Objective To explore the effects of breast-conserving surgery (BCS), simple mastectomy (SM), and modified radical mastectomy (MRM) on early postoperative upper limb motor function, physical and psychological status in breast cancer patients. Methods A total of 212 female breast cancer patients undergoing surgery at the Department of Breast Surgery of Zhangzhou Affiliated Hospital of Fujian Medical University from October 2024 to December 2025 were enrolled. Patients were divided into the BCS group (n＝34), SM group (n＝79), and MRM group (n＝99). General demographic and clinical data were collected. At 3–7 days postoperatively, the Constant-Murley score (CMS), active range of motion (AROM) of the shoulder joint, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score were used to assess upper limb function; the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Functional Assessment of Cancer Therapy-Breast (FACT-B), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate patients’ psychological status, quality of life, and sleep quality. Results The total CMS score, pain score, and range of motion score in the BCS group were higher than those in the SM and MRM groups (P＜0.05). The BCS group showed greater forward flexion range of motion than that in the SM and MRM groups (P＜0.05); and the SM group showed smaller internal rotation range of motion than that in the MRM and BCS groups (P＜0.05). The PHQ-9 depression score in the BCS group was significantly higher than that in the MRM group (P＜0.05). There were no statistically significant differences among the three groups in QuickDASH, GAD-7, FACT-B, or PSQI scores. Conclusions Early postoperative upper limb function and depression status varied among breast cancer patients undergoing different surgical procedures. Patients undergoing BCS had better preservation of upper limb function but higher depression scores.

Objective: To investigate the characteristics of intestinal microflora in patients with neuromyelitis optica spectrum disorders (NMOSDs) and related clinical significance. Methods: The data about basic clinical features, fecal specimens as well as cerebrospinal fluid samples of 28 patients with NMOSDs, 15 patients with multiple sclerosis (MS) and 16 healthy controls admitted to the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from July 2017 to January 2019 were collected. The differences about intestinal microbial characteristics and inflammatory index levels in each group were analyzed. The relevance between the diversity of intestinal microbiota and inflammatory index was explored. Results: Compared with healthy controls, the intestinal microfloras of patients with NMOSDs and MS respectively were structurally disordered. The levels of the microbial diversity (chao 1 index) were significantly decreased in patients with NMOSDs compared with healthy controls, while their inflammation indexes, including IL-6, IL-10 and transforming growth factor (TGF)-α, in cerebrospinal fluid were significantly increased ((12.9±4.6) pg/ml vs (2.6±1.8) pg/ml, t=4.197, P=0.001; (3.4±2.1) pg/ml vs (0.9±0.2) pg/ml, t=2.265, P=0.037; (21.4±12.7) ng/ml vs (13.7±7.8) ng/ml, t=3.702, P=0.004). Compared with control group, the relative abundance of butyrivibrio, prevotella and anaerostipes was decreased significantly in NMOSDs group (6.8%±3.5% vs 13.0%±4.7%, t=4.941, P<0.001; 3.9%±2.2% vs 6.9%±3.3%, t=3.282, P=0.003; 5.1%±2.5% vs 7.3%±3.0%, t=2.641, P=0.012), while the relative abundance of ackermania was increased obviously (7.0%±3.1% vs 4.4%±2.8%, t=2.802, P=0.008); Besides, the quantitative Streptococcus thermophilus and butyrivibrio reduced in MS group (3.4%±2.4% vs 5.5%±2.1%, t=2.784, P=0.009; 7.9%±5.4% vs 13.0%±4.7%, t=2.501, P=0.018). In the comparison between subgroups, the relative abundance of bacteroides of aquaporin (AQP) 4-IgG-positive patients was lower than that of AQP4-IgG-negative patients (23.1%±8.9% vs 32.6%±10.4%, t=2.572, P=0.016), while the former subgroup had the higher level of the relative abundance of bifidobacterium (3.4%±1.6% vs 1.7%±1.4%, t=2.977, P=0.006). Moreover, there was a significant relevance between the diversity of intestinal microflora and the level of inflammatory factor IL-6 in cerebrospinal fluid (r=-0.548, P=0.003). Conclusions The intestinal microflora structural disorder and diversity reduction exist in patients with NMOSDs. Moreover, there is a significant correlation between the intestinal microflora and the level of inflammatory factors in NMOSDs, which can be used as an important means of clinical auxiliary examination.