Guided by the concept of holism in traditional Chinese medicine （TCM）， it is believed that spinal vertebral disorders can affect the knee joint through meridians， physical forms， the relationship among tendons， bones， qi， and blood， as well as liver-kidney zang-fu （脏腑） functions， thereby triggering knee pain. In clinical practice， for conditions such as knee joint pain with poor local therapeutic effects or unexplained knee joint pain， it is recommended to start with an examination of the spine for lesions. By adopting the spine-adjusting and knee-benefiting method， through techniques of loosening and tightening acupoints， bone setting and curve adjustment， strengthening tendons and bones， and consolidating and protecting the liver and kidneys， the spine can be restored to its normal physiological state， achieving the goal of distal tendon-bone balance， harmonization of qi and blood， and the spontaneous disappearance of knee joint pain.

Objective:To conduct an integrative review of follow-up practices in post-bariatric surgery patients, clarify current follow-up strategies and influencing factors, and provide references for clinical practice and future research.Methods:An integrative review approach was employed. Systematic searches were conducted in PubMed, Web of Science, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang, and VIP for studies related to post-bariatric surgery follow-up. The search period extended up to December 1, 2024. Data extraction and synthesis were performed by two independent researchers.Results:A total of 30 studies were included, comprising 12 non-randomized quantitative studies, 11 descriptive quantitative studies, three randomized controlled trials, three qualitative studies, and one mixed-method study. Among them, 15 studies explored factors contributing to loss to follow-up, which were mainly categorized into subjective psychological factors, objective barriers, demographic characteristics, and medical-related factors. A total of 12 studies evaluated the effectiveness of various follow-up strategies, showing that telemedicine and IoT-based remote follow-up models could improve patient adherence and reduce the risk of postoperative complications. Additionally, multidisciplinary collaborative models demonstrated superior outcomes in increasing follow-up rates, lowering complication rates, and improving excess weight loss compared to traditional management approaches. The use of financial incentives exhibited short-term effectiveness, with quantitative studies indicating sustained adherence for up to six months; however, qualitative studies suggested that while patients acknowledged financial incentives as a supportive measure, they perceived their impact on long-term motivation to be limited. Furthermore, routine monitoring, continuity of care led by dedicated personnel, and efficient team communication were identified as effective strategies to enhance follow-up adherence and postoperative management.Conclusions:Multiple factors influence follow-up adherence in post-bariatric surgery patients. Technology-driven remote follow-up and personalized support strategies have shown significant advantages in enhancing follow-up rates. Future efforts should focus on standardizing post-bariatric surgery follow-up protocols.

Objective:To conduct an integrative review of follow-up practices in post-bariatric surgery patients, clarify current follow-up strategies and influencing factors, and provide references for clinical practice and future research.Methods:An integrative review approach was employed. Systematic searches were conducted in PubMed, Web of Science, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang, and VIP for studies related to post-bariatric surgery follow-up. The search period extended up to December 1, 2024. Data extraction and synthesis were performed by two independent researchers.Results:A total of 30 studies were included, comprising 12 non-randomized quantitative studies, 11 descriptive quantitative studies, three randomized controlled trials, three qualitative studies, and one mixed-method study. Among them, 15 studies explored factors contributing to loss to follow-up, which were mainly categorized into subjective psychological factors, objective barriers, demographic characteristics, and medical-related factors. A total of 12 studies evaluated the effectiveness of various follow-up strategies, showing that telemedicine and IoT-based remote follow-up models could improve patient adherence and reduce the risk of postoperative complications. Additionally, multidisciplinary collaborative models demonstrated superior outcomes in increasing follow-up rates, lowering complication rates, and improving excess weight loss compared to traditional management approaches. The use of financial incentives exhibited short-term effectiveness, with quantitative studies indicating sustained adherence for up to six months; however, qualitative studies suggested that while patients acknowledged financial incentives as a supportive measure, they perceived their impact on long-term motivation to be limited. Furthermore, routine monitoring, continuity of care led by dedicated personnel, and efficient team communication were identified as effective strategies to enhance follow-up adherence and postoperative management.Conclusions:Multiple factors influence follow-up adherence in post-bariatric surgery patients. Technology-driven remote follow-up and personalized support strategies have shown significant advantages in enhancing follow-up rates. Future efforts should focus on standardizing post-bariatric surgery follow-up protocols.

OBJECTIVETo explore the risk factors associated with the prognosis in poorly differentiated(G3) advanced gastric cancer (AGC) and the effect of number of harvested lymph nodes on the prognosis.

METHODSClinical data of 484 patients with G3 advanced gastric cancer undergoing gastrectomy combined with lymphadenectomy in Zhongshan Hospital from December 2002 to October 2007 were retrospectively analyzed. The χ(2) test or Fisher's exact probability method was used to test measurement data. Survival was calculated using Kaplan-Meier method. Clinicopathological factors such as age, invasion depth, number of harvested lymph nodes, lymph node metastasis, ratio of metastatic lymph node, lymphatic vessels involvement were analyzed using the Cox regression model.

RESULTSNumber of lymph node dissected, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement were significantly affected by groups of 15 lymph node dissected in G3 AGC patients (P<0.05). Invasion depth, number of lymph node dissected, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement were significantly independent predictors of survival in G3 AGC patients (all P<0.05). Patients with at least 20 lymph nodes had a better survival rate than those with less than 20(P<0.01).

CONCLUSIONSInvasion depth, number of harvested lymph nodes, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement are important factors influencing the prognosis of G3 AGC. At least 20 lymph nodes should be recommended to ensure the quality of lymphadenectomy for gastric cancer.

Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; pathology ; surgery ; Survival Rate

Objective To investigate the relationship between various clinicopatholngic factors and prognosis of early gastric cancer. Methods The clinical data of 459 patients with early gastric cancer who had undergone gastrectomy combined with extended (D2) lymphadenectomy at Zhongshan Hospital from January 2002 to October 2007 were retrospectively analyzed. Survival was calculated using the Kaplan-Meier method, and clinicopathologic factors such as age, sex, tumor size, gross morphology, tumor differentiation, depth of invasion, lymphatic vessels involvement and lymph node metastasis were analyzed using the Cox regression model. Univariate analysis was done by Log-rank test. Results Univariate analysis demonstrated that tumor size and differentiation, depth of invasion, lymphatic vessels involvement and lymph node metastasis significantly affected survival in patients with early gastric cancer (χ~2 = 8.476, 6.210, 4.014, 14. 197, 55.027, P < 0.05). The status of lymph node metastasis was an independent predictor of survival in patients with early gastric cancer, and the more metastatic lymph nodes detected, the greater the influence on the prognosis. Conclusions Lymph node metastasis is the most important factor influencing the prognosis of early gastric cancer. Appropriate lymph node dissection is necessary, especially for patients with risk factors associated with lymph node metastasis.