BACKGROUND Peroral endoscopic esophageal myotomy(POEM)is an innovative,minimally invasive endoscopic technique that has been widely adopted and recognized for the clinical management of achalasia because of its advant...BACKGROUND Peroral endoscopic esophageal myotomy(POEM)is an innovative,minimally invasive endoscopic technique that has been widely adopted and recognized for the clinical management of achalasia because of its advantages of minimal trauma and rapid recovery.Nevertheless,clinical data have indicated that approximately 67%of patients experience esophageal pain after POEM.This high prevalence of pain not only affects patients’post-POEM recovery experience and quality of life but also presents challenges to its clinical implementation.Therefore,it is urgently necessary to explore effective intervention strategies.AIM To accurately determine the incidence of post-POEM pain and to comprehensively investigate the potential risk factors for the development of post-POEM pain.METHODS In this study,123 patients who were clinically diagnosed with achalasia and who underwent POEM were included.Baseline demographic characteristics,post-POEM numerical rating scale(NRS)pain scores,and anesthesia/surgery-related parameters were systematically collected.Patients were categorized into a pain group and a non-pain group on the basis of whether the NRS score exceeded 4 at 12 hours post-POEM.Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors associated with post-POEM pain.RESULTS On the basis of the predefined inclusion and exclusion criteria,123 eligible patients were enrolled.After adjusting for confounding factors,stepwise multivariate logistic regression analysis revealed that the preoperative Eckardt score[odds ratio(OR)=1.317,95%confidence interval(95%CI):0.992-1.748,P=0.057]and preoperative anxiety status(OR=5.195,95%CI:1.691-15.959,P=0.004)were independent risk factors for post-POEM pain.Our multifactor model exhibited robust predictive ability for postoperative pain following POEM,with an area under the receiver operating characteristic curve of 0.760(95%CI:0.661–0.859).CONCLUSION Patients with achalasia who underwent POEM presented a high prevalence of post-POEM pain,which was moderate or severe in 26.8%of these patients.After adjusting for confounding factors,multivariate analysis revealed that preoperative anxiety and a higher Eckardt score were independent risk factors for post-POEM pain.展开更多
BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in t...BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in the peri-and postoperative care of patients.However,its effects after laparoscopic hepatectomy remains unclear.AIM To explore the influence of nursing under the ERAS concept on time to first ambulation and complications after laparoscopic hepatectomy.METHODS Data from 119 patients,who underwent laparoscopic hepatectomy for various indications between January 2020 and March 2025,were divided into 2 groups according to nursing mode:Observation[nursing based on the ERAS concept(n=59)],and control[basic nursing(n=60)].Time to first ambulation,complications,length of hospital stay,and numerical rating scale(NRS)scores were compared between the groups.Statistical analysis was performed using SPSS version 26.0(IBM Corp.,Armonk,NY,United States).Differences with P<0.05 were considered statistically significant.RESULTS Findings indicated that after post-nursing intervention,the observation group experienced significantly sooner initial discharge times and shorter hospital stays than the control group(P<0.05).The NRS score of the observation group was lower than that of the control group(P<0.05).The observation group experienced a significantly lower incidence of postoperative complications than the control group(P<0.05).CONCLUSION Operating room nursing based on the ERAS concept significantly shortens the time to first ambulation,reduces the incidence of postoperative complications,and improves patient quality of life after laparoscopic hepatectomy.展开更多
Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain manageme...Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain management.Methods:A retrospective study of 489 inpatient cancer patients(1081 visits)was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System.Data from a pilot prospective randomized controlled study on acupuncture for cancer pain was analyzed to validate the Edmonton Symptom Assessment System(ESAS)as the primary outcome in the integrative oncology research.Results:In the retrospective analysis,scores of the numerical rating scale(NRS)and the ESAS total score were significantly correlated(r=0.15,P=0.02),and the correlation coefficient between NRS and pain sub-scale in ESAS was 0.47(P<0.001).The pilot study showed the proportions of participants experiencing more than a 2-point reduction in NRS at the end of the treatment were 80%(n=12/15)in the acupuncture group and 50%(n=7/14)in the control group,without a significant difference between groups(P=0.13).For the total scores of ESAS,more responders were found in the acupuncture group(n=13/15)compared to that in the control group(n=7/14),with no significant difference between groups(P=0.05).Conclusions:ESAS is suitable for the comprehensive assessment in patients with cancer pain and could be an appropriate outcome measurement in acupuncture research for cancer pain.Trial registration:Registered on 09/07/2018 with ChiCTR1800017023(https://www.chictr/org.cn/edit.aspx?pid=28879&htm=4)展开更多
BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients’health-related quality of life(HRQoL).Although empirical evidence has demonstrated that novel Ther...BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients’health-related quality of life(HRQoL).Although empirical evidence has demonstrated that novel Thermobalancing therapy and Dr Allen’s Device can relieve chronic low back pain,there have been no randomised controlled trials for these indications.AIM To evaluate the efficacy of Dr Allen’s Device in lumbar disc herniation(LDH)and non-specific low back pain(NSLBP).METHODS A randomised clinical trial was conducted investigating 55 patients with chronic low back pain due to LDH(n=28)or NSLBP(n=27),out of which 15 were randomly assigned to the control group and 40 were assigned to the treatment group.The intervention was treatment with Dr Allen’s Device for 3 mo.Changes in HRQoL were assessed using the Numerical Pain Rating Scale and the Japanese Orthopedic Association Back Pain Questionnaire.RESULTS Thermobalancing therapy with Dr Allen’s Device showed a significant reduction in pain in the treatment group(P<0.001),with no recorded adverse effects.Both pain assessment scales showed a significant improvement in patients’perception of pain indicating improvement in HRQoL.CONCLUSION The out-of-hospital use of Thermobalancing therapy with Dr Allen’s Device for Low Back Treatment relieves chronic low back pain significantly and without adverse effects,improves the level of activity and HRQoL among patients with LDH and NSLBP.This study demonstrates the importance of this safe first-line therapy that can be used for effective at-home management of chronic low back pain.展开更多
Objective:Vulvar lichen planus(VLP),especially erosive VLP(EVLP),seriously affects women’s physiological function and quality of life.A retrospective analysis of erosive vulvar lichen planus(EVLP)was performed to rai...Objective:Vulvar lichen planus(VLP),especially erosive VLP(EVLP),seriously affects women’s physiological function and quality of life.A retrospective analysis of erosive vulvar lichen planus(EVLP)was performed to raise awareness on this chronic,deforming,and painful vulvar disease.Methods:This observational retrospective study involved 40 patients with EVLP among 1,368 patients with vulvar disease from 2017 to 2020.The patients’vulvar clinical features and extravulvar mucosal involvement were investigated.The patients’pain and quality of life were evaluated with the numeric rating scale and the Dermatology Life Quality Index(DLQI),respectively.Clinical characteristics were reported using frequencies and proportions for categorical variables.Continuous variables are expressed as mean±standard deviation.The association between NRS score for pain and DLQI score was analyzed by Pearson’s correlation test.Results:EVLP accounted for 2.9%(40/1,368)of all cases of vulvar disease,and the median age at onset was 42 years.Erosion mostly occurred on the labia minora and introitus.Half(20/40)of the patients had extravulvar mucosal involvement.Seventeen(42.5%)patients had oral lichen planus,and seven(17.5%)patients were diagnosed with vulvovaginal-gingival syndrome.The numeric rating scale score showed that 47.5%(19/40)of patients experienced mild pain,whereas 12.5%(5/40)described the pain as severe.Thirty-one patients(77.5%,31/40)had dyspareunia,and nine patients had aggravated pain after sexual intercourse.The mean DLQI score was 9.1±6.0,with 37.5%(15/40)of patients indicating that EVLP had severely affected their lives.The numeric rating scale score for pain was significantly correlated with the DLQI score(P=0.007).Conclusion:EVLP can affect the quality of women’s lives and cause severe deformations and painful architectural changes.The description of the characteristics of EVLP in this report will benefit the diagnosis and early treatment of this disease.展开更多
基金Supported by the Special Research Project on Optimal Management of Acute Pain,Wu Jie-ping Medical Foundation,No.320.6750.2024-15.101.
文摘BACKGROUND Peroral endoscopic esophageal myotomy(POEM)is an innovative,minimally invasive endoscopic technique that has been widely adopted and recognized for the clinical management of achalasia because of its advantages of minimal trauma and rapid recovery.Nevertheless,clinical data have indicated that approximately 67%of patients experience esophageal pain after POEM.This high prevalence of pain not only affects patients’post-POEM recovery experience and quality of life but also presents challenges to its clinical implementation.Therefore,it is urgently necessary to explore effective intervention strategies.AIM To accurately determine the incidence of post-POEM pain and to comprehensively investigate the potential risk factors for the development of post-POEM pain.METHODS In this study,123 patients who were clinically diagnosed with achalasia and who underwent POEM were included.Baseline demographic characteristics,post-POEM numerical rating scale(NRS)pain scores,and anesthesia/surgery-related parameters were systematically collected.Patients were categorized into a pain group and a non-pain group on the basis of whether the NRS score exceeded 4 at 12 hours post-POEM.Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors associated with post-POEM pain.RESULTS On the basis of the predefined inclusion and exclusion criteria,123 eligible patients were enrolled.After adjusting for confounding factors,stepwise multivariate logistic regression analysis revealed that the preoperative Eckardt score[odds ratio(OR)=1.317,95%confidence interval(95%CI):0.992-1.748,P=0.057]and preoperative anxiety status(OR=5.195,95%CI:1.691-15.959,P=0.004)were independent risk factors for post-POEM pain.Our multifactor model exhibited robust predictive ability for postoperative pain following POEM,with an area under the receiver operating characteristic curve of 0.760(95%CI:0.661–0.859).CONCLUSION Patients with achalasia who underwent POEM presented a high prevalence of post-POEM pain,which was moderate or severe in 26.8%of these patients.After adjusting for confounding factors,multivariate analysis revealed that preoperative anxiety and a higher Eckardt score were independent risk factors for post-POEM pain.
文摘BACKGROUND Traditional postoperative nursing methods implemented after laparoscopic hepatectomy often leads to slow patient recovery.As a new nursing mode,enhanced recovery after surgery(ERAS)has been widely used in the peri-and postoperative care of patients.However,its effects after laparoscopic hepatectomy remains unclear.AIM To explore the influence of nursing under the ERAS concept on time to first ambulation and complications after laparoscopic hepatectomy.METHODS Data from 119 patients,who underwent laparoscopic hepatectomy for various indications between January 2020 and March 2025,were divided into 2 groups according to nursing mode:Observation[nursing based on the ERAS concept(n=59)],and control[basic nursing(n=60)].Time to first ambulation,complications,length of hospital stay,and numerical rating scale(NRS)scores were compared between the groups.Statistical analysis was performed using SPSS version 26.0(IBM Corp.,Armonk,NY,United States).Differences with P<0.05 were considered statistically significant.RESULTS Findings indicated that after post-nursing intervention,the observation group experienced significantly sooner initial discharge times and shorter hospital stays than the control group(P<0.05).The NRS score of the observation group was lower than that of the control group(P<0.05).The observation group experienced a significantly lower incidence of postoperative complications than the control group(P<0.05).CONCLUSION Operating room nursing based on the ERAS concept significantly shortens the time to first ambulation,reduces the incidence of postoperative complications,and improves patient quality of life after laparoscopic hepatectomy.
基金Supported by the National Natural Science Foundation of China(no.82004447)Guangdong Basic and Applied Basic Research Foundation(no.2021A1515011597)Discipline-Collaborative Innovation Team for"Double First-Class"and High-Level University in Guangzhou University of Chinese Medicine(no.2021XK08)。
文摘Background:As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms,it is necessary to have a comprehensive assessment on promising intervention to improve pain management.Methods:A retrospective study of 489 inpatient cancer patients(1081 visits)was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System.Data from a pilot prospective randomized controlled study on acupuncture for cancer pain was analyzed to validate the Edmonton Symptom Assessment System(ESAS)as the primary outcome in the integrative oncology research.Results:In the retrospective analysis,scores of the numerical rating scale(NRS)and the ESAS total score were significantly correlated(r=0.15,P=0.02),and the correlation coefficient between NRS and pain sub-scale in ESAS was 0.47(P<0.001).The pilot study showed the proportions of participants experiencing more than a 2-point reduction in NRS at the end of the treatment were 80%(n=12/15)in the acupuncture group and 50%(n=7/14)in the control group,without a significant difference between groups(P=0.13).For the total scores of ESAS,more responders were found in the acupuncture group(n=13/15)compared to that in the control group(n=7/14),with no significant difference between groups(P=0.05).Conclusions:ESAS is suitable for the comprehensive assessment in patients with cancer pain and could be an appropriate outcome measurement in acupuncture research for cancer pain.Trial registration:Registered on 09/07/2018 with ChiCTR1800017023(https://www.chictr/org.cn/edit.aspx?pid=28879&htm=4)
文摘BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients’health-related quality of life(HRQoL).Although empirical evidence has demonstrated that novel Thermobalancing therapy and Dr Allen’s Device can relieve chronic low back pain,there have been no randomised controlled trials for these indications.AIM To evaluate the efficacy of Dr Allen’s Device in lumbar disc herniation(LDH)and non-specific low back pain(NSLBP).METHODS A randomised clinical trial was conducted investigating 55 patients with chronic low back pain due to LDH(n=28)or NSLBP(n=27),out of which 15 were randomly assigned to the control group and 40 were assigned to the treatment group.The intervention was treatment with Dr Allen’s Device for 3 mo.Changes in HRQoL were assessed using the Numerical Pain Rating Scale and the Japanese Orthopedic Association Back Pain Questionnaire.RESULTS Thermobalancing therapy with Dr Allen’s Device showed a significant reduction in pain in the treatment group(P<0.001),with no recorded adverse effects.Both pain assessment scales showed a significant improvement in patients’perception of pain indicating improvement in HRQoL.CONCLUSION The out-of-hospital use of Thermobalancing therapy with Dr Allen’s Device for Low Back Treatment relieves chronic low back pain significantly and without adverse effects,improves the level of activity and HRQoL among patients with LDH and NSLBP.This study demonstrates the importance of this safe first-line therapy that can be used for effective at-home management of chronic low back pain.
文摘Objective:Vulvar lichen planus(VLP),especially erosive VLP(EVLP),seriously affects women’s physiological function and quality of life.A retrospective analysis of erosive vulvar lichen planus(EVLP)was performed to raise awareness on this chronic,deforming,and painful vulvar disease.Methods:This observational retrospective study involved 40 patients with EVLP among 1,368 patients with vulvar disease from 2017 to 2020.The patients’vulvar clinical features and extravulvar mucosal involvement were investigated.The patients’pain and quality of life were evaluated with the numeric rating scale and the Dermatology Life Quality Index(DLQI),respectively.Clinical characteristics were reported using frequencies and proportions for categorical variables.Continuous variables are expressed as mean±standard deviation.The association between NRS score for pain and DLQI score was analyzed by Pearson’s correlation test.Results:EVLP accounted for 2.9%(40/1,368)of all cases of vulvar disease,and the median age at onset was 42 years.Erosion mostly occurred on the labia minora and introitus.Half(20/40)of the patients had extravulvar mucosal involvement.Seventeen(42.5%)patients had oral lichen planus,and seven(17.5%)patients were diagnosed with vulvovaginal-gingival syndrome.The numeric rating scale score showed that 47.5%(19/40)of patients experienced mild pain,whereas 12.5%(5/40)described the pain as severe.Thirty-one patients(77.5%,31/40)had dyspareunia,and nine patients had aggravated pain after sexual intercourse.The mean DLQI score was 9.1±6.0,with 37.5%(15/40)of patients indicating that EVLP had severely affected their lives.The numeric rating scale score for pain was significantly correlated with the DLQI score(P=0.007).Conclusion:EVLP can affect the quality of women’s lives and cause severe deformations and painful architectural changes.The description of the characteristics of EVLP in this report will benefit the diagnosis and early treatment of this disease.
