Impact of timing on protection of combined immunoprophylaxis in preventing mother-to-child transmission of hepatitis B virus: a retrospective study.

Objective: To evaluate the impact of timing combined immunoprophylaxis on mother-to-child transmission (MTCT) of the hepatitis B virus (HBV) in pregnant women living with hepatitis B. Methods: A retrospective cohort study was included HBsAg-positive pregnant women who delivered full-term at Tianjin Third Central Hospital from January 2019 to December 2021. The objective of this study is to determine whether early administration of hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccination after birth can further improve protection. Result: A total of 694 pregnant women living with hepatitis B were included; 93 infants from these mothers were lost to follow-up [including moving (n = 21), emigrating (n = 26), changing contact information (n = 27), and other reasons (n = 19)], leaving 601 infants for analysis. The incidence in babies born to mothers with hepatitis B was 1.50% (9/601). Based on the different timing of combined immunoprophylaxis administration after birth, 601 infants were divided into two groups (within 2 h and within 2-12 h). The incidence in babies born to mothers with hepatitis B were 0.32% (1/308) and 2.73% (8/293) for infants who received combined immunoprophylaxis within 2 h and between 2 and 12 h of birth, respectively (p = 0.037). The infection incidence of infants born to HBeAg-positive mothers and HBeAg-positive mothers who did not receive antiviral treatment during pregnancy was lower in the 2-h group compared to the 2-12 h group (0.72% vs. 5.84%, p = 0.04 and 1.20% vs. 9.46%, p = 0.047). Conclusion: Using combined immunoprophylaxis as soon as possible (within two hours of birth) may protect against MTCT of HBV more.

Effect of Endotracheal Suctioning on Infants Born through Meconium-Stained Amniotic Fluid: A Meta-analysis.

OBJECTIVE: Meconium is a common finding in amniotic fluid and placental specimens, particularly in term and post-term pregnancies. The objective of this paper was to perform a meta-analysis to examine the impact of endotracheal suctioning on the occurrence of meconium aspiration syndrome (MAS), mortality, and complications. STUDY DESIGN: PubMed, EMBASE, and the Cochrane library were systematically searched for comparative studies. Odds ratios (ORs), weighted mean differences (WMDs), and corresponding 95% confidence intervals (CIs) were used to compare the outcomes. RESULTS: Twelve studies were included in the meta-analysis. There were no significant impacts of endotracheal suctioning on the occurrence of MAS (OR = 3.05, 95% CI: 0.48-19.56), mortality (OR = 1.25, 95% CI: 0.35-4.44), the need for mechanical ventilation (OR = 4.20, 95% CI: 0.32-54.72), the occurrence of pneumothorax (OR = 0.99, 95% CI: 0.34-2.85), persistent pulmonary hypertension of the newborn (PPHN), (OR = 1.31, 95% CI: 0.58-2.98), hypoxic-ischemic encephalopathy (HIE) (OR = 0.82, 95% CI: 0.52-1.30), and length of stay (WMD = -0.11, 95% CI: -0.99-0.77). CONCLUSION: Routine endotracheal suctioning at birth is not useful in preventing MAS, mortality, mechanical ventilation, PPHN, HIE, and prolonged length of stay in neonates born through MSAF. KEY POINTS: · Routine suctioning is not recommended for newborns.. · Endotracheal aspiration is not beneficial for MAS.. · Future research may focus on selected neonates..

Diagnostic capacity of sFlt-1/PlGF ratio in fetal growth restriction: A systematic review and meta-analysis.

INTRODUCTION: We aimed to systemically investigate the diagnostic capacity of soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio in fetal growth restriction (FGR). METHODS: We systematically searched the PubMed, MEDLINE, Cochrane Library, and EMBASE databases for relevant studies from inception to 15 May 2022. All potentially relevant studies were assessed and then pooled. RESULTS: Eight studies with 339 patients and 5111 controls were included. A sFlt-1/PlGF ratio >33 was demonstrated a predictive value for FGR with a pooled sensitivity of [0.63, 95% confidence interval (CI) = 0.54-0.71], specificity of (0.84, 95% CI = 0.83-0.85), and area under the curve (AUC) of 0.8354. The pooled sensitivity, specificity, and AUC for the sFlt-1/PlGF ratio ≥85 group were 0.79 (95% CI = 0.66-0.89), 0.69 (95% CI = 0.65-0.74), and 0.8197, respectively. DISCUSSION: These findings revealed that the sFlt-1/PlGF ratio could be a potential indicator in predicting FGR and FGR + PE. More studies are needed to support the conclusion.

Correlation of Platelet Function with Postpartum Hemorrhage and Venous Thromboembolism in Patients with Gestational Hypertension Complicated with Diabetes.

Objective: This study was aimed at investigating the correlation of platelet function with postpartum hemorrhage and venous thromboembolism (VTE) in gestational hypertension patients with diabetes mellitus. Methods: A total of 93 patients with gestational hypertension complicated with diabetes treated from March 2020 to June 2021 were selected as the research group, and 56 healthy pregnant women during the same period were selected as the control group. Platelet function-related indicators (platelet count (PLT), platelet volume distribution width (PDW), and mean platelet volume (MPV)) were compared between the two groups. The patients were divided into a severe group (n = 13), mild group (n = 28), and nonbleeding group (n = 52) according to the severity of postpartum hemorrhage, and the value of combined detection of platelet function-related indicators on the severity of postpartum hemorrhage was evaluated and analyzed. According to the occurrence of VTE, the patients were divided into a VTE group and non-VTE group to analyze the predictive value of combined detection of platelet function-related indicators for VTE occurrence in patients. Results: The PLT value of the study group was lower than that of the control group, while the PDW and MPV values were higher than those of the control group (all P < 0.05). The PLT value increased with the aggravation of postpartum hemorrhage, while the PDW and MPV values decreased with the aggravation of postpartum hemorrhage among the three groups with different severities of postpartum hemorrhage (all P < 0.05). The area under the curve (AUC) of PLT, PDW, and MPV combination to evaluate the severity of postpartum hemorrhage in patients with gestational hypertension combined with diabetes was greater than that of PLT alone and PDW alone (both P < 0.05). The PLT value was negatively correlated with the severity of postpartum hemorrhage, while PDW and MPV values were positively correlated with the severity of postpartum hemorrhage (both P < 0.05). According to the occurrence of VTE, patients were divided into the VTE group (n = 10) and non-VTE group (n = 83). The PLT value of the VTE group was higher than that of the non-VTE group, while the PDW and MPV values were lower than those of the non-VTE group (all P < 0.05). The AUC of PLT, PDW, and MPV combination to predict the occurrence of VTE in patients with gestational hypertension combined with diabetes was greater than that of each index alone (all P < 0.05). Conclusion: Patients with gestational hypertension complicated with diabetes had abnormal platelet function, and the platelet function was related to postpartum hemorrhage and VTE.

Immediate versus delayed induction of labour in hypertensive disorders of pregnancy: a systematic review and meta-analysis.

BACKGROUND: Mothers with hypertensive disorder of pregnancy can be managed with either immediate or delayed induction of labour with expectant monitoring of both mother and baby. There are risks and benefits associated with both the type of interventions. Hence, this review was conducted to compare outcomes of immediate and delayed induction of labour among women with hypertensive disorder of pregnancy based on disease severity and gestational age. METHODS: We conducted systematic searches in various databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), Scopus, and Embase from inception until October 2019.Cochrane risk of bias tool was used to assess the quality of published trials. A meta-analysis was performed with random-effects model and reported pooled Risk ratios (RR) with 95% confidence intervals (CIs). RESULTS: Fourteen randomized controlled trials with 4244 participants were included. Majority of the studies had low or unclear bias risks. Amongst late onset mild pre-eclampsia patients, the risk of renal failure was significantly lower with immediate induction of labour (pooled RR: 0.36; 95%CI: 0.14 to 0.92). In severe pre-eclampsia patients, immediate induction of labour significantly reduced the risk of having small-for-gestational age babies compared to delayed induction of labour (pooled RR: 0.49; 95%CI: 0.29-0.84).Delayed induction was found to significantly reduce the risk of neonatal respiratory distress syndrome risk among late onset mild pre-eclampsia patients (pooled RR: 2.15; 95%CI: 1.14 to 4.06) None of the other outcomes demonstrated statistically significant difference between the two interventions. CONCLUSION: Delayed induction of labour with expectant monitoring may not be inferior to immediate induction of labour in terms of neonatal and maternal outcomes. Expectant approach of management for late onset mild pre-eclampsia patients may be associated with decreased risk of neonatal respiratory distress syndrome, while immediate induction of labour among severe pre-eclampsia patients is associated with reduced risk of small-for-gestational age babies and among mild pre-eclampsia patients, it is associated with reduced risk of severe renal impairment.

Inhibiting the HPV16 oncogene-mediated glycolysis sensitizes human cervical carcinoma cells to 5-fluorouracil.

BACKGROUND: Human papillomavirus (HPV), the major cause of cervical cancer worldwide, is associated with infection of HPV (Oncogenic HPV). Cancer patients who develop drug resistance are resulted in failure of chemotherapy. OBJECTIVE: We investigated the mechanisms for the HPV E6/E7 oncoprotein-mediated 5-fluorouracil (5-Fu) sensitivity. METHODS: HPV-16 E6/E7 was transfected into human cervical cancer cell lines. Glycolysis rate was assessed. Xenograft model was established to examine the in vivo therapeutic effects of E6/E7 inhibition and 5-Fu treatments. RESULTS: The HPV-16 E6/E7 oncoprotein induces 5-Fu resistance in cervical cancer cells. Overexpression of E6/E7 renders CaSki and SiHa cells resistant to 5-Fu treatments. We found E6/E7 expressions were significantly upregulated in 5-Fu-resistant cells compared with parental cells. Moreover, the cellular glycolysis rate was significantly increased in 5-Fu-resistant cells. The glucose uptake, lactate production, and expressions of glycolysis enzymes were upregulated in 5-Fu-resistant cells. We report the E6/E7-mediated 5-Fu resistance was through upregulation of glycolysis pathway. Importantly, inhibition of E6/E7 by shRNA effectively decreased cellular glycolysis and overcame 5-Fu resistance using in vitro and in vivo xenograft model. CONCLUSION: Our study contributed to understanding the molecular mechanisms for HPV E6/E7-mediated 5-Fu resistance and development of new therapeutic strategies against cervical cancer.

High-dose nifuratel for simple and mixed aerobic vaginitis: A single-center prospective open-label cohort study.

AIM: The efficacy and safety of two nifuratel dosages for the treatment of aerobic vaginitis (AV) were compared. METHODS: This was a prospective open-label cohort study of patients diagnosed and treated at the Tianjin Third Central Hospital between January 2012 and December 2013. The co-presence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), or/and trichomonal vaginitis (TV; mixed AV) was determined. Patients were randomized to nifuratel-500 (500 mg nifuratel, intravaginal, 10 days) or nifuratel-250 (250 mg nifuratel, intravaginal, 10 days), and followed-up for three to seven days after treatment completion. Primary and secondary outcomes were recovery rate and adverse events, respectively. RESULTS: The study included 142 patients with AV. Age was not significantly different between the groups (n = 71 each), and disease distribution was identical: 29 (40.85%) simple AV and 42 (59.15%) mixed AV (AV + BV, 42.86 %; AV + VVC, 30.95%; AV + TV, 26.19%). In patients with simple AV, the recovery rate did not differ significantly between the nifuratel-500 (26/29, 89.66%) and nifuratel-250 (22/29, 75.86%) groups. In patients with mixed AV, recovery rates were significantly higher in the nifuratel-500 than in the nifuratel-250 group (AV + BV, 88.89% vs 50.00 %; AV + VVC, 76.92 % vs 30.77 %; AV + TV, 90.91 % vs 36.36%; all P < 0.05). Only one patient (nifuratel-500) reported an adverse event (mild anaphylactic reaction). CONCLUSION: Nifuratel 500 mg showed good clinical efficacy for the treatment of AV, particularly mixed AV, and is superior to the 250 mg dosage in the treatment of mixed AV.