The glymphatic system, a key fluid clearance pathway in the central nervous system, is emerging as a potential therapeutic target for synucleinopathies. Dysregulation of this system may contribute to spinocerebellar ataxia type 3 (SCA3) pathogenesis, in which the accumulation of misfolded proteins acts as a central driver. The goal was to investigate glymphatic system function in SCA3 patients and evaluate its relationship with brain damage and clinical disability. Ninety-two SCA3 patients (14 with premanifest SCA3 and 78 with manifest SCA3) and 98 healthy controls underwent clinical evaluation and magnetic resonance imaging (MRI) scans. MRI parameters, including the diffusion along the perivascular space (DTI-ALPS) index (a proxy for glymphatic function); cerebral, cerebellar, and subcortical gray matter volumes; and whole-brain microstructural properties of white matter, were calculated. Patients with premanifest and manifest SCA3 had lower ALPS indices compared with healthy controls, and patients with manifest SCA3 had a lower ALPS index compared with premanifest SCA3. In SCA3 patients, lower ALPS index was associated with more severe disability and longer disease duration. A negative correlation between ALPS and disease duration emerged after 3 years, with no significant association observed before the 3-year cutoff. Moreover, lower ALPS index was correlated with more pronounced cortical and subcortical gray matter atrophy, decreased fractional anisotropy, and elevated mean diffusivity in white matter. Our findings demonstrate that glymphatic function is impaired, particularly in the presymptomatic stage of SCA3, and this impairment is associated with disability, neurodegeneration, and demyelination. Therefore, glymphatic dysfunction may contribute to the pathogenesis of SCA3. © 2026 International Parkinson and Movement Disorder Society.
Exposure of urban population to high concentrations of particulate matter is one of the most urgent worries, particularly in areas characterized by the presence of congested traffic and street canyons which confine polluted air. Therefore, robust tools are essential to simulate the effect of obstacles and reduced ventilation. The Lagrangian dispersion model GRAL is able to accurately represent the microscale spatial variability of concentrations in terms of long-term averages, however it demonstrates some deficiencies to predict detailed time series when the input is not carefully selected. In this study, the impact of certain configuration parameters was examined for the simulation of PM10 in the surroundings of a street canyon in Prague (Czech Republic) under contrasting meteorological conditions in summer and winter. First, the sensitivity of steady-state simulations to different atmospheric stability index schemes was analysed. Out of the three options compared, the solar radiation/delta-T (SRDT) method was the most effective. Secondly, the steady-state "match-to-observation" mode and transient mode were tested using the SRDT stability scheme, revealing a general reduction of unrealistic peaks of concentration encountered in the standard steady-state mode. Finally, some other factors causing bias were identified: unreliable sensor measurements, inappropriate boundary conditions, and absence of resuspension emissions.
Single-atom catalysts (SACs) and dual-atom catalysts (DACs) exhibit great potential in heterogeneous catalysis. However, studying their stability under practical reaction conditions remains a challenge. This work theoretically studies the electrochemical stability of N-doped graphene-supported SAC and DAC of five metals (Cr, Mn, Fe, Co, and Ni) under different pH and electric potentials. We propose a universal method that not only considers the chemical speciation of leached metal in solution (ions, hydroxides, and oxyanions) but also introduces structural modification for the substrate vacancy (binding with H). By constructing pH-potential dependent Gibbs free-energy criteria, Pourbaix diagrams (stability) for each catalyst without and with adsorbates were plotted. The results show that Co- and Ni-SAC possess good stability over a wide range of potentials and pH, and Co-SAC can be further stabilized by adsorbates (*H, *OH, or *OOH). Fe-SAC can only be stable with *H, *O, and *OOH, while Mn-SAC only exhibits stability with *O, under certain potentials and pH. Cr-SAC and Cr-, Mn-, Fe-DAC are unstable under all conditions. The stable regions of DAC are generally smaller than those of SAC, indicating potential difficulties in synthesis and applications. This study provides a theoretical model for evaluating and screening durable catalysts in realistic applications.
Stereoelectroencephalography (SEEG) plays a central role in the presurgical evaluation of drug-resistant epilepsy, and accurate planning of avascular trajectories is essential because hemorrhage represents the procedure's most relevant complication. This retrospective single-centre study assessed the spatial correspondence between gadolinium-enhanced MRI (Gd-MRI) and digital subtraction angiography (DSA) across vascular territories relevant to SEEG trajectory planning. Nine adult patients (mean age 36.3 ± 11.4 years) underwent both MRI and DSA between 2021 and 2022 after ethics approval and informed consent. Thirteen arterial and venous segments were analyzed, yielding 130 Cartesian displacement measurements after multimodal registration. Displacements ≤0.5 mm were reported as <0.5 mm for interpretability, while continuous values were retained for descriptive and inferential analyses. Of the 130 measurements, 88 (67.7%) fell within this threshold, while 42 (32.3%) exceeded it. Significant displacements were found in both insular M2 branches (0.91 ± 0.69 mm, p = 0.001; 0.63 ± 0.66 mm, p = 0.007), in the pericallosal artery (0.63 ± 0.50 mm, p = 0.002), and in the distal vein of Trolard (1.39 ± 0.78 mm, p < 0.001), which also showed the maximum misalignment (2.4 mm). A caudo-cranial trend was identified, with larger discrepancies involving the more superficial cortical vessels, whose injury during electrode placement carries the highest risk of clinically significant hemorrhage. These findings indicate that MRI and DSA are broadly concordant but may differ in regions that are critical for trajectory safety. This observation is hypothesis-generating and may be relevant to SEEG trajectory planning, given the anatomical vulnerability of the cortical entry zone.
This study investigated sixteen trace elements in the yolk and albumen of loggerhead turtle (Caretta caretta) eggs from nesting sites along the Campanian coastline (Southern Italy). The elements included both essential (Co, Cu, Mn, Fe, Se, Zn) and non-essential (As, Cd, Cr, Ga, Hg, Ni, Pb, Rb, Sr, V) ones. In the Principal Component Analysis (PCA), the essential elements were associated with each other and explained nearly 100% of the dataset variability, underscoring their fundamental biochemical roles and maternal transfer through shared physiological pathways. Conversely, non-essential elements showed weaker correlations, suggesting exogenous and potentially hazardous origins. Their presence in the eggs appears to be maternally derived, as females typically do not feed during the nesting period. Consequently, the element burdens in the eggs mainly reflect maternal contaminant exposure in foraging areas, particularly for Ni and V. These findings indicate that egg deposition represents a minor detoxification pathway for adult females.
Epilepsy with generalized tonic-clonic seizures alone (GTCA) is a distinct subtype of idiopathic generalized epilepsy (IGE), yet its prognostic markers remain poorly defined. This study aimed to evaluate whether prolonged ambulatory EEG (paEEG), when integrated with clinical variables, improves the identification of patients at increased risk of seizure recurrence. We retrospectively analyzed 32 paEEG recordings from 27 patients with GTCA, classifying them in two groups according to seizure recurrence within 1 year after paEEG (seizure recurrence vs no seizure recurrence). We included only paEEG recordings of patients who had maintained the same antiseizure medication (ASM) regimen (dosage and type) throughout the whole period from the EEG recording up to the outcome assessment (defined as seizure recurrence within 1 year or 1-year seizure freedom). EEG features and interictal epileptiform discharges (EDs), were quantified in both wakefulness and sleep. Predictors were evaluated through univariable analysis and multivariable logistic regression. Most paEEG parameters examined-including total frequency, density, and duration of EDs did not differ significantly between recordings with and without subsequent seizure recurrence during either wakefulness or sleep. In contrast, several wake-onset markers (ED frequency, spike density, and duration) were significantly different between the two groups (p < 0.05). In multivariable analysis, the use of valproate showed a protective effect, while longer ED duration at wake onset increased the likelihood of relapse, both remaining independent predictors. The combined model achieved good apparent discriminative performance (AUC = 0.879). Sensitivity analyses at the patient level and a GEE model accounting for within-subject correlation yielded consistent results, supporting the robustness of wake-onset EDs as predictors. These findings support the integration of paEEG and detailed sleep-wake transitional analysis into prognostic assessment in GTCA, although further validation in larger cohorts is required.
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Seeking to identify a new chemotype for the development of NLRP3 inhibitors, inspired by the structure of the tool compound MCC950 (9), we designed and synthesized new derivatives by choosing the indole heterocycle as spacer between the furanyl moiety and the chemically handy sulfonamide chain core. Four compounds (19c, 19e, 19g, and 19j) selectively reduced NLRP3-dependent IL-1β levels with micromolar inhibitory activity in THP-1 cells, and were safe at the same concentrations. Moreover, they inhibited lactate dehydrogenase release, caspase-1 enzymatic activity, and ASC speck formation with a dose-response effect. Indoles 19c and 19g confirmed their biological activity in primary human macrophages, with IC50 of 19 and 15 µM, respectively. Furthermore, no off-target effects were observed as the compounds did not inhibit LPS-induced TNF release. In silico studies helped us rationalize the binding mode and showed that these derivatives can accommodate the NACHT domain and make several interactions with crucial key residues of the protein. Remarkably, the target engagement assay displayed that 19c and 19g can displace MCC950, thus confirming their direct binding to the NACHT domain. These preliminary results suggest the potential for future development of this new class of indoles as NLRP3 inhibitors.
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Nowadays, systemic treatment with immune-based combinations for metastatic renal cell carcinoma (mRCC) is the gold standard. However, the benefit of these treatments in patients aged ≥70 years is uncertain. Thus, we evaluate the effectiveness and safety of first-line immune-based combinations in elderly patients with mRCC. We retrospectively collected data from mRCC patients who were treated with immune-based combinations in first-line setting at 75 hospitals from 23 countries. Patients were assessed for overall survival (OS), overall response rate (ORR) and severe adverse events (SAEs). The statistical analysis encompassed the Fisher's Exact Test, the Kaplan-Meier methodology, the log-rank test, as well as univariate and multivariate Cox proportional hazards regression models. Of the 1990 mRCC patients included in this analysis, 739 patients were aged ≥70 years. Median OS was 41 months for patients aged <70 years and 30.1 months in patients aged ≥71 years (P<0.001). The age was a prognostic factor in both univariate and multivariate analysis. There was no difference in ORR (52% versus 44%, P=0.262). There was no statistical difference in incidence SAEs as well as dose reductions or treatment discontinuation between elderly and young patients. This large real-world study with mRCC patients substantiates the effectiveness and safety of first-line immune-based combination treatments in elderly patients. Nonetheless, this population has a lower survival in comparison to younger patients.
The imminent transition from low Earth orbit operations to sustained deep-space exploration introduces significant demands upon crew health systems that extend well beyond the physiological and psychological domains traditionally addressed in aerospace medicine. Despite growing recognition that sexuality and reproductive health represent fundamental dimensions of human well-being, these domains have remained conspicuously absent from official mission planning, crew training curricula, and habitat design specifications. This narrative review was therefore undertaken to appraise and synthesize existing evidence on the biological, psychological, ethical, and technological dimensions of human sexuality relevant to long-duration spaceflight and to identify critical knowledge gaps and operational vulnerabilities. A structured literature search was performed across multiple academic repositories, including PubMed, PsycINFO, Web of Science, and Google Scholar, targeting English-language studies published from 1990 to 2026. The scope of the review comprised reproductive physiology within microgravity and high-radiation environments; the psychosocial and psychosexual dynamics of isolated, confined, and extreme settings; the intersection of habitat design, privacy, and ethical-regulatory frameworks; and the emergence of erotic technologies with potential aerospace applications. Eligible studies were thematically analyzed to construct a five-pillar operational framework. The narrative synthesis identified five operational pillars that require systematic integration into mission architecture. Reproductive risk assessment emerged as a foundational concern, encompassing radiation- and microgravity-induced impairment of gonadal function, gametogenesis, and embryonic development; however, the evidence base remains predominantly derived from animal models and in vitro studies. Psychosexual crew preparedness was identified as equally critical, necessitating the development of consent training, healthy intimacy education, and relationship management strategies. The review further highlighted the need for habitat design standards that incorporate spatial, acoustic, and hygiene requirements for intimate behavior in reduced-gravity environments. Regulatory and ethical governance represents an additional imperative, requiring the establishment of relationship policies, pregnancy contingency protocols, and sexual misconduct reporting mechanisms adapted to the jurisdictional complexities of extraterrestrial operations. Finally, a prioritized research agenda is proposed, targeting systematic reproductive health surveillance, analog-based psychosexual studies, stakeholder consultation, and erobotic technology evaluation. We conclude that the systematic neglect of sexuality and reproductive health in current mission planning may compromise crew well-being, interpersonal dynamics, and ultimately mission success as the duration and remoteness of human spaceflight increase. The proposed framework offers a structured conceptual roadmap for translating space sexology from academic discourse into actionable components of mission architecture but requires empirical validation through analog-based pilot studies and stakeholder engagement. This integration should be prioritized in parallel with the technological development of deep-space transportation systems.
Among prognostic factors influencing the achievement of molecular responses in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs), age has been suggested with contrasting results, while the role of gender is still uncertain. A large cohort of 1,394 newly diagnosed CML patients was analyzed by data collected in the Italian CML Network, evaluating the effect of age and gender on the probability of deep molecular responses (DMR). With a median follow-up of 5 years, female patients showed a higher rate of DMR as compared to males. The effect, constant over time, was more evident with imatinib and dasatinib. Indeed, age did not influence the probability of DMR, when considered overall or stratified according to the type of TKI. In a real-world analysis, it seems that age has no effect on DMR regardless of the TKI class, while female gender can be confirmed as significant prognostic factor.
Yiqi Yangxin Anshen Oral Liquid (YQYX) is a multi-herbs compound derived from the ancient Chinese formulae Suanzaoren Decoction and Guipi Tang. It has been clinically used to treat insomnia and anxiety for nearly three decades. To evaluate the efficacy of YQYX and to elucidate its therapeutic mechanisms in mitigating pathological changes induced by sleep deprivation (SD). Chemical constituents and serum-absorbed components were characterized using UHPLC-Orbitrap-MS/MS. Network pharmacology was employed to predicted therapeutic targets. PCPA-induced SD rats underwent pentobarbital-induced sleep test, Morris water maze, and open field test. Serum inflammatory cytokines were measured by ELISA, and hypothalamic neurotransmitters were quantified using a validated UHPLC-QQQ-MS/MS method. Hippocampal damage was evaluated by H&E and NeuN immunofluorescence, and cAMP/PKA/CREB/BDNF pathway was studied by Western blot and immunofluorescence. LC-MS identified 102 chemical constituents and 49 serum-absorbed components in YQYX. Network pharmacology analysis based on the serum-absorbed components predicted the cAMP signaling pathway as a key therapeutic target. YQYX significantly ameliorated SD-induced sleeplessness effects, spatial learning-memory impairments, and anxiety-like behaviors. It also reduced serum levels of IL-1β, TNF-α, and IL-6. Notably, YQYX restored hypothalamic neurotransmitters homeostasis (serotonin, dopamine, histamine, and acetylcholine). Histological analysis showed that YQYX prevented SD-induced hippocampal damage. Moreover, YQYX upregulated the cAMP/PKA/CREB/BDNF signaling pathway. YQYX exhibits multi-target therapeutic effects by maintaining neurotransmitter homeostasis, protecting hippocampal neurons, and activating neuroplasticity pathways, thereby validating its ethnopharmacological basis for treating sleep disorders.
Area-based centralization optimizes both patient access by minimizing long-distance transfers and enables hospitals to reach adequate surgical volumes to ensure optimal outcomes. This study aimed to analyze a Hub-and-Spoke system applied to pancreatic surgery by evaluating both patient logistics and clinical outcomes. Data from a Hub-and-Spoke system for pancreatic surgery were collected over a 3-year period. The Hub center managed patient referrals from its own region and three additional Spoke hospitals. Clinical decision-making was standardized through dedicated inter-institutional multidisciplinary team meetings. Surgical outcomes and quality metrics were collected and analyzed. Patient transfer patterns related to key steps in the care pathway were retrieved and quantified. Overall, 187 patients underwent surgical exploration at the Hub center, with pancreatic ductal adenocarcinoma as the most common indication (56.1%). A minimally invasive approach was used in 57 (33.1%) patients. Postoperative pancreatic fistula (POPF) rate following pancreaticoduodenectomy was 39.7%, with grade C POPF being 9.0%. The 90-day mortality for the entire cohort was 0.6%, with a failure-to-rescue rate of 2.8%. Textbook outcomes were obtained in 58.1% of cases. The median patient transfer distance from home to the Hub center was 43 kilometers (IQR 25-50), with an estimated travel time of 48 minutes. The cumulative distance required to complete the entire care process was 197 km (IQR 90-225) with an estimated travel time of less than 5 hours. The centralization of pancreatic care through a Hub-and-Spoke system ensured adequate surgical outcomes. Simultaneously, the model maintained patient proximity to care facilities, optimizing access to care pathways and enhancing patient-centered management.
This study explores organizational interventions aimed at mitigating heat-related challenges and stress for nurses in acute care settings, with a focus on adapting to the intensifying climate crisis. Six trans- and interdisciplinary participants participated in the workshop. The one-day workshop was based on the methodology of 'Zukunftswerkstatt' (Futures Workshop) and 'design thinking' principles. Participants analyzed challenges related to heat waves and developed actionable, future-oriented interventions based on scenarios and tools. Data collection involved photographs of handwritten workshop activities and researchers' notes. Data analysis followed three main steps to abstract and synthesize results: discussing results using the collected data, participants' feedback on the workshop documentation, and final synthesis. The study identified several key interventions to manage heat-related stress, including the development of a comprehensive Heat Health Action Plan (HHAP), modular training programs, and a mobile staff app for real-time communication. Interventions were categorized into four phases: prevention, preparation, response, and recovery, with organizational strategies outweighing individual-level interventions. Participants highlighted the need for leadership commitment, adequate resource allocation, cross-sector collaboration, and clear communication. Successful implementation of HHAP was viewed as dependent on engagement from middle management and its integration into hospital governance and strategic planning. This study highlights the complexity of heat adaptation in hospitals. Findings underscore the importance of successful heat adaptation for hospital employees. Strengthening institutional commitment and integrating staff-driven approaches are essential for developing robust, future-ready heat preparedness in hospitals.
Human epidermal growth factor receptor 2 (HER-2) overexpression/amplification is a known prognostic and predictive biomarker in breast and gastric cancer. However, its role in metastatic colorectal cancer (mCRC) is still debated. We conducted an exploratory analysis to investigate the role of HER-2 amplifications/mutations in patients with RAS/BRAF V600 wild type (WT), microsatellite stable (MSS) mCRC enrolled in the CAPRI-2 GOIM trial, who received FOLFIRI/cetuximab as first-line therapy. At baseline, plasma and tumor tissue samples were collected for comprehensive genomic profiling using the FoundationOne CDx assay. HER-2 positive tumors were defined in case of HER-2 mutations or gene amplification, defined by using a gene copy number cut-off of ≥4. Patients with HER-2 negative tumors had numerically higher objective response rates [78% versus 60%; odd-ratio, 1.95, 95% confidence interval (CI): 0.47-8; P = 0.4] compared with HER-2 positive tumors. Patients with HER-2 positive mCRC had worse median progression-free survival (PFS) [(7.54 months; 95% CI:4.99-Not evaluable (NE) versus 13.47 months (95% CI: 11.76-16.3); hazard ratio (HR): 2.47; 95% CI: 1.27-4.65; P = 0.007] as well as worse median overall survival [16.4 months (95% CI:9.4-NE) versus 33.4 (30.36-NE); HR: 2.54; 95% CI: 1.09-5.93; P = 0.031] compared with patients with HER-2 negative tumors. Of note, 6/7 cases with HER-2 mutations exhibited limited benefit from treatment with FOLFIRI plus cetuximab with PFS inferior to 8 months. Taken together, these results highlight the need to test HER-2 gene alterations for patients with RAS/BRAF V600 WT, MSS mCRC, who are candidates for anti-epidermal growth factor receptor therapies.
Corylin is a bioactive extract of Psoralea corylifolia L. with reported antioxidant, anti-tumor, and anti-inflammatory effects. Its anti-tumor effects have been investigated, but mechanistic explanations are lacking. This study mainly focuses on the role and mechanism of Corylin in inducing liver cancer cell death. The effects of Corylin on liver cancer cell proliferation were analyzed using crystal violet staining and cell counting kit-8 (CCK-8) assays. Nuclear changes were detected via Hoechst staining, while apoptosis levels were assessed using Annexin V- fluorescein isothiocyanate (FITC)/propidium iodide (PI) staining. Changes in mitochondrial membrane potential and reactive oxygen species (ROS) levels were analyzed using JC-1 and tetramethylrhodamine methyl ester (TMRM) staining combined with flow cytometry. Immunofluorescence staining and Western blot (WB) experiments assessed alterations in apoptosis- and autophagy-related proteins. Finally, the effects of Corylin on liver cancer cells in vivo were validated by establishing a subcutaneous tumor model. In this study, we found that Corylin had a significant anti-liver cancer effect and significantly increased the apoptosis level of liver cancer cells. Additionally, Corylin was found to significantly reduce mitochondrial membrane potential and significantly increase ROS release. It was also observed that Corylin significantly influenced autophagy levels in liver cancer cells. Further analysis revealed that Corylin induced mitophagy, with the increase in autophagy levels being directly proportional to the rise in apoptosis levels. Finally, the establishment of a subcutaneous tumor-bearing model showed that Corylin also had a significant anti-liver cancer effect in vivo. The above results demonstrated that Corylin mainly caused the death of liver cancer cells through the endogenous apoptosis and mitophagy pathway and had great potential as an anti-liver cancer drug.
In the present paper, it is first proposed that the acupuncture-moxibustion medicine can be divided into 2 branches, namely, traditional acupuncture-moxibustion and modern acupuncture-moxibustion, and then makes a comparative analysis on their connotations of the theoretical knowledge systems and cognitive methodology. It is believed that the conditions for the construction of the theoretical system of modern acupuncture-moxibustion are basically mature. It also puts forward that the three basic principles must be adhered to in the construction of the knowledge of theoretical framework of modern acupuncture-moxibustion, namely, to follow the attributes of modern natural science, to follow the basic findings of modern clinical and basic research, and to follow the basic characteristics of external treatment techniques. This article mainly explains the author's personal views on the construction of the basic theory of modern acupuncture-moxibustion, and puts forward the macroscopic ideal model of surface stimulation medicine on the human body, that is, the theoretical model is divided into "three-layer (three-facet) system" and "three-line network system" at the macro level. The so-called "three-layer system" refers to the peripheral tissue from the body surface to the deep layer, which can be divided into 3 different tissue layers: the superficial (upper) layer, the connective tissue layer and the skeletal muscle layer at the macro level, which mainly guides the external treatment and local treatment of acupuncture, as well as the depth of acupuncture needle insertion. The so-called "three-line network system" refers to the neural network composed of nerve tissue, the myofascial force line network composed of myofascial fascia in the connective tissue, and the vascular network composed of muscle tissue (smooth muscle) and connective tissue. The "three-line network" functions in connecting the whole body, and mainly guides the internal treatment via external stimulation, distal treatment or holistic treatment. In this paper, the tissue structure and functional characteristics involved in the "three-layer system" and "three-line network system" of modern research in recent years are integrated and refined, which is helpful to guide treatment of clinical disorders by using acupuncture and moxibustion, and the two theoretical systems of "nonlinear structure system" (three-layers) and "linear structure system" (three-line network) of modern acupuncture-moxibustion are formed. In view of the modern acupuncture stimulation point theory, several categories of acupuncture points are proposed based on the nerves, blood vessels, myofascial trigger points, skin, muscle and related soft tissues. Finally, it is pointed out that the construction of modern acupuncture-moxibustion will complement and promote each other with the traditional one, enrich its knowledge system, and thus promote the development of this subject. 本文首先提出了针灸学可划分为传统针灸学与现代针灸学两大分支的观点，随后对二者理论知识体系的内涵与认知方法学进行了比较分析，认为现代针灸学理论体系构建的条件已基本成熟;并提出了构建现代针灸学知识理论框架必须坚持的3个基本原则，即遵循现代自然科学的属性、遵循现代针灸临床与基础研究的基本发现及遵循外治法技术的基本特征。本文主要在现代针灸学的基本理论构建上阐释了个人观点，提出体表刺激医学关于人体的宏观理想性模型构想，即宏观上划分为“三面”“三线”理论模型。所谓“三面”就是指外周组织从体表到深层，宏观上可分为表（上）皮层、结缔组织层和骨骼肌层3个宏观的不同组织层面，主要指导针灸的以外治外、局部治疗，以及针刺的深度。所谓“三线”是指神经组织构成的神经网络、结缔组织中的肌筋膜构成的肌筋膜力线网络，以及肌肉组织（平滑肌）与结缔组织构成的脉管网络，三线网络则构成了联系全身的三大网络系统，主要指导针灸的以外治内、远端治疗或整体性治疗。文中对近年来现代研究有关“三面”与“三线”所涉及的组织结构与解剖、功能特点等有助于指导针灸治病的成果进行了集成与凝练，形成了现代针灸学的“非线性结构系”（三面）与“线性结构系”（三线网络）两大理论体系。针对现代针灸刺激点理论提出了基于神经、脉管、肌筋膜力线及激痛点、皮肤与肌肉及有关软组织的刺激点几个大类。最后，文中指出现代针灸学的构建必将与传统针灸学相互补充、相互促进，丰富其知识体系，从而推进针灸学的发展。.
To evaluate the feasibility and surgical impact of static digital twin reconstructions in patients undergoing resection for complex pelvic or abdominal recurrences of gynecologic cancers. Prospective and observational feasibility study. Academic tertiary care center with integrated biomedical engineering support. Four patients with suspected oligometastatic recurrence of gynecologic malignancy involving vascular, urinary, nervous, or skeletal structures, deemed eligible for curative-intent surgery and 8 historical controls with recurrent leiomyosarcoma selected for exploratory comparison. Included patients underwent high-resolution cross-sectional imaging followed by semiautomated 3D segmentation and static digital twin reconstruction using Mimics Medical software (Materialise, Leuven, Belgium). Virtual models were co-reviewed by surgeons and engineers for surgical planning. During surgery, the digital twin was available for intraoperative navigation. Postoperative concordance between the model and intraoperative findings was evaluated by a multidisciplinary team (surgeon, radiologist, and clinical engineer) using an internally developed 1-5 rating scale. All procedures were completed without intraoperative complications. The mean operative time was 191.5 minutes (range 120-270). In each case, the static digital twin allowed enhanced preoperative planning, identification of anatomical variants (e.g., duplicated ureter), and optimized team coordination. Surgical findings were highly concordant with the preoperative 3D models. No unplanned injuries or postoperative complications were observed. Intraoperative decision-making was positively influenced by the use of the model in all cases. Static digital twins are feasible and effective tools for surgical planning in complex gynecologic cancer recurrences. Their use supports anatomical understanding, interdisciplinary coordination, and intraoperative safety. Further research is needed to validate their impact on surgical outcomes and workflow efficiency.