Due to long-term use of immunosuppressive agents, solid organ transplant recipients (SOTR) belong to high-risk populations of multiple pathogenic infection, including SARS-CoV-2. In addition, SOTR are constantly complicated by chronic diseases, such as hypertension and diabetes mellitus, etc. After infected with SARS-CoV-2, the critically ill rate and fatality of SOTR are higher than those of the general population, which captivates widespread attention from experts in the field of organ transplantation. Omicrone variant is currently the significant pandemic strain worldwide, rapidly spreading to more than 100 countries worldwide and causing broad concern. According to the latest international guidelines on the diagnosis and treatment of SARS-CoV-2 infection and relevant expert consensus in China combined with current domestic situation of SARS-CoV-2 pandemic and China's "diagnosis and treatment regimen for SARS-CoV-2 infection (Trial Version 10)", the epidemiology, clinical manifestations and prognosis, diagnosis, clinical classification and treatment of SARS-CoV-2 infection were briefly reviewed.

OBJECTIVETo observe the therapeutic effect of Guben Xiaoliu Capsule (GXC) in treating advanced stage non-small cell lung cancer (NSCLC).

METHODSOne hundred and ninety-eight NSCLC in-patients were divided into the integrative treated group [Group A, 54 patients treated with chemotherapy (CT) plus GXC], the TCM treated group (Group B, 96 patients treated with GXC alone) and the chemotherapeutic group (Group C, 48 patients treated with CT alone). Randomized controlled observation was applied to the Group A and C. The clinical effect, quality of life (QOL), adverse reaction and survival period in the three groups were observed.

RESULTSThe immediate effective rate (CR + PR) in the Group A, B and C was 16.7%, 3.1% and 8.3%, respectively, in the Group A, it was better than that in the other two groups (P < 0.05). The improvement of clinical symptoms and QOL in the Group A and B were superior to those in the Group C (P < 0.05). The median survival rate in the three groups was 12, 15 and 9 months, respectively, the 1-, 2- and 3-year survival rate in Group A being 57.4%, 11.1% and 3.7%, respectively, in Group B, 67.7%, 9.4% and 3.1%, and in (Group C, 39.6%, 4.2% and 0, respectively, comparison between the three groups showed that the survival rates in the former two were higher than those in Group C (P < 0.05). Moreover, the incidence rate and degree of CT toxicity were milder in Group A than those in Group C (P < 0.05).

CONCLUSIONGXC has definite effect in treating NSCLC, it could raise the QOL, prolong the survival period of patients, also reduce the toxicity and enhance the efficacy of CT.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Capsules ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; Cisplatin ; administration & dosage ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; Male ; Middle Aged ; Mitomycins ; administration & dosage ; Phytotherapy ; Quality of Life ; Survival Analysis ; Survival Rate ; Vinblastine ; administration & dosage

Objective To study the clinical characteristics,diagnosis,treatment and prognostic factors of patients with postradiation nasopharyngeal necrosis(PRNN) in nasopharyngeal carcinoma(NPC).Methods Sixty patients with PRNN were studied retrospectively,50 males and 10 females,age ranging from 30-70 years of (median 51.5 years). All patients were treated with endoscopic debridement and systemic or local anti-inflammatory treatment. Kruskal-Wallis H test was used to assess the interval time between irradiation completion and necrosis onset and related factors of treatment outcome.Multivariate Cox proportional hazards regression survival analysis was performed to analyze risk factors.Results The latent period between the last irradiation and the onset of the symptom ranged from 1 to 156 months,with a median of 5 months.The median interval time was 7.0 months in 1 course group and 4.5 months in ≥ 2 courses group ( x2 =5.527,P =0.031 ),and 7.5 months in T2 group and 5.0 months in ≥T3 group ( X2 =4.330,P =O.037 ),respectively.Forty-one patients of them had nasopharyngeal infection,and the difference in curative effect between infection group and non-infection group was sigmficantly(x 2 =14.775,P ＜ 0.001 ).Symptoms were alleviated in all patients after endoscopic debridement and systemic or local anti-inflammatory treatment.Follow-up for all patients ranged from 2 to 46 months (median 12.5 months).Seven patients with internal carotid artery exposure died of sudden nasopharyngeal massive bleeding and fifteen patients died of tumor or systemic exhaustion; five cases were lost,and the rest were all in survival. Inter carotid artery erosion was an independent prognostic risk factor according to multivariate Cox proportional hazards regression survival analysis ( P ＜ 0.05 ). Conclusions Endoscopic debridement is effective in treating irradiation-related nasopharyngeal necrosis. The occurrence of nasopharyngeal necrosis is related to infection,irradiation dose and course,and T stage.Internal carotid artery erosion is a severe situation and also an independent prognostic factor for the patients.The most common causes of death were nasopharyngeal bleeding and systemic exhaustion.