Wei Zhang’s research while affiliated with Hangzhou First People's Hospital and other places

Background This study aimed to develop a scale to assess the physical activity (PA)-related parenting practices of Chinese parents of children aged 3–6 years based on general parenting theory. Methods A pool of scale items (123 items) was constructed based on a literature review and in-depth personal interviews. The pretest scale (60 items) was developed using Delphi correspondence and a presurvey. After two rounds of item screening of the pretest scale using exploratory factor analysis (EFA) and analysis of variance, we deleted 30 items. We ultimately developed a formal version of the Chinese Physical Activity Parenting Practices Scale (CPAPPS) using the remaining 30 items. We examined the structure of the scale using factor analysis and evaluated its reliability, validity, and discriminant ability using data from 899 parents of children aged 3–6 years. Results The CPAPPS includes 30 items in 6 dimensions scored on a 5-point Likert scale. The 6 dimensions are education, autonomy promotion, modeling, demands, expectations, and rewards. Both exploratory and confirmatory factor analyses confirmed the construct validity of the scale. Furthermore, the scale had adequate internal consistency, split-half reliability, test–retest reliability, and concurrent validity. Parents younger than 30 scored significantly lower on the demand dimension than parents aged 40–50 (p < 0.05). The differences in rewards and expectations between parents of different ethnicities were statistically significant (p < 0.05). Compared with married parents, parents who were currently single had lower scores for education, rewards, modeling, and autonomy promotion (p < 0.05). There was a significant difference in scores across all dimensions between parents with different places of residence (p < 0.05). Conclusion The CPAPPS satisfies the conditions for reliability and validity in accordance with psychometric requirements. The scale can be employed to evaluate the characteristics of Chinese parents’ physical activity-related parenting practices and to design family-based PA interventions.

Background Chemotherapy side effects can easily contribute to malnutrition and disrupt the normal diet of breast cancer patients. Offering early multidisciplinary team interventions during chemotherapy can establish a solid groundwork for dietary management and enhance the quality of life throughout the survival period. This study aims to assess the impact of early multidisciplinary team interventions on dietary management behavior, self-care self-efficacy, quality of life, and body mass index in breast cancer patients undergoing chemotherapy. Methods A prospective, two-arm, single-blind, single-center randomized controlled trial was conducted between November 2023 and July 2024 from a tertiary-level general hospital in Shaanxi, China. A total of 88 participants who were either preparing for or undergoing early or middle stage chemotherapy were enrolled for this intervention. The intervention group received diet-related early multidisciplinary team interventions, in addition to the usual dietary education. The control group only received the usual dietary education. The intervention program included 8 themes, which were covered each week. The data on dietary management behavior, self-care self-efficacy, quality of life, and body mass index were measured at baseline (T0), immediately after the intervention (T1), 1 month after (T2), and 3 months after (T3) the intervention. Results Seventy-nine participants, divided into an intervention group of 40 and a control group of 39, completed all the measures. There were statistically significant intergroup effects between the two groups and time effects on dietary management behavior, self-care self-efficacy, and quality of life. Additionally, there was an interaction effect (P < 0.05). However, there was no statistically significant intergroup effect on body mass index before and after the intervention (P > 0.05). Conclusion The early multidisciplinary team interventions are an effective method for improving dietary management behavior and confidence among breast cancer patients undergoing chemotherapy. Nurses should be attentive to the dietary issues faced by female patients during chemotherapy and should work to train and organize a multidisciplinary team to provide this intervention. This may lay a theoretical and capable foundation for managing a healthy lifestyle for future survival period. Trial registration This intervention was registered with the Chinese Clinical Trials Registry (ChiCTR2300076503, October 10, 2023).

Left-sided colorectal obstruction represents a formidable challenge in colorectal cancer management, often necessitating urgent intervention. Although self-expanding metal stents (SEMS) may act as a bridge to more controlled, elective surgery, the question remains whether this strategy confers measurable advantages over immediate emergency surgery (ES). We conducted a single-center, retrospective study comparing outcomes in patients with left-sided colorectal obstruction who underwent either SEMS placement followed by elective resection or direct ES. Between January 2018 and August 2023, 189 eligible patients were included. Perioperative variables, stoma formation, operative blood loss, and survival rates were documented. Kaplan–Meier analyses were performed to assess overall and disease-free survival in both groups. Of the 99 patients allocated to the SEMS group, 98 achieved successful stent deployment and 89 (91%) proceeded to elective surgery without stent-specific complications. Compared with the 100 patients in the ES group, the SEMS cohort exhibited significantly lower intraoperative blood loss (p < 0.001) and an increased rate of minimally invasive surgeries (p < 0.001). While all patients in the ES group underwent colostomy, only 80 in the SEMS group required ileostomy, and an additional 9 underwent primary anastomosis without a diversion. Ileostomy closure was completed more frequently (p = 0.002) and required less operative time (p < 0.001) than colostomy closure, resulting in reduced hospitalization. No significant differences in overall survival (p = 0.091) or disease-free survival (p = 0.22) were observed between the two treatment groups. In selected patients with obstructing left-sided colorectal cancers, SEMS placement as a bridge to elective surgery may reduce operative trauma, facilitate minimally invasive procedures, and lessen the burden of stoma formation, all without compromising long-term oncologic outcomes. Careful patient selection and strict procedural vigilance are fundamental to ensuring the safe adoption of this strategy.

Colorectal cancer (CRC) remains a formidable global health challenge, ranking among the most prevalent malignancies and a principal contributor to cancer-associated mortality. While traditional open surgery has historically been the cornerstone of CRC treatment, the advent of minimally invasive techniques, particularly robotic-assisted colorectal surgery (RACS), has garnered significant momentum owing to technological advancements in the field. Robotic platforms, exemplified by the da Vinci Surgical System, offer superior three-dimensional visualization, enhanced dexterity, and heightened precision, yielding improved perioperative outcomes, particularly in anatomically intricate regions such as the pelvis. This review provides a critical appraisal of the current landscape of RACS, emphasizing its superiority over conventional open and laparoscopic approaches. The increased control and precision afforded by robotic surgery have been shown to optimize outcomes in complex procedures such as total mesorectal excision, with evidence indicating reduced intraoperative blood loss, shortened hospital stays, and improved functional recovery. Nonetheless, challenges persist, including absence of haptic feedback, prohibitive costs, and steep learning curve associated with robotic systems. Despite these limitations, RACS has demonstrated considerable promise in sphincter-preserving and function-preserving procedures, ultimately enhancing postoperative quality of life. Beyond the surgical field, this review also investigates the integration of robotic surgery within multidisciplinary treatment strategies for CRC, particularly in the context of locally advanced rectal cancer. The combination of robotic techniques with total neoadjuvant therapy and immunotherapy—especially in tumors characterized by mismatch repair deficiency or high microsatellite instability has shown notable clinical efficacy. Furthermore, emerging personalized therapeutic approaches, including immunotherapies and targeted chemotherapeutic agents, emphasize the transformative potential of RACS in delivering superior oncologic outcomes. Looking towards the future, innovations in robotic platforms, including intraoperative imaging, artificial intelligence, and augmented reality, herald new possibilities for further enhancing the precision and efficacy of colorectal surgeries. The standardization of RACS protocols, alongside ongoing training and robust clinical research, will be critical to fully realizing the benefits of these advancements across diverse clinical settings. By incorporating cutting-edge technologies and personalized treatment methods, robotic-assisted surgery is prepared to become a cornerstone in future of CRC management, with the potential to significantly improve both survival outcomes and patient quality of life.

Background: Primary and secondary salivary gland malignancies differ significantly in treatment and prognosis. However, conventional ultrasonography often struggles to differentiate between these malignancies due to overlapping imaging features. We aimed to develop and evaluate noninvasive diagnostic models based on traditional ultrasound features, radiomics, and deep learning—independently or in combination—for distinguishing between primary and secondary salivary gland malignancies. Methods: This retrospective study included a total of 140 patients, comprising 68 with primary and 72 with secondary salivary gland malignancies, all pathologically confirmed, from four medical centers. Ultrasound features of salivary gland tumors were analyzed, and a radiomics model was established. Transfer learning with multiple pre-trained models was used to create deep learning (DL) models from which features were extracted and combined with radiomics features to construct a radiomics-deep learning (RadiomicsDL) model. A combined model was further developed by integrating ultrasound features. Least absolute shrinkage and selection operator (LASSO) regression and various machine learning algorithms were employed for feature selection and modeling. The optimal model was determined based on the area under the receiver operating characteristic curve (AUC), and interpretability was assessed using SHapley Additive exPlanations (SHAP). Results: The RadiomicsDL model, which combines radiomics and deep learning features using the Multi-Layer Perceptron (MLP), demonstrated the best performance on the test set with an AUC of 0.807. This surpassed the performances of the ultrasound (US), radiomics, DL, and combined models, which achieved AUCs of 0.421, 0.636, 0.763, and 0.711, respectively. SHAP analysis revealed that the radiomic feature Wavelet_LHH_glcm_SumEntropy contributed most significantly to the mode. Conclusions: The RadiomicsDL model based on ultrasound images provides an efficient and non-invasive method to differentiate between primary and secondary salivary gland malignancies.

Objective: This study examines the currently available Patient-Reported Experience Measures for cancer patients and provides a scoping overview of their definitions, evaluation frameworks, assessment tools, and current applications. The findings aim to inform and guide the development of a patient-centered care model. Methods: Using a combination of subject terms and free-text keywords, studies published by na�tional and international initiatives were reviewed across three online databases (PubMed, Web of Science, and MEDLINE) following the PRISMA guidelines. Results: A total of 2216 papers were reviewed, of which 24 were included in the scoping review. From these, 11 Patient-Reported Experience Measures were identified, each from 10 different national projects. Definitions of Patient-Reported Experience Measures were established, and the current status of Patient-Reported Experience Measures evaluation systems for cancer patients, along with their application across four domains, was analyzed. Conclusion: Currently, research on Patient-Reported Experience Measures in cancer patients re�mains in its early stages, and the effectiveness of several assessment tools has yet to be fully validated. Future studies should focus on developing high-quality, cancer-specific Patient�Reported Experience Measures assessment tools. These tools should be rigorously evaluated and tailored to the unique characteristics of cancer patients’ healthcare experiences, with the aim of supporting and enhancing patient-centered care practices.