Objective:To explore the relationship between gut microbiota and giant cell arteritis (GCA), and to identifyits potential therapeutic strategies.Methods:Gut microbiota data were obtained from the MiBioGen consortium genome-wide association study (GWAS), and GCA data were obtained from the FinnGen consortium public GWAS. Causal associations between gut microbiota and GCA were assessed using two-sample Mendelian randomization (MR) analyses, including inverse-variance weighted (IVW), weighted median, MR-Egger regression, simple mode, and weighted mode methods. Heterogeneity and horizontal pleiotropy were evaluated, and false positive results were excluded by using the Benjamini-Hochberg (BH) method of multiple hypothesis testing. All analyses were completed using the TwoSampleMR and MRPRESSO software packages (version 4.3.0) in R language. The analysis of the intestinal flora data, followed by conducting network pharmacology analysis were carried out by Cytoscape 3.9.1 and perform molecular docking verification was performed with AutoDock Vina software.Results:IVW simulations revealed 13 gut microbiota taxa were associated with GCA, of which Lachnospiraceae was significantly negatively associated with GCA risk[nSNP=16, OR(95% CI)=0.32(0.16, 0.63), β=-1.15, Se=0.35, P=0.001, FDR<0.05], and there was no heterogeneity (Cochran′s Q test, Q=13.42, P=0.490) as well as horizontal pleiotropy ( P=0.370). Further literature search and computer simulation docking analysis showed that genistein binds to MMP2 with a binding energy of -43.1 kJ/mol. Conclusion:Lachnospiraceae in the gut microbiota was is negatively associated with GCA, and genistein may be able to regulate the abundance of Lachnospiraceae through the MMP2 target to treat GCA, providing a new therapeutic approach for giant cell arteritis.

Objective:To explore the relationship between gut microbiota and giant cell arteritis (GCA), and to identifyits potential therapeutic strategies.Methods:Gut microbiota data were obtained from the MiBioGen consortium genome-wide association study (GWAS), and GCA data were obtained from the FinnGen consortium public GWAS. Causal associations between gut microbiota and GCA were assessed using two-sample Mendelian randomization (MR) analyses, including inverse-variance weighted (IVW), weighted median, MR-Egger regression, simple mode, and weighted mode methods. Heterogeneity and horizontal pleiotropy were evaluated, and false positive results were excluded by using the Benjamini-Hochberg (BH) method of multiple hypothesis testing. All analyses were completed using the TwoSampleMR and MRPRESSO software packages (version 4.3.0) in R language. The analysis of the intestinal flora data, followed by conducting network pharmacology analysis were carried out by Cytoscape 3.9.1 and perform molecular docking verification was performed with AutoDock Vina software.Results:IVW simulations revealed 13 gut microbiota taxa were associated with GCA, of which Lachnospiraceae was significantly negatively associated with GCA risk[nSNP=16, OR(95% CI)=0.32(0.16, 0.63), β=-1.15, Se=0.35, P=0.001, FDR<0.05], and there was no heterogeneity (Cochran′s Q test, Q=13.42, P=0.490) as well as horizontal pleiotropy ( P=0.370). Further literature search and computer simulation docking analysis showed that genistein binds to MMP2 with a binding energy of -43.1 kJ/mol. Conclusion:Lachnospiraceae in the gut microbiota was is negatively associated with GCA, and genistein may be able to regulate the abundance of Lachnospiraceae through the MMP2 target to treat GCA, providing a new therapeutic approach for giant cell arteritis.

Objective:To investigate the current status of affective commitment and feedback-seeking behavior in junior nurses in three Class Ⅲ Grade A hospitals in Wenzhou and to explore the effect of affective commitment of junior nurses on feedback-seeking behavior.Methods:Methods Using the convenient sampling method, a total of 400 junior nurses in 3 ClassⅢ Grade A hospitals in Wenzhou in Zhejiang Province from October to December 2019 were selected as research objects. General data questionnaire, Affective Commitment Scale and Feedback-Seeking Behavior Scale were used to investigate the effect of affective commitment of junior nurses on feedback-seeking behavior. In this study, a total of 400 questionnaires were issued, and 372 valid questionnaires were collected, with an effective recovery rate of 93%.Results:The total score of Affective Commitment Scale for 372 junior nurses was (29.07±4.86) and that of Feedback-Seeking Behavior Scale was (40.47±6.47) . The results of univariate analysis showed that there were statistically significant differences in the feedback seeking behavior scores of junior nurses in terms of title, education background, department and employment mode ( P<0.05) . Pearson correlation analysis showed that the total score of Affective Commitment Scale for junior nurses was positively correlated with the total score of Feedback-Seeking Behavior Scale ( P<0.05) . Stratified regression analysis results showed that affective commitment had a predictive effect on feedback-seeking behavior of junior nurses ( P<0.05) . Conclusions:The affective commitment and feedback-seeking behavior of junior nurses are in the middle level and need to be further strengthened. Affective commitment positively affects feedback-seeking behavior, so nursing managers can improve the level of feedback-seeking behavior by strengthening the affective commitment level of junior nurses.

Objective:To explore the relationship between readiness to return to work and family resilience in patients with breast cancer.Methods:Totally 158 patients with breast cancer were selected convenient sampling from a ClassⅢ Grade A hospital in Zhejiang Province between June and September 2019, and investigated with Readiness for Return-To-Work Scale (RRTW) , The Family Resilience Assessment Scale (FRAS) , and a self-made demographic and clinical information questionnaire. Ordered logistic regression analysis was used to analyze the influencing factors.Results:Totally 70.3% (111/158) of patients were at a lower level of readiness to return to work (pre-intention and intention phase) . The ordered logistic regression analysis revealed that family resilience ( OR=1.225; 95% CI: 1.160-1.294) , mentally-based work ( OR=3.016; 95% CI: 1.206-7.553) and low age group ( OR=3.403-4.217; 95% CI: 2.588-6.234) were the protective factors for breast cancer patients' readiness to return to work; low education level ( OR=0.029; 95% CI: 0.001-0.381) and short operation time ( OR=0.181; 95% CI: 0.065-0.505) were the risk factors for their readiness to return to work. Conclusions:Breast cancer patients have a low level of readiness to return to work, and relevant departments should pay attention to their re-employment. Medical personnel should focus on the patients' cognition of returning to work during the recovery phase, and encourage them to resume work within their ability after they recover physically.

Objective? To explore the application effect of self-help lower limb functional exercise shoes in elderly patients after total knee arthroplasty(TKA). Methods? A total of 58 patients with knee osteoarthritis who underwent TKA in the Second Affiliated Hospital of Wenzhou Medical University from September of 2017 to September 2018 were selected and randomly divided into the control group(n=28) and observation group(n=30). Routine functional exercise method was adopted in the control group while self-help lower limb functional exercise shoes were applied in the observation group. The time needed to master the functional exercise instruction, compliance with the functional exercise and knee joints activity post-operation in the two groups were compared. Results? The time needed to master the functional exercise instruction in the observation group was (4.3±1.5)min, shorter than the control group with statistical significance (t=4.87, P＜ 0.01). In the observation group there were 27 patients who had high compliance with the functional exercise, while 15 patients in the control group had high compliance, the difference was statistically significant (χ2=9.62,P＜0.05). Three months after operation, the knee joint activity of the observation group was better than that of the control group (115.3±11.3)°, the difference was statistically significant (t=2.45, P＜0.05). Conclusions? The use of self-help lower limb functional exercise can help the elderly TKA patients to master the functional exercise method faster, improve their compliance with postoperative functional exercise, improve postoperative rehabilitation exercise effects and promote early recovery of the affected limb functional.

Objective To explore stigma in patients after breast modified radical mastectomy, and analyze the correlation of stigma with coping style and self-esteem.Methods From January 2015 to February 2017, totally 186 patients after breast modified radical mastectomy were selected by convenience sampling method and investigated by self-designed general demographic questionnaire, Social Impact Scale, Medical Coping Modes Questionnaire and Self-Esteem Scale. Pearson correlation analysis was used to investigate the correlation of breast cancer patients' stigma with coping style and self-esteem, and multiple linear regression was adopted to analyze the influencing factors of stigma.Results Patients' stigma after surgery was (61.04±11.99), which was at a moderate level. The stigma was negatively correlated with confrontation and self-esteem (r= -0.421, -0.574;P<0.05), and positively correlated with resignation and avoidance (r=0.564, 0.414;P<0.05). The result of multiple linear regression showed that age and resigned coping style were the influencing factors of stigma (β'=0.291,0.263;P<0.05).Conclusions The stigma of patients after breast modified radical mastectomy is at a moderate level, and should be paid attention. Nurses should encourage patients to face difficulties and challenges, and communicate with others actively. Besides, young adult patients should be taken into consideration.

Objective To investigate the relationships among current alexithymia, social relational quality and quality of life in breast cancer patients receiving chemotherapy. Methods By convenient sampling method, from April 2015 to September 2016, totally 151 patients were invited to complete demographic questionnaire, Toronto alexithymia scale, social relational quality scale and functional assessment of cancer therapy-breast. The Pearson correlation method was used to analyze the relationship among current alexithymia, social relational quality and quality of life. Results All of the patients got the average score (59.11±15.75) on Toronto alexithymia scale, which was moderate level. The total scores of social relational quality and life quality were (53.45±5.13) and (93.84±15.17). There was a negative relationship between alexithymia with social relational quality (r=-0.441) and quality of life (r=-0.597) (P<0.05). Conclusions Breast cancer patients has serious alexithymia after the operation. Nurses can carry out activities which gives patients more opportunities to express emotion, encourage patients to face difficulties and challenges, communicate with others actively, and get more support from others and encourage family members participate in the patient care process to reduce alexithymia and improve quality of life.

Objective To explore the risk factors of postoperative activities of daily living in elderly patients after hip fracture. Methods By convenience sampling,from October 2013 to June 2015,150 elderly patients having undergone surgery after hip fracture were selected,with data of 141 cases finally collected. Gender,age,underlying diseases,surgical procedures,postoperative complications,ambulation time,whether walking with aids,family caregivers and reexamination conditions were recorded for evaluation of the patients about their activities of daily living half a year after the surgery. Mean comparison and chi-square test were used for univariate analysis about the above factors and Logistic regression analysis was used to identify possible risk factors. Results It was shown in univariate analysis that recovery of postoperative activities of daily living was influenced by age,surgical procedures,postoperative complications,ambulation time,walking aids,etc. (P< 0.05);it was shown in multivariate logistic regression that age (OR=1.065,95%CI:1.010-1.124, P=0.020),surgical procedures (OR=2.900,95%CI:1.200-7.008,P=0.018),postoperative complications (OR=6.366,95%CI:2.592-15.632,P< 0.001),ambulation time (OR=2.684,95%CI:1.133-6.359,P=0.025) and walking aids (OR=5.796,95%CI:1.542-21.780,P=0.009) were risk factors of postoperative daily living ability in elderly patients after hip fracture. Conclusions Old age,developing internal fixation surgery after incision,postoperative complications, walking more than 3 months after operation or walking without aids affect postoperative activities of daily living in elderly patients after hip fracture,thus affecting their quality of life, which makes it necessary for nursing staff to focus on risk factors for positive prevention and intervention.