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 current status of work readiness and its influencing factors among patients returning to work after lung cancer surgery. Methods A retrospective study was conducted on young and middle-aged postoperative lung cancer patients who were treated at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to September 2023 and returned to their jobs. Data were collected through a general information questionnaire, readiness for return-to-work scale (RRTW), general self-efficacy scale (GSES), and simplified coping style questionnaire (SCSQ). Univariate and multivariate logistic regression analyses were used to explore the factors affecting the work readiness of patients returning to work. Results A total of 219 patients were included, with 59 males and 160 females aged 18-60 years. Among the postoperative lung cancer patients returning to work, 73.1% were in the active maintenance stage of return-to-work readiness with a RRTW score of (17.59±1.48) points, and 26.9% were in the uncertain maintenance stage with a RRTW score of (16.22±1.50) points. Multivariate logistic regression analysis showed that patients aged≤30 years (OR=52.381), employees of enterprises and institutions (OR=7.682), agricultural, pastoral, fishery, forestry laborers (OR=15.665), positive coping (OR=5.043), those with higher self-efficacy (OR=1.157) and engaged in physically demanding work (OR=2.449) had higher return-to-work readiness, while patients with≥2 children (OR=0.055), self-payment (OR=0.044), and those working more than 40 hours per week (OR=0.122) had lower return-to-work readiness. Conclusion The return-to-work readiness of young and middle-aged postoperative lung cancer patients needs to be improved, and occupation, job nature, main coping styles, general self-efficacy and other factors are associated with return-to-work readiness.

Objective To investigate the effects of HIF1A-AS1 on the proliferation and apoptosis of gastric cancer cells lines BGC-823 and MKN28 and its possible mechanism.Methods The expression of HIF1A-AS1 in gastric cancer tissues was analyzed by bioinformatics.H1F1A-AS1 over expression and silenced BGC-823 and MKN28 cell strains were constructed.HIF1A-AS1 expression was detected by real-time PCR,cell proliferation was detected by CCK-8 assay,and apoptosis was detected by flow cytometry.Western blot was used to detect the expression of HIF1A protein in cytoplasm and nucleus and cellular immunofluorescence was used to detect HIF1A protein into nucleus.Results Models of BGC-823 and MKN28 gastric cancer cells with HIF1A-AS1 over-expression and silence were successfully constructed.HIF1A-AS1 over-expression decreased cell proliferation(P＜0.05),while HIF1A-AS1 over-expression significantly increased cell proliferation(P＜0.05).HIF1A-AS1 silencing significantly increased the apoptosis(P＜0.05),and HIF1A-AS1-over expression significantly decreased the apoptosis(P＜0.05).HIF1A-AS1 silencing inhibited the nucleation of HIF1A protein and over-expression promoted the nucleation of HIF1A pro-tein.HIF1A-AS1 silencing significantly decreased the expression of HIF1A cytoplasmic protein(P＜0.05)and over-expression of HIF1A-AS1 significantly increased the expression of HIF1A cytoplasm protein(P＜0.05).HIF1A-AS1 silencing significantly decreased the expression of HIF1A nuclear protein(P＜0.05)while HIF1A-AS1 over-expression significantly increased the expression of HIF1A nuclear protein(P＜0.05).Conclusions HIF1A-AS1 may promote the proliferation and inhibit apoptosis of BGC-823 and MKN28 gastric cancer cells by regulating the expression of parental gene HIF1A.

Objective To explore the efficacy,safety,and technical advantages of laparoscopic combined with calyceal lithotomy in the simultaneous treatment of parapelvic cyst with renal calculi.Methods The clinical data of two patients diagnosed with parapelvic cyst and renal calculi in our hospital were retrospectively analyzed.Both patients received transabdominal laparoscopic excision of parapelvic cyst and calyceal lithotomy under general anesthesia.Preoperative CT plus intravenous pyelography(IVP)was performed to localize the calculi within the renal calyx.During operation,the cyst wall was dissected and exposed using an ultrasonic scalpel,followed by incision of the cyst wall,aspiration of cystic fluid,and excision of redundant cyst wall.Methylene blue was instilled through the ureteral catheter to mark the renal pelvis and calyces,followed by incision of the target calyx and extraction of the calculi.The changes of the cysts and calculi were analyzed.Operation time and complications were recorded.Results Both patients were admitted due to recurrent right flank pain as the chief complaint and were diagnosed with right renal multiple calculi complicated with hydronephrosis and parapelvic cysts through preoperative imaging examinations.The parapelvic cyst measured approximately 6.4 cm ×5.3 cm and 4.5 cm × 4.1 cm,respectively.The operations were successfully completed without major complications such as hemorrhage or infection.The operation time was 180 and 125 minutes,respectively.Postoperative ultrasound and abdominal plain film confirmed complete resolution of cysts and calculi.During the 2-year follow-up,both patients experienced complete resolution of flank pain with no recurrence of cysts or calculi.Conclusion Transabdominal laparoscopic combined with calyceal lithotomy is a safe and feasible technique for synchronous treatment of parapelvic cysts with renal calculi,offering advantages such as minimal trauma,rapid postoperative recovery,and low recurrence rates.This procedure should be performed in patients with parapelvic cysts larger than 4 cm.Intraoperative ureteral catheterization with methylene blue infusion is utilized to delineate the renal pelvis and calyces,which is combined with preoperative imaging findings to assist in precise stone localization.

Objective:To evaluate the applicability of a new anti-G capability assessment trainer (AG-CAT) in high-performance (HP) anti-G maneuver training and positive pressure breathing for high-G (PHP) training for pilots.Methods:A total of 142 fighter pilots who were subjected to anti-G maneuver training at Dujiangyan Special Crew Sanatorium of PLA Air Force between January and November 2023 were enrolled. According to the Guidelines for Aviation Physiological Training, 123 pilots underwent both HP anti-G maneuver training and PHP positive pressure breathing training, 15 received only HP training, and 4 received only PHP training. Based on the training devices used, these pilots were divided into AG-CAT group and an anti-G and anti-hypoxia capability detection instrument (GHyCDI) group. The 2 groups were compared regarding the pedal force of lower limbs, blood pressure, and improvement of +G z tolerance during training. Results:Of the 138 pilots undergoing HP training, 88 used AG-CAT and 50 used GHyCDI. One hundred and twenty-seven pilots participated in PHP training, with 73 in the AG-CAT group and 54 in the GHyCDI group. During HP training, the pedal force of left lower limbs in the AG-CAT group was greater than that of the right limbs and of the GHyCDI group ( t=4.38, 2.64, P<0.001, =0.009). In PHP training, the AG-CAT group exhibited greater pedal force in left limbs than in right ones, while the GHyCDI group showed an opposite trend ( t=2.25, 3.37, P=0.029, 0.002). Systolic and diastolic blood pressures during HP training (with or without anti-G suits) were higher in the AG-CAT group than in the GHyCDI group ( t=3.50, 3.72, 2.55, 4.21, P=0.001,<0.001,=0.012,<0.001). Similarly, during PHP training, both systolic and diastolic pressures were higher in the AG-CAT group ( t=2.03, 3.81, P=0.045,<0.001). The AG-CAT group demonstrated superior improvements in +G z tolerance during HP training (without/with anti-G suits: Z=2.14, 3.21, P=0.049, 0.001) and PHP training ( Z=2.56, P=0.010) compared with the GHyCDI group. Conclusions:AG-CAT shows excellent applicability in aviation physiological training of pilots. Its ergonomic design, practical functionalities and enhanced compatibility with personnel protective equipment can better meet training requirements compared to conventional devices.

Purpose To evaluate the differential diagnostic value of 5.0T MRI susceptibility-weighted imaging(SWI)in hepatocellular carcinoma(HCC)and mass-forming intrahepatic cholangiocarcinoma(MICC).Materials and Methods A total of 56 patients with HCC and 36 patients with MICC confirmed by pathology from March 2023 to November 2024 in Anhui Provincial Hospital were retrospectively enrolled.Two radiologists independently analyzed three features of the lesions,including the low-signal rims around the lesion,hemorrhage within the lesion,and the relationship between lesions and adjacent vessels,on the SWI sequence between the two groups,respectively,via inter-rater consistency analysis.These above features between the two groups were compared and contrasted them with those obtained from conventional MR plain and enhanced scans,respectively.For intralesional hemorrhages,the diagnostic value was quantified by calculating the internal tissue susceptibility signal.Results The radiologists showed good consistency in the low-signal rims,intratumoral hemorrhage as well as the relationship between the lesion and the blood vessel on the SWI in the HCC group and the MICC group(Kappa=0.802-0.929,all P<0.001).Compared with conventional MR plain,SWI significantly enhanced the detection rates of perilesional low-signal rims and intratumoral hemorrhage(χ2=89.409,46.210,both P<0.001).These findings were more prevalent in HCC patients.The internal tissue susceptibility signal grading showed that HCC predominantly exhibited grade 3,whereas MICC predominantly exhibited grade 1,with statistically significant differences(Z=-4.059,P<0.05).Additionally,compared with enhanced MRI,SWI demonstrated higher accuracy in diagnosing the relationship between lesions and blood vessels in both groups;however,these differences were not statistically significant(χ2=0.275,0.247,P=0.871,0.619).In the HCC group,the relationship between tumors and blood vessels was primarily characterized by compression and tumor thrombus formation,while in the MICC group,it was predominantly marked by invasive changes,including vessel encasement,stenosis or occlusion,with a statistically significant difference between the two groups(Z=-6.809,P<0.001).Conclusion SWI sequence of 5.0T MRI provides clear visualization of the internal and peripheral structures of HCC and MICC.It can accurately delineate the relationship between lesions and blood vessels without the need for contrast agents,offering significant clinical utility in differentiating these two conditions.

Objective:Screening of hypertrophic cardiomyopathy-related signature genes and analysis of immune cell infiltra-tion characteristics by bioinformatics methods.Methods:The dataset was downloaded from the GEO database,and multiple algo-rithms in R language were used to analyze differentially expressed genes,construct weighted gene co-expression networks to obtain clinical relevance module,screen core genes,identify signature genes,identify signature gene prognosis efficacy and perform func-tional enrichment to explore immune cell infiltration.Results:A total of 117 differential genes and a core module containing 32 genes were screened,and 19 core genes were obtained.Among them,ABCA5,DNAJC16,LGALS14,MGAT4A,SLC30A8 were identified as signature genes.Statistically significant changes in the levels of macrophages,eosinophils,and plasmacytoid dendritic cells in the plasma of patients with hypertrophic cardiomyopathy compared with healthy controls were observed(P<0.05).Conclusion:The char-acteristic genes ABCA5,DNAJC16,LGALS14,MGAT4A and SLC30A8 may serve as prognosis markers for hypertrophic cardiomyop-athy,immune cells such as macrophages and eosinophils may be involved in the occurrence and development of hypertrophic cardio-myopathy.

Objective:To explore effects and mechanism of Hydroxylsafflower Yellow A(HSYA)on expression of NLRP3 in glial cells after cerebral ischemic injury.Methods:A middle cerebral artery occlusion/reperfusion(MCAO/R)model was established in male SD rats.After successfully modeling for 24 h,Longa scoring and corner test were used to evaluate degree of neurological dys-function.Western blot and immunofluorescence were used to detect expressions of JAK2/STAT3 molecules and NLRP3,ELISA was used to measure IL-1β,IL-6 and TNF-α levels.A glucose-oxygen deprivation/reperfusion(OGD/R)model was established in microg-lia,and JAK2 and STAT3 inhibitor AG490 was used to further verify action of HSYA on NLRP3.Results:Compared with sham group,neurological dysfunction aggravated in MCAO/R group(P<0.01),HSYA treatment improved neurological function(P<0.01).Expres-sions of p-JAK2,p-STAT3 and NLRP3 in MCAO/R group were higher than those in the sham group(P<0.01);and HSYA treatment reduced expressions of p-JAK2,p-STAT3 and NLRP3(P<0.01).Levels of inflammatory factors IL-1β,IL-6 and TNF-α were higher in MCAO/R group than sham group(P<0.01),and HSYA inhibited expressions of IL-1β,IL-6 and TNF-α(P<0.01 or P<0.05).In vi-tro experiments showed expressions of p-JAK2,p-STAT3 and NLRP3 in OGD/R group were significantly higher than normal control group(P<0.01),after adding AG490,phosphorylation of JAK2 and STAT3 decreased,NLRP3 expression was inhibited(P<0.01).Inflammatory cytokines IL-1β,IL-6 and TNF-α levels were higher in OGD/R group than normal control group(P<0.01),and HSYA inhibited expressions of IL-1β,IL-6 and TNF-α(P<0.01 or P<0.05).Conclusion:HSYA alleviates brain damage,probably by regu-lating JAK2/STAT3 signaling pathway and inhibiting NLRP3 expression in microglia after cerebral ischemia and hypoxia.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.