Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Objective To master the prevalence of plague and its trend in Guizhou Province,and to analyze the plague monitoring results from 2000 to 2012.Methods The report of infectious disease,the information of plague natural focus and the epizootic monitoring data of Xingyi City,Anlong County and Dingxiao Distract of Guizhou Province from 2000 to 2012 were collected and the status of the plague natural focus was analyzed.Results There were 137 cases of gland plague in Xingyi City and Arlong county from 2000-2003,1 death,and mt plague occurred in 66 villages.Fifty-four strains of Yersiniapestis were detected and 49 rats were plague antigen F1 positive(49/160).No human plague occurred between 2004-2012.A total of 4 plague antigen F1 positive rats were detected in Dingxiao District and Xingyi City in 2005 and 2006.There was no Yersinia pestis and F1 antibody in 2007-2012.The epidemic stage of plague was from 2000-2003; the active stage was from 2004-2006; and the quiescent stage was from 2007-2012.The dominant species of the plague natural focus was Rattus flavipestus (42.83％,7 966/18 597),but was replaced by Rattus norvegicus at the epidemic stage (47.22％,1 480/3 134) and the active stage(35.35％,2 071/5 196).The density of rodents was 5.34％ at the epidemic stage,which was higher than that of the active stage (3.27％) and the quiescent stage (1.71％,x2 =2 286.15,P ＜ 0.01).Xenopsylla cheopis(56.34％,10 034/17 811) was the dominant species,and the index was 1.537 9,which was greater than those of the active stage(0.959 6) and the quiescent stage(0.540 4,x2 =492.68,P ＜ 0.01).Conclusions The plague of Guizhou Province is at the quiescent stage.Both the density of rodents and the Xenopsylla cheopis index are lower than the national standard of controlling.

Medical profession is confronted with epidemiology changes,fast innovation in diagnosis and treatment and reform in medical system and management.Therefore,physicians face many new challenges in providing medical and social services.We should enhance doctors' understanding of professional moral,enhance their humanities accomplishment,promote their sense of responsibility,improve their service consciousness and sublimate their values.Meanwhile,we should reiterate the medical professional ethics aiming at boosting the development of medical and health services.

Objective To discuss the clinical features, diagnosis and therapy of primary adrenal lymphoma (PAL) . Methods Two patients (65-year old and 52-year old respectively) who complained vague pain were analyzed. Occupying lesions in adrenal gland were discovered by computed tomography (CT) and diagnosed by needle biopsy and laparoscopic surgery. Results The two patients in our hospital were diagnosed as nonHodgkin's lymphoma. They were treated with chemotherapy and one of them was partial response. Literatures on PAL were reviewed. In the literature, 7 of the 65 patients achieved complete response, 15 partial response, 43 death or unspecified and the survival duration was 3 days to 26 months. Conclusions Most of PAL are bilateral, without specific clinical characters. Neele biopsy is the first choice to make the diagnosis. The therapeutic modalities for PAL include surgery, chemotherapy, surgery followed by chemotherapy as well as radiation therapy. The prognosis of PAL is poor if other organs are involved.

1?105/ml。These cases were assigned to A or B group randomly.The management of A group:double-J tubes were placed and retained for 2 weeks again,and used susceptible antibiotics for 2 weeks→ discontinued drugs for 1 week→urine cultured,PA(+)→used susceptible antibiotics for 2 weeks→discontinued drugs for 1 week→urine cultured,PA(+)→used susceptible antibiotics for 2 weeks;the management of B group:double-J tube(sCook,F6,America)were placed again,and used susceptible antibiotics for 2 weeks→discontinued drugs for 1 week→urine cultured,PA(+)→used susceptible antibiotics for 2 weeks,until the infection was cured,the double-J tube was removed after the infection was cured.Results:A group:double-J tubes were retained for 2 weeks additionally;4 patients were cured during the first two-week,2 patients were cured during the second two-week,the cure rate was 40%after two courses,one was cured during the third two-week,the cure rate was 46.7%after three courses.B group:double-J tubes was retained for 4～12 weeks(mean 8 weeks)additionally,3 patients were cured during the first two-week,9 patients were cured during the second two-week,the cure rate was 80%after two courses,2 patients were cured during the third two-week,the cure rate was 93.3%after three courses.The cure rate ofBgroup was significantlyhigher than Agroup after twocourses and three courses,the difference was significan(tP

Objective: To evaluate the effect of Samarium etramthylene phosphoric acid(153Sm-EDTMP) in the treatment of painful bony metastases from prostate cancer after hormone therapy.Methods: 18 patients after being treated with hormone therapy(excision of testes+flutamide) for 3~6 months and with painful bony metastases from prostate cancer were injected 153Sm-EDTMP(dosage:37MBq/kg),After the patients underwent 1~3 dose treatment.The palliation of pain and change of bone metastases on bone scans were evaluated.Results: A significant decrease of bone pain was achieved,making up 77.8%(14/18) and X ray and bone radionuclide imaging exam showed that 2 patients achieved complete focus disappearance,and 8 patients achieved partial focus disappearance.The response rate is 55.5%.Conclusion: 153Sm-EDTMP radiotherapy is efficacious to the refractory painful bone metastases in prostate cancer.