Comparing prophylactic use of cefazolin for SSI in cesarean section: a systematic review and meta-analysis.

PURPOSE: To summarize the available evidence to explore the effect of different prophylactic cefazolin regimens on postoperative surgical site infection after cesarean section. METHODS: We searched WOS, Pubmed, and EMBASE Database also traced citations in the reference sections of the retrieved studies. English search words: Cesarean section, Surgical site infection, Cefazolin. The majority of the literature are randomized controlled trials comparing varied regimens of cefazolin. RESULTS: A total of 11 randomized controlled trials and 4 non-randomized controlled trials involving 16,328 pregnant women were eligible. There was no statistically significant difference in the risk of SSI after cesarean section when cefazolin was given at a high dose compared with cefazolin at a low dose (OR 0.77, 95% CI 0.57-1.04, I2 = 0.0%). The risk of SSI after cesarean section was reduced by prophylactic use of cefazolin before skin incision compared with that after the umbilical cord clamping (OR 0.48, 95% CI 0.29-0.82, I2 = 53.4%). Because of the extreme heterogeneity of the combined drug use, no meta-analysis results were provided. The consequences of cefazolin combined with other antibiotics (either orally or intravenously) vary widely. For pregnant women with different risk factors, cefazolin alone or the type, dose and drug route of cefazolin combined with additional antibiotics need to be further studied and explored. CONCLUSIONS: All in all, this article illustrates a better use of cefazolin for the control of Surgical incision site infection in the cesarean section. For pregnant women with cesarean section without high-risk factors of infection, the use of cefazolin is effective, but for pregnant women with different high-risk factors, the specific use of prophylactic antibiotics needs to be further explored.

Letter to the editor on "Wnt signaling pathway in early­ and late­onset preeclampsia: evaluation with Dickkopf­1 and R­Spondin­3 glycoproteins".

The aim of this Letter to the Editor was to report some methodological short comings in a recently published article. Issues regarding group dividing, misunderstanding of 5-min Apgar score and inconsistent findings. In conclusion, the results of this study should be interpreted with caution and further research is necessary.

Early age at menarche and risk of postpartum hemorrhage: a retrospective study in Chinese women.

OBJECTIVE: The objective of this study is to investigate whether early age at menarche is associated with increased risk of postpartum hemorrhage among Chinese women. MATERIALS AND METHODS: Clinical data from 6,383 Chinese women who gave birth to live singleton infants at The First Affiliated Hospital of Chengdu Medical College between October 2016 and October 2019 were extracted from the electronic medical records system. Patients were categorized into four groups according to their age at menarche (≤12, 13, 14 and ≥15 years). Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for postpartum hemorrhage for the different menarche age groups. RESULTS: After controlling for potential confounders, women with menarche at an early age (≤12 years) had a significantly higher risk of developing postpartum hemorrhage than women with an age at menarche of 13 years, and the ORs (95% CIs) for postpartum hemorrhage across the menarche age categories (≤12, 13, 14 and ≥15 years) were 1.27 (1.02-1.81), 1.00 (reference), 0.95 (0.61-1.57), and 0.91 (0.51-1.58), respectively. Moreover, age at menarche was inversely associated with the risk of postpartum hemorrhage after adjustment for all relevant confounding factors, and the OR (95% CI) for postpartum hemorrhage per year of increasing in the age at menarche was 0.93 (0.74-0.99). CONCLUSION: Early age at menarche was associated with a significantly increased risk of postpartum hemorrhage after adjustment for known confounding factors. This finding could help obstetricians and midwives to identify pregnant women at higher risk of developing postpartum hemorrhage, and allow early preventative strategies to be implemented.

Maternal serum, placental, and umbilical venous blood irisin levels in intrahepatic cholestasis of pregnancy.

OBJECTIVE: To explore the changes of serum, umbilical vein, placental irisin level, and the correlation between irisin level and relevant indicators in pregnant women with intrahepatic cholestasis of pregnancy (ICP), so as to provide a new perspective for in-depth studies on the causes and treatment of ICP. METHODS: This cross-sectional case-control study method, the serum, umbilical venous blood irisin, liver, kidney function, lipid metabolism, and other indicators of 108 normal pregnant women, 64 patients with mild ICP, and 39 patients with severe ICP were compared, and the changes in the levels of oxidative stress and irisin were observed by dihydroethidium staining and immunohistochemistry. RESULTS: The level of placental oxidative stress in severe ICP group and mild ICP group was significantly higher than that in normal pregnant women group, and the mild ICP group was significantly higher than that in severe ICP group (p < .05); the concentration of irisin in umbilical vein was significantly lower than that in peripheral blood; the serum irisin of normal pregnant women (918.51 ± 159.90 pg/ml) was significantly lower than that of pregnant women with mild ICP (1030.05 ± 137.98 pg/ml) and pregnant women with severe ICP (1094.34 ± 154.35 pg/ml). The concentration of irisin in umbilical vein blood of pregnant women with severe ICP (858.78 ± 97.42 pg/ml) was significantly higher than that of normal pregnant women (595.33 ± 162.70 pg/ml) and those with mild ICP (648.82 ± 164.81 pg/ml) (p < .05). Irisin was expressed in placental tissues of normal pregnant women group, mild ICP group and severe ICP group, and the differences were statistically significant in expression intensity of the three groups (χ2 = 19.959, p < .05). The irisin expression intensity in the ICP group was higher than that in the control group, and the irisin expression intensity in the ICP group was higher than that in the ICP group (ß = 0.292; t = 3.063; p < .05). At the best cutoff level of 989.168 pg/ml, irisin accurately predicted ICP [AUC = 0.622 (95%CI 0.543-0.701, p < .05)] with sensitivity and specificity rates of 60.9 and 40.1%, respectively. CONCLUSION: Irisin can reduce the level of oxidative stress and improve lipid metabolism in ICP patients during the pathophysiological process of ICP, and it is possible to become a new auxiliary factor of ICP diagnosis and indexing.

Correction to: Effect of closure of live poultry markets in China on prevention and control of human infection with H7N9 avian influenza: a case study of four cities in Jiangsu Province.

Due to an unfortunate oversight the acknowledgements has been omitted.

Effect of closure of live poultry markets in China on prevention and control of human infection with H7N9 avian influenza: a case study of four cities in Jiangsu Province.

As of August 2017, China had encountered five seasonal epidemics of H7N9 avian influenza. To prevent people from contracting H7N9 avian influenza, most cities closed live poultry markets (LPMs) to cut off the source of H7N9 virus. The objective of this study is to assess the impact of LPMs closure on reducing zoonotic transmission of avian influenza A (H7N9) virus and to make specific recommendations on the duration of closing the LPMs. Results show that the closure of LPMs can effectively control the spread of H7N9 avian influenza and reduce the incidence of human infection with H7N9. If cases of H7N9 avian influenza continue to occur, LPMs should close for at least 3-4 weeks in susceptible areas to control the spread of infection.