Background:Sleep apnea (SA) is a serious sleep disorder, and its diagnostic gold standard, polysomnography, is costly and time-consuming. Electroencephalogram (EEG) signals, due to their direct correlation with neural activity and ease of extraction, represent a promising tool. Despite increasing research on machine learning (ML) and deep learning for EEG-based SA detection, model performance has not been consistently evaluated. Objective:This systematic review evaluated the accuracy of ML in detecting SA from EEG data and provided an evidence base for further clinical application and future research. Methods:Following the PRISMA-DTA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 expanded checklists, we systematically searched PubMed, Embase, Web of Science, Cochrane Library (CENTRAL), Scopus, IEEE Xplore, and ClinicalTrials.gov databases from inception to April 2026. Studies evaluating the value of ML algorithms for detecting SA based only on EEG data were included. The Quality Assessment of Diagnostic Accuracy Studies-2 and Prediction Model Risk of Bias Assessment Tool for Artificial Intelligence tools were used to assess the risk of bias in each study. Statistical analysis was performed using the mada and metafor packages in R (version 4.6.0; R Foundation for Statistical Computing) and the Meta-DiSc (version 1.4; Hospital Ramón y Cajal) software. We used GRADE (Grading of Recommendations Assessment, Development and Evaluation) to evaluate the certainty of evidence. Results:A total of 27 retrospective studies were included. Segment-level analyses showed high diagnostic performance, with a pooled sensitivity of 0.90 (95% CI 0.85-0.94; 95% prediction interval 0.43-0.99) and specificity of 0.92 (95% CI 0.87-0.95; 95% prediction interval 0.46-0.99). The pooled area under the summary receiver operating characteristic curve was 0.95 (95% CI 0.92-0.99). Meta-regression identified EEG channel configuration, region, and validation strategy as significant sources of heterogeneity (P=.004, P=.003, and P=.046, respectively). Multichannel EEG, deep learning approaches, and hold-out validation strategies generally demonstrated better diagnostic performance. Only 2 studies evaluated patient-level diagnostic performance, which was summarized qualitatively. Conclusions:To our knowledge, this is the first systematic review and meta-analysis specifically focused on the diagnostic accuracy of EEG-based ML models in the detection of SA. This meta-analysis indicates that ML models based on EEG demonstrate good diagnostic accuracy in detecting SA at the segment level and show promise as tools for SA screening and clinical decision support. However, most current studies are retrospective segment-level analyses, which may overestimate the practical value of this technology in real-world clinical settings. To reliably integrate EEG-based ML models into clinical diagnostic workflows, further prospective studies incorporating full-night monitoring and patient-level validation are needed.

OBJECTIVE:To evaluate the effectiveness and feasibility of virtual pulmonary rehabilitation (PR) in patients with chronic respiratory diseases (CRDs). METHODS:PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, Wanfang, VIP and APA PsycInfo database were searched since the establishment of the database to July 26, 2024. Data extraction and quality assessment were independently conducted by two reviewers. The methodological quality was assessed using the Cochrane Risk of Bias Tool 2. RevMan v5.4 was performed to meta-analysis. RESULTS:This meta-analysis and systematic review included 19 studies (1222 CRDs patients). Meta-analysis showed that compared with the control group, virtual PR increased exercise capacity (MD: 22.88, 95 % CI: 15.54 to 30.23), quality of life (QOL) [COPD Assessment Test (CAT): -3.23, -3.62 to 2.85] and dyspnea (Modified Medical Research Council: -0.38, -0.62 to -0.14). Virtual PR demonstrated statistical significance in improving lung function (forced expiratory volume in 1 s in predicted: 6.30, 3.39 to 9.21; the ratio of forced expiratory volume to forced vital capacity in the first second: 9.18, 8.02 to 10.33) and compliance (4.05, 2.26 to 7.27). Mean changes in CAT, anxiety, depression, and cognitive function reached Minimal clinically important difference (MCID) thresholds. However, Borg score, St George' s respiratory questionnaire (SGRQ) did not show any change. In narrative analysis, virtual PR reported fewer adverse reactions, but the economic benefits should be considered. CONCLUSIONS:This systematic review thoroughly investigates the effectiveness and feasibility of virtual PR for patients with CRDs, and preliminarily verifies the potential promotion value of virtual PR. PROSPERO REGISTRATION NUMBER:CRD42024581851.

睡眠呼吸暂停综合征是一种睡眠时出现呼吸停止的睡眠呼吸障碍性疾病,多导睡眠监测是诊断睡眠呼吸暂停综合征的金标准.睡眠呼吸暂停可分为阻塞性睡眠呼吸暂停(OSA)、中枢性睡眠呼吸暂停(CSA)和混合性睡眠呼吸暂停(MSA).治疗上主要有病因治疗、无创辅助通气治疗、氧疗、上气道手术、减重等治疗方案.另外,日常生活照护也是非常重要的.

目的:观察两种完全植入式静脉输液港蝶翼针衬垫敷料摆放方法在输液港维护中的应用效果.方法:选取2022年1月—2022年4月在南京市某三级甲等医院呼吸科收治的采用完全植入式静脉输液港化疗的129例肺癌病人作为研究对象,采用随机数字表法分为对照组和试验组.将采用传统衬垫敷料摆放方法,即蝶翼针针下垫医用脱脂纱布,共65例病人作为对照组;将采用改良衬垫敷料摆放方法,即将医用脱脂纱布折叠包绕于蝶翼针针翼上下,共64例病人作为试验组.两组病人均在出院前拔除蝶翼针.比较两组病人拔针时疼痛程度及拔针时间.结果:试验组病人拔针疼痛程度为(0.59±0.58)分低于对照组(1.43±0.84)分(P<0.01);试验组拔针时间(3.81±0.38)min短于对照组(6.70±0.69)min(P<0.01).结论:采用改良输液港蝶翼针衬垫敷料设计能有效降低病人拔针时疼痛程度,缩短拔针用时.

目的 通过Meta分析方法评价慢性阻塞性肺疾病(COPD)并发肌少症的影响因素,为肌少症的早期预防提供循证依据.方法 检索中国知网、维普中文科技期刊、万方数据知识服务平台、PubMed、Web of Science、Cochrane Library、CINAHL 及 Embase 数据库关于 COPD 患者并发肌少症影响因素的文献,检索时限为建库至2023年4月3日.使用Stata 17.0软件进行Meta分析.结果 共纳入14篇文献,其中横断面研究13篇、队列研究1篇,共1 921例COPD患者,其中并发肌少症患者591例,共提取8个影响因素.分析结果显示,年龄[OR=1.09,95％置信区间(CI):1.06～1.12,P＜0.01]、GOLD分级(OR=8.83,95％CI:1.88～41.53,P＜0.01)、mMRC评分(OR=2.10,95％CI:1.30～3.40,P＜0.01)、体重指数(BMI)(OR=0.65,95％CI:0.56～0.76,P＜0.01)、FEV1/FVC(OR=0.95,95％CI:0.92～0.99,P＜0.01)是COPD患者并发肌少症的影响因素,而吸烟、性别、TNF-α不是COPD患者并发肌少症的影响因素.结论 年龄、GOLD分级、mMRC评分、BMI、FEV1/FVC是COPD并发肌少症的影响因素.临床医务人员应关注重点人群并进行肌少症早期筛查与防治.

目的:探讨针对肺癌化疗合并COPD患者应用气道专项护理的临床效果.方法:选取2020年8月1日—2021年3月31日在我院呼吸科接受肺癌化疗合并COPD的56例患者作为研究对象,采用随机法将其分为对照组和观察组,每组28例.对照组患者接受常规护理措施,观察组患者则在此基础上接受气道专项护理.分析两组患者的护理效果.结果:干预前,两组患者的生活质量评分、CAT评分差异无统计学意义(P>0.05);干预后,两组患者的生活质量评分均高于同组干预前(P<0.05),且观察组患者高于对照组(P<0.05),两组患者的CAT评分均低于同组干预前(P<0.05),且观察组患者低于对照组(P<0.05).护理前,两组患者的FVC、FEV1/FVC、FEV1/预计值各项指标差异无统计学意义(P>0.05);护理后,两组患者的各项指标均有所提升,且观察组患者均高于对照组(P<0.05).护理前,两组患者的CRP、血清IL-6、PCT各项炎性因子水平差异无统计学意义(P>0.05);护理后,两组患者的各项指标均有所降低,且观察组患者均低于对照组(P<0.05).结论:针对肺癌化疗合并COPD患者采取气道专项护理措施,能有效改善患者的肺部功能,降低患者体内炎性因子水平,进而保障患者的远期疗效,值得临床借鉴推广.

The self-care level of patients with chronic diseases changes over time, and trajectories can describe this dynamic process. This paper reviews the concept, origin, development and self-care trajectory of chronic disease patients in order to understand the current self-care trajectory, influencing factors and self-care intervention programs of chronic disease patients, and to look forward to the development of chronic disease self-care in China. It lays the foundation for the formulation of self-care intervention programs for patients with chronic diseases in China, so as to comprehensively and permanently improve the self-care level of patients with chronic diseases.

Objective:To explore the application effect of continuous quality improvement based on trauma team activation model in emergency triage.Methods:This study is a historical controlled study. A total of 12 215 trauma patients receiving initial treatment in the Emergency Department of the First Affiliated Hospital with Nanjing Medical University from January 2020 to June 2021 were selected as the research objects by the convenience sampling method, and 3 896 trauma patients from January to June 2020 were enrolled as the baseline group, and 4 054 patients from July to December 2020 were enrolled as the phaseⅠ improvement group, and 4 265 patients from January to June 2021 were enrolled as the phaseⅡ improvement group. The baseline group adopted the one-tiered trauma team activation model, which was evaluated and decided by the first-visiting doctor. The phaseⅠ improvement group received the one-tiered trauma team activation model, which was evaluated and decided by pretest triage nurses. The stageⅡ improvement group conducted the two-tiered trauma team activation model, which was evaluated and decided by pretest triage nurses. The trauma team activation time, overtriage rate and undertriage rate were compared between the three groups.Results:The trauma team activation time of the phaseⅠ improvement group and phaseⅡ improvement group was shorter than that of the baseline group, and the difference was statistically significant ( P<0.05). The overtriage rate of the phaseⅡ improvement group was lower than that of the baseline group and the phaseⅠ improvement group, and the differences were statistically significant ( P<0.05). The underage rate of the three groups were <5%, and the differences were not statistically significant ( P>0.05) . Conclusions:The two-tiered activation of trauma team mode led by nurses can shorten the trauma team activation time, reduce the overtriage rate and undertriage rate, improve the quality of trauma team activation.

Abstract Background Venous thromboembolism has been a major public health problem and caused a heavy disease burden. Venous thromboembolism clinical decision support system was proved to have a positive influence on the prevention and management of venous thromboembolism. As the direct users, nurses' acceptance of this system is of great importance to support the successful implementation of it. However, there are few relevant studies to investigate nurses' acceptance and the associated factors are still unclear. Objective To investigate the determinant factors of nurses' acceptance of venous thromboembolism clinical decision support system with the modified Unified Theory of Acceptance and Use of Technology. Methods We designed a questionnaire based on the modified Unified Theory of Acceptance and Use of Technology and then a cross-sectional survey was conducted among nurses in a tertiary hospital in Nanjing, China. Statistically, a Structural Equation Modeling -Partial Least Squares path modeling approach was applied to examine the research model. Results A total of 1100 valid questionnaires were recycled. The modified model explained 74.7%, 83.0% and 86% of the variance in user satisfaction, behavioral intention and user behavior, respectively. The results showed that performance expectancy (β = 0.254, p = 0.000), social influence (β = 0.136, p = 0.047), facilitating conditions (β = 0.245, p = 0.000), self-efficacy (β = 0.121, p = 0.048) and user satisfaction (β = 0.193, p = 0.001) all had significant effects on nurses' intention. Although effort expectancy (β = 0.010, p = 0.785) did not have a direct effect on nurses' intention, it could indirectly influence nurses' intention with user satisfaction as the mediator (β = 0.296, p = 0.000). User behavior was significantly predicted by facilitating conditions (β = 0.298, p = 0.000) and user intention (β = 0.654, p = 0.001). Conclusion The research enhances our understanding of the determinants of nurses' acceptance of venous thromboembolism clinical decision support system. Among these factors, performance expectancy was considered as the top priority. It highlights the importance of optimizing system performance to fit the users' needs. Generally, the findings in our research provide clinical technology designers and administrators with valuable information to better meet users' requirements and promote the implementation of venous thromboembolism clinical decision support system.

Objective:To explore the research hotspots and evolution of Common Sense Model (CSM) , in order to provide a clearer research direction for nursing workers to improve health-related outcomes of patients from the perspective of health psychology.Methods:English literature related to CSM was searched in Web of Science Core Collection database from January 1, 1985 to December 31, 2020. VOSviewer 1.6.15 software was used to draw a visual map of keyword density, clustering and time distribution and CiteSpace 5.6.R5 software was used to detect emerging words.Results:Finally, 364 papers were included, and the annual publication volume and citation frequency of CSM research showed an overall upward trend. CSM research hotspots mainly focused on interpreting or intervening patients' perception of disease, in order to improve self-management of patients, compliance, quality of life, anxiety, depression and psychological distress. The research objects were mainly cancer patients. Social support and psychological distress were explored based on the CSM framework and using Meta-analysis methods to summarize may be an important part of future CSM research work. CSM research was currently in the stage of summarizing and deepening after theoretical perfection and extensive application.Conclusions:The annual publication volume and citation frequency of CSM research have generally shown an upward trend, which has attracted the attention of domestic scholars, but there is still a big gap compared with foreign countries. Future research can explore the role of social support in the process of individual self-regulation after illness and explore effective methods to intervene in patients' negative disease perception through Meta-analysis, in order to improve patients' health outcomes.

目的:通过探讨老年急性肺血栓栓塞症(acute pulmonary thromboembolism,APTE)患者外周血白细胞(peripheral blood leukocytes,PBL)升高的相关因素及其预后意义,提高临床医生对APTE的认识.方法:收集南京医科大学第一附属医院2016年1月—2019年6月60岁以上老年住院APTE患者326例,分析患者PBL升高的原因及预后意义.采用Logistic回归方法,比较分析PBL升高组(n=78)和PBL正常组(n=248)患者的年龄、性别、D-二聚体水平、肺动脉栓塞部位、近端深静脉血栓(deep vein thrombosis,DVT)、远端DVT、基础疾病、深静脉置管、吸烟史、糖皮质激素的应用.结果:下肢近端、远端均存在DVT患者的PBL显著高于无DVT组和仅下肢远端DVT组(P＜0.05).统计学分析显示,心力衰竭、近期(＜30 d)骨折、间质性肺病和D-二聚体水平是老年APTE患者PBL升高的相关因素(P＜0.05).PBL升高组溶栓比例、在院死亡、血管活性药物使用、机械通气使用、心肺复苏率均高于PBL正常组(P＜0.05).结论:PBL升高的老年APTE患者预后较差,需要重点关注心肺功能不全、下肢近端及远端均存在DVT的老年APTE患者.

目的:以慢性疾病轨迹模式为框架,了解卡瑞利珠单抗致反应性皮肤毛细血管增生症(RCCEP)的肺癌病人在疾病发展各个阶段的行为体验,分析其动态变化,为提高病人在免疫治疗方面的照护提供指导.方法:采用目的性抽样法,选取2021年1月—2021年7月于江苏省某三级甲等医院呼吸与危重症医学科使用卡瑞利珠单抗治疗且出现RCCEP的15例肺癌住院病人为研究对象,运用质性研究中的现象学研究法,进行半结构式深度访谈.采用Colaizzi 7步分析法,了解病人出现RCCEP不同中位时间:初期(首次用药至1个月内)、增殖期(1～3个月内)、消退期(3～6个月内)各阶段中,在疾病相关行为方面、自我概念行为方面和日常生活行为方面这3个维度的需求和体验并提炼主题.结果:对15例病人均完成半结构式访谈,以慢性疾病轨迹模式为框架,提炼病人在3个不同中位时间段对反应性毛细血管增生症的需求和自我体验.分别为初期(首次用药至1个月内):①无法预料症状的出现;对症状认知的缺乏;②自我概念缺失:不能正确面对症状及处理;③不确定感严重.增殖期(1～3个月内):①缺乏多种症状共存时的管理知识;期待更多的医患沟通;②适应症状的存在,自我概念的重塑;③正性负性情绪交织并存;社交能力下降.消退期(3～6个月内):①注重预防感染;②自我概念稳定;③日常生活能力提高.结论:卡瑞利珠单抗致RCCEP的病人在不同中位时间段在疾病相关行为方面、自我概念行为方面和日常生活行为方面这3个维度的体验和需求是动态变化的.临床护理人员应主动为病人提供专业知识指导.

ABSTRACT Background Improving patient activation can lead to better health outcomes among patients with chronic obstructive pulmonary disease (COPD). However, no studies have focused on the issue of activation in patients with COPD in China. Purpose This study was designed to explore the status of activation in patients with COPD in China and explicate the significant influencing factors. Methods One hundred seventy patients with COPD were recruited using a convenience sampling method from eight tertiary and secondary hospitals in Nanjing, China. Sociodemographic, clinical, and patient-reported factor data were collected. Univariate analysis and multivariate linear regression were performed. Results Only 10.6% of the patients were identified as activated for self-management. Multivariate linear regression analysis revealed four explanatory elements as significantly associated with patient activation, including social support (β = .463, p < .001), free medical insurance (β = .173, p = .007), smoking status (β = −.195, p = .002), and health status (β = −.139, p = .04). Conclusions/Implications for Practice The findings of this study indicate that a minority of patients with COPD are activated for self-management in China. Having a higher level of patient activation was associated with having better social support, having free medical insurance, being a nonsmoker, and having a better health status. Creating a supportive environment, promoting smoking cessation, and improving medical security and health status may be considered as potential strategies to activate patients into better self-management.

目的:探讨缩唇腹式呼吸联合呼吸操训练对慢性阻塞性肺疾病(COPD)患者血气分析指标、肺功能和生活质量的影响.方法:选取2020年1月-2021年4月期间就诊于我院的82例COPD患者,根据随机数字表法分为对照组(缩唇腹式呼吸训练,41例)和研究组(缩唇腹式呼吸结合呼吸操训练,41例),对比两组疗效、血气分析指标[动脉血二氧化碳分压(PaCO2)、血氧分压(PaO2)、血氧饱和度(SaO2)]、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积所占FVC的比例(FE1/FVC)]、生活质量[圣乔治呼吸问卷(SGRQ)评分]、6分钟步行试验(6MWT)距离、BODE指数.结果:研究组的临床总有效率明显高于对照组(P＜0.05).研究组治疗3个月后PaO2、SaO2高于对照组,PaCO2低于对照组(P＜0.05).研究组治疗3个月后FEV1、FVC、FEV1/FVC高于对照组(P＜0.05).研究组治疗3个月后6MWT距离长于对照组,SGRQ评分、BODE指数低于对照组(P＜0.05).结论:缩唇腹式呼吸联合呼吸操训练可改善COPD患者血气分析指标,提高肺功能和运动耐力,改善生活质量,疗效显著.

目的 探讨基于云随访平台的延续护理对慢性阻塞性肺疾病(COPD)患者健康行为及生活质量的影响.方法 选择2020年1月至6月在江苏省人民医院治疗后出院的78例COPD患者,按照随机数字表法分为对照组和观察组,每组各39例.对照组出院后实施常规电话随访,观察组出院后实施基于云随访平台的延续护理.随访5个月,采用健康行为量表(HPL)评价两组健康行为,采用圣乔治呼吸问卷(SGRQ)评价两组生活质量.结果 随访5个月,观察组HPL评分明显高于本组随访前(P<0.05),对照组躯体活动、营养、心理健康评分明显高于本组随访前(P<0.05),观察组健康责任感、躯体活动、人际关系、压力管理、心理健康评分明显高于对照组(P<0.05).两组SGRQ评分明显低于本组随访前(P<0.05),观察组症状部分、活动能力部分及疾病对日常生活的影响部分评分明显低于对照组(P<0.05).结论 基于云随访平台的延续护理能够促进COPD患者养成良好的健康行为,进一步改善生活质量.

Objective:To explore the relationship among illness perception, patient activation and self-management in patients with lung cancer, and to investigate the mediating effect of patient activation between illness perception and self-management.Methods:A total of 270 inpatients with lung cancer were selected by convenience sampling method.They were investigated by self-made social demographic questionnaire, brief illness perception questionnaire(BIPQ), patient activation measure(PAM13)and cancer patient self-management scale.SPSS 26.0 software was used for data analysis.T-test, analysis of variance, Pearson correlation analysis and mediating effect test were used for statistical analysis.Results:A total of 255 questionnaires were collected effectively.The total score of illness perception, patient activation and self-management in patients with lung cancer were (41.91±7.94), (62.31±16.39)and (142.20±20.59) .The total score of illness perception of lung cancer patients was significantly negatively correlated with the total score of patient activation and patient self-management( r=-0.652, P<0.01; r=-0.762, P<0.01), and the total score of patient activation was significantly positively correlated with the total score of self-management in patients with lung cancer( r=0.746, P<0.01). Patient activation had a partial mediating effect between illness perception and self-management in patients with lung cancer, and the mediating effect accounted for 37.10% of the total effect. Conclusion:Patient activation plays a partial mediating role between illness perception and self-management in lung cancer patients, and it is an important protective factor for patients to actively participate in self-management of disease.On the basis of assessing the illness perception and patient activation of lung cancer patients, medical staff can timely correct the negative illness perception and help them establish and maintain a high positivity level to improve their self-management.

Objective: To evaluate the effectiveness of motivational interviewing (MI) for COPD in behavioral changes and health outcomes, and also verify the reliability of results in conjunction with trial sequential analysis and the Grading of Recommendations Assessment, Development, and Evaluation tool.Methods: Studies that implemented MI interventions for COPD patients were systematically searched by eight databases from inception to December 2021. Study screening, quality assessment, data extraction, and meta -analysis were conducted according to Cochrane standards.Results: Twenty-one studies involving 2344 patients were included. The results of meta-analyses indicated that MI made significant improvement in self-efficacy, lung function, quality of life, emotion, and COPD-related admission, but not in self-management and exercise capacity. Subgroup analyses found that the intervention duration was inversely associated with effect size for both self-efficacy and negative emotion severity. The trial sequential analysis showed MI improved patients' lung function and reduced COPD-related hospitalization with certainty, but the findings for exercise capacity need to be confirmed by further research.Conclusions: This systematic review suggested the positive effects of MI on self-efficacy, lung function, quality of life, emotion and COPD-related hospitalization. To make a firm conclusion, more well-designed clinical trials with bigger sample sizes required.Practice implications: Clinical and community nurses can use MI for COPD to increase healthy behaviors.Trial registration: CRD42021278674.

Objectives:To systematically evaluate effectiveness and safety of early warning and prevention of hospital-acquired venous thromboembolism (HAT) .Methods:Computers were used to search PubMed, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, China Biology Medicine disc, CNKI and Wanfang Database. RCTs of early warning and prevention HAT at home and abroad was searched systematically and the retrieval time was from the establishment of databases to June 1, 2020. Two researchers independently screened the literature according to the literature inclusion and exclusion criteria, extracted data and evaluated the risk of bias in the study. RevMan 5.3 software was used to conduct Meta-analysis of the incidences of HAT, pulmonary thromboembolism (PTE) , deep vein thrombosis (DVT) , bleeding and prevention rate of HAT.Results:A total of 8 articles were included. Results of Meta-analysis showed that the incidence of PTE in the early-warning group ( RR=0.69, 95% CI 0.53-0.91, P=0.009) and the prevention rate of HAT ( RR=1.45, 95% CI 1.14-1.84, P < 0.001) were statistically significantly different from those in the non-warning group. However, the incidences of HAT ( RR=0.89, 95% CI 0.68-1.16, P=0.380) , DVT ( RR=0.99, 95% CI 0.76-1.29, P=0.970) and bleeding ( RR=0.95, 95% CI 0.81-1.11, P=0.500) had no statistically significant difference between the two groups. HAT prevention was defined as a subgroup of appropriate prevention. There was no statistically significant difference in the HAT prevention rate of patients between the two groups ( RR=1.01, 95% CI 0.95-1.07, P=0.810) . In the subgroup that did not describe in detail whether prevention was appropriate, the HAT prevention rate in the early-warning group was higher than that in the non-early warning group, and the difference was statistically significant ( RR=2.28, 95% CI 2.09-2.49, P<0.001) . Conclusions:Early warning can reduce the incidence of PTE by increasing the prevention rate of HAT without increasing the incidence of bleeding, but it has no significant effect on the incidences of HAT and DVT. Limited by the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality studies.

Cardiopulmonary exercise test can objectively and quantitatively evaluate the cardiovascular function, pulmonary function and exercise tolerance of patients during exercise.Pulmonary hypertension is a serious disease characterized by increased mean pulmonary artery pressure with a poor prognosis.Its clinical symptoms have no specificity.It is easy to be misdiagnosed and missed diagnosed, especially in the early stage of the disease.Cardiopulmonary exercise test can be used for early diagnosis and assessment of pulmonary hypertension.This article reviews the application of cardiopulmonary exercise test in the diagnosis and treatment of pulmonary hypertension.

目的:调查并分析肺癌患者病耻感的影响因素,并探讨病耻感与生活质量和负性情绪的相关性.方法:选取2019年1月-2020年9月期间我院收治的肺癌患者159例作为研究对象.采用自制的一般资料调查表收集患者的临床资料,采用中文版肺癌患者病耻感量表(CLCSS)评估入选患者的病耻感,采用Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)评估患者的负性情绪,采用肿瘤患者专用的生活质量核心问卷(EORTCQLQ-C30)评估患者生活质量.应用单因素及多元线性COX回归分析病耻感的影响因素,应用Pearson相关分析病耻感与生活质量和负性情绪的相关性.结果:本研究共发放159份调查问卷,回收有效问卷156份,无效问卷3份,回收成功率为98.11％.肺癌患者病耻感中的社会隔离、耻辱与羞愧、吸烟、总评分以及SAS、SDS评分高于国内常模中位分(P＜0.05),EORTC QLQ-C30评分低于国内常模中位分(P＜0.05),而歧视与国内常模中位分对比无统计学差异(P＞0.05).Pearson相关分析结果显示,CLCSS总评分与SAS、SDS评分均呈正相关,而与EORTC QLQ-C30评分呈负相关(P＜0.05).单因素分析结果可知,不同性别、年龄、婚姻状况、居住地、医疗费用支付方式、文化程度、病程的肺癌患者病耻感评分对比差异无统计学意义(P＞0.05),是否合并慢性病、是否吸烟、不同个人月收入的肺癌患者病耻感评分对比差异有统计学意义(P＜0.05).多元线性COX回归分析结果显示,合并慢性病、吸烟、个人月收入＜2000元均是影响肺癌患者病耻感的危险因素(P＜0.05).结论:肺癌患者病耻感处于偏高水平,且与患者生活质量和负性情绪息息相关,其中合并慢性病、吸烟、个人月收入是影响患者病耻感的主要因素,应给予针对性干预,以降低其病耻感,促进患者身心健康.