Envita’s Precision Cancer Care: 35-Fold Improvement in Response Rates

New clinical approaches are imperative beyond the widely adopted National Comprehensive Cancer Network (NCCN) guidelines, utilized by prominent cancer institutions. Cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical Centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical Centers over a two-year period. Compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.

Aging Characteristics and Layout Planning of Old-age Care Facilities in the Downtown Area of Nanchang City

Compared to the situation of population aging and the elderly aging, the development of oldage undertaking in Nanchang is still undeveloped in that the old-age care industry lags behind the urban renewal speed and the objective needs of aging. Apart from discussions on the composition of elderly population and the status quo of aging, this paper took the institutional old-age care in the downtown area of Nanchang for example, explored problems in the current institutional old-age care facilities through field investigation, and proposed suggestions for the layout planning of old-age care facilities in the study area.

Influence of humanistic care-based operating room nursing on safety,recovery,and satisfaction after radical surgery for colorectal carcinoma

BACKGROUND Radical surgery is a preferred treatment for colorectal carcinoma,wherein nursing intervention is essential for postoperative recovery and prevention of complications.Recently,the application of humanistic care in medical care has attracted attention.Humanistic care emphasizes comprehensive care,with importance attached to patients’physical needs as well as psychological and emotional support to provide more humane and personalized care services.However,no clinical reports have examined the use of humanistic care in patients undergoing radical surgery for colorectal carcinoma.AIM To investigate the influence of humanistic care-based operating room nursing on the safety,postoperative recovery,and nursing satisfaction of patients who have undergone radical surgery for colorectal carcinoma.METHODS In total,120 patients with rectal cancer who underwent surgery in Zhongnan Hospital of Wuhan University between August 2023 and March 2024 were selected and grouped based on the nursing methods employed.Of these patients,55 were treated with routine nursing intervention(control group)and 65 were provided humanistic care-based operating room nursing(research group).The patients’vital signs were recorded,including systolic/diastolic blood pressure(SBP/DBP)and heart beats per minute(BPM),as well as serum stress indices,including norepinephrine(NE),adrenal hormone(AD),and cortisol(Cor).Postoperative recovery and complications were also recorded.Patients’negative emotions,life hope,and nursing satisfaction were evaluated using the Self-rating Depression/Anxiety Scale(SDS/SAS),Herth Hope Index(HHI),and self-deve-loped nursing satisfaction questionnaire,respectively.RESULTS During emergence from anesthesia,SBP,DBP,and BPM levels were found to be lower in the research group than those in the control group,also serum Cor,AD,and NE levels were lower.In addition,the research group had shorter operative,awakening,anal exhaust,first postoperative ambulation,drainage tube removal,intestinal recovery,and hospital times.The total complication rate and the SDS and SAS scores were lower in the research group than those in the control group.The HHI and nursing satisfaction scores were higher in the research group.CONCLUSION Humanistic care-based operating room nursing can mitigate physiological stress responses,reduce postoperative complications,promote postoperative recovery,relieve adverse psychological emotions,and enhance life hope and nursing satisfaction in patients undergoing radical surgery for colorectal carcinoma,which can be popularized in clinical practice.

Construction of Xi'an ecological old-age care community in the new urbanization

The new urbanization is an important carrier of ecological civilization construction, and ecological old-age care is the concrete manifestation of the perfect combination of the two, the proper meaning of the new urbanization connotation and an inevitable trend of its development. Based on the analysis of the connotation and relationship between the new urbanization and ecological old-age care, together with the current situation and existing problems of the current nursing institutions and ecological old-age care in Xi'an area, this paper discusses the major issues that should be noticed when constructing the ecological old-age care community in Xi'an and three main construction modes.

Stages of care for patients with chronic hepatitis C at a hospital in southern Brazil

BACKGROUND Hepatitis C virus(HCV)is defined as a public health problem by the World Health Organization(WHO)and since then has defined targets through the HCV elimination.The HCV cascade of care highlights the progress towards these goals and essential interventions that need to be delivered along this continuum care.AIM To document the treatment cascade for patients with HCV infection at the Hospital Nossa Senhora da Conceição(HNSC),defining the percentage of antibody-positive patients who collected molecular biology tests(polymerase chain reaction),attended outpatient clinic assistance,underwent treatment,and achieved a virologic cure termed sustained virologic response(SVR).METHODS With the retrospective cohort design,patients diagnosed with HCV infection in the period between January 1,2015 and December 31,2020 were included.Data from HCV notification forms,electronic medical records,Computerized Laboratory Environment Manager System,and Medicine Administration System(evaluation of special medications)were collected in 2022 and all information up to that period was considered.The data were analyzed with IBM SPSS version 25,and Poisson regression with robust simple variance was performed for analysis of variables in relation to each step of the cascade.Variables with P<0.20 were included in the multivariate analysis with P<0.05 considered significant.Pearson’s chi-square test was applied to compare the groups of patients who persisted in follow-up at the HNSC and who underwent follow-up at other locations.RESULTS Results were lower than expected by the WHO with only 49%of candidates receiving HCV treatment and only 29%achieving SVR,despite the 98%response rate to direct acting antivirals documented by follow-up examination.The city of origin and the place of follow-up were the variables associated with SVR and all other endpoints.When comparing the cascade of patients who remained assisted by the HNSC vs external patients,we observed superior data for HNSC patients in the SVR.Patients from the countryside and metropolitan region were mostly assisted at the HNSC and the specialized and continuous care provided at the HNSC was associated with superior results,although the outcomes remain far from the goals set by the WHO.CONCLUSION With the elaboration of the HCV cascade of care using local data,it was possible to stratify and evaluate risk factors associated with losses between each step of the cascade,to inform new strategies to guide elimination efforts in the future.

Improvement of the Legal System for Addressing the Issue of Elderly Care in China in the Context of Population Aging

Rapid population aging is a social reality facing China at present,and the issue of elderly care has become a hot topic of social concern.Legislation to address the issue of elderly care in the context of population aging should follow systematic concepts to achieve“vertical and horizontal integration.”In terms of content,it is necessary to formulate specific legal approaches around“the elderly and children,”with a focus on guaranteeing the livelihood and protection of the rights of the elderly while taking into account childbirth,employment and other issues.the laws should not only safeguard the social participation and labor rights of the elderly,but also effectively respond to the social challenges brought about by the aging of the population.It is also necessary to optimize the family planning policy to ease the burden of child-raising,improve the population structure and promote the long-term balanced development of the population,thus fundamentally solving the problem of population aging.the effort to improve the legal system to deal with the issue of elderly care in the context of population aging will better advance Chinese modernization.

残疾人托养照护筹资体系与政策的责任边界

托养照护是重度残疾人长期而迫切的现实需要。近年来,我国残疾人托养照护制度逐步建立,初步形成了财政投入为主、多项政策配合的筹资体系,重点保障了困难重度残疾人基本生活照护。现行政策与残疾人自主生活愿望和未来托付关切尚有较大差距,促进发展功能发挥不足,家庭自费和保险付费很少,服务系统处于松散配合的分割运行状态。从责任边界视角看,需要基于残疾人家庭照护能力、收入水平及需求层级,厘清各方职责与配合关系,强化保险和信托作用,建立以残疾人为主体、回应多层级目标的托养照护制度。

数字化重症快速反应体系建设探索

目的:建设数字化重症快速反应体系,实现急危重症患者早期识别和干预,保障患者医疗安全。方法:利用物联网、大数据和人工智能等技术,建设重症快速反应信息平台,完善快速反应管理体系。结果:构建急危重症大数据中心、智能预警及快速反应系统、组织管理体系三位一体的重症快速反应体系,为患者提供智慧、同质、高效的医疗服务。结论:重症快速反应体系建设在我国尚处于探索阶段,通过全流程的信息化、数字化管理,切实提高患者医疗安全保障,不断推动构建适合我国医疗高质量发展的重症快速反应体系。

分阶段护理在达芬奇机器人辅助肺癌根治术患者中的应用

目的分析基于德尔菲法的分阶段护理在达芬奇机器人辅助肺癌根治术患者中的应用效果。方法选取医院2021年5月至2022年10月收治的87例肺癌患者,均在全麻下接受达芬奇机器人辅助肺癌根治术治疗,依照随机数字表法分为两组,对照组(43例)接受常规护理干预,观察组(44例)在对照组基础上接受基于德尔菲法指导的分阶段护理,比较两组干预前后心理应激反应、生理应激反应、癌因性疲乏程度、生活质量。结果术前30 min,两组14项汉密尔顿焦虑量表(HAMA)、17项汉密尔顿抑郁量表(HAMD)评分均降低,且观察组低于对照组(P<0.05);术前30 min,两组心率、收缩压、舒张压水平均升高,但观察组较对照组低(P<0.05);干预后,观察组Piper疲乏量表(PFS)评分低于对照组,肺癌患者生存质量测定量表(FACT-L)评分高于对照组(P<0.05)。结论基于德尔菲法指导的分阶段护理应用于全麻下达芬奇机器人辅助肺癌根治术患者,能有效减少心理、生理应激,缓解癌因性疲乏程度,提高生活质量。

社会网络对中青年群体养老责任认同的影响研究——基于CGSS 2018年数据的检验

从人口代际更迭的角度看,我国目前的中青年群体步入老年阶段后将面临重度老龄化和高龄老龄化并存的养老困境,亟须通过前瞻性制度规划和资源准备避免养老压力的代际叠加。由于认知是意愿形成和行为选择的前提与基础,中青年群体对养老责任归属的态度直接关系未来规模庞大的老年人口的养老方式,厘清其对养老责任主体的倾向与偏好可以在一定程度上预判未来潜在的养老需求,从而在养老资源总量不足、结构不均的情况下实现“有备而老”的积极老龄化目标。同时,我国是典型的人情关系社会,人们往往会借助血缘、亲缘、地缘等社会关系网络及相应资源降低养老活动的运行成本,尤其在家庭养老功能日趋萎缩的背景下,社会网络正在成为个体应对养老风险的重要支持力量,以互联网为代表的新型社交形式日益普及,也为保障老年福祉提供了新的可能。但目前学界相关研究对中青年群体和社会网络因素关注不足,仍然存在研究内容和研究维度上的缺位。基于此,本研究使用中国综合社会调查(CGSS)数据,分析我国中青年养老责任认同的变迁趋势,采用无序多分类Logistic回归模型探究社会网络各因素对中青年养老责任认同的作用机制,并以倾向得分匹配法(PSM)对结果进行稳健性检验。研究发现:在家庭赡养功能持续弱化的宏观背景下,传统的代际责任伦理在我国中青年群体中仍具有相当强的生命力,同时其对社会养老机制和自我养老机制的接受度逐渐提高。而社会关系网络能够发挥非正式保险的效用,对正式养老制度形成补充,进而降低社会风险对家庭的冲击。其中,以朋友交往为代表的强关系对子女养老发挥强有力的替代作用,弱关系网络主要具有补充功能,说明群体信任更强的强关系网络具备弱关系无法比拟的养老资源优势。而互联网作为社会网络中交往行为和互动关系的新表征形态,通过信息传递与政策普及,增强互助养老意识,社会信任则代表个体获取社会关系网络中信息与资源的能力,通过建构社会资本,弱化人们对子女和家庭养老的依赖。因此,以社会支持网络对现有养老实践作出补充,或将在有限养老资源的约束下缓解我国持续加剧的养老压力。

互联网模式下专家咨询专线对儿童保健需求的影响

目的:探讨互联网模式下,新型诊疗模式对儿童保健需求的影响。方法:采用横断面观察性研究,对通过《儿童健康有约》专家在线栏目咨询保健需求问题的484例研究对象,采用电话咨询收集其一般资料,在1周后对其监护人进行随访,将单因素分析差异有统计学意义的变量进行Logistic回归分析,探讨影响儿童就医问题的独立影响因素。结果:共纳入研究对象484例,就医问题解决度达80.58%(390/484),单因素分析结果显示,在儿童保健需求的就医过程中,获取资讯途径与咨询内容是其影响因素(P<0.05),Logistic回归分析显示,获取资讯途径是儿童保健就医问题解决度的独立影响因素(P<0.05)。结论:开通电话专线是解决儿童保健问题(80.58%)的重要举措;获取资讯途径可以作为一种特殊儿童保健需求的应对措施,可以有效解答儿童保健问题。

床旁即时超声测量动脉峰流速呼吸变异度评价危重症患者容量反应性的临床价值

目的评估床旁即时超声(POCUS)测量动脉峰流速呼吸变异度(△Vpeak)评价危重症患者容量反应性的临床价值。方法回顾性选取川北医学院附属医院于2021年1月至2023年6月收治的100例危重症患者作为研究对象,所有患者均接受容量负荷(VE)试验,根据患者容量反应性分为有反应组[容量负荷后心脏每搏量(SV)增加≥15%,n=56]与无反应组(心脏指数增加<15%,n=44)。容量负荷前后均对患者实施床旁即时超声测量及中心静脉压(CVP)、脉压变异率(PPV)检测,比较两组容量负荷前后△Vpeak[主动脉血流峰流速(△Vpeak-AO)、颈总动脉血流峰流速(△Vpeak-CA)、肱动脉血流峰流速(△Vpeak-BA)、股动脉血流峰流速(△Vpeak-FA)]、CVP、PPV指标,并绘制受试者工作特征(ROC)曲线分析△Vpeak对危重症患者容量反应性的预测价值。结果容量负荷前,有反应组患者的△Vpeak-AO、△Vpeak-CA、△Vpeak-BA、△Vpeak-FA以及PPV分别为(15.42±4.24)%、(14.24±3.24)%、(13.29±2.54)%、(12.35±2.24)%、(13.32±2.53)%,均高于无反应组[(10.93±4.63)%、(10.48±3.16)%、(9.48±2.68)%、(7.84±2.16)%、(9.35±1.27)%],差异均有统计学意义(P<0.05),两组患者CVP比较差异无统计学意义(P>0.05);容量负荷后,有反应组与无反应组各项△Vpeak指标与PPV、CVP比较差异均无统计学意义(P>0.05)。△Vpeak-AO、△Vpeak-CA、△Vpeak-BA、△Vpeak-FA对危重症患者容量反应性敏感度、特异度及曲线下面积高于PPV。结论床旁即时超声测量△Vpeak能够有效预测危重症患者容量反应性,为临床诊断及治疗提供指导,具有较高临床价值。

本科护生社会责任感对亲社会行为的影响:关怀能力的中介作用

了解本科护生社会责任感、亲社会行为与关怀能力的现状并探讨三者之间的关系机制,采用大学生社会责任感调查问卷、亲社会行为量表及关怀能力量表调查内蒙古呼和浩特市某高校637名本科护生,采用层次回归模型和Bootstrap法进行结果统计描述与分析。研究结果显示,新时代“健康中国”战略背景下应加强本科护生社会责任感认知、行为的培养,并继续注重护生关怀能力的提升,关怀能力是社会责任感与亲社会行为的中介变量,可通过培养本科护生社会责任感和关怀能力促进其亲社会行为的形成与发展。

基于加速康复外科理念的护理干预在腹腔镜胆囊切除术患者围手术期的应用效果

目的 探讨基于加速康复外科(ERAS)理念的护理干预在腹腔镜胆囊切除术(LC)患者围手术期的应用效果。方法 选取2021年1月至2022年3月河北省邯郸市中心医院接受LC治疗的100例患者为研究对象,采用随机数字表法将其分为常规组和干预组,各50例。常规组实施常规围手术期护理,干预组在常规组的基础上行ERAS理念下围手术期护理。观察并比较两组应激反应指标水平变化、术后疼痛程度、并发症发生情况及患者术后康复速度。结果 术后24 h,两组皮质醇、肾上腺素水平均高于术前1 h,且干预组术前1 h、术后24 h时指标水平低于常规组,差异有统计学意义(P<0.05);干预组术后视觉模拟评分法评分、并发症总发生率低于常规组,差异有统计学意义(P<0.05);干预组术后首次下床、肛门首次排气、首次排便、停止输液及住院时间均短于常规组,差异有统计学意义(P<0.05)。结论 基于ERAS理念围手术期干预模式用于LC治疗患者,可避免患者出现强烈应激反应,缓解疼痛感,预防并发症发生,缩短患者术后康复时间。

早期预警评分联合快速反应团队救护重度子痫前期患者的研究

目的 探讨早期预警评分联合快速反应团队对重度子痫前期患者的应用效果。方法 将2020年1-12月在急诊就诊的126例重度子痫前期患者为对照组,采用常规护理方法;2021年7月至2022年6月同类患者126作为干预组,采用早期预警评分表,客观对孕妇进行评估,早期预警评分触动快速反应系统,立即启动快速反应团队对患者进行紧急救护。比较两组患者母婴结局情况。结果 干预组孕妇就诊后收缩压和舒张压控制情况优于对照组,在急诊留观时间显著缩短(均P<0.05);干预组孕妇HELLP综合征、胎盘早剥、胎膜早破、宫缩乏力和产后出血发生率显著低于对照组(均P<0.05);干预组早产、胎儿窘迫和新生转ICU率显著低于对照组(均P<0.05)。结论 早期预警评分联合快速反应团队可有效降低重度子痫前期患者母婴不良结局,有助于保障母婴安全。

基于二元应对出院准备服务在老年肺癌患者中的应用

目的:探讨基于二元应对出院准备服务在老年肺癌患者中的应用方法及效果。方法:选取2020年3月1日~2023年3月31日收治的83例老年肺癌患者及其照顾者随机分为实验组42例和对照组41例,对照组采用常规护理干预,实验组在此基础上开展基于二元应对出院准备服务;比较两组患者干预前后医学应对方式问卷(MCMQ)、老年人出院准备度量表(RHDS-OP-SF)评分,照顾者干预前后家庭照顾负担访谈量表(FBIS)、癌症照顾者综合需求量表(CNAT-C)评分。结果:干预后,两组患者MC-MQ中面对评分及RHDS-OP-SF评分高于干预前(P<0.05),且实验组高于对照组(P<0.05);干预后,两组患者MCMQ中回避、屈服评分低于干预前(P<0.05),且实验组低于对照组(P<0.05);干预后,实验组照顾者FBIS中对家庭活动影响、对家庭成员沟通影响、对家庭成员心理健康、总分及CNAT-C评分均低于干预前(P<0.05),且实验组低于对照组(P<0.05)。结论:对老年肺癌患者实施基于二元应对出院准备服务,有助于改善患者应对方式,提升出院准备度,减轻家属照护负担。

浅析长护险经办管理中政府与承办机构的职责——基于国际经验比较视角

为进一步厘清长护险经办管理中政府的职责边界,本研究系统整理了国内试点城市在待遇申请、失能评估和护理服务机构管理等关键环节的职责分配情况。通过与典型国家及地区实践经验的比较,识别并分析现阶段我国长护险试点中委托承办环节面临的主要问题。基于以上分析,建议顶层设计突出权责清晰,明确长护险各经办环节管理职责,准确界定长护险经办中政府和商保公司的职责。

Clinical nursing value of predictive nursing in reducing complications of pregnant women undergoing short-term massive blood transfusion during cesarean section

BACKGROUND Cesarean hemorrhage is one of the serious complications,and short-term massive blood transfusion can easily cause postoperative infection and physical stress response.However,predictive nursing intervention has important clinical significance for it.AIM To explore the effect of predictive nursing intervention on the stress response and complications of women undergoing short-term mass blood transfusion during cesarean section(CS).METHODS A clinical medical record of 100 pregnant women undergoing rapid mass blood transfusion during sections from June 2019 to June 2021.According to the different nursing methods,patients divided into control group(n=50)and observation group(n=50).Among them,the control group implemented routine nursing,and the observation group implemented predictive nursing intervention based on the control group.Moreover,compared the differences in stress res-ponse,complications,and pain scores before and after the nursing of pregnant women undergoing rapid mass blood transfusion during CS.RESULTS The anxiety and depression scores of pregnant women in the two groups were significantly improved after nursing,and the psychological stress response of the observation group was significantly lower than that of the control group(P<0.05).The heart rate and mean arterial pressure(MAP)of the observation group during delivery were lower than those of the control group,and the MAP at the end of delivery was lower than that of the control group(P<0.05).Moreover,different pain scores improved significantly in both groups,with the observation group considerably less than the control group(P<0.05).After nursing,complications such as skin rash,urinary retention,chills,diarrhea,and anaphylactic shock in the observation group were 18%,which significantly higher than in the control group(4%)(P<0.05).CONCLUSION Predictive nursing intervention can effectively relieve the pain,reduce the incidence of complications,improve mood and stress response,and serve as a reference value for the nursing of women undergoing rapid mass transfusion during CS.

中国居民养老责任主体观念时空演化及影响因素研究——基于CGSS数据的实证分析

[目的]梳理中国居民养老责任主体观念的现状、时空演变规律及其影响机制,为推动养老服务高质量发展提供参考。[方法]基于中国综合社会调查数据2012年、2015年、2018年、2021年数据,使用莫兰指数、HAPC模型等方法进行实证分析。[结果]2012年、2015年、2018年、2021年选择由子女养老的受访者占比分别为52.00%、49.84%、49.75%、55.81%。省域间养老责任主体观念存在正空间自相关,中西部地区更倾向于选择主要由子女负责养老。队列效应及时期效应显示选择子女以外作为养老主体的概率有逐渐增强的趋势。男性、身体健康、受教育程度低、无配偶、有代际陪同、未参加养老保险、社交频繁度一般、主观幸福度高的居民更倾向于选择主要由子女负责养老。[结论]家庭养老观念仍占据主流地位,居民养老责任观念出现区域差异,且随着时间推移发生不同程度的变化,个人、家庭、社会资本因素对居民养老责任认知均有显著影响。

帕金森病患者姑息照护影响因素及应对措施的研究进展

介绍国内外帕金森病患者姑息照护的发展及研究现状,总结目前帕金森病患者姑息照护的影响因素及应对措施,以期为建立适合帕金森病患者的专业化姑息照护体系提供理论基础和实践依据。帕金森病的疾病特点、社会支持未得到满足、医护人员提供姑息照护服务能力不足、民众和医务工作者对姑息照护认知不足、现存姑息照护模式不完善、启动姑息照护时机尚无明确标准等是影响帕金森病患者姑息照护的因素,未来可从培养专业姑息照护医护人员、建立多学科合作模式、加强姑息照护学业教育、做好姑息照护院外延伸、构建帕金森病姑息照护模型以及形成以政府为主导的姑息照护体系等方面做出干预措施,以提高帕金森病患者的生活质量,逐步完善帕金森病患者的全周期护理。