Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

AIM To study the phenylethanoid glycosides from Verbenae Herba.METHODS The 80%ethanol extract from Verbenae Herba was isolated and purified by silica gel,Sephadex LH-20,TLC and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Nine compounds were isolated and identified as verbofficoside A(1),cistanoside D(2),epimeredinoside A(3),verbascoside(4),isoverbascoside(5),cistanoside C(6),cistanoside F(7),decaffeoylacteoside(8),jionoside C(9).CONCLUSION Compound 1 is a new compound.Compounds 3 and 6-9 are isolated from this plant for the first time.

Objective To investigate the relationship between serum lipid profiles and colorectal adenomas,and to benefit the prevention of colorectal cancer.Methods This study retrospectively analyzes the serum lipid profiles and clinical parameters of 2,960 patients who were diagnosed with colorectal adenomas,and 3,156 individuals without colorectal adenomas in Meizhou People's Hospital from May 2018 to May 2020.The association between serum lipid profiles and colorectal adenoma was evaluated by Logistic regression analysis.Results It was observed that the serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and apoliprotein B(ApoB)were significantly elevated in patients with colorectal adenomas.Dyslipidemia was more prevalent in adenoma cases than in controls.The Logistic regression analysis suggested that serum TC and TG levels were positively associated with the occurrence of colorectal adenomas.Conclusion Elevated serum TG and TC levels are independent risk factors for adenoma,and adenoma patients with elevated serum TG and TC levels may be more likely to develop high-risk adenoma.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Thyroid cancer is the most common malignant tumor of the head and neck, among which papillary thyroid carcinoma is the most common. Papillary thyroid carcinoma with a diameter of ≤ 1.0 cm is called thyroid micropapillary carcinoma. In recent years, thermal ablation technology for the treatment of thyroid micropapillary carcinoma has developed rapidly at home and abroad. At present, many guidelines, consensus and clinical studies related to thermal ablation treatment of thyroid micropapillary carcinoma have been published at home and abroad. Based on the existing literature, guidelines and clinical studies, this article summarizes, discusses and analyzes the advantages, indications, efficacy, safety, and existing problems of thermal ablation therapy for thyroid cancer.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

AIM To investigate the clinical effects of Lingxian Tongluo Capsules combined with Wentong Acupuncture Method on patients with lumbar disc herniation.METHODS One hundred and four patients were randomly assigned into control group(52 cases)for 30-day intervention of both Wentong Acupuncture Method and conventional treatment,and observation group(52 cases)for 30-day intervention of Lingxian Tongluo Capsules,Wentong Acupuncture Method and conventional treatment.The changes in clinical effects,TCM syndrome scores,lumbar function indices(ODI index score,JOA score),VAS score,inflammatory factors(TNF-α,IL-1β,IL-6),hemorheological indices(plasma viscosity,whole blood high-shear viscosity,whole blood low-shear viscosity)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,ODI index score,VAS score,inflammatory factors and hemorheological indices(P＜0.05),and increased JOA score(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with lumbar disc herniation,Lingxian Tongluo Capsules combined with Wentong Acupuncture Method can safely and effectively relieve clinical symptoms,promote lumbar function recovery,reduce pain degree,alleviate inflammatory responses,and improve hemorheology.

Objective　To explore the application of time series models based on meteorological factors in the population density of Aedes albopictus in Hainan Province, and to provide a scientific basis for the prevention and control of dengue fever in Hainan Province. Methods　The density of Aedes albopictus in different habitats in 18 cities and counties of Hainan Province from 2017 to 2022 was monitored monthly using the double-mosquito net trapping index and the Breteau index. Mann-Kendall trend test was used to analyze the temporal trends of the two density indices; Spearman's correlation analysis was employed to assess the correlation strength between each meteorological factor and the two indexes, eliminating unrelated variables, and further selecting the final variables through the full-subset regression method. Three time-series models were constructed for the two density indices, with root mean square error (RMSE), mean absolute error (MAE), and other accuracy metrics used to determine the optimal model; predictions for the density indices for 2023-2024 were made. All statistical analyses were performed in R (4.3.1). Results　The net trapping and Breteau indices showed an overall decrease over the years (Z-values of Mann-Kendall trend test were -6.15 and -4.03, respectively, and P<0.05). The meteorological factor most strongly associated with the trap index was the monthly average minimum temperature; monthly mean minimum temperature and monthly mean relative humidity were strongly correlated with the Breteau index. Based on various evaluation indicators, the multivariate time series model demonstrated the highest accuracy. The study predicts one to two peaks in both the trap index and Breteau Index for the years 2023 and 2024, with peak periods occurring between June to September and May to September, respectively. The predicted value for 2023 aligns with the measured value, demonstrating outstanding predictive accuracy. Conclusions　This study has introduced meteorological factors into the seasonal time series model, allowing for more accurate predictions of the density of Aedes albopictus in Hainan Province from 2023 to 2024, providing a model framework for the prevention and control of dengue fever in Hainan Province.

Abstract: Objective　To explore the tolerance of Aedes albopictus to typical insecticides and mutations in its knockdown resistance (kdr) and acetylcholinesterase number one (ace-1) genes in Hainan Province. Methods　Ae. albopictus larvae were collected from Danzhou, Sanya, Qiongzhong, Qionghai, Changjiang, and Wanning in Hainan Province in 2020 and 2021 to assess their resistance to 10 insecticides. Surviving samples from the resistance tests were examined for mutations in genes encoding acetylcholinesterase (AChE) and voltage-gated sodium channel (VGSC) using DNA Sanger sequencing. Results　The 24-hour corrected mortality rates of adult Ae. albopictus in different areas of Hainan to deltamethrin (0.03%), permethrin (0.40%), Beta-cypermethrin (0.40%), Beta-cypermethrin (0.08%), and lambda-cyhalothrin (0.07%) ranged from 5.56% to 83.33%, 29.89% to 92.22%, 26.67% to 97.78%, 11.11% to 88.89%, and 40.00% to 83.33%, respectively. The mortality rates after 24-hour exposure to propoxur (0.05%), bendiocarb (0.20%), malathion (0.50%), fenitrothion (0.20%), and chlorpyrifos (2.00%) ranged from 94.89% to 100.00%, among which the Ae.albopictus population from Changjiang showed a mortality rate of 97.78% to propoxur, and populations from Sanya, Wanning, and Qionghai showed mortality rates of 94.89%, 96.67%, and 96.67% to malathion respectively. The mortality rate of Ae.albopictus populations in Sanya and Qionghai to fenitrothion was 97.78%, while in other populations, it was 100.00%. Sequencing results showed that the kdr gene exhibited a mutation solely at locus 1534, featuring four alleles: wild-type TTC/F and the mutant types TGT(TGC)/C, TCC/S, and TTG/L with the mutation frequencies of 40.47%, 22.25%, 36.44%, and 0.85%, respectively. There are seven types of these mutations: wild-type homozygotes F/F, wild-type/mutant heterozygotes F/C, F/S, and F/L, mutant heterozygotes S/C, and wild-type homozygotes C/C and S/S, with mutation frequencies of 19.92%, 6.78%, 32.63%, 1.69%, 11.44%, 13.14%, and 14.41%, respectively. Notably, No related amino acid mutations were detected at position 119 of the ace-1 gene. Conclusions　The Ae.albopictus populations in various areas of Hainan Province have developed a high resistance to pyrethroid insecticides such as deltamethrin, permethrin, beta-cypermethrin, and beta-cyfluthrin, but are sensitive or possibly resistant to carbamates and organophosphates insecticides. The resistance gene mutations mainly occur at position 1 534 of the kdr gene, suggesting that its mutation frequency could be a significant factor contributing to resistance in Ae. albopictus in Hainan.

Abstract: Objective　To understand the level of Aedes aegypti resistance in Hainan and to provide a reference for developing local preventive and control measures against the dengue vector Ae. aegypti. Methods In 2020, Aedes aegypti larvae and pupae were collected from Danzhou and Changjiang in Hainan Province and reared to the first filial generation (F1). The adult mosquito contact tube method was used to determine the resistance of Aedes aegypti to commonly used insecticides. The allele-specific PCR (AS-PCR) was used to detect the mutations in V1016G and F1534C knockdown resistance (kdr) gene in Aedes aegypti. Results There was no significant difference in the knockdown rate of Ae. aegypti from Changjiang and Danzhou after 1 hour of exposure to four pyrethroids insecticides, namely deltamethrin (0.03%), permethrin (0.40%), beta-cypermethrin (0.04%) and lambda-cyhalothrin (0.02%). However, the 24-hour mortality rates of Ae. aegypti from Changjiang and Danzhou city were 95.56%, 85.56%, 81.11%, 48.89% and 94.44%, 68.60%, 61.11%, 30.00%, respectively. Except for deltamethrin (0.03%), the other differences were statistically significant. Aedes aegypti in Changjiang showed 100.00% mortality to propoxur (0.03%) and bendiocarb (0.20%), while in Danzhou, these rates were 100.00% and 98.89%, respectively. Ae. aegypti both from Changjiang and Danzhou showed 100.00% mortality to malathion (1.50%) and chlorpyrifos (0.80%), and mortality rates to 0.25% fenthion were 100.00% and 98.89%, respectively. V1016G and F1534C mutations were found in Ae. aegypti from Danzhou and Changjiang with mutation frequencies of 12.50% (20/160) and 97.50% (156/160), showing significant differences (χ2=233.54, P<0.001). In Changjiang, Aedes aegypti exhibited both V1016G and F1534C mutations with frequencies of 20.00% and 100.00%, respectively, whereas in Danzhou, only F1534C mutations occurred with a frequency of 98.75%. Conclusions Ae. aegypti in Hainan Province exhibited varying levels of resistance to four insecticides: deltamethrin, permethrin, beta-cypermethrin, and lambda-cyhalothrin, but showed sensitivity to propoxur, bendiocarb, malathion, and chlorpyrifos. The primary knockdown resistance gene mutation was F1534C.