To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To investigate the relationship between oral frailty (OF) in patients with cerebral small vessel disease (CSVD) and body composition, as well as neuroimaging biomarkers.

The study included patients with CSVD hospitalized in the Department of Neurology at the Seventh Medical Center of the Chinese People's Liberation Army General Hospital from January 2022 to June 2023. OF was assessed by the oral frailty index-8 (OFI-8), with patients stratified into a low-risk group (score ≤3) and a high-risk group (score ≥4). Data collected encompassed body fat percentage (BF), appendicular skeletal muscle mass index (ASMI), and basal metabolic rate (BMR). Cognitive function was also evaluated, alongside neuroimaging markers of CSVD, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), and CSVD composite score. Variables conforming to a normal distribution were compared using the Student's t-test, while those not following a normal distribution were analyzed with the Mann-Whitney U test. Categorical data were compared using the Chi-square test. Binary Logistic regression was employed to identify independent risk factors associated with OF.

This study enrolled a total of 95 patients, comprising 48 males (31 in the low-risk group and 17 in the high-risk group) and 47 females (33 in the low-risk group and 14 in the high-risk group). Among male CSVD patients, individuals in the high-risk group exhibited a significant reduction in ASMI (OR=0.058, P=0.002) and a marked increase in BF (OR=1.331, P=0.002). Even after adjusting for confounding factors, both ASMI and BF remained independently associated with oral frailty (ASMI: OR=0.038, P=0.003; BF: OR=1.359, P=0.005). Gender differences were observed, with female CSVD patients showing a significant increase in BF exclusively within the high-risk group (OR=1.274, P=0.023). After adjusting for confounding variables, BF remained an independent risk factor for oral frailty (OR=1.308, P=0.028). Moreover, the high-risk group exhibited a significantly higher CSVD composite score (OR=6.532, P=0.004). After adjusting for potential confounders, the CSVD composite score remained an independent predictor of oral frailty risk (OR=5.898, P=0.008).

Among patients with CSVD, body composition is significantly associated with oral frailty, with this relationship exhibiting notable gender differences. Additionally, the overall burden of CSVD plays a crucial role in the onset and progression of oral frailty, with a higher CSVD composite score serving as a key risk factor for its development.

To investigate the effects of muscle health on ischemic stroke and the glymphatic system (GS), and to analyze the mediating role of the GS between the two.

Based on data from the UK Biobank, patients diagnosed with ischemic stroke [International Classification of Diseases, Tenth Revision (ICD-10) codes G45 and/or I63] at the time of first imaging acquisition were included in the analysis. Muscle health measures (walking pace and grip strength) were collected for all participants. The diffusion tensor imaging along the perivascular space (DTI-ALPS) index was derived from diffusion-weighted magnetic resonance imaging, including anterior (aALPS), middle (mALPS), posterior (pALPS), and total (tALPS) indices. Walking pace was self-reported and categorized into slow, steady, and fast pace groups. Grip strength was divided into tertiles based on absolute and relative values, resulting in low, medium, and high grip strength groups. Logistic regression was used to analyze the association of walking pace and grip strength with ischemic stroke risk, while multivariate linear regression assessed their association with the DTI-ALPS index. A causal mediation analysis framework was applied to examine the mediating effect of the DTI-ALPS index.

This study included a total of 37 370 ischemic stroke patients with data on grip strength, walking pace, and DTI-ALPS index. Slow walking pace was a risk factor for ischemic stroke (OR=1.577, 95%CI: 1.186 – 2.070, P=0.001), while high absolute grip strength was a protective factor (OR=0.774, 95%CI: 0.628 – 0.952, P=0.016). In contrast, relative grip strength showed no significant effect on the risk of ischemic stroke (OR=0.819 – 0.871, both P＞0.05). Compared with the steady pace group, the slow pace group showed a decrease in all DTI-ALPS indices (β: -0.037 – -0.025, all P＜0.001), while the fast pace group showed an increase in all DTI-ALPS indices (β: 0.009 – 0.012, all P＜0.001). Relative to the low absolute grip strength group, the medium absolute grip strength group exhibited increased DTI-ALPS indices (β: 0.010 – 0.013, all P＜0.001), and the high absolute grip strength group demonstrated even greater increases (β: 0.015 – 0.020, all P＜0.001). Logistic regression analysis revealed that higher DTI-ALPS indices were associated with significantly lower risk of ischemic stroke (aALPS: OR=0.577, P=0.011; mALPS: OR=0.631, P=0.015; pALPS: OR=0.574, P=0.016; tALPS: OR=0.526, P=0.006), with the tALPS index being the most significant. Mediation analysis revealed that all DTI-ALPS indices partially mediated the association of ischemic stroke with slow walking pace (mediation proportion: 2.19% – 3.11%) and high absolute grip strength (mediation proportion: 3.60% – 4.80%) with ischemic stroke.

Individuals with better muscle function, characterized by faster walking pace and stronger grip strength, exhibited improved GS function and a lower risk of ischemic stroke. Improving muscle health in patients with ischemic stroke may help regulate GS function, thereby reducing the risk of stroke occurrence.

To assess whether there are causal associations between four air pollutants [nitrogen dioxide (NO₂), nitrogen oxides (NO_x), fine particulate matter (PM_2.5), and inhalable particulate matter (PM₁₀)] and the risk of ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage.

A two-sample Mendelian randomization (MR) approach was employed. Single nucleotide polymorphisms associated with air pollutants such as NO₂, NO_x, PM_2.5, and PM₁₀ were used as instrumental variables, with summary data sourced from the UK Biobank database. Data for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were obtained from the MEGASTROKE project, the International Stroke Genetics Consortium, and the dataset of aneurysmal subarachnoid hemorrhage with European populations in the 2020 genome-wide association study, respectively. The primary analysis method was the inverse variance weighting (IVW) method, with sensitivity analyses conducted using the simple median, weighted median, MR-Egger regression, leave-one-out and MR-PRESSO methods.

The random-effects IVW analysis showed a nominal association between PM_2.5 and subarachnoid hemorrhage, but the confidence interval was wide (OR=5.75, 95%CI: 1.13 – 29.20, P=0.035). After Bonferroni correction, this nominal association was no longer statistically significant. Further sensitivity analyses using MR-PRESSO and leave-one-out methods identified an outlier SNP; after correction for this outlier, the effect estimate substantially decreased and lost statistical significance (OR=2.05, 95%CI: 0.98 – 4.29, P=0.069). No associations were observed between subarachnoid hemorrhage and other air pollutants (NO₂, NO_x, and PM₁₀), and no significant associations were found between any air pollutants and intracerebral hemorrhage or ischemic stroke.

This study found no robust causal association between genetically predicted exposure to common air pollutants (NO₂, NO_x, PM_2.5, and PM₁₀) and the risk of ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. The nominally significant association between PM_2.5 and subarachnoid hemorrhage was largely driven by an outlier SNP, the signal was mainly driven by an outlier SNP, suggesting hat this genetic variant may act as an effect modifier in gene-environment interactions.

Cerebral small vessel disease (CSVD) is the primary cause of ischemic stroke and vascular cognitive impairment, and its occurrence and development are closely related to multi-scale hemodynamic dysfunction from intracranial large arteries to distal microcirculation. However, it is difficult for traditional imaging assessment methods to achieve precise, non-invasive, and integrated quantitative analysis of this complete pathway. In recent years, the rapid development of artificial intelligence (AI) technology has provided innovative tools to solve this problem. This article systematically reviews the research progress and clinical translation status of AI-empowered hemodynamic assessment of CSVD. First, we elaborate on the technical support role of AI in the pre-processing steps such as automated segmentation, noise reduction, and registration of multimodal imaging data. Then, we focus on the application progress of AI in the precise quantification of key parameters such as intracranial large artery blood flow velocity and wall shear stress, cerebral microcirculation perfusion heterogeneity, cerebral autoregulatory function, three-dimensional morphology of perforating arteries, and blood-brain barrier permeability. Finally, we summarize the predictive value of AI through multi-scale information fusion in the subtype differentiation of CSVD, cognitive decline, and risk stratification of disease progression. Based on this, we further explore the current core bottlenecks in clinical translation, including: the lack of structured human-factor usability verification for explainable AI technology, the potential for automated biases triggered by post hoc explanations, the mismatch between the traditional evidence-based medical framework and the dynamic evolving AI system paradigm, and the discontinuity of the evidence chain of health technology assessment. Future breakthroughs need to focus on constructing a "surrogate endpoint - intermediate indicator - hard endpoint" hierarchical verification path, placing human-factor verification prior to the AI model development process, and establishing a dynamic regulatory assessment system covering the entire life cycle.

Cardiovascular and cerebrovascular diseases are a serious threat to human health. Endovascular interventional therapy is an important means for treating these diseases. In recent years, the emergence and application of artificial intelligence (AI) technology in the medical field, particularly the rapid development of the clinical application of deep learning, have provided significant opportunities for the innovation and optimization of cardiovascular and cerebrovascular interventional diagnosis and treatment pathways. AI innovation brings a technological revolution and innovative paradigms, reshaping the current landscape and future development paths of cardiovascular and cerebrovascular disease diagnosis and treatment. This article provides a comprehensive overview of the current state of AI technology in the medical field and its latest applications in cardiovascular and cerebrovascular interventional diagnosis and treatment.

Sepsis is one of the leading causes of death among critically ill patients in intensive care units (ICUs). Sepsis-associated encephalopathy (SAE) can lead to long-term cognitive dysfunction and diagnosis and treatment, thereby increasing the economic burden on families and society. Therefore, cerebral function monitoring in septic patients is of great clinical significance. In the ICU setting, the neurological assessment of septic patients is often hindered by multiple confounding factors. Electroencephalogram (EEG) plays a critical role in the assessment of SAE due to its non-invasive nature and high sensitivity. Therefore, this article focuses on the specific advances in the application of EEG in SAE, aiming to provide a methodological basis and evidence-based support for the early identification and prediction of SAE.

To explore the potential early effect of "Tiaoshen Yizhi" acupuncture on the resting-state electroencephalogram (EEG) phase lag index (PLI) in patients with amnestic mild cognitive impairment (aMCI), and to evaluate the correlation between PLI and Montreal Cognitive Assessment (MoCA) score.

A total of 48 patients with aMCI recruited from the Second Affiliated Hospital of Shenzhen University and its affiliated community health service centers from June 2020 to December 2023 were randomly divided into acupuncture group (24 cases) and sham acupuncture group (24 cases) using the random number table method. In the acupuncture group, Sishencong (EX-HN1), Yintang (GV29), bilateral Neiguan (PC6), Fenglong (ST40), Sanyinjiao (SP6), Taixi (KI3) and Taichong (LR3) were selected. The sham acupuncture group adopted non-meridian non-acupoint points 1.0 cun lateral to the above acupoints. Both groups received treatment 3 times a week (Monday, Wednesday and Friday), 30 minutes each time, for 8 consecutive weeks. The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores were compared between the two groups before and after intervention. Resting-state EEG signals were collected for 6 minutes respectively before and after intervention, the PLI of EEG functional connectivity was calculated, and the correlation between PLI and MoCA score was analyzed. Safety evaluation was also performed.

After intervention, the MoCA score of the acupuncture group was significantly higher than that before intervention (t=3.74, P<0.05); the MMSE and MoCA scores in the acupuncture group were higher than those in the sham acupuncture group (t=2.818, 2.309, P<0.05). After intervention, the PLI of δ band in the acupuncture group was markedly increased compared with baseline (t=5.41, P<0.05), and was higher than that in the sham acupuncture group (t=5.14, P<0.05). In the acupuncture group, the difference value of MoCA score before and after treatment was significantly positively correlated with the difference value of δ band PLI (r=0.567 5, P=0.003 8).

"Tiaoshen Yizhi" acupuncture can regulate EEG functional connectivity and improve cognitive function in aMCI patients. The δ-band PLI may serve as a neurophysiological marker for the early curative effect of acupuncture. Its mechanism may be related to enhancing the synchrony of slow-wave oscillations and delaying cognitive decline.

To explore the electroencephalogram (EEG) characteristics of acupuncture at Neiguan (PC6) poin in the Xingnao Kaiqiao Acupuncture Method.

The subjects of this study were patients with ischemic stroke (IS) who met the inclusion criteria and were treated in the Acupuncture Department of the First Teching Hospital of Tianjin University of Traditional Chinese Medicine from September 2024 to February 2025. EEG was used to record the brain electrical activity of the subjects during acupuncture at Neiguan (PC6). The immediate effects of acupuncture at Neiguan (PC6) were explored by power spectral density (PSD) and microstate parameter analysis methods, and the characteristic changes of resting-state EEG before and after acupuncture at Neiguan (PC6) were compared.

EEG data of 13 cases of acupuncture at Neiguan (PC6) were collected. The average PSD of Theta band after acupuncture was higher than that before acupuncture (Z=-2.691, P<0.05); there were no statistically significant differences in the average PSD of Delta, Alpha and Beta bands before and after acupuncture (Z=-1.363, -1.922, t=-2.035, all P>0.05). After acupuncture, the GEV, time coverage rate and average duration in microstate B were all higher than those before acupuncture (t=-2.717, -2.359, -2.307, all P<0.05). After acupuncture, the GEV, occurrence frequency, time coverage rate and average duration in microstate C were all lower than those before acupuncture (Z=-2.830, -2.970, -2.760, -2.062, all P<0.05). After acupuncture, the occurrence frequency, time coverage rate and average duration in microstate D were all higher than those before acupuncture (t=-2.704, -4.164, -3.969, all P<0.05).

Acupuncture at Neiguan (PC6) has the effect of regulating brain functional activities with obvious immediate effects, and its effect is closely related to the dynamic changes of the brain electrical network, which provides an important basis for further explaining the central regulatory mechanism of acupuncture.

To retrospectively analyze the clinical data of patients undergoing robot-assisted segmentectomy since the implementation of the Da Vinci robotic surgical system at a single center, summarizing its safety, feasibility, and perioperative outcomes, thereby providing data support for the promotion and optimization of this technique.

A total of 472 patients who underwent robot-assisted anatomical segmentectomy in Shanghai Pulmonary Hospital between October 2020 and December 2023 were included. Baseline patient characteristics, surgical details, perioperative indicators, and complications were collected. The primary endpoint was perioperative complications. Secondary endpoints included conversion rate to thoracotomy, operative time, intraoperative blood loss, rates of 30-day readmission and 90-day mortality.

All 472 procedures were completed successfully without conversion to thoracotomy or mortality. The mean patient age was (57.45±11.88) years. The overall surgical volume showed an increasing trend. The dual-port approach was predominant (72.0%), with a rising proportion of single-port surgeries. The mean operative time was (100.19±41.93) min. Fitting of the learning curve was performed based on operative time. Intraoperative blood loss was <100 mL in 98.7% of cases, with only one patient (0.2%) requiring intraoperative blood transfusion. The mean postoperative hospital stay was (3.29±1.54) days. The overall complication rate was low, mainly consisting of persistent air leak (18 patients, 3.8%). The 30-day readmission rate was 0.6%, with no deaths within 90 days. Single-port group had a significantly shorter operative time, hospital stay, and early drainage than the multi-port group.

This study preliminarily confirms that robot-assisted segmentectomy is safe and feasible in experienced centers, with a low perioperative complication rate and favorable short-term outcomes. Robotic surgery is a safe and viable alternative to video-assisted thoracoscopic segmentectomy, although its long-term oncological efficacy requires further validation by prospective studies..

To overcome the limitations imposed by traditional wall-mounted negative pressure thoracic drainage systems on postoperative lung patients’ mobility, we developed a new portable negative pressure thoracic drainage device.

The new portable negative pressure thoracic drainage device is composed of a main unit and a three-chamber closed drainage bottle. The maximum water column height of the pressure regulating chamber of the three-chamber closed drainage bottle is approximately 20 cm. The new device adopts a split structure design: using 3D printing manufacturing, the micro air pump, rechargeable power supply and noise reduction system are integrated into an independent portable main unit, which is fixed to the side wall of the three-chamber closed drainage bottle by means of strong double-sided adhesive tape.

The main unit measures 162 mm × 108 mm × 54 mm and weighs approximately 800 g. The maximum negative pressure is about 20 cmH₂O, and the noise is less than 60 decibels at a flow rate of 3 L/min. The battery life is approximately 3 to 6 hours, and the maximum flow rate is about 9 L/min. The estimated material cost for each device is about 800 RMB, and the cost of disposable consumables (three-chamber closed drainage bottle and strong double-sided tape) is about 48 RMB.

This study developed a new type of closed thoracic drainage device, which has the engineering feasibility to achieve portable negative pressure drainage. It is expected to improve the mobility of patients who need negative pressure drainage in the thoracic cavity after lung surgery, but it still needs to be verified by clinical trials.

To explore the teaching model that combines digital Bridge-in, Objective, Pre-assessment, Participatory learning, Post-assessment, Summary (BOPPPS) with case-based learning (CBL), and evaluate its practical application effects in the clinical teaching of cardiothoracic surgery nursing.

Thirty fourth-year undergraduate nursing students rotating in the Cardiothoracic Surgery Department at Tianjin Medical University General Hospital were selected as the study subjects. They were randomly divided into an experimental group (15 students) and a control group (15 students). During the teaching process, the experimental group received instruction using an online BOPPPS combined with CBL teaching method, while the control group was taught using the traditional teaching model. After the teaching period, the teaching effectiveness of the two groups was compared and analyzed through tests and questionnaires.

The students in the experimental group outperformed those in the control group in assessments of theoretical knowledge, case analysis, and skill operations. Additionally, the experimental group reported higher satisfaction with the teaching and gave more favorable evaluations of this teaching model compared to the control group. These differences were all statistically significant (P<0.05).

The digital-based BOPPPS combined with CBL teaching model can effectively stimulate learners’ interest in learning, enhance their ability to analyze and solve clinical problems, and also help strengthen their teamwork and communication skills, providing strong support for a smooth transition to clinical work in cardiothoracic nursing. This study serves as an initial investigation with a small sample size and limited statistical power, and the generalizability of the conclusions is restricted. Future research should plan to increase the sample size and conduct multicenter studies for additional confirmation..

The success of lung cancer surgery critically depends on the precise identification of complex pulmonary anatomy and the accurate definition of surgical margins. Virtual reality (VR) technology offers a novel technical approach to addressing these key issues by creating immersive, multisensory and interactive virtual simulation environments. In the preoperative planning phase, VR technology enables non-invasive and precise lesion localization through high-fidelity 3D reconstruction and supports individualized surgical simulation, thereby optimizing surgical strategies. During intraoperative navigation, the integration of VR with augmented reality (AR) or mixed reality (MR) technologies allows for the superimposition of virtual scenes onto the real surgical field. This provides real-time spatial guidance for procedures such as lobectomy or segmentectomy and lymphadenectomy, significantly enhancing surgical precision and safety. In the realm of medical education and training, VR simulators create highly realistic surgical scenarios coupled with immediate feedback mechanisms, offering physicians a risk-free, repeatable training platform that effectively shortens the learning curve. Furthermore, as a non-pharmacological intervention, VR technology has also demonstrated positive effects in alleviating perioperative anxiety and pain in patients. This review systematically examines the specific applications and research progress of VR technology in the field of lung cancer surgery, aiming to provide references for related clinical practices and future research.