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.

Objective To explore the surgical techniques and therapeutic effects of hematoma evacuation for hypertensive cerebral hemorrhage(HCH)with different bleeding sites under neuroendoscopy.Methods This study enrolled 101 patients with HCH treated in our hospital from May 2022 to January 2024.Based on CT imaging results,patients were divided into lobar cerebral hemorrhage group(n=43)and basal ganglia hemorrhage group(n=58).The Pearson was used to analyze the correlations between cerebral microcirculation indicators and the scores of national institutes of health stroke scale(NIHSS),mini mental state examination(MMSE),and the Barthel index(BI)of activities of daily living.The generalized estimating equation was employed to analyze the improvement effects of neuroendoscopic hematoma evacuation on cerebral microcirculation indicators in patients with different hemorrhage locations.A difference-in-differences equation model with full specifications was applied to analyze the improvement effects of neuroendoscopic hematoma evacuation on NIHSS score,MMSE score,and BI score in patients with different hemorrhage locations,incorporating baseline indicators as control variables.Results The operative time of basal ganglia hemorrhage group was significantly longer than those of lobar cerebral hemorrhage group,and the differences of NIHSS,MMSE,BI,mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV)and mean arterial pressure(MAP)before and after treatment were significantly smaller than those of lobar cerebral hemorrhage group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The correlation analysis results showed that MTT was positively correlated with NIHSS,and negatively correlated with BI and MMSE;CBF,CBV and MAP were negatively correlated with NIHSS,but positively correlated with BI and MMSE,the differences were statistically significant(P<0.05).The result of generalized estimating equation analysis showed that the improvement of MTT,CBF,CBV and MAP in patients with lobar cerebral hemorrhage group was better than those in patients with basal ganglia hemorrhage group,the differences were statistically significant(P<0.05).The result of difference-in-differences equation model analysis showed that increase of age,prolongation of MTT and prolongation of the time from onset to operation had positive effects on NIHSS score(B=0.884,1.291,0.758,P<0.05),and had negative effects on MMSE score(B=-1.014,-1.569,-0.821,P<0.05).The prolongation of MTT had a negative effect on BI score(B=-0.973,P<0.05).The increase of CBV,CBF and MAP had a negative effect on NIHSS score(B=-0.841,-0.767,-1.213,P<0.05),and had a positive effect on MMSE and BI score(MMSE:B=0.932,0.738,0.874;BI:B=0.897,0.751,0.842,P<0.05).Conclusion Neuroendoscopic hematoma evacuation can improve the NIHSS score,MMSE score,BI score of patients with HCH by adjusting MTT,CBF,CBV and MAP,and the improvement effect of patients with lobar cerebral hemorrhage is significantly better than that of patients with basal ganglia hemorrhage.

Objective:To mine the risk signal of acute kidney injury (AKI) induced by different oral anticoagulant drugs (OACs) in various populations and provide a reference for clinical use of OACs.Methods:Reports of AKI induced by OACs and non-OACs in the US Food and Drug Administration Adverse Event Reporting System database from the 1st quarter of 2004 to the 3rd quarter of 2023 were collected. The relationship between the drugs mentioned above and the AKI in patients were analyzed by methods of reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN). When the number of reports of the target adverse event (AE) for the target drug was ≥3, and the lower limit of the 95% confidence interval ( CI) of ROR was >1 or the lower limit of the 95% CI of the information component ( IC025) was >0, it indicated a statistically significant association between the target drug and the target AE. Results:A total of 12 402 AKI reports related to OACs were collected, including 1 313 for warfarin, 3 086 for dabigatran, 4 730 for rivaroxaban, 2 918 for apixaban, and 365 for edoxaban; 454 378 AKI reports were related to non-OACs. The overall analysis of OACs showed an ROR (lower limit of 95% CI) of 1.791 (1.759) and an IC ( IC025) of 0.813 (0.787) for AKI caused by OACs. Analysis of individual OACs showed that warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban all posed risks for AKI, with ROR (lower limit of 95% CI) of 1.220(1.156), 2.386(2.302), 2.044(1.986), 1.375(1.326), 3.003(2.706), respectively, and IC ( IC025) of 0.284(0.204), 1.231(1.178), 1.010(0.968), 0.452(0.399), 1.560(1.407), respectively. Edoxaban had the highest ROR and IC values, while warfarin had the lowest. Subgroup analysis showed that in the <18 years subgroup, neither warfarin nor rivaroxaban showed a risk of AKI; the ROR method did not show dabigatran to have a risk of AKI, but the BCPNN method did. In the 18-45 years subgroup, both methods showed that apixaban did not have a risk of AKI, while all other OACs did. In the 45-64 years subgroup, all OACs showed a risk of AKI. In the ≥65 years subgroup, warfarin and apixaban posed risks for AKI. Gender subgroup analysis showed that both methods indicated a risk of AKI with warfarin in males; all OACs showed a risk of AKI in females. Conclusions:OAC has a statistically significant risk of AKI, among which edoxaban has the highest risk intensity and warfarin has the lowest. Different OACs have different risks of AKI in patients with different ages.

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.

Objective To explore the surgical techniques and therapeutic effects of hematoma evacuation for hypertensive cerebral hemorrhage(HCH)with different bleeding sites under neuroendoscopy.Methods This study enrolled 101 patients with HCH treated in our hospital from May 2022 to January 2024.Based on CT imaging results,patients were divided into lobar cerebral hemorrhage group(n=43)and basal ganglia hemorrhage group(n=58).The Pearson was used to analyze the correlations between cerebral microcirculation indicators and the scores of national institutes of health stroke scale(NIHSS),mini mental state examination(MMSE),and the Barthel index(BI)of activities of daily living.The generalized estimating equation was employed to analyze the improvement effects of neuroendoscopic hematoma evacuation on cerebral microcirculation indicators in patients with different hemorrhage locations.A difference-in-differences equation model with full specifications was applied to analyze the improvement effects of neuroendoscopic hematoma evacuation on NIHSS score,MMSE score,and BI score in patients with different hemorrhage locations,incorporating baseline indicators as control variables.Results The operative time of basal ganglia hemorrhage group was significantly longer than those of lobar cerebral hemorrhage group,and the differences of NIHSS,MMSE,BI,mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV)and mean arterial pressure(MAP)before and after treatment were significantly smaller than those of lobar cerebral hemorrhage group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The correlation analysis results showed that MTT was positively correlated with NIHSS,and negatively correlated with BI and MMSE;CBF,CBV and MAP were negatively correlated with NIHSS,but positively correlated with BI and MMSE,the differences were statistically significant(P<0.05).The result of generalized estimating equation analysis showed that the improvement of MTT,CBF,CBV and MAP in patients with lobar cerebral hemorrhage group was better than those in patients with basal ganglia hemorrhage group,the differences were statistically significant(P<0.05).The result of difference-in-differences equation model analysis showed that increase of age,prolongation of MTT and prolongation of the time from onset to operation had positive effects on NIHSS score(B=0.884,1.291,0.758,P<0.05),and had negative effects on MMSE score(B=-1.014,-1.569,-0.821,P<0.05).The prolongation of MTT had a negative effect on BI score(B=-0.973,P<0.05).The increase of CBV,CBF and MAP had a negative effect on NIHSS score(B=-0.841,-0.767,-1.213,P<0.05),and had a positive effect on MMSE and BI score(MMSE:B=0.932,0.738,0.874;BI:B=0.897,0.751,0.842,P<0.05).Conclusion Neuroendoscopic hematoma evacuation can improve the NIHSS score,MMSE score,BI score of patients with HCH by adjusting MTT,CBF,CBV and MAP,and the improvement effect of patients with lobar cerebral hemorrhage is significantly better than that of patients with basal ganglia hemorrhage.

Objective:To mine the risk signal of acute kidney injury (AKI) induced by different oral anticoagulant drugs (OACs) in various populations and provide a reference for clinical use of OACs.Methods:Reports of AKI induced by OACs and non-OACs in the US Food and Drug Administration Adverse Event Reporting System database from the 1st quarter of 2004 to the 3rd quarter of 2023 were collected. The relationship between the drugs mentioned above and the AKI in patients were analyzed by methods of reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN). When the number of reports of the target adverse event (AE) for the target drug was ≥3, and the lower limit of the 95% confidence interval ( CI) of ROR was >1 or the lower limit of the 95% CI of the information component ( IC025) was >0, it indicated a statistically significant association between the target drug and the target AE. Results:A total of 12 402 AKI reports related to OACs were collected, including 1 313 for warfarin, 3 086 for dabigatran, 4 730 for rivaroxaban, 2 918 for apixaban, and 365 for edoxaban; 454 378 AKI reports were related to non-OACs. The overall analysis of OACs showed an ROR (lower limit of 95% CI) of 1.791 (1.759) and an IC ( IC025) of 0.813 (0.787) for AKI caused by OACs. Analysis of individual OACs showed that warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban all posed risks for AKI, with ROR (lower limit of 95% CI) of 1.220(1.156), 2.386(2.302), 2.044(1.986), 1.375(1.326), 3.003(2.706), respectively, and IC ( IC025) of 0.284(0.204), 1.231(1.178), 1.010(0.968), 0.452(0.399), 1.560(1.407), respectively. Edoxaban had the highest ROR and IC values, while warfarin had the lowest. Subgroup analysis showed that in the <18 years subgroup, neither warfarin nor rivaroxaban showed a risk of AKI; the ROR method did not show dabigatran to have a risk of AKI, but the BCPNN method did. In the 18-45 years subgroup, both methods showed that apixaban did not have a risk of AKI, while all other OACs did. In the 45-64 years subgroup, all OACs showed a risk of AKI. In the ≥65 years subgroup, warfarin and apixaban posed risks for AKI. Gender subgroup analysis showed that both methods indicated a risk of AKI with warfarin in males; all OACs showed a risk of AKI in females. Conclusions:OAC has a statistically significant risk of AKI, among which edoxaban has the highest risk intensity and warfarin has the lowest. Different OACs have different risks of AKI in patients with different ages.

Bone Transplantation/adverse effects* ; Transplantation, Autologous/adverse effects*

Objective:To investigate the necessity of adaptive re-planning during radiotherapy for nasopharyngeal carcinoma (NPC) and its impact on dose improvement.Methods:Clinical data of 89 NPC patients admitted to Sun Yat-sen University Cancer Center from July 2014 to December 2017 were retrospectively analyzed. All patients received 25+7 rounds of adaptive re-planning during radiotherapy. Plan-A was defined as the initial CT scan-based 25-fraction radiotherapy plan, while plan-B was defined as the re-planned 7-fraction radiotherapy plan based on a subsequent CT scan. The changes in the target and parotid gland volumes were compared between plan-A and plan-B. Plan-I was a one-time simulation of plan-A extended to 32 fraction radiotherapy plan, and plan-II was generated through registration and fusion of the plan-A and plan-B for adaptive re-planning. The differences in dose metrics, homogeneity index (HI), conformity index (CI), and dose to organs at risk (OAR) were compared between plan-I and plan-II. Statistical analysis was performed by using paired t-test. Results:Compared with plan-A, the gross tumor volume of massive bleeding lesions (GTV nx) and parotid gland volume of plan-B were decreased by 13.14% and 11.12%, respectively (both P<0.001). While planning clinical target volume of metastatic lymph nodes (PCTV nd) of plan-B was increased by 7.75%( P<0.001). There were significant changes in the lymph nodes of plan-A and plan-B. The D mean, D 5%, D 95% of massive bleeding lesions planning target volume (PTV nx) and D 5% of high risk planning target volume (PTV1) in plan-II were all significantly higher than those in plan-I (all P<0.05). The CI of PTV nx and PTV1 in plan-II was closer to 1 than that in plan-I. In all assessed OAR, the D mean, D 50%, and D max of plan-II were significantly lower than those of plan-I (all P<0.05). Conclusions:During radiotherapy, NPC patients may experience varying degrees of primary tumor shrinkage, parotid gland atrophy, and lymph node changes. It is necessary to deliver re-planning and significantly improve the dose of target areas and OAR.