ObjectiveTo analyze the research status, hotspots and development trends in the application of virtual reality (VR) technology in managing negative emotions and postoperative rehabilitation of perioperative patients over the past decade. MethodsLiteratures related to the application of VR technology in managing negative emotions and postoperative rehabilitation of perioperative patients were retrieved from Web of Science Core Collection database and CNKI, covering the period from January, 2015 to August, 2025, and CiteSpace 6.3.R1 was used for bibliometric analysis. ResultsA total of 267 English literatures and 130 Chinese literatures were included, with the annual number of publications showing an upward trend. The United States was the country with the largest number of publications in English literatures, and Erasmus University Rotterdam was the institution with the largest number of publications. High-frequency keywords included virtual reality, pain, surgery, anxiety and distraction. Research hotspots mainly focused on functional exercise, negative emotions, pain management and multimodal intervention strategies. English researches were deepening towards virtual reality exposure therapy, mechanism exploration and personalized schemes, while Chinese researches focused more on the verification of rehabilitation effects. ConclusionResearches on the application of VR technology in the management of perioperative patients are rapidly developing, with research hotspots shifting from single technology application to multimodal and personalized integrated intervention. Future research should focus on exploring its intervention mechanisms, personalized schemes and the breadth of cross-departmental applications.

Objective To investigate the expression and prognostic value of microRNA-29b-2-5p(miR-29b-2-5p)and syntaxin 16(STX16)in hepatocellular carcinoma(HCC).Methods The cancer tissues and adjacent tissues of 88 HCC patients diagnosed in Nantong Tumor Hospital from January 2013 to September 2020 were collected.The expressions of miR-29b-2-5p and STX16 in cancer tissues and adjacent tissues were analyzed by real-time fluorescent quantitative PCR.The expression of STX16 protein in cancer tissues and adjacent tissues were analyzed by immunohistochemistry.Pearson correlation analysis was used to analyze the correlation be-tween miR-29b-2-5p and STX16.Non-parametric χ2 test was used to analyze the relationship between the ex-pression of the two proteins and clinicopathological parameters,and Kaplan-Meier survival curve was used to analyze the relationship between the expression of the two proteins and prognosis.Results The relative ex-pression level of miR-29b-2-5p was 0.780(0.351,1.708)in cancer tissues and 1.014(0.458,3.124)in adja-cent tissues in 88 HCC patients.The relative expression level of miR-29b-2-5p in cancer tissues was signifi-cantly lower than that in adjacent tissues(P=0.012).The relative expression level of STX16 mRNA was 0.775(0.406,0.946)in cancer tissues and 0.368(0.080,1.301)in adjacent tissues in 88 HCC patients.The relative expression level of STX16 mRNA in cancer tissues was significantly higer than that in adjacent tissues(P<0.01).Immunohistochemical results showed that STX16 was expressed in the cytoplasm,and the expres-sion of STX16 in cancer tissues was higher than that in adjacent tissues(P<0.05).The expression of miR-29b-2-5p in cancer tissues was related to cancer stage(P<0.05),and the expression of STX16 was related to cancer stage and alpha-fetoprotein(P<0.05).Patients with low miR-29b-2-5p expression had a shorter over-all survival(OS)than those with high miR-29b-2-5p expression,and patients with high STX16 expression had a shorter OS than those with low STX16 expression(P<0.05).Conclusion The expression of miR-29b-2-5p is low and STX16 is high in HCC tissues.The combined detection of miR-29b-2-5p and STX16 can effectively evaluate the prognosis of HCC patients.

Objective To explore the relationship between hemoglobin/red blood cell distribution width ra-tio(Hb/RDW)and chemotherapy sensitivity and prognosis in patients with oral squamous cell carcinoma(OSCC).Methods A total of 150 patients with advanced OSCC admitted to the hospital from January 2017 to January 2021 were selected into the study group.150 patients with other oral diseases who were diagnosed and treated for non-OSCC in the hospital during the same period were selected into the control group.Another 100 healthy subjects who underwent physical examination in the hospital during the same period were selected into the healthy group.Patients with OSCC were treated with chemotherapy,and blood routine indexes were detec-ted by automatic blood analyzer,and Hb/RDW ratio was calculated.Hb,RDW and Hb/RDW ratio were com-pared between the two groups and the relationship between Hb/RDW ratio and the sensitivity and prognosis of OSCC patients with chemotherapy were analyzed.The factors affecting the sensitivity of OSCC patients to chemotherapy were explored by multivariate Logistic regression.Results Hb and Hb/RDW in the study group were significantly lower than those in the control group and the healthy group,and RDW levels were significantly higher than those in the control group and the healthy group(P＜0.05).The patients with OS-CC were divided into high Hb/RDW group and low Hb/RDW group using the median Hb/RDW ratio(8.16)as the cut off value.The total effective rate of chemotherapy in Hb/RDW high ratio group was 70.67％,which was higher than that in Hb/RDW low ratio group 53.33％(P＜0.05).According to the sensitivity of chemo-radiotherapy,the study group was divided into sensitive group(n=103)and resistant group(n=47).The proportion of patients with stage Ⅳ,low differentiation and lymph node metastasis in resistance group was higher than that in sensitive group(P＜0.05).Multivariate Logistic regression analysis shows that TNM stage Ⅳ(OR=2.512,95％CI:1.588-3.973),low tumor differentiation(OR=2.237,95％CI:1.427-3.938),lymph node metastasis(OR=2.821,95％CI:1.607-4.951),Hb/RDW≤8.16(OR=3.540,95％CI:2.001-6.261)were risk factors for chemotherapy sensitivity in cases with OSCC(P＜0.05).The 3-year survival rate of OSCC cases in the high Hb/RDW group was 74.67％(56/75)and that in the low Hb/RDW group was 58.67％(44/75),There was a statistically significant difference in the 3-year survival rate between two groups(x2=4.320,P=0.038).Conclusion Hb/RDW is low expression in patients with OSCC,and is re-lated to the sensitivity and prognosis of patients with chemotherapy,which is expected to be a potential mark-er for predicting the sensitivity and prognosis of OSCC.

Objective To introduce a modified technique of right ventricular outflow tract (RVOT) reconstruction using a handmade bicuspid pulmonary valve crafted from expanded polytetrafluoroethylene (ePTFE) and to summarize the early single-center experience. Methods Patients with complex congenital heart diseases (CHD) who underwent RVOT reconstruction with a handmade ePTFE bicuspid pulmonary valve due to pulmonary regurgitation at Guangdong Provincial People’s Hospital from April 2021 to February 2022 were selected. Postoperative artificial valve function and right heart function indicators were evaluated. Results A total of 17 patients were included, comprising 10 males and 7 females, with a mean age of (18.18±12.14) years and a mean body weight of (40.94±19.45) kg. Sixteen patients underwent reconstruction with a handmade valved conduit, with conduit sizes ranging from 18 to 24 mm. No patients required mechanical circulatory support, and no in-hospital deaths occurred. During a mean follow-up period of 12.89 months, only one patient developed valve dysfunction, and no related complications or adverse events were observed. The degree of pulmonary regurgitation was significantly improved post-RVOT reconstruction and during follow-up compared to preoperative levels (P<0.001). Postoperative right atrial diameter, right ventricular diameter, and tricuspid regurgitation area were all significantly reduced compared to preoperative values (P<0.05). Conclusion The use of a 0.1 mm ePTFE handmade bicuspid pulmonary valve for RVOT reconstruction in complex CHD is a feasible, effective, and safe technique.

Objective:To investigate differentially expressed lipid molecules and their associated metabolic pathways in lung tissue using lipidomic analysis in a rat model of acute lung injury (ALI).Methods:An ALI rat model was established via intratracheal instillation of lipopolysaccharide (LPS). Twenty rats were randomly allocated into an ALI group and a control group ( n = 10 per group). The left lung was subjected to histopathological evaluation, while the right lung underwent untargeted lipidomics analysis. Ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was employed for lipid profiling. Principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) were performed to assess intergroup differences and determine variable importance in projection (VIP) scores. Differential lipids were screened based on VIP and fold change.Lipid identification and metabolic pathway analysis were conducted using MetaboAnalyst 5.0 and the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Results:Among 1 022 detected lipid molecules, 47 were differentially expressed (VIP > 1, FC > 2.0 or < 0.5, P< 0.05). Subsequent analysis identified 12 structurally annotated lipids ( P < 0.05), predominantly enriched in glycerophospholipid metabolism, linoleic acid metabolism, and α-linolenic acid metabolism pathways. Notably, phosphatidylcholines (PCs) and lysophosphatidylcholines (LPCs) exhibited significant alterations in the ALI group. Conclusions:The ALI model demonstrated substantial dysregulation of lipid metabolism, particularly involving PCs and LPCs, with prominent perturbations in glycerophospholipid metabolism. This provides a scienctific basis for indepth research on the pathogenesis mechanism of ALI/acute respiratory distress syndrome (ARDS) .

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Homo- or heterodimeric compounds that affect dimeric protein function through interaction between monomeric moieties and protein subunits can serve as valuable sources of potent and selective drug candidates. Here, we screened an in-house dimeric natural product collection, and panepocyclinol A (PecA) emerged as a selective and potent STAT3 inhibitor with profound anti-tumor efficacy. Through cross-linking C712/C718 residues in separate STAT3 monomers with two distinct Michael receptors, PecA inhibits STAT3 DNA binding affinity and transcription activity. Molecular dynamics simulation reveals the key conformation changes of STAT3 dimers upon the di-covalent binding with PecA that abolishes its DNA interactions. Furthermore, PecA exhibits high efficacy against anaplastic large T cell lymphoma in vitro and in vivo, especially those with constitutively activated STAT3 or STAT3^Y640F. In summary, our study describes a distinct and effective di-covalent modification for the dimeric compound PecA to disrupt STAT3 function.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*