Objective To investigate the changes in oral microbiota of db/db mice and provide an experimental basis for exploring the relationship between type 2 diabetes mellitus and oral microecology.Methods Eight 10-week-old male db/db mice were designated as the diabetes experimental group(db/db group),while eight 10-week-old male db/m mice were assigned as the normal control group(db/m group).After a 5-day adaptive feeding period,tail venous blood samples were collected on the 6th and 37th days,and fasting blood glucose(FBG)levels and oral glucose tolerance test(OGTT)were performed for both groups to verify the reliability of the diabetes model.On the 15th day of feeding with the same diet,oral microbiota samples were collected from the buccal mucosa,dorsal and ventral tongue surfaces,oral floor mucosa,hard palate mucosa,and the gingival areas of both the upper and lower jaws of the two groups.Genomic DNA from the oral microbiota was extracted,and the V3-V4 regions of the 16S ribosomal RNA(16S rRNA)gene were amplified using a GeneAmp 9700 thermocycler.The composition of the oral microbiota was evaluated through double-labelled amplification and sequencing on the Illumina MiSeq platform,followed by bioinformatics analysis using QI I ME software(version 1.6.0).Results The FBG levels and OGTT results on the 6th and 37th days after the start of the experiment indicated that db/db mice exhibited more pronounced symptoms of type 2 diabetes compared to db/m mice.Alpha diversity(αdiversity)analysis showed no significant difference in the diversity of oral microbiota between the two groups(P＞0.05);however,there was a significant difference in richness(P＜0.05).Principal coordinate analysis(PCoA)revealed differences in the oral microbiota composition between the db/db group and db/m group(P＜0.05).Species composition analysis and LEfSe analysis demonstrated that the relative abundance of oral microbiota in db/db group mice,predominantly composed of p_Proteobacteria,increased significantly at the phylum level(P＜0.05).At the genus level,the relative abundances of g_Proteus and g_Enterococcus showed a significant increase(P＜0.001).Conclusion The composition and diversity of oral microbiota in db/db mice with type 2 diabetes mellitus significantly differed from those without the disease.

Objective To investigate the changes in oral microbiota of db/db mice and provide an experimental basis for exploring the relationship between type 2 diabetes mellitus and oral microecology.Methods Eight 10-week-old male db/db mice were designated as the diabetes experimental group(db/db group),while eight 10-week-old male db/m mice were assigned as the normal control group(db/m group).After a 5-day adaptive feeding period,tail venous blood samples were collected on the 6th and 37th days,and fasting blood glucose(FBG)levels and oral glucose tolerance test(OGTT)were performed for both groups to verify the reliability of the diabetes model.On the 15th day of feeding with the same diet,oral microbiota samples were collected from the buccal mucosa,dorsal and ventral tongue surfaces,oral floor mucosa,hard palate mucosa,and the gingival areas of both the upper and lower jaws of the two groups.Genomic DNA from the oral microbiota was extracted,and the V3-V4 regions of the 16S ribosomal RNA(16S rRNA)gene were amplified using a GeneAmp 9700 thermocycler.The composition of the oral microbiota was evaluated through double-labelled amplification and sequencing on the Illumina MiSeq platform,followed by bioinformatics analysis using QI I ME software(version 1.6.0).Results The FBG levels and OGTT results on the 6th and 37th days after the start of the experiment indicated that db/db mice exhibited more pronounced symptoms of type 2 diabetes compared to db/m mice.Alpha diversity(αdiversity)analysis showed no significant difference in the diversity of oral microbiota between the two groups(P＞0.05);however,there was a significant difference in richness(P＜0.05).Principal coordinate analysis(PCoA)revealed differences in the oral microbiota composition between the db/db group and db/m group(P＜0.05).Species composition analysis and LEfSe analysis demonstrated that the relative abundance of oral microbiota in db/db group mice,predominantly composed of p_Proteobacteria,increased significantly at the phylum level(P＜0.05).At the genus level,the relative abundances of g_Proteus and g_Enterococcus showed a significant increase(P＜0.001).Conclusion The composition and diversity of oral microbiota in db/db mice with type 2 diabetes mellitus significantly differed from those without the disease.

Objective:To investigate the relationship between different states of cardiac function and their changes during the course of diabetic foot ulcers(DFU), and to evaluate their impact on patient prognosis.Methods:A retrospective analysis was conducted on 194 DFU patients who were rehospitalized at approximately 3-month intervals. Basic clinical data and cardiac function-related indicators were collected at baseline and follow-up. Patients were followed until death or until November 10, 2024. Outcomes including ulcer healing, recurrence, minor amputation, and death were recorded. Logistic regression models were used to analyze the effects of cardiac function status and its changes on these four outcomes. Results:After treatment, the proportion of patients with NYHA class Ⅱ-Ⅲ decreased significantly from 33.5% at baseline to 21.6%( P=0.009). Serum N-terminal pro-B-type natriuretic peptide(NT-proBNP) level also decreased after treatment compared with baseline [635.85(59.83, 453.28) pg/mL vs 728.67(81.48, 696.15) pg/mL, P=0.055]. Serum NT-proBNP level was significantly higher in the death group compared to the survival group( P=0.002). The proportion of DFU patients with baseline NYHA class Ⅱ-Ⅲ was significantly higher than that in those with class Ⅰ( P=0.012). Regression analysis showed that an improvement in NT-proBNP levels was associated with a lower risk of DFU recurrence( OR=0.378, 95% CI 0.183-0.779, P=0.008), and improvement in NYHA class was associated with a lower mortality risk( OR=0.074, 95% CI 0.020-0.275, P<0.001). Conclusion:Cardiac function status and its changes during the treatment of DFU patients have strong prognostic implications, particularly in predicting the risk of recurrence and death outcomes.

Objective This study applies Roy adaptation theory to deeply explore the experience of food avoid-ance behavior in patients with inflammatory bowel disease(IBD),offering insights for developing dietary management strategies.Methods A descriptive qualitative research method was employed.By purposive sampling,24 IBD pa-tients hospitalized in the gastroenterology department of a tertiary hospital in Nanjing from July 2022 to December 2024 were selected for semi-structured interviews.Data were analyzed using a directed content analysis approach.Results This study identified 4 main themes and 11 sub-themes,encompassing overattribution leading to inappro-priate avoidance(recurrent symptoms triggering overattribution,disease staging triggering inappropriate avoidance),negative self-perception leading management struggles(illness fear diminishing self-efficacy,disease trauma eroding self-identity,knowledge deficiency constraining self-determination),functional impairment intensifying role challenges(role internalization undermining social function,social roles relinquishing dietary management),and external con-straints amplifying practical difficulties(family and friend oversight heightening dietary stress,healthcare gaps foster-ing practical helplessness,traditional beliefs restricting dietary exploration,economic hardship limiting balanced nu-trition).Conclusion The interplay of overattribution,negative self-perception,functional impairment,and external constraints in IBD patients hinders their ability to adapt to disease fluctuations,ensnaring them in the adaptive predicament of food avoidance behavior.Healthcare professionals should comprehensively address these factors by fostering accurate perceptions,enhancing psychological support,guiding effective coping strategies,and optimizing ex-ternal resources,thereby improving patients' overall adaptive capacity and promoting their recovery.

Objective This study applies Roy adaptation theory to deeply explore the experience of food avoid-ance behavior in patients with inflammatory bowel disease(IBD),offering insights for developing dietary management strategies.Methods A descriptive qualitative research method was employed.By purposive sampling,24 IBD pa-tients hospitalized in the gastroenterology department of a tertiary hospital in Nanjing from July 2022 to December 2024 were selected for semi-structured interviews.Data were analyzed using a directed content analysis approach.Results This study identified 4 main themes and 11 sub-themes,encompassing overattribution leading to inappro-priate avoidance(recurrent symptoms triggering overattribution,disease staging triggering inappropriate avoidance),negative self-perception leading management struggles(illness fear diminishing self-efficacy,disease trauma eroding self-identity,knowledge deficiency constraining self-determination),functional impairment intensifying role challenges(role internalization undermining social function,social roles relinquishing dietary management),and external con-straints amplifying practical difficulties(family and friend oversight heightening dietary stress,healthcare gaps foster-ing practical helplessness,traditional beliefs restricting dietary exploration,economic hardship limiting balanced nu-trition).Conclusion The interplay of overattribution,negative self-perception,functional impairment,and external constraints in IBD patients hinders their ability to adapt to disease fluctuations,ensnaring them in the adaptive predicament of food avoidance behavior.Healthcare professionals should comprehensively address these factors by fostering accurate perceptions,enhancing psychological support,guiding effective coping strategies,and optimizing ex-ternal resources,thereby improving patients' overall adaptive capacity and promoting their recovery.

Objective:To investigate the relationship between different states of cardiac function and their changes during the course of diabetic foot ulcers(DFU), and to evaluate their impact on patient prognosis.Methods:A retrospective analysis was conducted on 194 DFU patients who were rehospitalized at approximately 3-month intervals. Basic clinical data and cardiac function-related indicators were collected at baseline and follow-up. Patients were followed until death or until November 10, 2024. Outcomes including ulcer healing, recurrence, minor amputation, and death were recorded. Logistic regression models were used to analyze the effects of cardiac function status and its changes on these four outcomes. Results:After treatment, the proportion of patients with NYHA class Ⅱ-Ⅲ decreased significantly from 33.5% at baseline to 21.6%( P=0.009). Serum N-terminal pro-B-type natriuretic peptide(NT-proBNP) level also decreased after treatment compared with baseline [635.85(59.83, 453.28) pg/mL vs 728.67(81.48, 696.15) pg/mL, P=0.055]. Serum NT-proBNP level was significantly higher in the death group compared to the survival group( P=0.002). The proportion of DFU patients with baseline NYHA class Ⅱ-Ⅲ was significantly higher than that in those with class Ⅰ( P=0.012). Regression analysis showed that an improvement in NT-proBNP levels was associated with a lower risk of DFU recurrence( OR=0.378, 95% CI 0.183-0.779, P=0.008), and improvement in NYHA class was associated with a lower mortality risk( OR=0.074, 95% CI 0.020-0.275, P<0.001). Conclusion:Cardiac function status and its changes during the treatment of DFU patients have strong prognostic implications, particularly in predicting the risk of recurrence and death outcomes.

Objective To explore the potential categories and influencing factors of the fear of progression in patients with inflammatory bowel diseases(IBD).Methods IBD patients who received inpatient treatment in a tertiary hospital in Nanjing from July 2022 to July 2023 were selected as the study subjects by convenience sampling method.The General Demographic Information Questionnaire,the Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the Chinese version of Inflammatory Bowel Disease Self-efficacy Scale(IBD-SES),and Social Support Rating Scale(SSRS)were administered to the participants.We applied one-way ANOVA and Logistic regression analysis to identify the factors associated with the potential categories of the fear of progression.Results A total of 303 retumed questionnaires(out of the 310)were valid,resulting an effective response rate of 97.74％.According to the results of latent profile analysis,we classified the respondents into 3 categories by the fear of progression,namely"low risk fear of disease adaptation group"(n=127,41.91％),"medium risk fear of illness distress group"(n=139,45.88％),"high risk fear of dysfunction group"(n=37,12.21％).3 groups showed statistically significant differences in permanent address,self-rated financial pressure,current disease status and self-efficacy(P＜0.05).Conclusion Patients with IBD had obvious differences in characteristics on the fear of progression.Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of the fear of progression of IBD patients.Moreover,nurses should focus on improving patients'self-efficacy and promoting patients to treat medical care,stress and emotion management correctly.

Objective:To translate the Illness Identity Questionnaire (IIQ) into Chinese and test its reliability and validity.Methods:The English version of IIQ was translated into Chinese and back-translated according to the Brislin model. The item of the Chinese version was determined after cross-cultural adaptation and pre-experiment. A total of 368 patients with IBD treated in the First Affiliated Hospital with Nanjing Medical University from September 2022 to March 2023 were selected for a questionnaire survey to evaluate the reliability and validity of the questionnaire.Results:The Chinese version of IIQ contained 24 items in four dimensions. Four common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 64.025%. Confirmatory factor analysis showed that each fitting index of the modified model was within the acceptable range. The Cronbach's α coefficients of rejection, acceptance, engulfing, and enrichment in Chinese IIQ were respectively 0.780, 0.800, 0.921, and 0.917. The split-half reliability coefficients were 0.824, 0.818, 0.943, and 0.929; the retest reliability coefficients were 0.695, 0.667, 0.725, and 0.572, respectively.Conclusions:The Chinese version of IIQ is reliable and valid and can be used to assess illness identity in patients with chronic diseases.

Objective:To deeply explore the supportive care needs of patients with inflammatory bowel disease, in order to provide reference for the development of supportive care strategies.Methods:A qualitative description was conducted based on the supportive care needs framework. Objective sampling method was used to select 17 patients with inflammatory bowel disease from the First Affiliated Hospital with Nanjing Medical University from August to November 2021 for semi-structured in-depth interview and directed content analysis was used to analyze the interview data.Results:The final analysis yielded a total of 5 categories. These were physiological need, information need, practical (daily life) need, emotional and social support need, psychological and spiritual needs. They were all within the framework of supporting care needs.Conclusions:In the future, targeted education and diversified social support should be implemented based on the needs of patients with inflammatory bowel disease and from the perspectives of hospital, family members and peers.

After undergoing the long-term lived experience of symptoms and suffering, chronic patients change the understanding of self and try to create or regain a coherent sense of self, resulting in different degrees of illness identity. This research reviewed the origin, connotation, assessment tools, and summarized the performance level, influencing factors and intervention studies of illness identity in patients with chronic disease. It would provide references for research of illness identity, and to provide new ideas for promoting patients with chronic diseases to cope with and manage diseases.