Inflammation plays important roles in the initiation and progress of many diseases. Caffeic acid (CaA) is a naturally occurring hydroxycinnamic acid derivative, which shows hypotoxicity and diverse biological functions, including anti-inflammation. The molecular mechanisms involved in the CaA-inhibited inflammatory response are very complex; generally, the down-regulated phosphorylation of such important transcriptional factors, for example, nuclear factor κB (NF-κB) and signal transducers and activators of transcription-3 (STAT-3), plays an important role. Here, we found that in RAW264.7 macrophage cells, CaA blocked lipopolysaccharide (LPS)-stimulated inflammatory response by attenuating the expression of 14-3-3ζ (a phosphorylated protein regulator). Briefly, the increased expression of 14-3-3ζ was involved in the LPS-induced inflammatory response. CaA blocked the LPS-elevated 14-3-3ζ via attenuating the LPS-induced tumor necrosis factor-α (TNF-α) secretion and via enhancing the 14-3-3ζ ubiquitination. These processes inhibited the LPS-induced activation (phosphorylation) of NF-κB and STAT-3, in turn blocked the transcriptional activation of inducible NO synthase (iNOS), interleukin-6 (IL-6), and TNF-α, and finally attenuated the productions of nitric oxide (NO), IL-6, and TNF-α. By understanding a novel mechanism whereby CaA inhibited the 14-3-3ζ, our study expanded the understanding of the molecular mechanisms involved in the anti-inflammation potential induced by CaA.

Hysterectomy is the most common gynaecological surgery in the world (Barker, 2016;Hammer et al., 2015), which is an important treatment for benign gynaecological diseases such as fibroids, endometriosis and uterine prolapse (Lundholm et al., 2009;Whiteman et al., 2008). When non-operative treatment cannot solve the pain of common gynaecological benign diseases, hysterectomy to relieve symptoms and improve women's quality of life has become a possible choice (Rannestad, 2005). However, several studies have reported that patients experience varying degrees of anxiety and depression before and after hysterectomy due to multiple factors such as individual personality traits, fear of surgery, concerns about altered self-image and the strength of family support (Donoghue et al., 2003;Thornton et al., 1997;Wilson et al., 2018). Studies have also reported potentially important associations between age and disease progression and the mental health status of women undergoing hysterectomy, particularly before the age of 40 and in the case of more severe disease, which can increase the psychological burden of women (Cooper et al., 2009). Therefore, fully understanding and exploring the real experience of hysterectomy patients can promptly identify the possible psychological and spiritual needs of patients

The associations of preconceptional folic acid use with menstruation-related changes were examined by a retrospective study through 219 questionnaires. The kind of folic acid (alone or with other vitamins), the using time and frequency, the menstrual regularity, the cycle length before and after use, and other menstruation-related changes after use were obtained. Two hundred of 219 participants were users, and menstruation-related changes occurred in 32 women, with abnormalities of involvement being longer cycles (increase of 3-20 days, 7.7 ± 4.8 days), shorter cycles (decrease of 3-7 days, 5.7 ± 2.3 days), irregular cycles, less blood loss, bleeding or spotting between cycles, and algomenorrhea. Seventeen women stopped using folic acid or folic acid-containing multivitamin, and sixteen of the seventeen women experienced at least one menstruation before conception. Fifteen of sixteen women found complete recovery, indicating the high possibility that these changes were attributed to the use of folic acid or folic acid-containing multivitamin.