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.

The nervous system not only affects the core processes of tumors such as proliferation, metastasis and angiogenesis, but is also closely related to symptoms such as tumor-related pain and cachexia. Meanwhile, tumor cells can invade adjacent tissues through nerve pathways to induce perineural invasion, which promotes tumor development. This article reviews the research progress in role of the nervous system in tumor occurrence and development from perspectives of tumor perineural invasion, neurotrophic factors, autonomic and sensory nerves, and influence of the neuroimmune system in tumors, in order to provide new perspective and method for tumor treatment.

OBJECTIVE To investigate the ameliorative effect of Pinelliae Rhizoma Praeparatum Cum Alumine and its effective components on inflammatory response in mice with acute lung injury(ALI).METHODS A mice model of acute lung injury induced by lipopolysaccharide(LPS)was used as the in vivo animal model.The levels of inflammatory factors TNF-α,IL-6,and IL-1β,the total protein concentration,the number of inflammatory cells in bronchoalveolar lavage fluid,the ratio of lung wet weight to dry weight,and the pathological damage of lung tissues were taken as the evaluation indexes.RAW264.7 macrophages induced by LPS were used as the in vitro experimental model,with the mRNA levels of intracellular inflammatory factors TNF-α,IL-1β,and IL-6 as indicators,systematic solvent extraction and silica gel column chromatography were used to separate and screen the effective parts and components of Pinelliae Rhizoma Praeparatum Cum Alumine for treating acute lung injury.The component composition of the effective fractions was analyzed by mass spectrometry,the content of cyclic dipeptide components in the effective fraction was determined,and the anti-in-flammatory activity of cyclic dipeptides was verified in vitro.RESULTS The ethyl acetate extraction fraction obtained by extracting the supernatant of water extraction and ethanol precipitation of Pinelliae Rhizoma Praeparatum Cum Alumine(referred to as the ethyl acetate fraction for short)significantly improved the inflammatory response in mice with acute lung injury and significantly reduced the mRNA levels of TNF-α,IL-1β,and IL-6 in RAW264.7 cells induced by LPS.The Fr.1 fraction isolated from the ethyl acetate frac-tion by silica gel column chromatography had anti-inflammatory effects in vitro.Mass spectrometry determined the content of two main cyclic dipeptide components,cyclo-(Pro-Phe)and cyclo-(Pro-Val),in the Fr.1 fraction.After mixing these two cyclic dipeptide components in the molar ratio in the Fr.1 fraction and administering them in vitro,the results showed that the combination of these two cyclic dipeptide components could significantly inhibit the mRNA expression levels of TNF-α,IL-1β,and IL-6 in RAW264.7 cells induced by LPS.CONCLUSION Cyclic dipeptide component is one of the main material basis categories for the anti-inflammatory effect of Pinelliae Rhizoma Praeparatum Cum Alumine.

Objective The identification of TCM constitution plays an important role in"treating and preventing diseases"of TCM.At present,the identification of damp-heat constitution and balanced constitution is mostly determined by questionnaire,and subjective factors have a great influence.Aiming at the identification of damp-heat constitution and balanced constitution in TCM,this paper utilizes voice signal to automatically realize the constitution identification task,in order to provide assistance for the clinical identification of TCM constitution.Methods Based on deep learning Transformer and transfer learning,a pure attentional mechanism model was designed for the identification of constitution in TCM sound diagnosis.We collected 700 voices from 34 subjects,pre-processed the voice data to obtain the corresponding Mayer spectrum diagram,and used the Transformer model pre-trained based on the public data set to improve the performance of the model for audio classification.Results The accuracy of the experimental results was 83.33%,the AUC was 92.16%,the sensitivity was 80.25%,and the specificity was 87.03%.Compared with the Convolutional Neural Network(CNN),the performance of the deep learning model was better.Conclusion In this paper,the damp-heat constitution and balanced constitution identification model Transformer has achieved better identification effect,indicating that it can improve the efficiency of TCM acoustic diagnosis of constitution identification,and promote the objective and intelligent development of constitution identification.

The nervous system not only affects the core processes of tumors such as proliferation, metastasis and angiogenesis, but is also closely related to symptoms such as tumor-related pain and cachexia. Meanwhile, tumor cells can invade adjacent tissues through nerve pathways to induce perineural invasion, which promotes tumor development. This article reviews the research progress in role of the nervous system in tumor occurrence and development from perspectives of tumor perineural invasion, neurotrophic factors, autonomic and sensory nerves, and influence of the neuroimmune system in tumors, in order to provide new perspective and method for tumor treatment.

OBJECTIVE To prepare hyaluronic acid(HA)-modified emodin(EMD)-contained multi-walled carbon nanotubes(MWCNTs)drug delivery system(HA-MWCNTs-EMD)and explore its in vitro inhibitory effect on breast cancer cells.METHODS EMD was loaded onto MWCNTs to prepare a drug delivery system MWCNTs-EMD;subsequently,the system was further modified with HA to obtain the drug delivery system HA-MWCNTs-EMD.The two drug delivery systems mentioned above were characterized.With free EMD as the reference,the drug release in vitro of the above two drug delivery systems was investigated;the uptake of EMD by two breast cancer cells(MCF-7,MDA-MB-231 cells)was detected.The impacts of the above two drug delivery systems on the expression of surface glycoprotein differentiation group 44(CD44),activity,apoptosis and lactate dehydrogenase(LDH)release of two breast cancer cells were detected.RESULTS The encapsulation efficiencies of MWCNTs-EMD and HA-MWCNTs-EMD were both(63.52±2.74)%,with drug loading rates of(25.01±1.83)%and(12.13±1.96)%,particle sizes of(865.95±2.16)and(351.86±1.68)nm,polydispersity indexes of 0.54±0.02 and 0.23±0.01,and Zeta potentials of(23.87±0.14)and(-42.79±0.39)mV,respectively.The 2,4,6,8,10,12 and 24-hour cumulative release rates of EMD in MWCNTs-EMD and HA-MWCNTs-EMD were significantly lower than those in free EMD,while the cumulative release rate of HA-MWCNTs-EMD was significantly higher than that of MWCNTs-EMD(P＜0.05);the EMD uptakes of MWCNTs-EMD and HA-MWCNTs-EMD by the two types of breast cancer cells were significantly higher than their uptake of free EMD(P＜0.05).Compared with the free EMD group,the MWCNTs-EMD and MWCNTs-EMD groups showed significantly higher apoptosis rate and LDH release,significantly lower surface CD44 expression(except for the MWCNTs-EMD group)and cell viability in both cell types,and the effect of HA-MWCNTs-EMD was more pronounced(P＜0.05).CONCLUSIONS A novel drug delivery system HA-MWCNTs-EMD loaded with EMD is developed successfully;the drug delivery system has a certain slow-release effect,which can significantly reduce the activity of breast cancer cells,promote their apoptosis and increase the release of LDH,and the above anti-breast cancer effect is significantly stronger than that of free EMD and MWCNTs-EMD.

Objective:To examine frailty in residents aged over 50 in the Chengdu community, investigate the risk factors linked to frailty, and analyze the impact of exercise habits on frailty.Methods:This retrospective study utilized a stratified whole-sample method to select Chengdu residents aged over 50 from 6 communities.Relevant information was collected through face-to-face interactions using a self-developed frailty questionnaire between May 2022 and May 2023.Exercise habits were defined as engaging in physical activity more than three times a week for at least 30 minutes per session, consistently maintained for a minimum of five years prior to the survey.The frailty index(FI)was established based on the multiple-deficit cumulative model.Respondents were classified into categories of no frailty(FI<0.1), mild frailty(0.1 ≤ FI<0.2), and moderate-severe frailty(FI≥0.2).Univariate and multivariate logistic regression analyses were conducted to investigate the factors influencing frailty and to compare the prevalence and progression of frailty among individuals with and without exercise habits across different age groups.Results:A total of 999 participants, comprising 483(48.3%)males and 516(51.7%)females, were enrolled in the study.The average age of the participants was 65.70±9.61 years.Among them, 346(34.6%)were classified as having mild frailty, while 107(10.7%)had moderate-severe frailty.Univariate analysis revealed that age, gender, marital status, education, smoking, alcohol consumption, and exercise habits were potential factors influencing frailty( P<0.05).Multifactorial logistic regression models indicated that individuals aged 70-79 and 80-85 were predictors of mild and moderate-severe frailty, respectively.Being female was identified as an independent risk factor for both mild frailty( OR: 1.196; 95% CI: 1.262-3.073)and moderate-severe frailty( OR: 2.721; 95% CI: 1.282-5.774).Additionally, not engaging in regular exercise was associated with an increased risk of mild frailty( OR: 1.588; 95% CI: 1.149-2.193)and moderate-severe frailty( OR: 3.186; 95% CI: 1.819-5.583).Statistical analysis revealed significant differences in frailty distribution and frailty index changes between individuals with and without exercise habits over the age of 60( P<0.05). Conclusions:Age and gender were found to be closely associated with frailty, with the impact of exercise habits on frailty becoming more pronounced after the age of 60.Encouraging middle-aged and older individuals to adopt regular exercise routines can play a significant role in promoting healthy aging in China.

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.

Objective:To develop an intelligent recognition and precise segmentation technique using ultrasonic images，and to enhance diagnostic efficiency and accuracy.Methods:A total of 1，430 patients diagnosed with uterine fibroids through transvaginal ultrasonography at the Maternal and Child Health Hospital of Guangming from November 2020 to October 2024 were retrospectively included. Ultrasonic images were manually annotated by two experienced physicians and reviewed by a senior expert. The Mask DINO deep learning model was used for lesion segmentation，and the segmentation results were optimized using ellipse fitting technology. Model performance was evaluated using the Dice coefficient，intraclass correlation coefficient（ICC），mean absolute error（MAE），and measurement accuracy.Results:In the test set of 286 cases，the average Dice coefficient of model prediction was 0.992，indicating extremely high segmentation accuracy. The average accuracy of lesion identification by the model was 0.909，with 241 correctly identified samples，19 basically correct samples，and 26 incorrect samples. In terms of long and short axis measurements，the ICC of the model's direct predictions were 0.871（short axis）and 0.784（long axis），with MAE of 0.436 cm（short axis）and 0.508 cm（long axis）. After optimization with ellipse fitting，the ICC increased to 0.893（short axis）and 0.866（long axis），and the MAE decreased to 0.191 cm（short axis）and 0.274 cm（long axis），the measurement accuracy improved significantly.Conclusions:The intelligent recognition and precise segmentation technique for uterine fibroids based on ultrasonic images constructed in this study performed excellently in lesion segmentation and measurement，it can significantly improve the efficiency and accuracy of diagnosis.

Objective:To investigate the expression of homeobox protein C4(HOXC4)in gastric cancer tissues and cells,as well as its effects on the proliferation,migration and invasion of gastric cancer cells and the underlying mechanisms.Methods:The cancer and adjacent tissue specimens surgically removed from 16 patients with advanced gastric cancer at the Department of Oncology,Nanyang First People's Hospital,between May 2020 and April 2021 were collected.Additionally,human normal gastric epithelial cells(GES-1)and gastric cancer cell lines(AGS,SGC-790,and MGC-803)were included.Western blot(WB)was performed to detect HOXC4 expression in gastric cancer tissues and cells.RNA interference technology was used to knockdown or overexpress HOXC4 in SGC-790 and AGS cells,with experimental groups divided as follows:the sh-HOXC4#1 group,sh-HOXC4#2 group,sh-Con group,sh-HOXC4+pc-integrin β1 group,pc-HOXC4 group,pc-Con group,and pc-HOXC4+pc-integrin β1 group.EdU assay,CCK-8 assay,and Transwell assay were employed to evaluate the effects of HOXC4 knockdown or overexpression on cell viability,proliferation,migration,invasion,and integrin β1 expression in each group.A tumor-bearing mouse model was established using HOXC4-knockdown AGS cells to observe the impact of HOXC4 knockdown on tumor volume and the expressions of Ki67 and integrin β1 proteins in xenograft tissues.Results:The expression of HOXC4 in gastric cancer tissues and cells was significantly up-regulated(all P<0.01).Compared with those in the sh-Con group,the expression levels of HOXC4 and integrin β1 in SGC-790 and AGS cells,and the cell viability,proliferation,migration and invasion ability decreased significantly in sh-HOXC4#1 and sh-HOXC4#2 groups(all P<0.01).Compared with those in the sh-HOXC4 group,the cell viability,invasion and migration abilities of cells in the sh-HOXC4+pc-integrin β1 group increased significantly(all P<0.01).Compared with those in the pc-Con group,the cell viability,invasion and migration abilities of cells in the pc-HOXC4 group increased significantly(all P<0.01).Compared with those in the pc-HOXC4 group,the cell viability,invasion and migration abilities of cells in the pc-HOXC4+integrin β1-shRNA group decreased significantly(all P<0.01).Compared with those in the sh-Con group,the tumor grew slowly,and the volume decreased,and the expressions of Ki67 and integrin β1 decreased significantly in the sh-HOXC4#1 and sh-HOXC4#2 groups(all P<0.01).Conclusion:The expression of HOXC4 is up-regulated in gastric cancer tissues and cells,and it promotes the proliferation,migration and invasion of gastric cancer cells by activating the integrin β1 signaling pathway.