Objective To elucidate the changes in the gut microbiota and molecular mechanism of huaier in enhancing the efficacy of oxaliplatin (OXA) chemotherapy in gastric cancer (GC). Methods The effects of huaier on the gut microbiota structure and intestinal barrier function in MKN45-bearing mice were analyzed by using 16S rRNA sequencing, RT-qPCR, and IHC. UPLC-MS and network pharmacology, as well as in vivo experimental approaches, were employed to investigate the key bioactive constituents of huaier systematically and elucidate the underlying mechanisms by which huaier exerts therapeutic effects against GC. The expression of the PI3K/AKT/SREBP pathway was detected in cancer cells and tissues via Western blot analysis. The safety profile of huaier combined with OXA was verified through serum biochemistry and HE-stained tissue section analyses. Results Huaier inhibited the PI3K/AKT/SREBP pathway by increasing the abundance of Akkermansia muciniphila, reduced lipid droplet deposition, and ultimately enhanced the sensitivity to OXA in the treatment of GC. Conclusion This study demonstrates the value of huaier in gastric cancer treatment by enhancing chemosensitivity and provides novel insights into its systemic therapeutic effects through molecular mechanisms and gut microbiota modulation.

Objective:To explore the risk factors of postpartum hemorrhage in parturients undergoing vaginal delivery with a second child and establish a risk prediction model.Methods:Using the convenient sampling method, a total of 2 500 parturients undergoing vaginal delivery with a second child who underwent regular prenatal examinations at Peking University Third Hospital from July 2019 to March 2023 were selected as the research objects. According to the amount of blood loss, parturients with blood loss greater than or equal to 500 ml within 24 hours after delivery were selected as the case group ( n=278), while parturients with blood loss less than 500 ml within 24 hours after delivery in the same period were selected as the control group ( n=2 222). Univariate analysis and binomial Logistic regression were used to analyze the influencing factors of postpartum hemorrhage in parturients with vaginal delivery with a second child. Based on the selected risk factors, a nomogram prediction model was established using R software, and the consistency of the model was tested. Results:The incidence of postpartum hemorrhage in 2 500 parturients undergoing vaginal delivery with a second child was 11.12% (278/2 500). Binomial Logistic regression analysis showed that in in vitro fertilization-embryo transfer, pre-delivery body mass index, lateral perineal incision, neonatal weight, placenta previa, placenta implantation and manual extraction of placenta were the influencing factors for postpartum hemorrhage in parturients undergoing vaginal delivery with a second child ( P<0.05). According to the influencing factors, a nomogram model was established to predict the probability of postpartum hemorrhage in women who gave birth to a second child. The C- index of the prediction model was 0.706, the area under the receiver operating characteristic curve was 0.706, and the χ 2 value of the Hosmer-Lemeshow goodness-of-fit test was 7.720 ( P=0.461) . Conclusions:In vitro fertilization embryo transfer, pre-delivery body mass index, perineal lateral resection, neonatal weight, placenta previa, placental implantation and manual extraction of placenta are risk factors for postpartum hemorrhage in parturients undergoing vaginal delivery for a second child. The prediction model constructed based on risk factors has certain accuracy and clinical value for predicting postpartum hemorrhage in parturients with vaginal delivery of a second child.

Objective? To explore the effects of interpregancy interval (IPI) on pregnancy outcomes in multiparas with vaginal delivery and to provide a scientific reference for preconception counseling and clinical guidance for women who planned to bear another child. Methods? All the multiparas who labored via vaginal delivery in Peking University Third Hospital between January and December 2016 were selected in this retrospective analysis. The multiparas were divided into three groups based on their IPI. The IPI of the first group was 0-35 months (n=134); The IPI of the second group was 36-71 months (n=274); and the IPI of the third group was≥72 months(n=256). The relationship between IPI and pregnancy complications, comorbidities, labor time, hemorrhage and perinatal outcome was analyzed. SPSS 22.0 was used for statistical analysis. Results? Premature rupture of membranes (PROM) was found in 18 multiparas in the first group, 37 in the second group and 58 in the third group; uterine fibroid was found in 7 multiparas in the first group, 17 in the second group and 31 in the third group; there was statistically significant difference in PROM and the incidence rate of uterine fibroid between the groups with different IPI (χ2=9.379,8.143;P＜0.05); when confounding factors such as the mothers' age were adjusted, the risk of PROM and uterine fibroid continued to rise since the 72nd month of IPI (OR=1.888,2.519;P＜0.05). Conclusions? Longer IPI is associated with the increase in the risk of PROM and uterine fibroid. Pre-pregnancy and pregnancy education should be enhanced to ensure maternal and child health according to the characteristics of multiparas with longer IPI.

Objective To evaluate the effect of surface electromyography (sEMG) applied bilaterally to the limbs in the rehabilitation of motor dysfunction among stroke survivors.Methods Sixty stroke survivors were randomized into a bilateral group (n =30) and a control group (n =30).Both groups received routine rehabilitation for 4 weeks,but the bilateral group accepted additional limb rehabilitation training for the uninjured side.Before and after the intervention,motor function was assessed using sEMG during maximal voluntary contraction of the deltoid,biceps,triceps,rectus femoris,biceps femoris and tibialis anterior muscles.Integrated EMG (iEMG) and root mean square (RMS) values were computed.Results Before the training there was no significant difference in any of the measurements between the two groups.After the training both groups had significantly improved the average strength of their maximum contractions and their average iEMG and RMS values.The bilateral group,though,demonstrated significantly better results than the control group.Conclusion Bilateral limb rehabilitation training is superior to the conventional unilateral procedure in improving the motor function of stroke survivors.

Objective To discuss the application of Occupational Functioning Model (OFM) in occupational therapy teaching. Methods The students in grade 2009 and 2010 for their course of Occupational Therapy Clinical Application were included. The former were taught in routine way, and the latter were taught with OFM. They were investigated with questionnaires of satisfaction of course and teaching. Results There were 94.1% of the students felt beneficial in the clinical thinking, 86.3% in the comprehensive quality. There was more in the grade 2010 than 2009 of students reported to be benefited in such as guidance of the occupation mode for the clinical practice, independent thinking, clinical thinking, and the capability of evaluation and plan of systemic rehabilitation (P<0.05). Conclusion OFM may help students to understand occupational therapy deeply, develop the clinical thinking, and improve the comprehensive quality.

Objective:To explore value of plasma N terminal pro B type natriuretic peptide (NT-proBNP)assessing prognosis of patients With diastolic heart failure (DHF)complicated type 2 diabetes mellitus (T2DM).Methods:The folloW-up data of 206 inpatients With DHF and T2DM from our hospital Were retrospectively analyzed.Ac-cording outcome,they Were divided into no event group (n=108)and event group [n=98,With major adverse car-diovascular events (MACE)occurred].Levels of NT-proBNP,glycosylated hemoglobin (HbA1c),total cholesterol (TC)and loW density lipoprotein cholesterol (LDL-C),left ventricular end-diastolic dimension (LVEDd),left ventricular peak early diastolic velocity/peak late diastolic velocity (E/A)and left ventricular ejection fraction (LVEF)during admission Were measured and compared betWeen tWo groups. Results:Compared With no event group,there Were significant increase in NT-proBNP level and LVEDd,and significant decrease in LVEF and E/A in event group (P<0.05 all).Single factor linear analysis indicated that NT-proBNP,HbA1c,LVEDd and E/A Were positively correlated With MACE incidence rate (r=0.075~0.091,P<0.05 all).Mutivariate Logistic regres-sion analysis indicated that NT-proBNP Was an independent predictor for MACE (OR=1.003,P=0.009).Areaunder recieve operating characteristic curve (ROC)Was 0.803 for NT-proBNP predicting mortality of patients during admission (P <0.05),and survival rate of patientsWith plasma NT-proBNP≤4010pg/mlWas significantly higher than that of patients With NT-proBNP>4010 pg/ml (OR=5.028,P <0.05).Conclusion:Plasma NT-proBNP can independently predict prognosis of patients With diastolic heart failure complicated type 2 diabetes mellitus.

Objective To observe the effects of total flavone from litchi chinensis sonn (TFL) on the liver function in-cluding p16 protein, pro collagen type 3 (PC3) and pro collagen typeⅠ(PCⅠ) in model rats with liver fibrosis induced by bile duct ligation. Methods Forty rats were randomly divided into four groups:sham operation (SO) group, bile duct liga-tion (BDL) group, TFL group and silibinin (SIL) group. Rats were gavaged with saline (5 mL·kg-1·d-1) in SO and BDL group, rats were gavaged with TFL (200 mL·kg-1·d-1) in TFL group and rats were gavaged with SIL (5 mL·kg-1·d-1) in SIL group for four weeks. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin direct (BILD) and bilirubin total (BILT) were detected in four groups. The liver tissues were stained by HE and Masson methods. The ex-pression levels of p16, PC3 and PCⅠin liver tissues were determined by Western blot assay. Results The serum levels of ALT (44.6 IU/L±8.0 IU/L), AST (103.8 IU/L±18.1 IU/L), BILD (0.76 μmol/L±0.28μmol/L) and BILT (1.48μmol/L±0.35μmol/L) were lower in SO group. There was a higher level of ALT in BDL group (147.4 IU/L±86.3 IU/L) than that of TFL group (92.9 IU/L±47.3 IU/L). The serum level of ALT was higher in AST group (362.7 IU/L±106.6 IU/L) than that of TFL group (290.1 IU/L ± 171.7 IU/L) and SIL group (250.2 IU/L ± 54.9 IU/L). The serum level of BILD was lower in BDL group (99.71μmol/L±40.87μmol/L) than that of SIL group (137.01μmol/L±38.86μmol/L). The serum levels of BILD and BILT were significantly lower in TFL group (81.48μmol/L±47.50μmol/L, 106.64μmol/L±61.04μmol/L) than those of SIL group (P<0.05). There were small amount of new bile duct and no obvious cells degeneration, small amount of infiltration of in-flammatory cells and collagen deposition in TFL group. The liver fibrosis improved significantly in TFL group than that of BDL group. There were more new bile duct in hepatic portal area in SIL group than those of TFL group. The expression levels of p16, PC3 and PCⅠwere significantly higher in BDL group than those of TFL group. The expression level of PC3 was significantly lower in BDL group than that of SIL group. The expression level of PCⅠwas significantly higher in BDL group than that of SIL group (P<0.05). There was no significant difference in the expression level of p16 between BDL group and SIL group. The expression levels of PC16 and PC3 were significantly lower in TFL group than those of SIL group (P<0.05). There was no significant difference in the ex-pression level of PCⅠbetween TFL group and SIL group. Conclusion TFL can improve the liver function in model rats with choles-tatic liver fibrosis and reduce liver fibrosis, which may be related with inhibitory effects on the expressions of p 16, PC3 and PCⅠ.

Objective To discuss the impact of the pattern of student-autonomous laboratories opening on the experimental teaching of rehabilitation specialty. Methods Laboratories were opened to sophomore students of rehabilitation specialty. Planned opening pattern is employed on students of 2009 class and autonomous opening pattern is used on students of 2010 class. At the end of each term, results of these opening patterns are compared. Results The total opening hours of planned opening pattern were 89 with 755 person-times involved. The accumulated opening hours of autonomous opening pattern were 323 with 2677 person-times involved. Students of the autonomous opening pattern class achieved better academic results than students of planned opening pattern (P<0.05) in 7 major courses. Opening laboratories to students contributed to the improvement of rehabilitation skills, better understanding of the curricular knowledge, the enhancement of problem-analyzing and problem solving abilities, the stimulation of interest in major study and also the fostering of teamwork spirit. And the autonomous opening pattern achieved more desirable results (P<0.05). Conclusion The student-autonomous lab opening pattern contributes more to the improvement of students' practical skills, innovative spirit as well as comprehensive clinical rehabilitation abilities.

Objective To analyse the CT features of solitary bronchioalveolar carcinoma(SBAC) so that to improve the CT diagnostic accuracy.Methods CT findings of 39 cases with SBAC proved by operation and pathology were studied,and an analysis as compared with 48 cases other type of peripheral pulmonary carcinoma.Results CT findings included lobulations in 32,spiculation in 33,pleural tags in 25,bronchovascular bundles in 14,vacuole or/and bronchiologram in 18 and ground glass changs in 8 cases.Conclusion The characteristic CT manifestations of SBAC are:(1)Vacuole or/and bronchiologram;(2)Long spiculation;(3)Ground-glass.It is important to recognize the CT appearances of SBAC in order to improve diagnostic ability.