Symptom clusters and impact on quality of life in esophageal cancer patients.

BACKGROUND: Esophageal cancer patients can experience co-occurring, related symptoms labeled symptom clusters. This study aimed to identify symptom clusters and explore which SCs independently affect the quality of life (QoL) among esophageal cancer patients. METHODS: This cross-sectional study was performed in Shenyang, China, from February 2021 to February 2022. Finally, 118 esophageal cancer patients effectively completed the survey. Questionnaires' information included the Functional Assessment of Cancer Therapy-General (FACT-G), the MD Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI), the Multidimensions Scale of Perceived Social Support, and demographic and clinical characteristics. Exploratory factor analysis with principal axis factoring was used to identify symptom clusters, and multiple regression analysis was employed to analyze the influencing factors of QoL. RESULTS: The mean score of FACT-G was 69.88 (SD = 17.85) among 118 esophageal cancer patients. Four symptom clusters were identified: psychological-somatic, dysphagia, fatigue-pain, and gastrointestinal symptom clusters. Results of regression analysis indicated a significant impact on QoL for chemotherapy (ß = 0.140, P < 0.045), psychological-somatic symptom cluster (ß = - 0.329, P = 0.013), and social support (ß = 0.409, P < 0.001) after adjusting demographic and clinical characteristics. The linear combination explained 47.8% of the variance in QoL. CONCLUSIONS: There is a critical need to emphasize the importance of psychological-somatic symptoms clusters management programs and increasing social support to improve QoL in esophageal cancer patients.

Choosing the appropriate ShangRing size for paediatric circumcision using the no-flip technique.

AIM: To determine the correct ShangRing size for paediatric circumcision using the no-flip technique. METHODS: A cohort of 104 boys (from 6 to 14 years) underwent ShangRing circumcision at Ningbo First Hospital, China. The patients were randomly divided into three groups according to the different methods used for choosing the ring size. For Group A, the ring size was chosen using the ShangRing measuring tape; for Group B, ring size was chosen based on the diameter of penis measured using a self-designed scale plate; and for Group C, ring size was chosen based on the diameter of the glans measured using the self-designed scale plate. The surgery duration, foreskin dorsal slit rate, intra-operative and post-surgery pain score, pain duration, post-surgery ring detachment duration, pain score for ring detachment, complication rate and satisfaction rate were compared. RESULTS: Group A had the highest dorsal slit rate and the longest surgical period. There were no significant differences in intra-/post-surgery pain or ring detachment duration among the three groups. The post-surgery oedema rate and foreskin asymmetry occurrence rate was the highest in Group A at 40.62 and 21.88%, respectively. Group C had the highest satisfaction rate (97.14%), with a significant difference from Group A (75.00%). Oedema and asymmetry of the foreskin increased, while the satisfaction rate simultaneously decreased when a larger ShangRing was chosen. CONCLUSIONS: The size of the ShangRing should be chosen in accordance with the diameter of the glans in paediatric ShangRing circumcision using the no-flip technique.