Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects around 35%–50% of men during their lifetime. The efficacy of current oral medication for CP/CPPS remains limited. Recent studies demonstrated that vagus nerve stimulation may improve chronic pelvic and abdominal pain. Accordingly, transcutaneous auricular vagus nerve stimulation (taVNS) might represent a promising, non-invasive therapeutic approach for the clinical management of CP/CPPS.

The trial of Transcutaneous Auricular vagus nerve Stimulation for moderate to severe Chronic Prostatitis/CPPS is a prospective, randomised, sham-controlled trial with a 1:1 allocation ratio. Participants will be assigned randomly to either the taVNS group or the sham-taVNS group. The intervention period will consist of a 4-week treatment (a total of 40 sessions), followed by an 8-week follow-up period. The primary outcome is the change from baseline in the National Institutes of Health Chronic Prostatitis Symptom Score Index total score at week 4. Secondary outcomes include the International Prostate Symptom Score Scale, European Quality of Life 5-Dimensions-5-Levels questionnaire, Self-Rating Anxiety Scale and Self-Rating Depression Scale. Safety assessments will be conducted throughout the entire study period.

This study protocol and informed consent documents were reviewed and approved by the Institutional Review Board of Guang’anmen Hospital, China Academy of Chinese Medical Sciences (approval number: 2023-250 KY). Written informed consent will be obtained from all participants and/or their legal guardians prior to trial participation. The findings will be disseminated through publication in a peer-reviewed journal and presentations at scientific conferences. The research data will be made available on reasonable request.

NCT06287970.

Embryo aneuploidy increases substantially with maternal age, contributing to implantation failure and miscarriage. Conventional morphological assessment cannot determine euploidy. Non-invasive preimplantation genetic testing (ni-PGT) evaluates cell-free DNA in spent embryo culture medium, potentially improving embryo selection without trophectoderm biopsy. Robust evidence of clinical benefit in women aged 35–42 years remains limited.

This is a multicentre, open-label, parallel-group randomised controlled trial conducted in three centres in China. Infertile women aged 35–42 years undergoing their first intracytoplasmic sperm injection cycle and having ≥2 good-quality days 5–6 blastocysts (Gardner grade ≥4BC,defined as an expansion grade of at least 4, with an inner cell mass grade of B or better and a trophectoderm grade of C or better) will be randomised 1:1 to ni-PGT-guided embryo selection or conventional morphology-based selection. Randomisation will be stratified by study centre using variable permuted block sizes of 4 and 6 and implemented through a unified centralised randomisation system. After a multicentre set-up period for investigator training and harmonisation of spent culture-medium sampling procedures, during which no participant was enrolled or randomised, recruitment and randomisation commenced on 14 February 2025 at the lead site; additional sites started recruitment after local ethics approval and site initiation. A freeze-all strategy will be applied; frozen-thawed single blastocyst transfer will start from the second menstrual cycle after oocyte retrieval.

For the primary endpoint, embryo transfers using embryos from the index retrieval cycle that occur within 12 months after randomisation and within the first three frozen-thawed single embryo transfer attempts will contribute to the cumulative outcome, whichever occurs first. Clinical care will not be restricted beyond this prespecified analysis range. The primary outcome is the cumulative ongoing pregnancy rate within 12 months after randomisation, defined as the proportion of participants achieving at least one ongoing pregnancy (clinical pregnancy continuing to ≥12 weeks’ gestation) following a qualifying embryo transfer within the prespecified analysis range. Key secondary outcomes include early miscarriage rate (

The trial will be conducted according to the Declaration of Helsinki. Ethics approval has been obtained from all participating centres before participant recruitment at each site. Written informed consent will be obtained from all participants. Results will be disseminated through peer-reviewed publication and conference presentations.

ChiCTR2400088283

To establish optimal pre-pregnancy body mass index (BMI)-specific gestational weight gain (GWG) ranges for twin pregnancies and compare their association with maternal and neonatal adverse outcomes against Institute of Medicine (IOM) recommendations.

Retrospective cohort study. Retrospective cohort study. Adjusted ORs (aORs) with 95% CI were used to quantify associations; average marginal effects (AME) with 95% CI (in percentage points) were used to compare absolute risk differences.

Perinatal data from >70 obstetric institutions in Wuhan, China, collected via the Wuhan Maternal and Child Health Service Management Information System.

10 636 women with twin deliveries at ≥28 weeks (2011–2023). Pre-pregnancy BMI categorised using Chinese cut-offs: underweight

Hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), premature rupture of membranes (PROM), small for gestational age (SGA) and large for gestational age.

Optimal GWG ranges were: underweight 18.0–25.0 kg, normal 14.0–24.0 kg, overweight 12.2–24.0 kg, obesity 13.3–20.0 kg. Compared with IOM guidelines, study-derived ranges showed more favourable risk identification. In normal weight women, excessive GWG increased HDP risk (aOR 1.79, 95% CI 1.49 to 2.14); 13.57% versus 8.79%, AME 5.90 pp (95% CI 3.88 to 7.91 pp). In underweight women, inadequate GWG increased PROM (aOR 1.64, 95% CI 1.05 to 2.57); 14.48% versus 7.51%, AME 4.18 pp (95% CI 0.31 to 8.06 pp) and SGA (aOR 1.72, 95% CI 1.29 to 2.31); 45.58% versus 41.40%, AME 11.74 pp (95% CI 5.55 to 17.94 pp). In overweight women, excessive GWG increased HDP (aOR 1.81, 95% CI 1.21 to 2.70); 24.39% versus 16.32%, AME 9.68 pp (95% CI 2.49 to 16.88 pp) and inadequate GWG increased SGA (aOR 1.60, 95% CI 1.20 to 2.14); 35.15% versus 27.82%, AME 9.85 pp (95% CI CI 3.72 to 15.97 pp), which IOM failed to detect. In obese women, inadequate GWG increased SGA (aOR 2.76, 95% CI 1.37 to 5.53); 27.18% versus 17.16%, AME 17.95 pp (95% CI 5.74 to 30.17 pp), which was missed by IOM.

Our findings support adopting region-specific GWG standards for twin pregnancies in Asian populations.

Major depressive disorder (MDD) is a leading cause of disability among adolescents, yet available treatments remain limited. Bright light therapy (BLT) is a non-pharmacological intervention with demonstrated efficacy in adults. However, its clinical utility and underlying neural mechanisms in adolescents remain unclear. This trial aims to evaluate the clinical efficacy, time to onset, safety and applicability of home-based BLT in outpatient adolescents with MDD, and to explore its underlying neural mechanisms using functional near-infrared spectroscopy (fNIRS).

This is a randomised, placebo-controlled, three-arm multicentre clinical trial. A total of 126 outpatient adolescents aged 13–17 years with MDD will be randomly assigned to receive high-intensity BLT, medium-intensity BLT or placebo dim red light using a portable light box in a home-based setting for 40 min each morning over 4 weeks, followed by a 2-week follow-up. 42 age-matched and gender-matched healthy controls will also be enrolled for baseline assessments only, serving as normative references for comparison. The primary outcome will be the change in total scores on the 17-item Hamilton Rating Scale for Depression from baseline to week 4. All analyses will follow an intention-to-treat framework to ensure methodological rigour. The primary outcome will be analysed using analysis of covariance and linear mixed-effects models. Secondary outcomes will include response and remission rates, time to onset, maintenance of efficacy, self-reported depressive symptoms, sleep quality, cognitive function, anxiety, irritability, suicidal ideation, non-suicidal self-injury, self-efficacy and the overall safety profile of BLT. Prefrontal cortical activity will be measured using fNIRS at baseline and week 4 to explore potential neural mechanisms. Approximately 15% of participants will additionally take part in a qualitative substudy exploring experiences and acceptability of BLT.

The study protocol has been approved by the Ethics Committee of Peking University Sixth Hospital (approval number: 2025–24). Written informed consent will be obtained from all participants and their legal guardians prior to enrolment. Study findings will be disseminated through peer-reviewed journals and conference presentations.

NCT06913309.

This study aimed to explore the lived experiences of fear of complications (FoC) among hospitalised people with type 2 diabetes (T2D) in China and to provide insights for targeted nursing interventions.

A phenomenological research approach was employed to conduct semistructured interviews and the Colaizzi’s seven-step analysis method was used for data analysis. This study followed the Consolidated Criteria for Reporting Qualitative Research checklist.

15 people with T2D were purposively recruited between March and July 2025 from the endocrinology departments of two tertiary hospitals in Daqing City, Heilongjiang Province.

Three themes and 11 subthemes were identified: (1) experiencing multiple negative psychological responses (distress from negative emotions, contradictory and painful psychological states, social alienation); (2) the triggers of fear are complex (adverse outcomes of similar patients, illness uncertainty, symptom burden, self-perceived burden, economic burden) and (3) employing diverse coping strategies (negative avoidance, positive self-adjustment, seeking social support).

Healthcare professionals should pay greater attention to FoC among people with T2D. Early psychological assessment, identification of fear triggers, strengthening social support and promoting adaptive coping strategies may help reduce fear and improve quality of life.

This study investigated the knowledge and attitudes (KA) towards perioperative pulmonary embolism (PE) in patients undergoing major orthopaedic surgery, a population at particular risk.

A single-centre, cross-sectional study.

A tertiary care hospital in Shanghai, China.

454 patients scheduled for major orthopaedic surgery (Grade III or above) were enrolled between February and September 2024. Selection criteria included adult patients undergoing eligible procedures, while exclusion criteria encompassed cognitive impairment or refusal to participate. All enrolled participants completed the study.

The primary outcomes were the total scores on validated knowledge and attitude questionnaires. Secondary outcomes included the identification of demographic factors associated with these scores and the analysis of the direct relationship between knowledge and attitude using structural equation modelling (SEM).

The average knowledge score was 52.9% (23.82/45), indicating poor understanding. The average attitude score was 66.4% (29.88/45), indicating a moderate attitude. The multivariable analysis showed that a college diploma (OR=4.824, 95% CI 2.399 to 9.703, p

Patients undergoing major orthopaedic surgery possess poor knowledge but moderately positive attitudes toward PE. Educational level is a key factor influencing KA. Improving patient knowledge and attitudes is crucial for supporting informed surgical decision-making and enhancing perioperative self-management, though the complex relationship between knowledge and attitude warrants further investigation.

Mechanical ventilation during patient transport is a high-risk clinical practice. While the novel Mindray TV80, a high-performance emergency transport ventilator, offers potential advantages for use across complex transport settings, rigorous clinical data comparing its oxygenation performance in critically ill, mechanically ventilated patients during transport are lacking. This study aims to address this gap by evaluating the non-inferiority of TV80 to Hamilton T1 in maintaining oxygenation stability.

This is a prospective, single-blind, single-centre, parallel-group, non-inferiority randomised controlled trial. Mechanically ventilated patients (18–80 years) requiring intrahospital or interhospital transport will be recruited. Eligible patients will be randomised at a 1:1 ratio to the TV80 group (intervention) or Hamilton T1 group (control) using a permuted block design stratified by transport type (intrahospital vs interhospital) via the electronic data capture system. The intervention involves using the assigned ventilator during transport, with parameters replicated from the patient’s pre-transport ventilator. The primary outcome is the difference in oxygenation index (P/F) before (within 1 hour) and after (within 1 hour) transport as measured by blood gas analyser. Continuous SpO₂ monitoring will be performed throughout the transport period to capture real-time oxygenation changes. Secondary outcomes include transport preparation time, changes in PaCO₂ and pH, variability of ventilator parameters (tidal volume, FiO₂) and vital signs (heart rate, SpO₂, mean arterial pressure) and incidence of adverse events (AEs)/serious AEs. Sample size is 98 (49 per group) to achieve 80% power with a non-inferiority margin of –30 mm Hg. Pre-specified subgroup analyses by transport type will be performed.

This study has been approved by the Human Research Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval number: LSY-2025-0903). Written informed consent will be obtained from participants’ legal representatives. All results will be submitted to a peer-reviewed journal for publication.

NCT07198269 (ClinicalTrials.gov).

To synthesise existing qualitative and conceptual literature on the implementation, ethical considerations and policy implications of Medical Assistance in Dying for Mental Disorder as a Sole Underlying Medical Condition (MAiD MD-SUMC) in Canada and internationally.

A qualitative evidence synthesis using a thematic analysis approach. Empirical, conceptual and policy papers addressing MAiD for mental disorders were identified through major databases and grey literature. Studies were thematically analysed to identify recurring ethical, clinical and policy themes related to eligibility, assessment and implementation.

Data was extracted from a systematic search of Medline and Embase for peer-reviewed studies published from 1974 onwards, supplemented by relevant policy documents and legal cases.

Studies were included if they examined MAiD MD-SUMC and explored ethical, legal or clinical considerations or provided stakeholder perspectives. Exclusion criteria included studies focusing solely on non-psychiatric conditions or not published in English.

Two independent reviewers screened, extracted and analysed data using an iterative thematic synthesis approach. Key themes were identified through consensus discussions.

The synthesis identified four major themes: (1) Irremediability and treatment resistance—persistent uncertainty regarding when mental disorders can be considered irremediable. (2) Capacity and vulnerability—ongoing debate about assessing capacity amid fluctuating symptoms and social influences. (3) Ethical and policy considerations—divergent interpretations of autonomy, justice and safeguards highlighting the need for standardised criteria. (4) Public and professional perspectives—public and family support for inclusion, although clinician hesitancy exists.

The evidence supports a thoughtful, structured approach to potential implementation of MAiD MD-SUMC in Canada. Future priorities include refining criteria for irremediability, standardising capacity assessments, addressing disorder-specific complexities and strengthening mental health infrastructure. Continued research, engagement and transparent policy dialogue will be essential to ensure that any expansion of MAiD upholds ethical integrity, protects vulnerable persons and maintains public trust.

Postoperative delirium (POD) is a common complication following cardiac surgery and is closely associated with adverse clinical outcomes. The effect of perioperative dexmedetomidine on reducing POD remains controversial in the existing literature. In our previous meta-analysis, we obtained preliminary evidence suggesting that dexmedetomidine may reduce the incidence of POD by improving sleep quality, which may partly explain the heterogeneity reported in previous studies. Based on these findings, the present randomised controlled trial aims to test the hypothesis that preoperative intranasal administration of dexmedetomidine reduces the incidence of POD in patients undergoing cardiopulmonary bypass assisted cardiac surgery by enhancing preoperative sleep quality.

This trial is a single-centre, investigator-initiated, parallel, double-blind, randomised, placebo-controlled trial. Individuals aged 18 years or older who are scheduled for elective cardiopulmonary bypass—assisted cardiac surgery will be enrolled in the study. The planned sample size is 686. Participants will be randomly assigned to either the dexmedetomidine group receiving two doses of dexmedetomidine (1.5 µg/kg according to ideal body weight) administered between 21:00 and 21:30 on the night before surgery and 15 min before anaesthesia induction, or the placebo group, receiving an equivalent volume of normal saline at the same time points. The primary outcome is the incidence of delirium within 7 days after surgery. Secondary outcomes include the severity, subtypes and duration of delirium, length of postoperative hospital stay, in-hospital all-cause mortality, postoperative sleep assessed by the Numerical Rating Scale score, pain intensity, postoperative anxiety and depression scores. Mediation analyses will be conducted using the preoperative Sleep Quality Index to assess whether dexmedetomidine reduces POD by improving preoperative sleep quality. The Baron and Kenny causal steps framework in conjunction with bootstrap resampling will be employed to estimate the direct, indirect and total effects.

The study is approved by the Institutional Review Board of Xijing Hospital (KY20242259). Written informed consent will be obtained from all participants. The results will be submitted for publication in peer-reviewed journals.

NCT06619912.

With an ageing population, understanding leading causes of hospitalisation in older adults is critical for care strategies. These leading causes may vary across residential settings and by seasonal patterns. This study examines the temporal trends of leading causes of hospitalisation among older adults in community-dwelling and nursing home settings, specifically comparing patterns during winter and summer seasons.

A retrospective analysis of electronic medical records from Hong Kong public hospitals (2012–2018) was conducted for three million adults aged ≥65. Age-standardised and sex-standardised monthly hospitalisation rates and average annual percentage change (AAPC, representing the average yearly percentage change in rates) were examined for leading causes during summer and winter across settings.

Among community-dwelling individuals, the top five causes in 2018 were symptoms, signs and abnormalities not classified elsewhere (NEC), neoplasms, genitourinary, circulatory and respiratory diseases in winter, with digestive diseases replacing respiratory diseases in summer. Symptoms, signs and abnormalities NEC (AAPC: 2.7% (95% CI 1.8% to 3.6%) in winter; 3.4% (2.8% to 4.0%) in summer), neoplasms (2.4% (1.4% to 3.4%) in winter; 2.5% (1.6% to 3.4%) in summer), genitourinary (2.5% (2.1% to 2.9%) in winter; 2.4% (1.8% to 3.0%) in summer) and digestive diseases (2.5% (1.6% to 3.3%) in winter; 2.6% (1.7% to 3.5%) in summer) increased, while circulatory diseases decreased in winter. In nursing home residents, the top five causes in 2018 were respiratory diseases, symptoms, signs and abnormalities NEC, genitourinary, circulatory and digestive diseases in winter and summer. Symptoms, signs and abnormalities NEC increased (2.9% (0.9% to 5.0%) in winter; 2.9% (0.8% to 5.1%) in summer), while circulatory diseases declined across seasons. Genitourinary diseases remained stable across seasons, whereas digestive diseases declined in winter.

In Hong Kong’s ageing population, seasonal and temporal shifts in hospitalisation causes were observed. Symptoms, signs and abnormalities NEC emerged as the top two causes across settings, highlighting challenges for primary care and hospital management and need for enhanced prevention and care strategies.

Early screening of non-alcoholic fatty liver disease (NAFLD) is critical for early diagnosis and management. The disease was renamed and its diagnostic criteria revised as metabolic-associated FLD (MAFLD) in 2020 and further updated to metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023. This study evaluated the predictive performance and clinical feasibility of non-invasive diagnostic indicators across the NAFLD, MAFLD and MASLD diagnostic criteria.

Cross-sectional study.

Health Management Centre in China.

A total of 5810 participants aged ≥18 years were enrolled. Individuals with missing laboratory data, imaging results or self-reported information were excluded.

Disease-specific indicators included Fatty Liver Index (FLI), Hepatic Steatosis Index and Zhejiang University index (ZJU). Non-disease-specific indicators included lipid accumulation product (LAP), Visceral Adiposity Index and the Triglyceride and Glucose Index. Subgroup analysis was performed by gender and Body Mass Index (BMI).

The area under the receiver operating characteristic curve (AUROC) for all six non-invasive indicators exceeded 0.7. FLI showed the optimal predictive performance across the three criteria (NAFLD-AUROC: 0.802, MAFLD-AUROC: 0.847 and MASLD-AUROC: 0.811), with comparable performance observed for ZJU (0.797, 0.838 and 0.809, respectively). Pairwise z-tests demonstrated a significant difference between FLI and ZJU for MAFLD (p0.05). Subgroup analyses revealed that ZJU performed better in males (NAFLD-AUROC: 0.790, MAFLD-AUROC: 0.839 and MASLD-AUROC: 0.803), while FLI was superior in females (NAFLD-AUROC: 0.832, MAFLD-AUROC: 0.838 and MASLD-AUROC: 0.838) and in participants who were overweight (NAFLD-AUROC: 0.709, MAFLD-AUROC: 0.765 and MASLD-AUROC: 0.709). LAP exhibited the highest predictive efficacy in the normal BMI subgroup (NAFLD-AUROC: 0.758, MAFLD-AUROC: 0.804 and MASLD-AUROC: 0.796).

FLI exhibited the highest predictive efficacy across all diagnostic criteria, and ZJU showed comparable performance. Considering diagnostic accuracy and clinical practicality, ZJU is recommended as a favourable, non-invasive tool for population-based screening in the Chinese population.

Robust assessment of health-related quality of life (HRQoL) is essential for evaluating the disease burden in patients with haematologic malignancies. This study examined the performance of the EuroQol-5 Dimensions-5 Levels (EQ-5D) instrument in patients with multiple myeloma (MM), acute leukaemia (AL) and lymphoma using time trade-off (TTO)-elicited utility scores as the reference, and explored factors contributing to discrepancies between EQ-5D and TTO utilities.

We performed a cross-sectional observational study using EQ-5D and TTO to assess HRQoL.

A leading tertiary care hospital in China.

158 patients consecutively admitted to hospital for MM (n=50), AL (n=63) and lymphoma (n=45) between January and August 2024.

The primary outcome was the EQ-5D performance in terms of internal consistency (Cronbach’s α), criterion validity (Spearman’s correlation with TTO), and structural validity (exploratory factor analysis). The secondary outcome was the patient characteristics associated with discrepancies between EQ-5D and TTO utilities.

TTO utility scores were highest in AL (0.798), followed by lymphoma (0.755) and MM (0.693). EQ-5D utility values were consistently higher than TTO across all groups. Among the three groups, EQ-5D demonstrated the best psychometric performance in patients with MM, with excellent internal consistency (Cronbach’s α=0.899), strongest correlation with TTO (r=0.538, p

EQ-5D performed well in patients with MM, supporting its use in this population. In patients with AL, adjustments for clinical characteristics such as chronic kidney failure may improve the accuracy of EQ-5D utility values. The poor psychometric performance of EQ-5D in patients with lymphoma raises concerns about its appropriateness as a standalone instrument for HRQoL.

Adverse neurological complications, including postoperative delirium (POD) and stroke, remain one of the major risks after cardiac surgery. A lack of comprehensive knowledge about their causes and neuroprotective strategies has hindered the development of effective interventions to reduce these events. Personalised cerebral autoregulation (CA)-oriented blood pressure monitoring aims to identify blood pressure targets tailored to each individual patient, thereby reducing brain injury. The PRECISION study aims to assess whether perioperative duration and magnitude of mean arterial pressure (MAP) deviation from an individual’s CA limits are associated with adverse neurological complications.

This international, multicentre, prospective cohort study is conducted at two Swiss and one British hospital. Patients aged 65 years or older undergoing elective primary or re-operative coronary artery bypass graft and/or valvular and/or ascending aorta surgery requiring cardiopulmonary bypass are included. Preoperatively, the patient’s baseline of physical, cognitive and mental status is established. Intraoperatively, near-infrared spectroscopy (NIRS) and transcranial Doppler (TCD) are recorded in real-time to generate NIRS-derived and TCD-derived CA indices. The primary endpoint is POD, assessed daily on postoperative days 0 to 7 or up to discharge, whichever occurs earlier with the 3D-Confusion Assessment Method (3D-CAM) or CAM-Intensive Care Unit. Secondary endpoints include a composite neurological outcome of POD and overt stroke, postoperative neurocognitive disorders, major morbidity and mortality. Associations between neurologic outcomes, neurobiomarkers and genetic variation will be explored.

A total of 500 participants is required to achieve 90% power to find a statistically significant effect of the area under the curve MAP

Ethical approval has been obtained from all responsible ethics committees (Swiss lead ethics committee EKNZ 2022-01457 and Health Research Authority and Health and Care Research Wales, UK, REC 23/SW/0076). Results will be disseminated at national and international conferences and published in peer-reviewed journals.

NCT05595954.

Hand osteoarthritis (OA) is a prevalent and debilitating joint disorder that impairs daily functioning and quality of life. Current treatments are often inadequate in managing the symptoms and progression of the disease. The cytokine interleukin (IL)-17 has been implicated in the inflammatory processes associated with OA, making it a potential target for therapeutic intervention. This trial aims to evaluate the efficacy of vunakizumab, an IL-17A inhibitor, in reducing pain and improving functional outcomes in patients with erosive hand OA.

This multicentre, randomised, placebo-controlled, double-blind trial will enrol 150 participants aged 30–80 years with symptomatic erosive hand OA. Participants will be randomised in a 1:1 ratio to receive either vunakizumab 120 mg or placebo subcutaneously every 4 weeks for 24 weeks, with a loading dose injection period during the first 4 weeks. The primary outcome is the change in hand pain assessed by the Visual Analogue Scale at 28 weeks. Secondary outcomes include changes in physical function measured by the Functional Index for Hand Osteoarthritis, the Quick Disabilities of the Arm, Shoulder and Hand questionnaire and the Health Assessment Questionnaire, as well as changes in grip strength and radiographic and MRI evaluations of the hands.

Written informed consent will be obtained from all participants. The study was approved by the Ethics Committee of Shanghai Sixth People’s Hospital (2024–217) and will adhere to the Declaration of Helsinki. Research results will be published in peer-reviewed journals.

ChiCTR2500101031; https://www.chictr.org.cn/showproj.html?proj=264789.

Early mobilisation represents a core element of enhanced recovery after surgery (ERAS) and is recommended after minimally invasive spine surgery including unilateral biportal endoscopy (UBE). However, strategies to facilitate early mobilisation after UBE remain limited. Transcutaneous electrical acupoint stimulation (TEAS) may improve postoperative pain and recovery after spine surgery, but available evidence in UBE remains inconclusive.

To investigate whether perioperative TEAS enhances postoperative recovery after UBE.

This single-centre randomised controlled trial with blinded assessors will enrol 114 patients undergoing elective UBE discectomy. Participants will be randomly allocated (1:1) by simple randomisation to receive stimulation via self-adhesive electrodes, either single-session TEAS at Neiguan, Dazhui, Chengshan and Sanyinjiao initiated 30 min before surgery until the end of the procedure using a disperse–dense waveform (2/100 Hz) with individualised intensity (10–15 mA) or sham stimulation applied at four non-meridian, non-acupoint sites with brief initial stimulation followed by 0 mA output. Standardised general anaesthesia with bispectral index and analgesia nociception index monitoring will be provided following ERAS recommendations. The primary outcome is successful ambulation rate at 6 hour postoperatively; baseline pain, nausea, quality of recovery and functional status will be assessed using the Numerical Rating Scale, Visual Analogue Scale, Quality of Recovery-15 questionnaire, Oswestry Disability Index (ODI) and Japanese Orthopaedic Association (JOA) score at baseline before intervention while postoperative pain, nausea and vomiting, opioid consumption and Quality of recovery will be evaluated at 6, 24 and 48 hours after surgery, with ODI and JOA assessed during longer-term follow-up and surgery-related adverse events monitored postoperatively. Continuous outcomes will be analysed using parametric (repeated-measures analysis of variance) or non-parametric (Mann-Whitney U) tests, and categorical variables using ² or Fisher’s exact tests.

This study was approved by the Ethics Committee of Beijing Friendship Hospital (No: 2024-P2-087-01) and registered with Chinese Clinical Trial Registry. Results will be published in peer-reviewed journals.

ChiCTR2400083344.

Mentoring has been identified as a promising strategy for implementing and sustaining evidence-based practice (EBP) in healthcare organisation. However, no appropriate tools were specifically developed or cross-culturally adapted into Chinese context to assess nurse’s perceived EBP mentoring, impeding comprehensive evaluation of the effects of mentoring intervention studies. This study aimed to cross-cultural adapt the Evidence-Based Practice Mentoring (EBPM) scale into Mainland China and evaluate its psychometric properties, including validity and reliability.

A comprehensive translation and adaptation process was adopted to achieve the Chinese version of the EBPM (C-EBPM) scale. It consists of four steps: (1) trilateral translation procedure, (2) cognitive interview, (3) psychometric testing and (4) cross-time confirmatory factor analysis (CFA).

This study was conducted in four 3A-level hospitals located in Shaanxi and Zhejiang provinces, China, during two different data collection periods.

A total of 598 registered nurses participated in this study.

After two rounds of the trilateral translation procedure, a 9-item version of the C-EBPM scale was generated. Ten registered nurses participated in cognitive interview understood the meaning of all items but the response options. All items had significant critical ratio values (t=15.866~20.584, p²/df=65.681/27 0.950, Tucker-Lewis Index=0.966 > 0.950, and standardised root mean square residual=0.026 0.70) and average variance extracted was 0.60 (>0.50).

The 9-item C-EBPM scale demonstrated robust reliability and validity and is suitable for assessing EBP mentoring among nurses.

Paediatric kidney transplantation, while life-saving, presents significant academic challenges for children. Frequent hospitalisations, medical treatments and the psychosocial impact of chronic illness can severely disrupt educational trajectories. This study aimed to explore the post-transplant academic experiences of children from the perspective of their parents.

A qualitative phenomenological study. Data were collected through in-depth, semistructured interviews and analysed using inductive thematic analysis.

The study was conducted in Lahore, Pakistan, with participants recruited from the registry of the Punjab Human Organ Transplantation Authority (PHOTA).

Thirteen parents of children who had undergone a kidney transplant and were enrolled in a formal school.

Five major themes emerged from the analysis: (1) academic disruption and coping, detailing declines in performance and motivation alongside efforts to maintain engagement; (2) cognitive fatigue and emotional strain, encompassing reduced focus, memory difficulties and psychological distress; (3) school attendance, participation and support, highlighting frequent absenteeism, limited engagement in activities, and the critical role of institutional flexibility; (4) social identity and peer exclusion, revealing fears of stigma, self-isolation and misunderstanding from peers and (5) navigating the future, reflecting parental anxieties about long-term educational and career prospects alongside adaptive hope. The findings underscore that formal support systems in schools and healthcare settings are currently underdeveloped to meet these children’s complex needs.

This study illuminates the profound and multifaceted academic challenges faced by children after kidney transplantation. The results emphasise that a transplant is not merely a medical event but a life-altering experience with significant educational consequences. There is a critical need for integrated, targeted interventions that provide robust psychological support, flexible educational policies and comprehensive school reintegration programmes to ensure these children can achieve their full academic and personal potential.

Norepinephrine (NE) and phenylephrine (PE) are routinely administered vasopressors used to maintain haemodynamic stability during caesarean section. Emerging evidence suggests that sustained infusion of these agents may disrupt maternal blood glucose regulation. This randomised controlled trial aims to compare the effects of NE and PE infusion on changes in postpartum blood glucose levels, insulin concentrations and insulin resistance in women after caesarean delivery.

In this double-blind, randomised trial, 100 eligible parturients will receive prophylactic intravenous infusion of either NE or PE at a rate of 30 mL/hour immediately after subarachnoid anaesthesia, continuing until the end of surgery. The primary outcome is the difference between maternal preoperative and immediate postoperative blood glucose levels. Secondary outcomes include immediate and 6-hour postoperative insulin levels, as well as Homeostasis Model Assessment of Insulin Resistance.

The Institutional Ethics Committee of Xuancheng People’s Hospital approved the trial protocol (ID: 2025-yjky022-02). Findings will be published in an appropriate journal, and original data will be made available in November 2029 via the ResMan primary data-sharing platform of the China Clinical Trial Registry (http://www.medresman.org.cn).

ChiCTR2500107683.

The aim of this study was to explore the application of enhanced recovery after surgery (ERAS) in patients undergoing gynaecological surgery. This investigation included an analysis of the postoperative recovery curve and the factors that influenced the number of postoperative recovery days. This study also aimed to further investigate the impact of various factors on health economics.

A retrospective cohort study was conducted in the Fourth Ward of the General Gynaecology Centre of the Peking Union Medical College Hospital. A total of 1000 patients who had undergone elective benign gynaecological surgery between July 2021 and December 2022 were included. Demographic, perioperative and other relevant data were collected, and a visual analogue scale (VAS) survey was conducted using the European Five-Dimensional Health Scale (EQ-5D). The factors that influenced the number of postoperative recovery days were analysed using a multivariate linear regression analysis. Additionally, patients who had undergone laparoscopic myomectomy, laparoscopic ovarian cystectomy, laparoscopic total hysterectomy, abdominal myomectomy and abdominal total hysterectomy were grouped based on whether their ERAS implementation rate was ≥70%. Our goal was to evaluate the health economic value of the diagnosis-related group (DRG) payments from multiple perspectives and provide actionable recommendations for health insurance bureaus, hospitals and patients from a multi-dimensional perspective.

ERAS completion rates for measures such as avoiding preoperative sedation and early postoperative ambulation exceeded 95%, whereas rates for chewing gum and intraoperative temperature monitoring were

An analysis of the relationship between hospital costs and different ERAS measures, insurance types and disease types showed that seven measures could reduce hospital costs without negatively affecting the patient recovery speed, and five measures could slightly increase hospital costs. In addition, hospitalisation cost differences based on various insurance types and disease categories were statistically significant (p

The postoperative recovery speed was accelerated, the recovery time was shortened and the patient’s quality of life was enhanced during gynaecological surgery due to the implementation of ERAS practices. Increasing the ERAS completion rate can significantly reduce patient average hospitalisation costs. Additionally, variations in medical insurance, disease categories and specific ERAS measures influenced these costs. Therefore, hospitals that are unable to fully implement all ERAS measures must prioritise those that promote recovery. In addition, hospitals should adopt flexible strategies to minimise costs, thereby achieving mutual benefits for patients and hospitals. These findings establish a foundation for the implementation of a simplified ERAS version. It has been observed through the perspective of DRG implementation in China that payment standards exceed the average hospitalisation costs associated with specific surgical procedures. This result suggests that DRG implementation can benefit both patients and hospitals. These study results will serve as a valuable reference for decision-making by health insurance bureaus, hospitals and patients.

Statins are a cornerstone of cardiovascular disease prevention yet remain underused among eligible patients. Clinical decision support systems embedded in electronic health records (EHRs) are commonly used to encourage guideline-concordant prescribing. Interruptive reminders (eg, pop-ups) may be effective but interfere with clinical workflows and contribute to alert fatigue. Non-interruptive alerts are less intrusive, but their effectiveness remains unclear. The Interruptive versus Non-Interruptive Reminders for Statin tHerApy in Primary Care (INIRSHA-PC) trial is designed to evaluate the comparative effectiveness of interruptive and non-interruptive reminders on statin-prescribing rates.

INIRSHA-PC is a single-centre, pragmatic, three-arm, parallel-group randomised controlled trial embedded in the EHR at Vanderbilt University Medical Center. The trial will enrol adults aged 18–74 seen in primary care who are eligible for, but not currently prescribed, statin therapy. The planned sample size is 3000 patients (1000 per arm). Enrolled patients will be randomised 1:1:1 to (1) interruptive reminder, (2) non-interruptive reminder or (3) no reminder (usual care). The primary outcome is statin prescription within 24 hours of enrolment. Secondary outcomes are statin prescribing within 12 months and low-density lipoprotein cholesterol levels measured between 30 days and 12 months after enrolment. Enrolment began on 14 August 2024. The study is expected to be completed on 19 November 2025.

The trial has been approved by the Vanderbilt University Medical Center Institutional Review Board with waiver of patient informed consent (IRB number: 240419). Results will be disseminated through peer-reviewed publication and presentation at scientific conferences.

NCT06456658.