Objective To explore the latent classes of the change trajectory of postoperative nutritional literacy in gastric cancer patients, and to analyze its influencing factors. MethodsA total of 243 patients with primary gastric cancer who underwent radical gastrectomy for gastric cancer in the Department of General Surgery of Suzhou Ninth People’s Hospital from January 2023 to March 2025 were selected by convenience sampling. The basic data of patients were collected by general information table and Herth hope scale. The nutritional literacy questionnaire was used to evaluate the nutritional literacy of patients on the day of discharge (T0), 1 month after surgery (T1), 3 months after surgery (T2), and 6 months after surgery (T3). Using latent growth mixture model to identify the latent categories of changes in nutritional literacy trajectory, and explore the influencing factors of postoperative nutritional literacy changes in gastric cancer patients through unordered multi-class logistic regression analysis. ResultsA total of 202 gastric cancer patients completed this study, and their nutritional literacy scores at T0, T1, T2 and T3 were (19.06±1.63), (20.60±2.17), (22.04±2.91) and (23.36±3.57) points respectively, the points were gradually increasing over time (F=96.912, P<0.001). Latent growth mixture model fitting identified three valid latent classes: low literacy-stable group (38 cases), medium literacy-slow increase group (104 cases) and medium literacy-rapid increase group (60 cases). A multi-class logistic regression analysis was conducted using the medium literacy-slow increase group as a control, which showed that: ① older age (OR=1.105, P=0.015), no participation in internet nutrition intervention (OR=3.496, P=0.003), lower Herth hope scale score (OR=0.832, P=0.042) were associated with the formation of low literacy-stable trajectory in patients with gastric cancer after surgery. ② High educational attainment (OR=0.417, P=0.021), presence of nutritional risk before surgery (OR=2.330, P=0.017), higher Herth hope scale score (OR=1.151, P=0.035) were associated with the formation of a medium literacy-rapid increase in gastric cancer patients after surgery. ConclusionsThere is group heterogeneity in postoperative nutritional literacy among gastric cancer patients and medical staff should take targeted measures to improve patients’ nutritional literacy based on the group characteristics and influencing factors of the patient’s nutritional literacy change trajectory.
Objective To compare the clinical efficacy and safety of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive ventilation (NIV) in treatment of acute respiratory distress syndrome (ARDS) induced by coronavirus disease 2019 (COVID-19). Methods Sixty-eight patients with ARDS induced by COVID-19 in Wuhan Concorde Red Cross Hospital form January 25, 2020 to March 10, 2020 were included in the study. They were divided into an HFNC group (n=36) and an NIV group (n=36) according to the treatment. All patients received basic routine treatment, antiviral treatment and prevention therapy of secondary infection. The HFNC group received high-flow nasal cannula oxygen therapy, and the NIV group received NIV therapy. Then respiration and circulation parameters, comfort and tolerance, complications were compared between the two groups. Results After treatment for 3 days, 1 week, and 2 weeks in all patients with COVID-19 induced ARDS, respiratory rate (RR) was lower than that before therapy, arterial partial pressure of oxygen (PaO2), pulse oxygen saturation (SpO2), PaO2/FiO2 were higher than those before therapy (P<0.05), and therapeutic effect was time-dependent. But there was no significant difference of RR, PaO2, SpO2, PaO2/FiO2 between the HFNC group and the NIV group at different time points (P>0.05). After treatment for 2 weeks, the HFNC group patients' comfort, difficulty breathing, tolerance score were lower than the NIV group (P<0.05, P<0.01), the incidence rate of gastric distension and dry mouth etc. was lower than that in the NIV group (11.11% vs. 37.50%, P<0.05). There was no significant difference in rate of invasive mechanical ventilation or mortality between the two groups (P>0.05). Conclusions HFNC and NIV can improve respiratory and circulatory parameters of patients with COVID-19 induced ARDS. HFNC has better comfort and tolerance, and can reduce related complications.