Objective:To investigate the prevalence and risk factors of the 4 most common functional gastrointestinal disorders (FGID) among school-aged children in Shanghai.Methods:A cross-sectional questionnaire survey was conducted from January to December 2019. Using stratified cluster sampling, 26 097 students in grades 1-12 from Huangpu and Jiading District, Shanghai were enrolled. The questionnaire of pediatric gastrointestinal symptoms-Rome Ⅳ (QPGS-Ⅳ) and the pediatric quality of life inventory (PedsQL) were used to assess the prevalence and health-related quality of life (HRQoL) of functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and functional constipation (FC). Multivariate Logistic regression analysis was performed to identify correlations between sociodemographic factors, lifestyle habits, comorbidities and 4 major FGID. A trend chi-square test was used to explore the relationship between HRQoL scores and FGID prevalence.Results:A total of 26 097 valid participants (26 097/27 036, 96.5%) were included in the study, with the age of (10.8±3.1) years and 12 441 cases (47.7%) were female. The prevalence of FC was found to be the highest (5 537 cases, 21.2%), followed by IBS (797 cases, 3.1%), FAP-NOS (267 cases, 1.0%) and FD (218 cases, 0.8%). Multivariate Logistic regression analysis revealed the following findings: junior high school (FD: OR=1.88 (95% CI 1.35-2.61); IBS: OR=1.42 (95% CI 1.18-1.71); FAP-NOS: OR=1.39 (95% CI 1.02-1.90)), senior high school (FD: OR=2.67 (95% CI 1.84-3.86);IBS: OR=2.36 (95% CI 1.93-2.89) ;FAP-NOS: OR=2.20 (95% CI 1.56-3.11)) and frequent respiratory infections (FD: OR=2.15 (95% CI 1.45-3.18); IBS: OR=2.59 (95% CI 2.12-3.16); FAP-NOS: OR=1.49 (95% CI 1.00-2.21)) were common risk factors for FD, IBS and FAP-NOS. Allergic symptoms (FD: OR=2.21 (95% CI 1.56-3.14); IBS: OR=2.30 (95% CI 1.04-1.51); FAP-NOS: OR=2.54 (95% CI 1.85-3.50); FC: OR=1.09 (95% CI 1.01-1.17)) was a common risk factor for FD, IBS, FAP-NOS and FC. Family history of allergy was a risk factor for IBS ( OR=1.41 (95% CI 1.20-1.65)) and FAP-NOS ( OR=1.33 (95% CI 1.01-1.74)). Female exhibited increased risks for FD ( OR=1.49 (95% CI 1.13-1.96)), IBS ( OR=1.50 (95% CI 1.30-1.74)) and FC ( OR=1.10 (95% CI 1.03-1.17)). The presence of dietary bias was associated with of IBS ( OR=1.46 (95% CI 1.26-1.69)) and FC ( OR=1.26 (95% CI 1.19-1.34)); late bedtime ( OR=1.32 (95% CI 1.06-1.64)) and allergen exposure ( OR=1.25 (95% CI 1.04-1.51)) were risk factors for IBS. Insufficient sleep ( OR=1.11 (95% CI 1.02-1.21)), insufficient outdoor time ( OR=1.20 (95% CI 1.01-1.43)) and severe lack of outdoor time ( OR=1.48 (95% CI 1.23-1.76)) were significant risk factors for FC. Pet ownership ( OR=1.39 (95% CI 1.07-1.81)) was a risk factor for FAP-NOS. HRQoL scores were significantly lower in children with FD, IBS, or FAP-NOS compared to non-FGID peers (all P<0.05). χ2 trend test analysis showed that the Pearson correlation coefficients between the prevalence of FD, IBS, FAP-NOS, FC and HRQoL scores were -0.93, -0.93, -0.97 and -0.84, respectively. Conclusions:The prevalence of FGID among school-aged children in Shanghai varies by sub-type. FC was the most prevalence. Junior and senior high school, female sex, allergic symptoms and frequent respiratory infections were major risk factors. Meanwhile, dietary bias, late bedtime, insufficient outdoor time and pet ownership were associated with specific subtypes. The HRQoL is significantly reduced in children with FD, IBS and FAP-NOS.

Objective:To explore the population heterogeneity of discharge readiness of patients with type 2 diabetes mellitus (T2DM) treated with insulin for the first time, and to analyze its population characteristics and influencing factors.Methods:From January to May 2024, 240 patients with T2DM admitted to the Department of Endocrinology of the First Affiliated Hospital and the Second Affiliated Hospital of Anhui Medical University for their first insulin treatment were selected for the study by convenience sampling method. Patients were surveyed using the General Information Questionnaire, Discharge Readiness Assessment Scale of Adult Patients with Type 2 Diabetes, Insulin Use Knowledge-Behavior Questionnaire, Readiness for Hospital Discharge Scale, Attitudes toward Insulin Scale, and Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Questionnaire. Heterogeneity was tested using latent class analysis to explore the latent class of the discharge readiness. Factors influencing the latent classes were analyzed using unordered multinomial Logistic regression.Results:A total of 240 questionnaires were distributed, 15 questionnaires with regular answers or logical errors were excluded, 225 valid questionnaires were recovered, and the valid recovery rate was 93.75% (225/240) . Three latent classes of discharge readiness existed in 225 first-time insulin-treated T2DM patients, including negative discharge readiness, ordinary discharge readiness, and active discharge readiness. Unordered multinomial Logistic regression analysis showed that work status, whether or not it was the first hospitalization, insulin use knowledge-behavior, and psychological insulin resistance were influencing factors of discharge readiness in first-time insulin-treated patients with T2DM ( P<0.05) . Conclusions:Three latent classes of discharge readiness exist in first-time insulin-treated T2DM patients, with differences in discharge readiness between classes. Nurses should focus on patients with negative discharge readiness and develop targeted interventions to improve their readiness for discharge and reduce readmission rates and the risk of adverse events.

Objective:To explore the population heterogeneity of discharge readiness of patients with type 2 diabetes mellitus (T2DM) treated with insulin for the first time, and to analyze its population characteristics and influencing factors.Methods:From January to May 2024, 240 patients with T2DM admitted to the Department of Endocrinology of the First Affiliated Hospital and the Second Affiliated Hospital of Anhui Medical University for their first insulin treatment were selected for the study by convenience sampling method. Patients were surveyed using the General Information Questionnaire, Discharge Readiness Assessment Scale of Adult Patients with Type 2 Diabetes, Insulin Use Knowledge-Behavior Questionnaire, Readiness for Hospital Discharge Scale, Attitudes toward Insulin Scale, and Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Questionnaire. Heterogeneity was tested using latent class analysis to explore the latent class of the discharge readiness. Factors influencing the latent classes were analyzed using unordered multinomial Logistic regression.Results:A total of 240 questionnaires were distributed, 15 questionnaires with regular answers or logical errors were excluded, 225 valid questionnaires were recovered, and the valid recovery rate was 93.75% (225/240) . Three latent classes of discharge readiness existed in 225 first-time insulin-treated T2DM patients, including negative discharge readiness, ordinary discharge readiness, and active discharge readiness. Unordered multinomial Logistic regression analysis showed that work status, whether or not it was the first hospitalization, insulin use knowledge-behavior, and psychological insulin resistance were influencing factors of discharge readiness in first-time insulin-treated patients with T2DM ( P<0.05) . Conclusions:Three latent classes of discharge readiness exist in first-time insulin-treated T2DM patients, with differences in discharge readiness between classes. Nurses should focus on patients with negative discharge readiness and develop targeted interventions to improve their readiness for discharge and reduce readmission rates and the risk of adverse events.

Objective:To investigate the prevalence and risk factors of the 4 most common functional gastrointestinal disorders (FGID) among school-aged children in Shanghai.Methods:A cross-sectional questionnaire survey was conducted from January to December 2019. Using stratified cluster sampling, 26 097 students in grades 1-12 from Huangpu and Jiading District, Shanghai were enrolled. The questionnaire of pediatric gastrointestinal symptoms-Rome Ⅳ (QPGS-Ⅳ) and the pediatric quality of life inventory (PedsQL) were used to assess the prevalence and health-related quality of life (HRQoL) of functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and functional constipation (FC). Multivariate Logistic regression analysis was performed to identify correlations between sociodemographic factors, lifestyle habits, comorbidities and 4 major FGID. A trend chi-square test was used to explore the relationship between HRQoL scores and FGID prevalence.Results:A total of 26 097 valid participants (26 097/27 036, 96.5%) were included in the study, with the age of (10.8±3.1) years and 12 441 cases (47.7%) were female. The prevalence of FC was found to be the highest (5 537 cases, 21.2%), followed by IBS (797 cases, 3.1%), FAP-NOS (267 cases, 1.0%) and FD (218 cases, 0.8%). Multivariate Logistic regression analysis revealed the following findings: junior high school (FD: OR=1.88 (95% CI 1.35-2.61); IBS: OR=1.42 (95% CI 1.18-1.71); FAP-NOS: OR=1.39 (95% CI 1.02-1.90)), senior high school (FD: OR=2.67 (95% CI 1.84-3.86);IBS: OR=2.36 (95% CI 1.93-2.89) ;FAP-NOS: OR=2.20 (95% CI 1.56-3.11)) and frequent respiratory infections (FD: OR=2.15 (95% CI 1.45-3.18); IBS: OR=2.59 (95% CI 2.12-3.16); FAP-NOS: OR=1.49 (95% CI 1.00-2.21)) were common risk factors for FD, IBS and FAP-NOS. Allergic symptoms (FD: OR=2.21 (95% CI 1.56-3.14); IBS: OR=2.30 (95% CI 1.04-1.51); FAP-NOS: OR=2.54 (95% CI 1.85-3.50); FC: OR=1.09 (95% CI 1.01-1.17)) was a common risk factor for FD, IBS, FAP-NOS and FC. Family history of allergy was a risk factor for IBS ( OR=1.41 (95% CI 1.20-1.65)) and FAP-NOS ( OR=1.33 (95% CI 1.01-1.74)). Female exhibited increased risks for FD ( OR=1.49 (95% CI 1.13-1.96)), IBS ( OR=1.50 (95% CI 1.30-1.74)) and FC ( OR=1.10 (95% CI 1.03-1.17)). The presence of dietary bias was associated with of IBS ( OR=1.46 (95% CI 1.26-1.69)) and FC ( OR=1.26 (95% CI 1.19-1.34)); late bedtime ( OR=1.32 (95% CI 1.06-1.64)) and allergen exposure ( OR=1.25 (95% CI 1.04-1.51)) were risk factors for IBS. Insufficient sleep ( OR=1.11 (95% CI 1.02-1.21)), insufficient outdoor time ( OR=1.20 (95% CI 1.01-1.43)) and severe lack of outdoor time ( OR=1.48 (95% CI 1.23-1.76)) were significant risk factors for FC. Pet ownership ( OR=1.39 (95% CI 1.07-1.81)) was a risk factor for FAP-NOS. HRQoL scores were significantly lower in children with FD, IBS, or FAP-NOS compared to non-FGID peers (all P<0.05). χ2 trend test analysis showed that the Pearson correlation coefficients between the prevalence of FD, IBS, FAP-NOS, FC and HRQoL scores were -0.93, -0.93, -0.97 and -0.84, respectively. Conclusions:The prevalence of FGID among school-aged children in Shanghai varies by sub-type. FC was the most prevalence. Junior and senior high school, female sex, allergic symptoms and frequent respiratory infections were major risk factors. Meanwhile, dietary bias, late bedtime, insufficient outdoor time and pet ownership were associated with specific subtypes. The HRQoL is significantly reduced in children with FD, IBS and FAP-NOS.

Objective This study aimed to explore the relationship between the spontaneous changes of mesiodistal angulation of lower second molars(L2M)and individual clinical characteristics in patients with early permanent dentition correction.Methods A total of 44 patients with a total of 88 mandibular second molars were included in this study after screening.Based on the frequency distribution histogram of the initial angle of inclina-tion(L2M initial angle)of the L2M crown before treatment,it was divided into three groups:Group A:small angle group,L2M initial angle is 0°～17.5°;Group B:medium angle group,L2M initial angle is 17.5°～42.5°;Group C:large angle group,L2M initial angle is 42.5°～60°.According to whether L2M has erupted and exposed most of the crown,it was divided into erupted group and unerupted group.According to the mandibular plane angle,it can be divided into high angle,low angle,and average angle.CBCT reconstructed panoramic images were used to measure the mesiodistal inclination of L2M and analyze the relationship between each group and the change in mesiodistal inclination angles of L2M.Results After treatment,L2M mesiodistal angulation in the small angle,large angle,non-eruption,and high angle groups became more significant.The angle in the middle angle group was significantly smaller.The L2M mesiodistal angulation in the eruption and average angle group did not change significantly.The angles of ANB,Y-axis,and mandibular plane have no correlation with the initial angle of L2M.Conclusion The L2M in patients with large and high angles is more likely to topple during a correc-tion.During the correction,the L2M tends to approach the normal axial inclination.

Objective:To understand the status quo of postoperative exercise adherence in patients with non-small cell lung cancer (NSCLC) and analyze the pathways through which disease perception, exercise self-efficacy, and coping style influence postoperative exercise adherence based on the Revised Common Sense Model (CSM) .Methods:NSCLC patients who underwent surgery in the Department of Thoracic Surgery of the First Affiliated Hospital of Anhui Medical University from March to September 2023 were selected by convenience sampling. Data were collected using a general information questionnaire, the Postoperative Exercise Adherence Questionnaire for Lung Cancer Patients, the Brief Illness Perception Questionnaire (BIPQ), and the Exercise Self-Efficacy Scale for Lung Cancer Patients.Results:A total of 245 questionnaires were distributed, with 241 valid responses collected. The postoperative exercise adherence score among the 241 NSCLC patients was (39.70±9.55). Exercise self-efficacy and coping style partially mediated the relationship between disease perception and exercise adherence, accounting for 81.31% and 13.64% of the total indirect effects, respectively. Exercise self-efficacy and coping style also had a chain mediating effect between disease perception and exercise adherence, accounting for 5.05% of the total indirect effects.Conclusions:The level of exercise adherence in NSCLC patients needs improvement. Negative disease perception not only directly negatively affects exercise adherence but also indirectly affects it through the mediating roles of exercise self-efficacy and coping style. Clinical healthcare providers should focus on guiding patients to develop healthy disease perceptions, increase their confidence in participating in exercise, and encourage the adoption of positive coping styles to enhance exercise adherence levels.

Objective:To explore the current status of central venous catheter (CVC) maintenance knowledge, attitude and practice among Intensive Care Unit (ICU) nurses, and analyze its influencing factors.Methods:From March to May 2021, convenience sampling was used to select 445 ICU nurses from 9 ClassⅢ Grade A hospitals in Anhui Province as the research object. The self-designed General Information Questionnaire and CVC Maintenance Knowledge, Attitude and Practice Questionnaire for ICU Nurses were used to investigate the nurses. Multiple linear regression was used to explore the influencing factors of CVC maintenance knowledge, attitude and practice among ICU nurses. A total of 445 questionnaires were distributed, 11 invalid questionnaires were excluded, and 434 valid questionnaires were recovered, and the valid recovery rate was 97.5%.Results:Among 434 ICU nurses, the scores of CVC maintenance knowledge, attitude, and practice dimensions were (22.14±3.16) , (37.31±3.28) , and (75.65±6.35) , respectively. The results of multiple linear regression analysis showed that hospital category and CVC training times were the influencing factors of ICU nurses' CVC maintenance knowledge ( P<0.05) . CVC training times, educational background, ICU working years, and ICU category were the influencing factors of ICU nurses' CVC maintenance attitude ( P<0.05) . ICU working years, CVC training times, professional title and hospital category were the influencing factors of ICU nurses' CVC maintenance practice ( P<0.05) . Conclusions:ICU nurses have a good attitude to CVC maintenance, but the level of knowledge and practice needs to be improved. Nursing managers should focus on ICU nurses with low educational background, short ICU working years, low professional titles, non-teaching hospitals and few trainings, strengthen relevant knowledge training, increase the level of CVC maintenance practice, and then improve the quality of nursing.

Objective:To explore hot spots and trend of medical education quality assurance research in China and provide reference for future research.Methods:We searched the database of CNKI, VIP, Wanfang Database for published studies on quality assurance of medical education research in China. In the form of knowledge mapping, word frequency analysis, social network analysis and cluster analysis were used to explore the research hot spots from the perspective of high frequency keywords. SATI3.2 and Excel tables were used as statistical analysis tools for bibliographic information, the field extraction and word frequency statistics of literature keywords. Using SPSS 20.0, cluster analysis was carried out according to the similarity matrix of high frequency keywords co-occurrence.Results:Totally 249 articles were included in the study and 33 high frequency words were taken into account. The research hot spots of medical education quality assurance in China were divided into four categories: the practical application of medical education quality assurance, the effective methods of medical education quality assurance, the exploration of the construction of medical education quality assurance system, and the management of medical teaching quality assurance.Conclsion:Medical education in our country should perfect the safeguard measures to form characteristic theory framework, explore other methods for medical education quality assurance, establish medical education education quality guarantee system, and strengthen the teaching quality monitoring. The future researches should comply with the national "Double First-rate" construction and the development trend of international medical education, and enhance the research of connotative quality assurance.

Objective:To analyze the efficacy and safety of the biological agent infliximab (IFX) in the treatment of pediatric Crohn′s disease.Methods:A total of 86 children with Crohn′s disease who had received IFX in three hospitals (Ruijin Hospital, Ruijin Hospital North and Shanghai Children's Hospital) in Shanghai from January 2007 to December 2017 were included in this retrospective study. The efficacy of IFX was assessed by comparing clinical and laboratory data before and after IFX treatment. Student t test, Mann-Whitney U test or chi-square test were used to analyze the data of the two groups. Logistic reggression analysis were used to analyze the effects of variables such as age, clinical characteristics, disease behavior and combined medications on the efficacy and safety of IFX. Results:Among the 86 children with Crohn′s disease in the study, 50 were males and 36 females. The IFX treatment was initiated at 12.0 (7.1, 13.6) years of age, and the follow-up period was 94.1 (47.8, 185.5) weeks. Efficacy analysis showed that in the induction remission phase, the clinical response rate was 97% (79/81) and the remission rate was 74% (60/81). In the maintenance remission phase, the clinical response rate was 75% (51/68) and the remission rate was 68% (46/68). After 34 weeks of treatment with IFX, pediatric Crohn′s disease activity index (PCDAI) (5 (0, 10) vs. 36 (26, 45)), C-reactive protein (3 (1, 8) vs. 8 (3, 31) mg/L), erythrocyte sedimentation rate (10 (6, 10) vs. 35 (20, 50) mm/1 h), platelet ( (327±107)×10 9vs. (438±159) ×10 9/L), albumin ((37±6) vs. (30±6) g/L), hemoglobin ((116±16) vs. (103±18) g/L), change of body weight (-0.5±1.2 vs. -1.0±0.9), anemia (29% (20/68) vs. 75% (51/68)), and perianal disease (13/21 vs. 0) were significantly improved (all P<0.05). By the end of 34 weeks of IFX treatment, 25% (17/68) of children experienced secondary loss of response to IFX. Logistic reggression analysis showed that PCDAI>30 was positively correlated with secondary loss of response ( OR=3.823, 95% CI 1.015 -15.328, P=0.048), and combined with azathioprine was conducive to maintaining efficacy of IFX ( OR=0.440, 95% CI 0.106 -1.033, P=0.044). The IFX-related adverse events included infusion reactions in 17% (15/86) and infections in 42% (36/86) of children. Analysis showed that age<6 years was a risk factor for infusion reactions (χ 2=6.556, P=0.010), and combined use of steroids (χ 2=5.230, P=0.022) may increase the incidence of infection. Conclusions:IFX is effective in the treatment of pediatric Crohn′s disease with favorable safety. Reducing secondary loss of response to IFX is an urgent issue that need to be addressed. At the same time, it is necessary to pay close attention to the adverse events during IFX treatment.

Objective: To analyze the clinical characteristics of chronic pancreatitis (CP) and evaluate its impact on growth of children. Methods: A retrospective study was conducted in 94 children (male 49 cases, female 45 cases) who were diagnosed with CP in the Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from August 2008 to July 2015. Clinical characteristics, such as features of abdominal pain, etiologies, image data, levels of serum amylase and lipase, and physical development data were extracted from electronic medical records. The comparison between groups based on etiology or with normal control was performed with student′s t test. Results: The age of first episode was (8.2±3.7) years. There were 61 (65%) children diagnosed with idiopathic CP, and 25 (27%) with anatomic abnormalities. The age of onset in the group with anatomic abnormalities was lower than that in the idiopathic CP group ((6.3±3.5) vs. (8.9±3.4) years, t=3.211, P=0.002). There were 51 (54%) patients with serum amylase elevation, 41(44%) patients with lipase elevation, and 35 (37%) with elevation in both. The questionnaire showed that 28 out of 30 children had moderate to severe abdominal pain. The patients′ weight standard score (SDS) was significantly lower than the overall average in normal control (-0.4±1.1 vs. 0, t=-3.308, P=0.001). Meanwhile, the mean level of insulin like growth factor-1 (IGF-1) SDS of 35 children was significantly decreased (-1.8±1.8 vs. 0, t=-6.136, P<0.01). There were 69% (37/54) patients diagnosed by magnetic resonance cholangiopancreatography (MRCP) combined with magnetic resonance imaging (MRI), higher than that diagnosed by abdominal ultrasound (29%, 27/94). Conclusions Idiopathic CP and anatomic abnormalities were the two main etiologies. Normal level of serum amylase and lipase or negative finding of ultrasound cannot exclude CP, while MRCP and MRI should be considered to improve CP diagnostic rate. It is noteworthy that growth delay would happen in children with CP history.