Background Currently, hypoglycemia poses a critical challenge in managing older patients with type 2 diabetes mellitus (T2DM), threatening their long-term health and overall well-being. This meta-analysis is the first to comprehensively quantify the pooled prevalence of hypoglycemia and identify its key influencing factors specifically in the elderly population. Methods We conducted a systematic study across 11 databases to identify relevant observational studies reporting the prevalence of hypoglycemia or its influencing factors. The search was limited from database inception all the way until July 9th, 2025, and updated November 13th, 2025. In addition, we conducted a meta-analysis of the overall prevalence of hypoglycemia and its influencing factors using Stata 17.0 and RevMan 5.4, respectively. Results Among the 37 studies included, the overall prevalence of hypoglycemia in elderly patients with T2DM was 21% (95%CI, 20–23%). The results of this meta-analysis showed that age, diabetes duration, insulin treatment, hypertension, malignant tumors, renal impairment, cognitive dysfunction, and glycosylated hemoglobin were the key determinants influencing the risk of hypoglycemia in the elderly T2DM population. Conclusion Early clinical risk assessment is essential for older adults with type 2 diabetes mellitus at high risk of hypoglycemic complications, along with the implementation of evidence-based diagnostic and therapeutic protocols for hypoglycemia management.

BACKGROUND:Incontinence-associated dermatitis (IAD) is a prevalent and distressing skin complication in critically ill patients, leading to increased pain, infection risk and healthcare costs. While several risk prediction models have been developed to guide IAD prevention, their methodological quality, predictive performance and clinical utility remain unclear. A systematic synthesis and evaluation of these models is currently lacking. AIM:This study aimed to systematically review and meta-analysis existing risk prediction models for IAD in critically ill patients, critically appraising their methodological rigour and summarizing their predictive performance. STUDY DESIGN:We searched PubMed, Embase, The Cochrane Library, Web of Science, CINAHL and Chinese databases (CNKI, WanFang, Weipu and SinoMed) from inception to January 2026 for studies developing or validating multivariable prediction models for IAD in adult ICU patients. Two reviewers independently screened records, extracted data and assessed risk of bias using the PROBAST tool. A meta-analysis of pooled AUC values was performed in Stata 15.0 when sufficient quantitative data were available. RESULTS:A total of 834 records screened, 14 studies encompassing 14 prediction models were included. The models demonstrated good to excellent discrimination, with AUC values ranging from 0.810 to 0.993. The most frequently reported predictors across studies were the PAT score, stool frequency, age and serum albumin. Meta-analysis yielded a pooled AUC of 0.88 (95% CI: 0.84-0.91). However, all studies were rated at high risk of bias on the PROBAST tool, primarily due to analytical limitations and participant selection issues. CONCLUSION:Current risk prediction models for incontinence-associated dermatitis in critically ill patients show good discriminative ability but are limited by methodological shortcomings. Future research should focus on developing models with high-quality prospective data and rigorous external validation. A well-validated tool would help ICU teams identify high-risk patients early and improve preventive care. RELEVANCE TO CLINICAL PRACTICE:This review provides a comprehensive synthesis of existing prediction models, offering clinicians a consolidated overview of tools to identify ICU patients at highest risk for IAD, thereby supporting targeted prevention. REVIEW REGISTRATION:CRD420261282052.

BACKGROUND:Postoperative delirium (POD) is a serious complication in pediatric surgery that may induce prolonged hospital stays, while increasing risks of cognitive impairment and mortality. Its incidence after low-risk surgery remains incompletely characterized, despite extensive study in critically ill children, especially those following cardiac surgery. This meta-analysis systematically evaluated POD prevalence and its influencing factors in children undergoing low-risk surgeries to inform clinical prevention and management strategy development. METHODS:This meta-analysis was conducted by retrieving studies in PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CNKI, SinoMed, Wanfang, and VIP Database from their inception to 21 March 2025. Data processing was performed using RevMan 5.4 and Stata 15.0, with subgroup analyses, meta-regression, and sensitivity analyses. RESULTS:This study screened 31 studies involving 13,718 pediatric patients. The overall pooled POD prevalence was 23.4% (95% CI: 0.185-0.286, P < 0.001). Furthermore, significant risk factors included age < 5 years (OR = 2.75, 95% CI: 1.85-4.08, P < 0.001), preoperative anxiety (OR = 1.16, 95% CI: 1.02-1.32, P = 0.03), postoperative pain (OR = 5.52, 95% CI: 3.15-9.67, P < 0.001), otolaryngologic surgery (OR = 2.61, 95% CI: 1.47-4.63, P < 0.001), and midazolam use (OR = 2.33, 95% CI: 1.48-3.67, P < 0.001). CONCLUSION:POD is particularly prevalent in children following low-risk pediatric surgery. IMPLICATIONS FOR PRACTICE:Priority should be given to early identification and suitable intervention targeting modifiable risk factors (preoperative anxiety, postoperative pain, and midazolam use), particularly in young children (<5 years) and those undergoing otolaryngologic surgeries.

Dementia is a progressive neurodegenerative disorder that severely impairs cognition and daily function among older adults. Non-pharmacological interventions, particularly cognitive training integrated with individualized nursing care, have been proposed to enhance cognitive and emotional outcomes. This study aimed to evaluate the effects of cognitive training combined with nursing care compared with routine daily care in elderly patients with dementia. A retrospective observational study was conducted among 126 dementia patients treated between November 2023 and December 2024. Patients were divided into a control group (routine care) and an intervention group (cognitive training + nursing care). Each session lasted 40 minutes, 3 times weekly for 8 weeks. Cognitive, emotional, and functional outcomes were assessed using the mini-mental state examination (MMSE), Montreal cognitive assessment, Hamilton anxiety scale and depression Scales, Barthel index of activities of daily living, and general quality of life inventory-74. Propensity-score matching and receiver operating characteristic analysis were applied. After 8 weeks, the intervention group showed significantly greater improvement in MMSE (+5.4 vs +2.6) and Montreal cognitive assessment (+5.0 vs +2.4) scores than the control group (both P < .001). Hamilton anxiety scale and depression scores decreased more markedly in the intervention group (-6.7 and -5.5 points, P < .001). Barthel index of activities of daily living and general quality of life inventory-74 scores also increased significantly (both P < .001). Correlation analysis revealed significant negative associations between cognitive and emotional improvements (r = -0.67 to -0.46, P < .001). Receiver operating characteristic analysis showed that ΔMMSE had a strong predictive value for emotional recovery (area under the curve = 0.93, 95% confidence interval: 0.88-0.98), with 90.4% sensitivity and 87.5% specificity. Cognitive training combined with nursing intervention significantly improved cognition, emotion, and daily function in elderly patients with dementia. Cognitive improvement strongly predicted emotional recovery, underscoring the value of integrated, person-centered dementia care models in clinical practice.

BackgroundSleep is a pivotal component of cardiovascular health. However, clinical efforts in coronary heart disease (CHD) disproportionately focus on sleep-disordered breathing, while insomnia, the most prevalent sleep disorder among adults, remains underdiagnosed and undertreated.AimsThis meta-analysis systematically evaluates the prevalence of insomnia and its influencing factors in patients with CHD to inform clinical prevention and management strategies.MethodsTen databases were searched from inception to 7 September 2025. The prevalence rates, odds ratios (ORs), and 95% confidence intervals (CIs) were extracted to evaluate the prevalence of insomnia and its influencing factors in patients with CHD. RevMan 5.4 and Stata 15.0 software was used for data processing. Subgroup analyses, meta-regression, and sensitivity analyses were performed.ResultsNineteen studies involving 5928 patients with CHD were included. The overall pooled prevalence of insomnia was 51.8% (95% CI: 0.446–0.590, P < 0.001). Significant risk factors identified were female sex(OR = 2.00, 95% CI: 1.58–2.52, P < 0.001), anxiety (OR = 1.61, 95% CI: 1.36–1.91, P < 0.001), depression (OR = 2.15, 95% CI: 1.48–3.13, P < 0.001), CHD duration ≥3 years (OR = 1.73, 95% CI: 1.25–2.40, P = 0.001), diabetes (OR = 1.50, 95% CI: 1.45–1.56, P < 0.001), and gastritis (OR = 2.24, 95% CI: 1.62–3.11, P < 0.001).Conclusioninsomnia has a substantial prevalence in patients with CHD. Clinicians should prioritize early identification and intervention targeting modifiable risk factors (anxiety, depression, diabetes, and gastritis), particularly in female patients and those with a CHD duration ≥3 years.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024617785.

Background The global population is aging rapidly, and suicide among older adults aged 60 and over is a critical public health issue. Suicidal ideation (SI) is the strongest precursor to suicidal behavior. However, a comprehensive global synthesis of the prevalence and distribution of SI among older adults worldwide has been lacking. Objective This study aimed to systematically review the global prevalence of SI in older adults and explore its distribution across demographic, geographical, and methodological dimensions through subgroup analyses. Methods We systematically searched nine databases from inception to November 3, 2025, for observational studies. Two reviewers independently conducted study selection, data extraction, and quality assessment. Data were pooled using a random-effects model in Stata15.0 to calculate prevalence and perform subgroup analyses. The review was registered with PROSPERO (CRD420251233412). Findings Seventy-two studies comprising 625,891 older adults were included and the pooled prevalence was 12.8% (95%CI: 11.4% -14.1%). However, extreme heterogeneity was observed (I2=99.9%), and significant publication bias was present. The trim-and-fill adjusted prevalence was 5.7%. Subgroup analyses revealed significantly higher prevalence among the oldest old (≥80 years, 13.7%), women (17.8%), residents of Asia (13.8%), and developing countries (14.7%), and assessment of “current” SI reported significantly higher rates than other timeframes. Conclusion Although the precise pooled prevalence is uncertain due to substantial heterogeneity and publication bias, this study confirms that SI is prevalent concern among older adults globally, with risk disproportionately concentrated among the oldest old, women, and those in developing countries. The findings call for targeted public health strategies and underscore the imperative to use standardized assessment tools and address critical evidence gaps in future research.

AIM:Currently, frailty has become a central issue in health management among middle-aged and older people living with HIV/AIDS (PLWHA) worldwide. The objective is to develop targeted strategies to improve frailty in this group, enhance their long-term quality of life, and advance the management of chronic diseases in healthcare settings. METHODS:A comprehensive computer-based search was conducted across 11 databases to identify observational studies that reported the prevalence or influencing factors of frailty among middle-aged and older PLWHA. The search period spanned from the database's inception to August 19, 2025. The meta-analysis of the overall prevalence of frailty and associated factors was performed using Stata 17.0 and RevMan 5.4, respectively. Two independent researchers assessed the risk of bias using the Agency for Healthcare Research and Quality (AHRQ) and the Newcastle-Ottawa scale (NOS). RESULTS:This study screened 43 studies from 2040 publications. The meta-analysis revealed an overall prevalence of frailty among middle-aged and older PLWHA of 12%. Factors significantly associated with frailty in this population included age ≥ 60 years, single, widowed, or divorced, low educational level, history of tobacco use, ≥ 1 comorbidities, diabetes, hepatitis, renal disease, osteoporosis, sleep disorders, neurocognitive impairment, cardiovascular disease, presence of depressive symptoms, and current CD4 cell count < 200 cells/μL. CONCLUSION:Based on the evidence generated by this study, frailty management should be prioritized among PLWHA to support the transition of AIDS from a life-threatening disease to a manageable chronic condition, ultimately achieving the goal of enabling patients to live with quality and dignity.

Large language models (LLMs) may help with patient education, but clinicians must check LLM responses for accuracy, comprehensiveness, readability, and safety. This study compared responses from the LLMs ChatGPT-4.0, DeepSeek, Gemini, and Perplexity to 20 English-language questions about COPD that patients could present. Each question was submitted once to each LLM. Three COPD experts were blinded to the source LLM and independently scored 80 LLM responses for accuracy and comprehensiveness. Three readability indices were recorded; because they were strongly correlated, Flesch-Kincaid Grade Level (FKGL) was used as the primary readability metric. Accuracy differed across responses from the four LLMs (Friedman χ²(3) = 38.902, P < 0.001, Kendall’s W = 0.648), as did comprehensiveness (χ²(3) = 52.468, P < 0.001, Kendall’s W = 0.874). ChatGPT-4.0 and DeepSeek did not differ significantly on either outcome, and both scored higher than Gemini and Perplexity. Mean ratings from three experts showed moderate inter-rater reliability for accuracy [ICC(A,3) = 0.571] and comprehensiveness [ICC(A,3) = 0.685]. Perplexity had the highest FKGL, and no LLM consistently met the approximate eighth-grade target. Patient-facing LLM responses require clinical review.

Objective:To systematically evaluate the prevalence characteristics of sleep disorders among older adults residents in Chinese nursing homes and the differences among various subpopulations, providing evidence for promoting healthy aging. Methods:Search formulas were developed to systematically retrieve literature from the CNKI, VIP, Wan fang Data, CBM, PubMed, Web of Science, and Cochrane Library databases. Cross-sectional studies published from the inception of each database until May 2025 on the incidence of sleep disorders among older adults individuals in Chinese nursing homes were collected. Meta-analysis was performed using Stata 15.1 and R language (version 4.3.2). Results:A total of 35 articles were finally included, involving 15,996 older adults individuals residing in nursing homes. Meta-analysis revealed a pooled detection rate of sleep disorders of 43% (95% CI: 38-48%) among this population. Temporal trend analysis indicated significant fluctuations in the incidence of sleep disorders from 2008 to 2024, coupled with an overall downward trend. Subgroup analyses revealed statistically significant differences (p < 0.05) based on geographic region, sample size, gender, and the sleep disorder assessment tool used. Conclusion:The detection rate of sleep disorders among older adults residents in Chinese nursing homes is relatively high, with marked disparities across different groups. Significant attention should be directed toward the sleep health of this population. Comprehensive preventive and intervention measures tailored to the characteristics of different subpopulations should be developed and implemented to effectively improve sleep quality and reduce the risk of sleep disorders. Systematic review registration:https://crd.york.ac.uk/prospero/, identifier (CRD420251056822).

Background:Venous thromboembolism (VTE) is a common complication of malignant tumors. The incidence of VTE in patients with pancreatic cancer (PC) may be higher than that in other patients, but varies significantly between studies. Therefore, we aimed to investigate the incidence and risk factors for VTE in patients with PC. Methods:We searched relevant studies from seven electronic databases from their inception to December 25, 2024. The incidence of VTE, odds ratio (OR), and 95% confidence interval (CI) were extracted to evaluate the incidence of VTE and its risk factors in PC patients. The robustness of the results was tested by sensitivity analysis. We used funnel plot and Egger test to assess publication bias. Results:A total of 61 articles were included in this study, including 29,921 patients. The incidence of VTE was 15.6%. Tumor location (OR =1.92; 95% CI: 1.25-2.94), poorly differentiated (OR =2.54; 95% CI: 1.53-4.23), tumor, node, metastasis (TNM) stage IV (OR =2.82; 95% CI: 1.12-7.08), metastasis (OR =2.16; 95% CI: 1.59-2.93) and higher D-dimer (OR =4.33; 95% CI: 1.26-14.86) were risk factors for VTE. Conclusions:The incidence of VTE is high in patients with PC. The tumor located in the body or tail, poorly differentiated, stage IV cancer, distant metastasis, and increased D-dimer levels after surgery are risk factors for VTE. The limitations mainly include high heterogeneity. This indicates that such high-risk patients should be identified early in clinical work, and attention should be paid to the evaluation and intervention for VTE in patients with PC.

BACKGROUND:The predictive ability of the modified frailty index (mFI) for postoperative outcomes and survival in patients with gastric cancer (GC) remains uncertain. METHODS:Studies were retrieved from 11 electronic databases. Odds ratio (OR) and 95% confidence intervals (CIs) were used to report surgical outcomes, including overall survival (OS), complications, mortality, readmission, and nonhome discharge. The fixed or random effects model was used depending on the heterogeneity. Subgroup and meta-regression analyses were performed to determine the source of heterogeneity. RESULTS:This meta-analysis of 13 studies, including 15 359 GC patients, showed that high mFI scores were associated with reduced OS (OR = 1.35) and increased risk of poor postoperative outcomes (OR = 2.61). The older patients with higher mFI scores had a higher risk of worse OS after gastrectomy (OR = 1.69). CONCLUSIONS:This study demonstrated that high mFI scores were strongly associated with reduced OS and increased risk of poor outcomes following surgery in patients with GC, with a more than two-fold increase in the overall risk of poor outcomes. Compared to other tools, the mFI is easy to operate, making it an effective tool for prognosis assessment and personalized treatment and care planning. TRIAL REGISTRATION:PROSPERO (Registration Number: CRD42024613727).

To summarize the risk factors for Nosocomial Infection(NI) in patients after Percutaneous coronary intervention(PCI). The databases of PubMed, Web of Science, Embase, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Biological Medical Database (CBM), Chinese Wanfang Database, and China Science and Technology Journal Database (VIP) were searched for relevant articles from its inception to November 2024. This meta-analysis is based on RevMan5.4 software. The results' robustness was assessed using sensitivity analysis, and publication bias was assessed using Egger's test and funnel plot. The quality of the included studies was evaluated using the Newcastle–Ottawa scale. Twenty-six studies were included, involving 18,825 patients. The meta-analysis showed that: combined diabetes(Patients with post-PCI infection had diabetes) [OR = 2.17, 95

To summarise the available evidence concerning the incidence and risk factors of UTIs in bladder cancer patients after surgery. Systematic searches were conducted on PubMed, Embase, Web of Science, Cochrane Library, CINAHL, the China National Knowledge Base Database (CNKI), Wanfang Database, Vips Database (VIP), and the China Biomedical Database (Sinomed). These searches encompassed literature from the inception of each database up to March 2025. This study adhered rigorously to the PRISMA guidelines. The quality of the studies included in the review was assessed using the Joanna Briggs Institute (JBI) Centre for Evidence-Based Health Care in Australia and the Newcastle-Ottawa Scale. A total of 19 original studies were included in this analysis, encompassing 5,905 patients. The meta-analysis results indicated that the incidence of UTIs in patients with bladder tumor resection was 22.3

BackgroundOral health has emerged as a subject of significant public concern. Oral frailty represents the clinical presentation of advanced oral health decline and serves as a significant indicator of systemic frailty. However, current research on oral frailty in patients with chronic kidney disease (CKD) is quite limited.ObjectivesThis study aimed to investigate the prevalence and influencing factors of oral frailty among middle-aged and older CKD patients.MethodsThis was a cross-sectional study involving 307 CKD patients from two tertiary general hospitals in Chengdu, Sichuan Province, from November 2024 to March 2025. The Oral Frailty Index-8 (OFI-8), Mini Nutritional Assessment Short-Form (MNA-SF), Revised Piper Fatigue Scale (RPFS) and Hospital Anxiety and Depression Scale (HADS) were used to assess CKD patients. Chi-square tests and logistic regression analyses were used to determine the associated factors of oral frailty among CKD patients.ResultsThe prevalence of oral frailty among CKD patients was 61.9% (190/307). In binary logistic regression analysis, marital status, educational level, self-care ability, dentures, dry mouth, and the RPFS-CV score were identified as factors significantly increasing the risk of oral frailty in middle-aged and older hospitalized patients with CKD.ConclusionCompared with non-CKD patients, CKD patients demonstrate poorer oral health status, and oral frailty is common among CKD patients. This finding suggests the necessity for healthcare professionals to develop individualized and evidence-based strategies for the prevention and management of oral frailty, with particular emphasis on high-risk populations requiring targeted interventions.

ObjectiveTo conduct a meta-analysis of the prevalent characteristics of the injury-related behaviors among adolescents in China based on Chinese literature, so as to inform the prevention and control of injury-related behaviors of this population.MethodsA cross-sectional study on the prevalent characteristics of adolescent injury-related behaviors was conducted with the data collected from CNKI, VIP, Wanfang Data, CBM, PubMed, and Web of Science. The review included publications from the inception of the databases to November 2023. Meta-analysis was performed with Stata 15.1 software.ResultsA total of 40 articles were included in this study, and the meta-analysis results showed that cycling violation rate was 38% (95%CI: 32%‒43%), walking violation rate was 29% (95%CI: 22%‒36%), rate of unsafe swimming was 13% (95%CI: 11%‒14%), suicidal ideation rate was 13% (95%CI: 12%‒15%) and the prevalence of fighting was 19% (95%CI: 17%‒22%). Subgroup analysis showed that the cycling violation rate was (44%) for boys and 34% (95%CI: 28%‒40%) for girls. Adolescents in Northeast, East, and Southwest of China had the highest rate of cycling violation (44%), of which junior high school students had the highest rate of violation [42% (95%CI: 36%‒49%)]. As for the walking violation rate, male students [29% (95%CI: 21%‒37%)] was higher than that of female students [22% (95%CI: 15%‒30%)]. Adolescents in North of China had the highest rate of walking violation [54% (95%CI: 30%‒76%)], of which vocational school students accounted for 38% (95%CI:21%‒56%) of the total violation. In terms of the detection rate of unsafe swimming, male students [18% (95%CI: 14%‒24%)] was higher than that of female students [8% (95%CI: 6%‒10%)]. Adolescents in Central South China had the highest rate of unsafe swimming [15% (95%CI: 12%‒18%)], of which, vocational school students accounted for the highest [15% (95%CI: 10%‒19%)]. When it comes to the prevalence of suicidal ideation, female students [16% (95%CI: 13%‒19%)] was higher than that of male students [13% (95%CI: 11%‒15%)]. Adolescents in Southwest of China had the highest rate of suicidal ideation [17% (95%CI: 10%‒25%)], of which high school students accounted for the highest [15% (95%CI: 12%‒18%)]. Finally, the detection rate of fights was 30% (95%CI: 26%‒34%) for boys and 11% (95%CI: 10%‒14%) for girls. Adolescents from Southwest of China had the highest rate [29% (95%CI: 24%‒34%)] for fights, and junior high school students accounted for the highest [26% (95%CI: 22%‒31%)].ConclusionThe prevalence of harmful behaviors among adolescents in China is notably high, with statistical differences across gender, region, and school stages. These behaviors pose a risk to adolescent health, underscoring the need for targeted interventions by health and educational authorities.

Objective To quantitatively synthesise evidence on the prevalence of and risk factors of frailty in older patients with coronary heart disease. Methods Nine electronic databases were searched from the inception to July 20th 2024. Random-effects model was performed to calculate to estimate the prevalence of frailty in older patients with coronary heart disease. Meta-regression analysis and subgroup analysis were conducted to explore the potential sources of heterogeneity. Sensitivity analysis was conducted using a study-by-study exclusion method. Meta-analysis of risk factors was performed using the Mantel-Haenszel or inverse variance method and only on the risk factors that have been reported in a minimum of two studies. Results A total of 42 studies from 5 countries met the inclusion criteria, involving 11954 older patients. The pooled prevalence in older adults with coronary heart disease was 36% (95%CI: 31%-40%) for frailty. We found a higher prevalence of frailty among older patients with coronary heart disease in females, ≥80 years, case-control studies, EFS evaluation tool and acute coronary syndrome. Age, female, cardiac classification, malnutrition, fall within 1 year, sleep disorder, hypoproteinemia (albumin<35g/L), low level of literacy, depression, anxiety, low BMI, polypharmacy, comorbidities, CCI, diabetes, hypertension, high level of BNP, ADL disability, gait speed, living alone, low level of 25(OH)D3 were risk factors of frailty among older patients with coronary heart disease. Conclusions Coronary heart disease patients have a significantly higher prevalence of frailty. Early screening and timely prevention of frailty by medical practitioners are needed to provide more targeted measures for CHD patients.

BackgroundMetabolic syndrome, a significant risk factor for cardiovascular mortality in patients with end-stage renal disease, profoundly impacts patient prognosis and survival. Despite its clinical importance, the prevalence of metabolic syndrome remains unexplored in this population. Therefore, the objective of this study was to systematically assess the prevalence of metabolic syndrome among patients with end-stage renal disease and raise awareness among healthcare professionals.MethodsWe conducted a comprehensive search in CNKI, WANFANG, WeiPu, CBM, PubMed, Web of Science, EMBASE, and The Cochrane Library databases. The search time was until August 21, 2023. Standardized tables were employed for data extraction and imported into Stata 16.0 software for subsequent meta-analysis. A random-effects model was employed to estimate combined prevalence and 95% confidence intervals. Subgroup and sensitivity analyses were conducted to explore potential sources of heterogeneity, while publication bias was evaluated using a funnel plot and Egger's test. This study has been registered with PROSPERO under the registration number CRD42023456284.ResultsThis meta-analysis comprised 35 studies involving a total of 14,202 participants. The pooled prevalence estimate for metabolic syndrome was 49.0% [95% CI (46.0,53.0)]. We conducted subgroup analyses based on participant characteristics, gender distribution, publication year, national economic status, diagnostic criteria employed, and components of metabolic syndrome.ConclusionsThe prevalence of metabolic syndrome is higher among patients with end-stage renal disease, necessitating early prevention and control measures to reduce its incidence and delay the progression of the disease, thereby improving patient life expectancy.

Aims Post-transplant diabetes is a prevalent and consequential complication following kidney transplantation, which significantly augments the risk of cardiovascular disease, graft loss, infection, and mortality, thereby profoundly impacting both graft and patient survival. However, the early stages of post-transplant diabetes often go unnoticed or receive inadequate management. Consequently, this study systematically assesses the incidence of new-onset diabetes after kidney transplantation with the aim to enhance medical staff awareness regarding post-transplantation diabetes and provide clinical management guidance. Methods We conducted a comprehensive search across multiple databases including PubMed, Web of Science, Embase, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed until September 21, 2023. Data extraction was performed using standardized tables and meta-analysis was conducted using Stata 16.0 software. A random effects model was employed to estimate the combined prevalence along with its corresponding 95% confidence interval. The source of heterogeneity was explored using subgroup analysis and sensitivity analysis, while publication bias was assessed through funnel plot and Egger's test. This study has been registered with PROSPERO under the registration number CRD42023465768. Results This meta-analysis comprised 39 studies with a total sample size of 16,584 patients. The prevalence of new-onset diabetes after transplantation was found to be 20% [95% CI (18.0, 22.0)]. Subgroup analyses were conducted based on age, gender, body mass index, family history of diabetes, type of kidney donor, immunosuppressive regimen, acute rejection episodes, hepatitis C infection status and cytomegalovirus infection. Conclusions The incidence of post-kidney transplantation diabetes is substantial, necessitating early implementation of preventive and control measures to mitigate its occurrence, enhance prognosis, and optimize patients' quality of life. Clinical trial registration : PROSPERO: CRD42023465768.

Background: Restless legs syndrome is associated with quality of life and risk of death in maintenance hemodialysis patients. Although relevant meta-analyses have been conducted, epidemiological studies of restless legs syndrome have increased in recent years.Objective: Our aim was to systematically assess the prevalence of restless legs syndrome in maintenance hemodialysis patients and to evaluate the effect of different geographic regions, genders, study designs, and years of publication on the prevalence of restless legs syndrome. Methods: PubMed, Web of Science, EMBASE, The Cochrane Library, China Knowledge Resource Integrated Database, Wanfang Database, Weipu, and Chinese Biomedical Database were searched before March 16, 2023 for the published literature. Two investigators independently performed literature screening, data extraction for eligible studies, and risk of bias assessment. A random-effects model using the stata 15.0 software was used to assess the pooled prevalence of restless legs syndrome.Results: Fifty-seven articles were included in this meta-analysis, and the pooled prevalence of restless legs syndrome in 12,573 maintenance hemodialysis patients was 24.0 % (95 % CI: 21.0%-26.0 %). Maintenance hemodialysis patients from the Americas region and females had severe symptoms of restless legs syndrome, and the prevalence of restless legs syndrome increased from year to year. The prevalence of restless legs syndrome was higher in maintenance hemodialysis patients in cross-sectional studies and cohort studies compared to casecontrol studies. Conclusions: Maintenance hemodialysis patients have a significantly higher prevalence of restless legs syndrome. These findings may provide some reference value for hospital nursing staff to focus on the management and treatment of restless legs syndrome in maintenance hemodialysis patients.

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic disease worldwide, with significant negative impacts on the quality of life, family economic burden, and social healthcare burden of patients. Aims: The aim of this study was to explore the effects of virtual reality technology on exercise function and lung function in COPD patients. Methods: A meta-analysis of randomized controlled trials was utilized. PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, Medline, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) were systematically searched. We included randomized controlled trials published from the establishment of the database to August 10, 2022, on virtual reality technology in COPD patients. Literature retrieval and screening was carried out independently by two reviewers to obtain literature that met our inclusion and exclusion criteria and to extract relevant data. Two reviewers assessed the risk of bias in the included literature. A meta-analysis was performed using Revman 5.4 Software. Results: A total of 10 randomized controlled trials with 539 participants were included. The results showed that virtual reality technology significantly improved the lung function of COPD patients, such as forced expiratory volume (FEV1; MD = 7.29, 95% CI [4.34, 10.24], p < .01) and forced expiratory volume/forced vital capacity (FEV1/FVC; MD = 6.71, 95% CI [4.72, 8.71], p < .01). The combined intervention with different virtual reality technology had different effects on motor function. Compared with endurance training (ET) alone, virtual reality technology combined with ET had no significant effect on the 6-minute walk test (6WMT) in COPD patients (p > .05). Compared with pulmonary rehabilitation (PR) alone, virtual reality technology combined with PR was more effective in increasing 6WMT in COPD patients (MD = 30.80, 95% CI [10.85, 50.74], p < .01). Linking Evidence to Action: Virtual reality technology can help to improve lung function in COPD patients, and virtual reality combined with PR can improve exercise tolerance in COPD patients. However, due to the limited number of included studies, large-sample, multicenter, high-quality randomized controlled trial studies are needed to provide clear evidence.