Objective:To systematically evaluate the transitional care experience of family caregivers in palliative care from hospital to home.Methods:A computer-based search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP, and Wanfang Data for qualitative studies on the transitional care experience of family caregivers in palliative care, from database inception to November 25, 2024. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (2016 edition). Data were synthesized and integrated using meta-aggregation.Results:A total of 10 studies were included, from which 33 primary findings were extracted. These findings were classified into nine new categories and further synthesized into four overarching themes: development and exacerbation of physical and psychological distress during the transition, multiple challenges and dilemmas during the transition, multidimensional support needs during the transition, and positive coping and personal growth.Conclusions:Family caregivers in palliative care experience complex physical and psychological changes, multiple challenges, and diverse care needs during the hospital-to-home transition. Healthcare professionals should pay close attention to the lived experiences and actual needs of family caregivers during this period, so as to facilitate a successful transition from hospital to home.

Objective:To systematically evaluate the transitional care experience of family caregivers in palliative care from hospital to home.Methods:A computer-based search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP, and Wanfang Data for qualitative studies on the transitional care experience of family caregivers in palliative care, from database inception to November 25, 2024. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (2016 edition). Data were synthesized and integrated using meta-aggregation.Results:A total of 10 studies were included, from which 33 primary findings were extracted. These findings were classified into nine new categories and further synthesized into four overarching themes: development and exacerbation of physical and psychological distress during the transition, multiple challenges and dilemmas during the transition, multidimensional support needs during the transition, and positive coping and personal growth.Conclusions:Family caregivers in palliative care experience complex physical and psychological changes, multiple challenges, and diverse care needs during the hospital-to-home transition. Healthcare professionals should pay close attention to the lived experiences and actual needs of family caregivers during this period, so as to facilitate a successful transition from hospital to home.

Objective:To describe the application methods, types, and effects of wearable devices in sarcopenia.Methods:Following the guidelines for scoping reviews, a systematic search was conducted in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data, and VIP for literature related to wearable device applications in sarcopenia. The search period covered publications from database inception to August 1, 2024.Results:A total of 12 studies were included. Wearable devices in sarcopenia were primarily used for monitoring gait speed, surface electromyography, sleep duration, activity time, and supporting exercise interventions. Common types of wearable devices included activity trackers, smart belts, and smart wristbands. Their effectiveness, feasibility, and role in ensuring activity safety have been preliminarily demonstrated.Conclusions:The application of wearable devices in sarcopenia is still in its early stages but shows great potential. Currently, wearable devices are mainly used to monitor one or a few individual indicators. Future research should focus on developing multi-parameter monitoring devices and conducting large-scale, high-quality trials to validate their effectiveness in both monitoring and supporting exercise interventions. This will help promote their broader application and assist healthcare professionals in the early identification, diagnosis, prevention, and treatment of sarcopenia.

Objective:To describe the application methods, types, and effects of wearable devices in sarcopenia.Methods:Following the guidelines for scoping reviews, a systematic search was conducted in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data, and VIP for literature related to wearable device applications in sarcopenia. The search period covered publications from database inception to August 1, 2024.Results:A total of 12 studies were included. Wearable devices in sarcopenia were primarily used for monitoring gait speed, surface electromyography, sleep duration, activity time, and supporting exercise interventions. Common types of wearable devices included activity trackers, smart belts, and smart wristbands. Their effectiveness, feasibility, and role in ensuring activity safety have been preliminarily demonstrated.Conclusions:The application of wearable devices in sarcopenia is still in its early stages but shows great potential. Currently, wearable devices are mainly used to monitor one or a few individual indicators. Future research should focus on developing multi-parameter monitoring devices and conducting large-scale, high-quality trials to validate their effectiveness in both monitoring and supporting exercise interventions. This will help promote their broader application and assist healthcare professionals in the early identification, diagnosis, prevention, and treatment of sarcopenia.

Objective:To gain a deeper understanding of the comorbidity status of elderly patients with coronary heart disease and the effect of comorbidity on their hospitalization costs.Methods:Using the convenient sampling method, a total of 8 334 elderly hospitalized patients diagnosed with coronary heart disease in Beijing Hospital from January 2018 to December 2021 were selected as the research objects. General Inforamtion Questionnaire and Charson comorbidity index (CCI) were used to investigate the comorbidity of patients.Results:Among the 8 334 elderly patients with coronary heart disease included, 88.18% (7 349/8 334) had comorbidity, and there was a statistically significant difference in hospital costs among patients with different CCI scores ( P<0.01). Elderly patients with coronary heart disease with comorbidity had higher hospital costs. The results of the binomial logistic regression analysis showed that comorbidities increased the hospitalization costs of elderly coronary heart disease patients in both the unadjusted model and the gradually adjusted model for age, gender, occupation, education level, admission department, admission status, admission year, admission mode length of stay and disease classification ( P<0.05) . Conclusions:The comorbidity in elderly patients with coronary heart disease is serious, which is an important factor affecting hospitalization costs. In medical practice, it is necessary to strengthen the comprehensive management of elderly patients with coronary heart disease, pay attention to the influencing factors of hospitalization costs, optimize prevention and treatment strategies, control the occurrence and progression of comorbidities among patients, deepen the reform of medical insurance payment methods such as grouping payments based on disease diagnosis, so as to accurately reduce hospitalization costs and promote the sustainable and healthy development of the medical and health system.

Objective:To analyze the characteristics and hot spots of hospital management projects funded by National Natural Science Foundation of China(NSFC), for the reference for furthering improving the modernization level of hospital management.Methods:The NSFC funded research projects in hospital management during 2010-2020 was searched. Project name, keywords, approval year, affiliation and other informations were obtained. CiteSpace was used for bibliometric analysis of these research projects, while all the data acquired were subject to descriptive analysis and frequency analysis.Results:The number of hospital management projects funded by NSFC increased from 4 in 2010(0.93 million yuan) to 32(9.94 million yuan) in 2020, totaling 192 projects and 72.76 million yuan. These numbers consisted of 90 general projects(46.9%) and 79(41.1%) youth fund projects respectively. All the funded projects were distributed in sub-disciplines under the NSFC first-level discipline of macro management and policy, namely health management and policy(154) and medical/drug management and policy(38). The hotspots of the funded projects covered performance evaluation, payment method, public health system, health economics, hierarchical diagnosis and treatment, utility theory, regional medical alliance, essential medicine system, capitation and incentive strategy, and so on.Conclusions:Recent years are witnessing a rising trend in the number and grants of NSFC projects on hospital management. More and more funds are granted to universities, especially young researchers, and a hospital management research system has been initially taken shape. Hospital management in China should take into full account of the management characteristics and the status quo of the medical and health field, focus on performance appraisal incentive mechanism, hierarchical medical system, construction of medical alliances. and patient medical experience as well. In addition, the cooperation between hospitals and universities should be strengthened in order to promote the translation of research results.

Objective To explore the expression,correlation and clinical significance of mammalian target of rapamycin (mTOR) and vascular endothelial growth factor (VEGF) in gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods From October 1995 to December 2012,the paraffin tissue specimens of 114 pathological diagnosed GEP-NEN were collected.The expressions of mTOR and VEGF at protein level were detected with EnVision immunohistochemical staining method.Chi-square test was performed to compare the differences in the expressions of mTOR and VEGF among every clinicopathological factors of patients.Spearman's correlation analysis was used to find out the correlation between the expressions of mTOR and VEGF.Kaplan Meier method and Log-rank test were implemented for survival analysis.Results The overall positive expression rates of mTOR and VEGF in GEP-NEN tissues were 66.7％ (76/114) and 71.1％ (81/114),respectively.The expressions ofmTORand VEGF at protein level were not correlated with gender,age,functional status of tumor,location of tumor,grading and classification of tumor and distant metastasis (all P＞0.05).The co-expression rate of mTOR and VEGF in GEP-NEN tissues was 51.8％ (59/114).The expression of mTOR was positively correlated with the expression of VEGF at protein level (r=0.205,P=0.029).Among 82 followed-up patients,the mean survival time of patients with mTOR positive or negative expression was 8.3 and 7.9 years,and respectively,and there was no statistical significance (x2 =0.201,P=0.654).The mean survival time of patients with VEGF positive or negative expression was 9.6 and 5.9 years,respectively,and the difference was statistically significant (x2 =4.415,P=0.036).Among the patients with G1 grading tumor,classified as neuroendocrine tumor and without distant metastasis,the survival time of patients with positive VEGF expression was longer than that of patients with negative VEGF expression (11.8 years vs 7.3 years,x2 =5.349,P=0.021; 11.2 years vs 6.8 years,x2=6.375,P=0.012; 11.2 years vs 7.2 years,x2 =4.630,P=0.031).Conclusions mTOR and VEGF proteins are highly expressed in GEP-NEN with different location,grading and classification.The expression of them is positively correlated.The prognosis of GEP-NEN patients with positive VEGF expression is better.

Objective To explore the value of serum chromogranin A (CgA) in clinical diagnosis and efficacy evaluation of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods From January 2011 to December 2012,87 GEP-NEN patients were enrolled,which included 50 patients with lesions and 37 patients without lesions after surgery.Eighty-four healthy subjects were taken as control group.The serum CgA levels of all subjects were measured with enzyme linked immunosorbent assay.Nonparametric test,receiver operating characteristic curve and Cox regression univariate analysis were performed for analysis.Results The median of serum CgA level of GEP-NEN patients with lesions was 97μg/L,which was significantly higher than that of patients without lesions after surgery (42 μg/L,Z=3.451,P=0.001) and healthy control (47 μg/L,Z=3.149,P=0.002).The value of 95 μg/L was taken as diagnostic cut-off value for healthy controls,patients without lesions and patients with lesions,the sensitivity and specificity were 54.0％ and 90.1％,respectively.The median of serum CgA level of the patients with distant metastasis was 231 μg/L,which was higher than that of patients without distant metastasis (46 μg/L,Z=3.340,P=0.001).After treatment,the serum CgA levels of 12 patients with complete remission,partial remission or stable tumor decreased more than 20％ of baseline values.The serum CgA levels of five patients increased more than 20 ％ of baseline values and the tumors of them showed progress.Cox regression analysis showed that there was no correlation between CgA levels of patients with lesions and prognosis (r=1.000,P=0.252).Conclusion Neuroendocrine marker CgA has high diagnostic value in GEP-NEN,and can be used as an important biomarker in clinical diagnosis and efficacy evaluation of GEP-NEN.