Objective This study summarized the clinical data of IBD patients receiving upadacitinib treatment in our hospital,and provided more Chinese data to better guide the treatment of upadacitinib in Chinese IBD population.Methods Clinical data of 11 patients with IBD who received upadacitinib treatment at Anhui Provincial Hospital from March 1,2023 to September 8,2024 were retrospectively analyzed.Platelet count,ESR,CRP,disease severity score,endoscopic score,and adverse reactions were compared before treatment,at the 4th and 8th week of treatment,and clinical response rate,clinical response rate,endoscopic response rate,and endoscopic response rate were calculated.SPSS 25.0 software was used for statistical analysis.Results The platelets,ESR and CRP of patients at the 4th and 8th week after upadacitinib treatment were decreased compared with those before treatment,with statistical significance.At the 4th week,the clinical response rate was 72.72％(8/11),the clinical remission rate was 0,the clinical response rate of UC patients was 83.33％(5/6),and the clinical response rate of CD patients was 60％(3/5).At the 8th week of treatment,the clinical response rate was 100％(10/10),the clinical remission rate was 80.00％(8/10),the clinical response rate of UC patients was 100％(6/6),the clinical remission rate of UC patients was 83.33％(5/6),the clinical response rate of CD patients was 100％(4/4),and the clinical remission rate of CD was 75％(3/4).There were no adverse reactions during treatment.Three patients were re-examined by colonoscopy,all of whom were severe UC patients and achieved mucosal healing.Conclusion Upadacitinib can rapidly,effectively and sustainably control the disease in patients with moderate and severe IBD,with high safety.

Objective:To construct a chain mediating model based on two mediating variables of positive psychological capital and general self-efficacy, so as to explore the impact mechanism of social support on posttraumatic growth in thyroid cancer patients.Methods:From March to December 2023, convenience sampling was used to select 270 postoperative patients with thyroid cancer from the Chinese People's Liberation Army General Hospital as participants. The patients were surveyed using the General Information Questionnaire, Post Traumatic Growth Inventory, Social Support Rating Scale, Positive Psychological Questionnaire, and General Self-efficacy Scale. Spearman correlation was used to analyze the correlation between social support, positive psychological capital, general self-efficacy, and posttraumatic growth in thyroid cancer patients. SPSS PROCESS program was used to test for the chain mediating effect.Results:A total of 270 questionnaires were distributed, and 257 questionnaires were collected. After excluding questionnaires with missing items exceeding 10% and regular responses, 246 valid questionnaires were collected, with a valid response rate of 91.11% (246/270). Spearman correlation showed that there was positive correlations between social support, positive psychological capital, general self-efficacy, and posttraumatic growth in patients ( P<0.01). Mediating effect analysis showed that social support directly and positively predicted posttraumatic growth in thyroid cancer [ β=0.403, 95% CI (0.258, 0.547) ], and also affected patients' posttraumatic growth through three indirect pathways, namely social support → positive psychological capital → posttraumatic growth, with an effect value of 0.083 [95% CI (0.002, 0.173) ], accounting for 13.63% of the total effect, and social support → general self-efficacy → posttraumatic growth, with an effect value of 0.099 [95% CI (0.040, 0.166) ], accounting for 16.26% of the total effect, and social support → positive psychological capital → general self-efficacy → posttraumatic growth, with an effect value of 0.025 [95% CI (0.005, 0.051) ], accounting for 4.11% of the total effect. The total indirect effect accounted for 33.83% of the total effect. Conclusions:Social support can not only directly affect the post-traumatic growth of thyroid cancer patients, but also indirectly affect post-traumatic growth through the mediating effect of positive psychological capital and general self-efficacy.

Objective: To explore the dose-response relationship between pre-pregnancy body mass index (BMI) and gestational diabetes mellitus (GDM), so as to provide insights into the cut-off values of pre-pregnancy BMI and optimizing GDM prevention and control strategies. Methods: Pregnant women that admitted to Zhengzhou Central hospital in 2021 were recruited, and demographics, family history, pregnancy and delivery history and blood glucose levels during pregnancy were collected. The dose-response relationship between pre-pregnancy BMI and GDM was analyzed using restricted cubic spline (RCS) analysis. The predictive ability of pre-pregnancy BMI for GDM risk was evaluated using receiver operating characteristic (ROC) curve. Results: A total of 2 279 participants were included in the study. The median age was 29.0 (interquartile range, 5.0) years. The median pre-pregnancy BMI was 21.1 (interquartile range, 3.8) kg/m2. There were 312 underweight women (13.69%), 825 women with low-normal weight (36.20%), 730 women with high-normal weight (32.03%), 345 overweight women (15.14%) and 67 obese women (2.94%).The prevalence of GDM was 17.20%. RCS analysis suggested a linear dose-response relationship between age, pre-pregnancy BMI and GDM (P<0.05). When pre-pregnancy BMI was higher than 21.1 kg/m2, the risk of GDM increased with pre-pregnancy BMI (P<0.05). When women aged over 29.0 years, the risk of GDM increased with age, and the dose-response relationship of GDM caused by pre-pregnancy BMI was stronger in the women aged over 29.0 years than in the women aged 29.0 years and below (P<0.05). The area under curve (AUC) was 0.654 (95%CI: 0.624-0.684). If the cut-off value of pre-pregnancy BMI was 23.0 kg/m2, the Youden index, sensitivity and specificity was 0.238, 0.472 and 0.766, respectively. If it was 24.0 kg/m2, the Youden index, sensitivity and specificity was 0.195, 0.342 and 0.853, respectively. If it was 21.1 kg/m2, the Youden index, sensitivity and specificity was 0.213, 0.676 and 0.537, respectively. Conclusions There is a linear dose-response relationship between pre-pregnancy BMI and GDM, and higher than 21.1 kg/m2 of the pre-pregnancy BMI could increase the risk of GDM.

Objective:To construct an evaluation system for clinical nurse research ability training based on the Kirkpatrick model, and provide methods and strategies for clinical nurse research ability training.Methods:Based on literature review and group discussion, the item pool of an evaluation system for clinical nurse research training was constructed using the Kirkpatrick model as the theoretical framework. Using the Delphi method, two rounds of expert consultation were conducted on 17 experts to determine the final evaluation system.Results:In both rounds of expert consultation, 17 questionnaires were distributed, and 17 valid questionnaires were collected. The effective recovery rate of the questionnaires was 100%. After two rounds of expert consultation, the significance tests for the Kendall coordination coefficients of the first, second, and third level indicators were all P<0.05. The expert authority coefficients for the first and second rounds of expert consultation were 0.840 and 0.895, respectively. The evaluation system for clinical nurse research ability training established after two rounds of consultation included four first-level indicators, 11 second-level indicators, and 40 third-level indicators. Conclusions:The evaluation system for clinical nurse research ability training based on the Kirkpatrick model has reliable results, and experts have high levels of enthusiasm, coordination, and authority. It can be used as a tool for evaluating clinical nurse research ability training.

Objective:To investigate the application and curative effect of fat grafting in supraorbital area in double blepharoplasty in patients with negative vector of the eyelid- globe.Methods:From January 2019 to January 2020, 78 patients who came to Fuzhou Meilai Huamei Beauty Hospital for double blepharoplasty were collected as patients with negative eyelid- globe vector. The patients were randomly divided into 2 groups, with 42 cases in the combined group and 36 cases in the simple group. The combined group underwent double blepharoplasty combined with fat grafting in the supraorbital area, and the simple group only underwent double blepharoplasty.Results:The postoperative follow-up was 3-12 months, with an average follow-up of 6 months. The efficacy of the combined group and the simple group was compared. There was no surgical complications in both groups. In improving the eyelid-globe vector, the combined group was higher than that of the simple group. The overall satisfaction of the combined group was higher than that of the simple group. Among them, the satisfaction of eye appearance, self-confidence, mental health, surgical results, decision-making and facial rejuvenation were all higher than those of the simple group, and there was no difference in the impact on early life between the two groups.Conclusions:Double blepharoplasty undergoing fat grafting in the supraorbital area at the same time are safe and conforms to the aesthetic standard. The patients are satisfied with the postoperative effects.

Background:The clinical characteristics and management approaches of inflammatory bowel disease(IBD)change accordingly with the increasing incidence of the disease. Aims:To investigate the clinical changes of IBD in the last decade(2008-2017)in Anhui Provincial Hospital. Methods:Hospitalization data of patients with newly diagnosed IBD admitted from Jan. 2008 to Nov. 2017 at the Anhui Provincial Hospital were collected,and then the clinical characteristics and management approaches were compared between Group A(2008-2012)and Group B(2013-2017). Results:A total of 515 IBD cases were enrolled in this study. Hospitalized IBD cases increased significantly from 2013 to 2017. Cases of ulcerative colitis(UC)was 3.72 times and cases of Crohn's disease(CD)was 3 times in 2017 as that in 2013. In Group A,UC mainly involved the left colon(47.8%),with mild-to-moderate activity(85.3%);while the majority of UC in Group B presented as pancolitis(54.5%),and mostly with moderate-to-severe disease(83.8%). In group B,the proportion of CD involving ileocolon(65.5%)and with moderate-to-severe disease(58.6%)was significantly increased;complications occurred in 50.9% of the CD patients,predominantly the perianal lesions(44.8%). In the past 5 years, colonoscopy and biopsied pathology were more accessible(>95%),and the detection rate of typical pathological changes, as well as the comprehensive diagnosis based on clinical,colonoscopic and pathological findings were significantly increased. In respect of treatment modalities,steroids and immunosuppressants were more frequently used in UC,and immunosuppressants,biological agents and enteral nutrition were more frequently used in CD in the past 5 years. Conclusions:The number of hospitalized IBD patients admitted in Anhui Provincial Hospital increased significantly in the past 5 years. The clinical characteristics and management approaches of IBD changed as time passed. The diagnosis and treatment were significantly improved.

Background:It was demonstrated that vitamin D has extensive biological effects,and evidence exists on association between vitamin D and a variety of immune mediated diseases such as inflammatory bowel disease. Aims:To investigate the relationship between serum level of 25-hydroxyvitamin D(25OHD)and disease activity and quality of life in patients with ulcerative colitis( UC). Methods:Serum level of 25OHD was detected by electrochemiluminescence in 50 outpatients/inpatients with UC from Oct. 2015 to Mar. 2016 at the Anhui Provincial Hospital;35 healthy subjects were served as normal controls. CRP,ESR and PLT were determined by routine laboratory tests in UC patients. Disease activity of UC was assessed by improved Mayo score,and Chinese version IBD questionnaire( IBDQ)was employed to assess quality of life. Results:Vitamin D deficiency defined as serum 25OHD ﹤20 ng/mL was detected in 68. 0% of the UC patients. The mean value of serum 25OHD was significantly lower in UC group than in normal control group[(16. 73 ± 8. 83)ng/mL vs.(19. 84 ± 4. 56)ng/mL,P﹤0. 05]. When patients were stratified with disease activity,serum level of 25OHD decreased in the order of remission,mild,moderate and severe active stage(P ﹤0. 05). In UC patients with vitamin D deficiency,the value of CRP,ESR and PLT were significantly increased(P all ﹤0. 05)and the overall score of IBDQ and scores of four dimensions of IBDQ referring to bowel symptom,systemic symptom,emotional function and social function were significantly decreased(P all ﹤0. 05). Spearman and Pearson correlation coefficients analyses showed that serum level of 25OHD was negatively correlated with Mayo score,CRP,ESR and PLT(P all ﹤0. 05),and positively correlated with scores of IBDQ,including overall score and four dimensional scores in UC group( P all ﹤0. 05 ). Conclusions:Vitamin D deficiency occurs frequently in patients with UC and might have a negative impact on disease activity and quality of life.

Background:Irritable bowel syndrome( IBS)patients are often accompanied by anxiety,depression and other psychological abnormalities,but the effects of psychological abnormalities on daily life have not yet been fully clarified. Aims:To investigate the effects of psychological abnormalities on life quality,sleep quality and symptom severity in IBS patients. Methods:A total of 101 IBS patients admitted from Nov. 2014 to May 2015 at Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled in this study. Zung self-rating anxiety scale(SAS)and Zung self-rating depression scale(SDS)were used to evaluate the mental state;IBS-quality of life(IBS-QOL)was used to evaluate the life quality;Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality;IBS symptom severity score (IBS-SSS)was used to evaluate the symptom severity. Correlations between psychological factors,life quality,sleep quality and symptom severity were analyzed. Results:57. 4%(58 / 101)of IBS patients were accompanied by varying degrees of anxiety and/ or depression. The IBS-QOL score of 101 patients was 73. 28 ± 12. 79,in which anxiety,loss of appetite and health concerns were the most severely affected. 73. 3%(74 / 101)of IBS patients were accompanied by varying degrees of sleep disorders,in which daytime dysfunction,sleep quality and sleep efficiency were the most severely affected. Of the 101 IBS patients,the symptom of 13 cases was mild,63 cases was moderate and 25 cases was severe. IBS-SSS score was 253. 00 ± 72. 58. Correlation analysis showed that anxiety,depression were negatively correlated with life quality(r = - 0. 426,P < 0. 001;r = - 0. 501,P < 0. 001)and positively correlated with sleep quality(r = 0. 556, P = 0. 000;r = 0. 513,P = 0. 000)and symptom severity(r = 0. 231,P = 0. 020;r = 0. 357,P < 0. 001). Life quality was negatively correlated with symptom severity(r = - 0. 417,P < 0. 001). Conclusions:IBS patients have psychological abnormalities and their life and sleep qualities are decreased,the more serious the psychological abnormalities,the more damage on life and sleep qualities and the more severe the IBS symptoms.

Background:Multidrug resistance of tumor cells is one of the important factors that cause failure of chemotherapy in advanced gastric cancer. Tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)may enhance the killing effect of chemotherapeutics on tumor cells,and reverse drug-resistant cell lines to sensitive cell lines,but its mechanism is not yet clear. Aims:To study the effect of TRAIL on expression of multidrug resistance gene glutathione S-transferase-π(GST-π)in drug-resistant human gastric cancer cell line SGC-7901 / VCR and the potential mechanism of TRAIL in reversing multidrug resistance of gastric cancer cells. Methods:SGC-7901 / VCR cells were treated with TRAIL in different doses (50,100,200 and 400 μg/ L)for 48 hours. After treatment,expression of GST-π mRNA in SGC-7901 / VCR cells and concentration of GST-π in culture supernatant were detected by RT-PCR and ELISA,respectively. Results:TRAIL could inhibit mRNA expression and protein secretion of GST-π in SGC-7901 / VCR cells in a dose-dependent manner within a certain range(≤200 μg/ L). The relative expression levels of GST-π mRNA in 50,100,200 and 400 μg/ L TRAIL groups were 0. 89 ± 0. 04,0. 77 ± 0. 08,0. 65 ± 0. 06 and 0. 61 ± 0. 03,respectively,and the concentrations of GST-π in culture supernatant in these groups were(57. 56 ± 1. 19)ng/ mL,(56. 30 ± 0. 80)ng/ mL,(31. 41 ± 1. 65)ng/ mL and (30. 80 ± 1. 34)ng/ mL,respectively,all were significantly lower than those in control group[1. 01 ± 0. 13 and(58. 62 ± 1. 38)ng/ mL,P all < 0. 05]. Conclusions:TRAIL may play a potential role in reversing multidrug resistance of gastric cancer cells through down-regulating GST-π expression.

Patients who have functional gastrointestinal disorders(FGIDs)often together with psychological disorders and damaged quality of live. Management of FGIDs patients failed to conventional drug therapy,so-called the refractory FGIDs,is a challenge for gastroenterologists. Till now,FGIDs are still not fully recognized and clarified and having only limited therapeutic approaches. In this article,we reviewed the clinical characteristics of refractory FGIDs accompanying with psychological disorders and the progress in research on their diagnosis and treatment for improving the understanding and formularizing the management of this disease.