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 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 investigate the effects of glycated low density lipoprotein (Gly⁃LDL) on the growth of human umbilical vein endothelial cells (HUVECs) and the expression of toll like receptor 4 (TLR4) and hypoxia inducible factor⁃1α (HIF⁃1α), and to explore its possible mechanism . Methods : HUVECs were cultured in vitro and divided into control group, positive control group[50 mg/L normal low density lipoprotein(n⁃LDL)], low concentration, medium concentration and high concentration Gly⁃LDL(50, 75, 100 mg/L) groups . Respectively, the effects of different concentrations of Gly⁃LDL on survival rate of HUVECs were detected by CCK⁃8; The motility of HUVECs under different treatments were detected by wound healing assays; The level of inflammatory cytokine, such as tumor inducing factor⁃α(TNF⁃α), interleukin⁃6(IL⁃6), intercellular adhesion molecule⁃1(ICAM⁃1) and vascular cell adhesion molecule⁃1(VCAM⁃1) were detected by ELISA; The mRNA levels of TLR4, HIF⁃1α, TNF⁃α and IL⁃6 were detected by qRT⁃PCR; Protein expressions of TLR4, HIF⁃1α, TNF⁃α and IL⁃6 were detected by Western blot; Respectively, si⁃RNA of TLR4 and HIF⁃1α was used to intervene the effects of Gly⁃LDL on HUVECs . The experiment was divided into control group, model group (Gly⁃LDL 100 mg/L), si⁃TLR4 group (Gly⁃LDL 100 mg/L + si⁃TLR4), TLR4 unloading group( Gly⁃LDL 100 mg/L + si⁃NC1), si⁃HIF⁃1α group ( Gly⁃LDL 100 mg/L + si⁃HIF⁃1α) and HIF⁃1α unloading group ( Gly⁃LDL 100 mg/L + si⁃NC2) . Protein expressions of TLR4 and HIF⁃1α were detected by Western blot to verify the interaction between TLR4 and HIF⁃1α . Results: The survival rate and migration rate of HUVECs were inhibited in Gly⁃LDL(50 mg/L, 75 mg/L, 100 mg/L) group (P < 0. 01), the inflammatory cytokines, such as TNF⁃α, IL⁃6, ICAM⁃1,VCAM⁃1 increased by Gly⁃LDL function on HUVECs(P < 0. 001), and the mRNA and protein levels of TLR4, HIF⁃1α, TNF⁃α and IL⁃6 increased by Gly⁃LDL in a dose dependent manner. After TLR4 was knocked out, the proteins expression of TLR4 and HIF⁃1α were down⁃regulated compared with model group(P < 0. 05),but after HIF⁃1α was knockout, only the protein expression of HIF⁃1α was down⁃regulated compared with model group( P < 0. 01),while the protein expression of TLR4 was up⁃regulated under the influence of Gly⁃LDL. Conclusion Gly⁃LDL may inhibit the proliferation and migration of HUVECs by up⁃regulating TLR4/HIF⁃1α inflammatory signaling pathway, and promote the expression of inflamma⁃tory cytokines, leading to vascular endothelial injury .

Objective:To analyze the effect of percutaneous transluminal angioplasty (PTA) in the treatment of autogenous arteriovenous fistula (AVF) stenosis and influcing factors of restenosis/loss of function after PTA.Methods:The medical records of 104 patients with AVF stenosis treated by PTA in People′s Hospital of Huadu District from March 2019 to July 2020 and the 1-year follow-up were retrospectively analyzed. Kaplan-meier curves were used to analyze the primary patency rates at 3 months, 6 months and 1 year. COX regression was used to analyze the influencing factors of restenosis/loss of function after PTA.Results:The primary patency rates of AVF at 3, 6 and 12 months after PTA were 86.2%, 83.2% and 64.7%, respectively. Guide wire entry into the distal end of radial artery, the use of two balloons in stepwise mode, postoperative dilatation diameter, and dialysis blood flow after PTA were independent risk factors for restenosis/loss of fuction after PTA for AVF stenosis (all P<0.05). Conclusions:The guide wire into the distal end of the artery and passive use of more than two balloons are important factors affecting AVF restenosis/loss of function after PTA .

A 62-year-old male patient received aspirin, clopidogrel, and atorvastatin calcium after percutaneous coronary intervention for coronary atherosclerotic heart disease. One week later, the patient received anti- Helicobacter pylori (Hp) therapy with amoxicillin capsules, clarithromycin tablets, bismuth tartrate capsules, and pantoprazole sodium enteric coated tablets due to Hp infection, and two to three days after taking the drugs, the patient developed systemic fatigue, nausea, joint discomfort and muscle soreness, which were gradually aggravated. Laboratory tests showed muscle hemoglobin (MYO)>1 000 μg/L, serum creatinine (Scr) 69 mmol/L, urea nitrogen (BUN) 3.5 mmol/L, alkaline phosphatase (ALP) 148 U/L, alanine aminotransferase (ALT) 750 U/L, aspartate aminotransferase (AST) 850 U/L, g-glutamyl transpeptidase (γ-GT) 181 U/L, lactate dehydrogenase (LDH) 1 177 U/L, creatine kinase (CK) 8 144 U/L, CK-MB 255 U/L. Atorvastatin calcium was stopped, and symptomatic and supportive treatments such as alkalized urine and fluid replacement were given, and anti-Hp treatments were continued. However, the CK level was continued to increase. CK reached 15 794 U/L 4 days after atorvastatin calcium discontinuation. It was considered that the patient′s rhabdomyolysis might be related to interaction between atorvastatin calcium and clarithromycin. Then the anti-Hp drugs were discontinued. On the 2nd of drug withdrawal, the patients′ muscle soreness was alleviated than before; on the 4th day, CK and other serum enzymology indexes began to decline; on the 8th day, the patient′s fatigue and muscle soreness completely disappeared, with CK 908 U/L; on the 15th day, ALT was 105 U/L, AST was 42 U/L, γ-GT was 107 U/L, CK was 143 U/L, CK-MB was 29 U/L, and LDH was 339 U/L; 5 weeks later, the patient took atorvastatin again, myalgia and fatigue did not recur, and no abnormality was found in blood biochemical indexes.

A 62-year-old male patient received aspirin, clopidogrel, and atorvastatin calcium after percutaneous coronary intervention for coronary atherosclerotic heart disease. One week later, the patient received anti- Helicobacter pylori (Hp) therapy with amoxicillin capsules, clarithromycin tablets, bismuth tartrate capsules, and pantoprazole sodium enteric coated tablets due to Hp infection, and two to three days after taking the drugs, the patient developed systemic fatigue, nausea, joint discomfort and muscle soreness, which were gradually aggravated. Laboratory tests showed muscle hemoglobin (MYO)>1 000 μg/L, serum creatinine (Scr) 69 mmol/L, urea nitrogen (BUN) 3.5 mmol/L, alkaline phosphatase (ALP) 148 U/L, alanine aminotransferase (ALT) 750 U/L, aspartate aminotransferase (AST) 850 U/L, g-glutamyl transpeptidase (γ-GT) 181 U/L, lactate dehydrogenase (LDH) 1 177 U/L, creatine kinase (CK) 8 144 U/L, CK-MB 255 U/L. Atorvastatin calcium was stopped, and symptomatic and supportive treatments such as alkalized urine and fluid replacement were given, and anti-Hp treatments were continued. However, the CK level was continued to increase. CK reached 15 794 U/L 4 days after atorvastatin calcium discontinuation. It was considered that the patient′s rhabdomyolysis might be related to interaction between atorvastatin calcium and clarithromycin. Then the anti-Hp drugs were discontinued. On the 2nd of drug withdrawal, the patients′ muscle soreness was alleviated than before; on the 4th day, CK and other serum enzymology indexes began to decline; on the 8th day, the patient′s fatigue and muscle soreness completely disappeared, with CK 908 U/L; on the 15th day, ALT was 105 U/L, AST was 42 U/L, γ-GT was 107 U/L, CK was 143 U/L, CK-MB was 29 U/L, and LDH was 339 U/L; 5 weeks later, the patient took atorvastatin again, myalgia and fatigue did not recur, and no abnormality was found in blood biochemical indexes.

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 study the maximum volume of oral cavity (MVOC) of the young adults with normal occlusion and to explore the correlation of MOVC with the height,weight,mouth opening degree and masticatory efficiency.Methods:100 volunteers with normal occlusion(50 for each sex) were enrolled.MVOC was measured by the maximum water capacity method,the height,weight,degree of mouth opening and masticatory efficiency value of the subjects were measured.Results:The average values of MVOC of the male and female were (117.63±15.31) ml and (92.08±14.06) ml respectively(P<0.01).MVOC was positively correlation with the height(r=0.67,P<0.01),weight(r=0.63,P<0.01),degree of mouth opening(r=0.47,P<0.01) and masticatory efficiency(r=0.45,P<0.01).Conclusion:MVOC is moderate-positively correlated and low-positively correlated with mouth opening degree and masticatory efficiency.