CgSHIP2 negatively regulates the mRNA expressions of CgIL-17s in response to Vibrio splendidus stimulation in Crassostrea gigas.

SH2 domain containing inositol polyphosphate5-phosphatase-2 (SHIP2) is a member of the 5-phosphatase family, acting as a vital negative regulator of immune response in vertebrates. In the present study, a SHIP2 homologue (designed as CgSHIP2) was identified from Pacific oyster, Crassostrea gigas. There was a SH2 domain, an IPPc domain and a SAM domain in CgSHIP2. The mRNA transcripts of CgSHIP2 were widely expressed in all the tested tissues with the highest expression in haemolymph. The mRNA expressions of CgSHIP2 in haemocytes increased significantly at 6, 12, 48 and 72 h after Vibrio splendidus stimulation. The positive green signals of CgSHIP2 protein were mainly located in cytoplasm of haemocytes. After the expression of CgSHIP2 was inhibited by RNA interference, the mRNA transcripts of interleukin 17s (CgIL-17-1, CgIL-17-2, CgIL-17-3 and CgIL-17-6) in the haemocytes increased significantly at 24 h after V. splendidus stimulation, which were 8.15-fold (p < 0.001), 3.44-fold (p < 0.05), 2.15-fold (p < 0.01) and 4.63-fold (p < 0.05) compared with that in NC-RNAi group, respectively. Obvious branchial swelling and cilium shedding in gills were observed in CgSHIP2-RNAi group at 24 h after V. splendidus stimulation. The results suggested that CgSHIP2 played an important role in controlling inflammatory response induced by bacteria in oysters.

A national-scale assessment of land subsidence in China's major cities.

China's massive wave of urbanization may be threatened by land subsidence. Using a spaceborne synthetic aperture radar interferometry technique, we provided a systematic assessment of land subsidence in all of China's major cities from 2015 to 2022. Of the examined urban lands, 45% are subsiding faster than 3 millimeters per year, and 16% are subsiding faster than 10 millimeters per year, affecting 29 and 7% of the urban population, respectively. The subsidence appears to be associated with a range of factors such as groundwater withdrawal and the weight of buildings. By 2120, 22 to 26% of China's coastal lands will have a relative elevation lower than sea level, hosting 9 to 11% of the coastal population, because of the combined effect of city subsidence and sea-level rise. Our results underscore the necessity of enhancing protective measures to mitigate potential damages from subsidence.

Application of nano-radiosensitizers in non-small cell lung cancer.

Radiotherapy stands as a cornerstone in the treatment of numerous malignant tumors, including non-small cell lung cancer. However, the critical challenge of amplifying the tumoricidal effectiveness of radiotherapy while minimizing collateral damage to healthy tissues remains an area of significant research interest. Radiosensitizers, by methods such as amplifying DNA damage and fostering the creation of free radicals, play a pivotal role in enhancing the destructive impact of radiotherapy on tumors. Over recent decades, nano-dimensional radiosensitizers have emerged as a notable advancement. Their mechanisms include cell cycle arrest in the G2/M phase, combating tumor hypoxia, and others, thereby enhancing the efficacy of radiotherapy. This review delves into the evolving landscape of nanomaterials used for radiosensitization in non-small cell lung cancer. It provides insights into the current research progress and critically examines the challenges and future prospects within this burgeoning field.

Novel Pyrazole-4-Carboxamide Derivatives Containing Oxime Ether Group as Potential SDHIs to Control Rhizoctonia solani.

In the search for novel succinate dehydrogenase inhibitor (SDHI) fungicides to control Rhizoctonia solani, thirty-five novel pyrazole-4-carboxamides bearing either an oxime ether or an oxime ester group were designed and prepared based on the strategy of molecular hybridization, and their antifungal activities against five plant pathogenic fungi were also investigated. The results indicated that the majority of the compounds containing oxime ether demonstrated outstanding in vitro antifungal activity against R. solani, and some compounds also displayed pronounced antifungal activities against Sclerotinia sclerotiorum and Botrytis cinerea. Particularly, compound 5e exhibited the most promising antifungal activity against R. solani with an EC50 value of 0.039 µg/mL, which was about 20-fold better than that of boscalid (EC50 = 0.799 µg/mL) and 4-fold more potent than fluxapyroxad (EC50 = 0.131 µg/mL). Moreover, the results of the detached leaf assay showed that compound 5e could suppress the growth of R. solani in rice leaves with significant protective efficacies (86.8%) at 100 µg/mL, superior to boscalid (68.1%) and fluxapyroxad (80.6%), indicating promising application prospects. In addition, the succinate dehydrogenase (SDH) enzymatic inhibition assay revealed that compound 5e generated remarkable SDH inhibition (IC50 = 2.04 µM), which was obviously more potent than those of boscalid (IC50 = 7.92 µM) and fluxapyroxad (IC50 = 6.15 µM). Furthermore, SEM analysis showed that compound 5e caused a remarkable disruption to the characteristic structure and morphology of R. solani hyphae, resulting in significant damage. The molecular docking analysis demonstrated that compound 5e could fit into the identical binding pocket of SDH through hydrogen bond interactions as well as fluxapyroxad, indicating that they had a similar antifungal mechanism. The density functional theory and electrostatic potential calculations provided useful information regarding electron distribution and electron transfer, which contributed to understanding the structural features and antifungal mechanism of the lead compound. These findings suggested that compound 5e could be a promising candidate for SDHI fungicides to control R. solani, warranting further investigation.

Epitaxial Growth of Two-Dimensional Nonlayered AuCrS2 Materials via Au-Assisted Chemical Vapor Deposition.

Two-dimensional (2D) nonlayered transition metal dichalcogenide (TMD) materials are emergent platforms for various applications from catalysis to quantum devices. However, their limited availability and nonstraightforward synthesis methods hinder our understanding of these materials. Here, we present a novel technique for synthesizing 2D nonlayered AuCrS2 via Au-assisted chemical vapor deposition (CVD). Our detailed structural analysis reveals the layer-by-layer growth of [AuCrS2] units atop an initial CrS2 monolayer, with Au binding to the adjacent monolayer of CrS2, which is in stark contrast with the well-known metal intercalation mechanism in the synthesis of many other 2D nonlayered materials. Theoretical calculations further back the crucial role of Cr in increasing the mobility of Au species and strengthening the adsorption energy of Au on CrS2, thereby aiding the growth throughout the CVD process. Additionally, the resulting free-standing nanoporous AuCrS2 (NP-AuCrS2) exhibits exceptional electrocatalytic properties for the hydrogen evolution reaction.

The experiences of children and adolescents with cancer returning to school: A qualitative meta-synthesis.

BACKGROUND: Returning to school can be challenging for children and adolescents with cancer who have been absent for a long time. As there is little known about the return to school experience of children and adolescents with cancer, this meta-synthesis aimed to describe the experiences of children and adolescent cancer patients as they return to school. METHODS: Seven English databases and three Chinese databases were searched from inception to March 14, 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to appraise study quality. Data were synthesized using the Thomas and Harden thematic and content analysis method. RESULTS: Twelve qualitative studies met the inclusion criteria and were analyzed into meta-synthesis. Data synthesis led to constructing four analytical themes and twelve sub-themes. The four major themes constructed were:benefits to school re-entry, barriers to school re-entry, motivators to school re-entry and the adaptation process after returning to school. CONCLUSION: Children and adolescents with cancer were willing to return to education and can adapt to school life over time. But they were faced with challenges, including physical, psychological, and social barriers. Appropriate measures need to be taken to reduce those barriers. IMPLICATIONS TO PRACTICE: Findings can be used to inform future research and interventions to support a successful return to education for children and adolescents with cancer. Healthcare providers should address the needs of children and adolescents at different stages and actively work with schools, hospitals and families to help childhood cancer survivors successfully return to school.

Research on Pedestrian Crossing Decision Models and Predictions Based on Machine Learning.

Systematically and comprehensively enhancing road traffic safety using artificial intelligence (AI) is of paramount importance, and it is gradually becoming a crucial framework in smart cities. Within this context of heightened attention, we propose to utilize machine learning (ML) to optimize and ameliorate pedestrian crossing predictions in intelligent transportation systems, where the crossing process is vital to pedestrian crossing behavior. Compared with traditional analytical models, the application of OpenCV image recognition and machine learning methods can analyze the mechanisms of pedestrian crossing behaviors with greater accuracy, thereby more precisely judging and simulating pedestrian violations in crossing. Authentic pedestrian crossing behavior data were extracted from signalized intersection scenarios in Chinese cities, and several machine learning models, including decision trees, multilayer perceptrons, Bayesian algorithms, and support vector machines, were trained and tested. In comparing the various models, the results indicate that the support vector machine (SVM) model exhibited optimal accuracy in predicting pedestrian crossing probabilities and speeds, and it can be applied in pedestrian crossing prediction and traffic simulation systems in intelligent transportation.

Anthropogenic disturbance exacerbates resilience loss in the Amazon rainforests.

Uncovering the mechanisms that lead to Amazon forest resilience variations is crucial to predict the impact of future climatic and anthropogenic disturbances. Here, we apply a previously used empirical resilience metrics, lag-1 month temporal autocorrelation (TAC), to vegetation optical depth data in C-band (a good proxy of the whole canopy water content) in order to explore how forest resilience variations are impacted by human disturbances and environmental drivers in the Brazilian Amazon. We found that human disturbances significantly increase the risk of critical transitions, and that the median TAC value is ~2.4 times higher in human-disturbed forests than that in intact forests, suggesting a much lower resilience in disturbed forests. Additionally, human-disturbed forests are less resilient to land surface heat stress and atmospheric water stress than intact forests. Among human-disturbed forests, forests with a more closed and thicker canopy structure, which is linked to a higher forest cover and a lower disturbance fraction, are comparably more resilient. These results further emphasize the urgent need to limit deforestation and degradation through policy intervention to maintain the resilience of the Amazon rainforests.

Relationship Between Microstructural Alterations and Cognitive Decline After Whole-Brain Radiation Therapy for Brain Metastases: An Exploratory Whole-Brain MR Analysis Based on Neurite Orientation Dispersion and Density Imaging.

BACKGROUND: Cognitive impairment frequently occurs in patients with brain metastases (BM) after whole-brain radiotherapy (WBRT). It is crucial to explore the underlying mechanisms of cognitive impairment in BM patients receiving WBRT. PURPOSE: To detect brain microstructural alterations in patients after WBRT by neurite orientation dispersion and density imaging (NODDI), and evaluate the performance of microstructural alterations in predicting cognitive impairment. STUDY TYPE: Prospective. POPULATION: Twenty-six patients (seven female; mean age, 60.9 years). FIELD STRENGTH/SEQUENCE: 3-T, multi-shell diffusion-weighted single-shot echo-planar sequence. Three-dimensional magnetization-prepared rapid acquisition with gradient echo sequence. ASSESSMENT: Mini-mental state examination (MMSE) evaluations were conducted prior to, following, 1 and 3 months after WBRT. The diffusion data were collected twice, 1 week before and 1 week after WBRT. NODDI analysis was conducted to assess microstructural alterations in whole brain (orientation dispersion index, neurite density index, volume fraction of isotropic water molecules). Reliable change indices (RCI) of MMSE were used to measure cognitive decline. The performance of support vector machine models based on NODDI parameters and clinical features (prednisone usage, tumor volume, etc.) in predicting MMSE-RCI was evaluated. STATISTICAL TESTS: Paired t-test to assess alterations of NODDI measures and MMSE during follow-up. Statistical significance level of P-value <0.05. RESULTS: Significantly decreased MMSE score was found at 3 months after WBRT. After WBRT, corpus callosum, medial prefrontal cortex, limbic lobe, occipital lobe, parietal lobe, putamen, globus pallidus lentiform, and thalamus demonstrated damage in NODDI parameters. The predicted MMSE-RCI based on NODDI features was significantly associated with the measured MMSE-RCI at 1 month (R = 0.573; P = 0.003) and 3 months (R = 0.687; P < 0.0001) after WBRT. DATA CONCLUSION: Microstructural alterations in several brain regions including the middle prefrontal and limbic cortexes were observed in patients with BM following WBRT, which may contribute to subsequent cognitive decline. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.

An unexpected interfacial Mo-rich phase in 2D molybdenum disulfide and 3D gold heterojunctions.

The interface engineering of two-dimensional transition metal dichalcogenides (2D-TMDs) and metals has been regarded as a promising strategy to modulate their outstanding electrical and optoelectronic properties. Chemical Vapour Deposition (CVD) is an effective strategy to regulate the contact interface between TMDs and metals via directly growing 2D TMDs on a 3D metal substrate. Nevertheless, the underlying mechanisms of interfacial phase formation and evolution during TMD growth on a metallic substrate are less known. In this work, we found a 2D non-van der Waals (vdW) Mo-rich phase (MoNSN+1) during thermal sulfidation of a Mo-Au surface alloy to molybdenum disulfide (MoS2) in a S-poor environment. Systematic atomic-scale observations reveal that the periodic Mo and S atomic layers are arranged separating from each other in the non-vdW Mo-rich phase, and the Mo-rich phase preferentially nucleates between outmost 2D MoS2 and a 3D nanostructured Au substrate which possesses copious surface steps and kinks. Theoretical calculations demonstrate that the appearance of the Mo-rich phase with a unique metallic nature causes an n-type contact interface with an ultralow transition energy barrier height. This study may help understand the formation mechanism of the interfacial second phase during the epitaxial growth of 2D-TMDs on 3D nanostructured metals, and provide a new approach to tune the Schottky barrier height by the design of the interfacial phase structure at the heterojunction.

Graphene metasurface hits the point.

Exceptional points pose exceptional difficulties to access and encircle. By simply gating graphene, it is now easier to hit the exceptional point.

Rapid Melt-Quenching Enables General Synthesis of High-Loading Single-Atom Catalysts with Bicontinuous Nanoporous Structure.

Single-atom catalysts have attracted extensive attention due to their unique atomic structures and extraordinary activities in catalyzing chemical reactions. However, the lack of general and efficient approaches for producing high-density single atoms on suitably tailored supporting matrixes hinders their industrial applications. Here, a rapid melt-quenching strategy with high throughput to synthesize single atoms with high metal-atom loadings of up to 9.7 wt% or 2.6 at% on nanoporous metal compounds is reported, representing several-fold improvements compared to benchmarks in the literature. Mechanism characterizations reveal that the high-temperature melting provides the essential liquid environment and activation energy to achieve the atomization of metals, while the following rapid-quenching pins the isolated metal atoms and stabilizes the coordination environment. In comparison with carbon-supported single-atom catalysts, various collaboration combinations of single atoms and nanoporous metal compounds can be synthesized using the strategy, thus achieving efficient hydrazine oxidation-assisted H2 production. This synthesis protocol is highly compatible with automatic operation, which provides a feasible and general route to design and manufacture specific single-atom catalysts with tunable atomic metal components and supporting matrixes, thus promoting the deployment of single-atom catalysts for various energy technology applications.

Role of social support in poststroke depression: A meta-analysis.

Poststroke depression significantly affects health and quality of life of stroke patients. This study evaluates the role of social support in influencing poststroke depression. The literature search was conducted in electronic databases and study selection was based on precise eligibility criteria. The prevalence rates reported by individual studies were pooled. A meta-analysis of standardized mean differences (SMD) in social support between depressed and non-depressed stroke patients was performed. The odds ratios and correlation coefficients showing the relationship between social support and depression were pooled to achieve overall estimates. Twenty-five studies (9431 patients) were included. The prevalence of depression was 36% [95% confidence interval (CI): 28, 45]. Patients with poststroke depression had significantly lower social support in comparison with patients with no or lower levels of depression [SMD in social support scores -0.338 (95% CI: -0.589, -0.087); p = 0.008]. The odds of depression were lower in patients receiving higher levels of social support [OR 0.82 (95% CI: 0.69, 0.95)] but were higher in patients who were receiving weaker social support [OR 5.22 (95% CI: -0.87, 11.31)]. A meta-analysis of correlation coefficients found a significantly inverse correlation between social support and poststroke depression [r -0.336 (95% CI: -0.414, -0.254)]. Poststroke depression has a significant independent inverse association with social support.

Scalable-doped Nanoporous 1T″ ReSe2 via a General Surface Co-Alloy Strategy.

Reliable and controllable doping of 2D transition metal dichalcogenides is an efficient approach to tailor their physicochemical properties and expand their functional applications. However, precise control over dopant distribution and scalability of the process remains a challenge. Here, we report a general method to achieve scalable in situ doping of centimeter-sized bicontinuous nanoporous ReSe2 films with transition metal atoms via surface coalloy growth. The distinct strains induced by the bending curvature of nanoporous structures and uniform dopants result in a local 1T' to 1T″ structure phase transition over nanoporous ReSe2 films. The as-prepared nanoporous Ru-ReSe2 with high 1T″ phase exhibits preferable electrochemical activity in hydrogen evolution reaction. The work demonstrates a unique and general approach to synthesize uniformly-doped transition metal dichalcogenides with 3D bicontinuous nanoporous structure, which can be scaled up to batch production for various applications.

Self-assembled flagella protein nanofibers induce enhanced mucosal immunity.

Nanofibers are potential vaccines or adjuvants for vaccination at the mucosal interface. However, how their lengths affect the mucosal immunity is not well understood. Using length-tunable flagella (self-assembled from a protein termed flagellin) as model protein nanofibers, we studied the mechanisms of their interaction with mucosal interface to induce immune responses length-dependently. Briefly, through tuning flagellin assembly, length-controlled protein nanofibers were prepared. The shorter nanofibers exhibited more pronounced toll-like receptor 5 (TLR5) and inflammasomes activation accompanied by pyroptosis, as a result of cellular uptake, lysosomal damage, and mitochondrial reactive oxygen species generation. Accordingly, the shorter nanofibers elevated the IgA level in mucosal secretions and enhanced the serum IgG level in ovalbumin-based intranasal vaccinations. These mucosal and systematic antibody responses were correlated with the mucus penetration capacity of the nanofibers. Intranasal administration of vaccines (human papillomavirus type 16 peptides) adjuvanted with shorter nanofibers significantly elicited cytotoxic T lymphocyte responses, strongly inhibiting tumor growth and improving survival rates in a TC-1 cervical cancer model. This work suggests that length-dependent immune responses of nanofibers can be elucidated for designing nanofibrous vaccines and adjuvants for both infectious diseases and cancer.

Transcriptome analysis of the response to low temperature acclimation in Calliptamus italicus eggs.

BACKGROUND: Calliptamus italicus is a dominant species in the desert and semi-desert grassland. It is widely distributed throughout many regions such as Asia, Europe, North Africa and the Mediterranean, and has enormous destructive potential for agriculture and animal husbandry. The C. italicus overwintering as eggs in the soil through diapause, and the cold tolerance of locust eggs is the key to their ability to survive the winter smoothly to maintain the population. RESULTS: Transcriptome analysis of C. italicus eggs was carried out in this paper in constant low temperature acclimation, natural low temperature acclimation and room temperature. The differentially expressed genes related to cold tolerance were screened out, the differences in expression patterns under different low temperature acclimation were analyzed, and the genes in the significantly up-regulated pathways may play an important role in cold tolerance. The results show that different domestication modes can induce C. italicus eggs to express a large number of genes to alleviate low temperature damage, but C. italicus eggs are more sensitive to changes in temperature. Compared with the control, there are 8689 DEGs at constant low temperature and 14,994 DEGs at natural low temperature. KEGG analysis showed that DEGs were mainly enriched in pathways related to metabolism and biological systems under constant low temperature, and were mainly enriched in pathways related to biological systems and environmental information processing under natural low temperature. In addition, RNAi technology was used to further verify the regulation of genes in the significantly enriched up-regulated pathways on C. italicus eggs, and it was confirmed that the hatching rate of C. italicus eggs at low temperature was significantly reduced after interference. CONCLUSIONS: Transcriptome analysis of C. italicus eggs treated at different temperatures provided a theoretical basis for further understanding the adaptation mechanism of C. italicus eggs to low temperature. In addition, four potential RNAi target genes were verified in the eggs of C. italicus for the first time, providing new ideas for effective control of this species.

Interplay of distributions of multiple guest molecules in block copolymer micelles: A dissipative particle dynamics study.

HYPOTHESIS: Delivery of multiple payloads using the same micelle is of significance to achieve multifunctional or synergistic effects. The interacting distribution of different payloads in micelles is expected to influence the loading stability and capacity. It is highly desirable to explore how intermolecular interactions affect the joint distribution of multi-payloads. EXPERIMENTS: Dissipative Particle Dynamics simulations were performed to probe the loading of three payloads: decane with a linear carbon chain, butylbenzene with an aromatic ring connected to carbon chain, and naphthalene with double aromatic rings, within poly(ß-amino ester)-b-poly(ethylene glycol) micelles. Properties of core-shell micelles, e.g., morphological evolution, radial density distribution, mean square displacement, and contact statistics, were analyzed to reveal payloads loading stability and capacity. Explorations were extended to vesicular, multi-compartment, double helix, and layer-by-layer micelles with more complex inner structures. FINDINGS: Different payloads have their own preferred locations. Decane locates at the hydrophilic/hydrophobic interface, butylbenzene occupies both the hydrophilic/hydrophobic interface and the hydrophobic core, while naphthalene enters the hydrophobic core. More efficient delivery of multi-payloads is achieved since the competition of payloads occupying preferred locations is minimized. The fusion of micelles encapsulating different payloads suggests that specific payloads will move to their preferred positions without interfering other payloads.

Relationship between cognitive emotion regulation strategies and coronary heart disease: an empirical examination of heart rate variability and coronary stenosis.

OBJECTIVE: Despite longstanding interest in emotion regulation and cardiovascular health, limited studies have investigated the relationship between cognitive emotion regulation (CER) strategies and coronary heart disease (CHD) using objective measures of heart rate variability (HRV) and coronary stenosis. This study aimed to objectively explore the associations between CER strategies and both HRV and coronary stenosis and provide empirical evidence for the relationship between emotion regulation and CHD. METHODS: Questionnaires on CER strategies were distributed to 251 CHD patients and 250 healthy persons. HRV and coronary stenosis were measured for CHD respondents using the 24-h dynamic electrocardiogram and coronary angiography, respectively. RESULTS: CHD patients with low HRV/severe stenosis used maladaptive emotion regulation more frequently and adaptive emotion regulation less frequently. Various maladaptive emotion regulation strategies (e.g. acceptance, rumination, putting into perspective) were positively associated with lower HRV and coronary stenosis severity, while adaptive emotion regulation strategies (e.g. positive refocusing, refocusing on planning) were negatively associated with lower HRV and coronary stenosis severity. CONCLUSIONS: Patients with more serious diseases exhibited increased maladaptive emotion regulation, which was associated with lower HRV and severe coronary stenosis. Further, adaptive emotion regulation was associated with higher HRV and moderate coronary stenosis.

Binding Peptide-Promoted Biofunctionalization of Graphene Paper with Hydroxyapatite for Stimulating Osteogenic Differentiation of Mesenchymal Stem Cells.

Graphene paper (GP), a macroscopic self-supporting material, has exceptional flexibility and preserves the excellent physical and chemical properties of graphene nanomaterials. But its applications in regenerative medicine remain to be further explored. Here, we biologically functionalized GP with hydroxyapatite (HA) nanorods by the use of GP-binding peptides as an affinity linker. This strategy solved two daunting challenges for regenerative medicine applications of GP: the lack of good hydrophilicity for supporting cell growth and the difficulty in forming composites by binding with nanobiomaterials. Briefly, we first screened a high-affinity GP-binding peptide (TWWNPRLVYFDY) by the phage display technique. Then we chemically conjugated the GP-binding peptide to the synthetic HA nanorods. The GP-binding peptide on the resultant HA nanorods enabled them to be bound and assembled onto the GP substrate with high affinity, forming a GP-peptide-HA composite with significantly improved hydrophilicity of GP. The composite promoted the attachment and proliferation of mesenchymal stem cells (MSCs), demonstrating its outstanding biocompatibility. Due to the unique compositions of the composite, it was also found to induce osteogenic differentiation of MSCs in vitro in the absence of other inducers in the medium, by verifying the expression of the osteogenic markers including collagen-1, bone morphogenetic proteins 2, runx-related transcription factor 2, osteocalcin, and alkaline phosphatase. Our work suggests that the GP-binding peptide can be used to link inorganic nanoparticles onto GP to facilitate the biomedical applications of GP.

The Psychological Adaptation Process in Chinese Parent Caregivers of Pediatric Leukemia Patients: A Qualitative Analysis.

BACKGROUND: Psychological stresses caused by caring for pediatric leukemia patients can affect their parent caregivers' health. How these stressors are successfully managed determines how well these caregivers adapt to the illness situation over time. Previous studies suggest that caregivers will adapt gradually to the adverse consequences of caring for their child with a long-term illness. However, studies of the psychological adaptation process of family caregivers of children with leukemia are limited. OBJECTIVE: The aim of this study was to study the psychological adaptation process of the parent caregivers of pediatric leukemia patients. METHODS: In this qualitative study, we interviewed 32 caregivers of children with leukemia in China. Data were collected through semistructured interviews and analyzed using the content analysis method. RESULTS: The psychological adaptation process in caregivers of pediatric leukemia patients seems to involve 5 stages: initial devastation, accumulation of hope, fluctuation in feelings, integration, and psychological adaptation. Significant emotional changes were observed at each stage. CONCLUSIONS: This study identified commonalities in the psychological adaptation process experienced by caregivers of children with leukemia in the Chinese social and cultural context. It also characterized the different emotions that the caregivers had in the 5 stages of adaptation. In addition, our research identified the possible psychological interventions at different stages. IMPLICATIONS FOR PRACTICE: The study described the adaptation process of Chinese parents of children with leukemia. The findings of this study will help nurses identify main coping resources, controllable intervention factors, and the timing of intervention for these caregivers of children with leukemia.