Objective This research aims to provide a theoretical basis for the nursing care for adolescent malignant lymphoma patients by probing into their emotional experience.Methods In-depth interview of qualitative study is adopted in the interviews with 9 adolescent malignant lymphoma patients,while Colaizzi' s seven-step data analytical approach is utilized to analyze and sort the data before the main idea is concluded and refined.Results These adolescent malignant lymphoma patients,with complicated psychological changes and a suicidal tendency,find it hard to cope with stress.Conclusions Nursing care should be provided to such patients and there should be a respect for their rights to know their disease as well as a timely crisis intervention to those who have a suicidal tendency.Furthermore,due attention should be given to the mental states of the family members and the stability of the family of the patients.We also call for the love and more support for these patients from the government and caring people in society.

Objective To analyze the side effects of in-vitro amplification human leukocyte antigen (HLA)-haploidentical donor immune cell infusion(HDICI) in childhood malignant patients,and to provide the basis for how to nurse these patients.Methods From September 2011 to September 2012,twelve hospitalized childhood malignant patients were recruited in Cancer Center of Sun Yat-sen University,and they received a total of 92 times of HDICIs for immunotherapy.Side effects were carefully observed both during and 2 hours and 24 hours after each infusion,and we also provided psychological nursing,pre-infusion nursing,side effect analysis and corresponding care during infusion,post-infusion education and follow-up for every childhood patient.Results Among 92 times of HDICIs,fever occurred in 20 cases,of whom 6 cases were with chills,1 case with febrile convulsion,all achieved remission after receiving symptomatic treatment.5 cases were also recorded with a slight change of mood.Vital signs were all stable both during and after every HDICIs; and no nausea,vomiting,abdominal pain,diarrhea,rash,swelling or allergic reaction was observed.Neither change of the hemogram nor biochemical indexes was recorded before or after every course of HDICI.Conclusions Our study showed that HDICIs for immunotherapy in childhood malignant patients were safe,and during the whole infusions,much attention should be paid both for psychological nursing,pre-infusion anti-anaphylactic treatment,temperature monitoring,discovery of the precursor of febrile convulsion promptly,symptomatic treatment against corresponding side effects,and post-infusion education and follow-up,all those above are of great importance for childhood malignant patients who received HDICIs for immunotherapy successfully.

Objective To probe into the psychological resilience and its influencing factor among parents of children with cancer.Methods A total of 125 parents were investigated by self-designed general information questionnaire,Connor-Davidson psychological resilience scale (CD-RISC),Chinese version of Parents' Perception Uncertainty in Illness Scale (PPUS),Social Support Rating Scale (SSRS),self-rating depression scale (SDS) and self-rating anxiety scale (SAS).Results The total score of psychological resilience was (54.86±12.88) and the illness uncertainty score was (91.52±14.66).The social support score was moderate with a total score of (39.86±7.99).The anxiety and depression among parents got a total score of (40.08±7.19) and (44.61±7.38) respectively.Psychological resilience was negatively correlated with illness uncertainty and depression,and was positively correlated with the social support.The depression,illness uncertainty,residence,children's age,clinical diagnosis entered into the multiple linear regression equation of psychological resilience,predicting 30.1％ of total variation in psychological resilience.Conclusions Social support,illness uncertainty and depression are the important factors which affect psychological resilience among parents of children with cancer.Nurses should assess the social support that parents receive,the level of depression and the disease feeling of the parents,and provide targeted interventions to relieve it,help to establish effective coping style and improve their psychological state.

ObjectiveTo investigated the effect of post-operative primary site radiotherapy on stage Ⅳ neuroblastoma.Methods From Jan 2003 to Dem 2010,47 newly diagnosed stage Ⅳ neuroblastoma treated in Sun Yet-sen university cancer center.The treatment protocol for these patients were induction chemotherapy 4- 12 cycles,followed by surgery if possible,then 4-6 cycles consolidation chemotherapy and/or primary site radiotherapy and maintenance immunotherapy.The median age was 4 years old,the median induction chemotherapy cycles was 5.37 patients received resection of the primary tumor (total resection and nearly gross resection).24 out of 37 received primary site radiotherapy.ResultsThe followup rate was 89％.34 cases were followed up more than 36 months.For patients with or without postoperative primary site radiotherapy,the local recurrence rate were 13％ ( 3/24 ) and 54％ ( 7/13 ),respectively ( P =0.016),the 3-year local control rate were 84％ and 47％,respectively ( χ2 =7.95,P =0.005 ).The 3-year overall survival rate were 56％ and 28％,respectively ( χ2 =5.44,P =0.020 ). There was no severe radiation side effect. Conclusions This study indicated that postoperative primary site after induction chemotherapy and surgery could reduce the local recurrence rate and possibly improve the overall survival rate of stage Ⅳ neuroblastoma.

BACKGROUND/AIMS: Resection of the diseased segment and suture of the victim segment is recommended for enteroenteric fistula in Crohn's disease (CD). The main difficulty in this procedure remains reliable diagnosis of the victim segment, especially for fistulas found intraoperatively and inaccessible on endoscopic examination. We aimed to explore whether intraoperative inspection alone is reliable. METHODS: Patients undergoing conservative surgery between 2011 and 2016 for enteroenteric fistulas complicating CD were identified from a prospectively maintained database. Patients were divided according to whether the victim segment was evaluated by preoperative endoscopy + intraoperative inspection (PI group) or by intraoperative inspection alone (I group). Outcomes were compared. RESULTS: Of 65 patients eligible for the study, 37 were in in the PI group and 28 were in the I group. The baseline characteristics were similar between the groups, except for the rate of emergency surgery (0/37 in PI group vs. 5/28 in I group, P=0.012). Fistulas involved more small intestines (4/37 in PI group vs. 15/28 in I group, P < 0.001) and fewer sigmoid colons (17/37 in PI group vs. 4/28 in I group, P=0.008) in I group due to accessibility with endoscopy. No difference was found in postoperative complications, stoma rates, postoperative recurrence, or disease at the repair site between the 2 groups (P>0.05). CONCLUSIONS: For fistulas found intraoperatively and inaccessible on endoscopic examination, intraoperative inspection was a reliable guide when choosing between en bloc resection and a conservative procedure.
Colon, Sigmoid ; Crohn Disease* ; Diagnosis ; Emergencies ; Endoscopy ; Fistula* ; Humans ; Intestine, Small ; Postoperative Complications ; Prospective Studies ; Recurrence ; Sutures

Objective: To investigate the effect of gross total resection on the local control and survival of patients with stage IV neuroblastoma (NB) and analyze the extent of surgical resection of primary tumors that affects patient survival. Methods: A total of 96 patients with stage Ⅳ NB who were admitted to the Sun Yat-Sen University Cancer Center between January 2000 and December 2011 were analyzed. The patients were treated with combined-modality therapy, including chemotherapy, surgery, and/or radiotherapy. The patients were divided according to the extent of surgical resection of primary tumor into the following groups: group A, biopsy or tumor removal of less than 50% of the primary lesion; group B, incomplete resection of more than 50% but less than 90% of the lesion; group C, removal of more than 90% of the lesion; and group D, complete resection with or without macroscopic residual tumors. The survival rates of each group were analyzed. Results: The median age of the 96 patients was 4.4 years, ranging from 1.2-18.8 years. The overall 3-year progression-free survival (PFS) and overall survival (OS) of the total patients were 32.8% and 36.7%, respectively. A total of 24 cases were assigned in group A, 10 in group B, 23 in group C, and 39 in group D. Subgroup analysis revealed that the 3-year PFS rate was 17.5% for group A, 20.0% for group B, 45.1% for group C, and 40.5% for group D. The PFS rates were not statistically significant-ly different between groups A and B (P=0.352) and between groups C and D (P = 0.792). However, the OS was higher in groups C and D than that in groups A and B. The 3-year PFS rates were 42.2% and 17.8% for groups C and D (P<0.001), respectively. Conclu-sion: Resection extension of more than 90% of the primary tumor combined with chemotherapy and (or) radiation therapy can improve the survival of patients with stage Ⅳ NB. However, this treatment modality does not affect the treatment outcomes for minimal gross tu-mor residuals.

Objective: To describe the post competency level and standardized training of new nurses in Guangzhou tertiary hospitals, and to explore the correlation between them. Methods: By using the questionnaire method, 525 new nurses from 8 tertiary hospitals in Guangzhou were surveyed in June 2016 by convenience sampling, using the general information questionnaire, nursing competency questionnaire and standardized training status questionnaire of new nurses in Guangzhou tertiary hospitals. Results: The competency level of new nurses in Guangzhou tertiary hospitals was 333.53±46.96. The scores of standardized training level were 131.43±23.20. The scores of training management level, training content level and nurses′ belief level were 28.30±5.49, 59.07±14.80, 44.06±2.91. Competency level was positively correlated with standardized training level and each dimension with statistical significance (r=0.099-0.132, P<0.05). Conclusions The post competence of new nurses in Guangzhou tertiary hospitals is at the middle level, and the post competence of new nurses is positively correlated with the level of standardized training. Improving the level of standardized training of new nurses is helpful to enhance the post competence of new nurses. The level of standardized training management, management content and nurse belief can improve the post competence of new nurses.

Objective:To introduce and validate the Pediatric Nausea Assessment Tool (PeNAT) and the Baxter Retching Faces Scale (BARF) in the assessment of chemotherapy induced nausea in Chinese children with malignant neoplasms, and to explore the cut-off value for rescue antiemetic.Methods:A prospective descriptive study was conducted, 244 children in Sun Yat-sen University Cancer Center with malignant neoplasms who received chemotherapy were selected by convenience sampling from July to August 2021. PeNAT, BARF, Visual Analogue Scale (VAS) and the Faces Pain Scale-Revised(FPS-R) were used to assess the severity of nausea and pain before and after chemotherapy, before and 30-60 minutes after the use of rescue antiemetic or analgesic. After chemotherapy, the children also were asked the changes of nausea severity and whether antiemetic was needed.Results:A test-retest reliability was conducted on the patients with the same severity of nausea before and after chemotherapy, and the intraclass correlation coefficient of the PeNAT and BARF were 0.940 (both P<0.05). After chemotherapy, the PeNAT and BARF were 1.5(1.0, 2.0) and 2.0(0, 2.0) points, which were significantly higher than the 1.0(1.0, 1.0) and 0(0, 0) points before chemotherapy ( Z = - 9.19, - 9.09, both P<0.01). The PeNAT and BARF of 11 cases receiving antiemetic before medication were 4.0 (4.0, 6.0) and 3.0(2.0, 4.0) points, which were higher than the 0(0, 2.0) and 1.0(1.0, 2.0) points without antiemetic ( Z = - 4.03, - 3.86, both P<0.05). After chemotherapy, the correlation coefficients between PeNAT or BARF and VAS-nausea were r = 0.933, 0.957 (both P<0.01), and FPS-R were r = 0.192, 0.189 (both P<0.05). After using antiemetic, PeNAT and BARF were 2.0(2.0, 3.0) and 2.5(2.0, 4.0) points, which were significant different than the 3.0(3.0, 3.8) and 4.0(4.0, 8.0) points before using antiemetic ( Z = - 2.97, - 2.83, both P<0.05). According ROC curves and cut-off values, it was determined that PeNAT≥3 and BARF≥4 had clinical significance and require clinical intervention. Conclusions:PeNAT and BARF have excellent reliability and validity in the assessment of chemotherapy induced nausea in children with malignant neoplasms, they can effectively identify the requirement of rescue antiemetic, and evaluate the efficacy of antiemetic.

OBJECTIVETo evaluate the long-term survival of children and adolescents with lymphoblastic lymphoma (LBL) treated by a modified NHL-BFM-90 protocol.

METHODSFrom March 1998 to November 2010, 107 untreated patients with LBL (age <18 years) were enrolled and stratified into three groups (R1, R2 and R3), according to the stage of disease and response to induction chemotherapy. All patients received different intensive chemotherapy regimens based on a modified NHL-BFM-90 protocol. Total treatment duration was 2 years.

RESULTSOf the 107 patients, 79 were boys and 28 were girls, with a median age of 10 years (range 2.5-18 years). Six patients (5.6%) were stage I/II, 101 (94.4%) stage III/IV. The R1, R2 and R3 groups accounted for 5.6%, 71.0% and 23.4%, respectively. 75.7% of the patients had T-LBL, and 24.3% was B-LBL. At a median follow-up duration of 60 months (range 1-186 months), 24 patients died. The 5-year event-free survival (EFS) and overall survival (OS) were 75.5% and 77.8 % for all patients, 100.0% and 100.0% for group R1, 84.5% and 87.5 % for R2, 44.0% and 44.0% for R3, 72% and 73.5% for T-LBL, 86.4% and 88.5% for B-LBL, respectively. Myleosuppression was the major toxicity and need aggressive management.

CONCLUSIONThe modified NHL-BFM-90 protocol is an effective therapy for children and adolescents with LBL in low and intermediate risk. T-LBL had the similar outcomes as B-LBL did. The patients in high-risk group had a poor survival and new protocols are needed.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; Asparaginase ; Child ; Child, Preschool ; Daunorubicin ; Disease-Free Survival ; Female ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisone ; Treatment Outcome ; Vincristine