Abstract:Objective To investigating the efficacy of ciprofol combined with sufentanil in thoracoscopic lung surgery.Methods A total of 111 patients who underwent thoracoscopic lung surgery at Fuyang Normal University Affiliated Second Hos-pital(Fuyang Fifth People's Hospital)from April 2024 to June 2025 were retrospectively selected and divided into an observation group and a control group based on anesthesia protocols.The propofol group(n=69) received propofol combined with sufentanil anesthesia,and the ciprofol group(n=42)received ciprofol combined with sufentanil anesthesia.The hemodynamic indicators,anesthesia depth,perioperative conditions,and incidence of anesthesia complications were compared at the time of entering the operating room(T0),after successful intubation(T1),30 minutes into the surgery(T2)and at the end of the surgery(T3)between the ciprofol group and the propofol group.Results In the intergroup comparison,the mean arterial pressure and heart rate at time points T1 and T2 in the ciprofol group were significantly higher than those in the propofol group((93.38±12.45)mmHg vs(87.97±12.81)mmHg(1 mmHg=0.133 kPa),(87.10±9.84)mmHg vs(81.00±10.54)mmHg,(73.55±11.40)beats/min vs(68.93±9.56)beats/min,(71.21±8.75)beats/min vs(66.67±8.74)beats/min)(t=2.118,3.031,2.294,2.653,all P<0.05).The bispectral index(BIS)values in the ciprofol group at time points T1 and T2 were higher than those in the propofol group((56.93±5.87)vs(52.16±7.03),(52.43±4.32)vs(47.84±5.26))(t=3.683,4.760,both P<0.05).The recovery time of the ciprofol group was shorter than that of the propofol group((15.13±4.02)min vs(17.14±5.53)min)(t=-2.048,P<0.05).The incidence of anesthesia complications in the cip-rofol group was 11.90%(5/42),lower than that in the control group(28.99%(20/69))(χ2=4.365,P<0.05).Conclusion The com-bination of ciprofol and sufentanil results in minimal hemodynamic impact,more stable maintenance of anesthetic depth,shorter recovery time,and a lower incidence of anesthetic complications in patients undergoing thoracoscopic lung surgery.

Abstract:Objective To investigate the risk factors for antibiotic-associated diarrhea(AAD)in children with severe pneumonia,construct a Nomogram prediction model,and explore corresponding prevention strategies.Methods A total of 293 children with severe pneumonia admitted to Henan Children's Hospital Zhengzhou Children's Hospital from January 2022 to December 2024 were retrospectively enrolled and divided into an AAD group and a non-AAD group based on the occurrence of AAD.Univariate and multivariate Logistic regression analyses(stepwise backward method)were performed to identify the inde-pendent predictors.R software packages were used to develop the Nomogram model.The model's predictive performance,cali-bration,internal validation,and clinical benefit were assessed using the receiver operating characteristic(ROC)curve,calibration curve,Hosmer-Lemeshow test,Bootstrap resampling(n=1 000),and decision curve analysis.Risk stratification was performed to validate the model's effectiveness.Results There were 89 cases(30.38%)in the AAD group and 204 cases(69.62%)in the non-AAD group.Multivariate Logistic regression analysis revealed that erythromycin and mechanical ventilation were excluded due to statistical insignificance.Age(≤2 years),C-reactive protein(CRP)level,use of cefoperazone-sulbactam,use of azithromycin,medication duration(≥5 days),and concurrent use of multiple antibiotics(≥3 types)were independent predictors of AAD in children with severe pneumonia(OR=6.836,1.703,3.850,3.196,2.061,and 6.082,respectively,all P<0.05).The Nomogram model built with these factors had an area under the ROC curve(AUC)of 0.812.The predicted probabilities were relatively close to the actual probabilities,indicating good model calibration(χ2=8.975,P=0.342).The corrected concordance index(C-index)was 0.770,and the model demonstrated good net clinical benefit.Risk stratification validation showed that the actual AAD incidence rates in the high-risk group(n=93,prediction probability>50.00%),medium-risk group(n=120,prediction probability 20.00%-50.00%),and low-risk group(n=80,prediction probability<20.00%)was 55.91%,23.33%,and 11.25%,respectively.Conclusion Age(≤2 years),CRP lev-el,use of cefoperazone-sulbactam,use of azithromycin,duration of antibiotic therapy(≥5 days),and concurrent use of multiple antibi-otics(≥3 types)are independent predictors of AAD in children with severe pneumonia.The constructed Nomogram prediction model demonstrates good predictive performance and can facilitate early identification of high-risk pediatric patients.

Abstract:Objective To explore the clinical efficacy and safety of sertraline in combination with low-dose que-tiapine in the treatment of adolescent depression complicated by non-suicidal self-injury(NSSI).Methods A randomized controlled trial was conducted.A total of 112 adolescent depressive patients with NSSI admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2023 to December 2024 were enrolled and randomly divided into two groups ac-cording to a random number table.After exclusions and dropouts,a total of 102 patients(51 in each group)completed the study and were included in the final analysis.The control group received sertraline monotherapy,while the observation group received sertraline combined with low-dose quetiapine.The treatment course lasted 8 weeks.Clinical symptoms,impulsive behaviors,and self-injurious behavior scores were compared between the two groups before and after treatment.Serum neurotransmit-ter levels were measured and compared.Clinical efficacy and the incidence of adverse reactions were statistically analyzed.Results After 8 weeks of treatment,the scores of the Hamilton Depression Scale((9.25±1.86)points),Hamilton Anxi-ety Scale((8.98±2.13)points),Barratt Impulsiveness Scale((34.62±7.85)points),and Self-Harm Behavior Screening Scale((5.15±1.42)points)in the observation group were significantly lower than those in the control group((13.12±2.05),(12.86±2.31),(47.89±8.21),(6.98±1.47)points,respectively)(t=9.984,8.818,8.343,6.394,all P<0.05).After 8 weeks of treatment,the ob-servation group showed significantly higher levels of norepinephrine((3.25±0.42)nmol/L),5-hydroxytryptamine((195.68±28.32)ng/mL),and dopamine((52.47±5.83)ng/L)compared to the control group((2.51±0.38)nmol/L,(158.45±27.64)ng/mL,and(44.16±4.92)ng/L,respectively)(t=9.330,6.740,7.779,all P<0.05).The total effective rate in the observation group was 92.16%(47/51),significantly higher than 76.47%(39/51)in the control group(χ2=4.744,P<0.05).The incidence of adverse re-actions in the observation group was 15.69%(8/51),showing no statistically significant difference compared to 11.76%(6/51)in the control group(χ2=0.331,P>0.05).Conclusion Within the 8-week observation period of this study,sertraline combined with low-dose quetiapine in the treatment of adolescent depression with NSSI was superior to sertraline monotherapy in improving depression,anxiety,impulsivity,and NSSI scores.It also more effectively regulated the imbalance of serum neurotransmitters,with a safety profile comparable to monotherapy.However,the long-term efficacy and safety still require further validation.

Abstract:Objective To investigate the additional benefits and safety of adding megestrol acetate capsules to the standard triple antiemetic regimen(ondansetron,NK-1 receptor antagounist,dexamethasone)for controlling chemotherapy-relat-ed gastrointestinal symptoms in breast cancer patients.Methods A total of 120 breast cancer patients receiving chemotherapy at the First Affiliated Hospital of Henan University between January 2022 and December 2024 were retrospectively analyzed.Based on the antiemetic regimen,patients were divided into two groups:the triple-therapy group(n=60)received the standard triple regi-men,while the quadruple-therapy group(n=60)received the standard triple regimen combined with megestrol acetate capsules for 5 days.The gastrointestinal symptom control rate,quality of life scores,serum albumin and serotonin levels,and drug safety were compared between the two groups.Results After treatment,the Karnofsky Performance Status Score and the Func-tional Living Index-Emesis scores in the quadruple-therapy group were superior to those in the triple-therapy group((79.68±5.46)points vs(74.42±6.83)points,t=4.660,P<0.05;(108.53±7.34)points vs(95.27±9.16)points,t=8.750,P<0.05).In terms of serological indicators,the quadruple-therapy had higher albumin levels((37.92±4.63)g/L vs(35.76±4.15)g/L)and lower 5-hydroxytryptamine levels((203.62±35.73)ng/mL vs(226.53±41.63)ng/mL)(t=2.691,3.235,both P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(10.00%(6/60)vs 6.67%(4/60))(χ2=0.436,P>0.05).Conclusion For breast cancer patients undergoing chemotherapy,adding megestrol acetate capsules to the standard triple antiemetic regimen can more effectively control nausea,vomiting,and anorexia,improve quality of life and nutri-tional status,without increasing safety risks.

Abstract:Objective To investigate the effects of phloroglucinol combined with misoprostol on cervical ripeness and the duration of labor in nulliparous women undergoing vaginal delivery.Methods A retrospective analysis was conducted on clinical data from 105 full-term nulliparous women with indications for labor induction who planned vaginal delivery at Yibin Maternal and Child Health Hospital from January 2023 to June 2024.They were divided into the combination group(n=53)and the monotherapy group(n=52)according to different medication regimens.The monotherapy group was administered misopros-tol alone,while the combination group received phloroglucinol combined with misoprostol.Cervical ripeness,Bishop score be-fore and after medication,duration of labor stages,mode of delivery,postpartum blood loss at 24 hours,neonatal Apgar scores,and adverse maternal and neonatal outcomes were compared between the two groups.Results The total effective rate for achieving cervical ripeness in the combination group was 88.68%(47/53),higher than 71.15%(37/52)in the monotherapy group(χ2=5.039,P<0.05).After medication,the post-treatment Bishop score and the extent of its increase in the combination group((8.11±1.31),(4.83±1.25)points)were higher than those in the monotherapy group((6.65±1.19),(3.35±1.30)points)(t=5.978,5.967,both P<0.05).The durations of the first,second,third stages of labor and total labor duration in the combination group((458.28±70.19),(41.23±8.46),(7.72±1.34),(507.23±69.50)min)were significantly shorter than those in the monotherapy group((525.87±82.41),(47.33±11.67),(8.94±1.29),(582.13±81.78)min)(t=4.527,3.070,4.781,5.061,all P<0.05).The rate of sponta-neous vaginal delivery in the combination group was 81.13%(43/53),significantly higher than 59.62%(31/52)in the monother-apy group(χ2=5.840,P<0.05).Postpartum blood loss at 24 hours in the combination group was(128.36±11.47)mL,lower than(133.15±12.52)mL in the monotherapy group(t=2.047,P<0.05).There were no statistically significant differences in neonatal Apgar scores at 1 minute and 5 minutes between the combination group((8.81±0.56),(9.13±0.34)points)and the monotherapy group((8.85±0.61),(9.17±0.38)points)(t=0.307,0.580,both P>0.05).The incidence of adverse maternal outcomes was 13.21%(7/53)in the combination group and 15.38%(8/52)in the monotherapy group,and the incidence of adverse neonatal outcomes was 3.77%(2/53)and 9.61%(5/52),respectively,with no statistically significant differences(χ2=0.102,0.654,both P>0.05).Conclusion Phloroglucinol combined with misoprostol can effectively enhance cervical ripeness,shorten the duration of labor,increase the rate of vaginal delivery,and reduce postpartum blood loss in nulliparous women,without increasing adverse mater-nal or neonatal outcomes.

Abstract:Objective To explore the efficacy of caffeine citrate combined with the intubation-surfactant-extubation(INSURE)technique in the treatment of neonatal respiratory distress syndrome(NRDS)and its impact on blood gas analysis parameters.Methods A prospective randomized controlled trial was conducted.A total of 328 neonates with NRDS admit-ted to Xianyang Rainbow Hospital from January 2024 to August 2025 were collected and randomly divided into the combined group and the control group using a random number table,with 164 cases in each group.The control group was treated with INSURE,while the combined group was additionally given caffeine citrate.Treatment lasted for 7 days.The clinical efficacy,treatment outcomes,blood gas analysis parameters,serological indicators,and incidence of adverse reactions(including bron-chopulmonary dysplasia,pulmonary hemorrhage,pulmonary infection,etc.)were compared between the control group and the combined group.Results The total effective rate was higher in the combined group(94.51%,155/164)than in the control group(88.41%,145/164)(χ2=3.905,P<0.05).The duration of oxygen therapy and hospitalization in the combined group((89.19±13.11)h,(21.31±5.26)d)were shorter than those in the control group((109.61±14.84)h,(27.48±6.84)d),and the number of apnea ep-isodes in the combined group((4.08±1.19)times)was less than that in the control group((7.36±1.61)times)(t=13.206,9.157,20.981,all P<0.05).After treatment,the combined group showed a higher partial pressure of oxygen((74.29±6.64)mmHg(1 mmHg=0.133 kPa))compared to the control group((66.51±5.41)mmHg),and the partial pressure of carbon dioxide in the combined group((41.51±5.26)mmHg)was lower than that in the control group((45.06±6.04)mmHg)(t=11.633,5.676,both P<0.05).After treatment,the levels of creatine kinase-MB,malondialdehyde,and C-reactive protein in the combined group((34.91±6.49)U/L,(23.59±3.41)μmol/L,(58.49±4.64)μg/L,respectively)were all lower than those in the control group((45.45±7.31)U/L,(30.24±4.64)μmol/L,(73.41±5.30)μg/L,respectively)(t=13.808,14.789,27.125,all P<0.05).The incidence of complications was 4.27%(7/164)in the control group and 2.44%(4/164)in the combined group,with no statistically signif-icant difference between the two groups(χ2=0.376,P=0.540).Conclusion Caffeine citrate combined with INSURE can im-prove the efficacy in neonates with NRDS,shorten the duration of oxygen therapy and hospitalization,improve blood gas analy-sis parameters,and ameliorate markers of myocardial injury,oxidative stress and inflammation,with a favorable safety profile.

Abstract:Objective To observe the clinical efficacy of butylphthalide combined with galantamine in the treatment of vascular dementia(VD).Methods A total of 128 VD patients admitted to Hai'an People's Hospital from October 2023 to April 2025 were selected and randomly divided into a control group(receiving basic intervention plus galantamine treatment)and an intervention group(receiving basic intervention plus butylphthalide and galantamine treatment)using a random number table,with 64 patients in each group.During the study,16 patients dropped out,resulting in a final completion of 56 cases in both the observation group and the control group.The efficacy,hemorheological indicators,activities of daily living,cognitive function,and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 85.71%(48/56),higher than that in the control group(69.64%(39/56))(χ2=4.171,P<0.05).The observation group showed higher scores on the Hasegawa Dementia Scale,Mini-Mental State Examination,and modified Barthel Index compared to the control group((25.01±3.14)vs(21.22±3.25),(21.07±4.52)vs(19.13±4.38),(62.52±3.13)vs(56.77±3.27),t=6.276,2.307,9.506,all P<0.05).The levels of high-shear whole blood viscosity,low-shear whole blood viscosity,and plasma viscosity in the observation group were lower than those in the control group((4.66±0.54)mPa/s vs(5.12±0.41)mPa/s,(7.17±1.83)mPa/s vs(8.78±1.77)mPa/s,and(1.42±0.12)mPa/s vs(1.61±0.15)mPa/s,respectively,t=-5.077,-4.732,-7.402,all P<0.05).The incidence rates of adverse reactions were 16.07%(9/56)in observation group and 10.71%(6/56)in the control group,and there was no statistical-ly significant difference(χ2=0.693,P>0.05).Conclusion The combination of butylphthalide and galantamine can significantly improve cognitive function,daily living ability,and hemorheological indicators in VD patients,without increasing the risk of ad-verse reactions,demonstrating a good safety profile.

Abstract:Objective To explore the anesthesia quality of esmolol in elderly patients undergoing radical resection of colorectal cancer.Methods A prospective controlled study design was adopted.A total of 120 elderly patients undergoing radical resection of colorectal cancer admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2021 to May 2024 were selected and divided into the control group(n=60)and the esmolol group(n=60)according to the random number table method.Both the esmolol group and the control group received tracheal intubation general anesthesia.The esmolol group was intravenously injected with 0.25-0.50 mg/kg esmolol before intubation,and maintained intravenously pumped with 50 μg/(kg·min)during surgery until 5 min before the end of surgery,and the control group was given the same amount of normal saline.The perioperative anesthesia indicators(anesthesia duration,time to awakening after entering the operating room,propofol dosage),hemodynamics parameters(mean arterial pressure(MAP),heart rate(HR),rate pressure product(RPP))and cardiovascular stress indicators(endothelin(ET),thromboxane B2(TXB2))before induction(T0),post-intubation(T1),the end of surgery(T2)and post-extubation(T3),cardiovascular stress indicators(norepinephrine(NE),dopamine(DA))at 1 day and 3 days after surgery and the incidence rates of adverse reactions were compared between the two groups.Results The awakening time after entering the operating room and the dosage of propofol in the esmolol group((18.73±2.56)min and(735.23±123.86)mg)were lower than(20.16±2.84)min and(807.35±146.50)mg in the control group,and the differences were statistically significant(t=2.897,P=0.004;t=2.912,P=0.004).There was no significant difference in anesthesia time between the esmolol group and the control group((3.41±0.43)h vs(3.29±0.37)h)(t=1.639,P=0.104).The HR,MAP and RPP in the esmolol group and the control group increased initially and then decreased.The HR,MAP and RPP of the esmolol group were lower than those of the control group at T1--T3,and the inter-group,time and interaction differences of all indicators were statistically significant(all P<0.05).Both ET and TXB2 levels showed an upward trend in the esmolol group and the control group.ET levels in the esmolol group were lower than those in the control group at T1-T3,and the inter-group,time and interaction differences were statistically significant(all P<0.05).TXB2 levels in the esmolol group were lower than those in the control group at T1-T2,and the inter-group,time and interaction differences were statistically significant(all P<0.05).The levels of NE and DA at 3 days after surgery in the esmolol group((321.51±41.33)pg/mL and(378.59±47.28)pmol/mL)were lower than(349.26±45.87)pg/mL and(410.52±52.14)pmol/mL in the control group(t=3.481,3.514,both P<0.001).There was no statistical significance in the total incidence rate of adverse reactions between the control group and the esmolol group(3.33%(2/60)vs 10.00%(6/60),χ2=1.205,P=0.272).Conclusion Esmolol can effectively stabilize hemodynamics during general anesthesia in elderly patients undergoing radical resection of colorectal cancer,improve stress response,with a good safety profile.

Abstract:Objective To investigate the efficacy of Sophora gel combined with vitamin C and fluconazole in the treatment of recurrent vulvovaginal candidiasis(RVVC).Methods A total of 116 patients with RVVC who received targeted treatment at Chengde Central Hospital from April 2022 to April 2024 were randomized using a computer-generated random num-ber sequence,and finally 53 cases were included in each group.The control group was treated with vitamin C and fluconazole,while the observation group was given additional Sophora gel on this basis.The clinical efficacy,recurrence rates at 3 and 6 months of follow-up,symptom improvement time,levels of inflammatory factors before and after treatment,and adverse reac-tions were compared between the two groups.Results The total effective rate in observation group was 83.02%(44/53),higher than that in the control group(64.15%(34/53)),with a statistically significant difference(χ2=4.853,P=0.028).At 3 and 6 months of follow-up,the recurrence rates in the observation group(3.77%(2/53)and 7.55%(4/53),respectively)were lower than those in the control group(16.98%(9/53)and 24.53%(13/53),respectively),with statistically significant differences(χ2=4.970,5.675,P=0.026,0.017).After treatment,the improvement times for abnormal vaginal discharge,vulvar itching,and vaginal burning pain in the observation group((6.40±0.77),(7.23±0.75),(7.21±0.95)days,respectively)were shorter than those in the control group((7.94±0.86),(8.92±0.92),(8.15±0.84)days,respectively),with statistically significant differences(t=9.712,10.365,5.396,all P<0.05).After treatment,the levels of interleukin-6,tumor necrosis factor-α,and C-reactive protein in the observation group((1.73±0.24)pg/mL,(2.60±0.54)pg/mL,(3.53±0.35)mg/L,respectively)were lower than those in the control group((2.27±0.35)pg/mL,(3.72±0.88)pg/mL,(4.45±0.62)mg/L,respectively),with statistically significant differences(t=9.263,7.898,9.407,all P<0.05).The incidence of adverse reactions in the observation group and the control group(5.66%(3/53)and 7.55%(4/53),re-spectively)showed no statistically significant difference(Fisher's exact test,P>0.05).Conclusion Sophora gel as an adjunct to vitamin C and fluconazole demonstrates favorable efficacy in the treatment of recurrent fungal vaginitis.It can reduce recurrence rates and inflammatory factor levels,alleviate clinical symptoms,and exhibit a high safety profile.

Abstract:Objective To investigate the efficacy of oxiracetam combined with Ginkgo biloba extract injection in the treatment of vascular cognitive impairment non-dementia(VCIND)and its impact on neuroelectrophysiological parameters.Methods A total of 152 VCIND patients treated in First Hospital of Qinhuangdao from January 2023 to December 2024 were randomly assigned via the random number table to the oxiracetam group(n=76)and the combination group(n=76).The oxirac-etam group received oxiracetam,while the combination group received oxiracetam combined with Ginkgo biloba extract.The cognitive scale scores,neuroelectrophysiological parameters,hemodynamic indicators,serum markers,and safety were observed and compared between the two groups.Results After treatment,the Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE),and modified Barthel Index scores in the combination group((24.52±1.73),(23.48±1.69),and(79.04±4.74)points,respectively)were all higher than those in the oxiracetam group((21.06±1.62),(20.06±1.63),and(74.58±4.33)points,respectively)(t=12.727,12.698,6.056,all P<0.05).After treatment,the P300 latency and θ/α power ratio in the combination group((291.54±18.62)ms,(1.27±0.36),respectively)were both lower than those in the oxiracetam group((328.63±19.54)ms,(1.54±0.43),respectively)(t=11.980,4.197,both P<0.05).The P300 amplitude and α wave relative power in the combination group((8.11±1.85)μV,(35.26±5.18)%,respectively)were both higher than those in the oxiracetam group((6.36±1.48)μV,(30.17±4.82)%,respectively)(t=6.439,6.271,both P<0.05).After treatment,the mean blood flow velocity in the combination group was(66.74±6.48)cm/s,higher than that in the oxiracetam group((62.83±6.52)cm/s)(t=3.708,P<0.05).The pulsatility index and resistance index in the combination group((1.03±0.12)and(0.64±0.14),respectively)were both lower than those in the oxiracetam group((1.17±0.18)and(0.73±0.16),respectively)(t=5.642,3.690,both P<0.05).After treatment,the levels of interleukin-6,neuron-specific enolase,and homocysteine in the combination group((7.74±5.48)μg/L,(14.03±3.12)ng/mL,and(11.64±3.14)μmol/L,respectively)were all lower than those in the oxiracetam group((10.83±5.52)μg/L,(16.17±3.18)ng/mL,and(15.73±3.16)μmol/L,respectively)(t=3.463,4.188,8.004,all P<0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(5.26%(4/76)vs 7.89%(6/76))(χ2=0.428,P>0.05).Conclusion Ox-iracetam combined with Ginkgo biloba extract demonstrates superior efficacy in treating VCIND.It effectively improves patients'cognitive function,activities of daily living,cerebral hemodynamics,and neuroelectrophysiological parameters.The combined therapy exhibits multiple mechanisms,including neuroprotection and anti-inflammatory effects,with a favorable safety profile.

Abstract:Objective To explore the clinical efficacy of calcitriol combined with zoledronic acid in treating el-derly patients with diabetic osteoporosis.Methods A prospective randomized controlled study was conducted.A total of 80 elderly patients with diabetic osteoporosis treated at the Second Affiliated Hospital of Zhengzhou University between March 2022 and February 2024 were randomly divided into a zoledronic acid group and a calcitriol combination group using a random number table method,with 40 cases in each group.Both groups received conventional basic treatment.The zoledronic acid group was treated with zoledronic acid,while the calcitriol combination group received calcitriol combined with zoledronic acid.Clinical efficacy,bone metabolism indicators,bone mineral density(BMD),electrolyte indicators,blood glucose indica-tors,and the incidence of adverse reactions were observed and compared between the two groups.Results After treatment,the total effective rate in the calcitriol combination group was 95.00%(38/40),significantly higher than 80.00%(32/40)in the zoledronic acid group(χ2=4.114,P<0.05).After treatment,the levels of bone-specific alkaline phosphatase and β-C-terminal telopeptide of type I collagen in the calcitriol combination group((11.37±2.26)U/L,(0.19±0.04)g/L)were significantly lower than those in the zoledronic acid group((14.53±2.23)U/L,(0.29±0.06)g/L),while the level of osteocalcin((11.06±1.04)ng/L)was significantly higher than that in the zoledronic acid group((8.36±1.53)ng/L)(t=6.295,8.771,9.230,all P<0.05).After treat-ment,the BMD at the Wards triangle,femoral neck,and lumbar spine(L1-4)in the calcitriol combination group((0.86±0.20),(0.89±0.25),(0.90±0.21)g/cm2)were significantly higher than those in the zoledronic acid group((0.75±0.21),(0.78±0.22),(0.79±0.23)g/cm2)(t=2.399,2.089,2.234,all P<0.05).The level of 25-hydroxyvitamin D3 in the calcitriol combination group((28.57±4.13)ng/mL)was significantly higher than that in the zoledronic acid group((21.36±3.52)ng/mL)(t=8.403,P<0.05).After treatment,there were no statistically significant differences between the two groups in serum calcium,serum phosphorus,fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,alanine aminotransferase,and serum creatinine levels(t=0.465,0.477,0.823,0.688,1.086,0.608,0.115,all P>0.05).There was no statistically significant difference in the in-cidence of adverse reactions between the zoledronic acid group and the calcitriol combination group(12.50%(5/40)vs 10.00%(4/40),Fisher exact test,P=1.000).Conclusion The combination of calcitriol and zoledronic acid demonstrates significant efficacy in treating elderly patients with diabetic osteoporosis.It effectively increases bone mineral density,optimizes bone me-tabolism,inhibits bone resorption,and promotes bone formation,without increasing the risk of electrolyte disturbances,blood glucose fluctuations,or additional adverse reactions,indicating a good safety profile.

Abstract:Objective To investigate the effects of dapagliflozin on renal hemodynamics and renal function parame-ters in patients with type 2 diabetic nephropathy(T2DN).Methods A total of 92 patients with T2DN admitted to Zhoushan Pu-tuo District People's Hospital from January 2023 to December 2024 were retrospectively analyzed and divided into the exposure group(n=49)and the non-exposure group(n=43).The non-exposure group received oral metformin hydrochloride tablets,while the exposure group received oral dapagliflozin tablets.Both groups were treated for 12 weeks.The efficacy,glycemic parameters,renal function indexes and renal hemodynamic assessment parameter(vascular resistance index(RI))were compared between the exposure group and the non-exposure group.Results The total effective rate in the exposure group was 87.76%(43/49),higher than 60.47%(26/43)in the non-exposure group(χ2=9.097,P=0.003).After treatment,fasting blood glucose and glycosylated hemoglobin in the exposure group were lower than those in the non-exposure group((6.83±0.92)mmol/L vs(8.15±1.24)mmol/L,t=5.843,P<0.001;(6.70±0.75)%vs(7.89±0.98)%,t=6.584,P<0.001).Glomerular filtration rate was improved in the exposure group compared with that in the non-exposure group((108.42±15.63)mL/min vs(119.25±12.71)mL/min,t=3.614,P<0.001).After treatment,blood urea nitrogen,serum creatinine,urinary protein-to-creatinine ratio,and urinary pro-tein were reduced in the exposure group compared to the non-exposure group((4.97±0.82)mmol/L vs(5.36±0.88)mmol/L,t=2.200,P=0.030;(75.55±8.43)μmol/L vs(81.26±8.57)μmol/L,t=3.216,P=0.002;(0.18±0.03)g/24 h vs(0.22±0.05)g/24 h,t=4.717,P<0.001;(21.09±3.61)g/mol vs(25.17±3.35)g/mol,t=5.593,P<0.001).In terms of renal hemodynamics,the exposure group showed a lower post-treatment RI compared to the non-exposure group((0.58±0.07)vs(0.62±0.09),t=2.394,P=0.019).Conclusion Dapagliflozin can significantly improve the renal RI in T2DN patients,reduce hyperfiltration,decrease urinary protein excretion,and protect renal function,demonstrating superior efficacy compared to metformin.

Abstract:Objective To investigate the effect of low-dose methylprednisolone in combination with azithromycin on lung function and the levels of inflammatory factors in children with Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 90 children with MPP treated at the Third People's Hospital of Yibin from February 2022 to February 2024 were selected and randomly divided into a observation group(n=45,treated with azithromycin combined with low-dose methylprednisolone)and a control group(n=45,treated with azithromycin alone).The lung function parameters,inflammatory markers,time to symp-tom relief,duration of hospitalization,therapeutic efficacy,and incidence of adverse reactions were compared between the two groups after one course of treatment.Results After treatment,children in the observation group demonstrated a peak expiratory flow of(4.02±0.61)L/s,forced vital capacity of(1.92±0.33)L,forced expiratory volume in one second of(1.68±0.25)L,and an FEV1/FVC ratio of(87.46±4.91)%,all of which were significantly higher than those in the control group((3.50±0.55)L/s,(1.73±0.31)L,(1.45±0.23)L,(84.15±4.52)%,respectively)(t=4.247,2.815,4.542,3.327,all P<0.05).The observation group exhibited lower levels of interleukin-6((18.53±3.21)pg/mL),tumor necrosis factor-α((12.61±2.15)pg/mL),and C-reactive protein((8.31±1.41)mg/L)compared with the control group((28.34±3.26)pg/mL,(21.43±3.21)pg/mL,and(15.73±2.09)mg/L,respectively)(t=14.384,15.332,19.743,all P<0.05).The observation group had shorter defervescence time((8.11±0.93)d),time to cough relief((9.23±1.17)d),time to resolution of pulmonary signs((10.57±1.36)d),and length of hospital stay((13.81±1.54)d)than the control group((12.54±1.21),(13.04±1.29),(14.89±1.96),and(16.94±1.69)d,respectively)(t=19.473,14.676,12.148,9.183,all P<0.05).The overall effective rates were 95.56%(43/45)in the observation group and 80.00%(36/45)in the control group,with a statistically significant difference(χ²=5.075,P=0.024).There was no statistically significant differ-ence in the incidence of adverse reactions between the two groups(24.44%(11/45)vs 15.56%(7/45),χ²=1.111,P=0.292).Conclusion The combination therapy demonstrates superior clinical efficacy in managing MPP,effectively improving pulmo-nary function and reducing inflammation in pediatric patients,with fewer adverse reactions.

Abstract:Objective To establish the drug utilization evaluation(DUE)criteria for acetylcysteine solution for inha-lation and evaluate its clinical application using the technique for order preference by similarity to ideal solution(TOPSIS)method.Methods A retrospective evaluation method was adopted.Based on the instructions for acetylcysteine solution for inhalation,relevant domestic and international guidelines and consensus,evidence-based medicine databases and pertinent literatures,evaluation criteria for this medication were established.Using these criteria,a retrospective evaluation was conducted through the TOPSIS method on 197 medical records of patients using acetylcysteine solution for inhalation at the Fifth Medical Center of Chinese PLA General Hospital from January 1 to December 31,2023.Results The DUE criteria for acetylcysteine solution for inhalation was established,comprising 13 evaluation indicators.Among 197 medical records evaluated,75 cases(38.07%,75/197)achieved an ideal relative closeness(Ci)of 1.0,26 cases(13.20%,26/197)had 0.8≤Ci<1.0,and 96 cases(48.73%,96/197)scored 0.6≤Ci<0.8.The existing unreasonable prob-lems are mainly manifested in the indication,course of disease,course of treatment,drug interaction,repeated use of drugs and so on.Conclusion The rational use evaluation of acetylcysteine solution for inhalation based on the weighted TOPSIS method is simple and easy to implement,and the evaluation results are scientific,objective,reasonable and standardized.

Abstract:Objective To evaluate the efficacy of sacubitril/valsartan combined with atorvastatin in the treat-ment of elderly patients with coronary heart disease(CHD)complicated by heart failure(HF).Methods A prospective controlled study design was adopted.A total of 122 elderly patients with CHD and HF treated at First Hospital of Qin-huangdao from May 2022 to November 2023 were selected as the study subjects.They were randomly divided into the control group(n=61)and the study group(n=61)using the lottery method.The control group received atorvastatin in addi-tion to conventional anti-HF treatment,while the study group received sacubitril/valsartan in combination with the control group's treatment regimen.Both groups received continuous treatment for 3 months,and clinical efficacy,cardiac func-tion indicators,inflammatory markers,blood lipid levels,and adverse reactions were compared between the two groups.Results The total effective rate in the study group was 93.44%(57/61),higher than that in the control group(80.33%(49/61))(χ2=4.604,P<0.05).After treatment,the left ventricular end systolic diameter((46.98±3.95),(50.33±4.77)mm),left ventricular end diastolic diameter((52.16±4.67),(54.32±5.74)mm),and the levels of N-terminal pro-brain natriuret-ic peptide((142.48±23.27),(185.38±28.34)ng/L)in both the study group and the control group were decreased,while the left ventricular ejection fraction levels((51.84±5.78)%,(48.33±5.46)%)were increased(all P<0.05),and the differences between the two groups were statistically significant(t=4.224,2.280,9.137,3.448,all P<0.05).After treatment,the levels of C-reactive protein((8.12±1.54),(10.23±1.89)mg/L),interleukin-6((4.56±0.89),(6.25±1.29)ng/L),and tumor necrosis factor-α((5.31±0.85),(6.57±1.43)ng/L)in the study group and control group were all decreased(all P<0.05),and the differenc-es between the two groups were statistically significant(t=6.760,8.422,5.916,all P<0.05).After treatment,the levels of total cholesterol((3.16±0.89),(3.93±0.78)mmol/L),triglycerides((1.16±0.31),(1.38±0.39)mmol/L),low-density lipoprotein choles-terol((2.31±0.64),(2.66±0.87)mmol/L)in the study group and the control group were significantly decreased,while high-densi-ty lipoprotein cholesterol levels((1.27±0.25),(1.18±0.21)mmol/L)were significantly increased(all P<0.05),and the differences between the two groups were statistically significant(t=5.082,3.449,2.531,2.153,all P<0.05).There was no statistically signifi-cant difference in the incidence of adverse reactions between the study group and the control group(11.48%(7/61)vs 6.56%(4/61))(χ2=0.899,P>0.05).Conclusion The combination of sacubitril/valsartan and atorvastatin demonstrates favorable efficacy in the treatment of elderly patients with CHD and HF.It can improve cardiac function,regulate lipid metabolism,suppress inflammato-ry responses,and exhibit a favorable safety profile.

Abstract:Objective To investigate the efficacy of recombinant human brain natriuretic peptide(rhBNP)and torasemide in patients with coronary heart disease(CHD)complicated by acute left heart failure(ALHF)and their impact on inflammatory markers.Methods A prospective randomized controlled design was adopted.A total of 148 patients with CHD complicated by ALHF treated at Linfen Central Hospital from June 2024 to June 2025 were enrolled and randomly divided into the control group and the experimental group using a random number table method,with 74 cases in each group.The control group received conventional treatment plus torasemide,while the experimental group received conventional treatment combined with torasemide and rhBNP.Both groups were treated continuously for 7 days.Clinical efficacy,cardiac function parameters,inflammatory markers,relevant laboratory indices,blood pressure,heart rate,and adverse reactions were compared between the two groups.Results The total effective rate in the experimental group was higher than that in the control group(91.89%(68/74)vs 79.73%(59/74),χ2=4.495,P<0.05).After treatment,the levels of systolic blood pressure,diastolic blood pressure,and heart rate in the experimental group((108.26±10.15)mmHg(1 mmHg=0.133 kPa),(76.33±7.42)mmHg,(70.07±7.12)beats/min,respectively)were all lower than those in the control group((114.02±10.73)mmHg,(81.52±8.01)mmHg,(75.13±7.56)beats/min,respectively)(t=3.355,4.089,4.191,all P<0.05).After treatment,the levels of left ventricular end-diastolic diameter and left ventricular end-systolic diameter in the experimental group((52.38±4.78)mm and(48.37±4.51)mm,respectively)were lower than those in the control group((56.25±5.14)mm and(51.74±4.62)mm,respectively)(t=4.743,4.490,both P<0.05),and the level of left ventricular ejection fraction((44.06±4.48)%)was higher than that in the control group((39.18±4.17)%)(t=6.859,P<0.05).After treatment,the levels of C-reactive protein,interleukin-6,N-terminal pro-B-type natriuretic peptide,soluble suppression of tumorigenicity 2,angiotensin Ⅱ,and endothelin-1 in the experimental group((5.78±0.92)mg/L,(10.26±2.52)pg/mL,(367.52±39.18)ng/L,(27.44±2.13)ng/mL,(60.35±5.28)ng/L,(37.36±4.68)ng/L,respectively)were all lower than those in the control group((8.03±1.26)mg/L,(15.34±3.37)pg/mL,(492.13±44.15)ng/L,(36.35±3.76)ng/mL,(73.26±6.55)ng/L,(44.25±4.13)ng/L,respectively)(t=12.406,10.385,18.160,17.737,13.200,9.496,all P<0.05).The incidence of adverse reac-tions was 5.41%(4/74)in the control group and 8.11%(6/74)in the experimental group,with no statistically significant differ-ence(χ2=0.429,P>0.05).Conclusion The addition of rBNP to conventional therapy combined with torasemide can effectively improve the overall clinical efficacy in patients with CHD and ALHF,enhance cardiac function,hemodynamic parameters,and neuroendocrine indicators,suppress inflammatory responses,and demonstrate a favorable safety profile.

Abstract:Objective To explore the effect of Tongfu Xiefei Formula combined with ulinastatin on oxygenation indexes and intestinal mucosal barriers of sepsis patients complicated with acute respiratory distress syndrome(ARDS).Methods A prospective controlled study design was adopted.A total of 132 sepsis patients complicated with ARDS who were treated in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from April 2021 to November 2023 were prospectively enrolled in the study and randomly divided into the ulinastatin group with 66 cases and the combination group with 66 cases.The ulinastatin group was given ulinastatin,and the combination group was treated with additional Tongfu Xiefei Formula non-decoction granules on the basis of treatment of the ulinastatin group.Both groups were treated continuously for 7 days.The arterial blood gas indexes(partial pressure of carbon dioxide(PaCO2),oxygenation indexes,and partial pressure of oxygen(PaO2))and intestinal mucosal barrier indexes(intestinal fat-ty acid binding protein(IFABP),diamine oxidase(DAO)and D-lactate)were measured for the two groups before and after treatment.The mechanical ventilation duration,length of ICU stay and clinical curative effect were compared between the two groups.Results The oxygenation index and PaO2 levels of the two groups increased after treatment,and the levels of PaCO2,IFABP,DAO and D-lactate of the two groups decreased.The oxygenation index and PaO2 levels of the combina-tion group were respectively(321.96±72.33)and(70.27±8.15)mmHg(1 mmHg=0.133 kPa),higher than(257.08±67.37),(63.29±6.82)mmHg of the ulinastatin group(t=5.332,5.336,both P<0.05).The levels of PaCO2,IFABP,DAO and D-lac-tic acid of the combination group were(41.08±4.83)mmHg,(6.37±1.12)mg/mL,(1.61±0.32)U/L and(0.93±0.19)mg/L,respectively,lower than(46.51±5.18)mmHg,(9.95±1.86)mg/mL,(3.14±0.77)U/L and(1.68±0.22)mg/L of the ulinastatin group(t=6.229,24.657,14.907,20.961,all P<0.05).The mechanical ventilation duration and length of ICU stay of the combina-tion group were(5.54±0.66)and(4.71±0.85)d,respectively,shorter than(6.21±0.78)and(5.96±0.92)d of the ulinastatin group(t=5.327,8.107,both P<0.05).The total effective rate was 75.76%(50/66)in the ulinastatin group,lower than 92.42%(61/66)in the combination group(χ2=6.852,P<0.05).Conclusion The combination of Tongfu Xiefei Formula and ulinastatin can ef-fectively improve the arterial blood gas indexes,boost the pulmonary ventilation function,protect the intestinal mucosal barriers,shorten the treatment time and increase the clinical efficacy.

Abstract:Objective To explore the efficacy of Reduning combined with oseltamivir phosphate in children with influenza A.Methods A prospective controlled study design was adopted.A total of 109 pediatric patients with influenza A ad-mitted to Xuchang Central Hospital from January 2024 to February 2025 were selected and divided into the combination group(oseltamivir phosphate plus Reduning Injection,55 cases)and the control group(oseltamivir phosphate,54 cases)using a random number table method.The symptom relief time,inflammatory markers,negative conversion rate of viral nucleic acid,and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the combination group was 96.36%(53/55),significantly higher than that in the control group(83.33%,45/54)(χ2=5.099,P<0.05).The time to disappearance of fever,cough,sore throat,and rhinorrhea in the combination group((2.81±0.56),(3.53±0.62),(3.62±0.59),(2.65±0.55)d,respectively)were all shorter than those in the control group((3.52±0.69),(4.71±0.73),(4.01±0.70),(3.14±0.81)d,respectively)(t=5.904,9.102,3.147,3.701,all P<0.05).The negative conversion rate of viral nucleic acid in the combination group was 90.91%(50/55),higher than that in the control group(75.93%,41/54)(χ2=4.437,P<0.05).After treatment,levels of white blood cell count,absolute neutrophil-to-lym-phocyte ratio,C-reactive protein,and interleukin-6 in the combination group((4.83±0.76)×109/L,(3.23±0.58),(8.15±1.72)mg/L,(1.05±0.23)pg/mL)were significantly lower than those in the control group((7.29±1.08)×109/L,(3.86±0.72),(10.96±2.84)mg/L,(1.72±0.45)pg/mL)(t=13.773,5.035,6.261,9.813,all P<0.05).The incidence of adverse reactions was 7.41%(4/54)in the control group and 10.91%(6/55)in the combination group,with no statistically significant difference(χ2=0.401,P>0.05).Conclusion The combination of Reduning and oseltamivir phosphate not only enhances clinical efficacy and shortens symp-tom duration in children with influenza A by limiting viral infection,but also further alleviates systemic inflammatory response and modulates immune function,with a favorable safety profile.

Abstract:Objective To analyze the efficacy of octreotide combined with esomeprazole in the treatment of pep-tic ulcer bleeding(PUB),and to compare the changes in the levels of serum neutrophil-to-lymphocyte ratio(NLR)and plate-let-to-lymphocyte ratio(PLR).Methods A prospective controlled study design was used.A total of 105 patients with PUB ad-mitted to Huainan Oriental Hospital Group General Hospital from January 2022 to January 2025 were included and divided into the control group(n=52,treated with esomeprazole)and the combined group(n=53,treated with esomeprazole plus octreotide)according to simple random sampling.The clinical efficacy between the two groups was compared,as well as the levels of serum NLR,PLR,and interleukins(IL)2,IL-6,IL-17 before and after treatment,the four coagulation indicators,and adverse reactions.Results The total effective rate of the combined group was significantly higher than that of the control group(96.23%(51/52)vs 82.69%(43/52))(χ2=5.126,P<0.05).The hospitalization time and hemostasis time of the combined group were both shorter than those of the control group((5.40±1.17)d,(23.46±3.33)h vs(7.59±2.28)d,(32.13±5.08)h)(t=6.209,10.362,both P<0.05),and the blood transfusion volume of the combined group was lower than that of the control group((284±56)mL vs(418±62)mL)(t=11.627,P<0.05).The prothrombin time,activated partial thromboplastin time and thrombin time in the combined group were shorter than those in the control group((9.40±1.17)s,(22.59±2.73)s,(12.76±1.65)s vs(11.61±1.68)s,(27.53±2.86)s,(15.73±2.78)s)(t=7.834,9.055,6.672,all P<0.05),and the level of fibrinogen in the combined group was higher than that in the control group((2.81±0.38)g/L vs(2.12±0.27)g/L)(t=10.742,P<0.05).The IL-2 level in the combined group was higher than that in the control group((3.70±0.71)ng/mL vs(2.81±0.66)ng/mL)(t=6.650,P<0.05),while the levels of PLR,NLR,IL-6 and IL-17 in the combined group were lower than those in the control group((5.40±0.72),(22.63±3.68),(33.29±3.63),(169.36±17.65)pg/mL vs(6.37±0.84),(26.37±4.28),(37.83±3.86),(182.27±20.78)pg/mL)(t=4.804,6.357,6.210,3.433,all P<0.05).The incidence of adverse reactions was 1.89%(1/53)in the combination group and 9.62%(5/52)in the control group,and the difference was not statistically significant(χ2=2.748,P=0.097).Conclusion Octreotide combined with esomeprazole has a significant effect in the treatment of PUB,and can improve coagulation function,regulate NLR and PLR levels,reduce inflamma-tory responses,without increasing the risk of adverse events.

Abstract:Objective To investigate the effects of Compound Huangbai Liquid combined with cefuroxime sodium on wound healing and inflammatory levels in patients after hemorrhoidectomy.Methods A prospective randomized controlled study design was adopted.A total of 312 patients who underwent hemorrhoidectomy at the No.4 People's Hospital of Hengshui from October 2023 to March 2025 were selected and randomly divided into the observation group and the control group using a random number table method,with 156 cases in each group.Both groups received routine symptomatic treatment and anti-in-fective therapy with cefuroxime sodium postoperatively.The observation group additionally received Compound Huangbai Liquid lotion for sitz baths.After 2 weeks of treatment,clinical efficacy,wound healing time,wound edema,Visual Analogue Scale(VAS)pain scores,serum levels of inflammatory factors(tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)),and the incidence of complications were compared between the two groups.Results The observation group showed higher disease control rate(90.39%(141/156)vs 76.93%(120/156))and edema control rate(79.49%(124/156)vs 6.79%(73/156))compared to the control group(χ²=10.337,35.820,both P<0.001).The wound healing time was significantly shorter in the observation group than in the control group((16.19±3.52)days vs(20.33±4.47)days,t=9.088,P<0.001).On day 3 and day 7 after treatment,VAS scores were lower in the observation group than those in the control group(t=4.631,14.144,both P<0.001).Repeated measures analysis of variance showed statistically significant effects in VAS scores across groups,over time,and in interaction effects.(F_group=15.632,P<0.001;F_time=125.367,P<0.001;F_interaction=85.214,P<0.001).The observation group also exhibited signifi-cantly lower levels of TNF-α((3.12±0.41)ng/mL vs(4.05±0.65)ng/mL,t=15.114,P<0.001)and IL-6((12.49±3.63)ng/mL vs(15.63±4.67)ng/mL,t=6.630,P<0.001)compared to the control group.The incidence of complications in the observa-tion group was significantly lower than that in the control group(8.33%(13/156)vs 18.59%(29/156),χ²=7.043,P<0.05).Conclusion The addition of Compound Huangbai Liquid to conventional antibiotic therapy after hemorrhoidectomy can sig-nificantly promote wound healing,alleviate pain and edema,reduce inflammatory response,lower complications,with a good safety and efficacy profile.