Objective To analyze the real experiences of patients with inflammatory bowel disease(IBD)during dietary restrictions,providing references for healthcare personnel to guide patients in standardizing dietary restriction behaviors.Methods Purposeful sampling was employed to select 14 patients with IBD who were treated at a tertiary A hospital in Shanghai between October 2022 and February 2023 for semi-structured in-depth interviews.Data were analyzed using the Colaizzi's 7-step method in phenomenological research.Results 4 themes and 13 sub-themes were extracted.Theme 1:facing multiple physiological challenges(hunger,nutritional imbalance,fatigue and muscle atrophy).Theme 2:experiencing negative psychological disturbances(craving and struggle for gourmet food,diminished zest for life and increased anxiety,feeling embarrassed during social activities).Theme 3:adopting various coping strategies(self-adjustment and adaptation to dietary restrictions,satisfying oral desires through various avenues,seeking knowledge and guidance on nutrition).Theme 4:gaining more growth and support(improved symptom and quality of life,enhanced awareness of dietary health,improved ability to manage diet,receiving support from peers and family).Conclusion The experience of dietary restrictions in IBD patients is complex and varied.Nursing staff should prioritize nutritional risk screening for IBD patients,pay attention to their mental health,provide patients with scientific and personalized dietary guidance,and strengthen social and family support to assist patients in better self-management of their diet.

Objective:To develop a nutritional assessment scale for patients with inflammatory bowel disease and examine its reliability and validity for assessing nutritional literacy in patients with inflammatory bowel disease.Methods:Based on the Nutbeam health literacy stratification model and knowledge-attitude-practice model, a preliminary scale was developed through literature review, semi-structured interviews, expert consultation and pre-surveys. A convenient sampling method was used to select 376 inflammatory bowel disease patients admitted to Tenth People′s Hospital Affiliated to Tongji University from September, 2022 to April, 2023 for questionnaire surveys, and reliability and validity tests were conducted to form the final scale.Results:The nutritional assessment scale for inflammatory bowel disease included 39 items. Exploratory factor analysis identified five common factors: nutritional knowledge, nutritional attitudes, nutritional practices, information interaction ability, and information evaluation ability. These factors explained 65.431% of the total variance. The content validity index of the scale was 0.857, and the item-level content validity index ranged from 0.800 to 1.000. The Cronbach α coefficient of the scale was 0.869, and the Cronbach α coefficients of each dimension ranged from 0.847 to 0.922. Conclusions:The developed nutritional assessment scale for inflammatory bowel disease demonstrates good reliability and validity, allowing for effective evaluation of patients′nutritional status.

Glycosylation of proteins, one of the most prevalent and complex post-translational modifications occurring in nature, plays a crucial role in regulating protein net charge, conformation, binding properties and, ultimately, biological function.Traditional structural techniques are not amenable for glycoproteins due to the inherent heterogeneity of oligosaccharides.With the advances in analytical technique, mass spectrometry displays an increasingly crucial role in elucidating the structure of glycoproteins.Mass spectrometry-based proteomic technique can dissect the chemical composition and site information of low-abundance glycosylation at the peptide level.Instead, native mass spectrometry (nMS) can analyze intact glycoproteins while maintaining the information for glycan heterogeneity, and the insights into the regulatory effects of glycosylation on protein higher order structures and interactions with other proteins or ligands.As a representative structural mass spectrometry tool, ion mobility-based nMS strategy is powered by its conformer-resolving capability and by the feasibility of conformer manipulation through collision-induced unfolding.Consequently, native IM-MS analysis can provide rich information of dynamic protein conformations, allowing for the rapid identification and differentiation of protein isoforms in an unprecedented manner.In this review, we briefly introduced two emerging native IM-MS analytical modes, dynamic conformer-resolving mode and glycoform-resolving mode.Besides, we also discussed the recent progress of conformational and topological characterization of intact glycoproteins with three typical model systems based on two above-mentioned emerging modes of native IM-MS.

Objective:To explore the value of detecting plasma donor-derived free DNA (dd-cfDNA) fraction in distinguishing antibody mediated-rejection (ABMR) and T cell-mediated rejection (TCMR) of renal allografts.Methods:Patients with acute rejection confirmed by allograft biopsy in the First Affiliated Hospital of Medical College of Zhejiang University from December 1, 2017 to July 18, 2019 were retrospectively included. Based on pathological classification of Banff renal allograft rejection in 2017, the patients were divided into ABMR group and TCMR group, and the latter was subdivided into TCMR Ⅰ subgroup and TCMR Ⅱ subgroup. The second generation sequencing and target region capture were used to detect candidates' peripheral blood dd-cfDNA. The demographic and clinicopathological data of the two groups were compared. The receiver operating characteristic curve (ROC) was used to evaluate the differential value of plasma dd-cfDNA and serum creatinine levels in two kinds of acute renal allograft rejection.Results:A total of 60 patients with acute rejection of renal transplantation were enrolled in this study, including 42 patients in TCMR group and 18 patients in ABMR group. The plasma dd-cfDNA percentage (%) in the ABMR group was significantly higher than that in the TCMR group [2.33(1.19, 4.30)% vs 0.98(0.50, 1.82)%, P=0.001]. The absolute value of dd-cfDNA in ABMR group was obviously higher than that in TCMR group [0.94(0.60, 2.27) ng/ml vs 0.43(0.20, 0.96) ng/ml, P=0.003]. ROC analysis to discriminate TCMR from ABMR showed that, the area under the curve ( AUC) of dd-cfDNA% was 0.76(95% CI 0.64-0.88), when the threshold was 1.11%, the sensitivity and specificity were 88.89% and 59.52%, respectively; the AUC of absolute value of dd-cfDNA was 0.74(95% CI 0.61-0.86), when the threshold was 0.53 ng/ml, the sensitivity was 88.89% and the specificity was 54.76%. TCMR subgroups were further analyzed, there was no significant difference between TCMR subgroups on the absolute value and percentage of dd-cfDNA (both P>0.05); dd-cfDNA% in ABMR group was apparently higher than that in TCMRⅠ subgroups ( P=0.008) and TCMRⅡsubgroup ( P=0.030). The absolute value of dd-cfDNA in ABMR group was significantly higher than that in TCMRⅠsubgroups ( P=0.003). Conclusion:Plasma dd-cfDNA level may help to distinguish between ABMR and TCMR rejection.

Background/Aims: This study aimed to explore the effect of gut microbiota-regulated Kupffer cells (KCs) on colorectal cancer (CRC) liver metastasis. Methods: A series of in vivo and in vitro researches were showed to demonstrate the gut microbiota and its possible mechanism in CRC liver metastasis. Results: Fewer liver metastases were identified in the ampicillin-streptomycin-colistin and colistin groups. Increased proportions of Parabacteroides goldsteinii, Bacteroides vulgatus, Bacteroides thetaiotaomicron, and Bacteroides uniforms were observed in the colistin group. The significant expansion of KCs was identified in the ampicillin-streptomycin-colistin and colistin groups. B.vulgatus levels were positively correlated with KC levels. More liver metastases were observed in the vancomycin group. An increased abundance of Parabacteroides distasonis and Proteus mirabilis and an obvious reduction of KCs were noted in the vancomycin group. P. mirabilis levels were negatively related to KC levels. The number of liver metastatic nodules was increased in the P. mirabilis group and decreased in the B. vulgatus group. The number of KCs decreased in the P. mirabilis group and increased in the B. vulgatus group. In vitro, as P. mirabilis or B. vulgatus doses increased, there was an opposite effect on KC proliferation in dose- and time-dependent manners. P. mirabilis induced CT26 cell migration by controlling KC proliferation, whereas B. vulgatus prevented this migration. Conclusions An increased abundance of P. mirabilis and decreased amount of B. vulgatus play key roles in CRC liver metastasis, which might be related to KC reductions in the liver.

Objective:To explore the mediating role of social support between mindfulness and perceived pressure in young and middle-aged patients with inflammatory bowel disease (IBD) .Methods:From January to September 2021, the convenient sampling method was adopted to select 350 patients with inflammatory bowel disease who were treated in 5 ClassⅢ Grade A hospitals in Shanghai. The general information questionnaire, Mindful Attention Awareness Scale (MAAS) , Social Support Ratings Scale (SSRS) and Chinese Perceived Stress Scale (CPSS) were used for survey. Pearson correlation analysis was used to test the correlation between variables. AMOS 22.0 was used to establish the structural equation model, the maximum likelihood method was used to fit and modify the data and the Bootstrap method was used to test the mediation effect. A total of 350 questionnaires were distributed in this study and 324 valid questionnaires were recovered, with an effective recovery rate of 92.57%.Results:The total score of perceived stress in young and middle-aged IBD patients was (27.81±3.86) . Social support, mindfulness and perceived stress were negatively correlated ( r=-0.306, -0.220, P<0.01) . Social support played a partial mediating role between mindfulness and perceived stress, accounting for 55.13% of the total effect. Conclusions:The perceived stress level of young and middle-aged IBD patients is relatively high, which is not optimistic. Mindfulness affects perceived stress in young and middle-aged IBD patients through social support. Clinical workers need to pay attention to condition of mindfulness and social support of patients and take targeted psychological interventions to reduce their perceived stress.

Although immune checkpoint inhibitors (ICIs) have great breakthrough in cancer treatment in recent years, most patients have not benefited from it on account of immune microenvironment. Studies have shown that tryptophan metabolism is not only involved in the formation of tumor immunosuppressive microenvironment but also plays an important role in the therapeutic application of ICIs. At present, inhibiting the kynurenine pathway of tryptophan metabolism is now in various stages of clinical trials, while the other two metabolic pathways, 5-HT and the indole pathway, also have aroused wide concern. This article reviews the latest developments in this field.

Objective: To analyze the research hotspots of domestic narrative nursing and explore its related research trends which provide reference and guidance for its application and development in China. Methods: Wanfang, CNKI, VIP, CBM and other databases were retrieved from inception until October 2018. Word frequency analysis and graph cluster analysis were performed on the main information using Excel, Bicomb, Ucinet, Netdraw and gCLUTO software. Results: A total of 649 articles were included. The result of visual analysis showed that the annual amount of publications showed an upward trend. The articles distributed abroad in many different journals which educational journals account mostly. The study regions were distributed in 34 provinces except Taiwan of China, Hainan, Tibet, and Macao Special Administrative Regions where mainly concentrated on East China and North China. The cooperation among authors and institutions both were not close; A total of 25 high-frequency key words were intercepted,and three hotspots of narrative nursing research in China were obtained,which respectively were: (1) The application of narrative medicine and the cultivation of narrative ability; (2) The application research of narrative therapy in humanistic care; (3) The application of narrative nursing in nursing practice. Conclusions Narrative nursing has attracted the attention of domestic scholars, but the depth and breadth of research still need to be improved. It is necessary to strengthen cooperation between inter-regional institutions, individuals and scientific research groups and pay attention to research hotspots in this field. Also,there is a need to conduct more high quality studies to verify the significance of narrative nursing.

Objective To investigate the effect of probiotics on the immune function and clinical efficacy in children with recurrent respiratory tract infection (RRTI). Methods A total of92 RRTI children were continuously enrolled and were randomly divided into study group and control group, with 46 cases in each group. Both groups were given oral treatment of pidotimod, and the study group added Bifid Triple Viable Bifidobacterium Power, all the children were treated for 3 months, and followed-up time lasted for more than 1 year. The changes of serum C-reactive protein (CRP), procalcitonin (PCT), immunoglobulin G (IgG), pmmunoglobulin A (IgA) and T cell subgroups were compared between the two groups, and the clinical efficacy between the two groups were compared. Results After treatment, serum CRP and PCT concentrations significantly decreased, serum IgG and IgA level significantly increased, the peripheral blood T cell count of CD4+was significantly increased, CD8+was significantly decreased in both groups when compared with that treatment before (P ＜ 0. 05). At the same time, the study group showed lower serum CRP and PCT concentration, higher serum IgG and IgA levels, higher peripheral blood CD4+T cell count, and lower CD8+T cell count after treatment, when compare to the control group (P ＜ 0. 05). However, there was no statistically difference between two groups in clinical efficiency (P＞ 0. 05). Conclusion Probiotics can effectively improve the immune function and reduce the inflammation level in RRTI children.

Objective To investigate the effect of probiotics on the immune function and clinical efficacy in children with recurrent respiratory tract infection (RRTI). Methods A total of92 RRTI children were continuously enrolled and were randomly divided into study group and control group, with 46 cases in each group. Both groups were given oral treatment of pidotimod, and the study group added Bifid Triple Viable Bifidobacterium Power, all the children were treated for 3 months, and followed-up time lasted for more than 1 year. The changes of serum C-reactive protein (CRP), procalcitonin (PCT), immunoglobulin G (IgG), pmmunoglobulin A (IgA) and T cell subgroups were compared between the two groups, and the clinical efficacy between the two groups were compared. Results After treatment, serum CRP and PCT concentrations significantly decreased, serum IgG and IgA level significantly increased, the peripheral blood T cell count of CD4+was significantly increased, CD8+was significantly decreased in both groups when compared with that treatment before (P ＜ 0. 05). At the same time, the study group showed lower serum CRP and PCT concentration, higher serum IgG and IgA levels, higher peripheral blood CD4+T cell count, and lower CD8+T cell count after treatment, when compare to the control group (P ＜ 0. 05). However, there was no statistically difference between two groups in clinical efficiency (P＞ 0. 05). Conclusion Probiotics can effectively improve the immune function and reduce the inflammation level in RRTI children.