Objective. To evaluate LEARNS model as a perioperative strategy for health education and nursing supervision of patients with laryngeal tumors. Methods. LEARNS scheme based on the best practice guidelines was applied to patients in the observation group: (1) analyze the needs of patients (Listen_L); (2) establish therapeutic partnership (Establish_E); (3) adopt intentional intervention (Adopt_A); (4) reinforce health awareness (Reinforce_R); (5) implement feedback assessment of knowledge (Name_N); (6) strengthen self-management based on community resources (Strengthen_S). In the control group, traditional medical care instructions were provided to the patients by medical staff. Parameters such as anxiety status, treatment compliance, nursing satisfaction, self-care ability, and life quality were compared between the observation and control groups. Results. Upon admission, there was no significant difference in self-care ability and anxiety level between two groups. However, the anxiety level of observation group was significantly lower than that of the control group 1 day before operation and 7 days after operation. Postoperative treatment compliance and nursing satisfaction were also improved in the observation group. In addition, self-care ability and life quality in the observation group were significantly enhanced as compared to the control group. Conclusion. As a mutual learning process between nurses and patients, LEARNS model motivates nurses to assess the needs of patients voluntarily. Furthermore, evidence-based education reinforces the self-care ability and health awareness of the patients. Our data suggests that LEARNS model is of great value in improving the life quality of the patients with laryngeal tumors and nursing satisfaction.

Background and Purpose: Recombinant tissue plasminogen activator (rt-PA) is one of the most effective therapies available for patients with known-onset stroke (KOS). Whether rt-PA treatment would improve functional outcomes in patients with stroke with unknown time of onset (UTOS) is undetermined. We aimed to systematically assess the efficacy and safety of thrombolysis for UTOS patients in this meta-analysis. Methods: A systematic literature search of Medline, Embase and Cochrane Library was conducted. We considered the relevant data comparing thrombolyzed UTOS patients vs. non-thrombolyzed UTOS patients or thrombolyzed UTOS patients vs. thrombolyzed KOS patients. Treatment efficacy and safety were measured according to modified Rankin Scale scores of 0-2 (mRS 0-2), and the presence of spontaneous intracerebral hemorrhage (SICH) or mortality at 90 days respectively. Results: A total of 12 studies with 3,084 patients from both clinical trial and database registries meeting the inclusion criteria were included in the meta-analysis. All the patients had an ischemic lesion that was assessed by imaging including computed tomography (CT) or magnetic resonance imaging (MRI). Among these studies, 7 compared the thrombolytic efficacy in thrombolyzed UTOS patients with that in non-thrombolyzed UTOS patients (mRS 0-2: odds ratio (OR)=1.65, 95% CI 1.19-2.27, P= 0.002), and 8 studies compared thrombolyzed UTOS patients with thrombolyzed KOS patients (mRS 0-2: OR=0.87, 95% CI 0.66-1.15, P=0.26). The incidence of SICH was higher in thrombolyzed UTOS patients than in non-thrombolyzed UTOS patients (OR 3.07, 95% CI 1.12-8.43, P=0.03), but there was no difference between thrombolyzed UTOS patients and thrombolyzed KOS patients (OR=1.10, 95% CI 0.55-2.22, P=0.79) at 90 days. Mortality was not different between thrombolyzed UTOS patients and non-thrombolyzed UTOS patients (OR=1.14, 95% CI 0.46-2.83, P=0.77) or between thrombolyzed UTOS patients and thrombolyzed KOS patients (OR=0.68, 95% CI 0.40-1.16, P=0.15). Conclusions: Compared with non-thrombolyzed patients, imaging-guided thrombolysis for UTOS patients had significantly favorable outcomes and more intracranial hemorrhage at 90 days. Keywords: Efficacy, safety, thrombolysis, unclear-onset stroke, meta-analysis

Purpose: This study was aimed to establish and validate a nomogram for predicting overall survival (OS) in young non-metastatic rectal-cancer (RC) patients after curative resection.Methods: Young RC patients (under 50 years of age) from 2010 to 2015 were extracted from the surveillance, epidemiology and results (SEER) database. Those patients randomly assigned to a training cohort and a validation cohort at a ratio of 7:3. The independent prognostic factors for OS were identified by univariate and multivariate Cox regression analysis. A nomogram model was built based on the independent prognostic variables and was evaluated by concordance index (C-index), receiver operating characteristics (ROC) curves, calibration plot and decision curve analysis (DCA).Results: A total number of 3026 young RC patients were extracted from SEER database. OS nomogram was constructed based on race, histological type, tumor grade, T stage, N stage, carcinoembryonic antigen (CEA) level, and number of lymph nodes (LN) examined. C-index, ROC curves, calibration plot and DCA curves presented satisfactory performance of the above nomogram in predicting the prognosis of young non-metastatic RC patients after curative resection. The nomogram can identify three subgroups of patients at different risks, which showed different prognostic outcomes both in the training cohort and validation cohort.Conclusion: We successfully established a reliable and insightful nomogram to predict OS for young non-metastatic RC patients after curative resection. The nomogram may provide accurate prognosis prediction to guide individualized follow-up and treatment plans.