Objective To investigate the effect of shenfu injection on immune function in severe trauma patients.Methods 60 severe trauma patients were divided into the control group (n =30)and shefu group (n =30) by random number table.Other 30 cases were chosen as the health control group at the same phase.All patients were received conventional treatments,however,patients of the shenfu group were additionally received the shenfu injection treatment in the early stage.The CD +3 ,CD +4 ,CD +8 cell,human leukocyte antigen (HLA -DR),interleukin -1(IL -1),interleukin -6(IL -6)were detected on 3rd and 7th day by double -antibody sandwich enzyme -linked immu-nosorbent assay (ELISA).Results Compared to the health control group,the IL -1,IL -6 in the control and shenfu group were significantly higher than the health control group(f=7.128,q =9.212,10.112,all P <0.05).The IL -1and IL -6 in the control and shenfu group were significantly increased on 3rd day (t =11.126,10.013,all P <0.05)and decreased on 7th day(t =17.121,14.213,all P <0.05).The IL -1 and IL -6 in shenfu group were sig-nificantly lower than that of the control group(χ2 =4.113,10.117,all P <0.05).The CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in the control and shenfu group were significantly lower than the health control group(f=11.071, q =10.229,12.032,all P <0.05).On 3rd day,the CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in shenfu group were significantly increased(t =10.013,P <0.05).On 7th day,CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in the control and shenfu group were both increased(t =11.126,15.932,all P <0.05).And the CD +3 ,CD +4 ,CD +8 ,HLA -DR and CD +3 /CD +8 rate in shenfu group were significantly higher than the control group(χ2 =3.771,P <0.05).Conclusion Shenfu injection can regulate immune function in severe trauma and improve clinical treatment.

Objective To establish the quality standard for Sanyuan Rupixiao Gel Paste. Methods Sparganii Rhizoma, Gleditsiae Sinensis Fructus, Cyperi Rhizoma and Impatientis Semen were identified by TLC method. The content of tetrahydropalmatine was determined by HPLC. Waters symmetry column was used with the mobile phase of acetonitrile-0.1% phosphatic acid in a gradient manner (pH was adjusted to 6.4 by triethylamine) (55:45) at the detection wavelength of 280 nm. The flow rate was 1.0 mL/min at the column temperature of 30 ℃. Results The spots in TLC were clear without any interference;tetrahydropalmatine showed a good linear relation in the range of 0.092–1.84 μg;the average recovery was 100.15%with RSD of 1.58%(n=6). Conclusion The method is simple and accurate with high reproducibility, which can be used for the quality control of Sanyuan Rupixiao Gel Paste.

Objective To explore the prognosis and risk factors for cervical cancer in elderly patients. Methods Clinical data of 337 elderly patients (≥ 65 years old )admitted into Zhejiang Cancer Hospital from June 2008 to June 2013 were retrospectively analyzed.Clinical data and the follow-up information were collected. The correlation of prognosis with age ,performance status score , International Federation of Gynecology and Obstetrics (FIGO )staging ,tumor size ,pathological type , treatment and comorbidities were analyzed. Results Among 337 elderly patients ,the 5-year overall survival(OS )rates for patients with stage Ⅰ,Ⅱ,Ⅲ,Ⅳ were 81.8% ,62.3% ,53.5% and 0.0% , respectively (χ2=63.414 ,P=0.000) ;local recurrence rate was 33.5% ;the 5-year OS rate of patients with and without comorbidities were 54.0% and 70.0% ,respectively(χ2=8.907 ,P=0.003).Among 119 cervical cancer patients with stage ⅠA-ⅡA ,5-year OS for surgery group and radiotherapy group were 83.5% and 55.0% ,respectively(χ2=13.161 ,P=0.000).Among 218 advanced cervical cancer patients ,the 5 year OS for chemoradiotherapy and radiotherapy groups were 69.7% and 51.9% , respectively(χ2=4.030 ,P=0.045). The acute toxicity reactions of radiotherapy and chemoradiotherapy groups were as follows. The incidences of acute grades 3-4 hematological toxicity were 9.7% and 42.4% in radiotherapy group and chemoradiotherapy groups respectively (χ2=21.362 ,P=0.000) ,and the incidences of acute grade 3 gastrointestinal toxicity were 5.9% and 9.1% (χ2=0.086 ,P=0.769)in radiotherapy group and chemoradiotherapy group ,respectively.No grade 4 gastrointestinal toxicity was found.Multivariate Cox regression analysis showed that age ,PS score , FIGO staging ,pathological type ,treatment and comorbidities were influencing factors for prognosis in elderly patients with cervical cancer (P＜0.05). Conclusions Elderly cervical cancer patients have a good tolerance to treatment. The comorbidity is one of negatively influencing factors for prognosis. The efficacy of definitive radiotherapy is inferior to surgery in elderly patients with early stage cervical cancer due to the high proportion of comorbidities.Concurrent chemoradiotherapy can improve the prognosis of middle and advanced cervical cancer in elderly patients.

Objective: This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events. Methods: This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching. Results: Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05). Conclusion Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.

Objective: This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events. Methods: This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching. Results: Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05). Conclusion Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.

Objective: This study aimed to compare outcomes and adverse events of patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT) with cisplatin single-agent chemotherapy vs. CCRT with cisplatin combined with paclitaxel dualagent therapy. The primary outcomes are overall survival (OS), progression-free survival (PFS), local recurrence (LR), distant metastasis (DM) and the occurrence of adverse events. Methods: This retrospective cohort study included patients with FIGO 2009 stage IB1-IVA cervical squamous cell carcinoma undergoing radical CCRT. Patients were divided into groups A and B, treatment outcomes were compared between the two groups after 1:1 proportional propensity score matching. Results: Medical records of 1,203 patients were reviewed and 572 patients were finally included for propensity score matching. After propensity score matching, 121 pairs of patients were selected for analysis. The OS, PFS, LR and DM rates were 78.5% and 83.5% (p=0.417), 73.3% and 78.5% (p=0.312), 6.6% and 2.5% (p=0.123), 19% and 15.7% (p=0.497) for groups A and B, respectively. Further subgroup analysis according to stage and lymph node metastatic status showed no difference in survival between the two groups. The incidence of grade 3–4 acute haematological toxicities was different between the two groups (p<0.05). Conclusion Cisplatin combined with paclitaxel CCRT couldn’t improve the survival rates of patients with LACC. However, the hematological toxicity of combination chemotherapy is more severe but controllable. Cisplatin single-agent therapy remains the first choice for CCRT. Further prospective studies are indicated to provide evidence for the efficacy of cisplatin plus paclitaxel in dual-agent concurrent therapy.

Objective To explore the clinical significance of serum squamous cell carcinoma antigen (SCC?Ag) in early cervical squamous cell carcinoma. Methods The clinicopathological data and follow?up information of 1435 patients with stageⅠA2?ⅡA cervical squamous cell carcinoma were collected. The correlation between serum SCC?Ag level and clinicopathological feature and prognosis were analyzed.The best cut?off of serum SCC?Ag for predicting pelvic lymph node metastasis and survival of cervical squamous cell carcinoma patients were also identified. Results The result of univariate analysis showed that The International Federation of Gynecology and Obstetrics (FIGO) staging, tumor size, depth of cervical stromal invasion, lymphovascular space involvement, pelvic lymph node metastasis, common iliac lymph node metastasis and para?aortic lymph node metastasis were significantly related with serum SCC?Ag level (all P＜0.05). The result of multivariate logistic regression analysis showed that tumor size, depth of cervical stromal invasion, pelvic lymph node metastasis and common iliac lymph node metastasis were the independent risk factors of preoperative serum SCC?Ag＞2.65 ng／ml ( all P＜0.001). Multivariate Cox regression analysis showed that lymphovascular space involvement, SCC?Ag＞3.15 ng／ml, common iliac lymph node metastasis and tumor size ＞4 cm were the independent prognostic risk factors ( all P＜0.05). The univariate analysis showed that, the tumor size, FIGO stage, depth of cervical stromal invasion and SCC?Ag level were significantly related with the recurrence of 1 096 patients without postoperative high risk factors ( all P＜0.05). Multivariate logistic regression analysis showed that FIGO stage (OR＝1.671) and SCC?Ag＞2.65 ng／ml (OR＝4.490) were the independent risk factors for recurrence (both P＜0.05). The best cut off of SCC?Ag for predicting early postoperative cervical lymph node metastasis of cervical squamous cell carcinoma was 2.65 ng／ml, the sensitivity was 60.8%,the specificity was 71.8%. The best cut off of SCC?Ag for predicting prognosis of cervical squamous cell carcinoma was 3.15 ng／ml, the sensitivity was 53.5%, the specificity was 71.1%.Conclusions Preoperative serum squamous cell carcinoma antigen is an independent prognostic risk factor of survival of patients with early cervical squamous cell carcinoma, and is significantly related with recurrence of patients without postoperative high?risk factors. It can be used as a reference factor for postoperative adjuvant radiotherapy.

Objective To explore the clinical significance of serum squamous cell carcinoma antigen (SCC?Ag) in early cervical squamous cell carcinoma. Methods The clinicopathological data and follow?up information of 1435 patients with stageⅠA2?ⅡA cervical squamous cell carcinoma were collected. The correlation between serum SCC?Ag level and clinicopathological feature and prognosis were analyzed.The best cut?off of serum SCC?Ag for predicting pelvic lymph node metastasis and survival of cervical squamous cell carcinoma patients were also identified. Results The result of univariate analysis showed that The International Federation of Gynecology and Obstetrics (FIGO) staging, tumor size, depth of cervical stromal invasion, lymphovascular space involvement, pelvic lymph node metastasis, common iliac lymph node metastasis and para?aortic lymph node metastasis were significantly related with serum SCC?Ag level (all P＜0.05). The result of multivariate logistic regression analysis showed that tumor size, depth of cervical stromal invasion, pelvic lymph node metastasis and common iliac lymph node metastasis were the independent risk factors of preoperative serum SCC?Ag＞2.65 ng／ml ( all P＜0.001). Multivariate Cox regression analysis showed that lymphovascular space involvement, SCC?Ag＞3.15 ng／ml, common iliac lymph node metastasis and tumor size ＞4 cm were the independent prognostic risk factors ( all P＜0.05). The univariate analysis showed that, the tumor size, FIGO stage, depth of cervical stromal invasion and SCC?Ag level were significantly related with the recurrence of 1 096 patients without postoperative high risk factors ( all P＜0.05). Multivariate logistic regression analysis showed that FIGO stage (OR＝1.671) and SCC?Ag＞2.65 ng／ml (OR＝4.490) were the independent risk factors for recurrence (both P＜0.05). The best cut off of SCC?Ag for predicting early postoperative cervical lymph node metastasis of cervical squamous cell carcinoma was 2.65 ng／ml, the sensitivity was 60.8%,the specificity was 71.8%. The best cut off of SCC?Ag for predicting prognosis of cervical squamous cell carcinoma was 3.15 ng／ml, the sensitivity was 53.5%, the specificity was 71.1%.Conclusions Preoperative serum squamous cell carcinoma antigen is an independent prognostic risk factor of survival of patients with early cervical squamous cell carcinoma, and is significantly related with recurrence of patients without postoperative high?risk factors. It can be used as a reference factor for postoperative adjuvant radiotherapy.

Objective:To retrieve, evaluate, and summarize the evidence on fertility management for cervical cancer patients of childbearing age, providing a basis for clinical medical and nursing staff to carry out fertility management for cervical cancer patients.Methods:The evidence on fertility in cervical cancer patients included clinical decision-making, guidelines, summary of evidence, expert consensus, and systematic review, which were systematically searched on domestic and international evidence-based medicine databases, clinical decision-making systems, guideline websites, professional association websites, medical literature service websites, and databases such as UpToDate, Cochrane Library, British Medical Journal (BMJ) Best Practice, China Guidelines Network, China National Knowledge Infrastructure, WanFang Med Online, China Biology Medicine disc, and VIP. The search period was from database establishment to March 1, 2023. Two researchers who received evidence-based nursing knowledge training independently conducted literature screening and quality evaluation, and jointly discussed with clinical experts on the literature that met the requirements to complete evidence extraction and summary.Results:A total of 11 articles were included, including three clinical decision-making, four guidelines, three expert consensus, and one systematic review. A total of 30 pieces of best evidence were summarized from six aspects, including fertility assessment and safety, fertility preservation methods, fertility preservation surgery and anti-tumor treatment, fertility timing, pregnancy management and follow-up, and special treatment for pregnancy with cervical cancer.Conclusions:The evidence on fertility management for cervical cancer patients of childbearing age provides a basis for clinical medical and nursing staff to provide fertility guidance for cervical cancer patients. In clinical application, factors such as patient willingness and condition should be fully considered, and personalized treatment plans should be provided to maximize patient benefits.

Asthma and chronic obstructive pulmonary disease overlap (ACO) is a hot topic in recent years. Although the precise definition of ACO is still controversial, scholars have found that the patients with overlapping features of asthma and COPD have a worse prognosis and increased medical cost than those with asthma or COPD alone. Thus, there is a big challenge to have a better understanding and to manage these patients in clinical practice. To strengthen awareness of this type of patients, the Global initiative for Chronic Obstructive Lung Disease (GOLD) and Global initiative for asthma (GINA) in 2014 named them as " Asthma Chronic Obstructive Lung Overlap Syndrome" (ACOS), which was further revised to the Asthma Chronic Obstructive Lung Overlap (ACO) in the follow-up GINA guidelines (2017). In the updated version, it emphasized that ACO was not a separate disease. However, although the research on ACO has increased significantly in recent years, there are still many controversies, which includes the definition, diagnostic criteria and treatment therapies. In this review, we provide the recent advances in the diagnosis and an overview of available treatment for of ACO.