Objective:To find benefit of adaptive challenges in age-related macular degeneration (AMD) patients of long-term treatment in the challenge of vision decline, and provide new ideas for improving the quality of life of patients.Methods:It was a phenomenological study from qualitative research, selected by purpose sampling method and semi-structured interview which involved 20 AMD patients who received intravitreal treatment of drug in the Ophthalmology Department of Affiliated Hospital of Nantong University from January to March 2023.Two interviewees comprehensively read and analyzed the transcript of the interview and its meaning, subsequently Colaizzi seven-step analysis method was used to classify and encode the transcribed data.Results:Among 20 patients, there were 9 males and 11 females, aged 56-81 years old. Patients with AMD experience a sense of benefit in their long-term management of the condition, adapting to the challenges posed by declining strength, which could be summarized into four main themes: moderate sense of decision control, satisfactory social support, active self-management of the disease, and an improvement in quality of life.Conclusions:Patients with AMD experience a sense of disease-related benefit during the long-term management of visual acuity challenges. Healthcare professionals should guide patients to seek this benefit from adverse events, identify the adaptive challenges patients face, and leverage their adaptive leadership skills. Furthermore, offering multi-channel low vision rehabilitation services can assist patients in enhancing their adaptive capabilities, ultimately contributing to further improving their quality of life.

Inflammatory bowel disease (IBD) is a disorder of immune and microbial dysregulation, induced by environmental factors in a genetically predisposed individual. Studies on IBD-associated genes have demonstrated that Paneth cells (PC) are central to the pathogenesis of IBD, especially in the development of Crohn′s disease (CD). The morphology, quantity and function of PC are easily affected by susceptible genes. In the intestine, PC participate in the formation of stem cell niche and secrete antimicrobial particles, which plays a vital role in regulating intestinal microbiota and maintaining intestinal mucosal homeostasis. Meanwhile, the proliferation and maturation of PC are also dependent on the symbiotic microbiota in the intestine. This review focuses on the interaction of susceptible genes, PC and intestinal microbiota, as well as their influence on the occurrence and development of IBD.

Inflammatory bowel disease (IBD) is a disorder of immune and microbial dysregulation, induced by environmental factors in a genetically predisposed individual. Studies on IBD-associated genes have demonstrated that Paneth cells (PC) are central to the pathogenesis of IBD, especially in the development of Crohn′s disease (CD). The morphology, quantity and function of PC are easily affected by susceptible genes. In the intestine, PC participate in the formation of stem cell niche and secrete antimicrobial particles, which plays a vital role in regulating intestinal microbiota and maintaining intestinal mucosal homeostasis. Meanwhile, the proliferation and maturation of PC are also dependent on the symbiotic microbiota in the intestine. This review focuses on the interaction of susceptible genes, PC and intestinal microbiota, as well as their influence on the occurrence and development of IBD.

Objective:To explore the factors affecting the compliance with hormone replacement therapy in children with short stature.Methods:Totally 14 parents of 14 children with short stature who had poor compliance with hormone replacement therapy in the Affiliated Hospital of Nantong University from August to December 2018 were selected by purposive sampling and received semi-structured interview. Colaizzi's 7-step analysis was used to analyze the data.Results:The factors affecting children's compliance with hormone replacement therapy were summarized into 4 themes, namely, parents' failure to cope with the disease, the psychological and physical problems of the children, the excessive financial burden, and the lack of humanistic care.Conclusions:The compliance with hormone replacement therapy in children with short stature is affected by many factors such as their own and social factors. Medical and nursing staff should pay special attention and provide personalized continuous care, and pay attention to humanistic care to improve their treatment compliance and achieve ideal treatment effects.

Objective? To explore the intervention effects of the group self-affirmation training on the stigma in the rectal cancer patients with colostomy. Methods? By convenience sampling, 89 rectal cancer patients with colostomy in Yancheng Third People's Hospital from April 2017 to April 2018 were selected and divided into the experimental group (n=45) and control group based on the random number table(n=44).The experimental group received group self-affirmation training on the basis of the conventional nursing care while the control group received the conventional nursing care. The self-designed General Information Questionnaire, Social Impact Scale(SIS), Self-Esteem Scale(SES) were used to evaluate the stigma and level of self-esteem before and after intervention. Results? Before intervention, the two groups had no statistical difference in the scores of stigma (t=-0.323, P=0.747) and level of self-esteem(t=-0.270,P=0.788); after intervention the experimental group had lower scores than the control group in stigma (t=-3.008, P＜0.01) and higher scores than the control group in self-esteem(t=4.033, P＜0.01) with statistical significance. Conclusions? Group self-affirmation training can reduce the stigma of rectal cancer patients with colostomy and improve their self-esteem.

Objective To understand the clinical epidemiology and manifestation of nontyphoidal Salmonella (NTS)enteric infections and serotypes and antibiotic resistance patterns of NTS in children.Method All cases with probable acute bacterial inflammatory diarrhea were included into this study from the Children's Hospital of Fudan University during January 2012 through December 2014.Salmonella species and other major enteric bacteria were routinely isolated from the fresh stool sample of the enrolled patients at their first visit to the enteric clinic.Salmonella isolates were serotyped and tested for antimicrobial susceptibility testing using Kirby-Bauer method at the reference laboratory of Shanghai Municipal Center for Disease Control and Prevention.All enrolled cases had clinical records.The enumeration data were described by constituent ratio.Result Of the enrolled 3 143 patients,742 (23.6％) were confirmed to have Salmonella infections,and NTS was identified in 738 (23.5％) cases and Salmonella Paratyphi B was identified in 4 (0.1％) cases,respectively.The isolation rate of NTS exceeded diarrheagenic Escherichia coli (6.7％,182/2 727),Campylobacter (4.1％,129/3 143) and Shigella (2.4％,77/3 143).Nine serogroups and 41 serovars were identified in 742 salmonella isolates.Salmonella Enteritidis and Salmonella Typhimurium were the most common serovars,representing 42.6％ (316/742) and 28.2％ (209/742) of isolates,respectively.NTS infections were prevalent year-round with a seasonal peak from May to October.The common symptoms included tever (57.5％,424/738) and blood-in-stool (31.0％,229/738).Antimicrobial susceptibility showed only 8 (1.1％) of 742 isolates sensitive to 16 tested antibiotics.Resistance to the current first-line antibiotics such as the third-generation and (or) fourth-generation cephalosporins (cefotaxime and cefepime),ciprofloxacin was detected in 10.0％ (74/738),8.1％ (60/738) and 1.1％ (8/738),respectively.Conclusion NTS is the leading causative agent responsible for bacterial inflammatory diarrhea in Shanghainese children.The prevalence of NTS enteric infections show an increasing trend year by year.It is essential to continuously monitor the antimicrobial resistance of NTS and trace the source of infection to prevent and treat NTS infections in Shanghai.

Objective To investigate the pathotypes,epidemiological characteristics and antimicrobial resistance of diarrheagenic Escherichia coli (DEC) in children with acute bacterial diarrhea in Shanghai.Methods A total of 2 071 outpatient children with probable acute bacterial diarrhea referred to the enteric clinic of Children's Hospital of Fudan University during June 2012 to June 2014 were enrolled in our study.The stool samples were processed for routine microbiologic and biochemistry tests to identify enteric bacteria,including enteropathogenic Escherichia coli (EPEC),enterotoxigenic Escherichia coli (ETEC),enteroinvasive Escherichia coli (EIEC) and enterohemorrhagic Escherichia coli (EHEC).Kirby-Bauer method was used to identify the antibiotic sensitivity.Difference of means between groups was compared by chi-square test.Results Of 2 071 enrolled children,DEC were identified in 145 (7.0 ％)cases.148 strains were isolated with three of mix infection strains.All DEC isolates in this study included 106 (71.6％) EPEC,24 (16.2％) ETEC,16(10.8％) EIEC and 2(1.4％) EHEC.The median ages of diarrheal children with DEC infections were 14 months (range:3 months to 13 years) and 62.8％ of them were ＜2 years.Among 125 DEC isolates tested for antimicrobial susceptibility,the rates of resistance to ampicillin,trimethoprim-sulfamethoxazole,cefotaxime,cefepime,gentamicin,ceftazidime,amoxicillinclavulanate,ciprofloxacin,and ofloxacin in a descending order were 55.2％,35.2％,28.0％,27.2％,23.2％,8.8％,5.6％,4.0％ and 4.0％,respectively.Resistance rates of EIEC to cefotaxime,cefepime and ceftazidime were 50.0％,43.8％ and 25.0％,respectively,which were higher than those of EPEC,ETEC and EHEC.Conclusion DEC is the important enteric bacteria that causes bacterial diarrhea in children in this study.

Objective:To observe the clinical efficacy and safety of Bianyan oral liquids in the treatment of acute pharyngitis. Methods:The clinical data of 200 patients with acute pharyngitis in the outpatient department of traditional Chinese medicine in our hospital from September 2010 to June 2012 were analyzed. They were divided into the control group with 100 cases and the observation group with another 100 cases. The control group was given Jinlianhua granules, while the observation group was received Bianyan oral liquids. After 5 days, the symptom score, effective rate, changes in accompanied symptoms and safety index were observed and com-pared. Results:The symptom score and effective rate of the observation group were better than those of the control group (P<0. 05), and the improvement in defecation was better than that of the control group (P<0. 05) as well. There were two cases in the observation group suffered nausea and stomachache, and one case in the control group suffered diarrhea while no untoward effect emerged. Conclu-sion:Bianyan oral liquids with the effects of heat-clearing and detoxicating, nourishing yin and fluid and treatment both manifestation and root cause show significant effect in the treatment of acute pharyngitis.

ObjectiveTo establish pediatric serum CysC reference intervals based on the children's hospital laboratory data in Zhejiang Province and analyse the effects of CysClevels on age and gender. MethodsCysC was one of tests of a routine biochemical screening panel employed for most outpatients and inpatients in the children's hospital, and 8 127 subjects (4 264 boys and 3 863 girls) were selected from 13 567 subjects from laboratory information system according to the exclusion criterion with seriously systemic diseases, cardiovascular diseases, kidney diseases, elevated values of creatinine, urea or ALT for which 1.5-fold upper limit, serum samples with hemolysis, icterus or lipid turbidity, same patients with non-first-time CysC results and living addresses which were not in Zhejiang. The serum CysC was determined by transmission turbidimetry on Roche DPP modular automatic biochemical analyzer. SPSS 17.0 software and EXCEL 2003 were employed for statistical analysis in this study. Results The serum CysC concentration was a Gaussian distribution after log transformation. The mean Log-transformated CysC lg (CysC) concentration of boys in five age groups ( ＜ 1 month, 1 to 3 months, 4 to 11 months, 1 to 2 years and 2 to 16 years) were 0. 224,0. 170,0. 112,0. 061, -0. 011 (mg/L,lg) respectively, and the mean Log-transformated CysC lg(CysC) concentration of girls in five age groups were 0. 222, 0. 164, 0. 089, 0. 057,-0. 010 ( mmg/L, lg) respectively, and no statistically significant differences between Ig( CysC ) and gender in five age groups were found ( t values were 0. 174, 0. 362, 0. 445,- 1. 464 and - 0. 093, respectively,and corresponding P values all were greater than 0. 05 ). The mean lg ( CysC ) concentrations in five age groups were 0. 222,0. 166,0. 100,0. 059, - 0. 010 ( mmg/L, lg), and significant differences between Lg ( CysC ) and ages by Analysis of Variance were observed ( F = 309. 785 and P = 0 in between-groups totally,P = 0 in any two groups). Serum CysC levels were highest in the age of ＜ 1 month, then declined to the age of 2 years and kept stable in the age of 2 to 16 years. The serum CysC reference intervals for children were as follows:0. 95 -2. 92 mg/L in the age of ＜ 1 month, 0. 81 -2.67 mg/L in the age of 1 to 3 months, 0. 65 -2.45 mg/L in the age of 4 tol2 months, 0. 56 -2. 35 mg/L in the age of 1 year and 0. 45 -2. 13 mg/L in the age of 2 to 16 years. ConclusionsThere is no significant effect on pediatric CysC levels with gender but close correlated with age below 2 years old. It is necessary to establish appropriate age-related reference intervals of serum CysC for efficiently evaluating renal function in local children.

Aim To investigate the effects of Y-IP5 on morphine-induced behavioral sensitization and CPP in mice.Methods Locomotor activity was detected after Y-IP5 administration or co-administration of Y-IP5 with morphine in mice.Mice were treated with morphine to induce behavioral sensitization. Then the effects of Y-IP5 on the development, transfer and expression of morphine-induced behavioral sensitization were investigated. Mice were treated with morphine to induce CPP. Then the effect of Y-IP5 on the acquisition of morphine-induced CPP was studied.Results Y-IP5 itself didn′t influence locomotor activity of mice.Co-administration of Y-IP5 with morphine inhibited morphine-induced hyperactivity (P<0.05) and the development of morphine-induced behavioral sensitization in mice (P<0.05), however, did not influence the transfer and expression of morphine-induced behavioral sensitization.Co-administration of Y-IP5 with morphine also inhibited the acquisition of morphine-induced CPP (P<0.05).Conclusion Y-IP5 may inhibit the psychological dependence induced by morphine.