Abstract:Objective To study the effect of mindfulness-based stress reduction combined with radiotherapy on patients with advanced head and neck cancer(nasopharyngeal carcinoma,laryngeal cancer)pain.Methods A total of 100 patients with advanced head and neck cancer pain admitted to the First Affiliated Hospital of Zhengzhou University from May 2023 to March 2024 were selected for the study.They were randomly divided into an observation group and a control group,with 50 patients in each group.The control group received routine care intervention after radiotherapy treatment,while the observation group received mindfulness-based stress reduction intervention in addition to the control group.Pain levels,negative emotions,and functional assessment of cancer therapy-head & neck(FACT-H&N)scale scores were recorded and compared between the two groups.Results After intervention,the VAS scores of both groups of patients were lower than before intervention,and the observation group had lower scores than the control group(P＜0.05).After intervention,the scores of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)in both groups of patients were lower than before intervention,and the observation group was lower than the control group(P＜0.05).After intervention,the emotional,physiological,functional,social/family,and head and neck condition scores of the two groups of patients were higher than before intervention,and the observation group was higher than the control group(P＜0.05).Conclusion Mindfulness-based stress reduction combined with radiotherapy can effectively relieve the pain of patients with advanced head and neck cancer,improve negative emotions and improve the quality of life.

Abstract:Objective To understand the willingness of patients' family members to choose non-accompanying care services and explore the influencing factors.Methods A general information questionnaire,family caregiver task inventory(FCTI)and Zarit burden interview(ZBI)were used to survey 210 patients' family members.Results Among the 210 patients' family members,109(51.90％)were willing to choose non-accompanying care services.Logistic regression analysis showed that the relationship with the patient,average monthly income,times of accompanying care in the past year,caregiving ability and caregiving burden were the influencing factors of the willingness of patients' family members to choose non-accompanying care services(P＜0.05).Conclusion The willingness of patients' family members to choose non-accompanying care services is at a medium level,but there is still considerable room for improvement.It is suggested that medical institutions build a non-accompanying care service system that accurately identifies needs,provides individualized services and offers full support for both physical and mental health,to further enhance the willingness to choose non-accompanying care services.

Abstract:Objective To investigate the clinical characteristics of neonatal appendicitis and improve the level of early clinical diagnosis and treatment.Methods Clinical data of 64 neonates with appendicitis admitted to the Third Affiliated Hospital of Zhengzhou University from January 2018 to December 2022 were retrospectively analyzed.Clinical indicators were compared between the surgical group and the non-surgical group,the perforation group and the non-perforation group,as well as between patients with and without neonatal necrotizing enterocolitis(NEC).Results The common early clinical manifestations in the 64 neonates were abdominal distension(60.9％)and poor response(59.4％).There were statistically significant differences in the first and second serum C-reactive protein levels after symptom onset between the surgical and non-surgical groups.There was no statistically difference inclinical date between the perforated and non-perforated groups of children(P＞0.05).Of the 64 neonates,16 were complicated with NEC.Significant differences were found in gestational age,birth weight and onset time between neonates with and without NEC.Conclusion Neonatal appendicitis has nonspecific clinical manifestations.For neonates presenting with abdominal distension,poor response and other symptoms,imaging and peripheral blood examinations should be performed in a timely manner and reviewed dynamically.Timely surgery may be required for patients with significantly elevated C-reactive protein.NEC is the most common complication of appendicitis.Neonates with appendicitis complicated with NEC have smaller gestational age,lower birth weight and later onset time.

Abstract:Objective To explore the effect of Shenfu injection combined with Xuebijing in patients with sepsis.Methods A total of 80 patients with sepsis who were treated in the First People's Hospital of Zhengzhou from January 2022 to January 2024 were selected as the research subjects and randomly divided into two groups using a random number table method,with 40 patients in each group.On the basis of conventional treatment,the control group was treated with Shenfu injection,while the study group was treated with Shenfu injection combined with Xuebijing.The efficacy and the changes in CD8+,CD4+,erythrocyte sedimentation rate(ESR),CD3+,CD4+programmed cell death molecule 1(PD-1),CD8+PD-1,interleukin-6(IL-6),procalcitonin(PCT),macrophage inflammatory protein 2(MIP-2),fibrinogen(Fib),whole blood viscosity at low shear rate(Nbl),high-sensitivity C-reactive protein(hs-CRP),and whole blood viscosity at high shear rate(Nbh)before and after treatment were compared between the two groups.Results The efficacy grade of the study group was better than that of the control group(P＜0.05),and the marked efficacy rate of 62.50％(25/40)was higher than that of the control group of 35.00％(14/40),but there was no statistically significant difference in the total effective rate between the two groups(P＞0.05).After treatment,the CD3+and CD4+in the study group were higher than those in the control group,while the CD4+PD-1,CD8+PD-1,and CD8+were lower than those in the control group(P＜0.05).After treatment,the hs-CRP,MIP-2,ESR,IL-6,Nbl,Fib,Nbh,and PCT in the study group were lower than those in the control group(P＜0.05).Conclusion The combination of Xuebijing and Shenfu injection in patients with sepsis has a good effect on improving hemodynamics and inhibiting inflammatory reaction,and may also play a role in improving immunity function by regulating the levels of CD8+PD-1,CD4+PD-1 and other factors.

Abstract:Objective To investigate the application of bedside-family empowerment management based on user profiles in maternal discharge readiness.Methods The study selected pregnant women admitted to the obstetrics department of a tertiary comprehensive hospital in Zhengzhou City from March to September 2025 as research subjects.Using continuous sampling,all admitted pregnant women were screened.Those who met the inclusion criteria and provided consent were sequentially enrolled until a pre-determined sample size of 100 was reached.An Excel software with the RAND function was used to generate a random number table,and 100 pregnant women were randomly divided into the observation group and the control group,with 50 cases in each group.General data such as age and gestational weeks of the patients in both groups were collected.The control group received routine nursing intervention,while the observation group received bedside-family empowerment management intervention based on user profiles.Both groups of parturients were intervened until discharge.The maternal and infant knowledge mastery degree,psychological consistency score,family function score,quality of life score,discharge readiness score,and nursing satisfaction of the two groups were compared.Results The overall mastery rate of the observation group was higher than that of the control group(P＜0.05).After the intervention,the scores of each dimension of the psychological consistency scale,the quality of life scale,and the discharge readiness scale in the observation group were all higher than those in the control group,while the scores of each dimension of the family function assessment scale were lower than those in the control group(P＜0.05).The total satisfaction rate of the observation group was higher than that of the control group(P＜0.05).Conclusion The bedside-family empowerment management intervention based on user profiles significantly improves maternal discharge readiness and demonstrates positive effects in knowledge mastery,psychological coherence,family functioning,quality of life,and nursing satisfaction.

Abstract:Objective To investigate the regulatory mechanism of placental trophoblast autophagy and apoptosis in fetal growth restriction(FGR).Methods Placental tissues from 30 pregnant women who delivered with FGR at the Second Affiliated Hospital of Zhengzhou University from January to December 2024 were selected as the FGR group,and placental tissues from 30 pregnant women with normal delivery during the same period were enrolled as the healthy control group.Clinical data of both groups were collected.The mRNA expression levels of BAX,BCL2,ATG7,CAPN1,Beclin1,and ATG3 in placental villus tissues were detected by qRT-PCR.The protein levels of BAX,BCL2,cleaved CASP3,cleaved CASP8,p62/SQSTM1,and CAPN1 were measured by ELISA.The differences between the two groups and the correlations among indicators were analyzed.Results Apoptosis-related indicators:compared with the healthy group,the expression of anti-apoptotic BCL2(both gene and protein)was decreased in the FGR group,while the levels of pro-apoptotic BAX,cleaved CASP3,and cleaved CASP8 were increased,accompanied by an elevated BAX/BCL2 protein ratio(P＜0.05).Autophagy-related indicators:the mRNA expression of the key autophagy gene ATG7 was reduced(P＜0.05),and the level of autophagy substrate protein p62/SQSTM1 was increased(P＜0.05)in the FGR group.In addition,the protein level of calpain CAPN1 was elevated(P＜0.05)and showed a positive correlation with p62 protein level(r=0.504,P＜0.001).The p62 protein level was negatively correlated with neonatal birth weight(r=-0.420,P=0.006).Conclusion Impaired autophagy(mediated by downregulated ATG7 and upregulated CAPN1)and increased apoptosis(induced by BAX/BCL2 imbalance)in placental trophoblasts are jointly involved in the pathogenesis of FGR.The accumulation of p62 is negatively correlated with fetal birth weight,which may affect fetal growth and development.

Abstract:Objective To analyze the clinical therapeutic effect of sodium oligomannate combined with intermittent θ burst stimulation(iTBS)on Alzheimer disease(AD)patients.Methods A prospective randomized controlled study was conducted to divide 104 AD patients admitted to Huaihe Hospital of Henan University from January 2021 to May 2024 into a control group and an observation group using a random number table method,with 52 patients in each group.The control group was treated with sodium oligomannate,and on this basis,the observation group was treated with iTBS,all were treated for 3 months.The cognitive function[Montreal cognitive assessment(MoCA),Alzheimer disease assessment scale-cognitive(ADAS-cog)],neurological function[5-hydroxytryptamine(5-HT),γ-aminobutyric acid(GABA),AD-associated neuronal thread protein(AD7 c-NTP)]and daily living ability[AD cooperative study-activities of daily living(ADCS-ADL)]were compared between the two groups before and after treatment.Results After 3 months of treatment,the MoCA and ADCS-ADL scores,5-HT and GABA levels increased in both groups,while the ADAS-cog score and AD7 c-NTP levels decreased.The MoCA and ADCS-ADL scores,5-HT and GABA levels in the observation group were higher than those in the control group,while the ADAS-cog score and AD7c-NTP levels were lower than those in the control group,with statistical significance(P＜0.05).Conclusion The combination of sodium oligomannate and iTBS therapy can significantly improve cognitive function,promote neurological recovery,and enhance daily living abilities in AD patients,with certain clinical application value.

Abstract:Objective To explore the value of serum carbohydrate antigen 125(CA125),human epididymis protein 4(HE4),and plasma D-dimer in the diagnosis of ovarian cancer.Methods A retrospective analysis was conducted on 134 patients with ovarian tumors,including 102 cases of ovarian cancer and 32 cases of benign ovarian tumors,all confirmed by pathology.Serum levels of CA125 and HE4,along with plasma D-dimer levels,were measured.Multivariable logistic regression was used to control for confounding factors such as age and thrombosis.The diagnostic efficacy of individual and combined biomarkers was assessed using receiver operating characteristic(ROC)curves,and optimal cut-off values were determined.Age distribution and the relationship between D-dimer levels and age were analyzed,and the status of thrombotic complications in the ovarian cancer group was supplemented.Results There was no significant difference in age distribution between ovarian cancer group and benign group(P＞0.05).D-dimer levels showed a weak positive correlation with age(r=0.212,P=0.023).In the ovarian cancer group,the D-dimer positivity rate was significantly higher in patients with thrombosis compared to those without(P＜0.01).The positivity rates of serum CA125,HE4,and D-dimer in the ovarian cancer group were higher than those in the benign group(P＜0.01).ROC curve analysis demonstrated that the areas under the curve(AUC)for CA125,HE4,and D-dimer alone were 0.843,0.884,and 0.816,respectively.The combined detection of the three biomarkers yielded an AUC of 0.907(95％CI:0.856-0.958),with a sensitivity of 84.5％and a specificity of 89.7％.Among the 84 ovarian cancer patients with definitive FIGO staging,the positivity rates for CA125+HE4 were 64.5％in stages Ⅰ+Ⅱ and 88.7％in stagesⅢ+Ⅳ,while D-dimer positivity rates were 77.4％and 96.2％,respectively and the differences were statistically significant(P＜0.05).Conclusion The combined detection of serum CA125,HE4,and plasma D-dimer significantly enhances the diagnostic performance for ovarian cancer,offering both high sensitivity and high specificity.Furthermore,D-dimer levels are closely associated with tumor stage and hypercoagulable states,providing multidimensional evidence for the early diagnosis and clinical assessment of ovarian cancer.

Abstract:Objective To explore the impact of multi-stage change of theoretical mode on the compliance behavior and self-efficacy of elderly patients with chronic heart failure.Methods A retrospective analysis was conducted to collect data from 47 elderly patients with chronic heart failure who received routine care at Luohe Central Hospital from January 2022 to December 2023,and they were included in the control group.Data of 47 elderly patients with heart failure who received routine nursing combined with multi-stage change of theoretical mode intervention in the Luohe Central Hospital during the same period were collected,and included in the observation group.Patient case data,nursing information,etc.were all kept intact.The patient's data were reviewed,and the evaluation results of the patient's compliance behavior questionnaire at 3 months of intervention were recorded.The general self-efficacy scale(GSES),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)evaluation results and 6-minute walking test(6MWT)results were recorded on the next day of admission and 3 months of intervention.Results Compared with the control group,the observation group showed better overall compliance with medical treatment,and the overall compliance rate was higher than that of the control group(P＜0.05).On the day after admission,there was no difference in the GSES,HAMA,HAMD scores,and 6MWT results between the two groups of patients(P＞0.05).After 3 months of intervention,the GSES scores of the two groups of patients improved,the HAMA and HAMD scores decreased,and the 6MWT results improved.The observation group had higher GSES scores and 6MWT results than the control group,while the HAMA and HAMD scores were lower than the control group.There were statistical significant differences between the groups and within the groups(P＜0.05).Conclusion The multi-stage change of theoretical mode has a positive effect on the improvement of compliance behavior and self-efficacy in elderly patients with chronic heart failure,and helps alleviate negative emotional states and promote better exercise endurance.

Abstract:Objective To explore the application effect of negative pressure closed drainage combined with mesh skin grafting technology in patients with large area skin tearing injuries.Methods A retrospective analysis was conducted on the data of 87 patients with large area skin tearing injuries who completed treatment in General Hospital of Pingmei Shenma Group from July 2019 to July 2023.According to compression methods,they were divided into a control group(43 cases,treated with mesh skin grafting technique and traditional compression technique)and an observation group(44 cases,treated with mesh skin grafting technique and negative pressure closed drainage).The clinical indexes,skin graft survival rate,wound healing,scar hyperplasia and postoperative complications were compared in both groups.Results The control group had more dressing changes than the observation group,longer hospital stay and wound healing time,lower skin graft survival rate,and higher incidence of postoperative wound infection compared to the observation group(P＜0.05).At 1 week and 4 weeks after surgery,the wound healing area in the control group were lower than those in the observation group(P＜0.05).At 1 month and 6 months after surgery,patient scar assessment scale(PSAS)and observer scar assessment scale(OSAS)scores of the control group were higher than those of the observation group(P＜0.05).Conclusion Patients with large area skin tearing injuries treated with negative pressure closed drainage combined with mesh skin grafting technology have a high survival rate of skin grafts,can achieve early healing,reduce dressing changes,and lower the risk of wound infection,without causing severe scar hyperplasia.

Abstract:Objective To study the clinical effect of Qiangli Dingxuan Tablets in the treatment of peripheral vertigo caused by vestibular neuritis and its influence on vertigo symptoms and sleep quality.Methods A total of 148 patients with peripheral vertigo caused by vestibular neuritis admitted to Kaifeng 155th Hospital from January 2022 to January 2025 were prospectively selected.They were randomly divided into conventional group(74 cases,treated with betahistine)and combined group(74 cases,treated with Qiangli Dingxuan Tablets combined with betahistine).All patients were treated for 4 weeks.The clinical efficacy of the two groups of patients was compared,as well as the scores of dizziness handicap inventory(DHI),dizziness assessment rating scale(DARS),visual analogue scale(VAS),vestibular activity participation(VAP),Pittsburgh sleep quality index(PSQI),activity specific balance confidence(ABC)scale before treatment,2 weeks and 4 weeks after treatment.The incidence of adverse reactions during treatment and the recurrence rate after 6 months of follow-up were also compared between the two groups.Results The overall clinical efficacy rate of the combined group was higher than the conventional group(P＜0.05).At 2 and 4 weeks after treatment,the scores of physical,functional and emotional dimensions of DHI,DARS and VAS scores in both groups decreased compared with baseline,and were lower in the combined group(P＜0.05).After 2 and 4 weeks of treatment,PSQI and VAP scores of the two groups were reduced,while ABC scores were increased,the combined group showed lower PSQI and VAP scores and higher ABC scores(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).During the 6-month follow-up,no case was lost to follow-up in the combined group and one case was lost in the conventional group.The recurrence rate in the combined group was lower than that in the conventional group(P＜0.05).Conclusion Qiangli Dingxuan Tablets combined with betahistine can improve the clinical efficacy of patients with peripheral vertigo,effectively relieve vertigo symptoms,improve sleep quality and balance function,reduce the recurrence rate,and have good safety.

Abstract:Objective To analyze the effect of bromhexidine assisted prednisone tablets in the treatment of secretory otitis media(SOM)and its impact on the serum levels of soluble interleukin-2 receptor(sIL-2R)and Toll-like receptor 2(TLR2)in patients.Methods The data of 150 patients with SOM in Puyang People's Hospital from October 2022 to March 2024 were retrospectively analyzed.Patients were divided into control group and study group according to treatment plans,with 75 cases in each group.The control group was treated with prednisone tablets,while the study group was treated with bromhexine combined with prednisone tablets.Clinical efficacy,symptom recovery time,bone conduction thresholds at different frequencies,tympanic pressure,R-value of pharyngeal manometry,eustachian tube dysfunction 7-item questionnaire(ETDQ-7)score,and serum sIL-2R and TLR2 levels were compared between the two groups.Results The total effective rate of the study group was higher than the control group(P＜0.05).The time of effusion disappearance,tinnitus disappearance and hearing recovery in the study group was shorter than that in the control group(P＜0.05).After treatment,1,2,4 kHz bone conduction threshold,tympanic pressure and ETDQ-7 score in the study group were better than those in the control group,and the R value of eustachian tube pressure at 30,40,50 mbar in the study group was higher than that in the control group(P＜0.05).After treatment,sIL-2R and TLR2 in the study group were lower than those in the control group(P＜0.05).Conclusion Bromhexine has definite therapeutic effect on SOM,which can balance the pressure inside and outside the patient's drum,improve hearing,downregulate the expression of TLR2 and sIL-2R,and promote disease recovery.

Abstract:Objective To analyze risk factors associated with postoperative mortality after hip fracture in elderly patients and develop a predictive model,so as to provide evidence for clinical assessment of postoperative mortality risk.Methods Four hundred elderly patients with hip fractures were selected from the Department of Orthopedics of Central Hospital of Zhoukou from May 2020 to October 2024,and they were randomly divided into a modeling and a verification group at a 3∶1 ratio.Based on patient survival within 1 year after surgery,the modeling group was further subdivided into a survival group(249 cases)and a death group(51 cases).Independent risk factors for 1-year postoperative mortality in elderly hip fracture patients were identified to develop a prognostic prediction model.The discriminative ability of the model was assessed by receiver operating characteristic(ROC)curve in the modeling and validation groups.Results Logistic regression showed that age ≥ 75 years,preoperative comorbidities＞2,preoperative prognostic nutritional index ≥ 45,American Society of Anesthesiologists(ASA)grade Ⅲ-Ⅳ,surgical delay,and postoperative complications were independent risk factors for mortality within 1 year after elderly hip joint surgery.The Hosmer-Lemeshow goodness-of-fit test was used to assess the regression model for 1-year postoperative mortality risk in elderly patients undergoing hip surgery,with a test P=0.411,indicating acceptable model calibration.The area under the curve(AUC)for the modeling group was 0.835(95％CI:0.776-0.894),with a sensitivity of 78.43％,specificity of 75.90％,and a cut-off point of 0.236;the validation group AUC was 0.793(95％CI:0.667-0.919),with a sensitivity of 81.25％and specificity of 77.38％.Conclusion The risk model for postoperative mortality in elderly patients with hip fracture has favorable discriminative validity and can be applied to identify high-risk individuals for 1-year postoperative death among such patients.

Abstract:Objective To explore the causality between gut microbiota(GM)and bronchiectasis through a two-sample Mendelian randomization(MR)analysis.Methods Genome-wide association study(GWAS)data for GM and bronchiectasis were obtained from the MiBioGen consortium and the FinnGen database,respectively.A two-sample MR analysis was employed to assess the causal effect of GM on bronchiectasis.Heterogeneity testing,horizontal pleiotropy assessment,and sensitivity analyses were also conducted.Results Four types of GM were found to have nominal significant associations with bronchiectasis.Among these,the Bifidobacterium(OR=0.76,95％CI:0.58-0.99,P=0.039)and the Lachnospiraceae FCS020(OR=0.75,95％CI:0.56-1.00,P=0.048)may potentially decrease the risk of bronchiectasis.Conversely,the Candidatus Soleaferrea(OR=1.27,95％CI:1.01-1.61,P=0.043)and the Gammaproteobacteria(OR=1.67,95％CI:1.08-2.59,P=0.022)showed a positive correlation with bronchiectasis.Conclusion At the genetic prediction level,specific GM exhibit a causal relationship with bronchiectasis,providing innovative insights for the management of patients with this condition.

Abstract:Objective To establish the reference interval for 25-OH vitamin D[25(OH)D]in pregnant women in Zhengzhou,Henan Province.Methods This study collected serum samples from 9 411 healthy pregnant women aged from 20 to 56 years who underwent prenatal checkups in Zhengzhou.The 25(OH)D levels were measured using the Siemens ADVIA Centaur XP chemiluminescence immunoassay analyzer.The reference intervals were determined by analyzing the test results and establishing percentiles(P2.5,P97.5).Subsequently,serum samples from an additional 2 664 healthy pregnant women undergoing prenatal checkups in Zhengzhou were collected,and the previously established reference intervals were validated according to the standard WS/T 402-2024 Determination of Reference Intervals of Quantitative Test Items in Clinical Laboratory.Results The reference interval of 25(OH)D in healthy pregnant women aged 20-56 years needed to be grouped by gestational week,season,and age.The reference intervals were as follows:early pregnancy was 12.45-64.00 nmol·L-1,mid-pregnancy was 12.33-63.77 nmol·L-1,late pregnancy was 12.89-77.67 nmol·L-1;spring was 12.67-67.68 nmol·L-1,summer was 13.95-67.11 nmol·L-1,autumn was 13.98-71.23 nmol·L-1,winter was 11.56-64.14 nmol·L-1;age-appropriate pregnancy was 12.45-67.18 nmol·L-1,advanced maternal age pregnancy was 12.47-69.88 nmol·L-1.Results from 2 664 validation specimens showed that＞90％fell within the reference range.Conclusion This study has preliminarily established the reference interval of 25(OH)D in healthy pregnant women aged 20-56 years in Zhengzhou,which has been verified and applied to clinical practice.This study is of key significance for the design of randomized controlled studies to analyze the effects of vitamin D(VD)supplementation on pregnancy outcomes and perinatal infants in different populations.By studying the correlation between VD supplementation and pregnancy outcomes,the optimal serum VD concentration for supplementation in Zhengzhou area can be determined.

Abstract:Objective To explore the application effect of the scenario-simulation teaching mode based on SimMan3G comprehensive simulator in the standardized training of resident physicians in the department of critical care medicine,so as to explore a more standardized training system for critical care medicine.Methods A total of 40 trainees who underwent standardized training of resident physicians(referred to as"resident training")in the Department of Critical Care Medicine of Henan Provincial People's Hospital from September 2022 to June 2023 were included as the research objects.They were divided into the observation group and the control group according to the random lottery method.In the first stage,both groups of trainees received 2 weeks skill and theoretical training.In the second stage,the observation group was taught by the scenario-simulation teaching method,while the control group was taught by the traditional teaching method,and the learning period for both groups was 1 month.After the teaching,the theoretical scores and comprehensive application scores of clinical skills of the two groups were compared through examinations,and the teaching satisfaction was evaluated by anonymous questionnaires.Results After the first-stage teaching,there was no significant difference in the single-skill test scores and theoretical test scores between the two groups of trainees(P＞0.05).After the second-stage teaching,compared with the control group,the theoretical scores and comprehensive application scores of clinical skills of the resident trainees in the observation group were higher.In addition,the satisfaction of the resident physicians in the observation group with the teaching design was better than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion In the teaching and training of critical care medicine resident training,the scenario-simulation teaching method based on SimMan3G comprehensive simulator can further consolidate the learning situation of resident physicians.It can not only improve the ability of resident physicians to apply what they have learned,but also enhance the teaching satisfaction,which is conducive to the cultivation of resident physicians in the department of critical care medicine.

Abstract:Objective To explore the effect of Triangle hierarchical management on elderly patients with hypertension.Methods The 104 elderly hypertensive patients treated in the First Affiliated Hospital of Zhengzhou University from June 2023 to October 2024 were divided into 2 groups by random number table method.On the basis of routine nursing in control group(52 cases),observation group(52 cases)was given Triangle stratified management.The levels of systolic blood pressure(SBP),diastolic blood pressure(DBP)and the scores of hospital anxiety and depression scale(HADS),self-perceived burden scale(SPBS)were compared between the two groups.Results After intervention,the levels of SBP and DBP decreased in both groups,and the levels of SBP and DBP were lower in the observation group(P＜0.05).After intervention,the scores of anxiety,depression in HADS and SPBS of both groups decreased,and the scores of anxiety,depression in HADS and SPBS of observation group were lower(P＜0.05).Conclusion The Triangle hierarchical management can effectively improve blood pressure level,and change the negative emotion and self-perceived burden in elderly patients with hypertension,which has clinical reference and promotion value.

Abstract:Objective To explore the influencing factors of early castration resistance in prostate cancer patients and construct a column chart risk prediction model.Methods A retrospective collection of data was conducted on 123 prostate cancer patients who received androgen deprivation therapy(ADT)in General Hospital of Pingmei Shenma Group.Based on the early progression of castration resistance during a 2-year follow-up period after ADT treatment,the patients were divided into a advanced group(75 cases)and an non advanced group(48 cases).The influencing factors of early castration resistance in prostate cancer patients were analyzed,a column chart model was constructed based on the influencing factors,and the predictive performance of the column chart model was analyzed.Results The preliminary comparison of data between the advanced group and the non advanced group revealed that the T stage of the primary lesion,pre-treatment alkaline phosphatase(ALP),Gleason score,number of bone metastases,combined metabolic syndrome,and the lowest prostate specific antigen(PSA)value after treatment were all influencing factors for early progression to castration resistance in prostate cancer patients after ADT(OR＞1,P＜0.05).A column chart prediction model was constructed based on the influencing factors,and the fit between the internal correction curve and the ideal curve was well reflected.The receiver operating characteristic(ROC)curve showed that the overall model predicted the risk of early progression to castration resistance in thyroid cancer patients with an area under the curve(AUC)of 0.872,indicating good prediction accuracy.Conclusion The early progression of castration resistance in prostate cancer patients may be influenced by the T staging of the primary lesion,pre-treatment ALP,Gleason score,number of bone metastases,metabolic syndrome,and the lowest PSA value after treatment.The column chart risk prediction model constructed based on this may have good predictive value.

Abstract:Objective To investigate the clinical effect of Xianyu Capsule combined with low frequency repetitive transcranial magnetic stimulation(LF-rTMS)in the treatment of primary epilepsy in children.Methods A total of 108 children with primary epilepsy admitted to Luohe Central Hospital from September 2021 to September 2024 were selected as the research objects and divided into two groups according to treatment schemes,with 54 cases in each group.Both groups were treated with sodium valproate.On this basis,the control group was treated with LF-rTMS,and the study group was treated with LF-rTMS and Xianyu Capsule.The efficacy of the two groups of children after treatment,as well as the number of seizures,the quality of life of children's general scale 4.0(PedsQL4.0)score,the average single time,the status epilepticus severity scale(STESS)score,serum factors[calcium,glial fibrillary acidic protein(GFAP),phosphorus,brain-derived neurotrophic factor(BDNF),alkaline phosphatase(ALP),neuron-specific enolase(NSE),insulin-like growth factor-1(IGF-1)]before and after treatment,and adverse reactions were compared.Results There was no significant difference in the total effective rate between the study group[92.59％(50/54)]and the control group[85.19％(46/54)](P＞0.05),but the clinical control rate of the study group[48.15％(26/54)]was higher than that[27.78％(15/54)]of the control group(P＜0.05).After treatment,the average single time,seizure frequency and STESS score of the study group were lower than those of the control group,and the scores of PedsQL4.0 were higher than those of the control group(P＜0.05).After treatment,compared with the control group,BDNF and IGF-1 in the study group were higher,GFAP and NSE was lower(P＜0.05).There was no significant difference in ALP,calcium and phosphorus between the two groups before and after treatment(P＞0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The combination of Xianyu Capsule and LF-rTMS is effective in the treatment of children with primary epilepsy.It can effectively regulate the level of nerve-related factors,improve the clinical symptoms of children,improve the quality of life,and do not increase the burden of bone metabolism.

Abstract:Objective To explore the effect of Tiaoshen Yunshu method combined with modified Huanglian Wendan Decoction in the treatment of post-stroke depression(PSD)and its influence on neurotransmitter.Methods A total of 164 patients with PSD in Zhumadian Hospital of Traditional Chinese Medicine Affiliated to Henan University of Traditional Chinese Medicine from September 2023 to October 2025 were selected.They were randomly assigned to conventional group,acupuncture group,decoction group and combined group,with 41 cases in each group.The conventional group was given conventional western medicine treatment,on this basis,the acupuncture group was treated with Tiaoshen Yunshu acupuncture,the decoction group was treated with modified Huanglian Wendan Decoction,and the combined group was treated with Tiaoshen Yunshu acupuncture combined with modified Huanglian Wendan Decoction,all groups were treated continuously for 6 weeks.The therapeutic effect,as well as the depression status score[24 Hamilton depression scale(HAMD-24),self-rating depression scale(SDS)],neurotransmitters[norepinephrine(NE),5-hydroxytryptamine(5-HT),dopamine(DA)]before and after treatment,and adverse reactions were compared among the four groups.Results The total effective rate of the combined group(97.56％)was higher than that of the acupuncture group(80.49％),the decoction group(80.49％)and the conventional group(58.54％)(P＜0.05).The total effective rate of the acupuncture group and the decoction group was higher than that of the conventional group(P＜0.05).After 6 weeks of treatment,the scores of HAMD and SDS in the combined group were lower than those in the acupuncture group,decoction group and conventional group(P＜0.05),and the scores in the acupuncture group and decoction group were lower than those in the conventional group(P＜0.05).After 6 weeks of treatment,the levels of serum 5-HT,NE and DA in the combined group were higher than those in the acupuncture group,decoction group and conventional group(P＜0.05),and those in the acupuncture group and decoction group were higher than those in the conventional group(P＜0.05).There was no significant difference in the incidence of adverse reactions among the four groups(P＞0.05).Conclusion Tiaoshen Yunshu method combined with Huanglian Wendan Decoction can significantly improve the clinical efficacy of PSD patients,and can effectively improve depression.Its effect may be related to the regulation of neurotransmitter levels,and the safety is good.