Objective:To explore the latent classes of fear of childbirth in late pregnancy women and its relationship with sense of coherence, providing reference for precise support interventions in clinical practice.Methods:From January to September 2023, convenience sampling was used to select 304 pregnant women who underwent antenatal examination at the Obstetrics Clinic of Affiliated Hospital of Hangzhou Normal University as participants. The General Information Questionnaire, Childbirth Attitudes Questionnaire, and the Sense of Coherence Scale-13 (SOC-13) were used for questionnaire survey. Latent profile analysis was used to explore the categories of fear of childbirth in late pregnancy women, and analyzed differences of SOC-13 scores among women with different categories of fear of childbirth.Results:Fear of childbirth in 304 late pregnant women was divided into three latent classes, including low-level fear group of (50.0%, 152/304), moderate-level fear group of (35.2%, 107/304), and high-level fear group of (14.8%, 45/304). ANOVA analysis showed that there were statistically significant differences in total score and dimension scores of SOC-13 among late pregnancy women with three different classes of fear of childbirth ( P<0.05) . Conclusions:There are three latent classes of fear of childbirth in late pregnancy women. The sense of coherence among pregnant women affects their fear of childbirth. Nursing staff should address the heterogeneity of fear of childbirth in late pregnancy women, starting from sense of coherence, and take targeted intervention measures to reduce the fear of childbirth in late pregnancy women.

Malignant tumors seriously threaten human life and health. Radiotherapy and chemotherapy are the conventional methods for the clinical treatment of advanced tumors. The prognosis and efficacy are still far from satisfactory due to the radiotherapy has serious adverse effects on the body and the chemotherapy often causes problems such as tumor resistance and cell proliferationinhibition. Therefore， the search for new， safe， and effective anti-tumor drugs and the elucidation of their molecular mechanisms are effective measures for clinical treatment of tumors and improvement of patients' quality of life. Active ingredients derived from Chinese herbal medicines and natural products have gradually become a hot spot in the research and development of anti-tumor drugs due to their multi-target and multi-channel anti-tumor pharmacological activity characteristics and their advantages such as less adverse reaction on the body. Bruceine D is a class of tetracyclic triterpenoids extracted from the fruit of the Chinese herbal medicine Bruceae Fructus， with anti-inflammatory， anti-malarial， anti-parasitic， and other pharmacological activities， and its anti-tumor activity is particularly significant. Pharmacological studies have found that bruceine D can regulate various cellular physiological activities such as proliferation， apoptosis， invasion， and migration of lung cancer， liver cancer， pancreatic cancer， intestinal cancer， and other cancer cells by targeting different signaling pathways. Bruceine D can be used in combination with other chemotherapeutic drugs to improve the sensitivity of tumor cells to chemotherapeutic drugs， thereby reducing the adverse effect of chemotherapy. Clinical application practice has shown that Bruceae Fructus oil emulsion injection containing bruceine D has significant advantages in the efficacy and safety of tumor treatment. Although there are many studies on the antitumor pharmacological activity of bruceine D and its clinical efficacy is significant， the specific antitumor molecular mechanism of bruceine D is still unclear， and there is a lack of systematic review on the existing antitumor mechanism of bruceine D. Therefore， based on the research on bruceine D in China and abroad in recent years， this paper reviewed the anti-tumor effect and related molecular mechanisms of bruceine D from six aspects， namely， tumor cell proliferation， apoptosis， metastasis and invasion， glucose metabolism process， autophagy， and chemotherapy sensitivity. This paper is expected to provide a pharmacological basis and scientific reference for the antitumor drug development and clinical application of bruceine D.

Objective To explore the effect of KCNQ1OT1 gene knockout combined with bruceine D on the proliferation, migration, and invasion of breast cancer MDA-MB-231 cells. Methods Cell Counting Kit-8, wound healing, and Transwell invasion assay were used to detect the effects of bruceine D and siKCNQ1OT1 on the viability, migration, and invasion of MDA-MB-231 cells. Effect of bruceine D and siKCNQ1OT1 on the expression of KCNQ1OT1 in MDA-MB-231 cells was detected by qRT-PCR. Western blot was used to detect the effect of bruceine D and siKCNQ1OT1 on the expression of EMT-related proteins and CDC42, p-MKK7, MKK7 proteins in MDA-MB-231 cells. Results Bruceine D and siKCNQ1OT1 could significantly inhibit the viability, migration, and invasion of MDA-MB-231 cells, and the inhibitory effect was enhanced when they were combined (all P < 0.05); bruceine D downregulated the expression of KCNQ1OT1 in MDA-MB-231 cells (all P < 0.05); bruceine D combined with siKCNQ1OT1 significantly decreased CDC42, p-MKK7, N-cadherin, and Vimentin expression in MDA-MB-231 cells and increased the expression of E-cadherin (all P < 0.05). Conclusion Bruceine D combined with siKCNQ1OT1 significantly inhibit the proliferation, migration, invasion, and EMT of human breast cancer MDA-MB-231 cells, and its molecular mechanism may be related to the blocking of CDC42/MKK7 signaling pathway.

OBJECTIVE To separ ate and identify the flavone C-glycosides from the leaves of Dendrobium officinale ，and to evaluate their in vitro inhibitory activities to α-glucosidase. METHODS The flavone C-glycosides from the leaves of D. officinale were separated and purified by macroporous adsorption resin and preparative high -performance liquid chromatography . The structure of obtained compound was elucidated and identified by spectroscopic methods ，such as ultraviolet spectrum ，nuclear magnetic resonance，high-resolution electrospray ionization mass spectrometry ，etc. The in vitro inhibitory activities of flavone C-glycosides and positive control （acarbose）to α-glucosidase were investigated . RESULTS Five apigenin -6，8-di-C-glycosides were isolated and purified from the leaves of D. officinale，and identified as apigenin -6-C-α-L-rhamnosyl-8-C-β-D-quinovoside（1）， schaftoside（2），isoschaftoside（3），isoviolanthin（4）and violanthin （5）. Half inhibitory concentration of compound 1-5 and acarbose inhibiting α-glucosidase were （1.79±1.27），（2.05±0.72），（1.93±0.67），（1.09±0.46），（1.36±0.58），（18.69±1.24）μmol/L， respectively. CONCLUSIONS Five apigenin -6，8-di-C-glycosides with α-glucosidase inhibitory activity are isolated from the leaves of D. officinale，of which compound 1 is a new compound and compound 2 is isolated from this plant for the first time .

Objective:To evaluate the feasibility and effectiveness of parathyroid autotransplantation in subcutaneous tissue of upper abdomen after total parathyroidectomy in patients with severe secondary hyperparathyroidism (SHPT).Methods:From January 2018 to January 2020, retrospective reviews were conducted for clinical data of 29 patients with secondary hyperparathyroidism undergoing epigastric parathyroid autotransplantation after total parathyroidectomy.Clinical and biochemical characteristics were recorded.Serum levels of calcium, phosphorus, parathyroid hormone and alkaline phosphatase before and after operation were analyzed by paired sample t-test and the difference was statistically significant ( P<0.01). The follow-up period was 1, 3, 6 and 12 months post-operation and yearly after 12 months. Results:All operations were successful.The postoperative levels of calcium[(2.25±0.32) vs.(2.49±0.24) mmol/L], phosphorus[(1.72±0.65) vs. (2.09±0.75) mmol/L], alkaline phosphatase[(199.02±77.68) vs.(384.21±154.5) U/L]and parathyroid hormone (PTH)[(8.01±7.00) vs.(1 930.64±620.51) pg/ml]were significantly lower than the preoperative levels ( P<0.01). And the differences were statistically significant.And 17/18 hypertensive patients improved post-operation; postoperative improvement was not obvious for 21 anemic patients, 17 patients improved within 1 year.Among 26 cases with bone pain, 16 cases disappeared immediately postoperatively, 5 disappeared within 1 month and 5 within 3 months.Among 13 cases with skin itch, 10 cases disappeared immediately and 3 cases at 1 month post-operation.The level of PTH recovered at different follow-up timepoints with an average recovery time of (4.45±2.31) months. Conclusions:Autologous transplantation of parathyroid gland in epigastric subcutaneous tissue after parathyroidectomy is both safe and effective for secondary hyperparathyroidism.

Abstract To study the antiviral effect ofZedoary TurmericOil Injection on novel coronavirus, SARS-CoV-2 viroid cell lines were preparedin vitroand treated with different concentrations of Zedoary Oil. The cell number and relative fluorescence value(RLU) were observed and measured, and the 50% effective inhibitory concentration(IC 50) was calculated. Four patients with Coronavirus Disease 2019 were clinically included, including 2 in the control group and 2 in the experimental group. The control group received conventional treatment, and the experimental group receivedZedoary TurmericOil Injection in addition to conventional treatment. The nucleic acid conversion rate, conversion time, pulmonary imaging changes, fever reduction time, clinical improvement time and adverse events of the patients were observed.In vitroexperiment, the relative fluorescence value decreased with increasing concentration ofZedoary TurmericOil, which was significantly different from that of the control group(P<0.05). The IC50 was 0.26 μg/ml.In vivostudy, the novel coronavirus nucleic acid in stool of case 1 in the test group turned negative in 3 days, the cough symptom of case 2 was significantly relieved, and there was obvious absorption in pulmonary imaging. The negative conversion time of novel coronavirus nucleic acid in the control group was 5 and 7 days respectively. No adverse events occurred in the experimental group.Zedoary TurmericOil had strong inhibitory effect on SARS-COV-2 virusin vitrowhich was dose-dependent.In vivotreatment of COVID-19,Zedoary TurmericOil Injection combined with conventional treatment can improve the cough caused by SARS-COV-2 infection, promote SARS-COV-2 to turn negative, promote absorption of lung lesions, and reduce lung injury, with no obvious adverse events.

Objective: : This study aims to investigate the relationship between aneurysm wall enhancement and clinical rupture risks based on the magnetic resonance vessel wall imaging (MR-VWI) quantitative methods. Methods: : One hundred and eight patients with 127 unruptured aneurysms were prospectively enrolled from Feburary 2016 to October 2017. Aneurysms were divided into high risk (≥10) and intermediate-low risk group (<10) according to the PHASES (Population, Hypertension, Age, Size of aneurysm, Earlier SAH history from another aneurysm, Site of aneurysm) scores. Clinical risk factors, aneurysm morphology, and wall enhancement index (WEI) calculated using 3D MR-VWI were analyzed and compared. Results: : In comparison of high-risk and intermediated-low risk groups, univariate analysis showed that neck width (4.5±3.3 mm vs. 3.4±1.7 mm, p=0.002), the presence of wall enhancement (100.0% vs. 62.9%, p<0.001), and WEI (1.6±0.6 vs. 0.8±0.8, p<0.001) were significantly associated with high rupture risk. Multivariate regression analysis revealed that WEI was the most important factor in predicting high rupture risk (odds ratio, 2.6; 95% confidence interval, 1.4–4.9; p=0.002). The receiver operating characteristic (ROC) curve analysis can efficiently differentiate higher risk aneurysms (area under the curve, 0.780; p<0.001) which have a reliable WEI cutoff value (1.04; sensitivity, 0.833; specificity, 0.67) predictive of high rupture risk. Conclusion : Aneurysms with higher rupture risk based on PHASES score demonstrate increased neck width, wall enhancement, and the enhancement intensity. Higher WEI in unruptured aneurysms has a predictive value for increased rupture risk.

Objective:To investigate the effect of complete decongestive therapy in the treatment of severe grade Ⅲ lower limb lymphedema.Methods:From January 2018 to December 2018, The patients were admitted to the lymphedema clinic of the cancer prevention and treatment center of Sun Yat-sen University, seven patients with severe gradeⅢ lower limb lymphedema were intervened with complete decongestive therapy, including problem skin care, special techniques of unarmed lymphatic drainage, foam block bandage combined with air wave pressure therapy, filled elastic bandage pressure bandage, functional exercise combined with home bare-handed lymphatic drainage and weight loss management. The intervention had two courses, and 20 times was a course of treatment. Perimeter measurement and weight measurement were used to evaluate the therapeutic effect at the 0, 5, 10, 15, 20, 30, 40 times of treatment.Results:After two courses of treatment, the circumference value of each measurement point on the affected side was lower than that before treatment, and the difference was statistically significant ( F values were 7.449-23.073, P < 0.05). The circumference value of the affected side decreased by 7.10 - 24.53 cm, and the weight after treatment was 9.0 - 20.5 kg less than that before treatment. During the follow-up period, it was found that the lower extremity diameter value at 3 months of follow-up at 5 sites increased and tended to be stable compared with that at 1 year of follow-up. Conclusion:Step 6 comprehensive swelling treatment can obviously improve the symptoms of patients with lower limb lymphedema of this research, and in the subsequent follow-up found that self-therapy at home, no recurrence or aggravate the limb swelling degree, and can reduce or stability treatment effect, enhance confidence in the treatment of patients, so as to improve the quality of life of patients and treatment compliance.

Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.

Objective:To explore the expression and clinical significance of S100A8 and S100A9 in Helicobacter pylori ( H. pylori) associated gastritis. Methods:A total of 101 patients with chronic gastritis diagnosed in the First Hospital of Shanxi Medical University from October 2018 to May 2019 were selected. The expression levels of S100A8 and S100A9 in the gastric mucosa tissues of 101 patients with chronic gastritis were determined by immunohistochemistry (in absorbance), and the mRNA expression levels of S100 A8 and S100 A9 in the gastric mucosa tissues of 48 patients were detected by reverse transcription-polymerase chain reaction. And the results combined with pathological diagnosis of routine staining and clinical H. pylori infection data were analyzed. Mann-Whitney U test, Kruskal-Wallis H test and Spearman rank correlation were used for statistical analysis. Results:Among 101 patients, there were 59 cases of chronic atrophic gastritis (CAG group) and 42 cases of chronic non-atrophic gastritis (NAG group); 59 cases were H. pylori positive ( H. pylori positive group) and 42 cases were H. pylori negative ( H. pylori negative group). There were statistically significant differences in the expression levels of S100A8 and S100A9 between CAG group and NAG group (0.10, 0.07 to 0.13 vs. 0.09, 0.06 to 0.10 and 0.13, 0.08 to 0.15 vs. 0.09, 0.07 to 0.10, respectively), and between H. pylori positive group and H. pylori negative group (0.11, 0.10 to 0.13 vs. 0.07, 0.06 to 0.08 and 0.13, 0.10 to 0.15 vs. 0.07, 0.07 to 0.08, respectively) ( U=754.00, 602.00, 5.00 and 40.00, all P<0.01). There were statistically significant differences in the expression levels of S100A8 and S100A9 between H. pylori positive patients (34 cases) and H. pylori negative patients (25 cases) in CAG group (0.13, 0.11 to 0.14 vs. 0.07, 0.07 to 0.08 and 0.15, 0.14 to 0.16 vs. 0.08, 0.08 to 0.09, respectively), similarly, there were significant differences in the expression levels of S100A8 and S100A9 between H. pylori positive patients (25 cases) and H. pylori negative patients (17 cases) in NAG group (0.10, 0.09 to 0.10 vs. 0.06, 0.05 to 0.07 and 0.10, 0.10 to 0.11 vs. 0.07, 0.06 to 0.07, respectively) ( U=1.00, 0.00, 0.00 and 0.00, all P<0.01). The results indicated that the expression levels of S100A8 and S100A9 were high in H. pylori positive patients in CAG group, the expression levels of S100A8 and S100A9 were low in H. pylori negative patients in NAG group, and the differences were statistically significant ( H=84.78 and 89.64, both P<0.01). There were statistically significant differences in the expression of S100 A8 and S100 A9 at mRNA level between CAG group (24 cases) and NAG group (24 cases) (0.12, 0.06 to 1.31 vs. 0.05, 0.03 to 0.08; 0.19, 0.03 to 0.43 vs. 0.03, 0.01 to 0.09), and the expression of S100 A8 and S100 A9 at mRNA level was significant between H. pylori positive patients (24 cases) and H. pylori negative patients (24 patients) (0.45, 0.10 to 1.90 vs. 0.05, 0.03 to 0.08 and 0.36, 0.24 to 0.81 vs. 0.03, 0.01 to 0.04) ( U=55.00, 74.00, 19.00 and 2.00, all P<0.05). There were statistically significant differences in the expression of S100 A8 and S100 A9 at mRNA level between H. pylori positive patients (12 cases) and H. pylori negative patients (12 cases) of CAG group (0.85, 0.27 to 2.28 vs. 0.06, 0.03 to 0.09 and 0.39, 0.25 to 0.87 vs. 0.03, 0.02 to 0.05), and the expression of S100 A8 and S100 A9 at mRNA level was significant between H. pylori positive patients (12 cases) and H. pylori negative patients (12 cases) of NAG group (0.09, 0.05 to 0.28 vs. 0.04, 0.03 to 0.07 and 0.20, 0.09 to 0.65 vs. 0.01, 0.01 to 0.03) ( U=5.00, 2.00, 0.00 and 0.00, all P<0.01). The results showed that the expression of S100 A8 and S100 A9 at mRNA level was high in H. pylori positive patients in CAG group, the expression of S100 A8 and S100 A9 at mRNA level was low in H. pylori negative patients in NAG group, and the differences were statistically significant ( H=20.43 and 24.15, both P<0.01). The expression levels of S100A8 and S100A9 were positively correlated at both protein level and mRNA level ( r=0.899 and 0.903, both P<0.01). Conclusions:S100A8 and S100A9 may involve in the inflammation process of H. pylori-infected gastric mucosa and promote the proliferation of gastric epithelial cells, which may be one of mechanisms of intrinsic glands reduction and CAG genesis. S100A8 and S100A9 are expected to be potential biomarkers for diagnosis and follow-up and potential targets for treatmert of CAG.