Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs.     

急性胰腺炎微创治疗进展

急性胰腺炎是一种起病急、病情危、进展快的临床危重症,其发病原因较为多样,易引发多种并发症,患者病死率较高,随着近些年医疗技术的不断进步,微创治疗已逐渐成为急性胰腺炎重要干预手段之一,使急性胰腺炎的综合治疗水平得以明显提升。本文作者拟结合临床经验,参考相关文献资料,就急性胰腺炎微创治疗的研究进展加以综述,以期为改善急性胰腺炎患者预后提供临床参考。     

肝移植受者延续护理中应用远程随访管理系统的效果研究

目的:探讨肝移植受者延续护理中应用远程随访管理系统的效果。方法:挑选2018年6月—2019年12月医院接受治疗的60例肝移植受者,在其出院后2周以自制的远程随访管理系统对其展开居家延续护理。结果:医护小组达成了对受者术后疾病状况的远程监控,通过视频交流为病人提供706例次健康指导。所有研究对象对远程随访管理系统的接受率、掌握率、应用时间、每次视频交流时间分别为81.08%、100.00%、(10.53±2.49)d、(12.13±2.69)min。肝移植受者满意度最高的3项依次是视频交流方式、延续护理模式、指导或者咨询内容;延续护理小组满意度最高的3项依次是病情变化处理方法、视频交流方式、指导或者咨询内容。结论:通过远程随访管理,为肝移植受者开展延续护理是现实可行的,不但能使肝移植受者的术后自我管理能力得到有效提升,且受者及延续护理小组都对此系统的应用具有较高的满意度。     

基于生物钟节律探讨前列腺癌的 发病机理及择时治疗策略

生物钟节律观与中医“天人一体”观相契合，生物钟节律紊乱可影响人体的生理病理状态，通过调节生物钟节律可达到提高治疗效果的目的。生物钟节律系统包括中枢生物钟节律系统与外周生物节律系统两大系统，分别在疾病发生发展中发挥不同的作用。与之相应，择时疗法是根据人体气血阴阳节律变化而选择相应药物治疗以达到最佳的疗效的一种时间医学治疗方法。临床上许多前列腺癌患者的发病与生物钟节律紊乱密切相关，通过调整生物钟节律具有预防和改善前列腺癌预后的积极作用。因此，本文将以现代生物钟节律的生理及病理机理为切入点，探讨不同生物钟节律系统紊乱在促前列腺癌中医主证形成过程中的发生机理，进而探讨择时治疗策略在不同类型前列腺癌治疗中运用的可行性，以期对前列腺癌的防治及预后产生一定的影响。     

腹腔镜精准肝切除术治疗原发性肝癌的临床效果

目的探究腹腔镜精准肝切除术治疗原发性肝癌的临床效果。方法选择2019年1月—2020年6月期间在医院接受腹腔镜肝切除术治疗的80例原发性肝癌患者作为实验分析对象,依据手术治疗方案的不同将患者分为腹腔镜常规肝切除组(对照组)40例和腹腔镜精准肝切除组(观察组)40例,对两组患者手术各项指标、手术前后肝功能指标改善情况及术后并发症发生率进行对比分析。结果观察组患者手术时间明显长于对照组,组间比较进行t检验,差异具有统计学意义(P<0.05);观察组患者术中出血量及术中输血量均少于对照组患者,术后恢复时间明显短于对照组患者,组间比较进行t检验,差异具有统计学意义(P<0.05);术后,两组患者ALT、AST、ALB及TBIL水平均显著降低,组内比较进行t检验,差异具有统计学意义(P<0.05),观察组患者ALT、AST、ALB及TBIL水平降低幅度显著大于对照组患者,组间比较进行t检验,差异具有统计学意义(P<0.05);观察组患者术后并发症发生率为10.00%,对照组患者术后并发症发生率为27.50%,组间比较进行χ2检验,差异具有统计学意义(χ2=4.021;P=0.045)。结论与腹腔镜常规肝切除术比较,腹腔镜精准肝切除术操作精细,手术时间相对较长,患者术中出血量更少,术后恢复时间更短,能够最大限度保护患者的肝脏,减低患者术后并发症发生率,提高手术治疗效果,改善患者预后。