Objective To analyzes the current status and hot spots of nursing of adverse drug reactions in chemotherapy for cancer patients,and provides reference for future research.Methods Literature related to the nursing of chemotherapy adverse drug reactions in cancer patients from 2018 to 2022 was retrieved from CNKI,Wanfang and VIP databases,and statistical analysis was conducted using bibliometrics.CiteSpace information visualization software was used to describe and analyze high-frequency keywords and to describe their graphs.Results A total of 1112 literatures were included,distributed in 256 domestic journals,and 537 literatures were co-authored,with a co-authored rate of 48.29％.Gastrointestinal reaction,cancer-induced fatigue,traditional Chinese medicine nursing,evidence-based nursing,negative emotion are the hot issues in this field.Conclusion The future nursing intervention for adverse reactions of cancer patients should adopt evidence-based nursing method to develop intervention programs.The research in this field has the problems of small sample size and single institution.It is suggested that the cooperation between authors and institutions should be strengthened in the future research,so as to build a closer cooperation network and a stable cooperation group.To construct nursing intervention plan and effect evaluation criteria suitable for nursing of adverse reactions of chemotherapy drugs in cancer patients.To ensure the safety of the intervention process,we should actively carry out multidisciplinary collaboration.

OBJECTIVE To compare the cost-utility of eight programmed death 1(PD-1)/programmed cell death-ligand 1(PD-L1) inhibitor combination regimens for first-line treatment of advanced non-small cell lung cancer(NSCLC) from the perspective of Chinese healthcare system. METHODS Relevant data were derived from a published network meta-analysis and randomized controlled trails, a three-state Markov model was established to analyze the cost-utility of eight immunotherapy combinations. The robustness of results were validated through sensitivity analyses and a series of scenario analyses was also conducted. RESULTS The incremental cost-utility ratio(ICUR) of the sintilizumab plus chemotherapy group and the tislelizumab plus chemotherapy group were ￥125143.88/quality adjusted life year(QALY) and ￥189609.64/QALY, respectively, which were less than the willingness-to-pay(WTP) threshold of ￥257094/QALY, and all the ICURs of other PD-1/PD-L1 inhibitor combination regimens exceeded the WTP threshold and were not economical. Scenario analyses found that even if the medical insurance reimbursement ratio reached 80%, the different combinations of pembrolizumab, nivolumab and atezolizumab were not economical. CONCLUSION Compared with other PD-1/PD-L1 inhibitor combination regimens, sintilizumab plus chemotherapy and tislelizumab plus chemotherapy have cost-utility advantages in the first-line treatment of advanced NSCLC, which can provide a certain reference for selecting a reasonable treatment plan for NSCLC patients.

Objective:To explore the clinical efficacy and adverse reactions of albumin-bound paclitaxel (Nab-P) and conventional paclitaxel combined with cisplatin and concurrent radiotherapy for the treatment of patients with locally advanced esophageal squamous cell carcinoma.Methods:Forty-nine patients with locally advanced esophageal squamous cell carcinoma admitted to the First People's Hospital of Suqian from November 2016 to May 2020 were included. Of the 49 patients, 23 cases were treated with Nab-P combined with cisplatin and concurrent radiotherapy (NP group), 26 cases were treated with conventional paclitaxel combined with cisplatin and concurrent radiotherapy (TP group). All patients received 2 cycles of chemotherapy. The curative efficacy was evaluated one month after the end of radiotherapy, and the curative effect and adverse reactions of the two treatment regimens were compared.Results:The objective remission rate in NP group was 78.3% (18/23), and the disease control rate was 100.0% (23/23). The objective response rate in TP group was 61.5% (16/26), and the disease control rate was 92.3% (24/26). The objective response rate and disease control rate in NP group were higher than those in TP group, but the differences were not statistically significant (both P > 0.05). The common adverse reactions were mainly hair loss, loss of appetite, bone marrow suppression, radiation esophagitis, radiation pneumonia, malaise and myalgia. The incidence rate of grade 3-4 acute bone marrow suppression in NP group (8.7%, 2/23) was lower than that in TP group (38.5%, 10/26), and the difference was statistically significant ( χ2 = 4.35, P = 0.037). The incidence rate of myalgia in NP group (26.1%, 6/23) was lower than that in TP group (61.5%, 16/26), and the difference was statistically significant ( χ2 = 4.85, P = 0.028). Conclusions:Nab-P combined with cisplatin and concurrent radiotherapy has good efficacy in the treatment of patients with locally advanced esophageal squamous cell carcinoma, and the incidence rate of adverse reactions is lower than that of conventional paclitaxel combined with cisplatin and concurrent radiotherapy, so that the regimen is safe.

Objective:To assess the applicability of the Chinese version of the symptom assessment in dry eye (SANDE) questionnaire refer to the ocular surface disease index (OSDI) questionnaire.Methods:A cross-sectional study was conducted.Three hundred and twenty-three students from a senior high school in Hongkou District in Shanghai were enrolled in June 2020.The Chinese version of the SANDE and the OSDI questionnaires were answered by the students to assess the dry eye symptom and were collected on-site.Scores of the two questionnaires were calculated.According to the OSDI score, the students were divided into the normal control group ( n=87), mild dry eye group ( n=82), moderate dry eye group ( n=87) and severe dry eye group ( n=67). Cronbach α was obtained to evaluate the internal consistency.Kruskal-Wallis test was used to analyze the difference in SANDE scores among dry eye groups with different severities and evaluate the discriminative validity.Correlation between the total scores of the two questionnaires was analyzed by using Spearman rank correlation analysis to evaluate the criterion validity.Factor analysis was used to evaluate the construct validity.Receiver operating characteristic curve (ROC) was drawn to obtain the area under the ROC curve (AUC) and cut-off point to evaluate the diagnostic threshold for dry eye.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shanghai General Hospital (No.2020KY026). Written informed consent was obtained from guardians of each subject. Results:The Cronbach α of the SANDE and OSDI questionnaires were 0.856 and 0.829, respectively.SANDE score of the four groups classified according to the OSDI score was 7.0 (2.5, 16.9) for the normal control group, 17.0 (8.4, 31.0) for the mild dry eye group, 29.2 (14.6, 49.4) for the moderate dry eye group and 49.1 (24.4, 60.7) for the severe dry eye group, respectively, which was increased in turn.There was a statistically significant overall difference in the SANDE score among the four groups ( H=113.213, P<0.001), and statistically significant pairuise differences were found (all at P<0.05). The SANDE score was moderately positively associated with the OSDI score ( rs=0.615, P<0.001). The factor analysis revealed that for the SANDE questionnaire, factor loadings of its two items on the common factors were higher than 0.5, among which the frequency of dry eye symptoms was 0.936, and the severity of dry eye symptoms was 0.936.The AUC of the SANDE questionnaire was 0.815 ( P<0.001, 95% CI: 0.770-0.860). When using 23 as the diagnostic threshold for dry eye, the sensitivity and specificity of the SANDE questionnaire were 60.59% and 88.51%, respectively. Conclusions:The Chinese version of the SANDE questionnaire shows good reliability, validity, discrimination ability and slightly poor sensitivity in detecting dry eye.As a simple assessment questionnaire, it is applicable to the Chinese population and is of good clinical application value.

Background The operation mode of automobile manufacturing industry (AMI) makes workers have different degrees of occupational stress and burnout, which may lead to negative emotions and depressive symptoms. Objective To study the relationship between occupational stress, job burnout, and depressive symptoms in AMI workers. Methods In this study, 1300 workers from a Guangzhou AMI company were selected as subjects by cluster random sampling method. Occupational stress, job burnout, and depressive symptoms of the workers were assessed by using the Effort-Reward Imbalance (ERI) questionnaire, the Maslach Burnout Inventory general survey questionnaire, and the Patient Health Questionnaire-9, respectively. Hierarchical regression was used to analyze the effects of occupational stress and job burnout on depressive symptoms in AMI workers. Mediating effect model was used to analyze the mediating effect of job burnout on the relationship between occupational stress and depressive symptoms. Results There were 1300 questionnaires distributed, 1228 valid questionnaires collected, with a 94.5% recovery rate. The ERI ratio of 1228 AMI workers was 1.06±0.72, and the positive rate of occupational stress was 37.3% (458/1228). The score of job burnout was 2.18±1.37, and the positive rate of job burnout was 62.6% (769/1228). The score of depressive symptoms was 10.27±6.42, and the positive rate of depressive symptoms was 47.1% (578/1228). The dimensional scores of effort and over-commitment in occupational stress as well as emotional exhaustion and depersonalization in job burnout of AMI workers were positively correlated with the depressive symptom scores (r_s=0.415, 0.571, 0.573, 0.593, P＜0.05). The dimensional scores of reward and personal achievement were negatively correlated (r_s=−0.454, −0.339, P＜0.05). The percentages of variance in depressive symptoms score explained by occupational stress and job burnout were 26.7% and 16.6%, respectively. Job burnout had a partial mediating effect between the three dimensions of occupational stress and depressive symptoms, and the mediating effect values were −0.2832 (95%CI: −0.3250– −0.2434), 0.3553 (95%CI: 0.3071–0.4041), and 0.4193 (95%CI: 0.3681–0.4725), respectively. Conclusion AMI workers' occupational stress affects job burnout, but also indirectly affects depressive symptoms. Job burnout partially mediates the association between occupational stress and depressive symptoms. Reducing occupational stress and burnout levels of AMI workers may alleviate depressive symptoms.

Objective:To compare biomechanical stabilities between screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury by a 3-D finite element analysis.Methods:A 3-D model of a healthy foot was developed from computed tomography images. The 1st and the 2nd dorsal tarsometatarsal ligaments and Lisfranc ligament were cut in the 3-D model of a healthy foot to establish a Lisfranc ligament injury model, in which screw-plate fixation (with 2 locking plates and 8 standard screws and one non-cannulated screw) and non-cannulated screw fixation (with 3 non-cannulated screws) for Lisfranc ligament injury were simulated respectively. Finite element analyses were carried out by Abaqus 6.14 software after loads were added in the 3-D models of screw-plate fixation and non-cannulated screw fixation for Lisfranc ligament injury. The overall stress-strain nephogram, the stress distribution and displacement of the foot bone, and the stress distribution on the internal fixation system were compared between the 2 kinds of models.Results:Under the same load, the stress of the whole screw-plate fixation was concentrated on the fixators, and the stress of the non-cannulated screws was also greater than that of the bones. In both models, the strain of the whole foot led to arch collapse, especially in the medial column. The maximum stress on the screw holes in the medial and middle columns in the screw-plate fixation model was 39.91 MPa, smaller than that in the non-cannulated screw fixation model (53.13 MPa). The relative displacement of the first metatarsal joint in the screw-plate fixation model was 8.515 × 10 -1 mm, much greater than that in the non-cannulated screw fixation model (3.893 × 10 -1 mm). Stress concentration was observed in both models. The stress of the screw-plate system was concentrated on the fibular side of the middle section of the plate used to fix the first tarsometatarsal joint, decreasing towards both ends. The maximum stress of the non-cannulated screws was located in the middle of the medial column screw for fixation of the first tarsometatarsal joint, significantly greater than those of the both ends. The maximum stress of the screw-plate system was 239.5 MPa, smaller than that of the non-cannulated screws (256.8 MPa). Conclusions:Non-cannulated screw fixation demonstrates a greater biomechanical stability for Lisfranc ligament injury than screw-plate fixation. However, the former may have a higher risk of screw breakage because it bears a greater stress.

Objective:To analyze the status quo of occupational engagement of junior nurses and related influencing factors, and to provide reference for managers to develop a positive incentive mechanism.Methods:From November 2020 to December 2020, 255 junior nursing staff with less than or equal to 3 years seniority at 3 tertiary general hospitals in Tianjin were selected. Questionnaire surveys were made on their occupational engagement, occupational values, job satisfaction for nursing, and general self-efficacy. Descriptive analysis and t test were used to probe into their current occupational engagement, and build a relational model on the occupational satisfaction, and the relational model of between their occupational values and self-efficiency in general of these nursing staff. Results:The total scoring of the occupational engagement scale for 255 junior nursing staff was 78.47±19.93, which was higher than the domestic norm level, and the difference was statistically significant( t=11.48, P<0.001). The results of the structural equation model showed that the overall effect on the occupational engagement of junior nurses from high to low were as follows: self-efficacy( β=0.599), professional values( β=0.323)and job satisfaction( β=0.275). Conclusions:These nursing staff feature high occupational engagement. Hospital administrators are recommended to strength training, provide timely support and incentives for their sustained improvement of self-efficiency, meet their individual career development needs for higher job satisfaction, and focus on shaping their occupational values as well.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Objective:To discuss the effect of low-dose ionizing radiation on the health of radiation workers, and provide a basis for occupational health risk assessment of radiation workers.Methods:In January 2020, 3165 radiation workers who performed radiation occupational health examinations in Guangzhou Prevention and Treatment Hospital for Occupational Disease from January 2017 to December 2019 were selected as the research objects, and compared and analyzed the health status of radiation workers with different examination types (pre-job, in-job and off-job) , types of work, gender, and length of service.Results:The off-job occupational radiological health examination was rare at 2.3% (74/3165) . The abnormal detection rate of chest radiographs, renal function, thyroid function, and blood routine of the radiation workers in-job group was higher than that of the pre-job group ( P<0.05) . No statistical difference was found in the abnormal detection rate of the examination items during the in-job group and the off-job group ( P>0.05) . The blood routine abnormality detection rate of medical application group and industrial application group were higher than those of nuclear fuel group ( P<0.05) . The abnormal detection rate of blood pressure and renal function of male radiation workers was higher than that of females, while the abnormal detection rate of blood routine of females was higher than that of males ( P<0.05) . The abnormal detection rate of electrocardiogram, chest radiograph, blood pressure, renal function, thyroid function, and blood routine of radiation workers increased with increasing working age ( P<0.05) . Conclusion:Occupational health status of radiation workers is not optimistic. Radiation occupational health monitoring should be strengthened, special attention should be paid to off-job radiation occupational health examination, focusing on the sensitive indicators of sensitive personnel, improving radiation protection conditions, and effectively protecting the occupational health of radiation workers.

Objective:To discuss the effect of low-dose ionizing radiation on the health of radiation workers, and provide a basis for occupational health risk assessment of radiation workers.Methods:In January 2020, 3165 radiation workers who performed radiation occupational health examinations in Guangzhou Prevention and Treatment Hospital for Occupational Disease from January 2017 to December 2019 were selected as the research objects, and compared and analyzed the health status of radiation workers with different examination types (pre-job, in-job and off-job) , types of work, gender, and length of service.Results:The off-job occupational radiological health examination was rare at 2.3% (74/3165) . The abnormal detection rate of chest radiographs, renal function, thyroid function, and blood routine of the radiation workers in-job group was higher than that of the pre-job group ( P<0.05) . No statistical difference was found in the abnormal detection rate of the examination items during the in-job group and the off-job group ( P>0.05) . The blood routine abnormality detection rate of medical application group and industrial application group were higher than those of nuclear fuel group ( P<0.05) . The abnormal detection rate of blood pressure and renal function of male radiation workers was higher than that of females, while the abnormal detection rate of blood routine of females was higher than that of males ( P<0.05) . The abnormal detection rate of electrocardiogram, chest radiograph, blood pressure, renal function, thyroid function, and blood routine of radiation workers increased with increasing working age ( P<0.05) . Conclusion:Occupational health status of radiation workers is not optimistic. Radiation occupational health monitoring should be strengthened, special attention should be paid to off-job radiation occupational health examination, focusing on the sensitive indicators of sensitive personnel, improving radiation protection conditions, and effectively protecting the occupational health of radiation workers.