Objective: To summarize the best evidence for the management of patients with gastrointestinal graft-versushost disease after hematopoietic stem cell transplantation, and provide evidence-based references for clinical nursing work. Methods: A systematic search was conducted for relevant evidence on the management of patients with gastrointestinal graft-versus-host disease after hematopoietic stem cell transplantation from domestic and foreign databases, as well as websites of blood and bone marrow transplantation related societies. The search period was from the establishment of the database until February 2026. Results: After screening, a total of 19 articles were included, encompassing 3 clinical decisions, 1 recommended practice, 4 guidelines, 7 expert consensuses, and 4 evidence summaries. Twenty-five pieces of best evidence were summarized across 8 aspects: multidisciplinary collaboration, influencing factors, assessment and monitoring, diagnostic differentiation, symptom management, dietary nutrition, medication guidance, and health education. Conclusion: Summarizing the relevant evidence on the management of patients with gastrointestinal graft-versus-host disease after hematopoietic stem cell transplantation can provide evidence-based support for clinical medical staff, and it is recommended to apply it in combination with clinical practice and patient wishes.

Objective:To explore effects of telephone transitional nursing after discharge from hospital on treatment effectiveness and quality of life of patients with lymphedema after breast cancer surgery.Methods:According to the convenient sampling method, a total of 85 patients with lymphedema after breast cancer surgery who were admitted to Department of Gynecology in Wuxi Maternal and Child Health Care Hospital from October 2017 to October 2019 were selected as research objects. According to the double-blind principle, the selected objects were divided into the study group ( n=43) and the control group ( n=42) . After discharge from hospital, patients in the study group were given telephone follow-up while patients in the control group were given routine follow-up. The effects of different methods on the quality of life and treatment effectiveness of patients with lymphedema after breast cancer surgery were compared. Results:After the follow-up, the difference in circumference of upper limbs of the study group was lower than that of the control group, and the difference was statistically significant ( P<0.01) . The anterior flexion and abduction of the shoulder joint of the study group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The total effective rate of treatment in the study group was higher than that in the control group, and the difference was statistically significant ( P<0.05) . After follow-up, except for role-physical, the quality of life scores in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of telephone transitional nursing after discharge from hospital in patients with lymphedema after breast cancer surgery can extend the nursing service, promote the recovery of shoulder joint function, ensure the effectiveness of treatment and improve the quality of life of patients, which is suitable for clinical promotion and application.

Objective To explore the effects of continuous urethral drainage in patients with long-term urethral catheter after radical operation for cervical cancer. Methods Totally 100 patients who received radical operation for cervical cancer in Wuxi Maternal and Child Health Hospital between January 2015 and December 2016, were selected and equally divided into the control group and the observation group, according to the random number table. The patients received indwelling urethral catheters post operation. Patients in the control group received convention nursing and the catheters were clipped during ambulation. The urethral catheters were removed on postoperative day 14 when the patients had to urinate after the functional recovery bladder was confirmed by a specially-assigned nurse. Patients in the observation group received continuous urethral drainage on the basis of conventional nursing. The indwelling urethral catheters were not clipped and were removed on day 14 postoperatively. First urine output, residual urine in bladders and replacement of urethral catheters were compared between the two groups. Results There was no significant difference between the two groups in first urine output, residual urine and replacement of urethral catheters (P＞ 0.05). Conclusions The continuous urethral drainage by indwelling catheters do not increase the incidence rate of uroschesis before they are removed in patients receiving radical operation for cervical cancer and is conducive to the functional recovery of bladders, which is worth promoting in clinical practice.

Objective To assess iodine nutritional status of lactating women and infants (0-2 years old) in six ecological regions of Gansu Province,and to provide a scientific basis for iodine supplementation of target people.Methods According to different topography and climate conditions,Gansu Province was divided into six ecological regions:the desert region,the Gobi region of Hexi Corridor,the hills and valleys region of Loess Plateau,the Zhongshan Valley of Qinling Mountains,the grassland meadow area of Gannan plateau and the Loess Plateaugully region.Totally 5 counties were selected from each ecological region,and each county was divided into five geographic locations (east,south,west,north and center).In each location,one township was identified and ten samples of lactating women and infants (0-2 years old) were selected randomly and 60 salt samples of residents were collected to determine iodine content.At the same time salt intake of 20 residents was surveyed in three townships as mentioned above.The water samples of all the centralized water supply projects were collected in each county,and one water sample of the decentralized water supply in ten townships with the largest population of each county from east,south,west,north and center locations was collected to determine iodine content.One soil sample was collected to determine iodine content in east,south,west,north and center townships of each county.The urinary iodine and water iodine levels were measured with the method for determination of iodine in urine by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006).The direct titration method among thegeneric methods for iodide testing in salt production industry (GB/T 13025.7-2012) was used to determine the salt iodine level,and the arbitration method was adopted for quantitative determination in the case of Sichuan salt or other special salts and the salt intake was estimated based on three day weighed food record.The soil iodine was determined using the amplified colorimetric method.Results Totally 1 476 and 1 461 urine samples of lactating women and infants were collected,and the total urine iodine medians of lactating women and infants (0-2 years old) were 149.05 and 151.34 μg/L,respectively,the urine iodine median of lactating women and infants in each ecological region was at the 100-199 μg/L appropriate level.Not weaning infants urine iodine (155.32 μg/L) was higher than that of the weaning infants (146.30 μg/L),the difference was significant statistically (Z =-2.808,P ＜ 0.05).There was a correlation between urine iodine of not weaning infants aged 0-2 years old and breastfeeding women (r =0.133,P ＜ 0.01),and there was no correlation between weaning infants and breastfeeding women (r =0.045,P ＞ 0.05).About 9 008 salt samples were collected,and the rates of qualified iodized salt intake in the six ecological regions were all higher than 93％.The daily salt intake per person ranged from 4.5 g to 12.6 g,in which the Loess Plateaugully region was the highest with 12.6 g and the grassland meadow area of Gannan plateau was the lowest with 4.5 g.The water iodine median of 1 513 water samples was 3.3 μg/L.The water iodine medians of the rest 4 ecological regions were all less than 5 μg/L except for the desert region (42.4 μg/L) and the Loess Plateau-gully region (30.0 μg/L) of which the median of water iodine was higher than 20 μg/L.The soil iodine median of 155 soil samples was 127 μg/kg,in which the desert region was the lowest with 78 μg/kg and the grassland meadow area of Gannan plateau was the highest with 218 μg/kg.Conclusion Lactating women and infants are in good iodine nutritional status and the present iodized salt concentration can meet the demand of iodine nutrition of lactating women and infants well.

Objective To explore the role of graph-text-combined health education in dieting health education for patients with hematologic diseases. Methods About 56 patients with hematologic diseases hospitalized in February 2015 were assigned as the control group and another 57 patients with the same diseases during March to April 2015 as the experiment group. In the control group, routine dieting health education was done and in the latter the graph-text-combined health education was used for the dieting health education. The two groups were compared in view of recognition on dieting knowledge, dieting compliance and patient's satisfaction level. Result The recognition on dieting knowledge, dieting compliance and patient's satisfaction level were all higher those of that the control group (P<0.05). Conclusions The graph-text-combined health education can improve the recognition on dieting knowledge, dieting compliance and patient's satisfaction level when it is used in the health education for the patients with hematologic diseases. Therefore, it is worth clinically popularizing.

Objective To evaluate the function of "high-dose methotrexate (HD-MTX) protocol" in the patients with HD-MTX-induced acute kidney injury (AKI).Methods The medical record data of patients with hematological malignancy received HD-MTX therapy in the First Affiliated Hospital of Soochow University from January 2013 to December 2016 were collected and retrospectively analyzed.The patients who received chemotherapy before the establishment of "HD-MTX protocol" were enrolled into the control group (between January 2013 to September 2014), and the patients who received chemotherapy after the establishment of "HD-MTX protocol" were enrolled into the observation group (between October 2014 to December 2016).The incidence of delayed MTX elimination and AKI between the 2 groups were compared.Results A total of 234 patients were enrolled in the study.There were 78 patients in the control group including 50 males and 28 females with the age 3 to 64 years and median age 25 years, of them, 57 patients with leukemia and 21 patients with lymphoma.There were 156 patients in the observation group including 92 males and 64 females with the age 6 to 64 years and median age 26 years, of them, 129 patients had leukemia and 27 patients had lymphoma.The percentage of patients with no-prehydration and no-preurine alkalinization in the control group was higher than that in the observation group[60.1% (47/78) vs.4.5% (7/156), 80.8% (63/78) vs.8.3% (13/156)], and the median volume of intravenous hydration was less than that in the observation group[0 (0-500) ml vs.1 750 (1 250-2 100) ml].The differences between the 2 groups were statistically significant (X2=91.168, P<0.001;X2=124.415, P<0.001;Z=-9.224, P<0.001).The incidence of delayed MTX elimination and AKI after MTX infusion in the control group was higher than that in the observation group [21.8% (17/78) vs.12.2% (18/156).20.5% (16/78) vs.10.3% (16/156)].The differences between the 2 groups were statistically significant (X2=4.300, P=0.038;X2=4.634, P=0.031).In the control group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 6, 2 and 8 respectively.In the observation group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 11, 4 and 1 respectively.The degree of kidney injury in the control group was higher than that in the observation group (Z=-2.286, P=0.022).Conclusion The "HD-MTX protocol" can significantly decrease the incidence of delayed MTX elimination and AKI, especially the incidence of grade Ⅲ AKI.

Objective To evaluate the function of "high-dose methotrexate (HD-MTX) protocol" in the patients with HD-MTX-induced acute kidney injury (AKI).Methods The medical record data of patients with hematological malignancy received HD-MTX therapy in the First Affiliated Hospital of Soochow University from January 2013 to December 2016 were collected and retrospectively analyzed.The patients who received chemotherapy before the establishment of "HD-MTX protocol" were enrolled into the control group (between January 2013 to September 2014), and the patients who received chemotherapy after the establishment of "HD-MTX protocol" were enrolled into the observation group (between October 2014 to December 2016).The incidence of delayed MTX elimination and AKI between the 2 groups were compared.Results A total of 234 patients were enrolled in the study.There were 78 patients in the control group including 50 males and 28 females with the age 3 to 64 years and median age 25 years, of them, 57 patients with leukemia and 21 patients with lymphoma.There were 156 patients in the observation group including 92 males and 64 females with the age 6 to 64 years and median age 26 years, of them, 129 patients had leukemia and 27 patients had lymphoma.The percentage of patients with no-prehydration and no-preurine alkalinization in the control group was higher than that in the observation group[60.1% (47/78) vs.4.5% (7/156), 80.8% (63/78) vs.8.3% (13/156)], and the median volume of intravenous hydration was less than that in the observation group[0 (0-500) ml vs.1 750 (1 250-2 100) ml].The differences between the 2 groups were statistically significant (X2=91.168, P<0.001;X2=124.415, P<0.001;Z=-9.224, P<0.001).The incidence of delayed MTX elimination and AKI after MTX infusion in the control group was higher than that in the observation group [21.8% (17/78) vs.12.2% (18/156).20.5% (16/78) vs.10.3% (16/156)].The differences between the 2 groups were statistically significant (X2=4.300, P=0.038;X2=4.634, P=0.031).In the control group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 6, 2 and 8 respectively.In the observation group, there were 16 patients with AKI, the patients with grade Ⅰ, grade Ⅱ and grade Ⅲ were 11, 4 and 1 respectively.The degree of kidney injury in the control group was higher than that in the observation group (Z=-2.286, P=0.022).Conclusion The "HD-MTX protocol" can significantly decrease the incidence of delayed MTX elimination and AKI, especially the incidence of grade Ⅲ AKI.

Objective To investigate the effect of cold underwear on acute radioactive dermatitis in the cervical cancer patients undergoing radiotherapy.Methods Ninety-seven patients with stage Ⅱb and above Ⅱb cervical cancer receiving radiotherapy were divided into the control group (n =48) and the experiment group (n =49) according to the random digit table.In the control group,Orgotein was sprayed on the local skins and the experiment group was treated with wearing cold underwear for 20 minutes in addition to local spraying of Orgotein.The two groups were compared in terms of dermatitis on the early stage,middle stage and final stage.Result On the early stage there was no statistical significant difference between two groups on dermatitis (P＞0.05),but the dermatitis in the experiment group was statistically less than that in the control group at the middle stage and final stage (P＜0.01).Conclusions The cold underwear for the cervical cancer patients undergoing radiotherapy can effectively prevent dermatitis or reduce its severity.It is designed suitable for patients prom anatomical perspective and simple for application.

Objective To investigate the effects of nurse companion on reducing complications of colposcopic cervical biopsy and improving satisfaction.Methods 724 patients who had cervical biopsy by colposcopy during August of 2014 in Maternal and Child Health Care Hospital of Wuxi were collected as control group,and another 932 cases in August of 2015 were sampled as observation group.Same doctor conducted the biopsy for all the patients in two groups.Each patient in observation group were accompanied by one nurse during the procedure.Results There were significant differences between the two groups on the incidence of pre-syncope,syncope,vaginal bleeding and patients′satisfaction (P <0.05).Conclusions Nurse companion can reduce the incidence of pre-syncope,syncope,vaginal bleeding greatly during colposcopic cervical biopsy and improve patients′satisfaction.

Objective To assess the iodine nutrition and thyroid function of pregnant women during different periods of pregnancy,to provide evidence for guiding iodine supplementation for them.Methods A cross-sectional survey was performed in 215 pregnant women in Yongjing couty from May to June 2013.Samples of blood and random urine were collected,and serum thyrotrophin (TSH),free triiodothyronine (FT3),free thyroxine (FT4),anti-thyroid peroxidase (anti-TPO),antithyroglobulin (anti-TG) and urinary iodine were measured.Results The medians of urinary iodine from the three groups of pregnant women (first,second and third trimester) were 189.8 μg/L,152.5 μg/L and 144.9 μg/L respectively.With the exception of pregnant women in the third trimester,the urinary iodine medians of pregnant women in the first and second trimesters were within the 150-249 μg/L range which was defined as optimal by WHO/UNICEF/ICCIDD.With the increase of gestational age,the level of FT3 decreased (P＜0.05),with the FT3 levels in the first trimester were higher than those in the second or third trimester (P＜0.05).The difference of TSH levels among the three groups of pregnant women was statistically significant (P＜0.01),with a U-shaped curve seen between the iodine TSH levels and the gestational age.The medians of anti-TG and anti-TPO appeared the lowest in the first trimester,and remained at a high level in women at second and third trimesters.Significant diffierence was seen in anti-TG,anti-TPO levels of the three groups of pregnant women (first,second and third trimester) (P＜0.01).The incidence of thyroidfunction disorder was 1.86％,including subclinical hypothyroidism accounted for 1.40％,and hypothyroidism accounted for 0.47％.The incidence of thyroidfunction disorder mainly appeared in the early pregnancy.Abnormal FT3,TSH,positive anti-TG and anti-TPO were mainly seen during early pregnancy.The changes of TSH,FT3,FT4,anti-TG and anti-TPO along with the changes of urine iodine levels were not obvious.Conclusion With the increase of gestational age,the incidence of iodine deficiency also increased among pregnant women.Abnormal thyroid hormones,TSH,positive anti-TG and anti-TPO were mainly existed in the early pregnancy.Programs as monitoring urinary iodine as well as thyroid function targeting all the pregnant women should be carried out.