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 explore the distribution of common TCM syndromes and symptoms of insomnia;To prepare for the construction of the theoretical framework and item pool of syndrome diagnosis and efficacy evaluation scale.Methods TCM guideline standards of insomnia,textbooks and journals over the years were retrieved,the information of TCM syndromes,syndrome elements and symptoms was extracted,the guideline textbook and journal database were established,and descriptive statistics,association rules,systematic clustering,factor analysis,potential categories and implicit structure analysis were carried out.Results Totally 116 guide standards and textbooks over the years were included,and 454 articles of journals were included.The high-frequency symptoms accounted for≥3%of the guide textbooks and journal databases were 87 and 79 categories,respectively,and the cumulative proportion was 87.48%and 87.75%,respectively.According to the analysis results,five common TCM syndromes and their characteristic symptom classification of insomnia were finally deduced.According to the frequency/person time distribution,they were heart and spleen deficiency syndrome,yin deficiency and fire hyperactivity syndrome,liver fire disturbing heart syndrome,phlegm heat disturbing heart syndrome,heart and gallbladder qi deficiency syndrome.Conclusion There are five common TCM syndromes of insomnia,and the characteristic symptoms of each TCM syndrome provide a reference source for the theoretical framework of syndrome diagnosis and efficacy evaluation scale and the establishment of item pool.

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 explore the distribution of common TCM syndromes and symptoms of insomnia;To prepare for the construction of the theoretical framework and item pool of syndrome diagnosis and efficacy evaluation scale.Methods TCM guideline standards of insomnia,textbooks and journals over the years were retrieved,the information of TCM syndromes,syndrome elements and symptoms was extracted,the guideline textbook and journal database were established,and descriptive statistics,association rules,systematic clustering,factor analysis,potential categories and implicit structure analysis were carried out.Results Totally 116 guide standards and textbooks over the years were included,and 454 articles of journals were included.The high-frequency symptoms accounted for≥3%of the guide textbooks and journal databases were 87 and 79 categories,respectively,and the cumulative proportion was 87.48%and 87.75%,respectively.According to the analysis results,five common TCM syndromes and their characteristic symptom classification of insomnia were finally deduced.According to the frequency/person time distribution,they were heart and spleen deficiency syndrome,yin deficiency and fire hyperactivity syndrome,liver fire disturbing heart syndrome,phlegm heat disturbing heart syndrome,heart and gallbladder qi deficiency syndrome.Conclusion There are five common TCM syndromes of insomnia,and the characteristic symptoms of each TCM syndrome provide a reference source for the theoretical framework of syndrome diagnosis and efficacy evaluation scale and the establishment of item pool.

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 assess respondents' understanding of the items in the Neck Dissection Impairment Index (NDII) through cognitive interviews and to revise the items accordingly.Methods:Totally 30 postoperative neck dissection patients returning for follow-up at Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University from November 2023 to February 2024, were selected by purposive sampling for two rounds of cognitive interviews. Based on the interview results, the Chinese version of the NDII was revised.Results:The Chinese version of the NDII included ten items. The first round of interviews identified issues such as "incomplete expression, abstract language, and written form, " leading to revisions of five items. The second round of interviews showed that all respondents understood the revised items, and no new suggestions for modification were made.Conclusions:Cognitive interviews can improve respondents' comprehension of the Chinese version of the NDII, identify cognitive biases caused by cultural differences and improper linguistic expressions during the translation process, and enhance the understanding and acceptance of the scale's content among the target population.

Objective To use Meta-analysis to compare the roles of bispectral index (BIS) monitoring and subjective rating scale in Intensive Care Unit (ICU) mechanical ventilation patients, and to provide a reference for selecting better sedation assessment tools in clinical practice. Methods Randomized controlled trials in ICU mechanical ventilation patients were collected from Scopus, Web of Science, PubMed, CNKI, Cochrane Library, VIP, WanFang Date, and CBM from database establishing to 2018 by BIS monitoring. The literatures were selected according to inclusion and exclusion criteria, data were extracted and the quality of the trials was evaluated. Meta-analysis was performed using RevMan5 software. Results Eleven randomized controlled studies were screened out. The total sample had 1354 cases, including 664 in the BIS group and 690 in the subjective rating scale group. Meta-analysis showed that sedative drug use (standardized mean difference [SMD]=0.28, 95％CI: -0.20-0.76), duration of sedation (mean difference [MD]=0.84, 95％CI: 2.00-3.67), arousal time after discontinuation (MD=-6.20, 95％CI: 19.76-7.35), mechanical ventilation time (MD=-0.33, 95％CI:-1.20-0.54]), ICU hospitalization stay (MD=-0.82, 95％CI: -3.94-2.30), and mortality (odds ratio [OR]=0.83, 95％CI: 0.52-1.32) showed no significant differences between the two groups (P>0.05). The incidence of unplanned extubation in the BIS group (OR=0.20, 95％ CI: 0.10-0.42) was significantly lower than that in the subjective rating scale group (P<0.05). Conclusion There is currently insufficient evidence to show that BIS monitoring is superior to subjective rating scale in sedative drug use and disease prognosis in ICU mechanical ventilation.

Objective To observe the clinical efficacy of cerebral palsy children with liver strong spleen weak syndrome treated with integrated traditional Chinese medicine therapy. Methods Eighty cerebral palsy children with liver strong spleen weak syndrome were divided into treatment group (40 cases) and control group (40 cases). Patients in control group were treated with conventional therapy (including exercise therapy, occupational therapy, guidance education, physical factors, and psychological therapy), and patients in treatment group were treated with integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) additionally. Three months were set for a course of treatment, and the whole treatment lasted for a total of four courses. TCM clinical symptoms were scored every six months, muscle tone (MAS), gross motor function (GMFM), and daily life activity ability (MBI) were evaluated every three months for both groups. Results There were significant differences in the total scores of TCM clinical symptom, MAS, GMFM, and MBI at different treatment time points in the two groups, compared with that before treatment (P<0.01). There were significant differences in the total scores of clinical symptom for Chinese medicine, MAS, GMFM, and MBI at different treatment time points for treatment group, compared with that of control group (P<0.05). Conclusion Integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) for cerebral palsy children on the basis of western medicine therapy can more effectively improve function and life quality of children patients.

Objective To establish a scientific and normative process for using physical restraint,and to increase the safety and efficiency of physical restraint.Methods On the basis of the previous studies,combined with the literature and clinical,we drafted a process framework of using physical restraint and then conducted consultation from 11 experts by using the Delphi technique.Results After 2 rounds of consulting,an evaluation form,consisted of 4 first-dimensions and 11 second-dimensions,and a process,consisted of 4 first-dimensions and 26 second-dimensions,were established.Kendall's W were 0.37 and 0.38 respectively,and expert authority coefficient was 0.84.Conclusions The results from the study is valid,feasible and reliable,however it still need to be further perfected.

One hundred and fifty femoral head necrosis patients with intramedullary decompression received autologous stem cell transplantation. The blood was taken from unilateral or bilateral iliac, in each group the volumes of blood taken were 200, 300 or 400 ml respectively. The number of mononuclear cells was counted before and after centrifugation. The mononuclear cell count in subgroup of 200 ml,300 ml and 400 ml taken from unilateral iliac after centrifugation was (3. 11 ±1. 42) × 1010/L, (2. 62 ±1. 31 ) × 1010/L and(2. 13 ±. 91) × 1010/L. The concentration was significantly lower in subgroup of 400 ml than that of 200 ml (t=5. 118, P<0. 01). The mononuclear cells count in subgroup of 200 ml,300 ml and 400 ml taken from bilateral iliac was(4. 51 ±. 21) × 1010/L, (3. 89 ±. 06) × 1010/L and (2. 98 ±1. 39) × 1010/L, the concentration was significantly lower in subgroup of 400 ml than that of subgroup of 200 ml (t = 6. 446, P < 0. 01). Whether 200 ml or 300 ml or 400 ml blood were taken, the mononuclear cell count in blood taken from bilateral iliac after centrifugation was significantly higher than that from unilateral iliac(t = 3. 119,P < 0. 01; t = 5. 544, P < 0. 01 ;t = 2. 207 ,P < 0. 05). The results indicate that the concentration of isolated bone marrow mononuclear cells is higher from bilateral iliac than unilateral iliac. The concentration of isolated monocytes is reduced gradually with the increased blood volume.