Objective To explore the potential categories and influencing factors of the fear of progression in patients with inflammatory bowel diseases(IBD).Methods IBD patients who received inpatient treatment in a tertiary hospital in Nanjing from July 2022 to July 2023 were selected as the study subjects by convenience sampling method.The General Demographic Information Questionnaire,the Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the Chinese version of Inflammatory Bowel Disease Self-efficacy Scale(IBD-SES),and Social Support Rating Scale(SSRS)were administered to the participants.We applied one-way ANOVA and Logistic regression analysis to identify the factors associated with the potential categories of the fear of progression.Results A total of 303 retumed questionnaires(out of the 310)were valid,resulting an effective response rate of 97.74％.According to the results of latent profile analysis,we classified the respondents into 3 categories by the fear of progression,namely"low risk fear of disease adaptation group"(n=127,41.91％),"medium risk fear of illness distress group"(n=139,45.88％),"high risk fear of dysfunction group"(n=37,12.21％).3 groups showed statistically significant differences in permanent address,self-rated financial pressure,current disease status and self-efficacy(P＜0.05).Conclusion Patients with IBD had obvious differences in characteristics on the fear of progression.Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of the fear of progression of IBD patients.Moreover,nurses should focus on improving patients'self-efficacy and promoting patients to treat medical care,stress and emotion management correctly.

BACKGROUND:Due to natural degradation,excellent biocompatibility and good mechanical properties,magnesium alloy has become a very valuable implant material in the biomedical field.However,the rapid degradation rate of magnesium alloy limits its further development and application. OBJECTIVE:To review the principle of the degradation of magnesium and its alloys in a physiological environment.The current research status of alloying elements selection is mainly introduced from the aspects of the safety of elements and their influence on the properties of magnesium and its alloys. METHODS:The articles were searched by using the databases of CNKI,PubMed,Web of Science and Elsevier.The key words were"magnesium(alloy),metal name(such as:bismuth(Bi),aluminum(Al)),corrosion,biocompatibility,metal toxicity,scaffold(stent)/screw"in Chinese and English.The search period was from 2013 to 2023.As a result,70 articles were applied for analysis after reading the contents of the articles. RESULTS AND CONCLUSION:Magnesium alloy has been widely studied in the medical field.Although some products have been applied in clinical practice,the high degradation rate of magnesium alloy in the human environment is still the main limitation of large-scale clinical application.The focus of future development is to control its corrosion rate.Alloying is a kind of method to improve the corrosion resistance of magnesium alloys,and various properties can also be improved by adding different alloy components.However,simple alloying cannot satisfy the pursuit of diversified properties of magnesium alloys.To develop multifunctional magnesium alloy products with excellent performance,it is necessary to combine various optimization methods,such as alloying and surface modification,to make up for the shortcomings of their respective methods in the future.In addition,the alloy structure updating with preparation process improvement is combined to enhance the properties of magnesium alloy.

Objective:To translate the Illness Identity Questionnaire (IIQ) into Chinese and test its reliability and validity.Methods:The English version of IIQ was translated into Chinese and back-translated according to the Brislin model. The item of the Chinese version was determined after cross-cultural adaptation and pre-experiment. A total of 368 patients with IBD treated in the First Affiliated Hospital with Nanjing Medical University from September 2022 to March 2023 were selected for a questionnaire survey to evaluate the reliability and validity of the questionnaire.Results:The Chinese version of IIQ contained 24 items in four dimensions. Four common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 64.025%. Confirmatory factor analysis showed that each fitting index of the modified model was within the acceptable range. The Cronbach's α coefficients of rejection, acceptance, engulfing, and enrichment in Chinese IIQ were respectively 0.780, 0.800, 0.921, and 0.917. The split-half reliability coefficients were 0.824, 0.818, 0.943, and 0.929; the retest reliability coefficients were 0.695, 0.667, 0.725, and 0.572, respectively.Conclusions:The Chinese version of IIQ is reliable and valid and can be used to assess illness identity in patients with chronic diseases.

Objective To compare the efficacy of arthroscopic rotator cuff repair using single row,double row,and suture bridge techniques in treating rotator cuff injuries and analyze the influencing factors of postoperative chronic pain.Methods Clinical data of 106 patients with rotator cuff injury to receive arthroscopic rotator cuff repair from January 2021 to February 2023 were retrospectively collected,were divided into single row group(n=35),double row(n=32)and suture bridge group(n=39).All patients from the three groups were evaluated using the pain visual analogue scale(VAS)and the Constant-Murley shoulder score(CMS)before surgery and 3,6,and 12 months after surgery,and their external rotation and forward flexion range of motion were measured.The incidence of postoperative retearing and chronic pain after surgery were compared among the three groups.Patients were divided into chronic pain group(n=21)and non-chronic pain group(n=85)depending whether chronic pain was seen or not after surgery and the clinical data was compared.Risk factors for postoperative chronic pain in arthroscopic rotator cuff repair patients were assessed via binary Logistic regression analysis.Results The VAS in suture bridge group was significant lower than that in single row group and double row group at 3,6 months after surgery,the VAS at 3,6,12 months after surgery in three groups were lower than that before surgery,the differences were statistically significant(P<0.05).The CMS score in suture bridge group was significant higher than that in single row group,double row group at 3,6 months after surgery,and all groups at 3,6,12 months after surgery were higher than that before surgery.The external rotation range of motion,and forward bending range of motion in suture bridge group were larger than those in single row group,double row group at 3,6 months after surgery,and all groups at 3,6,12 months after surgery were larger than those before surgery,the differences was statistically significant(P<0.05).The incidence of postoperative retearing in suture bridge group was significant lower than that in single row group and double row group,the difference was statistically significant(P<0.0167),but there was no difference between single row group and double row group(P>0.0167).The chronic pain occurrence was no statistical difference among the three groups(P>0.05).The chronic pain group had higher proportions of women,tear diameter<1.0 cm,and severe postoperative pain than those of non-chronic pain group(P<0.05).Other clinical data[age,body mass index(BMI),course of disease,location of injury,cause of injury,smoking and drinking history]were comparable between the two groups,the differences were not statistically significant(P>0.05).According to binary Logistic regression analysis,after adjusting for confounding factors(age,BMI,disease course,location and cause of injury),female gender,tear diameter<1.0 cm,and severe postoperative pain were independent risk factors for chronic pain after arthroscopic rotator cuff repair surgery(P<0.05).Conclusion In treating patients with rotator cuff injury,arthroscopic suture bridge outperforms single row and double row techniques in alleviating shoulder joint pain,promoting functional recovery and increasing range of motion,and presents lower risk of retearing.However,all three have some risk of chronic pain after surgery.Female gender,tear diameter<1.0 cm,and severe postoperative pain are independent risk factors for postoperative chronic pain.

Ictal asystole in epileptic seizure (IA) is one of the severe complications of epilepsy, which is associated with falls and traumatic injuries related to seizures. Epileptic patients with IA may require adjustment to their treatment, including antiseizure medications adjustment, evaluation for epilepsy surgery and consideration of cardiac pacemaker implantation. However, there is no consensus on treatment options for these patients. This review focuses on the mechanisms, clinical features, auxiliary examinations and the outcomes of different treatments in the IA patients. Machine learning has some application values in analyzing the long-term video electroencephalogram (EEG) results of such patients and exploring the correlated characteristics between EEG and heart rate variability, which may provide a new perspective for the research.

Objective:To investigate the clinical, genetic, and pathological features of nemaline myopathy type 8 (NEM8) caused by KLHL40 gene variation. Methods:The clinical data, gene sequencing results, and musculoskeletal pathophysiology of two cases (a pair of twins) with NEM8 admitted to our hospital in July 2022 were collected. CNKI, VIP, Wanfang, Yiigle, PubMed, Embase, and Web of Science Database were searched with the English and Chinese terms "nemaline myopathy type 8", "nemaline body myopathy type 8", and " KLHL40" from January 2007 to February 2023. The clinical, genetic, and musculoskeletal characteristics of the NEM8 cases were summarized using the descriptive statistical analysis method. Results:(1) Case report: The mother (G2P2) of the twins (Ⅳ-2 and Ⅳ-3) was conceived by IVF-embryo transfer and delivered at 37 +1 gestational weeks. The two cases were dizygotic twins whose maternal grandmother had lip and palate cleft. The first baby (Ⅳ-1) of the woman exhibited absent left pinna, contracture at the end of both fingers, talipes equinovarus in both feet and died of respiratory failure two hours after birth. Fetal edema and fetal movement delay in the twins and varus right foot in one twin were found during pregnancy. Both cases developed intrapartum asphyxia with the clinical manifestations of generalized muscle weakness, respiratory failure, dysphagia, multiple joint contractures, and fractures. The families withdrew the treatment and the twins died after maintaining life with ventilators for 53 days after birth. Whole exome sequencing of the pedigree found c.1779G>T (p.W593C) homozygous variants of the KLHL40 gene in the twins and c.1779G>T (p.W593C) heterozygous variants of the KLHL40 gene in the parents, both were de novo. Musculoskeletal pathophysiology indicated that muscle fibers are thin and round with a fetal shape and absent rod. (2) Literature review: Among the 29 cases of NEM8, including two current cases and 27 cases retrieved from 15 papers, eight cases terminated the pregnancies, and 21 were live births; seven cases (24.1%) with positive family history; 19 cases (65.5%) were found with abnormalities during pregnancy, including abnormal fetal movements, polyhydramnios, joint contracture, and fetal edema. Of the 21 live births, 20 cases had intrapartum asphyxia, 21 had postnatal respiratory failure, 20 had generalized muscle weakness, and 19 had dysphagia. Among the 29 cases, 17 cases (58.6%) were homozygous variants of the KLHL40 gene, and 12 cases (41.4%) were compound heterozygous variants. The detection rate of c.1516A>C(p.Thr506Pro) was the highest [72.4% (21/29)], followed by c.602G>A(p.Trp201*) [17.2% (5/29)]. Out of the 15 cases who underwent musculoskeletal pathological examination, all had abnormal muscle fiber size and morphology; 10 cases had rods. Conclusions:NEM8 should be considered for those with abnormal fetal movements, polyhydramnios, joint malformation, fetal edema during the fetal period and failure to establish respiration at birth as well as postnatal generalized muscle weakness, respiratory failure, dysphagia, multiple joint contractures, and fracture. Moreover, genetic detection should be performed as soon as possible. NEM8 can be diagnosed in ones with KLHL40 gene homozygous or compound heterozygous variants and musculoskeletal pathological results of abnormal size and shape of muscle fibers, regardless of the presence of rods.

Background Prolonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort. Objective To survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures. Methods By using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ² test was used to compare prevalence by selected factors, trend χ² test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain. Results There were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain. Conclusion Awkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.

After undergoing the long-term lived experience of symptoms and suffering, chronic patients change the understanding of self and try to create or regain a coherent sense of self, resulting in different degrees of illness identity. This research reviewed the origin, connotation, assessment tools, and summarized the performance level, influencing factors and intervention studies of illness identity in patients with chronic disease. It would provide references for research of illness identity, and to provide new ideas for promoting patients with chronic diseases to cope with and manage diseases.

Objective:To deeply explore the supportive care needs of patients with inflammatory bowel disease, in order to provide reference for the development of supportive care strategies.Methods:A qualitative description was conducted based on the supportive care needs framework. Objective sampling method was used to select 17 patients with inflammatory bowel disease from the First Affiliated Hospital with Nanjing Medical University from August to November 2021 for semi-structured in-depth interview and directed content analysis was used to analyze the interview data.Results:The final analysis yielded a total of 5 categories. These were physiological need, information need, practical (daily life) need, emotional and social support need, psychological and spiritual needs. They were all within the framework of supporting care needs.Conclusions:In the future, targeted education and diversified social support should be implemented based on the needs of patients with inflammatory bowel disease and from the perspectives of hospital, family members and peers.

Objective: To investigate the potential relationship between sensory characteristics and gray matter volumes in children with autism spectrum disorders (ASD), to provide a basis for the diagnosis and treatment of children with ASD. Methods: A total of 40 ASD children who were treated or recovered in Xi an medical institutions and 16 typically developing (TD) children who were from several kindergatens in Xi an were invited for participation. Sensory characteristics were evaluated by the sensory processing and self regulation checklist, 3D structural brain images were obtained with TIWI, and gray matter volumes were analyzed by voxel based morphometry. Sensory characteristics and gray matter volumes were compared between groups and the relationship between sensory characteristics and different gray matter volumes were analyzed. Results: The scores of auditory, visual, tactile, sensory processing ability and sensory under responsivity in the ASD group were lower than those in the TD group ( Z/t =-2.63, -2.57 , -3.11, -2.19, -3.83, P <0.05). Gray matter volumes in nine brain regions increased in the ASD group compared to the TD group, including the left and right posterior inferior lobe, right parahippocamal gyrus, left insula, left media frontal gyrus, left superion occipital gyrus, right superion occipital gyrus, right superion parietal lobe, and right posterion central gyrus ( t =3.53, 3.69 , 3.37, 3.86, 3.61, 3.37, 4.04, 3.38, 3.16, P <0.01). In the ASD group, the scores of visual, vestibular, proprioceptive, sensory processing ability, sensory seeking behavior and sensory over responsivity were negatively correlated with gray matter volumes of left superior occipital gyrus ( r =-0.36, -0.40, -0.39, -0.36, -0.40, -0.36), and the scores of visual, vestibular, and sensory over responsivity were negatively correlated with gray matter volumes of the right superior parietal lobule ( r =-0.36, -0.50, -0.42)( P <0.05). Conclusion The presence of paresthesia in children with ASD is associated with gray matter volumes of the left superior occipital gyrus and right superior parietal lobule.