The trillions of commensal microorganisms living in the gut lumen profoundly influence the physiology and pathophysiology of the liver through a unique gut-liver axis. Disruptions in the gut microbial communities, arising from environmental and genetic factors, can lead to altered microbial metabolism, impaired intestinal barrier and translocation of microbial components to the liver. These alterations collaboratively contribute to the pathogenesis of liver disease, and their continuous impact throughout the disease course plays a critical role in hepatocarcinogenesis. Persistent inflammatory responses, metabolic rearrangements and suppressed immunosurveillance induced by microbial products underlie the pro-carcinogenic mechanisms of gut microbiota. Meanwhile, intrahepatic microbiota derived from the gut also emerges as a novel player in the development and progression of liver cancer. In this review, we first discuss the causes of gut dysbiosis in liver disease, and then specify the pivotal role of gut microbiota in the malignant progression from chronic liver diseases to hepatobiliary cancers. We also delve into the cellular and molecular interactions between microbes and liver cancer microenvironment, aiming to decipher the underlying mechanism for the malignant transition processes. At last, we summarize the current progress in the clinical implications of gut microbiota for liver cancer, shedding light on microbiota-based strategies for liver cancer prevention, diagnosis and therapy.

The trillions of commensal microorganisms living in the gut lumen profoundly influence the physiology and pathophysiology of the liver through a unique gut-liver axis. Disruptions in the gut microbial communities, arising from environmental and genetic factors, can lead to altered microbial metabolism, impaired intestinal barrier and translocation of microbial components to the liver. These alterations collaboratively contribute to the pathogenesis of liver disease, and their continuous impact throughout the disease course plays a critical role in hepatocarcinogenesis. Persistent inflammatory responses, metabolic rearrangements and suppressed immunosurveillance induced by microbial products underlie the pro-carcinogenic mechanisms of gut microbiota. Meanwhile, intrahepatic microbiota derived from the gut also emerges as a novel player in the development and progression of liver cancer. In this review, we first discuss the causes of gut dysbiosis in liver disease, and then specify the pivotal role of gut microbiota in the malignant progression from chronic liver diseases to hepatobiliary cancers. We also delve into the cellular and molecular interactions between microbes and liver cancer microenvironment, aiming to decipher the underlying mechanism for the malignant transition processes. At last, we summarize the current progress in the clinical implications of gut microbiota for liver cancer, shedding light on microbiota-based strategies for liver cancer prevention, diagnosis and therapy.

The trillions of commensal microorganisms living in the gut lumen profoundly influence the physiology and pathophysiology of the liver through a unique gut-liver axis. Disruptions in the gut microbial communities, arising from environmental and genetic factors, can lead to altered microbial metabolism, impaired intestinal barrier and translocation of microbial components to the liver. These alterations collaboratively contribute to the pathogenesis of liver disease, and their continuous impact throughout the disease course plays a critical role in hepatocarcinogenesis. Persistent inflammatory responses, metabolic rearrangements and suppressed immunosurveillance induced by microbial products underlie the pro-carcinogenic mechanisms of gut microbiota. Meanwhile, intrahepatic microbiota derived from the gut also emerges as a novel player in the development and progression of liver cancer. In this review, we first discuss the causes of gut dysbiosis in liver disease, and then specify the pivotal role of gut microbiota in the malignant progression from chronic liver diseases to hepatobiliary cancers. We also delve into the cellular and molecular interactions between microbes and liver cancer microenvironment, aiming to decipher the underlying mechanism for the malignant transition processes. At last, we summarize the current progress in the clinical implications of gut microbiota for liver cancer, shedding light on microbiota-based strategies for liver cancer prevention, diagnosis and therapy.

Objective:To investigate the psychological crisis status of parents of pediatric bipolar disorder (PBD) patients and establish a risk prediction model, in order to provide a reference for medical workers to screen parents' mental health status early.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 478 parents of children with PBD who were treated in the Second Affiliated Hospital of Wenzhou Medical University in Zhejiang Province from January 2020 to May 2021 were selected as the research subjects. They were randomly divided into the modeling group ( n=318) and the validation group ( n=160) in a ratio of 2∶1. Questionnaires were conducted using general information questionnaires and Symptom Self-rating Scale. Univariate analysis and logistic regression were used to analyze the influencing factors of psychological crisis in the modeling group, and H- L test and receiver operating characteristic curve were used to verify the predictive performance of the model. Results:The detection rate of psychological crisis among the parents of 318 children with PBD was 25.7%, of which the detection rate was 26.1% in the modeling group and 25.0% in the validation group. First onset ( OR=2.337, P<0.05) , parental gender ( OR=1.846, P<0.05) , conscious care burden ( OR=3.527, P<0.05) , religious belief ( OR=3.113, P<0.05) and children's age ( OR=1.969, P<0.05) were independent predictors of psychological crisis in parents of children with PBD. Conclusions:Medical workers need to be good at observing the psychological status of parents of children, predict the risk of psychological crisis in parents in advance and timely conduct targeted interventions according to the risk level, so as to improve the psychological adaptability of parents and improve their mental health.

Objective:To investigate the psychological crisis status of parents of pediatric bipolar disorder (PBD) patients and establish a risk prediction model, in order to provide a reference for medical workers to screen parents' mental health status early.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 478 parents of children with PBD who were treated in the Second Affiliated Hospital of Wenzhou Medical University in Zhejiang Province from January 2020 to May 2021 were selected as the research subjects. They were randomly divided into the modeling group ( n=318) and the validation group ( n=160) in a ratio of 2∶1. Questionnaires were conducted using general information questionnaires and Symptom Self-rating Scale. Univariate analysis and logistic regression were used to analyze the influencing factors of psychological crisis in the modeling group, and H- L test and receiver operating characteristic curve were used to verify the predictive performance of the model. Results:The detection rate of psychological crisis among the parents of 318 children with PBD was 25.7%, of which the detection rate was 26.1% in the modeling group and 25.0% in the validation group. First onset ( OR=2.337, P<0.05) , parental gender ( OR=1.846, P<0.05) , conscious care burden ( OR=3.527, P<0.05) , religious belief ( OR=3.113, P<0.05) and children's age ( OR=1.969, P<0.05) were independent predictors of psychological crisis in parents of children with PBD. Conclusions:Medical workers need to be good at observing the psychological status of parents of children, predict the risk of psychological crisis in parents in advance and timely conduct targeted interventions according to the risk level, so as to improve the psychological adaptability of parents and improve their mental health.

At present, there are many problems in the nail-fold microcirculation detection devices, such as huge structure, inconvenience to carry. In addition, due to the patient's body shaking, the video is difficult to keep stable in collecting with the device, which brings great difficulties to the doctor's observation. We develop a small image acquisition device for nail-fold microcirculation based on the principle of SDF imaging principle and liquid lenses technology. An annular lighting device is fixed in front of the optical system, and the overall design of the system is based on the characteristics of human fingers. The device is small, easy to carry and conform to the fingertips. It can focus quickly through a controller. It can also achieve high quality images of the nail-fold microcirculation. This study can promote the usage of nail-fold microcirculation device at the bedside. It's an efficient tool for medical workers to observe the microcirculation of patients.
Humans ; Microcirculation

Objective Comparing the efficacy of endoscopic balloon dilatation and endoscopic stricteroto-my for postoperative anastomotic stenosis of colorectal cancer. Methods Retrospectively analyzed the clinical data of patients with postoperative anastomotic stenosis of colorectal cancer that underwent anastomotic dilatation from 2013 to 2016,and analyzed the anastomotic stenosis before and after treatment,and compared the efficacy of the two groups of dilatation methods. Results There was no statistically significant difference between the two groups in baseline characteristics. Balloon dilatation was effective in 3 cases(23.1%),ineffective in 10 cases(76.9%). 7 cases(63.6%)were effective in the stricterotomy group,4 cases(36.4%)were ineffective,the difference was statistically significant(P=0.045).Two groups of patients were not bleeding after surgery,infection and perfora-tion and other complications. Conclusion Endoscopic stricterotomy of postoperative anastomotic stenosis of colorectal cancer is more effective than conventional endoscopic balloon dilatation

OBJECTIVETo investigate the safety, feasibility, clinical value, indication, and distribution of diagnostic diseases in different age groups of colonoscopy in pediatric patients.

METHODSA retrospective analysis was performed on the data of pediatric patients receiving colonoscopy from April 2013 to June 2016 at The Sixth Affiliated Hospital of Sun Yat-sen University. Pediatric patients were divided into 0-6 years group (n=57) and 7-14 years group (n=172). Indication for colonoscopy, detective events and diagnostic diseases distribution were compared between two groups.

RESULTSA total of 229 pediatric patients (male 157 and female 72) were divided into 0-6 years group (57/229, 24.9%) and 7-14 years group(172/229, 75.1%). The main Indications for colonoscopy included abdominal pain (81/229, 35.4%), hematochezia (64/229, 27.9%), crissum abscess or fistula (40/229, 17.5%). Hematochezia was the most common complaint in 0-6 years group (40/57, 70.2%), while abdominal pain in 7-14 years group (74/172, 43.0%). Completion rate between 0-6 years group and 7-14 years group was not significantly different (87.72% vs. 85.47%, χ=0.181, P=0.671). Only one pediatric patient (1/229, 0.4%) developed transient oxygen desaturation and recovered quickly after oxygen supply and aspiration of sputum. No serious complications such as bleeding, perforation or death occurred. Including 45 pediatric patients in 0-6 years group and 102 pediatric patients in 7-14 years group, a total of 147 pediatric patients (147/229, 64.2%) were found to have colorectal lesions. Inflammatory bowel disease (57/147, 38.8%), colonic polyps (40/147, 27.2%) and other intestinal inflammation (39/147, 26.5%) were the main findings. The most frequent diagnosis in 0-6 years group was colonic polyps (28/57, 49.1%), among them, 25 pediatric patients (25/28, 89.3%) were with the complaint of hematochezia. The most frequent diagnosis in 7-14 years group was Inflammatory bowel disease (54/172, 31.4%), among them, 29 pediatric patients (29/54, 53.7%) were with the complaint of abdominal pain.

CONCLUSIONSPediatric colonoscopy is safe and effective. Hematochezia and abdominal pain are the most common complaints in 0-6 years group and 7-14 years group respectively. Colonic polyps and inflammatory bowel disease are the most frequent diagnosis in 0-6 years group and 7-14 years group respectively.

Objective To investigate the status of mental health and related factors in cervical cancer patients received radiotherapy and chemotherapy,and to implement individualized nursing intervention.Methods 60 cervical cancer patients with radiation and chemotherapy were enrolled in this study.The depression self rating scale(SDS),anxiety self-assessment scale(SAS) were evaluated,and the influence factors of self-designed questionnaires were investigated.During the same period,60 healthy women of 4 regions in Shantou were selected as control group.The SDS and SAS were compared in two groups.And combined with the influencing factors of the investigation group after the implementation of nursing intervention 7 d psychological assessment again.Results Cervical cancer patients with radiotherapy and chemotherapy,the SDS and SAS scores were (56.1±7.7)points,(45.2±7.5)points,which were significantly higher than those of healthy women [(45.0±6.3)points,(39.2±6.5)points,t=8.142,4.588,all P<0.01].After 7 days of nursing intervention,the SDS and SAS scores in cervical cancer patients decreased significantly[SDS(49.5±6.8)points,SAS(42.7±6.2)points,P<0.05],and the influence factors of patients' mental health were worry about the hospitalization expenses,do not understand the disease related knowledge,fear,the influence of family and society,and worry about the side effects of treatment on the prognosis of disease(88%,80%,80%,75%,68.3%,65%).Conclusion Cervical cancer patients received radiotherapy and chemotherapy have poor mental health status,in the treatment of diseases at the same time,the nursing staff should give psychological counseling and support,improve the patients' anxiety and depression,promote rehabilitation.

Objective To explore how to promote the early medical consultation of patients with advanced esophageal cancer to improve the curative rate and the survival rate. Methods With the phenomenological research method, 12 patients with advanced esophageal cancer were sampled for the research. The semi-structure interview method was conducted to collect the data for analyses. Result There were 6 factors influencing the early consultation from the patients with advanced esophageal cancer in their early medical treatment, which included 6 items: lack of knowledge of the disease, economic burden, ignorance of early symptoms, lower medical level, heavy psychological burden of the disease, ageing and delay in seeking medical care. Conclusions The promotion of early medical treatment to the patients with esophageal carcinoma is in critically emergency. The measures including reducing economic burden, corresponding nursing care and health education can improve the cure rate and life quality.