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Ischemia–reperfusion injury (IRI)-induced acute kidney injury (AKI) is a life-threatening disease. The activation of mitophagy was previously identified to play an important role in IRI. Maternally expressed 3 (MEG3) can promote cerebral IRI and hepatic IRI. The present study was designed to study the role of MEG3 in renal IRI. Renal IRI mice models were established, and HK-2 cells were used to construct the in vitro models of IRI. Hematoxylin–eosin staining assay was applied to reveal IRI-triggered tubular injury. MitoTracker Green FM staining and an ALP kit were employed for detection of mitophagy. TdT-mediated dUTP-biotin nick-end labeling assay was used to reveal cell apoptosis. The results showed that renal cortex of IRI mice contained higher expression of MEG3 than that of sham mice. MEG3 expression was also elevated in HK-2 cells following IRI, suggesting that MEG3 might participate in the development of IRI. Moreover, downregulation of MEG3 inhibited the apoptosis of HK-2 cells after IRI. Mitophagy was activated by IRI, and the inhibition of MEG3 can restore mitophagy activity in IRI-treated HK-2 cells. Mechanistically, we found that MEG3 can bind with miR-145-5p in IRI-treated cells. In addition, rhotekin (RTKN) was verified to serve as a target of miR-145-5p. MEG3 upregulated RTKN expression by binding with miR-145-5p. Further, MEG3 activated the Wnt/β-catenin pathway by upregulation of RTKN. The downstream effector of Wnt/β-catenin pathway, c-MYC, served as the transcription factor to activate MEG3. In conclusion, the positive feedback loop of MEG3/miR-145-5p/RTKN/Wnt/β-catenin/c-MYC promotes renal IRI by activating mitophagy and inducing apoptosis, which might offer a new insight into the therapeutic methods for renal IRI in the future.

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Aims:To evaluate the effectiveness of virtual reality (VR) intervention in the management of pain, anxiety and fear in paediatric patients undergoing needle-related procedures.Design: A systematic review and meta-analysis of randomized controlled trials (RCTs).

Aims and ObjectivesTo evaluate the effectiveness of home‐based cardiac telerehabilitation in patients with heart failure.DesignThis systematic review and meta‐analysis of randomised controlled trials were designed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines.MethodsTwo researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias within the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the mean difference, based on the results of the heterogeneity test.Data sourcesA librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI and Wanfang databases was conducted to identify studies in English or Chinese on randomised controlled trials up to 15 August 2022.ResultsA total of 2291 studies were screened. The meta‐analysis included data from 16 studies representing 4557 participants. The results indicated that home‐based cardiac telerehabilitation could improve heart rate, VO2 peak, 6‐minute walk distance, quality of life and reduce readmission rates. No significant differences were observed in the left ventricular ejection fraction percentages between the home‐based cardiac telerehabilitation and usual care groups. Compared with centre‐based cardiac rehabilitation, home‐based cardiac telerehabilitation showed no significant improvement in outcome indicators.ConclusionPatients with heart failure benefit from home‐based cardiac telerehabilitation intervention. With the rapid development of information and communication technology, home‐based cardiac telerehabilitation has great potential and may be used as an adjunct or substitute for centre‐based cardiac rehabilitation.ImpactThis systematic review and meta‐analysis found that patients with heart failure would benefit from home‐based cardiac telerehabilitation intervention in terms of cardiac function, functional capacity, quality‐of‐life management and readmission rate. Future clinical interventions should consider home‐based cardiac telerehabilitation as an alternative to conventional cardiac rehabilitation in patients with heart failure to improve their quality of life.No Patient or Public ContributionOur paper is a systematic review and meta‐analysis, and such details do not apply to our work.

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This review aimed to assess the effectiveness of non-immersive virtual reality intervention compared to traditional rehabilitation in improving the functions of the upper and lower extremities, balance, and social participation among children with spastic cerebral palsy. We used librarian-designed searches of 10 databases to identify research articles on randomized controlled trials that assessed the effectiveness of non-immersive virtual reality in intervening spastic cerebral palsy patients up to 4/15/2023. Independent evaluation was conducted by two trained investigators using the evaluation criteria of RCT quality indicated in the Cochrane Manual of Assessment ‘risk- of- bias tool.’ The PEDro scale was used to evaluate the method and quality of the literature. 21 research articles involving 779 patients with spastic cerebral palsy were included. Significant differences between the non-immersive virtual reality rehabilitation and traditional rehabilitation groups were observed in all indicators, except for the Jebsen-Taylor Hand Function Test. Non-immersive virtual reality intervention is effective in improving the function of the lower extremity, balance, and social participation in children with spastic cerebral palsy, but its effect on upper limb function is still controversial.

AimTo evaluate the impact of a virtual reality (VR) intervention on adult patients' preoperative anxiety, heart rate, respiration rate and blood pressure.DesignA systematic review and meta‐analysis of randomized controlled trials (RCTs).Data SourcesA librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI and Wanfang databases was conducted to identify research studies in English or Chinese on RCTs from their inception to 31 May 2022. Detailed search strategies and the checklist are provieded in Supplementary files S1 and S2.Review MethodsTwo researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test.ResultsThis study included 11 articles with a total of 892 participants. VR distraction comprised five studies, and VR exposure consisted of six studies. The results indicated that VR could reduce preoperative anxiety in adult patients and VR exposure seems to be more effective. The results also indicated that VR intervention can effectively reduce patients' heart rate and blood pressure compared to traditional intervention methods, but had no significant effect on respiration rate.ConclusionVR technology could relieve preoperative anxiety in adult patients through distraction or exposure. More well‐designed RCTs containing a wider range of surgical types are needed to verify our findings before we can make strong recommendations.ImpactOur systematic review and meta‐analysis show a positive effect of VR distraction and exposure interventions in reducing preoperative anxiety in adult patients. We suggest incorporating VR into preoperative procedures as an auxiliary way to reduce negative emotions in eligible patients.No Patient or Public ContributionOur paper is a systematic review and meta‐analysis and such details do not apply to our work.