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managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control.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.

Objective:To investigate the efficacy of transumbilical laparoendoscopic single-site supracervical hysterectomy in the treatment of benign uterine diseases.Methods:The clinical data of 39 patients with benign uterine diseases with the volume of uterus less than that at the 14 weeks of pregnancy who underwent supracervical hysterectomy in People's Hospital of Hechuan District of Chongqing, China between January 2018 and December 2019 were retrospectively analyzed. These patients were divided into transumbilical laparoendoscopic single-site supracervical hysterectomy group (single-site group, n = 21) and transumbilical laparoendoscopic multiple-site supracervical hysterectomy group (multiple-site group, n = 18) according to different surgical approaches. Operation time, specimen removal time, intraoperative blood loss, incision suture time, tissue debris shedding rate, postoperative off-bed time, length of hospital stay, pain score on postoperative day 1, time to anal exhaust, and the incidence of complications within 30 days after surgery were compared between the two groups. Results:Tissue debris shedding rate in the single-site group was significantly lower than that in the multiple-site group [0.00% (0/21) vs. 100.00% (18/18), χ2 = 39.00, P < 0.001]. Operation time in the single-site group was significantly longer than that in the multiple-site group [(74.20 ± 9.15) minutes vs. (62.90 ± 6.20) minutes, t = 3.323, P < 0.05). Specimen removal time and incision suture time in the single-site group were (11.10 ± 2.33) minutes and (3.90 ± 0.88) minutes, respectively, which were significantly longer than those in the multiple-site group [(4.90 ± 0.88) minutes, (2.90 ± 0.74) minutes, t = 7.97, 0.386, both P < 0.05]. There were no significant differences in intraoperative blood loss, postoperative off-bed time, pain score on postoperative day 1, length of hospital stay, time to anal exhaust, and the incidence of complications within 30 days after surgery between the two groups (all P > 0.05). Conclusion:Transumbilical laparoendoscopic single-site and multiple-site supracervical hysterectomy can acquire similar short-term surgical outcomes in the treatment of benign uterine diseases at the time of less than 14 weeks of pregnancy and transumbilical laparoendoscopic single-site supracervical hysterectomy can eliminate the long-term complications caused by tissue dissemination.

Objective:To study the risk factors affecting the prognosis of patients with type Ⅰ endometrial cancer.Methods:A total of 279 patients with type Ⅰ endometrial cancer admitted to the First Affiliated Hospital of Southwest Medical University were enrolled from January 2010 to January 2015. The clinical data of all patients were retrospectively analyzed. The Kaplan-Meier method was used to estimate patients′ survival rate. Cox regression risk model was used to analyze the risk factors that might affect the prognosis of patients with endometrial cancer.Results:Of 279 patients with endometrial cancer, postoperative recurrence was observed in 36 patients. The 5-year disease free survival rate was 87.10%(243/279). The 2, 3 and 5-year survival rates were 95.9% (95% CI: 93.6%-98.3%), 94.3% (95% CI: 91.6%-97.2%), and 90.4% (95% CI: 86.6%-94.3%). Univariate analysis showed that obesity ( HR=2.194, 95% CI: 1.031-4.671, P=0.041), myometrial invasion ( HR=2.957, 95% CI: 1.382-6.329, P=0.005), tissue grading (G2: HR=3.271, 95% CI: 1.336-8.010, P=0.010; G3: HR=9.933, 95% CI: 3.565-27.672, P<0.001), tumor size ( HR=8.067, 95% CI: 2.426-26.821, P=0.001), abdominal cytology ( HR=3.293, 95% CI: 1.523-7.121, P=0.002), surgery-pathological staging (Ⅲ stage: HR=28.357, 95% CI: 11.516-69.828, P<0.001), nature of lymph node ( HR=14.629, 95% CI: 5.023-42.606, P<0.001), cervical interstitial infiltration ( HR=3.806, 95% CI: 1.653-8.764, P=0.002), accessory metastasis ( HR=9.101, 95% CI: 3.831-21.622, P<0.001) and lymphovascular space invasion ( HR=5.011, 95% CI: 2.233-11.249, P<0.001) were all correlated with the prognosis of the patients. Multivariate analysis showed that the independent risk factors for the prognosis of endometrial cancer patients were depth of myometrial invasion ( HR=2.503, 95% CI: 1.115-5.616, P=0.026), histological grading (G2: HR=3.143, 95% CI: 1.205-8.198, P=0.019; G3: HR=3.655, 95% CI: 1.151-11.610, P=0.028), surgery-pathological staging (Ⅲ stage: HR=27.701, 95% CI: 9.608-79.869, P<0.001) and lymphovascular space invasion ( HR=3.297, 95% CI: 1.370-7.936, P=0.008). Conclusion:Obesity, myometrial invasion, tissue grading, tumor size, abdominal cytology, surgery-pathological staging, nature of lymph node, cervical interstitial infiltration, adnexal metastasis and lymphovascular space invasion all affect the prognosis of patients. Depth of myometrial invasion, histological grading, surgical-pathological staging and lymphovascular space invasion are independent risk factors for the prognosis of patients with Ⅰ endometrial cancer.

Objective To investigate the changes of hemoglobin levels in patients with ovarian cancer after chemotherapy and the influence of anemia on the prognosis of patients.Methods A total of 73 patients with ovarian cancer were selected.SPSS 25.0 statistical software was used to analyze the changes of hemoglobin levels after chemotherapy.According to the hemoglobin content before chemotherapy,the patients were divided into anemia group (Hb ＞ 110 g/L) and non-anemia group (Hb ＜ 110 g/L).Log Rand was used to compare the difference of survival time between the two groups.COX model was used to analyze the related factors affecting the prognosis of ovarian malignant tumors.Results The hemoglobin content before and after six chemotherapy cycles were (108.24 ± 18.09) g/L and (100.17 ±21.06) g/L respectively,with significant difference (P =0.021).The incidence of anemia and the degree of anemia gradually increased.The rate of anemia after six cycles of chemotherapy was higher than before chemotherapy,with significant difference (P =0.027).Survival analysis showed that progression free survival (PFS) was significantly lower in the anemic group than in the non-anemic group (P =0.01).COX regression analysis showed that anemia,postoperative residual lesion size,and surgical clinical staging were independent factors affecting the prognosis of patients with ovarian malignant tumors.Conclusions Chemotherapy reduces the hemoglobin content in patients with ovarian malignant tumors and aggravates anemia.Anemia affects the survival rate of patients with ovarian malignant tumors and is an independent factor affecting the prognosis of patients.

Objective To invOstigatO thO clinical OffOct of thO ultrasound monitoring curOttagO and balloon placOmOnt hOmostas in thO trOatmOnt of cOsarOan scar prOgnancy.Methods From May 2014 to May 2016, thO clinical data of 13 casOs with cOsarOan scar prOgnancy in thO POoplO＇s Hospital of HOchuan District wOrO rOtrospOctivOly analyzOd. All 13 casOs rOcOivOd mOthotrOxatO, ultrasonic monitoring curOttagO and balloon placOmOnt hOmostas thOrapy wOrO obsOrvOd.Results Of 13 casOs,11 casOs wOrO curOd, including 9 casOs of gOstational sac OndogOnous typO and mass typO 2 casOs. ThO intraopOrativO blOOding was (167 ± 101)mL, thO opOration timO was (12.3 ± 6.3)min, thO blood HCG droppOd to normal timO was (37.2 ± 13.8)d. ThOrO wOrO 2 casOs of failurO, all of which wOrO OxogOnous gOstational sac .Conclusion Utrasound monitoring curOttagO combinOd with balloon comprOssion is a simplO, safO and Oconomical mOthod for thO trOatmOnt of OndogOnous typO of caOsarOan scar prOgnancy, which is worthy of clinical promotion.

Objective To investigate the expression of USP22 in cervical cancer cells,and the effects of USP22 on cell proliferation and chemosensitivity to cisplatin in cervical cancer cells. Methods Quantitative real-time polymerase chain reaction(qRT-PCR)was conducted to detect the expression of USP22 mRNA in cervical cancer cells.Cell count kit-8,flow cytometry,and tumorigenesis were performed to detect the effects of USP22 on the proliferation,apoptosis,cycle cycle,and chemosensitivity of cervical cancer cells to cisplatin in vitro and in vivo. Results USP22 was upregulated in cervical cancer cells compared to human immortalized epidermal cells. Cell proliferation was inhibited,cell apoptosis was promoted,cell cycle was arrested in G1 stage and chemosensi-tivity to cisplatin was enhanced in cervical cancer cells transfected with USP22-siRNAs.Furthermore,tumorigene-sis assays proved tumor growth was inhibited and chemosensitivity to cisplatin was enhanced when USP22 was silenced in HeLa cells. Conclusion USP22 expression is upregulated in cervical cancer cells,and USP22 could promote cell proliferation and inhibit chemosensitivity to cisplatin in cervical cancer cells.

Objective To systematically evaluate the clinical effect and safety of repaglinide and metformin for treating diabetes mellitus (MD) of secondary failure of sulfonylurea (SFS).Methods The randomized controlled trials (RCT) at home and abroad on the comparison of effect and safety of repaglinide and metformin in treating MD with SFS were retrieved.The modified Jadad scale was employed to evaluate the literature quality.The RevMan5.3.1 software was used for conducting the meta analysis.Results A total of 10 RCT were included.The meta-analysis results showed that compared with metformin for treating MA with SFS,repaglinide decreased the fasting blood glucose effectively (MD=-2.30,95 ％ CI:-2.53--2.06,P＜0.01),increased the fasting C-peptide (MD=0.06,95％CI:0.02-0.11,P=0.01),reduced the postprandial 2 h blood glucose (MD=-2.17,95 ％CI:-2.44-1.89,P＜0.01) and decreased glycosylated hemoglobin (MD=-2.60,95％CI:-3.21--2.00,P＜0.01) as well as the adverse reactions (RR=0.05,95％CI:0.02-0.09,P＜0.01).However,there was no statistical difference in fasting insulin between the repaglinide and metformin groups (MD=0.18,95％CI:-0.18-0.54,P=0.32).Conclusion Currently evidences suggest that repaglinide is superior to metformin for treating MD with SFS.

Objective To study the effect of human homologue of polycomb 2 (HPC2) on the growth of cervical cancer cells siha and the regulation of E7 gene.Methods HPC2 and E7 genes of siha cells were silenced by siRNAs respectively.Detected the expression of HPC2 gene and protein in siha cell lines after E7 gene silencing,cell proliferation activity and the rate of cell apoptosis.Results The expressions of HPC2 mRNA and protein were decreased in siha cells with E7 gene silencing,cell proliferation was inhibited,and apoptosis was increased,which was similar to HPC2 gene silencing.Conclusion HPC2 may be involved in the regulation of cell proliferation and apoptosis,and its expression may be closely related to E7 gene in SiHa cells.

Objective To evaluate the impact of warmed and humidified CO2 on the gynecological laparoscopic operation. Methods We searched keywords related to gynecological laparoscopic and CO2 pneumoperitoneum temperature and humidity on Pubmed and Wanfang database, then analyze the postoperative pain, analgesic consumption, core temperature, operation time, length of hospital stay. Results 17 publications included into the meta analysis after screening. Compared with the standard laparoscopy, warmed and humidified CO2 can reduce postoperative pain and prevent intraoperative hypothermia. No significant difference in postoperative analgesic consumption, postoperative core temperature, duration of recovery and hospital stay, endoscope lens fog and operation time. Conclusions Only few beneficial effects on postoperative pain and core temperature have been identified in this meta-analysis, though more studies are probably needed to study the real impact of warmed and humidified CO2 for laparoscopic procedures.

Objective To evaluate and compare the short-term effects of two kinds of plastic mulch on Oncomelania hupensis snail control in irrigation and drainage ditches with snails in Yunnan Province. Methods The irrigation and drainage ditches with high density of Oncomelania hupensis snails were chosen as the investigation sites,and then 4 groups were set,namely a colorless plastic mulch group,black plastic mulch group,colorless plastic mulch with molluscicide group and black plastic mulch with molluscicide group. The snail situation of the 4 groups was surveyed before the experiment and 7,14,21,30 days after covering plastic mulch,and the snail death rates were compared among the 4 groups. Meanwhile,the hourly temperatures of soil surface,soil surface under plastic mulch and soil layer 5,15 cm under the surface as well as the weather situation during the study period were measured and recorded. Results The average snail mortality rate of the colorless plastic mulch group was only 15.29% that was higher than that of the black plastic mulch group(6.56%)(P < 0.01). The average snail mortality rates of the colorless and black plastic mulch with molluscicide groups were 40.80% and 50.15%,respectively,and there was no statis-tic difference between them(P > 0.05). Both kinds of plastic mulches could raise the temperature of the soil surface under plas-tic mulch and the soil layer below it,and the temperature of soil under the mulches increased over the cover time,and the aver-age temperature of the soil surface under the black mulch in 30 days was higher than that under the colorless mulch. Conclu-sion It is not suitable to use plastic mulch only in irrigation and drainage ditches with snails widely in Yunnan Province be-cause of its low effect,and if necessary,the molluscicide should be added.