Purpose: The prevalence of psychological distress is frequently observed among old adults with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, current researches are insufficient to clarify the correlation among these relevant factors. This study examined the effects of symptom burden, psychological resilience, coping styles, and social support on psychological distress. Methods: Two hundred fifty five elderly patients with AECOPD were conveniently selected in Taian, Shandong Province. The General Information Questionnaire, Distress Thermometer, The Revised Memorial Symptom Assessment Scale, Connor-Davidson Resilience Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale were used to investigate. The relationship among factors was estimated by using a structural equation model. Results: Psychological distress score of elderly patients with AECOPD was (5.25 ± 1.01); coping styles, psychological resilience, symptom burden, and social support directly affected psychological distress (thedirect effects were À.93, .17, .17, and À.09); coping styles had the largest total effect on psychological distress (the total effect was À.93); psychological resilience indirectly affected psychological distress through coping styles (the indirect effect was À.74); symptom burden indirectly affected psychologicaldistress through psychological resilience (the indirect effect was .25); social support indirectly affected psychological distress through symptom burden, psychological resilience, and coping styles (the indirecteffect was À.80). Conclusion The psychological distress of elderly patients with AECOPD is at a moderate level; coping styles, psychological resilience, and social support have positive effects on alleviating the psychological distress of elderly patients with AECOPD; symptom burden is negatively correlated with psychological distress.Healthcare professionals should pay more attention to elderly patients with AECOPD who are particularly prone to experience higher levels of psychological distress, especially in the presence of low coping style, limited psychological resilience, inadequate levels of social support, and high symptom burden.

Abstract Survival analysis has been widely used in the field of medical research. The Cox proportional hazard model is commonly used, but its practical application is limited. Machine learning method can compensate for the shortcomings of the Cox proportional hazard model in terms of nonlinear data processing and prediction accuracy. This article reviewed the advance of machine learning methods represented by neural networks, within the field of survival analysis, and highlighted the principles and benefits of three machine learning methods that DeepSurv, Deep-Hit and random survival forest, providing methodological insights for the analysis of complex survival data.

Purpose: The prevalence of psychological distress is frequently observed among old adults with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, current researches are insufficient to clarify the correlation among these relevant factors. This study examined the effects of symptom burden, psychological resilience, coping styles, and social support on psychological distress. Methods: Two hundred fifty five elderly patients with AECOPD were conveniently selected in Taian, Shandong Province. The General Information Questionnaire, Distress Thermometer, The Revised Memorial Symptom Assessment Scale, Connor-Davidson Resilience Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale were used to investigate. The relationship among factors was estimated by using a structural equation model. Results: Psychological distress score of elderly patients with AECOPD was (5.25 ± 1.01); coping styles, psychological resilience, symptom burden, and social support directly affected psychological distress (thedirect effects were À.93, .17, .17, and À.09); coping styles had the largest total effect on psychological distress (the total effect was À.93); psychological resilience indirectly affected psychological distress through coping styles (the indirect effect was À.74); symptom burden indirectly affected psychologicaldistress through psychological resilience (the indirect effect was .25); social support indirectly affected psychological distress through symptom burden, psychological resilience, and coping styles (the indirecteffect was À.80). Conclusion The psychological distress of elderly patients with AECOPD is at a moderate level; coping styles, psychological resilience, and social support have positive effects on alleviating the psychological distress of elderly patients with AECOPD; symptom burden is negatively correlated with psychological distress.Healthcare professionals should pay more attention to elderly patients with AECOPD who are particularly prone to experience higher levels of psychological distress, especially in the presence of low coping style, limited psychological resilience, inadequate levels of social support, and high symptom burden.

Purpose: The prevalence of psychological distress is frequently observed among old adults with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, current researches are insufficient to clarify the correlation among these relevant factors. This study examined the effects of symptom burden, psychological resilience, coping styles, and social support on psychological distress. Methods: Two hundred fifty five elderly patients with AECOPD were conveniently selected in Taian, Shandong Province. The General Information Questionnaire, Distress Thermometer, The Revised Memorial Symptom Assessment Scale, Connor-Davidson Resilience Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale were used to investigate. The relationship among factors was estimated by using a structural equation model. Results: Psychological distress score of elderly patients with AECOPD was (5.25 ± 1.01); coping styles, psychological resilience, symptom burden, and social support directly affected psychological distress (thedirect effects were À.93, .17, .17, and À.09); coping styles had the largest total effect on psychological distress (the total effect was À.93); psychological resilience indirectly affected psychological distress through coping styles (the indirect effect was À.74); symptom burden indirectly affected psychologicaldistress through psychological resilience (the indirect effect was .25); social support indirectly affected psychological distress through symptom burden, psychological resilience, and coping styles (the indirecteffect was À.80). Conclusion The psychological distress of elderly patients with AECOPD is at a moderate level; coping styles, psychological resilience, and social support have positive effects on alleviating the psychological distress of elderly patients with AECOPD; symptom burden is negatively correlated with psychological distress.Healthcare professionals should pay more attention to elderly patients with AECOPD who are particularly prone to experience higher levels of psychological distress, especially in the presence of low coping style, limited psychological resilience, inadequate levels of social support, and high symptom burden.

Objective:To investigate the clinical effects of modified automatic hemorrhoidal ligation using elastic string (RPH-4) combined with Xiaozhilling injection for grade Ⅲ hemorrhoids.Methods:The prospective randomized controlled study was conducted. The clinical data of patients with grade Ⅲ hemorrhoids who underwent modified RPH-4 combined with Xiaozhiling injection in Traditional Chinese Medicine Hospital of Chongqing Shapingba District from July 2021 to December 2022 were selected. Patients with grade Ⅲ hemorrhoids who meeting the inclusion criteria were randomly divided into the experimental group and the control group using a random number table method. Patients in the experiment group underwent submucosal injection of the Xiaozhilling injec-tion followed by modified RPH-4, and patients in the control group underwent submucosal injection of the 0.9% sodium chloride solution followed by modified RPH-4. Observation indicators: (1) grouping of enrolled patients; (2) postoperative situations; (3) short-term efficacy; (4) long-term efficacy. Com-parison of measurement data with normal distribution between groups was conducted using the inde-pendent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the nonparameter test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Grouping of enrolled patients. A total of 120 patients were selected. There were 72 males and 48 females, aged 48(range, 18-69)years, including 60 cases in the experiment group and 60 cases in the control group, respectively. There was no significant difference in gender, age, type of hemorrhoids, time to hemorrhoid prolapsis, stool blood, symptom score and Wexner score between the two groups ( P>0.05), confounding bias ensured comparability. At the end of the study, there were 59 cases in the experimental group and 58 cases in the control group. (2) Postoperative situations. There were 5 cases of secondary bleeding after modified RPH-4 in the experiment group and 15 cases of secondary bleeding after modified RPH-4 in the control group, showing a significant difference between the two groups ( χ2=6.239, P<0.05). The post-operative hemorrhoidal shedding time was (6.9±1.4)days in the experiment group, versus (8.1±2.2)days in the control group, showing a significant difference between the two groups ( t=-3.566, P<0.05). (3) Short-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing short-term follow-up. The cure rate was 88.14%(52/59) in the experiment group, versus 84.48%(49/58) in the control group, showing no significant difference in short-term efficacy between the two groups ( χ2=0.331, P>0.05). The wound healing time was (24±5)days in the experi-ment group, versus (25±5)days in the control group, showing no significant difference between the two groups ( t=-1.082, P>0.05). (4) Long-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing long-term follow-up. None of patient in the two groups had anal incontinence. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of rectal hard segment in the experiment group were 2 and 1, respectively, and there was no anorectal stenosis. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of anorectal stenosis were 8 and 1, respectively, and there was no rectal hard segment. There was no significant difference of above situations between the two groups ( P>0.05). Conclusion:The modified RPH-4 combined with Xiaozhiling injection for grade Ⅲ hemorrhoids can achieve double solid and hemorrhoidal removal efficacy, which can further reduce the risk of complications after severe hemorrhoids modified RPH-4 alone treatment.

Objective:To investigate the clinical effects of modified automatic hemorrhoidal ligation using elastic string (RPH-4) combined with Xiaozhilling injection for grade Ⅲ hemorrhoids.Methods:The prospective randomized controlled study was conducted. The clinical data of patients with grade Ⅲ hemorrhoids who underwent modified RPH-4 combined with Xiaozhiling injection in Traditional Chinese Medicine Hospital of Chongqing Shapingba District from July 2021 to December 2022 were selected. Patients with grade Ⅲ hemorrhoids who meeting the inclusion criteria were randomly divided into the experimental group and the control group using a random number table method. Patients in the experiment group underwent submucosal injection of the Xiaozhilling injec-tion followed by modified RPH-4, and patients in the control group underwent submucosal injection of the 0.9% sodium chloride solution followed by modified RPH-4. Observation indicators: (1) grouping of enrolled patients; (2) postoperative situations; (3) short-term efficacy; (4) long-term efficacy. Com-parison of measurement data with normal distribution between groups was conducted using the inde-pendent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the nonparameter test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Grouping of enrolled patients. A total of 120 patients were selected. There were 72 males and 48 females, aged 48(range, 18-69)years, including 60 cases in the experiment group and 60 cases in the control group, respectively. There was no significant difference in gender, age, type of hemorrhoids, time to hemorrhoid prolapsis, stool blood, symptom score and Wexner score between the two groups ( P>0.05), confounding bias ensured comparability. At the end of the study, there were 59 cases in the experimental group and 58 cases in the control group. (2) Postoperative situations. There were 5 cases of secondary bleeding after modified RPH-4 in the experiment group and 15 cases of secondary bleeding after modified RPH-4 in the control group, showing a significant difference between the two groups ( χ2=6.239, P<0.05). The post-operative hemorrhoidal shedding time was (6.9±1.4)days in the experiment group, versus (8.1±2.2)days in the control group, showing a significant difference between the two groups ( t=-3.566, P<0.05). (3) Short-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing short-term follow-up. The cure rate was 88.14%(52/59) in the experiment group, versus 84.48%(49/58) in the control group, showing no significant difference in short-term efficacy between the two groups ( χ2=0.331, P>0.05). The wound healing time was (24±5)days in the experi-ment group, versus (25±5)days in the control group, showing no significant difference between the two groups ( t=-1.082, P>0.05). (4) Long-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing long-term follow-up. None of patient in the two groups had anal incontinence. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of rectal hard segment in the experiment group were 2 and 1, respectively, and there was no anorectal stenosis. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of anorectal stenosis were 8 and 1, respectively, and there was no rectal hard segment. There was no significant difference of above situations between the two groups ( P>0.05). Conclusion:The modified RPH-4 combined with Xiaozhiling injection for grade Ⅲ hemorrhoids can achieve double solid and hemorrhoidal removal efficacy, which can further reduce the risk of complications after severe hemorrhoids modified RPH-4 alone treatment.