Food intake disorders are costly to treat,with an increasing prevalence over the years,and a higher risk of mortality compared to other psychiatric disorders.Avoidant/restrictive food intake disorder(ARFID),as a relatively new type of food intake disorder,is more prevalent in children and adolescents than in other age groups,affecting their normal growth and development,as well as psychosocial functioning.Currently,there are more foreign studies,while domestic studies are still in the initial stage.Therefore,this paper reviews assessment tools,influencing factors and treatment approaches for ARFID in children and adolescents,with the aim of providing a reference for related research in China.

进食障碍治疗成本高昂，发病率逐年增高，且与其他精神障碍相比，死亡风险较高。回避性/限制性摄食障碍作为较新的一类进食障碍，相比其他年龄群体在儿童青少年群体中更易出现，影响儿童青少年正常生长发育和社会心理功能。目前，国外研究较多，国内研究尚处于起始阶段。因此，本文对儿童青少年回避性/限制性摄食障碍评估工具、影响因素和治疗方式进行综述，以期为国内开展相关研究提供借鉴。

目的 探讨炎症性肠病患者患病过程中的疏离感并分析其产生原因,为制定针对性干预策略提供参考.方法 采用描述性质性研究法,通过目的抽样法选取 15 例炎症性肠病患者进行半结构式访谈.使用内容分析法对访谈资料进行分析整理并提炼主题.结果 归纳出 3 个核心主题及 13 个亚主题:患者疏离的客观表现形式(疾病疏离、人际疏离、自我疏离、劳动疏离、环境疏离)、患者疏离的主观情绪感知(无力感、无价值感、孤独感、厌世感)、患者产生疏离的原因(身体意象障碍、疾病管理过度、情绪心理障碍、社交能力受损).结论 炎症性肠病患者存在多维疏离,负性情绪明显且强烈.患者出现疏离感的原因纷繁复杂,未来应制定多维干预策略,以减轻患者疏离感,促进其更好地接受疾病、认同自我、融入社会、积极生活.

背景 炎症性肠病(IBD)患者因疾病症状反复发作且迁延不愈易产生多种负性情绪.随着积极心理学的兴起,学者发现个体在患病过程中除了产生负性情绪,还会对压力性事件进行认知重评,探寻疾病给自身带来的积极意义,即疾病获益感.目的 探究IBD患者疾病获益感的潜在类别,并分析IBD患者疾病获益感的影响因素.方法 本研究为横断面研究,采用便利抽样法选取2020年9月至2021年4月在南京医科大学第一附属医院门诊就诊或住院的IBD患者为研究对象.使用一般资料调查表、修订版疾病获益感量表(BFS)、中文版伯克利情绪表达量表(BEQ)、社会支持评定量表(SSRS)进行调查.采用有序多分类Logistic回归分析探讨疾病获益感潜在类别的影响因素.结果 共回收问卷230份,有效问卷226份,有效回收率为98.3％.根据IBD患者疾病获益感的评估结果拟合潜在类别模型,最终得到IBD患者疾病获益感可分为3个类别,分别定义为低获益-应对无力组〔115例(50.9％)〕、中等获益组〔64例(28.3％)〕和高获益-感知被爱组〔47例(20.8％)〕.三组患者职业状态、家庭年收入、疾病活动度、中文版BEQ及各维度、SSRS及各维度得分比较,差异有统计学意义(P<0.05).有序多分类Logistic回归分析结果显示,正性情绪表达〔OR=1.246,95％CI(1.040,1.492)〕、负性情绪表达〔OR=1.206,95％CI(1.038,1.402)〕及主观支持〔OR=2.746,95％CI(2.114,3.565)〕是IBD患者疾病获益感的影响因素(P<0.05).结论 IBD患者疾病获益感存在明显的分类特征,其中低获益-应对无力组患者占比较大(50.9％),且患者疾病获益感的影响因素包括正性情绪表达、负性情绪表达和主观支持,因此需重点关注疾病获益感为低获益-应对无力的患者,鼓励其表达疾病相关感受并促进其对社会支持的感知,以提高患者的疾病获益感.

Patients' subjective feelings, that is, patient-reported outcomes, has attracted increasing attention in patients with inflammatory bowel disease (IBD) , which plays an important role in monitoring the progress of patients' disease and guiding clinical decision-making. This article reviews the current status of assessment tools and clinical applications of patient-reported outcomes in IBD patients. This article aims to help medical and nursing staff choose assessment tools suitable for IBD patients in China, standardize the development and localization process of assessment tools, promote the application and development of patient-reported outcomes of IBD patients in China, and optimize disease management of IBD patients.

OBJECTIVES To verify the effects of self-care programs among adults with prediabetes, to identify the preferable structure components and to summarise the core content components of self-care programs. DESIGN A systematic review and meta-analysis of randomised controlled trials. METHODS PubMed, Embase, Cochrane, CINAHL, PsycINFO, Wanfang, CNKI, Chinese Biomedical Database and Open Grey were searched for studies published from January 2002 to December, 2021. Meta-analysis was conducted to verify the effects of self-care programs on diabetes incidence. Subgroup analyses based on structure components were performed to contrast the effects. We made a critical analysis to generalise the core elements of content components. The study was reported according to PRISMA statement. RESULTS Totally, 15 studies were included in systematic review, of which 14 studies were eligible for meta-analysis. The results of meta-analysis showed the incidence of diabetes for prediabetic adults receiving self-care programs was significantly lower than those who received usual care (OR 0.58; 95% CI 0.46 to 0.73). The results of subgroup analyses based on delivery mode, intervention implementer, health education brochures provided, and follow-up duration showed statistically significant reduction in incidence compared with control group (p < .05). However, the differences of these pair-wise comparisons (face-to-face or remote, individual or interdisciplinary team, with or without brochures provided, ≤1 year or >1 year) were not statistically significant (p > .05). Three core content elements were generalised: cognitive education, behaviour guidance and psychological support. CONCLUSIONS Self-care programs can effectively delay the progression of prediabetes to diabetes. Regardless of the diversified structure components, self-care programs can achieve better effects on the diabetes incidence than usual care, while the optimal structure components still remain unknown. Cognitive education, behaviour guidance and psychological support are core elements for these programs. RELEVANCE TO CLINICAL PRACTICE More clinical trials with rigorous study design are needed to provide further evidence.

目的 对炎症性肠病患者决策辅助工具的特征、功能及应用效果进行范围综述,为今后国内开展相关研究提供参考和借鉴.方法 系统检索中国生物医学文献库、中国知网、万方和维普数据库、PubMed、EMBASE、Web of Science核心合集、Cochrane Library、CINAHL数据库中的相关研究,检索时限为建库至2021年7月,应用范围综述方法框架对文献进行分析.结果 共纳入11个决策辅助工具,主要类型包括基于网络的决策辅助工具和纸质版决策辅助手册,通过收集患者偏好信息,提供疾病相关知识辅助医患共同决策;应用的效果评价包括医生与患者的接受度与满意度、工具的可行性和有效性等指标.结论 炎症性肠病患者决策辅助工具应用效果良好,建议医护人员在了解和评估国外决策辅助工具的基础上,研制和发展标准有效的工具提高炎症性肠病患者决策质量,推广其临床应用.

目的 通过文献计量分析,了解近10年炎症性肠病营养相关研究的现状及发展趋势.方法 以Web of Science核心合集数据库为数据源,检索2011年1月至2020年12月收录的炎症性肠病营养相关文献,利用该库自带的数据分析功能对文献年发文量、基金资助机构分布进行定量分析,应用CiteSpace软件对国家分布、作者发文分布及关键词情况进行可视化分析.结果 共纳入1339篇文献,其中中国发文量排名第3位;基金资助机构大部分集中在美国;RUSSELL RK为该领域的高产作者;除疾病类型及营养外,文献中出现较多的关键词为儿童、管理、植物萃取、抗氧化物.结论 炎症性肠病营养相关研究正处于稳步发展阶段,我国发文量处于世界前列,美国占该研究领域的主体地位.研究热点集中于儿童营养问题、饮食管理及抗氧化植物营养素.

Inflammatory bowel disease (IBD) is a chronic non-specific intestinal inflammatory disease of unknown etiology, which is characterized by recurrent episodes and prolonged refractory recovery. Financial toxicity refers to the objective economic burden and subjective economic distress caused by medical expenses caused by the disease to patients. IBD patients show a certain level of financial toxicity due to frequent visits to doctors for a long time. This article reviews the concept of financial toxicity, evaluation tools and the current status of financial toxicity in IBD patients, analyzes the influencing factors of financial toxicity in IBD patients from the aspects of general demography factors, disease and treatment and psychosocial aspects, summarizes and puts forward the countermeasures of toxicity of IBD patients to reduce the economic and the direction of the future study, so as to provide reference for related research.

目的 调查炎症性肠病患者疾病获益感水平,并分析其影响因素.方法 采用便利抽样法选取于2020年10月—2021年7月在南京医科大学第一附属医院就诊的246例炎症性肠病患者为研究对象,使用一般资料调查表、疾病获益感量表、慢性病病耻感量表、伯克利情绪表达量表、家庭亲密度与适应性量表进行调查,采用多元线性回归分析炎症性肠病患者疾病获益感的影响因素.结果 炎症性肠病患者疾病获益感得分为(60.83±18.28)分;多元线性回归分析结果显示,疾病活动度、病耻感、自我表露及家庭功能是疾病获益感的影响因素(P≤0.001),共解释总变异的50.6％.结论 炎症性肠病患者疾病获益感处于中等偏下水平,医护人员应重视对该人群疾病获益感的评估,重点关注处于疾病活动期的患者,鼓励存在病耻感的患者表达疾病相关感受,改善患者家庭成员的亲密关系和适应能力,以提升患者的疾病获益感.

BACKGROUND Ulcerative colitis, as a kind of inflammatory bowel disease (IBD) is characterized by abdominal pain. This study aimed to investigate the effect of icariin (ICA) on the intestinal microflora of colitis mice. METHODS Fifteen female C57BL/6 mice were randomly divided into the Control group, dextran sodium sulfate (DSS)-induced colitis (DSS) group, and ICA treatment (DSS+ICA) group. The severity of inflammation in DSS-induced colitis mice was evaluated using disease activity scoring (considering weight-loss percentage, stool-shape change, and stool-bleeding scoring). Pathological changes of mice intestinal tract were evaluated using hematoxylin-eosin (HE) staining. Serum levels of TNF-α and IL-6 were detected with enzyme-linked immunosorbent assay. Expressions of p65 and p-p65 (p-p65/p65 ratio) were analyzed using Western blot assay. 16S rDNA sequencing was used to analyze the abundance and composition of intestinal microflora. RESULTS Compared with DSS group, ICA significantly improved disease activity (P < .05) and reduced inflammatory damage of colon tissues (P < .05) in DSS-induced colitis mice. Compared with the DSS group, mice in the ICA group demonstrated significant weight and colon length (P < .05). ICA significantly inhibited expressions of IL-6 and TNF-α compared to the DSS group (P < .05). p-p65/ p65 ratio in the DSS + ICA group was remarkably enhanced compared to the DSS group (P < .05). ICA significantly reduced the proportion and activity of Bacteroides, Helicobacteraceae, Turicibacter, and significantly increased that of beneficial microflora (Lactobacillus, Lachnospiraceae, Akkermansia), so as improved damages of colon tissues. CONCLUSION ICA can improve intestinal flora abundance and composition of DSS-induced colitis mice, and inhibit tissue damage and inflammatory response through modulating the p-p65/p65 expression.