Search

Purpose: To examine the clinical efficacy of a chlorhexidine gargle combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel in the treatment of recurrent oral ulcers and its effects on inflammatory factors, immune function, and recurrence rate. Materials and Methods: Ninety-six patients with recurrent oral ulcers were randomly assigned to two groups: experimental (treatment with chlorhexidine gargle plus rb-bFGF gel) and control (treatment with chlorhexidine gargle alone) (n = 48 cases). The therapeutic efficacy, clinical improvement of symptoms, and recurrence rate within 3 months were compared between the two groups. Serum inflammatory factor and immune factor levels of patients in the two groups were measured before and after treatment. Results: A statistically significantly higher total effective rate was found in patients of the experimental group (95.83%) versus the control group (81.25%) (p < 0.05). The time to onset of pain relief was shortened, the duration of pain relief was prolonged, and VAS scores for pain level were lower in the experimental than the control group (p < 0.05). Among patients in the experimental group, the number of oral ulcers and ulcer area decreased, and faster onset of pain relief and time until normal eating improved in comparison to the control group (p < 0.05). Reduced levels of IL-2, IL-6, IL-8, and TNF-α were observed in the experimental vs the control group (p < 0.05). Elevated levels of CD3+, CD4+, and NKT and reduced levels of CD8+ were found in the experimental group compared to the control group (p < 0.05). The ulcer recurrence rate of patients in the experimental group (8.33%) was notably lower in comparison to the control group (29.17%). Conclusion: Chlorhexidine gargle plus rb-bFGF gel can improve the clinical outcome of patients with recurrent oral ulcers. It can reduce the levels of inflammatory factors, improve immune function, and reduce the recurrence rate. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical efficacy of surgery in Kummell's disease (KD) to help us select the optimum surgical strategy. Methods: We included 67 KD patients who underwent Percutaneous vertebral plasty (PVP), Percutaneous kyphosis plasty (PKP), Percutaneous pedicle screw fixation (PPSF) or Posterior decompression osteotomy fixation (PDOF). The differences in imaging parameters and prognosis changes of pre-operation, post-operative and follow-up endpoint were analyzed. Results: The incidence rate of KD was 10.02% (67/668) in vertebral compressibility fracture. 80.60% of patients underwent PVP/PKP, 14.93% underwent PPSF, and 4.47% underwent PDOF. The significant differences between the actual used surgical methods and the classification recommended surgical strategies could be found. In I type, there was no significant difference in total improvement of the radiography data and clinical efficacy between PVP and PKP. In II type, there was a significant correlation between opening and closing sign (OCS) and surgical choice. Compared with PPSF, the positive OCS patients who underwent PVP/PKP suffered a poor prognosis. PDOF is an effective surgical method for type III, but PVP could also achieve a good prognosis for patients with poor condition. Conclusion: The mainstream KD classification system has shortcomings, and completely following its treatment strategy may lead to poor prognosis. Compared to PKP, PVP is a better choice for type I patients. OCS is one of the important factors in surgical selection for type II patients. The Li's type III is mainly treated with PDOF but the overall condition of the body needs to be evaluated. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy and safety of Loratadine combined with Glucocorticoid nasal spray in the treatment of pediatric bronchial asthma with seasonal allergic rhinitis. Methods: A total of 100 pediatric patients with moderate to severe bronchial asthma and seasonal allergic rhinitis admitted to our hospital between January 2020 and January 2023 were included in this study. All patients met the complete inclusion and exclusion criteria. Based on different treatment interventions, they were divided into the control group (n = 50) and the observation group (n = 50). Patients in the control group received treatment with glucocorticoid nasal spray, while patients in the observation group received combined intervention with Loratadine in addition to the treatment received by the control group. The clinical treatment outcomes, incidence of adverse reactions, as well as the scores of nasal symptoms, asthma control, and peak expiratory flow rates at different treatment time points (baseline, T1: 30 days after treatment, T2: 60 days after treatment, T3: 90 days after treatment) were compared between the two groups. The combined treatment of Loratadine with Glucocorticoid nasal spray demonstrates significant clinical efficacy in the treatment of pediatric bronchial asthma with seasonal allergic rhinitis. It further promotes the recovery of peak expiratory flow rates, improves symptoms of rhinitis and asthma in pediatric patients. Importantly, the application of this combined treatment does not increase the risk of adverse reactions in pediatric patients, indicating its high safety profile. This treatment approach is worthy of clinical application and further promotion. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have examined the correlation between paroxetine concentrations and therapeutic efficacy in patients diagnosed with major depressive disorder (MDD), but findings have been contradictory. Aims: This study aimed to investigate the relationships among plasma concentrations, severity of symptoms, and adverse drug reactions (ADRs) to optimize individual dosing. Methods: Eighty-seven MDD patients, after completing treatment with paroxetine, were divided into low-concentration (LC, n = 38), medium-concentration (MC, n = 27), and high-concentration (HC, n = 22) groups, based on cutoff value concentrations with the 50% response rate and the laboratory alert level from the 2017 consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology. The severity of depression and anxiety was evaluated using a 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA), respectively. Dosage, plasma concentrations, scale scores, and ADRs were recorded across the three groups at different treatment stages to define the therapeutic reference range. Results: The 4-week plasma concentration of paroxetine (65.00 ng/mL) could predict the clinical response in MDD patients at 8 weeks. Symptom relief in patients with 4-week paroxetine concentrations ranging from 65.00 to 120.00 ng/mL at 8 weeks was greater than in those with concentrations below 65.00 ng/mL, with no significant difference observed above this range. In addition, more cases of liver injury and weight gain were observed in patients with high paroxetine concentrations. Conclusion: Our results support that early paroxetine concentration may predict clinical efficacy and the incidence of ADRs, thus improving individual dosing regimens for MDD patients. [ABSTRACT FROM AUTHOR]

To explore independent influencing factors for clinical efficacy of roxadustat in hemodialysis patients. Hemodialysis patients treated with roxadustat were enrolled. The plasma trough concentrations of roxadustat were measured using liquid chromatography–tandem mass spectrometry (LC–MS/MS). A multiple logistic regression model was established to determine the factors that affect clinical efficacy of roxadustat in patients undergoing hemodialysis. A total of 67 hemodialysis patients were enrolled in the study. The results showed that age, blood trough concentration of roxadustat, and baseline hemoglobin (Hb) level were independent factors of clinical efficacy of roxadustat (OR = 1.06, p =.025 for age; OR = 1.001, p =.037 for plasma concentration; and OR = 0.941, p =.003 for baseline Hb), with an AUC score of 0.859. Age, blood trough concentration of roxadustat, and baseline Hb level were independent influencing factors of the response to roxadustat in hemodialysis patients. [ABSTRACT FROM AUTHOR]

The national centralized drug procurement (NCDP) policy, known as the "4 + 7" policy in China, has transformed pharmaceutical procurement and access by leveraging healthcare institutions' collective buying power to reduce drug prices substantially. This policy has profoundly impacted drug pricing mechanisms, healthcare expenditures, market dynamics, and the quality of available drugs. This commentary evaluates the efficacy, challenges, and broader implications of the NCDP, summarizes the current state of post-marketing monitoring of selected generic drugs for centralized procurement, and presents relevant considerations. [ABSTRACT FROM AUTHOR]

Port-wine stains (PWS) are congenital vascular malformations characterized by capillary malformations that persist and often darken over time. Traditional treatment methods, including laser therapy, have shown varying degrees of effectiveness and can be associated with significant side effects. Hematoporphyrin Monomethyl Ether-Photodynamic Therapy (HMME-PDT) has emerged as a promising alternative, offering targeted treatment with potentially fewer adverse effects. This paper aims to evaluate the clinical efficacy and potential of HMME-PDT as a treatment strategy for PWS. It provides a comprehensive review of the literature and clinical investigations to assess the application and outcomes of HMME-PDT in treating PWS. Briefly introduce the nature of PWS, innovations and challenges in treatment, the mechanism of HMME-PDT, clinical effectiveness and sonographic appearance, safety and long-term effects, and challenges and suggestions for optimizing treatment. The review highlights the mechanism by which HMME-PDT works, focusing on its ability to target abnormal blood vessels selectively. Clinical evaluations included clinical and sonographic assessments to determine the efficacy of the treatment. The findings revealed significant improvements in the clinical appearance and sonographic features of vascular lesions following HMME-PDT. The paper also discusses the utility of dermoscopy in HMME-PDT applications, factors affecting treatment efficacy, the impact of thermal assistance on the effectiveness of PDT, and the management of adverse reactions through proper nursing care. The review underscores the considerable potential of HMME-PDT as an effective treatment for PWS, noting its promising outcomes in clinical and sonographic assessments. However, it also emphasizes the need for further research to standardize treatment protocols and assess long-term outcomes. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions This study sought to assess the clinical efficacy of honey suppositories in managing functional constipation in pre‐school children, with a focus on those exhibiting Yin deficiency and intestinal dryness according to traditional Chinese medicine principles. The investigation aimed to determine whether honey suppositories could serve as a safer and more efficacious alternative to standard treatments.A randomised controlled trial was conducted involving pre‐school children diagnosed with functional constipation. They were allocated to either a control group or a treatment group. While both groups received standard care, the treatment group also received honey suppositories. The efficacy of the treatment was evaluated based on the ‘Guiding Principles for Clinical Research of New Chinese Medicines’, and statistical analysis was performed using SPSS 25.0.Following treatment, the treatment group demonstrated significantly lower constipation scoring system scores and higher bowel movement frequencies compared with the control group (P < 0.05). The clinical efficacy of the treatment group was notably superior, with a higher rate of complete recovery and effectiveness observed (P < 0.05). Additionally, no significant differences in baseline characteristics were found between the groups, confirming the comparability of the study cohorts.Honey suppositories offer a promising therapeutic intervention for paediatric functional constipation, with significant clinical benefits over standard care. [ABSTRACT FROM AUTHOR]

Background: Calcaneal fractures are the most common type of tarsal fractures. The sustentaculum tali (ST) offers anatomical stability in calcaneal fractures, and recently, ST screws have been widely used in their treatment. This study aimed to investigate the clinical efficacy and value of ST screw fixation via a modified sinus tarsi approach (MSTA) for treating displaced intraarticular calcaneal fractures (DIACFs). Methods: This study enrolled 64 patients (64 feet): 32 patients in the calcaneal locking plate combined with the ST screw group (CLP-STS Group) and 32 patients in the simple calcaneal locking plate internal fixation group (CLP Group). The minimum follow-up duration was 18 months. Ankle function was evaluated using VAS, AOFAS, and Short Form-36 scores. Imaging evaluation included the Böhler angle, Gissane angle, length, height, and width of the calcaneus, and the Böhler angle in both groups 1 year after surgery. Results: Functional evaluation revealed that postoperative AOFAS and VAS scores in the CLP-STS Group were significantly better than those in the CLP Group. After surgery, the Böhler angle, Gissane angle, and length, height, and width of the calcaneus were significantly corrected compared to the preoperative values; however, the difference in these indicators between the two groups was not significant. Nevertheless, at the 1-year postoperative follow-up, the calcaneal Böhler angle loss in the CLP-STS Group was significantly better than that in the CLP Group. Conclusion: Compared to simple calcaneal locking plate internal fixation, combining the plate with the additionally free ST screw can resolve the limited intraoperative exposure of MSTA, reduce postoperative foot pain in patients, and improve clinical efficacy. [ABSTRACT FROM AUTHOR]

Objective To investigate the significance of neuregulin 1 (NRG-1) gene rs35753505 polymorphism and changes of serum NRG-1 level in children with focal epilepsy. Methods Totally 101 children with focal epilepsy (epilepsy group) and 101 healthy children (control group) were selected. According to the curative effect, the children with epilepsy were divided into the effective group (n=71) and ineffective group (n=30). The polymorphism of NRG-1 gene rs35753505 was detected by polymerase chain reaction and ligase detection reaction, and NRG-1 was detected by enzymelinked immunosorbent assay. Multivariate Logistic regression model was used to analyze the effect of serum NRG-1 level on the efficacy of ASM. Results The CC genotype and allele C gene frequencies in the epilepsy group were higher than those in the control group (both P<0. 05), and the serum NRG-1 level was lower than that in the control group (P<0. 05). The risk of focal epilepsy was higher in CC genotype than in TT (OR=1. 658, 95 % CI : 1. 506-1. 957) and CT (OR= 1. 404, 95 %CI : 1. 205-1. 733) genotypes (both P<0. 05); the risk of focal epilepsy was higher in C allele than in T allele (OR=1. 872, 95 %CI : 1. 643-2. 892, P<0. 05). The CC genotype and allele C gene frequencies in the ineffective group were higher than those in the effective group (both P<0. 05), and the serum NRG-1 level was lower than that in the effective group (P<0. 05). The risk of invalid ASM was higher in CC genotype than in TT (OR=1. 358, 95%CI: 1. 1061. 537) and CT (OR=1. 274, 95%CI: 1. 075–1. 465) genotypes (both P<0. 05), and the risk of invalid ASM was higher in C allele than in T allele (OR=1. 572, 95%CI: 1. 465–1. 432, P<0. 05). The serum NRG-1 level in focal epilepsy children with CC genotype was lower than that of children with CT and TT genotypes (all P<0. 05), and there was no significant difference in serum NRG-1 level between CT and TT genotypes in children with focal epilepsy (P>0. 05). The proportions of abnormal EEG and family history of epilepsy in the ineffective group were higher than those in the effective group (both P<0. 05). Abnormal EEG and CC genotype were risk factors for the efficacy of ASM (P<0. 05), and high serum NRG-1 level was a protective factor (P<0. 05). Conclusion NRG-1 gene rs35753505 polymorphism and serum NRG-1 level affect the susceptibility of focal epilepsy and the efficacy of ASM. [ABSTRACT FROM AUTHOR]

Qingdai (QD), derived from various plant sources, is commonly used in traditional Chinese medicine for ulcerative colitis (UC) treatment. However, the clinical efficacy and mechanisms of orally administered QD remain unclear. This study aims to evaluate QD's efficacy in UC treatment and uncover its active components and mechanisms. A randomized controlled trial compared QD to Adisa, followed by UPLC-Q-TOF/MS and network pharmacology analyses to identify QD's core components and targets. In vivo experiments on a UC mouse model explored QD's impact on the AHR-Th17/Treg pathway using PCR, WB, ELISA, and flow cytometry. Results showed QD's efficacy in UC treatment, with mucosal healing and remission comparable to Adisa. UPLC-Q-TOF/MS identified 16 core components in mouse colon tissue, with network pharmacology revealing 67 targets, potentially involving the IL-17 signaling pathway and Th17 cell differentiation. QD and its components up-regulated AHR, CYP1A1, and Foxp3, while down-regulating RORγt. Additionally, QD modulated pro-inflammatory (IL-6, IL-17 A) and anti-inflammatory (IL-10, TGF-β1) factors, and Treg/Th17 cell ratios in LPMC. Oral QD administration effectively promoted mucosal healing and improved UC symptoms, potentially through AHR-Th17/Treg pathway regulation. [ABSTRACT FROM AUTHOR]

In the past five years, repetitive transcranial magnetic stimulation (rTMS) has evolved significantly, driven by advancements in device design, treatment protocols, software integration, and brain-computer interfaces (BCIs). This review evaluates how these innovations enhance the safety, efficacy, and accessibility of rTMS while identifying key challenges such as protocol standardization and ethical considerations. A structured review of peer-reviewed studies from 2019 to 2024 focused on technological and clinical advancements in rTMS, including AI-driven personalized treatments, portable devices, and integrated BCIs. AI algorithms have optimized patient-specific protocols, while portable devices have expanded access. Enhanced coil designs and BCI integration offer more precise and adaptive neuromodulation. However, challenges remain in standardizing protocols, addressing device complexity, and ensuring equitable access. While recent innovations improve rTMS's clinical utility, gaps in long-term efficacy and ethical concerns persist. Future research must prioritize standardization, accessibility, and robust ethical frameworks to ensure rTMS's sustainable impact. [ABSTRACT FROM AUTHOR]

Objective: As the population ages and technology advances, lateral lumbar intervertebral fusion (LLIF) is gaining popularity for the treatment of degenerative lumbar scoliosis (DLS). This study investigated the feasibility, minimally invasive concept, and benefits of LLIF for the treatment of DLS by observing and assessing the clinical efficacy, imaging changes, and complications following the procedure. Methods: A retrospective analysis was performed for 52 DLS patients (12 men and 40 women, aged 65.84 ± 9.873 years) who underwent LLIF from January 2019 to January 2023. The operation time, blood loss, complications, clinical efficacy indicators (visual analogue scale [VAS], Oswestry disability index [ODI], and 36‐Item Short Form Survey), and imaging indicators (coronal position: Cobb angle and center sacral vertical line–C7 plumbline [CSVL–C7PL]; and sagittal position: sagittal vertical axis [SVA], lumbar lordosis [LL], pelvic incidence angle [PI], and thoracic kyphosis angle [TK] were measured). All patients were followed up. The above clinical evaluation indexes and imaging outcomes of patients postoperatively and at last follow‐up were compared to their preoperative results. Results: Compared to the preoperative values, the Cobb angle and LL angle were significantly improved after surgery (p < 0.001). Meanwhile, CSVL–C7PL, SVA, and TK did not change much after surgery (p > 0.05) but improved significantly at follow‐up (p < 0.001). There was no significant change in PI at either the postoperative or follow‐up timepoint. The operation took 283.90 ± 81.62 min and resulted in a total blood loss of 257.27 ± 213.44 mL. No significant complications occurred. Patients were followed up for to 21.7 ± 9.8 months. VAS, ODI, and SF‐36 scores improved considerably at postoperative and final follow‐up compared to preoperative levels (p < 0.001). After surgery, the Cobb angle and LL angle had improved significantly compared to preoperative values (p < 0.001). CSVL–C7PL, SVA, and TK were stable after surgery (p > 0.05) but considerably improved during follow‐up (p < 0.001). PI showed no significant change at either the postoperative or follow‐up timepoints. Conclusion: Lateral lumbar intervertebral fusion treatment of DLS significantly improved sagittal and coronal balance of the lumbar spine, as well as compensatory thoracic scoliosis, with good clinical and radiological findings. Furthermore, there was less blood, less trauma, and quicker recovery from surgery. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the clinical efficacy and prognostic factors associated with autologous osteoperiosteal transplantation for the treatment of single cystic osteochondral lesions of the talus (OLT). Methods: The clinical data of patients with single cystic OLT undergoing autologous osteoperiosteal transplantation at the Department of Foot and Ankle Surgery of our hospital between 2018 and 2022, including complete follow‐up, were retrospectively analyzed. Imaging data from each patient were imported into Mimics software to measure the surface area, volume and depth of the lesions. Then, the talus nine‐compartment partitioning method was used to partition the injury site. Preoperative and final follow‐up assessments were performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) for pain and 36‐item Short‐Form Health Survey (SF‐36) to evaluate treatment efficacy and analyze prognostic factors. Results: Of the 31 patients with single cystic OLT with a complete set of follow‐up data, there were 17 males and 14 females, with a mean age of 43.3 ± 13.6 years, a mean follow‐up time of 30.1 ± 14.0 months and a mean illness duration of 30.4 ± 20.0 months. The postoperative final follow‐up AOFAS score was 90.7 ± 5.5; this represented significant improvement when compared to the preoperative score of 57.0 ± 8.5 (P < 0.001). The final postoperative follow‐up VAS score was 18.5 ± 8.3; this was significantly better than the preoperative score of 57.8 ± 8.7 (P < 0.001). The physical component summary (PCS) score and mental component summary (MCS) score on the SF‐36 scale showed significant improvement at the final postoperative follow‐up when compared to preoperative scores (p < 0.001). No other complications were observed during follow‐up, such as wound infection or pain at the donor site. One of the patients showed less improvement, which may be related to premature weight‐bearing or re‐sprained ankle after surgery. There was no significant correlation between the duration of illness, gender and the location, depth, surface area and volume of the OLT and the postoperative scores. However, patient age showed a significant negative correlation with the postoperative SF‐36 PCS and MCS scores. Conclusion: Autologous osteoperiosteal transplantation for single cystic OLT demonstrated good clinical efficacy with a low incidence of complications. Furthermore, age represents an important factor influencing prognosis. Level of Evidence: Level II. [ABSTRACT FROM AUTHOR]

Background: The aim is to investigate the clinical efficacy of Alprostadil in diabetes mellitus (DM) combined with peripheral atherosclerosis and to investigate the molecular mechanisms. Methods: Patients included 154 cases with DM combined with peripheral atherosclerosis and were divided into the conventional group (77 cases) and the Alprostadil group (77 cases). Both groups of patients were given conventional treatment, and the Alprostadil group was given Alprostadil treatment on the basis of the conventional group. The therapeutic efficacy and clinical symptom improvement were compared, and the adverse reactions were observed. An in vitro cell model was constructed using high glucose (HG) (50 mM) and oxidized low-density lipoprotein (50 μg/mL) treatment. Results: The total effective rate of treatment in the Alprostadil group was higher than that in the conventional group. The biochemical indices of whole blood viscosity, plasma viscosity, erythrocyte pressure volume, and fibrinogen, as well as the level of inflammatory factors in the Alprostadil group were lower than those in the conventional group. The incidence rate of adverse reactions of Alprostadil administration was lower than that in the conventional group (P = .030). Alprostadil inhibited platelet aggregation and promoted platelet spreading. Alprostadil had an ameliorative effect on HG- and oxidized low-density lipoprotein cholesterol (ox-LDL)-induced human umbilical vascular endothelial cells (HUVECs), and promoted apoptosis and inflammatory response of HUVECs. Conclusion: Clinically, the use of Alprostadil as an adjunct to conventional therapy for the treatment of DM combined with peripheral atherosclerosis has high clinical efficacy. In addition, Alprostadil has a significant ameliorative effect on high glucose- and ox-LDLinduced HUVECs. [ABSTRACT FROM AUTHOR]

Clavicle fractures are one of the most common fractures and usually occur in the medial third of the clavicle. The study explored the efficacy of three internal fixation methods to treat Edinburgh IB fractures of the proximal clavicle. 68 patients with Edinburgh IB fractures of the proximal clavicle were divided into T-shaped plate group, double-miniature steel plate group and memory alloy embracing device group. Postoperative complications, return time to work, and fracture healing time were recorded. The clinical efficacy was evaluated by Constant-Murley score of shoulder joint, Visual Analogue Scale (VAS) score of pain, and arm-shoulder-hand dysfunction score. The operative time of the memory alloy embracing device group was significantly better than T-shaped plate group and double-miniature steel plate group. The length of surgical incision in the double-miniature steel plate group was significantly shorter than that in the T-shaped plate group and the memory alloy embracing device group. The hospitalization cost and recovery time of the double-plate and memory alloy hug groups were lower than those of the T-plate group. The double-miniature steel plate group and the memory alloy embracing device group were significantly better than the T-shaped plate group at two weeks after operation. Satisfactory clinical results can be obtained by using T-shaped plate, double-miniature steel plate and memory alloy embracing device in the treatment of Edinburgh IB fracture of proximal clavicle. However, the double-miniature steel plate group has the advantages of small incision, low cost, and quick postoperative recovery, and has more early advantages. [ABSTRACT FROM AUTHOR]

Platelet-rich plasma (PRP) with skin booster is a popular treatment for improving skin quality and reducing the signs of aging. However, few studies have evaluated its clinical efficacy in patients with aging face. This study aimed to evaluate the clinical efficacy, adverse reactions, and follow-up results of targeted injection of PRP with skin booster in treating patients with aging face. The study included 80 patients treated with targeted injection of PRP with skin booster from July 2022 to February 2023. The doctors compared the changes of the patients' facial skin indicators, quality of life, and satisfaction with their appearance before and after treatment, and analyzed the clinical efficacy, adverse reactions, and follow-up results of the patients after treatment. After one course of treatment, the patients' facial skin indicators, quality of life, and satisfaction with their appearance improved significantly, with P < 0.05. The total clinical effective rate was 88.75%, and the incidence of adverse reactions was 6.25%. After half a year of follow-up, 48.75% of the patients were willing to receive further treatment, and their facial soft feel, natural expression, and self-feeling comfort had significantly improved. Targeted injection of PRP with skin booster is an effective and safe treatment for improving facial skin symptoms such as coarse pores and wrinkles in patients with aging face. The results of this study provide evidence for the clinical use of PRP with skin booster in aesthetic medicine. [ABSTRACT FROM AUTHOR]

Background: The clinical efficacy of cancellous screws (CS) and femoral neck system (FNS) internal fixation in the treatment of femoral neck fracture (FNF) was compared in this research. Methods: Ninety-six patients with FNF were enrolled in this study. There were 47 cases in FNS group and 49 cases in CS group. The data of operation time, intraoperative bleeding, bed days and complication were recorded. Patients' joint function was evaluated by Harris score. At the last follow-up, the cost-effectiveness analysis of the two methods was analyzed according to the total cost of patients and hip function. Results: The intraoperative blood loss of the patients in FNS group was significantly higher than that in the CS group, but the length of hospitalization was significantly lower. There was no significant difference in the incidence of complications between FNS and CS. The joint function of FNS group was significantly better than that of CS group at 3 months after operation. There was no significant difference in Harris score between the two groups at the last follow-up. The overall medical cost of FNS group in 1 year is high. Cost-effectiveness analysis showed that compared with CS group, FNS group needs to pay 5761.1 yuan more for each additional Harris score. Conclusion: FNS and CS internal fixation can achieve satisfactory clinical results in the treatment of FNF. FNS treatment is helpful to the early functional recovery of patients, but the overall medical cost is high. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between the gut microbiome and the response to anti-PD-1-based combination therapy in unresectable hepatocellular carcinoma (HCC). We aimed to identify potential non-invasive biomarkers and new strategies to modulate immunotherapy in HCC. Methods: In this study, fresh stool samples and clinical data were collected from unresectable HCC patients treated with anti-PD-1-based combination therapy at the Cancer Hospital of the Chinese Academy of Medical Sciences between January 2020 and December 2021. The patients were divided into two groups based on their response to treatment: the treatment responder group (R group) and the treatment non-responder group (NR group). The composition and diversity of the gut microbiome were bioinformatically analyzed by using the Whole Genome Shotgun strategy, including taxonomic composition analysis, Alpha diversity analysis, Beta diversity analysis, and differentially enriched bacterial taxa analysis. Differentially enriched bacterial taxa between R and NR groups were identified based on the magnitude of the linear discriminant analysis effect size (LEfSe) and analyzed for their impact on the survival of the patient. Results: A total of 45 eligible patients with unresectable HCC treated with anti-PD-1-based combination therapy participated in this study. The gut microbiological composition and Alpha diversity of patients were not statistically different, but there was a statistically significant difference in Beta diversity between the R and NR groups. (PERMANOVA tests, P = 0.006). We further identified 56 enriched bacterial taxa in the R group and 44 enriched bacterial taxa in the NR group based on the LEfSe analysis (LDA >2.66, P< 0.05). Patients with a high abundance of Collinsella genus, Ruminococcus_AM4211, and Ruminococcus_AF25_28AC had a longer median PFS and median OS compared to those with low abundance (P < 0.05). On the contrary, the median PFS and OS of patients with a high abundance of Bacteroides_AF20_13LB and Veillonella_ atypica were significantly shorter than those of patients with low abundance (P < 0.05). The multivariate analysis showed that the abundance of Bacteroides_ AF20_13LB and Ruminococcus_ AF25_28AC was independent related factors for PFS, and the abundance of Bacteroides_AF20_13LB was an independent related factor of OS. Conclusion: The enrichment of specific gut microbiota affected clinical efficacy and survival benefits in HCC treated with anti-PD-1 therapy and may be a promising non-invasive gut microbial biomarker and a new strategy for modulating immunotherapy in HCC. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Enhancing post‐stroke cognitive impairment (PSCI) is a key aspect of prognosis for stroke patients. Low‐frequency repetitive transcranial magnetic stimulation (LF‐rTMS) is currently a widely utilised method for treating PSCI. With the increasing promotion of traditional Chinese medicine, Xingnao Kaiqiao (XNKQ) acupuncture has been progressively incorporated into clinical treatment. This paper observes the effect of LF‐rTMS with XNKQ acupuncture on patients with PSCI.Totally, 192 patients with PSCI were consecutively recruited and treated either with LF‐rTMS and XNKQ acupuncture (observation group) or LF‐rTMS only (control group) for 4 weeks. The pre‐ and post‐treatment Mini‐Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, P300 latency and amplitude, inflammatory factor levels were compared and clinical efficacy was assessed.Both groups exhibited increased MMSE/MoCA scores, and P300 amplitude, and shortened P300 latency, and the observation group had higher scores and P300 amplitude, and shorter P300 latency than the control group. Both groups displayed decreased inflammatory factor levels (Tumour necrosis factor‐α, interleukin (IL)‐6, IL‐10, IL‐1β) after treatment, which were lower in the observation group than the control group. Inflammatory factor levels in PSCI patients were negatively interrelated with MMSE, MoCA score and P300 amplitude, and positively with P300 latency. The observation group showed an increased number of patients showing cured and significantly effective results, a decreased number of patients showing effective and invalid results, and an observably elevated total effective rate.LF‐rTMS with XNKQ acupuncture can improve cognitive function and reduce inflammatory immune response, and has better clinical efficacy in PSCI patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the clinical efficacy of the full-endoscopic posterior cervical foraminotomy (FE-PCF) and the unilateral biportal endoscopic posterior cervical foraminotomy (UBE-PCF) in the treatment of cervical spondylotic radiculopathy (CSR). Methods: Patients who underwent posterior cervical spine surgery in our hospital from January 2020 to December 2022 were retrospectively analyzed. According to the surgical method, the patients were divided into two groups: FE-PCF group and UBE-PCF group. Perioperative data included operation time, Intraoperative blood loss and postoperative hospital stay were collected. The Visual Analog Scale (VAS)-arm, VAS-neck, and Neck Diability Index (NDI) was used to evaluate the clinical outcomes at preoperative, postoperative 1 week and Last follow-up. Serum creatine phosphokinase (CPK) and C-reactive protein (CRP) levels were recorded to evaluate surgical invasiveness. Results: A total of 160 patients were included, including 89 cases of FE-PCF and 71 cases of UBE-PCF. The demographic and preoperative data showed no significant differences between the two groups (P > 0.05). The mean operating time was significantly shorter in the UBE-PCF group compared to FE-PCF group (P < 0.05). Serum CRP and CPK levels of the two groups both exhibited a pattern of rising and then falling, peaking one day following surgery and decreasing to near normal values three days after the operation. Compared with preoperative, both groups showed significant improvement in postoperative VAS and NDI scores, with a statistically significant difference (P < 0.05). However, the differences in results between the groups were not significant. Conclusions: Both UBE-PCF and FE-PCF are secure and efficient methods for treating CSR by continuous visualization. UBE-PCF offers predictable and adequate decompression within a reduced surgical duration, facilitated by its separate observation and operation channels. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical efficacy of different species of polymyxin drugs in the treatment of Carbapenem- Resistant Gram-negative bacilli (CR-GNB) resistant to ceftazidime-avibactam (CZA). Methods: Patients infected by CR-GNB strains and treated with polymyxin drugs were selected and divided into colistin methanesulfonate (CMS) group and colistin sulfate/polymyxin B (CSPB) group to observe clinical efficacy and safety. Results: 65 patients were eventually included (CMS group, n = 29; CSPB group, n = 36). The clinical efficacy, microbiological eradication rate and 28-day mortality between the two groups were similar, with no statistical significance (51.72% vs. 50.00%, p = 0.890; 55.17% vs. 52.78%, p = 0.847; 17.24% vs. 25.00%, p = 0.449). With regard to renal safety, the incidence of acute kidney injury (AKI) in the CMS group was significantly higher than that in the CSPB group (34.48% vs. 5.56%, p = 0.003). Among them, the incidence of AKI grade 3 in the CMS group tended to be higher than that in the CSPB group (24.14% vs. 5.56%, p = 0.066). Conclusion: The results based on small sample size from a single center showed that clinical response to the treatment of ceftazidime-avibactam resistant Gram-negative bacillus infections is similar for CMS and Colistin Sulfate/Polymyxin B, but the nephrotoxicity of CMS is greater than that of polymyxin sulfates. [ABSTRACT FROM AUTHOR]

Objective: Interstitial lung disease (ILD) resulting from connective tissue disease (CTD) greatly undermines people's health. Cyclophosphamide (CYC) is a widely used agent in treating CTD‐ILD. We compared the efficacy and safety of oral and intravenous CYC in CTD‐ILD treatment. Methods: The retrospectively enrolled CTD‐ILD patients were divided into the oral and intravenous CYC groups. The chest high‐resolution computed tomography examination, forced vital capacity (FVC), lung carbon monoxide diffusion capacity (Dlco) determinations, and 6 min walk test (6MWT) were performed pre‐treatment and at the 3rd, 6th, and 12th months posttreatment. Radiographic ILD severity was assessed using the Warrick score. Krebs Von den Lungen‐6, surfactant protein A (SP‐A), SP‐D, and erythrocyte sedimentation rate (ESR) before and at the 12th month post‐treatment were determined. CYC cumulative dose and occurrence of adverse reactions during treatment were recorded. Results: CYC cumulative dose in the intravenous CYC group was reduced. Compared with oral CYC treatment, intravenous CYC caused decreased Warrick score and increased FVC and 6MWT at the 6th month, and elevated DLco at the 3rd and 6th months posttreatment. SP‐A, SP‐D and ESR levels in both groups were reduced 12 months posttreatment, with a more evident decrease in the intravenous CYC group. Intravenous CYC had lower total adverse reaction incidence. Conclusion: Compared with oral CYC, intravenous CYC decreases Warrick score and increases FVC and 6MWT at 6 months posttreatment, and reduces SP‐A, SP‐D, and ESR levels after 12 months of treatment, which shows low CYC cumulative dose and adverse reaction incidence in treating CTD‐ILD. [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-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 compare and analyze the efficacy and safety of different methods for injecting polidocanol in the treatment of venous malformations. Methods: The medical records of patients with venous malformations in our hospital from April 2021 to April 2023 were analyzed retrospectively, and they were divided into control group (n = 38) and observation group (n = 20) according to different treatment methods. Control group was injected with polidocanol under ultrasound guidance, while observation group was injected with polidocanol under digital subtraction angiography (DSA) monitoring. Therapeutic effects of observation group and control group after 3-6 months of treatment were compared and analyzed, and complications that can be used to reflect the safety of treatment in two groups were collected and recorded. Results: After treatment, the total effective rates of observation group and control group were 97.37% (37/38) and 75.00% (15/20) respectively, with significant differences (both p <.05). After 3-6 months of treatment, 13 complications occurred in observation group, while 16 occurred in control group. The number of complications in observation group was 6, with an incidence rate of 15.78%; while that in control group was 9, with an incidence rate of 45.00%, with a significant difference (p <.05). There were no significant differences among other baseline data, age and complications between two groups (all p >.05). Conclusion: Injection of polidocanol in patients with venous malformations under DSA monitoring was more effective and safer. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and feasibility of combined treatment with compound fluocinolone acetonide cream and guaiazulene in patients with neurodermatitis. Methods: A prospective study was conducted on 92 outpatient patients diagnosed with neurodermatitis at our dermatology department from January 2022 to December 2023. Using a random number table, these patients were evenly divided into a control group and an experimental group, with 46 individuals in each group. The control group received treatment with compound fluocinolone acetonide alone, while the experimental group additionally received oral guaiazulene tablets. Clinical symptom and sign scores, Visual Analog Scale (VAS) scores, skin lesion itching scores, comprehensive efficacy, treatment onset time, adverse reactions, and quality of life were monitored, recorded, and compared. Results: In the 2-week treatment period, patients in the experimental group showed significant improvement in skin symptoms and signs, with scores significantly lower than those in the control group (P < 0.05). After treatment, VAS and skin lesion itching scores in the experimental group were significantly reduced (P < 0.05), demonstrating a more pronounced therapeutic advantage compared to the control group (P < 0.05). Although the effective rate in the experimental group was as high as 86.96%, there was no significant advantage compared to the control group, and the difference in treatment efficacy was not significant (P > 0.05). The treatment onset time in the experimental group was significantly shorter than that in the control group (P < 0.05), and the incidence of adverse reactions was lower (P < 0.05). The quality of life in the experimental group improved significantly after treatment, with DLQI scores lower than those in the control group (P < 0.05). Conclusion: Combined treatment with compound fluocinolone acetonide cream and guaiazulene demonstrates excellent efficacy and feasibility in the management of neurodermatitis. Compared to standard treatment alone, it yields superior clinical outcomes. [ABSTRACT FROM AUTHOR]

To determine the clinical efficacy of Zuqing Xu 'Wuduling' powder for snake injury on the swelling of the affected limb bitten by Agkistrodon halys. Sixty-five patients with Agkistrodon halys bite were assigned to a treatment group (n = 35) or control group (n = 30). The treatment group was additionally given 'Wuduling' powder dressing locally based on the therapy to the control group with conventional Western medicine. Clinical efficacy and improvement of traditional Chinese medicine symptoms and signs in the two groups were evaluated. The treatment group showed a notably higher cure rate than the control group. After 3 days of therapy, the swelling and pain of the affected limb in the treatment group were greatly alleviated. Additionally, after 7 days of therapy, the swelling and pain of the affected limb in the treatment group were more greatly alleviated, and those in the control group were also alleviated. The comparison of the two groups during the same period showed more obvious alleviation of swelling and pain in the treatment group than that in the other. Moreover, the treatment group experienced notably shorter disappearing time of swelling and pain than the control group. After treatment, the levels of CRP, TBIL, Cr, ALT, AST, BUN, CK, LDH and CK-MB in both groups declined notably, with notably lower levels of them in the treatment group than those in the other. Zuqing Xu 'Wuduling' powder for snake injury can substantially alleviate the swelling and local pain of affected limbs bitten by Agkistrodon halys. [ABSTRACT FROM AUTHOR]

Wei-Jia Yang,1,&ast; Lian-dong Shi,2,&ast; Ye Liang,3,&ast; Li-ming Liang,4,&ast; Hao Zhang,5 Li Wang,2 Qian Zhou1 1Department of Eugenics and Genetics, Guilin People’s Hospital, Guilin, Guangxi Zhuang Autonomous Region, 541002, People’s Republic of China; 2Department of Ultrasound, Guilin People’s Hospital, Guilin, Guangxi Zhuang Autonomous Region, 541002, People’s Republic of China; 3Department of Cardiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, 530000, People’s Republic of China; 4Department of Genetic Metabolism Center Laboratory, Guilin Women and Children’s Hospital, Guilin, Guangxi Zhuang Autonomous Region, 541001, People’s Republic of China; 5Department of Pharmacy, Guilin People’s Hospital, Guilin, Guangxi Zhuang Autonomous Region, 541002, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei-Jia Yang, Department of Eugenics and Genetics, Guilin People’s Hospital, No. 12 of Wenming Road, Xiangshan District, Guilin, Guangxi Zhuang Autonomous Region, 541002, People’s Republic of China, Tel +86 18977300052, Fax +86 07732881579, Email weijiayangywj@126.comObjective: In this study, we evaluated the effectiveness and safety of thalidomide by clinically observing 48 individuals with β-thalassemia who have been administered thalidomide in small and medium doses over a period of two years.Methods: Thalidomide’s efficacy was gauged by tracking hemoglobin (Hb) level alterations post its administration. Liver and kidney function impact was measured through tests for alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, and creatinine. Hemolysis effects were assessed via total bilirubin and indirect bilirubin level measurements. Thrombosis detection was performed using ultrasound examinations of deep vein vessels in the upper and lower extremities. Any adverse effects of thalidomide were recorded during the observation period. Lower dose thalidomide effectiveness was evaluated by monitoring Hb level changes following dosage reduction.Results: The overall response rate (ORR) among the 48 participants was 91.7% (44 out of 48), with the main reaction (MaR) reaching 72.9% (35 out of 48). Hepatorenal toxicity was not monitored during the 2-year observation period, and there was no improvement in hemolysis. Most adverse effects were mild, with no instances of venous thrombosis and no cases of grade 2 or higher neurotoxicity. When the observation group was divided into three age categories (12– 14 years old, 14– 18 years old, and over 18 years old), there were no statistically significant differences in the occurrence of adverse reactions among the three groups. As there were some adverse reactions in ten cases, the treatment dose was reduced for them. The maintenance efficacy rate at one year of observation was 90% (9 out of 10).Conclusion: This study confirmed that thalidomide in small doses over a 2-year observation period is effective, and has no instances of grade 2 or higher neurotoxicity. Long-term maintenance with small doses is recommended for enhanced safety.Keywords: β-thalassemia, clinical efficacy, safety, thalidomide

Yuan Cheng, Qing-Feng Fang, Bi-Quan Chen Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, Anhui, 230022, People’s Republic of ChinaCorrespondence: Bi-Quan Chen, Email chengyi579593@163.comObjective: To analyze the clinical efficacy of azithromycin in the treatment of pediatric Mycoplasma pneumoniae pneumonia and its impact on platelet count and D-dimer levels.Methods: A comparison was made between the two groups regarding clinical treatment effects, recovery status, levels of blood indicators [C-reactive protein (CRP), white blood cell count (WBC), platelet count (PLT), D-dimer (D-D)], and the occurrence of adverse reactions. The control group received conventional symptomatic treatment, while the case group received both conventional treatment and azithromycin.Results: ① Clinical treatment effects: The total effective rate of treatment in the control group was 84.21%, while it was significantly higher at 96.83% in the case group (P < 0.05). ② Recovery status: After treatment, the case group exhibited significantly shorter durations for fever clearance, cough disappearance, rale disappearance, resolution of chest radiographic shadows, and hospital stay compared to the control group (P < 0.05). ③ Blood indicator levels: After treatment, the levels of C-reactive protein (CRP), white blood cell count (WBC), platelet count (PLT), and D-dimer (D-D) were significantly lower in the case group than in the control group, indicating an improvement in the inflammatory response and blood clotting status.Conclusion: Addition of azithromycin to conventional symptomatic treatment significantly improves the efficacy of Mycoplasma pneumoniae pneumonia treatment in children, reduces inflammatory response, improves blood circulation, further promotes recovery without a substantial increase in related adverse reactions, suggesting its relatively high safety in clinical application and advocating for its clinical promotion.Keywords: azithromycin, pediatric Mycoplasma pneumoniae pneumonia, clinical efficacy, platelet count, D-dimer

Objective To systematically evaluate the efficacy and safety of treating amyotrophic lateral sclerosis(ALS) based on the theory of “Deficient Qi Induced Stagnation”. Methods CNKI, Wangfang Data, VIP, CBM, PubMed, Embase, Cochrane Library, Web of Science were searched to collect randomized controlled trials of treating ALS based on the theory of “deficient qi induced stagnation” applying the method of replenishing deficiency and passing stagnation for the treatment of ALS published from the establishment of the databases to October 2023. Meta analysis was performed using Revman Manager 5.4 software and Stata 18 software. Results A total of 14 randomized controlled studies involving 844 patients were identified. The total effective rate and ALS functional scale score of combined therapy of traditional Chinese and western medicine in the intervention group were higher than those in the control group (P0.05). Conclusion Treatment of ALS based on the theory of “Deficient Qi Induced Stagnation” can effectively slow down the disease progression, improve neurological function, improve the quality of life, and doesn’s increase the occurrence of adverse effects.

Abstract Purpose The aim of this study is to evaluate the clinical efficacy and safety of treating patients with rigid degenerative scoliosis by restoring intervertebral balance through a combination of interbody release and asymmetric grade 1 and 2 osteotomy. Method The medical collected clinical and radiographic data of patients with rigid degenerative scoliosis from our department between 2015 and 2022. A total of 60 patients were included in the study, comprising 20 males and 40 females, with an average follow-up period of 30.7 months. Data recorded included surgery duration, blood loss, number of fixed segments, hospital stay, complications, clinical scores, and radiographic parameters. Results The sagittal vertical axis improved from 4.28 ± 1.48 cm preoperatively to 2.90 ± 1.18 cm postoperatively, while the coronal vertical axis improved from 3.29 ± 1.72 cm preoperatively to 1.12 ± 0.62 cm postoperatively. The preoperative coronal Cobb angle was 30.85 ± 7.33°, which improved to 4.14 ± 3.06°postoperatively. Additionally, lumbar lordosis increased from 24.50 ± 17.24°preoperatively to 30.35 ± 6.11°postoperatively. VAS scores for back pain and leg pain, ODI scores, and JOA scores showed varying degrees of improvement. Conclusion Interbody release combined with asymmetric Grade 1 and 2 osteotomy to restore intervertebral balance significantly improves spinal deformity and postoperative functional scores in patients with rigid degenerative scoliosis.

Abstract Qingdai (QD), derived from various plant sources, is commonly used in traditional Chinese medicine for ulcerative colitis (UC) treatment. However, the clinical efficacy and mechanisms of orally administered QD remain unclear. This study aims to evaluate QD’s efficacy in UC treatment and uncover its active components and mechanisms. A randomized controlled trial compared QD to Adisa, followed by UPLC-Q-TOF/MS and network pharmacology analyses to identify QD’s core components and targets. In vivo experiments on a UC mouse model explored QD’s impact on the AHR-Th17/Treg pathway using PCR, WB, ELISA, and flow cytometry. Results showed QD’s efficacy in UC treatment, with mucosal healing and remission comparable to Adisa. UPLC-Q-TOF/MS identified 16 core components in mouse colon tissue, with network pharmacology revealing 67 targets, potentially involving the IL-17 signaling pathway and Th17 cell differentiation. QD and its components up-regulated AHR, CYP1A1, and Foxp3, while down-regulating RORγt. Additionally, QD modulated pro-inflammatory (IL-6, IL-17 A) and anti-inflammatory (IL-10, TGF-β1) factors, and Treg/Th17 cell ratios in LPMC. Oral QD administration effectively promoted mucosal healing and improved UC symptoms, potentially through AHR-Th17/Treg pathway regulation.

Abstract Background Calcaneal fractures are the most common type of tarsal fractures. The sustentaculum tali (ST) offers anatomical stability in calcaneal fractures, and recently, ST screws have been widely used in their treatment. This study aimed to investigate the clinical efficacy and value of ST screw fixation via a modified sinus tarsi approach (MSTA) for treating displaced intraarticular calcaneal fractures (DIACFs). Methods This study enrolled 64 patients (64 feet): 32 patients in the calcaneal locking plate combined with the ST screw group (CLP-STS Group) and 32 patients in the simple calcaneal locking plate internal fixation group (CLP Group). The minimum follow-up duration was 18 months. Ankle function was evaluated using VAS, AOFAS, and Short Form-36 scores. Imaging evaluation included the Böhler angle, Gissane angle, length, height, and width of the calcaneus, and the Böhler angle in both groups 1 year after surgery. Results Functional evaluation revealed that postoperative AOFAS and VAS scores in the CLP-STS Group were significantly better than those in the CLP Group. After surgery, the Böhler angle, Gissane angle, and length, height, and width of the calcaneus were significantly corrected compared to the preoperative values; however, the difference in these indicators between the two groups was not significant. Nevertheless, at the 1-year postoperative follow-up, the calcaneal Böhler angle loss in the CLP-STS Group was significantly better than that in the CLP Group. Conclusion Compared to simple calcaneal locking plate internal fixation, combining the plate with the additionally free ST screw can resolve the limited intraoperative exposure of MSTA, reduce postoperative foot pain in patients, and improve clinical efficacy.

Objective As the population ages and technology advances, lateral lumbar intervertebral fusion (LLIF) is gaining popularity for the treatment of degenerative lumbar scoliosis (DLS). This study investigated the feasibility, minimally invasive concept, and benefits of LLIF for the treatment of DLS by observing and assessing the clinical efficacy, imaging changes, and complications following the procedure. Methods A retrospective analysis was performed for 52 DLS patients (12 men and 40 women, aged 65.84 ± 9.873 years) who underwent LLIF from January 2019 to January 2023. The operation time, blood loss, complications, clinical efficacy indicators (visual analogue scale [VAS], Oswestry disability index [ODI], and 36‐Item Short Form Survey), and imaging indicators (coronal position: Cobb angle and center sacral vertical line–C7 plumbline [CSVL–C7PL]; and sagittal position: sagittal vertical axis [SVA], lumbar lordosis [LL], pelvic incidence angle [PI], and thoracic kyphosis angle [TK] were measured). All patients were followed up. The above clinical evaluation indexes and imaging outcomes of patients postoperatively and at last follow‐up were compared to their preoperative results. Results Compared to the preoperative values, the Cobb angle and LL angle were significantly improved after surgery (p 0.05) but improved significantly at follow‐up (p 0.05) but considerably improved during follow‐up (p

BackgroundResults of genetic testing for antipsychotic drugs can guide the rational use of drugs in clinical practice and help improve the clinical symptoms of patients with schizophrenia. However， there is currently limited evidence in China regarding the impact of genetic testing results on medication adherence， social function and drug side effects of antipsychotic drug treatment.ObjectiveTo explore the improvement of clinical symptoms， medication adherence and social function in patients with schizophrenia under the guidance of antipsychotic drug gene testing results and examine the safety of drug treatment， so as to provide references for ifor precise treatment of schizophrenia patients.MethodsPatients with acute schizophrenia who received hospitalization at Dazhou Minkang Hospital from July 2019 to August 2021 as well as met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） were selected as research subjects （n=144）. Based on random number table， subjects were divided into study group and control group， with 72 cases in each group. Control group received drug treatment based on the doctor's clinical experience， while study group received drug treatment based on the results of gene testing for antipsychotic drug. Both treatments lasted for 12 weeks. At baseline as well as 2， 4， 8 and 12 weeks after treatment， Positive and Negative Syndrome Scale （PANSS）， 8-item Morisky Medication Adherence Scale （MMAS-8）， Social Functional Rating Scale （SFRS） and Treatment Emergent Symptom Scale （TESS） were adopted for assessment.ResultTime effect and group effect of the reducing rate of PANSS， MMAS-8 and SFRS scores in the groups were statistically significant （Ftime=95.251， 6.650， 14.101， Fgroup=38.055， 58.175， 128.221， P

This study investigated the clinical efficacy of Carbon dioxide (CO2) laser therapy combined with photodynamic therapy in male patients with condyloma acuminatum. A retrospective analysis was conducted on 120 male patients with genital warts treated at our hospital. Based on different treatment methods, they were divided into a control group and an observation group, each consisting of 60 cases. The control group received CO2laser treatment, while the observation group received photodynamic therapy and CO2 laser treatment. Levels of lymphocyte chemotactic factor (LTN), human beta-defensin-2 (HBD-2), B-cell lymphoma-2 (Bcl-2), interleukin-12 (IL-12), tumor necrosis factor-alpha (TNF-α), T lymphocytes (CD3+), inducible T cells (CD4+), suppressive T cells (CD8+), Male Sexual Function Index (MSFI) scores, Chinese version of the Genital Warts Quality of Life Scale (CECA10) scores, incidence of adverse reactions, recurrence rate, and total treatment effectiveness were compared between groups. After therapy, both groups showed reduced levels of Bcl-2 and TNF-α, but increased levels of IL-12. The observation group had significantly lower Bcl-2, TNF-α and greater IL-12 levels than the control group (p < 0.05). After therapy, both groups showed increased levels of CD3+ and CD4+ but lower levels of CD8+ than before treatment. The observation group had significantly greater CD3+ and CD4+ levels, but lower CD8+ levels than the control group (p < 0.05). The observation group had significantly higher CD3+ and CD4+ levels and lower CD8+ levels compared to the control group (p < 0.05). The incidence of complications in the observation group was significantly lower than in the control group (p < 0.05). CO2 laser therapy combined with 5-aminolevulinic acid photodynamic therapy demonstrates efficacy in treating male genital warts. This therapy can significantly reduce inflammation, improve immune function, and help improve quality-of-life.

Abstract Objective Acute myeloid leukemia (AML) is a malignant clonal proliferative disease with a high mortality rate. The combination therapy of BCL-2 inhibitor Venetoclax (VEN) and hypomethylating agents (HMAs) has significant anti-leukemia activity. Methods We analyzed the efficacy, safety and immune response characteristics of AML patients who were unfit for high-dose chemotherapy and accepted the medication of VEN + HMAs. Results After VEN + HMAs treatment, 31 newly diagnosed AML patients had the morphologic leukemia-free state rate (MLFS%) of 80.6% (25/31), complete response rate (CR%) of 54.8% (17/31), the minimal residual disease negative rate (MRD-%) of 51.6% (16/31), and the median progression-free survival (PFS) of 14 months. After treatment, the proportion of bone marrow primitive cells, the MRD level, white blood cell (WBC) count, fibrinogen (FIB) level and the proportion of B cells were significantly decreased. The red blood cell (RBC) count, hemoglobin (HGB) level, platelet count (PLT) count, activated partial thromboplastin time (APTT), the proportion of total T cells, CD8 + T cells and the IFN-γ level were significantly increased. After VEN + HMAs treatment, 12 relapsed AML patients had a MLFS% of 50% (6/12), CR% of 33.3% (4/12), MRD-% of 25% (3/12), and a median PFS of 7 months. After treatment, the proportion of bone marrow primitive cells and MRD level were slightly decreased, the proportions of CD8 + T cells and NK cells were significantly increased, the proportion of B cells and IL-10 level were significantly decreased. 12 AML patients who receive microtransplantation (MST) treatment using VEN + HMAs as a pretreatment regimen had a PFS of 20.5 months, which was much greater than VEN + HMAs group alone. Hematological recovery was better in the MST group with significantly increased RBC count, HGB level and PLT count. The most common adverse events were myelosuppression, agranulocytosis, infection and cardiovascular toxicity. No fatal adverse events were reported. Conclusion The combination of BCL-2 inhibitors and HMAs had good efficacy and safety in AML patients who were unfit for high-dose chemotherapy, which may improve the immune microenvironment and enhance anti-leukemia immune response.

Abstract Background Heart failure in elderly individuals poses significant challenges due to the decline in cardiac function associated with aging. This study aimed to investigate the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) for the treatment of heart failure, especially in elderly patients. Methods This was a retrospective case control study of the medical records of 60 elderly patients with heart failure admitted to our hospital between December 2020 and December 2023. Patients were divided into two groups based on treatment. The control group (n = 30) received diuretics, digitalis, and β receptor blockers, while the observation group (n = 30) received lyophilized rhBNP in addition to the control group treatment. Changes in BNP levels and clinical outcomes were compared between the two groups. Results Posttreatment BNP levels were significantly lower in the observation group than in the control group (p

Shi-Fan Ruan,1– 3,&ast; Xinhong Su,1,2,&ast; Zhixun Xiao,1,2,&ast; Yihua Zhang,1,2,&ast; Tingting Lin,1,2 Renwei Luo,1,2 Niu Xiang,1,2 Bo Cheng,1– 3 Ting Gong,4 Chao Ji1– 3 1Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350000, People’s Republic of China; 2Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, Fuzhou, Fujian, 350000, People’s Republic of China; 3Fujian Provincial Clinical Research Center for Immune Skin Diseases, Fuzhou, Fujian, 350000, People’s Republic of China; 4Central Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ting Gong, Central Laboratory, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, Fujian, 350000, People’s Republic of China, Email gongtingfy@fjmu.edu.cn Chao Ji, Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, Fujian, 350000, People’s Republic of China, Email jichaofy@fjmu.edu.cnPurpose: Recent studies have shown that novel biologics may provide significant clinical benefits for patients with generalized pustular psoriasis (GPP). Ustekinumab and secukinumab have been approved in Japan for GPP treatment in adult patients. However, the differences in efficacy and safety of these two drugs in GPP are not known.Aim: Based on the genetic background, we aimed to compare the efficacy and safety of secukinumab and ustekinumab in patients with GPP.Methods: Patients with moderate to severe GPP who were treated with ustekinumab/secukinumab at our department from July 2019 to May 2022 were included in this study and followed up for 48 weeks. The difference in efficacy between ustekinumab and secukinumab was evaluated by assessing changes in body temperature, laboratory indices, recovery of skin lesions, and changes in quality of life. Additionally, we collected patients’ saliva for genotyping and explored the effect of CARD14 genetic mutations on clinical efficacy.Results: A total of 65 patients (32 adults and 33 children) with moderate to severe GPP were included in this study. 31 patients received ustekinumab therapy, and 34 patients were treated with secukinumab. Secukinumab demonstrated superiority to ustekinumab, as evidenced by a higher GPPASI 90 response at week 2. Additionally, the efficacy of ustekinumab and secukinumab was found to be independent of the presence of the CARD14 mutation.Conclusion: Secukinumab is superior to ustekinumab in rapidly clearing the skin and improving health-related quality of life. Moreover, the responses to ustekinumab/secukinumab in patients were not influenced by CARD14 gene mutations.Keywords: generalized pustular psoriasis, secukinumab, ustekinumab, clinical efficacy, safety, gene mutations

Objective To investigate the clinical effect of low-load blood flow restriction training combined with intra-articular injection for elderly knee osteoarthritis. Methods A total of 126 elderly patients with knee osteoarthritis admitted to the Third Hospital of Shanxi Medical University in 2023 were selected as the study subjects by convenient sampling method, they divided into two groups according to the random number table, 63 cases for each group. The control group received simple intra-articular injection, and the observation group was additionally trained with low-load blood flow restriction. Western Ontario and the University of Manchester Osteoarthritis Index (WOMAC), efficacy, generic quality of life inventory 74 (GQOLI-74) score, knee extension moment, knee adduction moment, serum matrix metalloproteinase (MMP) -1, and MMP-3 levels were assessed before and after treatment. Results After treatment, the WOMAC dimensions and total score, MMP-1 and MMP-3 levels in the observation group were lower than those in the control group (P < 0.05), and the clinical total effective rate, GQOLI-74 score dimensions and total score, knee extension moment and knee adduction moment in the observation group were higher than those in the control group (P < 0.05) . Conclusion Low-load blood flow restriction training combined with intra-articular injection for elderly knee osteoarthritis has good clinical efficacy, which can significantly relieve pain, improve joint function and quality of life of patients, and its treatment mechanism may be related to lower levels of MMP-1 and MMP-3.

Abstract Objective This study aimed to evaluate the clinical effect of different vertebral body heights restoration rate after percutaneous kyphoplasty (PKP) for the treatment of osteoporotic vertebral compression fractures (OVCF). Methods The patients were divided into two groups according to the height restoration rate of the anterior edge of the vertebral body fracture after PKP operation using X-Ray imaging. The group A was below 80%, and the group B was above 80%. Clinical preoperative and postoperative efficacy (1st day, 1st month, 6th month, and 12th month after surgery) were evaluated according to VAS, Oswestry Disability Index(ODI), Quality of Life Questionnaire of the European Foundation for Osteoporosis(QUALEFFO), and Back Pain Life Disorder Questionnaire(RQD). Simultaneously, the preoperative and postoperative local Cobb angles and changes in the injured vertebrae in the two groups were calculated and analyzed. Results The postoperative Cobb angle in group A was significantly higher than that in group B. The correction rate in group B was significantly better than that in group A. The VAS, ODI, QUALEFFO, and RQD scores of group B patients were significantly lower than those of patients in group A at each follow-up time point. The correlation coefficients of vertebral body height restoration rate and VAS, ODI, QUALEFFO, and RQD scores at the last follow-up were − 0.607 (P

Ying-Chao Ma,1 Ya-Qing Sun,2 Xia Wu,1 Yong-Jing Wang,1 Xiu-Ling Yang,1 Jian-Jun Gu3 1Department of Pharmacy, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050000, People’s Republic of China; 2College of Pharmacy, Hebei Medical University, Shijiazhuang, Hebei Province, 050000, People’s Republic of China; 3Department of Cardiac Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050000, People’s Republic of ChinaCorrespondence: Jian-Jun Gu, Department of Cardiac Surgery, Second Hospital of Hebei Medical University, No. 215 of Heping West Road, Xinhua District, Shijiazhuang, 050000, Hebei Province, People’s Republic of China, Tel +8631166002991, Email jianjungu62@126.com Xiu-Ling Yang, Department of Pharmacy, Second Hospital of Hebei Medical University, No. 215 of Heping West Road, Xinhua District, Shijiazhuang, Hebei Province, 050000, People’s Republic of China, Tel +8631166002712, Email yangxuilingyxl0d@126.comObjective: To assess the efficacy and safety of colistin sulfate in treating infections caused by carbapenem-resistant organisms (CRO) and to analyze potential factors impacting its effectiveness.Methods: In this retrospective study, medical records of CRO-infected patients from June 2020 to June 2023 were analyzed, divided into effective and ineffective treatment groups, and compared for clinical outcomes and adverse reactions. Multifactorial logistic regression and ROC curve analysis were used to identify influencing factors.Results: The study included 226 patients, with 124 in the effective treatment group and 102 in the ineffective group. A total of 293 CRO strains were cultured. The clinical efficacy rate of colistin sulfate was 54.87%, the microbiological efficacy rate 46.46%, and the hospital mortality rate 20.80%, with nephrotoxicity observed in 11.50% of patients. Multifactorial analysis identified APACHE II scores and vasoactive drug use as independent predictors of ineffective treatment, while treatment duration and albumin levels predicted effective treatment. ROC analysis indicated that albumin levels > 34 g/L, APACHE II scores < 13, and treatment duration > 10 days correlated with better clinical efficacy.Conclusion: Colistin sulfate is both safe and effective in clinical settings. Factors such as treatment duration, albumin levels, APACHE II scores, and vasoactive drug use independently affect its clinical efficacy, providing valuable guidance for its informed clinical application.Keywords: colistin sulphate, carbapenem-resistant organism, clinical efficacy, influencing factors, safety evaluation

Rheumatoid arthritis (RA), a globally increasing autoimmune disorder, is associated with increased disability rates due to the disruption of iron metabolism. Tripterygium glycoside tablets (TGTs), a Tripterygium wilfordii Hook. f. (TwHF)-based therapy, exhibit satisfactory clinical efficacy for RA treatment. However, drug-induced liver injury (DILI) remains a critical issue that hinders the clinical application of TGTs, and the molecular mechanisms underlying the efficacy and toxicity of TGTs in RA have not been fully elucidated. To address this problem, we integrated clinical multi-omics data associated with the anti-RA efficacy and DILI of TGTs with the chemical and target profiling of TGTs to perform a systematic network analysis. Subsequently, we identified effective and toxic targets following experimental validation in a collagen-induced arthritis (CIA) mouse model. Significantly different transcriptome–protein–metabolite profiles distinguishing patients with favorable TGTs responses from those with poor outcomes were identified. Intriguingly, the clinical efficacy and DILI of TGTs against RA were associated with metabolic homeostasis between iron and bone and between iron and lipids, respectively. Particularly, the signal transducer and activator of transcription 3 (STAT3)–hepcidin (HAMP)/lipocalin 2 (LCN2)–tartrate-resistant acid phosphatase type 5 (ACP5) and STAT3–HAMP–acyl-CoA synthetase long-chain family member 4 (ACSL4)–lysophosphatidylcholine acyltransferase 3 (LPCAT3) axes were identified as key drivers of the efficacy and toxicity of TGTs. TGTs play dual roles in ameliorating CIA-induced pathology and in inducing hepatic dysfunction, disruption of lipid metabolism, and hepatic lipid peroxidation. Notably, TGTs effectively reversed “iron–bone” disruptions in the inflamed joint tissues of CIA mice by inhibiting the STAT3–HAMP/LCN2–ACP5 axis, subsequently leading to “iron–lipid” disturbances in the liver tissues via modulation of the STAT3–HAMP–ACSL4–LPCAT3 axis. Additional bidirectional validation experiments were conducted using MH7A and AML12 cells to confirm the bidirectional regulatory effects of TGTs on key targets. Collectively, our data highlight the association between iron-mediated metabolic homeostasis and the clinical efficacy and toxicity of TGT in RA therapy, offering guidance for the rational clinical use of TwHF-based therapy with dual therapeutic and toxic potential.

Honggang Zhang,1 Huiling Li,1 Shuangjun Zhao,2 Fangping Bao1,2 1Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China; 2The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, People’s Republic of ChinaCorrespondence: Fangping Bao, Email baofp@zju.edu.cnAbstract: Remimazolam is a novel ultra-short-acting benzodiazepine with a unique pharmacokinetic profile that makes it an attractive option for use in general anesthesia. This review paper provides an in-depth analysis of remimazolam’s applications in the field of general anesthesia, focusing on its pharmacological properties, clinical efficacy, safety profile, and potential advantages compared to other anesthetic agents. Remimazolam acts on GABAa receptors, offering rapid onset and recovery times due to its unique metabolic pathway involving tissue esterases. Clinical trials have demonstrated its efficacy in procedural sedation and general anesthesia, showing a favorable safety profile with minimal cardiovascular and respiratory depression. Compared to traditional anesthetics such as propofol, remimazolam presents distinct advantages, including predictable pharmacokinetics, reduced risk of prolonged sedation, and a reliable safety margin. These attributes position remimazolam as a promising agent in various clinical settings. The purpose of this review is to synthesize current evidence on remimazolam and discuss its potential to improve clinical outcomes in anesthesia practice.Keywords: remimazolam, clinical efficacy, general anesthesia, safety profile, respiratory depression

Abstract Objective This study aimed to evaluate the clinical efficacy and safety of anlotinib as maintenance therapy in patients with advanced cholangiocarcinoma following first-line chemotherapy. Methods This retrospective study enrolled 154 patients with advanced biliary tract cancer admitted to the hospital between January 2020 and December 2022. All patients received first-line intravenous chemotherapy with gemcitabine combined with cisplatin, oxaliplatin, or tegafur. Among the 106 patients who achieved disease control, 47 received oral anlotinib hydrochloride (12 mg daily, 2 weeks on/1 week off) as maintenance therapy. Clinical efficacy, including ORR, DCR, DOR, PFS, and OS, was compared between the anlotinib maintenance and non-maintenance groups. Subgroup analysis based on NLR levels was also performed. Results Among the 47 anlotinib maintenance patients, the ORR was 21.28% and the DCR was 51.06%. The median DOR was 36 weeks, and the median PFS was 43 weeks in the anlotinib group, versus 28 weeks and 38 weeks in the non-maintenance group, respectively. The median OS was not reached in the anlotinib group but was 48 weeks in the non-maintenance group. Patients receiving anlotinib maintenance had significantly longer DOR, PFS, and OS (all p

Abstract Background To assess the viability and efficiency of performing arthroscopic meniscoplasty in treating discoid meniscus (DM) in the knee joint. Methods A total of 29 patients diagnosed with symptomatic lateral DM between October 2014 and December 2019 were included in the study. Among them, 7 patients with intact DM underwent arthroscopic discoid meniscoplasty (group A), while 22 patients with torn DM received arthroscopic DM plasty along with repair and suturing (group B). Both Visual Analog Scale (VAS) score and Lysholm score assessments were conducted preoperatively and postoperatively. Result The favorable and acceptable outcome rate was 85.71% in group A and 95.45% in group B (P > 0.05). The VAS scores post-operatively at each follow-up time point were consistently lower compared to pre-operative values, while the Lysholm knee function scores showed improvement. There were no significant differences in VAS score and Lysholm score between group A and group B at different stages (P > 0.05). Both surgical techniques (discoid meniscoplasty and discoid meniscoplasty combined with repair and suture) showed significant improvement in postoperative VAS score and Lysholm score, but there was no difference in outcomes between the two groups. Conclusion Overall, the two surgical techniques studied in this study (discoid meniscoplasty and discoid meniscoplasty combined with repair and suture) produced similar results in terms of pain reduction and improved knee function.

Abstract Objective The aim of this study is to evaluate the clinical efficacy of injectable cemented hollow pedicle screw (CICPS) in the treatment of osteoporotic lumbar degenerative diseases through a large sample long-term follow-up study. Additionally, we aim to explore the risk factors affecting interbody fusion. Methods A total of 98 patients who underwent CICPS for transforaminal lumbar interbody fusion (TLIF) for osteoporotic lumbar degenerative disease from March 2011 to September 2017 were analyzed. X-ray and electronic computed tomography (CT) imaging data were collected during preoperative, postoperative, and follow-up periods. The data included changes in intervertebral space height (ΔH), screw failure, cement leakage (CL), and intervertebral fusion. The patients were divided into two groups based on their fusion status one year after surgery: satisfied group A and dissatisfied group B. Surgical data such as operation time, intraoperative bleeding volume and surgical complications were recorded, and visual analog scale (VAS) and Oswestry disability index (ODI) were used to evaluate the improvement of lumbar and leg pain. Results The mean follow-up time was 101.29 months (ranging from 70 to 128 months). A total of 320 CICPS were used, with 26 screws (8.13%) leaking, 3 screws (0.94%) experiencing cement augmentation failure, and 1 screw (0.31%) becoming loose and breaking. The remaining screws were not loose or pulled out. Female gender, decreased bone density, and CL were identified as risk factors affecting interbody fusion (P

Abstract Background Uterine artery embolisation is a recommended method of adenomyosis treatment with good clinical results. Changes in uterine volume and maximal junctional zone thickness (JZmax) after embolisation are thoroughly analyzed in the literature. In contrast changes in other suggested morphological diagnostic markers of adenomyosis (junctional zone differential / JZdiff—and junctional zone ratio / JZratio) are rarely evaluated. This single-centre retrospective study aimed to analyse the changes in morphological parameters used for the MR imaging diagnosis of adenomyosis (including JZdiff and JZratio) after UAE. Clinical effectiveness and safety were also analysed. Materials and methods Patients who underwent UAE for pure adenomyosis from Jan 2008 to Dec 2021 were evaluated. Adenomyosis was diagnosed based on JZmax, JZdiff, and JZratio measured on MR imaging. To assess clinical efficacy, the numerical-analog-quality-of-life (QoL) score was routinely obtained from patients at our centre. MRI morphological data were analysed. Statistical analysis was conducted using Wilcoxon signed-rank test, uni- and multivariate regression models, Pearson product-moment correlation, and Kruskal–Wallis tests. Results From our database of 801 patients who underwent UAE between Jan 2008 to Dec 2021, preprocedural MR images were available in 577 cases and, 15 patients had pure adenomyosis (15/577, 2.6%). Uterine volume, JZmax, and JZdiff decreased significantly after UAE; QoL score increased significantly. A significant correlation was found between QoL change vs. JZmax and JZdiff change. Permanent amenorrhoea and elective hysterectomy 5 years after UAE were both 7.1%. Conclusion Change of JZdiff after UAE in adenomyosis is a potential marker of clinical success. UAE is a clinically safe and effective treatment for adenomyosis. Graphical Abstract

Lixia Li,1,&ast; Xiaohui Huang,1,&ast; Jingxian Liu,2,&ast; Chao Li,1 Zhiyan Lin,1 Rongrong Ren,3 Yan Zhang,3 Haoshu Ding,3 Jihui Chen,1 Yanfei Mao3 1Department of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2Department of Clinical Laboratory, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 3Department of Anesthesiology and SICU, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yanfei Mao; Jihui Chen, Email maoyanfei@xinhuamed.com.cn; chenjihui@xinhuamed.com.cnBackground: Polymyxin B (PMB)-based combination therapies are used to treat severe carbapenem-resistant gram-negative bacterial (CR-GNB) infections. This observational study investigated the relationship between clinical factors, including PMB concentration, and clinical efficacy and safety.Patients and Methods: Polymyxin B regimens were optimized through therapeutic drug monitoring (TDM) and area under the concentration-time curve (AUC). In all, 382 samples were tested from 130 patients. Logistic regression was used to analyze the relationships between variables with clinical efficacy and 30-day mortality factors were analyzed by Cox regression. The sensitivity and specificity of Cmin and AUC for the occurrence of acute kidney injury (AKI) were determined by ROC curve analysis.Results: The clinical effectiveness of PMB was 65.4%. Multivariate logistic regression analysis revealed that lung infection, continuous renal replacement therapy, and C-reactive protein were independent factors significantly associated with efficacy. AKI occurred in 14.6% of the patients during treatment; age > 73 years (OR: 3.63; 95% CI: 1.035– 12.727; P = 0.044), Cmin greater than 2.3 μg/mL (OR: 7.37; 95% CI: 1.571– 34.580; P = 0.011), combined vancomycin (OR: 9.47; 95% CI: 1.732– 51.731; P = 0.009), and combined piperacillin-tazobactam (OR: 21.87; 95% CI: 3.139– 152.324; P = 0.002) were independent risk factors. The identified PMB cut-offs for predicting AKI were Cmin = 2.3 μg/mL and AUC = 82.0 mg h/L.Conclusion: Polymyxin B-based combination regimens are effective in treating CR-GNB infections, particularly bloodstream infections, but have shown unsatisfactory for lung infections. Cmin ≥ 2.3 μg /mL and AUC ≥ 82.0 mg h/L may increase PMB-associated AKI incidence. PMB dose should be adjusted based on TDM to ensure efficacy.Keywords: Polymyxin B, PMB therapeutic drug monitoring, TDM, carbapenem-resistant gram-negative bacteria, CR-GNB, clinical efficacy, acute kidney injury, AKI

Background Chronic atrophic gastritis (CAG) with intestinal metaplasia (IM) is an independent risk factor for gastric cancer. Long-term inflammation and oxidative stress response stimulate the physical and mental state of patients. Under the modern medical model, proton pump inhibitors and gastric mucosal protective agents are increasingly unable to meet the high drug resistance of patients. It is urgent to seek effective new Chinese medicine treatments and multiple methods to treat CAG and IM. Objective To evaluate the clinical efficacy and safety of modified Piwei Peiyuan Decoction combined with acupuncture in the treatment of CAG with IM. Methods From January 2022 to September 2023, 202 patients with CAG and IM diagnosed by gastroscopy and pathological examination in the Department of Spleen and Stomach, the Center for Preventive Treatment of Disease, the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine and the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine were selected. The patients were divided into control group (n=67), treatment group A (n=68) and treatment group B (n=67) by random number table method. All patients participated in 6 weeks of treatment: (1) Control group: aluminum magnesium suspension combined with folic acid tablets (3 times/d) ; (2) Treatment group A: to add and subtract syndrome types of Piwei Peiyuan Decoction (2 times/d) ; (3) Treatment group B: Piwei Peiyuan Decoction (the same as group A) combined with acupuncture (1 time/d), with Zusanli, Liangqiu, Gongsun, Neiguan, Zhongwan as the main points, according to the syndrome type selection of acupoints. Before and 6 weeks after treatment, OLGA, OLGIM staging, gastric mucosal pathological efficacy, gastric mucosal pathological score, clinical symptom score, PRO scale score, drug-related adverse events (AE) and adverse drug reactions (ADR) were recorded. Results A total of 192 patients completed the 6-week course of treatment (62 in the control group, 66 in the treatment group A, and 64 in the treatment group B). The effective rate of the control group was 48.39% (30/62), the effective rate of the treatment group A was 69.70% (46/66), and the effective rate of the treatment group B was 71.88% (46/64). There was a statistically significant difference in the effective rate among the three groups (χ2=9.144, P=0.01). After treatment, the gastric mucosal pathological score, clinical symptom score and PRO scale score in the three groups were lower than those in the same group before treatment (P0.05) . Conclusion The overall clinical efficacy of Piwei Peiyuan Decoction combined with acupuncture is better than that of aluminum magnesium suspension combined with folic acid tablets, which is better than that of traditional antacids and gastric mucosal protective agents.