OBJECTIVE: To investigate the effectiveness of nickel-titanium shape memory staples in treating multiple metatarsal fractures. METHODS: The clinical data of 27 patients with multiple metatarsal fractures who were treated between January 2022 and June 2023 and met the selection criteria were retrospectively analysed. The cohort consisted of 16 males and 11 females, aged 33-65 years (mean, 47.44 years). The causes of injury included heavy object impact in 11 cases, traffic accidents in 9 cases, and crush in 7 cases. Simultaneous fractures of 2, 3, 4, and 5 bones occurred in 6, 6, 4, and 8 cases, respectively, with tarsometatarsal joint injury in 3 cases. Fixation was performed using staples for 16, 22, and 9 fractures in the metatarsal neck, shaft, and the base, respectively, and 5 tarsometatarsal joint injuries. Preoperative soft tissue injuries were identified in 8 cases and classified according to the Tscherne-Oestern closed soft tissue injury classification as type Ⅰ in 5 cases and type Ⅱ in 3 cases. One case of type Ⅱexhibited preoperative skin necrosis. The patients were treated with fixation using nickel-titanium shape memory staples. Complications and fracture healing were documented. At last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used to evaluate the function, and the visual analogue scale (VAS) score was used to evaluate the pain. RESULTS: The 27 patients were followed up 9-19 months (mean, 12.4 months). Postoperative X-ray films revealed no loss of fracture reduction, and all fractures achieved bony union. No internal fixator loosening, breakage, or other mechanical failures was observed. The mean fracture healing time was 3.13 months (range, 3-4 months). Postoperatively, 4 cases (2 of Tscherne-Oestern type Ⅰ, 2 of type Ⅱ) developed superficial skin necrosis, which resolved with dressing changes. No infection was observed in the remaining patients, and all wounds healed. At last follow-up, the AOFAS forefoot score ranged from 70 to 95, with an average of 86.6, of which 19 cases were excellent, 6 cases were good, and 2 cases were fair, with an excellent and good rate of 92.6%; the VAS score ranged from 0 to 3, with an average of 0.9, of which 24 cases were excellent, and 3 cases were good, with an excellent and good rate of 100%. CONCLUSION The use of nickel-titanium shape memory staples in the treatment of multiple metatarsal fractures can effectively protect local skin and soft tissues and minimize secondary damage associated with internal fixator insertion. It is a viable surgical option for management of multiple metatarsal fractures.
Humans ; Male ; Female ; Middle Aged ; Adult ; Titanium ; Nickel ; Retrospective Studies ; Fracture Fixation, Internal/instrumentation* ; Aged ; Metatarsal Bones/surgery* ; Fractures, Bone/surgery* ; Treatment Outcome ; Sutures ; Fractures, Multiple/surgery*

As the brain's resident immune cells, microglia perform crucial functions such as phagocytosis, neuronal network maintenance, and injury restoration by adopting various phenotypes. Dynamic imaging of these phenotypes is essential for accessing brain diseases and therapeutic responses. Although numerous probes are available for imaging pro-inflammatory microglia, no PET tracers have been developed specifically to visualize anti-inflammatory microglia. In this study, we present an ¹⁸F-labeled PET tracer (QTFT) that targets the P2Y₁₂, a receptor highly expressed on anti-inflammatory microglia. [¹⁸F]QTFT exhibited high binding affinity to the P2Y₁₂ (14.43 nmol/L) and superior blood-brain barrier permeability compared to other candidates. Micro-PET imaging in IL-4-induced neuroinflammation models showed higher [¹⁸F]QTFT uptake in lesions compared to the contralateral normal brain tissues. Importantly, this specific uptake could be blocked by QTFT or a P2Y₁₂ antagonist. Furthermore, [¹⁸F]QTFT visualized brain lesions in mouse models of epilepsy, glioma, and aging by targeting the aberrantly expressed P2Y₁₂ in anti-inflammatory microglia. In a pilot clinical study, [¹⁸F]QTFT successfully located epileptic foci, showing enhanced radioactive signals in a patient with epilepsy. Collectively, these studies suggest that [¹⁸F]QTFT could serve as a valuable diagnostic tool for imaging various brain disorders by targeting P2Y₁₂ overexpressed in anti-inflammatory microglia.

Objective:To explore the clinical efficacy of a free superficial palmar branch of the radial artery (SPBRA)-pedicled wrist crease flap for bridging and repairing finger C-shape soft tissue defect.Methods:From March 2021 to January 2023, the clinical data of patients with finger C-shape soft tissue defects in Department of Orthopedics, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University were retrospectively analyzed. Preoperatively, color Doppler was used to locate the perforator point, and the position and size of the flap were designed. A free SPBRA-pedicled wrist crease flap was used in a Flow-through method to bridge and repair the defects. Postoperatively, the survival, color, texture, sense, and shape of the skin flap were observe, and the healing of the donor site was assessed. The clinical efficacy was evaluated using Evaluation Trail Standards for Replantation Function of Chinese Society of Hand Surgery.Results:All 10 patients completed the entry result analysis, including 8 males and 2 females. The age ranged from 22 to 54 years old. Among them, 3 cases involved the index finger, 5 cases involved the middle finger, and 2 cases involved the ring finger. All of them showed segmental defects of the unilateral volar medial artery with combined digital nerve defects, including 7 cases of radial injury and 3 cases of ulnar injury. 3 cases of the vascular defect ranged in the proximal phalanx areas, 6 cases in the middle phalanx region, and 1 case in the middle to distal phalanx region. The length of the proper artery defect ranged from 1.0 cm to 1.8 cm, the area of skin defect ranged from 1.0 cm×2.5 cm to 2.2 cm×4.0 cm, and the harvested flap area range ranged from 1.2 cm×2.8 cm to 2.5 cm×5.0 cm. The patients were followed up for 10 to 19 months. All flaps survived and healed well, with no bulky appearance, and a texture similar to normal finger skin. The static two-point discrimination ranged from 7.0~ 10.0 mm (average 8.5 mm). Superficial infection around the flap occurred in 1 case after surgery. It improved after dressing change. No vascular crisis occurred. The wounds at the donor site healed primarily, leaving linear scars. The flexion and extension activities of the wrist joint were not affected. According to the Evaluation Trail Standards for Replantation Function of Chinese Society of Hand Surgery: 8 cases received excellent results, 2 cases were good, and the patient satisfaction was high.Conclusion:The free SPBRA-pedicled wrist crease flap has good and accurate efficacy in bridging and repairing finger C-shape soft tissue defects. It has the advantages of convenient harvesting, minimal trauma, and low complication rate, and has clinical promotion and application value.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

To analyze the epidemiological characteristics of COVID-19 in Fujian Province from the 49th week of 2022 to the 5th week of 2023,after further optimization of China's COVID-19 prevention and control measures on December 7,2022(the 49th week of 2022),this study used multi-dimensional surveillance data to dynamically assess population infection levels and their changing trends.The aim of the study was to provide a scientific basis for early warning of epidemic risk,medical resource allocation,and evalu-ation of socio-economic impact.A multi-source data surveillance system was constructed,encompassing surveillance of fever clinics at medical institutions(weekly collection of visits,positive nucleic acid and antigen test results,inpatients,and severe cases in sec-ondary or above hospitals),population nucleic acid test monitoring(weekly person-times and positivity rates of single-tube tests from the provincial system),sentinel hospital monitoring(weekly proportion of influenza-like illness visits at 18 sentinel hospitals and re-lated viral testing data),and monitoring of novel coronavirus variants(weekly systematic collection of genomic sequences of local and imported cases).Line charts were plotted weekly,and time series analysis,molecular epidemiological methods,and an improved SEIAR model were used to simulate epidemic spread.During the study period,the COVID-19 epidemic in Fujian Province exhibited three distinct stages.In the infection peak stage(52nd week of 2022),the provincial fever clinic visits reached 606 893 person-times,and a 49.2%positivity rate in population single-tube nucleic acid tests and 63.8%positivity rate in sentinel hospital monitoring were observed.In the medical load peak stage(2nd week of 2023),274 460 inpatients and 28 487 severe cases were recorded.In the epidemic decline stage(4th to 5th weeks of 2023),fever clinic visits decreased by 96.3%with respect to the peak,the single-tube nucleic acid test positivity rate decreased to 6.3%,and the sentinel hospital COVID-19 nucleic acid test positivity rate was 6.4%.All 508 sequenced local cases were Omicron variants,predominantly BA.5.2 and its sub-lineages(67.4%).Among 56 imported se-quenced cases,BA.5.2 and its sub-lineages accounted for 50.0%,and 16.1%comprised nine variants of interest including XBB and BQ.The model predicted the infection peak in the 52nd week of 2022,whereas the hospitalization peak lagged by approximately 10.6 days.Multi-source data monitoring revealed a three-stage development of the COVID-19 epidemic in Fujian.The BA.5.2 strain was dominant during the epidemic.The combination of multi-source monitoring data and modeling provides important references for epi-demic prevention and control,and highlights the need to improve the monitoring system in follow-up.

Objective To explore the efficacy and safety of side-to-side anastomosis(SS)and end-to-side anastomosis(ES)of the ileocolon in laparoscopic right hemicolectomy of colon cancer,so as to provide evidence-based evidence for surgical selection.Methods PubMed,Embase,Web of Science,Cochrane Library,China National Knowledge Infrastructure,Wanfang Data,VIP database,Chinese BioMedical Literature database were searched from inception to November 2024 to collect relevant clinical studies of SS versus ES.The Newcastle-Ottawa Scale(NOS)was used to evaluate the literature quality of retrospective studies,and the Cochrane system was used to evaluate the literature quality of randomized controlled trials(RCT).Rev Man 5.3 software was used for Meta-analysis,sensitivity analysis,and publication bias analysis.Results 9 retrospective studies and 4 RCTs with a total of 2 632 patients were included.The Meta-analysis results of the retrospective study show that:Compared with SS,ES has a shorter tolerance time for liquid diet(MD=-0.20,95%CI:-0.40～0.00,P<0.05),fewer daily episodes of diarrhea(MD=-1.06,95%CI:-1.79～0.23,P<0.05),but a higher pain score at 12 hours post-surgery(MD=0.95,95%CI:0.50～1.40,P<0.05).Comparison of the overall complication rates of the two anastomosis methods showed no statistically significant difference((OR)=1.05,95%CI:0.22～5.14,P>0.05).Sensitivity analysis of the retrospective study shows:the incidence of ES bowel obstruction was higher than that of SS,with a statistically significant difference((OR)=2.18,95%CI:1.15～4.14,P<0.05);The sensitivity analysis of the RCT shows:the overall incidence of complications at the anastomotic site of SS was significantly higher than that of ES,with a statistically significant difference((OR)=5.26,95%CI:1.91～14.48,P<0.05),and the results of other outcome indicators did not show reversal.The analysis of publication bias risk showed no significant publication bias.Conclusion Ileocolonic ES has a slight advantage over SS in laparoscopic right hemicolectomy of colon cancer,both anastomoses are safe and effective,and the surgeon can choose the appropriate anastomosis technique according to the patient's specific situation,in order to improve the postoperative recovery.

Objective To investigate the effects of normal-high blood pressure and Grade 1 hypertension during early pregnancy on preeclampsia(PE)and adverse pregnancy outcomes in pregnant women.Methods A retrospective cohort study was conducted,enrolling 2,562 postpartum women who delivered at the Shiyan Maternal and Child Health Hospital from March 2020 to November 2023 as study participants.Prenatal examination data and delivery medical records were collected for analysis.Women were categorized into three groups based on blood pressure measurements taken before 20 weeks of gestation:normal blood pressure(n=2 029):systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg;normal high blood pressure(n=375):systolic blood pressure 120～139 mmHg or diastolic blood pressure 80～89 mmHg;and Level 1 hypertension(n=158):systolic blood pressure 140～159 mmHg or diastolic blood pressure 90～99 mmHg.The incidence rates of PE and adverse pregnancy outcomes(including cesarean section,placental abruption,spontaneous preterm delivery[before 37 weeks],postpartum hemorrhage,stillbirth after 20 weeks of gestation,Apgar score<7,neonatal admission to the NICU,small for gestational age,macrosomia,and neonatal death within 28 days of birth)were compared and analyzed across the three groups.Cox regression analysis was performed to investigate the impact of early pregnancy blood pressure levels on the risk of PE and adverse pregnancy outcomes.Results(1)Women with normal high blood pressure had a 2.163-fold increased risk of PE compared to women with normal blood pressure(95%CI:1.228～3.809,P=0.007).However,there were no statistically significant differences in the rates of cesarean section(OR=1.341,95%CI:0.528～3.405,P=0.537),placental abruption(OR=1.016,95%CI:0.925～1.115,P=0.740),Apgar score<7(OR=1.422,95%CI:0.976～2.071,P=0.066),spontaneous preterm birth(OR=1.027,95%CI:0.925～1.140,P=0.617),postpartum bleeding(OR=1.141,95%CI:0.873～1.491,P=0.334),stillbirth after 20 weeks of gestation(OR=1.276,95%CI:0.980～1.661,P=0.070),neonatal admission to NICU(OR=1.301,95%CI:0.674～2.511,P=0.432),small for gestational age(OR=1.089,95%CI:0.927～1.279,P=0.299),macrosomia(OR=1.336,95%CI:0.824～2.166,P=0.240),or neonatal death within 28 days of birth(OR=1.275,95%CI:0.918～1.770,P=0.147).(2)Compared to women with normal blood pressure,women with grade 1 hypertension had a significantly higher risk of preeclampsia(OR=3.829,95%CI:1.749～8.385,P<0.001),cesarean section(OR=2.414,95%CI:1.298～4.489,P=0.005),and placental abruption(OR=2.537,95%CI:1.196～5.384,P=0.015).Additionally,they had a higher rate of Apgar score<7(OR=1.829,95%CI:1.069～3.130,P=0.027).No statistically significant differences were observed for spontaneous preterm birth(OR=1.404,95%CI:0.713～2.764,P=0.326),postpartum bleeding(OR=1.236,95%CI:0.845～1.807,P=0.274),stillbirth after 20 weeks of gestation(OR=1.076,95%CI:0.902～1.283,P=0.415),neonatal admission to NICU(OR=1.346,95%CI:0.873～2.075,P=0.178),small for gestational age(OR=1.417,95%CI:0.926～2.168,P=0.108),macrosomia(OR=1.235,95%CI:0.629～2.424,P=0.539),or neonatal death within 28 days of birth(OR=1.275,95%CI:0.918～1.770,P=0.147).(3)ROC analysis shows that when the sample combination was normal high blood pressure(n=375),the predictive/evaluative efficacy AUC of early pregnancy blood pressure values(threshold 139/89)for PE was 0.757.When the sample combination was level 1 hypertension(n=158),the predictive/evaluative efficacy AUC of early pregnancy blood pressure values(threshold 159/99)for four adverse outcomes,including PE,cesarean section,placental abruption,and Asperger's score<7,were 0.789,0.717,0.709,and 0.742,respectively.Conclusion Compared with pregnant and parturient women with normal blood pressure,having a normal high blood pressure or grade 1 hypertension before 20 weeks of pregnancy will significantly increase the risk of PE;in addition,grade 1 hypertension is also associated with a higher incidence of adverse pregnancy outcomes,including cesarean section,placental abruption,and low Apgar score of the newborn.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective:To investigate the surgical techniques and clinical efficacy of arthroscopic-assisted posterior malleolus reduction for the management of ankle fracture-dislocation.Methods:A retrospective analysis was performed on the clinical data of 27 patients who underwent arthroscopy-assisted posterior malleolar reduction via the posterior approach for the surgical management of ankle fracture-dislocation at the Third Affiliated Hospital of Nanjing Medical University (Changzhou No.2 People's Hospital) between January 2022 and June 2023. The cohort comprised 17 males and 10 females, with a mean age of 43.67±9.56 years (range, 25-63 years). Based on the Bartonícek and Rammelt classification, there were 15 type II cases, 9 type III cases, and 3 type IV cases. The operation time, posterior ankle arthroscopy duration, and postoperative complications, such as neurovascular injury, wound infection, or skin necrosis, were recorded. X-ray and 3D CT imaging were utilized to assess joint surface reduction quality, tibiofibular matching and fracture healing status. The ankle plantarflexion, dorsiflexion and hallux flexion contractures were recorded at the last follow-up. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the Olerud-Molander ankle score (OMAS), while pain was evaluated using the visual analogue scale (VAS).Results:All 27 patients were followed up postoperatively, with a mean follow-up duration of 14.30±1.38 months (range, 12-18 months). Postoperatively, one patient experienced wound exudation, while another developed intermuscular venous thrombosis in the calf. No cases of neurovascular injury, wound infection, skin necrosis, or hallux flexion contracture occurred, and no reduction loss was observed. The mean operation time was 96.11±11.55 min (range, 80-120 min), and the posterior ankle arthroscopy duration was 35.74±5.67 min (range, 30-45 min). Postoperative X-ray evaluations demonstrated no loss of fracture reduction, and all fractures achieved bony union. The mean fracture healing time was 3.78±0.75 months (range, 3-5 months). Postoperative CT evaluations showed no joint surface malalignment, and distal tibiofibular matching was satisfactory. At the final follow-up, mean ankle plantarflexion was 46.74°±4.73° (range, 33°-50°), and dorsiflexion was 20.96°±3.29° (range, 14°-26°). There was no hallux flexion contracture occurred. The mean AOFAS ankle-hindfoot score was 92.11±7.19 (range, 74-100), with 20 excellent, 5 good, and 2 fair, yielding an excellent-good rate of 93%. The mean OMAS score was 94.44±7.25 (range, 75-100), comprising 20 excellent and 7 good results, yielding an excellent-good rate of 100%. The mean VAS score was 0.70±0.95 (range, 0-3).Conclusion:Arthroscopy-assisted posterior malleolar reduction in ankle fracture-dislocation surgery provides optimal soft tissue protection and ensures precise fracture reduction and fixation.

Objective To investigate the effects of normal-high blood pressure and Grade 1 hypertension during early pregnancy on preeclampsia(PE)and adverse pregnancy outcomes in pregnant women.Methods A retrospective cohort study was conducted,enrolling 2,562 postpartum women who delivered at the Shiyan Maternal and Child Health Hospital from March 2020 to November 2023 as study participants.Prenatal examination data and delivery medical records were collected for analysis.Women were categorized into three groups based on blood pressure measurements taken before 20 weeks of gestation:normal blood pressure(n=2 029):systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg;normal high blood pressure(n=375):systolic blood pressure 120～139 mmHg or diastolic blood pressure 80～89 mmHg;and Level 1 hypertension(n=158):systolic blood pressure 140～159 mmHg or diastolic blood pressure 90～99 mmHg.The incidence rates of PE and adverse pregnancy outcomes(including cesarean section,placental abruption,spontaneous preterm delivery[before 37 weeks],postpartum hemorrhage,stillbirth after 20 weeks of gestation,Apgar score<7,neonatal admission to the NICU,small for gestational age,macrosomia,and neonatal death within 28 days of birth)were compared and analyzed across the three groups.Cox regression analysis was performed to investigate the impact of early pregnancy blood pressure levels on the risk of PE and adverse pregnancy outcomes.Results(1)Women with normal high blood pressure had a 2.163-fold increased risk of PE compared to women with normal blood pressure(95%CI:1.228～3.809,P=0.007).However,there were no statistically significant differences in the rates of cesarean section(OR=1.341,95%CI:0.528～3.405,P=0.537),placental abruption(OR=1.016,95%CI:0.925～1.115,P=0.740),Apgar score<7(OR=1.422,95%CI:0.976～2.071,P=0.066),spontaneous preterm birth(OR=1.027,95%CI:0.925～1.140,P=0.617),postpartum bleeding(OR=1.141,95%CI:0.873～1.491,P=0.334),stillbirth after 20 weeks of gestation(OR=1.276,95%CI:0.980～1.661,P=0.070),neonatal admission to NICU(OR=1.301,95%CI:0.674～2.511,P=0.432),small for gestational age(OR=1.089,95%CI:0.927～1.279,P=0.299),macrosomia(OR=1.336,95%CI:0.824～2.166,P=0.240),or neonatal death within 28 days of birth(OR=1.275,95%CI:0.918～1.770,P=0.147).(2)Compared to women with normal blood pressure,women with grade 1 hypertension had a significantly higher risk of preeclampsia(OR=3.829,95%CI:1.749～8.385,P<0.001),cesarean section(OR=2.414,95%CI:1.298～4.489,P=0.005),and placental abruption(OR=2.537,95%CI:1.196～5.384,P=0.015).Additionally,they had a higher rate of Apgar score<7(OR=1.829,95%CI:1.069～3.130,P=0.027).No statistically significant differences were observed for spontaneous preterm birth(OR=1.404,95%CI:0.713～2.764,P=0.326),postpartum bleeding(OR=1.236,95%CI:0.845～1.807,P=0.274),stillbirth after 20 weeks of gestation(OR=1.076,95%CI:0.902～1.283,P=0.415),neonatal admission to NICU(OR=1.346,95%CI:0.873～2.075,P=0.178),small for gestational age(OR=1.417,95%CI:0.926～2.168,P=0.108),macrosomia(OR=1.235,95%CI:0.629～2.424,P=0.539),or neonatal death within 28 days of birth(OR=1.275,95%CI:0.918～1.770,P=0.147).(3)ROC analysis shows that when the sample combination was normal high blood pressure(n=375),the predictive/evaluative efficacy AUC of early pregnancy blood pressure values(threshold 139/89)for PE was 0.757.When the sample combination was level 1 hypertension(n=158),the predictive/evaluative efficacy AUC of early pregnancy blood pressure values(threshold 159/99)for four adverse outcomes,including PE,cesarean section,placental abruption,and Asperger's score<7,were 0.789,0.717,0.709,and 0.742,respectively.Conclusion Compared with pregnant and parturient women with normal blood pressure,having a normal high blood pressure or grade 1 hypertension before 20 weeks of pregnancy will significantly increase the risk of PE;in addition,grade 1 hypertension is also associated with a higher incidence of adverse pregnancy outcomes,including cesarean section,placental abruption,and low Apgar score of the newborn.