ObjectiveTo explore the effect of a novel initiation model on initiating behavioral requests in children with autism spectrum disorder (ASD). MethodsFrom November to December, 2022, 44 children with ASD were selected from Jiaxing Sunlight Rehabilitation Kindergarten, and divided into prelinguistic group (n = 23) and linguistic group (n = 21) according to the language function. The initiation-requested skills, and types and frequency of initiation-requested behaviors were observed under the novel initiation model and the conventional initiation model. ResultsBoth the groups scored higher in the novel initiation model than in the conventional initiation model for initiation-requested skills (|t| > 2.794, P < 0.05) and types of initiation-requested behaviors (|t| > 3.697, P < 0.01), and it increased for the frequency of the use of two- and three-behavioral initiation of requests (χ² > 7.986, P < 0.05). ConclusionThe novel initiation model can improve initiation request skills in children with ASD.

ObjectiveTo review the interoceptive assessment tools in terms of structure, content and psychometric properties, based on the framework of the International Classification of Functioning, Disability and Health (ICF). MethodsThe literature on interoceptive evaluation tools was retrieved from databases of CNKI, PubMed, Medline and EBSCO. The principal structures and contents of the assessment tools were analyzed based on the ICF framework, and the quality of the psychometric properties were appraised using COSMIN. ResultsA total of 13 interoceptive assessment tools were ultimately included, involving 16 literature references. There were five interoceptive sensitivity tools, four accuracy tools and four awareness tools. In terms of content, interoceptive sensitivity tools involved 33 categories of body functions, six categories of activities and participation, and one of environmental factors; while interoceptive accuracy tools only involved seven categories of body function, and two of activities and participation items; interoceptive awareness tools involved 30 categories of body function, four categories of activities and participation, and three of environmental factors. In terms of psychometric properties, Body Perception Questionnaire-Short Form (BPQ-SF) was the sensitivity tool with the best reliability and validity (qualified rate of 7/8), followed by Interoceptive Sensitivity Questionnaire (ISQ) (qualified rate of 6/8). Most of the accuracy tools adopted standardized measurement methods, but lacked sufficient reliability and validity verification. The awareness tools were good in reliability and validity (qualified rate above 5/8), especially Multidimensional Assessment of Interoceptive Awareness (MAIA-1) and Body Awareness Questionnaire (BAQ) (qualified rate of 8/8). ConclusionBPQ-SF and ISQ are recommended for interoceptive sensitivity assessment, Water-loading Test and Heart-beat Tracking Task for interoceptive accuracy assessment, and MAIA-1 and BAQ for interoceptive awareness assessment.

Objective To investigate the prevalence of functional gastrointestinal disorders(FGID)in soldiers stationed on an island based on the Rome IV diagnostic criteria,so as to clarify the incidence and types of FGID and their correlations with the age and psychological status of soldiers.Methods The prevalence of FGID was investigated from September to November 2022 by FGID Questionnaire Survey Platform Management System based on the Rome IV diagnostic criteria.Results A total of 397 soldiers stationed on an island were enrolled in this study.The most common digestive symptoms were diarrhea,belching and constipation.A total of 147 people(37.0%)met the Rome Ⅳ diagnosis of FGID,and common diseases were functional diarrhea,epigastric pain syndrome and postprandial discomfort syndrome.Among the various diagnoses of FGID,the prevalence rates of globus hystericus,functional chest pain and belching syndrome showed statistically significant differences across different age groups(all P<0.001).Among the 324 subjects with no abnormal SDS scores,61.4%(199/324)did not meet the diagnosis of FGID.Among the 71 subjects with SDS scores ranging from 53 to 62,71.8%(51/71)did not meet the diagnosis of FGID.All subjects with SDS scores ranging from 63 to 72 met the diagnosis of FGID.Conclusion Functional diarrhea is the most common disease of FGID among soldiers stationed on the island.The overall prevalence of FGID is not related to the age of the subjects.Relevant drugs and psychological support treatment should be strengthened in the future allocation of health service resources on islands.

Objective To explore the effect of multi-stage knowledge-attitude-practice(KAP)nursing on postoperative rehabilitation of patients with gastrointestinal polyps treated by gastrointestinal endoscopy.Methods A total of 624 patients with gastrointestinal polyps who were admitted to The First Hospital Affiliated of Naval Medical University from January 2021 to January 2024 were enrolled and assigned to control group(routine nursing,n=312)and observation group(multi-stage KAP nursing,n=312)by purposive sampling.The recovery time of gastrointestinal function,health-promoting behaviors,and self-disease management ability were compared between the two groups.Results There was no significant difference in the baseline data between the two groups(P>0.05).After intervention,the recovery time of gastrointestinal function and the time of first feeding in the observation group were significantly shorter than those in the control group(P<0.05);the health promotion and self-management ability of the observation group were significantly higher than those of the control group(P<0.05).Conclusion The multi-stage KAP nursing can accelerate the recovery of gastrointestinal function in patients with gastrointestinal polyps after endoscopy,and improve the cognitive level,health behaviors,and self-management ability.

Objective To investigate the association of estimated glucose disposal rate(eGDR)with metabolic dysfunction-associated liver steatosis and fibrosis,and to analyze the difference of the association in different population.Methods A total of 10,549 participants from 2017 to 2020 in National Health and Nutrition Examination Survey(NHANES)database who underwent vibration-controlled transient elastography(VCTE)were included.eGDR was calculated based on waist circ-umference,hypertension,and glycated hemoglobin(HbA1c).The controlled attenuation parameter(CAP)≥248 dB/m was used as diagnostic criterion for liver steatosis,and liver stiffness measure-ment(LSM)≥ 8.2 kPa was used as criterion for liver fibrosis.Multivariable Logistic regression a-nalysis was conducted to assess the relationship between eGDR and liver steatosis and fibrosis,with subgroup analysis and interaction tests performed.Results After adjusting for confounding factors,eGDR level was significantly negatively associated with the risks of both liver steatosis and fibrosis.The participants were divided into tertiles based on eGDR levels(Q1,Q2,Q3).Compared with the Q1 group,the risk ratios for liver steatosis in the Q2 and Q3 groups were 0.485(95％CI,0.394 to 0.597)and 0.286(95％CI,0.239 to 0.343),respectively(P＜0.001);the risk ratios for liver fibrosis were 0.457(95％CI,0.363 to 0.576)and 0.162(95％CI,0.100 to 0.263),respective-ly(P＜0.001).Subgroup analysis showed that the negative association between eGDR and liver steatosis differed among populations of different ages and smoking statuses,with statistically signifi-cant differences in interaction tests(P for interaction＜0.001);similarly,the negative association between eGDR and liver fibrosis differed among populations with different levels of physical activity,with statistically significant differences in interaction tests(P for interaction＜0.001).The associa-tions of eGDR levels with liver steatosis and fibrosis remained stable(P for interaction＞0.05).Conclusion eGDR levels are closely associated with the risks of liver steatosis and fibrosis and can serve as an effective indicator for assessing liver metabolic abnormalities.This finding provides new insights into early screening,risk stratification,and prognosis assessment for liver steatosis and fibrosis.

Small for gestational age (SGA) infants are more likely to experience neurocognitive impairments compared to appropriate for gestational age (AGA) infants. This paper reviews recent research on the neurocognitive development of SGA children. SGA can lead to a "brain-sparing effect" due to growth restriction, which may affect cerebral blood flow and brain structure. However, this does not guarantee normal brain development. Restrictive blood flow can result in changes in brain structure, such as reduced total white matter and gray matter volume in various brain regions, including the cerebral cortex, hippocampus and cerebellum, ultimately leading to decreased head circumference. SGA children also exhibit lower scores in all neurocognitive domains, including intelligence, attention, memory, and executive function. This may result in poor academic performance and an increased risk of social, behavioral, and neurological problems, such as cerebral palsy, epilepsy, visual and hearing impairments, as well as comorbidities like attention deficit hyperactivity disorder(ADHD), autism spectrum disorder(ASD), anxiety, depression, and schizophrenia. Several risk factors for SGA-related neurocognitive impairments have been identified, including gestational hypertension, abnormal gestational weight, smoking, and catch-up growth. Studies have shown that the best interventions to improve cognitive dysplasia include nutrient supplementation, continued breastfeeding, high-quality education, and appropriate early intervention (responsive parenting) are effective in improving cognitive outcomes for SGA children.

Objective To study the intervention effect of Ladder Model conversation training strategy on im-proving the conversation skills of children with autism.Methods A multi-probe design across participants was a-dopted to examine the intervention effectiveness of the strategy on two 7～8 year old autistic children.Intervention lasted for 4 weeks for subjuct A and 3 weeks for subject B.Thirty-five minutes each time,three times a week.The number and type of conversation initiation,maintenance and interruption were evaluated in the baseline period,in-tervention period,maintenance period and generalization period.The overlap rate and simplified time-series analysis were used to evaluate the outcome.Results The number of conversation initiation of subject A(overlap rate 8.33％,C=0.89,P＜0.01)and subject B(overlap rate 20％,C=0.83,P＜0.01)was significantly higher in in-tervention periods than that in baseline,but no significant difference was observed between the other adjacent peri-ods.The number of conversation maintenance of subject A(overlap rate 0％,C=0.89,P＜0.01)and subject B(o-verlap rate 10％,C=0.91,P＜0.01)was significantly higher in intervention periods than that in baseline,but no significant difference was found between the other adjacent periods.The type of conversation initiation and mainte-nance that subjects improved were mainly in verbal forms.The main type of interruption was"unexplained re-sponse",the proportion of interruption decreased obviously after intervention.Conclusion The strategy has posi-tive effect on improving conversation initiation and maintenance of children with autism,and reducing the proportion of interruption.

Objective To compare the application of main concept analysis(MCA)and story narration as-sessment(SNA)in aphasia discourse assessment,and study their clinical applicability.Methods A total of 8 apha-sic and 22 healthy control subjects were recruited.Local sequential picture materials were used to elicit language samples.The differences between groups in the assessment results of the MCA and the SNA were compared,the consistency of the assessment results of the two methods were also analyzed.The inter-rater and the intra-rater reli-ability of the two methods was discussed.Results The results of the MCA showed that the number of accurate and complete(AC)main concepts(P＜0.01),the number of accurate and complete main concepts per minute(AC/min)(P＜0.05)and main concept scores(MC scores)(P＜0.05)of the aphasia group were significantly lower than those of the healthy group.The number of absent(AB)main concepts(P＜0.05)were significantly higher than those of the control group.As for the result of SNA,the score of the content of sub picture description(P＜0.05),the total score of sub picture description(P＜0.05)and the total score of overall description(P＜0.05)in the aphasia group were significantly less than those in the control group(P＜0.05).No significant difference be-tween the standardized scores of the two methods were observed,and inter-rater and the intra-rater reliability were both in a good range.Conclusion The clinical applicability of the two methods is excellent and the evaluation results are conststent.The MCA has outstanding advantages in evaluating the quality and quantity of information,while SNA examines the syntax and content organization,which can reflect the overall discourse performance.

Children with specific language impairment(SLI)have normal cognitive abilities but experience language deficits.The heterogeneity of language disorders makes SLI children optimal subjects for investigating the correlation between language ability and theory of mind.This paper provides a comprehensive review of foreign em-pirical studies examining the relationship between language ability and theory of mind in SLI groups from various perspectives.The findings indicate that specific types of language disorders exhibit delayed development in theory of mind,which is closely associated with their language ability deficits.Among all linguistic elements,syntactic de-fects demonstrate the most concentrated evidence regarding their impact on theory of mind.It is noteworthy that al-though SLI children offer valuable insights into the correlation between language and theory of mind,further investi-gation is still required to comprehensively comprehend this association.The present study also provides recommenda-tions for future research endeavors in this domain.

Objective:To investigate the iodine nutritional status of children and the consumption condition of non-iodized salt in Henan Province after implementation of the new standard of "Definition and demarcation of water-borne iodine-excess areas and iodine-excess endemial areas" (GB/T 19380-2016, hereinafter referred to as new standard) for four years (2021), and to provide a basis for scientific adjustment of intervention strategies.Methods:In 2021, according to the requirements of the new standard and based on the results of the water iodine survey in Henan Province from 2017 to 2020, a survey was conducted on the iodine nutrition status of children in water-borne high iodine areas in 47 counties (cities, districts, hereinafter referred to as counties) with high iodine administrative village (neighborhood committee, hereinafter referred to as administrative village). In each county, 5 administrative villages with median water iodine > 100 μg/L were selected as the investigation villages, and water samples were collected to determine the water iodine value. Forty non-boarding students aged 8 - 10 (age balanced, half male and half female, age increased to 6 - 12 when less than 40) were selected from each village as investigation subjects. Salt samples from their homes and urine samples were collected to detect salt iodine and urine iodine content, and thyroid volume of children was measured. And the monitoring results of areas where the supply of iodized salt had been suspended for less than 4 years (in newly high iodine areas) and more than 10 years (in previously high iodine areas) were further compared and analyzed.Results:A total of 257 administrative villages in the province were monitored, and the range of water iodine was 1.6 - 609.5 μg/L, with a median of 132.5 μg/L. A total of 8 611 children were tested for salt iodine, urine iodine and thyroid volume. The non-iodized salt rate was 58.3% (5 017/8 611), and the median urine iodine was 342.2 μg/L, thyroid enlargement rate was 2.9% (250/8 611). The median water iodine (153.0 vs 118.4 μg/L), the median urine iodine in children (371.6 vs 287.7 μg/L) and the goiter rate [3.8% (211/5 537) vs 1.3% (39/3 074)] in the newly high iodine areas were higher than those in the previously high iodine areas, and the differences were statistically significant ( Z = 583.12, - 14.09, P < 0.001; χ 2 = 44.40, P < 0.001); the non-iodized salt rate was lower than that of the previously high iodine areas [37.2% (2 057/5 537) vs 96.3% (2 960/3 074)], and the difference was statistically significant (χ 2 = 2 841.37, P < 0.001). Conclusions:The iodine nutrition level of children in water-borne high iodine areas of Henan Province in 2021 is at an excess level, but the non-iodized salt rate in residential households is low. We should make every effort to ensure the precise supply of non-iodized salt in high iodine areas after implementation of the new standard, and strengthen iodine nutrition monitoring and health education for key populations to prevent the occurrence of high iodine hazards.