Objective:To evaluate the associations of COVID-19 vaccination during pregnancy with the risk of pregnancy complications and neonatal adverse birth outcomes, and to provide evidence for improving strategies for COVID-19 vaccination during pregnancy.Methods:"covid-19 vaccines" "covid19" "covid 19" "vaccin*" "neonatal outcomes" "perinatal outcomes" "pregnancy outcomes" "premature birth" were used as the main search terms. Articles published from January 1st 2020 to May 27th 2022 were searched in PubMed, Web of Science, Scopus, Cochrane library, CNKI, Wanfang Database, VIP Database and Chinese Biomedical Literature Database by adopting the method of the combination of MeSH words and free words. Stata16.0 software was used to calculate pooled effect values, perform heterogeneity test and sensitivity analysis and assess publication bias.Results:According to the inclusion and exclusion criteria, a total of 12 English papers were included from 482 relevant literatures retrieved, with 88 682 pregnant women vaccinated during pregnancy. Meta-analysis results showed that COVID-19 vaccination in pregnancy did not increase the risk of gestational hypertension, postpartum hemorrhage, neonatal preterm birth, small-for-gestational-age infants, and 5 min Apgar score<7, with pooled relative risk ( RR) and 95% confidence interval (95% CI) of 0.97 (0.91-1.05), 1.01 (0.83-1.23), 0.92 (0.77-1.10), 0.97 (0.90-1.04) and 0.93 (0.87-1.00), respectively. There was no significant difference in neonatal birth weight between the two groups of pregnant women who received COVID-19 vaccine or not, and the combined mean difference (MD) and 95% CI was -18.26 (-40.39-3.87) g. However, COVID-19 vaccination in pregnancy may increase the risk of gestational diabetes and the combined RR (95% CI) was 1.14 (1.03-1.26). In addition, sensitivity analysis showed that the results were stable and reliable. Egger's test and Begg's test showed that there was no publication bias among the included studies. Conclusion:This study does not support the increased risk of pregnancy complications and neonatal adverse birth outcomes for pregnant women vaccinated against COVID-19, but more researches are still needed to provide evidence of the safety of COVID-19 vaccination in pregnancy.

Objective:To evaluate the associations of COVID-19 vaccination during pregnancy with the risk of pregnancy complications and neonatal adverse birth outcomes, and to provide evidence for improving strategies for COVID-19 vaccination during pregnancy.Methods:"covid-19 vaccines" "covid19" "covid 19" "vaccin*" "neonatal outcomes" "perinatal outcomes" "pregnancy outcomes" "premature birth" were used as the main search terms. Articles published from January 1st 2020 to May 27th 2022 were searched in PubMed, Web of Science, Scopus, Cochrane library, CNKI, Wanfang Database, VIP Database and Chinese Biomedical Literature Database by adopting the method of the combination of MeSH words and free words. Stata16.0 software was used to calculate pooled effect values, perform heterogeneity test and sensitivity analysis and assess publication bias.Results:According to the inclusion and exclusion criteria, a total of 12 English papers were included from 482 relevant literatures retrieved, with 88 682 pregnant women vaccinated during pregnancy. Meta-analysis results showed that COVID-19 vaccination in pregnancy did not increase the risk of gestational hypertension, postpartum hemorrhage, neonatal preterm birth, small-for-gestational-age infants, and 5 min Apgar score<7, with pooled relative risk ( RR) and 95% confidence interval (95% CI) of 0.97 (0.91-1.05), 1.01 (0.83-1.23), 0.92 (0.77-1.10), 0.97 (0.90-1.04) and 0.93 (0.87-1.00), respectively. There was no significant difference in neonatal birth weight between the two groups of pregnant women who received COVID-19 vaccine or not, and the combined mean difference (MD) and 95% CI was -18.26 (-40.39-3.87) g. However, COVID-19 vaccination in pregnancy may increase the risk of gestational diabetes and the combined RR (95% CI) was 1.14 (1.03-1.26). In addition, sensitivity analysis showed that the results were stable and reliable. Egger's test and Begg's test showed that there was no publication bias among the included studies. Conclusion:This study does not support the increased risk of pregnancy complications and neonatal adverse birth outcomes for pregnant women vaccinated against COVID-19, but more researches are still needed to provide evidence of the safety of COVID-19 vaccination in pregnancy.

Objective:To compare the clinical effect of percutaneous minimally invasive suture and open suture in the treatment of acute closed Achilles tendon rupture in flying personnel.Methods:A retrospective study was performed on the flying personnel with acute closed Achilles tendon rupture admitted to Air Force Medical Center from January of 2010 to January of 2020. They were divided into percutaneous minimally invasive suture group and open suture group according to the surgical method. Incision length, operative time, intraoperative blood loss, postoperative wound infection, sural nerve injury, average hospitalization duration and ankle-hind foot score assessed by American Orthopaedic Foot and Ankle Society (AOFAS) were recorded and compared between 2 groups.Results:A total of 27 flying personnel with acute closed Achilles tendon rupture were enrolled, including 12 cases in the percutaneous minimally invasive suture group and 15 cases in the open suture group. The rupture of Achilles tendon was evaluated by local ultrasound and ankle MRI scanning before surgery. All flying personnel were followed up with an average time of (18.3±7.3) months. The incision length of the percutaneous minimally invasive suture group (2.5±0.5) cm was significantly smaller than that of the open suture group (12.2±1.7) cm. The operation time of the percutaneous minimally invasive suture group (34.1±4.6) min was significantly shorter than that of open suture group (75.1±8.7) min, and the intraoperative blood loss (4.6±1.4) ml was significantly lower than that of open suture group (23.0±5.4) ml. The differences were statistically significant ( t=15.45, 11.79, 9.27, P=0.004, <0.001, <0.001). The incisions of all cases were completely healed without infection and no sural nerve injury occurred during operation. The average hospitalization duration in percutaneous minimally invasive suture group (5.0±0.8)d was less than that in open suture group (6.5±0.9)d, and the difference was statistically significant ( t=3.55, P=0.003). The AOFAS scores in the percutaneous minimally invasive suture group were higher than that of the open suture group ( t=2.28, P=0.041) 3 months after the operation; but the AOFAS scores of 2 groups were excellent and with no statistical significance ( P>0.05) 6 months after the operation. Flying personnel in the percutaneous minimally invasive suture group returned to duty 3 months after surgery, comparing to those in the open suture group took 6 months. Conclusions:In the treatment of acute closed Achilles tendon rupture in flying personnel, percutaneous minimally invasive suture is superior to open suture in incision length, operation time, intraoperative blood loss, average hospitalization duration and postoperative functi onal recovery.

OBJECTIVES: Neuropathic pain (NP) is a chronic pain caused by somatosensory neuropathy or disease, and genistein (Gen) might be a potential drug for the treatment of NP. Therefore, this study aims to investigate the effect of Gen on lipopolysaccharide (LPS)-induced inflammatory injury of dorsal root ganglion neuron (DRGn) in rats and the possible molecular mechanism. METHODS: The DRGn of 1-day-old juvenile rats were taken for isolation and culture. The DRGn in logarithmic growth phase were divided into a control group, a LPS group, a tubastatin hydrochloride (TSA)+LPS group, a Gen1+LPS group, a Gen2+LPS group, a Gen2+LPS+TSA group, a Gen2+pcDNA-histone deacetylase 6 (HDAC6)+LPS group, and a Gen2+pcDNA3.1+LPS group. The LPS group was treated with 1 μg/mL LPS for 24 h; the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group were treated with 5 μmol/L TSA, 5 μmol/L Gen, 10 μmol/L Gen respectively for 0.5 h, and then added 1 μg/mL LPS for 24 h; the Gen2+TSA+LPS group was treated with 10 μmol/L Gen and 5 μmol/L TSA for 0.5 h and then added 1 μg/mL LPS for 24 h; the Gen2+pcDNA-HDAC6+LPS group and the Gen2+pcDNA3.1+LPS group received 100 nmol/L pcDNA-HDAC6 and pcDNA3.1 plasmids respectively, and 24 h after transfection, 10 μmol/L Gen was pretreated for 0.5 h, and then added 1 μg/mL LPS for 24 h. Real-time RT-PCR was used to detect the HDAC6 mRNA expression in DRGn; CCK-8 method was used to detect cell viability of DRGn; flow cytometry was used to detect cell apoptosis of DRGn; ELISA was used to detect the levels of IL-1β, IL-6, and TNF-α in DRGn culture supernatant; Western blotting was used to detect the protein expression of HDAC6, Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and NF-κB p65 in DRGn. RESULTS: Compared with the control group, the expression levels of HDAC6 mRNA and protein, the expression levels of TLR4 and MyD88 protein in DRGn of LPS group rats were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, and the activity of DRGn was significantly decreased, the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05). Compared with the LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group and the Gen2+TSA+LPS group were significantly down-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly decreased, the activity of DRGn was significantly increased, the apoptosis rate was significantly decreased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly decreased (all P<0.05), and the above changes were most obvious in the Gen2+TSA+LPS group. Compared with the Gen2+LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the Gen2+pcDNA-HDAC6+LPS group were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, the activity of DRGn was significantly decreased, and the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05). CONCLUSIONS Gen can alleviate LPS-induced DRGn inflammatory injury in rats, which might be related to down-regulating the expression of HDAC6 and further inhibiting the activation of TLR4/MyD88/NF-κB signaling pathway.
Animals ; Ganglia, Spinal ; Genistein/pharmacology* ; Histone Deacetylase 6/metabolism* ; Interleukin-6/metabolism* ; Lipopolysaccharides ; Myeloid Differentiation Factor 88 ; NF-kappa B/metabolism* ; Neurons/metabolism* ; RNA, Messenger ; Rats ; Toll-Like Receptor 4/metabolism* ; Tumor Necrosis Factor-alpha/metabolism*

Avermectins can affect biological processes of multiple tumor, including tumor cell proliferation and metastasis, cell cycle arrest, induction of apoptosis and autophagy, regulation of tumor microenvironment and tumor stem cells. Avermectins can be administered alone or combined with chemotherapeutic drugs to reverse multidrug resistance. To further explore the anti-tumor mechanism of avermectins will provide reliable experimental and theoretical guidance for future clinical application.

Objective:To compare the clinical effect of percutaneous minimally invasive suture and open suture in the treatment of acute closed Achilles tendon rupture in flying personnel.Methods:A retrospective study was performed on the flying personnel with acute closed Achilles tendon rupture admitted to Air Force Medical Center from January of 2010 to January of 2020. They were divided into percutaneous minimally invasive suture group and open suture group according to the surgical method. Incision length, operative time, intraoperative blood loss, postoperative wound infection, sural nerve injury, average hospitalization duration and ankle-hind foot score assessed by American Orthopaedic Foot and Ankle Society (AOFAS) were recorded and compared between 2 groups.Results:A total of 27 flying personnel with acute closed Achilles tendon rupture were enrolled, including 12 cases in the percutaneous minimally invasive suture group and 15 cases in the open suture group. The rupture of Achilles tendon was evaluated by local ultrasound and ankle MRI scanning before surgery. All flying personnel were followed up with an average time of (18.3±7.3) months. The incision length of the percutaneous minimally invasive suture group (2.5±0.5) cm was significantly smaller than that of the open suture group (12.2±1.7) cm. The operation time of the percutaneous minimally invasive suture group (34.1±4.6) min was significantly shorter than that of open suture group (75.1±8.7) min, and the intraoperative blood loss (4.6±1.4) ml was significantly lower than that of open suture group (23.0±5.4) ml. The differences were statistically significant ( t=15.45, 11.79, 9.27, P=0.004, <0.001, <0.001). The incisions of all cases were completely healed without infection and no sural nerve injury occurred during operation. The average hospitalization duration in percutaneous minimally invasive suture group (5.0±0.8)d was less than that in open suture group (6.5±0.9)d, and the difference was statistically significant ( t=3.55, P=0.003). The AOFAS scores in the percutaneous minimally invasive suture group were higher than that of the open suture group ( t=2.28, P=0.041) 3 months after the operation; but the AOFAS scores of 2 groups were excellent and with no statistical significance ( P>0.05) 6 months after the operation. Flying personnel in the percutaneous minimally invasive suture group returned to duty 3 months after surgery, comparing to those in the open suture group took 6 months. Conclusions:In the treatment of acute closed Achilles tendon rupture in flying personnel, percutaneous minimally invasive suture is superior to open suture in incision length, operation time, intraoperative blood loss, average hospitalization duration and postoperative functi onal recovery.

Objective:To figure out variety of the plasma level of Alpha-1-Antitrypsin(α1-AT) in patients who undergo AKI following cardiopulmonary bypass(CPB), and whether this biomarker serve as a competent predictor.Methods:We recruited 75 patients undergoing cardiac surgery with CPB from January 2018 to January 2019. Patients were categorized into two groups according to the development of AKI. The relationship between plasma concentration of α1-AT and renal injury in two groups was analyzed.Results:27 patients in the AKI group were aged (54.3±12.2)years old, including 15 males and 12 females, the time of cardiopulmonary bypass was(133.5±34.7)min. In the non-AKI group, 48 cases were aged(47.7±11.3)years old, including 26 males and 22 females, and the time of cardiopulmonary bypass was(133.5±34.7)min. α1-AT was significantly decreased in AKI group at 1 h after operation[(0.53±0.53)g/L vs. (1.46±0.91)g/L, P<0.05]compared with the non-AKI group. The sensitivity and specificity of α1-antitrypsin level at 1h after operation was the highest when α1-AT was 0.675 g/L. CPB time ( OR=5.890, 95% CI: 1.078-32.173) and age ( OR=4.427, 95% CI: 1.113-17.614) were independent risk factors for AKI after surgery, and α1-AT at 1h after CPB ( OR=0.084, 95% CI: 0.021-0.333) were protective factors after operation. Conclusion:Increased concentration of α1-AT after cardiopulmonary bypass at early time is a protective factor for AKI and the concentration of α1-AT in plasma could be used as an early biomarker of AKI after CPB.

Objective:To explore the feasibility and clinical effects of using free thinned deep inferior epigastric artery perforator flap to repair extensive soft tissue defects in extremities.Methods:From April 2010 to January 2014, 12 patients with extensive soft tissue defect in extremities after trauma, including 10 males and 2 females, aged 21 to 48 years, 6 patients with defect in the back of wrist and 6 patients with defect in ankle were admitted to the Department of Bone Microsurgery of Xi′an Honghui hospital. After debridement, the size of soft tissue defect ranged from 15.0 cm×4.5 cm to 28.0 cm×11.0 cm. The free thinned deep inferior epigastric artery perforator flap was designed, cut and transferred for reconstruction, with size of 15.0 cm×5.0 cm to 29.0 cm×12.0 cm. The flap thickness ranged from 4.0 to 6.5 cm before defatting, and was 0.6 to 0.9 cm after defatting. All the donor sites of flaps were closed directly by suturing. The flap survival and the appearance and function of flap and donor site were observed during follow-up.Results:All the flaps survived smoothly after surgery. During follow-up of 10 to 42 months, the flaps showed no bloat in appearance, no further flap revision or defatting procedures were required, the distance of static 2-point discrimination was 11 to 17 mm (14.5 mm on average). The abdominal function of patients was not affected, and no postoperative abdomen hernia or ulceration was noted.Conclusions:The free thinned deep inferior epigastric artery perforator flap is thin and suitable for repairing extensive soft tissue defects in extremities with very good outcomes.

Objective:To explore the effect of the hyperbaric oxygen therapy combined with percutaneous coronary intervention (PCI) on blood rheological properties in patients with unstable angina and its protective effect on myocardial injury.Methods:A total of 168 cases of patients with unstable angina admitted to Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from June 2017 to December 2018 were selected as research subjects and divided into control group (84 cases) and observation group (84 cases). The control group was given conventional PCI, and symptomatic and supportive treatment, while the observation group were given hyperbaric oxygen therapy (1 time/day, 10 days constitute one treatment course, 2 courses in total) on the basis of the treatments in the control group. The clinical efficacy was compared between the two groups. The changes in blood rheological indexes and myocardial injury markers of the patients were detected before and after treatment.Results:In the observation group, there were 45 cases with markedly efficacy, and 34 cases showed some efficacy. The total effective rate was 94.05%, which was significantly higher than that of 84.52% in the control group. The difference was statistically significant ( P<0.05). After treatment, the PaO 2 of the patients in the observation group significantly increased, while the PaCO 2 significantly decreased. The improvement of the blood oxygen metabolism was more significant than that in the control group ( P<0.05). Meanwhile, the levels of blood rheological indexes, e. g. whole blood viscosity (ηb), erythrocyte sedimentation rate (ESR), hematocrit (HCT), erythrocyte electrophoresis time (EET), erythrocyte aggregation index (EAI), and platelet aggregation rate (PAgT), in the two groups all declined obviously, and those in the observation group had greater decline than those in the control group ( P<0.05). The lysophospholipids acid (LPA) and platelet-activating factor P-selectin (CD62P) in the two groups significantly decreased, and the levels of LPA and CD62P in the observation group had greater decreases than those in the control group ( P<0.05). Moreover, the levels of the markers of myocardial injury, e. g. cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in both groups increased significantly, and the cTnI and CK-MB levels in the observation group were significantly lower than those in the control group. Conclusion:Through increasing blood oxygen content in body tissues, hyperbaric oxygen can effectively reduce blood viscosity, improve blood rheological properties, and therefore, reduce platelet activation, thus preventing thrombosis. It can also reduce myocardial injury and enhance the clinical efficacy for patients with unstable angina.

Objective:To explore the effect of the hyperbaric oxygen therapy combined with percutaneous coronary intervention (PCI) on blood rheological properties in patients with unstable angina and its protective effect on myocardial injury.Methods:A total of 168 cases of patients with unstable angina admitted to Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from June 2017 to December 2018 were selected as research subjects and divided into control group (84 cases) and observation group (84 cases). The control group was given conventional PCI, and symptomatic and supportive treatment, while the observation group were given hyperbaric oxygen therapy (1 time/day, 10 days constitute one treatment course, 2 courses in total) on the basis of the treatments in the control group. The clinical efficacy was compared between the two groups. The changes in blood rheological indexes and myocardial injury markers of the patients were detected before and after treatment.Results:In the observation group, there were 45 cases with markedly efficacy, and 34 cases showed some efficacy. The total effective rate was 94.05%, which was significantly higher than that of 84.52% in the control group. The difference was statistically significant ( P<0.05). After treatment, the PaO 2 of the patients in the observation group significantly increased, while the PaCO 2 significantly decreased. The improvement of the blood oxygen metabolism was more significant than that in the control group ( P<0.05). Meanwhile, the levels of blood rheological indexes, e. g. whole blood viscosity (ηb), erythrocyte sedimentation rate (ESR), hematocrit (HCT), erythrocyte electrophoresis time (EET), erythrocyte aggregation index (EAI), and platelet aggregation rate (PAgT), in the two groups all declined obviously, and those in the observation group had greater decline than those in the control group ( P<0.05). The lysophospholipids acid (LPA) and platelet-activating factor P-selectin (CD62P) in the two groups significantly decreased, and the levels of LPA and CD62P in the observation group had greater decreases than those in the control group ( P<0.05). Moreover, the levels of the markers of myocardial injury, e. g. cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in both groups increased significantly, and the cTnI and CK-MB levels in the observation group were significantly lower than those in the control group. Conclusion:Through increasing blood oxygen content in body tissues, hyperbaric oxygen can effectively reduce blood viscosity, improve blood rheological properties, and therefore, reduce platelet activation, thus preventing thrombosis. It can also reduce myocardial injury and enhance the clinical efficacy for patients with unstable angina.