Network evolution of core symptoms after lung cancer thoracoscopic surgery:A dynamic network analysis.

OBJECTIVES: To investigate relationships between various symptoms occurring 1-2 and 5-6 days following days after thoracoscopic surgery, to identify core symptoms, and to monitor changes in core symptoms over time following lung cancer thoracoscopic surgery. METHODS: We evaluated symptoms using the Anderson Symptom Scale (Chinese version) and the Lung Cancer-Specific Symptoms Template in 214 lung cancer patients hospitalized in the Department of Thoracic Surgery of a provincial hospital in Jiangsu Province from March 2023 to September 2023. Data was collected at 1-2 days and 5-6 days postoperatively. Symptom networks were constructed for each time point, and centrality indicators were analyzed to identify core symptoms while controlling for influencing factors. RESULTS: According to the network analysis, fatigue (rs = 26.00、rc = 0.05、rb = 1.02) had the highest strength, closeness, and betweenness in the symptom network 1-2 days after lung cancer surgery. At 5-6 days after surgery, shortness of breath (rs = 27.00) emerged as the symptom with the highest strength, fatigue (rc = 0.04) had the highest closeness, and cough (rb = 1.08) ranked highest in betweenness within the symptom network. CONCLUSION: Fatigue stands out as the most core symptom in the network 1-2 days after lung cancer surgery. Shortness of breath, fatigue and cough are the most core symptoms in the symptom network 5-6 days after surgery. Therefore, clinical staff can improve the postoperative symptom experience of lung cancer patients by developing symptom management programmes tailored to these core symptoms.

Association between dietary inflammatory potential and frailty is mediated by inflammation among patients with colorectal cancer: A cross-sectional study.

Patients with colorectal cancer (CRC) are at high risk of frailty, leading to reduced quality of life and survival. Diet is associated with frailty in the elderly through regulating inflammation. Thus, we hypothesized that dietary inflammatory potential (as assessed by dietary inflammatory index [DII]) might be associated with frailty in patients with CRC through regulating inflammatory biomarkers. A total of 231 patients with CRC were included in this cross-sectional study. Dietary intake was evaluated by 3-day, 24-hour dietary recalls, and frailty status was assessed in accordance with the Fried frailty criteria. Plasma inflammatory cytokines were determined in 126 blood samples. A total of 67 patients (29.0%) were frail, with significantly higher DII scores than nonfrail patients, accompanied with significantly increased interleukin-6 (IL-6) and decreased interleukin-10 (IL-10) concentrations. Each 1-point increase of DII was related to a 25.0% increased risk of frailty. IL-6 was positively correlated with frailty and DII, whereas IL-10 was negatively correlated. After adjusting for age, sex, body mass index, education level, smoking status, and energy, mediation analysis revealed that the association between DII and frailty was significantly mediated by IL-6 (average causal mediation effect [ACME], 0.052; 95% confidence interval, 0.020-0.087; P = .002) and IL-10 (ACME, 0.025; 95% confidence interval, 0.004-0.063; P = .016). The ρ values for the sensitivity measure at which estimated ACMEs were zero were 0.3 and -0.2 for IL-6 and IL-10, respectively. Therefore, a pro-inflammatory diet was associated with frailty in patients with CRC possibly in part by affecting circulating IL-6 and IL-10 concentrations.

Dyadic effects of social support, illness uncertainty on anxiety and depression among lung cancer patients and their caregivers: a cross-sectional study.

OBJECTIVES: To explore the dyadic relationships between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and their family caregivers. To examine the potential mediating role of illness uncertainty and the moderating role of disease stage in lung cancer patient-caregiver dyads. METHODS: A total of 308 pairs of lung cancer patients and their family caregivers from a tertiary hospital in Wuxi, China, from January 2022 to June 2022 were included. Participants' perceived social support, illness uncertainty, anxiety, and depression were assessed by corresponding questionnaires. To test for dyadic relationships between the variables, we employed the actor-partner interdependence mediation model. RESULTS: There were actor and partner effects of both patient and caregiver perceived social support on anxiety and depression, and illness uncertainty mediated the effect of perceived social support on anxiety and depression. Lung cancer stage plays a moderating role in lung cancer patient-caregiver dyads. There is an indirect positive partner effect of perceived social support from family caregivers on anxiety and depression in patients with early lung cancer; there is a direct or indirect negative partner effect of social support from family caregivers on anxiety and depression in patients with advanced lung cancer. CONCLUSIONS: This study confirmed the dyadic interdependence between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and family caregivers. Furthermore, studies on differences between different lung cancer stages may provide a theoretical basis for different dyadic supportive interventions based on lung cancer stages.

Impact of caregiver burden on caregiver mental health in patients with esophageal cancer: chain mediating effects of benefit finding and rumination, a cross-sectional study.

Background: Cancer caregivers are the main supporter for the tumor patients, they not only need to provide daily nursing to the patients, but also suffering the pressure from economy, emotion and even family members. The mental health of tumor patient is mostly noticed, while not caregivers. The mental health of caregiver greatly affected the nursing quality and even the treatment outcomes. In the current study, the mechanisms underlying the links between caregiver burden, benefit finding, mental health, and rumination in those caring for people with esophageal cancer were examined. Methods: The study was using a convenience sampling, 166 esophageal cancer patients in 2 general hospitals in Jiangsu Province, China, and caregivers of patients were included after excluded the non-conforming patients. Data were collected using investigator-developed questionnaires, the Benefit Finding Scale (BFS), the Event-Related Rumination Inventory (ERRI), the Zarit Burden Interview (ZBI), and the Hospital Anxiety and Depression Scale (HADS) during May 2020 to December 2020. The results were analyzed by SPSS, and the chain mediating effect was analyzed by the the SPSS PROCESS Macro Model. Results: The study comprised 166 caregivers with an average age of (59.96±11.48) years, most of them were female (85.5%). The ZBI was positive correlated with HADS (r=0.882, P<0.01), and negative correlated with BFS (r=-0.873, P<0.01). Intrusive rumination and deliberate rumination in caregivers were negatively correlated (r=-0.901, P<0.01) and positive correlated (r=0.904, P<0.01) with BFS scores, respectively. Furthermore, research have discovered a chain mediation impact of benefit finding and rumination between caregiver burden and psychological well-being among carers of esophageal cancer patients. Conclusions: The findings of this study imply that benefit finding and rumination are crucial components of the coping strategy used to buffer against negative emotion (such as anxiety and depression). Therefore, the mental health of caregivers should also be noticed, and health care professionals should provide targeted interventions to increase the caregiver's level of benefit finding and promote deliberate ruminative thinking.

Impact of Gut Microbiota on the Association between Diet and Depressive Symptoms in Breast Cancer.

Little is known about the relationship between diet and depression through the gut microbiota among breast cancer patients. This study aimed to examine the dietary intake differences between depressed breast cancer (DBC) and non-depressed breast cancer (NBC) patients, and whether the differences could lead to gut microbiota changes that affect depressive symptoms. Participants completed the Center for Epidemiological Studies-Depression Scale (CES-D) and 24 h dietary recall. Fecal samples of 18 DBC patients and 37 NBC patients were collected for next-generation sequencing. A total of 60 out of 205 breast cancer patients reported significant depressive symptoms suggested by a CES-D score ≥ 16, which might be related to lower intakes of energy, protein, dietary fiber, vitamin A, vitamin B2, niacin, calcium, phosphorus, potassium, iron, zinc, selenium, manganese and tryptophan, and a poor diet quality indicated by a lower total Chinese Healthy Eating Index (CHEI) score. Additionally, NBC patients demonstrated greater gut microbiota diversity and a healthier composition, in which the relative abundances of Proteobacteria and Escherichia-Shigella were both lower than in the DBC patients (p < 0.05). Alpha diversity was a significant mediator between diet quality and depression, while calcium, phosphorus and selenium significantly regulated depression independent of the gut microbiota. Breast cancer-related depressive symptoms might be associated with a poor diet quality via gut microbiota-dependent pathways and lower micronutrient intake via microbiota-independent pathways.

TNF-α Mediates the Association between Dietary Inflammatory Index and Depressive Symptoms in Breast Cancer.

This study examined the association between the energy-adjusted Dietary Inflammatory Index (E-DII)-based dietary inflammatory potential and depressive symptoms (DepS) among patients with breast cancer and explores whether systemic inflammation mediates this association. We assessed dietary intake and DepS in 220 breast cancer patients by three 24 h dietary recalls and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and determined plasma levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-1ß, IL-4, and IL-6 in 123 blood samples. We found that each one-point increase of E-DII was related to a 53% elevated risk of DepS. Patients with the most pro-inflammatory diets had a 5.13 times higher risk of DepS than those with the most anti-inflammatory diets. Among the E-DII components, vitamin B2, zinc, and iron were inversely associated with DepS risk. Furthermore, E-DII scores were positively associated with CRP and TNF-α. Higher levels of TNF-α and IL-6 were associated with higher DepS risk. A significant mediating effect of TNF-α was revealed between E-DII and DepS. Our findings suggest that a pro-inflammatory diet is positively associated with breast cancer-related DepS, which may be mediated by TNF-α.

The construction of the structural equation model of burden, benefit finding, and anxiety-depression of esophageal cancer caregivers based on Lazarus stress and coping theory.

BACKGROUND: A large number of studies have shown that the assignment of long-term care duties brings great pressure and negative emotions to caregivers of cancer patients, and also affects the quality of care. Lazarus and Folkman's stress and coping theory holds that the process of cognition and evaluation of stress is key to the stress response when a stressor acts on individuals. This study is to explore the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers, according to a model hypothesis constructed based on stress and coping theory. The design of this study involved correlation and theoretical testing using a structural equation model. METHODS: A total of 228 pairs of esophageal cancer patients from 2 tertiary hospitals and their family caregivers were recruited in this study from May 2020 to January 2021. A questionnaire survey was conducted using the general information questionnaire, the caregiver burden inventory (CBI), the benefit finding scale (BFS), and the hospital anxiety and depression scale (HADS). RESULTS: A good fitting model [chi-square (χ2)/degrees of freedom (df) =2.212, root mean square error of approximation (RMSEA) =0.07, comparative fit index (CFI) =0.976, Tucker-Lewis index (TLI) =0.964, goodness of fit (GFI) =0.954, normed fit index (NFI) =0.957] indicated the mediating effect of benefit finding between caregiver burden and anxiety-depression of esophageal cancer caregivers. A higher level of benefit finding had a negative effect on caregiver burden and anxiety-depression, which reduced the burden and psychological distress of caregivers. The theoretical hypothesis was validated. CONCLUSIONS: Clinical nurses should pay attention to the benefit finding level of caregivers. For caregivers with low-level of benefit finding, intervention measures should be taken to improve the psychological cognitive level of caregivers, which can ultimately improve the quality of life of patients.

Status quo of exercise participation among gastric cancer patients after radical gastrectomy and analysis of the influencing factors.

BACKGROUND: To investigate the status quo of participation in exercise among gastric cancer patients after radical gastrectomy and analyze the influencing factors. METHODS: Convenient sampling was used to conduct a questionnaire survey of 163 patients after radical gastric cancer surgery from January to December 2020. The survey content included general information, exercise participation, exercise knowledge, attitude, and social support. Descriptive statistics, single factor analysis, and multiple linear regression analysis were performed using Statistical Product and Service Solutions 24.0 (SPSS24.0, IBM, USA). RESULTS: After radical gastrectomy, the form of exercise that patients participated in was relatively simple. The average amount of exercise involved was 8.10 Mets-h/week, which was at the level of almost no exercise. Univariate analysis showed that differences in age, gender, education level, work status, main caregivers and sports knowledge, attitudes, and social support levels all led to different levels of exercise participation. Multiple linear regression analysis showed that the factors affecting the patient's level of participation in exercise included age, degree of self-care in life, attitude towards exercise after surgery, and level of social support. CONCLUSIONS: The status quo of exercise participation among gastric cancer patients after radical gastrectomy is not ideal. In this study, we found that age, level of self-care in life, sports attitude, and level of social support were the main factors affecting the exercise participation of patients. Therefore, improving patients' self-care ability, exercise attitude, and increasing social support may play an important role in improving the status quo of patients' exercise participation after radical gastric cancer surgery.

Effectiveness of aerobic exercise on upper limb function following breast cancer treatment: a systematic review and meta-analysis.

BACKGROUND: Aerobic exercise is currently considered to be an effective method of rehabilitation in breast cancer patients. Studies have shown that aerobic exercise after breast cancer surgery can improve upper limb function, cardiopulmonary function, and quality of life. Breast cancer rehabilitation guidelines encourage patients to actively participate in aerobic exercise to promote rehabilitation, the current study is to evaluate the effectiveness of aerobic exercise on upper limb muscle strength and range of motion (ROM) following breast cancer treatment. METHODS: Electronic databases (Cochrane Library, PubMed, Web of Science, EBSCO and Embase) were searched for randomized controlled trials (RCTs) published before September 1, 2019, using the search terms "aerobic exercise", "exercise", "breast cancer", "muscle strength", "strength", "flexibility" and "function". Grip strength and shoulder joint ROM were used to evaluate upper limb strength and upper limb flexibility respectively. All statistical tests were performed using RevMan5.3 software. RESULTS: Nine RCTs (421 patients) were included for analysis, with JBI scores ranging from 19 to 23, and bias grade B for all studies among which, there were six studies reported change in grip strength, and five studies reported change in shoulder joint ROM. Meta-analysis showed a statistically significant difference in shoulder flexion ROM (MD =4.97, 95% CI: 0.47-9.46, P=0.03), shoulder abduction ROM (MD =8.95, 95% CI: 0.99-16.91, P=0.03), shoulder internal rotation ROM (MD =3.45, 95% CI: 1.80-5.09, P<0.0001), shoulder external rotation ROM (MD =7.69, 95% CI: 0.06-15.32, P=0.05) between the intervention and control groups following completion of the aerobic exercise intervention, while there were no significant improvement with respect to grip strength and shoulder extension ROM (P>0.05). CONCLUSIONS: Aerobic exercise could improve shoulder joint ROM in breast cancer survivors, but shows no obvious effect on the improvement of upper limb strength.

[Clinical efficacy of heated humidified high-flow nasal cannula in preventing extubation failure in neonates: a Meta analysis].

OBJECTIVE: To evaluate the efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) in preventing extubation failure in neonates. METHODS: A literature search was performed using PubMed, Cochrane Library, FMRS, and CNKI to collect the randomized controlled trials (RCTs) and quasi-RCTs which compared the clinical efficacy of HHHFNC and nasal continuous positive airway pressure (NCPAP) in preventing extubation failure in neonates. The identified studies were finally selected after full-text search and quality assessment and then subjected to a Meta analysis using RevMan 5.3. RESULTS: Five eligible trials involving 1040 neonates were included in the Meta analysis. The Meta analysis showed that there was no significant difference in treatment failure rate between the HHHFNC and the NCPAP groups. The HHHFNC group had significantly lower incidence rates of nasal trauma (OR=0.49, 95% CI: 0.34-0.71, P=0.0001) and pneumothorax (OR=0.27, 95% CI: 0.07-0.97, P=0.04) than the NCPAP group, but there were no significant differences in the duration to reach full oral feedings and the incidence rates of serious adverse events or other complications between the two groups, such as in-hospital mortality, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity. CONCLUSIONS: HHHFNC is safe and effective in preventing extubation failure in neonates.