Abstract:Objective To explore the effect of a digital intelligent follow-up management system on out-of-hospital follow-up,self-management ability,and quality of life in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 74 post-PCI patients treated at Renmin Hospital of Wuhan University from March to August 2024 were enrolled and assigned by a random number table to an observation group and a control group,with 37 cases in each.The control group received routine telephone follow-up management,and the observation group received follow-up via a digital intelligent follow-up management system.Medication adherence and degree of satisfaction at 6 months of follow-up were compared between the two groups;incidence of cardiovascular adverse events within 6 months of follow-up was com-pared;and self-management ability and quality of life were compared before and after the intervention.Results At 6 months,the observation group had a significantly higher rate of good medication adherence than the control group(x2=4.097,P＜0.05).The incidence of cardiovascular adverse events in the observation group was significantly lower than that in the control group(P＜0.05).Before intervention,there were no significant differences between the two groups in sub-scale scores for emotional-cognitive management,treatment adherence management,first-aid management,symptom man-agement,disease-knowledge management,daily-life management,and total self-management scores(P＞0.05).After in-tervention,scores for these subscales and the total self-management score were higher than before in both groups,and the observation group's scores were higher than the control group's,with statistically significant differences(P＜0.05).Before intervention,there were no significant differences between the two groups in WHO Quality of Life-BREF(WHOQOL-BREF)subscale scores for environment,social,psychological and physical dimensions(P＞0.05);after intervention,scores in these WHOQOL-BREF subscales were higher than before in both groups,and the observation group's scores were higher than the control group's,with statistically significant differences(P＜0.05).The overall degree of satisfaction in the observation group was significantly higher than in the control group(P＜0.05).Conclusion The digital intelligent follow-up management system has a marked effect on out-of-hospital follow-up for post-PCI patients with coronary heart disease.It can improve medication adherence,reduce the incidence of cardiovascular adverse events,and strengthen patients' self-man-agement ability and quality of life,warranting clinical promotion and application.

Abstract:To systematically summarize recent research progress on acupuncture interventions for peripheral facial palsy,ex-tract advantageous treatment protocols,and analysing current research deficiencies,this article reviews recent literature in China and globally and synthesizes findings on etiology and pathogenesis,clinical research,commonly used acupoint selec-tion,and efficacy evaluation.Modern medicine tends to attribute the disease to factors such as viral infection,vascular le-sions,autoimmune disorder,and nerve injury;traditional Chinese medicine emphasizes mechanisms such as"right deficiency allowing evil invasion"and invasion of facial meridians by wind-cold or wind-heat.Intervention modalities include single tech-niques such as acupuncture and electroacupuncture,as well as combined approaches such as acupuncture plus herbal medi-cine,acupuncture with tuina,and acupuncture with cupping.Acupoint selection strategies give weight to local points,syn-drome differentiation points,and points along the meridians.In efficacy evaluation,Western medicine commonly uses quan-titative measures such as the House-Brackmann grading and the Portmann scale,while traditional Chinese medicine empha-sizes facial symmetry and improvement of accompanying symptoms as part of a comprehensive assessment.Existing studies indicate that acupuncture has definite efficacy,but research remains limited by inconsistent staging criteria,heterogeneity of study designs,insufficient elucidation of mechanisms of action,and lack of standardized procedures.Future work should strengthen multidisciplinary collaboration,further explore action pathways,and establish unified diagnosis and treatment protocols to enhance and promote the clinical effectiveness of acupuncture.

Abstract:Objective To investigate the effects of frailty and comorbidity status on quality of life in elderly stroke patients,providing a reference for optimizing intervention strategies.Methods We retrospectively analyzed clinical data from 130 eld-erly stroke patients admitted to Tangdu Hospital,Air Force Medical University between February 2021 and December 2023.Stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS):NIHSS 0-7 was classified as mild(n=39),8-16 as moderate(n=58),and ≥17 as severe(n=33).Frailty was assessed using a comprehensive frailty assessment tool.Cumulative illness burden was evaluated with the Cumulative Illness Rating Scale(CIRS),recording both the severity index and comorbidity index.Quality of life was measured by the World Health Organization Quality of Life-BREF(WHOQOL-BREF).Pearson correlation analysis was used to examine relationships among frailty,comorbidity sta-tus,and quality of life.Results Subscale(physical frailty,psychological frailty,social frailty,and environmental frailty)and total scores of frailty increased progressively across the mild,moderate,and severe groups,with statistically significant differences(F=152.743,61.140,97.789,92.033,92.456,respectively,P＜0.001).CIRS score,severity index,and comorbidity index also increased progressively across the three groups,with statistically significant differences(F=84.526,264.109,226.912,respectively,P＜0.001).Subscale(overall perception,social relationships,psychological function,en-vironmental function,physical function)and WHOQOL-BREF total scores decreased progressively from mild to severe groups,with statistically significant differences(F=39.080,59.117,39.171,55.771,35.590,43.625,respectively,P＜0.001).Pearson correlation analysis showed that the total frailty score was positively correlated with CIRS score,severity index,and comorbidity index(r=0.500,0.482,0.621,all P＜0.05)and negatively correlated with WHOQOL-BREF to-tal score(r=-0.525,P＜0.05).CIRS score,severity index,and comorbidity index were negatively correlated with WHOQOL-BREF total score(r=-0.469,-0.448,-0.591,all P＜0.05).Conclusion In elderly stroke patients,grea-ter frailty and higher comorbidity burden are associated with poorer quality of life.These findings highlight the challenges faced by elderly stroke patients in rehabilitation and quality of life and underscore the need for strengthening monitoring and interventions of frailty and comorbidity statuses to improve quality of life in this population.

Abstract:Objective To investigate the effects of a multidisciplinary team(MDT)-based three-phase check model in preven-ting intraoperatively acquired pressure injury(IAPI),providing references for perioperative nursing interventions in surgical patients.Methods A total of 123 surgical patients admitted to Chengdu 363 Hospital Affiliated to Southwest Medical Uni-versity from January to December 2022 were selected as the control group and received routine IAPI prevention nursing in-terventions.Another 94 surgical patients admitted from January to December 2023 were selected as the study group and re-ceived the MDT-based three-phase check model intervention.Surgical parameters,implementation of IAPI prevention meas-ures,incidence of IAPI,and healthcare staff's IAPI knowledge assessment scores were compared between the two groups.Results No significant difference was found in intraoperative blood loss between the two groups(P>0.05).The study group had a longer time of operation,higher body temperature at the end of surgery,and lower CORN IAPI risk assessment scale score than the control group(P<0.05).The study group showed higher accuracy rates for standard patient positio-ning,IAPI risk assessment,and implementation rates for standardized pre-and postoperative handovers,along with a lower IAPI incidence rate than the control group,with all differences being statistically significant(P<0.05).The study group's nursing staff also achieved significantly higher scores in both theoretical knowledge and practical skill assessments compared to the control group(P<0.05).Conclusion The MDT-based three-phase check model effectively reduces the incidence of IAPI in surgical patients,increases patient body temperature at the end of surgery,improves the implementation of IAPI prevention measures,and raises perioperative nursing quality.

Abstract:Objective Based on the Capability,Opportunity,Motivation-Behavior(COM-B)model,this study aims to ex-plore the current status and influencing factors of postoperative self-management behaviors in elderly breast cancer patients,providing references for clinical care.Methods A total of 300 elderly breast cancer patients admitted with the First Affilia-ted Hospital of Nanjing Medical University from December 2023 to June 2024 were enrolled.All participants completed questionnaires,including a general information survey,the Self-Management Scale for Cancer Patients,the Chinese version of the Brief Illness Perception Questionnaire(BIPQ),the Connor-Davidson Resilience Scale(CD-RISC),the Chinese version of the Multidimensional Scale of Perceived Social Support(MSPSS),and the Chinese version of the Breast Cancer Survivor Self-Efficacy Scale(BCSES).Pearson correlation analysis was used to examine relationships between self-management be-haviors and illness perception,psychological resilience,social support,and self-efficacy.Multiple linear regression analysis was performed to identify factors influencing postoperative self-management behaviors.Results The mean scores were as follows:self-management behavior(117.75±12.95),illness perception(48.82±19.42),psychological resilience(52.63±18.72),perceived social support(42.90±14.65),and self-efficacy(31.18±8.03).Pearson correlation analysis showed that self-management behavior was negatively correlated with illness perception(r=-0.502,P<0.05)and positively cor-related with psychological resilience,social support,and self-efficacy(r=0.401,0.856,0.494,respectively;P<0.05).Multiple linear regression analysis identified illness perception,perceived social support,and education level as independent influencing factors for postoperative self-management behaviors among these patients(P<0.05).Conclusion The level of postoperative self-management behavior among elderly breast cancer patients is moderate and requires further improvement.Healthcare professionals should promote health education during postoperative interventions,improve patients'illness per-ception and perceived social support,strengthen their psychological resilience,thereby boosting self-management confidence and motivation to foster better self-management behaviors.

Abstract:Objective To investigate the effect of mirror therapy combined with transitional care on postoperative finger joint function in patients undergoing finger replantation,providing a clinical quality reference.Methods This study enrolled 65 patients who underwent finger replantation at Shanghai Sixth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2023 to March 2025.According to different nursing interventions,patients were assigned to a control group(n=30)and an observation group(n=35).The control group received mirror therapy;the observation group re-ceived transitional care in addition to the mirror therapy.Hand function recovery at 12 weeks postoperatively was compared between the two groups.Barthel Index,Spitzer Quality of Life Index,and the Exercise of Self-Care Agency(ESCA)scores were compared before intervention and at 12 weeks after intervention.The degree of satisfaction with nursing and complica-tion rates were also compared.Results The observation group showed superior hand function recovery compared with the control group,with a significant difference(P<0.05).Before intervention,there were no significant differences between groups in Barthel Index and Spitzer Quality of Life Index scores(P>0.05).At 12 weeks of intervention,both groups'Bar-thel Index and Spitzer Quality of Life Index scores were higher than before intervention,and the observation group's scores were higher than the control group's,with statistically significant differences(P<0.05).At 12 weeks of intervention,ES-CA scores in both groups increased compared with pre-intervention levels,and ESCA scores in the observation group were higher than those in the control group(P<0.05).The degree of satisfaction with nursing in the observation group was sig-nificantly higher than in the control group(P<0.05).No significant difference was noted in complication rates between the two groups(P>0.05).Conclusion Mirror therapy combined with transitional care can improve postoperative finger joint function,quality of life,and self-care ability in patients after finger replantation,and can raise the degree of satisfaction with nursing;the approach is safe and worthy of clinical promotion.

Abstract:Objective To explore the influence pathways of medication-compliance intention and actual compliance behavior in patients infected with Helicobacter pylori(Hp)using the theory of planned behavior(TPB).Methods From September 2023 to March 2025,180 Hp-infected patients treated at Shaanxi Provincial People's Hospital were enrolled.A medication-compliance intention questionnaire was self-developed based on TPB and used to survey participants.Structural equation modeling was applied to analyze the factors influencing medication-compliance intention and behavior in Hp-infected pa-tients.Results Scores(mean±SD)were:cognitive attitude toward medication taking(13.68±1.59)points,social sub-jective norm(6.21±0.96)points,individually perceived behavioral control(9.24±1.65)points,behavioral intention(10.36±1.06)points;Morisky Medication Adherence Scale(MMAS-8)score(5.69±0.76)points.Spearman correlation analysis showed that cognitive attitude toward medication taking,social subjective norm,and individually perceived behav-ioral control were positively correlated with behavioral intention(r=0.302,0.312,0.262,P<0.05).Cognitive attitude,social subjective norm,individually perceived behavioral control,behavioral intention,and medication compliance behavior were also positively correlated(r=0.207,0.251,0.275,0.405,P<0.05).Direct path coefficients from cognitive atti-tude,social subjective norm,and individually perceived behavioral control to behavioral intention were 0.247,0.251,and 0.215,respectively.Individually perceived behavioral control had a direct effect on medication-compliance behavior.Among factors affecting behavioral intention,cognitive attitude toward medication taking and social subjective norm had more prom-inent effects;among factors affecting compliance behavior,behavioral intention had the largest effect(coefficient=0.352).Conclusion Cognitive attitude toward medication taking,social subjective norm,and individually perceived behavioral con-trol influence Hp-infected patients'behavioral intention,and behavioral intention is the most important determinant of pa-tients'medication compliance.

Abstract:Objective To analyze the correlation between fear of cancer recurrence(FCR)and perceived social support,quali-ty of life(QoL)in patients undergoing endoscopic treatment for early digestive tract cancer,providing references for imple-menting precise clinical intervention and support.Methods A total of 198 patients undergoing endoscopic treatment for ear-ly digestive tract cancer at our hospital from July 2022 to June 2025 were selected.A general information questionnaire,the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the Multidimensional Scale of Perceived Social Support(MSPSS),and the functional subscale of the Quality of Life Questionnaire-Core 30(QLQ-C30)were used to investigate pa-tients'general information,FCR,perceived social support,and QoL.Pearson correlation analysis was employed to explore the correlation between FCR and perceived social support and QoL;multiple linear regression analysis was used to identify influencing factors of FCR.Results The mean FoP-Q-SF score was 44.49±5.71,with 57.07%(113/198)of patients sco-ring 34 points or higher.The MSPSS score was 56.64±6.39,and the QLQ-C30 functional subscale score was 250.31±34.72.Patients'FCR was negatively correlated with both perceived social support and QoL(r=-0.486 and-0.511,re-spectively,P<0.001).Significant differences in FoP-Q-SF scores were found among patients with different ages,education levels,monthly household income per capita,medical payment methods,family history of digestive tract tumors,number of lesions,and postoperative complications(P<0.05).Multiple linear regression analysis indicated that education level,monthly household income per capita,postoperative complications,MSPSS score,and functional subscale score of QLQ-C30 were influencing factors of patients'FCR(P<0.05).Conclusion The level of FCR in patients undergoing endoscopic treat-ment for early digestive tract cancer remains moderate to high and is significantly correlated with education level,monthly household income per capita,postoperative complications,perceived social support,and QoL.

Abstract:Objective To investigate the clinical value of the red blood cell distribution width-to-albumin ratio(RAR)and the monocyte/high-density lipoprotein cholesterol ratio(MHR)for predicting recurrence after transurethral resection of bladder tumor(TURBT)in high-risk non-muscle-invasive bladder cancer(NMIBC)patients,thereby providing a reference for indi-vidualized treatment and follow-up strategies for high-risk NMIBC.Methods A total of 128 high-risk NMIBC patients who underwent TURBT at Beijing Friendship Hospital,Capital Medical University from April 2022 to April 2024 were enrolled and followed for 6 months.According to recurrence during follow-up,patients were assigned to a recurrence group(n=31)and a non-recurrence group(n=97).Baseline data,clinicopathological features,and laboratory results were collected,and RAR and MHR were calculated.Receiver operating characteristic(ROC)curves were used to evaluate the ability of RAR and MHR to predict postoperative recurrence;multivariate stepwise logistic regression was used to analyze factors affecting postoperative recurrence among high-risk NMIBC patients after TURBT.Results RAR and MHR were significantly higher in the recurrence group than in the non-recurrence group(P<0.05).The AUC(95%CI)for RAR,MHR,and their com-bination to predict postoperative recurrence in high-risk NMIBC were 0.794(0.749-0.844),0.859(0.814-0.904),and 0.923(0.878-0.973),respectively.The AUC of RAR combined with MHR was significantly higher than that of either single marker(Z=8.749,10.604;P<0.05).Multivariate stepwise logistic regression analysis showed that multiple tumors(OR=2.246,95%CI:1.214-4.156),pathological T stage T1(OR=2.614,95%CI:1.484-4.606),RAR≥5.91(OR=2.986,95%CI:1.655-5.387)and MHR≥0.50(OR=3.121,95%CI:1.757-5.542)were independent risk factors for postoperative recurrence in high-risk NMIBC patients after TURBT(P<0.05).Conclusion Elevated RAR and MHR are closely associated with postoperative recurrence in high-risk NMIBC patients after TURBT,and both indica-tors have predictive value for recurrence;combined detection yields higher predictive performance.

Abstract:Objective To investigate the effects of graded pulmonary rehabilitation management based on empowerment theo-ry on lung function and quality of life in patients with stable chronic obstructive pulmonary disease(COPD),so as to provide a reference for clinical practice.Methods One hundred and twenty patients with stable COPD admitted to Shanghai Pulmo-nary Hospital from January 2023 to January 2024 were enrolled.Using a random number table,patients were assigned to an observation group(n=60)and a control group(n=60).The control group received routine management for one year.The observation group received,in addition,graded pulmonary rehabilitation management based on empowerment theory for one year.Lung function,quality of life,symptom severity,psychological status,and exercise capacity were compared between the two groups before intervention and at 3 months after intervention;body-mass index,obstruction,dyspnea,exercise ca-pacity index(BODE)index scores were compared before intervention and at 1,2,and 3 months after intervention;the rate of readmission for acute exacerbation within one year was also compared.Results Before intervention,there were no signifi-cant differences between the two groups in forced expiratory volume in one second(FEV1),forced vital capacity(FVC),or FEV1/FVC(P>0.05).At 3 months after intervention,FEV1,FVC,and FEV1/FVC in both groups were significantly higher than before intervention,and values in the observation group were higher than those in the control group(P<0.05).Before intervention,St.george's respiratory questionnaire(SGRQ),COPD assessment test(CAT),and 12-item general health questionnaire(CHQ-12)scores did not differ significantly between groups(P>0.05).At 3 months after interven-tion,SGRQ,CAT,and CHQ-12 scores in both groups were lower than before intervention,and the scores in the observa-tion group were lower than those in the control group,with statistically significant differences(P<0.05).Before interven-tion,maximal oxygen uptake(VO2max),maximum power(Wmax),and time to exhaustion did not differ significantly be-tween groups(P>0.05).At 3 months after intervention,VO2max and Wmax in both groups were higher than before in-tervention,and were higher in the observation group than in the control group;time to exhaustion was longer in both groups than before intervention and longer in the observation group than in the control group,with statistically significant differ-ences(P<0.05).Before intervention,BODE index scores did not differ significantly between groups(P>0.05).At 2 and 3 months after intervention,BODE index scores in both groups were significantly lower than before intervention,and scores in the observation group were lower than those in the control group(P<0.05).The observation group had a significantly lower rate of readmission for acute exacerbation than the control group within one year(P<0.05).Conclusion Graded pul-monary rehabilitation management based on empowerment theory contributes to comprehensive improvements in lung function,quality of life,psychological status,and BODE index in patients with stable COPD,and helps prevent acute exacerbations.

Abstract:Objective To construct a risk prediction nomogram model for poor prognosis in elderly coronary heart disease(CHD)patients with frailty.Methods A total of 120 elderly CHD patients with frailty admitted to the First Affiliated Hos-pital of Xinjiang Medical University from July 2021 to July 2023 were enrolled.Based on unscheduled visits,major adverse cardiac and cerebrovascular events(MACCE),or all-cause death during follow-up,patients were assigned to poor prognosis(n=66)and good prognosis(n=54)groups.Clinical data were compared between groups.Logistic multivariate regression analysis was used to identify risk factors for poor prognosis.Based on these factors,a nomogram prediction model was con-structed using R Studio 3.6.5 software and the rms package.The model's calibration,predictive performance,and clinical net benefit were evaluated using the Hosmer-Lemeshow goodness-of-fit test,receiver operating characteristic(ROC)curves,and decision curve analysis(DCA),respectively.Results During follow-up,66 patients experienced poor prognosis events,with an incidence of 55.00%.The poor prognosis group had lower left ventricular ejection fraction(LVEF)levels,and higher Charlson Comorbidity Index,Fried Frailty Score,Mini Nutritional Assessment-Short Form(MNA-SF)score,homocysteine(Hcy)levels,and proportions of patients with New York Heart Association(NYHA)class Ⅲ-Ⅳ heart function,smoking history,and taking≥7 types of medication than the good prognosis group,with statistically significant differences(P<0.05).Logistic multivariate regression analysis showed that LVEF<60%,Charlson Comorbidity Index≥2,Fried Frailty Score≥4,MNA-SF score≥11,Hcy level≥15 μmol/L,NYHA class Ⅲ-Ⅳ,and smoking history were independent risk factors for poor prognosis(P<0.05).The calibration curve of the nomogram model based on these risk factors showed high agreement between predicted and observed curves within a prediction probability range of 19%-77%.Internal validation showed the model had an area under the curve(AUC)of 0.885 for predicting poor prognosis,with a sen-sitivity of 85.71%and a specificity of 88.24%.The Kolmogorov-Smirnov goodness-of-fit test indicated good model calibra-tion(χ2=3.268,R2=0.857,P>0.05).DCA results demonstrated that within a threshold probability range of 5%-92%,the model provided higher net benefit than both the"intervene-for-all"and"intervene-for-none"strategies.Conclusion LVEF<60%,Charlson Comorbidity Index≥2,Fried Frailty Score≥4,MNA-SF score≥11,Hcy level≥15 μmol/L,NYHA class Ⅲ-Ⅳ,and smoking history are independent risk factors for poor prognosis in elderly CHD patients with frail-ty.The constructed nomogram model demonstrates good discrimination,calibration,and clinical application value,provi-ding a reference for risk assessment and management strategy development in clinical practice for this patient population.

Abstract:Objective To investigate the predictive value of the Age,Blood tests,Comorbidities(ABC)score,Glasgow-Blatchford Bleeding Score(GBS),and prostaglandin E2(PGE2)level for the short-term prognosis of patients with acute up-per gastrointestinal bleeding(AUGIB),providing references for clinical treatment.Methods A total of 180 AUGIB pa-tients admitted to the No.2 Hospital of Baoding from March 2023 to June 2024 were enrolled and assigned to good progno-sis and poor prognosis groups based on their outcomes within 30 days after admission.Data including gender,age,comor-bidities,ABC score,GBS,and serum PGE2 level were collected at admission.Multivariate logistic regression analysis was used to identify independent risk factors affecting prognosis.MedCalc 20.0 software was used to plot receiver operating characteristic(ROC)curves to analyze the predictive value of each factor for poor prognosis.Results The poor prognosis group had significantly higher ABC and GBS scores but lower serum PGE2 levels than the good prognosis group(P<0.05).Logistic regression analysis showed that ABC score,GBS,and serum PGE2 level were influencing factors for poor prognosis in patients with AUGIB(P<0.05).ROC analysis indicated that the areas under the curve(AUC)for predicting prognosis were 0.685 for ABC score,0.622 for GBS,and 0.873 for serum PGE2,all of which were significantly small er than the AUC of the combined model(0.902)(all P<0.05).Conclusion The ABC score,GBS,and serum PGE2 level all have cer-tain predictive value for the short-term prognosis of patients with AUGIB,but the combined predictive model outperforms any single indicator.The combination of ABC score,GBS,and PGE2 level holds promise as a more precise tool for clinical risk stratification.

Abstract:In contemporary society,issues related to body weight management among female college students are becoming increasingly severe.Abnormal body weight in this population is influenced by congenital factors,acquired unhealthy lifestyle habits,and physiological characteristics.Furthermore,this group commonly harbors misconceptions regarding cognitive perceptions,dietary control,exercise methods,daily habits,and medication use.To align with the strategic requirements of the"Healthy China 2030"initiative and promote the health status of female college students,this paper focuses on health education interventions.It proposes collaborative efforts from five aspects:the individual,family,peers,university,and society.Individuals should correct cognitive biases,regulate behaviors,and adjust psychological states.Families should es-tablish healthy concepts and provide emotional support.Peer groups can promote healthy role models and establish mutual support groups.Universities need to offer relevant courses and foster a positive atmosphere.Society can improve the medi-cal service support system,strengthen publicity and regulation,and promote the optimization of services in the healthy product industry.

Abstract:Objective To analyze the postoperative frailty change trajectories in patients with esophageal cancer,understand their progression patterns,and explore the influencing factors.Methods A total of 120 esophageal cancer patients admitted to Jiangsu Cancer Hospital from October 2021 to June 2024 were enrolled.The Clinical Frailty Scale(CFS)was used to as-sess their frailty status preoperatively and at 1 month,3 months,and 6 months postoperatively.A growth mixture model(GMM)was employed for change trajectory analysis.Clinical data were compared between patients with persistent or pro-gressive frailty and those with no frailty or frailty improvement.A logistic multivariate model was used to analyze factors in-fluencing the persistence or progression of frailty.Results Using a CFS level≥5 as the criterion for frailty,the incidence of frailty was highest at 1 month postoperatively and then gradually declined.ANOVA results showed that frailty levels signif-icantly increased at 1 month postoperatively,subsequently eased,but had not returned to baseline by 6 months postopera-tively(P<0.001).GMM analysis indicated that the 3C model with free estimation was the optimal model for predicting frailty change trajectories.Model categories 1,2,and 3 were identified as persistent frailty,improved frailty,and progres-sive frailty,respectively,comprising 11(9.20%),81(67.50%),and 28(23.30%)patients.Multivariate analysis demon-strated that age≥65 years,living alone,clinical stage Ⅲa-Ⅲb,receiving neoadjuvant therapy,postoperative chemoradio-therapy,and having nutritional risk were independent risk factors for persistent or progressive postoperative frailty in esoph-ageal cancer patients(P<0.05).Conclusion The incidence of postoperative frailty is high in esophageal cancer patients,manifesting three distinct trajectories:persistence,improvement,and progression.The persistence and progression of frail-ty are influenced by multiple factors,including patient age,living status,clinical stage,treatment strategy,and nutritional status.Clinical attention should be paid to the change trajectories of postoperative frailty and its influencing factors.Individ-ualized management strategies should be developed based on an integrated biopsychosocial medical model to improve patient prognosis.

Abstract:Objective To investigate the effects of soothing liver and subduing yang auricular scraping therapy on blood pres-sure control,sleep quality,and quality of life in patients with essential hypertension(EH)of liver-yang hyperactivity pat-tern.Methods A total of 100 EH patients with liver-yang hyperactivity pattern admitted to Foshan Hospital of Traditional Chinese Medicine from October 2023 to October 2024 were selected and randomly allocated to observation and control groups(n=50 each).The control group received conventional antihypertensive treatment,while the observation group received ad-ditional soothing liver and subduing yang auricular scraping therapy.Both groups were treated for 8 weeks.Changes in blood pressure,Traditional Chinese Medicine(TCM)symptoms,sleep quality,and quality of life at pre-treatment and post-treatment were compared.Results The overall response rate was 92.00%(46/50)in the observation group,significantly higher than 76.00%(38/50)in the control group(χ2=4.762,P=0.029).At pre-treatment,no significant differences were noted in systolic blood pressure(SBP)or diastolic blood pressure(DBP)levels between groups(P>0.05).At post-treatment,SBP and DBP levels decreased in both groups compared to pre-treatment levels,with lower levels in the observation group than in the control group,and the differences were statistically significant(P<0.05).Pre-treatment scores for the three main TCM symptoms—headache,dizziness,and irritability—showed no intergroup differences(P>0.05).At post-treatment,scores for all three symptoms decreased in both groups versus pre-treatment,with lower scores in the observation group,and the differences were statistically significant(P<0.05).Pre-treatment Pittsburgh Sleep Quality Index(PSQI)scores showed no inter-group difference(P>0.05);post-treatment PSQI scores decreased in both groups versus pre-treatment,with a lower score in the observation group,and the differences were statistically significant(P<0.05).Pre-treatment scores for the eight subscales of the 36-Item Short-Form Health Survey(SF-36)—physical functioning,role-physical,bodily pain,general health,vitality,social func-tioning,role-emotional,and mental health—showed no intergroup differences(P>0.05).At post-treatment,scores for all SF-36 subscales increased in both groups versus at pre-treatment,with higher scores in the observation group,and the differences were statistically significant(P<05).Conclusion Soothing liver and subduing yang auricular scraping therapy demonstrates favorable efficacy in treating EH patients with liver-yang hyperactivity pattern.It aids in blood pressure control and improves sleep quality and quality of life,showing good clinical application value.

Abstract:Objective To investigate the effects of a digital management pathway based on the Global Initiative for Chronic Obstructive Lung Disease(GOLD)guidelines on acute exacerbation frequency,respiratory muscle function,and quality of life in patients with moderate-to-severe chronic obstructive pulmonary disease(COPD),providing references for clinical de-cision-making.Methods A total of 100 patients with moderate-to-severe COPD recruited from Northern Jiangsu People's Hospital and Yangzhou Second People's Hospital from January 2020 to September 2024 were selected.Using a random number table,patients were assigned to four groups(n=25 each):routine intervention group,expectoration group,pulmo-nary rehabilitation exercise group,and drug delivery device group.The routine intervention group received standard health education and follow-up.The expectoration group received additional digitally assisted expectoration training.The pulmona-ry rehabilitation exercise group underwent digital respiratory muscle training.The drug delivery device group used an intelli-gent drug delivery management system to enhance medication adherence.The intervention lasted 48 weeks.Changes in moderate-to-severe exacerbation frequency,time to first exacerbation,pulmonary function indices(forced expiratory volume in 1 second[FEV1],forced vital capacity[FVC],FEV1/FVC ratio,maximal mid-expiratory flow[MMEF]),modified Medical Research Council(mMRC)dyspnea score,Miller and Jones classification score,6-minute walk test(6MWT)dis-tance,and COPD Assessment Test(CAT)score were compared.Results After intervention,all four groups showed sig-nificant improvement in pulmonary function indices,exercise tolerance,and quality of life compared to baseline.The drug delivery device group demonstrated the most significant effects in reducing moderate-to-severe and any-grade exacerbation frequency,delaying the time to first exacerbation,and lowering CAT scores(P<0.05).The expectoration group showed the most pronounced improvement in Miller and Jones classification score(P<0.05),indicating optimal enhancement in sputum expectoration ability.Conclusion The GOLD guideline-based digital management pathway effectively reduces acute exacerbation risk and improves respiratory muscle function,exercise tolerance,and quality of life in moderate-to-severe COPD patients.The comprehensive intervention model combining intelligent medication management with digital pulmonary rehabilitation yields particularly favorable outcomes.

Abstract:Objective To investigate the effects of Jiejin point blade needle release on pain,joint mobility,and inflammatory factor levels in patients with knee osteoarthritis(KOA),providing references for clinical treatment.Methods A total of 120 KOA patients treated at Pengzhou Hospital of Traditional Chinese Medicine from October 2023 to December 2024 were enrolled and divided into control(n=58,simple blade needle therapy)and study(n=62,Jiejin point blade needle release)groups based on treatment modality.Traditional Chinese Medicine(TCM)syndrome scores before and after treatment were compared;Visual Analogue Scale(VAS)scores before treatment and at 2 weeks and 1 month after treatment were also compared.Levels of matrix metalloproteinase-3(MMP-3),cyclooxygenase-2(COX-2),and interleukin-1β(IL-1β)before treatment and at 3 months after treatment were measured,and adverse reactions during treatment were recorded.Results Before treatment,no significant differences were observed in TCM syndrome scores between groups(P>0.05);after treat-ment,all TCM syndrome scores decreased in both groups versus pre-treatment,with significantly lower scores in the study group than in THE control group(P<0.05).Pre-treatment VAS scores showed no significant intergroup difference(P>0.05);at 2 weeks and 1 month post-treatment,VAS scores decreased in both groups versus pre-treatment,with lower scores in the study group,with statistically significant differences(P<0.05).Pre-treatment knee range of motion,Ly-sholm Knee Scoring Scale(LKSS),and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores showed no significant intergroup differences(P>0.05);post-treatment LKSS scores and knee range of motion increased while WOMAC scores decreased in both groups versus pre-treatment,with greater improvements in the study group than in controls,and the differences were statistically significant(P<0.05).Pre-treatment MMP-3,COX-2,and IL-1β levels showed no significant intergroup differences(P>0.05);post-treatment levels of all three inflammatory markers were sig-nificantly lower in the study group than in controls(P<0.05).No significant difference was observed in adverse reaction rates between groups(P>0.05).Conclusion Jiejin point blade needle release effectively alleviates pain,improves joint mobility,modulates inflammatory signaling pathways,and reduces inflammatory marker levels in KOA patients,with good safety profiles.Its efficacy surpasses that of simple blade needle therapy,offering a new treatment option for KOA.

Abstract:Objective To provide recommendations for asphyxia prevention and control in the elderly by analyzing trends in asphyxia mortality and related mortality burden among residents aged 60 years and older in Chongqing from 2012 to 2023.Methods Death cases from asphyxia in residents aged≥60 years during 2012-2023 were obtained from Chongqing's resi-dent cause-of-death surveillance system.Indicators analyzed included crude mortality rate,standardized mortality rate,age-specific mortality rate,years of life lost(YLL)rate due to premature death,and average years of life lost(AYLL).The χ2 test was used to compare mortality by sex and region.Trend analyses of rates were expressed by average annual percent change(AAPC)and calculated with Joinpoint regression analysis.Results From 2012 to 2023,the crude and standardized mortality rates for asphyxia among Chongqing residents aged≥60 years decreased from 8.05/100,000 and 8.14/100,000 to 2.73/100,000 and 2.66/100,000,respectively;the AAPCs were-10.95%and-11.31%,respectively(P<0.001).Overall,male mortality exceeded female mortality,and rural rates exceeded urban rates.Mortality rose with increasing age.The YLL rate attributable to asphyxia declined at an average annual rate of 11.49%,and AYLL declined at an average annu-al rate of 0.50%.Comparison analysis of proportional mortality rate by different asphyxia over the years showed that as-phyxia due to"other causes"decreased by an average annual 4.16%,whereas the proportions attributable to airway obstruc-tion from swallowed or aspirated food,airway obstruction from aspirated or swallowed other objects,and aspiration of gas-tric contents increased by average annual rates of 10.17%,10.60%and 19.72%,respectively(P<0.05).Conclusion Be-tween 2012 and 2023,the asphyxia mortality rate among Chongqing residents aged≥60 years showed a downward trend,but the burden of disease remains substantial.Men and rural older adults are focus groups for asphyxia prevention and con-trol.

Abstract:Objective To analyze the characteristics of elderly care policies in Sichuan and Chongqing under the background of the Chengdu-Chongqing Economic Circle construction,providing references for improving local elderly care services and co-ordinated policy development in these regions.Methods A three-dimensional analytical framework of"Policy Instruments-Service Elements-Empowerment Perspectives"was constructed to conduct content and social network analysis on jointly is-sued(n=9)and separately issued(Sichuan n=28,Chongqing n=39)elderly care policies from Sichuan and Chongqing.Results For both jointly and separately issued policies,environmental-type policy instruments were predominant,while de-mand-type and actor empowerment had the lowest proportions.Policy content focused on service foundation,methods,and actors.Sichuan emphasized strategic planning,regulations,and institutions,forming a network centered on"policy instru-ments";Chongqing concentrated on standards,norms,supervision,and assessment,forming a network structure centered on"empowerment perspectives."There was high interaction between supply-type instruments and service empowerment,and between environmental-type instruments and environmental empowerment.The cross-matching between actor empow-erment and both policy instruments and service elements was inadequate.Conclusion Elderly care policies in Sichuan and Chongqing should promote precise and coordinated development by optimizing the structure of policy instruments,improving the allocation of service elements,and strengthening actor empowerment.

Abstract:Objective To investigate the efficacy of alteplase combined with rosuvastatin in patients with acute cerebral infarc-tion(ACI)and its effects on serum B-type natriuretic peptide(BNP),D-dimer(D-D),and high-sensitivity C-reactive pro-tein(hs-CRP).Methods One hundred ACI patients admitted to the Affiliated Chuzhou Hospital of Anhui Medical Univer-sity from June 2022 to December 2024 were enrolled.Patients were assigned to a control group and an observation group u-sing a random number table,with 50 cases each.The control group received alteplase;the observation group received rosuv-astatin calcium in addition to the control regimen.Clinical efficacy was compared between the two groups.National Institu-tes of Health Stroke Scale(NIHSS)and modified Rankin Scale(mRS)scores,and serum BNP,D-D,hs-CRP,and hemato-crit(HCT)were measured before treatment and at day 14 of treatment.Adverse events during treatment were recorded and compared.Results The overall response rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in NIHSS or mRS scores between the two groups(P>0.05).After treatment,NIHSS and mRS scores in both groups were decreased,and the observation group scores were lower than those of the control group;the differences were statistically significant(P<0.05).Before treatment,BNP,D-D,hs-CRP,or HCT levels did not differ significantly between groups(P>0.05).After treatment,BNP,D-D,hs-CRP,HCT levels in both groups showed reductions,and levels in the observation group were lower than those in the control group;the differences were statistically significant(P<0.05).The incidence of ad-verse reactions did not differ significantly between the two groups(P>0.05).Conclusion Combined treatment with alte-plase and rosuvastatin for ACI yields favorable clinical efficacy,can improve neurological function,reduce serum BNP,D-D,hs-CRP,and HCT levels,and demonstrate good clinical safety.