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Objective: To investigate the clinical efficacy of roxithromycin combined with azithromycin sequential therapy in the treatment of mycoplasma pneumoniae pneumonia in children. Methods: A retrospective study was conducted on 100 patients with mycoplasma pneumoniae pneumonia admitted to The First Affiliated Hospital of Yangtze University from January 2020 to December 2022. All patients were divided into the observation group (roxithromycin combined with azithromycin sequential therapy) and the control group (azithromycin sequential therapy), with 50 cases in each group. The clinical efficacy, improvement time of clinical symptoms/signs, inflammation indexes, oxidative stress indexes and immune function levels of the two groups were compared. Moreover, the improvement of lung function indexes and the adverse reactions were observed. Results: The overall response rate of the observation group was 96.00%, which was higher than the control group (84.00%) (p<0.05). The time of clinical symptoms/signs in the observation group were significantly lower than those in the control group(p<0.05). After treatment, significant improvements were seen in the levels of CRP, TNF-α, IL-6, GSH-Px, SOD, MDA, CD3+, CD4+, CD4+/CD8+, IgM, IgG, IgA, FEV1, FEV1%, FVC and FEV1/FVC of the two groups compared with those before treatment (p<0.05), and the improvement in the observation group was more obvious than that in the control group (p<0.05). The overall incidence of adverse reactions in the observation group was 6.00%, which was slightly lower than that in the control group (8.00%) (c²=0.154, P=0.695). Conclusion: Roxithromycin combined with azithromycin sequential therapy is a safe regimen for the treatment of mycoplasma pneumoniae pneumonia in children. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with targeted therapy for primary hepatocellular carcinoma (PHC). Methods: This was a retrospective study. Retrospective selection of 150 PHC patients admitted to the Renmin Hospital, Hubei University of Medicine January 2019 and June 2021 were included. The patients were divided into the control group and the experimental group according to their treatment regimens. The control group received TACE treatment, while the experimental group received TACE combined with targeted therapy. We analyze the relevant data of two groups of patients and evaluate the clinical efficacy and safety of TACE combined with targeted therapy. Results: The tumor remission rate and control rate in the control group were 41.89% and 75.68%, respectively, while those in the experimental group were 77.63% and 90.79%, with statistically significant differences (p<0.05). The 1-year and 3-year recurrence rates in the control group were 52.71% and 98.65%, respectively, while those in the experimental group were 39.47% and 61.84%, with statistically significant differences (p<0.05). After treatment, the AFP, VEGF, ALT, and AST in the experimental group were significantly reduced compared to the control group (p<0.05). During the treatment period, the incidence and severity of nausea, vomiting, and fever in the experimental group were significantly lower than those in the control group (p<0.05). Conclusion: The clinical efficacy of TACE combined with targeted therapy for PHC is superior to that of TACE alone, with improved disease control rate, improved long-term survival rate, and good safety. [ABSTRACT FROM AUTHOR]

Objective: To compare and analyze the clinical effectiveness of conventional puncture hematoma drainage and stereotactic robot-guided puncture hematoma drainage in managing intracerebral hemorrhage. Methods: This is clinical comparative research. One hundred and twenty patients with the intracerebral hemorrhage who underwent puncture hematoma drainage in Baoding No.1 Central Hospital from March 2020 to May 2023 were included and were assigned into the control groups(n=60) and experimental groups(n=60) according to different treatment methods. The experimental group underwent stereotactic robot-guided puncture hematoma drainage, while the control group underwent conventional puncture hematoma drainage treatment. The duration and situation of surgery, levels of inflammatory factors, as well as preoperative and 1-week postoperative GCS scores and NIHSS scores were compared and analyzed between the two groups. Results: In comparison with the control group, the experimental group exhibited considerably less surgical duration(p=0.00), higher amount of intraoperative blood drainage and hematoma clearance rate(p=0.00). The experimental group possessed a substantially more reduced incidence of complications(10%) in comparison with the control group(25%), with a statistically substantial distinction(p=0.03). After therapy, CRP, TNF-a, and IL-6 degrees were considerably more decreased (p=0.00) in the experimental group in comparison with the control group, while GCS grades were considerably more prominent and NIHSS grades were considerably more reduced (p=0.00). Conclusion: Stereotactic robot-guided puncture hematoma drainage is a dependable and safe operative method to treat patients who had intracerebral hemorrhage, resulting in various benefits such as short length of operation, less injury, less inflammatory reaction, high hematoma clear efficiency and satisfactory recovery of neurological function. [ABSTRACT FROM AUTHOR]

Objective: To analyze the factors affecting the long-term clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia (ALL). Methods: This is a retrospective study. One hundred children with ALL were collected before June, 2018 at The First Affiliated Hospital of Yangtze University and followed up for five years. Not only were their five-years survival rates analyzed, but univariate and multivariate analyses were also performed for factors that might affect their five-year survival rates. The MOS 36-Item Short Form of Health Survey (SF-36) was utilized to investigate the surviving children after five years in order to analyze the factors that may affect the quality of life of the children. Results: The five-years survival rate of one hundred children with ALL after treatment was 91.00% (91/100). Univariate and multivariate Logistic regression analyses were performed on the factors that may affect the long-term efficacy of pediatric ALL. The results showed that white blood cell count at first diagnosis, prednisone response test, treatment compliance and recurrence were independent risk factors for the long-term efficacy of pediatric ALL(p<0.05). The SF-36 survey of 91 surviving children after five years showed that prednisone response test and treatment compliance were independent risk factors affecting the quality of life of pediatric ALL (p<0.05). Conclusion: In the initial diagnosis of pediatric ALL, sufficient attention and control should be given to the factors that may affect the long-term clinical efficacy and quality of life, and appropriate treatment plans should be adopted. Meanwhile, the treatment compliance of children should be improved during treatment to improve the survival rate and quality of life of pediatric ALL. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the clinical efficacy of cyclosporin (CYSP) and natamycin (NAT) as a combination therapy in patients with fungal keratitis. Methods: This is a retrospective study. A total of 64 patients (64 eyes) with fungal keratitis treated by Baoding No.1 Central Hospital between December 2018 and May 2022 according to their treatment methods were divided into a monotherapy (MT) group receiving NAT eye drops solely and a combination therapy (CT) group given CYSP eye drops in addition to the exact treatment provided for the MT group. The clinical responses, visual acuity changes, severity of eye symptoms, and adverse reactions were compared between the two groups. Results: At two and four weeks post-treatment, the CT group had an overall response rate (ORR) significantly higher than that of the MT group (P< 0.05, respectively); both groups showed improved visual acuity and eye symptoms compared with the pre-treatment condition, and these improvements were more pronounced in the CT group (P < 0.05, respectively). Compared with the MT group, the CT group experienced a significantly shorter duration of eye symptoms (P < 0.05). The adverse reaction rate(ARR) was 9.38% in the CT group and 6.25% in the MT group, and the difference was not significant (P > 0.05). Conclusion: Using CYSP and NAT as a combination therapy for fungal keratitis can substantially heighten the therapeutic effects, promote visual acuity recovery, and induce rapid remission of eye symptoms without increasing the risk of adverse reactions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of multi-segmental lumbar disc herniation (msLDH). Methods: From January 2021 to December 2021, 75 patients with msLDH admitted to Baoding No.1 Hospital of Traditional Chinese Medicine were selected and divided into PTED group (n=40) and posterior lumbar interbody fusion (PLIF) group (n=35) according to different surgical methods. The operative time, intraoperative blood loss, surgical complications, Oswestry disability index (ODI) and Japanese Orthopedic Association score (JOA) scores were compared between the two groups. Results: In the PTED group, the average operation time was 57.45±12.01minutes, and the average intraoperative blood loss was 50.57±16.69ml. There were three patients with surgical complications, including one case of hematoma, one case of aggravation of neurological symptoms and one case of new onset of neurological symptoms. In the PLIF group, there were 12 cases undergoing single-segment operation, 15 cases undergoing double-segment operation and 8 cases undergoing three-segment operation, the average operation time was 137.26±34.64minutes, and the average intraoperative blood loss was 456.06±33.06ml, there were four cases of wound fat liquefaction or delayed healing, two cases of hematoma, and three cases of exacerbation of original neurological symptoms or new neurological symptoms. At one month, six months, and one year of postoperative, the ODI and JOA scores of the two groups were significantly improved compared with those preoperative, and the ODI scores of the PTED group were better than those of the PLIF group (t=3.131, 2.263, 3.768, all P<0.05). Conclusion: The surgical effect of PTED in the treatment of LDH is similar to that of PLIF. However, PTED has the advantages of short operation time, less blood loss, fewer surgical complications, and high surgical safety. It is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Objective: To observe the efficacy and imaging of surgical treatment of thoracolumbar fractures via the paravertebral muscle space approach. Methods: A retrospective analysis was conducted on patients with thoracolumbar fractures receiving surgery in Baoding First Central Hospital from January 2019 to December 2020. According to different surgical approaches, they were divided into paravertebral approach group, posterior median approach group and minimally invasive percutaneous approach group. They received surgery via the paravertebral muscle space approach, posterior median approach and minimally invasive percutaneous approach, respectively. Results: Statistically significant differences were found in surgical duration, intraoperative bleeding volume, intraoperative fluoroscopy frequency, postoperative drainage volume and hospital stay among the three groups. One year after surgery, the VAS, ADL and JOA scores of the paravertebral approach group and the minimally invasive percutaneous approach group had statistically significant differences from the posterior median approach group (P < 0.05). Conclusion: For the surgical treatment of thoracolumbar fractures, the clinical efficacy of the paravertebral muscle space approach is superior to that of the traditional posterior median approach, and the clinical efficacy of the minimally invasive percutaneous approach is similar to that of the posterior median approach. All the three approaches can effectively improve the postoperative function and pain symptoms of patients without increasing the incidence of complications. Compared with the posterior median approach, the surgery via the paravertebral muscle space and minimally invasive percutaneous approaches presents shorter surgical duration, less bleeding and shorter hospital stay, which is more conducive to postoperative recovery of patients. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the benefits of Sufu medical chitosan hydrogel dressing(Sufu) in the prevention and control of radiation skin damage during radiotherapy for cervical cancer as a combined modality. Methods: Ninety-seven cervical cancer patients who underwent radiotherapy at the Cancer Hospital of China Medical University between May 2017 and November 2018 were recruited according to given inclusion and exclusion criteria. The patients were assigned to a control group (n=48, washing the perineal area with normal saline) and an observation group (n=49, application of Sufu onto the site of radiotherapy in addition to washing the perineal area with normal saline). The treatment regimens for the two groups continued until the end of radiotherapy. A comparison of the RTOG (Radiation Therapy Oncology Group) grading of acute radiation-induced skin reactions (ARISRs), pain intensity (measured by the verbal rating scale (VRS)) and post-treatment wound healing was drawn between the two groups. Results: In the observation group, 81.6% (40/49) of the patients had radiation dermatitis, which was significantly lower than the incidence rate (95.8%, 46/48) in the control group (P <0.05). The observation group was at higher risk of radiation dermatitis when given a high radiation dose, while the control group was more likely to have radiation dermatitis when administered with a moderate radiation dose (P <0.05). The median time of occurrence of pain and the median time of onset of skin reactions were significantly later in the observation group as compared with the control group (P <0.05, respectively). In the observation group, the pain relief rate was 92.50% at Day-3, and the wound healing rate was 95.0% at Day-7, significantly higher than in the control group (73.9% and 80.4%) (P <0.05, respectively). Conclusions: During radiotherapy for cervical cancer, Sufu can effectively prevent and control radiationinduced skin and mucous membrane damage, delay the onset of radiation dermatitis and substantially reduce the incidence rate, relieve radiation dermatitis and pain and promote wound healing. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy of roxithromycin combined with azithromycin sequential therapy in the treatment of mycoplasma pneumoniae pneumonia in children., Methods: A retrospective study was conducted on 100 patients with mycoplasma pneumoniae pneumonia admitted to The First Affiliated Hospital of Yangtze University from January 2020 to December 2022. All patients were divided into the observation group (roxithromycin combined with azithromycin sequential therapy) and the control group (azithromycin sequential therapy), with 50 cases in each group. The clinical efficacy, improvement time of clinical symptoms/signs, inflammation indexes, oxidative stress indexes and immune function levels of the two groups were compared. Moreover, the improvement of lung function indexes and the adverse reactions were observed., Results: The overall response rate of the observation group was 96.00%, which was higher than the control group (84.00%) ( p< 0.05). The time of clinical symptoms/signs in the observation group were significantly lower than those in the control group( p< 0.05). After treatment, significant improvements were seen in the levels of CRP, TNF-ɑ, IL-6, GSH-Px, SOD, MDA, CD3 + , CD4 + , CD4 + /CD8 + , IgM, IgG , IgA, FEV 1 , FEV 1 %, FVC and FEV 1 /FVC of the two groups compared with those before treatment ( p< 0.05), and the improvement in the observation group was more obvious than that in the control group( p< 0.05). The overall incidence of adverse reactions in the observation group was 6.00%, which was slightly lower than that in the control group (8.00%) (c²=0.154, P =0.695)., Conclusion: Roxithromycin combined with azithromycin sequential therapy is a safe regimen for the treatment of mycoplasma pneumoniae pneumonia in children., Competing Interests: Declaration of conflicting interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objectives: To observe the clinical efficacy on total or near-total thyroidectomy in the treatment of thyroid cancer. Methods: Ninety-four patients with thyroid cancer treated in Meiris Branch of the First Affiliated Hospital of Qiqihar Medical College from June 2018 to June 2020 were selected as subjects. According to different surgical methods, they were divided into observation group and control group, with 47 patients in each group. The control group was treated with total thyroidectomy, while the observation group received near-total thyroidectomy. The two groups were both followed up for one year. The therapeutic effect, surgery-related indexes (surgical duration, intraoperative bleeding volume, postoperative analgesia time and postoperative 24-h VAS score), the incidence of complications three months after surgery, and the serum levels of relevant indexes [parathyroid hormone (PTH), calcium ion (Ca2+) and signal transducer and activator of transcription 3 (STAT3)] before and 14 d after surgery were compared between the two groups. The difference in quality of life [the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)] between the two groups one year after surgery was observed. Results: During the one year follow-up, there was no death in both groups. The total efficacy of the observation group was higher than that of the control group (0.05). The surgical duration, postoperative analgesia time and postoperative 24-h VAS score of the observation group were higher than those of the control group (p<0.05). However, no statistically significant difference was found in intraoperative bleeding volume between the two groups (p> 0.05). Three months after surgery, the total incidence of postoperative complications in the observation group was higher than that in the control group (p< 0.05). Fourteen days after surgery, the levels of PTH, Ca2+ and STAT3 in the two groups were lower than those before surgery, and the levels in the observation group were lower than those in the control group (p< 0.05). One year after surgery, cognitive, emotional, role, social and physical scores in the observation group were all lower than those in the control group, without statistically significant differences (p> 0.05). Conclusion: Total thyroidectomy is effective in the treatment of thyroid cancer, but has many postoperative complications. Clinicians need to choose the appropriate surgical method according to the actual condition of patients. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical efficacy of early postoperative intensity-modulated radiotherapy (IMRT) combined with temozolomide chemotherapy in the treatment of patients with malignant glioma. Methods: In this retrospective cohort study 80 patients with glioma surgery admitted to Chengde Central Hospital from January 2019 to January 2021 were selected and divided into two groups according to postoperative treatment: the experimental group and the control group, with 40 cases in each group. Patients in the experimental group received IMRT combined with temozolomide chemotherapy postoperatively, while those in the control group received IMRT alone. The clinical effects of patients were analyzed before treatment and three months after treatment, and the incidence of adverse reactions such as bone marrow suppression, gastrointestinal reactions, fever, and liver dysfunction were analyzed in the two groups within one month after treatment. Before treatment and two months after treatment, MMSE scale, QOL scale and KPS were used to compare the cognitive function and health status of the patients. All patients were followed up for one year after treatment, and the difference of disease progression-free survival and overall survival rate between the two groups was analyzed. Results: The effective rate of the experimental group was 70% after treatment, while that of the control group was 43.3%, with a statistically significant difference (P=0.04). The incidence of adverse reactions was 50% in the experimental group and 40% in the control group, with no statistically significant difference between the two groups (P=0.25). After treatment, MMSE score, QOL score and KPS score of the experimental group were significantly improved compared with those of the control group, with statistically significant differences between the two groups (MMSE score, QOL, P=0.00; KPS, P=0.01). Moreover, the two groups of patients were followed up for one year after treatment. The disease progression-free survival rate of the experimental group was 70% and that of the control group was 47.5%, with a statistically significant difference (P=0.04), and the overall survival rate of the experimental group was significantly higher than that of the control group after treatment, with a statistically significant difference (P=0.03). Conclusion: Early postoperative IMRT combined with temozolomide chemotherapy is an effective treatment regimen for patients with malignant glioma, boasting a variety of advantages such as high efficiency, cognitive function, favorable recovery of health status, significantly improved progression-free survival rate and overall survival rate, and no significant increase in adverse reactions. [ABSTRACT FROM AUTHOR]

Objectives: This study was aimed to investigate the efficacy and safety of vortioxetine hydrobromide in the treatment of major depressive disorder (MDD). Methods: One hundred and eighty patients with the newly diagnosed depression in our hospital between August 2018 and August 2019 were selected and randomly divided into an observation group and a control group, 90 each group. The control group was treated with escitalopram, and the observation group was treated with voltaxetine. The efficacy and adverse reactions were evaluated by the Hamilton Depression scale-17 (HAMD-17), Sheehan Disability Scale (SDS), Perceived Deficits Questionnaire-Depression (PDQ-D), and treatment emergent symptom scale (TESS) before treatment and at the end of the 8th and 24th week after treatment. Results: At the end of the 8th and 24th week after treatment, the HAMD-17 scores of the two groups were lower than those before treatment (P<0.05); at the end of the 8th and 24th week after treatment, the PDQ-D and SDS scores of the two groups were lower than those before treatment (P<0.05), and the above scores of the observation group were lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Voltaxetine can improve cognitive function and clinical symptoms of patients with severe depression and has high safety, which is worth clinical attention. [ABSTRACT FROM AUTHOR]

Objectives: To explore the clinical effect and prognostic factors of mechanical thrombectomy in the treatment of acute ischemic stroke. Methods: The records of patients with acute ischemic stroke treated in our hospital from April 2020 to April 2021 were retrospectively selected. A total of 65 patients were treated with mechanical thrombectomy. After treatment, they were scored with modified Rankin Scale (MRS). The treatment effect and prognostic factors were analyzed. Results: The occluded vessels were successfully opened in 65 patients. The recanalization rate was 96.92%. There were no serious complications of thrombectomy. The time from femoral artery puncture to vascular recanalization was (84.06±16.64) minutes and the number of thrombectomies was (2.52±0.71). There were 42 patients with good prognosis and 23 patients with poor prognosis. Analysis of the prognostic factors showed that the time from onset to admission in the good prognosis group was shorter, the NIHSS score before thrombectomy was higher, and the Alberta stroke program early CT Score (ASPECT) score was lower as compared to the patients in the poor prognosis group. The grade of vascular recanalization in the good prognosis group was better than that in the poor prognosis group, and the level of PCT was lower (P<0.05). Logistic regression analysis showed that the time from onset to admission, NIHSS and ASPECT scores before thrombectomy were the prognostic factors of mechanical thrombectomy in the treatment of acute ischemic stroke. Conclusion: Mechanical thrombectomy is effective in the treatment of acute ischemic stroke and can effectively promote the recanalization of occluded vessels, but the NIHSS and ASPECT scores from the onset to the time of admission before thrombectomy can directly affect the prognosis of patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with targeted therapy for primary hepatocellular carcinoma (PHC)., Methods: This was a retrospective study. Retrospective selection of 150 PHC patients admitted to the Renmin Hospital, Hubei University of Medicine January 2019 and June 2021 were included. The patients were divided into the control group and the experimental group according to their treatment regimens. The control group received TACE treatment, while the experimental group received TACE combined with targeted therapy. We analyze the relevant data of two groups of patients and evaluate the clinical efficacy and safety of TACE combined with targeted therapy., Results: The tumor remission rate and control rate in the control group were 41.89% and 75.68%, respectively, while those in the experimental group were 77.63% and 90.79%, with statistically significant differences (p<0.05). The 1-year and 3-year recurrence rates in the control group were 52.71% and 98.65%, respectively, while those in the experimental group were 39.47% and 61.84%, with statistically significant differences (p<0.05). After treatment, the AFP, VEGF, ALT, and AST in the experimental group were significantly reduced compared to the control group (p<0.05). During the treatment period, the incidence and severity of nausea, vomiting, and fever in the experimental group were significantly lower than those in the control group (p<0.05)., Conclusion: The clinical efficacy of TACE combined with targeted therapy for PHC is superior to that of TACE alone, with improved disease control rate, improved long-term survival rate, and good safety., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To compare and analyze the clinical effectiveness of conventional puncture hematoma drainage and stereotactic robot-guided puncture hematoma drainage in managing intracerebral hemorrhage., Methods: This is clinical comparative research. One hundred and twenty patients with the intracerebral hemorrhage who underwent puncture hematoma drainage in Baoding No.1 Central Hospital from March 2020 to May 2023 were included and were assigned into the control groups(n=60) and experimental groups(n=60) according to different treatment methods. The experimental group underwent stereotactic robot-guided puncture hematoma drainage, while the control group underwent conventional puncture hematoma drainage treatment. The duration and situation of surgery, levels of inflammatory factors, as well as preoperative and 1-week postoperative GCS scores and NIHSS scores were compared and analyzed between the two groups., Results: In comparison with the control group, the experimental group exhibited considerably less surgical duration(p=0.00), higher amount of intraoperative blood drainage and hematoma clearance rate(p=0.00). The experimental group possessed a substantially more reduced incidence of complications(10%) in comparison with the control group(25%), with a statistically substantial distinction(p=0.03). After therapy, CRP, TNF-a, and IL-6 degrees were considerably more decreased (p=0.00) in the experimental group in comparison with the control group, while GCS grades were considerably more prominent and NIHSS grades were considerably more reduced (p=0.00)., Conclusion: Stereotactic robot-guided puncture hematoma drainage is a dependable and safe operative method to treat patients who had intracerebral hemorrhage, resulting in various benefits such as short length of operation, less injury, less inflammatory reaction, high hematoma clear efficiency and satisfactory recovery of neurological function., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To analyze the factors affecting the long-term clinical efficacy and quality of life in the treatment of pediatric acute lymphoblastic leukemia (ALL)., Methods: This is a retrospective study. One hundred children with ALL were collected before June, 2018 at The First Affiliated Hospital of Yangtze University and followed up for five years. Not only were their five-years survival rates analyzed, but univariate and multivariate analyses were also performed for factors that might affect their five-year survival rates. The MOS 36-Item Short Form of Health Survey (SF-36) was utilized to investigate the surviving children after five years in order to analyze the factors that may affect the quality of life of the children., Results: The five-years survival rate of one hundred children with ALL after treatment was 91.00% (91/100). Univariate and multivariate Logistic regression analyses were performed on the factors that may affect the long-term efficacy of pediatric ALL. The results showed that white blood cell count at first diagnosis, prednisone response test, treatment compliance and recurrence were independent risk factors for the long-term efficacy of pediatric ALL(p<0.05). The SF-36 survey of 91 surviving children after five years showed that prednisone response test and treatment compliance were independent risk factors affecting the quality of life of pediatric ALL(p<0.05)., Conclusion: In the initial diagnosis of pediatric ALL, sufficient attention and control should be given to the factors that may affect the long-term clinical efficacy and quality of life, and appropriate treatment plans should be adopted. Meanwhile, the treatment compliance of children should be improved during treatment to improve the survival rate and quality of life of pediatric ALL., Competing Interests: Declaration of conflicting interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objectives: To investigate the clinical efficacy of cyclosporin (CYSP) and natamycin (NAT) as a combination therapy in patients with fungal keratitis., Methods: This is a retrospective study. A total of 64 patients (64 eyes) with fungal keratitis treated by Baoding No.1 Central Hospital between December 2018 and May 2022 according to their treatment methods were divided into a monotherapy (MT) group receiving NAT eye drops solely and a combination therapy (CT) group given CYSP eye drops in addition to the exact treatment provided for the MT group. The clinical responses, visual acuity changes, severity of eye symptoms, and adverse reactions were compared between the two groups., Results: At two and four weeks post-treatment, the CT group had an overall response rate (ORR) significantly higher than that of the MT group ( P < 0.05, respectively); both groups showed improved visual acuity and eye symptoms compared with the pre-treatment condition, and these improvements were more pronounced in the CT group ( P < 0.05, respectively). Compared with the MT group, the CT group experienced a significantly shorter duration of eye symptoms ( P < 0.05). The adverse reaction rate(ARR) was 9.38% in the CT group and 6.25% in the MT group, and the difference was not significant ( P > 0.05)., Conclusion: Using CYSP and NAT as a combination therapy for fungal keratitis can substantially heighten the therapeutic effects, promote visual acuity recovery, and induce rapid remission of eye symptoms without increasing the risk of adverse reactions., Competing Interests: Conflict of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To study and compare the clinical effects of azithromycin and erythromycin on children with mycoplasma pneumonia. Methods: Total 132 children with mycoplasma pneumonia who were admitted to our hospital between November 2017 and September 2018 were selected as the research subjects. All the children were divided into an observation group and a control group according to random number table, 66 each. The observation group was treated with azithromycin, while the control group was treated with erythromycin. The therapeutic effect, incidence of adverse reactions and disappearance time of clinical symptoms were compared between the two groups. Results: The total efficacy of the observation group was 98.04%, and that of the control group was 74.51%; there was a significant difference (X²=7.184, P=0.007). The incidence of adverse reactions in the observation group was 15.69%, significantly lower than that in the control group (41.18%) (X²=6.376, P=0.002). The disappearance of fever, cough, rale and X ray shadow of the observation group was significantly earlier than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: Compared with erythromycin, azithromycin is more effective in the treatment of mycoplasma pneumonia in children. Azithromycin can further shorten the improvement time of clinical symptoms and signs and has few adverse reactions and high safety. It is worth clinical application. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of multi-segmental lumbar disc herniation (msLDH)., Methods: From January 2021 to December 2021, 75 patients with msLDH admitted to Baoding No.1 Hospital of Traditional Chinese Medicine were selected and divided into PTED group (n=40) and posterior lumbar interbody fusion (PLIF) group (n=35) according to different surgical methods. The operative time, intraoperative blood loss, surgical complications, Oswestry disability index (ODI) and Japanese Orthopedic Association score (JOA) scores were compared between the two groups., Results: In the PTED group, the average operation time was 57.45±12.01minutes, and the average intraoperative blood loss was 50.57±16.69ml. There were three patients with surgical complications, including one case of hematoma, one case of aggravation of neurological symptoms and one case of new onset of neurological symptoms. In the PLIF group, there were 12 cases undergoing single-segment operation, 15 cases undergoing double-segment operation and 8 cases undergoing three-segment operation, the average operation time was 137.26±34.64minutes, and the average intraoperative blood loss was 456.06±33.06ml, there were four cases of wound fat liquefaction or delayed healing, two cases of hematoma, and three cases of exacerbation of original neurological symptoms or new neurological symptoms. At one month, six months, and one year of postoperative, the ODI and JOA scores of the two groups were significantly improved compared with those preoperative, and the ODI scores of the PTED group were better than those of the PLIF group (t=3.131, 2.263, 3.768, all P<0.05)., Conclusion: The surgical effect of PTED in the treatment of LDH is similar to that of PLIF. However, PTED has the advantages of short operation time, less blood loss, fewer surgical complications, and high surgical safety. It is worthy of clinical promotion., Competing Interests: Conflicts of Interest: None. Declaration of conflicting interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To observe the efficacy and imaging of surgical treatment of thoracolumbar fractures via the paravertebral muscle space approach., Methods: A retrospective analysis was conducted on patients with thoracolumbar fractures receiving surgery in Baoding First Central Hospital from January 2019 to December 2020. According to different surgical approaches, they were divided into paravertebral approach group, posterior median approach group and minimally invasive percutaneous approach group. They received surgery via the paravertebral muscle space approach, posterior median approach and minimally invasive percutaneous approach, respectively., Results: Statistically significant differences were found in surgical duration, intraoperative bleeding volume, intraoperative fluoroscopy frequency, postoperative drainage volume and hospital stay among the three groups. One year after surgery, the VAS, ADL and JOA scores of the paravertebral approach group and the minimally invasive percutaneous approach group had statistically significant differences from the posterior median approach group ( P < 0.05)., Conclusion: For the surgical treatment of thoracolumbar fractures, the clinical efficacy of the paravertebral muscle space approach is superior to that of the traditional posterior median approach, and the clinical efficacy of the minimally invasive percutaneous approach is similar to that of the posterior median approach. All the three approaches can effectively improve the postoperative function and pain symptoms of patients without increasing the incidence of complications. Compared with the posterior median approach, the surgery via the paravertebral muscle space and minimally invasive percutaneous approaches presents shorter surgical duration, less bleeding and shorter hospital stay, which is more conducive to postoperative recovery of patients., Competing Interests: Declaration of conflicting interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To evaluate the clinical effect of minimally invasive intracranial hematoma in treating hypertensive cerebral hemorrhage. Methods: One hundred and fifty-six patients with hypertensive cerebral hemorrhage were selected. They were randomly divided into the control group (78 cases) and observation group (78 cases). The control group was treated with conventional craniotomy evacuation of hematoma, while the observation group was treated with minimally invasive intracranial hematoma. Neurological impairment score, treatment efficacy and Barthel index were compared between two groups. Comparison results and clinical data of these patients were retrospectively analyzed. Results: Neurological impairment score in observation group had a significantly obvious decrease compared to control group (p < 0.05). Curative effect of observation group was superior to control group and the difference was significant (p < 0.05). Average operation time in observation group (51.20±10.30 minutes) was much shorter than control group (108.60±12.80 minutes). Amount of hematoma cleared for the first time in control group (75.40±10.20 (%)) was more than observation group (45.10±8.70 (%)). Hematoma in observation group (3.90±0.80 days) disappeared faster than control group (5.80±0.90 days). Differences of the above indexes between two groups were all significant (p < 0.05). Moreover, Barthel index of observation group was much better than control group (p < 0.05). Conclusion: Treating hypertensive cerebral hemorrhage with minimally invasive intracranial hematoma is remarkably effective. It should be promoted and practiced extensively. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the benefits of Sufu medical chitosan hydrogel dressing(Sufu) in the prevention and control of radiation skin damage during radiotherapy for cervical cancer as a combined modality., Methods: Ninety-seven cervical cancer patients who underwent radiotherapy at the Cancer Hospital of China Medical University between May 2017 and November 2018 were recruited according to given inclusion and exclusion criteria. The patients were assigned to a control group (n=48, washing the perineal area with normal saline) and an observation group (n=49, application of Sufu onto the site of radiotherapy in addition to washing the perineal area with normal saline). The treatment regimens for the two groups continued until the end of radiotherapy. A comparison of the RTOG (Radiation Therapy Oncology Group) grading of acute radiation-induced skin reactions (ARISRs), pain intensity (measured by the verbal rating scale (VRS)) and post-treatment wound healing was drawn between the two groups., Results: In the observation group, 81.6% (40/49) of the patients had radiation dermatitis, which was significantly lower than the incidence rate (95.8%, 46/48) in the control group (P <0.05). The observation group was at higher risk of radiation dermatitis when given a high radiation dose, while the control group was more likely to have radiation dermatitis when administered with a moderate radiation dose (P <0.05). The median time of occurrence of pain and the median time of onset of skin reactions were significantly later in the observation group as compared with the control group (P <0.05, respectively). In the observation group, the pain relief rate was 92.50% at Day-3, and the wound healing rate was 95.0% at Day-7, significantly higher than in the control group (73.9% and 80.4%) (P <0.05, respectively)., Conclusions: During radiotherapy for cervical cancer, Sufu can effectively prevent and control radiation-induced skin and mucous membrane damage, delay the onset of radiation dermatitis and substantially reduce the incidence rate, relieve radiation dermatitis and pain and promote wound healing., Competing Interests: Conflicts of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objectives: To evaluate the clinical efficacy of early postoperative intensity-modulated radiotherapy (IMRT) combined with temozolomide chemotherapy in the treatment of patients with malignant glioma., Methods: In this retrospective cohort study 80 patients with glioma surgery admitted to Chengde Central Hospital from January 2019 to January 2021 were selected and divided into two groups according to postoperative treatment: the experimental group and the control group, with 40 cases in each group. Patients in the experimental group received IMRT combined with temozolomide chemotherapy postoperatively, while those in the control group received IMRT alone. The clinical effects of patients were analyzed before treatment and three months after treatment, and the incidence of adverse reactions such as bone marrow suppression, gastrointestinal reactions, fever, and liver dysfunction were analyzed in the two groups within one month after treatment. Before treatment and two months after treatment, MMSE scale, QOL scale and KPS were used to compare the cognitive function and health status of the patients. All patients were followed up for one year after treatment, and the difference of disease progression-free survival and overall survival rate between the two groups was analyzed., Results: The effective rate of the experimental group was 70% after treatment, while that of the control group was 43.3%, with a statistically significant difference (P=0.04). The incidence of adverse reactions was 50% in the experimental group and 40% in the control group, with no statistically significant difference between the two groups (P=0.25). After treatment, MMSE score, QOL score and KPS score of the experimental group were significantly improved compared with those of the control group, with statistically significant differences between the two groups (MMSE score, QOL, P=0.00; KPS, P=0.01). Moreover, the two groups of patients were followed up for one year after treatment. The disease progression-free survival rate of the experimental group was 70% and that of the control group was 47.5%, with a statistically significant difference (P=0.04), and the overall survival rate of the experimental group was significantly higher than that of the control group after treatment, with a statistically significant difference (P=0.03)., Conclusion: Early postoperative IMRT combined with temozolomide chemotherapy is an effective treatment regimen for patients with malignant glioma, boasting a variety of advantages such as high efficiency, cognitive function, favorable recovery of health status, significantly improved progression-free survival rate and overall survival rate, and no significant increase in adverse reactions., Competing Interests: Conflicts of Interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objectives: To observe the clinical efficacy on total or near-total thyroidectomy in the treatment of thyroid cancer., Methods: Ninety-four patients with thyroid cancer treated in Meiris Branch of the First Affiliated Hospital of Qiqihar Medical College from June 2018 to June 2020 were selected as subjects. According to different surgical methods, they were divided into observation group and control group, with 47 patients in each group. The control group was treated with total thyroidectomy, while the observation group received near-total thyroidectomy. The two groups were both followed up for one year. The therapeutic effect, surgery-related indexes (surgical duration, intraoperative bleeding volume, postoperative analgesia time and postoperative 24-h VAS score), the incidence of complications three months after surgery, and the serum levels of relevant indexes [parathyroid hormone (PTH), calcium ion (Ca 2+ ) and signal transducer and activator of transcription 3 (STAT3)] before and 14 d after surgery were compared between the two groups. The difference in quality of life [the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)] between the two groups one year after surgery was observed., Results: During the one year follow-up, there was no death in both groups. The total efficacy of the observation group was higher than that of the control group (0.05). The surgical duration, postoperative analgesia time and postoperative 24-h VAS score of the observation group were higher than those of the control group ( p <0.05). However, no statistically significant difference was found in intraoperative bleeding volume between the two groups ( p> 0.05). Three months after surgery, the total incidence of postoperative complications in the observation group was higher than that in the control group ( p< 0.05). Fourteen days after surgery, the levels of PTH, Ca 2+ and STAT3 in the two groups were lower than those before surgery, and the levels in the observation group were lower than those in the control group ( p< 0.05). One year after surgery, cognitive, emotional, role, social and physical scores in the observation group were all lower than those in the control group, without statistically significant differences ( p> 0.05)., Conclusion: Total thyroidectomy is effective in the treatment of thyroid cancer, but has many postoperative complications. Clinicians need to choose the appropriate surgical method according to the actual condition of patients., Competing Interests: Conflict of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Objectives: To explore the clinical effect and prognostic factors of mechanical thrombectomy in the treatment of acute ischemic stroke., Methods: The records of patients with acute ischemic stroke treated in our hospital from April 2020 to April 2021 were retrospectively selected. A total of 65 patients were treated with mechanical thrombectomy. After treatment, they were scored with modified Rankin Scale (MRS). The treatment effect and prognostic factors were analyzed., Results: The occluded vessels were successfully opened in 65 patients. The recanalization rate was 96.92%. There were no serious complications of thrombectomy. The time from femoral artery puncture to vascular recanalization was (84.06±16.64) minutes and the number of thrombectomies was (2.52±0.71). There were 42 patients with good prognosis and 23 patients with poor prognosis. Analysis of the prognostic factors showed that the time from onset to admission in the good prognosis group was shorter, the NIHSS score before thrombectomy was higher, and the Alberta stroke program early CT Score (ASPECT) score was lower as compared to the patients in the poor prognosis group. The grade of vascular recanalization in the good prognosis group was better than that in the poor prognosis group, and the level of PCT was lower (P<0.05). Logistic regression analysis showed that the time from onset to admission, NIHSS and ASPECT scores before thrombectomy were the prognostic factors of mechanical thrombectomy in the treatment of acute ischemic stroke., Conclusion: Mechanical thrombectomy is effective in the treatment of acute ischemic stroke and can effectively promote the recanalization of occluded vessels, but the NIHSS and ASPECT scores from the onset to the time of admission before thrombectomy can directly affect the prognosis of patients., (Copyright: © Pakistan Journal of Medical Sciences.)

Objectives: This study was aimed to investigate the efficacy and safety of vortioxetine hydrobromide in the treatment of major depressive disorder (MDD)., Methods: One hundred and eighty patients with the newly diagnosed depression in our hospital between August 2018 and August 2019 were selected and randomly divided into an observation group and a control group, 90 each group. The control group was treated with escitalopram, and the observation group was treated with voltaxetine. The efficacy and adverse reactions were evaluated by the Hamilton Depression scale-17 (HAMD-17), Sheehan Disability Scale (SDS), Perceived Deficits Questionnaire-Depression (PDQ-D), and treatment emergent symptom scale (TESS) before treatment and at the end of the 8th and 24th week after treatment., Results: At the end of the 8th and 24th week after treatment, the HAMD-17 scores of the two groups were lower than those before treatment (P<0.05); at the end of the 8th and 24th week after treatment, the PDQ-D and SDS scores of the two groups were lower than those before treatment (P<0.05), and the above scores of the observation group were lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05)., Conclusion: Voltaxetine can improve cognitive function and clinical symptoms of patients with severe depression and has high safety, which is worth clinical attention., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To explore the effect of risperidone combined with olanzapine in the treatment of schizophrenia and its influence on cognitive function., Methods: Ninety-eight schizophrenic patients in our hospital who were admitted and treated between June 2018 and December 2019 were selected. The study group was treated with risperidone combined with olanzapine, and the control group was treated with risperidone. The clinical efficacy, Positive and Negative Syndrome Scale (PANSS) score, Wisconsin Card Sorting Test (WCST) result and adverse reactions of the two groups were compared., Results: After treatment, the scores of classification completion number and correct times of the observation group were higher than those of the control group, and the scores of the random error number and continuous error number were higher than those of the control group; the differences were statistically significant (P<0.05). The total effective rate of the observation group was 95.56%, which was higher than 77.78% of the control group (P<0.05). After treatment, the PANSS scores of the observation group were significantly lower than those of the control group (P<0.05). The total incidence of adverse reactions in the observation group and control group were 9.30% and 6.98%, respectively, and there was no significant difference between the two groups (P>0.05)., Conclusion: Risperidone combined with olanzapine in the treatment of schizophrenia can effectively reduce symptoms of patients and induce fewer adverse reactions, showing high safety and significant treatment effect., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To evaluate the clinical effect of minimally invasive intracranial hematoma in treating hypertensive cerebral hemorrhage., Methods: One hundred and fifty-six patients with hypertensive cerebral hemorrhage were selected. They were randomly divided into the control group (78 cases) and observation group (78 cases). The control group was treated with conventional craniotomy evacuation of hematoma, while the observation group was treated with minimally invasive intracranial hematoma. Neurological impairment score, treatment efficacy and Barthel index were compared between two groups. Comparison results and clinical data of these patients were retrospectively analyzed., Results: Neurological impairment score in observation group had a significantly obvious decrease compared to control group (p < 0.05). Curative effect of observation group was superior to control group and the difference was significant (p < 0.05). Average operation time in observation group (51.20±10.30 minutes) was much shorter than control group (108.60±12.80 minutes). Amount of hematoma cleared for the first time in control group (75.40±10.20 (%)) was more than observation group (45.10±8.70 (%)). Hematoma in observation group (3.90±0.80 days) disappeared faster than control group (5.80±0.90 days). Differences of the above indexes between two groups were all significant (p < 0.05). Moreover, Barthel index of observation group was much better than control group (p < 0.05)., Conclusion: Treating hypertensive cerebral hemorrhage with minimally invasive intracranial hematoma is remarkably effective. It should be promoted and practiced extensively.