Medical Thoracoscopic Thermal Ablation Therapy for Metastatic Pleural Tumors with Malignant Effusion: An Exploratory Retrospective Study

[Predictive Value of Prognostic Nutritional Index in Prognosis and Spontaneous Pleurodesis of Patients with Advanced Non-small Cell Lung Cancer and Malignant Pleural Effusion]

BACKGROUND

A prognostic nutritional index (PNI) developed by nutritional status and inflammation are closely associated with poor prognosis in malignant tumors. However, the predictive impact of PNI in patients with malignant pleural effusion (MPE) remains inconclusive. The study aimed to determine the predictive value of PNI in prognosis and spontaneous pleurodesis among patients with MPE.

METHODS

The patients diagnosed with advanced non-small cell lung cancer (NSCLC) with MPE in West China Hospital between January 2015 and December 2022 were reviewed and allocated randomly to development set(60%) and validation set(40%). After collecting clinical data, peripheral blood inflammation indices and calculating systemic inflammation indices, the effects of PNI on prognosis and spontaneous pleurodesis have been evaluated by Cox proportional hazards models, Kaplan-Meier method and Nelson-Aalen cumulative risk curve.

RESULTS

In total, 261 patients diagnosed NSCLC with MPE were selected (development set: n=157; validation set: n=104), of whom 58.2% were aged <65 years, 53.6% were male and 95.8% were diagnosed with adenocarcinoma. The dichotomous cut-off value for PNI was 44.1, respectively. Compared with lower PNI (PNI<44.1) cases, patients with higher PNI (PNI≥44.1) showed significantly longer overall survival (36.5 vs 24.3 mon, P=0.02) and higher incidence of spontaneous pleurodesis (P=0.009). According to the multivariate Cox analysis, higher PNI was associated with good prognosis and successful spontaneous pleurodesis (P<0.05). According to the results of Cox regression analysis, the PNI-prognosis and PNI-spontaneous pleurodesis models are determined, the receiver operating characteristic (ROC) curves are drawn, and the area under the curves (AUC) value of development set are 0.694 (95%CI: 0.620-0.776) and 0.673 (95%CI: 0.590-0.737).

CONCLUSIONS

PNI is a reliable biomarker of prognosis and spontaneous pleurodesis in patients with MPE. Attention to the patient's nutritional status and inflammation may improve the prognosis and efficacy of pleural effusion.

The Psychological Nursing Interventions Based on Pygmalion Effect Could Alleviate Negative Emotions of Patients with Suspected COVID-19 Patients: a Retrospective Analysis

PURPOSE

This study aims to explore the psychological status of suspected COVID-19 patients during quarantine and put forward a new yet effective psychological nursing strategy for intervention.

PATIENTS AND METHODS

We performed a retrospective study with suspected COVID-19 patients who were hospitalized to the two hospitals of Hunan province, China and accepted the intervention of psychological nursing from 01/2020 to 03/2020. The control group received routine psychological nursing care and the observation group received the new psychological nursing intervention according to Pygmalion effect.

RESULTS

A total of 89 objects were included in the analysis. Results of the questionnaire before intervention showed that the majority of isolated suspected COVID-19 patients showed negative emotions, with the incidence of depression (51.69%), anxiety (14.617%), inverted provocation (22.47%), extraverted provocation (25.84%). And the extraverted provocation scores of female patients was significantly higher than that of male counterparts (P < 0.05). At discharge, compared with the control group, the scores of depression, anxiety, introversion and extraversion of patients in the observation group were significantly lower after nursing intervention based on Pygmalion effect. The satisfaction rate of psychological care based on Pygmalion effect was 86.66%.

CONCLUSION

Suspected COVID-19 patients tend to show the symptoms of depression, anxiety and irritation during quarantine. The psychological nursing based on Pygmalion effect is helpful to alleviate their negative emotions.