC-Q-TOF-MS/MS data processing methods. Based on this, network pharmacology was employed to predict the mechanism by which WTX improved dyspepsia. The dyspepsia mouse model was constructed, and histopathology as well as intestinal permeability were assessed using H&E staining, PAS staining and FITC-dextran assay. Protein expression was detected using Western blot, immunofluorescence, immunohistochemistry and ELISA kits. RESULTS: A total of 100 chemical components of WTX were preliminarily identified. Network pharmacological analysis indicated that the therapeutic mechanism of WTX in treating dyspepsia may be related to the regulation of inflammation and oxidative stress-related signaling pathways. In vivo studies showed that WTX mitigated duodenal inflammation and oxidative stress responses, repairing the intestinal mucosal barrier damaged by cisplatin (CIS). Additionally, WTX restored the number of glial cells diminished by inflammatory damage, and ameliorated the serotoninergic neuronal dysfunction caused by insufficient secretion of glia-derived neurotrophic factor (GDNF), and enhanced intestinal transit. CONCLUSIONS: In this study, a total of 100 components of the WTX extract were identified through literature review and mass spectrometry database search. Utilizing computer technology, in conjunction with pharmacodynamic and mechanistic studies, WTX has been found to restore serotoninergic neuronal function by reducing intestinal mucosal inflammatory and oxidative damage, ultimately promoting intestinal transport and treating dyspepsia.

Epigenetic modification of hepatitis B virus infection and related hepatocellular carcinoma.

Hepatitis B virus (HBV) infection poses a challenge to global public health. Persistent liver infection with HBV is associated with an increased risk of developing severe liver disease. The complex interaction between the virus and the host is the reason for the persistent presence of HBV and the risk of tumour development. Chronic liver inflammation, integration of viral genome with host genome, expression of HBx protein, and viral genotype are all key participants in the pathogenesis of hepatocellular carcinoma (HCC). Epigenetic regulation in HBV-associated HCC involves complex interactions of molecular mechanisms that control gene expression and function without altering the underlying DNA sequence. These epigenetic modifications can significantly affect the onset and progression of HCC. This review summarizes recent research on the epigenetic regulation of HBV persistent infection and HBV-HCC development, including DNA methylation, histone modification, RNA modification, non-coding RNA, etc. Enhanced knowledge of these mechanisms will offer fresh perspectives and potential targets for intervention tactics in HBV-HCC.

Mirror-Image RNA: A Right-Handed Z-Form RNA and Its Ligand Complex.

Until now, Z-form RNAs were believed to only adopt a left-handed double-helix structure. In this study, we describe the first observation of a right-handed Z-form RNA in NMR solution formed by L-nucleic acid RNA and present the first resolution of structure of the complex between a right-handed Z-form RNA and a curaxin ligand. These results provide a platform for the design of topology specific to Z-form-targeting compounds and are valuable for the development of new potent anticancer drugs.

The SIRT5-Mediated Upregulation of C/EBPß Promotes White Adipose Tissue Browning by Enhancing UCP1 Signaling.

Sirtuin 5 (SIRT5) plays an important role in the maintenance of lipid metabolism and in white adipose tissue browning. In this study, we established a mouse model for diet-induced obesity and the browning of white fat; combined with gene expression intervention, transcriptome sequencing, and cell molecular biology methods, the regulation and molecular mechanisms of SIRT5 on fat deposition and beige fat formation were studied. The results showed that the loss of SIRT5 in obese mice exacerbated white adipose tissue deposition and metabolic inflexibility. Furthermore, the deletion of SIRT5 in a white-fat-browning mouse increased the succinylation of uncoupling protein 1 (UCP1), resulting in a loss of the beiging capacity of the subcutaneous white adipose tissue and impaired cold tolerance. Mechanistically, the inhibition of SIRT5 results in impaired CCAAT/enhancer binding protein beta (C/EBPß) expression in brown adipocytes, which in turn reduces the UCP1 transcriptional pathway. Thus, the transcription of UCP1 mediated by the SIRT5-C/EBPß axis is critical in regulating energy balance and obesity-related metabolism.

Dual osmotic controlled release platform for antibiotics to overcome antimicrobial-resistant infections and promote wound healing.

Methicillin-Resistant Staphylococcus aureus forming into biofilms can trigger chronic inflammation and disrupt skin wound healing processes. Prolonged and excessive use of antibiotics can expedite the development of resistance, primarily because of their limited ability to penetrate microbial membranes and biofilms, especially antibiotics with intracellular drug targets. Herein, we devise a strategy in which virus-inspired nanoparticles control the release of antibiotics through rapid penetration into both bacterial cells and biofilms, thereby combating antimicrobial-resistant infections and promoting skin wound healing. Lipid-based nanoparticles based on stearamine and cholesterol were designed to mimic viral highly ordered nanostructures. To mimic the arginine-rich fragments in viral protein transduction domains, the primary amines on the surface of the lipid-based nanoparticles were exchanged by guanidine segments. Levofloxacin, an antibiotic that inhibits DNA replication, was chosen as the model drug to be incorporated into nanoparticles. Hyaluronic acid was coated on the surface of nanoparticles acting as a capping agent to achieve bacterial-specific degradation and guanidine explosion in the bacterial microenvironment. Our virus-inspired nanoparticles displayed long-acting antibacterial effects and powerful biofilm elimination to overcome antimicrobial-resistant infections and promote skin wound healing. This work demonstrates the ability of virus-inspired nanoparticles to achieve a dual penetration of microbial cell membranes and biofilm structures to address antimicrobial-resistant infections and trigger skin wound healing.

IFN-γ induces acute graft-versus-host disease by promoting HMGB1-mediated nuclear-to-cytoplasm translocation and autophagic degradation of p53.

Acute graft-versus-host disease (aGVHD) poses a significant impediment to achieving a more favourable therapeutic outcome in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our prior investigations disclosed a correlation between p53 down-regulation in CD4+ T cells and the occurrence of aGVHD. Notably, the insufficiency of the CCCTC-binding factor (CTCF) emerged as a pivotal factor in repressing p53 expression. However, the existence of additional mechanisms contributing to the reduction in p53 expression remains unclear. Interferon (IFN)-γ, a pivotal proinflammatory cytokine, assumes a crucial role in regulating alloreactive T-cell responses and plays a complex part in aGVHD development. IFN-γ has the capacity to induce autophagy, a vital catabolic process facilitating protein degradation, in various cell types. Presently, whether IFN-γ participates in the development of aGVHD by instigating the autophagic degradation of p53 in CD4+ T cells remains an unresolved question. In the present study, we demonstrated that heightened levels of IFN-γ in the plasma during aGVHD promoted the activation, proliferation, and autophagic activity of CD4+ T cells. Furthermore, IFN-γ induced the nuclear-to-cytoplasm translocation and autophagy-dependent degradation of p53 in CD4+ T cells. The translocation and autophagic degradation of p53 were contingent upon HMGB1, which underwent up-regulation and translocation from the nucleus to the cytoplasm following IFN-γ stimulation. In conclusion, our data unveil a novel mechanism underlying p53 deficiency in CD4+ T cells among aGVHD patients. This deficiency is induced by IFN-γ and relies on autophagy, establishing a link between IFN-γ, HMGB1-mediated translocation, and the autophagic degradation of p53.

Regulating Functional Groups to Construct a Mild Passivator Enhancing the Efficiency and Stability of Carbon-Based Perovskite Solar Cells.

The abundant defects on the perovskite surface greatly impact the efficiency improvement and long-term stability of carbon-based perovskite solar cells. Molecules with electron-donating or electron-withdrawing functional groups have been cited for passivating various defects. However, few studies have investigated the potential adverse effects arising from the synergistic interactions among functional groups. Herein, we investigate the correlation between functional group configurations and passivation strength as well as the potential adverse impacts of strong electrostatic structures by methodically designing three distinct interface molecules functionalized with different ending groups, which both belong to biguanide derivatives, including 1-(3,4-dichlorophenyl) biguanide hydrochloride (DBGCl), metformin hydrochloride (MFCl), and biguanide hydrochloride (BGCl). The results indicate that DBGCl establishes comparatively mild active sites, not only passivates defects but also aids in forming a surface with a uniform potential. Conversely, MFCl exerts a more pronounced adverse effect on the perovskite surface, which is attributable to the electronic state perturbations induced by its functional groups. Due to the lack of hydrophobic groups, devices treated with BGCl demonstrate insufficient moisture resistance. Devices passivated with DBGCl demonstrate superior average efficiency, showcasing a 12% enhancement relative to the pristine. Furthermore, DBGCl-treated devices exhibit enhanced stability in three different environments, respectively, achieving the highest PCE retention rates under nitrogen conditions (25 °C), room-temperature air conditions (25 °C, RH = 40 ± 2%), and high-temperature air conditions (65 °C, RH = 40 ± 2%).

Lactonization of Diols Over Highly Efficient Metal-Based Catalysts.

Lactones has gained increasing attention in recent years due to wide application in polymer and pharmaceutical industries. Traditional synthetic methods of lactones often involve harsh operating temperature, use of strong alkalis and toxic oxidants. Therefore, lactonization of diols under milder conditions have been viewed as the most promising route for future commercialization. A variety of metal catalysts (Ru, Pt, Ir, Au, Fe, Cu, Co, and Zn) have been developed for highly efficient oxidant-, acceptor-, base- and additive-free lactonization processes. However, only a few initial attempts have been reported with no further details on catalytic mechanism being disclosed in literature. There demands a systematic study of the mechanistic details and the structure-function relationship to guide the catalyst design. In this work, we critically reviewed and discussed the structure-function relationship, the catalytic reaction mechanism, the catalyst stability, as well as the effect of oxidant and solvent for lactonization of diols. This work may provide additional insights for the development of other oxygen-containing functional molecules for material science and technologies.

Inducing weak and negative Jahn-Teller distortions to alleviate structural deformations for stable sodium storage.

In the quest for efficient supercapacitor materials, manganese-based layered oxide cathodes stand out for their cost-effectiveness and high theoretical capacity. However, their progress is hindered by the Jahn-Teller (J-T) distortion due to the unavoidable Mn4+ to Mn3+ reduction during ion storage processes. Our study addresses this challenge by stabilizing the K0.5MnO2 cathode through strategic Mg2+ substitution. This substitution leads to an altered Mn3+ electronic configuration, effectively mitigating the strong J-T distortion during ion storage processes. We provide a comprehensive analysis combining experimental evidence and theoretical insights, highlighting the emergence of the weak and negative J-T effects with reduced structural deformation during electrochemical cycling. Our findings reveal that the K0.5Mn0.85Mg0.15O2 cathode exhibits remarkable durability, retaining 96.0% of initial capacitance after 8000 cycles. This improvement is attributed to the specific electronic configurations of Mn3+ ions, which play a crucial role in minimizing volumetric changes and counteracting structural deformation typically induced by the strong J-T distortion. Our study not only advances the understanding of managing J-T distortion in manganese-based cathodes but also opens new avenues for designing high-stability supercapacitors and other energy storage devices by tailoring electrode materials based on their electronic configurations.

Mn─O Covalency as a Lever for Na⁺ Intercalation Kinetics: The Role of Oxygen Edge-Sharing Co Octahedral Sites in MnO2.

The strategic enhancement of manganese-oxygen (Mn─O) covalency is a promising approach to improve the intercalation kinetics of sodium ions (Na⁺) in manganese dioxide (MnO2). In this study, an augmenting Mn─O covalency in MnO2 by strategically incorporating cobalt at oxygen edge-sharing Co octahedral sites is focused on. Both experimental results and density functional theory (DFT) calculations reveal an increased electron polarization from oxygen to manganese, surpassing that directed toward cobalt, thereby facilitating enhanced electron transfer and strengthening covalency. The synthesized Co-MnO2 material exhibits outstanding electrochemical performance, demonstrating a superior specific capacitance of 388 F g-1 at 1 A g-1 and maintaining 97.21% capacity retention after 12000 cycles. Additionally, an asymmetric supercapacitor constructed using Co-MnO2 achieved a high energy density of 35 Wh kg-1 at a power density of 1000 W kg-1, underscoring the efficacy of this material in practical applications. This work highlights the critical role of transition metal-oxygen interactions in optimizing electrode materials and introduces a robust approach to enhance the functional properties of manganese oxides, thereby advancing high-performance energy storage technologies.

High-throughput and multimodal profiling of antigen-specific T cells with a droplet-based cell-cell interaction screening platform.

Identifying antigen-specific T cells from tumor-infiltrating lymphocytes is essential for designing effective T cell immunotherapies. Traditional methods can detect antigen-specific T cells but struggle with high-throughput screening and multimodal profiling simultaneously. To address this issue, we developed DropCCI, a new strategy that transfers antigen information to co-incubated T cells for high-throughput, non-contaminated multimodal profiling. In DropCCI, droplets encapsulated DNA barcodes and antigen-loaded antigen-presenting cells (APCs), while click chemistry-modified T cells were injected into these droplets to capture free barcodes and acquire the corresponding antigen information. Following cell-cell interaction, APCs were removed via streptavidin-biotin conjugation, to prevent contamination. The resulting T cells underwent single-cell omics sequencing for comprehensive profiling of their antigen specificity, transcriptome, and genomics accurately. This click-chemistry method allowed detection of antigen-specific T cells without lysing APCs, avoiding cross-cell contamination and enabling low-noise multimodal profiling of primary T cells. With a completion time within 12 h and no requirement for complex equipment, DropCCI provides unbiased single-cell sequencing results that offer a comprehensive understanding of anti-tumor T cell responses. The concept of DropCCI holds great promise not only for advancing the field of T cell immunotherapy but also for its potential application in studying other cell-cell interactions.

Quantum Spin Exchange Interactions Trigger O†p Band Broadening for Enhanced Aqueous Zinc-Ion Battery Performance.

The pressing demand for large-scale energy storage solutions has propelled the development of advanced battery technologies, among which zinc-ion batteries (ZIBs) are prominent due to their resource abundance, high capacity, and safety in aqueous environments. However, the use of manganese oxide cathodes in ZIBs is challenged by their poor electrical conductivity and structural stability, stemming from the intrinsic properties of MnO2 and the destabilizing effects of ion intercalation. To overcome these limitations, our research delves into atomic-level engineering, emphasizing quantum spin exchange interactions (QSEI). These essential for modifying electronic characteristics, can significantly influence material efficiency and functionality. We demonstrate through density functional theory (DFT) calculations that enhanced QSEI in manganese oxides broadens the O p band, narrows the band gap, and optimizes both proton adsorption and electron transport. Empirical evidence is provided through the synthesis of Ru-MnO2 nanosheets, which display a marked increase in energy storage capacity, achieving 314.4 mAh g-1 at 0.2 A g-1 and maintaining high capacity after 2000 cycles. Our findings underscore the potential of QSEI to enhance the performance of TMO cathodes in ZIBs, pointing to new avenues for advancing battery technology.

Nursing students' perspectives on peer assessment in basic nursing procedures: A qualitative study.

BACKGROUND: Traditionally, the assessment of student nursing skills relies heavily on lecturer evaluations. However, lecturers, as the primary evaluators, may be influenced by their individual subjective preferences, experience, and knowledge background. This limitation needs thorough consideration to improve students' assessment skills and ensure that assessment tasks are more objective and accurate. Peer assessment appears to take it into account. Currently, improving the quality of peer assessment in Basic Nursing skills remains a challenge for educators. AIM: To assess the effectiveness of peer assessment as applied to the basic nursing skills examination process and suggestions for improvement, to understand nursing students' perceptions of it, and to explore the feasibility of peer assessment as an alternative to single faculty assessment as perceived by nursing students. DESIGN: Qualitative research. SETTINGS: Conducted in a clinical skills simulation laboratory at a university in Wuxi, Jiangsu Province, China. PARTICIPANTS: 23 Second-year nursing students applying peer assessment to Basic Nursing course exams. METHODS: Used face-to-face, semi-structured interviews, and thematic analysis to analyze data. RESULTS: Three major themes and nine subthemes were identified: (1) Positive sentiments towards peer evaluation (e.g., enhancing the learning capacity, increasing emotional intelligence, and improving the objectivity and fairness of nursing skills assessment); (2) Challenges encountered in the peer evaluation process (e.g., inconsistent scoring criteria, exacerbate anxiety, and triggering team conflict); (3) Suggestions for improving peer evaluation (e.g., applying the design of peer assessment exam content, incorporation of lecturer evaluation, and refinement and materialization of marking criteria). CONCLUSIONS: In this study, while the positive impact is evident, the challenges faced by nursing students and future recommendations for peer assessment application are critical. This study provides valuable insights into the potential of peer assessment to enhance nursing education and provides recommendations for optimizing peer assessment strategies for meaningful integration into Nursing Education practice.

Comparison of the efficacy of pulsed radiofrequency in treating acute herpetic neuralgia and postherpetic neuralgia in the thoracic segment.

Objectives: This study aimed to compare the efficacy of pulsed radiofrequency (PRF) to dorsal root ganglia (DRG) in treating acute herpetic neuralgia (AHN) and postherpetic neuralgia (PHN) in the thoracic segment. Methods: A total of 243 patients with thoracic herpes zoster-related pain (AHN or PHN) from January 2020 to September 2022 were retrospectively analyzed. They were divided into two groups based on the timing of PRF after herpes zoster onset: an acute herpetic neuralgia group (within 90 days) and a postherpetic neuralgia group (more than 90 days). All patients were treated with PRF at the thoracic DRG. The Visual Analog Scale (VAS), the Athens Insomnia Scale (AIS), the Generalized Anxiety Disorder-7 items (GAD-7), and the Patient Health Questionnaire-9 items (PHQ-9) scores were assessed before and at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery, and the results were then compared between the two groups. Results: Postoperative scores of VAS, AIS, GAD-7, and PHQ-9 in both groups were significantly lower than preoperative scores (P < 0.001). From 1 month to 12 months after surgery, the AHN group showed significantly lower VAS, AIS, GAD-7, and PHQ-9 scores compared to the PHN group (P < 0.001). In the AHN group, there was a gradual improvement in these scores from 1 week to 12 months post-surgery. Conversely, the PHN group's scores began to worsen slowly from 1 week to 12 months post-surgery. Over time, the difference in scores between the two groups also increased gradually. Conclusion: PRF to the DRG is an effective treatment for patients with AHN or PHN who do not respond well to conventional treatments. For AHN patients, PRF to the DRG significantly enhances early pain control, improves sleep and psychological status, and may even prevent the development of PHN.

Widespread Autonomic Physiological Coupling Across the Brain-Body Axis.

The brain is closely attuned to visceral signals from the body's internal environment, as evidenced by the numerous associations between neural, hemodynamic, and peripheral physiological signals. We show that these brain-body co-fluctuations can be captured by a single spatiotemporal pattern. Across several independent samples, as well as single-echo and multi-echo fMRI data acquisition sequences, we identify widespread co-fluctuations in the low-frequency range (0.01 - 0.1 Hz) between resting-state global fMRI signals, neural activity, and a host of autonomic signals spanning cardiovascular, pulmonary, exocrine and smooth muscle systems. The same brain-body co-fluctuations observed at rest are elicited by arousal induced by cued deep breathing and intermittent sensory stimuli, as well as spontaneous phasic EEG events during sleep. Further, we show that the spatial structure of global fMRI signals is maintained under experimental suppression of end-tidal carbon dioxide (PETCO2) variations, suggesting that respiratory-driven fluctuations in arterial CO2 accompanying arousal cannot explain the origin of these signals in the brain. These findings establish the global fMRI signal as a significant component of the arousal response governed by the autonomic nervous system.