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 investigate the factors affecting willingness of pregnant and parturient women for epidural labor analgesia and to provide the basis for further promoting epidural labor analgesia.Methods:Using the convenient sampling method, a total of 225 parturient women who underwent vaginal delivery in Department of Obstetrics in Peking University Third Hospital from March to May 2019 as the research objects. General information questionnaire, Questionnaires on Information Sources of Epidural Labor Analgesia and Suggestions of Medical Staff, Relatives and Friends for Epidural Labor Analgesia and Epidural Labor Analgesia Brief Scale were used to investigate them. A total of 225 questionnaires were distributed and 214 valid questionnaires were returned.Results:Among the 214 parturient women, 106 pregnant women (49.53%) had willingness for epidural labor analgesia. The results of binary Logistic regression analysis showed that gravidity, whether or not epidural labor analgesia was used and belief of epidural labor analgesia were the influencing factors of willingness of pregnant and parturient women for epidural labor analgesia ( P<0.05) . Conclusions:In the future, it is necessary to strengthen the education of medical staff on the professional knowledge of epidural labor analgesia for pregnant women and improve the belief of epidural labor analgesia for pregnant women, so as to further promote epidural labor analgesia.

OBJECTIVE: To observe the effects of maternal low-level decabromodiphenyl( BDE209) exposure on nervous system and secretion of thyroid hormones in offspring mice. METHODS: Sixty-four specific pathogen free female,aged 4 weeks Kunming mice were used. These mice were randomly divided into control group and low,medium and high exposure groups after successful mating was confirmed. The rats of control group were fed with 0. 01 L/kg body mass of peanut oil.The maternal mice in the experimental groups were given BDE209 at doses of 50,100 and 300 μg/kg body mass by oral gavage once per day. Continuous exposure was given until 21 days after birth of offspring,the exposure model from gestation to lactation was established. At the end of the exposure,10 mice of each group including half female and half male were randomly selected and the body mass and growth development status were observed. Morris water maze was used to examine the learning and memory ability in offspring mice. The serum levels of total triiodothyronine( TT3),free triiodothyronine( FT3), total tetraiodothyronine( TT4) and free tetraiodothyronine( FT4) were measured by chemiluminescence immunoassay. The levels of glutathione transferase( GST), superoxide dismutase( SOD) and malondialdehyde( MDA) level in hippocampus were measured by colorimetry. RESULTS: The escape latency of the medium exposure group was longer than that of the control group( P < 0. 05). The escape latency of high exposure group was longer than that of control group,low exposure group and medium exposure group( P < 0. 05). The time of quadrant movement and number of crossing the platform in offspring rats in high exposure group were less than that of the control group and the low and medium exposure groups( P < 0. 05). The serum levels of TT3,FT3,TT4 and FT4 increased,the activities of GST and SOD in hippocampus tissue decreased,the MDA level increased with the increasing exposure dose( P < 0. 05).CONCLUSION: Maternal low-level BDE209 exposure can result in decrease the learning and memory ability of offspring mice. It also can increase the serum thyroid hormone level and induce oxidative stress injury in hippocampus in a dose dependent manner in offspring mice.

Objective To investigate the effect of low dose of BDE209 on thyroid hormone and thyroid hormone metabolism enzyme-iodothyroninedeiodinases Ⅱ(D2) in off spring mice after pregnancy exposure .Methods Total 64 adult SPF female Kun-ming mice were randomly divided into 4 groups ,which treated with oral gavage of 0 ,50 ,100 ,300 μg · kg -1 · d-1 dose of BDE209 after successful pregnancy ,the exposure continue to 21 days after delivery .10 mice was randomly selected in each offspring group and get the peripheral blood and brain sample ,the serum thyroid hormones level ,oxidative damage and the expression of D2 mRNA in brain were detected .Results Compared with the control group(0μg · kg -1 · d-1 dose of BDE209) ,the TT4 ,TT3 ,FT4 and FT3 levels of offspring mice increased significantly in every exposure group (P< 0 .05);antioxidant enzyme glutathione-S transferees (GST) ,superoxide dismutase (SOD) activity decreased with the BDE209 dose increase (P<0 .05) ,and malondialdehyde (MDA) level increased (P<0 .05);the D2 mRNA relative expression of brain in middle(100μg · kg -1 · d-1 dose of BDE209) and high(300μg · kg -1 · d-1 dose of BDE209) dose group decreased when compared with control group (P< 0 .05) .Conclusion Low level of BDE209 exposure in pregnancy resulted in the increasing of thyroid hormone levels in offspring mice ,which may cause oxidative damage and decrease expression of D2 mRNA in the brain .

Objective To discuss the relationship between repetitive variable deceleration with a short interval (RDSI) in labor and neonatal acidosis.Methods One hundred and seventy-seven electronic fetal heart monitoring (EFM) patterns within one hour preceding delivery in term singleton pregnancies were collected in Peking University Third Hospital between February 2011 to October 2013.Continued EFM were recorded before delivery.Analysis was conducted on general information of both mothers and babies,including pregnant complications,duration of labor,cord and placental factors,nature of amniotic fluid,Apgar score and neonatal cord blood gas.RDSI was defined as that over 50％ intervals between two decelerations (the end of the last deceleration to the beginning of the next one) ≤ 60 s which appeared repetitevly in a period of 20 minutes.Independent sample t test,rank sum test,Chi-square test and Fisher's exact test were applied for statistics and receiver operating characteristic curve was obtained from the information of those with RDSI.Results Twenty-four of the 177 women with RDSI were assigned to the study group (24 cases,13.6％) and the rest 153 cases without RDSI to the control group.Background information of women in the two groups was comparable according to the maternal age,gestational weeks at delivery and duration of labor (all P ＞ 0.05).The occurrence of meconium stained amniotic fluid in the study group was higher than that of the control group [16.7％ (4/24) vs 5.2％ (7/153),x2=5.204,P=0.045],while the pH and base excess value of the neonatal blood gas in the study group were lower [7.20 (7.13-7.28) vs 7.29 (7.25-7.33),Z=-4.490;-6.10 (-4.67 to-9.62) mmol/L vs-3.20 (-4.90 to-1.55) mmol/L,Z=-5.044;P ≤ 0.01] resulting a higher rate of neonatal acidosis [50.0％(12/24) vs 7.8％ (12/153),x2=31.456,P ＜ 0.01].No significant difference was found in the incidence of neonatal asphyxia between the two groups.The area under the curve was 0.774 (95％CI:0.579-0.969).Conclusion RDSI in labor might indicate a high risk of neonatal acidosis.

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.

To explore the effects of Western medicine including Ca(2+) channel antagonist and angiotensin-receptor antagonist combined with Songling Xuemaikang Capsule (SXC), a compound traditional Chinese herbal medicine for calming liver and suppressing liver yang, on blood pressure indexes derived from 24-hour ambulatory blood pressure monitoring (ABPM), and to evaluate the effects and stability of SXC in lowering blood pressure.

Objective To study the sex difference among PHC patients' ABO blood types and HBV infection,hepatic cancer family history,drunking alcohol hobby in Guilin district.Methods 192 cases of PHC were classified according to sexes,we compared the ABO blood types distribution,HBV infection,family history of PHC and drunking alcohol hobby between the two sexes.Results PHC infective ratio of male to female was 85.94∶14.06;the O blood type distribution in the male was more than that of the female's(P