Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized ...Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.展开更多
Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(...Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(NPWT)has shown considerable advantages in accelerating wound healing and mitigating functional impairment.A retrospective study by Lipatov et al.demonstrated that NPWT significantly reduced the time needed for wound closure preparation while enhancing the success rate of local repair.Despite its benefits,certain limitations highlight the need for further optimization.This paper investigates the potential for personalized dynamic regulation of NPWT,its integration with adjunctive therapies,and the role of multidisciplinary collaboration.Furthermore,it explores the incorporation of advanced technologies such as artificial intelligence,imaging modalities,and biomaterials,presenting novel pathways for the personalized management and global standardization of NF treatment.展开更多
BACKGROUND Necrotizing enterocolitis(NEC)of the newborn is a frequently occurring clinical disease in infants.The mortality rate of NEC in premature infants is as high as 50%,and the morbidity rate is on the rise.NEC ...BACKGROUND Necrotizing enterocolitis(NEC)of the newborn is a frequently occurring clinical disease in infants.The mortality rate of NEC in premature infants is as high as 50%,and the morbidity rate is on the rise.NEC has already caused serious impacts on newborn survival and poses serious threats to both children and families.AIM To investigate the expression and significance of mucin 1(MUC1)and interleukin-11(IL-11)in the intestinal mucosa of infants with neonatal NEC after surgery.METHODS Forty-eight postoperative intestinal mucosal specimens from children with NEC(NEC group)and twenty-two intestinal mucosal specimens from children with congenital intestinal atresia(control group)were collected in our hospital.Immunohistochemical staining and Western blot analysis were used to examine the protein expression of MUC-1 and IL-11 in the two groups.The serum levels of tumor necrosis factor-α(TNF-α)and IL-1βin the two groups were measured by enzyme-linked immunosorbent assay,and the relationship between MUC-1 and IL-11 protein expression and serum TNF-αand IL-1βlevels was analyzed by the linear correlation method.RESULTS The protein expression of MUC-1 and IL-11 in the NEC group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The levels of serum TNF-αand IL-1βin the NEC group were significantly higher than those in the control group(P<0.05).The protein expression of MUC-1 and IL-11 in the NEC group negatively correlated with serum TNF-αand IL-1βlevels(P<0.05).There was a significant negative correlation between the protein expression of MUC-1 and IL-11 and the levels of serum TNF-αand IL-1βin the NEC group.CONCLUSION The protein expression of MUC1 and IL-11 in the intestinal mucosa of children with NEC is significantly downregulated after surgery.This downregulation may be involved in the pathogenesis of this disease and has a certain correlation with inflammatory response factors in children with NEC.展开更多
BACKGROUND Necrotizing fasciitis(NF)is a potentially fatal bacterial infection of the soft tissues.Liver cirrhosis appears to be a contributing factor to higher morbidity and mor-tality in patients with NF.This resear...BACKGROUND Necrotizing fasciitis(NF)is a potentially fatal bacterial infection of the soft tissues.Liver cirrhosis appears to be a contributing factor to higher morbidity and mor-tality in patients with NF.This research article explores the relationship between these two conditions.AIM To evaluate whether liver cirrhosis increases morbidity and mortality in patients with NF,focusing on inpatient mortality,septic shock,length of stay,and hospital costs.METHODS This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2019 National Inpatient Sample.Cases were identified as pa-tients with both NF and cirrhosis,while controls were non-cirrhotic.The study focused on inpatient mortality as the primary outcome,with secondary outcomes including surgical limb amputation,mechanical ventilation rates,septic shock,length of stay,and hospital costs.RESULTS A total of 14920 patients were admitted to the hospital for management of NF,of which 2.11%had liver cirrhosis.Inpatient mortality was higher in cirrhotic patients(9.5%vs 3%;adjusted odds ratio=3.78;P value=0.02).Cirrhotic patients also had higher rates of septic shock(10.5%vs 4.9%,P value<0.01).Length of hospital stay,total charges,and rates of mechanical ventilation were not statistically different between groups.CONCLUSION Liver cirrhosis is an independent risk factor of in-hospital mortality and morbidity in patients with NF.Clinicians should be aware of this association to ensure better clinical outcomes and spare healthcare expenditure.展开更多
Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 ne...Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 neonates with NEC admitted to our hospital were selected as study subjects.During the study,these 88 patients were evenly divided into two groups,namely the observation group and the control group,with 44 patients in each group based on the random number table method.In terms of treatment,the control group was treated with meropenem,while the observation group received additional treatment with Bifidobacterium triple viable bacteria powder based on the treatment plan of the control group.The clinical efficacy and differences in serum inflammatory factor levels between the two groups were compared.Results:The efficacy of the observation group(90.91%)was better than that of the control group(72.73%)(P<0.05).After treatment,the levels of C-reactive protein(CRP)and procalcitonin(PCT)in both groups decreased compared to those before treatment,and the values of the above indicators in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on conventional treatment for NEC neonates,the use of Bifidobacterium triple viable bacteria tablets has significant efficacy and can effectively reduce serum inflammatory factor levels.展开更多
Objective:To summarize the nursing experience of a patient with necrotizing fasciitis(NF)secondary to hypoproteinemia after spinal tumor resection.Methods:We analyzed the clinical data of a patient with hypoproteinemi...Objective:To summarize the nursing experience of a patient with necrotizing fasciitis(NF)secondary to hypoproteinemia after spinal tumor resection.Methods:We analyzed the clinical data of a patient with hypoproteinemia and described in detail his symptoms,examination results,and diagnosis.We explored the evaluation method of hypoproteinemia in orthopedic patients and its relationship with adverse postoperative outcomes,including the risk of reoperation and rehospitalization,the impact on postoperative wound healing,and the increased probability of wound infection.We also introduced the symptoms of NF and traditional Chinese medicine treatment methods,including debridement and drainage of NF and corresponding nursing measures.These measures involve wound management,antiinfection treatment,psychological nursing,pain management,complication monitoring and treatment,dietary guidance,etc.TCM nursing includes treatment methods such as hip bath and moxibustion.Results:After careful treatment and nursing,the patient was discharged 36 d after admission.Conclusions:The nursing experience from this case shows that early diagnosis and comprehensive treatment are essential for NF secondary to hypoproteinemia after resection of a spinal tumor.While evaluating and managing hypoproteinemia,it is essential that the postoperative condition of patients must be closely monitored,any occurrence of complications must be dealt with in time,and effective nursing measures,including TCM treatment methods,must be taken to promote the recovery and good prognosis of patients.展开更多
BACKGROUND Necrotizing enterocolitis(NEC)remains a prominent gastrointestinal emergency among infants,particularly term infants with congenital heart defects(CHD)being at high risk.The molecular processes that contrib...BACKGROUND Necrotizing enterocolitis(NEC)remains a prominent gastrointestinal emergency among infants,particularly term infants with congenital heart defects(CHD)being at high risk.The molecular processes that contribute to NEC have yet to be completely understood.The high mortality rates necessitate an active search for noninvasive biomarkers that can aid in the preclinical diagnosis and prognosis of NEC.MicroRNAs(miRs),which are involved in many biological processes in both health and disease,have been discovered to play an important role in regulating inflammation and immune responses via various signaling pathways.AIM To determine the plasma levels of miR-155,miR-221,miR-223,miR-320a,miR-451a as potential NEC biomarkers in term newborns with CHD.METHODS This prospective cohort study included twenty-tree term newborns with CHD who underwent cardiac surgery on the median day of life(DOL)=7.Nine of them developed NEC(Bell’s stage IIA and IIIA)within 1 week of cardiac surgery(NEC newborns).Blood samples were collected before(median DOL=5)and following(median DOL=13)cardiac surgery.Levels of plasma miR-155-5p,miR-221-3p,miR-223-3p,miR-320a-3p,and miR-451a were determined using real-time polymerase chain reaction.The functional analysis was executed using the DIANA-miRPath v4.0.RESULTS Preoperatively,NEC newborns had significantly lower plasma levels of miR-155(2.70-fold,P=0.020),miR-223(2.42-fold,P=0.030),and miR-320a(3.62-fold,P=0.006)than newborns without NEC.Postoperatively,miR-451a levels differed significantly between the newborn groups,showing a 4.70-fold decrease(P=0.014)in expression when clinical NEC symptoms appeared.According to receiver operating characteristic analysis,miR-320a was found to be the most effective predictive biomarker for NEC[area under the curve(AUC)=0.835,63%sensitivity,100%specificity],while miR-451a was identified as a NEC biomarker(AUC=0.835,85.7%sensitivity,76.9%specificity).Preoperatively,miR-155-5p,miR-223-3p,and miR-320a-3p were differentially expressed and targeted the forkhead box O and Hippo pathways(P<0.01).CONCLUSION Our study demonstrates,for the first time,that plasma miR-320a-3p levels can be used as a preclinical biomarker for NEC in term newborns with CHD.展开更多
Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment ...Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment options. This case report underscores the technique’s efficacy, clinical outcomes, and role in reducing complications. Clinical Observation: A 59-year-old male with a history of smoking and alcoholism presented with severe abdominal pain, nausea, and vomiting. Over the following weeks, he developed symptoms including asthenia, weight loss, and melena. Diagnostic workup revealed severe anemia and Balthazar E necrotizing pancreatitis, with significant intra-abdominal fluid collections and signs of infection. After initial conservative management, the patient underwent transgastric necrosectomy via laparoscopy due to deteriorating clinical status. The procedure involved removing necrotic tissue and performing a cystogastroanastomosis and jejunostomy. Postoperative care included fasting, parenteral nutrition, broad-spectrum antibiotics, and enzymatic replacement. The patient recovered well, with reduced necrotic tissue on follow-up imaging, and was discharged twelve days post-surgery [1]. Conclusion: Transgastric necrosectomy by laparoscopy is a valuable first-line surgical option for patients with symptomatic necrotizing pancreatitis, particularly in cases without prior interventions. This minimally invasive technique helps reduce major complications and mortality, offering a less invasive alternative to traditional open necrosectomy. The multidisciplinary approach and careful postoperative management were crucial to the patient’s favorable outcome. The case highlights the potential of transgastric necrosectomy as an effective treatment strategy in managing complex pancreatitis cases, including those with associated duodenal perforation [2].展开更多
The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which...The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.展开更多
Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive ca...Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.展开更多
1Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied a...1Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied any history of hepatitis,hypertension,diabetes,cardiovascular disease,or other significant conditions.The patient was diagnosed with external auditory canal cholesteatoma and subsequently underwent canalplasty under general anesthesia.Routine anesthetic drugs,including 2%lidocaine,dexamethasone,propofol,sufentanil,rocuronium bromide,ondansetron,flurbiprofen axetil,neostigmine,and atropine,were used during surgery and anesthesia recovery.No significant events were noted,and the patient experienced only a blood loss of 10 mL.展开更多
Background Computed tomography(CT) and cone-beam computed tomography(CBCT) image registration play pivotal roles in computer-assisted navigation for orthopedic surgery. Traditional methods often apply uniform deformat...Background Computed tomography(CT) and cone-beam computed tomography(CBCT) image registration play pivotal roles in computer-assisted navigation for orthopedic surgery. Traditional methods often apply uniform deformation models, neglecting the biomechanical differences between rigid structures and soft tissues, which compromises registration accuracy, especially during significant bone displacements. Method To address this issue, we introduce RE-Reg, a rigid-elastic CT-CBCT image registration framework that jointly learns rigid bone motion and soft tissue deformation. RE-Reg incorporates a rigid alignment(RA) module to estimate global bone motion and an elastic deformation(ED) module to model soft tissue deformation, preserving bony structures through bone shape preservation(BSP) loss. Result Our comprehensive evaluation on publicly available datasets demonstrates that RE-Reg significantly outperforms existing methods in terms of registration accuracy and rigid bone structure preservation, achieving a 1.3% improvement in Dice similarity coefficient(DSC) and a 23% reduction in rigid bone deformation(%Δvol) compared with the best baseline. Conclusion This framework not only enhances anatomical fidelity but also ensures biomechanical plausibility and provides a valuable tool for image-guided orthopedic surgery. This code is available athttps://github.com/Zq-Huang/RE-Reg.展开更多
AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing techn...AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.展开更多
The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatme...The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.展开更多
Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and pr...Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and prolonged intraoperative pressure.Objective:To evaluate the effectiveness of the curvilinear supine position(CSP)in preventing PI among children undergoing congenital heart disease(CHD)surgery.Methods:Between October 2024 and February 2025,a single-center randomized controlled trial was conducted.Of the 80 children initially enrolled for congenital heart disease(CHD)surgery,77(aged 1 month to 14 years)completed the study and were included in the final analysis after 3 were excluded due to protocol violations.Participants were randomly assigned to the CSP group(n=38)or the conventional supine position group(n=39).Results:The incidence of PI was significantly lower in the CSP group(2.6%)compared to the control group(20.5%)(p=0.029).Postoperative LDH levels were also significantly reduced in the CSP group(422.67±86.52 U/L vs.592.92±215.71 U/L;p=0.031),while preoperative LDH and surgical variables(e.g.,cardiopulmonary bypass time)were comparable between groups.Although the CSP group had a shorter hospital stay(17.24 vs.22.51 days),the difference was not statistically significant(p=0.085).Caregiver satisfaction was significantly higher in the CSP group(100.0%vs.84.6%;p=0.025).Conclusion:CSP effectively reduces PI incidence,mitigates tissue injury,and enhances caregiver satisfaction in pediatric cardiac surgery,offering a safe and feasible strategy for perioperative PI prevention.展开更多
Objective:To analyze the impact of nursing interventions based on quantitative assessment using the Kano model on the quality of rehabilitation in patients with early-stage ovarian cancer following laparoscopic radica...Objective:To analyze the impact of nursing interventions based on quantitative assessment using the Kano model on the quality of rehabilitation in patients with early-stage ovarian cancer following laparoscopic radical surgery.Methods:A prospective clinical study was conducted involving 96 patients with newly diagnosed early-stage ovarian cancer who underwent laparoscopic radical surgery from December 2023 to December 2025.Patients were randomly assigned to groups using a random number table method before surgery.After surgery,the control group(n=48)received routine quantitative assessment nursing interventions,while the observation group(n=48)received nursing interventions based on quantitative assessment using the Kano model.Both groups received continuous nursing care until discharge.Differences between the groups were compared in terms of negative emotions,quality of life scores before and after postoperative intervention,postoperative recovery indicators,and nursing satisfaction evaluations on the day of discharge.Results:After intervention,the observation group had lower scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS),as well as shorter recovery times for gastrointestinal function and food intake,and a shorter hospital stay compared to the control group.Additionally,the observation group had higher scores on the Quality-of-Life Instrument for Cancer Patients-Ovarian Cancer(QLICP-OV)than the control group,with statistically significant differences(p<0.05).The overall satisfaction with nursing care in the observation group was also higher than that in the control group,with a statistically significant difference(p<0.05).Conclusion:Implementing quantitative evaluation nursing interventions based on the Kano model for patients with early-stage ovarian cancer after laparoscopic radical surgery can,by addressing their postoperative basic health,disease awareness,and other intervention content needs to a comprehensive degree,actively promote postoperative recovery and improve their mental health and quality of life.展开更多
BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and...BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.展开更多
With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative...With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.展开更多
BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investig...BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.展开更多
Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategie...Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategies and prognostic assessment.However,trajectory clustering analysis of time-series clinical data poses substantial methodological challenges for researchers.This study provides a comprehensive tutorial framework demonstrating six trajectory modeling approaches integrated with proteomic analysis to guide researchers in identifying sepsis subtypes after laparoscopic surgery.Methods:This study employs simulated longitudinal data from 300 septic patients after laparoscopic surgery to demonstrate six trajectory modeling methods(group-based trajectory modeling,latent growth mixture modeling,latent transition analysis,time-varying effect modeling,K-means for longitudinal data,agglomerative hierarchical clustering)for identifying associations between predefinedsequential organ failure assessment trajectories and 25 proteomic biomarkers.Clustering performance was evaluated via multiple metrics,and a biomarker discovery pipeline integrating principal component analysis,random forests,feature selection,and receiver operating characteristic analysis was developed.Results:The six methods demonstrated varying performance in identifying trajectory structures,with each approach exhibiting distinct analytical characteristics.The performance metrics revealed differences across methods,which may inform context-specificmethod selection and interpretation strategies.Conclusion:This study illustrates practical implementations of trajectory modeling approaches under controlled conditions,facilitating informed method selection for clinical researchers.The inclusion of complete R code and integrated proteomics workflows offers a reproducible analytical framework connecting temporal pattern recognition to biomarker discovery.Beyond sepsis,this pipeline-oriented approach may be adapted to diverse clinical scenarios requiring longitudinal disease characterization and precision medicine applications.The comparative analysis reveals that each method has distinct strengths,providing a practical guide for clinical researchers in selecting appropriate methods based on their specificstudy goals and data characteristics.展开更多
基金Supported by the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Xizang Autonomous Region,No.XZ2024ZR-ZY100(Z)Program for Youth Innovation in Future Medicine,Chongqing Medical University,China,No.W0138.
文摘Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.
基金Supported by Henan Province Key Research and Development Program,No.231111311000Henan Provincial Science and Technology Research Project,No.232102310411+2 种基金Henan Province Medical Science and Technology Key Project,No.LHGJ20220566 and No.LHGJ20240365Henan Province Medical Education Research Project,No.WJLX2023079Zhengzhou Medical and Health Technology Innovation Guidance Program,No.2024YLZDJH022.
文摘Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(NPWT)has shown considerable advantages in accelerating wound healing and mitigating functional impairment.A retrospective study by Lipatov et al.demonstrated that NPWT significantly reduced the time needed for wound closure preparation while enhancing the success rate of local repair.Despite its benefits,certain limitations highlight the need for further optimization.This paper investigates the potential for personalized dynamic regulation of NPWT,its integration with adjunctive therapies,and the role of multidisciplinary collaboration.Furthermore,it explores the incorporation of advanced technologies such as artificial intelligence,imaging modalities,and biomaterials,presenting novel pathways for the personalized management and global standardization of NF treatment.
基金Suzhou Science and Technology Program,No.SLT202005Suzhou Municipal Commission of Health and Family Planning,No.LCZX202031+1 种基金Suzhou New District Science and Technology Plan,No.2019Z009Independent Innovation Project of National High Tech Development Zone Hospital,No.SGY2018C03.
文摘BACKGROUND Necrotizing enterocolitis(NEC)of the newborn is a frequently occurring clinical disease in infants.The mortality rate of NEC in premature infants is as high as 50%,and the morbidity rate is on the rise.NEC has already caused serious impacts on newborn survival and poses serious threats to both children and families.AIM To investigate the expression and significance of mucin 1(MUC1)and interleukin-11(IL-11)in the intestinal mucosa of infants with neonatal NEC after surgery.METHODS Forty-eight postoperative intestinal mucosal specimens from children with NEC(NEC group)and twenty-two intestinal mucosal specimens from children with congenital intestinal atresia(control group)were collected in our hospital.Immunohistochemical staining and Western blot analysis were used to examine the protein expression of MUC-1 and IL-11 in the two groups.The serum levels of tumor necrosis factor-α(TNF-α)and IL-1βin the two groups were measured by enzyme-linked immunosorbent assay,and the relationship between MUC-1 and IL-11 protein expression and serum TNF-αand IL-1βlevels was analyzed by the linear correlation method.RESULTS The protein expression of MUC-1 and IL-11 in the NEC group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The levels of serum TNF-αand IL-1βin the NEC group were significantly higher than those in the control group(P<0.05).The protein expression of MUC-1 and IL-11 in the NEC group negatively correlated with serum TNF-αand IL-1βlevels(P<0.05).There was a significant negative correlation between the protein expression of MUC-1 and IL-11 and the levels of serum TNF-αand IL-1βin the NEC group.CONCLUSION The protein expression of MUC1 and IL-11 in the intestinal mucosa of children with NEC is significantly downregulated after surgery.This downregulation may be involved in the pathogenesis of this disease and has a certain correlation with inflammatory response factors in children with NEC.
文摘BACKGROUND Necrotizing fasciitis(NF)is a potentially fatal bacterial infection of the soft tissues.Liver cirrhosis appears to be a contributing factor to higher morbidity and mor-tality in patients with NF.This research article explores the relationship between these two conditions.AIM To evaluate whether liver cirrhosis increases morbidity and mortality in patients with NF,focusing on inpatient mortality,septic shock,length of stay,and hospital costs.METHODS This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2019 National Inpatient Sample.Cases were identified as pa-tients with both NF and cirrhosis,while controls were non-cirrhotic.The study focused on inpatient mortality as the primary outcome,with secondary outcomes including surgical limb amputation,mechanical ventilation rates,septic shock,length of stay,and hospital costs.RESULTS A total of 14920 patients were admitted to the hospital for management of NF,of which 2.11%had liver cirrhosis.Inpatient mortality was higher in cirrhotic patients(9.5%vs 3%;adjusted odds ratio=3.78;P value=0.02).Cirrhotic patients also had higher rates of septic shock(10.5%vs 4.9%,P value<0.01).Length of hospital stay,total charges,and rates of mechanical ventilation were not statistically different between groups.CONCLUSION Liver cirrhosis is an independent risk factor of in-hospital mortality and morbidity in patients with NF.Clinicians should be aware of this association to ensure better clinical outcomes and spare healthcare expenditure.
基金Project Name:Correlation Analysis between Intestinal Flora and Differential Proteins in Intestinal Tissue of Neonatal Necrotizing Enterocolitis(Project No.:FYX202336)。
文摘Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 neonates with NEC admitted to our hospital were selected as study subjects.During the study,these 88 patients were evenly divided into two groups,namely the observation group and the control group,with 44 patients in each group based on the random number table method.In terms of treatment,the control group was treated with meropenem,while the observation group received additional treatment with Bifidobacterium triple viable bacteria powder based on the treatment plan of the control group.The clinical efficacy and differences in serum inflammatory factor levels between the two groups were compared.Results:The efficacy of the observation group(90.91%)was better than that of the control group(72.73%)(P<0.05).After treatment,the levels of C-reactive protein(CRP)and procalcitonin(PCT)in both groups decreased compared to those before treatment,and the values of the above indicators in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on conventional treatment for NEC neonates,the use of Bifidobacterium triple viable bacteria tablets has significant efficacy and can effectively reduce serum inflammatory factor levels.
文摘Objective:To summarize the nursing experience of a patient with necrotizing fasciitis(NF)secondary to hypoproteinemia after spinal tumor resection.Methods:We analyzed the clinical data of a patient with hypoproteinemia and described in detail his symptoms,examination results,and diagnosis.We explored the evaluation method of hypoproteinemia in orthopedic patients and its relationship with adverse postoperative outcomes,including the risk of reoperation and rehospitalization,the impact on postoperative wound healing,and the increased probability of wound infection.We also introduced the symptoms of NF and traditional Chinese medicine treatment methods,including debridement and drainage of NF and corresponding nursing measures.These measures involve wound management,antiinfection treatment,psychological nursing,pain management,complication monitoring and treatment,dietary guidance,etc.TCM nursing includes treatment methods such as hip bath and moxibustion.Results:After careful treatment and nursing,the patient was discharged 36 d after admission.Conclusions:The nursing experience from this case shows that early diagnosis and comprehensive treatment are essential for NF secondary to hypoproteinemia after resection of a spinal tumor.While evaluating and managing hypoproteinemia,it is essential that the postoperative condition of patients must be closely monitored,any occurrence of complications must be dealt with in time,and effective nursing measures,including TCM treatment methods,must be taken to promote the recovery and good prognosis of patients.
基金Supported by The Russian Science Foundation,No.19-75-20076.
文摘BACKGROUND Necrotizing enterocolitis(NEC)remains a prominent gastrointestinal emergency among infants,particularly term infants with congenital heart defects(CHD)being at high risk.The molecular processes that contribute to NEC have yet to be completely understood.The high mortality rates necessitate an active search for noninvasive biomarkers that can aid in the preclinical diagnosis and prognosis of NEC.MicroRNAs(miRs),which are involved in many biological processes in both health and disease,have been discovered to play an important role in regulating inflammation and immune responses via various signaling pathways.AIM To determine the plasma levels of miR-155,miR-221,miR-223,miR-320a,miR-451a as potential NEC biomarkers in term newborns with CHD.METHODS This prospective cohort study included twenty-tree term newborns with CHD who underwent cardiac surgery on the median day of life(DOL)=7.Nine of them developed NEC(Bell’s stage IIA and IIIA)within 1 week of cardiac surgery(NEC newborns).Blood samples were collected before(median DOL=5)and following(median DOL=13)cardiac surgery.Levels of plasma miR-155-5p,miR-221-3p,miR-223-3p,miR-320a-3p,and miR-451a were determined using real-time polymerase chain reaction.The functional analysis was executed using the DIANA-miRPath v4.0.RESULTS Preoperatively,NEC newborns had significantly lower plasma levels of miR-155(2.70-fold,P=0.020),miR-223(2.42-fold,P=0.030),and miR-320a(3.62-fold,P=0.006)than newborns without NEC.Postoperatively,miR-451a levels differed significantly between the newborn groups,showing a 4.70-fold decrease(P=0.014)in expression when clinical NEC symptoms appeared.According to receiver operating characteristic analysis,miR-320a was found to be the most effective predictive biomarker for NEC[area under the curve(AUC)=0.835,63%sensitivity,100%specificity],while miR-451a was identified as a NEC biomarker(AUC=0.835,85.7%sensitivity,76.9%specificity).Preoperatively,miR-155-5p,miR-223-3p,and miR-320a-3p were differentially expressed and targeted the forkhead box O and Hippo pathways(P<0.01).CONCLUSION Our study demonstrates,for the first time,that plasma miR-320a-3p levels can be used as a preclinical biomarker for NEC in term newborns with CHD.
文摘Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment options. This case report underscores the technique’s efficacy, clinical outcomes, and role in reducing complications. Clinical Observation: A 59-year-old male with a history of smoking and alcoholism presented with severe abdominal pain, nausea, and vomiting. Over the following weeks, he developed symptoms including asthenia, weight loss, and melena. Diagnostic workup revealed severe anemia and Balthazar E necrotizing pancreatitis, with significant intra-abdominal fluid collections and signs of infection. After initial conservative management, the patient underwent transgastric necrosectomy via laparoscopy due to deteriorating clinical status. The procedure involved removing necrotic tissue and performing a cystogastroanastomosis and jejunostomy. Postoperative care included fasting, parenteral nutrition, broad-spectrum antibiotics, and enzymatic replacement. The patient recovered well, with reduced necrotic tissue on follow-up imaging, and was discharged twelve days post-surgery [1]. Conclusion: Transgastric necrosectomy by laparoscopy is a valuable first-line surgical option for patients with symptomatic necrotizing pancreatitis, particularly in cases without prior interventions. This minimally invasive technique helps reduce major complications and mortality, offering a less invasive alternative to traditional open necrosectomy. The multidisciplinary approach and careful postoperative management were crucial to the patient’s favorable outcome. The case highlights the potential of transgastric necrosectomy as an effective treatment strategy in managing complex pancreatitis cases, including those with associated duodenal perforation [2].
文摘The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.
文摘Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.
基金supported by grants from Young Scientists Fund of the National Natural Science Foundation of China(grant number.82301295).
文摘1Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied any history of hepatitis,hypertension,diabetes,cardiovascular disease,or other significant conditions.The patient was diagnosed with external auditory canal cholesteatoma and subsequently underwent canalplasty under general anesthesia.Routine anesthetic drugs,including 2%lidocaine,dexamethasone,propofol,sufentanil,rocuronium bromide,ondansetron,flurbiprofen axetil,neostigmine,and atropine,were used during surgery and anesthesia recovery.No significant events were noted,and the patient experienced only a blood loss of 10 mL.
基金Supported by the National Natural Science Foundation of China(Grant Nos.62025104,62331005,and U22A2052)the Beijing Natural Science Foundation(Grant No.L242100).
文摘Background Computed tomography(CT) and cone-beam computed tomography(CBCT) image registration play pivotal roles in computer-assisted navigation for orthopedic surgery. Traditional methods often apply uniform deformation models, neglecting the biomechanical differences between rigid structures and soft tissues, which compromises registration accuracy, especially during significant bone displacements. Method To address this issue, we introduce RE-Reg, a rigid-elastic CT-CBCT image registration framework that jointly learns rigid bone motion and soft tissue deformation. RE-Reg incorporates a rigid alignment(RA) module to estimate global bone motion and an elastic deformation(ED) module to model soft tissue deformation, preserving bony structures through bone shape preservation(BSP) loss. Result Our comprehensive evaluation on publicly available datasets demonstrates that RE-Reg significantly outperforms existing methods in terms of registration accuracy and rigid bone structure preservation, achieving a 1.3% improvement in Dice similarity coefficient(DSC) and a 23% reduction in rigid bone deformation(%Δvol) compared with the best baseline. Conclusion This framework not only enhances anatomical fidelity but also ensures biomechanical plausibility and provides a valuable tool for image-guided orthopedic surgery. This code is available athttps://github.com/Zq-Huang/RE-Reg.
文摘AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.
文摘The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.
文摘Background:Pressure injury(PI)is a prevalent complication in pediatric cardiac surgery,with higher incidence than in general pediatric populations due to children’s thin skin,underdeveloped subcutaneous tissue,and prolonged intraoperative pressure.Objective:To evaluate the effectiveness of the curvilinear supine position(CSP)in preventing PI among children undergoing congenital heart disease(CHD)surgery.Methods:Between October 2024 and February 2025,a single-center randomized controlled trial was conducted.Of the 80 children initially enrolled for congenital heart disease(CHD)surgery,77(aged 1 month to 14 years)completed the study and were included in the final analysis after 3 were excluded due to protocol violations.Participants were randomly assigned to the CSP group(n=38)or the conventional supine position group(n=39).Results:The incidence of PI was significantly lower in the CSP group(2.6%)compared to the control group(20.5%)(p=0.029).Postoperative LDH levels were also significantly reduced in the CSP group(422.67±86.52 U/L vs.592.92±215.71 U/L;p=0.031),while preoperative LDH and surgical variables(e.g.,cardiopulmonary bypass time)were comparable between groups.Although the CSP group had a shorter hospital stay(17.24 vs.22.51 days),the difference was not statistically significant(p=0.085).Caregiver satisfaction was significantly higher in the CSP group(100.0%vs.84.6%;p=0.025).Conclusion:CSP effectively reduces PI incidence,mitigates tissue injury,and enhances caregiver satisfaction in pediatric cardiac surgery,offering a safe and feasible strategy for perioperative PI prevention.
文摘Objective:To analyze the impact of nursing interventions based on quantitative assessment using the Kano model on the quality of rehabilitation in patients with early-stage ovarian cancer following laparoscopic radical surgery.Methods:A prospective clinical study was conducted involving 96 patients with newly diagnosed early-stage ovarian cancer who underwent laparoscopic radical surgery from December 2023 to December 2025.Patients were randomly assigned to groups using a random number table method before surgery.After surgery,the control group(n=48)received routine quantitative assessment nursing interventions,while the observation group(n=48)received nursing interventions based on quantitative assessment using the Kano model.Both groups received continuous nursing care until discharge.Differences between the groups were compared in terms of negative emotions,quality of life scores before and after postoperative intervention,postoperative recovery indicators,and nursing satisfaction evaluations on the day of discharge.Results:After intervention,the observation group had lower scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS),as well as shorter recovery times for gastrointestinal function and food intake,and a shorter hospital stay compared to the control group.Additionally,the observation group had higher scores on the Quality-of-Life Instrument for Cancer Patients-Ovarian Cancer(QLICP-OV)than the control group,with statistically significant differences(p<0.05).The overall satisfaction with nursing care in the observation group was also higher than that in the control group,with a statistically significant difference(p<0.05).Conclusion:Implementing quantitative evaluation nursing interventions based on the Kano model for patients with early-stage ovarian cancer after laparoscopic radical surgery can,by addressing their postoperative basic health,disease awareness,and other intervention content needs to a comprehensive degree,actively promote postoperative recovery and improve their mental health and quality of life.
基金Supported by 2025 Henan Medical Education Research Project,No.WJLX2025038.
文摘BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.
文摘With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.
文摘BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.
基金funding from the China National Key Research and Development Program(No.2023YFC3603104)the National Natural Science Foundation of China(Nos.82472243 and 82272180)+6 种基金the Fundamental Research Funds for the Central Universities(No.226-2025-00024)the Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China(No.LHDMD24H150001)the Key Research&Development Project of Zhejiang Province(No.2024C03240)a collaborative scientific project co-established by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine(No.GZY-ZJ-KJ-24082)he General Health Science and Technology Program of Zhejiang Province(No.2024KY1099)the Project of Zhejiang University Longquan Innovation Center(No.ZJDXLQCXZCJBGS2024016)Wu Jieping Medical Foundation Special Research Grant(No.320.6750.2024-23-07).
文摘Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategies and prognostic assessment.However,trajectory clustering analysis of time-series clinical data poses substantial methodological challenges for researchers.This study provides a comprehensive tutorial framework demonstrating six trajectory modeling approaches integrated with proteomic analysis to guide researchers in identifying sepsis subtypes after laparoscopic surgery.Methods:This study employs simulated longitudinal data from 300 septic patients after laparoscopic surgery to demonstrate six trajectory modeling methods(group-based trajectory modeling,latent growth mixture modeling,latent transition analysis,time-varying effect modeling,K-means for longitudinal data,agglomerative hierarchical clustering)for identifying associations between predefinedsequential organ failure assessment trajectories and 25 proteomic biomarkers.Clustering performance was evaluated via multiple metrics,and a biomarker discovery pipeline integrating principal component analysis,random forests,feature selection,and receiver operating characteristic analysis was developed.Results:The six methods demonstrated varying performance in identifying trajectory structures,with each approach exhibiting distinct analytical characteristics.The performance metrics revealed differences across methods,which may inform context-specificmethod selection and interpretation strategies.Conclusion:This study illustrates practical implementations of trajectory modeling approaches under controlled conditions,facilitating informed method selection for clinical researchers.The inclusion of complete R code and integrated proteomics workflows offers a reproducible analytical framework connecting temporal pattern recognition to biomarker discovery.Beyond sepsis,this pipeline-oriented approach may be adapted to diverse clinical scenarios requiring longitudinal disease characterization and precision medicine applications.The comparative analysis reveals that each method has distinct strengths,providing a practical guide for clinical researchers in selecting appropriate methods based on their specificstudy goals and data characteristics.
