Objective:To apply the best evidence for prevention of oral mucositis in children with hematopoietic stem cell transplantation (HSCT) to clinical practice and evaluate its efficacy.Methods:Evidence-based nursing method was applied to obtain the best evidence, the evidence quality review indexes were established and the obstacle factors were analyzed, and then the action strategy was constructed. Using the convenient sampling method, a total of 60 children who were admitted to HSCT ward of Beijing Children's Hospital of Capital Medical University and 14 nurses working in HSCT ward were selected as the research objects from August 2019 to October 2020. The children admitted from August 2019 to February 2020 were included in the control group, and children admitted from March to October 2020 were included in the experimental group, with 30 cases in each group. Children in the control group received routine preventive measures for oral mucositis, while children in the experimental group received preventive measures for oral mucositis constructed based on the best evidence. Before and after the application of the evidence, the nurses' knowledge of preventing oral mucositis in children with HSCT was investigated through self-developed test papers. The incidence of oral mucositis and parents' satisfaction with prevention measures for oral mucositis were compared between the two groups.Results:Evidence-based nursing practice used 10 pieces of evidence. The incidence of oral mucositis in the experimental group was 50% (15/30) , lower than 83% (25/30) in the control group, and the difference was statistically significant (χ 2=7.50, P < 0.05) . The score of satisfaction with for preventive measures of oral mucositis of parents in the experimental group was (4.96±0.05) , which was higher than (3.65±1.60) of the control group, and the difference was statistically significant ( t=-9.69, P<0.01) . After the application of the evidence, the score of nurses' knowledge of prevention of oral mucositis was (98.22±6.65) , which was higher than (78.72±12.03) before the application, and the difference was statistically significant ( t=5.30, P<0.01) . Conclusions:Management of oral mucositis in children with HSCT through evidence-based nursing practice can effectively reduce the incidence of oral mucositis in children, improve parents' satisfaction with prevention measures for oral mucositis and nurses' knowledge of prevention of oral mucositis.

Objective:To retrieve, evaluate and integrate domestic and foreign relevant evidence on the prevention of oral mucositis related to chemoradiotherapy in children, and summarize the best evidence, so as to provide clinical practice guidelines for medical staff.Methods:We systematically searched the evidence on the prevention of oral mucositis related to chemoradiotherapy in children in British Medical Journal (BMJ) Best Practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-based Health Care Center Database, National Guideline Clearinghouse, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, United Kingdom National Institute for Health and Care Excellence, International Practice Guideline Registry Platform (Chinese) , Multinational Association of Supportive Care in Cancer, International Society of Oral Oncology, European Society for Medical Oncology, American Society of Clinical Oncology, Cochrane Library, BMJ Journals, PubMed, Embase, China National Knowledge Infrastructure (CNKI) , WanFang Data and China Biology Medicine Database. The evidence included clinical practice guidelines, expert consensus, best practices, systematic reviews and evidence summaries, and the search time limit was to build the database until November 1, 2019. The searched guidelines were independently evaluated by four guideline reviewers, and the rest of literature was independently evaluated by two researchers who received evidence-based training to evaluate the quality of the included literature, combined with the judgment of professionals. Evidence extraction and evidence summary were carried out on literature that met the quality standards.Results:A total of 8 articles were included, including 1 BMJ best practice, 5 JBI evidence summaries, 1 guideline, and 1 systematic review. The best evidence included 16 pieces of evidence in 7 areas of basic oral care, nursing evaluation, diet prevention, physical therapy, drug prevention, fungal infection prevention, and multidisciplinary team management.Conclusions:This study summarizes the best evidence for the prevention of oral mucositis related to chemoradiotherapy in children, and provides clinical practice guidelines for medical staff. Medical institutions should establish preventive measures for children's oral mucositis related to chemoradiotherapy based on the transformation of evidence-based evidence, and establish standardized multidisciplinary collaboration and nursing procedures to improve patient health outcomes.

Objective: To study the influences of dihydrotestosterone (DHT) on the development of experimental autoimmune Graves disease (EAGD), and to observe the effect of DHT on cytokines in male BALB/c mice model. Methods: Male BALB/c mice aged 6-8 weeks were divided into 4 groups using random number table: (1) control group; (2) EAGD group; (3) placebo group; (4) DHT group. EAGD mice were induced with an adenovirus expressing the human thyroid stimulating hormone receptor antibody A-subunit (Ad-TSHR289). DHT (5mg) or a matching placebo were implanted one week before the first immunization. Thyroid hormones were detected with radioimmunoassay kit.. Cytokines [such as interferonγ (IFNγ), interleukin (IL)-4, IL-10, IL-9, and IL-17] producing cells from the spleen were detected using flow cytometry. Results: As expected Ad-TSHR289 treatment increased total thyroxine [EAGD group vs. control group: (117.76±32.69) nmol/L vs. (33.08±12.61) nmol/L, P<0.0001] and free thyroxine [EAGD group vs. control group: (15.01±11.55) pmol/L vs. (3.55±1.88) pmol/L, P<0.0001]. Treatment of DHT slightly lowered thyroid hormones [DHT group vs. placebo group: total thyroxine (114.80±44.27) nmol/L vs. (123.17±77.73) nmol/L; free thyroxine (13.48±6.01) pmol/L vs. (14.19±12.65) pmol/L], without significant difference (all P>0.05)]. However, the percentage of IL-10, but not IFN γ, IL-4, IL-9 and IL-17, secreted spleen cells increased in DHT group than in the placebo group [(7.11±3.29)% vs. (3.51±1.36)%, P<0.05]. Conclusion The effects of DHT on thyroid hormone are mild. It might play an immunomodulatory role in the male mouse Graves disease model by up-regulating the cytokine IL-10.

Objective To investigate the knowledge,attitude,and behavior of patients with chronic kidney disease(CKD)in the community.Methods A questionnaire survey on knowledge,attitude and behavior through the mobile WeChat was conducted among 1 006 CKD patients in 57 villages of Jinze and Huaxin communities in Shanghai Qingpu district from June 2016 to May 2018,and the results were analyzed.Results The accuracy rate about CKD knowledge in 1 006 CKD patients was 69.98％.The participants who were very willing to accept referral,learning CKD knowledge,periodic follow-up,health education and lifestyle counseling accounted for 60.40％,those who were willing accounted for 32.59％ and not willing for 7.01％.The survey of behavioral patterns showed that 29.17％ often participated in actively learning disease knowledge,periodic follow-up and counseling,reasonable diet and regular exercise;52.96％ occasionally participated and 17.87％ never participated.There were no significant differences in knowledge about CKD among patients of different sex,age and occupation(t=0.475,F=7.111,F=0.563;all P＞0.05);while the CKD knowledge level was higher in patients with college or above educational levels(7.80± 3.96),or patients with a disease history over 5 years(7.64 ± 2.84),or patients with stage 5 CKD(8.25 ± 1.16).Conclusion The rate of knowledge,attitude and behavior in CKD patients is relatively low,especially in attitude and behavior.In order to control the disease progression and reduce the adverse impact of the disease,it is necessary to take effective measures to improve the attitude and behavior of CKD patients.