Objective:To investigate gut microbiota differences between individuals with and without colorectal adenoma(CRA)and to identify gut microbes associated with CRA.Methods:This cross-sectional study analyzed the gut microbiota of 100 patients with CRA and 68 individuals without CRA(aged 40-75 years)who underwent colonoscopies between March 2021 and March 2022 at Tianjin Nankai Hospital.Fecal samples were sequenced for the V3-V4 region of the bacterial 16S rRNA gene using the Illumina NovaSeq platform.Results:Compared to the non-CRA group,the CRA group exhibited reduced relative abundances of identified and unidentified Lachnospiraceae,with increased Faecalibacterium and Streptococcus.In the non-CRA group,the relative abundances of Coprococcus,unidentified Clostridiaceae,and Clostridium were higher.LEfSe analysis revealed significant enrichment of Gammaproteobacteria,Proteobacteria,Enterobacteriales,and Faecalibacterium in the CRA group,while the non-CRA group was enriched for Moraxellaceae,Acinetobacter,and Anaerostipes.Conclusions:These findings suggest a discernible disparity in the gut microbiota structure between CRA patients and individuals without adenoma.The enrichment of potential pathogenic taxa,such as Faecalibacterium and Streptococcus,in the CRA group suggests a possible association with adenoma development.

Objective:To explore the mediating role of negative automatic thoughts between health literacy and childbirth fear of primiparas.Methods:The primiparas who underwent obstetric examination in Department of Obstetrics, Lishui People′s Hospital from January 2021 to December 2023 were selected as the research objects by convenience sampling method. Using cross-sectional survey, the general information questionnaire, Childbirth Attitude Questionnaire, The Automatic Thought Questionnaire and Perinatal Pregnant Women′s Health Literacy Scale were used to investigate. Pearson correlation analysis was performed by SPSS 26.0, AMOS 24.0 was used to construct the mediating effect model of negative automatic thoughts between health literacy and childbirth fear of primiparas, and Bootstrap method was used to test the mediating effect.Results:A total of 246 questionnaires were distributed, and 235 valid questionnaires were collected. The age of 235 primiparas was (27.56 ± 3.74) years old. The total score of health literacy, negative automatic thoughts, childbirth fear was (173.29 ± 20.20), (88.13 ± 16.50), (46.52 ± 12.67) points. The direct effect of health literacy on childbirth fear of primiparas was -0.319 (95% CI -0.495--0.144), accounting for 56.00% of the total effect. The indirect effect of negative automatic thoughts between health literacy and childbirth fear was -0.251 (95% CI -0.393--0.127), accounting for 44.00% of the total effect. Conclusions:Negative automatic thoughts plays a partial mediating role between health literacy and childbirth fear of primiparas. Nursing staff should formulate intervention measures according to the path of influencing childbirth fear, so as to minimize the level of childbirth fear.

Objective:To investigate gut microbiota differences between individuals with and without colorectal adenoma(CRA)and to identify gut microbes associated with CRA.Methods:This cross-sectional study analyzed the gut microbiota of 100 patients with CRA and 68 individuals without CRA(aged 40-75 years)who underwent colonoscopies between March 2021 and March 2022 at Tianjin Nankai Hospital.Fecal samples were sequenced for the V3-V4 region of the bacterial 16S rRNA gene using the Illumina NovaSeq platform.Results:Compared to the non-CRA group,the CRA group exhibited reduced relative abundances of identified and unidentified Lachnospiraceae,with increased Faecalibacterium and Streptococcus.In the non-CRA group,the relative abundances of Coprococcus,unidentified Clostridiaceae,and Clostridium were higher.LEfSe analysis revealed significant enrichment of Gammaproteobacteria,Proteobacteria,Enterobacteriales,and Faecalibacterium in the CRA group,while the non-CRA group was enriched for Moraxellaceae,Acinetobacter,and Anaerostipes.Conclusions:These findings suggest a discernible disparity in the gut microbiota structure between CRA patients and individuals without adenoma.The enrichment of potential pathogenic taxa,such as Faecalibacterium and Streptococcus,in the CRA group suggests a possible association with adenoma development.

Objective:To explore the mediating role of negative automatic thoughts between health literacy and childbirth fear of primiparas.Methods:The primiparas who underwent obstetric examination in Department of Obstetrics, Lishui People′s Hospital from January 2021 to December 2023 were selected as the research objects by convenience sampling method. Using cross-sectional survey, the general information questionnaire, Childbirth Attitude Questionnaire, The Automatic Thought Questionnaire and Perinatal Pregnant Women′s Health Literacy Scale were used to investigate. Pearson correlation analysis was performed by SPSS 26.0, AMOS 24.0 was used to construct the mediating effect model of negative automatic thoughts between health literacy and childbirth fear of primiparas, and Bootstrap method was used to test the mediating effect.Results:A total of 246 questionnaires were distributed, and 235 valid questionnaires were collected. The age of 235 primiparas was (27.56 ± 3.74) years old. The total score of health literacy, negative automatic thoughts, childbirth fear was (173.29 ± 20.20), (88.13 ± 16.50), (46.52 ± 12.67) points. The direct effect of health literacy on childbirth fear of primiparas was -0.319 (95% CI -0.495--0.144), accounting for 56.00% of the total effect. The indirect effect of negative automatic thoughts between health literacy and childbirth fear was -0.251 (95% CI -0.393--0.127), accounting for 44.00% of the total effect. Conclusions:Negative automatic thoughts plays a partial mediating role between health literacy and childbirth fear of primiparas. Nursing staff should formulate intervention measures according to the path of influencing childbirth fear, so as to minimize the level of childbirth fear.

Objective To analyze the main active components and potential molecular mechanism of Sophora flavescens against breast cancer based on network pharmacology and molecular docking. Methods The chemical constituents were collected and screened by TCMSP, ETCM database and literature review. The targets of active ingredients were predicted by Swiss Target Prediction database. Breast cancer-related targets were collected by GeneCards, TTD, Drugbank and OMIM. The anti-breast cancer targets of Sophora flavescens were screened by Venny 2.1.0 software. Cytoscape software was used to construct the network diagram of Sophora flavescens-key active ingredients-targets. STRING database was used to analyze the common targets, and PPI network diagram was constructed. GO function enrichment analysis and KEGG pathway enrichment analysis of key target proteins were performed by DAVID database and Hiplot online platform. Schrodinger software was used to calculate the molecular docking between the active ingredients and targets. Molecular biological methods were used to verify the key targets. Results A total of 36 active components with clear structures were screened from Sophora flavescens. 70 anti-breast cancer targets of Sophora flavescens were screened out. 12 core targets including EGFR, AKT1, ESR1, SRC, CYP19A1, AR and ABCB1 participate in endocrine resistance, EGFR tyrosine kinase inhibitors and estrogen signaling pathways in breast cancer. Moreover, the docking score between the core component and the key target AR is the highest. In vitro experiments showed that the extract of Sophora flavescens can inhibit the proliferation of breast cancer cells, induce cell apoptosis and up-regulate AR protein expression. Conclusion It was revealed that Sophora flavescens plays an anti-breast cancer role by regulating complex biological processes through multiple components acting on multiple targets and signaling pathways. The upregulation of AR protein by Sophora flavescens may become a new therapeutic strategy for the treatment of breast cancer.

Objective:To investigate the effect of applying foam dressing combined with self-made adhesive penile hood fixation in children after circumcision.Methods:A total of 101 cases of children who received circumcision from January to December 2020 in the urology department of the People′s Hospital of Xuancheng City were selected. The patients were randomly divided into experimental group (50 cases) and control group (51 cases). In the experimental group, the incision was wound with foam dressing combined with the self-made adhesive penile hood fixation method, while in the control group, the incision was wound with the conventional sterile gauze dressing combined with the simple plastic basket fixation method.The postoperative incision bleeding, prepuce edema, incision pain, incidence of complications and the satisfaction of the children′s family members on postoperative dressing and fixation were compared between the two groups.Results:The incidence of prepuce edema in the experimental group was 88.00% (44/50), 12.00% (6/50), 0, which in the control group was 43.14% (22/51), 45.10% (23/51), 11.76% (6/51), and the difference between the two groups was statistically significant ( Z= -4.80, P<0.05). In the experimental group, pain score at 24 hours after operation and at the time of dressing change were 3.50 ± 1.04, 2.48 ± 0.54, respectively, which were lower than that of the control group 5.31 ± 1.36 and 7.12 ± 0.97, and the difference between the two groups was statistically significant ( t=7.53, 29.66, all P<0.05). The incidence of postoperative infection and urinary retention in the experimental group were 0 and 2.00% (1/50), respectively, which were lower than 7.84% (4/51) and 7.84% (4/51) in the control group, and the difference between the two groups was statistically significant (Fisher′s exact probability method, P<0.05). The degree of family satisfaction in the experimental group was 96.00% (48/50), which was higher than that in the control group (78.43%, 40/51), and the difference between the two groups was statistically significant ( χ2=6.95, P<0.05). Conclusions:The application of foam dressing combined with pasting penile hood after circumcision can reduce the degree of foreskin edema, pain and the incidence of complications, and improve the satisfaction of the children′s family members.

Paclitaxel is the first-line chemotherapy drug for a variety of cancers. However， the paclitaxel resistance greatly reduced the efficacy in the later treatment stage， which seriously increased the mortality and recurrence rate of cancer and limited the clinical application of paclitaxel. At present， Chinese medicine compound prescription， proprietary Chinese medicine， and Chinese medicine injection are widely used as the adjuvant chemotherapy drugs for the treatment of cancer in clinic. Chinese medicine has shown unique advantages in improving the efficacy of chemotherapy drugs and the prognosis of chemotherapy， and reducing the toxic and side effects. However， the specific mechanism and effective monomer composition of Chinese medicine for reversing the resistance of chemotherapy drugs are unclear， and the application of Chinese medicine in different types of cancer is also limited， which are worthy of further exploration. This review summarized the composition of Chinese medicine monomer with synergistic antitumor effect combined with paclitaxel in recent years. The specific mechanism and pharmacological activities of Chinese medicine monomer reversing paclitaxel resistance were classified. This review found that through acting on the membrane transport protein， Chinese medicine monomer promoted the accumulation of paclitaxel in tumor cells， inhibited the expressions of protein and metabolic enzyme related to multidrug resistance and the metabolism of paclitaxel， and regulated the levels of apoptosis genes and factors and apoptosis-related pathways to promote the inhibitory effect of paclitaxel on cell proliferation. Chinese medicine monomer also significantly improved paclitaxel chemotherapy sensitivity by regulating the expression levels of micro ribonucleic acid （microRNA） and long non-coding ribonucleic acid RNA （lncRNA）， inhibiting the characteristics of tumor stem cells and tumor metabolic reprogramming， improving tumor microenvironment， and triggering tumor cell death autophagy and oxidative stress response. This review provides a theoretical basis for clarifying the specific anti-tumor mechanism of Chinese medicine monomer combined with paclitaxel， which is of great significance for the development of new Chinese medicine and the clinical research of the drugs combined with paclitaxel， and has certain value for the application of Chinese medicine combined with other chemotherapy drugs.

Objective:To analyze the risk factors of postpartum type 2 diabetes (T2DM) in patients with family history of diabetes mellitus with gestational diabetes mellitus (GDM).Methods:From January 2017 to January 2019, 275 patients with GDM and family history of diabetes were selected. According to the occurrence of postpartum T2DM, the patients were divided into postpartum normal group (207 cases) and postpartum disease group (68 cases). The clinical data of the two groups were compared, and the independent risk factors of postpartum T2DM were analyzed by logistic regression, and a line chart prediction model was constructed. Receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive ability of the model. X-tile software was used to obtain the integral truncation value of the line graph model, and survival curve was drawn and internal verification was carried out.Results:Of 275 GDM patients, 68 had T2DM after delivery, with a incidence rate of 24.73%. There were significant differences between the two groups in age, body mass index (BMI) before pregnancy, weight gain during pregnancy, fasting blood glucose during pregnancy and glycosylated hemoglobin during pregnancy (all P<0.05). There was no significant difference in pregnancy outcome between the two groups ( P>0.05). Age≥30 years, high pre-pregnancy BMI, weight gain≥6 kg during pregnancy, fasting blood glucose>5.8 mmol/L during pregnancy, and glycosylated hemoglobin>5.2% during pregnancy were independent risk factors for postpartum T2DM in GDM patients with diabetes family history (all P<0.05). The nomogram model predicted that the C-index value of postpartum T2DM was 0.912 (95% CI: 0.854-0.960), and the area under the ROC curve was 0.799 (95% CI: 0.742-0.856), with good discrimination; The calibration curve indicated that the accuracy of the model was good. According to the integral cutoff value of the line chart model, the probability of postpartum T2DM in GDM patients with family history of diabetes was divided into three groups: low (≤67.24 points), medium (>67.24 points and ≤129.82 points) and high-risk groups. The incidence rate of postpartum T2DM were 13.71%, 29.29% and 59.62%, respectively, with statistical significance (all P<0.05). Conclusions:Age≥30 years old, high pre-pregnancy BMI, pregnancy weight gain≥6 kg, pregnancy fasting blood glucose>5.8 mmol/L and pregnancy glycosylated hemoglobin>5.2% were independent risk factors for postpartum T2DM in GDM patients with family history of diabetes.

Nutcracker syndrome complicated with chronic kidney disease is easy to be missed clinically.We report a case of nutcracker syndrome (NCS) complicated with IgA nephropathy, and summarize the clinical features of nutcracker syndrome complicated with chronic kidney disease.Through literature search, we found that Nutcracker with chronic kidney disease is not rare.We think that we should pay attention to the possibility of chronic kidney disease when Nutcracker (+ ) is combined with persistent or massive proteinuria, and percutaneous renal biopsy is helpful for the diagnosis and treatment.

Objective To provide nutritional supportive scheme for patients with radiation injury through the treatment of the one exposed to Nanjing 192Ir source accident.Methods The reasonable nutrition treatment scheme was made on the basis of dietary survey and nutritional index monitoring during clinical stages of the patient,including body weight,body mass index(BMI),biochemical indexes,electrolyte,etc.,as well as metabolic cart determination of resting energy expenditure (REE).Results Patient on admission (days 5 post-irradiated) weighing 42.5 kg,172 days after the first irradiated (the first skin grafting) fell to a minimum of 36 kg,then gradually rise,hen rose back to normal range on days 383 before discharge.Normal admission hemoglobin was 135 g/L,172 d after irradiated to a minimum of 54 g/L,normal discharge;when lymphocytes admission low as 0.5 × 109/L,58 days back to normal after exposure,172 days after irradiated down to 0.4 × 109/L.Serum albumin was normal admission 41.2 g/L,172 days after irradiated down to 25.3 g/L.The normal level of serum prealbumin was 0.22 g/L,248 days to a minimum of 0.04 g/L,the basic return to normal at discharge was 0.17 g/L.Admission normal liver function,bilirubin index slightly higher,the all in one parenteral nutrition after about 2.5 months later,bilirubin and liver function indicators were gradually increased,the adjusted treatment and nutrition liver and gallbladder and other gradually returned to normal after treatment.REE and the body weight were determined by metabolic cart on days 294,308 and 342 for the energy requirements.Conclusions For patient with radiation injury,appropriate nutrition therapy is a key method for the clinical treatment and rehabilitation,which can maintain the nutritional status of patients and improve clinical treatment.