Objective:To construct a program for improving care ability of caregivers for children with home enteral tube feeding (HETF) based on timing theory, and explore its preliminary effects.Methods:Based on the framework of timing theory and literature review, intervention measures to improve the care ability of caregivers for children with HETF were extracted and summarized to form a preliminary program draft. Fourteen caregivers with experience in caring for children with HETF were subjected to qualitative interviews to supplement the content of the program, and the program was revised through expert meetings to form the final draft. Non-synchronous control method was adopted, and 89 children with HETF and 89 caregivers of them admitted to the Children's Hospital of Fudan University from March 2022 to February 2023 were continuously included as study subjects. The children and their caregivers included from March to August 2022 were in control group ( n=42), and the children and their caregivers included from September 2022 to February 2023 were in intervention group ( n=47), and the plan was preliminarily applied. Family Caregiver Task Inventory (FCTI) was used to evaluate the impact of the program on improving caregiver care ability. Age specific body weight z-values, height specific body weight z-values, and complications were used to evaluate the impact of the program on the growth and development of children and the incidence of tube feeding complications. The data was collected at the time of enrollment and one, two, and three months after discharge. Results:There were 66 children who completed the whole study, including 33 children in the control group and the intervention group, and 33 caregivers in each group. The application results showed that the total score of FCTI in the intervention group decreased from (25.91±2.94) at enrollment to (5.85±2.60) at three months after discharge, while the total score of FCTI in the control group decreased from (26.12±4.34) at enrollment to (12.52±3.60) at three months after discharge, and the total score of FCTI in both groups decreased over time. At one, two, and three months after discharge, the total FCTI score of the intervention group was lower than that of the control group, and the difference was statistically significant ( P<0.05). At three months after discharge, the incidence of complications in children with HETF in the intervention group was lower than that in the control group with a statistical difference ( P<0.05) . Conclusions:The program for improving care ability of caregivers for children with HETF based on timing theory is scientific and provides basis for the management of home tube feeding of children.

Objective:To describe the implementation status of home enteral nutrition (HEN) in pediatric patients, providing reference for the management of HEN in pediatric patients.Methods:This study was a cross-sectional study. From March 2020 to May 2021, convenience sampling was used to select 161 pediatric patients who were discharged from the Children's Hospital of Fudan University and underwent HEN as participants. The survey questionnaire was designed to collect clinical data based on the research purpose.Results:Among the 161 pediatric patients who underwent HEN, congenital malformations, digestive system diseases, neurological diseases, malignant tumors, and respiratory system diseases accounted for 38.5% (62/161), 21.7% (35/161), 19.3% (31/161), 11.2% (18/161), and 9.3% (15/161), respectively. A total of 120 pediatric patients were followed up and recorded with nutritional supplements, 49 pediatric patients received whole protein nutritional supplements, 19 received amino acid nutritional supplements, 16 received whole protein nutritional supplements with homemade homogenization, 15 received short peptide nutritional supplements, seven received breast milk with whole protein nutritional supplements, five received homemade homogenization, five received animal milk, two received breast milk, and two received amino acid nutritional supplements with homemade homogenization. A total of 118 pediatric patients were followed up with tube feeding, including 107 cases using intermittent feeding, nine cases using continuous feeding, and two cases using intermittent combined continuous feeding. There were 46 children with tube slippage, nine cases of vomiting, six cases of tube blockage, three cases of abdominal pain and bloating, two cases of diarrhea, one case of nasal redness, one case of aspiration pneumonia, and one case of exudation around the stoma. After a short-term HEN, 74 cases continued to receive tube feeding, 49 cases were successfully removed from the tube and switched to oral feeding, three cases were switched to tube and oral combined feeding, five cases died due to severe illness.Conclusions:Pediatric patients undergoing HEN have a wide range of diseases and a high incidence of tube slippage. Education should be provided to family caregivers to enhance their ability to identify and handle complications, as well as to make correct choices in feeding formulations and methods. We should also establish a sound follow-up system, closely monitor the nutritional status of pediatric patients, and actively assist in preventing complications.

Tumor-associated macrophage(TAM)play a crucial role in the immune microenvironment of lung can-cer.Through changes in their phenotype and phagocytic functions,TAM contribute to the initiation and progression of lung cancer.By promoting the formation of an immune-suppressive microenvironment and accelerating the growth of abnormal tumor vasculature,TAM facilitate the invasion and metastasis of lung cancer.Macrophages can polarize into different subtypes with distinct functions and characteristics in response to various stimuli,categorized as anti-tumor M1 and pro-tumor M2 types.In tumor tissues,TAM typically polarize into the alternatively activated M2 phenotype,exhibiting inhibitory effects on tumor immunity.This article reviews the role of anti-angiogenic drugs in modulating TAM phenotypes,highlighting their po-tential to reprogram M2-type TAM into an anti-tumor M1 phenotype.Additionally,the functional alterations of TAM play a significant role in anti-angiogenic therapy and immunotherapy strategies.In summary,the regulation of TAM polarization and function opens up new avenues for lung cancer treatment and may serve as a novel target for modulating the immune microen-vironment of tumors.

To investigate the effects of genistein (Gen) on the biosynthesis of N-glycolylneuraminic acid (Neu5Gc) in rats, 80 4-week-old male SD rats were randomly equally into the control and genistein groups. The rats of control and genistein groups were fed 5% ethanol and 300 mg/(kg·d) genistein respectively by gavage. The contents of Neu5Gc in hind leg muscle, kidney and liver tissues of rats were measured by using high performance liquid chromatography coupled with fluorescence detector (HPLC/FLD), and the mechanism of inhibition of Neu5Gc synthesis was investigated by using the molecular docking of Gen and sialyltransferase. On the 15th day, the content of Neu5Gc in hind leg muscle and liver tissues decreased 13.77% and 15.45%, respectively, and there was no significant change in the content of Neu5Gc in kidney tissues. On the 30th day, the content of Neu5Gc in liver tissues decreased 13.35%, however, there was no significant change in the content of Neu5Gc in kidney tissues and Neu5Gc was not detected in hind leg muscle. The content of Neu5Gc in hind leg muscle, kidney and liver tissues decreased respectively 32.65%, 32.78%, 16.80% and 12.72%, 11.42%, 12.30% while rats fed on the 45th and the 60th days. Genistein has formed the hydrogen bond with sialyltransferase activity site residues His319, Ser151, Gly293, Thr328 and formed a hydrophobic interactions with the residues His302, His301, Trp300, Ser271, Phe292, Thr328, Ser325 and Ile274. The results of molecular docking indicated that the weak intermolecular interaction was the main cause of genistein inhibiting sialyltransferase activity. The research results provided an experimental basis for the subsequent reduction of Neu5Gc in red meat before slaughter.
Animals ; Gene Expression Regulation, Enzymologic ; drug effects ; Genistein ; pharmacology ; Male ; Molecular Docking Simulation ; Neuraminic Acids ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Transferases ; metabolism