Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To construct a core competency indicator system for oncology advanced practice nurses.Methods:This study is a cross-sectional study. A preliminary draft of the core competency indicator system for oncology advanced practice nurses was developed through literature review and expert group coordination from June to November 2022. The core competency indicator system for oncology advanced practice nurses was established using the Delphi method for expert consultation and the analytic hierarchy process.Results:A total of 54 experts from 11 hospitals and four medical schools in 10 provinces and municipalities directly under the central government across the country were included in two rounds of expert consultation. The effective response rates of the questionnaire were all 100%, with an expert authority coefficient of 0.90, Kendall coordination coefficients of 0.089 to 0.179 and 0.101 to 0.176 ( P<0.01). The final established core competency indicator system for oncology advanced practice nurses included seven primary indicators and 69 secondary indicators. Conclusions:The core competency indicator system for oncology advanced practice nurses is comprehensive and has the characteristics of specialized oncology nursing, and the construction process is scientific and reliable, laying the foundation for future training of oncology advanced practice nurses.

Objective:To construct a communication strategy and implementation method for advanced cancer patients based on two communication models widely used at home and abroad, so as to reduce the difficulty of clinical disease notification.Methods:From January to October 2022, based on the communication model of SPIKES (Setting, Perception, Invitation, Knowledge, Empathy, Summary) and NURSE(Name, Understand, Respect, Support, Explore), combined with literature analysis, qualitative interviews, and expert argumentation, the communication strategy items of advanced cancer patients were constructed.Results:A total of 18 articles were included in the literature analysis. Qualitative interviews were conducted with 20 interviewees (including 4 doctors, 11 nurses, and 5 patients),6 males, 14 females, aged (35.94 ± 8.03) years old. A total of 8 experts participated in the demonstration, 2 males and 6 females, aged (41.88 ± 6.58) years old. Finally, the specific items and words of the disease notification process and communication strategies of advanced cancer patients in line with China ′s clinical practice were constructed. A total of 3 first-level items, 16 second-level items, 53 third-level items, and speech techniques were constructed, including pre-communication preparation, regular communication strategies, and poor communication disposal strategies. The importance score of the item was 4.50 to 5.00, and the coefficient of variation of the item was 0 to 0.12. Conclusions:The communication strategy of advanced cancer patients based on the communication model is scientific and feasible, and can be used as a tool to inform advanced cancer patients.

Objective:To gain a deeper understanding of the experience of medical staff in the oncology department in understanding and managing chemotherapy-induced taste alterations (CITAs).Methods:Using phenomenological research methods, in-depth interviews were conducted with 15 medical staff in the oncology department of Fudan University Shanghai Cancer Center, and the interview materials were transcribed, encoded, categorized, and described by Colaizzi 7-step analysis method.Results:Totally 15 respondents aged 26-43, 3 males and 12 females. Three themes were extracted, including the perception of benefits of CITAs symptom management ("hard outcome" benefit perception - improving symptom management level; "soft outcome" benefit perception-enhancing effective communication among multiple parties); the obstacles between the lack of awareness of knowledge about CITAs and symptom management (differences in medical staff′s understanding of CITAs; low accessibility of acquisition channels about CITAs knowledge); the management and intervention measures of CITAs lack specialization and high efliciency (CITAs′ management measures mostly stem from work experience; CITAs′ management may be based on information construction in the future).Conclusions:Hospital managers should fully utilize the opportunity of symptom management in CITAs, develop professional and efficient intervention and management strategies, strengthen the learning of relevant knowledge of the symptom among medical staff in oncology department, reduce symptom distress and patient self-perception burden, and improve the level of symptom management among medical staff in the oncology department.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Objective The development of the expert consensus on self-management of skin adverse reactions in patients undergoing targeted cancer therapy(hereinafter referred to as"the consensus")aims to enhance the effectiveness of self-management for skin-related adverse reactions in cancer patients receiving targeted therapy.It seeks to reduce the incidence of these reactions and alleviate their severity.Methods Utilizing evidence-based approaches,a systematic search was conducted across both domestic and international databases and relevant websites.This process included the evaluation and summarization of pertinent evidence to create a preliminary draft of the consensus.Through 2 rounds of Delphi expert inquiries and a round of expert panel discussion,the content was refined,leading to the final draft of the consensus.Results The consensus comprises 11 sections:gathering information before medication,identifying risk factors prior to medication,self-assessment and proactive reporting,skin cleansing,skin moisturizing,sun protection,makeup application,appropriate clothing,engaging in household activities,prophylactic medication,and common management techniques.Conclusion This consensus provides a valuable reference for clinical nurses to guide cancer patients in the self-management of skin adverse reactions associated with targeted drug therapy.

Objective:This study aims to gain insight into the emotional experiences encountered by healthcare professionals when disclosing cancer diagnoses to patients.Methods:The CNKI,Wanfang Datebase,SinoMed,Weipu Database,PubMed,Web of Science,Scopus,The Cochrane Library,CINAHL,Embase and PsycINFO were searched until May 31,2024.The quality of included studies was evaluated according to 2017 JBI Critical Appraisal Tool for qualitative studies,and Meta-synthesis method was used to integrate the results.Results:A total of 15 studies were included,36 results were extracted,and 13 new categories were summarized.Additionally,three integrated results were synthesized,which were the promoters of disease notification,the internal barriers of disease informing,and the external barriers of disease informing.Conclusion:The current findings reveal a dual experience among medical staff during the notification process,with negative experiences outweighing the positive.Strengthening communication skills,enhancing the support system for disease notification,and advocating for early disclosure of the condition of patients with advanced cancer are imperative.

Objective:To identify the trajectory of fatigue-related symptom clusters(fatigue-decreased appetite-pain)in patients with lung cancer receiving immunotherapy and their influencing factors.Methods:From March 2022 to March 2023,114 patients with lung cancer receiving immunotherapy for the first time in Fudan University Shanghai Cancer Center were selected as research subjects.A 6-month longitudinal follow-up was performed using the PRO-CTCAE-based subset for lung cancer immunotherapy,and the demographic,disease physiological,psychological,social and healthy lifestyle data of patients were collected before the first dose.Growth mixed model and logistic regression analysis were used to identify the trajectory categories and influencing factors of fatigue-related symptom clusters.Results:Two fatigue trajectories of patients with lung cancer receiving immunotherapy were identified,named"mild to moderate fatigue persistent group"and"mild fatigue production-relief group".Three trajectories of decreased appetite were identified and named"decreased appetite aggravation group","mild decreased appetite maintenance group"and"decreased appetite exacerbation-relief group".Three trajectories of pain were identified,named"mild pain relief group","mild pain maintenance group"and"mild to moderate pain aggravation group".Logistic regression analysis showed that the age(OR=1.076,P=0.015)and targeted therapy(OR=10.743,P=0.009)were influential factors for fatigue.Duration of disease(OR=0.112,P=0.015),pemetrexed(OR=3.210,P=0.027)and targeted therapy(OR=7.077,P=0.032)were influential factors for pain.No influencing factors for decreased appetite have been identified.Conclusion:There is variability in the trajectory of symptom change in the fatigue-related symptom cluster in patients receiving immunotherapy for lung cancer.A small number of patients showed a trend of persistent worsening of appetite loss and pain.Future studies may continue to analyze intervention nodes based on symptom profile categories and help healthcare professionals identify key populations through influencing factors to provide personalized and holistic symptom management for patients with lung cancer receiving immunotherapy.

Objective:To identify the trajectory of fatigue-related symptom clusters(fatigue-decreased appetite-pain)in patients with lung cancer receiving immunotherapy and their influencing factors.Methods:From March 2022 to March 2023,114 patients with lung cancer receiving immunotherapy for the first time in Fudan University Shanghai Cancer Center were selected as research subjects.A 6-month longitudinal follow-up was performed using the PRO-CTCAE-based subset for lung cancer immunotherapy,and the demographic,disease physiological,psychological,social and healthy lifestyle data of patients were collected before the first dose.Growth mixed model and logistic regression analysis were used to identify the trajectory categories and influencing factors of fatigue-related symptom clusters.Results:Two fatigue trajectories of patients with lung cancer receiving immunotherapy were identified,named"mild to moderate fatigue persistent group"and"mild fatigue production-relief group".Three trajectories of decreased appetite were identified and named"decreased appetite aggravation group","mild decreased appetite maintenance group"and"decreased appetite exacerbation-relief group".Three trajectories of pain were identified,named"mild pain relief group","mild pain maintenance group"and"mild to moderate pain aggravation group".Logistic regression analysis showed that the age(OR=1.076,P=0.015)and targeted therapy(OR=10.743,P=0.009)were influential factors for fatigue.Duration of disease(OR=0.112,P=0.015),pemetrexed(OR=3.210,P=0.027)and targeted therapy(OR=7.077,P=0.032)were influential factors for pain.No influencing factors for decreased appetite have been identified.Conclusion:There is variability in the trajectory of symptom change in the fatigue-related symptom cluster in patients receiving immunotherapy for lung cancer.A small number of patients showed a trend of persistent worsening of appetite loss and pain.Future studies may continue to analyze intervention nodes based on symptom profile categories and help healthcare professionals identify key populations through influencing factors to provide personalized and holistic symptom management for patients with lung cancer receiving immunotherapy.