Abstract:Objective To explore the efficacy of Xiaozhiling injection in the treatment of constipation in patients with rectal hyposensitivity.Methods A retrospective analysis was conducted on 54 patients with outlet obstructive constipation(rectal mucosal prolapse)who were admitted to Department of Anorectum,Guang'anmen Hospital,China Academy of Chinese Medical Sciences from January 2021 to January 2024 and underwent submucosal Xiaozhiling injection.Rectal sensory threshold was measured by the balloon method before surgery and at 1,2,and 6 months after surgery,while patients were asked to complete the Constipation Assessment Scale(CAS)for self-rating before surgery and at 1,2,6,and 12 months after surgery.Results At 1 and 2 months after surgery,the patients' sensory threshold,initial defecation desire volume,and maximum tolerance volume were all lower than those before surgery(all P＜0.05),while at 6 months after surgery,the sensory threshold,initial defecation desire volume,and maximum tolerance volume were all higher than those at 2 months after surgery(all P＜0.05).At 1,2,6,and 12 months after surgery,the patients' CAS scores were all lower than those before surgery[(3.7±1.0),(3.9±1.1),(4.6±1.4),(5.4±1.4)vs(12.3±1.7)](F=278.700,P＜0.001).Additionally,the CAS score at 12 months after surgery was higher than that at 1,2,and 6 months after surgery(all P＜0.05).Conclusion Submucosal injection of Xiaozhiling is effective for constipation in patients with rectal hyposensitivity,and its therapeutic effect lasts for a relatively long time.

Abstract:Objective To investigate the effect of the timing of camrelizumab intervention on the tumor response rate,immune function and survival prognosis of patients with locally advanced unresectable non-small cell lung cancer(NSCLC)undergoing radiotherapy.Methods A total of 140 patients with NSCLC treated with concurrent chemoradiotherapy(carboplatin,pemetrexed and camrelizumab)in Shandong Provincial General Hospital of the Chinese People's Armed Police Force from January 2018 to February 2020 were retrospectively selected.According to the timing of camrelizumab intervention,the patients were divided into the control group and the observation group,with 70 cases in each group.The control group was treated with camrelizumab from days 42 to 60 after radiotherapy.The observation group received camrelizumab from day 1 to 21 after the end of radiotherapy.The tumor response rate,immune function,overall survival,progression-free survival and adverse reactions were compared between the two groups.Results After 2 cycles of treatment,there were significant differences in partial response rate,disease progression rate and objective response rate between the two groups(all P＜0.05).After 4 cycles of treatment,there were significant differences in the complete remission rate,stable disease rate and objective response rate between the two groups(all P＜0.05).After 2 and 4 cycles of treatment,the CD4+and CD4+/CD8+ratio of the two groups showed an upward trend,and those of the observation group were higher than those of the control group at each time point.The CD8+in the two groups showed a downward trend,and those of the observation group were lower than those of the control group at each time point(all P＜0.05).After 4 cycles of treatment,the expression levels of natural killer cells in the two groups were higher than those before treatment;after 2 cycles of treatment,those in the observation group were higher than those in the control group(all P＜0.05).After 48 months of follow-up,the overall survival and progression-free survival of the observation group were longer than those of the control group[(37±4)months vs(29±6)months,(31±3)months vs(24±4)months](all P＜0.001).Kaplan-Meier survival curve showed that the cumulative survival rate of the observation group was higher than that of the control group(Log-rank x2=24.873,P＜0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Camrelizumab can improve the tumor response rate,immune function and survival prognosis of patients with locally advanced unresectable NSCLC after radiotherapy.

Abstract:Objective To investigate the efficacy and prognosis of paclitaxel for injection(albumin-bound)combined with pyrotinib in the treatment of human epidermal growth factor receptor 2(HER-2)positive breast cancer with lung metastasis.Methods A total of 80 patients with HER-2 positive breast cancer and lung metastasis admitted to the Department of Oncology,Cangzhou Central Hospital,Hebei Medical University from January 2023 to January 2024 were selected.According to the random number table method,they were divided into the control group and the observation group,with 40 cases in each group.The control group was treated with paclitaxel for injection(albumin-bound)intravenous injection,and the observation group was treated with pyrotinib on the basis of the control group,with 21 d as a treatment cycle,a total of 4 cycles of treatment.The therapeutic effects of the two groups were evaluated.The levels of T lymphocyte subsets and serum tumor markers carcinoem-bryonic antigen and carbohydrate antigen 153(CA153)were detected by flow cytometry and chemiluminescence immunoassay before and after treatment,respectively.The quality of life of the two groups before and after treatment was evaluated according to the Quality of life of Chemobiological Therapy scale for Cancer patients in China(QLQ-CCC).The adverse reactions during treatment and the overall survival rate of the two groups after 1-year follow-up were recorded.Results The disease control rate of the observation group was higher than that of the control group[95.0％(38/40)vs 77.5％(31/40)](P=0.023).Before treatment,there were no significant differences in the levels of immune indexes,carcinoembryonic antigen and CA153 between the two groups(all P＞0.05).After treatment,the level of CD8+cells in the observation group was lower than that in the control group,while the levels of CD4+,CD3+cells and CD4+/CD8+ratio were higher than those in the control group(all P＜0.05).After treatment,the levels of CEA and CA153 in the two groups were significantly lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the QLQ-CCC scores of the two groups were significantly higher than those before treatment,and that in the observation group was significantly higher than that in the control group[(83±9)vs(72±8)](all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.157).At the end of follow-up in May 2025,the survival rate of the observation group was 95.0％(38/40),and the survival rate of the control group was 77.5％(31/40).There was statistically significant difference in the survival curve between the two groups(Log-rank x2=5.165,P=0.023).Conclusion Paclitaxel for injection(albumin-bound)combined with pyrotinib in the treatment of HER-2 positive breast cancer with lung metastasis has a significant effect,which can effectively regulate cellular immune function,reduce serum tumor marker levels,improve the quality of life of patients,improve the prognosis of patients,and the adverse reactions can be managed and tolerated,with good safety.

Abstract:Stroke is currently one of the most common causes of death in the world.The mammalian forkhead box(Fox)O1 plays important roles in the occurrence and development of stroke,such as inducing cell death and inflammatory response,inhibiting oxidative damage,affecting the blood-brain barrier,and regulating hepatic gluconeogenesis.In view of these roles of FoxO1 in the occurrence and development of stroke,different measures and treatments have been adopted,but the role and mechanism of FoxO1 remain elusive and even contradictory.Therefore,the identification of these effects and their mechanisms will further reveal the FoxO1 signal transduction and related targeted drugs,and then provide an important method or basis for the prevention and treatment of stroke.This article reviews the research progress of FoxO1 in the pathogenesis of stroke and its mechanism.

Abstract:Objective To analyze the current status of randomized controlled trials(RCT)of exercise therapy in the treatment of chronic kidney disease(CKD),and to provide suggestions for the evaluation method of clinical effect of exercise therapy in the treatment of CKD.Methods A number of Chinese and English databases were systematically searched for RCT of exercise intervention in CKD from the establishment of the database to March 2025.The characteristics of the literature were extracted,and the selection of outcome indicators of RCT of exercise intervention in CKD was analyzed.Results A total of 52 articles were included,involving 58 outcome indicators that appeared twice or more,and a total of 406 reports were reported.The outcome indicators included renal function(66 times,16.3％),exercise ability test(34 times,8.4％),physical function performance(60 times,14.8％),risk factors(135 times,33.2％),and pathogenesis related indicators(66 times,16.3％),questionnaires and scales(20 times,4.9％),and safety indicators(25 times,6.2％).Conclusion The outcome indicators of RCT on exercise intervention in CKD have some problems,such as large selection differences,some outcome indicators need to be improved,and less attention is paid to clinical symptoms and mental health.Future research should be committed to building a core index set to make the selection of indicators scientific,representative and clinical practicability,and improve the rigor of outcome indicators.

Abstract:The prevalence and mortality of cardiovascular disease in China are increasing year by year,and the number of patients undergoing coronary artery bypass grafting is increasing year by year.It is essential to actively implement postoperative cardiac rehabilitation.The core link of the current consensus on cardiac rehabilitation is exercise rehabilitation,and traditional Chinese medicine also has its own unique advantages in cardiac rehabilitation.This article reviews the research progress of traditional Chinese medicine on bleeding,infection,pain and other common complications after coronary artery bypass grafting.

Abstract:Objective To explore the risk factors of early enteral nutrition(EEN)intolerance in elderly patients with severe pneumonia,and to construct and verify a nomogram model.Methods A total of 209 elderly patients with severe pneumonia in The Second Affiliated Hospital of Naval Medical University of Chinese People's Liberation Army from January 2023 to January 2025 were selected.EEN tolerance of patients was recorded.According to the presence or absence of EEN intolerance symptoms,the patients were divided into tolerance group and intolerance group.The risk factors of EEN intolerance were analyzed and a nomogram was drawn.The receiver operating characteristic curve was used to test the predictive efficacy of the nomogram model.Results Among 209 elderly patients with severe pneumonia,86 cases had EEN intolerance.The incidence was 41.1％(86/209).Among the patients with EEN intolerance,74.4％(64/86)had single symptom,mainly diarrhea,gastric retention and abdominal distension,25.6％(22/86)had two or more symptoms,and EEN intolerance mainly occurred on the first and second day of the implementation of EEN.Old age,late start of enteral nutrition,high clinical pulmonary infection score(CPIS),long duration of mechanical ventilation and intermittent injection were independent risk factors for EEN intolerance in elderly patients with severe pneumonia(all P＜0.05).The prediction model of EEN intolerance in elderly patients with severe pneumonia was constructed according to the influencing factors screened from the results of Logistic regression analysis.Logit(P)=-15.541+0.923 × age+0.966 × initiation time of enteral nutrition+0.854 × CPIS+0.338 × mechanical ventilation time-0.959 × feeding mode.Hosmer-Lemeshow goodness of fit test showed that x2=4.138,degree of freedom=8,P=0.830.The nomogram showed that when the sum of the scores of each influencing factor was more than 144,the risk of EEN intolerance was more than 80％.The consistency index of the nomogram model was 0.888,and the area under the curve for predicting EEN intolerance in elderly patients with severe pneumonia was 0.888(95％confidence interval:0.837-0.927).Conclusion The risk factors of EEN intolerance in elderly patients with severe pneumonia include old age,late start time of enteral nutrition,high CPIS,long duration of mechanical ventilation and intermittent injection.The nomogram model based on the above influencing factors has a high predictive efficiency for EEN intolerance in elderly patients with severe pneumonia,which is helpful for medical staff to accurately identify high-risk groups.It has guiding significance for the improvement of nutrition management strategy.

Abstract:Cardiogenic shock is a serious and fatal complication of acute myocardial infarction.About 5％-10％of patients with acute myocardial infarction will develop cardiogenic shock,and the mortality rate is as high as 40％-50％.Timely and effective revascularization can maximize the rescue of ischemic myocardium,restore heart pump function,and significantly improve the survival rate of patients.Percutaneous coronary interven-tion is currently the main revascularization method.In percutaneous coronary intervention,the choice of vascular approach has an important impact on the prognosis of patients and the incidence of complications.At present,radial artery and femoral artery are commonly used interventional access.Radial artery approach has significant advantages in reducing bleeding complications,but femoral artery approach still plays an irreplaceable role in complex operations and mechanical support.Most access studies recommend that radial access should be preferred when conditions permit,and femoral access should be selected in certain circumstances,but the best access for patients with cardiogenic shock is still inconclusive.This article will briefly review the related research and clinical practice of the choice of percutaneous coronary intervention approach in patients with acute myocardial infarction complicated with cardiogenic shock.

Abstract:Objective To explore the SMOTE algorithm based epilepsy risk prediction model after successful resuscitation of cardiac arrest.Methods A total of 200 patients with successful resuscitation of cardiac arrest admitted to the 910th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army from October 2016 to October 2023 were retrospectively collected as observation objects.According to whether epilepsy occurred after successful resuscitation,the patients were divided into epilepsy group(50 cases)and non-epilepsy group(150 cases).Data of the subjects were collected and analyzed.Univariate and multivariate Logistic regression analysis were used to screen the risk factors of epilepsy after successful resuscitation of cardiac arrest,and then the SMOTE algorithm was used to reconstruct the original data set of influencing factors to obtain the risk early warning model and verify its predictive efficiency.Results There were 50 cases of epilepsy after successful resuscitation in 200 cases of cardiac arrest,and the incidence was 25.0％.Multivariate Logistic regression analysis showed that age,history of epilepsy,intracranial infection,cardiovascular and cerebrovascular diseases,and hypoxic-ischemic brain injury were risk factors for epilepsy after successful resuscitation of cardiac arrest(all P＜0.05).The original early warning model P1=1.107X1+1.221X2+1.025X3+1.227X4+1.162X5-3.909 was obtained.Hosmer-Lemeshow test results showed that the model had a good fit(coefficient of determination R2=0.418,P=0.599).The early warning model based on the SMOTE algorithm was P2=1.212X1+1.351X2+1.208X3+1.357X4+1.271X5-4.241.The Hosmer-Lemeshow test results indicated that the model had a good fit(coefficient of determination R2=0.617,P=0.833).The results of receiver operating characteristic curve analysis showed that the area under the curve of the original warning model P1 was 0.791,and the area under the curve of the early warning model P2 was 0.825.Conclusion The SMOTE early warning model is better than the original warning model,and can accurately predict epilepsy after successful resuscitation of cardiac arrest.

Abstract:Objective To explore the characteristics of QRS complex duration in patients with atrial fibril-lation and its relationship with recurrence after radiofrequency catheter ablation(RFCA).Methods A total of 188 patients with atrial fibrillation who underwent RFCA at Mianyang 404 Hospital from May 2022 to October 2024 were selected retrospectively.According to whether recurrence occurred within 3 months after surgery,the patients were divided into the recurrence group(n=52)and non-recurrence group(n=136).General data,QRS complex duration,ultrasonic parameters,and admission routine blood test indicators of the patients were collected.A hierarchical regression model was used to analyze the effects of different clinical characteristics on QRS complex duration.Multivariate Logistic regression was applied to analyze risk factors.Stratified interaction analysis was conducted to explore the effect of gender on the relationship between QRS complex duration and recurrence after RFCA.Receiver operating characteristic(ROC)curve was used to evaluate diagnostic efficacy.Restricted cubic spline(RCS)was employed to analyze the dose-response relationship between QRS complex duration and the risk of recurrence after RFCA.Results Hierarchical regression analysis showed that electrocardiographic f-wave pattern,brain natriuretic peptide(BNP),homocysteine(Hey),left atrial diameter(LAD),and left ventricular ejection fraction(LVEF)all had significant effects on QRS complex duration(all P＜0.05).Multivariate analysis revealed that electrocardiographic f-wave pattern,BNP,Hey,QRS complex duration,LAD,and LVEF were independent influencing factors for recurrence in atrial fibrillation patients after RFCA(all P＜0.05).Interaction test analysis indicated that gender had no impact on the relationship between QRS complex duration and recurrence after RFCA(Pinteraction＞0.05).The risk of postoperative recurrence in the high-risk group of QRS complex duration(＞150 ms)was 68.8％(22/32),with an interval likelihood ratio of 4.400.ROC curve analysis results showed that the area under the curve of QRS complex duration for diagnosing the risk of recurrence after RFCA was 0.753.RCS analysis demonstrated that there was a non-linear dose-response relationship between QRS complex duration and the risk of recurrence in atrial fibrillation patients after RFCA(P＜0.05).Conclusions Prolonged QRS complex duration is an independent risk factor for recurrence in patients with atrial fibrillation after RFCA.Preoperative measurement of QRS complex duration can effectively identify high-risk patients and provide a reference for individualized postoperative management.

Abstract:Objective To explore the application and operation analysis of umbrella type spray tube and original straight head spray tube in endoscopic hemostasis with medical glue in patients with upper gastrointestinal bleeding.Methods A total of 202 patients with upper gastrointestinal bleeding who underwent endoscopic hemo-stasis with medical glue in Beijing Anzhen Hospital,Capital Medical University from January 2022 to December 2024 were retrospectively analyzed.According to the spray tube used,they were divided into straight head spray tube group(control group,147 cases)and hemostatic umbrella spray tube group(observation group,55 cases).The spraying effect data and endoscopic blockage of the two groups were analyzed.Results There was no significant difference in the treatment examination time between the observation group and the control group(P＞0.05).The spraying and observation time of the observation group was longer than that of the control group(P＜0.001).In the observation group,after spraying medical glue on the bleeding site of duodenal bulb ulcer and cardia laceration,the umbrella was retracted into the outer sheath tube,and the wound after spraying could be clearly observed.In the control group,after spraying medical glue,the lens was blurred,and the lens was withdrawn immediately.There were 52 cases of excellent lens clarity and 3 cases of good lens clarity in the observation group after medical glue spraying,there were 76 cases of excellent lens clarity,22 cases of good lens clarity and 49 cases of poor lens clarity in the control group,and the difference between the two groups was statistically significant(x2=31.954,P＜0.001).The proportion of rubber tube blockage in the observation group was lower than that in the control group[0(0/55)vs 7.5％(11/147)](x2=4.362,P=0.037).In recent 3 years,the number of endoscopic repairs due to the blockage of medical glue after spraying in the control group was 11 times,and the cost was 54 893 yuan.The medical glue was not blocked in the observation group,and the cost was 0 yuan.Conclusions The umbrella type spray tube used in endoscope can clearly observe the spraying effect of medical glue on the wound after bleeding,and the plug rate in the lumen and maintenance cost are lower than those of the control group.

Abstract:Lymph node calcification in the parotid gland region is a rare chronic secondary disease with potential clinical significance.This article reports a case of a 41-year-old female patient with left parotid gland region lymph node calcification,who presented with a mass in the left preauricular area for 30 years.The patient had no obvious symptoms in the early stage and sought medical attention recently due to occasional pain.Imaging examinations suggested a calcified nodule in the left parotid gland,and intraoperative and postoperative pathology further confirmed lymph node calcification in the parotid gland region.Open surgical treatment was performed,and the patient recovered well postoperatively.The uniqueness of this case lies in its long disease course and rare anatomical location.The diagnosis and treatment of such diseases require a comprehensive consideration of patient symptoms,lesion characteristics,and pathological results.This report aims to provide a therapeutic reference for clinicians when encountering similar rare cases.

Abstract:Objective To explore the impact of non-matching nucleic acid extraction reagents on human papillomavirus(HPV)genotyping results.Methods A total of 171 cervical exfoliated cell samples were collected from female patients who visited the Department of Gynecology,Dongzhimen Hospital,Beijing University of Chinese Medicine from March to April 2025.HPV DNA was extracted by manual boiling method and magnetic bead method(automatic nucleic acid extraction using non-matching nucleic acid extraction reagents),respectively.Fluorescence quantitative polymerase chain reaction was performed to detect HPV genotypes.The negative coincidence rate,positive coincidence rate,and total coincidence rate of nucleic acid detection results obtained by different extraction methods were analyzed,as well as their impacts on single infection,multiple infections of HPV subtypes,and sample viral load.Results The negative coincidence rate and positive coincidence rate of the detection results by the two methods were 100.0％(128/128)and 93.0％(40/43),respectively,with a total coincidence rate of 97.1％(166/171).Consistency analysis of gene subtypes and internal reference in 43 positive samples showed that the automatic nucleic acid extraction method did not cause a significant increase in the internal reference Ct value due to the reduced sample volume.Kendall's concordance coefficient test showed statistical significance(both P＜0.001),indicating consistency between the two extraction methods.The Kendall's concord-ance coefficients were 0.953 and 0.943,respectively,suggesting a strong degree of consistency.Analysis of the viral load of samples extracted by the two methods showed that consistent results and an increase of 1 order of magnitude accounted for 84.0％(42/50).Conclusion Compared with the manual boiling method,the magnetic bead method(automatic nucleic acid extraction with non-matching reagents)can obtain HPV DNA solutions with higher concentration and purity,which is more suitable for laboratory promotion and application.

Abstract:Purple urine bag syndrome is a rare clinical condition with an incompletely clarified pathogenesis,and there is currently a lack of systematic and effective treatment methods.As a novel therapeutic approach,ultrasound combined with bladder irrigation has potential advantages in improving local bladder circulation,reducing inflammatory responses,and promoting tissue repair.This article reports a case of purple urine bag syndrome in a patient with long-term indwelling urinary catheterization due to cervical spine fracture complicated by complete paralysis,aiming to provide clinical reference.Ultrasound combined with bladder irrigation was adopted,and changes in urine bag color,routine urine test indicators,and urine properties were recorded before and after treatment.After 1 week of treatment,the purple color of the patient's urine bag disappeared,the urine color lightened,flocculent substances decreased,bacterial count dropped,urine odor vanished,and the symptoms improved significantly.

Abstract:Objective To analyze the different clinical characteristics and laboratory indicators of respiratory tract infections in children caused by influenza B,adenovirus,and respiratory syncytial virus.Methods A total of 668 children who visited the outpatient department or were hospitalized in Beijing Friendship Hospital,Capital Medical University from December 2023 to March 2024 were selected as the research subjects.According to the results of etiological nucleic acid detection,they were divided into influenza B group(259 cases),adenovirus group(216 cases),and respiratory syncytial virus group(193 cases).The clinical symptoms,laboratory indicators,and lymphocyte subset indicators of the three groups were compared.Results There were statistically significant differences in the proportions of moderate fever,high fever,sore throat,wheezing,vomiting,abdominal pain,headache,and concurrent Mycoplasma infection among the three groups(all P<0.05).There were statistically significant differences in white blood cell count,neutrophil count,lymphocyte count,monocyte count,and platelet count among the three groups(all P<0.05).There were statistically significant differences in CD+3,CD+8,CD+4,and CD+16 levels among the influenza B group,adenovirus group,and respiratory syncytial virus group[(1.86±0.25)vs(2.09±0.53),(2.14±0.46);(0.47±0.11)vs(1.02±0.26),(1.07±0.19);(1.25±0.38)vs(0.67±0.19),(1.18±0.35);(0.51±0.13)vs(0.54±0.07),(0.30±0.06)](all P<0.05).Conclusion After infection with the three viruses,children have common clinical manifestations and laboratory indicators of viral infection,as well as distinct manifestations and characteristics specific to each virus.

Abstract:Objective To compare the efficacy and safety of moxifloxacin and omadacycline in the treatment of adult Mycoplasma pneumoniae pneumonia(MPP).Methods The clinical data of 139 adult MPP patients admitted to Beijing Ditan Hospital,Capital Medical University,from August to December 2024 were retrospectively collected.Among them,73 cases were treated with omadacycline(observation group)and 66 cases with moxifloxacin(control group).The clinical indicators,antipyretic time,symptom remission rate,improvement of pulmonary imaging and safety of the two groups were analyzed.Results After treatment,the levels of white blood cell count,neutrophil/lymphocyte ratio,C-reactive protein,procalcitonin,serum amyloid A and interleukin-6 in both groups were significantly better than those before treatment(all P<0.05),while there were no statistically significant differences between the two groups(all P>0.05).The antipyretic time in the observation group was shorter than that in the control group[(1.3±0.5)d vs(2.1±0.8)d](P=0.02).There was no significant difference in the total effective rate between the observation group and the control group[91.8％(67/73)vs 90.9％(60/66)](P=0.85).After 1 and 4 weeks of treatment,there were no significant differences in the imaging absorption rate between the two groups(both P>0.05).During the treatment period,the incidence of adverse reactions in the observation group was lower than that in the control group[2.7％(2/73)vs 12.1％(8/66)](χ2=7.93,P<0.01).Conclusion Omadacycline has comparable efficacy to moxifloxacin in the treatment of adult MPP,with the advantage of better safety.

Abstract:Objective To investigate the clinical efficacy of Xiao'er Xuanfei Zhike granules combined with ceftazidime in the treatment of children with bronchopneumonia.Methods A total of 126 children with bronchopneumonia who were treated in Wuhan Hospital of Traditional Chinese Medicine from April 2021 to September 2023 were enrolled and divided into the control group and the observation group according to the random number table method,with 63 cases in each group.The control group was given intravenous drip of ceftazidime for injection at a dose of 50 mg/kg,twice a day.On the basis of the control group's regimen,the observation group was additionally treated with Xiao'er Xuanfei Zhike granules,1 bag each time for children aged 5-7 years old and 1.5 bags each time for children aged 8-11 years old,taken orally three times a day.Both groups were treated continuously for 7 d.The clinical efficacy,symptom relief time,pulmonary function indexes before and after treatment,serum inflammatory markers and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The relief times of asthma,cough,fever and disappearance time of pulmonary rales in the observation group were significantly shorter than those in the control group[(3.3±0.5)d vs(4.5±0.5)d,(4.1±0.7)d vs(5.1±0.8)d,(2.1±0.4)d vs(3.2±0.6)d,(4.2±0.6)d vs(5.4±0.8)d](all P<0.001).After treatment,the pulmonary function indexes of both groups were significantly higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group(all P<0.05).After treatment,the serum inflammatory markers of both groups were significantly lower than those before treatment,and the markers in the observation group were significantly lower than those in the control group(all P<0.05).In the control group,1 case of nausea and vomiting and 1 case of abdominal pain occurred,with the incidence of adverse reactions being 3.2％(2/63).In the observation group,1 case of diarrhea and 2 cases of nausea and vomiting occurred,with the incidence of adverse reactions being 4.8％(3/63).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Xiao'er Xuanfei Zhike granules combined with ceftazidime has a reliable therapeutic effect in the treatment of children with bronchopneumonia,which is helpful to relieve clinical symptoms,improve pulmonary function,reduce inflammatory response,and has good safety.

Abstract:Objective To investigate the clinical characteristics of ectopic pregnancy in plateau area.Methods A total of 283 patients with ectopic pregnancy admitted to Department of Gynecology,Lhasa People's Hospital,Tibet Autonomous Region from December 2021 to December 2024 were retrospectively selected,including 192 cases of tubal pregnancy,7 cases of cornual pregnancy,11 cases of uterine scar pregnancy,5 cases of ovarian pregnancy,and 68 cases of unspecified location.The clinical data of the patients were retrospectively analyzed.Results The average age of 283 patients was(31±6)years old,of which219 patients(77.4％)were Tibetan,66 patients(23.3％)were from areas with altitude≥4 000 m,121 patients(42.8％)had a history of abortion,101 patients(35.7％)had a history of pelvic surgery,27 patients(9.5％)had a history of ectopic pregnancy,and 26 patients(9.2％)with intrauterine device placement.A total of 203 cases of 283 patients were treated with laparoscopic or open surgery,including 43 cases(21.2％)with rupture and hemorrhagic shock symptoms,which were included in the combined shock group,including 35 cases(81.4％)of Tibetan patients,11 cases(25.6％)from altitude≥4 000 m,and the remaining 160 cases were included in the non combined shock group.There were no significant differences in age,pregnancy,parity,number of miscarriages,history of ectopic pregnancy,history of pelvic surgery,altitude≥4 000 m,and proportion of Tibetans between the two groups(all P>0.05).The intraoperative blood volume,blood loss,and total effusion volume in the combined shock group were greater than those in the non combined shock group,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower than those in the non combined shock group(all P<0.05).The bleeding volume of patients with ectopic pregnancy rupture hemorrhagic shock was 2 100(1 550,2 550)ml,and the preop-erative hemoglobin value of some patients was still within the normal range.Conclusion The occurrence of ectopic pregnancy complicated with hemorrhagic shock at high altitude has nothing to do with nationality,altitude of living area,number of miscarriages,ectopic pregnancy history or pelvic surgery history.The intraoperative blood volume,blood loss,and total effusion volume of the combined shock group were larger,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower.Due to the compensatory increase of hemoglobin in patients with hypoxia in plateau area,the hemoglobin value of patients with ectopic pregnancy in plateau area often cannot reflect the severity of the disease.It is necessary to pay attention to dynamic monitoring changes and make decisions as soon as possible combined with other examination methods.

Abstract:Heart failure is a syndrome caused by abnormalities in cardiac structure or function,leading to decreased cardiac output or elevated intracardiac pressure,with fluid retention as one of its core pathological mechanisms.Accurate assessment of volume status is crucial for alleviating patient symptoms and reducing the risk of readmission.Traditional volume assessment methods,such as physical examination,natriuretic peptide testing,and right heart catheterization,have limitations.This includes in accuracies invasiveness,or high operational costs.The inferior vena cava(IVC)is the largest-diameter venous system in the human body,and its morphological and dynamic changes can reflect the body's hemodynamic status.In recent years,ultrasound-based measurement of IVC diameter and calculation of IVC variability have provided a non-invasive tool for assessing intravascular volume status and guiding fluid management.With the standardization of assessment protocols and technological advance-ments,the clinical value of IVC parameters in individualized fluid management for patients with heart failure has become increasingly prominent.

Abstract:Objective To explore the correlation and predictive value of the aggregate index of systemic inflammation(AISI)with hypertension in non-overweight or non-obese population.Methods A total of 8 920 non-overweight or non-obese adults who underwent health checkups at Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 1,2021 to September 30,2024 were enrolled.They were divided into hypertension group and control group(non-hypertensive population)according to the presence of hypertension.Due to the skewed distribution of AISI,logarithmic transformation(Log2)was performed for subsequent analysis,and baseline characteristics were observed with hypertension status as the grouping basis.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of AISI for hypertension in non-overweight or non-obese population.Results Among 8 920 non-overweight or non-obese subjects,1 289 were hypertensive patients(hypertension group)and the rest were non-hypertensive(control group).The hypertension group had significantly higher levels of age,body mass index,total cholesterol,triglycerides,low-density lipoprotein cholesterol,fasting blood glucose,serum creatinine,serum uric acid,and Log2 AISI(all P<0.05).In addition,there were statistically significant differences between the two groups in the proportions of drinking history,diabetes mellitus,kidney disease history,other cardio-cerebrovascular disease history,and family history of hypertension(all P<0.05).In the continuous variable analysis,Model 1 without covariate adjustment showed that for each 1-unit increase in Log2 AISI in non-overweight or non-obese individuals,the risk of hypertension increased by 24％.This association remained significant even after full adjustment for covariates(both P<0.001).In the categorical variable analysis,Model 1 without covariate adjustment revealed that individuals in the highest quartile of Log2 AISI had a significantly higher risk of hypertension than those in the lowest quartile,and this association persisted in the fully adjusted Model 3(both P<0.001).ROC curve analysis showed that the area under the curve of Log2 AISI for predicting the risk of hypertension in non-overweight or non-obese population was 0.615(95％confidence interval:0.599-0.629).Conclusion In the non-overweight or non-obese population,AISI is significantly non-linearly and positively correlated with the risk of hypertension and has good predictive efficacy,which can be used for the early diagnosis of hypertension in non-overweight or non-obese individuals.