Objective To build prenatal health education programs for primiparities and their spouses based on the concept of flipped classroom.Methods Expert questionnaires for prenatal health education programs for primiparities and their spouses based on the concept of flipped classroom were prepared by searching for original literatures from international and domestic databases. The Delphi method was used to investigate a total of 50 obstetrics experts from 18 ClassⅢ hospitals from Shandong province for two rounds. Results The concentration degree of these experts' opinions was high with an authority coefficient of 0.956 and a familiarity coefficient of 0.958, the determination coefficient was 0.954; the coordination coefficients for primary, secondary and tertiary indicators were 0.617, 0.423 and 0.391, respectively. The final health education program included 2 primary indicators, 11 secondary indicators and 55 tertiary indicators. Conclusions The experts' opinions on the prenatal education program for primiparities and their spouses are consistent. The program is highly scientific and reliable, which provides reference for prenatal health education for primiparities and their spouses based on flipped classroom.

The effects of adverse childhood experiences on adult health has aroused increasing concern in the world in recent years, but limited studies have been conducted in China. This study synthesized the measurement of adverse childhood experiences, the association between adverse childhood experiences and the prevalence common chronic diseases in adulthood and possible mechanisms. It was found that though measurement range of adverse childhood experiences might be different among studies, current used measurement scales basically met the requirement of disease prevention. Most categories of adverse childhood experiences were positively related to risk of common chronic diseases, and the relationship was influenced by social economic status, sex and age. However, people with exposure to famine in childhood had lower prevalence of hypertension compared with those without the exposure. The possible mechanisms might be that the occurrence of adverse childhood experiences might damage physiological functions or increase the adoption of poor healthy behaviors and lifestyles, and finally increased the risk of chronic diseases directly or indirectly. While premature death due to adverse childhood experiences might reverse the association because of nonrandom selection. It is necessary for us to select appropriate indexes of adverse childhood experiences and conduct more studies to prove the association between adverse childhood experiences and prevalence of common chronic diseases in adulthood and explore the related mechanism for the better prevention of chronic diseases in China.

Objective: To determine the effect of gut microbiota on a rat model of post-traumatic stress disorder(PTSD)and explore the correlation of gut microbiota with behavior and neurotransmitters.Methods: We established a single prolonged stress(SPS)model to examine the pathogenesis of PTSD on rat behavior,gut microbiota,and neurotransmitter levels.Rats were separated into control and model groups,and neurotransmitter levels were measured using enzyme linked immunosorbent assay.Then,16 S rRNA sequencing was used to compare the gut microbiota between the control and model groups.Results: Compared with those in the control group,freezing time significantly increased,while number of standing upright,crossing frequency,time spent in the central arena,and total distance traveled were significantly reduced in the model group after exposure to SPS(all P<.05).Meanwhile,serotonin,or 5-hydroxytryptamine,levels in the brain in the model group were significantly lower than those the control group(P=.0332).In addition,changes were observed in the gut microbiota diversity and relative abundances of bacterial phyla,orders,families,and genera in the model group.Especially,changes in Firmicutes,Bacteroidetes,Cyanobacteria,and Proteobacteria levels were most pronounced after SPS exposure.Correlation analysis showed that the strongest positive correlation was found between Bac-teroidaceae and 5-HT(P =.0009).Moreover,RF32 abundance was the most negatively related to 5-HT(P=.0009),crossing frequency(P=.0007),and total distance(P=.0003).Conclusion: Our results suggest that SPS model rats showed differences in behavior,neurotransmitter levels,and gut microbiota with control rats.Moreover,Firmicutes,Bacteroidetes,Cyanobacteria,and Proteobacteria were most relevant to the exhibited fear-like and anxiety-like behaviors and significant serotonin content reduction in SPS model rats.