Postoperative Patients Research Articles

The Impact of Frailty on the Toxic Reaction of Chemotherapy in Patients With Cervical Cancer: A Longitudinal Study.

Longitudinal research on the impact of frailty on chemotherapy toxicity in patients with cervical cancer is limited. To explore the impact of frailty on chemotherapy toxicity in patients with cervical cancer. Two hundred fifty-nine postoperative cervical cancer patients from a hospital located in Northwest China were enrolled between July 2020 and December 2021. Participating patients were followed up for 4 chemotherapy cycles after surgery. Frailty was measured using the Tilburg Frailty Indicator. Chemotherapy toxic reactions were evaluated using the Common Terminology Criteria for Adverse Events 4.0. Repeated-measures analysis of variance and Cox regression analysis were used to analyze the effect of frailty on chemotherapy toxicity. Cox regression analysis showed that frailty could serve as an independent risk factor for total toxicity (hazard ratio [HR], 5.423; 95% confidence interval [CI], 3.260-9.023; P < .001), nausea (HR, 3.967; 95% CI, 2.446-6.433; P < .001), and vomiting (HR, 3.081; 95% CI, 1.921-4.942; P < .001). Repeated-measures analysis of variance showed that the white blood cell values of the frail group were lower than those of the nonfrail group (Fgroup effect = 4.172, P = .043), and the hemoglobin values of the frail group were lower than those of the nonfrail group (Fgroup effect = 6.589, P = .012). Frailty can increase the risk of total chemotherapy toxicity, nausea, and vomiting. Frailty can reduce the white blood cell and hemoglobin values of postoperative adjuvant chemotherapy cervical cancer patients. Findings may assist healthcare providers in taking effective measures to reduce the toxicity of chemotherapy.

Study on the Application of Integrated Medical and Nursing Care Model in the Postoperative Period of Patients with Sclerotherapy for Esophageal Varicose Veins

Objective: To explore the application effect of medical and nursing integration management mode in the postoperative period of patients treated with sclerotherapy for esophageal varices. Methods: Randomly divided 64 cases of esophageal varices patients admitted to our hospital from October 2022 to October 2023 who underwent surgical treatment into two groups, and gave 32 cases of patients in the control group postoperative implementation of basic nursing care, and 32 cases of patients in the research group postoperative implementation of healthcare integration management mode, and compared the effect of the nursing care of the two groups of patients. Results: There are differences in nursing satisfaction, incidence of postoperative rebleeding, complication rate, and patients’ knowledge of disease-related common grip scores between the two groups of patients with esophageal varices after nursing care (P &lt; 0.05), which is statistically significant. Conclusion: The implementation of integrated medical and nursing management mode for postoperative patients with sclerotherapy for esophageal varices has a significant effect on the prognosis of patients, reduces the occurrence of complications, and shortens the length of hospital stay.

Impact of Prehabilitation With Preoperative Swallowing Exercises on Postoperative Swallowing Morbidity in Oral Cavity Cancer: Randomized Controlled Trial.

Oral cancer surgery and the associated reconstructive procedures cause mechanical and neurological impairment of swallowing. Despite postoperative rehabilitation, functional impairment of swallowing remains a concern. This study is to investigate the potential benefits of prehabilitation with preoperative swallowing exercises to patients undergoing composite resections and compartmental tongue resections so that it results in better swallowing outcomes and improved quality of life after surgery. Sixty patients included in the study were randomized into an exercise and control group of 30 each. Patients with squamous cell carcinoma of the oral cavity undergoing composite resection or compartmental tongue resections were included, and patients with severe trismus at presentation were excluded. Patients in the exercise group were instructed on a set of six active exercises to be followed strictly for a period of at least 1week before surgery. Preoperative swallowing exercises comprised of evidence-based exercises targeting the muscle groups involved in swallowing. Postoperative swallowing rehabilitation was the same as that of the control group. Patients were assessed after 6months of surgery. Outcomes were assessed both subjectively and objectively. Objective assessment was done by inexpensive, novel clinical methods of repetitive saliva swallow test (RSST), water swallow test (WST) and food swallow test (FST) to and graded using dysphagia severity scale (1-7). Average oral intake scale (1-Oral solids, 2-Oral semisolids/easy to chew foods, 3-Oral liquids only and 4-Non-oral, orogastric tube dependent) assessed subjectively was significantly lower in exercise arm, and the control arm had a significantly higher OIS score. Exercise arm had higher number of patients in DSS scores of 5, 6 and 7. The control arm had a higher number of patients in DSS scores of 3 and 4. The differences between the two groups were found to be statistically significant taking into consideration the confounding factors of radiation, wound morbidity and tongue resections. Preoperative swallowing exercises have shown a positive impact on postoperative swallowing ability. This is the first randomized trial to assess the effect of PSE in postoperative oral cancer patients. Our exercise protocol needs standardization, and clinical objective method of dysphagia assessment requires further validation. However, prehabilitation with PSE has the potential to improve the quality of life in oral cancer patients.

Study of whey protein on muscle mass and functional rehabilitation in postoperative total knee arthroplasty patients.

Patients who underwent total knee arthroplasty (TKA) often experience muscle loss due to pain and limited mobility. Nutritional supplementation and rehabilitation may positively affect the decline in muscle function. The purpose of this study is to evaluate whether whey protein intervention, in addition to conventional rehabilitation training, is beneficial in improving muscle function and quality of life in patients after TKA. 72 patients who met the criteria were selected for this randomized controlled study. For the experimental group, whey protein was used as a daily supplement for 12 weeks, while the control group was given a placebo, during which both groups received conventional rehabilitation training. Muscle strength and each of the secondary observables needed to be measured and statistically analyzed preoperatively and at 4, 8, and 12 weeks post-intervention. In total, 62 subjects completed the study: 32 in the experimental group and 30 in the control group. Both groups showed significant improvement in muscle strength, VAS, ROM, AKS and leg circumference after 12 weeks of treatment. Compared to the control group, patients in the experimental group showed significant improvement in muscle strength, VAS, ROM, AKS and leg circumference (p= 0.001, p= 0.002, p= 0.001, p= 0.001, p= 0.001, respectively) after 12 weeks of treatment. The 12-week intervention of whey protein nutritional supplement showed significant improvement in muscle mass and function among post-TKA patients besides aiding with conventional rehabilitation exercise.

The impact of discharge readiness on post-traumatic growth in patients after thyroid cancer surgery: the mediating role of sickness-related stigma.

To investigate the relationship between post-traumatic growth, morbidity stigma and readiness for discharge in post-operative thyroid cancer patients. 422 post-operative thyroid cancer patients from three tertiary care hospitals in Hunan and Tianjin were surveyed using the General Information Questionnaire, the Post-traumatic Growth Scale, the Readiness for Discharge Scale, and the Social Influence Scale. Discharge readiness positively predicted the level of post-traumatic growth in thyroid cancer patients (P < 0.01), and morbidity stigma negatively predicted post-traumatic growth (P < 0.01), with morbidity stigma playing a mediated role between discharge readiness and post-traumatic growth. Readiness for discharge can positively predict post-traumatic growth, and morbidity stigma plays a mediating role between readiness for discharge and post-traumatic growth. It is suggested that clinical and nursing staff should strengthen patients' discharge readiness guidance and education, help patients and their families establish an effective feedback mechanism for disease condition and psychological cognitive condition, focus on reducing patients' sense of shame, and improve patients' physical and mental health.

Analyzing Risk Factors for Delayed Extubation Following Posterior Approach Surgery for Congenital Scoliosis: A Retrospective Cohort Study.

Retrospective cohort study. Investigate the risk factors for delayed extubation after posterior approach orthopedic surgery in patients with congenital scoliosis. The clinical data of patients who received surgery for congenital scoliosis at the First Affiliated Hospital of Xinjiang Medical University between January 2021 and July 2023 have been gathered. Patients are categorized into the usual and the delayed extubation groups, depending on the duration of tracheal intubation after surgery. The study employs univariate and multivariate logistic regression models to examine the clinical characteristics of the two cohorts and discover potential risk factors linked to delayed extubation. In addition, a prediction model is created to visually depict the significance of each risk factor in terms of weight according to the nomogram. A total of 119 patients (74.8% females), with a median age of 15 years, are included. A total of 32 patients, accounting for 26.9% of the sample, encountered delayed extubation. Additionally, 13 patients (10.9%) suffered perioperative complications, with pneumonia being the most prevalent. The multivariate regression analysis revealed that the number of osteotomy segments, postoperative hematocrit, postoperative Interleukin-6 levels, and weight are predictive risk factors for delayed extubation. Postoperative hematocrit and Interleukin-6 level, weight, and number of osteotomy segments can serve as independent risk factors for predicting delayed extubation, with combined value to assist clinicians in evaluating the risk of delayed extubation of postoperative congenital scoliosis patients, improving the success rate of extubation, and reducing postoperative treatment time in the intensive care unit.

Systemic immune-inflammatory markers and long-term prognosis after revascularization in Moyamoya disease: a retrospective study.

Systemic immune-inflammatory markers combine various individual inflammatory cell parameters to comprehensively explore their relationship with the development and long-term outcomes of cardiovascular, cerebrovascular, and oncological disorders. The systemic immune-inflammatory marker index has not been extensively studied in terms of its impact on the long-term prognosis following cerebral revascularization in MMD patients. Our research aims to address this gap and improve the prediction of long-term outcomes for these patients. We included 851 patients with Moyamoya disease who underwent cerebral revascularization at our medical center from 2009 to 2021. Systemic immune-inflammatory markers were calculated based on routine blood test results at admission, and follow-up was conducted for over 6 months after surgery. During monitoring and upon release, we evaluated patient neurological condition by utilizing the modified Rankin Scale (mRS). We examined the correlation between alterations in mRS ratings and systemic immune-inflammatory markers. Comparing the unfavorable long-term prognosis group to the favorable long-term prognosis group, it was found that the NLR level was markedly higher (p = 0.037), while the LMR was lower in the unfavorable long-term prognosis group (p = 0.004). Results from logistic regression analysis revealed that the high-level LMR group had a lower risk of unfavorable long-term prognosis compared to the low-level group (T3: OR = 0.433, 95% CI [0.204-0.859], p = 0.026). The AUC of the model was 0.750 (95% CI [0.693-0.806]). Lymphocyte-to-monocyte ratio levels are independently linked to an increased risk of unfavorable long-term prognosis, highlighting LMR as a new and effective predictor for postoperative Moyamoya patients.

Evaluation under loading detects medial meniscus extrusion in patients with reconstructed anterior cruciate ligament and restricted knee extension.

Some patients who undergo anterior cruciate ligament (ACL) reconstruction experience abnormal mechanical stress in the meniscus. Medial meniscal extrusion (MME) is reflected in the pathological condition of the meniscus, which expands owing to repetitive mechanical stress. Thus, the effect of the reconstructed ACL on increasing MME under weight-bearing conditions remains unclear. This study investigated the effect of ACL reconstruction on meniscal extrusion under non-weight-bearing and weight-bearing conditions. Seventeen patients who underwent unilateral ACL reconstruction (ACL group) and 20 age-matched healthy volunteers (control group) were enrolled. Ultrasonography was performed in the supine, standing, and walking positions in preoperative and postoperative ACL patients. MME during walking was evaluated based on the dynamic behavior of extrusion, and kinetic and kinematic data were synchronously obtained. Moreover, the ACL group underwent magnetic resonance imaging (MRI) evaluation at two points: preoperatively and 12months postoperatively, and the ultrasound findings were compared. MME in the supine position measured using both ultrasonography and MRI was not significantly different preoperatively and postoperatively in the ACL group. However, postoperative MME and dynamic behavior of extrusion under standing and walking conditions were significantly higher than those in the preoperative state (dynamic behavior: 0.9 ± 0.4mm preoperatively, 1.2 ± 0.4mm postoperatively). Moreover, the deficits in knee extension during walking persisted postoperatively and were significantly higher than those in the control group. MME in patients with ACL reconstruction including meniscus repair was different under mechanical stress compared to the non-weight bearing condition.

Prevalence and risk factors for ventilator-associated pneumonia after cardiac surgery: a systematic review and meta-analysis.

There is currently significant variation in the reported incidence of ventilator-associated pneumonia (VAP) among postoperative cardiac patients. Moreover, the risk factors for VAP in postoperative cardiac patients remain controversial. This study aims to assess the incidence and risk factors of VAP in postoperative cardiac patients to provide a basis for further prevention and treatment of VAP. We systematically reviewed PubMed, EMBASE, and Cochrane Library databases to select studies that met the inclusion criteria until November 2023. Fifteen studies involving 10,478 patients who underwent cardiac surgery were selected for meta-analysis. The incidence of VAP in postoperative cardiac patients was 10%. The preoperative risk factors for VAP after cardiac surgery included age >70 years, chronic obstructive pulmonary disease (COPD), peripheral vascular disease, renal disease, and severe pulmonary hypertension. Furthermore, the perioperative risk factors for VAP after cardiac surgery included emergency surgery, redo surgery, airway instrumentation, gastric aspiration, reintubation, mechanical ventilation duration >3 days, intra-aortic balloon, New York Heart Association >3, American Society of Anesthesiologists >3, need for transfusion during surgery, and ascending aortic surgery. The incidence of VAP after cardiac surgery was found to be 10%, and the comprehensive risk factors for VAP were identified, emphasizing the critical need for targeted interventions, including optimization of preoperative health and refined surgical protocols, to effectively reduce the occurrence of VAP in postoperative cardiac patients.

The Relationship Between Facilitation of Patient Involvement and Self-Perceived Burden in Postoperative Lung Cancer Patients: The Mediating Role of Social Support.

Patients with lung cancer often experience a high level of self-perceived burden, which significantly affects their quality of life and psychological health. Social support is closely related to the self-perceived burden, yet there is scant research on the relationship between social support, facilitation of patient involvement, and self-perceived burden. This study aims to understand the current situation of self-perceived burden in postoperative lung cancer patients and to explore the mediating role of social support between facilitation of patient involvement and self-perceived burden. A cross-sectional design was used in this study. Using a convenience sampling method, a total of 331 lung cancer patients who were hospitalized for surgical treatment at a tertiary cancer hospital in Beijing, China, from August 2022 to May 2023, were selected to participate in this survey. The survey included a self-designed sociodemographic questionnaire, the Facilitation of Patient Involvement Scale (FPIS), the Perceived Social Support Scale (PSSS), and the Self-Perceived Burden Scale (SPBS). Data were analyzed using SPSS 24.0 for statistical description and Pearson correlation analysis, while AMOS 24.0 was utilized to construct a structural equation model to examine the mediation effect. The score of self-perceived burden in lung cancer patients was 26.42 ±8.23 points. Bot facilitation of patient involvement and social support was negatively correlated with self-perceived burden (r = -0.313, r = -0.332, P < 0.001). Social support plays a partially mediated role in the relationship between facilitation of patient involvement and self-perceived burden, accounting for 44.3% of the total effect. The self-perceived burden of patients after lung cancer surgery was at a moderate level, and social support partially mediates the relationship between facilitation of patient involvement and self-perceived burden. Medical staffshould encourage patient participation in their own treatment decisions and alleviate the burden associated with lung cancer and surgical treatment by enhancing their social support.

Investigation of Exercise Interventions on Postoperative Recovery in Lung Cancer Patients: A Qualitative Study Using Web Crawling Technology.

Rapid recovery after lung cancer surgery is challenging. Exercise is a low-cost, effective method to expedite recovery. Despite numerous exercise interventions, many fail to consider patient perspectives, leading to low adherence and short-term effects. Understanding lung cancer patients' perspectives on postoperative exercise and exploring their exercise-related concerns and needs are crucial for enhancing the effectiveness of exercise-based rehabilitation programs. This study aims to analyze lung cancer patients' perspectives on postoperative exercise in their daily lives, exploring their concerns and needs related to postoperative exercise to help healthcare professionals develop personalized exercise plans. An internet crawling technique collected online inquiries from Baidu webpages about postoperative physical activity in lung cancer patients, using "lung cancer", "surgery", and"exercise" as keywords. The data was encoded, categorized, and analyzed using a large-scale semantic analysis platform in natural language processing and information retrieval to examine term frequency, sentiment tendencies, and attributes in the inquiry texts. Initially, 2727 queries were retrieved; after screening, deduplication, and cleansing, 201 unique queries were identified. Queries related to "modes of exercise" constituted the largest proportion. The most frequently occurring words in the word frequency analysis were "lung", "cancer", "should", "can", "long", "early", and "surgery", "exercise", "respiratory". Postoperative lung cancer patients demonstrate significant interest in whether they should engage in exercise, as well as in the appropriate types and duration of such activities, indicating a strong need for detailed guidance and knowledge related to exercise. The sentiment analysis showed a positive score of 87.5% and a negative score of 12.5%, indicating that postoperative lung cancer patients view exercise positively and have an enthusiastic attitude towards it. Among the positive sentiment attributes, "good" was the most frequently mentioned term, whereas "bad" and "surprising" were the most prevalent terms within the negative sentiment attributes. Postoperative physical activity receives limited attention from lung cancer patients, who emphasize their preferences for exercise modalities. Their inquiries often reflect psychological concerns, such as fear and helplessness caused by symptoms. Understanding patients' perspectives on postoperative physical activity within their real-life contexts can help integrate psychological support into exercise plans. This integration could guide healthcare professionals in developing more personalized postoperative exercise regimens for lung cancer patients.

Impact of Aromatase Inhibitors Treatment Duration on Coronary Artery Calcification in Postoperative Patients With Breast Cancer

Impact of Aromatase Inhibitors Treatment Duration on Coronary Artery Calcification in Postoperative Patients With Breast Cancer

Application Of Robotic Systems In Healthcare And Reduced Infection Risk In Cancer Patients In Postoperative Oncology Surgical Patients

This research aims to investigate the impact of robotic systems in oncology surgery, focusing on sensitive cases such as brain and colon cancer. The study includes a group of 5 male and female patients, and data is collected post-surgery, particularly after patient recovery. The significant advantages of robotic surgery are documented in observational tables and charts. The findings suggest a promising future for robotic systems in surgery, with reduced recorded risks

Biparietal expansion with partial suturectomy of the sagittal suture and linear frontal osteotomies for the scaphocephaly correction in children over 12 months of age

Introduction: Sagittal craniosynostosis (SC) has a prevalence of 1: 2500 live births and represents 40-60% of all craniosynostosis. The objective of this work is to share the preliminary results, with the use of the surgical technique mentioned above for the treatment of SC in children older than 12 months. Methods: A retrospective study from April 2019 to September 2023. Four patients with a diagnosis of non-syndromic scaphocephaly were evaluated, who met the following inclusion criteria: (i) age over 12 months, (ii) CT scan with 3D reconstruction, (iii) scaphocephaly due to postoperative restenosis and (iv) patients operated on with this surgical technique. Results: There were 2 females (50%) and 2 males (50%), with an average age of 39.25 months. All four patients had complete closure of the sagittal suture; there was no evidence of entrapment of the superior sagittal sinus by the stenosed suture. Papilledema was evaluated with the modified Frisén scale. All four patients had grade 2 bilateral papilledema preoperatively and this reversed 6 months postoperatively. The cranial index (CI) preoperatively was 64 (range 58-72) and postoperatively 72.25 (range 66-83). There was no need to reoperate on any patient and we had no complications Conclusion: This surgical technique is presented as an option for the treatment of scaphocephaly in children older than 12 months, and in scaphocephaly due to postoperative restenosis, proving to be a reproducible and effective procedure to achieve adequate brain decompression and reach satisfactory aesthetic results.

Post-Surgical Dental Precautions/Prophylaxis in Pediatric Patients: Results of a 2023 Survey of the Membership of the Pediatric Orthopaedic Society of North America (POSNA)

IntroductionGuidelines regarding post-surgical dental care have been common in adult total joint arthroplasty patients, despite limited supporting evidence in the literature. There is anecdotal evidence that similar precautions are implemented frequently in post-operative pediatric orthopaedic patients without any published evidence to guide clinicians. Material and MethodsA survey of the Active Members of the Pediatric Orthopaedic Society of North America (POSNA) was performed to assess the use of post-surgical guidelines regarding dental care (procedures and prohylaxis) in pediatric patients. A 20-question survey regarding this subject was developed with the input of, and approved by, the Evidence-Based Practice Committee of POSNA, and a link to participate was distributed to the Active Membership. ResultsOne hundred and seventy-three POSNA members opened the link to the survey. 163 respondents self-identified as Active, for a response rate of 19.8%. One hundred and fifty-seven (96.3%) reported direct involvement in surgical and post-surgical care of pediatric orthopaedic patients. Sixty-two (39.4%) indicated use of a post-operative protocol regarding dental interventions. Forty percent of those indicating use of guidelines were uncertain of the specifics of the protocol(s) used at their institution. Eighty-five percent of those utilizing protocols felt that the use of guidelines was a valuable topic for investigation. ConclusionsThese results demonstrate that many of the active members of POSNA utilize post-surgical guidelines for dental care, particularly for those patients who have undergone spinal surgery with permanent implants. This is despite the fact that there is limited evidence to support their use in adult total joint patients, and no literature regarding use of such guidelines in pediatric orthopaedic patients. Level of EvidenceLevel V

Analytical and Diagnostic Performance of a Dual-Target Blood Detection Test for Hepatocellular Carcinoma.

Surveillance approaches with high sensitivity and specificity for hepatocellular carcinoma (HCC) are still urgently needed. Previous studies have shown that methylation of GNB4 and Riplet can effectively diagnose HCC. This study plan to analyze the performance of a blood test for detecting HCC using GNB4 and Riplet methylation. This study mainly investigated the analytical performance of the dual-target HCC blood test (DT-HBT), including cut-off value, limit of detection (LOD), precision, analytical specificity, and coincidence rate. In addition, the detection performance for HCC was validated in 1030 clinical plasma samples (214 HCC and 816 non-HCC). Plasma samples from 25 HCC patients after hepatectomy were collected to assess the feasibility of the kit for postoperative recurrence monitoring. All analytical performance of the DT-HBT met prespecified requirements. The LOD for GNB4, Riplet, and β-actin was 1% methylation/100 copies/μL with cut-offs of 43, 43, and 35, respectively. The DT-HBT showed excellent precision, within 5% CV. It had a specificity of 91.5% for detecting other cancers, and 100% for breast, lung, and bladder cancer. No cross-reactions were observed with 9 potential interfering substances. The DT-HBT achieved a 100% coincidence rate in detecting reference and clinical samples. The clinical performance study found that the kit showed a sensitivity of 81.7% for stage I HCC, and an overall sensitivity and specificity of 87.4% and 92.3%, respectively. The detection sensitivity for postoperative recurrent patients was 95.8%, with a specificity of 100%. The analytical performance of the DT-HBT met prespecified criteria. It provided HCC patients with a reliable and high-performing new blood test for the HCC diagnosis and surveillance. ClinicalTrials.gov identifier: NCT05685524.

PE039 Comparison of DaVinci® and Hugo RAS® radical prostatectomy: Analysis of postoperative recovery, pathological results, and patients' reported outcomes after 100 sequential cases (the compar-p prospective trial)

PE039 Comparison of DaVinci® and Hugo RAS® radical prostatectomy: Analysis of postoperative recovery, pathological results, and patients' reported outcomes after 100 sequential cases (the compar-p prospective trial)

Impact of ultra-early enteral nutrition support on the prognosis of young and middle-aged postoperative patients with cerebral hemorrhage

To investigate the effect of ultra-early enteral nutrition (UEEN) support on the prognosis of young and middle-aged postoperative patients with cerebral hemorrhage. The clinical data of young and middle-aged patients (aged 18-59 years) admitted to Tianjin Fifth Central Hospital from January 2020 to June 2023 after surgery for intracerebral hemorrhage were retrospectively analyzed, and the general data, nutritional indexes, gastrointestinal complications, neurological function recovery and long-term prognosis of the patients were recorded. According to the time of initiation of enteral nutrition (EN) support, patients were divided into UEEN group (EN implementation within 12 hour after surgery) and early enteral nutrition (EEN) group (EN implementation within 24 to 48 hour after surgery). The differences of the above indexes between the two groups were analyzed and compared. A total of 64 young and middle-aged postoperative patients with cerebral hemorrhage were enrolled, including 32 cases in the UEEN group and 32 cases in the EEN group. There were no significant differences in gender, age, proportion of hypertension and diabetes, Glasgow coma score (GCS) on admission and surgical methods between the two groups. In terms of nutritional indexes, serum total protein, albumin and hemoglobin levels of patients in both groups on day 7 after admission were lower than those on day 1, and higher than those on day 3, and the above indexes levels in UEEN group were significantly higher than those in EEN group on day 7 [total protein (g/L): 63.05±5.79 vs. 59.02±6.63, albumin (g/L): 40.40±5.26 vs. 37.66±4.63, hemoglobin (g/L): 133.33±12.58 vs. 123.80±22.12, all P < 0.05]. In terms of gastrointestinal complications, the incidence of stress ulcer in the UEEN group within 14 days after admission was significantly lower than that in the EEN group [12.5% (4/32) vs. 31.3% (10/32), P < 0.05], but there was no statistically significant difference in feeding intolerance symptoms between the two groups. In terms of neurological recovery and long-term prognosis, GCS scores and Barthel index scores of 14 days after admission were higher than those of 1 day after admission, but there was no statistical significance between the two groups. Six months after surgery, Glasgow outcome scale (GOS) and Barthel index score of the UEEN group were significantly higher than those of the EEN group (GOS score: 3.81±1.06 vs. 3.18±1.07, Barthel index score: 60.78±7.24 vs. 54.52±5.13, both P < 0.05). UEEN support can improve the nutritional level of young and middle-aged postoperative patients with cerebral hemorrhage, reduce the occurrence of postoperative gastrointestinal complications, promote the recovery of neurological function, and improve the long-term prognosis.

ASO Author Reflections: Impact of 1-Year Changes in Skeletal Muscle Quality on Prognosis in Postoperative Patients with Early Gastric Cancer.

ASO Author Reflections: Impact of 1-Year Changes in Skeletal Muscle Quality on Prognosis in Postoperative Patients with Early Gastric Cancer.

Effect of physical exercise on postoperative shoulder mobility and upper limb function in patients with breast cancer: a systematic review and meta-analysis.

The shoulder pain and reduced range of motion caused by breast cancer seriously affect the quality of life of women. Such persistent impairments can escalate into chronic pain, diminished muscle strength, lymphedema, and compromised cardiorespiratory health potentially culminating in permanent disability. This systematic review aims to evaluate how physical exercise impacts shoulder mobility and upper limb function in breast cancer patients post-surgery, examining various aspects of exercise such as type, intensity, duration, frequency, and intervention timing to determine the influence on outcomes. A comprehensive search was conducted across seven databases up to April 16, 2024. Two reviewers independently assessed randomized controlled trials (RCTs) focusing on the effects of physical exercise on postoperative outcomes in breast cancer patients. Quality was assessed using the Cochrane risk of bias tool, with meta-analyses and publication bias tests performed via RevMan5.4, and evidence quality evaluated using GRADEPro. Effect sizes were calculated using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Twenty studies (25 RCTs involving 2,171 patients) were included for both the systematic review and the meta-analysis. Meta-analysis confirmed that physical exercise significantly enhanced shoulder flexion (SMD =0.59; 95% CI: 0.32, 0.86; P<0.001) and abduction (SMD =1.01; 95% CI: 0.43, 1.60; P<0.001) in postoperative patients, and improved upper limb function (SMD =0.87; 95% CI: 0.48, 1.26; P<0.001). Subgroup analyses indicated that comprehensive exercise, particularly when performed ≤3 times a week or over 8-12 weeks, was most effective for improving shoulder flexion, while shorter durations (<8 weeks) and similar frequencies were optimal for abduction. Resistance exercises, especially when started early (<2 weeks post-surgery), showed significant benefits for upper limb function. The included studies were of moderate to high quality, though some lacked detailed reporting on blinding or allocation concealment. Analysis suggests that the timing of intervention initiation, along with exercise type and frequency, may contribute to observed variations in outcomes. Evidence quality assessments did not reveal significant issues with indirectness or imprecision, and no significant publication bias was detected. Given the low heterogeneity and absence of significant downgrade factors, intermediate evidence quality was assigned for upper limb function and shoulder abduction, with high quality for shoulder flexion. Physical exercise is notably effective in enhancing both upper limb function and shoulder mobility in breast cancer patients, with the timing and frequency of exercise interventions influencing these improvements. This provides valuable evidence for clinical rehabilitation strategies.