Lung cancer ranks among the most prevalent and lethal malignancies globally. Its prognostic outcomes are not only contingent upon tumor characteristics and therapeutic interventions but also intricately linked to the nutritional and immune profiles of patients. This article conducts a thorough review of both domestic and international research, providing a comprehensive synthesis of the prognostic value of widely investigated nutritional and immune indicators in the context of lung cancer. The primary objective is to identify optimal prognostic markers in clinical practice, offering guidance for precise post-treatment assessment and early intervention for lung cancer patients.
Objective To analyze the research hotspots and trends of Chinese literature on medical quality evaluation indicators in China in recent years. Methods We searched for relevant Chinese literature on medical quality evaluation indicators on China National Knowledge Infrastructure from January 2000 to December 2024, and analyzed the annual publication volume, authors and institutions, research hotspots and frontiers. Results Finally, 177 articles were included in the literature. From 2000 to 2024, the number of Chinese literature on medical quality evaluation indicators in China showed a fluctuating upward trend, reaching 15 articles per year in both 2015 and 2024. The issuing units mainly included the National Institute of Hospital Administration, the School of Public Health of Peking University, Huazhong University of Science and Technology, etc. The publishing team mainly included author teams such as MA Xiemin, LIANG Minghui, XIA Ping, etc. The high frequency keywords and top 10 keywords for centrality ranking included medical quality, evaluation indicators, indicator system, Delphi method, evaluation, evaluation system, quality evaluation, indicators, clinical pathways, and hospital management. “Case classification” was the earliest emerging term in the study of medical quality evaluation indicators. In terms of burst intensity, the top 5 keywords for burst intensity included Delphi method, case classification, problem, data quality, and evidence-based evaluation. Conclusion The publishing institutions and research teams of Chinese literature on medical quality evaluation indicators in China are relatively loose, and there are still problems such as insufficient practical application of medical quality evaluation indicators and single research tools and methods.
ObjectiveTo identify differences in blood routine indicators between lung cancer patients and healthy controls, and between different subgroups of lung cancer patients, so as to improve the early detection of lung cancer prognosis, and provide a basis for risk stratification and prognostic judgment for patients with lung cancer.MethodsThis study enrolled 1 227 patients pathologically diagnosed with lung cancer from December 2008 to December 2013 and 2 454 healthy controls 1∶2 matched by sex and age. The blood routine data of lung cancer patients were collected when they were first diagnosed with lung cancer. Gender and age stratified analysis of blood routine indicators between lung cancer patients and controls were conducted. Comparisons of blood routine indicators among lung cancer patients with different pathological types, stages, and prognosis were performed, followed by Cox regression survival analysis. Normally distributed quantitative variables were presented as mean ± standard deviation and non-normally distributed quantitative variables as medium (lower quartile, upper quartile).ResultsCompared to healthy controls, the counts of platelet [(206.84±80.47) vs. (175.27±55.74)×109/L], white blood cells [(7.04±2.29) vs. (6.08±1.40)×109/L], neutrophil [(4.90±2.08) vs. (3.61±1.07)×109/L], monocyte [0.42 (0.30, 0.54) vs. 0.33 (0.26, 0.42)×109/L], and eosinophil [0.14 (0.07, 0.24) vs. 0.12 (0.07, 0.19)×109/L], as the well as neutrophil-lymphocytes ratio (3.91±2.82 vs. 2.03±0.89) and platelet-lymphocyte ratio (160.35±96.06 vs. 96.93±38.02) in lung cancer patients increased significantly, while the counts of red blood cells [(4.41±0.58) vs. (4.85±0.51)×1012/L] and lymphocyte [(1.49±0.60) vs. (1.93±0.59)×109/L] in lung cancer patients decreased, and the differences were statistically significant (P<0.05). The counts of platelet, red blood cells, white blood cells, neutrophil, and monocyte differed among patients with different pathological types, tumor stages, and prognosis (P<0.05). Neutrophil-lymphocytes ratio and platelet-lymphocyte ratio were higher in squamous cell carcinoma patients than those in other pathological patients, higher in advanced lung cancer patients than those in early stage patients, and higher in dead lung cancer patients than those in survival patients (P<0.05). Neutrophil-lymphocyte ratio was an independent factor affecting the prognosis of lung cancer [hazard ratio=1.077, 95% confidence interval (1.051, 1.103), P<0.001].ConclusionsThe inflammatory index of blood routine indicators are higher in lung cancer patients than those in healthy controls, which indicates that lung cancer is closely related to chronic inflammation. There are significant differences in blood routine inflammation index among lung cancer patients with different pathological types, stages, and prognosis, which reflects the heterogeneity and complexity of lung cancer. Neutrophil-lymphocytes ratio inverse correlates with the prognosis of lung cancer.
In the context of the burgeoning development of day surgery, the shortened hospital stay has led to a relative reduction in the professional care that patients receive. As a result, more stringent requirements for nursing quality management have emerged. Scientific and objective sensitive indicators can provide quantitative standards for monitoring and evaluating nursing quality. This article comprehensively reviews the definition, classification, construction steps, and methods of nursing quality sensitive indicators. Additionally, it delves into the current status of the construction and application of such indicators for day surgery both at home and abroad. Those insights can offer a scientific foundation for the management of nursing quality in day surgery settings.
Objective To construct a multi-dimensional risk assessment system and scale for the prevention and control risk of respiratory infectious diseases in general hospitals, and make evaluation and early warning. Methods Through the collection of relevant literature on the prevention and control of respiratory infectious diseases during the period from January 1st, 2020 to December 31st, 2022, the articles related to the risk assessment of respiratory infectious diseases such as severe acute respiratory syndrome, COVID-19 and influenza A (H1N1) were screened, and the Delphi method was used to evaluate the articles and establish an indicator system. The normalized weight and combined weight of each item were calculated by analytic hierarchy process. The technique for order preference by similarity to the ideal solution method was used to calculate the risk composite index of 38 clinical departments in a tertiary general hospital in Jiangxi Province in December 2022. Results A total of 16 experts were included, including 4 with senior titles, 8 with associate senior titles, and 4 with intermediate titles. After two rounds of Delphi consult, a total of 4 first-level indicators, 11 second-level indicators, and 38 third-level indicators of risk assessment for the prevention and control of respiratory infectious diseases were determined. The reliability and validity of the scale were good. The top three items with the largest combined weights in the scale were spread by aerosol, spread by respiratory droplet, and commonly used instruments (inspection instruments and monitoring equipment). After a comprehensive analysis on the 38 departments, the top 10 departments in the risk index were the departments of medical imaging, pediatrics, ultrasound, cardiac and vascular surgery, infection, emergency, respiratory and critical care, general medicine, otolaryngology and neck surgery, stomatology, and obstetrics. Conclusions This study constructed the risk assessment scale of respiratory infectious diseases in general hospitals, and the scale has good reliability and validity. The use of this scale for risk assessment of general hospitals can provide a theoretical basis for the risk characteristics of prevention and control of respiratory infectious diseases in general hospitals.
Controlling intraoperative bleeding is the core technology of liver surgery, and it is also an important way to improve the benefits of liver surgery and reduce the risk of surgery. In recent years, a number of methods to maintain low central venous pressure have been proposed, including inferior vena cava clamping, restricted fluid infusion, postural changes, intraoperative assisted ventilation, intraoperative hypovolemic venous incision, etc. In addition, more and more indicators used to guide intraoperative fluid input management to maintain low central venous pressure have been discovered, including global end-diastolic volume and stroke volume variability. Therefore, this article summarizes the relationship between low central venous pressure and surgical effect in liver surgery, and the ways to achieve low central venous pressure on the basis of previous research.
Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.
Objective To investigate the predictive value of the prognostic nutritional index (PNI) for 28-day all-cause mortality in patients with chronic obstructive pulmonary disease (COPD) in intensive care unit (ICU). Methods The relationship between PNI and short-term mortality in COPD patients was analysed using COX proportional hazards and restricted cubic spline (RCS) models. Receiver operating characteristic (ROC) curves were plotted and area under the ROC curve (AUC) was calculated to assess the predictive performance of PNI. The optimal cut-off value for PNI was determined using the Youden index, and the data were divided into a low PNI group and a high PNI group. Kaplan-Meier curves were then constructed and the log-rank test was used to assess differences in survival between the two groups. Results A total of 980 COPD patients were included in the study. Multivariable COX regression analysis showed that PNI was an independent factor influencing short-term mortality in the severe COPD patients (HR=0.972, 95%CI 0.948 - 0.995, P=0.019). RCS curve results showed a non-linear relationship between PNI and short-term mortality in the severe COPD patients (P for non-linear=0.032), with the risk of death gradually decreasing as PNI increased. The ROC curve indicated that PNI had some predictive power, comparable to that of SOFA score [(AUCPNI=0.693) vs. (AUCSOFA=0.672)]. Kaplan-Meier curve analysis showed a significant difference in survival time between the low (≤38.3) PNI group and the high (>38.3) PNI group (P<0.05). Conclusions PNI has a certain predictive role for short-term all-cause mortality in patients with severe COPD. Patients with low PNI at ICU admission have a higher risk of short-term mortality.
Smart wearable devices play an increasingly important role in physiological monitoring and disease prevention because they are portable, real-time, dynamic and continuous.The popularization of smart wearable devices among people under high-altitude environment would be beneficial for the prevention for heart and brain diseases related to high altitude. The current review comprehensively elucidates the effects of high-altitude environment on the heart and brain of different population and experimental subjects, the characteristics and applications of different types of wearable devices, and the limitations and challenges for their application. By emphasizing their application values, this review provides practical reference information for the prevention of high-altitude disease and the protection of life and health.
ObjectiveTo overview of systematic reviews of the efficacy and safety of antimicrobials in the prevention of postpartum infection after vaginal delivery, and to provide evidence for the rational use of antimicrobials. MethodsThe CNKI, WanFang Data, VIP, PubMed, Embase, and Cochrane Library databases were searched to collect systematic reviews/meta-analyses on antibiotic prophylaxis for transvaginal delivery from inception to June 25, 2023. The data of the included systematic reviews were extracted by 2 investigators independently, and the methodological quality, risk of bias, and report quality were evaluated by AMSTAR 2.0 scale, ROBIS tool, and PRISMA, respectively. And a pool of outcomes for assessing the effectiveness of antimicrobials in prevention of postpartum infection after transvaginal delivery was developed. ResultsA total of 7 systematic reviews were included. And the AMSTAR 2.0 indicated that most studies (5/7) were from very low quality to low quality. The ROBIS tool showed 3 studies with low risk of bias, 3 with high risk of bias, and 1 with unclear risk of bias. The results of the PRISMA statement showed that the included system evaluation reports were relatively complete. The present evidence showed that prophylactic use of antimicrobials may be beneficial and recommended in women with Ⅲ-Ⅳ perineal fissures, with no significant benefit in women with manual placenta removal, but prophylactic use of antimicrobials was recommended considering their invasive nature, but it was controversial whether antimicrobials should be used in the categories of vaginal assisted delivery, perineal lateralization, and spontaneous delivery (without complications). ConclusionAntimicrobial prophylaxis may not be recommended for all the pregnant women undergoing vaginal delivery to prevent the postpartum infection, but considering the low methodological quality of the included systematic review and the inconsistent outcomes in this field, the conclusion should be further verified by future research with high-quality.