Current Research in Medical Sciences

Application of Individual Case Management Nursing Model in Symptom Management of Palliative Care for Patients Undergoing Chemotherapy

2026-05-21T06:46:11+00:00

Objective: To investigate the effect of symptom management strategies in palliative care for patients undergoing chemotherapy, analyze their impacts on symptom relief, quality of life and treatment adherence, and establish a nurse-led integrated intervention program. Methods: A total of 154 chemotherapy patients from a tertiary hospital were enrolled. A quantitative multi-method design was used, including questionnaire survey, Spearman correlation analysis and linear regression analysis to evaluate the current status and predictive effect of symptom management. Results: Symptom management in palliative care was generally effective: pain management (3.65), nausea and vomiting control (3.60), emotional and psychological support (3.62), spiritual care (3.60), fatigue management (3.55). Palliative care-enhanced components significantly improved symptom relief (3.63), quality of life (3.61) and treatment adherence (3.58). Symptom management strategies had a very strong positive correlation with palliative care outcomes (r=0.972, P<0.001) and significantly predicted patient outcomes (R²=0.953, P<0.001). Conclusion: Symptom management for chemotherapy patients in palliative care is generally effective but remains to be optimized. The quality of symptom management directly determines the effect of palliative care. A nurse-led integrated symptom management program is recommended to strengthen assessment, education, psychological support and spiritual care, so as to further improve patient prognosis and quality of life.

The Application of the T1WI Sequence in High-Grade Serous Ovarian Cancer

2026-05-21T06:50:39+00:00

T1-weighted magnetic resonance imaging (T1WI) sequences are emerging as a powerful tool for the assessment of high-grade serous ovarian cancer (HGSOC), providing unique insights into tumour biology, the composition of the microenvironment, and treatment response. The intrinsic T1 signal changes in HGSOC arise from intrinsic pathophysiological features such as intratumoural haemorrhage, necrosis and increased protein content; these factors shorten T1 relaxation times and are independent of contrast agent administration. Following contrast administration, dynamic T1 changes reflect vascular remodelling and extracellular matrix expansion—hallmark features of aggressive disease—whilst genomic instability (particularly BRCA-associated phenotypes) further modulates T1-visible tissue characteristics. Technological advances have driven the evolution of T1 assessment from qualitative imaging towards quantitative pixel-level T1 mapping and dynamic contrast-enhanced (DCE) modelling, thereby enabling the extraction of pharmacokinetic parameters associated with tumour biology. The integration of synthetic MRI with machine learning algorithms has significantly improved the reproducibility and accuracy of T1 feature quantification. Clinically, pre-treatment T1 metrics show promise in predicting platinum resistance, whilst early post-contrast T1 kinetics during neoadjuvant chemotherapy correlate with treatment response and progression-free survival, often demonstrating superior predictive value compared to CA-125 trends. Compared with diffusion-weighted imaging, FDG-PET/CT and conventional CT, T1-based detection methods exhibit higher specificity in identifying microenvironmental features, can reduce inflammatory false positives, and improve the detection rate of peritoneal lesions by enhancing soft tissue contrast. Practical application requires standardisation of protocols regarding timing, fat suppression and magnetic field strength, whilst consensus must be reached on the definition of regions of interest and clinically relevant thresholds. Despite these advances, challenges remain, including inter-platform variability, interference from iron deposition and ascites, and a lack of prospective, multicentre validation, which hinder its inclusion in current guidelines. Looking ahead, AI-driven radiomics, multi-parametric MRI features, and the role of T1 sequences as dynamic biomarkers for anti-angiogenic therapies will position T1 sequences at the forefront of precision oncology and therapeutic diagnostic strategies for HGSOC.

Combined Acupuncture and Moxibustion for Chronic Nonspecific Low Back Pain: A Three-Arm Assessor-Blinded Randomized Trial with Inflammatory Biomarker Assessment

2026-06-23T02:42:07+00:00

Background: Chronic nonspecific low back pain (CNLBP) represents a leading global cause of disability. Long-term pharmacological management is restricted by various adverse effects, while complementary acupuncture-moxibustion is widely applied in clinical practice. High-quality three-arm randomized trials quantifying the incremental benefit of supplementary moxibustion remain scarce, and correlations between clinical gains and systemic inflammatory changes require further clinical verification. Objective: This trial aimed to evaluate incremental clinical benefits of adding moxibustion to standardized acupuncture relative to acupuncture monotherapy and conventional rehabilitation, and explore potential correlations between symptom improvement and peripheral inflammatory fluctuations. Methods: This prospective single-center assessor-blinded three-arm randomized trial was performed following CONSORT 2010 and STRICTA 2010 guidelines, prospectively registered at Chinese Clinical Trial Registry (ChiCTR240008569, registration date: March 12, 2024; recruitment initiated from March 15, 2024 to September 30, 2024; final follow-up finished March 2025). A total of 156 eligible participants were randomized at a 1:1:1 ratio. The primary endpoint was adjusted between-group difference in week-8 NRS change from baseline. Secondary endpoints included ODI, PSQI, EQ-5D-5L, PGIC, weekly paracetamol consumption and serum hs-CRP, IL-6, TNF-α. Intention-to-treat (ITT) served as primary analysis set, per-protocol (PP) for sensitivity analysis (Global Burden of Disease Collaborative Network, 2023); multiple imputation with 20 chained datasets was adopted for missing values. Linear mixed-effects model and ANCOVA corrected for baseline covariates; Bonferroni correction was applied for secondary outcome pairwise comparisons. Results: Among 192 screened patients, 36 were excluded and 156 randomized. Eleven participants dropped out within the 8-week intervention, with another six lost to follow-up from week 8 to week 24; 145 completed 8-week treatment and 139 finished the final 24-week follow-up. All baseline indicators were balanced across three groups (all P>0.05). At week 8, combined therapy yielded superior NRS reduction versus acupuncture alone (adjusted MD = −1.18, 95% CI: −1.74 to −0.62, P < 0.001, Cohen’s d=0.78) and rehabilitation (adjusted MD = −2.31, 95% CI: −2.89 to −1.73, P < 0.001, Cohen’s d=1.24), and the inter-group difference exceeded predefined MCID of 1.0 point. Significant improvements in ODI, PSQI and EQ-5D persisted up to week 24. The proportion of patients achieving ≥50% NRS reduction was 61.5%, 38.5% and 19.2% for combined, acupuncture and rehabilitation groups respectively; weekly paracetamol intake decreased by 74.2%, 50.0% and 25.0% (Qaseem A, et al., 2017). Serum pro-inflammatory cytokines declined more substantially in combined cohort. Only mild, self-limited adverse events occurred with no severe adverse incidents recorded. Conclusion: Combined acupuncture-moxibustion generates statistically and clinically meaningful extra benefits for CNLBP in pain relief, physical function, sleep and quality of life alongside reduced rescue analgesic intake, with durable therapeutic effects sustained for six months. Reduced peripheral inflammatory markers suggest potential associations between clinical remission and alleviated systemic low-grade inflammation, without definitive causal evidence. Further multicenter sham-controlled trials are required to validate present findings.

Diagnostic Limitations and Antibiotic Overuse in Nigerian Primary Care

2026-06-24T06:14:14+00:00

Antibiotic overuse in Nigerian primary care is not only a problem of prescribing behavior. It is also closely related to the diagnostic conditions under which primary care workers make everyday clinical decisions. In many primary health facilities, limited laboratory access, delayed test results, weak referral links, and shortage of basic diagnostic support make it difficult to distinguish bacterial infections from viral or self-limiting illnesses. Under this uncertainty, antibiotics may be used as a safer and faster option, especially when patients present with fever, respiratory symptoms, diarrhea, wound infection, or childhood illness. This paper discusses how diagnostic limitations contribute to empirical prescribing and antibiotic overuse in Nigerian primary care. It also considers the influence of patient expectations, community access to antibiotics, and weak antimicrobial stewardship at the primary care level. The paper argues that reducing antibiotic overuse should not rely only on asking clinicians to prescribe less. A more realistic response requires better diagnostic support, clearer prescribing guidance, continuing training for health workers, patient education, and stronger links between primary care, pharmacies, and surveillance systems. In this sense, antibiotic stewardship in Nigerian primary care should be built around clinical uncertainty rather than separated from it.

Standardized Traditional Chinese Medicine External Therapy for Chronic Soft Tissue Pain: A Multicenter Observational Study

2026-06-24T06:16:59+00:00

Chronic soft tissue pain has brought a heavy global social and economic burden, while conventional treatments have obvious limitations in efficacy and safety. Traditional Chinese Medicine external therapies (TETs) including cupping, scraping and moxibustion are widely used clinically, yet inconsistent operation standards lead to high research heterogeneity and poor repeatability. This multicenter observational study aimed to evaluate the clinical efficacy, safety, dose-response relationship and cost-effectiveness of standardized TETs for chronic soft tissue pain, and explore the influencing factors of therapeutic effects. A total of 1000 eligible patients from 5 tertiary hospitals across China were divided into three groups: standard TET combined with conventional management (Arm A, n=500), conventional management alone (Arm B, n=300), and high-intensity TET combined with conventional management (Arm C, n=200). All operators received unified training and quantitative operational parameters were adopted to reduce research heterogeneity. Outcome indicators included Numerical Rating Scale (NRS), functional scales, quality of life scales, inflammatory cytokines and neurotrophic factors, with a 24-week observation and 6-month follow-up. Results showed that at the 12th week, the mean NRS reduction of Arm A, B and C was 31.8, 22.0 and 37.9 points respectively. Standardized TETs significantly relieved pain, improved physical function and quality of life, and down-regulated inflammatory factors while up-regulating neurotrophic factors. The weekly treatment frequency of twice was confirmed as the optimal regimen with an obvious ceiling effect in high-frequency intervention. Operation standardization was an independent positive predictor of clinical efficacy. The adverse reactions of TETs were mild and transient, and the intervention had good cost-effectiveness. In conclusion, standardized TETs combined with conventional management is an effective, safe and economically superior regimen for chronic soft tissue pain. The established quantitative standard system effectively solves the problem of poor repeatability of TCM external therapies, which is worthy of clinical popularization and further international research and promotion.

Kupffer Cell Activation and Inflammatory Progression in MASLD

2026-06-24T09:07:42+00:00

Metabolic dysfunction-associated steatotic liver disease, or MASLD, is not only a disorder of hepatic fat accumulation, but also a disease shaped by metabolic stress and immune activation. Among the immune cells involved in this process, Kupffer cells play a central role because they are liver-resident macrophages located at the interface between hepatocytes, gut-derived signals, and systemic metabolic inflammation. Under normal conditions, Kupffer cells help maintain liver homeostasis by clearing pathogens, removing cellular debris, and regulating immune tolerance. In MASLD, however, persistent lipid overload, hepatocyte injury, oxidative stress, endotoxin exposure, and adipose tissue inflammation can shift Kupffer cells toward chronic inflammatory activation. Activated Kupffer cells release cytokines and chemokines such as TNF-α, IL-1β, IL-6, and CCL2, which worsen hepatocyte stress, recruit additional immune cells, and support the transition from simple steatosis to metabolic dysfunction-associated steatohepatitis. Their interaction with hepatic stellate cells also connects inflammation with fibrosis development. This essay discusses Kupffer cell activation as a key mechanism in MASLD progression and argues that the disease should be understood as a dynamic process involving metabolic overload, immune response, failed inflammatory resolution, and fibrotic remodeling. Recognizing the dual role of Kupffer cells may help explain why MASLD progression cannot be reduced to fat accumulation alone.