BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
Treatment with immune checkpoint inhibitors(ICIs)is an innovative therapy for managing certain types of malignancy and has the potential to improve overall patient survival significantly.The most widely used ICIs sele...Treatment with immune checkpoint inhibitors(ICIs)is an innovative therapy for managing certain types of malignancy and has the potential to improve overall patient survival significantly.The most widely used ICIs selectively target different receptors comprising programmed cell death-1 receptor,programmed cell death-ligand 1 receptor,and cytotoxic T lymphocyte antigen 4 receptor.The widespread utilization of ICIs over the past several years,however,is frequently accompanied by immune-related adverse events(irAEs)that substantially impact the patient’s quality of life,particularly those affecting the digestive system,including both the upper and lower gastrointestinal tract.Based on a literature search covering databases such as PubMed,Web of Science,Embase,and the Cochrane Library,we present an insight into primary gastrointestinal irAEs,with a special focus on endoscopic manifestations.Additionally,we analyze data regarding the pathogenetic mechanisms,diagnostic approaches,histological characteristics,and proposed therapeutic interventions for managing irAEs involving the gastrointestinal tract.展开更多
Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for me...Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for medication-induced urticaria through comprehensive analysis of the FDA Adverse Event Reporting System(FAERS)database.Methods:We employed reporting odds ratios(ROR)to evaluate drug-urticaria associations using FAERS data spanning from Q12004 to Q32024.Analytical approaches included univariate screening,LASSO regression,and multivariate logistic regression to identify potential risk factors.Multiple comparison adjustments were implemented using the Bonferroni method.Results:The study identified 1807 pharmaceutical agents potentially associated with urticaria development.Univariate analysis categorized these agents into several therapeutic classes:antimicrobials(19/85),biologics(16/85),analgesics(8/85),dermatologicals(3/85),anti-rheumatic agents(4/85),hormonal preparations(3/85),antihypertensives(2/85),neuropsychiatric medications(2/85),uric acid-lowering drugs(2/85),multiple sclerosis therapies(2/85),and miscellaneous agents(17/85).Multivariate analysis identified three significant risk determinants:middle-aged individuals(36-53 years),female gender,and exposure to any of 82 specific medications.Conclusion:These evidence-based findings provide valuable insights for early clinical recognition of drug-induced urticaria and establish a foundation for subsequent mechanistic investigations into medication-related hypersensitivity reactions.展开更多
BACKGROUND In randomized controlled trials(RCTs),the placebo arm has often been ignored as the attention tends to be focused on the treatment arm.We undertook a meta-analysis based on the data from the placebo arm in ...BACKGROUND In randomized controlled trials(RCTs),the placebo arm has often been ignored as the attention tends to be focused on the treatment arm.We undertook a meta-analysis based on the data from the placebo arm in RCTs of hepatocellular carci-noma(HCC),the response rates and survival status,and adverse events(AEs)were summarized and evaluated.AIM To systematically evaluate the response rates,survival status and AEs in the placebo arms of RCTs for HCC.METHODS A systematic search was performed on PubMed,Ovid MEDLINE,Embase and Cochrane Library to identify relevant trials evaluating the efficacy of drugs for the treatment of HCC,published until December 31,2023.Statistical analysis was performed using R statistical software(version 4.3.2).RESULTS A total of 18 RCTs,involving 2390 patients,met the criteria for inclusion in the meta-analysis.The pooled overall disease control rate and objective response rate in the placebo group were 38%[95%confidence interval(CI):33%-42%]and 1%(95%CI:1%-2%),respectively.Overall survival and progression-free survival in the placebo group were 7.9 months(95%CI:7.6-8.31 months)and 1.9 months(95%CI:1.6-2.1 months),respectively.The incidence of grade 3 or 4 AEs was 37%(95%CI:30%-43%).Additionally,the incidence of interruptions or dose reductions due to AEs was 20%(95%CI:13%-27%),while the incidence of treatment discontinuation due to AEs was 9%(95%CI:6%-12%).CONCLUSION Over one-third of advanced HCC patients exhibit therapy-free disease control,with placebo-arm AEs observed.These findings guide single-arm trials design and enhance patient acceptance of anticancer therapies.展开更多
BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study desc...BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.展开更多
To address the early separation problem in the Menter Shear-Stress Transport(SST)turbulence model,a correction for the Turbulent Kinetic Energy(TKE)production term,P_(k),is introduced to account for the effect of the ...To address the early separation problem in the Menter Shear-Stress Transport(SST)turbulence model,a correction for the Turbulent Kinetic Energy(TKE)production term,P_(k),is introduced to account for the effect of the Adverse Pressure Gradient(APG).The correction is determined based on the distribution of Pkin the APG region before separation.When the friction coefficient C_(f) is decomposed,its direct dependence on Pkis clearly observed.However,with the introduction of Bradshaw’s assumption,Pkin the SST turbulence model is over-suppressed,resulting in a lower inner peak or no significant inner peak distribution at all.To address this problem,this paper proposes a Gaussian function,HGauss,which corrects the numerical values of P_(k) involved in the calculation of the Menter SST model by focusing on the inner peak region of P_(k).The modified SST model is then applied to four cases with APGs.The modification leads to an increase in the wall friction coefficient C_(f)in the APG region and causes a downstream shift in the separation location,improving the model’s consistency with high-accuracy data and experimental results.It is demonstrated that this correction can improve the early separation problem in the Menter SST turbulence model.展开更多
Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies a...Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies associated with adverse geology provide a novel strategy for addressing these limitations.However,statistical methods for identifying geochemical anomalies are insufficient for tunnel engineering.In contrast,data mining techniques such as machine learning have demonstrated greater efficacy when applied to geological data.Herein,a method for identifying adverse geology using machine learning of geochemical anomalies is proposed.The method was identified geochemical anomalies in tunnel that were not identified by statistical methods.We by employing robust factor analysis and self-organizing maps to reduce the dimensionality of geochemical data and extract the anomaly elements combination(AEC).Using the AEC sample data,we trained an isolation forest model to identify the multi-element anomalies,successfully.We analyzed the adverse geological features based the multi-element anomalies.This study,therefore,extends the traditional approach of geological analysis in tunnels and demonstrates that machine learning is an effective tool for intelligent geological analysis.Correspondingly,the research offers new insights regarding the adverse geology and the prevention of hazards during the construction of tunnels and underground engineering projects.展开更多
Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent...Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.展开更多
Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study anal...Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.展开更多
Obesity is a global pandemic that has been threatening the worldwide population.It has been reported to be associated with an increase in the risk of chronic diseases such as type 2 diabetes mellitus(T2DM),cardiovascu...Obesity is a global pandemic that has been threatening the worldwide population.It has been reported to be associated with an increase in the risk of chronic diseases such as type 2 diabetes mellitus(T2DM),cardiovascular disease,and other diseases,including some malignancies.Currently,the first line of management includes lifestyle modifications.However,recently,bariatric surgeries were introduced to combat obesity.The previous modalities of management are always challenging since lifestyle could have limited long-term effectiveness and difficulty to achieve,and surgeries are invasive and also require a lifestyle modification and commitment.Glucagon-like peptide-1 receptor agonists(GLP-1RAs)were initially introduced as a rising star for managing T2DM,with patients benefiting from the control of blood sugar and weight loss.These medications work by enhancing feelings of fullness,slowing down digestion,and ultimately reducing calorie intake.However,GLP-1RAs are not without side effects and have some costs.Common side effects include gastrointestinal(GI)adverse events such as nausea,vomiting,diarrhea,and a lack of GI motility,which is the main mechanism through which the drug induces a feeling of fullness and promotes weight loss,potentially resulting in treatment discontinuation.More serious,though less frequent,risks include pancreatitis,gallbladder diseases,and,rarely,thyroid Ccell cancers.This review aimed to discuss the globally emerging role of GLP-1RAs in obesity management and highlight some safety considerations for patients taking these drugs.展开更多
BACKGROUND Major adverse cardiovascular(CV)events(MACEs)are the primary cause of morbidity and mortality in kidney transplantation(KT)recipients.The risk for MACEs is impacted by an array of traditional and transplant...BACKGROUND Major adverse cardiovascular(CV)events(MACEs)are the primary cause of morbidity and mortality in kidney transplantation(KT)recipients.The risk for MACEs is impacted by an array of traditional and transplant-related non-traditional CV risk factors.AIM To investigate the association between potential CV risk factors related to KT and MACEs,and their potential modification by hyperuricemia(HU).METHODS The relationship between CV risk factors related to KT and MACEs was examined in a cohort of 545 patients who underwent transplantation between 2008 and 2019.The mean age of patients at KT was 55.0 years±14.2 years(range 15.0–89.0 years).Univariate and multivariate logistic regression models were constructed to identify risk factors influencing MACEs.To explore the potential effect modification by uric acid(UA),patients were categorized into groups based on UA levels:(1)Low(<356μmol/L);(2)Normal(356–416μmol/L);(3)High(416–475μmol/L);and(4)Very high(>475μmol/L).RESULTS MACEs occurred in 145 of 545(26.6%)KT recipients.The most prevalent comorbidities were hypertension(87%),dyslipidemia(78%),secondary hyperparathyroidism(68%),HU(63%)and anemia(33%).In the multivariate logistic regression model,the most significant factors associated with MACEs were previous CV events[odds ratio(OR)=70.6,95%CI:24.9–200.1],left ventricular hypertrophy(LVH)(OR=12.6,95%CI:2.7–58.3),HU treatment(OR=4.3,95%CI:2.4–7.6),and anemia(OR=5.3,95%CI:2.9–9.8).Effect modification by the presence of HU revealed that independent factors associated with MACEs were age(OR=1.03,95%CI:1.0–1.1),previous CV events(OR=41.7,95%CI:13.6–127.6),LVH(OR=15.3,95%CI:2.0–116.6),HU treatment(OR=2.5,95%CI:1.3–4.6)and anemia(OR=5.4,95%CI:2.8–10.5).Effect modification by UA levels dichotomized at 475μmol/L(very high level of UA)revealed that HU treatment was not associated with MACEs in groups with or without very high UA levels.CONCLUSION A very high level of UA was observed to act as an effect-modifying factor for MACEs,especially when combined with other risk factors such as age,previous CV events,LVH,and anemia.展开更多
Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interle...Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.展开更多
BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead...BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead to severe consequences such as suicidal thoughts.Respiratory failure,a disorder of pulmonary ventilation and gas exchange,is frequently complicated by depression,aggravating the condition and creating complications in treatment.Patients with both conditions tend to exhibit poor compliance with medical advice,resulting in adverse outcomes such as sleep disorders,arrhythmias,and electrolyte imbalances.Therefore,effective nursing interventions are crucial for improving patient outcomes.While routine nursing care can provide basic support,dedicated nursing,which involves specialized and personalized care by highly trained professionals,may offer additional benefits.AIM To examine the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure.METHODS A total of 160 patients with depression complicated by respiratory failure admitted to the Second Affiliated Hospital of Soochow University from January to December 2024 were randomly categorized into a control group(n=80)receiving routine nursing care and observation group(n=80)receiving routine nursing combined with dedicated nursing care.The establishment of a specialized nursing team;the development of a personalized nursing plan;and the implementation of comprehensive care strategies targeting emotional support,sleep improvement,pulmonary function enhancement,and adherence to medical advice were included in the dedicated nursing intervention.Emotional state[evaluated using the Self-Rating Depression Scale(SDS)],sleep quality[assessed using the Pittsburgh Sleep Quality Index(PSQI)],hope level[measured using the Herth Hope Scale(HHS)],pulmonary function[comprising forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],exercise endurance[6-minute walk distance test(6MWD)],compliance with medical advice,and incidence of adverse events were compared between the two groups.RESULTS No significant differences were observed in SDS,PSQI,HHS,FVC,FEV1,6MWD,or compliance with medical advice between the two groups(P>0.05)before the intervention.However,after the intervention,the control group exhibited significantly lower SDS and PSQI scores;higher HHS scores;greater improvements in FVC,FEV1,and 6MWD;and higher compliance with medical advice compared with the control group(P<0.05).In addition,the incidence of adverse events was significantly lower in the control group(P<0.05).CONCLUSION Dedicated nursing intervention significantly improves emotional state,sleep quality,hope level,pulmonary function,exercise endurance,and compliance with medical advice while reducing adverse events in patients with depression complicated by respiratory failure.Therefore,dedicated nursing appears to be an effective approach to enhance patient outcomes in this population.展开更多
This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk facto...This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk factors such as chronic obstructive pulmonary disease and hypoalbuminemia,the model demonstrated strong predictive accuracy and offered a pathway to personalized perioperative care.This correspondence highlighted the clinical significance,emphasizing its potential to optimize patient outcomes through tailored inter-ventions.Further prospective validation and application across diverse settings are essential to realize its full potential in advancing esophageal surgery practices.展开更多
BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other a...BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other adverse reactions.Standardized evidence-based nursing practices are essential for enhancing patient care by addressing both physical and psychological health issues.AIM To analyze the impact of standardized evidence-based nursing on psychological status and adverse reactions of patients undergoing endoscopic colonic polypectomy.METHODS Data from 200 patients who underwent endoscopic colonic polypectomy at the authors’hospital between January and June 2024 were randomly assigned to two groups:Control[received routine nursing care(n=100)]and study[received standardized evidence-based nursing intervention(s)(n=100)].Psychological status,visual analog scale,and Short-Form 36 Health Survey scores,adverse events,and satisfaction with nursing were compared between the two groups.RESULTS After the interventions,the study group exhibited significantly lower scores on the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale,along with a reduced incidence of adverse events compared with the control group(P<0.05).Short-Form 36 Health Survey scores and overall satisfaction with nursing care were also significantly higher in the intervention group(P<0.05).CONCLUSION Standardized evidence-based nursing interventions effectively reduced negative patient emotions and enhanced quality of life and satisfaction,demonstrating high safety.展开更多
Minimally invasive esophagectomy(MIE)has transformed esophageal surgery by reducing morbidity,accelerating recovery,and improving postoperative out-comes compared to traditional open esophagectomy.By utilizing techniq...Minimally invasive esophagectomy(MIE)has transformed esophageal surgery by reducing morbidity,accelerating recovery,and improving postoperative out-comes compared to traditional open esophagectomy.By utilizing techniques such as laparoscopic,thoracoscopic,and robotic-assisted approaches,MIE mini-mizes surgical trauma while maintaining oncological thoroughness.However,it also presents unique challenges,including risks of complications such as ana-stomotic leakage,pulmonary complications,and atrial fibrillation.Zhong et al developed and validated a risk stratification model for predicting surgical adverse events after MIE,enhancing preoperative assessment and patient management.This editorial further examines the advantages of MIE,its comparable oncological and long-term outcomes,as well as the incidence and contributing factors of post-operative complications.Emerging technologies,including machine learning models,intraoperative nerve monitoring,and robotic-assisted surgery,are high-lighted as innovative solutions for risk prediction and prevention.Strategies such as enhanced recovery after surgery protocols and multidisciplinary collaboration are emphasized for their critical roles in minimizing complications and optimizing patient outcomes.By addressing these aspects,this editorial provides guidance to surgical teams in maximizing the benefits of MIE while effectively managing its associated risks.展开更多
Objective:To monitor the incidence of immune-related adverse events(irAEs)in patients treated with immune checkpoint inhibitors(ICIs)and programmed cell death protein-1(PD-1),and to evaluate the effectiveness of nursi...Objective:To monitor the incidence of immune-related adverse events(irAEs)in patients treated with immune checkpoint inhibitors(ICIs)and programmed cell death protein-1(PD-1),and to evaluate the effectiveness of nursing interventions using a quantitative scoring system.Methods:A retrospective analysis was performed on 65 cancer patients who received PD-1 therapy at the Oncology Department of Baotou Cancer Hospital from December 2023 to December 2024.The study examined the clinical features and blood test results related to irAEs.The National Cancer Institute’s Common Terminology Criteria for Adverse Events(NCI-CTCAE)was used to grade the severity of these events,which were classified into five levels.Based on the NCI-CTCAE scores,appropriate nursing measures were implemented,and a comprehensive risk assessment framework was developed.Results:The study group showed lower complication rates,overall incidence,and average hospital stay compared to the control group(P<0.05).Among the 65 patients,twenty-eight(43.07%)experienced a total of 35 irAEs,with 2(5.71%)being grade 3 or 4.The most frequent irAEs were dermatological conditions(34.29%),particularly rash with itching.The occurrence of irAEs did not correlate with patient gender,age,blood parameters(hemoglobin,white blood cell count,platelet count,etc.),or liver function(P>0.05),but it was associated with tumor type(P<0.05).Conclusion:PD-1 treatment is generally safe,with a low incidence of severe(grade 3 or higher)irAEs.Close monitoring is essential to ensure early detection,intervention,and management of irAEs,thereby maintaining a low level of adverse events and enhancing the safety and efficacy of PD-1 therapy.Implementing a quantitative risk scoring system for nursing care can decrease the rate of complications,enhance patient safety,and potentially reduce hospital stays and medical costs.展开更多
Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the cou...Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the country has a 6.5%prevalence of small-for-gestational-age(SGA),ranking fifth globally in total SGA birth numbers^([1,2]).展开更多
Objective:To explore clinicopathological predictors of adverse pathological changes(APCs)(upgrading,upstaging,and positive surgical margin[PSM])after robot-assisted radical prostatectomy(RARP)in clinical tumor stage 2...Objective:To explore clinicopathological predictors of adverse pathological changes(APCs)(upgrading,upstaging,and positive surgical margin[PSM])after robot-assisted radical prostatectomy(RARP)in clinical tumor stage 2c(cT2c)prostate cancer(PCa)patients.Methods:From January 2018 to December 2022,cT2cN0M0 PCa patients who underwent prostate biopsies and subsequent RARP at the Peking University First Hospital with an interval between biopsy and RARP of ≤90 days were included.Univariable and stepwise multivariable logistic regression analyses were performed to identify independent risk factors associated with APCs.Nomograms were constructed based on these predictive models.The performance of the nomograms was evaluated by receiver operating characteristic curves,decision curve analyses,and calibration plots.Results:A total of 423 eligible cT2cN0M0 PCa patients were included.The rates of upgrading,upstaging,and PSM in our cohortwere 33%,51%,and 35%,respectively.The stepwise multivariate logistic analysis suggested that PSA density and the percentage of positive cores in systematic biopsy were significantly associated with the occurrence of APCs.The score of the Prostate Imaging Reporting and Data System,PSA density,and the International Society of Urological Pathology grade group(IGG)of needle-biopsy specimens(or clinical IGG[cIGG])were significantly associated with upgrading.The PSA density,percentage of positive cores in systematic biopsy,and largest tumor percentage in all cores of each patient(LTP)were significantly associated with upstaging.The PSA density and LTP were significantly associatedwith the PSM.Based on these results,four nomogramswere developed.Receiver operating characteristic curves,decision curve analyses,and calibration plots implied that the nomograms exhibited excellent accuracy.Conclusion:The predictive models we developed could help to identify high-risk PCa early,and optimize clinical decisions of cT2cN0M0 PCa patients.展开更多
Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have diffe...Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have different degrees of adverse reactions, which will cause damage to the patient’s body once they occur. This paper retrospectively analyzed the clinical data of patients with severe allergic reactions such as fecal incontinence and numbness of hands and feet caused by the use of paclitaxel liposome during postoperative chemotherapy in a case of ovarian cancer admitted to our hospital. The causes and corresponding treatment measures were analyzed, in order to provide the reference for medical staff to take effective countermeasures in advance in the future.展开更多
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
文摘Treatment with immune checkpoint inhibitors(ICIs)is an innovative therapy for managing certain types of malignancy and has the potential to improve overall patient survival significantly.The most widely used ICIs selectively target different receptors comprising programmed cell death-1 receptor,programmed cell death-ligand 1 receptor,and cytotoxic T lymphocyte antigen 4 receptor.The widespread utilization of ICIs over the past several years,however,is frequently accompanied by immune-related adverse events(irAEs)that substantially impact the patient’s quality of life,particularly those affecting the digestive system,including both the upper and lower gastrointestinal tract.Based on a literature search covering databases such as PubMed,Web of Science,Embase,and the Cochrane Library,we present an insight into primary gastrointestinal irAEs,with a special focus on endoscopic manifestations.Additionally,we analyze data regarding the pathogenetic mechanisms,diagnostic approaches,histological characteristics,and proposed therapeutic interventions for managing irAEs involving the gastrointestinal tract.
文摘Objective:Despite established associations between certain medications and urticaria,the risk profiles of most pharmaceutical agents remain poorly characterized.This investigation aimed to identify risk factors for medication-induced urticaria through comprehensive analysis of the FDA Adverse Event Reporting System(FAERS)database.Methods:We employed reporting odds ratios(ROR)to evaluate drug-urticaria associations using FAERS data spanning from Q12004 to Q32024.Analytical approaches included univariate screening,LASSO regression,and multivariate logistic regression to identify potential risk factors.Multiple comparison adjustments were implemented using the Bonferroni method.Results:The study identified 1807 pharmaceutical agents potentially associated with urticaria development.Univariate analysis categorized these agents into several therapeutic classes:antimicrobials(19/85),biologics(16/85),analgesics(8/85),dermatologicals(3/85),anti-rheumatic agents(4/85),hormonal preparations(3/85),antihypertensives(2/85),neuropsychiatric medications(2/85),uric acid-lowering drugs(2/85),multiple sclerosis therapies(2/85),and miscellaneous agents(17/85).Multivariate analysis identified three significant risk determinants:middle-aged individuals(36-53 years),female gender,and exposure to any of 82 specific medications.Conclusion:These evidence-based findings provide valuable insights for early clinical recognition of drug-induced urticaria and establish a foundation for subsequent mechanistic investigations into medication-related hypersensitivity reactions.
文摘BACKGROUND In randomized controlled trials(RCTs),the placebo arm has often been ignored as the attention tends to be focused on the treatment arm.We undertook a meta-analysis based on the data from the placebo arm in RCTs of hepatocellular carci-noma(HCC),the response rates and survival status,and adverse events(AEs)were summarized and evaluated.AIM To systematically evaluate the response rates,survival status and AEs in the placebo arms of RCTs for HCC.METHODS A systematic search was performed on PubMed,Ovid MEDLINE,Embase and Cochrane Library to identify relevant trials evaluating the efficacy of drugs for the treatment of HCC,published until December 31,2023.Statistical analysis was performed using R statistical software(version 4.3.2).RESULTS A total of 18 RCTs,involving 2390 patients,met the criteria for inclusion in the meta-analysis.The pooled overall disease control rate and objective response rate in the placebo group were 38%[95%confidence interval(CI):33%-42%]and 1%(95%CI:1%-2%),respectively.Overall survival and progression-free survival in the placebo group were 7.9 months(95%CI:7.6-8.31 months)and 1.9 months(95%CI:1.6-2.1 months),respectively.The incidence of grade 3 or 4 AEs was 37%(95%CI:30%-43%).Additionally,the incidence of interruptions or dose reductions due to AEs was 20%(95%CI:13%-27%),while the incidence of treatment discontinuation due to AEs was 9%(95%CI:6%-12%).CONCLUSION Over one-third of advanced HCC patients exhibit therapy-free disease control,with placebo-arm AEs observed.These findings guide single-arm trials design and enhance patient acceptance of anticancer therapies.
文摘BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.
基金supported by the National Natural Science Foundation of China(No.92252201)。
文摘To address the early separation problem in the Menter Shear-Stress Transport(SST)turbulence model,a correction for the Turbulent Kinetic Energy(TKE)production term,P_(k),is introduced to account for the effect of the Adverse Pressure Gradient(APG).The correction is determined based on the distribution of Pkin the APG region before separation.When the friction coefficient C_(f) is decomposed,its direct dependence on Pkis clearly observed.However,with the introduction of Bradshaw’s assumption,Pkin the SST turbulence model is over-suppressed,resulting in a lower inner peak or no significant inner peak distribution at all.To address this problem,this paper proposes a Gaussian function,HGauss,which corrects the numerical values of P_(k) involved in the calculation of the Menter SST model by focusing on the inner peak region of P_(k).The modified SST model is then applied to four cases with APGs.The modification leads to an increase in the wall friction coefficient C_(f)in the APG region and causes a downstream shift in the separation location,improving the model’s consistency with high-accuracy data and experimental results.It is demonstrated that this correction can improve the early separation problem in the Menter SST turbulence model.
基金the support from the National Natural Science Foundation of China(Nos.52279103,52379103)the Natural Science Foundation of Shandong Province(No.ZR2023YQ049)。
文摘Geological analysis,despite being a long-term method for identifying adverse geology in tunnels,has significant limitations due to its reliance on empirical analysis.The quantitative aspects of geochemical anomalies associated with adverse geology provide a novel strategy for addressing these limitations.However,statistical methods for identifying geochemical anomalies are insufficient for tunnel engineering.In contrast,data mining techniques such as machine learning have demonstrated greater efficacy when applied to geological data.Herein,a method for identifying adverse geology using machine learning of geochemical anomalies is proposed.The method was identified geochemical anomalies in tunnel that were not identified by statistical methods.We by employing robust factor analysis and self-organizing maps to reduce the dimensionality of geochemical data and extract the anomaly elements combination(AEC).Using the AEC sample data,we trained an isolation forest model to identify the multi-element anomalies,successfully.We analyzed the adverse geological features based the multi-element anomalies.This study,therefore,extends the traditional approach of geological analysis in tunnels and demonstrates that machine learning is an effective tool for intelligent geological analysis.Correspondingly,the research offers new insights regarding the adverse geology and the prevention of hazards during the construction of tunnels and underground engineering projects.
文摘Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.
基金Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project(2025AFD278)Three Gorges University Scientific Fund Project(2022kj008)Three Gorges University Special Scientific Fund Project(2023kjzx001)。
文摘Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.
文摘Obesity is a global pandemic that has been threatening the worldwide population.It has been reported to be associated with an increase in the risk of chronic diseases such as type 2 diabetes mellitus(T2DM),cardiovascular disease,and other diseases,including some malignancies.Currently,the first line of management includes lifestyle modifications.However,recently,bariatric surgeries were introduced to combat obesity.The previous modalities of management are always challenging since lifestyle could have limited long-term effectiveness and difficulty to achieve,and surgeries are invasive and also require a lifestyle modification and commitment.Glucagon-like peptide-1 receptor agonists(GLP-1RAs)were initially introduced as a rising star for managing T2DM,with patients benefiting from the control of blood sugar and weight loss.These medications work by enhancing feelings of fullness,slowing down digestion,and ultimately reducing calorie intake.However,GLP-1RAs are not without side effects and have some costs.Common side effects include gastrointestinal(GI)adverse events such as nausea,vomiting,diarrhea,and a lack of GI motility,which is the main mechanism through which the drug induces a feeling of fullness and promotes weight loss,potentially resulting in treatment discontinuation.More serious,though less frequent,risks include pancreatitis,gallbladder diseases,and,rarely,thyroid Ccell cancers.This review aimed to discuss the globally emerging role of GLP-1RAs in obesity management and highlight some safety considerations for patients taking these drugs.
文摘BACKGROUND Major adverse cardiovascular(CV)events(MACEs)are the primary cause of morbidity and mortality in kidney transplantation(KT)recipients.The risk for MACEs is impacted by an array of traditional and transplant-related non-traditional CV risk factors.AIM To investigate the association between potential CV risk factors related to KT and MACEs,and their potential modification by hyperuricemia(HU).METHODS The relationship between CV risk factors related to KT and MACEs was examined in a cohort of 545 patients who underwent transplantation between 2008 and 2019.The mean age of patients at KT was 55.0 years±14.2 years(range 15.0–89.0 years).Univariate and multivariate logistic regression models were constructed to identify risk factors influencing MACEs.To explore the potential effect modification by uric acid(UA),patients were categorized into groups based on UA levels:(1)Low(<356μmol/L);(2)Normal(356–416μmol/L);(3)High(416–475μmol/L);and(4)Very high(>475μmol/L).RESULTS MACEs occurred in 145 of 545(26.6%)KT recipients.The most prevalent comorbidities were hypertension(87%),dyslipidemia(78%),secondary hyperparathyroidism(68%),HU(63%)and anemia(33%).In the multivariate logistic regression model,the most significant factors associated with MACEs were previous CV events[odds ratio(OR)=70.6,95%CI:24.9–200.1],left ventricular hypertrophy(LVH)(OR=12.6,95%CI:2.7–58.3),HU treatment(OR=4.3,95%CI:2.4–7.6),and anemia(OR=5.3,95%CI:2.9–9.8).Effect modification by the presence of HU revealed that independent factors associated with MACEs were age(OR=1.03,95%CI:1.0–1.1),previous CV events(OR=41.7,95%CI:13.6–127.6),LVH(OR=15.3,95%CI:2.0–116.6),HU treatment(OR=2.5,95%CI:1.3–4.6)and anemia(OR=5.4,95%CI:2.8–10.5).Effect modification by UA levels dichotomized at 475μmol/L(very high level of UA)revealed that HU treatment was not associated with MACEs in groups with or without very high UA levels.CONCLUSION A very high level of UA was observed to act as an effect-modifying factor for MACEs,especially when combined with other risk factors such as age,previous CV events,LVH,and anemia.
基金supported by Clinical Research Operating Fund of Central High Level Hospitals(2022-PUMCH-B-088).
文摘Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.
基金Supported by the Second Nursing Research Project of the Humanities Nursing Professional Committee,No.RW2024PY03the Open Project of Suzhou Key Laboratory of Elderly Smart Nursing and Health Care in 2024.
文摘BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead to severe consequences such as suicidal thoughts.Respiratory failure,a disorder of pulmonary ventilation and gas exchange,is frequently complicated by depression,aggravating the condition and creating complications in treatment.Patients with both conditions tend to exhibit poor compliance with medical advice,resulting in adverse outcomes such as sleep disorders,arrhythmias,and electrolyte imbalances.Therefore,effective nursing interventions are crucial for improving patient outcomes.While routine nursing care can provide basic support,dedicated nursing,which involves specialized and personalized care by highly trained professionals,may offer additional benefits.AIM To examine the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure.METHODS A total of 160 patients with depression complicated by respiratory failure admitted to the Second Affiliated Hospital of Soochow University from January to December 2024 were randomly categorized into a control group(n=80)receiving routine nursing care and observation group(n=80)receiving routine nursing combined with dedicated nursing care.The establishment of a specialized nursing team;the development of a personalized nursing plan;and the implementation of comprehensive care strategies targeting emotional support,sleep improvement,pulmonary function enhancement,and adherence to medical advice were included in the dedicated nursing intervention.Emotional state[evaluated using the Self-Rating Depression Scale(SDS)],sleep quality[assessed using the Pittsburgh Sleep Quality Index(PSQI)],hope level[measured using the Herth Hope Scale(HHS)],pulmonary function[comprising forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],exercise endurance[6-minute walk distance test(6MWD)],compliance with medical advice,and incidence of adverse events were compared between the two groups.RESULTS No significant differences were observed in SDS,PSQI,HHS,FVC,FEV1,6MWD,or compliance with medical advice between the two groups(P>0.05)before the intervention.However,after the intervention,the control group exhibited significantly lower SDS and PSQI scores;higher HHS scores;greater improvements in FVC,FEV1,and 6MWD;and higher compliance with medical advice compared with the control group(P<0.05).In addition,the incidence of adverse events was significantly lower in the control group(P<0.05).CONCLUSION Dedicated nursing intervention significantly improves emotional state,sleep quality,hope level,pulmonary function,exercise endurance,and compliance with medical advice while reducing adverse events in patients with depression complicated by respiratory failure.Therefore,dedicated nursing appears to be an effective approach to enhance patient outcomes in this population.
文摘This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk factors such as chronic obstructive pulmonary disease and hypoalbuminemia,the model demonstrated strong predictive accuracy and offered a pathway to personalized perioperative care.This correspondence highlighted the clinical significance,emphasizing its potential to optimize patient outcomes through tailored inter-ventions.Further prospective validation and application across diverse settings are essential to realize its full potential in advancing esophageal surgery practices.
文摘BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other adverse reactions.Standardized evidence-based nursing practices are essential for enhancing patient care by addressing both physical and psychological health issues.AIM To analyze the impact of standardized evidence-based nursing on psychological status and adverse reactions of patients undergoing endoscopic colonic polypectomy.METHODS Data from 200 patients who underwent endoscopic colonic polypectomy at the authors’hospital between January and June 2024 were randomly assigned to two groups:Control[received routine nursing care(n=100)]and study[received standardized evidence-based nursing intervention(s)(n=100)].Psychological status,visual analog scale,and Short-Form 36 Health Survey scores,adverse events,and satisfaction with nursing were compared between the two groups.RESULTS After the interventions,the study group exhibited significantly lower scores on the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale,along with a reduced incidence of adverse events compared with the control group(P<0.05).Short-Form 36 Health Survey scores and overall satisfaction with nursing care were also significantly higher in the intervention group(P<0.05).CONCLUSION Standardized evidence-based nursing interventions effectively reduced negative patient emotions and enhanced quality of life and satisfaction,demonstrating high safety.
文摘Minimally invasive esophagectomy(MIE)has transformed esophageal surgery by reducing morbidity,accelerating recovery,and improving postoperative out-comes compared to traditional open esophagectomy.By utilizing techniques such as laparoscopic,thoracoscopic,and robotic-assisted approaches,MIE mini-mizes surgical trauma while maintaining oncological thoroughness.However,it also presents unique challenges,including risks of complications such as ana-stomotic leakage,pulmonary complications,and atrial fibrillation.Zhong et al developed and validated a risk stratification model for predicting surgical adverse events after MIE,enhancing preoperative assessment and patient management.This editorial further examines the advantages of MIE,its comparable oncological and long-term outcomes,as well as the incidence and contributing factors of post-operative complications.Emerging technologies,including machine learning models,intraoperative nerve monitoring,and robotic-assisted surgery,are high-lighted as innovative solutions for risk prediction and prevention.Strategies such as enhanced recovery after surgery protocols and multidisciplinary collaboration are emphasized for their critical roles in minimizing complications and optimizing patient outcomes.By addressing these aspects,this editorial provides guidance to surgical teams in maximizing the benefits of MIE while effectively managing its associated risks.
基金Baotou City Health Science and Technology Plan(Project No.:2023wsjkkj109)。
文摘Objective:To monitor the incidence of immune-related adverse events(irAEs)in patients treated with immune checkpoint inhibitors(ICIs)and programmed cell death protein-1(PD-1),and to evaluate the effectiveness of nursing interventions using a quantitative scoring system.Methods:A retrospective analysis was performed on 65 cancer patients who received PD-1 therapy at the Oncology Department of Baotou Cancer Hospital from December 2023 to December 2024.The study examined the clinical features and blood test results related to irAEs.The National Cancer Institute’s Common Terminology Criteria for Adverse Events(NCI-CTCAE)was used to grade the severity of these events,which were classified into five levels.Based on the NCI-CTCAE scores,appropriate nursing measures were implemented,and a comprehensive risk assessment framework was developed.Results:The study group showed lower complication rates,overall incidence,and average hospital stay compared to the control group(P<0.05).Among the 65 patients,twenty-eight(43.07%)experienced a total of 35 irAEs,with 2(5.71%)being grade 3 or 4.The most frequent irAEs were dermatological conditions(34.29%),particularly rash with itching.The occurrence of irAEs did not correlate with patient gender,age,blood parameters(hemoglobin,white blood cell count,platelet count,etc.),or liver function(P>0.05),but it was associated with tumor type(P<0.05).Conclusion:PD-1 treatment is generally safe,with a low incidence of severe(grade 3 or higher)irAEs.Close monitoring is essential to ensure early detection,intervention,and management of irAEs,thereby maintaining a low level of adverse events and enhancing the safety and efficacy of PD-1 therapy.Implementing a quantitative risk scoring system for nursing care can decrease the rate of complications,enhance patient safety,and potentially reduce hospital stays and medical costs.
基金funded by the Natural Science Foundation of Hunan Province(grant number 2024JJ5283 to XH)。
文摘Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the country has a 6.5%prevalence of small-for-gestational-age(SGA),ranking fifth globally in total SGA birth numbers^([1,2]).
基金supported by the Interdepartmental Research Project of Peking University First Hospital(No.2023IR27 to Liu Y)the Scientific Research Seed Fund of Peking University First Hospital(No.2023SF40 to Qiu J)+3 种基金the High Quality Clinical Research Project of Peking University First Hospital(No.2022CR75 to Gong K)the Beijing Natural Science Foundation(No.QY23068 to Deng R)the National Natural Science Foundation of China(No.82141103,No.82172617,and No.81872081 to Gong K)the Capital’s Funds for Health Improvement and Research(No.2022-2-4074 to Gong K).
文摘Objective:To explore clinicopathological predictors of adverse pathological changes(APCs)(upgrading,upstaging,and positive surgical margin[PSM])after robot-assisted radical prostatectomy(RARP)in clinical tumor stage 2c(cT2c)prostate cancer(PCa)patients.Methods:From January 2018 to December 2022,cT2cN0M0 PCa patients who underwent prostate biopsies and subsequent RARP at the Peking University First Hospital with an interval between biopsy and RARP of ≤90 days were included.Univariable and stepwise multivariable logistic regression analyses were performed to identify independent risk factors associated with APCs.Nomograms were constructed based on these predictive models.The performance of the nomograms was evaluated by receiver operating characteristic curves,decision curve analyses,and calibration plots.Results:A total of 423 eligible cT2cN0M0 PCa patients were included.The rates of upgrading,upstaging,and PSM in our cohortwere 33%,51%,and 35%,respectively.The stepwise multivariate logistic analysis suggested that PSA density and the percentage of positive cores in systematic biopsy were significantly associated with the occurrence of APCs.The score of the Prostate Imaging Reporting and Data System,PSA density,and the International Society of Urological Pathology grade group(IGG)of needle-biopsy specimens(or clinical IGG[cIGG])were significantly associated with upgrading.The PSA density,percentage of positive cores in systematic biopsy,and largest tumor percentage in all cores of each patient(LTP)were significantly associated with upstaging.The PSA density and LTP were significantly associatedwith the PSM.Based on these results,four nomogramswere developed.Receiver operating characteristic curves,decision curve analyses,and calibration plots implied that the nomograms exhibited excellent accuracy.Conclusion:The predictive models we developed could help to identify high-risk PCa early,and optimize clinical decisions of cT2cN0M0 PCa patients.
文摘Paclitaxel is one of the commonly used drugs in postoperative chemotherapy for ovarian cancer patients. However, affected by drug dosage and individual differences in the course of medication, patients will have different degrees of adverse reactions, which will cause damage to the patient’s body once they occur. This paper retrospectively analyzed the clinical data of patients with severe allergic reactions such as fecal incontinence and numbness of hands and feet caused by the use of paclitaxel liposome during postoperative chemotherapy in a case of ovarian cancer admitted to our hospital. The causes and corresponding treatment measures were analyzed, in order to provide the reference for medical staff to take effective countermeasures in advance in the future.
