Objective:To investigate the potential causal relationships between gut microbiota composition and the risk of developing various subtypes of breast cancer by using bidirectional two-sample Mendelian randomization(MR).Methods:The research utilized genome-wide association studies(GWAS) data on gut microbiota from the MiBioGen database and GWAS data on breast cancer from the Breast Cancer Association Consortium (BCAC). In this MR study, inverse variance weighted (IVW), weighted median, MR Egger, and MR-PRESSO methods were used. Additionally, reverse MR and stratified analyses were conducted to assess reverse causality and the impact on different subtypes of breast cancer.Results:Adlercreutzia (IVW OR=0.92, 95% CI: 0.87-0.98, P=0.01) and Parabacteroides (IVW OR=0.87, 95% CI: 0.79-0.96, P=0.007) exhibited a statistically significant protective effect on breast cancer. Conversely, Sellimonas (IVW OR=1.05, 95% CI: 1.01-1.09, P=0.01) was significantly associated with an increased risk of breast cancer. Desulfovibrio (IVW OR=0.94, 95% CI: 0.88-1.00, P=0.04) and Ruminococcaceae (UCG013) (IVW OR=0.92, 95% CI: 0.86-0.99, P=0.03) presented suggestive protective effects against breast cancer. Furthermore, stratified analysis revealed that the protective effect of Adlercreutzia against breast cancer persisted in the estrogen receptor(ER)-positive subtypes, while Desulfovibrio persisted in the ER-negative subtypes. Sellimonas was causally associated with the risk of ER-positive subtypes. CACNA1S was identified as the functional gene of Adlercreutzia, and associated with favorable prognosis in breast cancer, while ERBB4 was identified as the functional gene of Sellimonas and associated with poor prognosis in breast cancer. Conclusions:This study identifies the causal relationships between gut microbiota and breast cancer, suggesting a novel target for early clinical intervention and treatment, with potential implications for future functional analysis.

Objective:To observe the current status of the use of personal protective equipment (PPE) by the dust working population, and to analyze the factors affecting its use, so as to provide a reference basis for proposing scientific intervention methods.Methods:From October to December 2023, random sampling method was used to conduct a self-designed Questionnaire on the Use of Personal Protective Equipment by the Dust Working Population. A total of 1216 dust workers were randomly selected from each city in Guangdong Province, and their mask wearing status was evaluated. The Wilcoxon rank sum test was used for comparison between measurement data sets, and the Chi-square test or Fisher exact probability method was used for counting data. A binary logistic regression model was used to analyze the factors affecting the use of PPE in dust workers.Results:The correct rate of wearing PPE in dust working group was 66.12% (804/1216). In univariate analysis, there were statistical significances in different knowledge score, wearing PPE to reduce exposure to dust particles, wearing occupational health protective equipment such as masks was uncomfortable, wearing occupational health protective equipment such as masks reduced work efficiency, attending pre-employment occupational health examination, attending occupational health examination on a regular basis, receiving occupational health training during work in the enterprise, being urged or reminded by workmates, supervisors, or family members to use PPE, the correct use of PPE when workers or shift leaders were exposed to dust particles, second-hand smoke inhalation, smoking, and alcohol consumption ( P<0.05). Multiple logistic regression results showed that gender ( OR=2.00, 95% CI: 1.48-2.72), knowledge score ( OR=1.18, 95% CI: 1.11-1.26), neutral attitude towards the discomfort of wearing occupational health protective equipment such as masks during work ( OR=1.64, 95% CI: 1.18-2.27), and participation in pre-job occupational health examination ( OR=0.23, 95% CI: 0.10-0.54) were the main influencing factors on the use of PPE to be worn correctly ( P<0.05) . Conclusion:The rate of correct wearing of PPE for dust working population still needs to be improved. Factors such as gender, knowledge score, neutral attitude towards the discomfort of wearing masks during work, and participation in pre-job occupational health examination may be the influencing factors on the use of PPE for dust working population.

Objective:To explore the direct effect of perceived social support on self-advocacy and the mediating effect of active coping strategies in breast cancer patients.Methods:A convenience sampling method was used to select 240 breast cancer patients hospitalized at Qilu Hospital of Shandong University from April 2023 to April 2024. General information questionnaire, the Female Self-Advocacy Scale in Cancer Survivorship (FSACS), the Simplified Ways of Coping Questionnaire (SWCQ), and the Perceived Social Support Scale (PSSS) were used to collect the data.Results:The effective response rate for the questionnaires was 93.75% (225/240). The total score for FSACS in 225 breast cancer patients was (75.36±9.88), the active coping score for SWCQ was (21.68±6.07), and the total score for PSSS was (55.63±8.04). The mediating effect analysis revealed that perceived social support had a direct positive predictive effect on self-advocacy ( β=0.420, P<0.01). Active coping played a mediating role in the relationship between perceived social support and self-advocacy, with a mediating effect value of 0.210, a 95% confidence interval of 0.112 to 0.318, and the mediating effect accounting for 33.33% of the total effect. Conclusions:Perceived social support not only positively affects the self-advocacy level of breast cancer patients but also indirectly influences it through the mediating role of active coping. Medical staff should emphasize improving perceived social support levels and encourage patients to adopt active coping strategies to enhance their self-advocacy.

Objective:To explore the direct effect of perceived social support on self-advocacy and the mediating effect of active coping strategies in breast cancer patients.Methods:A convenience sampling method was used to select 240 breast cancer patients hospitalized at Qilu Hospital of Shandong University from April 2023 to April 2024. General information questionnaire, the Female Self-Advocacy Scale in Cancer Survivorship (FSACS), the Simplified Ways of Coping Questionnaire (SWCQ), and the Perceived Social Support Scale (PSSS) were used to collect the data.Results:The effective response rate for the questionnaires was 93.75% (225/240). The total score for FSACS in 225 breast cancer patients was (75.36±9.88), the active coping score for SWCQ was (21.68±6.07), and the total score for PSSS was (55.63±8.04). The mediating effect analysis revealed that perceived social support had a direct positive predictive effect on self-advocacy ( β=0.420, P<0.01). Active coping played a mediating role in the relationship between perceived social support and self-advocacy, with a mediating effect value of 0.210, a 95% confidence interval of 0.112 to 0.318, and the mediating effect accounting for 33.33% of the total effect. Conclusions:Perceived social support not only positively affects the self-advocacy level of breast cancer patients but also indirectly influences it through the mediating role of active coping. Medical staff should emphasize improving perceived social support levels and encourage patients to adopt active coping strategies to enhance their self-advocacy.

Objective:To investigate the potential causal relationships between gut microbiota composition and the risk of developing various subtypes of breast cancer by using bidirectional two-sample Mendelian randomization(MR).Methods:The research utilized genome-wide association studies(GWAS) data on gut microbiota from the MiBioGen database and GWAS data on breast cancer from the Breast Cancer Association Consortium (BCAC). In this MR study, inverse variance weighted (IVW), weighted median, MR Egger, and MR-PRESSO methods were used. Additionally, reverse MR and stratified analyses were conducted to assess reverse causality and the impact on different subtypes of breast cancer.Results:Adlercreutzia (IVW OR=0.92, 95% CI: 0.87-0.98, P=0.01) and Parabacteroides (IVW OR=0.87, 95% CI: 0.79-0.96, P=0.007) exhibited a statistically significant protective effect on breast cancer. Conversely, Sellimonas (IVW OR=1.05, 95% CI: 1.01-1.09, P=0.01) was significantly associated with an increased risk of breast cancer. Desulfovibrio (IVW OR=0.94, 95% CI: 0.88-1.00, P=0.04) and Ruminococcaceae (UCG013) (IVW OR=0.92, 95% CI: 0.86-0.99, P=0.03) presented suggestive protective effects against breast cancer. Furthermore, stratified analysis revealed that the protective effect of Adlercreutzia against breast cancer persisted in the estrogen receptor(ER)-positive subtypes, while Desulfovibrio persisted in the ER-negative subtypes. Sellimonas was causally associated with the risk of ER-positive subtypes. CACNA1S was identified as the functional gene of Adlercreutzia, and associated with favorable prognosis in breast cancer, while ERBB4 was identified as the functional gene of Sellimonas and associated with poor prognosis in breast cancer. Conclusions:This study identifies the causal relationships between gut microbiota and breast cancer, suggesting a novel target for early clinical intervention and treatment, with potential implications for future functional analysis.

Objective:To observe the current status of the use of personal protective equipment (PPE) by the dust working population, and to analyze the factors affecting its use, so as to provide a reference basis for proposing scientific intervention methods.Methods:From October to December 2023, random sampling method was used to conduct a self-designed Questionnaire on the Use of Personal Protective Equipment by the Dust Working Population. A total of 1216 dust workers were randomly selected from each city in Guangdong Province, and their mask wearing status was evaluated. The Wilcoxon rank sum test was used for comparison between measurement data sets, and the Chi-square test or Fisher exact probability method was used for counting data. A binary logistic regression model was used to analyze the factors affecting the use of PPE in dust workers.Results:The correct rate of wearing PPE in dust working group was 66.12% (804/1216). In univariate analysis, there were statistical significances in different knowledge score, wearing PPE to reduce exposure to dust particles, wearing occupational health protective equipment such as masks was uncomfortable, wearing occupational health protective equipment such as masks reduced work efficiency, attending pre-employment occupational health examination, attending occupational health examination on a regular basis, receiving occupational health training during work in the enterprise, being urged or reminded by workmates, supervisors, or family members to use PPE, the correct use of PPE when workers or shift leaders were exposed to dust particles, second-hand smoke inhalation, smoking, and alcohol consumption ( P<0.05). Multiple logistic regression results showed that gender ( OR=2.00, 95% CI: 1.48-2.72), knowledge score ( OR=1.18, 95% CI: 1.11-1.26), neutral attitude towards the discomfort of wearing occupational health protective equipment such as masks during work ( OR=1.64, 95% CI: 1.18-2.27), and participation in pre-job occupational health examination ( OR=0.23, 95% CI: 0.10-0.54) were the main influencing factors on the use of PPE to be worn correctly ( P<0.05) . Conclusion:The rate of correct wearing of PPE for dust working population still needs to be improved. Factors such as gender, knowledge score, neutral attitude towards the discomfort of wearing masks during work, and participation in pre-job occupational health examination may be the influencing factors on the use of PPE for dust working population.

Eclipta prostrata L.has been used in traditional medicine and known for its liver-protective properties for centuries.Wedelolactone(WEL)and demethylwedelolactone(DWEL)are the major coumarins found in E.prostrata L.However,the comprehensive characterization of these two compounds on non-alcoholic fatty liver disease(NAFLD)still remains to be explored.Utilizing a well-established zebrafish model of thioacetamide(TAA)-induced liver injury,the present study sought to investigate the impacts and mechanisms of WEL and DWEL on NAFLD through integrative spatial metabolomics with liver-specific transcriptomics analysis.Our results showed that WEL and DWEL significantly improved liver function and reduced the accumulation of fat in the liver.The biodistributions and metabolism of these two compounds in whole-body zebrafish were successfully mapped,and the discriminatory endogenous metabolites reversely regulated by WEL and DWEL treatments were also characterized.Based on spatial metabolomics and transcriptomics,we identified that steroid biosynthesis and fatty acid metabolism are mainly involved in the hepatoprotective effects of WEL instead of DWEL.Our study unveils the distinct mechanism of WEL and DWEL in ameliorating NAFLD,and presents a"multi-omics"platform of spatial metabolomics and liver-specific transcriptomics to develop highly effective compounds for further improved therapy.

ObjectiveTo investigate the clinical features and outcomes of critically ill pregnant and parturient women with chronic hepatitis B virus （HBV） infection， and to provide clinical experience for the rescue of critically ill pregnant and parturient women and the prevention and treatment of the severe exacerbation of liver disease. MethodsA total of 41 pregnant and parturient women with chronic HBV infection who were admitted to Department of Critical Care Medicine， Nanjing Second Hospital， from March 2013 to March 2023 were enrolled in this study， and their clinical data were collected through the electronic medical record system of hospital to summarize the main causes of transfer to the intensive care unit （ICU）， the causes of death， and treatment. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between two groups. ResultsAmong the 41 patients， 13 （31.71%） did not receive regular antenatal examination and 8 （19.51%） with a high viral load （HBV DNA ≥2×10⁵ IU/mL） did not receive antiviral therapy. Cesarean section was the main mode of delivery in 32 patients （78.05%）； 23 patients （56.10%） had premature delivery， and 5 patients died （12.20%）. The top three causes of transfer to the ICU were liver failure， postpartum hemorrhage， and hypertensive disorders of pregnancy. Liver failure mainly occurred in late pregnancy， with hepatic encephalopathy as the most common complication （28.57%） and intrahepatic cholestasis of pregnancy as the most common comorbidity （21.43%）； among the 14 patients with liver failure， 6 （42.86%） received regular antenatal examination， and 13 （92.86%） did not receive antiviral therapy before admission. The mean length of ICU stay was 3.31±1.65 days for the patients with postpartum hemorrhage， among whom the patients with severe liver disease had coagulation disorders before delivery， which were difficult to correct after 48 hours of treatment. ConclusionPregnant and parturient women with chronic HBV infection tend to have complex conditions and a relatively high mortality rate. For pregnant and parturient women with chronic HBV infection， assessment of liver status， regular antenatal examination， and timely antiviral therapy are of vital importance to reduce severe exacerbation and mortality rate.

Objective:To investigate the effect of modified percutaneous closure in the treatment of ventricular septal rupture.Methods:This study is a retrospective cohort study. Forty-four patients with ventricular septal rupture who underwent percutaneous closure at the Fuwai Central China Cardiovascular Hospital from December 2017 to October 2023 were included. According to the closure method, patients were divided into the modified group (11 cases) and the traditional group (33 cases). Surgical success was defined as successful placement of the occluder. The operation time, X-ray intake, sheath bending rate, incidence of ventricular fibrillation and pericardial tamponade, and postoperative residual shunt were compared between the two groups.Results:The age of the patients was (75.0±5.7) years, with 20 (45%) males. There were 3 cases of operation failure in the traditional group, while all patients in the modified group were successfully occluded. The procedure time in the modified group was shorter than that in the traditional group (40 (35, 45) min vs. 60 (50, 65)min, P<0.001); X-ray dose intake was lower ((442.43±73.26)mGy vs. (784.45±247.78)mGy, P<0.001). There was no occurrence of sheath bending in the modified group, while the incidence of sheath bending in the traditional surgery group was 46% (15/33), and the difference was statistically significant ( P=0.017). Intraoperative ventricular fibrillation and pericardial tamponade occurred in 7 cases (21%) and 2 cases (6%) in the traditional group respectively, while none occurred in the modified group, but the differences between the groups were not statistically significant (both P>0.05). There was no significant difference in residual shunt between the two groups (3.6 (2.5, 4.3) mm vs. 4.0 (3.5, 4.5) mm, P=0.506). Conclusion:The procedure of modified ventricular septal rupture closure is more simplified, with a lower incidence ofventricular fibrillation and pericardial tamponade.

Objective:To analyze the influencing factors of lung function in pneumoconiosis patients, and to provide reference for clinical treatment.Methods:From July 2020 to December 2020, a questionnaire survey was conducted on pneumoconiosis patients in the jurisdiction by using the "Guangdong Province Occupational Disease Prevention and Control Institute" questionnaire, and the relevant items of patients were examined. The rate of counting data is expressed, and the measurement data is expressed by mean and standard deviation. Chi-square test was used for comparison between groups, trend chi-square test was used for trend analysis of ordered classified data. Multivariate analysis was carried out with binary logistic regression model.Results:A total of 1409 pneumoconiosis patients were enrolled. The abnormal rate of lung function in pneumoconiosis patients was 68.77%. The results of trend Chi-square test showed that the abnormal rate of lung function increased with the age of exposure to dust in different age groups (Chi Sqnare Trend=64.12、8.49、24.20, P<0.05) . In univariate analysis, there were statistical significance in different dust exposure age, working age, pneumoconiosis stage, complications and occupational pneumoconiosis diseases ( P<0.05) . Multiple logistic regression results showed that age of exposure to dust, years of service, stage of pneumoconiosis and complications were the main influencing factors of lung function in pneumoconiosis patients ( P<0.05) . Compared with patients aged 0-30 years, patients aged 50-70 years and older had a higher rate of abnormal lung function ( OR=2.16, 95% CI: 1.12~4.16; OR=4.82, 95% CI: 2.05~11.35, all P<0.05) ; Compared with patients with 0~20 years of service, patients with 20~30 years of service and more than 30 years of service had a higher rate of abnormal lung function ( OR=1.58, 95% CI: 1.10~2.25; OR=1.63, 95% CI: 1.28~2.40, P<0.05) ; Compared with stage Ⅰ patients, Stage Ⅱ and Stage Ⅲ patients had a higher rate of abnormal lung function ( OR=1.62, 95% CI: 1.20~2.17; OR=2.23, 95% CI: 1.40~3.55, all P<0.05) ; Compared with patients without comorbidities, patients with comorbidities had a higher rate of abnormal lung function ( OR=1.68, 95% CI: 1.20~2.38, P<0.05) . Conclusion:The factors such as age of exposure to dust, working age, stage of pneumoconiosis and complications may be the influencing factors of lung function in pneumoconiosis patients.