Objective To observe the effects of fecal microbiota transplantation on intestinal microbiota and brain function in sepsis rats. Methods Sixty male Sprague Dawley (SD) rats were divided into sham operation group, model group and fecal microbiota transplantation (FMT) group by random number table, each group 20 rats. The rat model of sepsis was established by injection of lipopolysaccharide (LPS) 10 mg/kg in tail vein. FMT group received nasogastric infusion of feces from healthy donor. Fecal samples were collected on the 6th day after the modeling to detect the levels of intestinal microbiota composition; the brain function was also evaluated by electroencephalogram (EEG), and the proportion of each waveform in EEG was calculated. After sacrifice of rats in different groups, the brain tissues were taken, the levels of protein expression and positive cells of Iba-1 in brain tissue were detected by Western Blot and immunohistochemistry method. Results ① Intestinal flora analysis showed that: the diversity index and Chaol index of the intestinal microbiota in model group were significantly lower than that in sham operation group (observed species:282±40 vs. 473±37, Chao1 index: 730±21 vs. 837±27, both P < 0.05); compared with the model group, the diversity index and Chaol index in FMT group were obviously higher (observed species: 461±20 vs. 282±40, Chao1 index:840±16 vs. 730±21, both P < 0.05). At phylum, family, genus level analysis showed that the proportion of Firmicutes phylum and Fusobacterium were obviously lower than those of sham operation group [Firmicutes phylum (22.12±1.34)% vs. (78.01±1.23)%, Fusobacterium: (2.03±0.17)% vs. (5.03±0.19)%, both P < 0.05], and the proportions of Proteobacteria, Bacteroidetes phyla and Acidaminococcaceae, Fusobacteriaceae, Enterbacteriacecae, Alistipes were markedly higher in model group [Proteobacteria: (70.21±2.35)% vs. (19.45±2.17)%, Bacteroidetes phyla: (4.12±0.19)% vs. (2.50±0.64)%, Acidaminococcaceae: (12.51±0.87)% vs. (1.01±0.12)%, Fusobacteriaceae: (13.62±1.27)% vs. (2.31±0.19)%, Enterbacteriacecae: (18.24±2.13)% vs. (4.15±1.51)%, Alistipes: (4.53±0.27)% vs. (1.47±0.33)%, all P < 0.05]; compared with the model group, the proportion of Firmicutes phylum and Faecalibacterium in FMT group were significantly higher [Firmicutes phylum: (72.14±2.31)% vs. (22.12±1.34)%, Faecalibacterium: (5.01±0.27)% vs. (2.03±0.17)%, both P < 0.05], and Proteobacteria, Bacteroidetes phyla and Acidaminococcaceae, Fusobacteriaceae, Enterbacteriacecae in FMT group were obviously lower [Proteobacteria: (14.23±1.98)% vs. (70.21±2.35)%, Bacteroidetes phyla: (3.15±0.18)% vs. (4.12±0.19)%, Acidaminococcaceae: (0.91±0.11)% vs. (12.51±0.87)%, Fusobacteriaceae: (1.25±0.15)% vs. (13.62±1.27)%, Enterbacteriacecae: (3.50±0.21)% vs. (18.24±2.13)%, all P < 0.05]. ② EEG analysis showed that the percentages of δ wave in EEG in model group was significantly higher after modeling than that in sham operation group [(16.86±0.50)% vs. (10.67±0.65)%, P < 0.05]; the ratios of δ wave in EEG was significantly lower in FMT group than that in the model group [(12.87±0.60)% vs. (17.35±0.41)%, P <0.05]. The incidence of abnormal EEG in sham operation group was 0, the incidence of abnormal EEG in model group was significantly increased [the ratios of δpredominant wave, θpredominant wave, low-voltage were 66.7% (6/9), 66.7% (6/9), 77.8% (7/9) respectively], the ratios of above abnormal waves in EEG in FMT group were obviously lower than those in model group [the ratios of above abnormal waves in FMT group were respectively 9.1% (1/11), 9.1% (1/11), 18.2%(2/11)]. ③ Western Blot analysis showed that the protein expression of Iba-1 in cortex in model group obviously was higher than that in sham operation group (Iba-1/β-actin: 1.39±0.16 vs. 0.67±0.18, P < 0.05); the expression of Iba-1 in cortex tissue of FMT group was markedly lower than that in model group (Iba-1/β-actin: 0.51±0.14 vs. 1.39±0.16, P < 0.05). ④ Immunohistochemistry of Iba-1 in cortex analysis showed that there were no Iba-1 positive cells in the cortex in sham operation group; Iba-1 positive cells were found in the cortex in model group; the number of Iba-1 positive cells in FMT group was less than that in model group. Conclusion FMT can improve the construction of intestinal microbiota, and ameliorate the brain dysfunction in SAE.

Objective:To explore the application effect of coaching technique in respiratory function exercise of patients with chronic obstructive pulmonary disease (COPD) in stable stage.Methods:Using the convenient sampling method, a total of 40 COPD patients in stable stage who were treated in Geriatric and Respiratory Departments of 3 provincial hospitals in Hangzhou were selected as the research objects from August 2018 to June 2019. They were given a six-month breathing intervention based on coaching techniques by trained health coaches. COPD Self-Efficacy Scale (CSES) and COPD Assessment Test (CAT) were used to evaluate self-efficacy and quality of life of patients before and after intervention. The awareness and implementation of respiratory function exercise were compared before and after intervention.Results:After6 months of intervention, compared with those before intervention, the score of awareness and implementation of respiratory function exercise of patients increased, and the differences were statistically significant ( P<0.05) . After the intervention, the score of CSES increased and the scores of CAT decreased, and the differences were statistically significant compared with those before the intervention ( P<0.05) . Conclusions:The application of coaching technique in the respiratory function exercise of COPD patients in stable period has a certain effect, which can improve the awareness and implementation of patients with respiratory function exercise and improve their sense of self-efficacy and quality of life.

Objective To observe the application effect of magnetic resonance imaging technology in evaluating the brain structure and function of patients with type 2 diabetic painful neuropathy(PDN).Methods Forty patients with type 2 diabetes mellitus hospitalized in our hospital were se-lected as the study objects,and were divided into diabetes mellitus(DM)group(n=12),peripheral neuropathy(DPN)group(n=14)and PDN group(n=14).General clinical biochemical indexes of three groups were analyzed.The structural brain and function of brain area in three groups were com-pared.Results Age,duration of diabetes,systolic blood pressure,diastolic blood pressure,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),free fatty acid(FFA),albumin(ALB),creatinine(Cr),uric acid(UA),estimated glomerular filtration rate(eGFR),cystatin C(Cys-C),total cholesterol(TC),triglyceride(TG)of the three groups were compared,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase anti-body(TPO-Ab)and serum calcium(Ca)in the three groups showed no significant differences(P＞0.05).Compared with the DM group,the gray matter volume(GMV)in the DPN group was signifi-cantly decreased(P＜0.05).Compared with the DM group,amplitude of low frequency fluctuation(ALFF)and fractional amplitude of low frequency fluctuation(fALFF)of left medial superiorfrontal gyrus in the PDN group were significantly decreased(P＜0.05).Conclusion Abnormal GMV in the left angular gyrus in DPN patients may be associated with a higher risk of concomitant cognitive impairment.The decrease of ALFF in the right cerebellar vermis and fALFF in the left medial superior frontal gyrus in PDN patients may be related to the pathogenesis of pain.

Objective To observe the application effect of magnetic resonance imaging technology in evaluating the brain structure and function of patients with type 2 diabetic painful neuropathy(PDN).Methods Forty patients with type 2 diabetes mellitus hospitalized in our hospital were se-lected as the study objects,and were divided into diabetes mellitus(DM)group(n=12),peripheral neuropathy(DPN)group(n=14)and PDN group(n=14).General clinical biochemical indexes of three groups were analyzed.The structural brain and function of brain area in three groups were com-pared.Results Age,duration of diabetes,systolic blood pressure,diastolic blood pressure,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),free fatty acid(FFA),albumin(ALB),creatinine(Cr),uric acid(UA),estimated glomerular filtration rate(eGFR),cystatin C(Cys-C),total cholesterol(TC),triglyceride(TG)of the three groups were compared,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase anti-body(TPO-Ab)and serum calcium(Ca)in the three groups showed no significant differences(P＞0.05).Compared with the DM group,the gray matter volume(GMV)in the DPN group was signifi-cantly decreased(P＜0.05).Compared with the DM group,amplitude of low frequency fluctuation(ALFF)and fractional amplitude of low frequency fluctuation(fALFF)of left medial superiorfrontal gyrus in the PDN group were significantly decreased(P＜0.05).Conclusion Abnormal GMV in the left angular gyrus in DPN patients may be associated with a higher risk of concomitant cognitive impairment.The decrease of ALFF in the right cerebellar vermis and fALFF in the left medial superior frontal gyrus in PDN patients may be related to the pathogenesis of pain.

Objective : To explore the association of time in range(TIR) and glucose management indicator ( GMI) with the risk of type 2 diabetic nephropathy (DN) ． Methods : The clinical data of 215 patients with type 2 diabetes mellitus (T2DM) were collected and analyzed．According to the results of estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio( UACR) ，they were divided into 117 patients with T2DM and 98 patients with DN．The clinical data，biochemical indicators and continuous glucose monitoring ( CGM) indicators of the two groups were compared．Logistic regression was used to analyze the influencing factors of DN risk．The predictive value of TIR and GMI on the risk of DN was evaluated by receiver operating characteristic (ROC) curve. Results: There were significant differences in age，duration of diabetes，systolic blood pressure，glycosylated hemoglobin ( HbA1c) ，fasting plasma glucose (FPG) ，2 hour postprandial plasma glucose (2hPG) ，creatinine( Cr) ，UACR, eGFR between the two groups(P＜0. 05) ．There were statistically significant differences between the two groups in the CGM indexes of GMI，mean absolute difference of mean of daily differences ( MODD) ，glucose above target range time(TAR) and TIR(P＜0. 05) ．The results of logistic regression analysis showed that TIR was a protective factor of DN．In the ROC curve analysis of TIR prediction DN，the area under the ROC curve was 0. 718 (95% CI = 0. 648 ～0. 789，P＜0. 001) ，and the Yoden index was 0. 38．At this time，the sensitivity was 66. 7% ，and the specificity was 71. 3%．In the ROC curve analysis of GMI prediction DN，the area under the ROC curve was 0. 701 (95% CI = 0. 629 ～0. 774，P＜0. 001) ，and the Yoden index was 0. 368．At this time，the sensitivity was 63. 3% ， and the specificity was 73. 5%． Conclusion Specifically，lower TIR and higher GMI increase the risk of DN.