Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.

Objective To investigate the changes in the complex network of brain functions associated with sodium channel blocker (SCB) treatment and the neural mechanisms underlying the effects on executive control functions. Methods Twenty-one patients with temporal lobe epilepsy taking SCB (TLE-SCB) and 12 patients with temporal lobe epilepsy not taking SCB (TLE-N) were enrolled in the study along with 18 healthy controls (HC). Resting-state functional magnetic resonance imaging (rsfMRI) and attentional network testing (ANT) were completed,and graph theoretic methods were applied to study the changes in the complex networks of brain function in the three groups of subjects,and to investigate the relationship between changes in brain networks and executive function. Results The TLE-SCB and TLE-N groups showed executive function impairment compared to the HC group. Analysis of brain network topological properties showed that multiple node median centrality was reduced in the TLE-SCB group compared to the TLE-N group (all Bonferroni corrected,P<0.017);right amygdala node clustering coefficient,and local efficiency of the left suboccipital gyrus were reduced (t=-2.953,P=0.006;t=-2.597,P=0.0142). The TLE-SCB compared to the HC group had decreased multiple node median centrality (all Bonferroni corrected,P<0.017);increased node clustering coefficients in the left orbital middle frontal gyrus (t=2.861,P=0.007);and decreased localized efficiency in the left inferotemporal gyrus (t=-2.870,P=0.007). The TLE-N group compared to the HC group had decreased right paracentral lobule mediator centrality,local efficiency increased (t=2.644,P=0.013;t=3.464,P=0.002);right amygdala node clustering coefficient increased (t=2.884,P=0.007). Correlation analysis showed that decreased centrality of left suboccipital gyrus mediators was negatively correlated with executive efficiency in the TLE-SCB group (P=0.045,r=-0.441). Conclusion Patients using SCB medication showed impairment of brain functional network topological properties,with the left suboccipital gyrus as an important node;altered brain functional network topological properties may underlie the network of cognitive impairment in SCB.

Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.

Objective To observe the value of 18F-prostate specific membrane antigen(PSMA)-1007 PET/MRI for diagnosing seminal vesicle invasion(SVI)of prostatic cancer(PCa).Methods Totally 92 male patients with PCa who underwent radical prostatectomy were retrospectively enrolled and divided into positive group(n=26)and negative group(n=66)based on postoperative pathology showed SVI or not.PET/MRI parameters,including maximum standard uptake value(SUVmax),minimum apparent diffusion coefficient(ADCmin),mean apparent diffusion coefficient(ADCmean),SUVmax/ADCmin,SUVmax/ADCmean,PSMA tumor volume(PSMA-TV)and total lesion PSMA(TL-PSMA)were compared between groups.The receiver operating characteristic curve was drawn,and the efficacy of each parameter for diagnosing SVI was analyzed.Results Among 92 cases of PCa,18F-PSMA-1007 PET/MRI showed 30 cases with SVI and 62 cases without SVI,with accuracy of 73.91％,sensitivity of 61.54％,specificity of 78.79％,positive predictive value of 53.33％and negative predictive value of 83.87％.Significant differences of ADCmin,PSMA-TV and TL-PSMA were found between groups(all P＜0.05).The area under the curve(AUC)of SUVmax,ADCmin,ADCmean,SUVmax/ADCmin,SUVmax/ADCmean,PSMA-TV and TL-PSMA for diagnosing SVI of PCa was 0.554,0.341,0.396,0.603,0.581,0.755 and 0.705,respectively.The AUC of PSMA-TV was higher than other parameters except for TL-PSMA,with sensitivity of 84.60％and specificity of 56.10％.Conclusion 18 F-PSMA-1007 PET/MRI was helpful for diagnosing SVI of PCa.

Objective To investigate the changes in the complex network of brain functions associated with sodium channel blocker (SCB) treatment and the neural mechanisms underlying the effects on executive control functions. Methods Twenty-one patients with temporal lobe epilepsy taking SCB (TLE-SCB) and 12 patients with temporal lobe epilepsy not taking SCB (TLE-N) were enrolled in the study along with 18 healthy controls (HC). Resting-state functional magnetic resonance imaging (rsfMRI) and attentional network testing (ANT) were completed,and graph theoretic methods were applied to study the changes in the complex networks of brain function in the three groups of subjects,and to investigate the relationship between changes in brain networks and executive function. Results The TLE-SCB and TLE-N groups showed executive function impairment compared to the HC group. Analysis of brain network topological properties showed that multiple node median centrality was reduced in the TLE-SCB group compared to the TLE-N group (all Bonferroni corrected,P<0.017);right amygdala node clustering coefficient,and local efficiency of the left suboccipital gyrus were reduced (t=-2.953,P=0.006;t=-2.597,P=0.0142). The TLE-SCB compared to the HC group had decreased multiple node median centrality (all Bonferroni corrected,P<0.017);increased node clustering coefficients in the left orbital middle frontal gyrus (t=2.861,P=0.007);and decreased localized efficiency in the left inferotemporal gyrus (t=-2.870,P=0.007). The TLE-N group compared to the HC group had decreased right paracentral lobule mediator centrality,local efficiency increased (t=2.644,P=0.013;t=3.464,P=0.002);right amygdala node clustering coefficient increased (t=2.884,P=0.007). Correlation analysis showed that decreased centrality of left suboccipital gyrus mediators was negatively correlated with executive efficiency in the TLE-SCB group (P=0.045,r=-0.441). Conclusion Patients using SCB medication showed impairment of brain functional network topological properties,with the left suboccipital gyrus as an important node;altered brain functional network topological properties may underlie the network of cognitive impairment in SCB.

Objective To observe the value of 18F-prostate specific membrane antigen(PSMA)-1007 PET/MRI for diagnosing seminal vesicle invasion(SVI)of prostatic cancer(PCa).Methods Totally 92 male patients with PCa who underwent radical prostatectomy were retrospectively enrolled and divided into positive group(n=26)and negative group(n=66)based on postoperative pathology showed SVI or not.PET/MRI parameters,including maximum standard uptake value(SUVmax),minimum apparent diffusion coefficient(ADCmin),mean apparent diffusion coefficient(ADCmean),SUVmax/ADCmin,SUVmax/ADCmean,PSMA tumor volume(PSMA-TV)and total lesion PSMA(TL-PSMA)were compared between groups.The receiver operating characteristic curve was drawn,and the efficacy of each parameter for diagnosing SVI was analyzed.Results Among 92 cases of PCa,18F-PSMA-1007 PET/MRI showed 30 cases with SVI and 62 cases without SVI,with accuracy of 73.91％,sensitivity of 61.54％,specificity of 78.79％,positive predictive value of 53.33％and negative predictive value of 83.87％.Significant differences of ADCmin,PSMA-TV and TL-PSMA were found between groups(all P＜0.05).The area under the curve(AUC)of SUVmax,ADCmin,ADCmean,SUVmax/ADCmin,SUVmax/ADCmean,PSMA-TV and TL-PSMA for diagnosing SVI of PCa was 0.554,0.341,0.396,0.603,0.581,0.755 and 0.705,respectively.The AUC of PSMA-TV was higher than other parameters except for TL-PSMA,with sensitivity of 84.60％and specificity of 56.10％.Conclusion 18 F-PSMA-1007 PET/MRI was helpful for diagnosing SVI of PCa.

Objective:To design an improved lamina hook system and compare its biomechanical properties with traditional lamina hook system in fixation of lumbar spondylolysis.Methods:The thin layer CT data of the lumbosacral vertebrae of 20 healthy young male servicemen who underwent physical examination in the outpatient department of the 940th Hospital of Joint Logistics Support Force of PLA from January 2021 to August 2022 were collected. The age of the subjects was 20-30 years [(25.0±3.0)years]. A 3-dimensional model of the L 5 vertebral body was constructed using the 3-dimensional modeling software. The new improved lamina hook was designed according to the measurements including the thickness of the middle area, the longest longitudinal diameter, the curvature radius of the lower edge, the angle between the upper and lower tail ends, the thickness of the lower edge, and the longest diameter of the lower edge of the bilateral L 5 vertebral plates. One serviceman was selected from the aforementioned group to construct a linear finite element model of segments L 4-S using the 3-dimensional virtual software (normal model, model A), based on which, the L 5 bilateral spondylolysis model (model B), improved lamina hook model (model C) and traditional lamina hook models (model D) were designed. By constraining both sides of the sacrum and applying a longitudinal load of 400 N on the L 4 vertebral body, the upper 1/3 gravity of the body was simulated, and with a bending moment of 10 N·m along the X, Y, and Z directions, motions of forward flexion, backward extension, lateral bending, rotation, etc were simulated. The range of motion of segment L 4/5 and L 5/S 1 of model A was evaluated and compared with the findings of the previous researches to verify its effectiveness. The overall range of motion of models A, B, C, and D, the range of motion of segment L 4/5 and L 5/S 1, the maximum overall displacement, the maximum displacement and stress of the isthmus, the stress distribution and maximum stress of internal fixation of models C and D, and the stress distribution and maximum stress of the vertebral body of models C and D were compared. Results:(1) During forward flexion, backward extension, lateral bending and rotation, the range of motion of model A was 5.01°, 4.03°, 3.91° and 1.42° in segment L 4/5, and was 4.62°, 2.51°, 2.40° and 1.23° in segment L 5/S 1. (2) The overall range of motion, range of motion of segment L 4/5 and L 5/S 1 and maximum overall displacement of models A, C, and D were similar in axial compression, forward flexion, backward extension, left bending, and left rotation, while those of model B were significantly increased. (3) There was no significant difference in the maximum displacement of the isthmus of models A, C, and D under different motion modes, while the maximum displacement of model B in the isthmus was significantly larger than that of models A, C, and D, especially during rotation, increased by 295%, 277%, and 276% respectively. The maximum stress of the isthmus of model C was 0.938 MPa, 1.698 MPa, 0.410 MPa, 2.775 MPa, and 1.554 MPa respectively. The maximum stress in the isthmus of model D was 0.590 MPa, 1.297 MPa, 0.520 MPa, 3.088 MPa, and 2.072 MPa respectively. The maximum stress of the isthmus of models C and D was similar during axial compression and forward flexion, while the stress of the isthmus of model C was smaller than that of model D during backward extension, lateral bending, and rotation, decreased by 21.1%, 10.2%, and 25.0% respectively compared with model D. (4) The maximum stress of internal fixation in models C and D during forward flexion, backward extension, left bending, and left rotation was 135.220 MPa, 130.180 MPa, 200.940 MPa and 306.340 MPa respectively, and was 131.840 MPa, 112.280 MPa, 349.980 MPa and 370.140 MPa respectively. The maximum stress of internal fixation in the two models of internal fixation during forward flexion and backward extension was similar, while it was decreased by 42.6% and 17.2% in model C during left bending and left rotation, compared with model D. (5) The maximum stress of the vertebral body during forward flexion, backward extension, left bending, and left rotation was 79.787 MPa, 36.857 MPa, 37.943 MPa and 96.965 MPa respectively in model C, but was 80.104 MPa, 64.236 MPa, 196.010 MPa and 193.020 MPa respectively in model D. The maximum stress of models C and D was all distributed in the contact area with the internal fixation, and especially during backward extension, left bending, and left rotation, when it was reduced by 42.6%, 80.6%, and 49.8% of model C respectively, compared with that of model D. Conclusions:The improved laminar hook is more consistent with the Chinese anatomized structure of the lamina. Compared with the traditional lamina hook system, the improved lamina hook system can effectively reduce the displacement in all directions and range of motion of lumbar spondylolysis, therefor can significantly reduce the stress of internal fixation and vertebral body and has better biomechanical performance.

Objective:To study the neural mechanism between abnormal brain functional activity and alertness function in temporal lobe epilepsy (TLE) patients with or without hippocampal sclerosis.Methods:A total of 21 TLE patients with hippocampal sclerosis (TLE-HS), and 18 TLE patients without hippocampal sclerosis (TLE-N) diagnosed in the Department of Neurology of the First Affiliated Hospital of Guangxi Medical University from May 2016 to November 2022 and 28 healthy controls (HC) matched with demographic data were recruited.All the 67 participants completed the attention network test (ANT) and resting-state fMRI (rs-fMRI) scans. The REST software was used to analyze fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) based on one-way ANOVA in order to obtain differential brain regions in abnormal spontaneous neuronal activity and functional connectivity among the three groups. The SPSS 26.0 software was used to analyze the correlation between fALFF/FC values in differential brain regions and alertness network efficiency by Pearson correlation analysis.Results:There was a significant difference in the alerting network effect among the three groups ( F=4.621, P=0.013), and the post-hoc analysis showed that the alerting network effect in the TLE-HS group((59.40±22.85)ms)was significantly higher than that in the HC group((38.85±21.08)ms)(Bonferroni correction, P=0.017). The fALFF analysis showed that the fALFF values of the right superior frontal gyrus in the TLE-HS group (0.16±0.52) and the TLE-N group (0.49±0.51) were significantly lower than that in the HC group (1.01±0.46), while the fALFF values of the left precentral gyrus in the TLE-HS group (0.60±0.55) was significantly higher than that in the TLE-N group (-0.19±0.51) and the HC group (-0.15±0.36) (Bonferroni correction, all P<0.05). The functional connectivity analysis revealed that the FC values between the left inferior frontal gyrus and the right superior frontal gyrus in the TLE-HS group (0.11±0.16) and TLE-N group (0.02±0.19) were significantly higher than those in the HC group (-0.18±0.18). The FC values between the right supramarginal gyrus and the right superior frontal gyrus in the TLE-HS group (0.10±0.21) were significantly higher than those in the HC group (-0.18±0.16). The FC values between the left supplementary motor area and the right superior frontal gyrus in the TLE-HS group (0.20±0.21) were significantly higher than those in the TLE-N group (-0.03±0.31) and the HC group (-0.10±0.15) (Bonferroni correction, all P<0.05). The correlation analysis showed that the FC values between the left supplementary motor area and the right superior frontal gyrus in the TLE-HS group were significantly positively correlated with alertness network efficiency ( r=0.436, P=0.048). Conclusions:There are abnormal spontaneous neuronal activity and brain functional connectivity in TLE patients with or without hippocampal sclerosis, and the abnormality is more pronounced in the TLE-HS group. The abnormal brain functional connectivity may play an essential role in alertness dysfunction.

Exosomes are a kind of extracellular vesicles,which directly stimulate target cells through receptor-mediated interaction,or exert their biological functions by transferring various bioactive molecules to target cells,playing a key role in intercellular communi-cation between cells and their microenvironment.From the perspective of tissue engineering,pulp regeneration refers to the combination of scaffolds,stem cells,and signaling factors implanted into a properly treated pulp cavity.Under the action of scaffolds and signaling factors,stem cells proliferate and differentiate to form pulp dentin-like complexes,restoring pulp function.In recent years,studies have found that p38MAPK,TGF-β/SMAD,Wnt/β-Catenin signaling pathway and some other signaling pathways are important for the se-cretion in regulating pulp regeneration,and play a key role in pulp regeneration.Therefore,this article reviews the mechanism and re-search progress of signaling pathways related to the regulation of pulp regeneration by exosomes.

Objective To evaluate the effect of different operation methods on the early swallowing function in the patients with laryngocarcinoma.Methods A total of 138 patients with the first time of open laryngectomy in this hospital from January 2021 to December 2022 were selected as the research subjects by convenience sampling method.The patients were divided into the vertical laryngeal resection group(vertical group,n=34),horizontal laryngeal partial resection(horizontal group,26 cases),suprachloroid laryngeal par-tial resection annular hyoid epiglottis fixation group(SCPL-CHEP group,n=26)and total laryngeal resection group(total laryngeal group,n=52)according to the operation methods.The Anderson Dysphagia Scale,Syd-ney Dysphagia Scale and modified swale drinking water test were used to evaluate the swallowing function on the first day of postoperative oral feeding in the patients.Results The total scores and scores of various di-mensions of the Chinese version of Anderson Dysphagia Scale,total scores and scores of various dimensions of Sydney Swallowing Scale and the results of the modified swale drinking water test had statistical differences a-mong the various groups(P＜0.01);the above indexes had statistical difference between the total laryngeal group and the other groups(P＜0.01),but the above indexes had no statistical difference between the two groups in the horizontal group,vertical group and SCPL-CHEP group(P＞0.05).Conclusion In the patients with laryngeal cancer undergoing open laryngectomy,the dysphagia is less severe during early eating after to-tal laryngectomy,which has little impact on life.