Objective To develop an expert consensus on the subcutaneous injection of targeted drugs for breast cancer,to guide clinical nursing practice.Methods A consensus building group was established to create the initial draft of the consensus based on a review of literature.From December 2023 to February 2024,a total of 84 experts from various fields including breast cancer clinical nursing or medical practice,pharmacology,cancer hospital nursing or medical management were invited to participate in 2 rounds of expert letter consultations.Additionally,an on-site expert discussion meeting and an online expert finalization meeting were conducted to finalize the draft"consensus".Results The finalized consensus includes sections covering basic drug introduction,drug injection nursing(injection personnel,injection preparation,injection points,observation and recording after injection),nursing care for adverse reactions,patient education and follow-up.Conclusion This consensus is scientific and practical.It can serve as a valuable reference for clinical practice related to subcutaneous therapy using targeted drugs for breast cancer.

Objective:To retrieve and evaluate the best evidence on the nutrition management of patients with cancer-related sarcopenia at domestic and abroad, and summarize it, so as to provide a basis for medical staff to carry out relevant practices.Methods:Systematically search Chinese and English databases, guidelines, and academic websites such as China national knowledge infrastructure, Wanfang Database, PubMed, Web of Science, with evidence retrieval up to April 30, 2024. The evidence was summarized by 2 researchers.Results:A total of 13 articles were included: 3 guides, 5 expert consensus, 3 systematic evaluations, 2 evidence summaries. 21 pieces of evidence were summarized in 7 categories: establish diagnosis of sarcopenia, multidisciplinary team, nutrition support methods, nutrient selection, dynamic monitoring, related symptom management and outpatient nutrition management.Conclusions:The best evidence for nutritional management of patients with cancer related sarcopenia is rigorous and scientific. Medical staff can carefully select the best evidence based on specific clinical scenarios to formulate relevant management strategies, improve the nutritional status of patients.

Objective:To construct a self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer, so as to provide a reference for clinical nursing intervention.Methods:In the chronic disease self-management domain theory as the instruction, using literature research, the semi-structured interview to build the first draft of the plan, through the expert meeting law to plan to revise the first draft, and form a self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer.Results:A total of 10 experts were included, aged 37-47 (42.70 ± 3.43) years. The recovery rate of the expert questionnaire was 10/10, the expert authority coefficient was 0.93, and the coefficient of variation of each item ranged from 0.06 to 0.19. The final formed self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer includes three intervention modules: self-prevention, self-monitoring, and self-coping. It encompasses six intervention themes: enhancing knowledge reserves, non-pharmacological prevention, pharmacological prevention, risk assessment and self-reporting of symptoms, non-pharmacological intervention, and pharmacological intervention.Conclusions:The construction of the self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer is of great significance. The content of the scheme is scientific, reliable and targeted, which can provide guidance for the self-management of osteoporosis in patients with early breast cancer during endocrine therapy.

Objective:To identify the core symptoms of prostate cancer patients with endocrine therapy by constructed the symptom network, and provide a basis for precise intervention of symptoms management.Methods:In a cross-sectional study, we conveniently sampled patients receiving endocrine therapy for prostate cancer at Fudan University Shanghai Cancer Center between March and August 2018. The Expanded Prostate cancer Index Composite 26-item version (EPIC-26) and the Hospital Anxiety and Depression Scale (HADS) were used to assess symptoms.Symptom networks were constructed, and network indexes and the accuracy and stability of core symptoms were computed based on various packages of R4.3.1. Subgroup network comparison tests were conducted by Prostate-specific antigen (PSA) level, stratifying patients into PSA>0.2 ng/ml and PSA≤0.2 ng/ml groups.Results:A total of 270 questionnaires were distributed, and 261 valid questionnaires were returned, yielding a valid response rate of 96.7%. The included patients were aged 43 - 87(67.81 ± 8.14) years. Symptom network analysis revealed that the core symptom in patients undergoing endocrine therapy for prostate cancer was endocrine disorder ( rs = 1.86, rc = 0.048). However, in the population with PSA ≤ 0.2 ng/ml, depression ( rs = 1.80, rc = 0.028) occupied a more central position. There was no statistically significant difference in the network structure among patients with different PSA levels ( M = 0.294, P = 0.100). But the difference in network strength was statistically significant ( S = 1.15, P<0.05). The strongest associations were observed between depression and anxiety, as well as between endocrine disorder anddepression.The network demonstrated good stability and accuracy,indicating a reliable network model. Conclusions:Endocrine disorder is the core symptom in patients undergoing endocrine therapy for prostate cancer, serving as a critical target for intervention. Special attention should be given to the interconnected effects between endocrine disorder and depression. For the population with PSA ≤ 0.2 ng/ml, negative emotions such as depression still require ongoing focus. In the future, comprehensive interventions centered on psychological support and endocrine symptom management should be implemented for prostate cancer patients receiving endocrine therapy.

Objective To develop an expert consensus on the subcutaneous injection of targeted drugs for breast cancer,to guide clinical nursing practice.Methods A consensus building group was established to create the initial draft of the consensus based on a review of literature.From December 2023 to February 2024,a total of 84 experts from various fields including breast cancer clinical nursing or medical practice,pharmacology,cancer hospital nursing or medical management were invited to participate in 2 rounds of expert letter consultations.Additionally,an on-site expert discussion meeting and an online expert finalization meeting were conducted to finalize the draft"consensus".Results The finalized consensus includes sections covering basic drug introduction,drug injection nursing(injection personnel,injection preparation,injection points,observation and recording after injection),nursing care for adverse reactions,patient education and follow-up.Conclusion This consensus is scientific and practical.It can serve as a valuable reference for clinical practice related to subcutaneous therapy using targeted drugs for breast cancer.

Objective:To retrieve and evaluate the best evidence on the nutrition management of patients with cancer-related sarcopenia at domestic and abroad, and summarize it, so as to provide a basis for medical staff to carry out relevant practices.Methods:Systematically search Chinese and English databases, guidelines, and academic websites such as China national knowledge infrastructure, Wanfang Database, PubMed, Web of Science, with evidence retrieval up to April 30, 2024. The evidence was summarized by 2 researchers.Results:A total of 13 articles were included: 3 guides, 5 expert consensus, 3 systematic evaluations, 2 evidence summaries. 21 pieces of evidence were summarized in 7 categories: establish diagnosis of sarcopenia, multidisciplinary team, nutrition support methods, nutrient selection, dynamic monitoring, related symptom management and outpatient nutrition management.Conclusions:The best evidence for nutritional management of patients with cancer related sarcopenia is rigorous and scientific. Medical staff can carefully select the best evidence based on specific clinical scenarios to formulate relevant management strategies, improve the nutritional status of patients.

Objective:To construct a self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer, so as to provide a reference for clinical nursing intervention.Methods:In the chronic disease self-management domain theory as the instruction, using literature research, the semi-structured interview to build the first draft of the plan, through the expert meeting law to plan to revise the first draft, and form a self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer.Results:A total of 10 experts were included, aged 37-47 (42.70 ± 3.43) years. The recovery rate of the expert questionnaire was 10/10, the expert authority coefficient was 0.93, and the coefficient of variation of each item ranged from 0.06 to 0.19. The final formed self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer includes three intervention modules: self-prevention, self-monitoring, and self-coping. It encompasses six intervention themes: enhancing knowledge reserves, non-pharmacological prevention, pharmacological prevention, risk assessment and self-reporting of symptoms, non-pharmacological intervention, and pharmacological intervention.Conclusions:The construction of the self-management scheme for osteoporosis related to endocrine therapy in patients with early-stage breast cancer is of great significance. The content of the scheme is scientific, reliable and targeted, which can provide guidance for the self-management of osteoporosis in patients with early breast cancer during endocrine therapy.

Objective:To identify the core symptoms of prostate cancer patients with endocrine therapy by constructed the symptom network, and provide a basis for precise intervention of symptoms management.Methods:In a cross-sectional study, we conveniently sampled patients receiving endocrine therapy for prostate cancer at Fudan University Shanghai Cancer Center between March and August 2018. The Expanded Prostate cancer Index Composite 26-item version (EPIC-26) and the Hospital Anxiety and Depression Scale (HADS) were used to assess symptoms.Symptom networks were constructed, and network indexes and the accuracy and stability of core symptoms were computed based on various packages of R4.3.1. Subgroup network comparison tests were conducted by Prostate-specific antigen (PSA) level, stratifying patients into PSA>0.2 ng/ml and PSA≤0.2 ng/ml groups.Results:A total of 270 questionnaires were distributed, and 261 valid questionnaires were returned, yielding a valid response rate of 96.7%. The included patients were aged 43 - 87(67.81 ± 8.14) years. Symptom network analysis revealed that the core symptom in patients undergoing endocrine therapy for prostate cancer was endocrine disorder ( rs = 1.86, rc = 0.048). However, in the population with PSA ≤ 0.2 ng/ml, depression ( rs = 1.80, rc = 0.028) occupied a more central position. There was no statistically significant difference in the network structure among patients with different PSA levels ( M = 0.294, P = 0.100). But the difference in network strength was statistically significant ( S = 1.15, P<0.05). The strongest associations were observed between depression and anxiety, as well as between endocrine disorder anddepression.The network demonstrated good stability and accuracy,indicating a reliable network model. Conclusions:Endocrine disorder is the core symptom in patients undergoing endocrine therapy for prostate cancer, serving as a critical target for intervention. Special attention should be given to the interconnected effects between endocrine disorder and depression. For the population with PSA ≤ 0.2 ng/ml, negative emotions such as depression still require ongoing focus. In the future, comprehensive interventions centered on psychological support and endocrine symptom management should be implemented for prostate cancer patients receiving endocrine therapy.

Objective:To evaluate the risk of bias and applicability of the risk prediction models for pancreatic fistula after pancreaticoduodenectomy (PD).Methods:The relevant studies were systematically searched from Chinese database (Chinese medical journals database, CNKI, Wanfang, Weipu, Sinomed) and English databases (PubMed, Embase, Web of Science, Cochrane Library, CINAHL Database) and the retrieval time limit was from the establishment of the database to December 31, 2023. Based on the risk of bias assessment tool of the predictive model study, the risk of bias and applicability of the model were evaluated, and the predictors with high repetition rate in the model were meta-analyzed by RevMan 5.4 software.Results:A total of 23 studies involving 30 models were included. The incidence of pancreatic fistula was 11.4%-41.7%. nineteen studies reported the discrimination index of model construction and/or validation, and the area under the curve (AUC) was 0.62-0.94. The other four studies reported the consistency index (c-index). The predictive performance of the 23 studies is good, but there is a high risk of bias. The main reasons are that the sample size is not saturated, the research object from the appropriate source is not selected, the continuous variables are not properly processed, and the predictive factors are screened by single factor analysis. Eight studies were rated as " high risk" for applicability due to inconsistencies between the included study subjects and outcome measures and the systematic review study questions. The meta-analysis results showed that the dilation of main pancreatic duct (>3 mm) ( OR=0.70, 95% CI: 0.65-0.76), soft pancreas texture ( OR=5.18, 95% CI: 3.90-6.88), and body mass index ≥25 kg/m 2 ( OR=1.12, 95% CI: 1.07-1.17) were effective predictors of postoperative pancreatic fistula (POPF). Conclusion:The existing predictive models for pancreatic fistula risk in patients undergoing PD both domestically and internationally have good predictive performance, but there is a certain risk of bias and some models have poor applicability. Predictors such as dilation of main pancreatic duct, soft pancreas texture, and body mass index≥25 kg/m 2 should be more emphasized in future predictive models.

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.