ObjectiveTo assess the reporting characteristics and quality of patient-reported outcomes (PROs) in randomized controlled trials (RCTs) of targeted therapy and/or immunotherapy for liver cancer.MethodsWe systematically searched six electronic databases for relevant RCTs published in English or Chinese from inception to April 17, 2025. The reporting quality of PROs was assessed using the CONSORT-PRO extension and the CONSORT 2010 guidelines.ResultsWe included 64 RCTs with 8,494 participants. Of these, 14 studies were confirmatory studies, 31 studies were exploratory studies and 19 studies were categorized as “Other” studies. 23.4% (15/64) of these RCTs reported PROs as the primary outcome. Twenty-seven patient-reported outcome measures (PROMs) about 17 relevant domains were observed in these studies. The domain with the highest reporting frequency was quality of life (53/64). Forty trials utilized a single PROM, while 24 trials employed multiple PROMs. The EORTC QLQ-C30 was the most often used PROM (25/53). Nineteen trials employed single-domain symptoms or specific functioning PROMs. Eight symptomatic adverse events were reported in less than 30% of studies. The mean score of the CONSORT-PRO adherence was 7.5 (3-14) for confirmatory studies, 5.8 (4-9) for exploratory studies and 6.0 (3-9) for other studies. The adherence to CONSORT 2010 was poor among the included trials. Only 3 trials achieved good reporting quality.ConclusionAmong the 64 included RCTs, the reporting of specific symptoms and the application of specific PROMs related to targeted and/or immunotherapy were poor. Meanwhile, the integration of PROs with clinical endpoints was suboptimal, and PRO data were seldom used to guide nursing practice. More importantly, the overall adherence to CONSORT-PRO among the included studies was low. Although confirmatory studies demonstrated higher scores than exploratory studies and other types of studies, there was considerable variation within this category. Future studies should prioritize the use of validated, standard disease-specific tools and strengthen the evaluation of treatment-related adverse events. Furthermore, we advocate establishing a collaborative framework that integrates medical, nursing, and patient perspectives. Future studies, particularly confirmatory studies and nursing intervention or supportive care studies, strictly adhere to the CONSORT-PRO guideline.

In busy clinical settings, timely access to comprehensive and actionable guideline recommendations can be constrained, motivating interest in large language models (LLMs) as adjunct tools for scalable evidence access and education. This study aimed to evaluate the performance of LLMs in domain-specific question-answering tasks within the nursing field and assess the effectiveness of GraphRAG technology in optimizing LLMs. A knowledge graph was constructed from high-quality clinical practice guidelines for pressure injury management and integrated with two base models—Qwen-turbo-0715 and DeepSeek-V3.1—to develop optimized versions (Qwen-turbo-0715-GraphRAG and DeepSeek-V3.1-GraphRAG). Model performance was compared between 10 non-specialist nurses, 10 specialist nurses, and the LLMs using a self-developed 25-item questionnaire designed with expert input to assess knowledge of pressure injury management. Group differences were analyzed using the Kruskal–Wallis H test with Bonferroni correction, followed by post hoc pairwise analysis. Average response times were also recorded for each model. Significant differences were observed among non-specialist nurses, specialist nurses, and LLMs (H = 17.662, P-value < 0.001). On this structured, guideline-derived benchmark under the study conditions, the LLM groups obtained higher scores than the nurse groups. The Qwen-turbo-0715-GraphRAG achieved the highest mean score (98.4), followed by DeepSeek-V3.1-GraphRAG (87.2), Qwen-turbo-0715 (86.4), ChatGPT-5 (82.4), and DeepSeek-V3.1 (77.6). GraphRAG optimization was associated with higher benchmark scores, but at the cost of longer response times. Overall, knowledge graph-enhanced LLMs showed more guideline-aligned and source-grounded outputs on this benchmark. However, these improvements were observed within a standardized, guideline-based assessment framework and may not capture the full complexity of clinical expertise. The findings support further evaluation of knowledge graph–enhanced LLMs in larger, more practice-oriented nursing settings and highlight the importance of considering the relative strengths of different base models before clinical application.

BACKGROUND:To systematically evaluate the effectiveness and safety of Chinese herbal medicine mouthwash (CHMM) in preventing ventilator-associated pneumonia (VAP) in patients with endotracheal intubation (ETT). METHODS:Computer searches were conducted for relevant randomized controlled trials (RCTs) in the China National Knowledge Infrastructure (CNKI), WANFANG DATA, Chinese Scientific and Technical Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), PubMed, Embase, Cochrane Library, and CINAHL Database from the establishment to April 5, 2023. The data were analyzed by RevMan 5.3 software. The methodological quality of papers was evaluated by the Cochrane version 5.1.0 and the certainty of evidence was evaluated by the GRADE system. RESULTS:We included 27 RCTs with 2426 patients. Most of the included studies were of poor methodological quality. Meta-analysis showed that CHMM (RR = 0.41, 95% CI: 0.34-0.50, P < .00001, low-certainty evidence) or CHMM + routine oral care (RR = 0.31, 95% CI: 0.18-0.56, P < .0001) could reduce the incidence of VAP compared to non-CHMM. CHMM may be superior to saline (low-certainty evidence) and chlorhexidine (moderate-certainty evidence) in preventing VAP (P < .05). CONCLUSION:Low-certainty evidence shows that CHMM may be more advantageous in reducing the incidence of VAP compared to non-CHMM. However, due to some limitations and the low certainty of evidence, we cannot recommend CHMM for routine clinical use at this time. Large-scale and high-quality RCTs are also needed to definitively evaluate the safety and clinical benefits of CHMM in the future.

Pressure injuries (PIs) remain difficult to avoid in high-risk populations, especially in older adults who are immobile, unconscious, or living with multiple comorbidities, and the inconsistency of research outcomes used to evaluate the effectiveness of intervention measures complicates the advancement of evidence-based practice. The objective of this paper was to conduct a comprehensive review of the application of outcome measures in randomized controlled trials and systematic reviews of PIs treatment. We conducted a comprehensive search in PubMed, Embase, Cochrane Library, and Web of Science for relevant research in Oct 2024. Outcomes were extracted by two reviewers. We consolidated different expressions of the same outcome indicators. VOSviewer 1.6.17 software was used to generate network maps for outcomes. A total of 204 randomized controlled trials and 51 systematic reviews were included in this analysis. Commonly reported outcomes in randomized controlled trials include "change in wound surface area," "pressure ulcer healing status," and "percentage of complete healing," whereas systematic reviews primarily report "percentage of complete healing," "time to complete healing," and "change in wound surface area." Despite efforts to unify numerous indicators with similar definitions or content, over 150 different outcome indicators have still been identified as being used in research. Clustering analysis further reveals substantial variability in the selection of outcome indicators across studies, indicating significant gaps in standardization efforts. This study highlights significant discrepancies in outcome reporting for PIs treatment research, highlighting inconsistencies in the selection of outcome indicators, and establishes a foundation for developing a core outcome set of standardized outcome indicators for PIs treatment.

目的 对乳腺癌首次手术患者需求的研究现状及需求内容进行总结.方法 计算机检索PubMed、Cochrane Library、Web of Science、Embase、中国知网、万方数据库、维普网、中国生物医学文献数据库中有关乳腺癌首次手术患者需求的文献,检索时限均为2013年1月1日-2022年12月31日.结果 共纳入17篇文献,研究设计以质性研究和观察性研究为主.乳腺癌首次手术患者的需求程度高,需求内容呈现多样性,主要包括信息需求、健康指导需求、情感需求和社会支持需求;不同年龄段、不同治疗阶段的乳腺癌手术患者的需求不同.结论 建议制订个性化需求干预计划,满足乳腺癌患者的多样化需求.

BackgroundThe inconsistencies between randomized clinical trials (RCTs) registrations and peer-reviewed publications may distort trial results and threaten the validity of evidence-based medicine. Previous studies have found many inconsistencies between RCTs registrations and peer-reviewed publications, and outcome reporting bias is prevalent. AimsThe aims of this review were to assess whether the primary outcomes and other data reported in publications and registered records in RCTs of nursing journals were consistent and whether discrepancies in the reporting of primary outcomes favored statistically significant results. Moreover, we reviewed the proportion of RCTs for prospective registration. MethodsWe systematically searched PubMed for RCTs published in the top 10 nursing journals between March 5, 2020, and March 5, 2022. Registration numbers were extracted from the publications, and registered records were identified from the registration platforms. The publications and registered records were compared to identify consistency. Inconsistencies were subdivided into discrepancies and omissions. ResultsA total of 70 RCTs published in seven journals were included. The inconsistencies involved sample size estimation (71.4%), random sequence generation (75.7%), allocation concealment (97.1%), blinding (82.9%), primary outcomes (60.0%) and secondary outcomes (84.3%). Among the inconsistencies in the primary outcomes, 21.4% were due to discrepancies and 38.6% resulted from omissions. Fifty-three percent (8/15) presented discrepancies in the primary outcomes that favored statistically significant results. Additionally, although only 40.0% of the studies were prospective registrations, the number of prospectively registered trials has trended upward over time. Linking Evidence to ActionWhile not including all RCTs in the nursing field, our sample reflected a general trend: inconsistencies between publications and trial registrations were prevalent in the included nursing journals. Our research helps to provide a way to improve the transparency of research reports. Ensuring that clinical practice has access to transparent and reliable research results are essential to achieve the best possible evidence-based medicine.

BACKGROUND:As pharmacotherapy often leads to adverse reactions, mind-body exercise (MBE) treatments have become a more popular option for treating depression in people living with breast cancer (BC). However, the most effective type of MBE treatment for this population remains unclear. AIMS:The aim of this systematic review and network meta-analysis (NMA) was to compare the efficacy of the different MBE modes for depression in people with BC. METHODS:A systematic search for randomized controlled trials (RCTs) from inception to March 25, 2023, was conducted in the following database: EMBASE, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine, OpenGrey, and ClinicalTrials.gov. A traditional meta-analysis was conducted using the random-effects model to directly assess the effectiveness of various MBE interventions. Stata 16.0 software was used for performing the NMA. RESULTS:The NMA was performed in 32 eligible RCTs including 2361 participants. The efficacy of MBE treatments on depression was ranked as the following: Liuzijue (surface under the cumulative ranking curve [SUCRA] = 95.4%) > Tai chi (SUCRA = 76.9%) > yoga (SUCRA = 55.0%) > Baduanjin (SUCRA = 53.9%) > Pilates (SUCRA = 38.6%) > dance (SUCRA = 30.2%) > Qigong (SUCRA = 28.1%) > control (SUCRA = 21.9%). LINKING EVIDENCE TO ACTION:Our research showed that Liuzijue and Tai chi might be the most significantly effective MBE intervention for mitigating depression among BC survivors. Healthcare professionals could consider recommending Liuzijue and Tai Chi as a complementary therapy for BC survivors who experience depression.

Objective:To systematic review the efficacy and safety of external application of traditional Chinese medicine on treatment of breast cancer related lymphedema.Methods:CNKI, Wanfang Data, VIP, Sino-Med, The Cochrane Library, PubMed, Web of Science were searched for related randomized controlled trials, the retrieval time was from inception to May 25, 2020. Two researchers independently screened and evaluated the included studies. Meta-analysis was performed by RevMan 5.4 software.Results:A total of 16 studies involving 1 315 patients with breast cancer related lymphedema were included, and the methodological quality of the included studies was not high. Compared with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment had advantages in improving the total efficiency( P<0.01) and quality of life( P<0.01), reducing pain( P<0.01) and improving upper limb function( P<0.01), without obvious adverse reactions( P>0.05), but there was no improvement in depression( P>0.05). Compared with conventional treatment, external application of traditional Chinese medicine could improve the total efficiency( P<0.01). Compared with placebo sticker combined with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment can reduce circumference( P<0.05) and reduce pain( P<0.01), without obvious adverse reactions( P>0.05). Conclusions:Available evidence suggests that external application of traditional Chinese medicine may be a potential treatment method for breast cancer related lymphedema. Due to the poor methodological quality of the included studies, high-quality randomized controlled trials are still needed.

本文对6个国内外早产儿疼痛特异性评估量表进行综述,并对疼痛评估量表的应用情况、量表比较分析和应用启示进行论述.旨在为早产儿疼痛管理提供参考,并为早产儿疼痛特异性量表的本土化发展提供借鉴.

目的 对涉及胃癌术后化疗自我管理的相关指南进行质量评价和内容分析,为制订我国胃癌术后化疗患者自我管理方案提供参考.方法 检索国内外临床实践指南网站、胃癌专业协会网站及部分中英文数据库,搜集胃癌术后化疗患者自我管理相关指南,检索期限为2015年7月至2020年6月.采用AGREE Ⅱ评价指南质量,并对各指南推荐意见进行汇总分析.结果 共纳入8部指南,总体质量评价为A级2部,B级3部,C级3部.胃癌术后化疗患者自我管理相关推荐意见涉及解决自身健康问题、如何进行决策、获取资源、建立医患合作关系、制订行动计划、自我监测6个方面35条.结论 纳入的指南部分质量较高,但指南开发的应用性、严谨性、参与人员等领域亟待加强.未来可借鉴国外质量较高指南进行本土化实践,并遵循国际标准尽快构建适应我国国情的胃癌术后化疗患者自我管理指南.

目的 对乳腺癌相关淋巴水肿评估与管理的相关指南进行质量评价和内容分析,为我国本土化乳腺癌相关淋巴水肿评估与管理指南的制定提供参考.方法 计算机检索国内外指南网站、相关专业协会网站及中英文数据库,搜集乳腺癌相关淋巴水肿评估与管理相关指南.采用AGREE Ⅱ评价纳入指南的质量,并对各指南推荐意见进行汇总分析.结果 最终纳入4部指南,2部A级,2部B级.推荐意见涉及评估、治疗与健康指导3个方面.结论 纳入的指南质量较高,纳入的指南涵盖了较为全面的乳腺癌相关淋巴水肿评估方法,对我国临床实践有一定的指导意义,但治疗方法不全,可进一步补充中医护理等方面内容,开发本土化乳腺癌相关淋巴水肿评估与管理指南.

Objective:To explore the development status and research hotspots of international mobile medical application, so as to provide references for domestic research on mobile medical applications.Methods:We systematically searched English documents included in the Web of Science core database from 2009 to 2019, and the document type was the article. CiteSpace (V.5.6.R2 version) software was used to visually analyze research institutions, source journals, cited documents and keywords of international mobile medical applications.Results:A total of 4 705 documents were included. Research on international mobile medical applications continued to increase. The institution and journal with the most publications were the University of Washington and JMIR Mhealth and Uhealth respectively. Through the keyword co-occurrence clustering of related literature, four research hotspots were obtained: the feasibility study of mobile medical applications, the intervention research of mobile medical applications, disease management and self-care, and the evaluation of mobile medical applications. Conclusions:In order to promote the development of mobile medical application in China, it is recommended that future researchers should pay attention to the research result of international authoritative institutions and journals in a timely manner, learn from the knowledge base of international mobile medical application research, and explore the road of application development in line with my country's national conditions.At the same time, it is necessary to standardize the design of research programs, carry out high-quality intervention research, and build my country's mobile medical application evaluation system as soon as possible.

目的 系统评价俯卧位对早产儿喂养的有效性和安全性.方法 计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Cochrane图书馆、Embase数据库中有关不同体位对早产儿胃潴留影响的随机对照试验.检索时限从建库至2020年3月18日.由2名经过培训的研究员独立筛选文献、提取资料并评价文献质量,采用RevMan5.3软件、StataMP16软件进行Meta分析.结果 共纳入28项随机对照试验和3项随机交叉试验,包括3178例研究对象.与仰卧位相比,俯卧位能够降低早产儿胃潴留量、发生率[RR =0.34,95％CI(0.17,0.70),P=0.003];呕吐次数和发生率[RR=0.30,95％CI(0.19,0.46),P=0.000];腹胀次数、发生率[RR =0.28,95％CI(0.17,0.44),P=0.000];呼吸暂停次数和发生率[RR=0.36,95％CI(0.25,0.52),P=0.000].与侧卧位相比,俯卧位能够降低早产儿胃潴留量.结论 俯卧位可有效减少早产儿胃潴留、呕吐、腹胀及呼吸暂停的发生,但受纳入研究数量和质量的影响,上述结论尚需开展更多高质量研究予以进一步证实.

目的 通过检索国内外胃癌移动医疗应用程序的相关文献,了解该领域的研究现状和发展动态,并对可用性评价进行重点分析,以期为今后相关研究提供参考.方法 检索2010年1月至2020年4月发表的胃癌移动医疗应用程序相关的中、英文文献,检索的中文数据库包括中国知网、万方、重庆维普数据库和中国生物医学文献数据库,英文数据库包括Web of Science、PubMed、Embase、Medline、Science Direct、Springer Link及Cochrane Library等.结果 经过文献筛选,本研究共纳入15篇英文文献.胃癌移动医疗应用程序的功能以自我监测、疼痛管理、健康教育、营养咨询和监测以及加强体育锻炼为主.应用程序的可用性评价以量性评价为主,评价方法多采用问卷调查的方式进行,评价对象大多针对目标患者用户,评价持续时间差异较大,可用性评价要素以可用性、可行性、有效性和满意度为主.结论 胃癌移动医疗应用程序相关研究呈持续性增加趋势,仅适用于胃癌患者的移动医疗应用程序相对不足.应用程序设计时应在尽可能考虑胃癌患者全面需求的同时注重个性化服务,应用程序的可用性评价应贯穿应用程序研发的全过程,且如何规范实施移动医疗应用程序可用性评价应受到相关研究人员的重视.

Objectives: This study aimed to assess the reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire (HaNiQ). Methods: The HaNiQ was translated into a Chinese version using internationally recognized forward-and back-translation procedures. The reliability and validity of the HaNiQ were measured using Cronbach's alpha coefficient, split-half reliability, exploratory factor analysis, and Pearson correlation analysis. Results: A total of 207 patients in different head and neck cancer (HNC) stages and 174 caregivers completed the Chinese version of the HaNiQ. Internal consistencies varied between good and very well (Cronbach's alpha coefficient 0.74-0.90); the split-half coefficient and the content validity index (CVI) of the questionnaire were 83.5% and 83.33%, respectively. The cumulative contribution rates of the 5 subscales in patients with HNCand their caregivers were 62.41% and 61.19%, respectively. However, there are some differences between the Chinese questionnaire for caregiver and the original questionnaire regarding the attribution of items. Items 22, 23, and 27 in the Psychosocial subscale of the English version were assigned to the Survivorship subscale in the Chinese version for caregivers. Conclusions: The results demonstrated that the Chinese version of the HaNiQ is a reliable and valid instrument for measuring the information needs of patients with HNC and that of their caregivers. Though the structure of the Chinese version was different from the English version for caregivers of HNC patients, the Chinese version of the HaNiQ appears to be reliable and would benefit from further testing. (C) 2021 The authors. Published by Elsevier B.V. on behalf of the Chinese Nursing Association.

目的:系统评价穴位按摩治疗产后缺乳的疗效.方法:计算机检索中国知网(CNKI)、万方数据(WANFANG DA-TA)、维普中文科技期刊数据库(VIP)、PubMed、The Cochrane Library、中国生物医学文献服务系统(Sinomed)等数据库中有关穴位按摩应用于产后缺乳患者的随机对照试验,检索时限为建库至2020年2月10日.由2位研究者独立进行文献筛选、资料提取和方法学质量评价.采用RevMan 5.3软件进行数据分析.结果:最终纳入6篇文献,共586例患者.Meta分析结果显示:与治疗前相比,穴位按摩联合常规护理可有效提高产后缺乳患者血清泌乳素含量,差异有统计学意义[MD=59.69,95％CI(56.94,62.45),P＜0.00001].对产后缺乳患者泌乳量、乳房充盈度及乳汁黏稠度的影响通过描述性分析发现,穴位按摩可增加产后缺乳患者泌乳量,改善乳房充盈度和增加乳汁黏稠度.结论:穴位按摩治疗产后缺乳可能存在优势,但纳入研究的方法学质量普遍偏低,仍需开展高质量的研究来进一步验证其疗效和安全性.

目的 了解新型冠状病毒肺炎(COVID-19)出院患者社会支持现状及其影响因素,提出中医特色干预措施,为制定新型冠状病毒肺炎出院患者健康干预计划提供参考.方法 于2020年2-3月,采用方便抽样法,对湖北省COVID-19定点收治医院湖北省中西医结合医院、武汉市中西医结合医院、武汉市江夏方舱医院3家单位治愈出院的171例患者进行社会支持水平问卷调查,利用SPSS 22.0统计软件进行数据分析.结果 COVID-19出院患者社会支持水平得分区间为12～40分,得分中位数为30分,处于中等社会支持水平,社区情感支持相对不足.影响COVID-19出院患者的社会支持状况的因素主要有教育程度、婚姻状态.结论 应建立并完善COVID-19出院患者社会支持网络;重视精神支持和人文关怀;积极探索社区居家康复新模式;充分发挥中医情志护理的优势作用.

目的 了解新型冠状病毒肺炎(简称"新冠肺炎")患者出院后康复期间的现状.方法 选择2020年2月17日-3月14日于湖北省中西医结合医院、武汉市中西医结合医院、武汉江夏方舱医院治疗后出院的新冠肺炎患者,采用自行设计的问卷进行调查,内容包括一般人口学资料、身体不适症状、不良情绪反应及社会支持情况,共调查171例患者.结果 身体不适症状方面,肺脾气虚证的各项症状均分最低,为(4.02 +0.69)分,其中得分较低的5个表现分别是少气懒言(3.28±1.19)分,心悸(3.91±1.05)分,舌苔白腻(3.98±1.03)分,疲倦乏力、周身困重(4.00±1.01)分,气短(4.05±0.90)分.不良情绪反应方面,67.84％存在不同程度焦虑;43.27％存在不同程度抑郁.社会支持方面,得分最低的前3位分别是感到被朋友、家人等疏远,为(3.29+1.24)分;需要时能从社区工作人员那里获得支持与安慰,为(3.47±1.09)分;需要时能得到周围人陪伴,为(3.57±1.42)分.结论 新冠肺炎患者出院后,在身体健康、不良情绪改善及社会支持方面仍存在不同程度的康复指导需求,应采取积极有效的干预措施,为其制定适宜的康复指导方案.

This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1 (PD-1) immunotherapy-related myocarditis combined with coronary heart disease (CHD) after receiving said treatment. In this case, immune myocarditis with CHD occurred shortly after implementing the PD-1 immunotherapy, yet the patient presented no clinical symptoms. Frequent nursing attention and close observation are so required for monitoring the patient's status and updating the physicians for a swift control of the myocarditis. For this case, nursing care procedures vital for the successful recovery of the patient included condition observation, position management, pre- and postcoronary angiography care, infection prevention, hemorrhage prevention, venous access port maintenance, pain care, trachea care, psychological care, diet care, environment management, and health education. After receiving effective, successful treatment and care, the patient was discharged after 13 days of treatment with generally satisfying overall conditions.

目的:检索、评价和整合儿童血流感染患儿血培养采集的最佳实践证据.方法:按照6S模型,检索BMJ best practice,UpToDate、英国国家卫生与临床优化研究所指南网(NICE Guidance)、苏格兰院际指南网(SIGN)、安大略注册护士协会(RNAO)、国际指南协作网(GIN)、美国国立指南库(NGC)、医脉通、美国临床和实验室标准协会(CLSI)、世界卫生组织官网(WHO)、PubMed、CINAHL、Cochrane Library英文数据库、中国期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、Sinomed中关于血培养标本采集管理的相关指南、标准、临床决策,补充检索最新指南发表时间之后发表的系统评价.由2名研究者对纳入的文献进行质量评价,对符合质量标准的文献进行证据提取和汇总.结果:共纳入文献7篇,包括临床决策1篇、指南4篇、系统评价2篇,最终从采血时机、采集前消毒、采集工具、采血途径、采血量、管理策略6个方面总结证据22条.结论:所总结的关于儿童血培养采集的证据可用于临床实践,促进儿童血培养采集的规范化管理,提升检出率.