Objective:To elucidate the correlation between phase angle and malnutrition and to determine the cut-off value for phase angle to predict malnutrition in pancreatic cancer patients.Methods:This prospective cross-sectional study enrolled patients with pancreatic cancer hospitalized in the Department of Hepato-pancreato biliary Surgery at Beijing Hospital between December 2021 and March 2024. Baseline data, diet survey results, and body composition of these patients were recorded. Phase angle was measured with the InBody 720(Biospace, Korea). The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose malnutrition.Results:A total of 110 cases (75 males and 35 females) aged 29-87(63.00±12.37) years were included. The prevalence of malnutrition was 63.6% (70/111) among the patients. Patients were divided into malnutrition ( n=77) and non-malnutrition ( n=33) groups as per the GLIM criteria. Phase angle was significantly lower in the malnutrition group than in the non-malnutrition group ( t=-3.808, P<0.001). Positive correlations were found between phase angle and body mass index, appendicular skeletal muscle mass index, fat-free mass index , fat-free mass, total energy intake, total protein, albumin, and prealbumin (all P<0.05).After adjusting for sex and age, low phase Angle remained an independent risk factor for malnutrition ( OR=3.809, 95% CI: 1.150-12.612, P=0.029). The cut-off values of phase angle for predicting malnutrition were 4.43 for males (with a sensitivity of 0.955, specificity of 0.585, area under the curve of 0.636; 95% CI: 0.508-0.763, P=0.037) and 4.54 for females (with a sensitivity of 1.000, specificity of 0.708, area under the curve of 0.799; 95% CI: 0.653-0.946, P<0.001). Conclusion:Phase angle may serve as a valid and simple indicator of malnutrition in pancreatic cancer patients.

Objective:To elucidate the correlation between phase angle and malnutrition and to determine the cut-off value for phase angle to predict malnutrition in pancreatic cancer patients.Methods:This prospective cross-sectional study enrolled patients with pancreatic cancer hospitalized in the Department of Hepato-pancreato biliary Surgery at Beijing Hospital between December 2021 and March 2024. Baseline data, diet survey results, and body composition of these patients were recorded. Phase angle was measured with the InBody 720(Biospace, Korea). The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose malnutrition.Results:A total of 110 cases (75 males and 35 females) aged 29-87(63.00±12.37) years were included. The prevalence of malnutrition was 63.6% (70/111) among the patients. Patients were divided into malnutrition ( n=77) and non-malnutrition ( n=33) groups as per the GLIM criteria. Phase angle was significantly lower in the malnutrition group than in the non-malnutrition group ( t=-3.808, P<0.001). Positive correlations were found between phase angle and body mass index, appendicular skeletal muscle mass index, fat-free mass index , fat-free mass, total energy intake, total protein, albumin, and prealbumin (all P<0.05).After adjusting for sex and age, low phase Angle remained an independent risk factor for malnutrition ( OR=3.809, 95% CI: 1.150-12.612, P=0.029). The cut-off values of phase angle for predicting malnutrition were 4.43 for males (with a sensitivity of 0.955, specificity of 0.585, area under the curve of 0.636; 95% CI: 0.508-0.763, P=0.037) and 4.54 for females (with a sensitivity of 1.000, specificity of 0.708, area under the curve of 0.799; 95% CI: 0.653-0.946, P<0.001). Conclusion:Phase angle may serve as a valid and simple indicator of malnutrition in pancreatic cancer patients.

Objective:To analyze the effect of acidic or alkaline diluents of the direct dilution method on the results of multiple elements measurement in whole blood by inductively coupled plasma mass spectrometry (ICP-MS) and to explore the possibility whether the two diluents can be substituted for each other in elemental measurement results.Methods:A total of 162 human whole blood samples collected from the National Human Biomonitoring Programme in August 2018 were used for dilution with different diluents followed by centrifugation, then the supernatants of the samples were measured by ICP-MS. The methodological characteristics of the two pre-treatment methods including acidic diluent (0.1% nitric acid+0.01% tralatone solution) and alkaline diluent (0.05% n-butanol+0.01% tralatone+1% ammonium hydroxide solution) were evaluated separately. Spearman correlation coefficient analysis was used for the correlation of 19 elements results in whole blood measured by 2 diluents, then, Passing-Bablok linear regression and Bland-Altman plots were used to evaluate the consistency of the 19 elements results in 162 whole blood samples between the two diluents.Results:The methodological data of 19 elements using the two diluents were good, with the limits of quantification (LOQ) of the 19 elements were 0.1-15.8 μg/L for acidic diluents and 0.3-19.2 μg/L for alkaline diluents, and the linear correlation coefficients of the standard curves of the 19 elements using the acidic and alkaline diluents were all≥0.995. Except for strontium, cadmium, tin, and thallium, the recovery percents of the 19 elements were all in the range of 80%-120%, and for all elements the total coefficients of variation of within-and between-run in the acidic and alkaline diluents were 0.5%-12.4%. The correlation coefficients of the two diluents for the measured values of chromium, manganese, cobalt, zinc, copper, arsenic, selenium, strontium, molybdenum, silver, cadmium, antimony, barium, mercury, and lead were relatively strong ( R2>0.8), while the correlation coefficients of vanadium, nickel, tin, and thallium were relatively weak ( R2<0.8). For the vanadium, cadmium, tin, barium, and mercury, 95% confidence intervals of slopes were<1. The 95% confidence intervals of intercepts of chromium, nickel, arsenic, silver, barium, and mercury contain point 0. The Bland-Altman plot showed that vanadium, chromium, arsenic, strontium, silver, cadmium, tin, and mercury have good consistency in using acidic and alkaline diluents. Conclusion:The results of the mean values measured with the 2 diluents differed among different elements and could not be completely substituted.

Objective:To improve the skin toxicity management model of tumor targeted drugs based on evidence-based practice method and apply it to clinical practice.Methods:Using the evidence-based practice method of Joanna Briggs Institute, evidence of skin toxicity management of tumor targeted drugs was formed by searching relevant guidelines and evidence-based medical literature at home and abroad, and conducting interviews and surveys with nurses and patients. Based on the evidence and in consultation with evidence-based medicine, nursing and clinical experts, the evidence was transformed into management improvement plans, and the skin toxicity checklist and care checklist were developed. The improvement scheme was applied to clinical practice, the training of nurses was strengthened, the nursing process was standardized and improved, and various forms of health education were provided to patients. Patients with skin toxicity who received targeted drug therapy in the Department of Oncology of Anhui Cancer Hospital from May to August 2023 were collected. Implementation of various management indicators by nurses before and after management improvement were compared. The occurrence and severity of skin toxicity in patients were compared to verify the effect of the improvement.Results:A total of 35 tumor patients with skin toxicity to targeted drugs were entered, including 26 males and 9 females, with age (60±10) years. Compared with before, the implementation rate of the 5 indicators after the management improvement, including the evaluation of skin toxicity and risk factors by nurses using the common terminology criteria for adverse events version 5.0, the qualified status of related nursing documents, the health education of skin care, and regular follow-up of patients, were significantly increased (from 0-31.4% up to 80%-100%), the differences were statistically significant (all P<0.05). After improvement, the incidence and severity of skin rash, skin dryness, skin reaction of hands and feet, and paronychia were significantly reduced, the score of skin care knowledge questionnaire was significantly increased [6.00(5.00, 8.00) vs. 8.00(7.00, 9.00), P=0.002], and the dermatology life quality index was significantly decreased [8.00(6.00, 9.00) vs. 6.00(5.00, 8.00), P=0.033]. The differences in anxiety and depression scores were not statistically significant (both P>0.05). Conclusion:The skin toxicity management of targeted drugs based on JBI evidence-based practice method can standardize the clinical nursing practice of nurses, improve the severity of skin toxicity in tumor patients, and improve their quality of life.

Objective:To improve the skin toxicity management model of tumor targeted drugs based on evidence-based practice method and apply it to clinical practice.Methods:Using the evidence-based practice method of Joanna Briggs Institute, evidence of skin toxicity management of tumor targeted drugs was formed by searching relevant guidelines and evidence-based medical literature at home and abroad, and conducting interviews and surveys with nurses and patients. Based on the evidence and in consultation with evidence-based medicine, nursing and clinical experts, the evidence was transformed into management improvement plans, and the skin toxicity checklist and care checklist were developed. The improvement scheme was applied to clinical practice, the training of nurses was strengthened, the nursing process was standardized and improved, and various forms of health education were provided to patients. Patients with skin toxicity who received targeted drug therapy in the Department of Oncology of Anhui Cancer Hospital from May to August 2023 were collected. Implementation of various management indicators by nurses before and after management improvement were compared. The occurrence and severity of skin toxicity in patients were compared to verify the effect of the improvement.Results:A total of 35 tumor patients with skin toxicity to targeted drugs were entered, including 26 males and 9 females, with age (60±10) years. Compared with before, the implementation rate of the 5 indicators after the management improvement, including the evaluation of skin toxicity and risk factors by nurses using the common terminology criteria for adverse events version 5.0, the qualified status of related nursing documents, the health education of skin care, and regular follow-up of patients, were significantly increased (from 0-31.4% up to 80%-100%), the differences were statistically significant (all P<0.05). After improvement, the incidence and severity of skin rash, skin dryness, skin reaction of hands and feet, and paronychia were significantly reduced, the score of skin care knowledge questionnaire was significantly increased [6.00(5.00, 8.00) vs. 8.00(7.00, 9.00), P=0.002], and the dermatology life quality index was significantly decreased [8.00(6.00, 9.00) vs. 6.00(5.00, 8.00), P=0.033]. The differences in anxiety and depression scores were not statistically significant (both P>0.05). Conclusion:The skin toxicity management of targeted drugs based on JBI evidence-based practice method can standardize the clinical nursing practice of nurses, improve the severity of skin toxicity in tumor patients, and improve their quality of life.

Objective:To analyze the correlation between nutritional status and frailty and sarcopenia in geriatric inpatients (GIPs) planning to receive major hepatopancreatobiliary (HPB) surgery.Methods:From December, 2020 to September, 2022, GIPs who were planning to receive major HPB surgery were recruited. Nutritional assessment was performed using nutritional risk screening 2002 (NRS-2002) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty and sarcopenia assessment were performed using Fried frailty phenotype (FFP) and Asian Working Group for Sarcopenia (AWGS) 2019 consensus on sarcopenia diagnosis and treatment. The prevalence and concurrence of malnutrition, frailty and sarcopenia were investigated, and the correlation between nutritional status and frailty and sarcopenia was analyzed.Results:A total of 144 participants at the mean age of (70.10±7.44) years were included. The prevalence of nutritional risk, malnutrition, and severe malnutrition were 73.6% ( n ?=?106), 68.1% ( n ?=?98), and 34.7% ( n ?=?50) respectively. The prevalence of frailty was 20.8% ( n ?=?30) and that of sarcopenia was 35.4% ( n ?=?51). The prevalence of severe malnutrition increased significantly in older participants and the prevalence of nutritional risk, malnutrition and severe malnutrition decreased significantly with higher BMI. The prevalence was 35.4% (51/144) for concurrent sarcopenia and malnutrition, 19.4% (28/144) for frailty and malnutrition, 14.6% (21/144) for sarcopenia and weakness, and 14.6% (21/144) for sarcopenia, malnutrition, and weakness. There was a positive correlation between nutritional risk and frailty ( r = 0.603, P < 0.001). The risk of pre-frailty and frailty in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 31.830, P < 0.001). The risk of pre-frailty and frailty in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 36.727, P < 0.001). Logistic regression analysis showed that the risk of frailty in patients with severe malnutrition was 12.303 times higher than that in patients with normal nutrition status (95% CI: 2.592 to 58.409, P = 0.002). The risk of sarcopenia in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 13.982, P < 0.001). The risk of sarcopenia in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 37.066, P < 0.001). Conclusions:The prevalence and concurrence rate of malnutrition, frailty, and sarcopenia are high in GIPs undergoing major HPB surgery. GIPs with malnutrition are susceptible to frailty.

Medical disputes caused by suspected AIDS infection via blood transfusion are characterized by high sensitivity, involvement of many persons, great difficulty in carrying out investigation and obtaining evidence, and demand for a large compensation. The key to handling this kind of medical dispute lies in clarifying whether there is a causal relationship between the blood transfusion and the AIDS infection, whether there have been illegal activities in the process of blood collection and transfusion, and whether there is a causal relationship between such activities and the AIDS infection. In addition, the partys right of privacy should be protected. Measures of prevention include: handling without gloves activities of illegal blood supply and collection and the arrangement for other people selling their blood; strictly assessing and consolidating the blood centers; blood centers and hospitals jointly preventing the spread of AIDS via blood transfusion; taking proper care of the raw data of blood supply and collection; and speeding up the establishment of an insurance system for blood transfusion and the implementation of the States plans for AIDS prevention and treatment.