Objective To form an expert consensus on nasogastric tube and intestinal tube placement in children(hereinafter referred to as the"consensus"),and provide a reference for pediatric medical workers regarding the operation of gastrointestinal tube placement in children.Methods A"consensus"formulation group was established.The"5.0"EBHC Pyramid Model was employed to systematically search,evaluate,summarize and extract relevant evidence to form the initial draft of the"consensus".The RAND-UCLA expert consensus method was utilized.Through a round of expert inquiries by correspondence and a round of face-to-face expert discussions,the data were collated,analyzed,refined,and modified to form the final version of the"consensus".Results The effective recovery rate of the expert inquiry questionnaire was 100％.The coefficient of expert authority(Cr)was 0.891.The Kendall's concordance coefficient of the inquiries was 0.692(P＜0.01),which was statistically significant.The median of the"RAND-UCLA"suitability score were 7-9 points,and the disagreement index(DI)value was＜1.00.The final"consensus"encompasses 9 aspects,including qualification requirements for the tube placement personnel,indications and contraindications,preoperative assessment,preoperative preparation,measurement of tube length,key points of tube placement,methods for confirming the position,tube flushing,fixation,and recording,with 47 recommendations.Conclusion This"consensus"is scientific,rigorous,and practical,covering all links of the gastrointestinal tube placement process in children,providing reference and guidance for the safe and standardized implementation of gastrointestinal tube placement in children.

Objective To investigate the relationship between prolactin and mild cognitive impairment(MCI)in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 319 postmenopausal women with T2DM who were hospitalized in the Department of Endocrinology,Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University were enrolled in this study from August 2016 to October 2023.All the patients were divided into two groups according whether they had MCI:T2DM group(n=161)and MCI group(n=158).Differences in clinical characteristics were compared between the two groups.Pearson correlation was used to analyze the correlation between sex hormones and cognitive domains,and Logistic regression analysis was used to evaluate the influencing factors for MCI development.Results Serum prolactin levels were significantly lower in the MCI group than in the T2DM group[(5.5±2.1)vs(7.2±2.9)μg/L,P<0.05].Serum prolactin level was positively correlated with mini-mental state examination score,Montreal cognitive assessment score,immediate memory score,visuopatial constructional score,attention score and hippocampal volume(P<0.05),and negatively correlated with processing speed test(time)and executive function test(time)(P<0.05).Logistic regression analysis demonstrated that serum prolactin level was an influencing factor for the risk of MCI in postmenopausal women with T2DM(OR 0.715,95%CI 0.605～0.845,P<0.01).Conclusions The decrease of serum prolactin level is associated with an increased risk of MCI in postmenopausal women with T2DM.

Objective To investigate the relationship between prolactin and mild cognitive impairment(MCI)in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 319 postmenopausal women with T2DM who were hospitalized in the Department of Endocrinology,Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University were enrolled in this study from August 2016 to October 2023.All the patients were divided into two groups according whether they had MCI:T2DM group(n=161)and MCI group(n=158).Differences in clinical characteristics were compared between the two groups.Pearson correlation was used to analyze the correlation between sex hormones and cognitive domains,and Logistic regression analysis was used to evaluate the influencing factors for MCI development.Results Serum prolactin levels were significantly lower in the MCI group than in the T2DM group[(5.5±2.1)vs(7.2±2.9)μg/L,P<0.05].Serum prolactin level was positively correlated with mini-mental state examination score,Montreal cognitive assessment score,immediate memory score,visuopatial constructional score,attention score and hippocampal volume(P<0.05),and negatively correlated with processing speed test(time)and executive function test(time)(P<0.05).Logistic regression analysis demonstrated that serum prolactin level was an influencing factor for the risk of MCI in postmenopausal women with T2DM(OR 0.715,95%CI 0.605～0.845,P<0.01).Conclusions The decrease of serum prolactin level is associated with an increased risk of MCI in postmenopausal women with T2DM.

Objective:To analyze the current application of the Theoretical Domains Framework (TDF) in implementation science research within the field of pediatric public health and to provide a reference for future research in this area.Methods:A systematic literature search was conducted in China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, EBSCO, Web of Science, and Embase databases to identify studies related to the application of TDF in pediatric public health. The search period was from the inception of each database to January 30, 2025. Two researchers independently screened the literature, extracted relevant data, and performed qualitative analysis and summary.Results:A total of 83 studies were included in the synthesis. The number of publications applying TDF in pediatric public health has shown an upward trend from 2013 to 2022, with a slight decline after 2022. The primary countries contributing to this research were the United Kingdom, Australia. Common research designs included qualitative studies hybridization studies and randomized controlled trials. Research topics mainly focused on dietary management, physical activity, and children's healthcare. The most frequently integrated theoretical model alongside TDF was the Capability, Opportunity, Motivation-Behavior (COM-B) model.Conclusions:The application of TDF in pediatric public health implementation science research is wide-ranging and involves diverse study designs. Its multidisciplinary integration provides a comprehensive and solid theoretical foundation for healthcare professionals conducting implementation research.

Objective To form an expert consensus on nasogastric tube and intestinal tube placement in children(hereinafter referred to as the"consensus"),and provide a reference for pediatric medical workers regarding the operation of gastrointestinal tube placement in children.Methods A"consensus"formulation group was established.The"5.0"EBHC Pyramid Model was employed to systematically search,evaluate,summarize and extract relevant evidence to form the initial draft of the"consensus".The RAND-UCLA expert consensus method was utilized.Through a round of expert inquiries by correspondence and a round of face-to-face expert discussions,the data were collated,analyzed,refined,and modified to form the final version of the"consensus".Results The effective recovery rate of the expert inquiry questionnaire was 100％.The coefficient of expert authority(Cr)was 0.891.The Kendall's concordance coefficient of the inquiries was 0.692(P＜0.01),which was statistically significant.The median of the"RAND-UCLA"suitability score were 7-9 points,and the disagreement index(DI)value was＜1.00.The final"consensus"encompasses 9 aspects,including qualification requirements for the tube placement personnel,indications and contraindications,preoperative assessment,preoperative preparation,measurement of tube length,key points of tube placement,methods for confirming the position,tube flushing,fixation,and recording,with 47 recommendations.Conclusion This"consensus"is scientific,rigorous,and practical,covering all links of the gastrointestinal tube placement process in children,providing reference and guidance for the safe and standardized implementation of gastrointestinal tube placement in children.

Objective:To analyze the current application of the Theoretical Domains Framework (TDF) in implementation science research within the field of pediatric public health and to provide a reference for future research in this area.Methods:A systematic literature search was conducted in China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, EBSCO, Web of Science, and Embase databases to identify studies related to the application of TDF in pediatric public health. The search period was from the inception of each database to January 30, 2025. Two researchers independently screened the literature, extracted relevant data, and performed qualitative analysis and summary.Results:A total of 83 studies were included in the synthesis. The number of publications applying TDF in pediatric public health has shown an upward trend from 2013 to 2022, with a slight decline after 2022. The primary countries contributing to this research were the United Kingdom, Australia. Common research designs included qualitative studies hybridization studies and randomized controlled trials. Research topics mainly focused on dietary management, physical activity, and children's healthcare. The most frequently integrated theoretical model alongside TDF was the Capability, Opportunity, Motivation-Behavior (COM-B) model.Conclusions:The application of TDF in pediatric public health implementation science research is wide-ranging and involves diverse study designs. Its multidisciplinary integration provides a comprehensive and solid theoretical foundation for healthcare professionals conducting implementation research.

Objective·To explore the effects and possible molecular mechanisms of nanoplastics(NPs)on severe asthma.Methods·A mouse model of severe asthma was established by using house dust mite(HDM)and lipopolysaccharide(LPS)co-stimulation.Polystyrene nanoplastics(PS-NPs)were instilled into the severe asthma mice's airways.Subsequently,bronchoalveolar lavage fluid(BALF)was collected and lung tissue sections were prepared.Flow cytometry,hematoxylin-eosin(H-E)staining,periodic acid-Schiff(PAS)staining,immunohistochemistry,and terminal dexynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL)staining,were used to observe the effects of PS-NPs on airway inflammation,mucus secretion,alveolar structure,and the proliferation and apoptosis of alveolar type Ⅱ epithelial cells(AT2 cells)in severe asthma mice.The CCK-8 assay and Annexin Ⅴ/PI double staining were performed to evaluate the effects of PS-NPs on the proliferation and apoptosis of the mouse AT2 cell line MLE-12.DNA damage in AT2 cells caused by PS-NPs was detected by using anti-γ-H2A.X immunofluorescence staining.The expression of genes in the ATR/Chk1/p53 signaling pathway was detected by real-time fluorescent quantitative polymerase chain reaction(qPCR),Western blotting,Tyramide signal amplification(TSA)multiplex immunofluorescence staining,and immunofluorescence co-localization,respectively.The ATR-specific inhibitor Ceralasertib(AZD6738)was administrated to MLE-12 cells in combination with PS-NPs to evaluate the recovery effect on cell proliferation and apoptosis.Results·Flow cytometry revealed that exposure to PS-NPs increased the total number of inflammatory cells and the number of each type of inflammatory cells in the BALF of mice with severe asthma,with a predominance of neutrophils.H-E and PAS staining showed significant increase in airway inflammatory cell infiltration and mucus secretion,as well as disruption of alveolar structure.In vitro,the CCK-8 assay demonstrated significant,dose-dependent inhibition of MLE-12 cell proliferation by PS-NPs.The Annexin V/PI double staining assay indicated a higher apoptosis rate of(56.20±3.84)%in PS-NP-exposed cells compared to(23.22±2.52)%in the control group.Immunofluorescence staining demonstrated that PS-NPs were phagocytosed by MLE-12 cells and localized around the nucleus.TUNEL staining confirmed enhanced apoptosis in AT2 cells in vivo.The immunofluorescence assay revealed that compared to the control group,the expression of the DNA damage marker γ-H2A.X increased in the experimental group.qPCR,Western blotting,and TSA multiplex staining results showed that PS-NP-induced elevated expression of mRNA and proteins was related to the ATR/Chk1/p53 pathway in MLE-12 cells.Moreover,immunofluorescence co-localization also confirmed the induction of ATR and p53 proteins in AT2 cells in vivo.The ATR-specific inhibitor Ceralasertib partially restored the PS-NP-induced inhibition of cell proliferation and enhancement of apoptosis in MLE-12 cells.Conclusion·NPs exposure leads to DNA damage in AT2 cells,activating the ATR/Chk1/p53 signaling pathway and exacerbating airway inflammation and alveolar damage in mice with severe asthma.

Subarachnoid hemorrhage (SAH) is the third common type of stroke in the world,and its mortality and disability rates have declined over the past few decades due to the advances in neuroimaging technology and endovascular interventional therapy and promotion of healthy physical examination,but long-term neurological deficits and cognitive impairment of the patients have not significantly improved,which may be related to the white matter injury (WMI) after SAH.Little attention has been paid to WMI after SAH in the past,which may be an important reason for the poor prognosis of the patients with SAH.The neuroin-flammation response is an important pathophysiological process after SAH,and the neuroinflammation after SAH can aggravate WMI.This article reviews the relationship between neuroinflammation and WMI after SAH in order to deepen the understanding of its effects on cognitive function after SAH.

Ulcerative colitis is a common disease of the digestive system in China,which seriously affects the quality of life of patients due to its disease characteristics,such as easy recurrence,repeated course of disease and carcinogenic tendency.Neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are considered as new inflammatory biomarkers,which have been found to be related with ulcerative colitis.This article reviewed the clinical value of NLR and PLR in ulcerative colitis.

Objective To observe the value of ultrasonic biomicroscopy(UBM)imaging for diagnosing chestnut thorn foreign bodies in anterior segment.Methods A total of 70 patients who underwent UBM examination due to chestnut thorn injury or residue of chestnut thorn after removal and then operation were retrospectively enrolled.The distance of chestnut thorn foreign bodies from corneal limbus,and the subconjunctival depth and length of them were measured based on UBM imaging.The efficacy of UBM for diagnosing chestnut thorn foreign bodies in anterior segment was evaluated according to surgical findings,and the correlation of quantitative parameters of foreign bodies were analyzed.Results Among 70 cases of chestnut thorn foreign bodies in anterior segment,single ocular tissue(5/70,7.14％)involvement was detected in 5 cases,while multiple ocular tissues involvement(65/70,92.86％)were noticed in 65 cases according to UBM.Totally 109 foreign bodies were detected by UBM,among which 98 were consistent with surgical findings,with the diagnostic accuracy of 89.91％(98/109),while 11 foreign bodies were not found during operation,with the false positive rate of 10.09％(11/109).Meanwhile,4 foreign bodies found and removed with operation were not displayed with UBM,and the false negative rate of UBM was 3.92％(4/102).Among 98 chestnut thorn foreign bodies correctly diagnosed with UBM,10 located in stromal layer of cornea(10/98,10.20％)and 88 located in ocular wall(88/98,89.80％),including 43 subconjunctival(43/88,48.86％)and 45 sclerotic(45/88,51.14％)foreign bodies,with the median length of 0.200 mm.The distance of 88 foreign bodies in ocular wall from corneal limbus was(2.963±1.504)mm,and the subconjunctival depth was(0.785±0.388)mm.The distance of foreign bodies from corneal limbus were positively correlated with their subconjunctival depth(r,=0.361,P＜0.010),while their lengths were not correlated with their distance from corneal limbus and subconjunctival depth(both P＞0.05).Conclusion UBM imaging was valuable for clinical diagnosis and localization of chestnut thorn foreign bodies in anterior segment.