Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To study the epidemiological and clinical characteristics of patients infected with Streptococcus suis in Hainan Province. Methods:Clinical data of patients diagnosed with human infection with Streptococcus suis at the Second Affiliated Hospital of Hainan Medical University from January 2017 to December 2023 were collected, and their epidemiological characteristics, clinical manifestations, auxiliary examination results, treatment and prognosis were retrospectively analyzed. Results:A total of 29 patients infected with Streptococcus suis were included, with 26 males (89.66%) and 3 females (10.34%). The age of the patients was (54.52 ± 10.89) years old, with the highest number of patients aged 51 to 60 years, accounting for 41.38% (12 cases). Farmers were the main occupation (72.41%, 21/29). Forty-four point eighty-three percent (13/29) of the patients had a history of direct or indirect contact with dead or sick pigs. The number of cases from January to December was 0, 0, 2, 2, 4, 8, 2, 3, 2, 2, 3, and 1, respectively. June was the peak period of incidence (27.59%, 8/29). The main clinical manifestations were fever (100.00%, 29/29), altered state of consciousness (51.72%, 15/29), headache (48.28%, 14/29), and hearing impairment (44.83%, 13/29). In clinical classification, common type, meningitis type, and mixed type accounted for 20.69% (6/29), 75.86% (22/29), and 3.45% (1/29), respectively. In the pathogen examination, all 29 patients underwent blood culture, and 18 patients (62.07%, 18/29) had positive blood culture; 26 patients underwent cerebrospinal fluid culture, and 8 cases (30.77%) tested positive for cerebrospinal fluid culture. Eighty-nine point sixty-six percent (26/29) of the patients were treated with ceftriaxone sodium; 55.17% (16/29) of the patients were treated with combined treatment of ceftriaxone sodium and glucocorticoids, including 11 cases treated with dexamethasone and 5 cases treated with methylprednisolone. After treatment, 7 patients were cured and discharged, and 22 patients showed improvement in their condition and discharged from hospital. At discharge, both blood and/or cerebrospinal fluid cultures turned negative. Telephone follow-up was conducted 6 months after discharge, and 20 patients had no sequelae, 9 patients still had hearing impairment, including one who also developed walking difficulties. Conclusions:The patients infected with Streptococcus suis in Hainan Province are mainly middle-aged, elderly, male and farmers, with June being the peak period of the disease. The main clinical manifestations are fever, altered state of consciousness, headache, and hearing impairment. After follow-up, there are still patients with residual hearing impairment. In clinical practice, patients with fever and hearing impairment should be considered as this disease as early as possible.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To study the epidemiological and clinical characteristics of patients infected with Streptococcus suis in Hainan Province. Methods:Clinical data of patients diagnosed with human infection with Streptococcus suis at the Second Affiliated Hospital of Hainan Medical University from January 2017 to December 2023 were collected, and their epidemiological characteristics, clinical manifestations, auxiliary examination results, treatment and prognosis were retrospectively analyzed. Results:A total of 29 patients infected with Streptococcus suis were included, with 26 males (89.66%) and 3 females (10.34%). The age of the patients was (54.52 ± 10.89) years old, with the highest number of patients aged 51 to 60 years, accounting for 41.38% (12 cases). Farmers were the main occupation (72.41%, 21/29). Forty-four point eighty-three percent (13/29) of the patients had a history of direct or indirect contact with dead or sick pigs. The number of cases from January to December was 0, 0, 2, 2, 4, 8, 2, 3, 2, 2, 3, and 1, respectively. June was the peak period of incidence (27.59%, 8/29). The main clinical manifestations were fever (100.00%, 29/29), altered state of consciousness (51.72%, 15/29), headache (48.28%, 14/29), and hearing impairment (44.83%, 13/29). In clinical classification, common type, meningitis type, and mixed type accounted for 20.69% (6/29), 75.86% (22/29), and 3.45% (1/29), respectively. In the pathogen examination, all 29 patients underwent blood culture, and 18 patients (62.07%, 18/29) had positive blood culture; 26 patients underwent cerebrospinal fluid culture, and 8 cases (30.77%) tested positive for cerebrospinal fluid culture. Eighty-nine point sixty-six percent (26/29) of the patients were treated with ceftriaxone sodium; 55.17% (16/29) of the patients were treated with combined treatment of ceftriaxone sodium and glucocorticoids, including 11 cases treated with dexamethasone and 5 cases treated with methylprednisolone. After treatment, 7 patients were cured and discharged, and 22 patients showed improvement in their condition and discharged from hospital. At discharge, both blood and/or cerebrospinal fluid cultures turned negative. Telephone follow-up was conducted 6 months after discharge, and 20 patients had no sequelae, 9 patients still had hearing impairment, including one who also developed walking difficulties. Conclusions:The patients infected with Streptococcus suis in Hainan Province are mainly middle-aged, elderly, male and farmers, with June being the peak period of the disease. The main clinical manifestations are fever, altered state of consciousness, headache, and hearing impairment. After follow-up, there are still patients with residual hearing impairment. In clinical practice, patients with fever and hearing impairment should be considered as this disease as early as possible.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.