Objective To systematically evaluate the impact of pulmonary hypertension (PH) on the prognosis of patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). Methods A computerized search was conducted in CNKI, Wanfang Data, VIP, CBM, PubMed, The Cochrane Library, EMbase, and Web of Science databases from inception to June 2023 for cohort studies on the prognostic impact of PH in severe AS patients undergoing TAVR. Two researchers independently screened the literature, extracted data, and assessed the quality of included studies. Stata 17.0 software was used for meta-analysis. Results A total of 16 cohort studies were included, all with Newcastle-Ottawa Scale scores≥7. Meta-analysis results showed that, compared with AS patients without PH, those with PH had significantly higher 1-year all-cause mortality after TAVR [OR=2.10, 95%CI (1.60, 2.75), P<0.01], 30-day all-cause mortality [OR=2.09, 95%CI (1.54, 2.83), P<0.01], and cardiovascular mortality [OR=1.49, 95%CI (1.18, 1.90), P<0.01]. The differences between the two groups in major bleeding events, stroke, myocardial infarction, pacemaker implantation, and postoperative renal failure were not statistically significant. For outcome indicators with significant heterogeneity, subgroup analyses were performed based on PH measurement methods, diagnostic criteria, and different types of PH. The results showed that most subgroup combined results were consistent with the overall findings and that heterogeneity was significantly reduced. Conclusion PH significantly increases the 30-day all-cause mortality, 1-year all-cause mortality, and cardiovascular mortality in patients with severe AS undergoing TAVR.

Objective:To investigate the clinical efficacy of combination of a Flow-through anterolateral thigh myocutaneous flap with a contralateral great saphenous vein grafting in reconstruction of Gustilo ⅢC foot and ankle injury in emergency surgery.Methods:This retrospective study analysed the clinical data of 9 patients who were admitted in the Department of Wound Repair Surgery, Suzhou Ruihua Orthopaedic Hospital between September 2021 and October 2023. All patients were diagnosed with Gustilo ⅢC foot and ankle injury and met the predefined inclusion criteria. The average age of the patients was 45 (26-64) years. The mean of Mangled Extremity Severity Score (MESS) was 8.2 points, with a range from 5 to 10 points. The wound area after debridement ranged from 15.5 cm×6.0 cm to 24.5 cm×12.5 cm, with the vascular occlusion or defect at 4.0-20.0 (mean, 6.3) cm in length. The size of the flap was 16.5 cm×7.0 cm-25.5 cm×13.5 cm. During surgery, segments of the great saphenous vein were excised in the length of 5.0-21.0 cm, at an approximately 6.5 cm in length. The Flow-through anterolateral thigh myocutaneous flap was employed to reconstruct the soft tissue defect and to establish vascular connections between the anterior or posterior tibial arteries and veins, with the vessels carried by the flap. Additionally, the contralateral great saphenous vein was taken to bridge the posterior or anterior tibial arteries and veins. Follow-ups were carried out by outpatient visits, telephone calls and WeChat interviews. The flap viability, limb blood circulation, wound healing at both donor and recipient sites, as well as functional recovery of the affected limbs was observed. Sensation recovery of the flap was assessed according to the rating standard established by the British Medical Research Council (BMRC) , while the function recovery of foot and ankle was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale.Results:All flaps successfully survived without vascular complication. Eight affected limbs were effectively cured, while a calf that had an infection and necrosis of a long segment of tibia and fibula was amputated below-the-knee in the stage-II surgery. One of the donor sites of flap was covered with a medium-thickness skin graft from lower abdomen due to the large size of the flap, while the other donor sites were directly sutured and healed at first intention. One patient developed postoperative bone infection, which was successfully treated through re-debridement and antibiotic bone cement filling. Another patient experienced partial necrosis at the distal hallux due to a prolonged limb ischemia, and a stump repair surgery was performed. All patients were entered into the postoperative follow-up for 15.3 (6-24) months. At the final follow-up visit, satisfactory colour and texture were observed on all flaps, although minor oedema was present. Donor sites healed well and the donor limb function was not affected. Sensory evaluation rated S 2 in 5 flaps and S 3 in 3 flaps according to BMRC. Functional assessment of foot and ankle of the affected limb yielded excellent in 2 patients, good in 5 patients and fair in 1 patient according to AOFAS. Conclusion:Flow-through anterolateral thigh myocutaneous flap combined with a contralateral great saphenous vein grafting enables one-stage reconstruction for soft tissue defect and blood circulation of the affected limb. It is a good method in the treatment of Gustilo ⅢC foot and ankle injury in emergency surgery.

Objective:To investigate the clinical efficacy of combination of a Flow-through anterolateral thigh myocutaneous flap with a contralateral great saphenous vein grafting in reconstruction of Gustilo ⅢC foot and ankle injury in emergency surgery.Methods:This retrospective study analysed the clinical data of 9 patients who were admitted in the Department of Wound Repair Surgery, Suzhou Ruihua Orthopaedic Hospital between September 2021 and October 2023. All patients were diagnosed with Gustilo ⅢC foot and ankle injury and met the predefined inclusion criteria. The average age of the patients was 45 (26-64) years. The mean of Mangled Extremity Severity Score (MESS) was 8.2 points, with a range from 5 to 10 points. The wound area after debridement ranged from 15.5 cm×6.0 cm to 24.5 cm×12.5 cm, with the vascular occlusion or defect at 4.0-20.0 (mean, 6.3) cm in length. The size of the flap was 16.5 cm×7.0 cm-25.5 cm×13.5 cm. During surgery, segments of the great saphenous vein were excised in the length of 5.0-21.0 cm, at an approximately 6.5 cm in length. The Flow-through anterolateral thigh myocutaneous flap was employed to reconstruct the soft tissue defect and to establish vascular connections between the anterior or posterior tibial arteries and veins, with the vessels carried by the flap. Additionally, the contralateral great saphenous vein was taken to bridge the posterior or anterior tibial arteries and veins. Follow-ups were carried out by outpatient visits, telephone calls and WeChat interviews. The flap viability, limb blood circulation, wound healing at both donor and recipient sites, as well as functional recovery of the affected limbs was observed. Sensation recovery of the flap was assessed according to the rating standard established by the British Medical Research Council (BMRC) , while the function recovery of foot and ankle was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale.Results:All flaps successfully survived without vascular complication. Eight affected limbs were effectively cured, while a calf that had an infection and necrosis of a long segment of tibia and fibula was amputated below-the-knee in the stage-II surgery. One of the donor sites of flap was covered with a medium-thickness skin graft from lower abdomen due to the large size of the flap, while the other donor sites were directly sutured and healed at first intention. One patient developed postoperative bone infection, which was successfully treated through re-debridement and antibiotic bone cement filling. Another patient experienced partial necrosis at the distal hallux due to a prolonged limb ischemia, and a stump repair surgery was performed. All patients were entered into the postoperative follow-up for 15.3 (6-24) months. At the final follow-up visit, satisfactory colour and texture were observed on all flaps, although minor oedema was present. Donor sites healed well and the donor limb function was not affected. Sensory evaluation rated S 2 in 5 flaps and S 3 in 3 flaps according to BMRC. Functional assessment of foot and ankle of the affected limb yielded excellent in 2 patients, good in 5 patients and fair in 1 patient according to AOFAS. Conclusion:Flow-through anterolateral thigh myocutaneous flap combined with a contralateral great saphenous vein grafting enables one-stage reconstruction for soft tissue defect and blood circulation of the affected limb. It is a good method in the treatment of Gustilo ⅢC foot and ankle injury in emergency surgery.

Objective To evaluate the efficacy and safety of ozone injection therapy for lumbar disc hemiation(LDH).Methods A computerized retrieval of academic papers concerning the randomized controlled trial(RCT)on ozone injection therapy for LDH from the databases of Embase,PubMed,Cochrane library and Web of science was conducted.The retrieval time period was from the establishment of the database to February 2023.The literature retrieval,screening,and data extraction were independently performed by two researchers.Cochrane bias risk assessment tool was used to assess the quality of the included literature.Stata 17.0 software was used to make meta-analysis.Results A total of 9 RCTs including 702 patients were finally included in this study.The results of meta-analysis showed that compared with radiofrequency thermocoagulation,percutaneous rotation and other treatments for LDH,the combination use of ozone injection could signifiicantly improve the effective rate based on Macnab efficacy evaluation criteria(RR=1.097,95％CI:1.038～1.159,P=0.001)and the excellent rate(RR=1.185～95％CI:1.074～1.309,P=0.001),and decrease the visual analog scale(VAS)pain score(WMD=-0.810～95％CI:-1.205～-0.414,P=0.000),and the differences in the above indexes were statistically significant.Conclusion Compared with the simple use of radiofrequency thermocoagulation,percutaneous rotation,and other treatment for LDH,the combination use of ozone injection therapy can significantly improve the effective rate and excellent rate based on Macnab efficacy evaluation criteria,decrease VAS score,with a high clinical safety.Limited by the quantity and quality of the original studies included in this study,the above conclusions need to be further verified by multi-center,large-sample and high-quality studies.

Objective:To systematically evaluate the prevalence of norovirus causing sporadic acute gastroenteritis in China.Methods:Relevant articles on acute gastroenteritis caused by norovirus in China published between January 2010 and October 2023 were retrieved from Wanfang, CNKI and PubMed database. The articles met inclusion and exclusion criteria were enrolled in this study. Excel software and SPSS20.0 software were used for statistical analysis. The epidemiological features of sporadic cases of acute gastroenteritis caused by norovirus in China were summarized using descriptive statistical analysis.Results:A total of 500 articles were included in this study, involving 784 486 cases of acute gastroenteritis and 670 292 samples in 32 provinces and regions. Norovirus GⅡ was the predominant genogroup causing acute gastroenteritis in China in recent years, but there were significant differences in the distribution of genotypes and epidemic strains at different times. GⅡ.4 was the predominant genotype in each year, and GⅡ.4/2006b and GⅡ.4 /Sydney_2012 were the main epidemic strains. Norovirus-related diarrhea occurred throughout the year, especially between the months of October and December. The incidence of norovirus infection was high in children under five years old and varied in different regions.Conclusions:Norovirus GⅡ was the predominant genogroup causing norovirus-related sporadic acute gastroenteritis in China, but there was an obvious genetic evolutionary trend in the epidemic strains. Factors such as epidemic strains, season and geographical region should be considered when making strategies for the prevention and control of norovirus-related diarrhea and developing vaccines.

Objective: To explore the application of grid health education model in improving college students health literacy. Methods: The clustered stratified random sampling method was used among the pre-formative education freshmen in a Xi-an university, with 1 123 students randomly selected totally. The intervention group (578) received health literacy education based on grid health education model, while the control group (545) receuved the original health education model. The effect of gird model of health education on health literacy was compared between two groups of college students after one-semester intervention. Results: Insufficient health literacy was found among freshmen participants in Xi an(17.12%, 17.61%); health literacy on prevention and treatment of chronic diseases (15.92%, 16.70%) was significantly lower than the national average level of urban residents(22.73%). Health literacy of the two groups of college students was significantly improved(47.75%, 27.71%, χ 2=20.50, 5.47, P<0.05). The grid health education model had significant effects in improving health literacy among college students, except for health literacy on safety and emergency(P<0.05). Conclusion Health literacy of college students is insufficient compared to that of urban residents in China. Grid model of health education model is superior to conventional health education model, which is in line with the requirements of health education in colleges in the new era.

Objective To investigate awareness and influencing factors of human papilloma virus (HPV)self-sampling for cervical cancer screening of female in Shenzhen.Methods A total of 544 female,who during July 2014 to June 2015,participated in live and online HPV self-sampling detection organized by our hospital,were surveyed by self-designed questionnaire.Their epidemiological data,HPV and cervical cancer related knowledge,awareness of HPV self-sampling for cervical cancer screening,their attitude,willingness and acceptance to HPV self-sampling for cervical cancer screening were investigated.Effects of awareness of HPV self-sampling to the cervical cancer screening and main influencing factors were analyzed.Results Among the 544 women,47.1% were aware of HPV;22.8% were aware of what diseases could be caused by HPV;12.5%had heard of and done by themselves self-sampling for cervical cancer screening;only 6.3% had heard of and participated in online self-sampling for cervical cancer screening.Women,who were enterprise /corporate white collar/independent enterprise manager or whose monthly income was over 30,000 yuan,were less aware of HPV self-sampling than other women (χ2 =13.058,12.626;P <0.05).81.6% of the female were apparently inclined to be sampled by doctors,and only 7.0% of the female believed that credibility of self-sampling screening was above 80%.The biggest concern about online self-sampling was mainly metamorphic specimens during transport,pollution,etc.Conclusions Awareness of female in Shenzhen about HPV and HPV self-sampling cervical cancer screening are relatively low.Intervention should be emphasized in reliability degree of self-sampling result,discomfort degree of sampling,complexity,specimen preservation,transport and result feedback.

Objective To study the postpartum pelvic floor rehabilitation on the improvement of pelvic floor electrical physiological indexes and the prevention of female pelvic floor dysfunction in China. Methods A multicenter prospective randomized controlled study was carried out. From October 2011, postpartum women in five provinces were randomly assigned into treatment group and control group. The women in treatment group received electrical stimulation and biofeedback treatment. The women in control group performed pelvic floor muscle exercise at home. When 6 months and 12 months after delivery, comparing two groups of patients with pelvic floor electrical physiological indexes and pelvic organ prolapse quantitation measurements (POP-Q), to evaluate the effect of postpartum pelvic floor rehabilitation on the prevention of pelvic floor dysfunction. Pelvic floor impact questionnaire short form (PFIQ-7) and pelvic organ prolapse/incontinence sexual questionnaire-12 (PISQ-12) were used to evaluate the influence on quality of life and sexual life. Results Until June 2013, 324 women were participated, 124 in control group, 200 in treatment group. According to the baseline results, there was statistical significance in the results of pelvic floor electrical physiological indexes between the treatment and control groups in postpartum 6 months and 12 months; the proportion above level Ⅲ of type Ⅰ and type Ⅱ muscle fibers strength in the treatment group, it was from 41.5% (83/200) and 40.5% (81/200) to 76.3% (145/190) and 79.5% (151/190) in postpartum 6 weeks and postpartum 6 months, increased to 80.6%(58/72) and 80.6%(58/72) in postpartum 12 months, improved significantly comparing with the control group (P<0.01). According to Point Aa, treatment group and control group in the postpartum 6 weeks was (-2.2 ± 0.7) versus (-2.4 ± 0.6) cm, in postpartum 12 months (-2.5 ± 1.1) versus (-2.7 ± 0.6) cm, the improvement in treatment group was statistically significant (P<0.01). And the other points were not significantly different (P>0.05). There was no significant difference in the questionnaires in quality of life and quality of sexual life (P>0.05). Conclusion Neuromuscular electrical stimulation and biofeedback therapy in the early postpartum period could obviously improve pelvic floor electrical physiological indexes, and is beneficial to prevent the pelvic floor dysfunction.

Objective To observe the therapeutic effect of consciousness-restoring needling combined with comprehensive rehabilitation training on motor function and the activities of daily living of poststroke patients with hemiplegia. Methods Sixty qualified patients were evenly randomized into observation group and control group. All of the patients were given conventional medicine treatment and conventional rehabilitation training, and the treatment group was given consciousness-restoring needling additionally. The therapeutic effects were compared at the end of first session of treatment for 4 weeks and 12 weeks after the first session of treatment. The Fugl-Meyer motor assessment scale (FMA), modified Barthel Index (MBI) and Stroke-Specific Quality of Life Scale ( SS-QQL) were taken as the main evaluation indexes. Results The differences of FMA, MBI and SS-QOL scores were insignificant between the two groups before treatment ( P>0.05). At the end of treatment for 4 weeks, FMA, MBI and SS-QOL scores were increased in the two groups (P<0.05), and the increase was more obvious in the observation group (P<0.05). The results of follow-up till the 12th week showed that FMA, MBI and SS-QOL scores were still higher than the baseline level ( P<0.05). Conclusion Consciousness-restoring needling combined with comprehensive rehabilitation training has better effect on improving motor function and the activities of daily living of poststroke hemiplegia patients than comprehensive rehabilitation training alone.

Objective To explore the effect of the gene silencing of phosphatidic acid-preferring phospholipase A1 (PA-PLA1) on insulin secretion in mouse insulin-secreting cell line MIN6. Methods The siRNA expression vector of mouse PA-PLA1 gene targeting was constructed using mouse PA-PLA1 mRNA sequence available in GenBank, and MIN6 cells were transfected with the vector. Fluorescence quantitative PCR and Western-blotwere applied to screen efficient RNAi-vector. After transfection with obtained efficient RNAi-vectors for 48 hours, glucose-stimulated insulin secretion experiments were conducted, and the changes of insulin secretion were examined. Results Four siRNA expression vectors of mouse PA-PLA1 gene targeting were confirmed to be successfully constructed by the analyses of enzyme cleavage and sequencing. The results of fluorescence quantitative PCR and Western blot analyses indicated that the siRNA expression vectorpGPU6-PA-PLA1-1885was the most effective RNAi-vector in the four vectors. The expression levels of the PA-PLA1 mRNA and protein of the MIN6 cells transfectedwith pGPU6-PA-PLA1-1885 decreased to 46.3% and 33.9% of that of the control, respectively, and meanwhile the insulin secretion levels of the cells decreased to 65.0% of that of the control (P < 0.05). Conclusion The gene silencing of phosphatidic acid-preferring phospholipase A1 might decrease insulin secretion in MIN6 cells.