The incidence of delayed chemotherapy-induced nausea and vomiting is relatively high among pediatric cancer patients. Nausea and vomiting symptoms can exacerbate physical and psychological burdens, potentially leading to aversion and reduced treatment adherence. This paper analyzes and summarizes delayed chemotherapy-induced nausea and vomiting in pediatric cancer patients, covering overview, influencing factors, assessment tools, and non-pharmacological interventions, aiming to provide insights for clinical prevention and intervention strategies targeting delayed chemotherapy-induced nausea and vomiting in pediatric patients.

Diabetes is a chronic disease that requires lifelong medication and long-term management. The longer the duration of the disease, the more likely it is to lead to progressive chronic complications affecting the eyes, kidneys, nervous system, and cardiovascular system. These complications may result in gradual functional decline or even organ failure, and may also trigger severe acute metabolic disorders. The cumulative financial burden on patients and their families can be substantial, giving rise to what is known as financial toxicity, which in turn may negatively affect patients' health outcomes. This review comprehensively explores the concept of financial toxicity in diabetic patients, including its assessment tools, influencing factors, and coping strategies. It also offers targeted suggestions aimed at informing the development of more scientific and effective systemic interventions, with the ultimate goal of improving treatment outcomes and quality of life for individuals living with diabetes.

Intraoperative neural monitoring (IONM) combines electrophysiology with anatomy to monitor nerve function during thyroid surgery,and has become an important auxiliary technology for neuroprotection. After more than ten years of development,the technology has been widely applied and popularized in China,promoting the development of a number of new technologies in the industry. Combined with the questionnaire survey data of the Chinese Neural Monitoring Study Group,this paper aims to summarize the clinical effect of IONM technology, the application status and existing problems at home and abroad, and propose the possible future development direction.

The 2025 American Thyroid Association Guidelines for the Management of Differentiated Thyroid Cancer in Adults incorporate the latest evidence-based medical research to systematically update the strategies for diagnosis, treatment, and follow-up of thyroid cancer. Integrating multidisciplinary perspectives from internal medicine, surgery, radiology, pathology, and other fields—and for the first time including input from patient representatives—the guidelines comprehensively cover the entire management process of differentiated thyroid cancer, significantly enhancing their clinical applicability. Regarding the current focus on active surveillance, the new edition provides clear recommendations based on a rigorous evaluation of existing evidence and multidisciplinary input. This article reviews and discusses key updates and practical aspects of the active surveillance section in the guidelines, with reference to relevant Japanese and Korean guidelines, with the aim of improving the application of active surveillance in thyroid cancer management.

Peritoneal metastasis is a common form of metastasis and recurrence in advanced gastric cancer. In recent years, immunotherapy has shown promising applications in the treatment of various malignancies, including gastric cancer. Given the limited efficacy of conventional treatment modalities, such as surgery and chemotherapy, in managing gastric cancer peritoneal metastasis, immunotherapy has garnered increasing attention and recognition among researchers worldwide. However, the application of immunotherapy in gastric cancer peritoneal metastasis still faces significant challenges, including the immunosuppressive tumor microenvironment, drug delivery barriers, and tumor resistance. This review aims to summarize the immunological mechanisms underlying gastric cancer peritoneal metastasis and discuss the latest advances in immunotherapy from both domestic and international studies, with the goal of providing insights for the development of novel immunotherapeutic agents and the optimization of treatment strategies for patients.

Objective:To compare bowel function 12 months after surgery between side-to-end anastomosis (SEA) and end-to-end anastomosis (EEA) groups of patients who had undergone rectal cancer resection.Methods:This single-center, prospective, open-label, phase III randomized controlled trial was approved by the Ethics Committee of Peking University People's Hospital (2018PHB040-01) and registered at ClinicalTrials. org (NCT03669237). Inclusion criteria were as follows: (1) histologically confirmed rectal adenocarcinoma; (2) tumor located 0 to 12 cm from the anal verge; (3) age≥18 years; and (4) planned R0 resection with primary reconstruction. Exclusion criteria included: (1) emergency surgery; (2) cognitive impairment; (3) non-primary anastomosis; (4) history of left-sided colonic or anorectal surgery; and (5) preexisting chronic defecation dysfunction. Eligible rectal cancer patients scheduled for elective sphincter-preserving surgery at Peking University People's Hospital were prospectively enrolled between October 2018 and March 2021 and randomly assigned to either the EEA group or the SEA group via computer-generated numbers prior to entering the operating room. All patients underwent standard radical tumor resection. Bowel function was evaluated by the low anterior resection syndrome (LARS) questionnaire. It consists of five single-choice questions and yields a total score ranging from 0 to 42. Defecation function is categorized into three levels: no LARS (0-20 points), minor LARS (21-29 points), and major LARS (30-42 points). The primary endpoint was the LARS score 12 months after surgery. Secondary endpoints included LARS scores from 1 to 11 months and during long-term follow-up(>12 months). The final follow-up was completed in July 2022. All randomized patients were included in the intention-to-treat set (ITTS). The full analysis set (FAS) was defined as ITTS patients with valid outcome data. All primary statistical analyses were performed in the FAS, and results were further compared in the per-protocol set (PPS) based on the actual treatment received.Results:A total of 323 patients underwent eligibility assessment, of whom 71 did not meet the inclusion criteria and 52 declined to participate. Ultimately, 200 patients were randomized. Median age was 64 years and 85 were women. The SEA and EEA groups comprised 102 and 98 patients, respectively. A total of 181 patients (90.5%) were included in the FAS, and 170 (85.0%) were included in the PPS. Among these, the 12-month LARS score was evaluated in 178 patients (98.3%) in the FAS and in 167 (98.2%) in the PPS. Median LARS score at 1–12 months were significantly lower in the SEA group in both the FAS dataset [12 months:8 (interquartile range [IQR], 0–22) vs. 14 (IQR, 8–29); Z=2.687, P=0.007] and the PPS dataset [12 months: 8 (IQR, 0–22) vs. 14 (IQR, 6–29); Z=2.543, P=0.011]. During long-term follow-up, the median LARS score was also significantly lower in the SEA group in the FAS dataset [2 (IQR, 0–4) vs. 11 (IQR, 2–23); Z=2.968, P=0.003] and the PPS dataset [2 (IQR, 0–14) vs. 11 (2, 27); Z=2.687, P=0.007]. Conclusion:Compared with the EEA group, bowel function was superior in the SEA group 1 year after surgery and during long-term follow-up.

Total mesorectal excision (total mesorectal excision, TME) has currently become the standard procedure for the treatment of rectal cancer. However, whether to preserve the left colic artery (LCA) during TME surgery remains controversial. The debates mainly focus on whether preserving the LCA can achieve complete dissection of No. 253 lymph nodes and its impacts on patients' defecation, urination, and sexual functions, and prognosis. This article systematically reviews the recent research progress necessity surgical techniques for LCA preservation by combining the anatomical characteristics of the inferior mesenteric artery (IMA) and LCA with clinical experience.

Robotic surgery, as an increasingly widespread application in the treatment of gastric and colorectal cancer, still faces obvious discrepancies in recommendations, indications, and evidence strength across existing guidelines. This study systematically analyzed 31 relevant guidelines and consensus statements (retrieved from Chinese and English databases from January 2010 to May 2025) from two dimensions: feasibility (effectiveness, safety, etc.) and training quality control.The results showed that colorectal cancer guidelines had a higher proportion (4 guidelines) of "clear recommendations" for robotic surgery, while gastric cancer guidelines predominantly presented "conditional recommendations" or no recommendations. In the training and quality control dimension, although structured suggestions received positive recommendations, more than half were based on low or very low-quality evidence. Evidence mapping indicated insufficient matching between "case-specific recommendations" and evidence grades in the feasibility dimension, while training processes emphasized the importance of standardized systems and team collaboration.The study highlights the existing heterogeneity in evidence-based guidelines for robotic gastrointestinal surgery, with colorectal cancer demonstrating a more mature evidence base and gastric cancer showing notable evidence gaps. It is recommended that future guideline development should strengthen the consistency between recommendation grades and evidence levels, promote high-quality research in upper gastrointestinal surgery, and improve surgeon training and certification systems to facilitate standardized clinical translation of robotic gastrointestinal surgery.

Total mesorectal excision (total mesorectal excision, TME) has currently become the standard procedure for the treatment of rectal cancer. However, whether to preserve the left colic artery (LCA) during TME surgery remains controversial. The debates mainly focus on whether preserving the LCA can achieve complete dissection of No. 253 lymph nodes and its impacts on patients' defecation, urination, and sexual functions, and prognosis. This article systematically reviews the recent research progress necessity surgical techniques for LCA preservation by combining the anatomical characteristics of the inferior mesenteric artery (IMA) and LCA with clinical experience.

Robotic surgery, as an increasingly widespread application in the treatment of gastric and colorectal cancer, still faces obvious discrepancies in recommendations, indications, and evidence strength across existing guidelines. This study systematically analyzed 31 relevant guidelines and consensus statements (retrieved from Chinese and English databases from January 2010 to May 2025) from two dimensions: feasibility (effectiveness, safety, etc.) and training quality control.The results showed that colorectal cancer guidelines had a higher proportion (4 guidelines) of "clear recommendations" for robotic surgery, while gastric cancer guidelines predominantly presented "conditional recommendations" or no recommendations. In the training and quality control dimension, although structured suggestions received positive recommendations, more than half were based on low or very low-quality evidence. Evidence mapping indicated insufficient matching between "case-specific recommendations" and evidence grades in the feasibility dimension, while training processes emphasized the importance of standardized systems and team collaboration.The study highlights the existing heterogeneity in evidence-based guidelines for robotic gastrointestinal surgery, with colorectal cancer demonstrating a more mature evidence base and gastric cancer showing notable evidence gaps. It is recommended that future guideline development should strengthen the consistency between recommendation grades and evidence levels, promote high-quality research in upper gastrointestinal surgery, and improve surgeon training and certification systems to facilitate standardized clinical translation of robotic gastrointestinal surgery.