The Effect of Reading Leaflets During the Observation Period After Vaccination on Knowledge of COVID-19 and Vaccines Among Chinese Small Town Residents: A Randomized Controlled Trial.

Background: Public health education is essential for epidemic prevention and control in the post-COVID-19 era. This randomized controlled trial (RCT) aims to evaluate the effect of reading leaflets during the observation period after vaccination on knowledge of COVID-19 disease and vaccines in Chinese small town residents and to provide suggestions for public health education. Methods: Residents were recruited during the observation period after getting vaccinated against COVID-19 in Xidian and were randomly divided into an education group and a control group. The education group was asked to complete the questionnaire after reading a leaflet, whereas the control group directly completed the questionnaire. The questionnaire comprised two sections on COVID-19 knowledge and vaccine knowledge, and the scores were used to assess the resident's knowledge. Results: A total of 142 participants in the education group and 154 participants in the control group were enrolled. The rates of correct knowledge in the education group and the control group were 90.7 and 83.1%, respectively. The scores of the two sections and the aggregate knowledge score of the education group were significantly higher than those of the control group (P < 0.001). The rates of correct responses to questions on clinical manifestations and transmission routes of COVID-19 and indications and contraindications of vaccines significantly increased after reading the leaflets (P < 0.05). Knowledge of different groups of genders, ages, marital statuses, education levels and occupations all improved (P < 0.05), and the 18-29-year-old and never-married group revealed a higher growth rate of correct responses. Conclusion: Chinese small town residents have a median level of knowledge regarding COVID-19 disease and vaccines. Reading leaflets during the observation period after vaccination effectively improved their knowledge. This low-cost and efficient health education approach can be widely applied.

Liver test abnormalities in asymptomatic and mild COVID-19 patients and their association with viral shedding time.

BACKGROUND: Asymptomatic infections and mild symptoms are common in patients infected with the Omicron variant, and data on liver test abnormalities are rare. AIM: To evaluated the clinical characteristics of asymptomatic and mild coronavirus disease 2019 (COVID-19) patients with abnormal liver test results. METHODS: This retrospective study included 661 laboratory-confirmed asymptomatic and mild COVID-19 patients who were treated in two makeshift hospitals in Ningbo from April 5, 2022 to April 29, 2022. Clinical information and viral shedding time were collected, and univariate and multivariate logistic regression models were performed in statistical analyses. RESULTS: Of the 661 patients, 83 (12.6%) had liver test abnormalities, and 6 (0.9%) had liver injuries. Abnormal liver tests revealed a reliable correlation with a history of liver disease (P < 0.001) and a potential correlation with male sex and obesity (P < 0.05). Elevated alanine aminotransferase was reliably associated with obesity (P < 0.05) and a history of liver disease (P < 0.001). Elevated aspartate transaminase (AST) was reliably correlated with a history of liver disease (P < 0.001), and potentially correlated with age over 30 years (P < 0.05). There was a reliable correlation between AST ≥ 2× the upper limit of normal and a longer viral shedding time, especially in mild cases. CONCLUSION: Obesity and a history of liver disease are risk factors for liver test abnormalities. Being male and an older age are potential risk factors. Attention should be given to liver tests in asymptomatic and mild COVID-19 patients, which has crucial clinical significance for evaluating the viral shedding time.

Knowledge, Attitudes, and Practices toward COVID-19 and Vaccines among Chinese Small-Town Residents: A Cross-sectional Study.

China has basically controlled the COVID-19 epidemic as a result of widespread vaccination and other containment strategies, despite localized outbreaks, as of September 2021. This study investigates the knowledge, attitudes, and practices (KAP) of COVID-19 and COVID-19 vaccines among Chinese small-town residents to provide suggestions for public health policy. Residents who were vaccinated against COVID-19 were asked to complete a paper questionnaire on KAP in Xidian, Zhejiang. The knowledge questionnaire consisted of 12 questions regarding COVID-19 and 12 questions regarding COVID-19 vaccines. Attitude and practice evaluation included agreement on the eventual control of COVID-19 and having recently worn a mask outside. Of 405 survey responders, 52.3% were male, 71.4% had middle school education or less, and 59.0% engaged in physical labor as an occupation. The correct answer rates of the COVID-19 section and the vaccine section were 79.2% and 71.7%, respectively. Age groups of 18 to 29 years and > 50 years, occupations of physical labor and unemployment, and primary school education and less were associated with lower knowledge scores. The majority of participants (91.6%) believed that COVID-19 will eventually be controlled, whereas women, students, and patients with chronic held relatively negative attitudes toward epidemic control. Most participants (87.4%) wore masks outside recently. In conclusion, Chinese small-town residents have a medium level of knowledge regarding COVID-19 and vaccines, hold positive attitudes, and have appropriate practices. Health education should be provided to the target populations to enrich their knowledge of COVID-19 and vaccines, and to improve their attitudes toward epidemic control.

[Three-column plate internal fixation for the treatment of complex tibial plateau fracture through antero-midline and postero-medial approaches].

OBJECTIVE: To study technique and clinical therapeutic effects of internal fixation with three-column plates for the treatment of complex tibial plateau fractures through antero-midline and postero-medial approaches. METHODS: From January 2010 to December 2012, 28 patients with complex tibial plateau fractures were treated with internal fixation using three-column plates through antero-midline and postero-medial approaches. There were 17 males and 11 females, with an average age of 45.3 years old (ranged, 28 to 64 years old). Twelve patients had injuries in the left side and 16 patients had injuries in the right side. According to Schatzker classification, 12 patients were type V, 16 patients were type VI. According to three-column classification, all the patients had injuries of lateral, medial and posterior columns. The mean interval from injury to operation was 9.4 days (ranged, 6 to 15 days). The main clinical symptoms were knee joint swelling, deformity and limitation of motion before operation. The X-ray and CT showed all patients had complex tibial plateau fractures, which involved in the lateral, medial and posterior columns. The therapeutic effects were evaluated by fracture healing time, hospital for special surgery knee score (HSS) at one year after operation. The indexes such as tibial plateau-tibial shaft angle (TPA), posterior slope angle (PA) and femoral-tibial angle (FfA) were compared between immediate postoperation and one year after operation. RESULTS: All incisions primarily healed without postoperative complications such as infection and cutaneous necrosis. All the patients were followed up, and the duration ranged from 12 to 24 months, with a mean of 18.1 months. The bone union time ranged from 5 to 10 months (mean, 7.8 months) after operation. Knee joint swelling and pain disappeared after bony union, and joint function completely recovered. The results of hospital for special surgery knee score (HSS) was 27.81 ± 2.17 in pain, 19.52 ± 2.05 in function,15.82 ± 1.73 in passive range of motion, 8.51 ± 1.32 in muscle strength, 8.33 ± 1.08 in flexion deformity, 9.36 ± 0.52 in joint stability, and the total mean score was 89.35 ± 3.19. According to results of HSS, 20 patients got an excellent result, 5 good,2 fair and 1 poor. There were no significant differences in tibial plateau-tibial shaft angle (TPA), posterior slope angle (PA) and femoral-tibial angle (FTA) between immediate postoperation and one year after operation. CONCLUSION: Three-column plate internal fixation for the treatment of complex tibial plateau fractures through antero-midline and posteromedial approaches is effective to achieve anatomic reduction,rigid internal fixation and early functional exercise.

[Effects of Huoxue Zhitong decoration on transmembrane protein I and II induced apoptosis of signal transmission of the epidural scar tissue].

OBJECTIVES: To study the effect of Houxue Zhitong decoration on the expression of the mitochondria-initiated apoptosis pathway and transmembrane protein I an II of the epidural scar tissue. METHODS: A total of 60 New Zealand rabbits (weight: 2.5-3.0 kg) were randomly divided into four groups, sham operation group (D, n=15), control group (B, n=14), sodium hyaluronate group (C, n=15), Houxue Zhitong decoration group (D, n=15). Except for group A, 1.0 cm x 1.0 cm dura mater uncovered area laminectomy was performed at I (4) and I(5), covered with 0.5 ml sodium hyaluronate in group C, covered with same amount of saline in group B and D. First 2 weeks after operation, animals in group D were lavaged with 2.5 ml/kg Houxue Zhitong decoction by one a day for 14 days. Five rabbits of each group selected randomly were killed in the 2,4,8 weeks after laminectomy. The specimens were prepared for determination of the expression of Fas and FasL, at scar tissue by semiquantitative reserve transcription-polymerase chain reaction (RT-PCR). The degree of scar adhesion was evaluated according by Rydell method. RESULTS: The adhesion area in group B was larger than of group C and D in the 4th and 8th week. However, the number of fibroblasts and inflammantory cells in group D was the least among the three groups in the 8th week. At 2, 4, 8 weeks after operation, as compared with group B the expression of Fas, FasL of group C and D were decreased (P < 0.05). Especially, at 2 weeks, as compared with group B the expression of this two cytokines of group D was significant decreased (P < 0.05), too. In group C and D the duramater adhesion was decreased (P < 0.05). The proliferation of fibroblast and fibroblastic function were inhibited (P < 0.05). CONCLUSION: Huoxue Zhitong is able to down-regulated the expression of Fas, FasL, which inhibited the proliferation of fibroblast, the fibroblastic function and the synthesis of extracellular matrix in the epidural scar tissue. It is an effective way of reducing peridural scar formation and prevent the failed back surgery syndrome.

[Effects of Huoxuezhitong recipe on the pathway of mitochondrial apoptosis and the expression of related gene in epidural scar tissue].

OBJECTIVE: To study the effect of Huoxuezhitong recipe on the pathway of mitochondrial apoptosis and the expression of related gene (Caspase-3, -9, Bax, Bcl-2) in epidural scar tissue. METHODS: A total of 60 New Zealand rabbits, ranging in weight from 2.5 to 3.0 kg, were randomly divided into sham operative group (group A), control group (group B), sodium hyaluronate group (group C), Huoxuezhitong recipe group (group D, included Danggui 20 g, Chishao 20 g, Honghua 20 g, Ruxiang 15 g, Myrrh 15 g etc.) with 15 rabbits in each group. Except for group A, L4,5 vertebral plate were resected leading to 1.0 cm x 1.0 cm dura mater exposed area, which were covered with 0.5 ml sodium hyaluronate in group C, covered with same amount of saline in group B and D. At 2 weeks after operation, the rabbits of group D were administered with Huoxuezhitong recipe (2.5 ml/kg, once a day, continuous 14 d). Five rabbits of each group were selected randomly and were killed at 2, 4 and 8 weeks after operation; and the expression of Caspase-3, -9, Bax, Bcl-2 in scar tissue were surveyed by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The results by RT-PCR showed significant different in expressions of Caspase-3, -9, Bax, Bcl-2 of group A and others groups at each period (P < 0.01). At 2, 4, 8 weeks after operation, compared with group B, the expressions of Caspase-3, -9, Bcl-2 in group C and D were decreased (P < 0.05), but the expression of Bax in group C and D were increased (P < 0.05). At 8 weeks after operation, the expressions of Caspase-3, -9, Bax, Bcl-2 in group D was significant decreased compared with group C (P < 0.05). CONCLUSION: Huoxuezhitong recipe can regulate the levels of expression of Caspase-3, -9, Bax, Bcl-2 mRNA and further induce the pathway of mitochondrial apoptosis, thereby, achieve the effect of prophylaxis for the proliferation and conglutination of epidural scar tissue.