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CT-derived fractional flow reserve combined with atherosclerotic extent to determine long-term outcomes in diabetic patients with coronary artery disease 认领 引用 被引量：2
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作者 Zhi-Qiang WANG Zhen-Nan LI +1 位作者 Zhi-Hui HOU Bin LU 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2026年第1期27-35,共9页
Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value ... Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value of CT-FFR combined with CCTA–defined atherosclerotic extent in diabetic patients with coronary artery disease(CAD).Methods A retrospective pooled analysis of individual patient data was performed. Deep-learning-based vessel-specific CTFFR was calculated. All patients enrolled were followed-up for at least 5 years. Predictive abilities for major adverse cardiac events(MACE) were compared among three models(model 1), constructed using clinical variables;model 2, model 1+CCTA–derived atherosclerotic extent(Leiden risk score);and model 3, model 2+CT-FFR.Results A total of 480 diabetic patients [median age, 61(55–66) years;52.9% men] were included. During a median follow-up time of 2197(2126–2355) days, 55 patients(11.5%) experienced MACE. In multivariate-adjusted Cox models, Leiden risk score(HR: 1.06;95% CI: 1.01–1.11;P = 0.013) and CT-FFR ≤ 0.80(HR: 6.54;95% CI: 3.18–13.45;P < 0.001) were the independent predictors. The discriminant ability was higher in model 2 than in model 1(C-index, 0.75 vs. 0.63;P < 0.001) and was further promoted by adding CT-FFR to model 3(C-index, 0.81 vs. 0.75;P = 0.002). Net reclassification improvement(NRI) was 0.19(P = 0.009) for model 2 beyond model 1. Of note, adding CT-FFR to model 3 also exhibited significantly improved reclassification compared with model 2(NRI = 0.14;P = 0.011).Conclusion In diabetic patients with CAD, CT-FFR provides robust and incremental prognostic information for predicting longterm outcomes. The combined model exhibits improved prediction abilities, which is beneficial for risk stratification. 展开更多
关键词 fractional flow reserve ct ffr coronary artery disease cad methods tomography angiography ccta derived coronary artery disease atherosclerotic extent fractional flow reserve diabetic patients coronary computed tomography angiography
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Influence of aerobic exercise on the cognitive and social functions of elderly patients with schizophrenia 认领 引用 被引量：1
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作者 Can Ao Lu Zhan +2 位作者 Yu-Lan Mou Shu Hu Yong-Hong Huang 《World Journal of Psychiatry》 SCIE 2026年第3期180-190,共11页
BACKGROUND Schizophrenia presents complex challenges in older patients due to cognitive and social decline.Existing drug treatments offer limited benefits and pose risks,while aerobic exercise shows promise as a nonin... BACKGROUND Schizophrenia presents complex challenges in older patients due to cognitive and social decline.Existing drug treatments offer limited benefits and pose risks,while aerobic exercise shows promise as a noninvasive intervention whose impact remains underexplored.AIM To investigate the effects of aerobic exercise on cognitive and social function in older patients with schizophrenia.METHODS A retrospective study was conducted in 158 older patients with schizophrenia treated at The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College(June 2023 and December 2024).The patients were divided into an observation group(n=86),which received 3 months of aerobic rehabilitation alongside routine treatment,and a control group(n=72),which received routine treatment alone.Cognitive function was assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery,social function using the Inpatient Psychiatric Rehabilitation Outcome Scale(IPROS),and psychotic symptoms using the Positive and Negative Syndrome Scale.RESULTS Post-treatment,Positive and Negative Syndrome Scale total scores were lower in the observation group than in the controls(P<0.001),with significant improvements in positive,negative,and general symptoms.Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery domain scores were improved in processing speed,working memory,verbal/visual learning,and executive function(all P<0.05).IPROS total scores were decreased(P<0.001),indicating better social functioning.Longer exercise duration correlated with greater cognitive gains and lower social function deficits.Body mass index declined(P<0.001),and adverse events were mild and transient(9.3%).Multivariate linear regression confirmed that aerobic exercise was independently associated with a significant reduction in IPROS scores(Adjustedβ=-4.57,95%confidence intervals:-6.08 to-3.05,P<0.001).CONCLUSION Aerobic exercise effectively improves cognitive function,social function,and psychotic symptoms in older patients with schizophrenia,is safe,and serves as a valuable adjunctive intervention. 展开更多
关键词 Schizophrenia Aerobic exercise Cognitive function Social function Elderly patients
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Fibroscan and fibrosis-4 in recovered hepatitis C patients 认领 引用
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作者 Nouhoum Bouare Jean Delwaide 《World Journal of Gastroenterology》 SCIE CAS 2026年第30期8-15,共8页
The management of chronic hepatitis C,particularly focusing on patient followup after hepatitis C virus(HCV)cure,has been extensively documented.da Silva et al recently evaluated the prognostic value of liver stiffnes... The management of chronic hepatitis C,particularly focusing on patient followup after hepatitis C virus(HCV)cure,has been extensively documented.da Silva et al recently evaluated the prognostic value of liver stiffness measurements and the fibrosis-4 index at baseline and 1 year after HCV therapy with direct-acting antiviral.They aimed to predict hepatocellular carcinoma occurrence in patients with compensated advanced chronic liver disease who achieved a sustained viral response.This editorial comments on an article by da Silva et al published in a recent issue of the World Journal of Gastroenterology.We discuss da Silva et al’s work in the context of patients who have recovered from hepatitis C,highlighting the current knowledge in the field and providing guidance.Articles from the Google Scholar database,PubMed,European Association for the Study of Liver and American Association for the Study of Liver Diseases guidelines,and other relevant databases and studies were used in this study. 展开更多
关键词 Fibroscan Fibrosis-4 Non-invasive tests Hepatitis C recovered patients Hepatitis C sustained viral response Direct-acting antiviral therapy Patients follow-up Hepatocellular cancer prediction
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Commentary on“Neutrophil-to-lymphocyte and monocyte-tolymphocyte ratios as inflammatory markers in the assessment of glycemic status in diabetic patients of Asir region” 认领 引用
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作者 Mostafa Javanian Majid Khalilizad +2 位作者 Mohammad Barary Ebrahim Hejazian Soheil Ebrahimpour 《Animal Models and Experimental Medicine》 CAS CSCD 2026年第6期1273-1274,共2页
Dear Editor,Dera et al.1 report that neutrophil-to-lymphocyte(NLR)and monocyte-to-lymphocyte(MLR)ratios differ across fasting-glucose and HbA1c strata in 3545 Saudi adults,concluding that these indices“could serve as... Dear Editor,Dera et al.1 report that neutrophil-to-lymphocyte(NLR)and monocyte-to-lymphocyte(MLR)ratios differ across fasting-glucose and HbA1c strata in 3545 Saudi adults,concluding that these indices“could serve as valuable indicators”of dysglycemia.Although the dataset is sizeable,several issues temper that inference. 展开更多
关键词 monocyte lymphocyte ratio glycemic status neutrophil lymphocyte ratio inflammatory markers Asir region fasting glucose HbA c diabetic patients
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Olfactory enrichment mitigates delayed neurocognitive recovery after major orthopaedic surgery in older patients:A randomised controlled trial 认领 引用
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作者 Xinchun Mei Zihan Ni +7 位作者 Shiyu Zhong Jiayi Wang Lin Zhu Zhongyong Shi Yupeng Chen Hailin Zheng Jingxiao Hu Yuan Shen 《General Psychiatry》 CAS CSCD 2026年第2期93-102,共10页
Background Delayed neurocognitive recovery(dNCR)is a prevalent complication in older patients undergoing surgery.It may progress to long-term cognitive impairment and increase the risk of Alzheimer's disease.Aims ... Background Delayed neurocognitive recovery(dNCR)is a prevalent complication in older patients undergoing surgery.It may progress to long-term cognitive impairment and increase the risk of Alzheimer's disease.Aims This study aimed to evaluate the effects of olfactory enrichment on dNCR and to examine the association between olfactory function and dNCR.Methods This sham-controlled,assessor-blind,parallelgroup randomised trial enrolled 149 participants aged65 or older undergoing elective total knee or hip replacement under general anaesthesia.Participants were assigned to either the olfactory enrichment group or the sham group.The intervention group received daily olfactory enrichment from 3 days preoperatively to 7 days postoperatively.Cognitive function was evaluated using a neuropsychological test battery3 days before and 7 days after surgery.Olfactory identification ability was assessed by five-odour olfactory detection arrays.Propensity score matching analysis was employed to mitigate potential confounding and selection bias.Results A total of 131 patients completed the study(62 in the olfactory enrichment group and 69 in the sham group).The overall incidence of dNCR was 26.7%(35 out of 131).In the intention-to-treat analysis,the difference between groups was not statistically significant(19.4%vs.33.3%;χ2=3.259;p=0.071).However,in the 1:1 propensity score-matched cohort(n=82),the incidence of dNCR was significantly lower in the olfactory enrichment group than in the sham group(12.2%vs.39.0%;χ2=7.476;p=0.005).Raw postoperative cognitive scores and individual change scores did not differ between the groups.Participants with decreased olfactory identification scores(n=32)had a significantly higher incidence of dNCR than those with stable or improved scores(40.6%vs.22.2%;χ2=4.183;p=0.041).Conclusions In older patients undergoing major orthopaedic surgery,perioperative olfactory dysfunction is associated with an increased risk of dNCR.Olfactory enrichment may represent a potential nonpharmacological strategy for reducing postoperative cognitive decline in this population. 展开更多
关键词 Older Patients olfactory enrichment delayed neurocognitive recovery dncr alzheimers diseaseaims Major Orthopaedic Surgery olfactory function total knee hip replace Delayed Neurocognitive Recovery
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From feasibility to biological recovery:Reframing enhanced recovery pathways after surgery in elderly gastric cancer patients 认领 引用 被引量：2
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作者 Gang Wang Sheng-Jie Pan 《World Journal of Gastroenterology》 SCIE CAS 2026年第7期1-8,共8页
Enhanced recovery after surgery(ERAS)has reshaped perioperative care in gastrointestinal oncology,but its application in elderly gastric cancer patients requires a shift from feasibility toward a biologically grounded... Enhanced recovery after surgery(ERAS)has reshaped perioperative care in gastrointestinal oncology,but its application in elderly gastric cancer patients requires a shift from feasibility toward a biologically grounded understanding of recovery.Aging is characterized by frailty,sarcopenia,multimorbidity,chronic inflammation,and circadian vulnerability,which collectively influence postoperative resilience.Contemporary evidence shows that ERAS pathways remain feasible and safe in older adults,yet responsiveness varies widely due to physiological heterogeneity rather than chronological age alone.This Editorial reframes recovery as a multidomain process encompassing nutritional-inflammatory balance,sleep-circadian regulation,psychological resilience,and functional mobility.Targeted perioperative nutrition may support metabolic competence;structured sleep-protection strategies can stabilize endocrine-immune rhythms;psychological interventions may mitigate stress-related inflammatory activation;and digital monitoring using step-count trajectories or heart-rate variability provides early indicators of recovery deviation.Implementation challenges-including clinical workload,variable frailty,cognitive impairments,digital acceptance,and uneven access to multidisciplinary expertise-highlight the need for adaptive and pragmatic pathways.As global aging accelerates,ERAS must evolve from standardized protocols to biologically informed,patient-centered systems that align interventions with host physiology and real-time recovery signals.Such an approach may better capture recovery depth,enhance functional outcomes,and promote equitable care for elderly surgical populations. 展开更多
关键词 Enhanced recovery after surgery Gastric cancer Elderly patients Functional recovery Biological resilience Nutritional support
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The epidemiology and outcomes of adult cancer patients with suspected neutropenic fever in the emergency department 认领 引用
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作者 Shi Yeow Lee Rex Pui Kin Lam +6 位作者 Siu Chung Leung Yan Yiu Yu Tat Chi Tsang Rock Yuk Yan Leung ChungYan Joanne Leung Michael Chun Kai Lau Timothy Hudson Rainer 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2026年第3期258-261,共4页
Neutropenic fever(NF)is an oncologic emergency associated with significant mortality and healthcare burden in patients with hematologic and solid organ malignancies.Cancer patients with fever often present to the emer... Neutropenic fever(NF)is an oncologic emergency associated with significant mortality and healthcare burden in patients with hematologic and solid organ malignancies.Cancer patients with fever often present to the emergency department(ED).The American Society of Clinical Oncology and the European Society for Medical Oncology recommend administering the first dose of empirical antibiotics to patients with NF within 1 h of ED triage. 展开更多
关键词 epidemiology adult cancer patients outcomes emergency department ed neutropenic fever hematologic solid organ malignanciescancer neutropenic fever nf emergency department
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Association of dietary energy and protein intake with frailty among patients with cirrhosis and implications for nursing practice 认领 引用
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作者 Guangju Li Yaqi Wang +1 位作者 Kunli Wang Kefang Wang 《International Journal of Nursing Sciences》 CSCD 2026年第2期201-208,共8页
Objectives:This study aimed to examine the relationships among frailty,dietary energy intake,protein intake,and protein type in patients with cirrhosis.Methods:This study enrolled 267 eligible patients with liver cirr... Objectives:This study aimed to examine the relationships among frailty,dietary energy intake,protein intake,and protein type in patients with cirrhosis.Methods:This study enrolled 267 eligible patients with liver cirrhosis from a tertiary hospital in Shandong Province between April 2024 and July 2024.Participants were divided into three groups based on the Liver Frailty Index:non-frail group(n=63),pre-frail group(n=132),and frail group(n=72).Patients were assessed using the following questionnaires and scales:the General Demographic Information Questionnaire,the Child-Pugh Score Scale,the Liver Frailty Index,the Food Frequency Questionnaire,the International Physical Activity Questionnaire–Short Form(IPAQ-SF),and the Patient Health Questionnaire-9(PHQ-9)for depression.Multiple logistic regression was used to examine the associations between frailty and dietary energy intake,protein intake,and the animal-to-plant protein ratio.Receiver operating characteristic(ROC)curve analysis was employed to identify the optimal thresholds for energy,protein,and protein ratio to differentiate between non-frail and frail states.Results:Based on the Liver Frailty Index,63 patients(23.6%)were classified as non-frail,132(49.4%)as pre-frail,and 72(27.0%)as frail.The prevalence of frailty was significantly higher in females(37.0%)than in males(22.6%)(P<0.05).Multivariable logistic regression analysis,after adjustment for potential confounders(including age,sex,education level,etiology,Child-Pugh class,physical activity,depressive symptoms,and polypharmacy),higher dietary energy(P=0.044),total protein(P=0.003),animal protein(P=0.004),and a higher animal-to-plant protein ratio(P=0.015)were associated with a lower risk of frailty.ROC curve analysis further identified the optimal thresholds for distinguishing frailty from non-frailty as 30 kcal/(kg·d)for energy intake,0.83 kcal/(kg·d)for total protein intake,and 0.34 for the animal-to-plant protein ratio,respectively.When patients maintained their nutritional intake above these thresholds,their risk of frailty was significantly reduced.Conclusions:Increasing dietary energy and protein intake,particularly from animal sources,is associated with a reduced risk of frailty in cirrhosis patients.This suggests that in clinical nursing practice,guiding patients to appropriately increase their dietary energy and protein intake,particularly by optimizing the proportion of animal protein,may help reduce the risk of frailty. 展开更多
关键词 Diet Energy intake Frailty Liver cirrhosis Nursing Patients Protein
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Risk factors for prolonged postoperative ileus in elderly patients undergoing laparoscopic radical resection for colorectal cancer 认领 引用
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作者 Huan Liu Yang Chen +6 位作者 Shi-Gang Guo Zhu Liu Yong-Shuai Huang Zhen-Dong Zhu Yu-Jie Feng Qing Yang Ya-Lei Liu 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第6期223-234,共12页
BACKGROUND As the elderly population of patients with colorectal cancer(CRC)has increased,the risk of postoperative complications,particularly prolonged postoperative ileus(PPOI),has similarly increased in frail patie... BACKGROUND As the elderly population of patients with colorectal cancer(CRC)has increased,the risk of postoperative complications,particularly prolonged postoperative ileus(PPOI),has similarly increased in frail patients;this finding has hindered the postoperative recovery process.However,the risk factors for PPOI in elderly patients following laparoscopic radical resection for CRC remain unclear.AIM To investigate and analyze the incidence and potential risk factors for PPOI in elderly patients with CRC following laparoscopic radical resection.METHODS A single-center,retrospective study was conducted involving 167 patients who underwent laparoscopic radical CRC resection from November 2018 to June 2025.Clinical data on baseline characteristics,preoperative laboratory tests,intraoperative and postoperative parameters,and pathological outcomes were collected and analyzed.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for PPOI,and a P value of<0.05 was considered to indicate statistical significance.Receiver operating characteristic curves were plotted,bootstrap validation was performed,and calibration curves and decision curve analysis were constructed.RESULTS In this study,49 patients developed PPOI(29.30%),whereas 71 patients experienced frailty(42.50%).The multivariate analysis revealed that modified 5-item Frailty Index(mFI-5)≥2(P=0.028),postoperative opioid use(P=0.021),and serum potassium levels on postoperative day 1(POD 1)<3.61 mmol/L(P=0.003)were associated with PPOI.The area under the curve(AUC)analysis demonstrated a predictive performance of 0.730[95%confidence interval(CI):0.649-0.811]for PPOI in elderly patients,with a bootstrap-validated AUC of 0.730(95%CI:0.644-0.800).CONCLUSION PPOI is a common postoperative complication in elderly patients with CRC following laparoscopic radical resection,while an mFI-5≥2,postoperative opioid use,and low serum potassium levels on POD 1 are independent risk factors.The predictive model constructed on the basis of these indicators demonstrated moderate discrimination.The optimization of perioperative evaluation and management protocols is crucial for reducing the incidence of PPOI. 展开更多
关键词 Frailty Elderly patients Colorectal cancer Prolonged postoperative ileus Risk factors
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Predictive lipidaemic and clinical factors for PVR formation after RRD surgery in nondiabetic patients 认领 引用
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作者 Yan Jiang Tian Niu +2 位作者 Guo-Hui Lan Yu-Peng Xu Kun Liu 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2026年第4期733-741,共9页
AIM:To investigate the potential impact of lipidaemic and clinical factors on the development of proliferative vitreoretinopathy(PVR)following uncomplicated primary rhegmatogenous retinal detachment(RRD)surgery in non... AIM:To investigate the potential impact of lipidaemic and clinical factors on the development of proliferative vitreoretinopathy(PVR)following uncomplicated primary rhegmatogenous retinal detachment(RRD)surgery in nondiabetic individuals.METHODS:This was a retrospective,single-center,case-control study of consecutive patients who underwent primary RRD surgery.The study group comprised 145 patients who developed PVR within 3y of follow-up,while the control group comprised 161 patients with RRD who did not develop PVR.Cox regression analysis was utilized to identify independent associations between various risk markers and the occurrence of PVR.RESULTS:The mean age of patients was 52.31y(SD=13.29),and 54.25%(n=166)were male.The median time to PVR formation after surgery was 150d.Multivariate Cox regression indicated that cigarette smoking status[hazard ratio(HR):0.43,95%confidence interval(CI):0.31-0.60,P<0.001],retinal detachment(RD)not involving the macula(HR:0.52,95%CI:0.37-0.73,P<0.001),apolipoprotein A1(ApoA1;HR:1.01,95%CI:1.01-1.02,P<0.001)and apolipoprotein E(ApoE;HR:3.81,95%CI:1.64-8.85,P=0.002)were independent predictors of PVR.CONCLUSION:Apart from macular involvement and smoking,the lipidaemic factors ApoA1 and ApoE are risk factors of PVR after primary RRD surgery. 展开更多
关键词 apolipoprotein A1 apolipoprotein E nondiabetic patients prognostic nomogram proliferative vitreoretinopathy rhegmatogenous retinal detachment vitrectomy
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Electroencephalogram-guided anesthesia and postoperative anxiety and depression in elderly gastric cancer patients with sleep disorders 认领 引用
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作者 Xiao-Min Zhang Li Yuan +3 位作者 Yan-Lin Chen Shi-Chao Shuai Xiao-Ming Ye Ji-Bo Zhao 《World Journal of Psychiatry》 SCIE 2026年第2期127-140,共14页
BACKGROUND Preoperative sleep disorders are common in elderly gastric cancer patients and may increase the risk of postoperative anxiety and depression.Traditional anesthesia depth monitoring relies on clinical signs,... BACKGROUND Preoperative sleep disorders are common in elderly gastric cancer patients and may increase the risk of postoperative anxiety and depression.Traditional anesthesia depth monitoring relies on clinical signs,which may not accurately reflect the true anesthetic state in elderly patients.This study evaluates the effect of individualized anesthesia guided by electroencephalogram(EEG)monitoring on postoperative anxiety and depression symptoms in elderly gastric cancer patients with preoperative sleep disorders.AIM To determine whether EEG-guided anesthesia improves psychological recovery by stabilizing anesthesia depth in elderly gastric cancer patients with preoperative sleep disorders.METHODS This retrospective study included 240 patients aged≥65 years with preoperative sleep disorders(Pittsburgh Sleep Quality Index≥5)who underwent elective radical gastrectomy between January 2022 and December 2023.Patients were divided into an EEG monitoring group(n=118)and a conventional monitoring group(control,n=122).The EEG group used Bispectral Index(BIS)monitoring to adjust anesthetic dosage,maintaining BIS values between 40 and 60,while the control group relied on conventional clinical indicators for anesthesia depth adjustment.The primary outcomes were Hospital Anxiety and Depression Scale(HADS)scores at 3 days and 1 month postoperatively;secondary outcomes included postoperative delirium incidence,length of stay,and quality of life scores.RESULTS A total of 240 elderly gastric cancer patients with preoperative sleep disorders were included(118 EEG group,122 control group)with well-matched baseline characteristics.EEG-guided anesthesia significantly reduced anesthetic drug consumption(propofol:5.8±1.2 mg/kg/hour vs 7.3±1.4 mg/kg/hour,P<0.001;remifentanil:0.18±0.04μg/kg/minute vs 0.24±0.05μg/kg/minute,P<0.001)and achieved 18.6% cost reduction.Primary outcomes showed the EEG group had significantly lower postoperative anxiety and depression scores at 3 days(HADS total:11.8±3.7 vs 15.9±4.9,P<0.001)and 1 month(8.7±3.2 vs 13.2±4.1,P<0.001).The proportion of patients with clinically significant symptoms was reduced from 62.3% to 39.0% at 3 days and from 45.9% to 21.2% at 1 month(both P<0.001).Multivariate analysis identified EEG-guided anesthesia as the strongest protective factor[odds ratio(OR)=0.56,95%CI:0.41-0.78,P=0.003],while poor sleep efficiency(OR=2.24,P<0.001)and frequent sleep disturbances(OR=1.95,P=0.001)were the most significant risk factors.Subgroup analysis revealed a doseresponse relationship,with greatest benefits in patients with severe sleep disorders.BIS stability metrics strongly correlated with psychological outcomes(r=-0.462 for target range maintenance,P<0.001).Secondary outcomes demonstrated significant improvements in the EEG group:(1)Lower complication rates(32.2%vs 48.4%,P=0.010);(2)Reduced postoperative delirium(8.5%vs 17.2%,P=0.038);and(3)Superior pain control,faster recovery,and shorter hospital stay(10.8±2.7 days vs 12.5±3.0 days,P<0.001).CONCLUSION For elderly gastric cancer patients with preoperative sleep disorders,individualized anesthesia guided by EEG monitoring significantly reduces postoperative anxiety and depression symptoms,lowers postoperative delirium risk,shortens hospital stay,and improves postoperative quality of life.The stability of anesthesia depth is closely associated with postoperative mental health outcomes,providing new clinical evidence and individualized strategies for perioperative management of high-risk elderly patients. 展开更多
关键词 Elderly patients Gastric cancer Sleep disorder Electroencephalogram monitoring Anesthesia depth Postoperative anxiety Postoperative depression
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Fu Zheng Li Qi Tang combined with FOCUS-PDCA model in postoperative rehabilitation of elderly biliary surgery patients 认领 引用
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作者 Liu-Liu Zhou Chun-Ling Li +2 位作者 Jin-Feng Zhang Chun Wu Zhi-Jun Cheng 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期218-227,共10页
BACKGROUND Elderly patients undergoing biliary surgery face high risks of postoperative complications and delayed recovery due to reduced physiological reserve and frequent comorbidities.Effective rehabilitation strat... BACKGROUND Elderly patients undergoing biliary surgery face high risks of postoperative complications and delayed recovery due to reduced physiological reserve and frequent comorbidities.Effective rehabilitation strategies are urgently needed.Traditional Chinese medicine,such as Fu Zheng Li Qi Tang,may support recovery through multi-targeted regulation,while the find,organize,clarify,understand,select,plan,do,check and act(FOCUS-PDCA)model offers a systematic approach to optimize nursing quality.We hypothesized that combining Fu Zheng Li Qi Tang with the FOCUS-PDCA model would significantly improve postoperative recovery in elderly biliary surgery patients compared to routine care.AIM To evaluate the effect of Fu Zheng Li Qi Tang plus FOCUS-PDCA on postoperative recovery in elderly biliary surgery patients.METHODS One hundred and twenty elderly biliary surgery patients(age≥60 years)were randomized into a control group(n=60)receiving Fu Zheng Li Qi Tang and routine nursing, and an observation group (n = 60) receiving additional FOCUS-PDCA model. Postoperativerecovery indicators (time to first flatus, ambulation, hospitalization), Visual Analog Scale pain scores, complications,and nursing satisfaction were compared.RESULTSThe duration of postoperative bed rest, time to first flatus, and length of hospital stay in the observational groupwere all shorter than those in the control group (P < 0.0001). The Visual Analog Scale scores of patients in bothgroups at all time points after the operation were significantly reduced, and the scores of the observation group atall time points were lower than that of the control group (P < 0.0001). Moreover, the total incidence rate of complicationsin the patients of the observation group was lower, and the satisfaction with the nursing care was higher (P< 0.05).CONCLUSIONFu Zheng Li Qi Tang combined with FOCUS-PDCA model accelerates postoperative recovery, relieves pain,reduces complications, and improves nursing satisfaction in elderly biliary surgery patients, demonstratingsignificant clinical value. 展开更多
关键词 Fu Zheng Li Qi Tang FOCUS-PDCA model Elderly patients Biliary surgery Postoperative recovery
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Integrated drug management for elderly patients with congestive heart failure:enhancing medication accuracy using the MINE(Medicine IN gEriatric)application 认领 引用
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作者 Welinda Dyah Ayu Umi Athiyah +1 位作者 Carta Agrawanto Gunawan Elida Zairina 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2026年第5期296-308,共13页
Background This study evaluated the impact of the Medicine IN Geriatric(MINE)application,which integrates the Integrated Medicine Management(IMM)model and STOPP/START criteria,on improving prescribing practices in eld... Background This study evaluated the impact of the Medicine IN Geriatric(MINE)application,which integrates the Integrated Medicine Management(IMM)model and STOPP/START criteria,on improving prescribing practices in elderly patients with congestive heart failure(CHF).Methods A two-phase study was conducted:validation of the IMM model and its implementation via the MINE app.A quasiexperimental pretest-posttest control group design was used in a hospital in East Kalimantan,Indonesia.Patients aged 60-79 years were randomly assigned to the intervention or control group.The intervention group received IMM-based pharmaceutical services,including medication reconciliation,repeated medication reviews,and individualized discharge counseling.The outcomes assessed included polypharmacy rates,potentially inappropriate medications(PIMs),potential prescribing omissions(PPOs),and health-related quality of life,using the EQ-5D-5L and EQ-VAS tools.Results Expert validation showed high content validity,with I-CVI≥0.86 and S-CVI=0.94.During implementation,the use of antiplatelets,statins,angiotensin converting enzyme inhibitors(ACEI),and angiotensin receptorβ-blockers(ARB)declined from admission to discharge.PIMs,such as beta-blockers in patients with conduction disorders and ACE-I/ARBs in those with hyperkalemia,also decreased.The intervention group's EQ-5D-5L scores improved from 0.552 to 0.664,whereas the control group's scores declined slightly.EQ-VAS scores also increased significantly in the intervention group.Conclusion The MINE-based IMM intervention effectively reduced inappropriate prescribing and enhanced the quality of life in elderly patients with CHF.This technology-enabled multidisciplinary approach supports safer prescribing in geriatric care. 展开更多
关键词 improving prescribing practices congestive heart failure chf methods integrated medicine management imm model Medicine Geriatric Application Elderly Patients Integrated Drug Management STOPP START Criteria Prescribing Practices
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Impact of pre-chemotherapy locomotive syndrome status on shortterm adverse outcome events in elderly lung cancer patients:A longitudinal study 认领 引用
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作者 Dan-Hua Liang Xiao-Rui Feng +2 位作者 Lan Li Ying Chen Yu-Ling Yang 《World Journal of Orthopedics》 2026年第3期104-112,共9页
BACKGROUND Despite growing recognition of locomotive syndrome(LS)in the general elderly population,research focusing on its prevalence and clinical implications among elderly lung cancer patients remains limited.Exist... BACKGROUND Despite growing recognition of locomotive syndrome(LS)in the general elderly population,research focusing on its prevalence and clinical implications among elderly lung cancer patients remains limited.Existing studies have predominantly examined nutritional,immune,or systemic functional factors influencing chemotherapy tolerance and prognosis,while musculoskeletal health-an equally critical determinant of patient outcomes-has received insufficient attention.AIM To investigate the effect of pre-chemotherapy LS status on short-term adverse outcome events among elderly lung cancer patients.METHODS This study employed convenience sampling to recruit 410 elderly lung cancer patients admitted to the Affiliated Hospital of Jiangnan University from January 2024 to June 2024.Clinical data of the patients were collected,and they were divided into the LS group and the non-LS group according to their LS status before chemotherapy.The patients were followed up for 6 months.Toxicity during chemotherapy and adverse outcomes such as death,incapacitation,and unplanned hospitalization during the follow-up period were recorded.RESULTS This study finished data collection on 386 elderly lung cancer patients.Among them,161 were diagnosed with LS before chemotherapy,while 225 were non-LS patients.After chemotherapy,the incidence of LS was significantly higher in the LS group than in the non-LS group(P<0.05).During the chemotherapy,the LS group experienced a significantly greater incidence of toxicities when compared to the non-LS group(P<0.05).The toxicity grading in the LS group was significantly higher than that in the non-LS group(P<0.05).During the follow-up period,the mortality rate of the LS group was significantly higher than that of the non-LS group(P<0.05).Moreover,patients in the LS group faced more severe incapacitation and a higher rate of unplanned hospitalizations than those in the non-LS group(P<0.05).CONCLUSION Pre-chemotherapy LS has become more prevalent among elderly lung cancer patients,and its incidence further increases after chemotherapy.Elderly lung cancer patients with pre-chemotherapy LS experience numerous and severe toxic side effects during chemotherapy.They also face a high risk of death,suffer from severe disability,and have a high rate of unplanned hospitalization during the follow-up period. 展开更多
关键词 Elderly lung cancer patients Antitumor combination chemotherapy regimens Locomotive syndrome Drug-related adverse effects Pre-chemotherapy
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The utility of the trans-splenic retrocardiac view in supine critically ill patients 认领 引用
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作者 Issac Cheong Pablo Martín Merlo Francisco Marcelo Tamagnone 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2026年第2期205-206,共2页
Monitoring cardiac function is a fundamental component of the diagnosis and management of critically ill patients.While pulmonary artery catheterization has long served as the standard for hemodynamic assessment,its i... Monitoring cardiac function is a fundamental component of the diagnosis and management of critically ill patients.While pulmonary artery catheterization has long served as the standard for hemodynamic assessment,its invasive nature and associated risks have shifted clinical practice toward non-invasive modalities.[1] Among these methods,point-of-care ultrasound(POCUS) has gained widespread acceptance,offering real-time bedside evaluation of cardiac function. 展开更多
关键词 cardiac function monitoring monitoring cardiac function hemodynamic assessmentits trans splenic retrocardiac view non invasive modalities cardiac function pulmonary artery catheterization supine critically ill patients
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Correlation of mild cognitive impairment with locomotive syndrome in geriatric cancer patients:A cross-sectional study 认领 引用
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作者 Ying Chen Wen-Jing Xu +9 位作者 Hui Lu Jing Wang Ling Li Hui Su Dan-Hua Liang Yu-Qing Zhou Yong-Ping Xu Jing-Fang Xia Hui Yu Yu-Ling Yang 《World Journal of Psychiatry》 SCIE 2026年第4期295-306,共12页
BACKGROUND Locomotive syndrome(LS),a criterion capable of evaluating physical function at an earlier stage,has been less studied in relation to mild cognitive impairment(MCI).Clarifying the correlation between LS stat... BACKGROUND Locomotive syndrome(LS),a criterion capable of evaluating physical function at an earlier stage,has been less studied in relation to mild cognitive impairment(MCI).Clarifying the correlation between LS status and MCI in geriatric cancer patients may aid in identifying early risks for cognitive and motor impairments,providing new insights into maintaining patient independence.AIM To explore risk factors and the correlation between MCI and LS in geriatric cancer patients.METHODS A total of 467 geriatric cancer patients admitted to our hospital from July 2024 to June 2025 were enrolled.MCI was assessed using the Mini Mental State Examination,while locomotive function was evaluated using the Geriatric Locomotive Function Scale-25.Univariate analysis was conducted to evaluate differences in MCI and LS among geriatric cancer patients with different clinical characteristics.Logistic regression was performed to identify independent risk factors.Spearman correlation analysis was employed to assess the relationship between MCI and LS.RESULTS The prevalence of LS was 58.0%,and that of MCI was 30.5%.Logistic regression analysis indicated that age,number of chronic comorbidities,educational level,and MCI were independent risk factors for LS.Age,number of chronic comorbidities,and LS were risk factors for MCI.Spearman correlation analysis revealed a negative correlation between Geriatric Locomotive Function Scale-25 and Mini Mental State Examination scores(r=-0.436,P<0.001).CONCLUSION A significant correlation exists between MCI and LS in geriatric cancer patients.Clinical management and nursing care should concurrently address cognitive impairment and LS to improve patients’overall quality of life and prognosis. 展开更多
关键词 Geriatric cancer patients Locomotive syndrome Cognitive impairment Musculoskeletal function Correlation
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Effect of the Internet+5A nursing model on patients with middle-and late-stage digestive tract tumors pain 认领 引用
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作者 Lei Wang Xiao-Qin Ma +1 位作者 Chen-Xia Ju Jue Fu 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第4期180-190,共11页
BACKGROUND Patients diagnosed with middle-and late-stage digestive tract tumors often experience persistent pain,which seriously affects their quality of life(QoL)and treatment adherence.Although traditional nursing m... BACKGROUND Patients diagnosed with middle-and late-stage digestive tract tumors often experience persistent pain,which seriously affects their quality of life(QoL)and treatment adherence.Although traditional nursing models of pain management rely primarily on regular assessments by medical personnel and simple pharmacological interventions,they lack attention to patients’individualized needs and continuous nursing support.However,the development of“Internet+”technologies and the 5A(Ask,Assess,Advise,Assist,And Arrange)nursing model,along with their application medical care,has gradually attracted attention.AIM To explore the effect of the Internet+5A nursing model on patients experiencing middle-and late-stage digestive tract tumor pain.METHODS One hundred patients experiencing pain from middle-and late-stage digestive tract tumors were prospectively divided into two groups:control[routine pain management(n=50)]and observation[Internet+5A nursing model(n=50)].The Numerical Rating Scale(NRS),European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30),Chinese Version of the Self-Management Efficacy Scale for Cancer Patients(CSUPPH),and Chinese Version of the American Pain Society Patient Outcome Questionnaire(APS-POQ-C)scores were compared between the groups.RESULTS After 1 month of nursing intervention,the NRS score of the observation group was significantly lower than that of the control group(P<0.05).Both groups exhibited significant improvements in all items of the EORTC QLQ-C30 scale(P<0.05);however,the observation group exhibited higher scores in cognitive,role,emotional,physical,and social functions(P<0.05).After one month of treatment,the increases in all C-SUPPH scores in the observation group were greater than those in the control group(P<0.05).Moreover,the observation group had lower scores for pain intensity,activity interference,sleep interference,emotion,and adverse reactions related to pain treatment drugs on the APS-POQ-C scale,with a higher score for pain management perception than the control group(P<0.05).CONCLUSION The Internet+5A nursing model reduces pain intensity in patients with middle-and late-stage digestive tract tumors,improves enhances QoL,thereby supporting its implementation in clinical practice. 展开更多
关键词 Internet+ 5A nursing model Middle-and late-stage digestive tract tumors Pain Numerical Rating Scale European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Chinese Version of the Self-Management Efficacy Scale for Cancer Patients Chinese Version of the American Pain Society Patient Outcome Questionnaire
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Association between illness perception and depression in colorectal cancer patients:Chain mediating effects of self-efficacy and posttraumatic growth 认领 引用
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作者 Fu-Zhuo Wang Jia-Shuang Xu +2 位作者 Hong Sun Xiu-Li Wang Ye Huang 《World Journal of Psychiatry》 SCIE 2026年第6期379-388,共10页
BACKGROUND Illness perception is a known correlate of depression in cancer patients,yet the mechanisms explaining this association remain incompletely understood.Selfefficacy and post-traumatic growth represent two ps... BACKGROUND Illness perception is a known correlate of depression in cancer patients,yet the mechanisms explaining this association remain incompletely understood.Selfefficacy and post-traumatic growth represent two psychological resources that may explain the association between illness perceptions and depressive symptoms.Understanding these pathways could inform targeted interventions for colorectal cancer patients.AIM To investigate the mediating roles of self-efficacy and post-traumatic growth in the relationship between illness perception and depression among colorectal cancer patients.METHODS A cross-sectional study was conducted from May to November 2024 in two tertiary hospitals in Liaoning Province,China.A total of 290 colorectal cancer patients were recruited using multistage stratified sampling.Data were collected via questionnaires assessing demographic characteristics,illness perception(Brief Illness Perception Questionnaire),self-efficacy(General Self-Efficacy Scale),post-traumatic growth(Post-Traumatic Growth Inventory),and depression(Patient Health Questionnaire-9).Mediation analysis was performed using the PROCESS macro(model 6)with 5000 bootstrap samples.RESULTS Illness perception was positively associated with depression[β=0.2575,95%confidence interval(CI):0.1827-0.3323].Three significant mediating pathways were identified:(1)Via self-efficacy alone(β=0.1099,95%CI:0.0700-0.1599),accounting for 27.47%of the total effect;(2)Via post-traumatic growth alone(β=0.0275,95%CI:0.0014-0.0537),accounting for 6.80%;and(3)Via the sequential pathway of self-efficacy and post-traumatic growth(β=0.0051,95%CI:0.0001-0.0122),accounting for 1.28%.The total indirect effect explained 35.63%of the variance.CONCLUSION Self-efficacy and post-traumatic growth mediate the relationship between illness perception and depression.Interventions targeting both cognitive appraisal and positive psychological growth may help mitigate depressive symptoms in this population. 展开更多
关键词 Colorectal cancer patients Illness perception Self-efficacy Post-traumatic growth Depression
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Safety of opening wounds after cold resection of colorectal cancer patients’intestinal polyps ten mm or larger 认领 引用
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作者 Lin-Da Li Zhang-Han Chen +4 位作者 Yun-Shi Zhong Dong-Li He De-Xiang Zhu Jian-Min Xu Jia-Chen Jing 《World Journal of Gastrointestinal Endoscopy》 2026年第5期29-36,共8页
BACKGROUND Current guidelines have not reached consensus on hemostatic management for large polyps(10-20 mm)removed by cold snare polypectomy(CSP).In light of the low complication rate of CSP and the potential hyperco... BACKGROUND Current guidelines have not reached consensus on hemostatic management for large polyps(10-20 mm)removed by cold snare polypectomy(CSP).In light of the low complication rate of CSP and the potential hypercoagulability in colorectal cancer(CRC)patients,prophylactic hemoclip use after CSP for polyps≥10 mm appears unlikely to reduce bleeding risk in patients with suspected colorectal cancer.AIM To evaluate the necessity of prophylactic hemoclip use after CSP for polyps≥10 mm in patients with CRC.METHODS This prospective cohort study with a historical control was conducted in Zhongshan Hospital.A total of 110 patients undergoing CSP without prophylactic hemoclip closure were prospectively enrolled(November 2022-October 2023),while 94 patients who received prophylactic hemoclip closure(November 2021-November 2022)served as controls.Inverse probability of treatment weighting(IPTW)was applied to balance baseline confounders.Rare bleeding events were analyzed using Firth penalized-likelihood logistic regression,and quantile regression was used to evaluate procedural time and cost.RESULTS Before weighting,the non-clipping group showed significantly shorter procedural time(25.31±16.75 minutes vs 29.31±14.97 minutes;Z=2.49,P=0.01)and lower cost(4604.75±2564.28 CNY vs 4915.55±2327.80 CNY;Z=2.06,P=0.04)compared to the control group.After IPTW adjustment,no statistically significant differences were found in intraoperative or postoperative bleeding rates between the groups.Quantile regression indicated no significant difference in operative time across quantiles(all P>0.05).However,a significant association was observed at the 0.25 quantile with cost(coefficient=-382.282,P=0.035),suggesting non-use of clips was associated with reduced cost in the lower-cost subgroup.CONCLUSION In this cohort,prophylactic hemoclip use does not significantly alter bleeding risk or procedural time for CSP of polyps≥10 mm,but its utilization strategy may impact cost containment. 展开更多
关键词 Colorectal cancer patients Colonic polyps Rectal polyps Post-polypectomy bleeding Cold snare polypectomy Metal clips
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Root cause analysis from the perspectives of patients in primary care units:cases study of typical adverse drug events 认领 引用
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作者 Ping Gong Xing-Yang Chen +1 位作者 Qin Long Ting-Ting Zhou 《Frontiers of Nursing》 2026年第1期61-68,共8页
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth... Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients. 展开更多
关键词 adverse drug events case study medication safety patients safety primary care units root cause analysis qualitative study theory
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