Objective:To explore the impact of adverse childhood experience on self-injury behavior and the mediating role of self hating in adolescents.Methods:A cross-sectional survey was conducted in 6 high schools and 5 middle schools in Shandong Province from August 1 to December 31, 2022, using the adverse childhood experience questionnaire, self-hating scale and non-suicidal self-injury behavior rating questionnaire for adolescents. A total of 7 313 questionnaires were collected, of which 6 948 were valid. SPSS 22.0 software was used for Spearman correlation analysis, and biased-corrected non-parametric percentile Bootstrap method was used to test the significance of mediating effect.Results:(1) The scores of adverse childhood experience(4.0(2.0, 6.0)), self-hating (22.0 (13.0, 29.0)) and self-injury behavior (12.0 (7.0, 19.0)) in adolescents with self-injury behavior were higher than those without self-injury behavior(0(0, 2.0), 2.0(0, 9.0), 0(0, 1.0)), and the differences were statistically significant ( Z=-21.700, -22.654, -29.519, all P<0.001). (2) Adverse childhood experience was positively correlated with self-hating ( r=0.46, P<0.01) and self-injury behavior ( r=0.47, P<0.01). Self-hating was positively correlated with self-injury behavior ( r=0.51, P<0.01). (3) Adverse childhood experience directly predicted self-injury behavior with a direct effect of 0.163 (95% CI =0.127-0.200, P<0.01)and the effect size of 53.80%(0.163/0.303).Adverse childhood experiences indirectly predicted self-injury behavior through self-hating, with an indirect effect of 0.140 (95% CI=0.122-0.160, P<0.001) and the effect size of 46.20%(0.140/0.303).The total effect was 0.303 (95% CI=0.270-0.336, P<0.001). Conclusions:There is a close relationship between adverse childhood experiences, self-hating and self-injury behavior in adolescents. Adverse childhood experiences can directly predict self-injury behavior, and can also indirectly affect self-injury behavior through self-hating.

Objective:To retrieve, evaluate and summarize the clinical practice evidence of nursing care for critically ill patients with naso-intestinal tube feeding, so as provide a basis for correcting feeding intolerance and nutritional substandard.Methods:According to the "6S" evidence model, evidence on nursing care for critically ill patients with naso-intestinal tube feeding was retrieved in Registered Nurses' Association of Ontario, Cochrane Library, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Guidelines International Network, Medive, PubMed, CINAHL, Embase, UpToDate, Joanna Briggs Institute Evidence-based Practice Database, China National Knowledge Infrastructure (CNKI) , WanFang Data, VIP database from January 31, 2015 to September 30, 2019. Evidence included guidelines, expert consensus, best practices, systematic reviews, evidence summary, and original research. Two researchers evaluated the quality of the included literature, extracted and summarized literature that met the quality standards.Results:A total of 24 articles were included, of which 2 guidelines were derived from the American Society of Critical Care Medicine and the American Society of Parenteral Enteral Nutrition, and the European Society of Parenteral Enteral Nutrition, 3 expert consensus, 1 systematic review, 4 evidence summaries, 10 randomized controlled studies, 3 quasi experiments, and 1 diagnostic test. This study summarized 24 evidences of clinical suitability, involving 10 aspects, namely, naso-intestinal tube placement indications, catheter material, placement position, placement method, confirmation method, feeding method, fixation, intolerance, catheter blockage and indwelling time limit.Conclusions:This study provides a management process and evidence-based evidence for critically ill patients with naso-intestinal tube feeding, which is conducive to promoting safe practice and in-depth research for the nursing staff.

Objective:To study the effects of LY294002, a phosphatidylinositol 3 kinase(PI3K) inhibitor, on the AKT/GSK3β/CRMP2 signaling pathway, and the effect of pathway alterations on the depression-like behavior and microtubulin proteins of SD rats.Methods:Sixteen adult male SD rats were randomly divided into LY294002 group and solvent DMSO group by blind method, 8 rats in each group.After anesthesia, the rats were subjected to stereotactic tube placement in the hippocampal CA1 area. After 1 week of the tube placement, stereoscopic injection of LY294002 or DMSO was given, and depression-like behaviors were detected. RT-qPCR technology was used to detect hippocampal AKT, GSK3β, CRMP2, and tubulin mRNA expression levels, and Western blot technology was used to detect the expression levels of hippocampal AKT, p-AKT, GSK3β, p-GSK3β, CRMP2, p-CRMP2, and microtubule dynamic-related proteins markers Acet-tubulin, Tyr-tubulin. Analysis and comparison of behavioral and molecular expression differences between the two groups were conducted.Results:The open field experiment showed that the central movement distance of the rats in the LY294002 group were significantly lower than those in the control group((3.64±2.17) cm, (31.51±12.68) cm; t=2.69, P=0.03), and the duration of the central area in the LY294002 group were also significantly lower than those in the control group((0.73±0.46)s, (4.85±2.10)s; t=2.33, P=0.04). The results of the forced swimming test showed that the immobility time of rats in the LY294002 group had upward trend, but the difference was not statistically significant. The sucrose preference results showed no significant difference in sugar water consumption between the two groups ( P>0.05). The RT-qPCR results showed that the expression level of CRMP2 mRNA in the LY294002 group decreased significantly ( P<0.05). Western blot results showed that compared with solvent DMSO group, the expression levels of p-AKT and p-GSK3β in the LY294002 group decreased ( P<0.05), the expression level of CRMP2 was decreased and the expression level of p-CRMP2 was significantly increased. At the same time, the expression level of Tyr-tubulin decreased, while Acet-tubulin level increased significantly, and the differences were statistically significant ( P<0.05). Conclusion:LY294002 affects AKT/GSK3β/CRMP2 signaling pathway, induces impairment of microtubular dynamic, and results in depression-like behavior in rats.