BACKGROUND Coronavirus disease 19 (COVID-19) is a global pandemic and has had a profound impact on our routine surgical activities. Acute appendicitis is the most common abdominal emergency worldwide. Therefore, it is highly essential to assess the influence the pandemic has on acute appendicitis. AIM To assess the efficacy of the management of acute appendicitis during the COVID-19 pandemic. METHODS We retrospectively analyzed 90 patients who presented with acute appendicitis during the outbreak of COVID-19 in Jiaxing, China. Clinical data regarding appendectomies patients were also collected for the corresponding time frame from 2019. Preoperative management, intraoperative protective measures, and postoperative management were conducted. RESULTS After screening, six patients were identified as unqualified due to fever and were then referred to the COVID-19 expert group. The results of the nucleic acid test were negative. Of the 76 patients enrolled in the simple group, nine patients received medication therapy, and all others underwent surgery. From this same group, 66 patients were diagnosed with suppurative appendicitis, and one patient was diagnosed with perforated appendicitis after surgery. There were 14 patients in the complex group, for which the postoperative diagnosis indicated perforated appendicitis. The proportion of men with perforated appendicitis was higher than that in 2019 ( P < 0.05). The chief complaint duration for perforated appendicitis patients in 2020 was longer than that in 2019 ( P < 0.05). The routine blood test showed that white blood cell counts and neutrophil ratios were higher in perforated appendicitis patients in 2020 than in 2019 ( P < 0.05). The ratio of open appendectomies to the amount of mean blood loss during surgery was greater in 2020 than in 2019 ( P < 0.05). Online consultation after discharge was selected in 59 cases (65.6%). No perioperative infection with COVID-19 or long-term postoperative complications were found. CONCLUSION The management of acute appendicitis from Jiaxing effectively reduced the influence of the pandemic and minimized the risk of nosocomial infection.

Nuclear factor of activated T cells 5 (NFAT5), a Rel/nuclear factor- (NF-) κB family member, is the only known gene regulator of the mammalian adaptive response to osmotic stress. Exposure to elevated glucose increases the expression and nuclear translocation of NFAT5, as well as NFAT5-driven transcriptional activity in vivo and in vitro. Increased expression of NFAT5 is closely correlated with the progression of diabetes in patients. The distinct structure of NFAT5 governs its physiological and pathogenic roles, indicating its opposing functions. The ability of NFAT5 to maintain cell homeostasis and proliferation is impaired in patients with diabetes. NFAT5 promotes the formation of aldose reductase, pathogenesis of diabetic vascular complications, and insulin resistance. Additionally, NFAT5 activates inflammation at a very early stage of diabetes and induces persistent inflammation. Recent studies revealed that NFAT5 is an effective therapeutic target for diabetes. Here, we describe the current knowledge about NFAT5 and its relationship with diabetes, focusing on its diverse regulatory functions, and highlight the importance of this protein as a potential therapeutic target in patients with diabetes.

BACKGROUND With rapid and extensive administration of inactivated coronavirus disease 2019 (COVID-19) vaccine to the general population in China, it is crucial for clinicians to recognize neurological complications or other side effects associated with COVID-19 vaccination. CASE SUMMARY Here we report the first case of Bell’s palsy after the first dose of inactivated COVID-19 vaccine in China. The patient was a 36-year-old woman with a past history of Bell’s palsy. Two days after receiving the first dose of the Sinovac Life Sciences inactivated COVID-19 vaccine, the patient developed right-side Bell’s palsy and binoculus keratoconjunctivitis. Prednisone, artificial tears and fluorometholone eye drops were applied. The patient’s symptoms began to improve by day 7 and resolved by day 54. CONCLUSION As mRNA COVID-19 vaccine trials reported cases of Bell’s palsy as adverse events, we should pay attention to the occurrence of Bell’s palsy after inactivated COVID-19 vaccination. A history of Bell’s palsy, rapid increase of immunoglobulin M and immunoglobin G-specific antibodies to severe acute respiratory syndrome coronavirus 2 may be risk factors for Bell‘s palsy after COVID-19 vaccination.

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Background The coronavirus disease (COVID-19) was leading to a worldwide pandemic, which affected surgical operation. This study assessed the efficacy of perioperative management of patients scheduled for gastrointestinal surgery during COVID-19 pandemic of 2020. Methods We retrospectively analyzed 188 patients who underwent gastrointestinal surgery during the COVID-19 outbreak in Jiaxing, China. Perioperative data were collected, including data on pre-, intra-, and postoperative management strategies. The same data over the same period in 2019 were also collected for comparison. Results A total of 117, 63, and 8 patients underwent emergency, semi-elective, and elective surgeries, respectively. The locals: nonlocals ratio was significantly higher during this investigation period in 2020 than during the same period in 2019 ( P < .05). After screening, 12 patients were identified as unqualified. The number of gastrointestinal surgeries was reduced in 2020. There were no differences in the ratio of emergency surgery or semi-elective surgery between in 2020 and in 2019. The elective surgery ratio between January 27 and February 28 was found to be lower in 2020 than in 2019 ( P < .05). The disease spectra of emergency surgery and semi-elective surgery were similar. A total of 31 elective surgeries were postponed. There were five cases of short-term complications for emergency surgeries and two cases of short-term complications for semi-elective surgeries. No long-term complications or COVID-19 infection occurred in any of the cases, and no medical staff member was infected. Conclusion Perioperative management strategies minimize the risk of nosocomial infection and reduce the influence of epidemics on gastrointestinal surgery.