Objective:To evaluate the factors influencing test failure after resampling in non-invasive prenatal testing (NIPT) and to explore its impact on pregnancy outcomes.Methods:The information of pregnant women who failed to undergo NIPT for the first time and resampled for testing in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2018 to January 2022 were collected and retrospectively analyzed. According to the results of resampled NIPT, the pregnant women were divided into the failure group (170 cases) and the success group(485 cases), and the general clinical data and pregnancy outcomes of the two groups were compared.Results:(1) A total of 88 928 pregnant women underwent NIPT in Beijing Obstetrics and Gynecology Hospital during the study period, of which 1 299 (1.461%, 1 299/88 928) failed in the first NIPT. Among the 1 299 pregnant women who failed in the first NIPT, 720 were resampled for testing. Finally, 655 pregnant women who met the inclusion criteria and had complete clinical information and perinatal outcomes were collected. The success rate of resampling was 74.0% (485/655). Compared with the success group, the pregnant women in the failure group had a later gestational age at resampling, a higher pre-pregnancy body mass index (BMI) and a higher fetal fraction, and the differences were statistically significant (all P<0.001). (2) Among the 485 pregnant women in the success group, 130 cases (26.8%, 130/485) were detected with chromosome aneuploidy. Among the 170 pregnant women in the failure group, 8 cases had abnormal amniocentesis, 2 cases had abnormal maternal serum screening of aneuploidy in the second trimester, 3 cases had abnormal ultrasound anomaly removal, and 157 cases had no abnormality. (3) The incidence of fetal or neonatal malformation in the failure group was significantly higher than that in the success group [11.2% (19/170) vs 5.8% (28/485), P=0.019], but after adjusting for age and pre-pregnancy BMI, fetal or neonatal malformation was not associated with the success of resampling ( RR=0.675, 95% CI: 0.346-1.319; P=0.250). The incidences of gestational diabetes mellitus and hypertensive disorders in pregnancy in the failure group were significantly higher than those in the success group (all P<0.05), but after adjusting for age and pre-pregnancy BMI, only the incidence of gestational diabetes mellitus in the failure group was higher ( RR=0.630, 95% CI: 0.426-0.932; P=0.021). Conclusions:For pregnant women who failed the initial NIPT, the success of the resampling test is associated with pre-pregnancy BMI and the gestational week at the time of resampling. Those who failed the resampling test are more likely to develop gestational diabetes mellitus. When providing genetic counseling for pregnant women who failed the initial NIPT, it is important to consider the successful rate of resampling testing. The risk of chromosomal abnormalities should be comprehensively considered to develop further screening strategies.

Objective To establish animal models by implanting Gynemesh polypropylene mesh and Mersilene tape into the abdominal walls of rats,followed by conducting mechanical experiments and performing HE staining on abdominal wall tissues at 30 and 90 days post-implantation,respectively,in order to evaluate the biomechanical properties and histocompatibility of the two types of meshes.Methods The Gynemesh mesh and Mersilene tape were implanted into the abdominal wall of adult female rats(n=10)using W6977M polyester non-absorbable sutures and V-Loc absorbable sutures.The rats were randomly assigned to either a 30-day group or a 90-day group(n=5 per group)based on different experimental time points.Mechanical tests were conducted at these time points to evaluate the ultimate load required for avulsion of the meshes from the abdominal wall.Following the mechanical experiments,the tissues surrounding the meshes were harvested for hematoxylin and eosin(HE)staining.The inflammatory response,neovascularization,and fibroblast proliferation in the tissues were scored to compare the histocompatibility of the two types of meshes.Results(1)In the 30-day group,the ultimate load values were as follows:Gynemesh+6977(14.96±2.22)N,Gynemesh+V-Loc(12.73±1.11)N,Mersilene+6977(10.65±0.91)N,and Mersilene+V-Loc(8.70±1.18)N.No statistically significant difference was observed in the ultimate load between the Gynemesh+6977 and Gynemesh+V-Loc groups(P=0.12),whereas statistically significant differences were noted among the other groups(P<0.05).(2)In the 90-day group,the ultimate load values were as follows:Gynemesh+6977(18.97±0.59)N,Gynemesh+V-Loc(18.18±0.54)N,Mersilene+6977(13.87±0.67)N,and Mersilene+V-Loc(10.41±0.73)N.No statistically significant difference was observed in the ultimate load between the Gynemesh+6977 and Gynemesh+V-Loc groups(P=0.06),while statistically significant differences were noted among the other groups(P<0.05).(3)The ultimate load at 90 days for each group was significantly greater than that at 30 days,with statistically significant differences observed across all groups(P<0.05).(4)In the 30-day group,Gynemesh exhibited a lower inflammatory response compared to Mersilene tape(2.0±0.69 vs.3.10±0.71,P<0.05),with no statistically significant differences in neovascular-ization or fibroblast proliferation(2.37±0.61 vs.2.40±0.62,P=0.84;2.43±0.73 vs.2.63±0.67,P=0.27).In the 90-day group,Gynemesh demonstrated a lower inflammatory response score(1.10±0.66 vs.2.00±0.74,P<0.05),reduced fibroblast proliferation(2.87±0.68 vs.3.27±0.67,P<0.05),and no significant difference in neovascular proliferation(2.20±0.55 vs.2.13±0.68,P=0.68)compared to Mersilene tape.(5)The inflam-matory response for both mesh types was higher in the 30-day group compared to the 90-day group(Gynemesh group:2.0±0.69 vs.1.10±0.66,P<0.05;Mersilene group:3.13±0.73 vs.2.0±0.74,P<0.05).Additionally,the degree of fibroblast proliferation was lower in the 30-day group than in the 90-day group(Gynemesh group:2.43±0.73 vs.2.87±0.68,P<0.05;Mersilene group:2.63±0.67 vs.3.27±0.69,P<0.05).However,there was no statistically significant difference in neovascularization proliferation between the two groups(Gynemesh group:2.53±0.74 vs.2.47±0.74,P=0.81;Mersilene group:2.40±0.62 vs.2.13±0.68,P=0.12).Conclusion Compared with Mersilene tape,Gynemesh polypropylene mesh exhibits superior tensile strength and enhanced biocompatibility.

Objective To investigate the impacts of percutaneous endoscopic interlaminar discectomy(PEID)on pain level and lumbar function in patients with lumbar disc herniation(LDH).Methods From January 2022 to August 2023,84 patients were diagnosed with L4/5 LDH based on clinical data and imaging information were selected as the study subjects.And they were assigned into 42 cases in experimental group and 42 cases in traditional groups complying with treatment methods.The traditional group underwent traditional open approach treatment,while the experimental group underwent PEID.The surgical indicators(including hospitalization time,surgical time,bed rest time,and intraoperative fluoroscopy frequency),the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared between the two groups,the visual analogue scale(VAS)score and Oswestry disability index(ODI)were used to quantify the pain level of waist and lower limbs and lumbar function,and the excellent and good rate of clinical satisfaction and the incidence of complications were compared.Results The hospitalization time and bed rest time of the experimental group were obviously shorter than those of the traditional group,while the fluoroscopy frequency was less than that of the traditional group,and surgical time was longer than that of the traditional group,the differences were statistically significant(P＜0.05).After treatment,the pain VAS score and ODI of waist and lower limbs,the IL-6,and TNF-α in the two groups were lower than those before treatment,the experimental group was lower than the traditional group,the differences were statistically significant(P＜0.05).The excellent and good rate of the experimental group and the traditional group were 88.10％and 83.33％,respectively,with no statistically significant difference(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion PEID surgery can effectively alleviate nerve compression,alleviate pain of waist and lower limbs,promote the recovering of lumbar function,and facilitate postoperative recovery in LDH patients.

Objective:To evaluate the factors influencing test failure after resampling in non-invasive prenatal testing (NIPT) and to explore its impact on pregnancy outcomes.Methods:The information of pregnant women who failed to undergo NIPT for the first time and resampled for testing in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2018 to January 2022 were collected and retrospectively analyzed. According to the results of resampled NIPT, the pregnant women were divided into the failure group (170 cases) and the success group(485 cases), and the general clinical data and pregnancy outcomes of the two groups were compared.Results:(1) A total of 88 928 pregnant women underwent NIPT in Beijing Obstetrics and Gynecology Hospital during the study period, of which 1 299 (1.461%, 1 299/88 928) failed in the first NIPT. Among the 1 299 pregnant women who failed in the first NIPT, 720 were resampled for testing. Finally, 655 pregnant women who met the inclusion criteria and had complete clinical information and perinatal outcomes were collected. The success rate of resampling was 74.0% (485/655). Compared with the success group, the pregnant women in the failure group had a later gestational age at resampling, a higher pre-pregnancy body mass index (BMI) and a higher fetal fraction, and the differences were statistically significant (all P<0.001). (2) Among the 485 pregnant women in the success group, 130 cases (26.8%, 130/485) were detected with chromosome aneuploidy. Among the 170 pregnant women in the failure group, 8 cases had abnormal amniocentesis, 2 cases had abnormal maternal serum screening of aneuploidy in the second trimester, 3 cases had abnormal ultrasound anomaly removal, and 157 cases had no abnormality. (3) The incidence of fetal or neonatal malformation in the failure group was significantly higher than that in the success group [11.2% (19/170) vs 5.8% (28/485), P=0.019], but after adjusting for age and pre-pregnancy BMI, fetal or neonatal malformation was not associated with the success of resampling ( RR=0.675, 95% CI: 0.346-1.319; P=0.250). The incidences of gestational diabetes mellitus and hypertensive disorders in pregnancy in the failure group were significantly higher than those in the success group (all P<0.05), but after adjusting for age and pre-pregnancy BMI, only the incidence of gestational diabetes mellitus in the failure group was higher ( RR=0.630, 95% CI: 0.426-0.932; P=0.021). Conclusions:For pregnant women who failed the initial NIPT, the success of the resampling test is associated with pre-pregnancy BMI and the gestational week at the time of resampling. Those who failed the resampling test are more likely to develop gestational diabetes mellitus. When providing genetic counseling for pregnant women who failed the initial NIPT, it is important to consider the successful rate of resampling testing. The risk of chromosomal abnormalities should be comprehensively considered to develop further screening strategies.

Objective To establish animal models by implanting Gynemesh polypropylene mesh and Mersilene tape into the abdominal walls of rats,followed by conducting mechanical experiments and performing HE staining on abdominal wall tissues at 30 and 90 days post-implantation,respectively,in order to evaluate the biomechanical properties and histocompatibility of the two types of meshes.Methods The Gynemesh mesh and Mersilene tape were implanted into the abdominal wall of adult female rats(n=10)using W6977M polyester non-absorbable sutures and V-Loc absorbable sutures.The rats were randomly assigned to either a 30-day group or a 90-day group(n=5 per group)based on different experimental time points.Mechanical tests were conducted at these time points to evaluate the ultimate load required for avulsion of the meshes from the abdominal wall.Following the mechanical experiments,the tissues surrounding the meshes were harvested for hematoxylin and eosin(HE)staining.The inflammatory response,neovascularization,and fibroblast proliferation in the tissues were scored to compare the histocompatibility of the two types of meshes.Results(1)In the 30-day group,the ultimate load values were as follows:Gynemesh+6977(14.96±2.22)N,Gynemesh+V-Loc(12.73±1.11)N,Mersilene+6977(10.65±0.91)N,and Mersilene+V-Loc(8.70±1.18)N.No statistically significant difference was observed in the ultimate load between the Gynemesh+6977 and Gynemesh+V-Loc groups(P=0.12),whereas statistically significant differences were noted among the other groups(P<0.05).(2)In the 90-day group,the ultimate load values were as follows:Gynemesh+6977(18.97±0.59)N,Gynemesh+V-Loc(18.18±0.54)N,Mersilene+6977(13.87±0.67)N,and Mersilene+V-Loc(10.41±0.73)N.No statistically significant difference was observed in the ultimate load between the Gynemesh+6977 and Gynemesh+V-Loc groups(P=0.06),while statistically significant differences were noted among the other groups(P<0.05).(3)The ultimate load at 90 days for each group was significantly greater than that at 30 days,with statistically significant differences observed across all groups(P<0.05).(4)In the 30-day group,Gynemesh exhibited a lower inflammatory response compared to Mersilene tape(2.0±0.69 vs.3.10±0.71,P<0.05),with no statistically significant differences in neovascular-ization or fibroblast proliferation(2.37±0.61 vs.2.40±0.62,P=0.84;2.43±0.73 vs.2.63±0.67,P=0.27).In the 90-day group,Gynemesh demonstrated a lower inflammatory response score(1.10±0.66 vs.2.00±0.74,P<0.05),reduced fibroblast proliferation(2.87±0.68 vs.3.27±0.67,P<0.05),and no significant difference in neovascular proliferation(2.20±0.55 vs.2.13±0.68,P=0.68)compared to Mersilene tape.(5)The inflam-matory response for both mesh types was higher in the 30-day group compared to the 90-day group(Gynemesh group:2.0±0.69 vs.1.10±0.66,P<0.05;Mersilene group:3.13±0.73 vs.2.0±0.74,P<0.05).Additionally,the degree of fibroblast proliferation was lower in the 30-day group than in the 90-day group(Gynemesh group:2.43±0.73 vs.2.87±0.68,P<0.05;Mersilene group:2.63±0.67 vs.3.27±0.69,P<0.05).However,there was no statistically significant difference in neovascularization proliferation between the two groups(Gynemesh group:2.53±0.74 vs.2.47±0.74,P=0.81;Mersilene group:2.40±0.62 vs.2.13±0.68,P=0.12).Conclusion Compared with Mersilene tape,Gynemesh polypropylene mesh exhibits superior tensile strength and enhanced biocompatibility.

Objective To investigate the impacts of percutaneous endoscopic interlaminar discectomy(PEID)on pain level and lumbar function in patients with lumbar disc herniation(LDH).Methods From January 2022 to August 2023,84 patients were diagnosed with L4/5 LDH based on clinical data and imaging information were selected as the study subjects.And they were assigned into 42 cases in experimental group and 42 cases in traditional groups complying with treatment methods.The traditional group underwent traditional open approach treatment,while the experimental group underwent PEID.The surgical indicators(including hospitalization time,surgical time,bed rest time,and intraoperative fluoroscopy frequency),the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared between the two groups,the visual analogue scale(VAS)score and Oswestry disability index(ODI)were used to quantify the pain level of waist and lower limbs and lumbar function,and the excellent and good rate of clinical satisfaction and the incidence of complications were compared.Results The hospitalization time and bed rest time of the experimental group were obviously shorter than those of the traditional group,while the fluoroscopy frequency was less than that of the traditional group,and surgical time was longer than that of the traditional group,the differences were statistically significant(P＜0.05).After treatment,the pain VAS score and ODI of waist and lower limbs,the IL-6,and TNF-α in the two groups were lower than those before treatment,the experimental group was lower than the traditional group,the differences were statistically significant(P＜0.05).The excellent and good rate of the experimental group and the traditional group were 88.10％and 83.33％,respectively,with no statistically significant difference(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion PEID surgery can effectively alleviate nerve compression,alleviate pain of waist and lower limbs,promote the recovering of lumbar function,and facilitate postoperative recovery in LDH patients.

OBJECTIVE To investigate the clinical incidence and severity of adverse reactions related to nano-albumin-bound paclitaxel(Nab-P) and traditional solvent-based paclitaxel chemotherapy, and analyze the improvement of adverse reactions of paclitaxel treatment by nano-albumin delivery system. METHODS A hospital information system was used to retrospectively investigate 326 cancer patients received Nab-P chemotherapy and 303 paclitaxel chemotherapy patients who were diagnosed in the Department of Oncology of the Affiliated Hospital of Jiangnan University from July 2019 to December 2021. The information of the adverse reactions related to Nab-P and paclitaxel treatment was extracted from the electronic medical records and nursing record sheets, to explore the effect and clinical status of the nano albumin drug delivery system to improve the adverse reactions of chemotherapy. RESULTS Nab-P and paclitaxel-related adverse reactions such as nausea, vomiting, allergic reactions, myelosuppression, liver injury, paresthesias, phlebitis and others were significantly different in incidence and severity(P<0.05). The incidence and severity of Nab-P-related myelosuppression was higher than that of paclitaxel, while the incidence and severity of all other adverse reactions treated with Nab-P were lower. CONCLUSION Except for myelosuppression, Nab-P-related adverse reactions are significantly lower than traditional paclitaxel. Therefor, for patients undergoing Nab-P chemotherapy, more attention should be paid to the occurrence of myelosuppression.

ObjectiveTo evaluate the effect of antihypertensive and lipid-regulating Chinese patent medicine combined with conventional Western medicine in the treatment of hypertension with dyslipidemia. To carry out the evidence synthesis of clinical research and provide evidence-based evidence support for clinical decision-making. MethodThe databases including China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform （WF），VIP，SinoMed，Embase，PubMed，Web of Science （WOS），and the Cochrane Library were searched for randomized controlled trials （RCT） of all listed Chinese patent medicines in the treatment of hypertension with dyslipidemia from the establishment of the databases to April 15，2023. The literature was screened and extracted，and the risk of bias tool 2.0 （RoB2） was used to assess the quality and risk of bias of the methodology. Revman 5.4.1 software was used to analyze the outcome indicators. Grading of Recommendations Assessment，Development and Evaluation （GRADE） was applied to assess the quality of evidence formed by clinical research data. The inclusion and recommendation of Chinese patent medicines in the National Drug Catalogue for Basic Medical Insurance，Work-related Injury Insurance and Maternity Insurance （2022） and domestic guidelines and consensus were searched to form a bubble chart. ResultA total of 15 studies were included. The evaluation of the methodological quality of each study showed that the risk of bias stemmed from the lack of blinding and allocation concealment，and low sample size. The comprehensive analysis of clinical studies showed that Dengzhan Shengmai capsules combined with rosuvastatin and amlodipine besylate，Yindan Xinnaotong capsules combined with simvastatin and levamlodipine tablets，Xiaoshuan Tongluo capsules combined with nifedipine controlled release tablets and pravastatin sodium tablets，Xinshubao capsules combined with atorvastatin calcium tablets and irbesartan，Wenyading capsules combined with enalapril，and Jiangzhining tablets combined with conventional Western medicines were all superior to conventional Western medicines used in the control group in improving systolic blood pressure （SBP），diastolic blood pressure （DBP），cholesterol （TC），triglyceride （TG），low density lipoprotein cholesterol （LDL-C），and high density lipoprotein cholesterol （HDL-C）. There was no significant difference in the incidence of adverse reactions between the two groups. The GRADE evaluation of the main outcome indicators showed that the evidence quality of SBP and incidence of adverse reactions was graded as B，that of DBP as C，and that of total TC，TG，LDL-C，and HDL-C as D. The evaluation of Chinese patent medicines covered by medical insurance and recommended by guidelines and consensus showed that Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules belonged to class B drugs of medical insurance，and were recommended for 7，6 and 3 times in the guidelines and consensus，respectively. ConclusionCompared with simple medicine treatment，Chinese patent medicine combined with conventional Western medicine has more advantages in improving blood pressure and blood lipid，and shows higher safety. Among them，Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules have stronger clinical applicability and economy. All the trials included in this article adhered to the principle of randomization and reported the outcome measures. However，the quality of evidence in related clinical studies was low. In terms of trial design，large-sample，multi-center，blinded randomized controlled trials based on the consolidated standards of reporting trials （CONSORT） statement are still needed for comprehensive trial designs and reporting，to further improve the GRADE quality evaluation and guideline formulation under the guidance of evidence-based medicine，so as to provide higher quality evidence-based research evidence for clinical decision-making.

ObjectiveTo evaluate the quality of research and evidence related to antihypertensive Chinese patent medicines combined with western medicines for the treatment of hypertension， synthesize and update the evidence， form expert consensus， and provide evidence for clinical decision-making. MethodThe databases of China National Knowledge Infrastructure （CNKI）， WanFang Data Knowledge Service Platform （WanFang）， Vip Chinese Science and Technology Journal Database （VIP）， Chinese Biomedical Literature Service System （Sinomed）， National Library of Medicine （PubMed）， Cochrane Library， Web of Science， and US Clinical Trials Registry were searched for randomized controlled trials of antihypertensive Chinese medicine combined with western medicine for the treatment of hypertension from database construction to July 31， 2022. The quality of the literature was evaluated using the bias risk assessment tool in Cochrane Handbook 6.3. Evidence synthesis of main outcome indicators was performed using R software. The Grading of Recommendations Assessment， Development， and Evaluation profiler （GRADEprofiler） 3.6 was employed to evaluate the quality of evidence. Expert consensus was formed based on the Delphi method after two rounds of voting. Result64 pieces of literature were included， and the results of literature quality evaluation and risk of bias showed that 70.31% （45/64） of the studies indicated some risks， and 29.69% （19/64） indicated high risks. Compared with conventional western medicines， the combination of Chinese patent medicines with western medicines can significantly lower systolic pressure （SBP） and diastolic pressure （DBP）， increase the effective rate of antihypertensive， reduce the incidence of adverse reactions， endothelin-1， and traditional Chinese medicine syndrome scores. Egger's test showed that Songling Xuemaikang capsules reduced SBP and DBP. Tianma Gouteng granules reduced SBP and DBP and increased the effective rate of antihypertensive， and Xinmaitong capsules reduced SBP and increased the effective rate of antihypertensive， without significant publication bias. Songling Xuemaikang capsules increased the effective rate of antihypertensive， and Xinmaitong capsules decreased DBP， with significant publication bias. The results of the GRADE evidence quality evaluation showed that most evidence was at grades B and C. Finally， four strong recommendations and 14 weak recommendations were formed. ConclusionCompared with conventional western medicines for the treatment of hypertension， antihypertensive Chinese patent medicines combined with western medicines have advantages in reducing blood pressure and improving drug use safety， but they are mostly weak recommendations in terms of efficacy， and more high-quality evidence is needed.

ObjectiveTo systematically collect， analyze， and evaluate the randomized controlled trials （RCT） of Chinese patent medicine combined with western medicine in the treatment of hypertension， map the evidence， and provide reference for the future clinical research and formulation of guidelines and policies. MethodThe relevant articles were retrieved from China Biology Medicine disc， China National Knowledge Infrastructure （CNKI）， VIP， Wanfang Data， PubMed， Embase， and Cochrane Library with the time interval from inception to December 31， 2022. The RCT of Chinese patent medicines combined with western medicine in the treatment of hypertension were included. The research characteristics and methodological quality were analyzed and evaluated. ResultA total of 330 RCTs of treating hypertension with Chinese patent medicines combined with Western medicine were included in this study， all of which were published in Chinese. These RCTs involved 88 Chinese patent medicines and 37 788 patients， and 46% of RCT had the sample size ≥100 patients. Eighty-seven percent of RCT showed the study period within 3 months. All the interventions in the RCTs were Chinese patent medicine + western medicine vs western medicine. Among the evaluation indicators， blood pressure， response rate， TCM syndrome score， endothelial cell function， and safety were mainly concerned. In terms of methodological quality， most articles did not mention the generation of random sequences， allocation concealment， or blinding method. The blinding evaluation of outcomes showed low risks of bias， and there was insufficient information to judge whether there was selective bias or other bias. ConclusionThere were many Chinese patent medicines used in combination with western medicine in the treatment of hypertension， and they were mainly taken orally. The existing RCT had problems such as small sample size， unclear clinical value positioning， imperfect design failing to reflect the value of Chinese patent medicines， unreasonable measurement indicators， and non-standard measurement methods. Future research should solve the above problems， improve the research quality， value， and authenticity， and enhance the reliability and extension of evidence.