Objective To investigate the sleep disorders and its effects on the changes in quality of life in patients with liver cancer from the hospital admission to 6 months after surgery and to analyse the correlation between the sleep disorder and quality of life.Methods A total of 214 patients who underwent surgery for liver cancer for the first time were included in the study.Demographic questionnaire,Pittsburgh sleep quality index(PSQI),and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)were used for the investigation at admission and at 1,3 and 6 months after surgery.Multiple linear regression was employed to analyse the correlation between the sleep disorders at the admission and its effect on quality of life up to 6 months after surgery.Results Toally 214 patients finished the study at admission and 209 finished the study 1 month after surgery,and 208 finished the stuoly 3 months after surgery,and 205 patients finished the study 6 months after surgery.The scores of both of PSQI at admission and the quality of life at 6 months after surgery varied across the tested time points with a statistically significant difference(both P<0.001).The overall level of sleep disorder in the patients showed a characteristic pattern with initially increasing and then decreasing,and the quality of life presented a characteristic tendency of starting from high to low and then gradually increasing.It showed that the sleep disorder at admission was attributive to the poorer quality of life at 6 months after surgery.The hierarchical regression analysis showed that among the patients at BCLC Stage A,sleep disorder at admission was the influencing factor of the quality of life at 6 months after surgery.Conclusions The sleep disorder and quality of life in the patients who had surgical operations for hepatocellular carcinoma both changed dynamically from admission to the 6 months after surgery.The quality of life was poor in the patients with sleep disorder at admission.Therefore,medical staff should enhance the sleep management at admission,conduct dynamic assessment of the sleep disorder and quality of life of the patients,and then develop continuity nursing measures to improve the quality of life after surgery.

Cancer patients generally suffer from depression,and long-term depression may exacerbate fatigue,sleep disor-ders,pain,and psychological distress,affecting the overall treatment effectiveness of cancer patients and ultimately impacting their quality of life and prognosis.Therefore,this article mainly reviews the research status and influencing factors of depression trajectories in cancer patients,providing reference for precise and personalized depression management for cancer patients.

Objective:To summarize the best evidence of rehabilitation exercise in patients with lumbar spinal stenosis surgery.Methods:The evidence-based questions were established based on PIPOST's principles, and Wanfang data, China National Knowledge Infrastructure, China Biology Medicine disc, UpToDate, PubMed, Embase, Web of Science, American Medical Association, Orthopedic Branch of Chinese Medical Doctor Association and other databases and websites were searched by computer. The search period was from the establishment of the databases to October 31, 2022. Two researchers conducted quality evaluation, evidence extraction, and summarization of the included literature.Results:A total of 10 articles were included, including six expert consensus articles, three systematic review articles, and one meta-analysis article. A total of 16 pieces of evidence were summarized from nine aspects of rehabilitation exercise evaluation, principles, timing, methods, health education, psychotherapy, pain management, evaluation and post discharge follow-up.Conclusions:This study summarizes the best evidence for rehabilitation exercise in patients with lumbar spinal stenosis after surgery, and it suggests that healthcare professionals apply evidence based on clinical context and patient willingness.

Objective:To explore the clinical effects of the best evidence-based practice plan for rehabilitation exercises in patients undergoing surgery for lumbar spinal stenosis (LSS) .Methods:Guided by the evidence-based practice model of the Joanna Briggs Institute (JBI) Center for Evidence-Based Healthcare in Australia, the best evidence was combined with the clinical context to develop quality review indicators for clinical practice. In December 2022, a baseline review was conducted with 30 patients undergoing surgery for LSS (before evidence application). From December 2022 to February 2023, the baseline review results were analyzed to identify facilitating and obstructive factors between the current status and the review indicators, and improvement strategies were implemented based on available resources. In February 2023, another 30 patients (after evidence application) were selected to evaluate the post-application effects. The Japanese Orthopedic Association (JOA) score, Oswestry Disability Index (ODI), Tampa Scale for Kinesiophobia (TSK) score, General Self-Efficacy Scale (GSES) score, and quality of life scores were compared between the two groups at 24 hours, 1 month, 3 months, and 6 months postoperatively. The execution rate of clinical quality review indicators and the knowledge scores on rehabilitation exercises of 25 nurses before and after training were also compared.Results:There were no statistically significant differences in JOA scores, ODI, TSK scores, GSES scores, and quality of life scores between the two groups at 24 hours postoperatively ( P > 0.05). However, there were statistically significant differences in these scores at 1, 3, and 6 months postoperatively ( P< 0.01). After evidence application, the execution rate of seven clinical quality review indicators improved, and the knowledge scores on rehabilitation exercises of the 25 nurses increased significantly ( P< 0.05) . Conclusions:The evidence-based practice for rehabilitation exercises in patients undergoing surgery for LSS is safe and feasible. It standardizes evidence-based nursing practice behavior, enhances nurses' knowledge levels, effectively improves postoperative lumbar function, promotes physical rehabilitation, and enhances the quality of life.

Objective:To explore the willingness to engage in geriatric nursing services of students in geriatric related majors in universities of Xinjiang Uygur Autonomous Region, China (Xinjiang for short) , and analyze its influencing factors, so as to provide a reference for cultivating the geriatric nursing service personnel in Xinjiang.Methods:From September 2019 to July 2020, 976 students in geriatric related majors (the nursing major and geriatric service and management major) from 2 universities, a medical university and a vocational university in Xinjiang, were selected as the research object. Students were investigated with the Students' Willingness to Engage in Geriatric Nursing Services Questionnaire, and 50 students were interviewed with the structured interview.Results:Among 976 university students in geriatric related majors, 606 (62.09%) were willing to engage in geriatric nursing services. Logistic regression analysis showed that attitudes towards the aged, registered residence, experience of caring for the aged, living with the aged, attention to geriatric nursing information, and views on the prospects of geriatric nursing services were the influencing factors of students' willingness to engage in geriatric nursing services with a statistical difference ( P<0.05) . The results of grey relation analysis showed that the driving strength of the influencing factors of the willingness to engage in geriatric nursing services of students in geriatric related majors from strong to weak was views on the prospects of geriatric nursing services (the relation index was 0.944) and attitudes toward the aged (the relation index was 0.828) , experience of caring for the aged (the relation index was 0.763) , attention to geriatric nursing information (the relation index was 0.658) , living with the aged (the relation index was 0.600) and the registered residence (the relation index was 0.563) . Conclusions:The most critical influencing factor for students in geriatric related majors in Xinjiang universities to engage in geriatric nursing services is their views on the prospects of geriatric nursing services and their attitudes towards the aged. Universities should further strengthen the discipline construction and curriculum reforms of geriatric related majors, pay attention to the education of career prospects, cultivate a positive attitude towards the aged, and increase the willingness of students to engage in geriatric nursing services.

Objective:To evaluate whether dialysis modality will affect cognitive function in dialysis population.Methods:This was a cross-sectional study. Chronic dialysis patients in our center was screened from July 2013 to July 2014. All of the subjects received brain magnetic resonance imaging (MRI) examination and comprehensive cognitive function evaluation.Results:A total of 189 chronic dialysis patients were enrolled in this study, 122 cases on hemodialysis (HD) and 67 cases on peritoneal dialysis (PD). There was no significant difference in age between HD and PD groups [(56.4±13.2) years vs (56.4±16.1) years, t=0.004, P=0.997]. The dialysis vintage and serum albumin of HD patients was higher than those of PD patients[58.0(16.8, 107.5) months vs 31.0(7.0, 67.0) months, Z=-3.490, P<0.001; (39.6±3.9) g/L vs (35.3±3.8) g/L, t=7.328, P<0.001, respectively]. The prevalence of cerebral small vessel diseases (CSVDs) was comparable between HD and PD groups (all P>0.05). Compared with HD patients, PD patients presented a 11.90-fold risk of immediate memory impairment (95% CI 1.40-101.08, P=0.023) and a 6.18-fold risk of long-delayed memory impairment (95% CI 2.12-18.05, P=0.001). After adjusting for age, educational lever, dialysis vintage, serum creatinine, and CSVDs, the influence of dialysis modality on memory still worked. PD patients presented a 43% risk of executive function impairment of HD patients ( OR=0.43, 95% CI 0.17-1.04, P=0.061). Conclusions:HD patients manifested better memory than PD patients, while PD probably performed better in executive function than HD patients. There was no significant difference in language function between the two groups. The difference in cognitive function may not be related to CSVDs.

Objective The objective of this study was to investigate the effect of depression on serum levels of C-reactive protein(CRP)and high-sensitivity C-reactive protein(hs-CRP),and prognosis in liver cancer patients. Methods A total of 251 patients with liver cancer undergoing hepatectomy were enrolled. The hospital anxiety and depression scale( HADS-D) and 9-item patients health questionnaire(PHQ9) were assessed for depression before 3 days for surgery. Patients were divided into depression group(n=95)and non-depression group(n=156) according to the scores. Preoperative serum levels of CRP,hs-CRP,ALT and AST were measured and compared between the depression and non-depression groups. Survival analysis Kaplan-Meier method was used to compare the disease-free survival(DFS)and total survival(OS)between the two groups. Results The serum levels of CRP, hs-CRP,ALT and AST in the depression group were significantly higher than those in the non-depression group(P<0. 05). The follow-up of 3. 5-year showed that 164 patients(65 in depression group and 99 in non-depression group)had recurrence or metas-tasis and 47 patients(22 in depression group and 25 in non-depression group) died. The DFS and OS in the depression group were significantly lower than those in the non-depression group(P< 0. 05). Cox multiple regression analysis showed that liver function grading,BCLC staging and depression were independent risk factors for the prognosis of liver cancer. Spearman correlation analysis showed that patients′degree of depression was positively correlated with serum levels of CRP and hs-CRP(P<0. 05),DFS and OS were negatively correlated with serum levels of CRP and hs-CRP(P<0. 05). Conclusion Depression may mediate elevated serum levels of CRP and hs-CRP,maintain inflammatory response in patients,lead to increased liver function damage,elevate levels of ALT and AST,and thus adversely affect the prognosis of patients with liver cancer.

Objective To analyze the risk factors of postoperative recurrence and metastasis of of BCLC stage A (BCLC-A) hepatocellular carcinoma (HCC).Methods Data of 210 cases of liver resection for HCC were retrospectively analyzed from Nov 2013 to June 2016.Multivariate logistic regression analysis was used to analyze the risk factors for postoperative recurrence.The cumulative survival rates were calculated using the Kaplan-Meier method and the diffrences of the related factors between various groups were analyzed by Log-rank test.Results Univariate analysis showed that alpha-fetoprotein (AFP),neutrophil-lymphocyte ratio (NLR),hepatitis B virus surface antigen (HBsAg) positive and intraoperative transfusion were associated with early recurrence and metastasis after hepatectomy (P ＜ 0.05).Multivariate analysis showed that AFP ＞ 400 ng/ml is an independent risk factor for early postoperative recurrence and metastasis (P =0.008).HBV DNA positive can affect the disease-free survival rate after HCC resection (P =0.030).Conclusion AFP is an independent risk factor for early postoperative recurrence and metastasis.Preoperative HBV DNA positive significantly decreases the disease-free survival rate in HCC patients.

Objective? To explore the effects of short-term structural psychological education on depression and immunity in patients with Barcelona clinic liver cancer B or C stage (BCLC-B/C) hepatocellular carcinoma. Methods? Totally 210 patients with BCLC-B/C hepatocellular carcinoma who were admitted in the Department of Hepatological Surgery, Guangxi Medical University Affiliated Tumor Hospital from June 2016 to March 2018 were selected by convenient sampling and divided into the non-depression group (n=79) and the depression group (n=131) according to Hospital Anxiety and Depression Scale-Depression (HADS-D) and Patient Health Questionnaire (PHQ-9). Patients in the depression group were randomly divided into the intervention group (n=66) and the control group (n=65). Patients in the non-depression group and the depression-control group received conventional nursing care, while patients in the depression-intervention group received short-term structural psychological education on the basis of conventional nursing care. HADS-D, PHQ-9 and cytoimmunity indexes were used to evaluate the effects of intervention. Results? The HADS-D and PHQ-9 scores of the depression-intervention group were lower than those of the control group on day 30 postoperatively(P＜0.01). The CD3+, CD3+CD4+, CD3+CD4+/CD3+CD8+ levels of the depression-intervention group were higher than those of the depression-control group on day 30 postoperatively (P＜0.05). Conclusions? Short-term structural psychological education can effectively improve the depression and immunity in patients with BCLC-B/C,which is worth promoting in clinical practice.

Objective To evaluate the prognostic significance of preoperative serum gamma glutamyl transpeptidase (GGT) level in patients with hepatocellular carcinoma (HCC) after liver resection.Methods A total of 432 patients undergoing hepatectomy for HCC were divided into normal GGT group (175 patients with GGT ≤ 50 U/L) and high GGT group (257 patients with GGT ＞ 50 U/L).After balancing baseline characteristics by propensity score analysis,disease-free survival (DFS) and overall survival (OS) were compared between the two groups.Independent risk factors influencing DFS and OS were identified by Cox multivariate analyses.Results Propensity score analysis identified 124 matched pairs of patients from each group.In the propensity-matched cohort,DFS at 1,3,and 5 years in normal GGT group (69.3％,36.1％,12.8％) was significantly higher than that in high GGT group (60.6％,18.7％,7.5％;P=0.039).OSat1,3,and5 years innommlGGTgroup (90.7％,73.7％,66.1％) was also significantly higher than that in high GGT group (89.2％,63.6％,43.3％;P =0.024).COX multivariate analyses revealed that alpha-fetoprotein ≥400 ng/ml,GGT ＞ 50 U/L,macrovascular invasion,tumor size ≥ 10 cm,and tumor number ≥3 were independent risk factors for DFS in patients with HCC after liver resection.Albumin ＜ 35 g/L,GGT ＞ 50 U/L,macrovascular invasion,tumor size ≥ 10 cm,and tumor number ≥ 3 were identified as independent risk factors for OS.Conclusions Preoperative serum GGT level is an independent factor predicting tumor recurrence and long-term survival in HCC patients after liver resection.