Objective:To explore the high-risk factors affecting the severity of neonatal necrotizing enterocolitis (NEC).Methods:This study involved 153 NEC patients admitted to the Neonatology Department of the Children's Hospital of Soochow University from January 1, 2017, to December 30, 2023. Based on the severity of NEC determined by Bell's criteria, these patients were divided into two groups: mild group (Bell stage Ⅱ, n=70) and severe group (Bell stage Ⅲ, n=83). Clinical data including general conditions, clinical treatment and disease status before the onset of NEC, laboratory test results, and perinatal conditions of the mothers were retrospectively collected. Univariate analysis (rank-sum test and Chi-square test) and multivariate analysis (logistic regression analysis) were used to explore the risk factors affecting the severity of NEC. Results:The proportion of infants with gestational age<37 weeks or birth weight<1 500 g, the rate of antibiotic usage, sepsis or shock were higher in the severe group than in the mild group [91.6% (76/83) vs. 75.7% (53/70); 55.4% (46/83) vs. 34.3% (24/70); 85.5% (71/83) vs. 71.4% (50/70); 55.4% (46/83) vs. 17.1% (12/70); 30.1% (25/83) vs. 8.6% (6/70); with χ 2 values of 7.22, 6.84, 4.57, 23.64, and 10.91, respectively, all P<0.05]. Furthermore, the severe group had a late initiation of breastfeeding and longer durations of peripherally inserted central catheter (PICC) placement and parenteral nutrition [2.00 d (1.00-2.00 d) vs. 1.00 d (1.00-2.00 d); 0.00 d (0.00-18.00 d) vs. 0.00 d (0.00-7.50 d); 14.00 d (5.00-21.00 d) vs. 10.50 d (0.00-18.25 d), with Z values of -2.90, -1.98, and -2.09, respectively, all P<0.05]. (2) Within 48 h before the onset, the severe group had higher proportions of infants with decreased white blood cell count, decreased platelet count, electrolyte imbalance, and metabolic acidosis than the mild group [53.0% (44/83) vs. 14.3% (10/70); 49.4% (41/83) vs. 10.0% (7/70); 38.6% (32/83) vs. 14.3% (10/70); 37.3% (31/83) vs. 14.3% (10/70), with χ2 values of 24.94, 27.38, 11.23, and 10.30, respectively, all P<0.05]. Besides, the levels of procalcitonin and C-reactive protein were higher in the severe group than in the mild group [2.31 ng/ml (0.26-11.71 ng/ml) vs. 0.22 ng/ml (0.00-2.19 ng/ml); 58.50 mg/L (14.34-125.25 mg/L) vs. 8.20 mg/L (0.23-34.56 mg/L), with Z values of -3.88 and -5.02, respectively, both P<0.05]. (3) Multivariate logistic regression analysis showed that prolonged duration of PICC placement, decreased platelet count, electrolyte imbalance, metabolic acidosis, and concurrent sepsis were independent risk factors affecting the severity of NEC [ OR (95% CI) values were 1.104 (1.020-1.196), 5.364 (1.667-17.253), 4.047 (1.171-13.986), 4.333 (1.290-14.556), and 3.290 (1.005-10.774), respectively, with all P<0.05]. Conclusions:Prolonged duration of PICC placement, concurrent sepsis, decreased platelet count, electrolyte imbalance, and metabolic acidosis in NEC patients are more likely to lead to severe cases. In clinical practice, attention should be paid to relevant indicators, and abnormal changes should be identified and intervened in a timely manner to reduce the occurrence of severe NEC.

Objective:To summarize the prediction model for inadequate bowel preparation in adults with colonoscopy to inform clinical practice.Methods:Literature on the prediction model of inadequate bowel preparation for colonoscopy was electronically searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, Yiigle, PubMed, Embase, Web of Science, CINAHL, PsycINFO, Cochrane Library and Google Scholar. The search period was from database establishment to December 31, 2023. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias and applicability of the included literature using the Prediction Model Risk of Bias Assessment Tool (PROBAST) .Results:A total of 22 articles covering 18 models were included. The incidence of inadequate bowel preparation for colonoscopy in adults ranged from 11.6% to 39.0%. The model construction method was dominated by Logistic regression, and some models had good predictive performance but lacked high-quality external validation results. Diabetes, chronic constipation, antidepressants, age, and body mass index were significant predictors of inadequate bowel preparation in colonoscopy.Conclusions:Nursing staff need to be aware of the influencing factors for inadequate bowel preparation and can choose models with good performance to guide clinical practice. Prediction models for inadequate bowel preparation in colonoscopy are currently in the developmental stage, and future research could leverage artificial intelligence to build high-performance, actionable models with extensive external validation.

Objective:To explore the high-risk factors affecting the severity of neonatal necrotizing enterocolitis (NEC).Methods:This study involved 153 NEC patients admitted to the Neonatology Department of the Children's Hospital of Soochow University from January 1, 2017, to December 30, 2023. Based on the severity of NEC determined by Bell's criteria, these patients were divided into two groups: mild group (Bell stage Ⅱ, n=70) and severe group (Bell stage Ⅲ, n=83). Clinical data including general conditions, clinical treatment and disease status before the onset of NEC, laboratory test results, and perinatal conditions of the mothers were retrospectively collected. Univariate analysis (rank-sum test and Chi-square test) and multivariate analysis (logistic regression analysis) were used to explore the risk factors affecting the severity of NEC. Results:The proportion of infants with gestational age<37 weeks or birth weight<1 500 g, the rate of antibiotic usage, sepsis or shock were higher in the severe group than in the mild group [91.6% (76/83) vs. 75.7% (53/70); 55.4% (46/83) vs. 34.3% (24/70); 85.5% (71/83) vs. 71.4% (50/70); 55.4% (46/83) vs. 17.1% (12/70); 30.1% (25/83) vs. 8.6% (6/70); with χ 2 values of 7.22, 6.84, 4.57, 23.64, and 10.91, respectively, all P<0.05]. Furthermore, the severe group had a late initiation of breastfeeding and longer durations of peripherally inserted central catheter (PICC) placement and parenteral nutrition [2.00 d (1.00-2.00 d) vs. 1.00 d (1.00-2.00 d); 0.00 d (0.00-18.00 d) vs. 0.00 d (0.00-7.50 d); 14.00 d (5.00-21.00 d) vs. 10.50 d (0.00-18.25 d), with Z values of -2.90, -1.98, and -2.09, respectively, all P<0.05]. (2) Within 48 h before the onset, the severe group had higher proportions of infants with decreased white blood cell count, decreased platelet count, electrolyte imbalance, and metabolic acidosis than the mild group [53.0% (44/83) vs. 14.3% (10/70); 49.4% (41/83) vs. 10.0% (7/70); 38.6% (32/83) vs. 14.3% (10/70); 37.3% (31/83) vs. 14.3% (10/70), with χ2 values of 24.94, 27.38, 11.23, and 10.30, respectively, all P<0.05]. Besides, the levels of procalcitonin and C-reactive protein were higher in the severe group than in the mild group [2.31 ng/ml (0.26-11.71 ng/ml) vs. 0.22 ng/ml (0.00-2.19 ng/ml); 58.50 mg/L (14.34-125.25 mg/L) vs. 8.20 mg/L (0.23-34.56 mg/L), with Z values of -3.88 and -5.02, respectively, both P<0.05]. (3) Multivariate logistic regression analysis showed that prolonged duration of PICC placement, decreased platelet count, electrolyte imbalance, metabolic acidosis, and concurrent sepsis were independent risk factors affecting the severity of NEC [ OR (95% CI) values were 1.104 (1.020-1.196), 5.364 (1.667-17.253), 4.047 (1.171-13.986), 4.333 (1.290-14.556), and 3.290 (1.005-10.774), respectively, with all P<0.05]. Conclusions:Prolonged duration of PICC placement, concurrent sepsis, decreased platelet count, electrolyte imbalance, and metabolic acidosis in NEC patients are more likely to lead to severe cases. In clinical practice, attention should be paid to relevant indicators, and abnormal changes should be identified and intervened in a timely manner to reduce the occurrence of severe NEC.

Objective:To summarize the prediction model for inadequate bowel preparation in adults with colonoscopy to inform clinical practice.Methods:Literature on the prediction model of inadequate bowel preparation for colonoscopy was electronically searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, Yiigle, PubMed, Embase, Web of Science, CINAHL, PsycINFO, Cochrane Library and Google Scholar. The search period was from database establishment to December 31, 2023. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias and applicability of the included literature using the Prediction Model Risk of Bias Assessment Tool (PROBAST) .Results:A total of 22 articles covering 18 models were included. The incidence of inadequate bowel preparation for colonoscopy in adults ranged from 11.6% to 39.0%. The model construction method was dominated by Logistic regression, and some models had good predictive performance but lacked high-quality external validation results. Diabetes, chronic constipation, antidepressants, age, and body mass index were significant predictors of inadequate bowel preparation in colonoscopy.Conclusions:Nursing staff need to be aware of the influencing factors for inadequate bowel preparation and can choose models with good performance to guide clinical practice. Prediction models for inadequate bowel preparation in colonoscopy are currently in the developmental stage, and future research could leverage artificial intelligence to build high-performance, actionable models with extensive external validation.

Objective:Meta-analysis of influencing factors of colonoscopy screening behavior of first-degree relatives of patients with colorectal cancer was conducted to provide basis for improving the rate of colonoscopy screening.Methods:The literatures and their references related to the influencing factors of colonoscopy screening behavior of first-degree relatives of colorectal cancer patients from the establishment of the database to July 1,2024 were searching in PubMed,Cochrane Library,Web of Science,CINAHL,Embase,China Biomedical Literature Database,China National Knowledge Infrastructure,Wanfang Database and VIP Database.The literatures were extracted and evaluated by two researchers independently according to the standards.In this study,the influencing factors of colonoscopy screening behavior were analyzed by Stata 18.0 software.Results:A total of 11 literatures were included,with a total sample size of 30 985 cases.The results of Meta-analysis showed that the colonoscopy screening rate of first-degree relatives of colorectal cancer patients was 35.30%(95%CI:24.30%-46.20%).First-degree relatives'education level[OR:1.586(95%CI:1.239-2.032)],colorectal cancer prevention and screening knowledge[OR:2.319(95%CI:1.626-3.307)],and perceived susceptibility[OR:1.301(95%CI:1.081-4.328)]and cues to action[OR:4.170(95%CI:2.686-6.469)]were the important factors influencing the colonoscopy screening behavior of the first-degree relatives of patients with colorectal cancer.Conclusion:The colonoscopy screening rate of first-degree relatives of colorectal cancer patients needs to be further improved,and the colonoscopy screening behavior is influenced by many factors.In the future,the results of this study can be referenced,in order to identify high-risk groups,take diversified and targeted intervention measures,improve the colonoscopy screening rate of first-degree relatives of colorectal cancer patients,and further improve the early detection rate of colorectal cancer in China.

Objective:To analyze the research status, hotspots and frontiers of symptom nursing of inflammatory bowel disease (IBD) .Methods:The Web of Science core collection database was searched, and CiteSpace 6.2.R4 software was used to analyze the literature visually.Results:A total of 350 articles were included. The number of articles on symptom nursing of inflammatory bowel disease showed an upward trend year by year. The author with the most significant number of articles was Christine. The authors were scattered and had not yet formed a core group. The country with the most significant number of articles was the United States. The keywords formed a total of 11 clusters, among which the home symptom monitoring of inflammatory bowel disease as a chronic disease, the current status of symptoms in inflammatory bowel disease patients and their relationship with other variables, the symptoms of active patients, and symptom intervention based on theoretical frameworks were research hotspots. The effectiveness of symptom-coping strategies and tools was at the forefront of research.Conclusions:The symptom nursing of inflammatory bowel disease shows a rapid development trend. In the future, researchers should develop more accurate symptom measurement tools based on previous research and construct precise symptom response strategies.

Objective To construct a continuous nursing quality evaluation indicator system for inflam-matory bowel disease patients and provide a basis for the evaluation of continuous nursing quality.Methods On the basis of Donabedian's three-dimensional(structure,process,and outcome)quality structure,we employed liter-ature review,qualitative interview,Delphi method,and hierarchical analysis to determine the content and weights of indicators of continuous nursing quality for the patients with inflammatory bowel disease.Results A total of 15 experts completed 2 rounds of consultation,which had the questionnaire recovery rates of 100％,the expert authority coefficients of 0.930 and 0.919,and the Kendall harmony coefficients of 0.149 and 0.177(both P＜0.001),respectively.The established nursing quality evaluation indicator system included 3 first-level indicators,10 sec-ond-level indicators,and 39 third-level indicators.Conclusion The continuous nursing quality evaluation indi-cator system for the patients with inflammatory bowel disease that was constructed in this study was reasonable,reliable,and practical,providing reference for evaluating the continuous nursing quality for the patients with in-flammatory bowel disease.

Objective:To isolate and identify SARS-CoV-2 epidemic strains and analyze the sequence characteristics of the virus strains following serial passages.Methods:Eleven nasopharyngeal swabs positive for SARS-CoV-2 antigen were collected from December 2022. Quantitative real-time PCR was used to detect SARS-CoV-2 nucleic acid, and positive specimens were inoculated onto Vero cells for virus isolation. The isolated strains were identified by Western blot and indirect immunofluorescence assay. The morphology of the isolated strains was observed using transmission electron microscopy. Nucleic acid was extracted from the isolates and passaged viruses for further sequencing and analysis.Results:All 11 specimens tested positive for SARS-CoV-2 using quantitative real-time PCR. SARS-CoV-2 strains were successfully isolated from seven specimens, and could be adaptively cultured, passaged, and expanded on Vero cells, achieving a peak titer exceeding 10 6.25 50% cell culture infectious dose (CCID 50)/ml. Western blot and indirect immunofluorescence results showed that the isolates could be specifically recognized by monoclonal antibodies and convalescent serum against SARS-CoV-2. Transmission electron microscopy revealed oval-shaped viral particles with diameters of approximately 100 nm. Next-generation sequencing of the viral isolates demonstrated a sequence homology greater than 99.50% with the Wuhan-Hu-1 reference strain (NC_045512) and 99.98% among the seven isolated strains, and all of the isolates belonged to the Omicron BF.7 variant. Sequence analysis after continuous passage and plaque purification of the BJ-NVSI-20230005 isolate showed that compared with passages 1-3, passages 4-6 had one nucleotide site mutation (C→T) in the ORF1ab gene and a deletion of 3 bp in the E gene, which resulted in a change from leucine to phenylalanine and the deletion of valine, respectively. Polymorphisms were observed in the sequences of plaque-purified clones. Conclusions:The seven successfully isolated SARS-CoV-2 strains all belong to the SARS-CoV-2 BF.7 variant, which is consistent with the prevalence trend in mainland China in December 2022.

Objective:To investigate the effect of modified bowel examination schedule and corresponding bowel preparation protocol on bowel preparation quality and satisfaction of patients with Crohn′s disease (CD) undergoing CT enterography (CTE) and colonoscopy during follow up.Methods:A total of 207 patients with CD in our hospital from December 2021 to October 2022 were prospectively included in the study, among whom 94 patients from West Hospital and South Hospital were used as control group, with routine examination arrangement and intestinal preparation protocol; 113 patients from East Hospital were used as observation group with modified examination arrangement and intestinal preparation protocol, meaning that these two examinations were adjusted to the same day and were combined with oral laxative bowel preparation. The differences between the two groups in the quality of bowel preparation, satisfaction and adverse effects of oral laxatives were analyzed.Results:Observation group was higher qualified rate of intestinal preparation (88.50% vs. 86.17%), and lower the adverse reaction rate of intestinal preparation (6.19% vs. 7.45%) as compared to, and both the differences were not statistically significant (both P>0.05). The total score of patient satisfaction (very satisfactory and satisfactory) in the observation group was significantly higher than that in the control group (92.04% vs. 53.20%), and the difference was statistically significant ( P<0.05) . Conclusion:Modified examination arrangement and intestinal preparation protocol are suitable for patients with CTE and colonoscopy during follow-up, which do not affect the quality of intestinal preparation and do not increase the incidence of adverse reactions, while can improve patient satisfaction. This protocal is worthy of clinical promotion and implementation.

Objective:To investigate the effect of modified bowel examination schedule and corresponding bowel preparation protocol on bowel preparation quality and satisfaction of patients with Crohn′s disease (CD) undergoing CT enterography (CTE) and colonoscopy during follow up.Methods:A total of 207 patients with CD in our hospital from December 2021 to October 2022 were prospectively included in the study, among whom 94 patients from West Hospital and South Hospital were used as control group, with routine examination arrangement and intestinal preparation protocol; 113 patients from East Hospital were used as observation group with modified examination arrangement and intestinal preparation protocol, meaning that these two examinations were adjusted to the same day and were combined with oral laxative bowel preparation. The differences between the two groups in the quality of bowel preparation, satisfaction and adverse effects of oral laxatives were analyzed.Results:Observation group was higher qualified rate of intestinal preparation (88.50% vs. 86.17%), and lower the adverse reaction rate of intestinal preparation (6.19% vs. 7.45%) as compared to, and both the differences were not statistically significant (both P>0.05). The total score of patient satisfaction (very satisfactory and satisfactory) in the observation group was significantly higher than that in the control group (92.04% vs. 53.20%), and the difference was statistically significant ( P<0.05) . Conclusion:Modified examination arrangement and intestinal preparation protocol are suitable for patients with CTE and colonoscopy during follow-up, which do not affect the quality of intestinal preparation and do not increase the incidence of adverse reactions, while can improve patient satisfaction. This protocal is worthy of clinical promotion and implementation.