Objective:To explore the care needs of primary caregivers of children with acute lymphoblastic leukemia (ALL) developed chemotherapy-induced oral mucositis (CTOM) during hospitalization and to provide a basis for improving the caregivers′ ability to care for the children and promoting their recovery.Methods:This study adopted the phenomenological design of a qualitative approach, using purposive sampling to select 10 primary caregivers of children with ALL who developed CTOM in Zhongshan People′s Hospital from September 2022 to August 2023. A semi-structured, in-depth interview was conducted to collect the data. Colaizzi analysis was used to analyze the qualitative data.Results:Among the 10 children, 5 were males and 5 were females, aged 3-13 years old; among the 10 primary caregivers, 3 were males and 7 were females, aged 31-44 years old. The primary caregivers′ care needs were categorized into four themes: wound care needs (active oral cleaning and hygiene maintenance, lack of ability to observe wounds, and anticipation of new and more effective medications); the need for knowledge of diseases (lack of knowledge related to the causes of CTOM, lack of knowledge about care and medication, seeking information from multiple sources); nutritional knowledge and dietary care needs (active supplementation awareness, limited dietary choices, lack of specific nutritional knowledge);and social network and psychological support needs (experience sharing in primary caregiver networks, psychosocial support in primary caregiver networks).Conclusions:Primary caregivers have particular problems in caring for children with ALL developed CTOM, including the need for nursing knowledge and practical skills, social support, etc. Healthcare professionals should provide the necessary support and assistance in terms of professional resources, hospital management resources and social resources.

Objective:To explore the care needs of primary caregivers of children with acute lymphoblastic leukemia (ALL) developed chemotherapy-induced oral mucositis (CTOM) during hospitalization and to provide a basis for improving the caregivers′ ability to care for the children and promoting their recovery.Methods:This study adopted the phenomenological design of a qualitative approach, using purposive sampling to select 10 primary caregivers of children with ALL who developed CTOM in Zhongshan People′s Hospital from September 2022 to August 2023. A semi-structured, in-depth interview was conducted to collect the data. Colaizzi analysis was used to analyze the qualitative data.Results:Among the 10 children, 5 were males and 5 were females, aged 3-13 years old; among the 10 primary caregivers, 3 were males and 7 were females, aged 31-44 years old. The primary caregivers′ care needs were categorized into four themes: wound care needs (active oral cleaning and hygiene maintenance, lack of ability to observe wounds, and anticipation of new and more effective medications); the need for knowledge of diseases (lack of knowledge related to the causes of CTOM, lack of knowledge about care and medication, seeking information from multiple sources); nutritional knowledge and dietary care needs (active supplementation awareness, limited dietary choices, lack of specific nutritional knowledge);and social network and psychological support needs (experience sharing in primary caregiver networks, psychosocial support in primary caregiver networks).Conclusions:Primary caregivers have particular problems in caring for children with ALL developed CTOM, including the need for nursing knowledge and practical skills, social support, etc. Healthcare professionals should provide the necessary support and assistance in terms of professional resources, hospital management resources and social resources.

With the change of coronavirus disease 2019 (COVID-19) prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.

With the change of COVID-19 prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.

Pulmonary adenocarcinoma in situ is reclassified as precursor glandular lesions in the fifth edition of WHO classification of thoracic tumours, causing widespread attention and heated debate among domestic thoracic oncologists, radiologists, pathologists and surgeons. We would like to comment on the topic and make a few suggestions on the management of pulmonary nodule during lung cancer screening. We are open to all suggestion and welcome debates.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

Background and objective As computed tomography (CT) screening for lung cancer becomes more common in China, so too does detection of pulmonary ground-glass nodules (GGNs). Although anumber of national or international guidelines about pulmonary GGNs have been published,most of these guidelines are produced by respiratory, oncology or radiology physicians, who might not fully understand the progress of modern minimal invasive thoracic surgery, and these current guidelines may overlook or underestimate the value of thoracic surgery in the management of pulmonary GGNs. In addition, the management for pre-invasive adenocarcinoma is still controversial. Based onthe available literature and experience from Shanghai Pulmonary Hospital, we composed this consensus about diagnosis and treatment of pulmonary GGNs. For lesions which are considered as adenocarcinoma in situ, chest thin layer CT scan follow-up is recommended and resection can only be adopt in some specific cases and excision should not exceed single segment resection. For lesions which are considered as minimal invasive adenocarcinoma, limited pulmonary resection or lobectomy is recommended. For lesions which are considered as early stage invasive adenocarcinoma, pulmonary resection is recommend and optimal surgical methods depend on whether ground glass component exist, location, volume and number of the lesions and physical status of patients. Principle of management of multiple pulmonary nodules is that primary lesions should be handled with priority, with secondary lesions taking into account.
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Adenocarcinoma ; diagnosis ; diagnostic imaging ; surgery ; Adenocarcinoma of Lung ; China ; Consensus ; Hospitals ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Physicians ; psychology ; Positron Emission Tomography Computed Tomography ; Practice Guidelines as Topic ; Retrospective Studies ; Solitary Pulmonary Nodule ; diagnosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

The correct thoughts and principles of diagnosis and treatment of chronic refractory wounds need to be formulated. Through the relevant domestic and international consensus and based on clinical experience, the Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China is proposed. It is considered that in the diagnosis and treatment of chronic refractory wounds, in the case of fully understanding the patient′s medical history, the following thoughts and principles should be complied in order. (1) Pay attention to the cleanliness of the wound after being cleaned. (2) Reasonably perform debridement to avoid being " excessive" or " not thorough". (3) Reasonably perform examination, diagnosis, and differential diagnosis of pathogenic factors. (4) Treat according to etiology. (5) Find comorbidities and prevent adverse outcomes. (6) Select the correct wound treatment method reasonably and timely. When the conservative wound care treatment is considered, pay attention to embodying the concept of etiological treatment, treat the wound according to the principles of safety, phase, selectivity, and effectiveness, and make a reasonable choice of continuing conservative treatment or surgical treatment in time after completing the preparation of the wound bed. When surgical treatment is considered, pay attention to the selection of reasonable surgical method and donor site, pay attention to the healing rate of surgical wound site and the outcome of donor site, and give reasonable protection to the wound site after surgery. (7) Carry out rehabilitation treatment after wound healing and related health education.

Hemophagocytic syndrome,also called hemophagocytic lymphohistiocytosis,includes primary hemophagocytic lymphohistiocytosis and secondary hemophagocytic lymphohistiocytosis.Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only effective therapy for familial hemophagocytic lymphohistiocytosis (FHL) and refractory EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH),but the differential diagnosis is still difficult.Meanwhile,much more complications and high mortality have attracted attention of many researchers.In this review,the recent advance in allo-HSCT for FHL and EBV-HLH about diagnosis,conditioning regimen,complication after HSCT,death causes and prognosis has been described.