Abstract:Objective To explore the clinical efficacy of Xuezhikang capsule combined with omeprazole in the treatment of hyperlipidemic pancreatitis.Methods This study is a prospective randomized controlled trial.A total of 80 patients with hyperlipidemic pancreatitis admitted to Changning County Hospital of Traditional Chinese from June 2023 to March 2025 were selected and divided into the control group and the observation group using a random number table method,with 40 cases in each group.The control group received conventional treatment plus Xuezhikang capsule,while the observa-tion group received omeprazole in addition to the control group's treatment regimen.Both groups were treated for one week.The clinical efficacy and adverse reactions after one week of treatment,as well as changes in blood lipid indicators and se-rum inflammatory markers before and after treatment,were compared between the control group and the observation group.Results The total effective rate in the observation group was 95.00%(38/40),higher than 77.50%(31/40)in control group(χ2=3.998,P<0.05).After treatment,the levels of triglycerides,total cholesterol,and low-density lipoprotein in the observation group((4.69±1.13),(4.12±1.28),(1.94±0.51)mmol/L,respectively)were lower than those in the control group((5.37±1.51),(4.97±1.41),(2.27±0.59)mmol/L,respectively),with statistically significant differences(t=2.280,2.823,2.676,all P<0.05).Af-ter treatment,the high-density lipoprotein level in the observation group((1.54±0.36)mmol/L)was higher than that in the control group((1.31±0.32)mmol/L),with a statistically significant difference(t=3.020,P<0.05).After treatment,the levels of high-sen-sitivity C-reactive protein,tumor necrosis factor-α,and interleukin-6 in the observation group((45.69±12.13)mg/L,(53.92±12.48)ng/L,(27.54±7.16)ng/L,respectively)were lower than those in the control group((52.37±12.51)mg/L,(67.17±12.71)ng/L,(31.21±7.31)ng/L,respectively),with statistically significant differences(t=2.425,4.705,2.268,all P<0.05).The incidence of adverse reactions in the observation group was 15.00%(6/40),compared to 10.00%(4/40)in the control group,with no statistically significant difference(χ2=0.457,P>0.05).Conclusion The combination of Xuezhikang capsules and ome-prazole demonstrated significant efficacy in treating hyperlipidemic pancreatitis,effectively improved blood lipid profiles and serum inflammatory markers,and exhibited a favorable safety profile.

Abstract:Objective To investigate the therapeutic efficacy of neutral protamine Hagedorn(NPH)insulin in the treatment of gestational diabetes mellitus(GDM).Methods A prospective controlled study design was adopted.A total of 780 patients with GDM who received treatment at the First Affiliated Hospital of Air Force Medical University between Janu-ary 2022 and January 2024 were chosen and divided into the control group(n=390)and the observation group(n=390)using a random number table method.After further screening by exclusion criteria,the observation group retained 328 cases and the control group retained 341 cases.The control group received treatment with insulin aspart,while the observation group received treatment with NPH insulin.Both groups received continuous treatment for 4 weeks.The indicators of blood glucose,pancre-atic function,renal function before and after treatment,pregnancy outcomes and neonatal outcomes were compared between the control group and the observation group.Results After treatment,the fasting and 2-hour postprandial blood glucose levels((4.71±0.94),(6.14±1.02)mmol/L),glycated hemoglobin((5.23±0.86)%),fasting insulin((4.78±0.37)μU/mL),insulin resis-tance index(1.22±0.33),homocysteine((8.32±2.76)μmol/L),and cystatin C level((0.83±0.18)mg/L)in the observation group were lower than those in the control group((5.68±1.06)mmol/L,(8.32±1.24)mmol/L,(6.85±1.12)%,(6.12±0.54)μU/mL,(2.60±0.41),(10.48±2.34)μmol/L,(1.16±0.29)mg/L),and the pancreatic β cell function in the observation group(68.37±3.59)was higher than that in the control group(58.26±3.84),with statistically significant differences(t=12.534,24.874,21.031,37.565,48.046,10.898,17.756,35.191,all P<0.05).The incidence of pregnancy complications(7.92%,27/341)and incidence of adverse neonatal outcomes(8.21%,28/341)in the observation group was lower than that in the control group(pregnancy complications:19.21%(63/328),incidence of adverse neonatal outcomes:17.68%(58/328)),with statistically significant differ-ences(χ2=18.301,13.389,both P<0.05).Conclusion NPH insulin is effective in controlling blood glucose levels in patients with GDM,improving pancreatic and renal function,and enhancing maternal and neonatal outcomes.

Abstract:Objective To explore the clinical efficacy of Xiao'er Xiaoji Zhike Oral Liquid as an adjunct to individ-ualized anti-infection regimens in children with severe community-acquired pneumonia(SCAP).Methods A prospective con-trolled study design was adopted.A total of 100 children with SCAP treated at Baoji Maternal and Child Health Hospital from April 2023 to March 2025 were selected and randomly assigned into two groups using a computer-generated random number sequence(50 cases each).Two cases in the control group discontinued treatment and one was lost to follow-up,while three cases in the observation group were lost to follow-up.Ultimately,both groups comprised 47 cases each.The control group received an individualized basic treatment regimen based on pathogen types,and the observation group additionally received Xiao'er Xiaoji Zhike Oral Liquid.The clinical efficacy,recovery time of respiratory symptoms,Traditional Chinese Medicine(TCM)syndrome scores,levels of inflammatory factors and incidence of adverse reactions were compared between the two groups before and af-ter treatment.Results After 7 days of treatment,the total effective rate in observation group was 95.74%(45/47),higher than that in the control group(78.72%(37/47))(χ2=6.114,P=0.013).The recovery times for fever,cough and expectoration,and pul-monary rales in the observation group((2.24±1.21),(3.77±0.98),(4.61±1.12)days,respectively)were shorter than those in the control group((3.37±1.81),(4.32±1.33),and(5.24±1.03)days,respectively)(t=3.558,2.282,2.838,all P<0.05).TCM syndrome scores for fever,wheezing,cough frequency,abdominal distension,fatigue and dizziness in the observation group((1.31±0.35),(1.36±0.29),(1.29±0.38),(0.66±0.23),(0.73±0.27),(0.69±0.25)points,respectively)were lower than those in the control group((2.45±0.37),(2.56±0.31),(2.48±0.38),(1.47±0.28),(1.37±0.24),(1.35±0.21)points,respectively)(t=15.345,19.380,15.181,15.325,12.146,13.858,all P<0.05).The proportion of neutrophils,the levels of serum interleukin-6 and C-reactive protein in the observation group((45.68±8.45)%,(53.12±1.31)pg/L,(13.03±1.98)mg/L,respectively)were lower than those in the control group((49.65±9.28)%,(55.21±1.19)pg/L,(16.89±2.01)mg/L,respectively)(t=2.169,8.096,9.379,all P<0.05).The incidence of adverse reactions was 12.77%(6/47)in the observation group and 17.02%(8/47)in the control group,with no statistically significant difference(χ2=0.336,P=0.562).Conclusion Xiao'er Xiaoji Zhike Oral Liquid as an adjunct to individualized an-ti-infection therapy can alleviate the clinical symptoms in children with SCAP,accelerate the recovery of respiratory function,reduce systemic inflammatory response,and exhibit a favorable safety profile.

Abstract:Objective To analyze the efficacy and safety of levofloxacin combined with the 3HRZE regimen in sur-gical patients with chronic tuberculous empyema.Methods A retrospective cohort study was conducted.A total of 82 patients undergoing surgery for chronic tuberculous empyema admitted to the Fifth People's Hospital of Suzhou between January 2022 and May 2025 were included in this analysis,with their clinical data extracted from the hospital's medical record system.Based on the actual treatment regimens documented in the medical records,patients were categorized into the 3HRZE group and the combination group.The 3HRZE group received basic treatment plus the 3HRZE regimen(41 cases),while the combination group received ba-sic treatment plus levofloxacin combined with the 3HRZE regimen(41 cases).Both groups underwent continuous treatment for 3 months.Efficacy,immune function,length of hospital stay,and the incidence of adverse reactions were extracted from the medical records for the 3HRZE group and the combination group for comparative analysis.Results The total effective rate was higher in the combination group than that in the 3HRZE group(92.68%(38/41)vs 75.61%(31/41)),with a statistically significant difference(χ2=4.479,P<0.05).The combination group showed higher CD4+percentage and levels of immunoglobulin A,and lower CD8+percentage,compared to the 3HRZE group((37.42±4.25)%vs(34.31±4.47)%,(2.54±0.42)g/L vs(2.27±0.39)g/L,(27.10±3.78)%vs(29.97±3.54)%),with statistically significant differences(t=3.229,3.016,-3.548,all P<0.05).The length of hospital stay was short-er in the combination group than that in the 3HRZE group((12.01±4.01)days vs(15.23±3.36)days),with a statistically significant difference(t=-3.941,P<0.05).The incidence of adverse reactions in the combination group and the 3HRZE group was 14.63%(6/41)and 12.20%(5/41),respectively,with no statistically significant difference(χ2=0.105,P>0.05).Conclusion For patients un-dergoing surgery for chronic tuberculous empyema,levofloxacin combined with the 3HRZE regimen demonstrated better treatment efficacy,greater improvement in immune function,and a shorter hospital stay compared to the control group.

Abstract:Objective To investigate the clinical efficacy of doxycycline combined with methylprednisolone in the treatment of macrolide-nonresponsive Mycoplasma pneumoniae pneumonia(MUMPP)in children.Methods A retrospective controlled study design was adopted.A total of 172 children with MUMPP who visited Suzhou Municipal Hospital from July 2023 to December 2024 were initially screened for this retrospective comparative study.After excluding cases that did not meet the inclusion criteria or were lost to follow-up during treatment,150 cases were ultimately included.Based on different treat-ment regimens,they were divided into two groups:75 cases receiving azithromycin combined with methylprednisolone were assigned to the azithromycin group,and 75 cases receiving doxycycline combined with methylprednisolone were assigned to the doxycycline group.The inflammatory level,immune level,clinical efficacy,post-treatment symptom improvement and in-cidence of adverse reactions were evaluated before and after treatment in two groups.Results The total effective rate in the doxycycline group was 92.00%(69/75),higher than that in the azithromycin group(80.00%(60/75))(χ2=4.485,P<0.05).After treatment,the time to fever resolution,cough relief,disappearance of lung rales,and hospitalization length in the doxycycline group((4.51±1.37),(5.62±1.53),(4.78±1.24),(8.59±2.36)days,respectively)were all lower than those in the azithromycin group((7.24±2.83),(8.15±2.46),(6.92±1.85),(12.33±3.72)days,respectively)(t=7.519,7.563,8.321,7.352,all P<0.05).After treatment,the levels of interleukin-6,tumor necrosis factor-α,and C-reactive protein in the doxycycline group((11.64±4.36)ng/L,(2.85±0.86)ng/L,(32.33±6.72)mg/L,respectively)were all lower than those in the azithromycin group((17.83±4.75)ng/L,(4.92±1.01)ng/L,(47.52±6.16)mg/L,respectively)(t=8.314,13.514,14.430,all P<0.05).After treatment,the levels of CD3+and CD4+/CD8+ratio in the doxycycline group((74.82±4.08)%,(1.77±0.28),respectively)were higher than those in the azith-romycin group((68.85±4.53)%,(1.47±0.26),respectively)(t=8.481,6.799,both P<0.05).No statistically significant difference was observed in the incidence of adverse reactions between the two groups(8.00%(6/75)vs 5.33%(4/75),χ2=0.429,P>0.05).Conclusion The combination of doxycycline and methylprednisolone is effective in treating MUMPP in children,significantly improving clinical outcomes and symptoms,modulating inflammatory and immune responses,with a favorable safety profile.

Abstract:Objective To investigate the clinical efficacy of dapagliflozin combined with spironolactone in the treatment of coronary heart disease(CHD)complicated by heart failure with reduced ejection fraction(HFrEF).Methods A prospective controlled study was adopted.A total of 156 patients with CHD complicated by HFrEF admitted to Hai'an People's Hospital from July 2023 to December 2024 were enrolled and randomly divided into the control group(foundational treatment plus spironolactone)and the experimental group(foundational treatment plus dapagliflozin combined with spironolactone),with 78 cases in each group.After attrition,74 cases per group were included in the final data analysis.Clinical efficacy,exercise tol-erance,ventricular remodeling indicators,blood pressure,blood glucose,blood biochemical markers,and incidence of adverse reactions were observed and compared between the two groups.Results After treatment,the total effective rate in the exper-imental group was 90.54%(67/74),significantly higher than 78.38%(58/74)in the control group(χ2=4.170,P<0.05).The ex-perimental group showed a greater improvement in the 6-minute walk test distance((378.48±31.58)m),higher than that in the control group((356.32±32.72)m)(t=4.192,P<0.05).Ventricular remodeling indicators,including left ventricular end-diastolic diameter,interventricular septal thickness,and left ventricular posterior wall thickness,were all lower in the experimental group compared to those in the control group((50.63±7.83),(9.67±1.62),(9.17±1.38)mm vs(55.42±6.41),(11.51±1.13),(11.73±2.56)mm),while left ventricular ejection fraction was higher in the experimental group((49.35±5.31)%vs(42.73±5.62)%)(t=4.072,8.014,7.572,7.365,all P<0.05).The experimental group also had lower levels of interleukin-6,C-reactive pro-tein,and N-terminal pro-brain natriuretic peptide((74.37±9.82)ng/L,(3.87±0.47)mg/L,(584.81±72.63)pg/mL vs(91.38±10.74)ng/L,(5.72±0.89)mg/L,(741.63±78.35)pg/mL)(t=10.055,15.812,12.627,all P<0.05).There were no significant dif-ferences in systolic blood pressure,diastolic blood pressure,and blood glucose parameters(fasting blood glucose,glycated hemoglobin)between the two groups(t=1.133,1.868,0.352,0.235,all P>0.05).The incidence of adverse reactions also showed no significant difference(5.41%(4/74)vs 9.46%(7/74),χ2=0.429,P>0.05).Conclusion Dapagliflozin combined with spirono-lactone can improve clinical efficacy,enhance cardiac function,and increase the quality of life in patients with CHD complicated by HFrEF,with a favorable safety profile.

Abstract:Objective To investigate the clinical efficacy of anisodamine hydrobromide combined with nor-epinephrine(NE)in treating septic shock.Methods A prospective controlled study design was adopted.A total of 262 patients with septic shock treated at Nanyang Central Hospital from January 2023 to September 2024 were enrolled and randomly divided into the control group and the experimental group using a random number method,with 131 cases in each group.The control group received intravenous infusion of NE after conventional anti-infection and anti-shock ther-apy,while the experimental group received intravenous injection of anisodamine in addition to the control group's treat-ment regimen.Both groups were observed for 24 hours after treatment.The total clinical effective rate,and the levels of systolic blood pressure,urine output,heart rate,arterial oxygen saturation(SaO2),left ventricular ejection fraction(LVEF),B-type natriuretic peptide(BNP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),activated partial thromboplastin time(APTT),and fibrinogen(FIB)before and after treatment were compared between the two groups.Results After treat-ment,the total effective rate in the experimental group was 86.26%(113/131),significantly higher than 75.57%(99/131)in the control group(χ2=4.838,P<0.05).After treatment,urine output,systolic blood pressure,SaO2,and LVEF increased in both groups compared to pre-treatment levels,with the experimental group showing higher values((121.63±6.97)mL/h,(114.51±6.04)mmHg(1 mmHg=0.133 kPa),(96.75±2.06)%,(64.08±2.98)%,respectively)than the control group((92.55±8.14)mL/h,(99.15±4.91)mmHg,(91.83±3.09)%,(53.69±6.55)%,respectively)(t=31.051,22.585,15.162,16.526,all P<0.05).After treatment,heart rate,the levels of BNP,PCT,TNF-α,APTT,and FIB decreased in both groups,with the experimental group showing lower values((88.63±5.06)beats/min,(74.42±3.15)pg/mL,(80.44±2.79)ng/L,(2.33±0.29)μg/L,(35.73±3.21)s,(3.18±0.51)g/L,respectively)than the control group((103.62±3.81)beats/min,(82.77±6.33)pg/mL,(89.63±7.05)ng/L,(3.82±0.42)μg/L,(32.11±2.46)s,and(3.73±0.36)g/L,respectively)(t=27.083,13.518,13.874,33.424,10.244,10.086,all P<0.05).The incidence of adverse reactions in the experimental group was 11.45%(15/131),significantly lower than 32.06%(42/131)in the control group(χ2=16.346,P<0.05).Conclusion Anisodamine combined with NE can more effectively maintain hemody-namic parameters,improve microcirculation,regulate immunity response,and enhance the therapeutic efficacy in septic shock.Close monitoring of clinical indicators is essential during medication administration.

Abstract:Objective To evaluate the effects of different tranexamic acid(TXA)administration on coagulation function and complications in patients undergoing total knee arthroplasty(TKA)receiving oral rivaroxaban.Methods A prospective study was conducted.A total of 72 patients who underwent TKA at Anyang People's Hospital from June 2023 to December 2024 were enrolled and divided into the control group(local TXA injection)and the experimental group(intravenous drip combined with local TXA injection)via a random number table method,with 36 cases in each group.Both groups received routine oral rivaroxaban postoperatively.Perioperative blood loss,coagulation parameters,and the incidence of complications were compared between the two groups.Results There were no statistically significant differences between the two groups in terms of operative time((106.15±31.05)min vs(102.77±30.96)min),tourniquet time((89.23±5.32)min vs(90.51±5.26)min),and intraoperative blood loss((152.27±20.03)mL vs(147.85±19.62)mL)(t=0.463,1.027,0.946,all P>0.05).The total blood loss and hemoglobin reduction at 24 hours postoperatively in the experimental group((712.62±125.77)mL,(18.73±4.55)g/L)were significantly lower than those in the control group((825.63±157.83)mL,(21.57±3.64)g/L)(t=3.360,2.924,both P<0.05).No significant intergroup differences were observed in the changes of prothrombin time((1.32±0.36)s vs(1.42±0.37)s)and acti-vated partial thromboplastin time((4.73±1.25)s vs(5.03±1.67)s)at 24 hours postoperatively(t=1.162,0.863,both P>0.05).The time effect,intergroup effect,and interaction effect of the Visual Analog Scale pain score were statistically significant(F=349.816,21.535,11.500,all P<0.05).For knee joint range of motion,only the time effect was statistically significant(F=75.516,P<0.05).No pulmonary embolism occurred in either group,and there were no statistically significant differences in transfusion rates(8.33%(3/36)vs 5.56%(2/36))or complication rates(16.67%(6/36)vs 11.11%(4/36))(χ2=0.465,P>0.05).Conclusion In TKA pa-tients receiving oral rivaroxaban,combined intravenous and local administration of TXA effectively reduces total postoperative blood loss and hemoglobin decline,without increasing the risks of coagulation dysfunction,blood transfusion,or complications.

Abstract:Objective To investigate the clinical efficacy of calcium dobesilate combined with enalapril in the treat-ment of patients with non-dipper hypertension complicated with type 2 diabetes mellitus(T2DM).Methods A prospective controlled study design was used.A total of 80 patients with non-dipper hypertension complicated by T2DM treated at Shou-guang People's Hospital from December 2022 to December 2024 were enrolled and randomly divided into two groups using a random number table.The control group(40 cases)received foundational medication plus enalapril,while the observation group(40 cases)received foundational medication plus enalapril plus calcium dobesilate.Both groups continued treatment for 6 months.Clinical efficacy,blood pressure rhythm changes,blood glucose levels,pancreatic islet function,vascular endothelial function,and adverse reactions were compared between the two groups.Results After treatment,the total effective rate in the obser-vation group was 92.50%(37/40),higher than that in the control group(75.00%(30/40))(χ2=4.501,P<0.05).After treatment,the daytime systolic and diastolic blood pressures and nighttime systolic and diastolic blood pressures in the observation group((126.03±6.31),(81.31±6.29),(115.62±6.40),(75.65±5.65)mmHg(1 mmHg=0.133 kPa),respectively)were lower than those in the control group((141.36±6.94),(87.54±6.27),(124.33±6.38),(80.31±5.40)mmHg,respectively)(t=10.337,4.437,6.096,3.771,all P<0.05).The nocturnal blood pressure decline rate in the observation group((12.02±2.18)%)was higher than that in the control group((7.53±1.79)%)(t=10.067,P<0.05).After treatment,the levels of fasting blood glucose,2-hour postprandial blood glucose,and glycated hemoglobin in the observation group((6.08±0.57)mmol/L,(9.57±0.56)mmol/L,(6.12±0.51)%,respectively)were lower than those in the control group((6.95±0.67)mmol/L,(10.28±0.91)mmol/L,(7.43±0.96)%,respective-ly)(t=6.255,4.203,7.622,all P<0.05).After treatment,the levels of fasting insulin and homeostasis model assessment of insulin resistance index in the observation group((11.22±1.63)mU/L,(3.36±0.35),respectively)were lower than those in the control group((13.01±1.76)mU/L,(3.91±0.38),respectively)(t=4.719,6.733,both P<0.05).After treatment,the endothelin-1 level in the ob-servation group((44.74±6.82)pg/mL)was lower than that in the control group((55.89±6.75)pg/mL)(t=7.349,P<0.05),while the nitric oxide level in the observation group((86.11±11.52)μmol/L)was higher than that in the control group((71.25±10.86)μmol/L)(t=5.936,P<0.05).The incidence of adverse reactions was 15.00%(6/40)in the observation group and 12.50%(5/40)in the con-trol group,with no statistically significant difference(χ²=0.105,P>0.05).Conclusion The combination of calcium dobesilate and enalapril demonstrates good efficacy in treating non-dipper hypertension associated with T2DM.It can effectively improve the patients'circadian blood pressure rhythm,regulate blood sugar levels,ameliorate insulin resistance,promote the repair of vascular endothelial function,and exhibit a favorable safety profile.

Abstract:Objective To investigate the additive effect of ezetimibe on lipid profile and cardiac function in patients with unstable angina pectoris(UAP)and dyslipidemia treated with standard nicorandil-based therapy.Methods A total of 108 patients with UAP and dyslipidemia admitted to the Department of Cardiology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province between April 2023 and February 2024 were randomly divided into the ob-servation group(54 cases)and the control group(54 cases)using a random number table method.All patients received conven-tional therapy.The control group received additional nicorandil,while the observation group received nicorandil combined with ezetimibe.Angina symptoms,lipid profiles,vascular endothelial function,left ventricular function,and adverse drug reactions were compared between the two groups.Results After treatment,the observation group had a lower frequency((1.48±0.50)times/week vs(2.35±0.48)times/week)and shorter duration((3.26±0.44)min/episode vs(5.39±0.60)min/episode)of angina attacks than the control group(t=9.168,21.082,both P<0.05).The total effective rate for electrocardiogram improvement was higher in the ob-servation group(88.89%(48/54)vs 72.22%(39/54),χ2=4.788,P<0.05).After treatment,the observation group showed lower left ventricular end-diastolic diameter and left ventricular end-systolic diameter((52.71±4.63),(36.52±4.54)mm)than the control group((55.46±4.18),(40.11±4.21)mm),while the left ventricular ejection fraction level in the observation group((54.63±6.62)%)was higher than that in the control group((51.24±6.15)%)(t=3.239,4.261,2.761,all P<0.05).After treatment,the observa-tion group also showed more significant improvements in levels of triglyceride,total cholesterol,and low-density lipoprotein cholesterol((1.14±0.35),(4.51±0.72),(1.74±0.59)mmol/L)compared to the control group((1.95±0.36),(4.92±0.74),(3.26±0.53)mmol/L),while the high-density lipoprotein cholesterol level in the observation group((3.11±0.68)mmol/L)was higher than that in the control group((2.25±0.56)mmol/L)(t=11.857,2.922,14.105,7.162,all P<0.05).After treatment,the observa-tion group showed higher nitric oxide levels((50.20±6.18)μmol/L)compared to the control group((42.91±5.91)μmol/L),and lower endothelin-1 levels((4.37±1.17)pg/mL)than the control group((4.84±1.23)pg/mL)(t=6.265,2.035,both P<0.05).The incidence of adverse reactions did not differ significantly between the observation group and the control group(12.96%(7/54)vs 11.11%(6/54))(χ2=0.087,P>0.05).Conclusion The combination of ezetimibe and nicorandil showed an additive effect in en-hancing the improvement of blood lipid profiles,vascular endothelial function,and left ventricular function in patients with UAP and dyslipidemia.

Abstract:Objective To evaluate of the effect of trimetazidine adjunctive to metoprolol on cardiac function and in-flammatory levels in patients with ischemic cardiomyopathy complicated by hypertension.Methods A prospective controlled study was conducted.A total of 82 patients with ischemic cardiomyopathy and hypertension from Huai'an First Hospital Affil-iated to Nanjing Medical University between January 2023 and June 2024 were enrolled and randomly divided into the control group(41 cases,receiving metoprolol monotherapy)and the observation group(41 cases,receiving trimetazidine combined with metoprolol)using a random number table.After 12 weeks of continuous treatment,cardiac function indices,serum inflammatory markers,and incidence of adverse reactions were compared between the two groups.Results After treatment,the observa-tion group showed lower left ventricular end-diastolic diameter and left ventricular end-systolic diameter((51.12±4.28)mm,(39.51±3.22)mm,respectively)compared to the control group((56.97±5.41)mm,(43.31±4.32)mm,respectively),while the left ventricular ejection fraction was higher in the observation group than in the control group((45.69±3.41)%vs(40.35±3.32)%)(t=5.430,4.516,7.184,all P<0.05).After treatment,the observation group showed lower levels of high-sensitivity C-reactive protein,tumor necrosis factor-α,and interleukin-6((45.59±12.14)mg/L,(50.92±12.78)ng/L,(14.54±3.15)ng/mL,respectively)compared to the control group((52.27±12.51)mg/L,(57.16±12.31)ng/L,(16.25±3.21)ng/mL,respectively)(t=2.454,2.252,2.435,all P<0.05).The incidence of adverse reactions in the observation group was 14.63%(6/41),showing no statistically significant difference compared to 12.20%(5/41)in the control group(χ2=0.105,P>0.05).Conclusion The combination of trimetazidine and metoprolol demonstrates better improvements in cardiac function and inflammatory markers in patients with ischaemic cardiomyopathy complicated by hypertension,with a favorable safety profile.

Abstract:Objective To investigate the efficacy and impact on liver function of reduced glutathione combined with a bedaquiline-containing regimen in patients with multidrug-resistant pulmonary tuberculosis.Methods A prospective controlled study design was adopted.A total of 60 patients with multidrug-resistant pulmonary tuberculosis admitted to the Third Hospital of Cangzhou from January 2023 to December 2023 were enrolled and randomly divided into the control group and the observation group(n=30 each)using a computer-generated random number table.The control group received bedaquiline-containing regimen,while the observation group received reduced glutathione combined with bedaquiline-containing regimen.Clinical efficacy(sputum culture conversion,lesion absorption,and cavity reduction rates),liver function parameters(alanine aminotransferase(ALT),as-partate aminotransferase(AST),total bilirubin,alkaline phosphatase(ALP)),drug-induced liver injury(DILI)grade,inflammatory markers(C-reactive protein(CRP),interferon-gamma(IFN-γ)),and pulmonary function were compared between the two groups.Results After treatment,there were no statistically significant differences in sputum culture conversion rate(86.67%(26/30)vs 93.33%(28/30)),lesion absorption rate(76.67%(23/30)vs 83.33%(25/30)),and cavity reduction rate(76.67%(23/30)vs 80.00%(24/30))between the control group and observation group(χ2=0.185,0.417,0.098,all P>0.05).After treatment,the levels of ALT,AST,total bilirubin,and ALP increased in both groups,and these indicators were significantly lower in the observation group((155.65±12.77)U/L,(123.49±12.27)U/L,(23.18±2.15)μmol/L,(78.16±9.32)U/L)compared to the control group((171.48±14.93)U/L,(139.61±13.52)U/L,(27.78±3.49)μmol/L,(86.92±10.27)U/L)(t=4.413,4.836,6.147,3.460,all P<0.05).Grade 2(moderate)DILI was predominant in both groups(the control group:86.67%(26/30),the observation group:83.33%(25/30)),with no statistically sig-nificant difference in DILI grade distribution between the two groups(Z=1.669,P>0.05).After treatment,CRP levels decreased and IFN-γ levels increased in both groups,with the observation group showing a lower CRP((10.13±1.77)mg/L vs(13.25±2.04)mg/L)and a higher IFN-γ((38.64±5.38)ng/mL vs(32.57±5.12)ng/mL)compared to the control group(t=6.327,4.477,both P<0.05).After treatment,pulmonary function(one-second forced expiratory volume(FEV1)and FEV1/forced vital capacity ratio)improved in both groups,with the observation group showing higher values((2.46±0.42)L,(81.21±9.64)%)compared to the control group((1.95±0.37)L,(70.59±9.01)%)(t=4.991,4.408,both P<0.05).Conclusion The combination of reduced glutathione and the bedaquiline-containing regimen for the treatment of multidrug-resistant pulmonary tuberculosis not only maintains clinical efficacy comparable to monother-apy with the betacarbazone-containing regimen,but also significantly improves patients'liver function parameters,reduces the severi-ty of liver injury,alleviates inflammatory responses,and promotes the recovery of pulmonary function.

Abstract:Objective To analyze the current status of potential adverse drug interactions(ADIs)in prescriptions containing celecoxib and provide reference for clinical medication safety.Methods A retrospective analysis was conducted on all combined prescriptions containing celecoxib issued at the outpatient department of Xuancheng Central Hospital from January to December,2023.Data including patient age,gender,prescription department,and clinical diagnosis for prescriptions with potential ADIs were collected and analyzed.Relevant interacting drugs were identified,and the associated potential risks were assessed and classified by severity.Results A total of 505 patient prescriptions were included.Among these,347 prescriptions(68.71%,347/505)were found to have potential ADIs,accounting for 369 case-times.These prescriptions originated from Or-thopedics,Emergency,and Endocrinology departments.The drugs interacting with celecoxib involved 13 major categories and 27 types,predominantly consisting of traditional Chinese medicine,non-steroidal anti-inflammatory drugs,and glucocorticoids.Among them,the risk severity for the combination of"celecoxib plus traditional Chinese medicines"was classified as"moderate".Conclusion The incidence of potential ADIs in outpatient prescriptions containing celecoxib is notably high.It is recommend-ed to strengthen prescription review and medication education,particularly targeting key prescribing departments and high-risk drug combinations.Furthermore,implementing an information-based pre-prescription review system to provide real-time alerts and interventions based on risk levels is crucial to ensure patient medication safety.

Abstract:Objective To explore the efficacy of citicoline combined with edaravone in patients with post-stroke vascular cognitive impairment(VCI)and its effect on serum levels of homocysteine(Hcy)and free triiodothyronine(FT3).Methods A prospective randomized controlled trial was conducted.A total of 122 patients with post-stroke VCI after cerebral infarction,admitted to Xingtai People's Hospital between January 2024 and June 2025,were enrolled and randomly assigned to the citicoline combination group and the edaravone group using a random number table method.The edaravone group(n=61)received edaravone monotherapy,while the citicoline combination group(n=61)received citicoline in combination with edara-vone.The clinical efficacy,cognitive function scores,serum levels of Hcy and FT3,inflammatory factors(C-reactive protein,tu-mor necrosis factor-α,interleukin-6),cerebral hemodynamic indicators(middle cerebral artery systolic flow velocity,mean flow velocity,pulsatility index),and the incidence of adverse reactions were compared between the two groups.Results The total effective rate in the citicoline combination group(88.52%(54/61))was higher than that in the edaravone group(72.13%(44/61))(χ2=5.187,P=0.023).After treatment,the scores of the Montreal Cognitive Assessment and the Mini-Mental State Examination in the citicoline combination group((25.82±1.23),(24.79±2.37)points)were higher than those in the edaravone group((23.94±1.17),(22.51±1.78)points)(t=8.649,6.008,both P<0.05).After treatment,the Hcy level in the citicoline combination group((15.39±2.52)μmol/L)was lower than that in the edaravone group((18.94±3.28)μmol/L),and the FT3 level((6.20±0.65)pmol/L)was higher than that in the edaravone group((5.21±0.42)pmol/L)(t=6.703,9.991,both P<0.05).After treatment,the levels of C-reactive protein,tumor necrosis factor α,and interleukin-6 in the citicoline combination group((6.32±1.04)mg/L,(32.56±4.57)pg/mL,(26.42±3.15)pg/mL)were lower than those in the edaravone group((8.19±1.67)mg/L,(40.19±5.58)pg/mL,(31.25±3.66)pg/mL)(t=7.424,8.262,7.812,all P<0.05).After treatment,the levels of systolic flow velocity,mean flow veloc-ity,and pulsatility index in the citicoline combination group((93.19±5.68)cm/s,(65.26±4.22)cm/s,(0.72±0.08))were superior to those in the edaravone group((89.44±5.50)cm/s,(61.83±4.77)cm/s,(0.79±0.10))(t=3.704,4.206,4.269,all P<0.05).The incidence of adverse reactions did not differ significantly between the citicoline combination group(13.11%(8/61))and the eda-ravone group(11.48%(7/61))(χ2=0.076,P=0.783).Conclusion Citicoline combined with edaravone demonstrates confirmed efficacy in treating patients with post-stroke VCI.It improves patients'cognitive function,cerebral hemodynamics,and inflam-matory responses,regulates serum Hcy and FT3 levels,and exhibits a favorable safety profile.

Abstract:Objective To explore the efficacy of pertuzumab and trastuzumab combined with chemotherapy(taxane plus platinum)in treatment of patients with human epidermal growth factor receptor-2(HER2)positive breast cancer.Methods A pro-spective randomized controlled trial was conducted.A total of 80 patients with HER2-positive breast cancer who were treated in The Affiliated Hospital of Guizhou Medical University between June 2021 and February 2024 were enrolled in the study and randomly di-vided into the control group and the combined therapy group,with 40 cases in each group.The control group was treated with trastu-zumab combined with chemotherapy(taxane plus platinum),while the combined therapy group was given additional pertuzumab on basis of the treatment regimen of the control group.Both groups received injections once every 3 weeks,which was considered as one treatment cycle,for a total of 4 cycles.The serum inflammatory factors,tumor markers and vascular endothelial growth factors before and after treatment,the clinical curative effects after treatment,adverse reactions and survival rates were compared between the control group and the combined therapy group.Results After treatment,the levels of serum interleukin-1β,interleukin-6 and tumor necrosis factor α of the combined therapy group were(90.36±9.13)pg/mL,(17.72±1.94)ng/L and(0.77±0.12)μg/mL,respectively,lower than(95.27±10.75)pg/mL,(19.80±2.13)ng/L and(0.89±0.15)μg/mL of the control group,and there were statistically significant dif-ferences(t=2.128,4.566,3.951,all P<0.05).The levels of carbohydrate antigen 15-3,tumor-specific growth factor and vascular endothelial growth factor of the combined therapy group were(27.65±3.83)U/mL,(42.40±5.36)U/L and(32.70±4.31)ng/mL,respectively,lower than(30.10±4.22)U/mL,(55.94±6.72)U/L and(41.83±5.25)ng/mL of the control group,and there were sta-tistically significant differences(t=2.719,9.962,8.501,all P<0.05).The total effective rate of the combined therapy group was 92.50%(37/40),higher than 75.00%(30/40)of the control group,and there was statistically significant difference(χ2=4.501,P<0.05).There were no statistically significant differences in the incidence rates of adverse reactions such as leukopenia(7.50%(3/40)vs 5.00%(2/40)),rash(12.50%(5/40)vs 7.50%(3/40)),gastrointestinal reactions(17.50%(7/40)vs 22.50%(22/40)),myelosuppression(15.00%(6/40)vs 15.00%(6/40))and cardiotoxicity(5.00%(2/40)vs 12.50%(5/40))between the combined therapy group and the control group(χ2<0.001,χ2=0.139,0.313,χ2<0.001,χ2=0.626,all P>0.05).The 1-year overall survival rate was 92.50%(37/40)in the combined therapy group and 75.00%(30/40)in the control group.Kaplan-Meier survival curve anal-ysis showed that there was statistically significant difference in the 1-year overall survival rate between the combined therapy group and the control group(χ2=4.539,P=0.033).Conclusion The combination of pertuzumab,trastuzumab and chemotherapy(taxane plus platinum)is effective and safe in treating patients with HER2-positive breast cancer.It can alleviate inflammatory reactions,reduce levels of tumor markers and vascular endothelial growth factor,and improve short-term survival outcomes.

Abstract:Objective To explore the influencing factors of the efficacy of recombinant human growth hormone(rhGH)in the treatment of children with prepubertal idiopathic short stature.Methods A retrospective cohort study was conducted.A total of 109 children with prepubertal idiopathic short stature admitted to Central Hospital of Qinghe County from January 2023 to July 2024 were included in the analysis,with their clinical data extracted from the hospital's medical record system.Based on the growth velocity recorded in the first year of treatment,the children were divided into the good efficacy group(n=72)and the poor efficacy group(n=37).The clinical data and growth indicators were compared between the two groups.A logistic regression analysis was performed to identify influencing factors of rhGH treatment efficacy in children with prepubertal idiopathic short stature.Results The age at treatment initiation was lower in the good efficacy group than in the poor efficacy group.The pro-portions of good treatment compliance,treatment duration≥12 months,parental genetic target height,peak value in the growth hormone stimulation test,and insulin-like growth factor 1(IGF-1)level were all higher in the good efficacy group than in the poor efficacy group((6.21±1.71)years vs(7.93±1.81)years,75.00%(54/72)vs 54.05%(20/37),91.67%(66/72)vs 75.68%(28/37),(162.54±3.31)cm vs(159.53±3.51)cm,(12.62±3.34)ng/mL vs(9.91±2.58)ng/mL,(132.23±26.56)ng/mL vs(108.89±21.31)ng/mL,t/χ2=4.875,4.919,5.266,4.404,4.315,4.631,all P<0.05).After treatment,the height,height standard deviation score,and first-year growth velocity were higher in the good efficacy group than those in the poor efficacy group((117.34±5.27)cm vs(112.14±4.67)cm,(-1.47±0.44)vs(-2.26±0.38),(6.83±1.45)cm/year vs(4.21±0.78)cm/year,respectively,t=5.064,9.282,10.240,all P<0.05).Multivariate logistic regression analysis revealed that age at treatment initiation,treatment compli-ance,treatment duration,parental genetic target height,peak value in growth hormone stimulation test,and IGF-1 level were influencing factors for poor therapeutic efficacy of rhGH treatment in children with prepubertal idiopathic short stature(OR=2.054,4.809,6.665,0.865,0.779,0.938,respectively,all P<0.05).Conclusion The efficacy of rhGH treatment in children with pread-olescent idiopathic short stature is influenced by multiple factors.Clinical attention should be paid to age at treatment initiation,treatment compliance,treatment duration,parental genetic height,peak value in growth hormone stimulation test,and IGF-1 lev-els,in order to develop individualized treatment plans and improve therapeutic outcomes.

Abstract:Objective To compare the application effect of arotinolol and propranolol on patients with cirrhotic portal hypertension.Methods A prospective controlled study design was adopted.A total of 86 patients with cirrhotic por-tal hypertension admitted to the Xinxiang Central Hospital from January 2021 to October 2024 were selected as test subjects and divided into two groups according to the random number table method.The two groups were treated with arotinolol(the arotinolol group,n=43)and propranolol(the propranolol group,n=43),respectively.The changes of portal vein flow velocity,hepatic vein damping index,nitric oxide,endothelin-1,angiopoietin-2,vascular endothelial growth factor,soluble cluster of differentiation 163,interleukin-6,alanine aminotransferase and aspartate aminotransferase,as well as treatment safety and the rate of gastrointestinal bleeding were observed in the two groups after treatment.Results The portal vein flow velocity in the arotinolol group was(18.71±3.51)cm/s,higher than(15.78±3.66)cm/s in the propranolol group(t=3.789,P<0.05),while the hepatic vein damping index was(0.60±0.08)in the arotinolol group,lower than(0.66±0.11)in the propranolol group(t=2.627,P<0.05).The level of nitric oxide was(79.74±11.11)μmol/L in the arotinolol group,higher than(74.55±10.21)μmol/L in the propranolol group(t=2.254,P<0.05),while the level of endothelin-1 was(58.10±9.16)pg/mL in the arotinolol group,lower than(63.67±9.27)pg/mL in the propranolol group(t=2.803,P<0.05).There were no statistically significant differences in the levels of angiopoietin-2 and vascular endothelial growth factor between the two groups(t=1.745,1.523,both P>0.05).The levels of soluble cluster of differentiation 163 and interleukin-6 in the arotinolol group were(2.01±0.41)ng/mL and(30.57±8.23)pg/mL,lower than(2.33±0.40)ng/mL and(35.42±10.61)pg/mL in the propranolol group(t=3.622,2.370,both P<0.05).The levels of alanine aminotransferase and aspartate aminotransferase were(66.32±9.02)and(65.09±8.40)U/L in the arotinolol group,which were not statistically different from(67.55±8.65)and(66.69±11.09)U/L in the propranolol group(t=0.646,0.752,both P>0.05).There were no statistically significant differences in treatment safety(13.95%vs 18.60%)and the rates of gastroin-testinal bleeding(9.30%vs 16.28%)between the arotinolol group and the propranolol group(χ2=0.341,0.938,both P>0.05).Conclusion Both arotinolol and propranolol can improve portal vein hemodynamics and vascular endothelial function,and inhibit inflammation in patients with cirrhotic portal hypertension.However,arotinolol demonstrates superior efficacy in enhanc-ing portal vein hemodynamics and vascular endothelial function.

Abstract:Objective To explore the clinical efficacy of the combination of evolocumab and atorvastatin in the treatment of acute myocardial infarction(AMI).Methods A retrospective controlled study method was adopted.A total of 120 AMI patients admitted to Puyang Oilfield General Hospital from January 2022 to October 2024 was selected and divided into two groups based on different treatment regimens.The statin group received atorvastatin treatment,and the combination group received evolocumab in addition to atorvastatin treatment.The clinical efficacy,lipid metabolism indicators,cardiac func-tion indicators,inflammatory marker levels before and after treatment,and the occurrence of adverse reactions were collected,extracted,and compared between the two groups.Results The total effective rate in the combination group was higher than that in the statin group(93.22%(55/59)vs 70.49%(43/61),χ2=10.348,P=0.001).After treatment,total cholesterol,triglycerides,and low-density lipoprotein cholesterol were all reduced in both groups,and the levels in the combination group((3.02±0.42),(1.16±0.21),(1.65±0.24)mmol/L)were lower than those in the statin group((3.92±0.59),(1.92±0.30),(2.62±0.38)mmol/L)(t=9.598,16.027,16.655,all P<0.05).After treatment,left ventricular ejection fraction(LVEF),left ventricular end-systolic di-ameter(LVESD),and left ventricular end-diastolic diameter(LVEDD)improved in both groups.LVEF in the combination group was(66.15±5.29)%,higher than that in the control group((56.48±4.51)%),while LVESD and LVEDD in the combination group((37.03±3.33),(46.20±4.16)mm)were lower than those in the statin group((40.95±3.69),(49.12±3.92)mm),with statistically significant differences(t=10.788,6.103,3.958,all P<0.05).After treatment,serum tumor necrosis factor-α and high-sensitivity C-reactive protein decreased in both groups,and the levels in the combination group((1.25±0.31)ng/mL,(4.60±1.15)mg/L)were lower than those in the statin group((1.64±0.42)ng/mL,(8.82±2.21)mg/L),with statistically significant differences(t=5.772,13.056,both P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(13.11%(8/61)vs 25.42%(15/59),χ2=2.933,P>0.05).Conclusion Evolocumab combined with atorvastatin can improve the clinical efficacy in AMI patients,reduce lipid levels,improve cardiac function and inflammatory levels,with a good safety profile.

Abstract:Objective To analyze the clinical efficacy of different doses of recombinant human prourokinase com-bined with sodium nitroprusside in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A retrospective controlled study was adopted.A total of 82 STEMI patients admitted to Luoyang Central Hospital from March 2023 to March 2025 were analyzed.All patients underwent percutaneous coronary intervention and received con-ventional drug therapy.According to the medical records,patients who actually received 10 mg of recombinant human prouroki-nase combined with sodium nitroprusside were assigned to the low-dose group(41 cases),while those who actually received 20 mg of recombinant human prourokinase combined with sodium nitroprusside were assigned to the high-dose group(41 cases).Data on reperfusion status,cardiac function improvement,serological indicators,bleeding events,and adverse reactions were ex-tracted from the medical records for comparative analysis.Results In the high-dose group,Thrombolysis in Myocardial Infarc-tion(TIMI)grade was as follows:grade 0 in 3 cases(7.32%),grade Ⅰ in 4 cases(9.76%),grade Ⅱ in 8 cases(19.51%),and gradeⅢ in 26 cases(63.41%).In the low-dose group,it was grade 0 in 5 cases(12.20%),grade Ⅰ in 8 cases(19.51%),grade Ⅱ in 15 cases(36.59%),and grade Ⅲ in 13 cases(31.71%).The high-dose group showed better results than the low-dose group(Z=-2.630,P<0.05).In the high-dose group,Myocardial Blush grade was as follows:grade 0 in 2 cases(4.88%),grade Ⅰ in 5 cases(12.20%),grade Ⅱ in 15 cases(36.59%),and grade Ⅲ in 19 cases(46.34%).In the low-dose group,it was grade 0 in 6 cases(14.63%),gradeⅠ in 10 cases(24.39%),grade Ⅱ in 18 cases(43.90%),and grade Ⅲ in 7 cases(17.07%).The high-dose group was superior to the low-dose group,with a statistically significant difference(Z=-3.018,P<0.05).After treatment,the electrocardiographic ST seg-ment resolution rate in the high-dose group was as follows:complete recovery in 27 cases(65.85%),partial recovery in 12 cases(29.27%),and no recovery in 2 cases(4.88%),while in the low-dose group,it was complete recovery in 17 cases(41.46%),par-tial recovery in 16 cases(39.02%),and no recovery in 8 cases(19.51%).The high-dose group was superior to the low-dose group,with a statistically significant difference(Z=2.451,P<0.05).Compared with the low-dose group,the high-dose group showed a lower postoperative peak troponin I level((3.15±0.82)μg/L vs(3.58±0.96)μg/L)and a shorter time to peak((12.67±2.54)h vs(14.97±2.58)h),and the postoperative peak of Creatine Kinase-MB(CK-MB)decreased in the high-dose group((352.62±51.83)U/L vs(385.72±56.14)U/L),with a shorter time to peak((11.47±1.83)h vs(13.06±1.75)h)(t=2.181,4.068,2.774,4.021,all P<0.05).After treatment,compared with the low-dose group,the high-dose group showed a higher left ventricular ejection fraction((50.62±3.44)%vs(48.96±3.51)%,t=2.163,P<0.05)and a lower N-terminal pro-B-type natriuretic peptide level((742.83±129.64)ng/L vs(895.73±136.25)ng/L,t=5.226,P<0.05).There was no statistically significant difference in TIMI bleeding grade between the low-dose group and the high-dose group(19.51%(8/41)vs 29.27%(12/41),χ2=1.058,P>0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(12.20%(5/41)vs 14.63%(6/41),χ2=0.105,P>0.05).Conclusion For STEMI patients,recombinant human prourokinase combined with sodium nitroprusside can effectively improve myocardial reperfusion and enhance cardiac function.Moreover,the therapeutic effect is further en-hanced with an increased dose of rhPro-UK,while maintaining a favorable safety profile.

Abstract:Objective To analyze the occurrence characteristics of adverse drug reactions(ADRs)to antineoplastic agents using Pareto method to identify key influencing factors,providing evidence for clinical safe medication.Methods A retrospective data analysis was adopted.A total of 271 reports of anti-tumor ADR submitted by Bozhou Hospital Affiliated to Anhui Medical University from January 2022 to May 2025 were collected.The Pareto method was used to statistically ana-lyze the patients'age,gender,administration route,drug type,involved system/organ,occurrence time and outcome of ADRs.Results Among the patients reported by ADRs,54.61%(148/271)were female and 45.39%(123/271)were male.The age group distribution was mainly 55～64 years old(31.37%,85/271),65～74 years old(29.52%,80/271),and 75～84 years old(18.08%,49/271).Intravenous infusion was the main route of administration(94.46%,256/271).The top three drugs causing ADRs were paclitaxel(28.41%,77/271),cisplatin(16.97%,46/271),and oxaliplatin(9.23%,25/271).Damage to the blood and hematopoietic system accounted for the highest proportion(68.63%,186/271),followed by gastrointestinal reactions(25.46%,69/271).ADR occurred mainly at 1～2 days,3～7 days,8～15 days and 16～30 days after medication,with a cumulative proportion of 78.97%(214/271).The proportion of physicians among the reported personnel was 96.31%(261/271).All ADRs improved or recovered after intervention.Conclusion Antineoplastic drug-related ADRs demonstrate distinct temporal patterns,drug-spe-cific risks,and age-related characteristics.Enhanced surveillance should be prioritized for high-risk populations,critical time periods,and specific medications,coupled with optimized multidisciplinary reporting mechanisms to improve medication safety.