Abstract:Objective To explore the efficacy and safety of meropenem combined with ulinastatin in the treatment of patients with septic shock.Methods A retrospective controlled study was conducted.A total of 78 patients with septic shock treated at Ningde Hospital Affiliated to Ningde Normal University from June 2022 to June 2024 was enrolled and divided into the combination therapy group(n=40)and the monotherapy group(n=38)based on their original treatment regimens.The com-bination therapy group was treated with meropenem plus ulinastatin,while the monotherapy group was treated with meropenem alone.Sequential Organ Failure Assessment(SOFA),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,length of intensive care unit(ICU)stay,clinical efficacy,levels of serum inflammatory factors(procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)),myocardial function indicators(cardiac troponin I(cTnI),creatine kinase-MB(CK-MB),brain natriuretic peptide(BNP)),blood lactate levels and lactate clearance rate before and after treatment,as well as the incidence of adverse reactions,were compared between the two groups.Results After treatment,the SOFA and APACHE Ⅱ scores in the combination therapy group and monotherapy group decreased,and the scores in the combination therapy group((6.51±2.19)points,(12.34±4.99)points)were lower than those in the monotherapy group((8.45±2.87)points,(15.67±5.24)points)(t=3.367,2.875,both P<0.05).The length of ICU stay was shorter in the combination therapy group((7.91±2.38)days)than in the monotherapy group((9.87±3.29)days)(t=3.026,P<0.05).The total effective rate in the combination therapy group was 85.00%(34/40),higher than that in the monotherapy group(63.16%(24/38))(χ2=4.876,P<0.05).After treatment,levels of PCT,CRP,IL-6,and TNF-α decreased in both groups compared to pre-treatment levels,and the above indicators in the combination therapy group((10.18±5.53)μg/L,(38.12±8.84)mg/L,(25.33±6.17)pg/mL,and(24.18±9.42)pg/mL,respectively)were lower than those in the monotherapy group((18.96±7.55)μg/L,(62.03±7.27)mg/L,(37.41±7.28)pg/mL,and(30.29±10.74)pg/mL,respectively)(t=5.880,13.009,7.920,2.675,all P<0.05).After treatment,levels of cTnI,CK-MB,and BNP decreased in both groups compared to pre-treatment levels,and the above indicators in the combination therapy group((1.18±0.23)μg/L,(128.07±12.11)U/L,and(0.43±0.16)mg/L,respectively)were lower than those in the monotherapy group((1.56±0.25)μg/L,(162.43±17.2)U/L,and(0.71±0.28)mg/L,respectively)(t=6.976,10.208,5.385,all P<0.05).After treat-ment,the combination therapy group showed lower blood lactate levels and higher lactate clearance rates((2.52±0.41)mmol/L and(41.37±8.55)%,respectively)compared to the monotherapy group((2.91±0.58)mmol/L and(32.84±7.92)%,respectively)(t=3.443,4.565,both P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the combination therapy group and the monotherapy group(17.50%(7/40)vs 10.53%(4/38),χ2=0.782,P>0.05).Conclusion The combination of meropenem and ulinastatin demonstrates significant efficacy in treating septic shock,effectively improving organ function,shorten-ing ICU stay,lowering levels of inflammatory factors and lactate,increasing lactate clearance rate,with a high safety profile.

Abstract:Objective To investigate the clinical efficacy of tinidazole combined with levofloxacin in the treatment of chronic pelvic inflammatory disease(CPID).Methods A prospective controlled study design was adopted.A total of 108 patients with CPID treated at Shijiazhuang Maternal and Child Health Hospital from April 2022 to November 2024 were select-ed and randomly divided into the control group(n=54)and the study group(n=54)using a random number table method.The control group received tinidazole combined with fleroxacin for 14 days,while the study group received tinidazole combined with levofloxacin for 14 days.Clinical efficacy,time to improvement of clinical symptoms,as well as inflammatory response markers and hemorheological indicators before and after treatment were compared between the two groups.Results The total effective rate was 96.30%(52/54)in the study group,significantly higher than 83.33%(45/54)in the control group(χ2=4.960,P<0.05).The time to improvement of clinical symptoms was shorter in the study group than in the control group(lower abdominal disten-sion and pain:(5.28±0.73)d vs(7.15±0.95)d;increased vaginal discharge:(5.85±0.86)d vs(8.87±1.32)d;fatigue and low-grade fever:(6.63±1.39)d vs(9.06±1.28)d;pelvic mass:(5.87±0.96)d vs(9.56±1.34)d),with statistically significant differences(t=11.470,14.086,9.450,16.450,all P<0.05).After 14 days of treatment,the levels of serum monocyte chemoattractant pro-tein-1,tumor necrosis factor-α,intercellular adhesion molecule-1,and macrophage colony-stimulating factor in the study group((3.52±0.64)ng/L,(0.83±0.21)μg/L,(3.19±0.56)μg/mL,(19.18±2.62)ng/L,respectively)were lower than those in the control group((5.14±0.93)ng/L,(1.66±0.47)μg/L,(5.38±0.83)μg/mL,(23.43±3.06)ng/L,respectively),and the differences were statis-tically significant(t=10.545,11.848,16.073,7.753,all P<0.05).The levels of fibrinogen,plasma viscosity,whole blood viscosi-ty,and whole blood high shear viscosity in the study group((2.63±0.38)g/L,(1.42±0.32)mPa·s,(1.15±0.27)mPa·s,(3.96±0.49)mPa·s,respectively)were lower than those in the control group((3.68±0.43)g/L,(1.78±0.37)mPa·s,(1.84±0.35)mPa·s,(4.82±0.58)mPa·s,respectively),and the differences were statistically significant(t=13.446,5.408,11.471,8.232,all P<0.05).Conclusion Tinidazole combined with levofloxacin can effectively relieve pain,reduce inflammatory responses,and improve blood circulation in patients with CPID,demonstrating significant therapeutic effects.

Abstract:Objective To investigate the factors influencing the efficacy of secukinumab in the treatment of patients with moderate to severe plaque psoriasis.Methods A retrospective controlled study design was adopted.A total of 102 pa-tients with moderate-to-severe plaque psoriasis treated with secukinumab at Shanghai Skin Disease Hospital from June 2022 to August 2024 were selected.Patients were grouped based on their Psoriasis Area and Severity Index(PASI)improvement rate after 2 months of treatment.Patients with a PASI improvement rate of 50%to<75%were classified into the PASI 50 group,those with 75%to<90%into the PASI 75 group,and those with 90%to 100%into the PASI 90 group.The time to achieve the respective PASI improvement threshold and clinical data were recorded,and multivariate ordinal logistic regression analysis was employed to identify factors influencing treatment efficacy.Results Patients were categorized as follows:74 into the PASI 50 group,18 into the PASI 75 group,and 10 into the PASI 90 group.The treatment course for the 102 patients ranged from 24 to 97 weeks.The time to achieve PASI 50,PASI 75,and PASI 90 improvement rates for all patients was(4.89±1.33),(12.37±3.62),and(35.37±8.36)weeks,respectively.No statistically significant difference was found in the PASI improvement rate after 2 months of secukinumab treatment among patients with moderate to severe plaque psoriasis in terms of age,gender,smoking history,family history of psoriasis,dermatology life quality index,and seasonal exacerbation patterns(F/χ²=0.215,0.330,0.731,1.631,1.242,0.497,all P>0.05).Statistically significant differences in PASI improvement rate were found across different body mass index(BMI)categories,disease durations,comorbidities,histories of prior biologic therapy,medication adherence levels,and baseline PASI scores(F/χ²=3.827,6.637,7.258,6.720,7.789,6.458,all P<0.05).Multivariate ordinal logistic regression analysis revealed that BMI(OR=0.760,95%CI:0.614-0.943),disease duration(OR=0.258,95%CI:0.133-0.503),comorbidities(OR=10.730,95%CI:1.657-69.477),history of prior biologic therapy(OR=7.622,95%CI:1.237-46.993),medication adher-ence(OR=5.865,95%CI:1.435-23.999),and baseline PASI score(OR=0.712,95%CI:0.578-0.876)all significantly influenced the efficacy of secukinumab in patients with moderate to severe plaque psoriasis(all P<0.05).Conclusion Secukinumab demonstrates rapid onset and sustained efficacy in the treatment of moderate to severe plaque psoriasis.BMI,disease dura-tion,comorbidities,history of prior biologic therapy,medication adherence,and baseline PASI score all significantly influence treatment outcomes.

Abstract:Objective To analyze the therapeutic effect of tegoprazan combined with amoxicillin in treating patients with gastric ulcer after Helicobacter pylori(Hp)infection.Methods A prospective controlled study design was adopted.A total of 155 patients with gastric ulcer after Hp infection admitted to the Tenth Affiliated Hospital of Southern Medical University(Dongguan People's Hospital)from November 2023 to October 2024 were divided into the control group and the observation group using random number table method.The control group was given a four-antibiotic treatment regimen,and the observation group was given a combination of tegoprazan and amoxicillin.The therapeutic effect,clinical symptom relief time,inflammato-ry indicators,gastric secretion indicators,and adverse reactions were compared between the observation group and the control group.Results After treatment,there were no significant differences between the control group and the observation group in terms of the total clinical effective rate((92.11%(70/76)vs(94.74%)72/76)and Hp negative conversion rate(93.42%(71/76)vs 97.37%(74/76))(χ2=0.428,P=0.513;Fisher's exact probability test,P=0.442).There was no significant difference in the time of acid reflux,belching,loss of appetite,upper abdominal pain,upper abdominal distension and relief of heartburn between the control group and the observation group((4.06±1.11),(6.03±1.54),(5.37±1.65),(4.16±1.13),(5.24±1.23)and(5.03±1.34)d vs(4.02±1.24),(5.84±1.29),(5.56±1.43),(4.27±1.21),(5.43±1.09)and(5.16±1.13)d)(t=0.210,0.825,0.759,0.579,1.008,0.647,P=0.834,0.411,0.449,0.563,0.315,0.519).No statistically significant differences were found in the levels of interleukin(IL)-1,IL-6,C-reactive protein,gastrin,pepsinogen(PG)I and PG II between the control group and the observation group((25.64±3.58)ng/L,(70.06±8.24)ng/L,(5.11±1.14)mg/L,(30.21±8.59)pmol/L,(106.65±15.58)μg/L and(14.03±3.24)μg/L vs(25.19±4.67)ng/L,(72.19±7.19)ng/L,(5.26±1.36)mg/L,(26.25±7.46)pmol/L,(107.36±17.43)μg/L and(13.65±3.02)μg/L)(t=0.667,1.698,0.737,0.730,0.265,0.748,P=0.506,0.092,0.462,0.467,0.792,0.456).The incidence of adverse reactions in the observation group(5.26%,4/76)was lower than that in the control group(15.79%,12/76),and the difference was statistical-ly significant(χ2=4.471,P=0.034).Conclusion The combination of tegoprazan and amoxicillin and the quadruple therapy can effectively alleviate clinical symptoms,improve inflammatory response and gastric secretion function in patients with gastric ul-cer after Hp infection,but the combination of tegoprazan and amoxicillin can reduce the types and doses of medication,and has better safety.

Abstract:Objective To investigate the clinical efficacy and safety of anlotinib combined with tislelizumab in the treatment of extensive-stage small cell lung cancer(ES-SCLC).Methods A randomized controlled trial was conducted.A total of 148 patients with ES-SCLC who had progressed/relapsed after first-line treatment from June 2021 to June 2023 in Linfen Peo-ple's Hospital were selected and randomly divided into the combination group(74 cases,receiving anlotinib combined with tisleli-zumab)and the control group(74 cases,receiving anlotinib monotherapy)using a random number table method.The short-term efficacy and long-term survival outcomes(including objective response rate,disease control rate,progression-free survival,and overall survival),changes in tumor marker levels,and the incidence of adverse reactions were compared between the two groups.Results The combination group demonstrated significantly higher objective response rate(59.46％(44/74))and disease control rate(91.89％(68/74))compared to the control group(41.89％(31/74)and 77.03％(57/74))(x2=4.568,6.299,both P＜0.05).As of December 31,2024,the median follow-up time was 22.3 months.Kaplan-Meier survival analysis showed that the combination group had both a longer median progression-free survival of 8.00 months(95％CI:6.073-9.927)and a longer median overall survival of 10.00 months(95％CI:4.815-15.185)compared to the control group(6.00 months(95％CI:5.252-6.748)and 8.00 months(95％CI:7.263-8.737),respectively)(Log-rankx2=4.066,5.467,both P＜0.05).After 4 cycles of treatment,the levels of neuron-specific enolase and cytokeratin 19 fragment in both groups decreased compared to before treatment,and the above indicators in the combination group((12.53±3.18)μg/L,(4.08±0.92)ng/mL)were lower than those in the control group((16.36±4.25)μg/L,(5.25±1.08)ng/mL)(t=6.207,7.094,both P＜0.05).The incidence of hypertension in the combination group was 35.14％(26/74),higher than that in the control group(18.92％(14/74))(x2=4.933,P＜0.05).Conclusion In patients with ES-SCLC after first-line treatment failure,the combination therapy of anlotinib and tislelizumab significantly improves short-term efficacy and long-term survival compared to anlotinib monotherapy,with overall manageable adverse reactions.

Abstract:Objective To explore the effects of brachial plexus block with nalbuphine combined with local anesthetics on anesthetic efficacy and postoperative analgesia in patients undergoing upper limb orthopedic surgery.Methods A prospective study was conducted.A total of 108 patients scheduled for upper limb orthopedic surgery at Dongtai Hospital of Chinese Medicine from January 2023 to April 2025 were selected and randomly divided into three groups:Group N(n=36,treated with ropivacaine plus lidocaine plus nalbuphine),Group D(n=36,treated with ropivacaine plus lidocaine plus dexamethasone),and Group S(n=36,treated with ropivacaine plus lidocaine).The anesthetic effects(onset time of sensory block and motor block,analgesia duration),postoperative pain intensity(Visual Analogue Scale(VAS)scores),hemodynamic indicators(heart rate(HR),mean arterial pres-sure(MAP)),and perioperative adverse reactions were compared among the three groups.Results Among Group N,Group D,and Group S,the onset time of sensory block((2.97±0.90),(4.05±1.03),and(5.20±1.37)min,respectively)and the onset time of motor block((8.91±2.76),(11.22±2.80),and(13.63±3.14)min,respectively)were progressively increased(F=35.838,23.763,both P＜0.05),and the duration of analgesia((11.06±1.27),(8.42±1.10),and(7.21±1.08)h,respectively)was progressively decreased(F=104.934,P＜0.05).At 2,4,8,and 12 hours postoperatively,the VAS scores were(1.34±0.44),(1.57±0.46),(1.88±0.51),and(2.84±1.27)points in Group N,(1.51±0.50),(1.85±0.52),(2.85±0.62),and(3.69±1.32)points in Group D,(1.87±0.61),(2.17±0.72),(3.06±0.93),and(4.55±1.44)points in Group S,respectively.The VAS scores in the three groups showed a gradual increase(F=9.696,9.731,28.351,14.543,all P＜0.05).At T2,the heart rates in Group N((81.35±9.14)beats/min),Group D((84.42±8.95)beats/min),and Group S((87.62±8.93)beats/min)were gradually increased(F=4.362,P＜0.05).At T3,the mean arterial pressures of Group N((87.51±6.22)mmHg(1 mmHg=0.133 kPa)),Group D((88.85±6.37)mmHg),and Group S((92.19±7.23)mmHg)were gradually increased(F=4.769,P＜0.05).The incidence of perioperative adverse reactions in Group N was 13.89％(5/36),and there was no statistically significant difference compared to Group D(11.11％(4/36))and Group S(2.78％(1/36))(Fisher's exact test,P=0.266).Conclusion Nalbuphine combined with local anesthetics provided the optimal effect for brachial plexus block.Dexamethasone combined with local anesthetics was superior to local anesthetics alone.All three regimens had comparable safety.

Abstract:Objective To investigate the safety and efficacy of remimazolam combined with remifentanil for non-intubated general anesthesia in ureteral stent removal(USR).Methods A total of 86 patients undergoing USR at Luoy-ang Central Hospital between February 2023 and August 2024 were selected and randomly assigned via computer-generated random numbers to the observation group(n=43)and the control group(n=43).The control group received propofol combined with remifentanil,while the observation group received remimazolam combined with remifentanil for general anesthesia main-tenance.Mean arterial pressure(MAP),heart rate(HR),and pulse oxygen saturation(SpO2)were compared between the two groups at different time points:before anesthesia(T1),during urethral insertion of the cystoscope(T2),during stent removal(T3),upon entering the post-anesthesia care unit(PACU)(T4),and upon leaving the PACU(T5).Anesthesia induction time,op-erative time,recovery time,PACU stay duration,and the incidence of adverse reactions were also compared between the two groups.Results The MAP in the observation group at T1,T2,T3,T4,and T5 were(91.49±7.04),(87.32±7.06),(85.21±6.89),(88.19±6.48),and(89.14±7.29)mmHg(1 mmHg=0.133 kPa),respectively,while those in the control group were(92.16±7.20),(84.26±6.77),(80.58±6.39),(83.07±6.44),and(88.70±6.24)mmHg,respectively.There were statistically significant time effects,interaction effects,and intergroup differences in MAP between the two groups of USR patients(Ftime=21.648,Finteraction=2.985,Fgroup=15.7 86,all P＜0.05).The HR of the observation group at T1,T2,T3,T4,and T5 were(75.23±8.49),(73.89±8.08),(71.28±5.25),(72.53±6.44),and(73.70±6.18)beats/min,respectively,while those of the control group were(75.34±9.63),(70.33±8.18),(64.16±5.58),(68.35±5.47),and(72.26±6.54)beats/min,respectively.There were statistically sig-nificant time effects,interaction effects,and intergroup differences in HR between the two groups of USR patients(Ftime=13.361,Finteraction=3.200,Fgroup=23.378,all P＜0.05).The SpO2 in the observation group at T1,T2,T3,T4,and T5 were(98.54±6.33),(98.49±5.34),(97.89±6.02),(98.62±5.67),and(99.13±3.60)％,respectively,while those in the control group were(97.21±6.12),(96.11±5.49),(95.09±6.08),(96.79±5.78),and(98.73±4.10)％,respectively.There was no statistically significant time effect or interaction effect on SpO2 in the two groups of USR patients(Ftime=2.253,Finteraction=0.625,both P＞0.05),while the between-group effect showed statistical significance(Fgroup=10.351,P＜0.05).Awakening time((3.15±1.21)min vs(3.86±1.52)min)and PACU stay time((30.12±6.03)min vs(32.87±6.09)min)were both shorter in the observation group than in the control group(t=2.396,2.104,both P＜0.05).The incidence of adverse reactions was 4.65％(2/43)in the observation group and 11.63％(5/43)in the control group,with no statistically significant difference(Fisher's exact probability test,P=0.438).Conclusion The use of remimazolam combined with remifentanil for general anesthesia maintenance in patients undergoing USR provides stable hemo-dynamics,shortens recovery and PACU stay times,and does not increase the incidence of adverse reactions.

Abstract:Objective To observe the preemptive analgesic effect of celecoxib combined with tizanidine in patients undergoing endoscopic lumbar spine surgery.Methods This prospective randomized controlled trial enrolled patients scheduled for surgical treatment of lumbar disc herniation at Beijing Haidian Hospital between March and November 2023.Participants were randomly assigned to the observation group and the control group(n=45 each)using a random number table method.The observation group received oral celecoxib(200 mg)and tizanidine(2 mg)the night before and on the morning of surgery.The control group received oral celecoxib(200 mg)the night before and on the morning of surgery.The rescue analgesia within 48 hours after surgery,Visual Analogue Scale(VAS)scores at rest and during activity,the pain intensity classification,vital signs and adverse reactions of the two groups were observed.Results Within 48 hours postoperatively,the observation group demonstrated a significantly lower rescue analgesia rate(55.55％(25/45)vs 77.78％(35/45),x2=5.000,P＜0.05),fewer rescue analgesic episodes((1.66±0.35)times vs(1.97±0.42)times,t=-3.804,P＜0.001),and a lower total rescue analgesic dosage((161.25±30.58)mg vs(188.41±38.94)mg,t=-3.680,P＜0.001)compared to the control group.At 48 and 72 hours postoperatively,the VAS scores for pain during the rest and activity phases in the observation group were significantly lower than those in the control group((1.2±0.4),(1.9±0.4),(1.7±0.4),(2.0±0.6)points vs(1.9±0.6),(2.3±0.5),(2.6±0.8),(2.9±0.9)points,respectively),with statistically significant differences(t=-6.512,-4.191,-6.750,-5.582,all P＜0.05).At 48 and 72 hours postoperatively,the proportions of patients with VAS scores＞3 in the observation group(11.11％(5/45)and 17.78％(8/45),respectively)were lower than those in the control group((33.33％(15/45)and 48.89％(22/45),respectively),with statistically significant differences(x2=6.629,9.800,both P＜0.05).The incidence rates of adverse reactions within 48 hours after surgery were 6.67％(3/45)in the observation group and 4.44％(2/45)in the control group,and the difference was not statistically significant(x2=0.000,P＞0.05).Conclusion The preemptive analgesic regimen of celecoxib combined with tizanidine provides effective postoperative pain relief with a favorable safety profile for patients undergoing lumbar endoscopic surgery.

Abstract:Objective To investigate the clinical efficacy of enoxaparin combined with rivaroxaban in patients with acute intermediate-low-risk pulmonary embolism.Methods A total of 80 patients with acute intermediate-low-risk pulmonary embolism admitted to the Department of Vascular Surgery at Huai'an First People's Hospital between December 2023 and De-cember 2024 were retrospectively enrolled and divided into two groups based on previous treatment regimens.40 patients who received enoxaparin combined with rivaroxaban were assigned to the enoxaparin group,and another 40 patients who received rivaroxaban monotherapy were assigned to the rivaroxaban group.The coagulation function index,pulmonary ventilation pa-rameter,overall clinical efficacy,and drug-related adverse reactions were compared between the enoxaparin group and the rivar-oxaban group.Results After treatment,the activated partial thromboplastin time,prothrombin time,oxygen saturation at rest,tidal volume,and minute ventilation in the enoxaparin group((42.19±3.41)s,(18.54±2.47)s,(96.37±3.24)％,(464.37±9.64)mL,(8.65±1.24)L/min,respectively)were higher than those in the rivaroxaban group((39.64±3.37)s,(14.29±2.51)s,(89.03±3.15)％,(429.61±8.17)mL,(7.30±0.15)L/min,respectively),with statistically significant differences(t=13.913,7.633,10.273,17.397,6.836,all P＜0.05).After treatment,the levels of fibrinogen,D-dimer,and end-tidal carbon dioxide partial pressure in the enoxa-parin group((2.17±0.46)g/L,(1.04±0.23)mg/L,(5.14±0.17)mmHg(1 mmHg=0.133 kPa),respectively)were lower than those in the rivaroxaban group((3.17±0.27)g/L,(1.37±0.21)mg/L,(5.29±0.23)mmHg,respectively),with statistically significant differences(t=1 1.857,6.701,3.317,all P＜0.05).After treatment,the end-diastolic diameter of the right ventricle and pulmonary artery systolic pressure in the enoxaparin group were both lower than those before treatment,and the values in the enoxapa-rin group((27.18±2.85)mm and(28.41±5.24)mmHg,respectively)were lower than those in the rivaroxaban group((30.27±3.16)mm and(34.79±5.87)mmHg,respectively)(t=4.593,5.128,both P＜0.05).The total effective rate in the enoxaparin group was 95.00％(38/40),significantly higher than 75.00％(30/40)in the rivaroxaban group(x2=6.275,P＜0.05).There was no statis-tically significant difference in the incidence of adverse reactions between the enoxaparin group(20.00％(8/40))and the rivar-oxaban group(27.50％(11/40))(x2=0.621,P=0.431).Conclusion In the treatment of acute intermediate-low-risk pulmonary embolism,the combination of enoxaparin and rivaroxaban can more effectively improve patients'coagulation function and pul-monary ventilation,enhance clinical efficacy,without increasing additional risks,demonstrating a favorable safety profile.

Abstract:Objective To explore the efficacy of dulaglutide combined with insulin glargine in the treatment of type 2 diabetes mellitus(T2DM).Methods Patients with T2DM treated at Shaanxi Provincial People's Hospital from December 2022 to December 2023 were prospectively selected and randomly divided into the observation group(treated with dulaglutide com-bined with insulin glargine)and the control group(treated with insulin glargine alone)by the random number table method,with 52 cases in each group.Both groups received continuous treatment for 3 months.The changes of glycemic-related indexes,blood glucose fluctuations,pancreatic β-cell function markers,and disease-related biochemical indexes were analyzed in the observation group and the control group before treatment and after 3 months of treatment.Adverse reactions were compared during 3 months of treatment.Results After 3 months of treatment,the mean amplitude of glycemic excursions,largest amplitude of glycemic excursions,mean of daily difference,homeostasis model assessment of insulin resistance,fasting plasma glucose,2h postprandial plasma glucose,glycosylated hemoglobin and triglyceride-glucose index in the observation group were(4.36±0.55)mmol/L,(4.13±0.60)mmol/L,(1.45±0.11)mmol/L,(1.22±0.14),(5.91±0.61)mmol/L,(7.04±0.47)mmol/L,(5.41±0.32)％and(7.09±0.62),lower than(4.69±0.72)mmol/L,(4.41±0.72)mmol/L,(1.82±0.24)mmol/L,(1.38±0.20),(6.29±0.52)mmol/L,(7.56±0.96)mmol/L,(5.77±0.41)％and(7.73±0.78)in the control group(t=2.626,2.154,10.107,4.726,3.419,3.508,4.991,4.632,all P＜0.05).The levels of pancreatic β cell function index,insulin-like growth factor-1,endogenous ligand for G protein-coupled receptor,microRNA-126 and microRNA-21 in the observation group were(138.29±18.73),(139.18±15.56)μg/L,(1 683.31±201.04)ng/L,(22.12±3.25)and(0.87±0.10),higher than(124.75±15.24),(133.25±12.47)μg/L,(1 584.39±216.18)ng/L,(19.97±2.86)and(0.79±0.08)in the control group(t=4.044,2.144,2.416,3.581,4.505,all P＜0.05).The incidence of adverse reactions in the observation group was 3.85％(2/52),higher than 1.92％(1/52)in the control group(Fisher's exact test,P≈1.000).Conclusion The combination of dulaglutide and insulin glargine in the treatment of T2DM can effectively promote the recovery of pancreatic β cell function,reduce the amplitude of the blood glucose fluctuations,improve insulin resistance,and help maintain the blood glucose stability.

Abstract:Objective To investigate the effect of cyclosporine eye drops on tear film stability and ocular surface inflammatory factor levels in patients with dry eye disease after phacoemulsification cataract surgery.Methods A total of 134 patients with dry eye disease after phacoemulsification cataract surgery,who received targeted treatment at Nanjing Hospital Affiliated to Nanjing Medical University from April 2023 to April 2025,were enrolled in this prospective randomized controlled trial.Using a random number table method,they were divided into the control group(n=67)and the observation group(n=67).All patients received standardized postoperative antibacterial and anti-inflammatory eye drops for 1-2 weeks,which were discon-tinued for at least 2 weeks prior to the study.Subsequently,the control group received deproteinized calf blood extract eye drops four times daily.The observation group received 0.05％cyclosporine eye drops twice daily,with an interval of at least 10 min-utes between the two types of drops.The total treatment course was 12 weeks.The subjective symptoms,meibomian gland func-tion,tear film stability and levels of ocular surface inflammatory factors were compared between the two groups before and after 12 weeks of treatment.Therapeutic efficacy and adverse reactions were also assessed.Results After 12 weeks of treatment,the Ocular Surface Disease Index and meibomian gland function scores in the observation group((12.25±2.96)and(1.33±0.50)points)were significantly lower than those in the control group((17.34±2.41)and(1.73±0.54)points)(t=10.913,4.470,both P＜0.001).After 12 weeks of treatment,the tear film break-up time and Schirmer Ⅰ test values in the observation group((8.33±0.87)s,(9.82±1.03)mm/5 min)were greater than those in the control group((6.37±0.69)s,(7.85±0.87)mm/5 min)(t=14.519,11.942,both P＜0.001),and the fluorescein staining score in the observation group((1.10±0.53)points)was lower than that in the control group((2.12±0.37)points)(t=12.914,P＜0.00l).After treatment,levels of tumor necrosis factor-α,inter-leukin-1β,and interleukin-6 in tear fluid were lower in the observation group((6.62±1.51),(16.52±3.27),(11.74±2.17)pg/mL,respectively)compared to the control group((8.15±1.32),(22.65±4.05),(15.22±3.02)pg/mL,respectively)(t=6.243,9.656,7.652,all P＜0.001).The total effective rate in the observation group was 83.58％(56/67),significantly higher than that in the control group(67.16％(45/67)(x2=4.865,P=0.027).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion 0.05％cyclosporine eye drops can further improve the subjective symptoms,tear film stability,and ocular surface inflammatory status,thereby enhancing clinical efficacy in patients with dry eye disease af-ter cataract surgery.

Abstract:Objective To evaluate the clinical efficacy and safety of Ganshuang Granules combined with polyene phosphatidylcholine(PPC)in the treatment of non-alcoholic fatty liver disease(NAFLD)patients complicated with abnormal glycolipid metabolism.Methods A total of 100 NAFLD patients complicated with abnormal glycolipid metabolism treated at the Third People's Hospital of Jiaozuo from September 2018 to October 2023 were retrospectively enrolled in the study and divided into the Ganshuang Granules group with 53 cases and the conventional PPC group with 47 cases according to different treatment programs.Both groups were given metformin and atorvastatin for basic treatment.The conventional PPC group was treated with PPC,while the Ganshuang Granules group was given Ganshuang Granules combined with PPC.The clinical curative effects of the two groups were observed,and the levels of liver function,blood glucose,and blood lipid metabolism indicators,as well as the incidence of adverse reactions,were compared between the two groups before and after treatment.Results The total effective rate of the Ganshuang Granules group was 94.34％(50/53),higher than 78.72％(37/47)of the conventional PPC group(x2=5.371,P＜0.05).The levels of alanine aminotransferase,aspartate aminotransferase and gamma-glutamyl transferase of the Ganshuang Granules group were lower than those of the conventional PPC group((16.89±2.79)U/L vs(34.34±3.12)U/L,(13.13±5.89)U/L vs(35.89±5.72)U/L,(44.89±9.23)U/L vs(62.34±9.92)U/L)(t=29.528,19.549,9.110,all P＜0.05).The levels of fasting plasma glucose,2-hour postprandial glucose and glycated hemoglobin of the Ganshuang Granules group were lower than those of the conventional PPC group((6.01±0.71)mmol/L vs(6.33±0.83)mmol/L,(6.74±1.13)mmol/L vs(7.32±1.05)mmol/L,(6.85±0.69)％vs(7.51±0.91)％)(t=2.078,2.648,4.113,all P＜0.05).The levels of total cholesterol,tri-glycerides and low-density lipoprotein cholesterol of the Ganshuang Granules group were lower than those of the conventional PPC group((3.21±0.71)mmol/L vs(4.12±0.53)mmol/L,(2.25±0.48)mmol/L vs(2.87±0.41)mmol/L,(2.21±0.71)mmol/L vs(2.77±0.63)mmol/L)(t=7.187,6.899,4.149,all P＜0.05).The incidence of adverse reactions was 9.43％(5/53)in the Gansh-uang Granules group and 12.77％(6/47)in the conventional PPC group,with no statistically significant difference(x2=0.282,P＞0.05).Conclusion Ganshuang Granules combined with PPC in the treatment of NAFLD patients complicated with abnor-mal glucose and lipid metabolism can effectively regulate the liver function and glucolipid metabolism,demonstrating a favor-able safety profile.

Abstract:Objective To investigate the efficacy of lipoic acid combined with ticagrelor in patients with acute coro-nary syndrome(ACS)complicated with type 2 diabetes mellitus(T2DM).Methods A total of 113 patients with ACS compli-cated with T2DM treated at Baoji Hospital of Traditional Chinese Medicine from February 2021 to February 2024 were selected and divided into 56 cases in the study group and 57 cases in the control group according to the random lottery method.After percutaneous coronary intervention,all patients received baseline therapy with oral atorvastatin,metformin,and aspirin.On top of this,the control group was treated with ticagrelor,and the study group was given lipoic acid and ticagrelor.The treatment duration was 4 weeks in both groups.The clinical efficacy,glucose metabolism,platelet function,oxidative stress indicators,the incidence of postoperative cardiovascular adverse events and adverse drug reactions were compared between the two groups.Results The total effective rate in the study group(98.21％(55/56))was better than 85.96％(49/57)in the control group(x2=5.782,P＜0.05).After treatment,the levels of fasting blood glucose,postprandial 2-hour blood glucose and malondialdehyde in the control group((6.97±1.45)mmol/L,(9.82±1.74)mmol/L,(5.08±1.17)μmol/L)and the study group((6.12±1.69)mmol/L,(8.96±1.81)mmol/L,(4.35±1.21)μmol/L)were lower than those before treatment,and the indexes in the study group were lower than those in the control group(t=2.871,2.575,3.260,all P＜0.05).The platelet inhibition status of adenosine diphosphate pathway,arachidonic acid pathway and superoxide dismutase in the control group((75.84±6.98)％,(71.92±5.74)％,(116.29±19.15)U/mL)and the study group((82.03±7.21)％,(78.38±6.81)％,(133.43±18.96)U/mL)were higher than those before treat-ment,and the indexes were higher in the study group than those in the control group(t=4.637,5.456,4.780,all P＜0.05).The incidence of cardiovascular adverse events was 15.79％(9/57)in the control group and 8.93％(5/56)in the study group,with no statistically significant difference(x2=0.853,P=0.356).The incidence of adverse drug reactions was 10.53％(6/57)in the con-trol group and 3.57％(2/56)in the study group,also showing no statistically significant difference(Fisher's exact test,P=0.134).Conclusion The combination of lipoic acid and ticagrelor can enhance the efficacy and platelet inhibition function in patients with ACS and T2DM,improve the glucose metabolism and oxidative stress level,and do not increase the occurrence of cardio-vascular adverse events and adverse reactions.

Abstract:Objective To observe the clinical efficacy of Yanghe Tongmai pills combined with argatroban in treat-ment of diabetic lower extremity artery disease and analyze the changes in the levels of various indicators.Methods A total of 70 diabetic patients with diabetic lower extremity artery disease of lower extremity who were diagnosed and treated at Cang-zhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from June 2022 to June 2023 were collected as the research objects and randomly grouped into the reference group and the experimental group,with 35 cases in each group.The reference group was treated with argatroban,while the experimental group was treated with Yanghe Tong-mai pills and argatroban.The efficacy,inflammatory factors,hemodynamics,traditional Chinese medicine syndrome scores,microcirculation indexes,and adverse reactions were observed and compared between the two groups.Results After treat-ment,the total effective rate of the experimental group was 88.57％(31/35),higher than 42.86％(15/35)of the reference group(x2=16.232,P＜0.05).After treatment,the levels of lectin-like oxidized low density lipoprotein receptor-1(LOX-1),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were obviously reduced in both groups;the levels of the above indexes of the experimental group were respectively(173.47±40.31)ng/mL,(6.32±1.56)mg/L,(41.58±6.72)ng/L and(28.37±8.14)ng/L,lower than(204.52±41.76)ng/mL,(12.87±3.41)mg/L,(56.35±6.47)ng/L and(40.65±7.32)ng/L of the reference group(t=3.165,10.334,9.367,6.636,all P＜0.05).After treatment,the ankle brachial index(ABI),toe brachial index(TBI),and dorsalis pedis artery blood flow were greatly increased in both groups;the levels of the above indexes of the experimental group were respectively(0.97±0.21),(0.86±0.25)and(48.76±7.62)mg/L,higher than(0.78±0.23),(0.69±0.13)and(39.45±7.19)mg/L of the reference group(t=3.609,3.569,5.257,all P＜0.05).After treatment,the scores of intermittent claudication,limb fear of cold,limb pain,and limb numbness in the two groups were obviously reduced;the scores of the above indexes of the experimental group were respectively(0.63±0.08),(0.46±0.12),(0.57±0.14)and(0.31±0.05)points,lower than(2.17±0.51),(2.03±0.47),(3.23±0.86)and(2.14±0.51)points of the reference group(t=17.648,19.148,18.061,21.127,all P＜0.05).After treatment,the diameter of apical loop was increased in both groups,and the above indicator of the experimental group was(24.63±5.26)mm,higher than(12.72±2.87)mm of the reference group(t=1 1.759,P＜0.05).The levels of tubular loop integral,periloop integral and flow pattern integral were decreased in both groups;the levels of the above indexes of the experi-mental group were respectively(0.91±0.24),(0.54±0.09)and(0.89±0.23)points,lower than(2.03±0.38),(1.20±0.18)and(2.03±0.45)points of the reference group(t=14.743,19.402,13.345,all P＜0.05).Conclusion The combination of Yanghe Tongmai pills and argatroban is effective in treating the diabetic patients with diabetic lower extremity artery disease of lower extremity.It can reduce inflammatory reactions,alleviate symptoms,have a low incidence of adverse reactions,raise the level of hemody-namics,and improve microcirculation.

Abstract:Objective To explore the efficacy of liposomal doxorubicin(DOX)-based neoadjuvant chemotherapy in the treatment of patients with breast cancer.Methods A total of 60 patients with breast cancer admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to January 2023 were prospectively included and divided into the conventional group and the liposome group by random number table method,with 30 cases in each group.The conventional group received neoadjuvant chemotherapy with DOX and cyclophosphamide(CPA)followed by docetaxel(DTX),while the liposome group received liposomal DOX and CPA followed by DTX.One treatment cycle was defined as 21 days,and both groups were treated for 8 cycles.Both groups were followed up until surgery.The curative effect,surgical treatment condi-tions,incidence of adverse reactions,tumor markers levels,and quality of life before and after treatment were compared between the two groups.Results After 8 cycles of treatment,the total effective rate in the liposome group was 76.67％(23/30),higher than that in the conventional group(50.00％(15/30))(x2=4.593,P＜0.05).The surgical duration and intraoperative blood loss in the liposome group were(73.23±8.68)min and(190.73±17.88)mL,compared to(84.88±7.77)min and(226.31±20.79)mL in the conventional group,with statistically significant differences(t=5.477,7.107,both P＜0.05).After 8 cycles of treatment,the serum levels of carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen,and CA15-3 decreased in the two groups,and the levels in the liposome group((41.42±6.23)U/L,(14.71±2.44)μg/L,(88.37±9.26)U/L,respectively)were lower than those in the conventional group((46.81±5.16)U/L,(19.73±2.12)μg/L,(97.10±9.29)U/L,respectively)(t=3.649,8.506,3.645,all P＜0.05).After 8 cycles of treatment,scores in the functional domains and overall health status improved in both groups,and the scores in the liposome group((78.21±7.37),(74.11±6.17)points)were higher than those in the conventional group((69.06±6.26),(63.00±6.96)points)(t=5.183,6.542,both P＜0.05).Symptom domain scores decreased in both groups,with lower scores in the liposome group((54.05±5.39)points)than in the conventional group((60.67±5.26)points)(t=4.815,P＜0.05).During treatment,the incidence of leukopenia and alopecia in the liposome group(33.33％(10/30)and 26.67％(8/30))was lower than that in the conventional group(60.00％(18/30)and 53.33％(16/30))(x2=4.286,4.444,both P＜0.05).Conclusion Liposomal doxorubi-cin-based neoadjuvant chemotherapy demonstrates favorable efficacy in breast cancer treatment.It improves subsequent surgical outcomes,reduces serum tumor marker levels,enhances patient quality of life,and exhibits a better safety profile.

Abstract:Objective To explore the clinical efficacy and safety of irbesartan in combination with metoprolol in the treatment of patients with hypertension complicated by atrial fibrillation.Methods A total of 125 patients with hypertension complicated by atrial fibrillation treated in the Department of Cardiovascular Medicine at Zhangjiagang Aoyang Hospital from January 2020 to June 2024 were included in this retrospective cohort study.Based on different treatment regimens,the patients were divided into the irbesartan group(n=63)and the metoprolol group(n=62).The metoprolol group was treated with metopr-olol monotherapy,while the irbesartan group was given irbesartan in combination with the treatment regimen of the metoprolol group.The treatment period for the irbesartan group and the metoprolol group was 6 months.The clinical efficacy,systolic blood pressure,diastolic blood pressure,frequency and duration of atrial fibrillation attacks,and changes in serum-related biomark-er levels of the irbesartan group and the metoprolol group before and after treatment were compared.Meanwhile,the occur-rence of adverse reactions was recorded.Results After 6 months of treatment,the total effective rate in the irbesartan group was significantly higher than that in the metoprolol group(92.06％(58/63)vs 77.42％(48/62),x2=5.199,P＜0.05).The systolic blood pressure and diastolic blood pressure in the irbesartan group((108.33±8.87),(76.79±5.87)mmHg(1 mmHg=0.133 kPa))were lower than those in the metoprolol group((121.23±8.92),(84.51±6.03)mmHg)(t=8.107,7.253,both P＜0.05).The atrial fibrillation attack frequency of the irbesartan group((10.45±2.58)times)was lower than that of the metoprolol group((12.89±2.45)times),and the attack duration in the irbesartan group((5.12±1.11)h)was shorter than that in the metoprolol group((6.51±1.23)h)(t=5.420,6.635,both P＜0.05).The levels of C-reactive protein,tumor necrosis factor-α,and matrix metalloproteinase-2 in the irbesartan group((4.69±1.62)mg/L,(103.23±10.67)ng/L,(255.82±34.21)μg/L)were all lower than those in the metoprolol group((5.88±1.13)mg/L,(118.34±9.78)ng/L,(311.49±34.56)μg/L)(t=4.756,8.250,9.501,all P＜0.05).The incidence of adverse reactions between the the irbesartan group and the metoprolol group was no statistically significant(11.11％(7/63)vs 16.13％(10/62),x2=0.670,P＞0.05).Conclusion Irbesartan combined with metoprolol can improve the clinical efficacy in patients with hypertension complicated by atrial fibrillation,effectively control blood pressure levels,reduce the attack frequency of atrial fibril-lation,decrease the levels of relevant biomarkers in serum,and demonstrate a good safety profile during the treatment period.

Abstract:Objective To investigate the clinical efficacy and safety of bevacizumab combined with neoad-juvant chemotherapy in the treatment of advanced ovarian cancer.Methods In this prospective study,92 patients with advanced ovarian cancer treated at the First Affiliated Hospital of Xinxiang Medical University from May 2020 to May 2023 were randomly assigned to the bevacizumab group(n=46,receiving bevacizumab plus paclitaxel and carboplatin chemotherapy)and the paclitaxel group(n=46,receiving paclitaxel and carboplatin chemotherapy)according to the ran-dom number table method.The therapeutic efficacy,changes in serum tumor marker cancer antigen 125(CA125),and the incidence of adverse reactions were compared between the bevacizumab group and the paclitaxel group after 3 cycles of treatment.The Kaplan-Meier analysis was used to analyze the prognosis of of patients in the bevacizumab group and the paclitaxel group.Results The total effective rate was 58.70％(27/46)and the disease control rate was 89.13％(41/46)in the bevacizumab group,higher than those in the paclitaxel group(36.96％(17/46)and 69.57％(32/46),respectively),and the differences were statistically significant(x2=4.356 and 5.373,both P＜0.05).After treatment,the reduction in se-rum CA125 levels in the bevacizumab group(309.56±43.12)U/mL was greater than that in the paclitaxel group(291.36±40.92)U/mL,and the difference was statistically significant(t=4.209,P＜0.05).There was no statistically significant difference in the incidence of gastrointestinal reactions,anemia,proteinuria,bone marrow suppression,hypertension,and bleeding between the two groups(P＞0.05).Among the patients who underwent interval debulking surgery,the R0 resection rate in the bevacizum-ab group was 79.41％(27/34),higher than 53.57％(15/28)in the paclitaxel group,and the difference was statistically significant(x2=4.692,P＜0.05).Kaplan-Meier analysis showed that the 2-year overall survival rate in the bevacizumab group(84.2％,95％CI:73.4％to 95.0％)was significantly higher than that in the paclitaxel group(64.7％,95％CI:50.8％to 78.6％),with a statisti-cally significant difference(Log Rankx2=4.994,P＜0.05).Conclusion Compared with neoadjuvant chemotherapy alone,bev-acizumab combined with neoadjuvant chemotherapy demonstrates superior efficacy in patients with advanced ovarian cancer.It effectively reduces tumor marker levels,prolongs overall survival,and has a controllable safety profile.

Abstract:Objective To explore the efficacy of levofloxacin eye drops combined with vancomycin in the treatment of patients with infectious endophthalmitis and analyze the drug resistance.Methods A total of 325 patients with infectious endophthalmitis who were admitted to the Hebei Eye Hospital from January 2014 to December 2023 were enrolled in the study.According to different treatment methods,the patients were divided into the VAN group(n=117)and the LEV group(n=208).The VAN group was treated with vancomycin injection,while the LEV group was given vancomycin injection combined with levofloxacin eye drops.Both groups were treated for 14 days.The drug resistance,bacterial clearance rates,visual improvement,inflammatory factor levels and adverse reactions were compared between the two groups.Results The bacterial clearance rate was 86.84％(198/228)in the LEV group,higher than 71.20％(89/125)in the VAN group,and there was significant differ-ence(x2=12.995,P＜0.05).After treatment,the visual acuity was(0.38±0.11)in the LEV group,better than(0.25±0.09)in the VAN group,and there was significant difference(t=1 1.517,P＜0.05).The levels of serum high-sensitivity C-reactive protein and tumor necrosis factor-α of the LEV group were respectively(11.50±2.96)mg/L and(20.35±4.64)ng/mL,lower than(17.25±3.28)mg/L and(33.82±5.25)ng/mL of the VAN group,and there were significant differences(t=15.702,23.130,both P＜0.05).The incidence of adverse reactions was 16.24％(19/117)in the VAN group and 17.31％(36/208)in the LEV group,and there was no significant difference(x2=0.061,P＞0.05).The result of drug susceptibility testing showed that vancomycin did not have remark-able resistance to gram-positive bacteria.Conclusion Levofloxacin combined with vancomycin can effectively increase the bacterial clearance rate,improve visual acuity and alleviate inflammatory response,demonstrating favorable safety profile.

Abstract:Objective To investigate the ameliorative effects and underlying mechanism of Shugan Yangyin Gran-ules(SG)on the depressive-like behaviors induced by lipopolysaccharide(LPS)in mice via the TLR4/MyD88/NF-κB pathway.Methods A mouse model of depressive-like behavior was established using LPS,and behavioral tests including open field test and tail suspension test were conducted to evaluate the behaviors.Hematoxylin and eosin staining was used to observe the struc-ture of the hippocampal CA1 region.ELISA and quantitative real-time PCR(qPCR)were used to detect peripheral and central inflammatory factors.Western blot was used to detect the proteins of the hippocampal pathway.BV2 cells were used to verify the anti-inflammatory effect of SG.Results SG improved the depressive-like behaviors,including reduced movement,decreased central exploration,prolonged immobility time in mice,and alleviated the disordered arrangement of hippocampal neurons and inflammatory infiltration.SG significantly inhibited the level of IL-1β in serum,as well as IL-1β,IL-6 in the cerebral cortex tissue,and downregulated the mRNA expression of Tlr4,MyD88,Rela,Nfκbl and the protein expression of TLR4,MyD88 and p-p65.The BV2 cell experiment further verified that SG could inhibit the upregulation of inflammatory factors and pathway genes induced by LPS within a concentration range that showed no obvious cytotoxicity.Conclusion SG inhibits the TLR4/MyD88/NF-κB signaling pathway,blocks the neuroinflammatory process,and thereby improves depressive-like behaviors.

Abstract:Objective To evaluate the efficacy of anthracycline-based sequential dual-target therapy combined with docetaxel in the treatment of human epidermal growth factor receptor 2(HER2)-positive breast cancer.Methods This study is a prospective controlled study.A total of 128 HER2-positive breast cancer patients admitted to Xingtai Central Hospital from March 2023 to March 2025 were selected and randomly divided into the observation group(n=64,receiving sequential anthra-cycline-based chemotherapy followed by dual-targeted therapy combined with docetaxel in 21-day cycles for a total of 8 cycles)and the control group(n=64,receiving dual-targeted therapy combined with docetaxel in 21-day cycles for a total of 4 cycles)using a random number table method.Clinical efficacy,tumor marker levels,cardiac function parameters,and the incidence of adverse reactions were analyzed and compared between the two groups.Results The objective response rate in the obser-vation group was 70.31％(45/64),higher than that in the control group(46.88％(30/64))(x2=7.245,P＜0.05).After treatment,the levels of carcinoembryonic antigen and carbohydrate antigen 153 decreased in both groups,with lower values observed in the observation group((5.08±1.02)ng/mL,(28.17±7.45)U/mL,respectively)compared to the control group((9.95±1.63)ng/mL,(46.42±10.52)U/mL,respectively)(t=20.262,11.326,both P＜0.05).After treatment,there were no statistically significant differences in left ventricular ejection fraction and N-terminal pro-B-type natriuretic peptide between the two groups(t=1.048,0.530,both P＞0.05).The incidence of alopecia in the observation group was 14.06％(9/64),lower than that in the control group(34.38％(22/64)),while the incidence of lower extremity edema in the observation group was 40.62％(26/64),higher than that in the control group(14.06％(9/64)(x2=7.194,11.365,both P＜0.05).Conclusion Sequential anthracycline-based chemother-apy followed by dual-target therapy combined with docetaxel is effective in treating HER2-positive breast cancer.It effectively reduces the levels of tumor markers,decreases the incidence of alopecia,and does not increase cardiotoxicity,although it notably increases the incidence of lower extremity edema.