Objective:While growing evidence supports the Geriatric Nutritional Risk Index (GNRI) as a prognostic indicator for various cancers, its predictive value in pancreatic cancer remains unclear. This meta-analysis systematically evaluates GNRI's ability to predict postoperative complications and long-term outcomes in pancreatic cancer patients. Methods:We conducted a comprehensive literature search across nine databases (Web of Science, PubMed, Embase, Cochrane Library, Scopus, WanFang, CNKI, VIP, and SinoMed) through June 1, 2025. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess overall survival (OS), while risk ratios (RRs) with 95% CIs evaluated postoperative complications. Results:From 233 initially identified studies, 10 met inclusion criteria (n = 2,003 patients). Pooled analysis revealed that lower GNRI significantly predicted worse OS (HR = 1.92, 95% CI 1.54-2.41, p < 0.0001) and higher postoperative pancreatic fistula (POPF) incidence (RR = 0.18, 95% CI 0.08-0.43, p < 0.001). No significant association was found between GNRI and post-pancreatectomy hemorrhage (PPH) (RR = 0.21, 95% CI 0.03-1.53, p = 0.13). Conclusion:GNRI shows promise as a clinically useful predictor of OS and POPF in pancreatic cancer patients. However, these findings require validation through prospective multicenter studies. Systematic review registration:Identifier CRD42023409362.

ObjectivesTo identify and compare published models that use related factors to predict the risk of intracranial hemorrhage (ICH) in acute ischemic stroke patients receiving intravenous alteplase treatment.MethodsRisk prediction models for ICH in acute ischemic stroke patients receiving intravenous alteplase treatment were collected from PubMed, Embase, Web of Science, and the Cochrane Library up to April 7, 2023. A meta-analysis was performed using Stata 13.0, and the included models were evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST).ResultsA total of 656 references were screened, resulting in 13 studies being included. Among these, one was a prospective cohort study. Ten studies used internal validation; five studies used external validation, with two of them using both. The area under the receiver operating characteristic (ROC) curve for subjects reported in the models ranged from 0.68 to 0.985. Common predictors in the prediction models include National Institutes of Health Stroke Scale (NIHSS) (OR = 1.17, 95% CI 1.09–1.25, p < 0.0001), glucose (OR = 1.54, 95% CI 1.09–2.17, p < 0.05), and advanced age (OR = 1.50, 95% CI 1.15–1.94, p < 0.05), and the meta-analysis shows that these are independent risk factors. After PROBAST evaluation, all studies were assessed as having a high risk of bias but a low risk of applicability concerns.ConclusionThis study systematically reviews available evidence on risk prediction models for ICH in acute ischemic stroke patients receiving intravenous alteplase treatment. Few models have been externally validated, while the majority demonstrate significant discriminative power.

ObjectivesTo systematically evaluate the risk prediction models for postoperative delirium in older adult hip fracture patients.MethodsRisk prediction models for postoperative delirium in older adult hip fracture patients were collected from the Cochrane Library, PubMed, Web of Science, and Ovid via the internet, covering studies from the establishment of the databases to March 15, 2023. Two researchers independently screened the literature, extracted data, and used Stata 13.0 for meta-analysis of predictive factors and the Prediction Model Risk of Bias Assessment Tool (PROBAST) to evaluate the risk prediction models for postoperative delirium in older adult hip fracture patients, evaluated the predictive performance.ResultsThis analysis included eight studies. Six studies used internal validation to assess the predictive models, while one combined both internal and external validation. The Area Under Curve (AUC) for the models ranged from 0.67 to 0.79. The most common predictors were preoperative dementia or dementia history (OR = 3.123, 95% CI 2.108–4.626, p < 0.001), American Society of Anesthesiologists (ASA) classification (OR = 2.343, 95% CI 1.146–4.789, p < 0.05), and age (OR = 1.615, 95% CI 1.387–1.880, p < 0.001). This meta-analysis shows that these were independent risk factors for postoperative delirium in older adult patients with hip fracture.ConclusionResearch on the risk prediction models for postoperative delirium in older adult hip fracture patients is still in the developmental stage. The predictive performance of some of the established models achieve expectation and the applicable risk of all models is low, but there are also problems such as high risk of bias and lack of external validation. Medical professionals should select existing models and validate and optimize them with large samples from multiple centers according to their actual situation. It is more recommended to carry out a large sample of prospective studies to build prediction models.Systematic review registrationThe protocol for this systematic review was published in the International Prospective Register of Systematic Reviews (PROSPERO) under the registered number CRD42022365258.

Background: Avoiding postoperative delirium (POD) can have a significant detrimental effect on the rehabilitation and prognosis of elderly urological patients. It is necessary to explore the risk factors associated with POD in elderly urology to provide a basis for clinical recognition of delirium. Methods: For relevant studies, we comprehensively searched Embase, MEDLINE, Ovid, PubMed, Scopus, The Cochrane Library, and Web of Science. The search deadline was September 2021. Results: We identified 2046 studies, 8 of which were included in the ultimate analysis. A total of 8 articles, including 356 cases in the delirium group and 1813 cases in the non-delirium group, were included in the relevant literature. The 2 groups mentioned above differed significantly in the following factors: history of delirium (odds ratio [OR] = 6.98, 95% confidence interval [CI]: 1.63–29.86, P = .009); Preoperative use of psychotropic drugs (OR = 1.97, 95% CI: 1.11–3.52, P = .02); age (OR = 3.10, 95% CI: 2.08–4.12, P < .0001). The meta-analysis demonstrated that smoking, alcohol consumption, gender (male), mode of anesthesia (general anesthesia) and being unmarried did not have a significant effect on POD in elderly urological patients. Conclusion: The risk factors for POD in elderly urological patients include history of delirium, preoperative use of psychotropic drugs, and age. The present study provides guidance for taking targeted preventive measures to reduce risks.

Objective: To investigate the effect of acupoint meridian therapeutic exercise on cardiopulmonary function in patients with chronic heart failure (CHF). Methods: One hundred patients diagnosed with CHF at the Department of Cardiology from June 2019 to October 2019 were enrolled. One hundred patients were randomly divided into an experimental group (n = 50) and a control group (n = 50) according to the treatment they received. The experimental group received conventional treatment combined with acupoint meridian therapeutic exercise for three months. The patients in the two groups were compared in terms of their results on the six-minute walk test and their cardiac function grade, plasma brain natriuretic peptide (BNP) concentration, left ventricular ejection fraction (LVEF), and quality of life. Results: A statistically significant increase in six-minute walking distance was observed in the experimental group compared with the control group. Cardiac function and plasma BNP concentration decreased and LVEF and quality of life increased. Conclusion: Acupoint meridian therapeutic exercise improves exercise tolerance, cardiopulmonary function, and quality of life in patients with CHF.

Objective The aim of this study is to evaluate the impact on blood pressure (BP) of a 10°C change in room temperature (between 18°C and 28°C). Methods A total of 112 volunteers, 56 males and 56 females, 55 with and 57 without hypertension, were enrolled in the study. First, the participants were placed in a 25°C room. Second, they were randomly assigned to either a 28°C (group A) or an 18°C room (group B). Finally, they were moved from the 28°C to the 18°C room, or vice versa. They stayed in each room for 20 minutes. Seated BP was measured at the 17th and 19th minute in each room, and the average was used. The difference in the subject’s BP between the second two rooms was recorded as delta BP. Results The baseline systolic BP (SBP), age, gender distribution, and incidence of hypertension were similar between the two groups. In group A, the decrease in room temperature of 10°C induced a mean rise in SBP of 4.1 mmHg. In group B, the increase of 10°C caused SBP to decrease by 4.0 mmHg. When compared with the group without hypertension, the group with hypertension had a significantly higher rise in mean SBP (6.8 vs 1.2 mmHg) as a result of the decrease in temperature and a significantly higher drop in SBP (7.3 vs 1.2 mmHg) as a result of the increase in temperature. The participants in the group with hypertension were older. Conclusion A 10°C change in room temperature, from 18°C to 28°C, for 20 min can cause a significant change in SBP. The extent of this change is more obvious in the older group.