Objective: This study aimed to explore the effectiveness and applicability of a psychological intervention using virtual reality (VR) to reduce preoperative anxiety in patients undergoing carotid artery stenting (CAS).Methods: A total of 114 patients aged 18–86 years who were scheduled to undergo CAS were randomized to the VR and control groups. Patients in the VR group used a VR headset to view a 16-min psychological intervention video, while those in the control group used a tablet for viewing. The primary assessment instrument was the State Anxiety Inventory (S-AI), which was given 20 min before and after the intervention and 24 h after surgery. Secondary assessment tools were the Self-efficacy for Managing Chronic Disease (SEMCD-6) scale, which was completed before the intervention and 24 h after the operation, a smart bracelet to assess sleep quality, monitored in the evening before the operation, and the VR Suitability and Satisfaction Questionnaire, completed 24 h after the operation.Results: The two groups were similar in terms of demographic information, preintervention STAI scores and preintervention SEMCD-6 scores (p > 0.05). S-AI scores were lower in both groups after the intervention and surgery, and the scores of the VR group were lower than those of the control group (p = 0.036, p = 0.014). SEMCD-6 scores post-surgery had improved in both groups, but the VR group had significantly higher scores than the control group (p = 0.005). Smart bracelet measurements showed no significant differences in postintervention sleep quality between the two groups (p = 0.540). For satisfaction, the VR group scored higher in all aspects except scheduling. A total of 47 (85.45%) patients reported having a comfortable experience, and only 5 (9.09%) experienced mild adverse effects.Conclusion: The use of a virtual reality psychological intervention was beneficial to reduce the anxiety of patients before CAS and improved their self-efficacy. As virtual reality devices evolve and demonstrate better comfort and safety, more comprehensive and in-depth research of the use of VR to reduce patient anxiety should be performed in the future.Clinical trial registration:https://www.chictr.org.cn/showproj.aspx?proj=186412, identifier ChiCTR2200066219.

Background: The World Health Organization highlights the essential role of effective self-management in the prevention and control of chronic diseases, noting that proper self-management can significantly slow disease progression. Stroke, which ranks as the third leading cause of death worldwide, is often accompanied by inadequate self-management among patients. While health information literacy (HIL) has been shown to influence self-management in conditions such as diabetes and hypertension, its role as a mediating factor linking disease perception and health behavior in patients with stroke remains insufficiently explored. Addressing this research gap is vital for developing targeted interventions. Objective: The aim of this study was to investigate the current status of HIL, stroke knowledge, and self-management abilities among patients with stroke in Southwest China. Additionally, the study analyzed the relationships among these three factors and their mechanisms of action, providing evidence to inform the development of effective health education strategies for enhancing self-management in patients with stroke. Methods: A multicenter cross-sectional design was employed, enrolling 514 patients with stroke from the neurology departments of three tertiary general hospitals in Chengdu between September 2022 and March 2023. Data collection used a standardized set of scales: the health information literacy questionnaire for stroke assessed HIL, the stroke prevention questionnaire evaluated knowledge levels, and the stroke self-management assessment scale measured self-management abilities. Regression analysis and bootstrap mediation effect testing were conducted using SPSS software (version 26.0). Results: Patients with stroke had a mean (SD) score of 17.61 (6.46) for stroke knowledge, 61.17 (13.58) for HIL, and 158.70 (19.07) for self-management skills. Correlation analysis indicated a positive correlation of stroke knowledge with both self-management (r=0.668; P<.001) and HIL (r=0.138; P<.001). The mediation test showed a significant mediating effect of HIL between stroke knowledge and self-management (β=0.543; 95% CI: 0.431‐0.663), with an effect share of 82.77%. Conclusion: There is a correlation between HIL and self-management; the higher the HIL, the better is the self-management behavior. Furthermore, HIL partially mediates the effect of stroke knowledge on self-management.

Background: Accumulating evidence has suggested that cystatin C is associated with cognitive impairment in patients with neurodegenerative diseases. However, the association between cystatin C and cognitive decline in patients with multiple system atrophy (MSA) remains largely unknown.Objectives: The objective was to determine whether cystatin C was independently associated with cognitive decline in patients with early-stage MSA.Methods: Patients with MSA underwent evaluation at baseline and the 1-year follow-up. Cognitive function was evaluated with Montreal cognitive assessment (MoCA). Changes in the MoCA score and the absolute MoCA score at the 1-year assessment were considered the main cognitive outcome. The cystatin C concentrations in patients with MSA and age, sex, and body mass index matched-healthy controls (HCs) were measured. A multiple linear regression model was used to test the association between cystatin C and cognitive decline.Results: A total of 117 patients with MSA and 416 HCs were enrolled in the study. The cystatin C levels were significantly higher in patients with MSA than in HCs (p < 0.001). Cystatin C levels were negatively correlated with MoCA score at baseline and at 1-year follow-up. Multiple linear regression model adjusted for potential confounders showed that baseline cystatin C levels were significantly associated with the MoCA score (p = 0.004) or change in the MoCA score (p = 0.008) at 1-year follow-up.Conclusion: Our results suggested that cystatin C may serve as a potential biomarker of cognitive decline in patients with early-stage MSA.

To compare the LDCT screening results between eligible and ineligible screening candidates in preventive health check-ups population. Using a real-world LDCT screening results among people who took yearly health check-up in health management center of West China Hospital between 2006 and 2017. Objects were classified according to the China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version) eligibility criteria. Descriptive analysis were performed between eligible and ineligible screening candidates. The proportion of ineligible screening candidates was 64.13% (10,259), and among them there were 4005 (39.04%) subjects with positive screenings, 80 cases had a surgical lung biopsy. Pathology results from lung biopsy revealed 154 cancers (true-positive) and 26 benign results (false-positive), the surgical false-positive biopsy rate was 4.17%, and ineligible group (7.69%) was higher than eligible group (2.47%), P < 0.05. Further, in ineligible screening candidates, the proportion of current smokers was higher among males compared to females (53.85% vs. 4.88%, P < 0.05). Of the 69 lung cancer patients detected in ineligible screening candidates, lung adenocarcinoma accounts for a high proportion of lung cancers both in male (75.00%) and female (85.00%). The proportion of ineligible screening candidates and the surgical false-positive biopsy rate in ineligible candidates were both high in health check-ups population.