Abstract:Objective To investigate the characteristics of immune system changes in pediatric patients with Kawasaki disease(KD)complicated with coronary artery lesion(CAL),and to provide a basis for its standardized diagnosis and treatment.Methods A total of 238 children with KD admitted to the Department of Cardiology,Hebei Children's Hospital,Hebei Province from August 2021 to May 2023 were selected as the KD group.According to CAL status,the patients were divided into CAL subgroup(61 cases)and non-CAL(NCAL)subgroup(177 cases).A total of 102 pediatric patients with fever who were diagnosed with bronchitis or upper respiratory tract infection during the same period were selected as the control group.The basic information and laboratory examination indexes of pediatric patients in each group were compared.Logistic regression method was used to analyze the risk factors of CAL in pediatric patients with KD.Based on the relevant variables,a nomogram model was established to predict the risk of CAL,and the receiver operating characteristic(ROC)curve was used to evaluate the performance of the nomogram and the predictive efficiency of each index.Results The proportion of males in the CAL subgroup was higher,the disease duration was longer,and the platelet count level was higher than those in the NCAL subgroup(all P＜0.05).The levels of interleukin-2(IL-2),IL-6,IL-10,IL-5,IL-8,complement C3,C4,and total B cells in the KD group were significantly higher than those in the control group;the levels of immunoglobulin(Ig)A,IgG,IgM,total T cells,CD8+T cells,γδT cells were lower than those in the control group;the levels of IL-2,IL-1β,interferon-α,IgA,IgG,IgM,and natural killer cells in CAL subgroups were significantly higher than those in the NCAL subgroup,while the levels of complement C3,C4,total T cells,and CD8+T cells were lower than those in the NCAL subgroup(all P＜0.05).Multivariate Logistic regression analysis showed that the decreased levels of CD8+T cells and complement C3 levels,as well as the increased levels of IgG and natural killer cell levels were independent risk factors for CAL(all P＜0.05).The prediction of CAL by the nomogram was consistent with the actual probability.The area under the curve of ROC for the combined prediction of CAL by CD8+T cells,natural killer cells,IgG,and complement C3 was 0.866(95％confidence interval:0.804-0.913),which was greater than the individual predictions of each indicator(0.800,0.631,0.653,0.651).Conclusion The changes of immune factors of natural killer cells,CD8+T cells,IgG and complement C3 is signifi-cant in patients with KD complicated with CAL,and this change may be involved in the pathogenesis of KD and CAL.

Abstract:Objective To investigate the clinical efficacy of anisodamine hydrobromide combined with dopamine in the treatment of septic shock.Methods The randomized single-blind controlled study was conducted.A total of 102 patients with septic shock admitted to Qingdao Municipal Hospital Affiliated to Qingdao University from June 2020 to June 2023 were selected.According to the random number table method,they were divided into control group and observation group,with 51 cases in each group.The control group was treated with intravenous dopamine on the basis of conventional treatment.The observation group was treated with intravenous injection of anisodamine hydrobromide on the basis of the control group,and the two groups were observed after 12 h of treatment.The clinical efficacy,urine volume,systolic blood pressure,heart rate,oxygen extraction rate,oxygen supply index,oxygen consumption index,and serum cardiac troponin Ⅰ(cTnⅠ),B-type natriuretic peptide(BNP),tumor necrosis factor-α(TNF-α),procalcitonin and interleukin-1(IL-1)levels before and after treatment were compared between the two groups.Results After treatment,the total effective rate of the observation group was higher than that of the control group[88.2％(45/51)vs 70.6％(36/51)](x2=4.857,P=0.028).After treatment,the urine volume,systolic blood pressure,oxygen extraction rate,oxygen delivery index and oxygen consumption index of the observation group were higher than those of the control group,and the heart rate and serum levels of cTnⅠ,BNP,TNF-α,procalcitonin,IL-1 were lower than those of the control group(all P＜0.05).Conclusion The clinical effect of anisodamine hydrobromide combined with dopamine in the treatment of septic shock is ideal,which is helpful to increase the urine volume of patients,increase blood pressure,improve cardiac function and tissue oxygen metabolism indexes,promote the stability of vital signs,and reduce inflammatory response.

Abstract:Breast cancer stands as the most common malignant tumor affecting women.The mortality rate due to breast cancer is alarmingly on the rise every year.The current arsenal of treatment methods includes surgical resection,chemotherapy,radiotherapy,and endocrine therapy.Nevertheless,the formidable obstacles of breast cancer recurrence and metastasis persist,posing a substantial challenge in the field.In recent years,immunotherapy has progressively found application in various tumor diseases,with significant advancements in related basic research and clinical trials.This article provides a concise overview of the latest research advancements in breast cancer immunotherapy,in order to provide basis for clinical treatment of breast cancer.

Abstract:Objective To investigate the relationship between lower extremity arterial calcification and hemodynamics and the effect of peripheral vascular stent combined with batroxobin in patients with lower extremity arteriosclerosis obliterans(ASO).Methods A total of 120 patients with ASO who received peripheral vascular stent combined with batroxobin in the Affiliated Hospital of Hebei University from February 2022 to February 2024 were selected as the observation group,and 60 patients with ankle brachial index ≥0.9 were selected as the control group(non-ASO patients).The patients were divided into the good prognosis group(62 cases,the degree of restenosis ≤50％)and the poor prognosis group(58 cases,the degree of restenosis＞50％)according to whether the restenosis was＞50％at 6 months after treatment.The clinical data of the observation group and the control group were compared,and the hierarchical regression analysis was used to analyze the relationship between hemodynamic parameters and superficial femoral artery calcification score(SFACS)and inferior genicular artery calcification score(BKACS).The clinical data,ankle-brachial index(ABI)and toe-brachial index(TBI)before and after treatment were compared between the good prognosis group and the poor prognosis group.Cox regression analysis was used to evaluate the relationship between SFACS,BKACS and poor prognosis of patients.Multiple linear regression analysis was used to analyze the relationship between SFACS,BKACS and ABI,TBI.Restricted cubic spline model was used to analyze the dose-effect relationship between SFACS,BKACS and the risk of poor prognosis in ASO patients.Results The age,proportion of males,proportion of smoking history,peak systolic blood flow velocity(Vs)of posterior tibial artery,Vs of dorsalis pedis artery,SFACS and BKACS of the observa-tion group were significantly higher than those of the control group,and the diameter of posterior tibial artery and dorsalis pedis artery were significantly lower than those of the control group(all P＜0.05).The internal diameter of posterior tibial artery and dorsalis pedis artery had a significant negative effect on SFACS and BKACS,and the posterior tibial artery Vs and dorsalis pedis artery Vs had a significant positive effect on SFACS and BKACS(all P＜0.05).There were significant differences in C-reactive protein,albumin,fibrinogen,SFACS[2 282(856,3 259)vs 4 236(1 547,6 325)]and BKACS[1 024(526,1 730)vs 1 951(1 157,2 968)]between the good prognosis group and the poor prognosis group(all P＜0.05).The ABI and TBI of the good prognosis group were significantly higher than those of the poor prognosis group at 6 months,1 year and 2 years after treatment(all P＜0.05).Before and after adjusting for confounding factors,SFACS and BKACS were positively correlated with the risk of poor prognosis,and were negatively correlated with ABI and TBI(all P＜0.05).The risk of poor prognosis in ASO patients increased with the increase of SFACS and BKACS(non-linear P=0.762,0.395).Conclusion The level of lower extremity arterial calcification is related to the hemodynamics of patients with ASO,and it can evaluate the therapeutic effect of peripheral vascular stent combined with batroxobin to a certain extent.Therefore,in the treatment of ASO,it can be used as one of the examination marks for clinical treatment to optimize the treatment plan in time.

Abstract:Objective To explore the effects of Huayu Xiaozhong decoction on early functional rehabilitation and blood related indexes in patients after total knee arthroplasty(TKA).Methods The medical records of 220 patients who underwent TKA in the Department of Orthopedics,Liaocheng Hospital of Traditional Chinese Medicine,Shandong Province from June 2023 to April 2024 were collected.The patients were divided into control group(103 cases)and observation group(117 cases)according to whether they took Huayu Xiaozhong decoction after operation.The general data,improvement of joint function,improvement of joint swelling and pain,serum indexes,and incidence of deep vein thrombosis of lower extremities were compared between the two groups.Results There were no significant differences in gender,age,body mass index and surgical side between the control group and the observation group(all P＞0.05).The knee joint function(HSS)score and knee range of motion of the two groups at 1 week after operation were lower than those before operation,and the HSS score and knee range of motion at 2 weeks and 1 month after operation were higher than those before operation(all P＜0.05).The HSS score and knee range of motion of the observation group were higher than those of the control group at 1 week,2 weeks and 1 month after operation(all P＜0.05).There were no significant differences in knee circumference between the two groups at each time point(all P＞0.05).The visual analogue scale(VAS)scores of the two groups at 1 week,2 weeks and 1 month after operation were lower than those before operation,the VAS scores of the observation group at 1 week and 2 weeks after operation were lower than those of the control group,and the VAS score of the observation group at 1 month after operation was higher than that of the control group(all P＜0.05).In the control group,the levels of D-dimer at 1 week and 2 weeks after operation,high-sensitivity C-reactive protein(hs-CRP)at 1 week,2 weeks and 1 month after operation,and interleukin-6(IL-6)at 1 week after operation were higher than those before operation,and the levels of IL-6 at 2 weeks and 1 month after operation were lower than those before operation(all P＜0.05).The levels of D-dimer,hs-CRP and IL-6 in the observation group at 1 week,2 weeks and 1 month after operation were higher than those before operation,and the levels of IL-6 in the observation group at 2 weeks and 1 month after operation were lower than those before operation(all P＜0.05).The levels of hs-CRP and IL-6 in the observation group were lower than those in the control group at 1 week and 2 weeks after operation,and the levels of IL-6 in the observation group at 1 month after operation were lower than those in the control group(all P＜0.05).The incidence of deep vein thrombosis of lower extremities in the observation group was lower than that in the control group[4.3％(5/117)vs 6.8％(7/103)],but the difference was not statistically significant(x2=0.676,P=0.411).Conclusions The application of Huayu Xiaozhong decoction after TKA can reduce the level of serum inflammatory factors in the early postoperative period,reduce the inflammatory response and relieve knee pain,so as to improve the range of motion of the joint,improve the joint function score,and promote the purpose of early postoperative rehabilitation.

Abstract:Objective To investigate the effect of Huoxue Tongmai tablets combined with alteplase in the treatment of acute myocardial infarction.Methods A total of 84 patients with acute myocardial infarction admitted to the Affiliated Hospital of Inner Mongolia Medical University from November 2021 to December 2023 were included in this study.The patients were divided into control group(42 cases)and observation group(42 cases)according to the random number table method.The control group was treated with alteplase thrombolytic therapy,and the observation group was treated with Huoxue Tongmai tablets combined with alteplase.The therapeutic effect,traditional Chinese medicine symptom improvement time,cardiac function index,hemorheology index and adverse reactions were compared between the two groups.Results The total effective rate of observation group was obviously higher than that of control group[97.6％(41/42)vs 85.7％(36/42)](P=0.048).The improvement time of chest tightness,chest tingling and dark tongue in the observation group were shorter than those in the control group[(4.3±1.2)d vs(5.1±1.5)d,(2.5±1.1)d vs(3.5±1.2)d,(6.3±1.5)d vs(8.6±1.9)d](all P＜0.05).After treatment,the levels of cardiac troponin I,N-terminal pro-brain natriuretic peptide and creatine kinase isoenzyme in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the plasma viscosity,high-cut whole blood viscosity and fibrinogen levels of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P＜0.05).There were no obvious adverse reactions in the two groups.Conclusion Huoxue Tongmai tablets combined with alteplase in the treatment of acute myocardial infarction can achieve good therapeutic effect,which can effectively improve the myocardial damage and hemorheo-logical indicators of patients,and has good safety.

Abstract:Cardiac surgery is difficult and the incidence of postoperative complications is high.Right heart failure is a serious complication after cardiac surgery,which affects the mortality of patients.Therefore,the diagnosis of right heart failure after cardiac surgery is very important.However,there is no universally accepted gold standard for the diagnosis of right heart failure after cardiac surgery.This article summarizes the current clinical application of right heart failure diagnosis methods after cardiac surgery,in order to provide help for clinicians.

Abstract:Objective To construct risk prediction models for major adverse cardiovascular and cerebrovascular events(MACCE)in patients with acute myocardial infarction(AMI)and renal insufficiency using different machine learning algorithms.Methods A total of 740 patients with AMI and renal insufficiency who were hospitalized in Beijing Anzhen Hospital,Capital Medical University from January 2014 to August 2019 were selected as the research objects.Clinical data such as general characteristics,vital signs,comorbidities and laboratory examination results of the patients were collected.The subjects were divided into training set(592 cases)and test set(148 cases)by the simple random sampling method at a ratio of 80％:20％.Five machine learning algorithms,including Logistic regression,random forest,extreme gradient boosting(XGBoost),support vector machine and deep neural network,were used to construct the prediction model of MACCE.The area under the receiver operating characteristic curve(AUC)was used to evaluate the reliability of the model and select the optimal model.Shapley's additive explanation algorithm was used to evaluate the feature influence and perform feature selection to construct the final model.Results MACCE occurred in 473(63.9％)of 740 patients with AMI and renal insufficiency.The XGBoost model had the largest AUC(AUC=0.862).After reducing the features according to their importance rank,an interpretable final XGBoost model with five features was built.The final model could accurately predict the occurrence of MACCE in the internal validation(AUC=0.955).The important clinical characteristics affecting the XGBoost model were serum uric acid,albumin,glycated albumin,body weight and platelet count.Conclusion Among the five models based on machine learning algorithms,XGBoost model has the best effect in predicting MACCE in patients with AMI and renal insufficiency.

Abstract:Sarcopenia is a common complication in maintenance hemodialysis(MHD)patients,which has a serious adverse impact on patients'mobility and quality of life,and is closely related to the poor prognosis of MHD patients.Therefore,early diagnosis and intervention of sarcopenia are of great clinical significance for MHD patients.MHD patients with high risk factors of sarcopenia should pay attention to the control of risk factors,reduce the exposure level,and prevent the occurrence or development of the disease.At present,the main treatment and intervention strategies for sarcopenia include drug therapy,exercise and nutritional intervention.In order to increase the awareness and improve the prevention and treatment level of MHD sarcopenia,this article reviews the prevalence,risk factors,treatment and intervention status of MHD sarcopenia.

Abstract:Objective To observe the effect of Shugan Jianpi Busui decoction on prevention and treatment of blood toxicity caused by poly(adenosine diphosphate-ribose)polymerase inhibitor(PARPi)in maintenance treatment of ovarian cancer.Methods A total of 60 patients with ovarian cancer who met the inclusion criteria were enrolled in the Oncology Department of Integrated Traditional Chinese and Western Medicine and the Department of Medical Consortium of the First Affiliated Hospital of Anhui Medical University from August 2021 to December 2023 were selected,and they were divided into observation group(30 cases)and control group(30 cases)according to the random number table method.The control group was treated with PARPi maintenance treatment,and the observation group was treated with Shugan Jianpi Busui decoction on the basis of the control group.After 3 months of treatment,the incidence,severity,duration,traditional Chinese medicine(TCM)syndrome score,efficacy and adverse reactions of the two groups were compared.Results After 3 months of treatment,the incidence and severity of anemia,thrombocytopenia and neutropenia in the observation group were lower than those in the control group[26.7％(8/30)vs 53.3％(16/30),23.3％(7/30)vs 50.0％(15/30),20.0％(6/30)vs 46.7％(14/30)](all P＜0.05).The duration of anemia and thrombocytopenia in the observation group were shorter than those in the control group[(2.56±1.33)d vs(4.21±2.00)d,(7.33±0.38)d vs(9.26±1.22)d](both P＜0.05).After 3 months of treatment,the TCM syndrome score of the observation group was significantly lower than that of the control group,and the TCM syndrome curative effect was better than that of the control group(both P＜0.05).The incidence of nausea and vomiting,diarrhea and constipation in the observation group were lighter than those in the control group(all P＜0.05).Conclusion Shugan Jianpi Busui decoction can reduce the incidence and severity of blood toxicity,shorten the occurrence time,improve the efficacy of TCM syndromes,and maintain the persistence of response to PARPi treatment.

Abstract:Functional dyspepsia(FD)overlapping irritable bowel syndrome(IBS)is a chronic disease with long course of disease,high recurrence rate,lingering and difficult to cure.The incidence is high in the world and is increasing year by year.The pathogenesis of FD overlapping IBS is very complex.Based on the existing research level and depth,it is basically known that its pathogenesis is due to gastrointestinal motility disorder,visceral hypersensitivity,social psychological factors and other factors.At present,western medicine treatment is mainly based on symptomatic treatment,such as improving gastrointestinal motility,symptomatic antidiarrheal,intervention of anxiety and depression,psychological counseling and other treatments.However,the clinical treat-ment effect is not good and the disease is in a state of recurrent attacks,which again damages the physical and mental health of patients,seriously increases the economic burden of patients'families and the consumption of medical resources.Current studies have shown that in recent years,traditional Chinese medicine monomer,tradi-tional Chinese medicine compound and external treatment of traditional Chinese medicine have excellent effects in the treatment of FD overlapping IBS symptoms,which may be related to its multi-pathway,multi-target and multi-effect intervention.Moreover,the clinical cure rate is much higher than that of single western medicine treatment,and the recurrence rate is much lower than that of pure western medicine treatment,which has significant advantages that western medicine treatment cannot replace.This article mainly reviews the pathogenesis of FD overlapping IBS and the research progress of traditional Chinese medicine treatment,in order to provide ideas for the treatment of FD overlapping IBS,the research and development of new drugs,and the inheritance and innovation of traditional Chinese medicine.

Abstract:Lianhua Qingwen capsules/granules is an innovative Chinese patent medicine guided by the theory of collaterals disease of traditional Chinese medicine,which has the functions of clearing away pestilence,detoxifying,ventilating lung and dissipating heat.It draws lessons from the traditional experience and modern pharmacological mechanism of ancient Chinese medicine in the treatment of influenza,fever and other respiratory exogenous diseases.It has dual effects of antiviral and antibacterial,and has become recommended medication for the treatment of respiratory diseases.Among them,the common respiratory diseases include respiratory tract infection,influenza,pneumonia,chronic obstructive pulmonary disease,etc.The clinical symptoms are fever,sore throat,cough and expectoration,nasal congestion,and Lianhua Qingwen can play a role in relieving cough,eliminating phlegm,asthma,anti-inflammation and enhancing the body immunity.In this paper,the composition,pharmacological effects,related research status and adverse reactions of Lianhua Qingwen in respiratory diseases are reviewed,in order to provide reference for the clinical application of Lianhua Qingwen.

Abstract:Objective To analyze the predictive value of cerebrospinal fluid microRNA-22(miR-22)and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury.Methods The clinical data of 124 patients with traumatic brain injury admitted to Jiangbin Hospital of Guangxi Zhuang Autonomous Region from October 2021 to October 2023 were retrospectively analyzed.The patients were divided into two groups according to whether they had secondary intracranial bacterial infection,50 patients with secondary intracranial bacterial infection were set as the infection group,and 74 patients without intracranial bacterial infection were set as the non-infection group.The levels of cerebrospinal fluid miR-22 and procalcitonin were compared between the two groups.Logistic regression was used to analyze the risk factors of secondary intracranial bacterial infection in patients with traumatic brain injury.The receiver operating characteristic curve was drawn to analyze the predictive efficacy of cerebrospinal fluid miR-22 and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury.Results The levels of miR-22 and procalcitonin in cerebrospinal fluid of infection group were higher than those of non-infection group[(3.61±0.51)vs(0.64±0.13),(3.36±0.62)μg/L vs(0.89±0.13)μg/L](t=47.929,33.266,both P＜0.001).Logistic regression analysis showed that cerebro-spinal fluid miR-22,cerebrospinal fluid procalcitonin,preoperative neutrophil to lymphocyte ratio,postoperative intracranial gas,postoperative cerebrospinal fluid leakage and drainage tube time were risk factors for secondary intracranial bacterial infection in patients with traumatic brain injury(all P＜0.05).The area under the curve of combination of cerebrospinal fluid miR-22 and procalcitonin in predicting secondary intracranial bacterial infection in patients with traumatic brain injury was 0.859,and 95％confidence interval was 0.806 to 0.944.The area under the curve of combination of cerebrospinal fluid miR-22 and procalcitonin in predicting secondary intracranial bacterial infection in patients with traumatic brain injury was larger than that of single detection(Z=2.913,P=0.006;Z=2.458,P=0.012).Conclusion The increase of cerebrospinal fluid miR-22 and procalcitonin is closely related to secondary intracranial bacterial infection in patients with traumatic brain injury.Combined detec-tion of cerebrospinal fluid miR-22 and procalcitonin can improve the prediction efficiency of secondary intracranial bacterial infection,and may become a new index to evaluate the condition of patients with traumatic brain injury.

Abstract:Cervical cancer is one of the major threats to women's health worldwide,and although it is a cancer that can be effectively prevented through early screening and diagnosis,accurate diagnosis still faces challenges.This article reviews the etiology and epidemiology of cervical cancer and precancerous lesions,and systematically reviews the latest progress in the field of cervical cancer screening at home and abroad,aiming to provide clinicians with comprehensive advances in cervical cancer screening technology,promote early detection and treatment,and reduce the incidence and mortality of cervical cancer.

Abstract:Objective To investigate the clinical effect of Xuebijing combined with ulinastatin in the treatment of sepsis.Methods Totally 78 patients with sepsis admitted to Zhangjiakou First Hospital,Hebei Province from March 2022 to January 2024 were selected.Patients were divided into observation group and control group by random number table method,with 39 cases in each group.The control group received ulinastatin for injection on the basis of comprehensive treatment.The observation group was treated with Xuebijing injection on the basis of the control group.Both groups were treated for 1 week and followed up until discharge.The clinical efficacy,traditional Chinese Medicine syndrome scale(TCM)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,thromboelastography(TEG)parameters,serological indicators and adverse reactions were compared between the two groups.Results After treatment,the total clinical effective rate of the observation group was higher than that of the control group[94.9％(37/39)vs 79.5％(31/39)](x2=4.129,P=0.042).After treatment,the TCM,APACHE Ⅱ and SOFA scores of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P＜0.05).The TEG reaction time,coagulation time and maximum amplitude of thrombosis in the two groups were shorter/lower than those before treatment,and those in the observation group were shorter/lower than those in the control group(all P＜0.05).The levels of serum creatinine,cystatin C,procalcitonin,neutrophil gelatinase-associated lipocalin,kidney injury molecule 1,microRNA-223 and microRNA-155 in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P＞0.05).Conclusion Xuebijing combined with ulinastatin can improve the clinical symptoms and organ function of patients with sepsis,reduce the severity of the disease,stabilize TEG parameters,control the inflammatory response of the body,relieve kidney injury,with significant efficacy and good safety.

Abstract:Objective To observe the efficacy and safety of gemcitabine or paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab as first-line treatment for advanced non-small cell lung cancer(NSCLC)without gene mutation.Methods Totally 120 patients with advanced NSCLC without gene mutation admitted to Chengdu Fifth People's Hospital,Sichuan Province from January 2022 to June 2023 were selected.They were divided into control group and observation group using a random number table method,with 60 cases in each group.The control group was treated with gemcitabine combined with lobaplatin and camrelizumab.The observation group was treated with paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab.The levels of serum squamous cell carcinoma associated antigen(SCC),cytokeratin 19 fragment antigen(CA21-1),transforming growth factor-β,(TGF-β1),serum CD3+,CD4+,CD8+and the ratio of CD4+/CD8+were compared between the two groups before and 14 d after treatment.The clinical efficacy and incidence of toxic side effects were compared between the two groups.Results After 14 d of treatment,the levels of SCC,CA21-1 and TGF-β1and CD8+in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group;the serum levels of CD3+,CD4+,and the ratio of CD4+/CD8+in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).The objective remission rate and disease control rate of the observation group were higher than those of the control group[45.0％(27/60)vs 28.3％(17/60),73.3％(44/60)vs 58.3％(35/60)](both P＜0.05).The incidences of granulocytopenia and thrombocytopenia in the observation group were lower than those in the control group,and the incidence of muscle/joint pain was higher than that in the control group[25.0％(15/60)vs 78.3％(47/60),30.0％(18/60)vs 66.7％(40/60),71.7％(43/60)vs 23.3％(14/60)](all P＜0.05),and there was no statistically significant difference in the incidence of nausea and vomiting between the two groups(P＞0.05).Conclusions Compared with gemcitabine combined with lobaplatin and camrelizumab,paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab is more effective in the first-line treatment of advanced NSCLC without gene mutations,which can effectively reduce the level of tumor markers.It also has the advantages of low toxicity,little effect on the immune system,helping the recovery of T lymphocyte subsets,and reducing bone marrow suppression.

Abstract:Objective To investigate the perioperative characteristics of blink reflex in patients with primary trigeminal neuralgia(PTN)undergoing percutaneous trigeminal gasserian ganglion balloon compression(PBC)and its relationship with long-term postoperative efficacy.Methods The clinical data of 150 PTN patients who underwent PBC in Hebei General Hospital from February to October 2020 were collected and retrospectively analyzed.All patients were evaluated for facial numbness and pain using the Barrow Neurological Institute painse-verity(BNI-P)and Barrow Neurological Institute facial numbness(BNI-N)at 1 d before surgery,1 d after surgery,and 1,3,6,and 12 months after surgery,respectively.Blink reflex testing(involving the latency and amplitude of conduction pathways R1,R2,and R2')was also performed.According to the follow-up results in the third year after surgery,the patients were divided into cure group(120 cases)and recurrence group(30 cases).The clinical data of the two groups were compared,and the Logistic regression method was used to analyze the influencing factors of the long-term prognosis of the patients,establish a prediction model,and evaluate the goodness of fit of the model.Results The BNI-P scores of patients at 1 d after surgery and at 1,3,6,and 12 months after surgery were significantly lower than that at 1 d before surgery(all P＜0.05).After PBC treatment,the latency of R1,R2,and R2'showed an overall decreasing trend,while the amplitude of R1,R2,and R2'showed an overall increasing trend(all P＜0.05).The results of the multivariate Logistic regression analysis incorporating the most comprehensive factors showed that body mass index(odds ratio=1.254,P=0.028),disease duration(odds ratio=1.072,P=0.008),preoperative BNI-P(odds ratio=2.189,P=0.040),preoperative R1,R2,and R2'latency(odds ratio=3.546,4.165,1.314;P=0.012,0.014,0.038),and preoperative R1,R2,and R2'amplitude(odds ratio=0.933,0.920,0.942;P=0.009,0.003,0.002)were all influencing factors for long-term prognosis.The Hosmer-Lemeshow test showed that the model had good goodness of fit(P=0.796).Conclusions PBC treatment of PTN patients can achieve good clinical efficacy,and the blink reflex indexes show a decreasing trend with the follow-up time,and there is a positive correlation between the symptoms of facial numbness.Individual factors,preoperative levels of BNI-P and blink reflex have important effects on the long-term efficacy of PTN patients after surgery.

Abstract:Objective To investigate the effect of Hanshibi granules combined with celecoxib in the treatment of ankylosing spondylitis.Methods A total of 128 patients with ankylosing spondylitis admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2020 to August 2023 were selected.According to the random number table method,the patients were divided into control group and observation group,with 64 cases in each group.The control group was treated with celecoxib capsule,and the observation group was treated with Hanshibi granules on the basis of the control group.Both groups were treated for 6 weeks.The therapeutic effect,visual analogue scale(VAS)score,Bath ankylosing spondylitis functional index(BASFI)score,serum inflammatory indexes and adverse reactions were compared between the two groups.Results In the control group,54 cases were improved and 10 cases were ineffective.In the observation group,61 cases were improved and 3 cases were ineffective.The total effective rate of the observation group was higher than that of the control group[95.3％(61/64)vs 84.4％(54/64)](x2=4.195,P=0.041).After treatment,the VAS and BASFI scores of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P＜0.05).After treatment,the levels of C-reactive protein,interleukin-17 and tumor necrosis factor-α in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(x2=0.175,P=0.676).Conclusion The combination of celecoxib and Hanshibi granules in the treatment of ankylosing spondylitis can achieve satisfactory results.It can rapidly improve the clinical symptoms such as low back pain,morning stiffness,aralgia and so on,reduce VAS,BASFI scores and inflammatory response in the body,with a low incidence of adverse reactions and mild symptoms.

Abstract:Objective To investigate the safety and efficacy of remimazolam as adjunctive sedation during spinal puncture in patients undergoing knee replacement surgery.Methods Sixty patients who underwent knee joint replacement surgery under spinal anesthesia at Hainan General Hospital from March 2022 to May 2023 were selected.The American Association of Anesthesiologists graded them as Grade Ⅰ-Ⅲ and divided into three groups using a random number table method:control group(group C),remimazolam 0.04 mg/kg group(group R1)and remimazolam 0.06 mg/kg group(group R2),with 20 cases in each group.After positioning the left flexion position,all patients were slowly injected with normal saline and remimazolam 0.04 mg/kg and 0.06 mg/kg,respectively,and Lumbar puncture was performed under local anesthesia in the L2-3 space 1 minute later.Heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SpO2),modified observer's assessment of alertness/sedation(MOAA/S)score and patient satisfaction were recorded before administration and 1,2,3,4,5,6,7,8,9,10,15 min after administration.Results HR and MOAA/S scores at 2,3,4,5,6,7,8,9,10 min after administration in group R2 were lower than those in group C(all P＜0.05),and MAP at 4,5,6 min after administration in group R2 were lower than those in group C(all P＜0.05).The MOAA/S scores in group R2at2,3,4,5,6,7,8 min after administration were lower than those in group R1(all P＜0.05).HR at 3,4,5,6,7,8,9,10,15 min after administration in group R2 were lower than those before administration(all P＜0.05),and MAP at 4,5,6,7,8,9,10,15 min after administration in group R2 were lower than those before administration(all P＜0.05).MOAA/S scores at 2,3,4,5,6,7,8,9,10 min after administration in group R2 were lower than those before administration(all P＜0.05).There were no significant differences in SpO2 among the three groups at each time point(all P＞0.05).The very satisfied percentage of patients in group R2 were higher than those in group R1 and group C[90.0％(18/20)vs 60.0％(12/20),30.0％(6/20)](both P＜0.05).Conclusion The use of 0.06 mg/kg remimazolam has better sedative effect during spinal puncture in patients undergoing knee replacement,with little effect on respiratory depression,stable HR and blood pressure,and high safety.

Abstract:Objective To explore the clinical efficacy of Jieyu Anshen granule combined with olanzapine in the treatment of schizophrenia with mild anxiety and depression.Methods A total of 102 schizophrenia patients with mild anxiety and depression who were treated in the Third People's Hospital of Qinghai Province from January 2020 to December 2022 were selected.They were randomly divided into observation group(51 cases)and control group(51 cases).On the basis of routine psychological counseling,the control group was treated with olanzapine tablets,and the observation group was treated with Jieyu Anshen granules on the basis of the control group.The total effective rate was compared between the two groups after 2 months of treatment.The positive and negative syndrome scale(PANSS)score,Loewenstein occupational therapy cognitive assessment(LOTCA)score,self-rating anxiety scale(SAS)score and self-rating depression scale(SDS)score before and after treatment were recorded and compared between the two groups.The adverse reactions of the two groups were recorded and compared.Results The total effective rate of the observation group was higher than that of the control group[88.2％(45/51)vs 70.6％(36/51)](P＜0.05).After treatment,the PANSS score,SAS score and SDS score of the two groups were significantly lower than those before treatment,and the LOTCA score was significantly higher than that before treatment.The PANSS score,SAS score and SDS score of the observation group were lower than those of the control group,and the LOTCA score was higher than that of the control group(all P＜0.05).After treatment,the levels of serum melatonin and 5-hydroxytryptamine in the two groups were significantly higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).The incidence of adverse reactions was compared between the observation group and the control group[15.7％(8/51)vs 23.5％(12/51)](P=0.318).Conclusion Jieyu Anshen granule combined with olanzapine in the treatment of schizophrenia with mild anxiety and depression has a good effect,which can improve the mental state and cognitive function of patients,reduce the degree of anxiety and depression,and the safety is good.