Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To explore the challenges in sedentary behavior modification among patients with lower extremity arteriosclerosis obliterans(ASO),with the goal of informing the development of personalized physical acti-vity interventions to address sedentary behavior patterns.Methods A purposive sample of 16 patients diagnosed with lower extremity ASO was recruited as participants from the department of vascular surgery at a tertiary hospital in Sichuan province between August and November 2024.Semi-structured interviews were conducted to collect data and the Colaizzi 7 steps was used to analyze the data based on Capacity-Opportunity-Motivation-Behavior model.Results 3 themes and 12 sub-themes were identified,namely capacity(lower extremity and somatic dysfunction,psychological perception constraints,disease literacy deficits),motivation(inadequate perceived value of physical activity,diminished self-efficacy,kinesiophobia,negative cognitive framing),opportunity(generalization of guidance on disease knowledge,constrained healthcare resources,the normalization of sedentary entertainment practices,financial burden constraints,inadequate family support).Conclusion The factors influencing sedentary behavior in ASO patients are complex and diverse.Healthcare professionals need to comprehensively assess the multifaceted factors contributing to patients' difficulties in changing sedentary behavior,and develop targeted strategies accordingly to promote improvements in their sedentary habits.

Objective To explore the challenges in sedentary behavior modification among patients with lower extremity arteriosclerosis obliterans(ASO),with the goal of informing the development of personalized physical acti-vity interventions to address sedentary behavior patterns.Methods A purposive sample of 16 patients diagnosed with lower extremity ASO was recruited as participants from the department of vascular surgery at a tertiary hospital in Sichuan province between August and November 2024.Semi-structured interviews were conducted to collect data and the Colaizzi 7 steps was used to analyze the data based on Capacity-Opportunity-Motivation-Behavior model.Results 3 themes and 12 sub-themes were identified,namely capacity(lower extremity and somatic dysfunction,psychological perception constraints,disease literacy deficits),motivation(inadequate perceived value of physical activity,diminished self-efficacy,kinesiophobia,negative cognitive framing),opportunity(generalization of guidance on disease knowledge,constrained healthcare resources,the normalization of sedentary entertainment practices,financial burden constraints,inadequate family support).Conclusion The factors influencing sedentary behavior in ASO patients are complex and diverse.Healthcare professionals need to comprehensively assess the multifaceted factors contributing to patients' difficulties in changing sedentary behavior,and develop targeted strategies accordingly to promote improvements in their sedentary habits.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

OBJECTIVE: Hypertension is a low-grade inflammation state of the disease and was easily complicated by kidneys' inflammatory response. Mangiferin (MGF), a pharmacologically active compound in various plants including Mangifera indica, has a strong anti-inflammatory activity. However, the effects of MGF on renal inflammatory injury in spontaneously hypertensive rats (SHRs) remain unclear. The purpose of this study was to investigate the protective effects and mechanisms of MGF on renal inflammatory injury in SHRs. METHODS: MGF was used in SHRs at the doses of 10, 20, 40 mg/kg/d for 8 weeks consecutively. The blood and urine were collected for assessment of renal function. Renal tissues were collected for histological, immunohistochemistry, ELISA, Western blot and real time reverse transcription PCR (RT-PCR) analysis. RESULTS: The results showed that the levels of interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1) and recombinant chemokine C-C-Motif receptor 2 (CCR2) were increased in SHRs, meanwhile, the level of IL-10 was decreased in SHR. Treatment of MGF inhibited the expression of IL-6, TNF-α, MCP-1 and CCR2, and promoted the expression of IL-10. Furthermore, the content of blood urea nitrogen (BUN) and serum uric acid (SUA) was significantly increased in the model group, and treatment of MGF had no obvious effects on these parameters at all dose levels. CONCLUSION Our study proved that the kidneys of SHRs had significant inflammatory injury, and MGF had the protective effects on renal inflammatory injury in SHRs; The protective mechanism may be mediated partly by the MCP-1/CCR2 signaling pathway. Thus, it is a potential new drug for the treatment of hypertension.

Objective:To study the clinical results of robot-assisted laparoscopic resection for choledochal cysts.Methods:From October 2020 to June 2022, clinical data on 20 patients who underwent choledochal da Vinci robot-assisted laparoscopic choledochal cyst resection at Fujian Provincial Hospital were retrospectively analyzed. Forty-two children with choledochal cysts were included in this study. There were 16 males and 26 females, aged 25 (range 15.0 to 45.0) months. The operations were carried out by the same team of surgeons. These patients were divided into two groups based on the surgical methods: children who underwent da Vinci robot-assisted laparoscopic surgery were in the robotic group ( n=20) and children who underwent single-port (transumbilical) laparoscopic surgery were in the laparoscopic group ( n=22). The general clinical data, operation time, intraoperative blood loss, fasting time, hospital stay, total medical costs and complications were collectd and analysed. Follow-up was performed in outpatient visits. Results:Both the 2 groups underwent surgery successfully, and no patient was converted to laparotomy. When compared with the laparoscopic group, intraoperative blood loss [(10.65±3.75) vs. (14.86±3.75) ml], indwelling time of abdominal drainage tube [(5.45±2.21) vs. (7.05±1.94) d] and fasting time [(4.00±1.49) vs. (6.05±1.43) d] in the robotic group were significantly less, while the operation time [394(299, 422) vs. 351(269, 380) min] and hospitalization cost [(79 200±4 000) vs. (31 100±3 000) yuan] were significantly increased (all P<0.05). The differences in postoperative complication rates and pain score between the two groups showed no significant differences (all P>0.05). On follow-up, no patients developed complications such as cholangitis, jaundice, intestinal obstruction and cholangiocarcinoma, except for one patient in the laparoscopic group who developed cholangitis after surgery. Conclusion:Robot-assisted laparoscopic choledochal cystectomy was effective and safe in treatment of children with choledochal cysts.

In recent years, the clinical guidelines for the diagnosis and treatment of rheumatoid arthritis (RA) have been constantly updated. Among the general principles, it is particularly emphasized that, in order to improve the ratio of treat to target(T2T) of RA, doctors and patients should work together to negotiate the details of the guidelines. Therefore, it is important for patients to further understand the disease and clinical guidelines of RA, and to better cooperate with doctors. This study was based on the most concerned issues of RA patients and international standard procedure of guideline study, we organized the working group and introduce the following 16 recommendations constituting the RA patients′ practice guidelines.

In recent years, osteoporosis (OP) has become one of the main diseases affecting the health of middle-aged and elderly people in China, and the prevalence of OP has increased significantly. The clinical diagnosis and treatment guidelines for this disease are also constantly updated. The overall principles speciallyemphasise that doctors and patients need to work together to negotiate the details of the diagnosis and treatment guidelines, in order to improve the OP clinical diagnosis and treatment rate. Therefore, patients′ knowledge of the disease, understanding of clinical guidelines, and cooperation with doctors to implement diagnosis and treatment plans are very important. In this study, from the most concerned issues of the patients, we established the OP patient practice guideline working group. 14 recommendations, as the OP patient practice guidelines, are proposed in accordance with the relevant principles of the "World Health Organization guidelines development manual" and the international normative process.

The procurement, preservation and transportation of the donor organs directly affect the clinical prognosis of the recipients. The establishment of process optimization and quality control standards of organ procurement, preservation and transportation contributes to improving the quality and utilization rate of donor organs and reducing the medical risk. According to Guide to the Quality and Safety of Organs for Transplantation (6th edition) proposed by European Union, the 11th chapter of organ procurement, preservation and transportation was interpreted and summarized in this article.