1.Expert consensus on nasogastric tube and intestinal tube placement in children
Yu ZOU ; Ying GU ; Zhuowen YU ; Yan HUANG ; Yuxia YANG ; Suyun LI ; Yingwen WANG
Chinese Journal of Nursing 2025;60(14):1700-1704
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.
2.Research status and advances in immunotherapy for chronic myeloid leukemia
Mengmeng WANG ; Jingyun MA ; Boyu XIONG ; Zhuowen DAI ; Yueyue PAN ; Qiong WANG
Chinese Journal of Blood Transfusion 2025;38(5):739-746
Chronic myeloid leukemia (CML) is a malignant hematologic disorder caused by abnormal proliferation of hematopoietic stem cells. In recent years, while the application of tyrosine kinase inhibitors (TKIs) has significantly improved the prognosis of CML patients through in-depth exploration of pathogenesis of CML and advancements in targeted therapies, some patients still face challenges including drug resistance, disease relapse, and failure to achieve treatment-free remission. Imunotherapy, as a complementary or alternative strategy, holds significant potential for overcoming these limitations, and has gradually emerged as a critical research focus in CML treatment. This review aims to summarize the current research status and latest advances in immunotherapy for CML.
3.The value of peripheral blood neutrophil extracellular traps as a marker for sepsis-induced coagulopathy
Zhuowen DAI ; Boyu XIONG ; Yueyue PAN ; AIERKEN AIZIMAITI ; Zelin WANG ; Qiong WANG
Chinese Journal of Blood Transfusion 2025;38(10):1340-1347
Objective: To develop a rapid quantification method for neutrophil extracellular traps (NETs) by quantifying neutrophils forming NETs (NETotic cells) on routine peripheral blood smears, and to evaluate the performance of an early warning model combining NETs with traditional coagulation indicators for risk of sepsis-induced coagulopathy (SIC) in septic patients. Methods: This prospective observational study was conducted in Wuxi People's Hospital Affiliated with Nanjing Medical University between May 2023 and May 2025. A total of 147 patients with sepsis (diagnosed based on Sepsis-3.0 criteria) who had not developed SIC [the international society on thrombosis and haemostasis (ISTH SIC score <4)] were enrolled. Blood samples were collected within 2 hours of admission. Neutrophil smudge cells (NETs%) were counted using an automated cell morphology analyzer. Serum levels of myeloperoxidase-DNA (MPO-DNA) complexes, circulating free DNA (cf-DNA) and sequential organ failure assessment (SOFA) scores were also determined. Based on progression to SIC (ISTH score ≥4) within 72 hours of admission, patients were categorized into a sepsis without SIC group (n=85) and a sepsis with SIC group (n=62). Risk factors were analyzed using binary logistic regression, receiver operating characteristic (ROC) curves were plotted, and the predictive value of NETs%, SOFA, and AT-Ⅲ for coagulation dysfunction was assessed. Results: The NETs% level was significantly higher in the sepsis with SIC group [8.50% (7.00, 11.50)] compared to both the healthy control group [1.00% (0.00, 2.00)] and sepsis without SIC group [4.40%(3.50, 6.50)] (P<0.01). NETs% was identified as an independent risk factor for SIC in sepsis patients. ROC analysis showed that the area under the curve (AUC) for predicting SIC was 0.90 for NETs%, 0.85 for MPO-DNA, and 0.79 for cf-DNA. The combined model of NETs% and SOFA score demonstrated the best performance, with an optimal cut-off value of 0.33, an AUC of 0.92, a sensitivity of 77%, and a specificity of 93%. Conclusion: NETs% shows promise as a novel biomarker for SIC. Peripheral blood smear morphology provides a simple, rapid, and cost-effective method for quantifying NETs%. NETs% enhances the early clinical identification of patients at high risk for SIC, and its combination with the SOFA score facilitates SIC prediction, offering a critical time window for initiating timely preventive interventions.
4.Application of the theoretical domains framework in implementation science research within pediatric public health: a scoping review
Yiwen ZHOU ; Ying GU ; Zhuowen YU ; Yingwen WANG
Chinese Journal of Modern Nursing 2025;31(24):3233-3239
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.
5.Expert consensus on nasogastric tube and intestinal tube placement in children
Yu ZOU ; Ying GU ; Zhuowen YU ; Yan HUANG ; Yuxia YANG ; Suyun LI ; Yingwen WANG
Chinese Journal of Nursing 2025;60(14):1700-1704
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.
6.Application of the theoretical domains framework in implementation science research within pediatric public health: a scoping review
Yiwen ZHOU ; Ying GU ; Zhuowen YU ; Yingwen WANG
Chinese Journal of Modern Nursing 2025;31(24):3233-3239
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.
7.Thinking on the Design of the Special Column of Local Medicine Culture in Academic Journals of Traditional Chinese Medicine
Zhuowen ZHANG ; Xiaoxuan FU ; Hui WANG
Journal of Zhejiang Chinese Medical University 2024;48(7):787-791
[Objective]To explore the way that can highlight the characteristics of traditional Chinese medicine(TCM).[Methods]By searching the literature,it analyzes the current situation of traditional Chinese medicine journals,discuss the necessity,feasibility and rally point of setting up local medical culture column in Chinese medicine journals.[Results]Only by highlighting the characteristics of TCM can the connotation of scientific and technological journals of TCM be fully reflected.TCM journals can develop special columns of local medicine culture by exploring local medicine culture,building high-quality editorial teams,establishing core author groups,setting up high-quality review teams and holding journal academic activities.TCM journals should adhere to the characteristics of TCM and take reviving the TCM culture as the first post;learn to keep constant and change,inherit and innovate at the same time;adhere to the principle of letting a hundred flowers bloom,and show the characteristic of local medicine;focus on integrity and innovation,maintain the continuity and stability of the column,and then enhance the reputation and core competitiveness of TCM journals.[Conclusion]TCM culture is the essence of Chinese culture.TCM journals are the main battlefields of TCM academic culture.The establishment of the special column of local medicine culture in TCM journals is not only conducive to the high-quality development of journals,but also conducive to the inheritance of TCM academic culture.
8.Exploring occupational hazards and protective strategies in power generation enterprises
Xian LI ; Xiao HOU ; Linzheng ZHANG ; Fei YAN ; Shufan CHANG ; Zhuowen WANG ; Yang CHEN ; Wei WANG
China Occupational Medicine 2023;50(2):235-241
Currently, power generation in China is dominated by thermal power, wind power, nuclear power, and hydropower enterprises. The power source mainly comes from thermal power generation. The occupational hazards in thermal power station are noise, high temperature, power frequency electric fields, dust, and chemical toxins and so on, with noise and dust (silica and coal dust) being the primary factors. The occupational hazards in wind power station are noise, power frequency electric fields, high temperature, low temperature, and chemical toxins (sulfur hexafluoride, toluene, styrene, etc.), with noise and power frequency electric fields being the major concerns. The occupational radiation hazards in nuclear power station are gamma rays, beta rays, X-rays, neutrons, alpha rays, and radioactive aerosols. There is special attention in radiation protection but not enough protection in non-radioactive hazards such as noise, high temperature, and ammonia. The occupational hazards in hydropower station are noise, power frequency electric fields, vibration, radon and its de-composites, and chemical toxins, with noise and power frequency electric fields being the primary hazards. Different categories of power generation enterprises should identify key hazards and work site for occupational disease prevention and control based on the features of occupational hazards. Improving occupational health management and protection levels are essential measures.
9.Bendamustine monotherapy for Chinese patient treatment with relapsed or refractory B cell non-Hodgkin lymphoma: a phase Ⅱ, prospective, multicenter, single-arm study
Yan GAO ; Yu YANG ; Hong CEN ; Hong LIU ; Jinxiang FU ; Shunqing WANG ; Ru FENG ; Ding YU ; Xinyou ZHANG ; Zhuowen CHEN ; Yufu LI ; Huiqiang HUANG
Chinese Journal of Hematology 2022;43(11):934-939
Objective:To evaluate the efficacy and safety of bendamustine monotherapy in Chinese patients with relapsed/refractory (R/R) B cell non-Hodgkin lymphoma (B-NHL) .Methods:This prospective, multicenter, open label, single-arm, phase Ⅱ study investigated bendamustine’s efficacy and safety in Chinese patients with R/R B-NHL. A total of 78 patients with B-NHL in 11 hospitals in China from March 2012 to December 2016 were included, and their clinical characteristics, efficacy, and survival were analyzed.Results:The median age of all patients was 58 (range, 24-76) years old, and 69 (88.4% ) patients had stage Ⅲ/Ⅳ disease. 61 (78.2% ) patients were refractory to previous treatments. Patients received a median of 4 (range, 1-10) cycles of bendamustine treatment. The overall response rate was 61.5 (95% CI 49.8-72.3) % , the median response duration was 8.3 (95% CI 5.5-14.0) months, and the complete remission (CR) rate was 5.1 (95% CI 1.4-12.6) % . In the full analysis set, median progression-free survival (PFS) and median OS were 8.7 (95% CI 6.7-13.2) months and 25.5 months (95% CI 14.2 months to not reached) , respectively, after a median follow-up of 33.6 (95% CI 17.4-38.8) months. Lymphopenia (74.4% ) , neutropenia (52.6% ) , and leukopenia (39.7% ) , thrombocytopenia (29.5% ) and anemia (15.4% ) were the most common grade 3-4 hematologic adverse events (AE) . The most frequent non-hematologic AEs included nausea (43.6% ) , vomiting (33.3% ) , and anorexia (29.5% ) . Univariate and multivariate analysis showed that <4 cycles of bendamustine treatment was a poor prognostic factor for PFS ( P=0.003) , and failure to accept fludarabine containing regimen was a poor prognostic factor for OS ( P=0.009) . Conclusion:Bendamustine monotherapy has good efficacy and safety in the treatment of patient with R/R B-NHL.
10.Promoting effect of 810 nm low-level laser on axonal regeneration of neurons in mice with spinal cord injury and its related mechanism
Jiawei ZHANG ; Jiakai SUN ; Qiao ZHENG ; Jiwei SONG ; Kun LI ; Zhuowen LIANG ; Xueyu HU ; Zhe WANG
Chinese Journal of Trauma 2019;35(4):359-367
Objective To investigate the effect of 810 nm low-level laser on neuronal axonal regeneration of mice with spinal cord injury and its related mechanism.Methods In vivo experiment:20 Balb/c mice were randomly divided into the spinal cord injury group(SCI group)and the 810 nm low-level laser irradiation group(low-level laser group)after spinal cord injury according to the random number table method,with each group containing ten mice.A mice SCI model was established through clamp injury and the low-level laser group continuously irradiated the damaged area with weak 810 nm low-level laser with selected parameters(continuous wave with wave length 810 nm,power density 2 mW/cm2,spot are 4.5 cm2,irradiation time 50 minutes,energy 6000J/cm2).Then immunofluorescence staining was used to observe the M1 macrophage marker-inducible nitric oxide synthase(iNOS),the M2 macrophage marker arginase 1(Arg-1)and the universal marker F4/80 of macrophages after 14 days.Furthermore,in the in vitro experiment,standardized low-level laser-macrophage irradiation model was established.Another 20 Balb/c mice were used to obtain primary bone marrow-derived macrophages which were induced into M1 macrophages using lipopolysaccharide(LPS)and interferon-gamma(INF-γ).The M1 macrophages were randomly divided into the M1 macrophage group(M1 group)and the low-level laser therapy group(M1 + low-level laser group)equally according to the random number table method.The M1 group was not treated,and the M1 + low-level laser group was treated with low-level laser of selected parameters.RT-qPCR and ELISA were used to detect the expression of interleukin-1 receptor antagonist(IL-1RA)and interleukin-10(IL-10)in M1 macrophages 24 hours after irradiation.Western blot was used to analyze the expression of iNOS,Arg-1,differentiation antigen cluster 206(CD206),protein kinase B(AKT),phosphorylated protein kinase B(p-AKT),cyclic adenosine response element binding protein(CREB)and phosphorylated cyclic adenosine response element binding protein(p-CREB)in M1 macrophages 48 hours after irradiation.Dorsal root gangtion neurons(DRG)were cultured in two groups of macrophage conditioned medium,and the length of DRG axon growth was measured 48 h later to evaluate the effect of low-level laser on neuronal axon growth.Results In the in vivo experiment,compared with mice with spinal cord injury alone,the fluorescence intensity of F4/80+ iNOS+ in the spinal cord injury area decreased(1.00±0.08vs. 0.06±0.04)(P< 0.05)and the fluorescence intensity of F4/80 + Arg-1 + increased after low-level laser(1.00±0.07vs.2.15±0.12)(P<0.01).In the in vitro experiment,compared with the M1 group,the expression of the M1 macrophage marker iNOS in the M1 + low-level laser group decreased(1.00±0.11 vs.0.08±0.01)(P< 0.01);the M2 macrophage marker Arg-1(1.00±0.14vs.2.44±0.16)(P<0.01),and the expression of CD206(1.00±0.12 vs.1.83±0.05)(P<0.01)increased.In addition,IL-1RA expression was increased in the M1 + low-level laser group compared with the M1 group(RT-qPCR:1.00±0.00vs.2.27±0.22)(P<0.01)(ELISA:1435.58±100.48vs.2006.12±123.91(P<0.05);IL-10 expression was also increased in the M1 +low-level laser group compared with the M1 group(RT-qPCR:1.00±0.00 vs. 3.45±0,56)(P<0.05)(ELISA:137.13±4.20 vs.188.29±8.49)(P< 0,01);compared with the M1 group,the macrophage polarization pathway protein in the M1 + low-level laser group increased,AKT(1.07±0.12vs.1.74±0.04)(P<0.01),p-AKT(1.00±0.12 vs.1.64±0.15)(P<0.05),p-CREB(1.00±0.10vs.2.12±0.18)(P<0.01).Compared with the M1 group,the conditioned medium of the M1 + low-level laser group significantly promoted DRG axon growth(567.66±63.59 vs.1068.95±130.14)(P< 0,05).Conclusions The 810 nm low-level laser irradiation can promote neuronal axon regeneration of mice with spinal cord injury,which may be related to the regulation of macrophage polarization phenotype by low-level laser through AKT/CREB pathway.

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