Abstract:Objective To explore the clinical effect of Yifei Qinghua ointment combined with TP chemo-therapy regimen in the treatment of patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 96 patients with advanced NSCLC who were treated in Shanxi Cancer Hospital from January 2023 to September 2024 were selected.According to the random number table method,they were divided into the control group and the observation group,with 48 cases in each group.The control group was treated with TP chemotherapy regimen(paclitaxel and cisplatin)by intravenous drip,and the observation group was treated with Yifei Qinghua ointment orally on the basis of the control group,21 d as a course of treatment.Patients in both groups were treated for 2 consecutive courses.The efficacy,serum tumor markers,immune function indexes and adverse reactions were compared between the two groups.Results The disease control rate and objective remission rate of the observation group were higher than those of the control group[70.8％(34/48)vs 45.8％(22/48),41.7％(20/48)vs 20.8％(10/48)](both P＜0.05).After treatment,the levels of cytokeratin 19 fragment antigen,carcinoembryonic antigen and neuron specific enolase in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the natural killer cells,CD3+,CD4+and CD4+/CD8+ratio of the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group,and the CD8+ratio was lower than that before treatment,and that in the observation group was lower than that in the control group(all P＜0.05).The incidences of bone marrow suppression,digestive tract reaction and alopecia in the observation group were lower than those in the control group[6.2％(3/48)vs 22.9％(11/48),10.4％(5/48)vs 37.5％(18/48),20.8％(10/48)vs 54.2％(26/48)](all P＜0.05).Conclusion On the basis of TP chemotherapy regimen,Yifei Qinghua ointment can enhance the immunity of patients with advanced NSCLC,improve the anti-tumor effect,significantly reduce the levels of serum tumor markers and reduce adverse reactions,indicating that integrated traditional Chinese and western medicine treatment has unique advantages in"increasing efficiency and reducing toxicity".

Abstract:Objective To investigate the clinical effect and safety of Yinhuang Qingfei capsules combined with ambroxol hydrochloride aerosol inhalation in the treatment of acute attack of chronic bronchitis.Methods A total of 96 patients with acute attack of chronic bronchitis treated in Yan'an University Affiliated Hospital from June 2022 to November 2024 were selected,and they were divided into control group and observation group according to the random number table method,with 48 cases in each group.Patients in the control group were treated with aerosol inhalation of ambroxol hydrochloride on the basis of antimicrobial agent,2-3 ml/time,1-2 times/d.The observation group was treated with Yinhuang Qingfei capsules oral on the basis of the control group,3 capsules/time,3 times/d.Both groups were treated continuously for 7 d.The total clinical effective rate,the improvement time of clinical symptoms,blood gas analysis indexes before and after treatment,serum inflammatory factor levels,and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group[95.8％(46/48)vs 81.2％(39/48)](P=0.025).After treatment,the relief times of cough,expectoration,wheezing and wheezing sound in the observation group were significantly shorter than those in the control group(all P＜0.05).After treatment,the levels of arterial partial pressure of oxygen(PaO2)and arterial oxygen saturation(SaO2)in the two groups were significantly higher than those before treatment,while the levels of arterial partial pressure of carbon dioxide(PaCO2)were significantly lower than those before treatment;at the same time,the levels of PaO2 and SaO2 in the observation group were significantly higher than those in the control group,while PaCO2 was significantly lower than that in the control group(all P＜0.05).After treatment,the serum levels of tumor necrosis factor-α,interleukin-6,interleukin-8 and C-reactive protein in the two groups were significantly lower than those before treatment,and the serum levels of inflammatory factors in the observation group were significantly lower than those in the control group after treatment(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the control group and the observation group[8.3％(4/48)vs 4.2％(2/48)](P=0.672).Conclusion Yinhuang Qingfei capsules combined with ambroxol hydrochloride aerosol inhalation in the treatment of acute attack of chronic bronchitis shows significant clinical effect,can improve clinical symptoms and blood gas analysis indicators,inhibit inflammatory response,and has high drug safety.

Abstract:Objective To compare the clinical efficacy and safety of the VDPAP regimen(vincristine+daunorubicin+pegaspargase+prednisone)and the VDLP regimen(vincristine+daunorubicin+L-asparaginase+prednisone)in the treatment of children with acute lymphoblastic leukemia(ALL).Methods A total of 146 children with ALL who received chemotherapy at Hainan General Hospital from March 2019 to March 2024 were enrolled.They were divided into a control group and an observation group using a random number table,with 73 cases in each group.The control group was treated with the VDLP regimen,while the observation group was treated with the VDPAP regimen.The treatment response rate,blood routine parameters[white blood cell count(WBC),platelet count(PLT),red blood cell count(RBC),and hemoglobin],coagulation function indices[activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT),and fibrinogen(FIB)],fibrinolytic indices[plasminogen,tissue-type plasminogen activator(t-PA),plasminogen activator inhibitor-1(PAI-1),and fibrin degradation products(FDP)],serum inflammatory factors[interleukin-6(IL-6),IL-8,high-sensitivity C-reactive protein(hs-CRP),and interferon-γ],serum tumor-specific growth factor(TSGF),vascular endothelial growth factor(VEGF),and incidence of adverse reactions were compared between the two groups.Results There was no statistically significant difference in the treatment response rate between the two groups(P＞0.05).After treatment,the levels of PLT,RBC,APTT,t-PA,PAI-1,and interferon-γ in the observation group were significantly higher than those in the control group,while the levels of WBC,FIB,IL-6,IL-8,hs-CRP,TSGF,and VEGF were significantly lower than those in the control group(all P＜0.05).The incidence of allergies in the observation group was significantly lower than that in the control group[1.4％(1/73)vs 11.0％(8/73)](P＜0.05).Conclusion Both the VDLP and VDPAP regimens are effective in the treatment of children with ALL.Compared with the VDLP regimen,the VDPAP regimen can improve blood routine parameters,inhibit the inflammatory response,and downregulate the serum levels of TSGF and VEGF,with higher safety.However,the VDPAP regimen has a more significant impact on the coagulation function and fibrinolytic indices of children with ALL,so clinicians should select an appropriate regimen based on the children's specific conditions.

Abstract:Objective To investigate the relationship between D-dimer to fibrinogen ratio(DFR),fibrinogen to albumin ratio(FAR)and the outcome of fetal protection in patients with recurrent spontaneous abortion(RSA).Methods A total of 100 patients with RSA in the First Affiliated Hospital of Zhengzhou University from May 2022 to November 2024 were selected as the observation group,and 100 healthy pregnant women in the same period were selected as the control group according to 1∶1 matching.The DFR and FAR of the two groups were compared,and the clinical data,DFR and FAR of patients with different tocolysis outcomes in the observation group were compared.Logistic regression was used to analyze the influencing factors of tocolysis outcomes in RSA patients,and restricted cubic spline was used to analyze the nonlinear relationship between DFR,FAR and tocolysis outcomes in RSA patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of DFR and FAR for the outcome of RSA.Results The DFR and FAR of the observation group were higher than those of the control group[(0.29±0.06)vs(0.15±0.04),(0.25±0.05)vs(0.12±0.03)](t=19.415,22.295,both P＜0.05).The previous history of induced abortion,the proportion of abortion times＞3,DFR and FAR of patients with failed tocolysis were higher than those of patients with successful tocolysis,and the proportion of more previous abortion time was lower than that of patients with successful tocolysis(all P＜0.05).Before and after propensity score matching method was used to adjust the variables such as previous history of induced abortion,number of abortions,and time of tocolation,Logistic regression analysis showed that DFR and FAR were the influencing factors of tocolation outcome in RSA patients(both P＜0.05).The levels of DFR and FAR had a nonlinear relationship with the risk of failed tocolysis in RSA patients(both P＜0.05).When DFR≥0.25 and FAR≥0.20,the risk of failed tocolysis in RSA patients increased with the increase of DFR and FAR levels(both P＜0.05).The results of ROC analysis showed that the area under the curve of DFR,FAR alone and in combination to predict the tocolysis outcomes in RSA patients was 0.752,0.745 and 0.881,respectively.Conclusion DFR and FAR have a nonlinear relationship with the outcome of fetal protection in RSA patients.When DFR≥0.25 and FAR≥0.20,the risk of fetal protection failure in RSA patients increases,and the two can be used to assist in evaluating the outcome of fetal protection in patients.

Abstract:Objective To explore the risk factors of thrombosis in patients with essential thrombocythemia(ET)and to construct a visual risk prediction model.Methods The clinical data of 156 ET patients admitted to Xiyuan Hospital,China Academy of Chinese Medical Sciences from January 2022 to December 2024 were retro-spectively analyzed.According to the presence or absence of thrombosis,the patients were divided into thrombosis group(44 cases)and non-thrombosis group(112 cases).Univariate and multivariate Logistic regression methods were used to analyze the risk factors of thrombosis,and a risk prediction model was constructed.Results The proportion of age ≥60 years,hypertension and hyperlipidemia,JAK2 mutation,white blood cell count,neutrophil count(NEUT),and neutrophil-to-lymphocyte ratio in the thrombosis group were significantly higher than those in the non-thrombosis group(all P＜0.05).Multivariate Logistic regression analysis showed that age ≥ 60 years(odds ratio=3.08,95％confidence interval:1.20-7.92),splenomegaly(odds ratio=3.04,95％confidence interval:1.06-8.71),hyperlipidemia(odds ratio=3.06,95％confidence interval:1.20-7.80)and high NEUT(odds ratio=1.35,95％confidence interval:1.20-1.52)were independent risk factors for thrombosis in ET patients(all P＜0.05).Based on the results of multivariate Logistic regression analysis,a nomogram model was constructed to predict the risk of thrombosis in ET patients.The area under the receiver operating characteristic curve was 0.922(95％confidence interval:0.834-0.971),the specificity was 81.3％,the sensitivity was 93.2％,and the Youden index was 0.744.The Hosmer-Lemeshow goodness of fit testx2=6.32,P=0.612.The calibration curve showed that the predicted probability of the model was in good agreement with the observed frequency.Conclusion Elevated NEUT,age ≥60 years,hyperlipidemia and splenomegaly are independent risk factors for thrombosis in ET patients.The nomogram model based on these factors has a good predictive ability and can be used as an important tool for thrombosis risk stratification and clinical decision-making in ET patients.

Abstract:Objective To investigate the clinical application value of magnetically controlled capsule endoscopy in patients with antithrombotic therapy.Methods The clinical data of 1 215 patients who underwent magnetically controlled capsule endoscopy at the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from January 2019 to December 2023 were retrospectively analyzed.The patients were divided into antithrombotic therapy group(413 cases)and control group(802 cases,without antithrombotic drugs)according to whether they took antithrombotic drugs or not.The general data and endoscopic findings were compared between the two groups and between the patients with gastrointestinal bleeding.Results The proportion of gastrointestinal bleeding in the antithrombotic therapy group was significantly higher than that in the control group[49.4％(204/413)vs 6.1％(49/802)],and the proportions of overt bleeding and occult bleeding were also higher than those in the control group(all P＜0.001).The proportions of gastric ulcer,small intestinal ulcer,jejunoileum ulcer,modified Lanza score of gastric mucosal injury and grading score of small intestinal mucosal injury in antithrombotic therapy group were significantly higher than those in control group(all P＜0.05).The proportion of small intestinal bleeding,Lanza score of gastric mucosal injury and small intestinal mucosal injury grading score in antithrombotic therapy group were significantly higher than those in control group[52.0％(106/204)vs 18.4％(9/49),2.0(1.0,4.0)vs 1.0(1.0,2.0),2.0(1.0,4.0)vs 1.0(1.0,2.0)](all P＜0.05).The proportion of oral proton pump inhibitors in the antithrombotic therapy group was significantly higher than that in the control group[27.0％(55/204)vs 6.1％(3/49)](P＜0.001).Conclusion Gastric and small intestinal mucosal injuries were significantly increased in patients with antithrombotic therapy compared with those without antithrombotic therapy.The proportion of small intestinal bleeding in bleeding patients increased signifi-cantly.Magnetically controlled capsule endoscopy can be used to observe gastric and small intestinal mucosal injury and lesions in patients with antithrombotic therapy.

Abstract:Magnetocardiography is a high-precision,non-invasive,non-contact detection and analysis technique for magnetic field signals of cardiac electrical activity.Compared with conventional electrocardiography,magnetocardiography has higher temporal and spatial resolution and is not interfered by heterogeneous conduction of human tissues,which can more directly reflect the real electrical activity of cardiomyocytes.In recent years,with the advancement of detection technology and signal analysis methods,magnetocardiography has shown unique value in the mechanistic research,clinical diagnosis,lesion localization,evaluation of therapeutic effect and prognosis of arrhythmias,as well as screening for fetal arrhythmias.This article systematically reviews the physical principles and examination methods of magnetocardiography,focuses on its latest application progress in arrhythmias.Meanwhile,it analyzes the current technical challenges and clinical limitations of magnetocardiography,and prospects its future development directions.

Abstract:Objective To explore how to help trainees quickly master the technique of tri-arm clip for wound closure after endoscopic submucosal dissection(ESD)of colorectal lesions.Methods Eight trainees who received standardized ESD training in the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from September 2024 to September 2025 were selected as subjects.A stepwise training model including theoretical lectures,video teaching,on-site observation,animal model practice and hands-on tutoring was adopted.The ability of trainees to independently complete wound closure with tri-arm clips was evaluated.The operation time of wound closure using tri-arm clips combined with ordinary metal clips and the incidence of postop-erative complications such as bleeding,perforation and infection were recorded.After training,questionnaires were used to collect trainees' evaluation and feedback.Results A total of 8 trainees were enrolled and all completed the whole stepwise training process.All trainees could independently complete wound closure with tri-arm clips after ESD.The diameter of the included wounds was(21±8)mm,and the average operation time for trainees to complete wound closure with tri-arm clips combined with ordinary metal clips was(20±11)min.No postoperative complications such as bleeding,perforation or infection occurred in any patient.All trainees reported that the training effect was significant,and the tri-arm clip wound closure technique could effectively improve their ability to manage wounds after ESD.The overall value score of the training in the Likert scale questionnaire was(4.8±0.5).Conclusion The stepwise training model can help trainees quickly master the tri-arm clip wound closure technique after endoscopic surgery.Tri-arm clip is efficient and safe for ESD wound closure,especially suitable for wounds with large area,special anatomical location,intraoperative muscular layer injury or suspected perforation,and high bleeding risk.

Abstract:Objective To investigate the predictive value of plasma platelet factor 4(PF4)and chemokine CX3C receptor 1(CX3CR1)for deep vein thrombosis(DVT)after cesarean section in patients with severe preeclampsia.Methods A total of 302 patients with severe preeclampsia who underwent cesarean section at Shanxi Children's Hospital from March 2020 to December 2024 were prospectively enrolled.According to the occurrence of DVT within 2 weeks after operation,the patients were divided into DVT group(72 cases)and non-DVT group(230 cases).Plasma levels of PF4 and CX3CR1 were measured preoperatively in all patients,and clinical data as well as laboratory indicators including fibrinogen and D-dimer were collected and compared.Pearson correlation analysis method was used to analyze the correlation of PF4 and CX3CR1 with fibrinogen and D-dimer.Multivariate Logistic regression analysis was performed to identify the risk factors of DVT after cesarean section in patients with severe preeclampsia.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of PF4 and CX3CR1 for postoperative DVT.Results Body mass index,proportion of gesta-tional diabetes mellitus,proportion of prolonged bed rest for fetal preservation,fibrinogen and D-dimer levels in DVT group were significantly higher than those in non-DVT group(all P＜0.05).Plasma levels of PF4 and CX3CR1 in DVT group were significantly higher than those in non-DVT group[(6.3±1.9)μg/L vs(3.0±0.7)μg/L,(82±16)ng/L vs(43±10)ng/L](t=22.274,25.139,both P＜0.001).Plasma levels of PF4 and CX3CR1 were positively correlated with fibrinogen and D-dimer in DVT group(all P＜0.001).Multivariate Logistic regression analysis showed that gestational diabetes mellitus,high body mass index,high PF4 and high CX3CR1 were independent risk factors for DVT after cesarean section in patients with severe preeclampsia(all P＜0.05).The area under the curve(AUC)of PF4 and CX3CR1 alone for predicting postoperative DVT was higher than that of gestational diabetes mellitus and body mass index,respectively,and the AUC of the combined prediction of PF4 and CX3CR1 was higher than that of each single indicator(all P＜0.05).Conclusions High preoperative plasma levels of PF4 and CX3CR1 are associated with the occurrence of postoperative DVT in patients with severe preeclampsia.The combination of PF4 and CX3CR1 has high value in predicting the risk of postoperative DVT.

Abstract:Metabolic-associated fatty liver disease(MAFLD)is the most common chronic liver disease worldwide,and Helicobacter pylori(Hp)is a highly prevalent intragastric colonizing bacterium.The correlation between their comorbidity has become a research hotspot.Several meta-analyses have confirmed a positive correla-tion between MAFLD and Hp infection.Basic and clinical studies suggest that Hp can aggravate MAFLD by inducing inflammatory response and insulin resistance.Early eradication of Hp can improve metabolic and inflam-matory status as well as hepatic steatosis in patients with MAFLD.Studies on traditional Chinese medicine(TCM)constitutions have confirmed that damp-heat constitution and phlegm-damp constitution are the common susceptible constitutions for both diseases.The core pathogenesis of spleen failing in transportation,damp-heat and phlegm-turbidity in comorbid patients provides a two-way confirmation of"pathogenesis-mechanism"with modern medical mechanisms.Therefore,Hp eradication therapy is expected to be a potential intervention strategy to delay the progression of MAFLD,and research on TCM constitutions of comorbid patients also provides a new direction for formulating individualized integrated TCM and western medicine diagnosis and treatment plans and improving the prevention and treatment level of comorbidity.

Abstract:Pulsed field ablation(PFA)is a non-thermal catheter ablation technique based on irreversible electroporation.With its unique tissue selectivity and safety,PFA has become a research hotspot in the field of arrhythmia treatment.This technology induces irreversible perforation of myocardial cell membranes through high-frequency electric pulses,and achieves targeted myocardial ablation while avoiding damage to adjacent tissues by utilizing the difference in tolerance thresholds to pulsed electric fields between myocardial cells and other tissues(such as blood vessels,nerves,and esophagus).Systematically summarizing the research progress of PFA plant models is crucial for clarifying the biophysical mechanism of PFA,optimizing pulse parameters and ablation strate-gies,and preventing potential complications.This article reviews the research progress of PFA plant models,aiming to provide a theoretical basis for the clinical translation and application expansion of this technology.

Abstract:Polycystic ovary syndrome(PCOS)is a common reproductive endocrine and metabolic disorder disease in women of childbearing age.Its etiology and pathophysiological mechanism have not been fully elucidated,and clinical management is challenging.In recent years,studies on the interaction between intestinal flora and host metabolism and endocrine have provided a new perspective for revealing the etiology and pathogenesis of PCOS.Intestinal flora may participate in the occurrence and development of PCOS through various pathways such as affecting intestinal barrier function,hormone metabolism,short-chain fatty acid production and inducing chronic inflamma-tion.Correspondingly,intervention strategies targeting intestinal microecological regulation(such as dietary intervention,prebiotics,probiotics and natural polyphenols)have shown potential in improving PCOS symptoms,which has been supported by preliminary evidence from animal experiments and initial clinical studies.This article systematically reviews the mechanism of intestinal flora dysbiosis in PCOS and the research progress of prevention and treatment strategies based on intestinal microecological regulation,aiming to provide theoretical reference and ideas for the development of new strategies for PCOS prevention and treatment.

Abstract:Ischemia-reperfusion injury(IRI)is a key bottleneck in the clinical treatment of major diseases such as acute myocardial infarction,stroke and organ transplantation.Traditional theories hold that IRI is mainly mediated by oxidative stress and is a passive process of tissue damage.However,with the advancement of molecular biological techniques,the diversity and complexity of programmed cell death(PCD)have been gradually revealed.Current studies have confirmed that cell death during IRI is not mediated through a single pathway,but rather involves a pathological process regulated by multiple modes of cell death,including apoptosis,necroptosis,pyroptosis,ferroptosis,autophagy,panoptosis,cuproptosisand disulfidptosis.This paper systematically reviews the core molecular mechanisms and potential targeted intervention strategies of the above PCD modes in IRI,aiming to deeply analyze the pathological essence of IRI and provide a theoretical basis for optimizing clinical prevention and treatment plans and improving patient prognosis.

Abstract:Lupus nephritis(LN)is the most severe and common end-organ manifestation of systemic lupus erythematosus.Renal involvement occurs in 35％-60％of patients,and at least 20％of patients with LN progress to chronic kidney disease.Due to its complex pathogenesis,the therapeutic effect of LN is unsatisfactory.Traditional treatment regimens based on glucocorticoids and broad-spectrum immunosuppressants have problems such as insufficient response,high recurrence rate and long-term toxicity.In recent years,based on the in-depth understanding of the immune pathogenesis of LN,a variety of novel biological agents and small-molecule drugs targeting specific pathways are in the late stage of research and development.In randomized controlled trials,all these drugs combined with standard treatment are superior to standard treatment alone in achieving renal response,bringing new hope for the treatment of LN.This article systematically reviews the latest progress in biological targeted therapy for LN.

Abstract:Objective To explore the effects of Tongdu Tiaofu method combined with Zaoren Ningshen capsules on arousal level and serum melatonin content in insomnia patients with heart-spleen deficiency syndrome.Methods A total of 96 insomnia patients treated at Shanxi Traditional Chinese Medical Hospital from September 2024 to September 2025 were selected as research subjects.Patients were divided into control group and observation group according to random number table method,with 48 cases in each group.The control group was treated with Zaoren Ningshen capsules,and the observation group was additionally treated with Tongdu Tiaofu method on the basis of the control group.The therapeutic effects,scores of traditional Chinese medicine(TCM)syndrome scale,Pittsburgh Sleep Quality Index(PSQI),Athens Insomnia Scale(AIS),Hyperarousal Scale(HAS),Hamilton Anxiety Scale(HAMA)before treatment,2 weeks after treatment,4 weeks after treatment and 4 weeks after the end of treatment,as well as serum levels of melatonin,cortisol,vasoactive intestinal peptide(VIP)and orexin A before and after treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.8％(46/48)vs 81.2％(39/48)](x2=5.031,P=0.025).At 2 weeks after treatment,4 weeks after treatment and 4 weeks after the end of treatment,TCM syndrome scores,PSQI,HAS and AIS scores in the observation group were significantly lower than those in the control group(all P＜0.05).At 4 weeks after treatment and 4 weeks after the end of treatment,HAMA scores in the observation group were significantly lower than those in the control group(both P＜0.05).After treatment,melatonin levels in both groups were higher than those before treatment,and the observation group was higher than the control group;levels of cortisol,VIP and orexin A in both groups were lower than those before treatment,and the observa-tion group were lower than the control group(all P＜0.05).Conclusion Tongdu Tiaofu method combined with Zaoren Ningshen capsules has definite efficacy in the treatment of insomnia with heart-spleen deficiency syndrome.It can effectively improve patients' TCM syndromes,sleep quality and anxiety state,regulate the body's arousal level,and exert therapeutic effects by affecting serum levels of related hormones and neuropeptides.

Abstract:Objective To investigate the effect of modified Ponseti technique combined with external application of Chinese herbs for"promoting blood circulation and removing blood stasis,relaxing sinews and activating collaterals"on skin complications during the casting period in children with clubfoot.Methods A total of 80 children with clubfoot treated at the First Affiliated Hospital of Xinjiang Medical University from January 2022 to January 2025 were enrolled.The children were randomly divided into control group and observation group by random number table method,with 40 cases in each group.According to the dropout criteria,3 cases dropped out in each group,and 37 cases were finally included in each group.The control group received traditional Ponseti technique with vaseline gauze for skin protection,and the observation group was treated with modified Ponseti technique combined with external application of traditional Chinese medicine gel patches.The incidence of skin complications,skin condition,pain level,transforming growth factor-β1(TGF-β1),interleukin-6(IL-6),microcirculation evaluation,biomechanical monitoring and curative effect were compared between the two groups.Results The total incidence of skin complications in the observation group was significantly lower than that in the control group[8.1％(3/37)vs 40.5％(15/37)](x2=10.571,P=0.001).After treatment,the Braden Q scores in both groups were higher than those before treatment,and the score in the observation group was higher than that in the control group;the faces,legs,activity,cry,and consolability scale scores in both groups were lower than those before treatment,and the score in the observation group was lower than that in the control group(all P＜0.05).TGF-β,in both groups showed a continuous increasing trend before treatment,at 4 weeks of treatment and at cast removal;IL-6 in the control group showed a trend of first increasing and then decreasing,while that in the observation group showed a continuous decreasing trend;at 4 weeks of treatment and at cast removal,TGF-β1 in observation group were higher than those in the control group,and IL-6 were lower than those in the control group(all P＜0.05).After treatment,the blood perfusion in both groups was higher than that before treatment,and that in the observation group was higher than that in the control group;the contact pressure,shear force and pressure-time integral in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).The total effective rate of the observation group was significantly higher than that of the control group[94.6％(35/37)vs 75.7％(28/37)](x2=5.234,P=0.022).Conclusion Modified Ponseti technique combined with external application of traditional Chinese medicine gel patches for"promoting blood circulation and removing blood stasis,relaxing sinews and activating collaterals"can significantly reduce the incidence of skin complications during cast fixation in children with clubfoot,relieve skin pain,improve skin condition and significantly increase the total effective rate.Its mechanism is related to improving microcirculation,regulating inflammatory repair balance and optimizing biomechanical environment.

Abstract:Objective To investigate the therapeutic effect of Shexiang Baoxin Pills combined with nicorandil on patients with coronary slow flow(CSF)and its influence on vascular endothelial function and levels of inflammatory factors.Methods A total of 100 CSF patients admitted to the Department of Cardiovascular Medicine,the Third People's Hospital of Hubei Province from June 2023 to December 2024 were selected as subjects.Patients were divided into control group and observation group by random number table method,with 50 cases in each group.The control group was treated with conventional basic drugs and nicorandil tablets;the observation group was additionally given Shexiang Baoxin pills on the basis of the control group.Both groups were treated for 6 months.Clinical efficacy,corrected TIMI frame count(CTFC)of main coronary branches,serum vascular endothelial function indexes,serum inflammatory factor indexes and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[96.0％(48/50)vs 84.0％(42/50)](x2=4.000,P=0.046).After treatment,the CTFC of main coronary branches in both groups was lower than that before treatment,and those in the observation group were significantly lower than those in the control group(all P＜0.05).After treatment,the serum endothelin-1 level in both groups was lower than that before treatment,and that in the observation group was lower than that in the control group;the nitric oxide level was higher than that before treatment,and that in the observation group was higher than that in the control group(all P＜0.05).After treatment,serum inflammatory factor indexes in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(x2=0.122,P=0.727).Conclusion Shexiang Baoxin pills combined with nicorandil has a definite effect in the treatment of CSF,which can regulate blood flow velocity of main coronary branches,improve vascular endothelial function,inhibit inflammatory response,and has high safety.

Abstract:Objective To investigate the diagnostic efficacy of multicolor probe melting curve analysis(MMCA)for drug resistance to six antituberculosis drugs,and to explore the influencing factors and predictive value of multidrug-resistant pulmonary tuberculosis(MDR-TB).Methods A total of 1 724 patients suspected to be tuberculosis who were hospitalized and treated in Hebei Chest Hospital from January 2024 to March 2025 were enrolled as study subjects.Early morning sputum samples were collected for Mycobacterium tuberculosis(MTB)culture,and 574 samples were identified as MTB-positive by mycobacteria growth indicator tube 960 system(MGIT960)rapid liquid MTB culture system.MMCA and MGIT960 rapid liquid MTB culture were used to detect drug resistance to six antituberculosis drugs including rifampicin,isoniazid,ethambutol,streptomycin,levofloxacin and moxifloxacin,respectively,and the diagnostic efficacy of MMCA for the six drugs was analyzed.Patients were divided into MDR-TB group and non-MDR-TB group according to the diagnostic results.Clinical data were compared between the two groups.Multivariate Logistic regression model was used to analyze the influencing factors of MDR-TB,and receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model.Results Taking MGIT960 rapid liquid MTB culture as the gold standard for drug resistance diagnosis,the sensitivities of MMCA for detecting rifampicin,isoniazid,ethambutol,streptomycin,levofloxacin and moxifloxacin were 95.24％,94.87％,92.75％,96.97％,92.42％and 89.47％,respectively;the specificities were 98.52％,97.37％,98.02％,98.74％,97.64％and 95.74％,respectively;and the Kappa values of consistency analysis were 0.941,0.917,0.880,0.946,0.861 and 0.758,respectively.A total of 136 patients were diagnosed with MDR-TB and 438 with non-MDR-TB by MGIT960 rapid liquid MTB culture.Multivariate Logistic regression analysis showed that residence,treatment history,tuberculosis contact history and tuberculous cavity were independent risk factors for MDR-TB.A regression equation was established based on these factors,and the area under the curve of the model for predicting MDR-TB was 0.843(95％confidence interval:0.805-0.882),with a sensitivity of 66.20％and a specificity of 87.00％.Conclusion MMCA shows favorable diagnostic efficacy in detecting drug resistance to rifampicin,isoniazid,ethambutol,streptomycin,levofloxacin and moxifloxacin,and is easy to operate,facilitating rapid screening of MDR-TB.The coexistence of rural residence,retreatment,tuberculosis contact history and tuberculous cavity strongly suggests MDR-TB.

Abstract:Objective To evaluate the clinical outcomes and real-world pharmacoeconomic value of subcutaneous(SC)versus intravenous(Ⅳ)administration in the de-escalated dual-target non-anthracycline regimen combined with albumin-bound paclitaxel(nab-PHP regimen)for human epidermal growth factor receptor 2(HER2)-positive breast cancer.Methods A total of 72 female patients with HER2-positive early invasive breast cancer scheduled for neoadjuvant therapy admitted to Peking University International Hospital from January 2024 to December 2025 were retrospectively enrolled and divided into SC group(37 cases)and Ⅳ group(intravenous control group,35 cases)according to administration route.Inverse probability of treatment weighting(IPTW)was applied to balance baseline covariates between groups.The primary clinical endpoint was overall pathological complete response rate,with a prespecified non-inferiority margin of-10％.The primary economic endpoint was total direct medical cost.Time-driven activity-based costing(TDABC)was adopted to accurately calculate medical staff labor and time costs,and cost-minimization analysis was conducted.Results After IPTW weighting,baseline characteristics were well balanced between the two groups(standardized mean difference＜0.1).For clinical efficacy,the absolute difference in overall pathological complete response rate between the SC group and Ⅳ group was merely 0.6％(95％confidence interval:-4.8％-6.0％),which verified the absolute non-inferiority of subcutaneous administration(Pnon-inf＜0.001).In terms of safety,the incidence of all-grade infusion-related reactions in the SC group was lower than that in the Ⅳ group[2.7％(1/37)vs 17.1％(6/35)](P＜0.05).Medical resource accounting based on TDABC showed that per-cycle chair-side administration time,pharmacy preparation time in intravenous admixture service,drug delivery and monitoring time were all shorter in the SC group(all P＜0.001).Comprehensive statistical results demonstrated that the total cost for completing the full course of neoadjuvant therapy in the SC group was lower than that in the Ⅳ group(P＜0.001).Conclusions For de-escalated neoadjuvant therapy of HER2-positive early breast cancer,the SC-nab-PHP regimen is non-inferior to the conventional intravenous regimen in pathological complete response rate,with improved safety and reduced medical costs.

Abstract:Objective To investigate the rehabilitation effect and its influencing factors in patients with cervical spondylotic radiculopathy(CSR)after anterior cervical discectomy and fusion(ACDF).Methods Clinical data of 142 CSR patients treated with ACDF in the Second Affiliated Hospital of Naval Medical University from June 2020 to June 2024 were retrospectively analyzed.All patients were followed up for 3 months postoperatively.The rehabilitation effect was evaluated using the rehabilitation evaluation scale for cervical spondylotic radiculopathy(RES-CSR).Multiple linear regression was used to analyze the influencing factors of postoperative rehabilitation effect,and the product term test in multiple linear regression was used to analyze the interaction between factors.Results The RES-CSR score of 142 CSR patients at 3 months after ACDF was 77±15,indicating a moderate rehabilitation level.Multiple linear regression analysis showed that age ≥65 years(β=-0.160,P=0.001),diabetes mellitus(β=-0.120,P=0.002),exercise intensity＜3 times/week(β=-0.229,P＜0.001),comorbid anxiety/depression(β=-0.199,P＜0.001),Japanese Orthopaedic Association(JOA)score＜12 at 1 month postoperatively(β=-0.268,P＜0.001),and postoperative dysphagia(β=-0.197,P＜0.001)were independent risk factors affecting the rehabilitation effect after ACDF.There was no significant interaction effect of these risk factors on rehabilitation outcome.Conclusion The overall rehabilitation effect of CSR patients after ACDF is moderate.Age,diabetes mellitus,exercise intensity,anxiety/depression,JOA score at 1 month postop-eratively,and dysphagia are core factors affecting postoperative rehabilitation.Targeted intervention strategies based on these factors can help improve the quality of postoperative rehabilitation.