Background: Cervical cancer is the second most common cancer in women in China. The majority of cervical cancer patients are diagnosed in comprehensive hospital, which mostly are not equipped with afterloading radiation. Currently, a majority of the specialized tumor hospital are equipped with afterloading radiotherapy. We experience survivors who survive more than 10 years after afterloading combined with external radiotherapy at advanced stages, even rare cases survived more than 20 year after radiationtherapy with stage IIIB, yet we observed many cases who relapsed within 4 months after operation with stage IB2 or IIA2, which prompted us to study the reason for the differences of the treatment outcome. So we analyzed factors associated with the recurrence based on the 136 cases of cross-sectional data of squamous cervical cancer to improve the management and outcome of cervical cancer in the current practice of clinical care. Methods: A total of 136 cases of cross-sectional data of squamous cervical cancer recurrence were included in the study. The initial stages ranged from FIGO IB to IIIB. The differences among the relapse-free interval (RFI) of various clinical stages and treatment methods in squamous cervical cancer were analyzed. The differences among the RFIs of various clinical stages and treatment methods were analyzed using GraphPad Prism 6. Data were compared using two-tailed Student's t-test. Data were expressed as mean 6 S.D., and values with p < 0.05 were considered statistically significant. Results: The RFI of stage IB2 treated with surgery was shorter than that of IB1 treated with surgery (p value 0.0036), and of IIIB and IIB treated with chemoradiotherapy (p value 0.0031). The RFI of stages IB2 þ IIA1 þ IIA2 primarily treated with surgery were shorter than that of stage IB1 primarily treated with surgery, or of stages IIB -III primarily treated with chemoradiotherapy (p values 0.0434 and 0.0268 respectively). Conclusions: These data illustrated that primary chemoradiotherapy is superior to primary surgery to postpone the relapse for stages of IB2 to IIA2. Bulky cervical cancer be treated with chemoradiation be justified.

Background: Fluvoxamine may be beneficial for the management of coronavirus disease 2019 (Covid-19) because of its effect on the sigma-1 receptor. Available evidence from randomized clinical trials (RCTs) has shown conflicting results. Objective: This study sought to analyze the efficacy and safety of fluvoxamine as an outpatient treatment for Covid-19. Methods: Using specific keywords, we comprehensively go through the potential articles on PubMed, Scopus, Europe PMC, and ClinicalTrials.gov sources until February 1, 2023. We collected all published clinical trials on fluvoxamine and Covid-19. We were using Review Manager 5.4 to conduct statistical analysis. Results: We include a total of 6 trials. Our pooled analysis revealed that fluvoxamine did not offer any significant benefit when compared with placebo in reducing the risk of clinical deterioration (risk ratio [RR] = 0.83; 95% CI: 0.65-1.06, P = 0.14, I2 = 29%), and hospitalization (RR = 0.80; 95% CI: 0.62-1.04, P = 0.09, I2 = 0%) of Covid-19 outpatients. The serious adverse events did not differ significantly between the 2 groups. Conclusions and Relevance: This study indicates that although safe, fluvoxamine was not effective for outpatient treatment of Covid-19. Until more evidence can be obtained from larger RCTs, our study did not encourage the use of fluvoxamine as routine management for patients with Covid-19.

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Long-held assumptions of poor prognoses for patients with HM have meant that clinicians have been reluctant to admit them to the intensive care unit (ICU). However, over the past few years several centers across the world have shown that it is possible to achieve a meaningful survival in these patients. Methods: The aim of this study was to assess the characteristics and outcomes of patient with haematological malignancy admitted to the intensive care unit (ICU). We performed a retrospective cohort study among adult HM patients admitted to the ICU in Moewardi Hospital between January 2015 and December 2016. Medical history, physical and laboratory findings on admission, and therapeutic interventions during ICU stay were recorded. The study endpoint was ICU mortality. Results: Nineteen patients were admitted to ICU, the median age was 52 years (21-73), and 67% were female. The mean ICU length of stay was 3 days (SD 2.8). The main acute life-threatening diseases precipitating ICU transfer were septic shock (8 patients, 44%) and respiratory failure (5 patients, 28%). Acute Myeloid Leukemia (AML) was the main diagnosis in this study (39%). Most of these patients had anemia (72%) with the median of hemoglobin was 8.8 (3.9-12). Twenty eight percent of patients needed invasive mechanical ventilation and 60% of these died. ICU mortality was 50%. Conclusions: Patients admitted to ICU with HM have high mortality. Early recognition of critical illness is required to enable prompt referral of patients who may benefit from critical care. Multicenter outcome studies on patients with HM who require ICU admission are needed.