Objective To investigate the clinical effect of longxuejie capsule in combination with tinidazole in the treatment of chronic cervicitis and its effects on levels of immunoglobulin.Methods 90 cases in our hospital from January 2013 to June 2014, with chronic cervicitis meeting the inclusion critera were randomly divided into 2 groups by method of stratified randomization equally.Control group (n=45) was treated with tinidazole and conventional treatments, while observation group ( n =45 ) was treated with tinidazole and longxuejie capsule.Then, the curative efficacy, scale of symptoms and levels of immunoglobulin were observed and compared.Results The therapeutic efficiency ratio of observation group was 95.6%, which was significantly higher than that of control group ( 80.0%, P<0.05 ).After the treatment, in comparison with the control group, scale of cervical secretion and severity of cervical lesion was statistically lower respectively than observation group ( P<0.05 ).As to immunological function, concentrations of IgG, IgM, IgA in observation group were statistically higher than that in control group after the treatment (P<0.05).The control group and observation group respectively in 2 cases and 3 cases of abdominal pain, alleviated by themselves without treatment.Conclusion longxuejie capsule combined with tinidazole is effective and reliable for patients with chronic cervicitis, which significantly improves symptoms and elevates levels of immunoglobulin.

OBJECTIVE:To study the chemical constituents of the flower of Zang Epipremnum aureum. METHODS:The con-stituents of ethyl acetate extract of the flower of E. aureum were separated and purified with varied chromatographic techniques, and the structures were identified based on spectral data and chemical properties. RESULTS:Ten compounds were isolated from eth-yl acetate extract of the flower of E. aureum,they were identified as rutamontine(1),edgeworoside C(2),edgeworin(3),tiliro-side (4),helichrysoside (5),kaempferol (6),2,4-dihydroxypheny-2-hydroxy-4-metho-xybenzyl-ketone (7),ethyl caffeate (8), phthalic acid bis-(2-ethyl-hexyl) ester (9) and noreugenin (10). CONCLUSIONS:Compound 7 is firstly isolated from natural source,compounds 5,8 and 9 is firstly isolated from the family Thymelaeaceae,compound 6 is firstly isolated from Edgeworthia and compound 2 and 10 are firstly isolated from the flowers of E. aureum. The study lays certain foundation for the quality evalua-tion of E. aureum.

The aim of the present study was to explore the prevalence characteristics of brucellosis in Hainan by investigating the biological characteristics and clinical type of pathogenic bacteria isolated from the blood of a patient infected by infective endocarditis.Bacteriological experiments were conducted according to the standard identification methods of Brucella including morphology,cultural characters,biochemistry characters,serological test and phage test,etc.At the same time,systematic analysis on the information about epidemiology,clinical manifestation and laboratory data of the patient was carried on.The Brucella melitensis was identified as Brucella melitensis biotype 2 and was significantly different from the Brucella melitensis biotypes 1 and 3 isolated in China reported in recent years.The urease test result of Brucella melitensis was variable and there is no strong positive result reported except the isolates in Hainan.As Brucellosis cause by Brucella melitensis biotype 2 was firstly reported in Hainan Province,great importance should be attached to its point-like prevalence.

Objective:To investigate the effect and prognostic factors of rituximab-containing chemotherapy regimen in treatment of patients with mantle cell lymphoma (MCL).Methods:The clinical data of 56 patients aged ≤65 years in the First Affiliated Hospital of Soochow University from June 2007 to November 2018 were retrospectively analyzed. Rituximab-containing chemotherapy regimen was used, and the effects of clinical features, treatment regimen and biological indexes on overall survival (OS) and progression-free survival (PFS) were observed.Results:The median age of 56 patients was 57 years old, including 43 males and 13 females. Among these cases, 24 patients received R-CHOP chemotherapy regimen; 29 patients received cytarabine-containing chemotherapy regimen, including R-hyper CVAD/R-MA regimen used in 15 patients and R-CHOP alternating with R-DAHP regimen used in 14 patients; and 3 patients received other treatment regimens. Among 56 patients, 19 patients received autologous hematopoietic stem cell transplantation (ASCT) consolidation therapy. The median OS time was 74 months, 2-year OS rate was 83.8%, 3-year OS rate was 70.9%, 2-year PFS rate was 72.0% and 3-year PFS rate was 49.7%. International prognostic index (IPI) high-risk and receiving ASCT or not during the treatment were independent influencing factors of OS and PFS in MCL patients. The overall response rate (ORR) in cytarabine-containing regimen group was higher compared with that in R-CHOP regimen group (93.1% vs. 83.3%), and there was no statistically significant difference ( χ2=0.465, P=0.495). In addition, there were no significant differences between two groups in both OS ( χ2=0.291, P=0.590) and PFS ( χ2=0.912, P=0.339). ASCT consolidation prolonged the median OS time (72 months vs.124 months, χ2=3.973, P=0.040) and the median PFS time (34 months vs. 90 months, χ2=3.984, P=0.046) in MCL patients achieving remission after induction therapy. Among patients in simplified MCL IPI (sMIPI) score middle-high risk group, compared with those not receiving ASCT, patients receiving ASCT therapy could obtain better OS and PFS (OS: χ2=5.037, P=0.025; PFS: χ2=6.787, P=0.009); among patients of sMIPI score low risk, there were no statistically significant differences in OS and PFS between the group receiving ASCT and not (all P > 0.05). Conclusions:Cytarabine-containing chemotherapy regimen has no predicatively satisfactory value in improving the prognosis and survival for MCL patients. For MCL patients who have achieved remission after reduction therapy and those in sMIPI score middle-high risk group, ASCT consolidation therapy can improve the prognosis and can be taken as the first-line consolidation treatment in young patients.

Abstract： Objective　To retrospectively analyze the investigation and disposal of the COVID-19 outbreak caused by the transmission of the Omicron variant in infected imported cases, and provide basis for COVID-19 outbreak management. Methods　The description epidemiological method was used to describe the COVID-19 outbreak in Sanya City from March 31 to April 15, 2022. The propagation chain was mapped and the experience gained and shortcomings identified in emergency responses were analyzed. Results　The outbreak resulted in 95 reported locally transmitted COVID-19 cases with a incubation period M(P25, P75) of 4 (3, 5) d. In the 95 cases, the proportion of cases detected through close contact screening, centralized isolation, community screening, control area screening, active treatment (examination), and key population screening were 33.68%, 22.11%, 18.95%, 12.63%, 6.32%, 4.21% and 2.11%, respectively. The epidemic spread for 6 generations, causing 5 clusters of outbreaks and 12 cases of cluster disease. The epidemic affected 12 villages/neighborhood committees, 1 bar, 1 hospital, 1 small clinic, 1 farmer's market, 1 large shopping mall and 1 restaurant in 2 districts of Sanya City. The result of gene sequencing was Omicron variant BA.1.1. Through the immediate launch of emergency plans, nucleic acid and antigen testing, controlling close contact between infected persons and close contacts, suspending indoor business sites, central urban control, and temporary suspension, COVID-19 was controlled within 16 days. Conclusions　The transmission chain of this outbreak was clear and was caused by imported cases. Strengthening the management of the pass, doing a good job in information sharing and docking, timely screening for cases, screening, pushing, controlling high-risk groups, and implementing comprehensive control measures, can effectively prevent the spread of the epidemic, providing a reference for the control of epidemic situations in relevant scenarios.

OBJECTIVETo evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection.

METHODSTen patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured.

RESULTSAs compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7±15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin: (285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01; transferrin: (4.86±0.21) vs. (3.60±0.25) g/L, P<0.05; pre-albumin: (291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05].

CONCLUSIONSmall intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Objective:To examine the efficacy of haploidentical stem-cell transplantation (haplo-SCT) for patients with refractory relapsed (R/R) non-Hodgkin lymphoma (NHL) by comparing with those contemporaneously undergoing HLA-matched SCT in myeloablative conditioning settings.Methods:Between January 2006 and December 2018, a total of 151 patients undergoing haplo-SCT ( n=81) or HLA-matched SCT ( n=70, sibling or unrelated) were enrolled. Median age of alloSCT was 30(5-59) years. And 150 patients received myeloablative conditioning (MAC) consisting of total body irradiation (12 Gy) plus cyclophosphamide or busulfan plus cyclophosphamide. Only one case had reduced intensity conditioning (RIC) with R-FBA (fludarabine, busulfan & cytarabina). It was followed by an infusion of granulocyte-colony stimulating factor-primed bone marrow (G-BM) and/or peripheral blood stem cells without in vitro T cell depletion. In haplo-SCT and HLA-matched unrelated donor for SCT, GVHD prophylaxis consisted of antithymocyte globulin, cyclosporine A, mycophenolate mofetil and a short course of methotrexate. Clinical efficacy, hematopoietic reconstitution and transplant-related complications were retrospectively analyzed. Results:Among them, 146(96%) patients engrafted with a median time to neutrophil and platelet recovery of 12 and 15 days respectively. During a median follow-up period of 19 months, 66 of them survived (43.7%) and 67 (44.4%) died (39 disease recurrence, 27 transplantation-related mortality). Between haplo-SCT and HLA-matched SCT groups, progression-free survival (PFS) rate was 49.4% and 50.5% ( P=0.577); overall survival (OS) rate 56.7% and 57.4% respectively ( P=0.963). The cumulative incidences of relapse (CIR) were 36.6% and 37.7% ( P=0.836) and those of cumulative incidences of non-relapse mortality (NRM) 22.0% and 24.7% ( P=0.530). And the cumulative incidences of chronic GVHD were 42.3% and 39.6% ( P=0.46) respectively. Conclusions:No inter-group difference exists in each major HSCT endpoint. Multivariate analysis reveals that occurrence of grade Ⅲ-Ⅳ aGVHD has a significantly worse prognosis. And primary chemorefractoriness is a strongest relapsing factor.

Objective: To investigate the efficiency and safety of hypofractionated radiotherapy (HFR) combined with chemotherapy using paclitaxel for the treatment of esophageal cancer (EC) patients with post-operative tracheoesophageal groove lymph node (TGLN) metastasis. Methods: A total of fifty-three post-operative EC patients with TGLN metastasis were randomly divided into HFR group (n=25), receiving a radiation of 60 Gy/20 fractions, and conventional fractionated radiotherapy (CFR) group (n=28), receiving a radiation of 60 Gy/30 fractions combined with chemotherapy using paclitaxel with a dosage of 50 mg once per week through tossing a coin. the adverse events and the prognosis between two groups were compared. Results: The incidence of radiation esophagitis and pneumonitis (grade 3-4) between the HFR group and CFR group showed no statistically significant difference (44.0%, 25.0%, P>0.05; 16.0%, 7.1%, P>0.05). No statistical difference was noticed in the efficiency between the HFR group and the CFR group (P>0.05). The efficiency in patients with lymph node metastasis at diameters ≤2 cm was significantly higher than that with lymph node metastasis at diameters >2 cm (P<0.05). The median overall survival (OS) of the HFR group showed a significant increase compared with that of the CRF group [24.2 months (95%CI 16.2-32.1 months) vs. 11.8 months (95%CI 9.2-14.4 months)] (χ²=5.063, P<0.05). Both univariate and multivariate analysis indicated that TGLN diameter (P<0.05) and fractioned types (P<0.05) were factors that affected the prognosis. Conclusions: The combination of HFR and chemotherapy contributed to the improvement of prognosis in EC patients with TGLN metastasis and there was no obvious increase in the adverse events. Trial registration Chinese clinical trial registry, ChiCTR1800016848

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.