Objective　To investigate the correlation between serum adenosine deaminase (ADA) level and prognosis of intravenous thrombolysis in patients with acute cerebral infarction (ACI). Methods　This study was a cohort study. A total of 188 ACI patients who received intravenous thrombolysis in Yan'an University Xianyang Hospital from May 2021 to March 2023 were selected as the study objects, including 105 males and 83 females, aged 51-76 (64.25±6.94) years. All 188 patients were treated with intravenous thrombolysis and were admitted to hospital for re-examination 90 days later. The general data [gender, age, weight, smoking history, underlying diseases, National Institutes of Health Stroke Scale (NIHSS) score at admission, time from onset to thrombolysis, etc.], laboratory indicators [low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), platelet count (PLT), fibrinogen (Fib), etc.], serum ADA, adenosine, and uric acid levels, and modified Rankin scale (MRS) score were collected. Independent sample t test and χ² test were used for statistical analysis. The correlation analysis was carried out by Pearson correlation analysis. Multivariate logistic regression analysis was used to analyze the factors affecting the prognosis in patients with ACI. The value of serum ADA level in predicting poor prognosis in ACI patients was analyzed by receiver operating characteristic curve (ROC). Results　According to the MRS score of 188 ACI patients who received intravenous thrombolysis, 127 (67.55%) had good prognosis and 61 (32.45%) had poor prognosis. The NIHSS score at admission and serum LDL-C, Fib, ADA, and uric acid levels of the poor prognosis group were higher than those of the good prognosis group [(13.97±3.95) points vs. (11.81±3.90) points, (2.95±0.66) mmol/L vs. (2.46±0.73) mmol/L, (3.32±0.78) g/L vs. (2.63±0.73) g/L, (21.30±6.62) U/L vs. (16.40±5.39) U/L, (306.42±50.29) μmol/L vs. (269.76±50.37) μmol/L], and the level of serum adenosine was lower than that of the good prognosis group [(261.62±85.29) μg/L vs. (312.47±93.40) μg/L] (all P<0.05). Pearson correlation analysis showed that serum ADA level was positively correlated with NIHSS score and serum LDL-C, Fib, and uric acid levels, and was negatively correlated with serum adenosine level in ACI patients (all P<0.05). Multivariate logistic regression analysis showed that NIHSS score at admission and serum LDL-C, Fib, ADA, and uric acid levels were all risk factors for poor prognosis of intravenous thrombolysis in ACI patients, and serum adenosine level was a protective factor (all P<0.05). The area under the curve of serum ADA level for predicting poor prognosis of ACI patients was 0.727 (95% CI: 0.654-0.801), with a critical value of 17.25 U/L, sensitivity of 70.5%, and specificity of 71.7%. Conclusion　Serum ADA level is negatively correlated with the prognosis of intravenous thrombolysis in ACI patients, and high ADA level may indicate poor prognosis of intravenous thrombolysis.

Objective　To study the efficacy of recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) thrombolysis combined with atorvastatin calcium in patients with acute cerebral infarction (ACI). Methods　This study was a randomized controlled trial. A total of 90 ACI patients admitted to Department of Neurology, The Third Affiliated Hospital of Xi'an Medical University from May 2021 to December 2023 were selected as the study objects. The patients were divided into a control group (45 cases) and an observation group (45 cases) by the random number table method. The control group included 23 males and 22 females, aged (51.47±7.70) years, with a body mass index (BMI) of (24.12±2.69) kg/m². The observation group included 26 males and 19 females, aged (53.18±8.45) years, with a BMI of (23.68±2.40) kg/m². The control group was treated with rhTNK-tPA thrombolytic therapy, and the observation group was treated with atorvastatin calcium based on the control group. Both groups were treated for 2 weeks and followed up for 6 months. The clinical efficacy, serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), myelin basic protein (MBP), and lipoprotein-associated phospholipase A2 (Lp-PLA2) before and after treatment, neurological function [National Institutes of Health Stroke Scale (NIHSS) score] and motor function [Fugl-Meyer Motor Function Assessment (FMA) score] before and after treatment and 3 months after treatment, occurrence of adverse drug reactions during treatment, and prognosis (death, vascular recanalization, and intracranial hemorrhage) during follow-up were compared between the two groups. Independent sample t test, χ² test and Fisher exact probability method were used for statistical analysis. Results　The total effective rate of the observation group was higher than that of the control group [93.33% (42/45) vs. 77.78% (35/45)] (P<0.05). After treatment, the levels of serum sICAM-1, MBP, and Lp-PLA2 in the observation group were lower than those in the control group [(291.45±22.81) μg/L vs. (308.62±23.50) μg/L, (2.24±0.41) μg/L vs. (2.58±0.46) μg/L, (142.71±20.56) μg/L vs. (157.31±19.40) μg/L] (all P<0.05). After treatment and 3 months after treatment, the NIHSS scores in the observation group were lower than those in the control group, and the FMA scores were higher than those in the control group [(5.56±1.08) points vs. (5.90±1.39) points, (3.64±0.75) points vs. (3.90±0.86) points, (68.73±10.46) points vs. (62.41±9.22) points, (79.44±10.34) points vs. (73.51±9.83) points] (all P<0.05). During treatment, there was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). After 6 months of follow-up, the vascular recirculation rate in the observation group was higher than that in the control group [95.56% (43/45) vs. 82.22% (37/45)] (P<0.05). Conclusion　rhTNK-tPA combined with atorvastatin calcium in the treatment of ACI patients can improve the clinical efficacy, serum sICAM-1, MBP, and Lp-PLA2 levels and exercise ability, and increase the vascular revascularization rate, which is safe and reliable.

Objective　To investigate the clinical effect of ozagrel trometamol and clopidogrel bisulfate dual antiplatelet therapy combined with traditional Chinese medicine in the treatment of progressive ischemic stroke. Methods　A total of 100 patients with progressive ischemic stroke without intravenous thrombolysis or intravascular thrombolysis were selected from Guangdong Sanjiu Brain Hospital from January 2022 to January 2023. The patients were divided into a control group (50 cases) and an experimental group (50 cases) by the random number table method. There were 23 males and 27 females in the experimental group, aged (62.21±10.77) years. There were 26 males and 24 females in the control group, aged (60.52±11.27) years. The control group was treated with clopidogrel bisulfate + ginkgo diterpene lactone meglumine, and the experimental group was treated with ozagrel trometamol on the basis of the control group. Both groups were treated for 14 days. The scores of National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI) of daily living ability before and after treatment, treatment effect, and occurrence of adverse drug reactions during treatment were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After treatment, the NIHSS score of the experimental group was lower than that of the control group [(16.62±3.07) points vs. (21.13±3.27) points], and the BI score of the experimental group was higher than that of the control group [(90.17±7.25) points vs. (84.41±7.05) points] (both P<0.05). The total effective rate of the experimental group was higher than that of the control group [90.00% (45/50) vs. 50.00% (25/50)] (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups [4.00% (2/50) vs. 0] (P>0.05). Conclusion　Ozagrel trometamol and clopidogrel bisulfate dual antiplatelet therapy combined with traditional Chinese medicine has a good effect on the treatment of progressive ischemic stroke, which has reference significance for the clinical treatment of progressive ischemic stroke.

Objective　To study the efficacy of Xingnaokaiqiao acupuncture combined with acupoint injection on patients with Qi deficiency and blood stasis syndrome of spastic upper limb paralysis after ischemic stroke (IS). Methods　This study was a randomized controlled trial. A total of 100 patients with Qi deficiency and blood stasis syndrome of spastic upper limb paralysis after IS treated in Ankang Hospital of Traditional Chinese Medicine from December 2021 to September 2023 were selected as the study objects. The patients were divided into an observation group (50 cases) and a control group (50 cases) by the random number table method. The observation group withdrew 1 case due to type 2 diabetes, 1 case due to pneumonia, and the control group withdrew 1 case due to hypertension. Finally, 97 cases were included. In the observation group, there were 25 males and 23 females, aged 41-76 (58.54±8.29) years, and the duration of disease was (1.63±0.27) months. In the control group, there were 22 males and 27 females, aged 40-74 (57.06±8.73) years, and the duration of disease was (1.52±0.31) months. The control group was given standardized stroke rehabilitation treatment, and the observation group was given Xingnaokai acupuncture combined with acupoint injection based on the control group. Both groups were treated for 2 weeks. The clinical efficacy and spasmodic degree [modified Ashworth Scale (MAS)], motor function [Fugl-Meyer Motor Function Assessment (FMA)], and ultrasonic shear wave velocity (SWV) of skeletal muscle (biceps, triceps, and brachioradialis) before and after treatment were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total effective rate of the observation group was higher than that of the control group [89.58% (43/48) vs. 73.47% (36/49)] (P<0.05). After treatment, the MAS score in the observation group was lower than that in the control group, and the FMA score was higher than that in the control group [(1.02±0.26) points vs. (1.44±0.25) points, (28.13±5.53) points vs. (20.29±5.01) points] (both P<0.05). The SWV of biceps, triceps, and brachioradialis in the observation group were lower than those in the control group [(1.59±0.19) m/s vs. (1.93±0.22) m/s, (1.61±0.20) m/s vs. (1.97±0.19) m/s, (1.54±0.15) m/s vs. (1.86±0.22) m/s] (all P<0.05). Conclusion　Xingnaokaiqiao acupuncture combined with acupoint injection can improve the clinical symptoms in patients with Qi deficiency and blood stasis syndrome of spastic upper limb paralysis after IS, reduce the degree of spasm of the affected limb, and improve the mobility of the affected limb.

Objective　To observe the effects of traditional Chinese medicine (TCM) acupuncture combined with Otago exercise on psychological disorders and quality of life in stroke patients. Methods　This study was a randomized controlled trial. A total of 130 stroke patients with severe psychological disorders admitted to the Department of Neurology of Baoji Central Hospital from January 2020 to May 2023 were selected as the study objects. The patients were divided into a combined treatment group (65 cases) and a control group (65 cases) using the random number table method. In the control group, there were 33 males and 32 females, aged (65.47±8.61) years, and the course of disease was (16.89±3.62) months. In the combined treatment group, there were 34 males and 31 females, aged (66.52±7.99) years, and the course of disease was (15.91±4.23) months. The control group received conventional basic neuropharmacological treatment, and the combined treatment group received TCM acupuncture combined with Otago exercise on the basis of the control group. Both groups were treated for 4 weeks. The stroke recovery [National Institutes of Health Stroke Scale (NIHSS) and Mini-Mental State Examination (MMSE)], cognitive function and language function [Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE)], psychological recovery [Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)], and daily living ability and quality of life [Barthel Index of daily living ability (BI) and World Health Organization Quality of Life Assessment (WHOQOL-BREF)] were compared between the two groups before and after treatment. Independent sample t test and χ² test were used for statistical analysis. Results　After treatment, the NIHSS score of the combined treatment group was lower than that of the control group [(8.85±2.89) points vs. (10.22±3.14) points], and the MMSE score was higher than that of the control group [(17.73±3.07) points vs. (15.82±3.62) points] (both P<0.05); the CRRCAE scores in the combined treatment group were higher than those in the control group (all P<0.05); the HAMD and HAMA scores in the combined treatment group were lower than those in the control group [(10.89±2.93) points vs. (12.81±3.62) points, (11.62±2.45) points vs. (13.09±3.52) points] (both P<0.05); the BI and WHOQOL-BREF scores in the combined treatment group were higher than those in the control group [(88.54±11.34) points vs. (83.26±15.13) points, (85.43±11.39) points vs. (79.74±10.62) points] (both P<0.05). Conclusion　TCM acupuncture combined with Otago exercise can improve the psychological disorders and quality of life in stroke patients.

Objective　To investigate the therapeutic effect of bedside unarmed limb movement training combined with the new Bobath technique in patients with post-stroke shoulder-hand syndrome. Methods　A total of 80 patients with post-stroke shoulder-hand syndrome who received treatment in the First Affiliated Hospital of Xi'an Medical College from November 2020 to December 2023 were selected as the study objects. The patients were divided into an observation group (40 cases) and a control group (40 cases) by the random number table method. There were 23 males and 17 females in the observation group, aged 53-75 (64.18±5.27) years, the course of disease was 40-69 (55.13±6.58) days, and the type of stroke was cerebral hemorrhage in 23 cases and cerebral infarction in 17 cases. There were 19 males and 21 females in the control group, aged 52-75 (63.59±5.43) years, the course of disease was 39-69 (54.38±7.28) days, and the type of stroke was cerebral hemorrhage in 28 cases and cerebral infarction in 12 cases. The control group received the new Bobath technique, and the observation group received bedside unarmed limb movement training based on the control group. Both groups were treated for 4 weeks. The clinical efficacy and treatment satisfaction of the two groups were compared, as well as pain degree [Visual Analogue Scale (VAS)], upper limb motor function [Fugl-Meyer Motor Function Assessment (FMA)], shoulder motion (anterior flexion, abduction, and external rotation), and quality of life [modified Barthel index (MBI)] before and after treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total effective rate and total satisfaction of the observation group were higher than those of the control group [90.00% (36/40) vs. 70.00% (28/40), 92.50% (37/40) vs. 75.00% (30/40)] (both P<0.05). After treatment, the VAS score of the observation group was lower than that of the control group [(3.13±0.48) points vs. (3.41±0.53) points], and the FMA score and MBI score were higher than those of the control group [(40.50±5.72) points vs. (37.77±5.68) points, (63.33±6.48) points vs. (59.66±5.12) points] (all P<0.05). The shoulder joint anterior flexion, abduction, and external rotation in the observation group were higher than those in the control group [(71.84±8.51)° vs. (67.32±8.19)°, (89.50±4.32)° vs. (84.77±4.68)°, (40.33±3.13)° vs. (36.52±3.07)°] (all P<0.05). Conclusion　Bedside unarmed limb movement training combined with the new Bobath technique has a good therapeutic effect in patients with post-stroke shoulder-hand syndrome, which can improve the patients' shoulder joint mobility and daily living ability, reduce the pain, and has a high treatment satisfaction degree.

Objective　To analyze the effects of virtual situational interactive training on motor function, daily activity ability, and quality of life in patients after stroke surgery. Methods　This study was a randomized controlled trial. A total of 88 patients after stroke surgery admitted to Ankang Hospital of Traditional Chinese Medicine from September 2021 to September 2023 were selected as the study objects, and the patients were randomly divided into a control group (44 cases) and an observation group (44 cases). In the control group, there were 20 males and 24 females, aged (62.43±2.01) years, the course of disease was (1.41±0.32) years, and the type of stroke was ischemic stroke in 27 cases and hemorrhagic stroke in 17 cases. In the observation group, there were 25 males and 19 females, aged (61.98±2.33) years, the course of disease was (1.37±0.40) years, and the type of stroke was ischemic stroke in 26 cases and hemorrhagic stroke in 18 cases. The control group received routine nursing, and the observation group received virtual situational interactive training based on the control group. Both groups were treated for 30 days. The motor function [Fugl-Meyer Motor Function Assessment (FMA)] and daily activity ability [modified Barthel Index (MBI)] of the two groups were compared 1, 15, and 30 days after surgery, and the quality of life [EuroQol Five-Dimensional Questionnaire (EQ-5D)] of the two groups were compared 1 and 30 days after surgery. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　On day 15 and 30 after surgery, the FMA scores in the observation group were higher than those in the control group [(20.76±2.86) points vs. (19.20±2.75) points, (28.81±1.47) points vs. (26.12±1.08) points] (both P<0.05); the MBI scores in the observation group were higher than those in the control group [(6.89±1.01) points vs. (5.76±1.03) points, (8.43±1.01) points vs. (7.21±1.26) points] (both P<0.05). On day 30 after surgery, the scores of mobility, self-management, activity, pain or discomfort, and anxiety or depression of the EQ-5D in the observation group were all higher than those in the control group [(2.01±0.64) points vs. (1.78±0.14) points, (1.95±0.43) points vs. (1.77±0.34) points, (1.82±0.26) points vs. (1.69±0.27) points, (2.01±0.27) points vs. (1.90±0.12) points, (1.92±0.14) points vs. (1.81±0.30) points] (all P<0.05). Conclusion　Virtual situational interactive training can improve the motor function, daily activity ability, and quality of life in patients after stroke surgery.

Alzheimer's disease (AD) is a degenerative disease of the central nervous system, whose pathogenesis is complex and diverse. The activation of the Wnt/β-catenin signaling pathway plays a key role in regulating inflammatory responses, improving synaptic function, and anti-oxidative stress in AD. This article elaborates that the Wnt/β-catenin signaling pathway may become a new therapeutic target for AD, providing a new research direction for the treatment of AD in the future.

Osteoarthritis is a common chronic degenerative disease in orthopedic clinical practice, and there is currently no clear treatment method to prevent or reverse knee osteoarthritis. Platelet rich plasma (PRP) is a plasma product rich in platelets, which has significant advantages in alleviating inflammation and repairing cartilage damage. In recent studies, PRP has become a new tool with promising therapeutic prospects for knee osteoarthritis. This article provides an overview of the clinical applications and trials of PRP conducted by recent scholars, providing reference for clinical practice.

Objective　To analyze the medication rules of traditional Chinese medicine (TCM) in the treatment of steroid-induced osteonecrosis of the femoral head (SONFH), in order to provide theoretical support and reference for the clinical medication of SONFH. Methods　The relevant literatures on the treatment of SONFH with TCM were searched in the National Knowledge Infrastructure Database (CNKI) and WanFang Data Knowledge Service Platform (WanFang) from July 2005 to July 2024, and the TCM included in the prescriptions was processed and standardized. WPS table, SPSS Statistics 25.0, SPSS Modeler18.0, and other software were used to analyze the drug frequency, property-flavor-meridians, association rules, and cluster analysis of TCM in the treatment of SONFH. Results　A total of 410 relevant literatures were searched and 31 were included. A total of 36 prescriptions were selected, involving 101 kinds of TCM, mainly involving 4 flavors, 3 properties, 12 meridians, and 17 drug categories. High frequency drugs included angelica sinensis, Astragalus membranaceus, Salvitis miltiorrhiza, Chuanxiong, Rehmannia Rehmannia, Achyranthes ulcommia, bone crushing supplement, Tuckaia poria, teasel root and so on. The medicinal properties were mainly warm, flat, and mild, and the flavors were mainly sweet, xin, bitter, and salty. The main meridians were liver meridian, kidney meridian, spleen meridian, heart meridian, and lung meridian. Efficacy categories of tonifying vacuity drugs, promoting blood circulation and removing blood stasis drugs, wind-dampness drugs were more common. Association rules obtained "Chuanxiong - Angelica", "Achyranthus - Angelica", "drynaria rhizome - Angelica", "Eucommia - Angelica", and other core drug pairs. The cluster analysis classified the drugs into 6 categories. Conclusions　The main pathogenesis of SONFH is kidney deficiency, phlegm dampness, and blood stasis. The treatment principle is "warming meridians and clearing collaterals, activating blood and relieving pain, tonifying liver and kidney, invigorating spleen and removing dampness". The main drugs used are warm, flat, and mild warm. The main meridian involved is liver meridian, followed by kidney meridian, spleen meridian, heart meridian, and lung meridian. The main therapeutic drugs are tonifying deficiency, promoting blood circulation and removing blood stasis, dispelling wind-dampness and rehydrating dampness.

Objective　To analyze the relationship between serum triglyceride-glucose index (TyG index) and coronary artery calcification (CAC), and investigate the risk factors of CAC. Methods　A retrospective analysis was performed on 399 subjects who underwent coronary angiography with chest tightness or chest pain as the main complaint in the Department of Cardiology, Baoji Central Hospital from January 2022 to January 2024. Among them, there were 192 males and 207 females, aged (66.35±11.48) years. The patients were divided into a CAC group (245 cases) and a non-CAC group (154 cases) according to the presence or absence of CAC. The differences of clinical indicators were compared between the two groups, the influencing factors of CAC were evaluated by binary logistic regression analysis, and the diagnostic value of TyG index and other indicators for CAC was evaluated by the receiver operating characteristic curve (ROC). Independent sample t test, rank sum test, χ² test, and Spearman correlation analysis were used for statistical analysis. Results　The age, triglyceride (TG), fasting blood glucose (FBG), serum creatinine, uric acid, N-terminal brain natriuretic peptide precursor (NT-proBNP), D-dimer, TyG index, and male and smoking ratios in the CAC group were all higher than those in the non-CAC group, while the high-density lipoprotein cholesterol (HDL-C) and diastolic blood pressure in the CAC group were lower than those in the non-CAC group, with statistically significant differences (all P<0.05). Spearman correlation analysis showed that CAC was positively correlated with age, TyG index, and uric acid, and was negatively correlated with HDL-C (r=0.424, 0.151, 0.196, and -0.152, all P<0.05). Binary logistic regression analysis showed that age (OR=1.087, 95%CI 1.064-1.111, P<0.001), male (OR=1.830, 95%CI 1.215-2.757, P=0.004), TG (OR=1.364, 95%CI 1.071-1.739, P=0.012), FBG (OR=1.191, 95%CI 1.079-1.314, P=0.001), TyG index (OR=1.589, 95%CI 1.177-2.145, P=0.002), serum creatinine (OR=1.018, 95%CI 1.009-1.028, P<0.001), and uric acid (OR=1.003, 95%CI 1.001-1.005, P=0.001) were independent risk factors for CAC, while HDL-C (OR=0.546, 95%CI 0.399-0.880, P=0.013) was a protective factor. ROC analysis showed that the area under the curve of TyG index combined with age was the largest [0.753 (95%CI 0.704-0.802), P<0.001]. Conclusion　Age, male, TG, FBG, TyG index, serum creatinine, and uric acid are independent risk factors for CAC, and TyG index combined with age has good diagnostic value for CAC.

Objective　To investigate the correlation between Napsin A expression and the efficacy of second or later-line bevacizumab combined with chemotherapy in the treatment of advanced lung adenocarcinoma. Methods　The clinical data of 103 patients with stage IIIB-IV lung adenocarcinoma admitted to the 901st Hospital of the Joint Logistics Support Force of PLA from January 2018 to March 2022 were retrospectively analyzed. The expression of Napsin A protein was detected by the immunohistochemical EnVision method, and the mutations of epidermal growth factor receptor (EGFR), KRAS, and TP53 were detected by the amplification arrest mutation system (ARMS). The influencing factors of short-term efficacy, progression-free survival (PFS), and overall survival (OS) in patients with advanced lung adenocarcinoma treated with second or later-line bevacizumab combined with chemotherapy were analyzed. Follow-up was completed on December 31, 2023. χ² test was used for comparison between groups. Kaplan-Meier method was used to plot the survival curve and Log-rank test was used for comparison between groups. Cox proportional hazards regression model was used for multivariate analysis. Results　Among the 103 patients with advanced lung adenocarcinoma, there were 58 males and 45 females, with a median age of 63 years old, 30 cases had a history of smoking, 31 cases had brain metastases, and there were 67 cases of second-line treatment and 36 cases of third or later-line treatment. The chemotherapy regimens included pemetrexed and platinum in 73 cases, pemetrexed alone in 16 cases, docetaxel in 7 cases, and paclitaxel in 7 cases. The number of treatment cycles was ≥4 in 67 cases and <4 in 36 cases. There were 12 cases of KRAS mutation (11.7%), 18 cases of TP53 mutation (17.5%), and 50 cases of EGFR mutation (48.5%). There were 76 cases (73.8%) of Napsin A positive. The objective response rate (ORR) was 32.0% (33/103), and the disease control rate (DCR) was 79.6% (82/103); the DCR of Napsin A-negative patients was lower than that of Napsin A-positive patients (P<0.001). The median PFS was 6.4 months (95%CI: 5.9-6.9), and univariate analysis showed that the patients' PFS was related to the number of treatment lines (P=0.009), treatment cycle (P<0.001), Napsin A expression (P<0.001), KRAS mutation (P=0.012), and TP53 mutation (P=0.045). The median OS was 12.7 months (95%CI: 10.5-14.9), and univariate analysis showed that the patients' OS was related to treatment cycle (P=0.020), KRAS mutation (P=0.046), and Napsin A expression (P=0.001). Multivariate Cox regression analysis showed that Napsin A positivity (P=0.020), number of treatment cycles ≥4 (P=0.004), second-line treatment (P=0.009), and wild-type KRAS (P=0.012) were independent protective factors for PFS; Napsin A positivity (P=0.013) and wild-type KRAS (P=0.042) were independent protective factors for OS. Conclusion　Patients with advanced lung adenocarcinoma receiving second or later-line bevacizumab combined with chemotherapy have definite efficacy, and Napsin A positive and wild-type KRAS patients have better prognosis.

Objective　To explore the influence of acupoint thread embedding combined with Jianpi Qingfei Decoction on traditional Chinese medicine (TCM) syndrome and prognosis of non-small cell lung cancer patients with spleen-lung Qi deficiency syndrome after chemotherapy. Method　A total of 140 non-small cell lung cancer patients with spleen-lung Qi deficiency syndrome after chemotherapy in Shaanxi Provincial Hospital of Traditional Chinese Medicine from May 2022 to January 2024 were selected and were randomly divided into two groups by drawing lots, with 70 cases in each group. There were 45 males and 25 females in the study group, aged (59.26±5.00) years; there were 25 cases of stage Ⅲ and 45 cases of stage Ⅳ; there were 30 cases of squamous cell carcinoma and 40 cases of adenocarcinoma. In the control group, there were 47 males and 23 females, aged (60.14±5.06) years; there were 27 cases of stage Ⅲ and 43 cases of stage Ⅳ; there were 33 cases of squamous cell carcinoma and 37 cases of adenocarcinoma. The control group was treated with Jianpi Qingfei Decoction (400 ml taken warmly twice in the morning and evening), 21 days as 1 cycle, a total of 3 cycles; the study group was treated with acupoint thread embedding on the basis of the control group, once every 10 days, 3 times as a course of treatment, a total of 2 courses of treatment. The TCM syndrome scores, immune cytokines, and tumor markers before and after 63 days of treatment and adverse reactions during treatment were compared between the two groups. t test and χ² test were used for statistical analysis. Results　After treatment, the TCM syndrome scores of both groups were decreased, and those in the study group were lower than those in the control group [cough and phlegm accumulation: (2.11±0.46) points vs. (2.95±0.53) points, fatigue: (2.26±0.16) points vs. (3.31±0.57) points, shortness of breath: (2.11±0.36) points vs. (2.89±0.24) points, loose stools: (1.25±0.43) points vs. (1.60±0.51) points, restlessness: (2.03±0.41) points vs. (3.26±0.53) points], with statistically significant differences (all P<0.05). The levels of squamous cell carcinoma associated antigen (SCC-Ag), gastrin-releasing peptide precursor (ProGRP), carcinoembryonic antigen (CEA), and cytokeratin 19 fragment (CYFRA21-1) in the study group after treatment were lower than those in the control group [(0.94±0.20) μg/L vs. (1.33±0.24) μg/L, (56.24±8.41) ng/L vs. (71.03±10.81) ng/L, (3.21±1.05) μg/L vs. (4.01±1.13) μg/L, (2.03±0.47) μg/L vs. (2.97±0.34) μg/L], with statistically significant differences (all P<0.05). After treatment, the levels of CD4+/CD8+, CD16+CD56+, and interferon (IFN) -γ in the study group were higher than those in the control group, and the level of interleukin-10 was lower than that in the control group, with statistically significant differences (all P<0.05). The incidence of adverse reactions in the study group was 8.57% (6/70), which was lower than that in the control group [22.86% (16/70)], with a statistically significant difference (χ²=5.393, P=0.020). Conclusion　In the treatment of non-small cell lung cancer patients with spleen-lung Qi deficiency syndrome after chemotherapy, acupoint thread embedding combined with Jianpi Qingfei Decoction can alleviate the TCM syndromes, improve the immune function, lower the levels of tumor markers, and has fewer adverse reactions, which can be promoted in clinical practice.

Objective　To study the efficacy of Sintilimab combined with recombinant human endostatin in the treatment of advanced non-small cell lung cancer (NSCLC). Methods　This study was a randomized controlled trial. A total of 62 patients with NSCLC admitted to Xianyang First People's Hospital from June 2019 to June 2022 were divided into an observation group and a reference group according to the random number table method, with 31 cases in each group. In the reference group, there were 20 males and 11 females, aged (66.64±9.59) years, 16 cases of stage ⅢB and 15 cases of stage Ⅳ. In the observation group, there were 19 males and 12 females, aged (65.55±9.16) years, 14 cases of stage ⅢB and 17 cases of stage Ⅳ. Both groups were given albumin-paclitaxel + carboplatin chemotherapy: intravenous infusion with 100 mg/m² of albumin-paclitaxel was given on day 1 and day 8 of the chemotherapy cycle for 30 min; carboplatin was given intravenously on day 1 of the chemotherapy cycle, with the area under the curve (AUC) of 5 mg/(ml·min) each time, with 21 days as a cycle. The reference group was given 15 mg/m² of recombinant human endostatin on the basis, added into 500 ml of normal saline, injected intravenously for 3-4 h, once a day, continuous administration for 14 days and then stopped for 7 days. The observation group was given Sintilimab on the basis of the reference group, 200 mg/time, diluted with 100 ml of normal saline, intravenous infusion for 30-90 min, and used on day 1 of the chemotherapy cycle. Both groups were treated for 3 consecutive cycles. The clinical efficacy, levels of tumor markers [cytokeratin 19 fragment (CYFRA21-1), carcinoembryonic antigen (CEA), and neuron-specific enolase (NSE)], and safety of the two groups were compared, and the survival of the two groups was recorded during 1-year of follow-up. t test, χ² test, and Log-rank test were used for statistical analysis. Results　The objective remission rate and clinical control rate of the observation group were higher than those of the reference group [45.16% (14/31) vs. 19.35% (6/31), 77.42% (24/31) vs. 48.39% (15/31)] (both P<0.05). After treatment, the levels of CEA, CYFRA21-1, and NSE in the observation group were lower than those before treatment and in the reference group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the reference group [19.35% (5/31) vs. 22.58% (7/31)] (P>0.05). At 1 year of follow-up, 1 and 2 cases were lost and 16 and 10 cases survived in the observation and reference groups, respectively, and the total survival curve of the observation group was better than that of the reference group by Log-rank test (χ²=6.987, P=0.010). Conclusion　Sintilimab combined with recombinant human endostatin in the treatment of NSCLC is effective, can reduce the levels of tumor markers, has good safety, and can prolong the patients' short-term survival.

Objective　To explore the clinical efficacy of the combination of furmonertinib and gemcitabine plus cisplatin (GC) chemotherapy regimen in patients with non-small cell lung cancer (NSCLC). Methods　A total of 92 patients with NSCLC admitted to Xi'an Daxing Hospital from April 2021 to August 2022 were prospectively selected and were divided into two groups with 46 cases in each group by computer random number method. In the control group, there were 21 males and 25 females, aged (59.32±6.59) years, 34 cases of stage Ⅲ and 12 cases of stage Ⅳ, 26 cases of squamous cell carcinoma and 20 cases of adenocarcinoma. In the observation group, there were 24 males and 22 females, aged (58.41±6.37) years, 31 cases of stage Ⅲ and 15 cases of stage Ⅳ, 23 cases of squamous cell carcinoma and 23 cases of adenocarcinoma. The control group was given GC chemotherapy regimen: on day 1 to day 3, 25 mg/m² of cisplatin was mixed with 250 ml of normal saline for intravenous infusion, once a day; on day 1 and 8, 1 000 mg/m² of gemcitabine was mixed with 250 ml of normal saline for intravenous infusion, 21 days as a chemotherapy cycle, for a total of 2 cycles. The observation group was given furmonertinib combined with GC chemotherapy regimen: GC chemotherapy regimen was the same as the control group, and oral furmonertinib was added since the first day of chemotherapy, 40 mg each time, twice a day, for a total of 2 cycles. The efficacy, tumor markers, angiogenesis related factors, and drug safety were compared between the two groups. The patients were followed up for 1 year and the survival rates of the two groups were compared. χ² test, t test, and Log-rank test were used for statistical analysis. Results　The objective remission rate (ORR) [52.18% (24/46) vs. 28.26% (13/46)] and disease control rate (DCR) [93.48% (43/46) vs. 78.26% (36/46)] in the observation group were higher than those in the control group (both P<0.05). In the observation group, the levels of carcinoembryonic antigen (CEA) [(10.33±1.47) μg/L vs. (11.49±1.64) μg/L], neuron-specific enolase (NSE) [(13.52±1.93) μg/L vs. (14.76±2.11) μg/L], cytokeratin 19 fragment (CYFRA21-1) [(2.18±0.39) μg/L vs. (2.43±0.44) μg/L], carbohydrate antigen 125 (CA125) [(36.25±4.53) U/ml vs. (39.47±4.93) U/ml], vascular endothelial growth factor (VEGF) [(365.48±45.69) ng/L vs. (395.47±49.43) ng/L], matrix metalloproteinase 9 (MMP-9) [(101.21±11.25) mg/L vs. (107.68±11.96) mg/L], platelet-derived growth factor (PDGF) [(1 511.62±167.95) ng/L vs. (1 623.40±180.38) ng/L] were lower than those in the control group (all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). The survival rate of the observation group was higher than that of the control group [89.13% (41/46) vs. 69.56% (32/46)] (P<0.05). Conclusion　The combination of furmonertinib and GC chemotherapy regimen for NSCLC patients can reduce the levels of tumor markers and angiogenesis related factors, inhibit tumor proliferation, improve efficacy, and has high drug safety and survival rate.

Objective　To investigate the influencing factors of class Ⅱ incision infection after radical operation for non-small cell lung cancer (NSCLC). Methods　Sixty-two patients with class Ⅱ incision infection after radical operation for NSCLC in Ankang Hospital of Traditional Chinese Medicine from March 2018 to March 2022 were retrospectively selected as an infection group, and 85 patients who did not have incision infection were selected as a control group. The clinical data of all the patients were collected, and the influencing factors of class Ⅱ incision infection after radical operation for NSCLC were analyzed by logistic regression analysis. The secretions from the incision of infected patients were collected for pathogen detection. χ² test and independent sample t test were used for statistical analysis. Results　In the infection group, there were 39 males and 23 females, aged (64.29±5.88) years. In the control group, there were 49 males and 36 females, aged (56.74±6.43) years. There was no statistically significant difference in the gender, intraoperative blood loss, smoking history, diabetes, or hypertension between the two groups (all P>0.05). The age in the infection group was older than that in the control group, the operation time was longer than that in the control group, and the proportions of thoracotomy, having visitors, and irrational use of antibiotics were higher than those in the control group (all P<0.05). Multivariate logistic regression analysis showed that age, operation time, operation method, whether there were visitors, and whether antibiotics were used rationally were the influencing factors of class Ⅱ incision infection after radical operation for NSCLC (all P<0.05). Sixty-two patients with class Ⅱ incision infection after radical operation for NSCLC were tested for pathogenic bacteria, and 96 strains were obtained. There were 54 strains of Gram-negative bacteria, accounting for 56.25%, among which Escherichia coli (27 strains, 28.13%) was the main strain; there were 40 strains of Gram-positive bacteria, accounting for 41.67%, among which Staphylococcus aureus (19 strains, 19.79%) was the main strain; there were 2 strains of fungi, accounting for 2.08%. Conclusions　The pathogenic bacteria in patients with class Ⅱ incision infection after radical operation for NSCLC are mainly Gram-negative bacteria. Age, operation time, operation method, whether there are visitors, and whether antibiotics are used rationally are the influencing factors of class Ⅱ incision infection after radical operation for NSCLC.

Objective　To investigate the clinical effect of endovascular spring coil interventional embolization in the treatment of splenic artery aneurysm through the distal radial artery approach. Methods　The clinical data of 56 patients with splenic artery aneurysm who received endovascular coil interventional embolization in Xi'an Third Hospital from December 2021 to December 2023 were retrospectively analyzed. The patients were divided into two groups according to the different surgical approaches: 25 patients who took the distal radial artery approach through the anatomical snuff bottle area were classified as a distal radial artery group, and 31 patients who took the femoral artery approach were classified as a femoral artery group. In the distal radial artery group, there were 15 males and 10 females, aged (55.2±8.5) years, with a tumor diameter of (3.9±1.3) cm. In the femoral artery group, there were 17 males and 14 females, aged (54.4±8.3) years, with a tumor diameter of (3.7±1.2) cm. The operation status, complication rate, and postoperative follow-up results were compared between the two groups. Independent sample t test, χ² test, and Fisher exact probability method were used for statistical analysis. Results　The puncture time [(5.6±1.1) min vs. (5.1±1.0) min], X-ray irradiation time [(12.1±3.2) min vs. (10.7±3.0) min], and operation time [(57.6±15.4) min vs. (50.8±14.1) min] in the distal radial artery group were all longer than those in the femoral artery group (all P<0.05), but no need to stay in bed after surgery. There was no statistically significant difference in the success rate of puncture or operation between the distal radial artery group and the femoral artery group (both P>0.05). The total incidence of complications in the distal radial artery group was lower than that in the femoral artery group [12.0% (3/25) vs. 35.5% (11/31)] (P<0.05). No spring coil displacement, ectopic embolism, tumor recalculation, recurrence or death were observed in both groups during follow-up. Conclusions　It is safe and feasible to embolize the splenic artery aneurysm through the distal radial artery approach. Although the operation time during perioperative period is slightly longer, there is no need to stay in bed after operation, and it can effectively shorten the postoperative hospitalization time, which is more conducive to the patients' postoperative recovery.

Objective　To analyze the influencing factors of death within half a year after hip fracture surgery in the elderly and construct an individualized prediction nomogram model. Methods　The clinical data of 458 elderly patients with hip fracture who underwent surgical treatment in Xi'an Honghui Hospital from May 2020 to August 2022 were retrospectively analyzed, including 214 males and 244 females, aged 65-94 (75.89±7.72) years. The patients were divided into a death group (43 cases) and a survival group (415 cases) according to whether they survived within half a year after surgery. The clinical data of the two groups were collected, and the influencing factors of death within half a year after hip fracture surgery were analyzed by multivariate logistic regression analysis. R software was used to draw the nomogram model, and the consistency of the nomogram model was verified by the calibration curve. The receiver operating characteristic curve (ROC) was used to evaluate the prediction value and discrimination of the model. Independent sample t test, Mann-Whitney U test, and χ² test were used for statistical analysis. Results　The mortality rate of elderly patients within half a year after hip fracture surgery was 9.39% (43/458). Multivariate logistic regression analysis showed that age (OR=1.167, 95%CI: 1.088-1.250) and type of comorbidities (OR=1.986, 95%CI: 1.143-3.452) were risk factors for death within half a year after hip fracture surgery in elderly patients, and skeletal muscle content (OR=0.814, 95%CI: 0.715-0.925) and hemoglobin (OR=0.923, 95%CI: 0.868-0.981) were protective factors (all P<0.05). The area under the curve was 0.899 (95%CI: 0.888-0.923) of the nomogram model in the prediction of death within half a year after hip fracture surgery in elderly patients, with good discrimination. The slope of calibration curve of the nomogram model for the prediction of death within half a year after hip fracture surgery in elderly patients was close to 1, and the Hosmer-Lemeshow goodness-fit test showed good consistency (χ²=4.091, P=0.849). Conclusions　This study constructed a nomogram model based on four influencing factors: age, type of comorbidities, skeletal muscle content, and hemoglobin, to predict the mortality risk within half a year after hip fracture surgery in elderly patients. It had relatively good discriminability and consistency, and could provide a reference basis for developing personalized intervention measures in clinical practice.

Objective　To investigate the relationships between serum signal peptide CUB epidermal growth factor domain containing protein-1 (SCUBE1) and Sestrin2 levels and microvascular obstruction in patients with acute ST segment elevation myocardial infarction (ASTEMI) after percutaneous coronary intervention (PCI). Methods　The medical records of 182 ASTEMI patients treated in Xi'an Central Hospital from July 2021 to June 2023 were retrospectively analyzed. All the patients underwent PCI after admission, and serum SCUBE1 and Sestrin2 levels were detected by enzyme-linked immunosorbent assay (ELISA) before surgery. One week after surgery, the microvascular occlusion was evaluated by cardiac magnetic resonance examination (MRI), and the patients were divided into an occurrence group and a non-occurrence group. The risk factors of microvascular obstruction in ASTEMI patients after PCI were screened by the logistic regression model, and the efficacy of serum SCUBE1 and Sestrin2 in predicting microvascular obstruction in ASTEMI patients after PCI were evaluated by the receiver operating characteristic curve (ROC). Independent sample t test and χ² test were used for statistical analysis. Results　Among 182 patients with ASTEMI treated by PCI, 72 patients had microvascular occlusion, with an incidence of 39.56%. In the occurrence group, there were 42 males and 30 females, aged (53.06±7.51) years, with a body mass index of (23.61±0.94) kg/m². In the non-occurrence group, there were 69 males and 41 females, aged (52.79±6.68) years, with a body mass index of (23.73±0.86) kg/m². The left ventricular ejection fraction in the occurrence group was lower than that in the non-occurrence group, and the infarct size, troponin T, serum SCUBE1, and serum Sestrin2 were higher than those in the non-occurrence group (all P<0.05). Logistic regression analysis showed that left ventricular ejection fraction (OR=0.271, 95%CI: 0.117-0.627), infarct size (OR=4.651, 95%CI: 2.009-10.764), troponin T (OR=3.773, 95%CI: 1.630-8.733), serum SCUBE1 (OR=4.491, 95%CI: 1.943-10.171), and serum Sestrin2 (OR=4.358, 95%CI: 1.882-10.087) were influencing factors for microvascular obstruction in ASTEMI patients after PCI (all P<0.05). The sensitivities, specificities, and areas under the curves of serum SCUBE1 and Sestrin2 alone and combined for microvascular obstruction in ASTEMI patients after PCI were 0.719, 0.783, 0.801, 0.800, 0.725, 0.824, 0.771 (95%CI: 0.674-0.867), 0.764 (95%CI: 0.669-0.860), and 0.882 (95%CI: 0.815-0.948), respectively. Conclusion　Serum SCUBE1 and Sestrin2 can be used to predict the occurrence of coronary microvascular occlusion in patients with ASTEMI after PCI, with good predictive efficacy.

Objective　To evaluate the relationships between monocyte chemotactic protein-1 (MCP-1) and periosteal protein levels and prognosis in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods　In this study, 106 patients with AMI who underwent PCI in Xingyuan Hospital of Yulin from March 2021 to January 2024 were included. Based on the occurrence of major adverse cardiovascular events (MACE) within 3 months after surgery, the patients were divided into a poor prognosis group and a good prognosis group. The levels of MCP-1 and periosteal protein were measured by enzyme-linked immunosorbent assay (ELISA) after PCI, and the levels of MCP-1 and periosteal protein in patients with different prognosis were compared. Spearman rank correlation analysis and logistic regression model were used to analyze the correlations between MCP-1 and periosteal protein levels and prognosis in AMI patients after PCI. The receiver operating characteristic curve (ROC) was drawn to analyze MCP-1 and periosteal protein in predicting the prognosis in AMI patients after PCI. Independent sample t test and χ² test were used for statistical analysis. Results　In the good prognosis group, there were 44 males and 31 females, aged (65.43±5.76) years, with a body mass index of (23.07±0.97) kg/m². In the poor prognosis group, there were 19 males and 12 females, aged (65.02±5.41) years, with a body mass index of (22.86±0.86) kg/m². The levels of MCP-1 and periosteal protein in the poor prognosis group were higher than those in the good prognosis group [(35.57±3.65) ng/L vs. (29.66±3.52) ng/L, (155.12±12.19) μg/L vs. (142.03±10.43) μg/L], with statistically significant differences (both P<0.05). Correlation analysis showed that both MCP-1 and periosteal protein were positively correlated with poor prognosis (r=0.594 and 0.444, both P<0.05). Logistic regression analysis showed that both MCP-1 and periosteal protein were risk factors for poor prognosis (OR=1.615 and 1.119, both P<0.05). ROC analysis showed that the areas under the curves (AUCs) of MCP-1 and periosteal protein alone were 0.877 and 0.782, respectively. When MCP-1 and periosteal protein were used in combination, the AUC increased to 0.929, the sensitivity and specificity were 87.1% and 86.7%, respectively, and the Yoden index was 0.738. Conclusions　MCP-1 and periosteal protein levels are closely related to the prognosis of AMI patients after PCI, and can be used as biomarkers for predicting poor prognosis. These findings support the use of MCP-1 and periosteal protein as potential tools for assessing risk and treatment response in AMI patients in clinical practice.

Objective　To study the effects of dexmedetomidine combined with sevoflurane on recovery quality and cognitive function in elderly patients after total knee arthroplasty (TKA). Methods　A total of 120 elderly TKA patients admitted to Weibei Central Hospital from September 2021 to March 2024 were selected for a prospective study, and were divided into an observation group and a control group with 60 cases in each group according to the random number table method. In the observation group, there were 37 males and 23 females, aged (68.79±6.37) years, 16 cases of grade Ⅰ and 44 cases of grade Ⅱ classified by the American Society of Anesthesiologists (ASA). In the control group, there were 39 males and 21 females, aged (68.44±7.41) years, 17 cases of ASA grade Ⅰ and 43 cases of ASA grade Ⅱ. In the control group, anesthesia was maintained by continuous inhalation of sevoflurane with 1%-2% concentration, and the concentration of sevoflurane was reasonably adjusted according to the patients' bispectral index until 0.5 h before the end of the operation. The observation group was supplemented with dexmedetomidine at 0.5 μg/kg per hour until 0.5 h before the end of the operation. The perioperative conditions, the incidence of agitation during the recovery period, and the change of the Montreal Cognitive Assessment Scale (MoCA) score before and after surgery were compared between the two groups, as well as the adverse reactions. t test and χ² test were used for statistical analysis. Results　The awakening time, spontaneous respiration recovery time, and extubation time in the observation group were (8.95±1.30) min, (10.05±1.27) min, and (12.22±1.67) min, which were shorter than those in the control group [(10.21±1.18) min, (13.16±1.40) min, and (16.95±1.74) min], with statistically significant differences (all P<0.05). The incidence of agitation during the recovery period in the observation group was 5.00% (3/60), which was lower than that in the control group [16.67% (10/60)], with a statistically significant difference (P<0.05). The MoCA scores in the observation group 6 h and 12 h after surgery were (24.61±1.83) and (26.79±1.40) points, which were higher than those in the control group [(23.45±1.57) and (25.68±1.31) points], with statistically significant differences (both P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion　Dexmedetomidine combined with sevoflurane can improve the recovery quality and reduce cognitive impairment in elderly patients after TKA, which is worthy of clinical promotion.

Objective　To observe the efficacy of sequential therapy with recombinant human interferon-α2b (rhIFN-α2b) and lamivudine in children with chronic hepatitis B in immune-tolerant phase. Methods　A total of 96 children with chronic hepatitis B in immune-tolerant phase who were admitted to the Third Affiliated Hospital of Xi'an Medical University from April 2020 to April 2023 were selected as the study objects, and were divided into a study group and a control group with 48 cases in each group according to the random number method. There were 29 boys and 19 girls in the study group, aged (7.54±1.36) years; the course of disease was (2.25±0.54) years; there were 28 cases with family history of hepatitis B. There were 26 boys and 22 girls in the control group, aged (7.63±1.41) years; the course of disease was (2.44±0.51) years; there were 26 cases with family history of hepatitis B. The control group was treated with lamivudine tablets orally, 0.1 g/time, once a day, for 24 weeks. The study group received sequential therapy with rhIFN-α2b and lamivudine: rhIFN-α2b was given by intramuscular or subcutaneous injection of 5 mIU/(m²·time), once every 2 days for the first 4 weeks, and lamivudine was added at 0.1 g/time, once a day after 4 weeks; after continuous treatment for 8 weeks, rhIFN-α2b was discontinued and lamivudine was used only for 12 weeks. The efficacy of the two groups was compared. After 4, 12, and 24 weeks of treatment, the negative conversion rates of hepatitis B virus E antigen (HBeAg) and hepatitis B virus DNA (HBV-DNA), and hepatitis B virus E antibody (HBeAb) conversion rate were recorded. The liver function [alanine aminotransferase (ALT), aspertate aminotransferase (AST), and total bilirubin (TBil)] and liver fibrosis indicators [hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen peptide (PⅢP), and type IV collagen (CⅣ)] were compared between the two groups before treatment and 24 weeks after treatment. The incidences of adverse reactions in the two groups were recorded. t test and χ² test were used for statistical analysis. Results　The total effective rate of the study group was higher than that of the control group [77.08% (37/48) vs. 52.08% (25/48)] (P<0.05). After 4 and 12 weeks of treatment, there was no statistically significant difference in the negative conversion rate of HBeAg or HBV-DNA between the study group and the control group (all P>0.05); after 24 weeks of treatment, the negative conversion rates of HBeAg and HBV-DNA in the study group were higher than those in the control group (both P<0.05). There was no statistically significant difference in the HBeAb conversion rate between the two groups at different time points after treatment (all P>0.05). After 24 weeks of treatment, the levels of ALT, AST, and TBil decreased in both groups, and those in the study group [(39.16±7.51) U/L, (41.92±8.26) U/L, and (15.13±4.29) μmol/L] were lower than those in the control group [(47.38±8.02) U/L, (52.36±8.73) U/L, and (18.67±4.86) μmol/L] (all P<0.05). After 24 weeks of treatment, the levels of HA, LN, PⅢP, CⅣ decreased in both groups, and those in the study group [(113.57±30.16) μg/L, (96.41±29.05) μg/L, (78.14±20.96) μg/L, and (90.26±26.31) μg/L] were lower than those in the control group [(208.34±64.72) μg/L, (124.27±32.19) μg/L, (104.37±22.48) μg/L, and (143.75±33.49) μg/L] (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion　The sequential therapy with rhIFN-α2b and lamivudine has clear efficacy in children with chronic hepatitis B in immune-tolerant phase, which can effectively reduce the virus content, prevent liver function deterioration and liver fibrosis, and has high safety.

Objective　To evaluate the effect of bronchoalveolar lavage and localized infusion of antibiotics on refractory pulmonary infection and its impact on distribution of pathogenic bacteria. Methods　This study was a randomized controlled trial. A total of 100 patients with refractory pulmonary infection treated in Xi'an Chest Hospital from June 2020 to June 2023 were selected and were divided into a control group (50 cases) and an observation group (50 cases) according to the random number table method. In the control group, there were 21 males and 29 females, aged (58.23±2.33) years, with a body mass index of (22.13±2.12) kg/m², who received conventional treatment, and the efficacy was evaluated after 9 days of continuous treatment. In the observation group, there were 24 males and 26 females, aged (60.12±3.05) years, with a body mass index of (21.53±2.31) kg/m², who received bronchoalveolar lavage and localized injection of antibiotics on the basis of conventional treatment, once every 3 days, and the efficacy were evaluated after 3 consecutive treatments. The serum indicators, clearance of pathogenic bacteria in sputum culture, and drug resistance of the two groups were compared. χ² test and t test were used. Results　After 9 days of treatment, serum levels of total oxidation state (TOS), C-reactive protein (CRP), adenosine deaminase (ADA), oxidative stress index (OSI), tumor necrosis factor α (TNF-α), interleukin-8 (IL-8), procalcitonin (PCT), renin (R), and angiotensin Ⅱ (AngⅡ) in both groups were decreased compared with those before treatment, and the levels of total antioxidant state (TAS) were increased compared with those before treatment (all P<0.05); serum levels of TOS, CRP, ADA, OSI, TNF-α, IL-8, PCT, R, and AngⅡ in the observation group were (13.65±1.39) µmol/L, (13.02±1.89) mg/L, (42.36±3.85) U/L, (5.54±1.06) U/L, (14.65±2.56) ng/L, (99.67±13.54) ng/L, (16.27±4.66) ng/L, (1.23±0.45) ng/L, and (23.14±6.43) ng/L, which were lower than those in the control group [(15.54±2.68) µmol/L, (25.38±2.14) mg/L, (50.28±4.11) U/L, (7.25±1.02) U/L, (26.57±5.12) ng/L, (148.39±21.28) ng/L, (22.57±4.53) ng/L, (1.98±0.65) ng/L, and (36.86±8.11) ng/L], and the TAS level was higher than that in the control group [(3.01±1.01) µmol/L vs. (2.25±0.97) µmol/L], with statistically significant differences (all P<0.05). The total effective rate of the observation group was higher than that of the control group [92.00% (46/50) vs. 76.00% (38/50)], with a statistically significant difference (χ²=4.762, P=0.029). Before treatment, 55 strains of pathogenic bacteria were detected in the sputum culture of the control group, including 31 strains of gram-negative bacteria (56.36%) and 24 strains of gram-positive bacteria (43.64%); 53 strains of pathogenic bacteria were detected in the sputum culture of the observation group, including 34 strains of gram-negative bacteria (64.15%) and 19 strains of gram-positive bacteria (35.85%). Sputum culture after 9 days of treatment showed that the clearance rate of pathogenic bacteria in the observation group was higher than that in the control group [76.00% (38/50) vs. 54.00% (27/50)], with a statistically significant difference (χ²=5.319, P=0.021). Conclusions　Bronchoalveolar lavage and localized infusion of antibiotics can significantly improve the biochemical indexes in patients with refractory pulmonary infection, increase the clearance rate of pathogenic bacteria, and improve the patients' prognosis. This provides a new treatment option for patients with severe lung infection.

Objective　To explore the effect of double filtration plasmapheresis (DFPP) combined with Bugan Lizhi decoction in the treatment of severe hypertriglyceridemia complicated with non-alcoholic fatty liver disease. Methods　This study was a randomized controlled trial. A total of 68 patients diagnosed with severe hypertriglyceridemia combined with non-alcoholic fatty liver disease in the Gastroenterology Department of Ankang Hospital of Traditional Chinese Medicine from June 2021 to June 2022 were selected as the study objects, and were divided into a control group and an observation group by the random number table method, with 34 cases in each group. In the control group, 18 males and 16 females, aged (42.62±8.55) years, were treated with DFPP plus oral bezafibrate: on the first day after DFPP treatment, bezafibrate 0.2 g was taken orally, 3 times a day, for 24 weeks. In the observation group, 20 males and 14 females, aged (43.43±7.25) years, were treated with DFPP + oral Bugan Lizhi decoction: the above traditional Chinese medicine was taken orally on the first day after blood purification treatment, 200 ml each time, 1 dose per day, within 30 minutes before meals, for 24 weeks. Biochemical indexes such as triglyceride, apolipoprotein A-Ⅰ (ApoA-Ⅰ), apolipoprotein B (ApoB), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) and liver function biochemical indexes such as alanine aminotransferase (ALT), albumin (ALB), and aspartate aminotransferase (AST) were compared between the two groups before and after treatment. The liver function indexes and liver imaging results were compared between the two groups before and after treatment. χ² test and t test were used for statistical analysis. Results　After 24 weeks of treatment, the levels of triglyceride, LDL-C, and ApoB in the observation group were lower than those in the control group [(4.13±1.09) mmol/L vs. (6.03±1.65) mmol/L, (3.13±0.58) mmol/L vs. (3.91±0.75) mmol/L, (0.76±0.23) g/L vs. (0.86± 0.17) g/L], and the levels of HDL-C and ApoA-I were higher than those in the control group [(1.88±0.53) mmol/L vs. (1.42±0.43) mmol/L, (1.81±0.39) g/L vs. (1.58±0.32) g/L], with statistically significant differences (t=5.602, 4.797, 2.039, 3.930, and 2.658, all P<0.05). After 24 weeks of treatment, the levels of ALT and AST in the observation group were lower than those in the control group [(28.62±3.23) U/L vs. (34.32±1.68) U/L, (21.29±4.34) U/L vs. (35.44±5.72) U/L], and the level of ALB was higher than that in the control group [(49.21±4.31) g/L vs. (45.34±4.28) g/L], with statistically significant differences (t=9.138, 11.488, and 3.715, all P<0.05). The results of liver imaging examination after 24 weeks of treatment showed that the oblique diameter of liver subcostal in the observation group was smaller than that in the control group [(9.98±3.54) cm vs. (12.05±4.78) cm], with a statistically significant difference (t=2.029, P=0.046). There were 7 cases (20.59%), 15 cases (44.12%), and 12 cases (35.29%) of mild, moderate, and severe hepatic cellular fat infiltration in the control group, and 20 cases (58.82%), 11 cases (32.35%), and 3 cases (8.82%) in the observation group, with a statistically significant difference (χ²=12.275, P=0.002). Conclusion　DFPP combined with Bugan Lizhi decoction can effectively improve the biochemical indicators and liver function in severe hypertriglyceridemia complicated with non-alcoholic fatty liver disease patients, with positive effects on hepatic imaging manifestations, suggesting its potential application value in the treatment of severe hypertriglyceridemia complicated with non-alcoholic fatty liver disease.

Objective　To investigate the levels of serum interleukin-26 (IL-26) and peripheral blood helper T cell 17/ regulatory T cells (Th17/Treg) in patients with psoriasis vulgaris, and analyze the clinical significance of detection. Methods　A total of 100 patients with psoriasis vulgaris admitted to Ankang Hospital of Traditional Chinese Medicine from December 2020 to December 2023 were retrospectively selected, and 50 cases of chronic skin diseases and 50 healthy subjects (control group) admitted to Ankang Hospital of Traditional Chinese Medicine during the same period were selected in the ratio of 2:1 for a control study. The differences in baseline data such as gender and age as well as levels of IL-26 and Th17/Treg among the groups were analyzed. The influencing factors of psoriasis vulgaris were analyzed by binary logistic regression analysis, and the diagnostic efficacies of IL-26 and Th17/Treg levels in psoriasis vulgaris were analyzed by the receiver operating characteristic curve (ROC). The relationships between Psoriasis Area and Severity Index (PASI) score and levels of IL-26 and Th17/Treg were analyzed. χ² test, t test, and variance analysis were used. Results　There was no statistically significant difference in the gender, age, body mass index, smoking rate, or drinking rate among the three groups (all P>0.05). There was no statistically significant difference in the course of disease between the psoriasis vulgaris group and chronic skin disease group (P>0.05). The levels of IL-26, Th17, Treg, and Th17/Treg were (641.82±192.05) ng/L, (5.36±1.34)%, (3.09±0.91)%, and 1.83±0.55 in the psoriasis vulgaris group, (571.15±155.31) ng/L, (4.58±1.06)%, (3.81±1.19)%, and 1.28±0.38 in the chronic skin disease group, (504.46±122.51) ng/L, (3.93±0.88)%, (5.14±1.51)%, and 0.81±0.24 in the control group, with statistically significant differences (F=11.535, 26.054, 52.482, and 90.638, all P<0.05). Binary logistic regression analysis showed that both IL-26 and Th17/Treg levels were risk factors for psoriasis vulgaris (both P<0.05). ROC analysis showed that the areas under the curves (AUCs) of IL-26 and Th17/Treg levels in the diagnosis of psoriasis vulgaris were 0.700 and 0.891, respectively. IL-26 and Th17/Treg levels were included in the regression equation, and the model data were obtained. The AUC, sensitivity, and specificity of the model data for diagnosing psoriasis vulgaris were 0.912, 0.920, and 0.790. Linear regression analysis results showed that IL-26, Th17, Treg, and Th17/Treg were significantly correlated with PASI in psoriasis vulgaris patients (all P<0.05). Conclusions　Serum IL-26 and Th17/Treg are elevated in patients with psoriasis vulgaris. IL-26 and Th17/Treg have some value in diagnosing psoriasis vulgaris, the combined model has a higher diagnostic value. The levels of IL-26 and Th17/Treg correlate closely with the severity of psoriasis vulgaris.

Objective　To investigate the effects of empagliflozin combined with sacubitril/valsartan on cardiac function, serum soluble suppression of tumorigenicity 2 protein (sST2) and matrix metalloproteinase-9 (MMP-9) in patients with heart failure with reduced ejection fraction (HFrEF). Methods　A total of 185 HFrEF patients from Shenmu Hospital from March 2020 to May 2022 were selected and were divided into an observation group (93 cases) and a control group (92 cases) by the random number table method. In the control group, 62 males and 30 females, aged (54.61±8.83) years, were treated with sacubitril/valsartan on the basis of conventional treatment, 50 mg each time, twice a day, and the dose was gradually increased according to the patients' conditions, with the maximum dose ≤400 mg/d. In the observation group, 65 males and 28 females, aged (55.32±8.21) years, were treated with sacubitril/valsartan combined with empagliflozin on the basis of conventional treatment, and the treatment with sacubitril/valsartan was the same as the control group, with empagliflozin 10 mg each time, once a day. Both groups were treated for 6 months. The cardiac function, motor ability, serological indexes, clinical efficacy, adverse drug reactions, and prognosis of the two groups were compared. Statistical methods used were t test and χ² test. Results　After treatment, the left ventricular end-systolic diameter, left ventricular ejection fraction, 6 min walking distance, and levels of sST2 and MMP-9 in the observation group were (40.03±3.36) mm, (56.97±6.78)%, (367.29±68.51) m, (3.47±1.20) µg/L, and (143.62±13.28) µg/L, and those in the control group were (44.10±4.22) mm, (50.34±5.68)%, (320.06±59.38) m, (8.61±2.34) µg/L, and (160.34±16.51) µg/L, with statistically significant difference (all P<0.05). After treatment, the total effective rates of the observation group and the control group were 78.49% (73/93) and 58.70% (54/92), with a statistically significant difference (χ²=8.424, P=0.004). The total incidence of cardiovascular adverse events and readmission rate were 20.43% (19/93) and 11.83% (11/93) in the observation group, and 47.83% (44/92) and 28.26% (26/92) in the control group, with statistically significant differences (both P<0.05). The incidence of adverse drug reactions was 16.13% (15/93) in the observation group and 10.87% (10/92) in the control group, without statistically significant difference (χ²=1.095, P=0.295). Conclusion　Empagliflozin combined with sacubitril/valsartan can improve the prognosis, exercise ability and cardiac function of HFrEF patients with significant efficacy, and inhibit myocardial fibrosis, which is safe and reliable.

Objective　To explore the effect of Xuefu Zhuyu Capsules combined with conventional western medicine treatment on patients with angina pectoris. Methods　This study was a randomized controlled trial. A total of 100 patients with angina pectoris admitted to the Department of Cardiovascular Medicine, Sun Simmiao Hospital of Beijing University of Chinese Medicine from January 2022 to January 2024 were selected and were divided into a conventional group (50 cases) and a combined group (50 cases) according to the envelope drawing method. In the conventional group, there were 27 males and 23 females, aged (62.32±7.38) years, with a course of disease of (5.33±0.67) years, and the New York Heart Association (NYHA) cardiac function grade was grade Ⅰ in 32 patients and grade Ⅱ in 18 patients. In the combined group, there were 29 males and 21 females, aged (62.44±7.32) years, with a course of disease of (5.37±0.72) years, and the NYHA cardiac function grade was grade Ⅰ in 30 cases and grade Ⅱ in 20 cases. The conventional group was given conventional western medicine treatment: oral isosorbide mononitrate tablet 20 mg/time, metoprolol tartrate tablet 100 mg/time, twice a day; oral aspirin enteric-coated tablet 100 mg/time, atorvastatin calcium tablet 20 mg/time, once a day. The combined group was treated with Xuefu Zhuyu Capsules on the basis of the conventional group: 6 capsules were taken orally each time, twice a day. Both groups were treated continuously for 2 months. The clinical indicators, cardiac function, Seattle Angina Questionnaire (SAQ) scores, and N-terminal pro B-type Natriuretic Peptide (NT-proBNP), creatine kinase isoenzyme (CK-MB), and soluble CD105 (sCD105) levels were compared between the two groups before and after treatment, along with adverse reactions. χ² test and t test were used. Results　Two months after treatment, the frequency of angina pectoris attack was (2.04±0.31) times/week in the combined group, the duration of angina pectoris was (1.35±0.21) min/time, the duration of shortness of breath was (1.64±0.32) d, the resting heart rate was (64.04±6.17) beats/min, the level of NT-proBNP was (135.41±22.70) U/L, the level of CK-MB was (52.33±5.46) ng/L, the level of sCD105 was (0.25±0.09) µg/L, which were lower than those in the conventional group [(3.51±0.48) times/week, (2.82±0.43) min/time, (3.03±0.55) d, (73.43±7.44) beats/min, (239.22±34.07) U/L, (66.41±6.77) ng/L, and (0.53±0.17) µg/L], with statistically significant differences (all P<0.05). In the combined group, the left ventricular ejection fraction was (65.22±7.17)%, the cardiac output was (5.23±0.66) L/min, the stroke volume was (74.77±8.16) ml/time, the cardiac index was (3.11±0.65) L·min^-1·m^-2, which were higher than those in the conventional group [(57.41±6.25)%, (4.32±0.47) L/min, (65.65±7.29) ml/time, and (2.62±0.56) L·min^-1·m^-2], with statistically significant differences (all P<0.05). The SAQ scores of the combined group were higher than those of the conventional group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the conventional group and the combined group [8.0% (4/50) vs. 10.0% (5/50)] (χ²=0.122, P=0.727). Conclusions　On the basis of conventional western medical treatment, combining Xuefu Zhuyu Capsules can significantly improve clinical indicators, cardiac function, SAQ score, and levels of NT-proBNP, CK-MB, and sCD105 in patients with angina pectoris. The safety profile is good, and it is recommended for widespread application.

Objective　To explore and analyze the accuracies and imaging characteristics of CT angiography (CTA) and digital subtraction angiography (DSA) in diagnosing cerebral arteriovenous malformations (AVM). Methods　The clinical data of 40 patients with AVM admitted to Tongchuan People's Hospital from January 2019 to December 2023 were retrospectively analyzed, including 31 males and 9 females, aged 35-73 years. All patients underwent CTA and DSA examinations, and the imaging characteristics of the two examination methods were compared. Meanwhile, the diagnostic accuracies and misdiagnosis rates of the two examination methods were compared with the postoperative pathological results as the gold standard. The spatial relationships between the two techniques on blood supply arteries, drainage veins, and intracranial aneurysms were observed. χ² test and t test were used. Results　CTA and DSA were relatively clear in the detection of lesions, and there was no statistically significant difference in the diagnosis of malformed vascular mass between the two methods (χ²=0.966, P=0.616). With postoperative pathological results as the gold standard, all patients could see clear supplying arteries, with 116 supplying arteries and 73 draining veins; DSA examination showed that the diagnostic accuracies of supplying arteries and draining veins were 100.00% (116/116) and 97.26% (71/73), which were higher than 97.41% (113/116) and 93.15% (68/73) of CTA, but the difference was not statistically significant (χ²=0.037, P=0.981). The clear rates of spatial relationship of intracranial aneurysms showed by DSA and CTA were 82.50% (33/40) and 85.00% (34/40), respectively, without statistically significant difference (χ²=0.214, P=0.898). The diagnostic accuracy and misdiagnosis rate of DSA for cerebral AVM were 92.50% (37/40) and 7.50% (3/40), respectively, while those of CTA were 87.50% (35/40) and 12.50% (5/40), respectively, without statistically significant difference (χ²=0.555, P=0.456). Conclusions　Considering the advantages and disadvantages of CTA and DSA, the diagnosis of malformed vascular mass in CTA and DSA is basically the same. CTA can be used as the first non-invasive method for diagnosis. If the diagnostic detection rate needs to be further improved, a combined scheme can be adopted to reduce diagnostic errors as much as possible, which is worthy of clinical attention.

Objective　To investigate the clinical efficacy and safety of inhaled compound ipratropium bromide combined with Lycium Barbarum L. granules in treating pediatric cough-variant asthma (CVA). Methods　This study was a randomized controlled trial. A total of 106 children with CVA admitted to Sun Simiao Hospital, Beijing University of Chinese Medicine from January 2022 to December 2023 were enrolled and were divided into two groups using the random number table method. In group B, 27 boys and 26 girls, aged (9.64±2.89) years, with a duration of disease of (3.72±1.03) months, were given inhaled compound ipratropium bromide at 0.5 mg/time, 15 min/time, twice a day, on the basis of conventional treatment. In group A, 28 boys and 25 girls, aged (9.37±2.93) years, with a duration of disease of (3.84±1.12) months, were in combination with Lycium Barbarum L. granules taken orally on the basis of group B, 10 g/time, twice a day. Both groups were treated for 2 weeks. The efficacy and the changes of Cough Evaluation Test (CET) score, Leicester Cough Questionnaire (LCQ) score, indicators of immune function [CD3⁺, CD4⁺, CD8⁺, immunoglobulin A (IgA), ad IgM], and pulmonary function test results [forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC], and inflammatory factors [interleukin-6 (IL-6), IL-8, and substance P (SP)] before and after treatment were compared between the two groups, and the adverse reactions were recorded. Statistical analysis was performed using t test and χ² test. Results　After 2 weeks of treatment, the total effective rate of group A was 96.23% (51/53), which was higher than that of group B [77.36% (41/53)], with a statistically significant difference (χ²=8.230, P=0.004); the CET scores in both groups were decreased, and that in group A was lower than that in group B [(2.97±0.47) points vs. (4.62±0.91) points] (t=11.728, P<0.001); the LCQ scores in both groups were improved, and that in group A was higher than that in group B [(18.00±1.60) points vs. (16.35±2.80) points] (t=3.725, P<0.001); the levels of CD8⁺ were decreased in both groups, and that in group A was lower than that in group B (all P<0.05); the levels of CD3⁺, CD4⁺, IgA, and IgM were increased in both groups, and those in group A were higher than those in group B (all P<0.05); the FEV₁, FVC, and FEV₁/FVC in both groups were increased, and those in group A were higher than those in group B [(1.70±0.22) L vs. (1.45±0.19) L, (2.53±0.37) L vs. (2.26±0.68) L, (67.19±6.23)% vs. (64.16±5.44)%] (all P<0.05); serum levels of IL-6, IL-8, and SP were decreased in both groups, and those in group A were lower than those in group B [(0.72±0.43) µg/L vs. (1.50±1.08) µg/L, (1.89±0.21) ng/L vs. (3.74±0.48) ng/L, (2.15±1.65) nmol/L vs. (3.70±2.35) nmol/L] (all P<0.05). There was no statistically significant difference in the incidence of mild adverse reactions between the two groups [5.66% (3/53) vs. 7.55% (4/53)] (χ²=0.153, P=0.696), and no serious adverse reactions were reported. Conclusion　In the treatment of pediatric CVA, inhaled compound ipratropium bromide combined with Lycium Barbarum L. granules can significantly improve the cough symptoms, quality of life, immune function, and lung function, reduce the inflammation level, and has good safety.

Objective　To evaluate the clinical efficacy of matrix acupuncture combined with Jingulian capsules in patients with post-stroke shoulder pain. Methods　This study was a randomized controlled trial. Ninety-eight patients with post-stroke shoulder pain admitted to Ankang Hospital of Traditional Chinese Medicine from March 2022 to February 2024 were randomly divided into a control group and an observation group, with 49 patients in each group. In the control group, 28 males and 21 females, aged (63.49±7.60) years, with a duration of disease of (3.32±1.19) months, received oral Jingulian capsules, 2 capsules each time, 3 times a day. In the observation group, 26 males and 23 females, aged (64.60±8.37) years, with a duration of disease of (3.56±1.30) months, were treated with matrix acupuncture on the basis of the control group, 30 min each time, 3 times a week. Both groups were treated continuously for 8 weeks. The changes in Visual Analogue Scale (VAS), Fugl-Meyer Motor Function Assessment (FMA), Constant-Murley Shoulder Joint Scale (CMS), and ability of daily living (Barthel index) scores before and after treatment were compared between the two groups. Serum levels of endorphin, enkephalin, dynorphin, and inflammatory markers [interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and nitric oxide (NO)] were detected, and the clinical efficacy was evaluated. t test and χ² test were used for statistical analysis. Results　After 8 weeks of treatment, the VAS score of the observation group was lower than that of the control group [(3.67±1.23) points vs. (4.52±1.47) points], with a statistically significant difference (t=3.104, P=0.003); the FMA score, CMS score, and Barthel index of the observation group were higher than those of the control group [(26.43±5.89) points vs. (21.78±5.64) points, (30.22±6.83) points vs. (25.79±5.60) points, (60.65±7.15) points vs. (55.91±6.56) points], with statistically significant differences (t=3.991, 3.511, and 3.419, all P<0.001). Serum levels of endorphin, enkephalin, and dynorphin of the observation group were higher than those of the control group [(932.85±102.44) ng/L vs. (858.33±82.67) ng/L, (61.94±12.10) ng/L vs. (54.75±9.73) ng/L, (110.42±16.58) ng/L vs. (98.63±13.47) ng/L], with statistically significant differences (t=3.963, 3.241, and 3.863, all P<0.05); the levels of IL-6, TNF-α, and NO were lower than those of the control group [(47.22±8.54) pg/L vs. (54.68±9.10) pg/L, (16.41±4.12) ng/L vs. (19.88±5.47) ng/L, (19.48±4.12) µmol/L vs. (22.88±4.60) µmol/L], with statistically significant differences (t=4.184, 3.547, and 3.854, all P<0.001). The total effective rate of the observation group was higher than that of the control group [95.92% (47/49) vs. 83.67% (41/49)], with a statistically significant difference (χ²=4.009, P=0.045). Conclusion　Matrix acupuncture combined with Jingulian capsules can significantly improve the degree of pain and dysfunction in patients with post-stroke shoulder pain, and has anti-inflammatory effects, which is worthy of clinical application.

Objective　To explore the effect of probiotics combined with paroxetine on intestinal flora in patients with postpartum depression caused by mother-infant separation. Methods　A total of 106 patients who gave birth in Xi'an Daxing Hospital from May 2020 to May 2023 and were diagnosed as postpartum depression caused by mother-infant separation were divided into two groups according to treatment methods, with 53 cases in each group. In the control group, 25 primiparas and 28 multiparas, aged (28.21±3.17) years, were given oral paroxetine tablets, 20 mg/time, once a day. In the observation group, 30 primiparas and 23 multiparas, aged (27.55±3.12) years, were treated with probiotics (oral Bifidobacterium tetrad tablets, 3 tablets/time, 3 times/day) combined with paroxetine. Both groups were treated continuously for 6 weeks. The clinical efficacy, inflammatory factors, neuroendocrine, intestinal flora level, quality of life, and medication safety were compared between the two groups. χ² test, t test, and rank sum test were used. Results　In the observation group, the cure rate, significantly effective rate, effective rate, and ineffective rate were 54.72% (29/53), 24.53% (13/53), 16.98% (9/53), and 3.77% (2/53), respectively. In the control group, the cure rate, significantly effective rate, effective rate, and ineffective rate were 37.74% (20/53), 22.64% (12/53), 22.64% (12/53), and 16.98% (9/53), respectively. The curative effect of the observation group was better than that of the control group (Z=2.274, P=0.023). Six weeks after treatment, the levels of interleukin-1β, malondialdehyde, and CC chemokine ligand 2 in the observation group were lower than those in the control group [(4.63±1.54) ng/L vs. (5.58±1.86) ng/L, (2.95±0.51) mmol/L vs. (3.24±0.54) mmol/L, (431.63±72.27) ng/L vs. (483.41±80.56) ng/L], the levels of superoxide dismutase, 5-hydroxytryptamine, dopamine, and neuropeptide Y were higher than those in the control group [(124.51±13.84) U/L vs. (112.69±12.52) U/L, (194.33±14.95) µg/L vs. (185.64±14.28) µg/L, (3.94±0.61) µmol/L vs. (3.65±0.57) µmol/L, (15.28±2.21) mg/L vs. (13.47±2.07) mg/L], the levels of Lactobacillus and Bifidobacterium were higher than those in the control group [(9.52±0.73) log N/g vs. (8.11±0.76) log N/g, (9.23±0.84) log N/g vs. (7.96±0.72) log N/g], with statistically significant differences (all P<0.05). The Pittsburgh Sleep Quality Index of the observation group was lower than that of the control group [(5.21±1.03) points vs. (5.84±1.16) points], and the SF-36 score was higher than that of the control group [(83.25±6.41) points vs. (78.49±6.04) points] (both P<0.05). Conclusion　Probiotics combined with paroxetine in the treatment of postpartum depression caused by mother-infant separation can effectively improve the efficacy and quality of life by reducing the level of inflammation, promoting the improvement of neuroendocrine function, and improving the intestinal flora, and the medication is relatively safe.

Objective　To explore the application effect of comprehensive nursing intervention in acute myocardial infarction treated by intravenous infusion with nitroglycerin. Methods　A total of 120 patients with acute myocardial infarction admitted to Cardiovascular Medicine Department, Zhengzhou Yihe Hospital from June 2021 to June 2023 were selected and were divided into a reference group and an experimental group by the random number table method, with 60 cases in each group. In the reference group, there were 31 males and 29 females, aged (53.78±8.23) years, and the onset time was (6.06±2.15) h. There were 28 males and 32 females in the experimental group, aged (53.81±8.14) years, and the onset time was (6.11±2.32) h. Both groups were given intravenous infusion with nitroglycerin. On the basis, the reference group was given routine nursing, and the experimental group was given comprehensive nursing intervention, including psychological intervention, environmental intervention, diet nursing, complication prevention, and rehabilitation nursing. The duration of nursing intervention in the two groups began from patients receiving intravenous infusion with nitroglycerin to the end of treatment. The negative emotion scores, self-care abilities, and qualities of life before and after intervention and complications were compared between the two groups. χ² test and t test were used. Results　After intervention, the scores of Self-rating Anxiety Scale and Self-rating Depression Scale in the experimental group were lower than those in the reference group [(35.05±3.52) points vs. (46.49±4.43) points, (36.11±3.32) points vs. (45.21±4.92) points] (t=11.554 and 9.265, both P<0.001). The scores of health cognition [(22.05±2.52) points], self-concept [(21.05±2.32) points], self-care [(21.72±2.23) points], self-responsibility [(22.76±2.61) points], psychological function [(72.05±6.52) points], social function [(74.11±6.32) points], material life status [(75.12±6.23) points], and somatic symptoms [(74.12±6.23) points] in the experimental group were higher than those in the reference group [(18.49±2.03), (19.01±2.92), (18.80±2.81), (19.01±2.26), (65.49±5.43), (64.21±5.92), (66.30±5.11), and (65.16±5.61) points], with statistically significant differences (t=8.521, 4.237, 6.305, 8.413, 5.988, 8.855, 8.478, and 8.278, all P<0.001). The complication rate of the experimental group was lower than that of the reference group [5.0% (3/60) vs. 16.7% (10/60)] (χ²=4.227, P=0.040). Conclusion　In patients with acute myocardial infarction treated by intravenous infusion with nitroglycerin, comprehensive nursing intervention can effectively reduce the patients' psychological burden, promote the recovery of the disease, improve the patients' self-care ability, improve the quality of life, reduce the risk of complications, and improve the prognosis.

Objective　To explore the effects of refined nursing combined with outpatient follow-up nursing under the King's mutual aid compliance theory on complications and psychological status in patients after brain tumor surgery. Methods　A retrospective study was conducted on 90 patients who underwent brain tumor surgery in Wuxi Second People's Hospital from March 2021 to January 2023, and they were divided into a control group and an experimental group according to different nursing methods, with 45 cases in each group. In the control group, 27 males and 18 females, aged (45.08±5.37) years, received conventional nursing mode. In the experimental group, 22 males and 23 females, aged (36.49±4.09) years, received refined nursing combined with outpatient follow-up nursing under the King's mutual aid compliance theory. Both groups were intervened for 2 months. The occurrence of complications within 1 week after surgery was compared between the two groups, the self-efficacy, sleep quality, and psychological status of the two groups were assessed before and after intervention, and the nursing satisfaction of the two groups was compared after discharge. Statistical methods used were t test and χ² test. Results　The total complication rate of the experimental group was lower than that of the control group [6.67% (3/45) vs. 26.67% (12/45)], with a statistically significant difference (χ²=6.48, P<0.05). After intervention, the scores of General Self-Efficacy Scale (GSES) and Pittsburgh Sleep Quality Index (PSQI) of the experimental group were better than those of the control group [(41.03±4.96) points vs. (34.85±3.66) points, (4.22±2.11) points vs. (7.06±2.30) points]; the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were lower than those of the control group [(41.40±2.64) points vs. (53.42±3.98) points, (43.98±3.11) points vs. (54.17±3.45) points], with statistically significant differences (t=6.73, 6.10, 16.88, and 14.72, all P<0.05). The nursing satisfaction rate of the experimental group was higher than that of the control group [95.56% (43/45) vs. 73.33% (33/45)], with a statistically significant difference (χ²=8.46, P<0.05). Conclusion　Refined nursing combined with outpatient follow-up nursing under the King's mutual aid compliance theory can effectively reduce the incidence of complications in patients after brain tumor surgery, improve their sleep quality, and alleviate depression and anxiety, which has a positive impact on their psychological status.

Objective　To evaluate the effect of nursing intervention based on the empowerment theory model on self-management capability and quality of life in patients with secondary epilepsy. Methods　This study was a randomized controlled trial. A total of 84 patients with secondary epilepsy admitted to Xianyang Central Hospital from June 2021 to June 2023 were divided into two groups according to the random number table method, with 42 cases in each group. In the reference group, there were 28 males and 14 females, aged 32-64 (41.63±5.37) years, and the types of seizures included simple partial seizures in 21 cases, complex partial seizures in 12 cases, and generalized seizures in 9 cases. In the experimental group, there were 23 males and 19 females, aged 36-66 (41.06±5.24) years, and the types of seizures included simple partial seizures in 23 cases, complex partial seizures in 11 cases, and generalized seizures in 8 cases. The reference group received routine nursing measures, the experimental group received nursing intervention based on the empowerment theory model, and both groups were intervened for 3 months. The self-management ability [Epilepsy Self-Management Scale (ESMS)], neurological function improvement [National Institutes of Health Stroke Scale (NIHSS)], disease uncertainty [Mishel Uncertainty in Illness Scale (MUIS)], and quality of life [Chinese version of the Quality of Life in Epilepsy Inventory-31 (QOLIE-31)] were observed and compared between the two groups before and after intervention, and the occurrence of secondary epilepsy within 3 months in the two groups was also evaluated. Statistical methods used were t test and χ² test. Results　After intervention, the scores of ESMS and QOLIE-31 in the experimental group were higher than those in the reference group [(155.21±19.87) points vs. (121.17±17.63) points, (73.14±8.32) points vs. (62.29±7.38) points], with statistically significant differences (t=8.31 and 6.32, both P<0.05); the scores of NIHSS and MUIS in the experimental groups were lower than those in the reference group [(21.07±3.08) points vs. (25.81±3.36) points, (62.48±7.51) points vs. (72.04±7.36) points], with statistically significant differences (t=6.74 and 5.89, both P<0.05). The incidence of secondary epilepsy seizures within 3 months in the experimental group was lower than that in the reference group [11.90% (5/42) vs. 38.10% (16/42)], with a statistically significant difference (χ²=7.68, P<0.05). Conclusion　The nursing intervention based on the empowerment theory model can effectively enhance the self-management in patients with secondary epilepsy, improve the quality of life, reduce the disease recurrence, and has a positive impact on improving neurological function.

Neurology is a comprehensive discipline with strong theoretical and practical elements, requiring high levels of professional knowledge and operational skills from practitioners. Traditional undergraduate education in neurology faces issues such as the inability of teacher-centered lectures to stimulate students' interest in learning and the insufficiency of students' learning effectiveness, posing challenges in cultivating specialized talents in neurology. This article explores the prospects of applying a combination of case-based learning (CBL), problem-based learning (PBL), and Sandwich teaching method in the undergraduate education system for the neurology specialty, based on the current situation of neurology undergraduate teaching.

Objective　To discuss the current situation of undergraduate mentorship in clinical medicine under the background of "double first-class", analyze the possible related factors and problems, and put forward optimization suggestions. Methods　In this study, 180 undergraduates of the clinical medicine major of Guangzhou Medical University in the class of 2023 were selected by random sampling method as the research objects from June to July 2024, and were surveyed using the general information survey method and five-dimensional satisfaction scores, of whom there were 82 males and 64 females, with an age of (18.90±0.83) years old. The results of the survey were analyzed by descriptive statistics and correlation analysis. Results　The overall satisfaction score of the mentoring system for undergraduates in clinical medicine in the context of the "double first-class" construction was (17.79±3.31), in which the way of choosing a mentor and the number of students led by the mentor were negatively correlated with the satisfaction of the mentoring system for undergraduates (r=-0.497 and -0.608, both P<0.05), whereas the amount of time students devote to extracurricular learning per week and the frequency of communication between mentors and students were positively correlated with satisfaction with the undergraduate mentoring system (r=0.374 and 0.636, both P<0.05). Conclusion　The overall satisfaction of the current undergraduate clinical mentoring system is average, significantly correlated with the number of students under the mentor's supervision, the frequency of communication between the mentor and the students, the way in which the students choose the mentor, and the amount of time that the students devote to extracurricular learning, which still needs to be further optimized and improved, with a view to constructing a more efficient mode of training for undergraduate students in clinical medicine.