Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Objective To explore the changes in trace elements and amino acid profiles in serum of patients with hepatocellular carcinoma(HCC) providing a reference for clinical diagnosis and treatment.Methods A total of 104 patients with HCC who underwent surgical treatment in the Department of Hepatobiliary Surgery of our hospital from January 2024 to April 2024 were selected as the study group, and 139 patients with benign biliary diseases during the same period were selected as the control group. Atomic absorption spectrometry was used to detect the levels of six trace elements (copper, zinc, calcium, magnesium, iron, and lead) in the serum of both groups, and liquid chromatography-tandem mass spectrometry was used to measure the concentrations of 21 amino acids.Results Compared with the control group, the serum copper level in the HCC group was significantly increased (P<0.05), while the levels of zinc and iron were significantly decreased (P<0.05). Amino acid profile analysis revealed that, compared with the control group, the concentrations of tyrosine, methionine, and phenylalanine in the HCC group were increased (P<0.05), while the concentrations of valine, leucine, isoleucine, glutamine, and arginine were decreased (P<0.05). Further analysis of the correlation between trace elements and amino acids with statistical differences between the groups showed that copper was negatively correlated with valine and leucine (P<0.05), while zinc and iron were positively correlated with valine, leucine, and isoleucine (P<0.01).Conclusions Imbalances in trace elements and amino acid metabolism changes are common in patients with HCC, and there may be an intrinsic connection between the two.

Objective:To retrieve, evaluate and summarize the relevant evidence for respiratory management in patients with amyotrophic lateral sclerosis (ALS), and provide reference for clinical nursing.Methods:The best practices, guidelines, expert consensus and other evidence on respiratory management in ALS patients were systematically retrieved from dometic and foreign relevant guide websites, professional associations and databases. The retrieve period was from January 1, 2016 to April 15, 2023. After the literature quality evaluation, the evidence was extracted from the literature that meets the quality standards.Results:A total of 12 references were included, including 3 guidelines, 1 expert consensus, 1 evidence summary, 4 systematic reviews, and 3 randomized controlled trails. The 25 pieces of evidence were summarized from the patients with ALS, including respiratory assessment, mechanical ventilation, secreta management, and respiratory rehabilitation.Conclusions:This study summarizes the best evidence on respiratory tract management in patients with ALS, which is convenient for clinical medical personnel to carry out more targeted and scientific respiratory assessment, intervention and guidance for patients with ALS.

Objective:To construct a structured education course for patients with neurogenic bladder during the rehabilitation period.Methods:This study consisted three stages of current situation survey, literature search, and expert consultation. From February 2022 to February 2023, a current survey was conducted on the self-management needs of 62 patients with neurogenic bladder. In April 2023, a literature search was conducted to summarize the best evidence on nursing and management of neurogenic bladder, and form the initial version of course indicators and content. From April to May 2023, 14 experts were selected for consultation, and the Delphi method was used to demonstrate the course indicators and content, and to construct the final draft of the course.Results:A total of 62 patients with neurogenic bladder were included, they have requirements for water management, bladder function training, and dietary requirements, etc. A total of 2 053 articles were retrieved, and 14 articles were ultimately included, including eight guidelines, four evidence summaries, one expert consensus, and one systematic review. The expert authority coefficients for the two rounds of expert consultation were 0.93 and 0.92, respectively. The Kendall coordination coefficient of various indicators in the second round of expert consultation was 0.227 to 0.288 ( P<0.01). After two rounds of expert consultation, a structured education course for patients with neurogenic bladder during the rehabilitation period was finally developed, including six primary indicators, 21 secondary indicators, and 30 tertiary indicators. Conclusions:The structured education course for patients with neurogenic bladder during the rehabilitation period, based on current situation survey, high-quality evidence, and expert consultation, is comprehensive in content and reasonably designed, which can provide supportive assistance for future nursing health education and management for patients with neurogenic bladder.

Objective:To investigate the expression of ras-related C3 botulinum toxin substrate 3 (RAC3) in glioma tissues and its effect on the migration and invasion of glioma cells.Methods:The expression of RAC3 in 57 glioma patients and their adjacent tissues from the First People’s Hospital of Shangqiu was detected by immunohistochemical assay. According to the experimental requirements, brain glioma cells U87MG were divided into experimental group and control group. The experimental group U87MG cells were transfected with RAC3-siRNA plasmid, and the control group U87MG cells were transfected with MOCK-siRNA plasmid. RAC3 mRNA in each group was detected by fluorescence quantitative PCR. The expressions of RAC3 and MMP2 in each group were detected by Western blot. Transwell was used to detect the migration and invasion ability of cells in each group.Results:The positive rate of RAC3 in glioma patients was 89.47% (51/57 cases) , and the expression rate in paracancer tissues was 14.04% (8/57 cases) . The expression rate of RAC3 in glioma tissues was significantly higher than that in paracancer tissues, with statistical significance ( P<0.01) . After siRNA transfection, mRNA expression of RAC3 in experimental group and control group was 1.23±0.20 and 0.43±0.12, and protein expression of RAC3 was 1.19±0.11 and 0.23±0.08, respectively. The expression of MMP2 protein was 1.19±0.11 and 0.23±0.08, respectively. The expression of MMP2 in experimental group was significantly decreased ( P<0.05) . Transwell assay showed that the number of invasive cells in experimental group and control group U87MG cells was (22±5) and (45±8) , and the number of migratory cells was (34±6) and (90±11) , respectively. In experimental group, U87MG cell migration and invasion ability decreased significantly (both P<0.05) . Conclusion:The high expression of RAC3 in glioma tissues may be related to the malignant degree of development, and affect the migration and invasion ability of glioma cells by regulating the expression of MMP2.

Nutritional support is one of the comprehensive treatments for the patients with novel coronavirus infection, especially for critically ill patients. Nutritional therapy needs to follow the standard process, which includes nutritional risk screening, assessment, intervention and monitoring. Nutrition intervention is recommended to follow the principle of "five-step" of nutritional therapy. Appropriated diet and evidence-based nutritional support should be given to improve the nutritional status and immunologic function of the patients, and to get best of overall clinical outcomes.

Objective:To translate Fear of Progression Questionnaire (FoP-Q) into Chinese and test its reliability and validity.Methods:After translation, back translation and cultural adaptation, the items of the simplified Chinese version of FoP-Q were determined. Using the convenient sampling method, a total of 269 patients with hematological malignancies from two Class Ⅲ Grade A hospitals in Beijing were selected as the research objects from August to December 2020. The general information questionnaire and the simplified Chinese version of FoP-Q were used to investigate the patients. Exploratory factor analysis was used to evaluate the structural validity of the simplified Chinese version of FoP-Q. Cronbach 's α coefficient and half-fold reliability coefficient were used to evaluate the reliability of the scale. Pearson correlation analysis method was used to analyze the correlation between each dimension and between each dimension and the total scale. A total of 269 questionnaires were distributed, and 256 valid questionnaires were returned. The effective response rate was 95.167% (256/269) . Results:The simplified Chinese version of FoP-Q extracted 5 factors through factor analysis, with a total of 41 items, and the cumulative variance contribution rate was 64.201%. The content validity index of each item of the scale was 0.857-1.000, the Kappa value was 0.850-1.000, the content validity index of the overall consistency scale was 0.814 and the content validity index of the average scale was 0.973. The total Cronbach 's α coefficient of the scale was 0.969, and the Cronbach 's α coefficient of the five factors was 0.815-0.941. The half-fold reliability coefficient of the total scale was 0.955. Conclusions:The simplified Chinese version of Fear of Progression Questionnaire has good reliability and validity, which can be used to evaluate the degree of fear of disease progression in patients with malignant tumors in China

Objective:To explore the situation and characteristics of the practice of severe cardiac analgesia, sedation and delirium in children in China, so as to lay a research foundation for standardizing the prevention process of severe cardiac analgesia, sedation and delirium in children.Methods:This study was a cross-sectional study, using questionnaire survey. The Analgesia, Sedation and Delirium Practice Questionnairewas designed according to consensus, clinical suggestions and clinical practice. In August 2021, the electronic questionnaire was issued to the Children's Cardiac Intensive Care Unit (ICU) in children's hospitals through the Pediatric Nursing Alliance Pediatric Congenital Nursing Group of the National Children's Medical Center. A total of 15 ICUs were included, all of which completed the survey, and the effective recovery rate of the questionnaire was 100%.Results:The 15 ICUs all had pain assessment system, including 11 with pain assessment standard operating procedures, 8 with sedation assessment standard operating procedures, and 4 with delirium assessment. However, there was no specific process or system for delirium assessment in ICU. All 15 ICUs used analgesics, 8 of them used opioids for analgesia immediately after cardiac surgery, 5 of them used analgesics according to the patient's condition, 2 of them used analgesics according to the pain score. Non-steroidal paracetamol was the first choice for non-postoperative children, and 6 of 15 ICUs used analgesics according to the pain score. All 15 ICUs used sedative drugs, 6 of which used sedative drugs within 1 hour after admission, 6 of which were decided by the doctor according to the situation of the child, 3 of which used sedative drugs according to the sedation score, and 7 of which used midazolam as the first choice. A total of 6 the 15 ICUs carried out some projects in the "ABCDEF" delirium prevention program.Conclusions:In this investigation, the use of analgesic and sedative drugs in ICU is heterogeneous, the evaluation process of analgesia and sedation has not been established, and delirium has not attracted enough attention. Rational sedation and analgesia need to develop standardized sedation and analgesia evaluation procedures. At present, high-quality clinical studies are still needed to provide data support for the construction of standardized processes.

Objective:To form a nursing standard for shoulder-hand syndrome (SHS) after stroke in accordance with the clinical situation by expert argumentation in the best evidence systematically retrieved and screened for SHS after stroke with the method of Delphi expert consultation.Methods:According to the level of evidence, we systematically retrieved and screened relevant guidelines, evidence summary, systematic reviews, original studies and expert consensus. Two researchers who had received Joanna Briggs Institute (JBI) evidence-based training used the Appraisal of Guidelines for Research & Evaluation (AGREE) Ⅱ, JBI quality evaluation tools for systematic reviews, randomized controlled trials/experimental studies and expert consensus to evaluate the included guidelines, systematic reviews, original studies and expert consensus. The included literature was classified and summarized, and recommendations and conclusions related to SHS after stroke were screened and extracted. According to the results of the literature summary, the first draft of the clinical nursing standard for SHS after stroke was formed. Using the Delphi method, 25 experts in related fields were selected for two rounds of expert consultation to demonstrate the contents of the first draft.Results:This study included 8 guidelines including 1 evidence summary, 2 systematic reviews, 7 original studies and 2 expert consensus. The overall quality of the guidelines was Grade B; one piece of evidence summary was of good quality and was Grade B; the overall quality of two systematic reviews was low, and the overall quality of seven original studies was average. The first draft of the clinical nursing standard for SHS after stroke included 6 content frameworks and 29 recommendations. Two rounds of expert consultation were conducted, the questionnaire response rates were 89.28% and 100%, and the expert authority coefficients were 0.864 and 0.894, respectively. The Kendell's W of important content framework and recommended in the second round of expert consultation were 0.118 ( P<0.05) and 0.188 ( P<0.001) . According to the results of the expert consultation, the clinical nursing standard for SHS after stroke was formed, including 6 content frameworks and a total of 31 recommendations. Conclusions:The clinical nursing standard for SHS after stroke is based on the best available evidence and expert argumentation, which is in line with the clinical situation in my country and can be sed in clinical nursing work.