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.

AIM:To explore the therapeutic effect of teprenone(geranylgeranylacetone,GGA)on lipopolysac-charide(LPS)-induced cardiac dysfunction and its mechanism.METHODS:(1)Eight-week-old male C57BL/6 wild-type mice and carboxyl terminus of heat shock protein 70(HSP70)-interacting protein(CHIP)gene knockout mice were randomly divided into control group,LPS group,LPS+GGA group and GGA group,with 8 mice in each group.The model was established by intraperitoneal injection of LPS(25 mg/kg),and 1 h after LPS stimulation,mice were given intraperito-neal injection of GGA(100 mg/kg).The technique of high-resolution ultrasonography system was used to evaluate the car-diac function of mice.The serum of mice from each group were collected to detect the levels of creatine kinase-MB(CK-MB)and lactate dehydrogenase(LDH).HE staining was performed to observe histological changes of cardiac tissues.ELISA was used to detect the levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in cardiac tissues.West-ern blot was used to detect the protein levels of HSP70,CHIP,karyopherin-α 2(KPNA2),myeloperoxidase(MPO),vas-cular cell adhesion molecule(VCAM),intercellular cell adhesion molecule(ICAM),and nuclear factor-κB(NF-κB)in cardiac tissues.(2)In vitro cell inflammation model was established using mouse myocardial cells HL-1 stimulated with LPS.ELISA was used to detect the levels of TNF-α and IL-6 in cell supernatants.Western blot was used to detect the pro-tein expression levels of HSP70,CHIP,and KPNA2 in myocardial cells.Immunofluorescence staining was performed to observe the content of nuclear NF-κB.RESULTS:(1)GGA effectively improved cardiac function of LPS-stimulated mice,significantly increased ejection fraction and left ventricular fractional shortening(P<0.01),reduced serum levels of CK-MB and LDH(P<0.01),and alleviated myocardial injury.(2)GGA significantly reduced the release of TNF-α and IL-6 caused by LPS(P<0.01),as well as nuclear translocation of NF-κB,decreased the levels of KPNA2,MPO,VCAM and ICAM in cardiac tissues,and increased the levels of HSP70 in cardiac tissues and cells(P<0.01).(3)In CHIP knockout myocardial cells and mice,GGA failed to inhibit LPS-induced inflammatory response and lost its effect on im-proving cardiac function.CONCLUSION:The protective effect of GGA against LPS-caused cardiac dysfunction of mice is related to increasing expression of HSP70 and promoting CHIP activation,which inhibits the translocation of NF-κB into nucleus and suppresses inflammatory factor release.CHIP knockout abolishes the effects of GGA on reducing LPS-induced inflammatory response and myocardial injury.

Objective:To investigate the status quo of intravenous (IV) infusion device selection among hospitalized children and provide direction for improving practices related to the selection of infusion devices.Methods:A total of 1 306 hospitalized children undergoing IV infusion treatment in 11 clinical departments of Children's Hospital of Fudan University in June 2021 were selected by convenience sampling. A self-developed data collection form for the selection of IV infusion devices in hospitalized children and criteria for the appropriateness of IV infusion device selection were used to survey and evaluate the appropriateness of IV infusion device selection among these children.Results:IV infusion devices were found to have been appropriately selected in 1 137 of the 1 306 children, while these devices were inappropriately selected in 169 children. The inappropriate selection was primarily due to the improper choice of peripheral intravenous catheters (PIVC), with 155 cases involving the administration of non-peripheral compatible medications through PIVC. No significant statistical difference was found in the appropriateness of IV infusion device selection between the infant group and the child and adolescent group ( P>0.05). Significant differences were observed in the appropriateness of IV infusion device selection based on different physicochemical properties of medications and the duration of therapy ( P<0.01) . Conclusions:The standardization of IV infusion device selection among hospitalized children needs improvement. It is urgent to apply evidence from the Clinical Practice Evidence- Based Guidelines for Pediatric Intravenous Therapy regarding recommendations for IV infusion device selection, to initiate evidence application projects, and to standardize the selection of IV infusion devices.

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.

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.