Application of drug-coated balloon in coronary artery intervention： challenges and opportunities

在最近的十年，冠的心疾病(CHD ) 的结果显著地改善了，它能部分被归因于新奇的药(特别 statins 和 antiplatelet 药) 并且部分的使用到经皮的冠的干预(一种总线标准) 的进化。从经皮的 transluminal 冠的 angioplasty 到赤裸金属的 stent 然后到 drug-eluting stent，一种总线标准的每步对 interventional 心脏病专家，有吸引力大进步与 CHD 为病人被取得了。在过去几年里，为对待 CHD 的一些继承人设备出现了。无疑，药涂的汽球(DCB ) 被 2014 个转换字符指南在心肌的 revascularization 上推荐，是在他们之中的一颗照耀的星。DCB 包含与能由在汽球接触期间渗入进容器墙施加 antirestenotic 功效的一个 anti-proliferative 代理人涂的一个半顺从的 angioplasty 汽球。这评论讨论从这种新奇 interventional 技术的临床的试用的概念和优点，现出症状之前的潜的数据，新兴的临床的指示，和结果。尽管 DCB 在 in-stent 狭窄的治疗显示出真功效，它在 de novo 的使用冠的损害仍然在争论。因此，担心和 DCB 的未来方向也在这份报纸被盖住。

Combined thrombectomy and intracoronary administration of glycoprotein IIb/IIIa inhibitors improves myocardial reperfusion in patients undergoing primary percutaneous coronary intervention： a meta-analysis

BackgroundSuboptimal 心肌的灌注在有圣片断举起的病人是普通的经历主要经皮的冠的干预(PPCI ) 的心肌的梗塞(STEMI ) 。而且，它导致增加的梗塞尺寸和死亡率。我们执行了元分析评估渴望 thrombectomy 的角色(在)在心肌的灌注和临床的 outcomes.MethodsPubMed 的改进与 glycoprotein IIb/IIIa 禁止者( GPI )的 intracoronary 管理结合了， Embase ，科学的网，并且中央数据库被寻找因为调查的使随机化的控制试用( RCT )联合了在并且 intracoronary GPI 治疗对在独自一个。利息的结果是在心肌的梗塞的 thrombolysis 心肌的灌注等级( TMPG )，梗塞尺寸()由心脏的磁性的回声成像估计了，左室的喷射部分( LVEF )，主要不利心脏的事件(向)在短期( 1 个月)并且长期( 6-12 月)后续，并且在包含 923 个病人的医院 stay.ResultsEight 试用期间为复杂并发症放血被包括。与相比在独自一个，联合了在， intracoronary GPI 显著地增加了 TMPG 3 流动(RR：1.15， 95% CI：1.04 ～ 1.26 ) ，减少[吝啬的差别(MD ) ：-3.46,95% CI：-5.18 到 -1.73], 和改进 LVEF (MD：1.44， 95% CI：0.54 ～ 2.33 ) 。而且， GPI 使用减少了在长期的后续的向的风险(RR：0.60， 95% CI：0.37 ～ 0.98 ) 。在未成年者的发生的二个组之间没有重要差别，主要流血 complications.ConclusionsOur 调查结果显示出那与相比在独自一个，联合了在， intracoronary GPI 治疗导致了改进心肌的灌注，更好心脏的功能，并且没有向的幸存与经历 PPCI 的 STEMI 为病人在长期的后续受益。

Additional manual thrombus aspiration for ST-segment elevation myocardial infarction during percutaneous coronary intervention： an updated meta- analysis

BackgroundThe 临床的功效和在有圣片断举起的病人的附属血栓渴望(TA ) 的安全心肌的梗塞(STEMI ) 在经皮的冠的干预(一种总线标准) 期间仍然是 controversial.MethodsTwenty 五合格使随机化的控制试用被包括把血栓渴望(TA ) 的使用与一种总线标准作比较并且为 STEMI 一种总线标准唯一。主要端点是所有原因死亡和死亡。第二等的端点是主要不利心脏的事件(向)，周期性的梗塞( RI )，目标容器 revascularization ( TVR )， stent 血栓(圣)，灌注代理人标记和 stroke.ResultsTIMI 流动分级 3 并且 MBG 2-3 显著地与一种总线标准唯一的手臂相比在 TA 正一种总线标准手臂被增加[相对风险( RR )：1.05， 95% 信心间隔(CI ) ：1.02-1.09， P = 0.004 ] 并且(RR：1.68， 95% CI：1.40-2.00， P &#x0003c；0.001 ) 分别地。在在二个组之间的所有原因死亡，权标， TVR 和圣率没有重要差别。RI 率在有短期的后续持续时间的一种总线标准唯一的手臂比那在 TA 正一种总线标准手臂是更低的(RR：0.60， 95% CI：0.38-0.96， P = 0.03 ) ，但是在在中期或长期的后续时期上的 RI 发生没有重要差别(RR：1.00， 95% CI：0.77-1.29， P = 0.98 ) ，并且(RR：0.96， 95% CI：0.81-1.15， P = 0.69 ) 分别地。在 TA 正一种总线标准在中期或长期的后续时期和粗略的击率上处于粗略的击和击的率有统计上重要的差别(RR：1.60， 95% CI：1.08-2.38， P = 0.02 ) 并且(RR：1.43， 95% CI：1.03-1.98， P = 0.03 ) 分别地；这没在短期的后续时期期间在二只手臂之间被观察(RR：1.47， 95% CI：0.97-2.21， P = 0.07 ).ConclusionsRoutine 在 STEMI 病人的帮助 TA 的一种总线标准能改进心肌的灌注并且得到与临床的端点有关的有限好处，它可以与中风风险被联系。

Contrast induced nephropathy after percutaneous coronary intervention： risk factors and preventive strategy

分析风险因素和对比的临床的结果的目的在经皮的冠的干预(一种总线标准)以后与冠的动脉疾病( CAD )在病人导致了 nephropathy ( CIN )并且讨论它的 prevention.Methods 有在收到了一种总线标准的 729 个病人之中的 CIN 的 54 个病人回顾地被学习并且相关风险因素，心血管的事件和预防策略是 analyzed.Results CIN 强烈与过程前被联系长期的肾的失败，糖尿病 mellitus 和

Dual versus single antiplatelet therapy for patients with long-term oral anticoagulation undergoing coronary intervention： a systematic review and meta-analysis

这元分析的 ObjectiveThe 主要目的为在冠的 intervention.MethodsPubMed 以后拿 OAC 的病人是为在最佳的政体仍然是的冠的 intervention.BackgroundThe 以后拿口头的 anticoagulation ( OAC )的病人比较双对单个的 antiplatelet 治疗的功效和安全争论的， Embase 和 Cochrane 控制试用的中央收款机为病人 requ 包括三倍的治疗( TT )对 OAC 正单个 antiplatelet 治疗的数据被在找合格研究主要结果是主要不利心脏、脑血管的事件(MACCE ) 。安全结果是与 32,825 个病人一起的主要 bleeding.ResultsFourteen 研究被包括。在未来的研究之中，有 TT 的病人向主要流血的更高的风险有一个趋势[机会比率(或) ：1.56， 95% 信心间隔(CI ) ：0.98-2.49， P = 0.06 ] 并且所有原因死亡的显著地更高的风险(或；2.11， 95% CI：1.10-4.06 P = 0.02 ) 与 OAC 正 clopidogrel 相比。同时， TT 与 MACCE 的减少的风险被联系(或：0.63， 95% CI：051-0.77 P < 0.0001 ) ，所有原因死亡(或：0.45， 95% CI：0.20-0.97， P = 0.04 ) ，并且 stroke/transient ischemic 攻击(TIA )/peripheral 栓塞(PE )( 或：0.29， 95% CI：0.09-0.96， P = 0.04 ) 与在冠的干预以后要求 OAC 的 OAC 正 aspirin.ConclusionsFor 病人相比， OAC 正 clopidogrel 可以比 TT 带更临床的网利益，而 OAC 正阿司匹林应该是最后选择。更大尺寸的使随机化的控制试用被需要证实这些调查结果。

Pharmacological interventions targeting the microcirculation following traumatic spinal cord injury

Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury.

A scoping review of methodologies for applying artificial intelligence to physical activity interventions

Purpose This scoping review aimed to offer researchers and practitioners an understanding of artificial intelligence(AI)applications in physical activity(PA)interventions;introduce them to prevalent machine learning(ML),deep learning(DL),and reinforcement learning(RL)algorithms;and encourage the adoption of AI methodologies.Methods A scoping review was performed in PubMed,Web of Science,Cochrane Library,and EBSCO focusing on AI applications for promoting PA or predicting related behavioral or health outcomes.AI methodologies were summarized and categorized to identify synergies,patterns,and trends informing future research.Additionally,a concise primer on predominant AI methodologies within the realm of PA was provided to bolster understanding and broader application.Results The review included 24 studies that met the predetermined eligibility criteria.AI models were found effective in detecting significant patterns of PA behavior and associations between specific factors and intervention outcomes.Most studies comparing AI models to traditional statistical approaches reported higher prediction accuracy for AI models on test data.Comparisons of different AI models yielded mixed results,likely due to model performance being highly dependent on the dataset and task.An increasing trend of adopting state-of-the-art DL and RL models over standard ML was observed,addressing complex human–machine communication,behavior modification,and decision-making tasks.Six key areas for future AI adoption in PA interventions emerged:personalized PA interventions,real-time monitoring and adaptation,integration of multimodal data sources,evaluation of intervention effectiveness,expanding access to PA interventions,and predicting and preventing injuries.Conclusion The scoping review highlights the potential of AI methodologies for advancing PA interventions.As the field progresses,staying informed and exploring emerging AI-driven strategies is essential for achieving significant improvements in PA interventions and fostering overall well-being.

How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review

Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following concussion.Methods:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web of Science up to May 2022.Two reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)checklists.Additional information was sought my study authors where reporting was incomplete.Risk of bias(ROB)was assessed with the Cochrane ROB-2 Tool.RCTs examining non-pharmacological interventions following concussion.Results:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck cooling.Median scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified supervisor.Reporting completeness improved after TIDieR and CERT publication,but publication in highly cited journals and low ROB do not guarantee reporting completeness.

Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

Epidemic threshold influenced by non-pharmaceutical interventions in residential university environments

The control of highly contagious disease spreading in campuses is a critical challenge.In residential universities,students attend classes according to a curriculum schedule,and mainly pack into classrooms,dining halls and dorms.They move from one place to another.To simulate such environments,we propose an agent-based susceptible–infected–recovered model with time-varying heterogeneous contact networks.In close environments,maintaining physical distancing is the most widely recommended and encouraged non-pharmaceutical intervention.It can be easily realized by using larger classrooms,adopting staggered dining hours,decreasing the number of students per dorm and so on.Their real-world influence remains uncertain.With numerical simulations,we obtain epidemic thresholds.The effect of such countermeasures on reducing the number of disease cases is also quantitatively evaluated.

Impact of frailty on outcomes of elderly patients undergoing percutaneous coronary intervention: A systematic review and metaanalysis

BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.

Scale offers the possibility of identifying adherence to lifestyle interventions in patients with non-alcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD therapy.Zeng et al established a prediction system to evaluate adherence to lifestyle interventions in patients with NAFLD and choose optimal management.Here,we discuss the application scenarios of the scale and the areas warranting further attention,aiming to provide a possible reference for clinical recommend-ations.

Effect of cardiac rehabilitation care after coronary intervention on cardiac function recovery and negative mood in patients with myocardial infarction

BACKGROUND Cardiovascular disease,particularly myocardial infarction(MI)profound impact on patients'quality of life and places a substantial burden on the healthcare and economy systems.Developments in medical technology have led to the emer-gence of coronary intervention as an essential method for treating MI.AIM To assess the effects of cardiac rehabilitation care on cardiac function recovery and negative emotions in MI after coronary intervention.METHODS This study included a total of 180 patients with MI during the period from June 2022 to July 2023.Selected patients were divided into two groups:An observation group,which receiving cardiac rehabilitation care;a control group,which re-ceiving conventional care.By comparing multiple observation indicators such as cardiac function indicators,blood pressure,exercise tolerance,occurrence of adverse cardiac events,and negative emotion scores between the two groups of patients.All the data were analyzed and compared between two groups.RESULTS There were 44 males and 46 females in the observation group with an average age of 36.26±9.88 yr;there were 43 males and 47 females in the control group,with an average age of 40.87±10.5 yr.After receiving the appropriate postoperative nursing measures,the results of the observation group showed significant improvement in several indicators compared with the control group.Indicators of cardiac function,such as left ventricular end-diastolic internal diameter and left ventricular ejection fraction were significantly better in the observation group than in the control group(P<0.05).Exercise endurance assessment showed that the 6-minute walking test distance was significantly increased in the patients of the observation group(P<0.01).In addition,the incidence of adverse cardiac events was significantly lower in the observation group,and negative mood scores were significantly reduced(P<0.05).CONCLUSION Cardiac rehabilitation care after coronary intervention has a significant positive impact on functional recovery.This emphasizes the importance of cardiac rehabilitation care to improve patient recovery.

Non-pharmacological interventions for diabetic peripheral neuropathy:Are we winning the battle?

Despite the advent of relatively reliable modalities of diagnosing diabetic peripheral neuropathy(DPN),such as nerve conduction studies,there is still a knowledge gap about the pathophysiology,and thus limited available in-terventions for symptom control and curtailing disease progression.The pharma-cologic aspect of management is mainly centred on pain control,however,there are several important aspects of DPN such as loss of vibration sense,pressure sense,and proprioception which are associated with risks to lower limb health,which pharmacotherapy does not address.Furthermore,published evidence suggests non-pharmacologic interventions such as glycaemic control through dietary modification and exercise need to be combined with other measures such as psychotherapy,to reach a desired,however modest effect.Acupuncture is emerging as an important treatment modality for several chronic medical conditions including neuropathic and other pain syndromes.In their study published in the World Journal of Diabetes on the potential of acupuncture to reduce DPN symptoms and enhance nerve conduction parameters,Hoerder et al have been able to demonstrate that acupuncture improves sensory function and that this effect is likely sustained two months after treatment cessation.Although previous studies also support these findings,larger multi-center randomized control trials including a sham-controlled arm accounting for a placebo effect are required.Overall,given the satisfactory safety profile and the positive results found in these studies,it is likely that acupuncture may become an important aspect of the repertoire of effective DPN management.

Effect of care intervention with a health education form for breastfeeding on breast distension,pain,and lactation in postpartum mothers

BACKGROUND Breastfeeding not only meets the nutritional needs of newborn growth and development but also promotes uterine contraction and discharge of lochia,which helps in maternal recovery.However,some mothers experience abnormal lactation and breast swelling due to a lack of breastfeeding knowledge,painful cesarean incisions,anesthesia,negative emotions,and other factors,resulting in a reduced breastfeeding rate,which adversely affects neonatal and maternal health.AIM To explore the effects of care intervention with a health education form for breastfeeding on breastfeeding-related conditions.METHODS In this study,207 mothers with postpartum breast pain and difficulty lactating were selected and divided into intervention and control groups using a random number table.Both groups of mothers were provided with basic nursing and related treatment measures after delivery.The intervention group additionally received care intervention with a health education form for breastfeeding.The scores of lactation volume,breast distension and pain,breastfeeding rate,breastfeeding self-efficacy,treatment effect,and complication rate of the two groups were compared.RESULTS After treatment,the breast pain score of the intervention group was significantly lower than that of the control group,while the lactation score,score of Breastfeeding Self-Efficacy Scale Short Form scale,parent-child communication score,maternal-infant interaction score,total score of maternal-infant communication,and breastfeeding rate of the intervention group were significantly higher than those of the control group.After intervention,the overall therapeutic effect of the intervention group was better than that of the control group,and the complication rate of the intervention group was lower than that of the control group.CONCLUSION Breastfeeding health education and nursing intervention combined with basic clinical treatment have good clinical effects in managing postpartum breast distension and pain and increasing lactation yield.

Sleep quality in middle-aged and elderly hemodialysis patients:Impact of a structured nursing intervention program

BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middleaged and elderly hemodialysis patients.AIM To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients.METHODS This cross-sectional study was conducted in a tertiary hospital,the First Affiliated Hospital of Nanchang University,in 2023.This study included 105 middle-aged and elderly hemodialysis patients aged≥45 years who underwent maintenance hemodialysis for at least 3 mo,utilizing the Pittsburgh Sleep Quality Index(PSQI)to identify poor sleepers.Those identified underwent a 12-wk nursing intervention program focusing on education,relaxation techniques,and counseling.Post-intervention,sleep quality was reassessed using the PSQI.RESULTS The study found that 68.6%of hemodialysis patients were poor sleepers.Following the 12-wk nursing intervention program,there was a significant decrease in the mean global PSQI score from 8.9±3.2 to 5.1±2.7(P<0.001),indicating improved sleep quality.This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients.CONCLUSION The structured nursing intervention program focusing on sleep hygiene education,relaxation techniques,and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients.The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population.These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.

Fragile hearts:Unveiling the crucial layers of frailty in elderly patients undergoing percutaneous coronary interventions

Wang and Liu's systematic review of frailty among elderly patients undergoing percutaneous coronary intervention(PCI)revealed that patients with frailty have significantly higher risks of all-cause and in-hospital death,major undesirable cardiovascular events,and major haemorrhage.Frailty is associated with adverse events,prolonged hospital stays,increased complications,and elevated mortality risk due to diminished physiological reserves.Integrating frailty into risk assessment tools is crucial,and gait speed has emerged as a key predictor of frailty.Recognizing the impact of frailty leads to personalized and informed decisionmaking,and frailty assessments should be performed.This holistic approach can inform tailored interventions,thereby optimizing outcomes for this vulnerable population undergoing PCI.

Risk factors for secondary infection after liver failure and effect of comprehensive nursing intervention

BACKGROUND In patients with liver failure(LF),the high rate of secondary infections,which are associated with poor prognosis,highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs.AIM To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions.METHODS This retrospective study included 64 patients with LF,including 32 with and 32 without secondary infections.A questionnaire was used to collect data on age;laboratory parameters,including total and direct bilirubin,prothrombin time,blood ammonia,and other biochemical parameters;invasive procedures;and complications.Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care,whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes.RESULTS The infection rate,which was not associated with age or complications,was significantly associated with biochemical parameters and invasive procedures(P<0.05).The infection rate was 61.6%in patients who had undergone invasive procedures and 32.1%in those who had not undergone invasive procedures during the hospital stay.The infection rate was also significantly associated with the type of LF(P<0.05),with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF.The nursing satisfaction rate was 58.3%in the uninfected group and 91.7%in the infected group,indicating significantly higher satisfaction in the infected group(P<0.05).CONCLUSION In patients with LF,the rate of secondary infections was high and associated with biochemical parameters and type of LF.Comprehensive nursing intervention can improve patient satisfaction.