Objective To investigate the current status of work readiness and its influencing factors among patients returning to work after lung cancer surgery. Methods A retrospective study was conducted on young and middle-aged postoperative lung cancer patients who were treated at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to September 2023 and returned to their jobs. Data were collected through a general information questionnaire, readiness for return-to-work scale (RRTW), general self-efficacy scale (GSES), and simplified coping style questionnaire (SCSQ). Univariate and multivariate logistic regression analyses were used to explore the factors affecting the work readiness of patients returning to work. Results A total of 219 patients were included, with 59 males and 160 females aged 18-60 years. Among the postoperative lung cancer patients returning to work, 73.1% were in the active maintenance stage of return-to-work readiness with a RRTW score of (17.59±1.48) points, and 26.9% were in the uncertain maintenance stage with a RRTW score of (16.22±1.50) points. Multivariate logistic regression analysis showed that patients aged≤30 years (OR=52.381), employees of enterprises and institutions (OR=7.682), agricultural, pastoral, fishery, forestry laborers (OR=15.665), positive coping (OR=5.043), those with higher self-efficacy (OR=1.157) and engaged in physically demanding work (OR=2.449) had higher return-to-work readiness, while patients with≥2 children (OR=0.055), self-payment (OR=0.044), and those working more than 40 hours per week (OR=0.122) had lower return-to-work readiness. Conclusion The return-to-work readiness of young and middle-aged postoperative lung cancer patients needs to be improved, and occupation, job nature, main coping styles, general self-efficacy and other factors are associated with return-to-work readiness.

AIM: To analyze the factors affecting non-contact intraocular pressure(IOPNCT)measurements after femtosecond laser-assisted small incision lenticule extraction(SMILE), explore the correlation of IOPNCT with central corneal thickness(CCT)and corneal curvature after SMILE, and construct the corresponding regression model which will provide scientific basis for clinical evaluation of the true IOP of patients after SMILE.METHODS: Data from a retrospective analysis of 107 myopic patients(206 eyes)who underwent SMILE and 107 myopic patients(201 eyes)received femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery from June 2023 to May 2024 were examined. IOPNCT, CCT, and corneal curvature before surgery and at 1 and 3 mo were collected. The preoperative and postoperative IOPNCT, CCT and corneal curvature were analyzed by ANOVA and Pearson correlation analysis, and multiple linear regression models were constructed to evaluate the association of postoperative changes of IOPNCT, CCT and corneal curvature.RESULTS: There were significant differences in IOPNCT, CCT, and corneal curvature of both SMILE and FS-LASIK patients(all P<0.001), there was no significant difference between two groups and interaction effects(all P>0.05), and the IOPNCT, CCT and corneal curvature at 1 and 3 mo post-surgery were significantly lower than preoperative(all P<0.05). Pearson correlation analysis showed a positive correlation between IOPNCT and CCT at 1 and 3 mo after SMILE(r=0.261, 0.267, all P<0.001), but no significant correlation with corneal curvature(all P>0.05). Multiple linear regression analysis of IOPNCT with CCT and corneal curvature at 1 mo after SMILE indicated that the regression equation was: Y=3.426+0.019X1-0.058X2(Y represents IOPNCT, X1 represents the CCT, and X2 represents the corneal curvature), with statistical significant difference in the equation(F=7.654, P=0.001); the regression equation for 3 mo after surgery was: Y=2.056+0.020X1-0.038 X2(Y represents IOPNCT, X1 represents the CCT, and X2 represents the corneal curvature), with statistically significance in the equation(F=7.903, P<0.001). The regression equation of postoperative IOPNCT change(△IOPNCT)and intraoperative cutting corneal thickness(△CCT)and corneal curvature at 1 mo was Y=-2.252+0.008X1+0.587X2(Y represents △IOPNCT, X1 stands for the △CCT, X2 represents the corneal curvature change value), with statistical significant difference in the equation(F=17.550, P<0.001); the regression equation for 3 mo after surgery was: Y=-2.168+0.024X1+0.281X2(Y represents △IOPNCT, X1 represents △CCT, X2 indicates the corneal curvature change values), with statistical significant difference in the equation(F=16.030, P<0.001).CONCLUSION: After SMILE and FS-LASIK surgery, the IOPNCT value of patients was mainly affected by CCT compared with preoperative surgery, and the short-term use of hormone eye drops, fluorometholone, did not cause a significant increase in IOP; both the IOP correction formula at 1 and 3 mo postoperatively can be used clinically to evaluate and correct actual IOP in patients after SMILE.

AIM: To analyze the factors affecting non-contact intraocular pressure(IOPNCT)measurements after femtosecond laser-assisted small incision lenticule extraction(SMILE), explore the correlation of IOPNCT with central corneal thickness(CCT)and corneal curvature after SMILE, and construct the corresponding regression model which will provide scientific basis for clinical evaluation of the true IOP of patients after SMILE.METHODS: Data from a retrospective analysis of 107 myopic patients(206 eyes)who underwent SMILE and 107 myopic patients(201 eyes)received femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery from June 2023 to May 2024 were examined. IOPNCT, CCT, and corneal curvature before surgery and at 1 and 3 mo were collected. The preoperative and postoperative IOPNCT, CCT and corneal curvature were analyzed by ANOVA and Pearson correlation analysis, and multiple linear regression models were constructed to evaluate the association of postoperative changes of IOPNCT, CCT and corneal curvature.RESULTS: There were significant differences in IOPNCT, CCT, and corneal curvature of both SMILE and FS-LASIK patients(all P<0.001), there was no significant difference between two groups and interaction effects(all P>0.05), and the IOPNCT, CCT and corneal curvature at 1 and 3 mo post-surgery were significantly lower than preoperative(all P<0.05). Pearson correlation analysis showed a positive correlation between IOPNCT and CCT at 1 and 3 mo after SMILE(r=0.261, 0.267, all P<0.001), but no significant correlation with corneal curvature(all P>0.05). Multiple linear regression analysis of IOPNCT with CCT and corneal curvature at 1 mo after SMILE indicated that the regression equation was: Y=3.426+0.019X1-0.058X2(Y represents IOPNCT, X1 represents the CCT, and X2 represents the corneal curvature), with statistical significant difference in the equation(F=7.654, P=0.001); the regression equation for 3 mo after surgery was: Y=2.056+0.020X1-0.038 X2(Y represents IOPNCT, X1 represents the CCT, and X2 represents the corneal curvature), with statistically significance in the equation(F=7.903, P<0.001). The regression equation of postoperative IOPNCT change(△IOPNCT)and intraoperative cutting corneal thickness(△CCT)and corneal curvature at 1 mo was Y=-2.252+0.008X1+0.587X2(Y represents △IOPNCT, X1 stands for the △CCT, X2 represents the corneal curvature change value), with statistical significant difference in the equation(F=17.550, P<0.001); the regression equation for 3 mo after surgery was: Y=-2.168+0.024X1+0.281X2(Y represents △IOPNCT, X1 represents △CCT, X2 indicates the corneal curvature change values), with statistical significant difference in the equation(F=16.030, P<0.001).CONCLUSION: After SMILE and FS-LASIK surgery, the IOPNCT value of patients was mainly affected by CCT compared with preoperative surgery, and the short-term use of hormone eye drops, fluorometholone, did not cause a significant increase in IOP; both the IOP correction formula at 1 and 3 mo postoperatively can be used clinically to evaluate and correct actual IOP in patients after SMILE.

Objective:To explore the effect of hospital-community continuous management based on mobile health and dyadic coping intervention in ileostomy patients and their spouses.Methods:This was a randomized controlled trial. Patients with rectal cancer who underwent ileostomy at Taizhou People′s Hospital between August 2018 and August 2023, along with their spouses, were enrolled. Patient-spouse dyads were randomly assigned to either the intervention group or the control group using a random number table method. Baseline demographic data were collected from both groups. The control group received routine care, whereas the intervention group was given a hospital-community transitional care program based on mHealth (mobile health) and a dyadic coping model. Stoma adaptation, family functioning, and dyadic coping capacity were evaluated at 1 week, 1 month, and 3 months postoperatively. Sedentary behavior time and exercise compliance were also assessed at 1 month and 3 months after surgery.Results:A total of 47 patient-spouse dyads were included in the control group and 48 dyads in the intervention group. There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05). Similarly, no significant differences were found in the age, sex or education level of the spouses (all P>0.05). At 1 week postoperatively, there were no significant differences in family cohesion and adaptability scores between the two groups (all P>0.05). However, at 1 and 3 months postoperatively, the intervention group had significantly higher family cohesion and adaptability scores than the control group (all P<0.05). With regard to dyadic coping capacity, no significant differences were observed in any of the subscale scores of the dyadic coping questionnaire at 1 week postoperatively (all P>0.05). At 1 and 3 months postoperatively, the intervention group scored significantly higher than the control group on stress communication, supportive coping, delegated coping, and joint coping ( P<0.05), but lower on negative coping ( P<0.05). In terms of stoma adaptation, no significant difference was found between the two groups at 1 week postoperatively ( P>0.05). At 1 and 3 months postoperatively, the intervention group showed significantly higher stoma adaptation and exercise compliance scores, as well as shorter sedentary behavior time, compared to the control group (all P<0.05). Conclusions:The hospital-community transitional care program developed by the research team effectively improves family functioning, dyadic coping capacity in ileostomy patient-spouse dyads, and postoperative stoma adaptation and rehabilitation outcomes.

OBJECTIVE To evaluate the influence of gram-negative bacterial infection on the prognosis of patients with heart failure with reduced ejection fraction(HFrEF),and to explore its effects on biomarker dynamics,car-diac function recovery,rehospitalization rates and all-cause fatality rate.METHODS Clinical data were retrospec-tively collected from 100 patients diagnosed with HFrEF and combined with gram-negative bacterial infection at the Second Affiliated Hospital of Guizhou Medical University and the Cardiovascular Medicine of the Army Medi-cal Center of Chinese PLA from Jan.2022 to Jan.2024.Clinical baseline data,including demographic information,medical history and biomarkers[interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT),brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NT-proBNP)and troponin]were collected through follow-up visits for 12 months.Follow-up visits were conducted at discharge,3 months,6 months and 12 months,left ventricular ejection fraction(LVEF),NYHA classification(New York heart asso-ciation functional classification for heart),rehospitalization status and all-cause fatality rate were recorded.RESULTS Gram-negative bacterial infection significantly increased the rehospitalization and all-cause fatality rates in patients with HFrEF.The cumulative rehospitalization rate reached 45.00％within 12 months,and the all-cause fatality rate was 15.00％(P＜0.05).Inflammatory markers such as IL-6 and CRP were significantly ele-vated at baseline(P＜0.001)and decreased at discharge,while NT-proBNP levels were higher during the follow up period than those after the discharge,positively correlating with the numbers of rehospitalizations and fatality rates(r=0.752,P＜0.001).LVEF and NYHA classification improved in the short term but showed poor long-term prognosis.CONCLUSIONS Gram-negative bacterial infection significantly affects the long-term prognosis of patients with HFrEF,exacerbating cardiac function damage through inflammatory responses,thus increases re-hospitalization and fatality rates.This study provides new directions for clinical management,and emphasize the importance of early infection control.

OBJECTIVE To evaluate the influence of gram-negative bacterial infection on the prognosis of patients with heart failure with reduced ejection fraction(HFrEF),and to explore its effects on biomarker dynamics,car-diac function recovery,rehospitalization rates and all-cause fatality rate.METHODS Clinical data were retrospec-tively collected from 100 patients diagnosed with HFrEF and combined with gram-negative bacterial infection at the Second Affiliated Hospital of Guizhou Medical University and the Cardiovascular Medicine of the Army Medi-cal Center of Chinese PLA from Jan.2022 to Jan.2024.Clinical baseline data,including demographic information,medical history and biomarkers[interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT),brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NT-proBNP)and troponin]were collected through follow-up visits for 12 months.Follow-up visits were conducted at discharge,3 months,6 months and 12 months,left ventricular ejection fraction(LVEF),NYHA classification(New York heart asso-ciation functional classification for heart),rehospitalization status and all-cause fatality rate were recorded.RESULTS Gram-negative bacterial infection significantly increased the rehospitalization and all-cause fatality rates in patients with HFrEF.The cumulative rehospitalization rate reached 45.00％within 12 months,and the all-cause fatality rate was 15.00％(P＜0.05).Inflammatory markers such as IL-6 and CRP were significantly ele-vated at baseline(P＜0.001)and decreased at discharge,while NT-proBNP levels were higher during the follow up period than those after the discharge,positively correlating with the numbers of rehospitalizations and fatality rates(r=0.752,P＜0.001).LVEF and NYHA classification improved in the short term but showed poor long-term prognosis.CONCLUSIONS Gram-negative bacterial infection significantly affects the long-term prognosis of patients with HFrEF,exacerbating cardiac function damage through inflammatory responses,thus increases re-hospitalization and fatality rates.This study provides new directions for clinical management,and emphasize the importance of early infection control.

Objective:To explore the effect of hospital-community continuous management based on mobile health and dyadic coping intervention in ileostomy patients and their spouses.Methods:This was a randomized controlled trial. Patients with rectal cancer who underwent ileostomy at Taizhou People′s Hospital between August 2018 and August 2023, along with their spouses, were enrolled. Patient-spouse dyads were randomly assigned to either the intervention group or the control group using a random number table method. Baseline demographic data were collected from both groups. The control group received routine care, whereas the intervention group was given a hospital-community transitional care program based on mHealth (mobile health) and a dyadic coping model. Stoma adaptation, family functioning, and dyadic coping capacity were evaluated at 1 week, 1 month, and 3 months postoperatively. Sedentary behavior time and exercise compliance were also assessed at 1 month and 3 months after surgery.Results:A total of 47 patient-spouse dyads were included in the control group and 48 dyads in the intervention group. There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05). Similarly, no significant differences were found in the age, sex or education level of the spouses (all P>0.05). At 1 week postoperatively, there were no significant differences in family cohesion and adaptability scores between the two groups (all P>0.05). However, at 1 and 3 months postoperatively, the intervention group had significantly higher family cohesion and adaptability scores than the control group (all P<0.05). With regard to dyadic coping capacity, no significant differences were observed in any of the subscale scores of the dyadic coping questionnaire at 1 week postoperatively (all P>0.05). At 1 and 3 months postoperatively, the intervention group scored significantly higher than the control group on stress communication, supportive coping, delegated coping, and joint coping ( P<0.05), but lower on negative coping ( P<0.05). In terms of stoma adaptation, no significant difference was found between the two groups at 1 week postoperatively ( P>0.05). At 1 and 3 months postoperatively, the intervention group showed significantly higher stoma adaptation and exercise compliance scores, as well as shorter sedentary behavior time, compared to the control group (all P<0.05). Conclusions:The hospital-community transitional care program developed by the research team effectively improves family functioning, dyadic coping capacity in ileostomy patient-spouse dyads, and postoperative stoma adaptation and rehabilitation outcomes.

Objective To investigate the application value of transumbilical single-port total laparoscopic hysterectomy by conventional instrument without uterine-lifting in the treatment of cervical lesions.Methods We selected 60 cases of total laparoscopic hysterectomy due to cervical high-grade squamous intraepithelial lesion(HSIL)or cervical cancer stage ⅠA1 from December 2021 to June 2023.According to the patients'preference,30 cases of single-port laparoscopy through the umbilicus and 30 cases of multi-port laparoscopy were performed,both using conventional instruments without uterine-lifting.The surgical indicators of the two groups were compared.Results No conversion to open surgery occurred in both groups,and no intraoperative injuries to the urinary system,bowel,or major blood vessels occurred.As compared with the multi-port group,the single-port group had significantly reduced amount of bleeding during surgery[(54.6±20.5)ml vs.(67.5±27.0)ml,P = 0.041],earlier anal exhaust time[(27.6±8.0)h vs.(32.2±9.0)h,P =0.040],and shorter total hospitalization time[(4.4±1.5)d vs.(5.1±1.2)d,P = 0.044].There were no significant differences in uterine weight,surgical time,and postoperative complications between the two group(P>0.05).The healing of the abdominal wall puncture wounds in both groups of patients were satisfied.There were no short-term complications related to the puncture device(such as puncture wound infection and bleeding)or long-term complications(such as umbilical hernia and incisional hernia).Conclusion Transumbilical single-port total laparoscopic hysterectomy without uterine-lifting presents advantages of less intraoperative bleeding,faster postoperative recovery,and almost no scarring,with complications similar to traditional laparoscopic surgery.

Objective:To investigate the correlation between sedentary behavior and exercise compliance in ileostomy patients for developing targeted exercise intervention.Methods:Patients undergoing laparoscopic low anterior rectal resection combined with prophylactic ileostomy from Aug 2018 to Aug 2023 were enrolled in this study by convenience sampling method. A survey was conducted at 3 months after surgery to investigate their sedentary behavior and exercise compliance.Results:The daily sedentary time of 144 patients was (7.94±1.76) h, and 63.8% (92/144) of patients had sedentary time ≥8 h/d. The exercise compliance score was 32.24±8.32 and the total adherence rate was 54.29%±13.85%. Sedentary behavior was inversely correlated with exercise rehabilitation compliance ( r=-0.222, P<0.05). Univariate analysis revealed that age, tumor stage, chronic medical history, NRS 2002 score, main caregiver, ostomy adaptability, frailty, previous exercise habits were important influencing factors of sedentary behavior (all P<0.05). Multivariate Logistic regression analysis indicated that stoma adaptability and exercise compliance, age, primary caregiver, and previous exercise habits were independent factors affecting postoperative sedentary behavior (all P<0.05). Combining the above factors to construct the receiver operating characteristic curve yielded an area under the curve of 0.806 (95% CI: 0.729-0.883), with an sensitivity and specificity of 72.8%, 80.8%, respectively. Conclusion:Exercise intervention in survivorship management is essential for enhancing the health-related quality of life in patients with ileostomy.

The long-acting cabotegravir and rilpivirine injection regimen（CAB+RPV regimen）is the first approved long-acting antiretroviral therapy（ART）for HIV in China，administered once every two months. This regimen provides an innovative alternative to daily oral ART，benefiting virologically suppressed patients. Several large clinical-studies have shown that the CAB+RPV regimen achieves comparable virologic suppression and safety to daily oral regimens，while significantly enhancing patient satisfaction. Based on international and domestic HIV/AIDs guidelines and clinical evidence，this consensus offers expert recommendations on patient selection，clinical management，and key communication strategies for healthcare providers to support the effective use of this regimen，aiming to improve quality of life for people living with HIV and accumulate domestic clinical experience with this advanced treatment approach.