Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.T...Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.展开更多
Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neu...Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.展开更多
Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general ...Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.展开更多
Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the...Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.展开更多
Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strate...Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.展开更多
This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensive...This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensively evaluated the research progress.The research indicates a shift from basic supportive care toward precision intervention strategies.Immunonutrition approaches,such as omega-3 fatty acid supplementation and probiotics for gut microbiota modulation,significantly mitigate chemotherapy-related side effects and enhance nutritional status.These targeted novel regimens demonstrate clear clinical advantages.The success of nutritional management depends on a multidisciplinary collaboration mechanism.The organic integration of innovative nutritional protocols with standard treatments from hematology,pediatrics,and nutrition departments significantly optimizes treatment outcomes and long-term quality of life for children with leukemia.This interdisciplinary synergy is reshaping contemporary medical models.展开更多
BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emoti...BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.展开更多
Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains ...Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains limited by fragmented service delivery,uneven technological capacity,and sociocultural factors that delay timely diagnosis.This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings.Methods:A mixed-methods design was employed across audiology facilities selected systematically from four Nigerian geopolitical zones.Twenty-five paediatric audiologists and twenty-three parents of children with congenital hearing loss participated.Quantitative data were collected using a structured questionnaire assessing awareness,diagnostic access,and intervention experiences.Qualitative data were obtained through semi-structured interviews and two focus group discussions.Thematic analysis followed Braun and Clarke's six-step framework,with dual coding,external auditing,and member validation to enhance credibility.Results:Quantitative findings demonstrated broad agreement on the diagnostic value of otoacoustic emissions(OAEs)and automated auditory brainstem responses(AABRs),the developmental benefits of early intervention,and the importance of active parental involvement.However,respondents identified persistent barriers including high costs of screening and therapy,poor public awareness of early hearing loss symptoms,and a critical shortage of trained personnel,and unequal distribution of diagnostic tools,particularly in rural and northern regions.Thematic analysis further underscored disparities in diagnostic capacity,sociocultural interpretations of deafness that delay clinical consultation,and economic constraints that hinder continuity of care.While families who accessed early intervention reported improved communication,social engagement,and learning readiness in their children,systemic gaps continue to limit widespread success.Conclusions:Despite growing technological capacity and awareness of EHDI benefits,significant structural,financial,and sociocultural challenges continue to impede timely diagnosis and intervention in Nigeria.Strengthening national policies,ensuring equitable distribution of diagnostic tools,expanding professional training,subsidising services,implementing culturally sensitive awareness campaigns and integration of Universal Newborn Hearing Screening into routine postnatal care are essential to improving outcomes for deaf infants.展开更多
Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interv...Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.展开更多
Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By...Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By reviewing relevant domestic and foreign studies and clinical practices,this paper summarizes and analyzes the main application forms of digital health interventions,including digital health education,intelligent detection equipment,telemedicine platforms,oral health big data platforms,and school-hospital collaborative screening robots.Results:Studies have shown that digital health interventions can effectively improve the public’s oral health knowledge level,optimize personal health behaviors,enhance clinical diagnosis efficiency,reduce overall medical costs,and promote the innovation and upgrading of oral health management models.Conclusion:Digital health intervention represents an inevitable trend in the future development of stomatology.In the future,it is still necessary to improve data security and privacy protection,technology adaptability and popularity,as well as relevant policies and norms,to give full play to its potential value.展开更多
Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic s...Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic stroke admitted to our hospital from June 2024 to June 2025 were selected and divided into two groups using the red and blue ball method:the control group(n=30,receiving routine interventional room nursing)and the observation group(n=31,receiving additional tirofiban medication-specific nursing+individualized interventional nursing on the basis of routine nursing).The cerebral hemodynamic indicators,adverse reactions,effectiveness of complication nursing,and nursing satisfaction were compared between the two groups.Results:After 7 days of treatment,the observation group had lower cerebrovascular peripheral resistance and higher mean blood flow velocity and mean blood flow volume compared to the control group(all p<0.05).The observation group had a higher effectiveness rate of complication nursing than the control group,with a statistically significant difference(p<0.05).The nursing satisfaction in the observation group(96.77%)was higher than that in the control group(80.00%),with a statistically significant difference(χ^(2)=4.223,p=0.040<0.05).Conclusion:Tirofiban combined with direct thrombectomy can significantly improve cerebral hemodynamics,enhance the effectiveness of complication nursing,and increase patient satisfaction in patients with ischemic stroke.展开更多
The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 ...The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.展开更多
Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and ...Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.展开更多
BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise lev...BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.展开更多
OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicent...OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.展开更多
Background Percutaneous coronary intervention(PCI)is a widely utilized revascularization technique for coronary artery disease(CAD).While clinical and biomarker-based prognostic tools are standard for predicting outco...Background Percutaneous coronary intervention(PCI)is a widely utilized revascularization technique for coronary artery disease(CAD).While clinical and biomarker-based prognostic tools are standard for predicting outcomes,there is growing interest in sarcopenia as a marker of frailty and its potential role in long-term prognosis.The prognostic value of the psoas muscle index(PMI),a sarcopenia metric,remains underexplored in PCI populations regarding long term survival.Methods This single-center retrospective cohort study evaluated 177 patients undergoing PCI from 2015 to 2019.PMI was calculated from computed tomography(CT)imaging at the L3 vertebral level using the formula:(left psoas area+right psoas area)/height2 and expressed in cm^(2)/m^(2).Sarcopenia was defined as the lowest sex-specific PMI quartile.Primary outcomes included 5-year all-cause mortality and 3-point major adverse cardiovascular events(MACE:non-fatal myocardial infarction,ischemic stroke,and cardiac death).Binary linear regression and Cox proportional hazards models were utilized to determine associations between PMI and outcomes Results Sarcopenic patients exhibited significantly higher 5-year all-cause mortality compared to non-sarcopenic counterparts(64.4%vs.35.6%,P<0.001),while no significant difference was observed in 3-point MACE incidence(55.6%vs.51.4%,P=0.520).Sarcopenia was independently associated with all-cause mortality on binary logistic regression(OR=3.49;95%CI:1.69–7.19;P=0.0007),but not MACE(OR=1.00;95%CI:0.50–1.98;P=0.99).In a multivariable Cox regression model,sarcopenia was associated with increased hazard of mortality(HR=1.60;95%CI:0.96–2.66;P=0.071),though this did not reach statistical significance.Kaplan-Meier analysis demonstrated significantly reduced survival among sarcopenic patients(χ^(2)=6.13,P=0.0133).Conclusions PMI is a significant independent predictor of 5-year all-cause mortality in PCI patients,underscoring the prognostic importance of assessing skeletal muscle mass in this population.展开更多
Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction affect approximately 20%-40%of patients,with a significantly greater prevalence in females(OR=1.8).These disorders manifes...Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction affect approximately 20%-40%of patients,with a significantly greater prevalence in females(OR=1.8).These disorders manifest through physiological symptoms,cognitive distortions,behavioral avoidance,and cardiacspecific concerns and typically emerge within 1-2 weeks post-procedure.Key risk factors include female sex,younger age(<55 years),psychiatric history,procedural complexity,and poor social support.Anxiety negatively affects cardiovascular outcomes when left untreated,leading to higher readmission rates(HR=1.47)and recurrent cardiovascular events(HR=1.31),as well as lower medication adherence and quality of life.Screening is optimally conducted 7-10 days postprocedure via validated tools such as the Hospital Anxiety and Depr-ession Scale,Anxiety.Heart-specific cognitive behavioral therapy(SMD=-0.72),selective serotonin reuptake inhibitors(especially sertraline),and integrated cardiac rehabilitation programs that incorporate both psychological and physical elements are among the beneficial interventions that have been supported by evidence.These all-encompassing strategies show long-term improvements in cardiovascular outcomes,functional ability,and healthcare expenses in addition to immediate benefits in lowering anxiety.Digital initiatives have the potential to increase access,especially in underprivileged areas.Early identification of highrisk patients and implementation of timely,targeted interventions represent crucial strategies for improving both psychological and cardiovascular outcomes in this vulnerable population.展开更多
Background Quantitative flow ratio(QFR)based lesion selection for percutaneous coronary intervention(PCI)treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revasculariz...Background Quantitative flow ratio(QFR)based lesion selection for percutaneous coronary intervention(PCI)treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revascularization.Whether this benefit is consistent across different age groups still needs further investigation.Methods In this prespecified subgroup study of FAVORⅢChina trial,we compared long-term clinical outcomes between QFR-guided and angiography-guided PCI among different age groups among 3825 enrolled subjects.The primary endpoint was major adverse cardiac events(MACEs),a composite of all-cause death,myocardial infarction,and ischemia-driven revascularization.Results Of the 3825 patients,1717(44.9%)were aged≥65 years.At baseline,patients≥65 had higher rates of hypertension,hyperlipidaemia,stroke history(P<0.0001),and peripheral vascular disease(P=0.024)and had higher SYNTAX scores(P=0.0095).Compared with standard angiography guidance,the QFR-guided strategy consistently reduced the 1-year(≥65 years,6.04%vs.9.19%,HR=0.65,95%CI:0.46–0.92;<65 years,5.53%vs.8.43%,HR=0.65,95%CI:0.47–0.91)and 3-year MACE rates in both age groups(≥65 years,11.8%vs.15.2%,HR:0.75,95%CI:0.58–0.98;<65 years,9.5%vs.14.6%,HR=0.63;95%CI:0.49–0.81),without a significant interaction(Pinteraction=0.99).Within the QFR-guided group,the 3-year MACE rate in patients with deferred vessels was numerically greater in patients aged≥65 years than in those aged<65 years(8.3%vs.3.0%,P=0.10).Conclusions Although with higher rate of comorbidities and more complex coronary anatomy,the long-term benefit of the QFR-guided PCI strategy remained consistent in patients≥65 years,compared with those<65 years.展开更多
BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutri...BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutritional deterioration and psychological distress,affecting treatment efficacy and quality of life.Currently,there are relatively few postoperative rehabilitation interventions for esophageal cancer.As such,it is particularly important to develop a systematic and comprehensive intervention model to improve the quality of life and nutritional status of patients.AIM To evaluate exercise,nutritional,and psychological interventions on the postoperative nutritional and mental status of patients with esophageal cancer.METHODS Data from 104 patients,who were diagnosed with postoperative esophageal cancer between August 2023 and February 2024,were retrospectively analyzed.Patients were divided into 2 groups using a random numbers table:control[routine nursing measures(n=53)];and observation[routine nursing+exercise,nutritional support,and psychological interventions(n=51)].Nutritional status,anxiety and depression,quality of life,incidence of complications,treatment compliance,and satisfaction with nursing care were compared between the two groups.RESULTS Serum albumin,prealbumin,hemoglobin,transferrin,and World Health Organization Quality of Life-Brief Version scores were higher in the observation group than those in the control group.After treatment,Self-rating Anxiety Scale,Self-rating Depression Scale,and Hamilton Anxiety and Depression Scale scores in the observation group were lower than those in the control group.No significant differences were observed in the incidence of complications between the observation and control groups.The observation group exhibited more satisfaction with nursing care and treatment compliance than the control group.CONCLUSION Exercise,nutritional support,and psychological interventions effectively improves the nutritional status and negative emotions of patients undergoing radiotherapy for esophageal cancer,and enhances treatment compliance and satisfaction with nursing.展开更多
Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients w...Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients who underwent hemodialysis catheter indwelling and were admitted between August 2023 and August 2025,totaling 108 cases.These patients were randomly divided into two groups using a random number table method,with 54 cases in each group.The control group received routine nursing interventions,while the observation group received targeted nursing interventions.The incidence of deep vein thrombosis and hemodynamic indicators were compared between the two groups.Results:The incidence of deep vein thrombosis in the observation group was lower than that in the control group(p<0.05).After two weeks of nursing,the hemodynamic indicators in the observation group were higher than those in the control group(p<0.05).Conclusion:Targeted nursing interventions can effectively prevent deep vein thrombosis and improve hemodynamics in patients with hemodialysis catheter indwelling,making them worthy of clinical promotion.展开更多
文摘Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.
基金Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),project numbers 324633948 and 409784463(DFG grants Hi 678/9-3 and Hi 678/10-2,FOR2953)to HHBundesministerium für Bildung und Forschung-BMBF,project number 16LW0463K to HT.
文摘Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.
文摘Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.
文摘Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.
文摘Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.
文摘This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensively evaluated the research progress.The research indicates a shift from basic supportive care toward precision intervention strategies.Immunonutrition approaches,such as omega-3 fatty acid supplementation and probiotics for gut microbiota modulation,significantly mitigate chemotherapy-related side effects and enhance nutritional status.These targeted novel regimens demonstrate clear clinical advantages.The success of nutritional management depends on a multidisciplinary collaboration mechanism.The organic integration of innovative nutritional protocols with standard treatments from hematology,pediatrics,and nutrition departments significantly optimizes treatment outcomes and long-term quality of life for children with leukemia.This interdisciplinary synergy is reshaping contemporary medical models.
文摘BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.
文摘Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains limited by fragmented service delivery,uneven technological capacity,and sociocultural factors that delay timely diagnosis.This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings.Methods:A mixed-methods design was employed across audiology facilities selected systematically from four Nigerian geopolitical zones.Twenty-five paediatric audiologists and twenty-three parents of children with congenital hearing loss participated.Quantitative data were collected using a structured questionnaire assessing awareness,diagnostic access,and intervention experiences.Qualitative data were obtained through semi-structured interviews and two focus group discussions.Thematic analysis followed Braun and Clarke's six-step framework,with dual coding,external auditing,and member validation to enhance credibility.Results:Quantitative findings demonstrated broad agreement on the diagnostic value of otoacoustic emissions(OAEs)and automated auditory brainstem responses(AABRs),the developmental benefits of early intervention,and the importance of active parental involvement.However,respondents identified persistent barriers including high costs of screening and therapy,poor public awareness of early hearing loss symptoms,and a critical shortage of trained personnel,and unequal distribution of diagnostic tools,particularly in rural and northern regions.Thematic analysis further underscored disparities in diagnostic capacity,sociocultural interpretations of deafness that delay clinical consultation,and economic constraints that hinder continuity of care.While families who accessed early intervention reported improved communication,social engagement,and learning readiness in their children,systemic gaps continue to limit widespread success.Conclusions:Despite growing technological capacity and awareness of EHDI benefits,significant structural,financial,and sociocultural challenges continue to impede timely diagnosis and intervention in Nigeria.Strengthening national policies,ensuring equitable distribution of diagnostic tools,expanding professional training,subsidising services,implementing culturally sensitive awareness campaigns and integration of Universal Newborn Hearing Screening into routine postnatal care are essential to improving outcomes for deaf infants.
文摘Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.
文摘Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By reviewing relevant domestic and foreign studies and clinical practices,this paper summarizes and analyzes the main application forms of digital health interventions,including digital health education,intelligent detection equipment,telemedicine platforms,oral health big data platforms,and school-hospital collaborative screening robots.Results:Studies have shown that digital health interventions can effectively improve the public’s oral health knowledge level,optimize personal health behaviors,enhance clinical diagnosis efficiency,reduce overall medical costs,and promote the innovation and upgrading of oral health management models.Conclusion:Digital health intervention represents an inevitable trend in the future development of stomatology.In the future,it is still necessary to improve data security and privacy protection,technology adaptability and popularity,as well as relevant policies and norms,to give full play to its potential value.
文摘Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic stroke admitted to our hospital from June 2024 to June 2025 were selected and divided into two groups using the red and blue ball method:the control group(n=30,receiving routine interventional room nursing)and the observation group(n=31,receiving additional tirofiban medication-specific nursing+individualized interventional nursing on the basis of routine nursing).The cerebral hemodynamic indicators,adverse reactions,effectiveness of complication nursing,and nursing satisfaction were compared between the two groups.Results:After 7 days of treatment,the observation group had lower cerebrovascular peripheral resistance and higher mean blood flow velocity and mean blood flow volume compared to the control group(all p<0.05).The observation group had a higher effectiveness rate of complication nursing than the control group,with a statistically significant difference(p<0.05).The nursing satisfaction in the observation group(96.77%)was higher than that in the control group(80.00%),with a statistically significant difference(χ^(2)=4.223,p=0.040<0.05).Conclusion:Tirofiban combined with direct thrombectomy can significantly improve cerebral hemodynamics,enhance the effectiveness of complication nursing,and increase patient satisfaction in patients with ischemic stroke.
文摘The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.
基金supported by grant 2011BAI11B01 from the Projects in the Chinese National Science and Technology Pillar Program during the 12th Five-year Plan Periodby grant 2017-I2M-1-004 from the Chinese Academy of Medical Science Innovation Fund for Medical Sciencesby the Major science and technology special plan project of Yunnan Province (202302AA310045)。
文摘Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
文摘BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.
基金supported by the National Key Research and Development Program of China(No.2022YFC3602500)Beijing High-level Public Health Technical Talents Construction Project(Discipline Leader-03-24)Beijing Hospitals Authority’s Ascent Plan(DFL20240601).
文摘OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.
文摘Background Percutaneous coronary intervention(PCI)is a widely utilized revascularization technique for coronary artery disease(CAD).While clinical and biomarker-based prognostic tools are standard for predicting outcomes,there is growing interest in sarcopenia as a marker of frailty and its potential role in long-term prognosis.The prognostic value of the psoas muscle index(PMI),a sarcopenia metric,remains underexplored in PCI populations regarding long term survival.Methods This single-center retrospective cohort study evaluated 177 patients undergoing PCI from 2015 to 2019.PMI was calculated from computed tomography(CT)imaging at the L3 vertebral level using the formula:(left psoas area+right psoas area)/height2 and expressed in cm^(2)/m^(2).Sarcopenia was defined as the lowest sex-specific PMI quartile.Primary outcomes included 5-year all-cause mortality and 3-point major adverse cardiovascular events(MACE:non-fatal myocardial infarction,ischemic stroke,and cardiac death).Binary linear regression and Cox proportional hazards models were utilized to determine associations between PMI and outcomes Results Sarcopenic patients exhibited significantly higher 5-year all-cause mortality compared to non-sarcopenic counterparts(64.4%vs.35.6%,P<0.001),while no significant difference was observed in 3-point MACE incidence(55.6%vs.51.4%,P=0.520).Sarcopenia was independently associated with all-cause mortality on binary logistic regression(OR=3.49;95%CI:1.69–7.19;P=0.0007),but not MACE(OR=1.00;95%CI:0.50–1.98;P=0.99).In a multivariable Cox regression model,sarcopenia was associated with increased hazard of mortality(HR=1.60;95%CI:0.96–2.66;P=0.071),though this did not reach statistical significance.Kaplan-Meier analysis demonstrated significantly reduced survival among sarcopenic patients(χ^(2)=6.13,P=0.0133).Conclusions PMI is a significant independent predictor of 5-year all-cause mortality in PCI patients,underscoring the prognostic importance of assessing skeletal muscle mass in this population.
文摘Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction affect approximately 20%-40%of patients,with a significantly greater prevalence in females(OR=1.8).These disorders manifest through physiological symptoms,cognitive distortions,behavioral avoidance,and cardiacspecific concerns and typically emerge within 1-2 weeks post-procedure.Key risk factors include female sex,younger age(<55 years),psychiatric history,procedural complexity,and poor social support.Anxiety negatively affects cardiovascular outcomes when left untreated,leading to higher readmission rates(HR=1.47)and recurrent cardiovascular events(HR=1.31),as well as lower medication adherence and quality of life.Screening is optimally conducted 7-10 days postprocedure via validated tools such as the Hospital Anxiety and Depr-ession Scale,Anxiety.Heart-specific cognitive behavioral therapy(SMD=-0.72),selective serotonin reuptake inhibitors(especially sertraline),and integrated cardiac rehabilitation programs that incorporate both psychological and physical elements are among the beneficial interventions that have been supported by evidence.These all-encompassing strategies show long-term improvements in cardiovascular outcomes,functional ability,and healthcare expenses in addition to immediate benefits in lowering anxiety.Digital initiatives have the potential to increase access,especially in underprivileged areas.Early identification of highrisk patients and implementation of timely,targeted interventions represent crucial strategies for improving both psychological and cardiovascular outcomes in this vulnerable population.
文摘Background Quantitative flow ratio(QFR)based lesion selection for percutaneous coronary intervention(PCI)treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revascularization.Whether this benefit is consistent across different age groups still needs further investigation.Methods In this prespecified subgroup study of FAVORⅢChina trial,we compared long-term clinical outcomes between QFR-guided and angiography-guided PCI among different age groups among 3825 enrolled subjects.The primary endpoint was major adverse cardiac events(MACEs),a composite of all-cause death,myocardial infarction,and ischemia-driven revascularization.Results Of the 3825 patients,1717(44.9%)were aged≥65 years.At baseline,patients≥65 had higher rates of hypertension,hyperlipidaemia,stroke history(P<0.0001),and peripheral vascular disease(P=0.024)and had higher SYNTAX scores(P=0.0095).Compared with standard angiography guidance,the QFR-guided strategy consistently reduced the 1-year(≥65 years,6.04%vs.9.19%,HR=0.65,95%CI:0.46–0.92;<65 years,5.53%vs.8.43%,HR=0.65,95%CI:0.47–0.91)and 3-year MACE rates in both age groups(≥65 years,11.8%vs.15.2%,HR:0.75,95%CI:0.58–0.98;<65 years,9.5%vs.14.6%,HR=0.63;95%CI:0.49–0.81),without a significant interaction(Pinteraction=0.99).Within the QFR-guided group,the 3-year MACE rate in patients with deferred vessels was numerically greater in patients aged≥65 years than in those aged<65 years(8.3%vs.3.0%,P=0.10).Conclusions Although with higher rate of comorbidities and more complex coronary anatomy,the long-term benefit of the QFR-guided PCI strategy remained consistent in patients≥65 years,compared with those<65 years.
基金Supported by the Special Project on Intravenous Therapy of Shanghai Nursing Society,No.2023JL-B08Naval Medical University Nursing“Zhuyuan”Talent Program.
文摘BACKGROUND Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate.Although radiotherapy is the primary treatment modality,it can easily lead to nutritional deterioration and psychological distress,affecting treatment efficacy and quality of life.Currently,there are relatively few postoperative rehabilitation interventions for esophageal cancer.As such,it is particularly important to develop a systematic and comprehensive intervention model to improve the quality of life and nutritional status of patients.AIM To evaluate exercise,nutritional,and psychological interventions on the postoperative nutritional and mental status of patients with esophageal cancer.METHODS Data from 104 patients,who were diagnosed with postoperative esophageal cancer between August 2023 and February 2024,were retrospectively analyzed.Patients were divided into 2 groups using a random numbers table:control[routine nursing measures(n=53)];and observation[routine nursing+exercise,nutritional support,and psychological interventions(n=51)].Nutritional status,anxiety and depression,quality of life,incidence of complications,treatment compliance,and satisfaction with nursing care were compared between the two groups.RESULTS Serum albumin,prealbumin,hemoglobin,transferrin,and World Health Organization Quality of Life-Brief Version scores were higher in the observation group than those in the control group.After treatment,Self-rating Anxiety Scale,Self-rating Depression Scale,and Hamilton Anxiety and Depression Scale scores in the observation group were lower than those in the control group.No significant differences were observed in the incidence of complications between the observation and control groups.The observation group exhibited more satisfaction with nursing care and treatment compliance than the control group.CONCLUSION Exercise,nutritional support,and psychological interventions effectively improves the nutritional status and negative emotions of patients undergoing radiotherapy for esophageal cancer,and enhances treatment compliance and satisfaction with nursing.
文摘Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients who underwent hemodialysis catheter indwelling and were admitted between August 2023 and August 2025,totaling 108 cases.These patients were randomly divided into two groups using a random number table method,with 54 cases in each group.The control group received routine nursing interventions,while the observation group received targeted nursing interventions.The incidence of deep vein thrombosis and hemodynamic indicators were compared between the two groups.Results:The incidence of deep vein thrombosis in the observation group was lower than that in the control group(p<0.05).After two weeks of nursing,the hemodynamic indicators in the observation group were higher than those in the control group(p<0.05).Conclusion:Targeted nursing interventions can effectively prevent deep vein thrombosis and improve hemodynamics in patients with hemodialysis catheter indwelling,making them worthy of clinical promotion.
