Gastrointestinal symptom clusters are a commonly observed and distressing set of symptoms in pediatric patients undergoing chemotherapy for cancer. Traditional Chinese Medicine therapies hold a unique advantage and prospective application in alleviating these symptom clusters caused by chemotherapy in pediatric cancer patients. This review seeks to offer insights into the understanding of gastrointestinal symptom clusters caused by chemotherapy from both Western and Chinese medical perspectives. Moreover, it summarizes the applications of Traditional Chinese Medicine therapies in managing these symptoms, discussing the shortcomings present in existing research and potential future directions.

Objective:To investigate parents′ proxy-assessment post-operative pain intensity of orthopedic children, and to analyze the relevant influencing factors.Methods:Using the purposive sampling method, 200 children and their parents who met the inclusion and exclusion criteria were mainly selected in pediatric orthopedics of Children′s Hospital of Soochow University from August to December in 2020. A general information questionnaire and the Wong-Baker Facial Pain Rating Scale (WBFP) were used to survey.Results:One hundred and ninety-five questionnaires were effectively recovered. Nearly 44.6%(87/195) and 28.7%(56/195), 36.9%(72/195) and 5.1%(10/195), 8.2%(16/195) and 1.0%(2/195) of parents reported (using WBFP Rating Scale) moderate to severe pain intensity of 1 d, 2 d and 3 d after surgery and the Cohen′s Kappa coefficient with child′s self-report which ranged from 0.556 to 0.631 were all higher than child-nurse (Cohen′s Kappa coefficient ranged from 0.318 to 0.406). The results of multiple linear regression analysis showed that using painkillers by children entered in the regression equation, which could explain the variation of 13.5% ( R 2=0.135). Conclusions:The self-report of the children was in good agreement with the assessment of the pain intensity by the parental agent, and the assessment of the pain intensity was affected by the painkillers used by the children. Therefore, medical institutions and personnel should create a supportive environment that values the positive role of parents to promote the management of children′s post-operative pain.

Objective:To investigate parents′ knowledge and attitude toward post-operative pain management in pediatric orthopedics and analyze influencing factors.Methods:A total of 170 parents of 6 to 16 years old children who underwent selective surgeries and were hospitalized because of limb fracture were conveniently selected in Children′s Hospital of Soochow University from April to December in 2019, They were investigated using the general data questionnaire, Pain Management Knowledge and Attitudes Questionnaire.Results:There were 167 parents completed questionnaires in our study. The mean score of parents′ knowledge, general attitude and negative attitude to pain medication were 15.0(3.00), 24.0(4.00) and 17.0(3.00) respectively. There were statistical differences between different educational levels of parents′ knowledge ( χ2 value was11.599, P=0.021), as well as different age of parent′s general attitude ( χ2 value was 7.053, P=0.029). Spearman-related results showed that parents′ cognition was positively correlated with general attitudes ( r value was 0.394, P<0.01). Conclusions:The majority of parents are at moderate to high level of knowledge, general attitude and negative attitude to pain medication. Pediatric nurses should pay more attention to parents′ knowledge deficit of and negative attitude toward pain assessment tools and pain-drugs to develop targeted educational intervention programs for promoting parental involvement.

The paper reviewed the application of child life in the care of children with acute leukemia in recent years, including related overviews, application effects, shortcomings and prospects in the process. The purpose is to provide references for further improving the application of child life in children with acute leukemia.

Objective:To explore the reports on the pain intensity and the use of pain relief strategies of parents in postoperative pain management of orthopedic children, and analyze related influencing factors.Methods:From January to August 2020, purpose sampling was used to select 200 parents of children who underwent elective surgery in the Department of Orthopedics of a Class Ⅲ Grade A children hospital in Suzhou City. The survey was conducted using the General Information Questionnaire, Wong-Baker FACES Pain Rating Scale, and Parents' Use of Pain Relief Strategies (PUPRS) Questionnaire. A total of 200 questionnaires were distributed, and 197 were effectively returned, with an effective rate of 98.5%.Results:The 197 orthopedic children's parents reported a score of (6.75±2.19) on the pain intensity of the children, 36.5% and 53.3% of them were moderate and severe respectively. The PUPRS score was 52.0 (9.00) , 70.6% and 28.4% were at medium and high levels, respectively. Multivariate analysis showed that parents' gender and education level were the influencing factors of PUPRS ( P<0.05) . Conclusions:Parents of most orthopedic children report severe postoperative pain intensity, and their use of pain relief strategies is at a medium to a high level, and is affected by gender and education level. However, the use of painkillers and certain pain relief strategies is lacking. In the future, clinical medical and nursing staff should formulate reasonable health education programs to further promote and improve parents' pain management practices.

BACKGROUND: Pulmonary fibrosis is a respiratory disease caused by the proliferation of fibroblasts and accumulation of the extracellular matrix (ECM). It is known that the lung ECM is mainly composed of a three-dimensional fiber mesh filled with various high-molecular-weight proteins. However, the small-molecular-weight proteins in the lung ECM and their differences between normal and fibrotic lung ECM are largely unknown. METHODS: Healthy adult male Sprague-Dawley rats (Rattus norvegicus) weighing about 150 to 200 g were randomly divided into three groups using random number table: A, B, and C and each group contained five rats. The rats in Group A were administered a single intragastric (i.g.) dose of 500 μL of saline as control, and those in Groups B and C were administered a single i.g. dose of paraquat (PQ) dissolved in 500 μL of saline (20 mg/kg). After 2 weeks, the lungs of rats in Group B were harvested for histological observation, preparation of de-cellularized lung scaffolds, and proteomic analysis for small-molecular-weight proteins, and similar procedures were performed on Group C and A after 4 weeks. The differentially expressed small-molecular-weight proteins (DESMPs) between different groups and the subcellular locations were analyzed. RESULTS: Of the 1626 small-molecular-weight proteins identified, 1047 were quantifiable. There were 97 up-regulated and 45 down-regulated proteins in B vs. A, 274 up-regulated and 31 down-regulated proteins in C vs. A, and 237 up-regulated and 28 down-regulated proteins identified in C vs. B. Both the up-regulated and down-regulated proteins in the three comparisons were mainly distributed in single-organism processes and cellular processes within biological process, cell and organelle within cellular component, and binding within molecular function. Further, more up-regulated than down-regulated proteins were identified in most sub-cellular locations. The interactions of DESMPs identified in extracellular location in all comparisons showed that serum albumin (Alb) harbored the highest degree of node (25), followed by prolyl 4-hydroxylase beta polypeptide (12), integrin β1 (10), apolipoprotein A1 (9), and fibrinogen gamma chain (9). CONCLUSIONS Numerous PQ-induced DESMPs were identified in de-cellularized lungs of rats by high throughput proteomics analysis. The DESMPs between the control and treatment groups showed diversity in molecular functions, biological processes, and pathways. In addition, the interactions of extracellular DESMPs suggested that the extracellular proteins Alb, Itgb1, Apoa1, P4hb, and Fgg in ECM could be potentially used as biomarker candidates for pulmonary fibrosis. These results provided useful information and new insights regarding pulmonary fibrosis.

By consulting relevant literatures on children's pain management, this article reviews parents' knowledge, beliefs or attitudes and related practice on children's pain management, analyzes the factors that affect parents' adoption of children's pain management behaviors, and provides a reference for pediatric nurses to guide parents to participate in a targeted manner when managing children's pain.

Objective: To investigate the dynamic changes of quality of life and its influencing factors in children with acute lymphoblastic leukemia during chemotherapy. Methods: A total of 134 children who were diagnosed with acute lymphoblastic leukemia were selected. The demographic questionnaire and Pediatric Quality of Life Inventory^TM General Core Module were completed in children at three different time points during chemotherapy (the first month, the third month, and the sixth month of chemotherapy). Results: There were significant differences in the quality of life between children with acute lymphoblastic leukemia (t=-23.117-209.225, P<0.01). Multiple factors analysis showed that the factors influencing the quality of life of children at the first month of chemotherapy were age (t=-10.413, P=0.000) , and family emotional support (t=2.231, P=0.027) ; the factors at the third month of chemotherapy included age (t=-12.439, P=0.000) , whether the child was the only child (t=2.267, P=0.025) , education level of primary caregiver (t=2.091, P=0.038) , and family emotional support (t=5.374, P=0.014) ; the factor at the sixth month of chemotherapy were age (t=-11.254, P=0.000) , and family emotional support (t=2.184, P=0.035) . Conclusions The total quality of life and the scores of all dimensions of children with acute lymphoblastic leukemia were lower and showed dynamic changes. Age and family emotional support were continuing factors influencing quality of life. Medical staff should take targeted interventions according to the characteristics of the quality of life of children at different ages, and guide and help parents and children to establish good family emotional support and improve their quality of life.

Objective To understand the negative emotion in primary caregivers of early diagnosed children with acute leukemia. Methods By purposive sampling, 17 cases were selected and investigated by semi-structuredinterviews. Colaizzi principles were used to analyze the data. Results Three themes were extracted:complex emotional response, too many concerns and weak support system. Conclusions The primary caregivers of children with acute leukemia at the early stage of diagnosis have negative emotions such as anxiety and fear, and suffer from psychological and economicpressures.Nurses should provide disease-related nursing skills training and personalized psychological care,and call for the establishment of the social support system and online communication platformto really meet their needs and alleviate the burden of care in order to better meet the follow-up treatment and care of children.

Objective To explore the work experience after the change of professional role of the new head nurse in pediatrics,and to provide a basis for development of a more scientific training program in the future.Methods A total of 12 cases of pediatric new head nurses were interviewed by semistructured interview.The NVivol0.0 software was used to supervise,excavate and seek data.The data were analyzed by the Colaizzi phenomenological methodology.Results Four themes were extracted including role maladjustment,difficult to cope with stress,achievement of self growth,and expectation of the nursing department.Conclusions The new head nurse in pediatrics is under great pressure,the nursing managers should pay more attention to their growth process,provide timely support and conduct regular pre job training for them,so that they can adapt to the head nurse's positions as soon as possible,so as to ensure the quality and safety of nursing.