This guideline focuses on the diagnosis and treatment of acute heart failure and the whole-process management of heart failure. The guideline covers the classification, treatment process, pharmacological and non-pharmacological treatment strategies of acute heart failure and the management of cardiogenic shock; elaborates the clinical characteristics and treatment principles of right heart failure, advanced and end-stage heart failure, and elderly heart failure; constructs a full-cycle comprehensive management system including follow-up, patient self-monitoring and comorbidity management; and standardizes rational drug use and hierarchical diagnosis and treatment pathways. This guideline aims to provide guidance for primary medical staff, reduce the readmission rate and mortality of heart failure, and improve the quality of life of patients.

Myasthenia gravis (MG) is an autoimmune disease mediated by autoantibodies and involved in neuromuscular junction (NMJ) transmission. Elderly MG patients are often complicated with multiple diseases, bringing severe challenges to clinical polypharmacy management. Starting with the medication risks of one elderly MG patient with multimorbidity, this article systematically summarizes the identification of high-risk drugs and related medication suggestions for MG patients with multiple diseases, and analyzes the combined medication risks of traditional MG drugs such as cholinesterase inhibitors, glucocorticoids and immunosuppressants. In view of the clinical dilemma of insufficient specificity and high combined medication risk of traditional MG regimens, this paper further expounds the mechanism of action, applicable population, administration route, safety characteristics and drug interaction of three targeted biological agents including efgartigimod, eculizumab and telitacicept, so as to achieve the dual goals of stable disease control and medication safety, and improve the long-term quality of life of patients.

Objective: To explore the clinical effect of evolocumab combined with atorvastatin in the treatment of elderly patients with coronary heart disease, and analyze its influence on vascular endothelial function, myocardial injury markers and microRNA (miRNA). Methods: A total of 194 elderly patients with coronary heart disease treated in our hospital from March 2022 to December 2023 were enrolled and divided into control group (atorvastatin treatment) and observation group (evolocumab combined with atorvastatin treatment) by random number table method, with 97 cases in each group. Blood lipid indexes [low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), lipoprotein(a) (LPa)], vascular endothelial function indexes [vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), nitric oxide (NO)], myocardial injury markers [creatine kinase (CK), creatine kinase isoenzyme (CK-MB)], miRNA levels (miR-499, miR-142-5p), clinical efficacy and adverse reactions were compared between the two groups before and after treatment. Results: After treatment, LDL-C, TC, TG, LPa, ET-1, CK, CK-MB, miR-499 and miR-142-5p in both groups decreased, and were lower in the observation group (P<0.05); HDL-C, VEGF and NO increased, and were higher in the observation group (P<0.05). The total effective rate of the observation group was 92.78%, higher than 77.32% of the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Evolocumab combined with atorvastatin can effectively regulate blood lipid levels, improve clinical efficacy, ameliorate vascular endothelial function, reduce myocardial injury marker levels and regulate miRNA expression in elderly patients with coronary heart disease, without increasing the risk of adverse reactions.

Objective: To investigate the effects of recombinant human growth hormone (rhGH) combined with letrozole (LE) on growth and hormone levels in boys with large bone age and adolescent short stature. Methods: A prospective study was conducted on 43 boys with large bone age and adolescent short stature who were treated at our hospital from July 2022 to September 2024. All subjects received rhGH combined with LE therapy. Before treatment and at 1, 6, 12, and 18 months of treatment, the following parameters were measured: height standard deviation scores [height standard deviation score for chronological age (HtSDS-CA) and height standard deviation score for bone age (HtSDS-BA)], sex hormones [luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), testosterone (T)], physical indicators [body mass index (BMI)], routine blood parameters [hemoglobin (HGB), red blood cell count (RBC), white blood cell count (WBC), platelet count (PLT)], growth factors [insulin-like growth factor-1 (IGF-1)], and biochemical parameters [urea, alkaline phosphatase (ALP)]. Adverse reactions were also recorded. Results: After 1, 6, 12, and 18 months of treatment, HtSDS-CA, HtSDS-BA, LH, FSH, T, BMI, HGB, RBC, and IGF-1 levels were significantly higher than those before treatment (P<0.05). No statistically significant differences were observed in WBC, PLT, or ALP compared with pretreatment levels (P>0.05). E2 levels were below the lower detection limit. After 6 and 12 months of treatment, urea levels were higher than those before treatment (P<0.05). Adverse reactions mainly included elevated gonadotropin and T levels, abnormal blood glucose, elevated total bilirubin and uric acid, thyroid dysfunction, and skin problems. Conclusion: rhGH combined with LE can effectively promote growth and development and improve hormone levels in boys with large bone age and adolescent short stature. The adverse reactions are transient and resolve after drug discontinuation.

Objective: To explore the efficacy of different doses of budesonide combined with cetirizine in the treatment of children with acute exacerbation of bronchial asthma, and its effect on the balance of peripheral blood helper T cell 17 (Th17)/regulatory T cell (Treg) immune. Methods: A total of 96 children with acute exacerbation of bronchial asthma admitted to our hospital from March 2022 to January 2024 were prospectively enrolled and divided into control group and observation group by random number table, with 48 cases in each group. Both groups were orally administered cetirizine hydrochloride tablets. On this basis, the control group received 0.5 mg of inhaled budesonide suspension by nebulization each time. while the observation group received 1.0 mg of inhaled budesonide suspension by nebulization each time. Peripheral blood Treg and Th17 cell levels and their ratio, lung function indicators including forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC, inflammatory factors including interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17 (IL-17) and transforming growth factor-β (TGF-β), as well as clinical efficacy and incidence of adverse reactions were compared between the two groups. Results: After treatment, Treg, FEV1, FVC, FEV1/FVC, IL-10 and TGF-β were increased in both groups, and were higher in the observation group (P<0.05); Th17, Th17/Treg, IL-6 and IL-17 were decreased in both groups, and were lower in the observation group (P<0.05). The total effective rate of the observation group was 95.83%, which was higher than 83.33% of the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compared with the inhalation of 0.5 mg budesonide, the combined inhalation of 1.0 mg budesonide and cetirizine in the treatment of children with acute bronchial asthma can significantly improve the clinical efficacy. regulate Th17/Treg immune balance, improve lung function and alleviate inflammatory response in children with acute exacerbation of bronchial asthma, without obviously increasing the risk of adverse reactions.

Objective: To compare the efficacy of doxycycline and azithromycin combined with methylprednisolone in the treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. Methods: A total of 108 children with RMPP diagnosed and treated in our hospital from July 2023 to December 2024 were prospectively selected as study subjects and divided into a control group ( n=54) and an observation group (n=54) using a random number table method. The control group was treated with azithromycin combined with methylprednisolone, while the observation group was treated with doxycycline combined with methylprednisolone. The clinical efficacy, time to clinical symptom resolution, length of hospital stay, inflammatory markers [C-reactive protein (CRP), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α)], pulmonary function [percentage of forced expiratory volume in one second (FEV1) to predicted value, FEV1/forced vital capacity (FVC), percentage of peak expiratory flow (PEF) to predicted value], and incidence of adverse reactions were compared between the two groups. Data mining was performed using Modeler software to analyze the influencing factors of clinical efficacy and adverse reactions in children. Results: The total effective rate in the observation group (90.74%) was higher than that in the control group (75.93%), and the time to clinical symptom resolution (fever, cough, wheeze, and lung rale) and length of hospital stay were shorter in the observation group than in the control group (P<0.05). After treatment, CRP, IL-10, and TNF-α levels were lower in the observation group, while the percentage of FEV1 to predicted value, FEV1/FVC, and percentage of PEF to predicted value were higher in the observation group than in the control group (P<0.05). During treatment, there was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). According to the automatic classifier model of Modeler software, TNF-α before treatment, percentage of FEV1 to predicted value before treatment, and CRP before treatment were the core driving factors affecting clinical efficacy. According to the Bayesian network model analysis of Modeler software, gender, age, body mass, and the duration of fever before treatment were key factors influencing the incidence of adverse reactions. Conclusion: The efficacy of doxycycline combined with methylprednisolone in the treatment of pediatric RMPP is superior to that of azithromycin combined with methylprednisolone, effectively shortening the duration of clinical symptoms, reducing inflammatory response, and improving lung function.

Objective: To analyze the effect of ulinastatin combined with insulin on homeostasis model assessment of insulin resistance (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) complicated with septic shock. Methods: A total of 74 patients with T2DM complicated with septic shock admitted to the intensive care unit from January 2023 to December 2024 were enrolled and randomly divided into control group (insulin monotherapy, n=36) and observation group (ulinastatin combined with insulin therapy, n=38). Blood glucose and acid-base metabolic indicators [blood lactic acid (Lac), carbon dioxide combining power (CO2CP), fasting blood glucose (FBG), glycated hemoglobin (HbA1c)], inflammatory and oxidative stress indicators [tumor necrosis factor-α (TNF-α), procalcitonin (PCT), malondialdehyde (MDA), superoxide dismutase (SOD)], fasting insulin (FINS) and HOMA-IR were detected, and clinical efficacy and adverse reactions were compared.Results: After treatment, Lac, FBG, HbA1c, TNF-α, PCT, MDA, FINS, HOMA-IR and in both groups decreased, and were lower in the observation group (P<0.05); CO2CP and SOD increased, and were higher in the observation group (P<0.05). The total clinical effective rate of the observation group was higher than that of the control group (94.74% vs 77.78%, P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Ulinastatin combined with insulin has good clinical efficacy in the treatment of T2DM patients complicated with septic shock, which can significantly improve blood glucose and acidbase metabolism, inflammatory response, oxidative stress and insulin resistance.

Objective: To explore the clinical efficacy of octreotide combined with pantoprazole in the treatment of gastric and duodenal ulcers complicated with upper gastrointestinal bleeding. Methods: A total of 60 patients with gastric and duodenal ulcers complicated with upper gastrointestinal bleeding admitted to our hospital from November 2021 to December 2024 were prospectively enrolled and divided into the control group and the observation group by random number table method, with 30 cases in each group. Both groups received conventional treatment. The control group was treated with pantoprazole sodium for injection, and the observation group was treated with octreotide acetate injection on the basis of the control group. Both groups were treated continuously for 5 days. The clinical efficacy, coagulation function indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB)], continuous bleeding time, continuous bleeding volume and the incidence of adverse reactions were compared between the two groups. Results: After treatment, the total clinical effective rate of the observation group was 93.33%, higher than 73.33% of the control group (P<0.05). The APTT, PT, TT and continuous bleeding time in the observation group were shorter than those in the control group, while FIB and continuous bleeding volume were lower than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Octreotide combined with pantoprazole has good efficacy in treating patients with gastric and duodenal ulcers complicated with upper gastrointestinal bleeding. It can effectively improve coagulation function, shorten continuous bleeding time, reduce continuous bleeding volume, and does not increase the risk of adverse reactions.

Objective: To retrieve and sort out randomized controlled trials (RCTs) of Chinese patent medicines in the treatment of lung cancer from 2014 to 2024 by evidence mapping, so as to understand the evidence distribution and clinical value of relevant studies. Methods: RCTs on Chinese patent medicines for lung cancer published from 2014 to 2024 in CNKI, WanFang, VIP, SinoMed, PubMed, Cochrane Library and EMbase were retrieved. The classification, sample size, intervention measures, course of treatment and efficacy evaluation indexes of Chinese patent medicines were visualized. Quality evaluation was carried out according to the Cochrane risk of bias assessment tool. Results: A total of 596 RCTs were screened out, involving 55 kinds of Chinese patent medicines (18 traditional Chinese medicine injections and 37 oral Chinese patent medicines). Most sample sizes were 61-100 cases, and intervention courses were mainly 6-12 weeks. Chinese patent medicines were mostly used in comprehensive treatment of lung cancer in the forms of concurrent treatment on the basis of combined medication and sequential medication. Outcome indexes were classified and merged according to their functional attributes, involving 11 categories such as short-term efficacy, long-term prognosis and quality of life. Conclusion: Chinese patent medicines have intervention advantages at different stages of lung cancer and are more suitable for the chronic disease management model of lung cancer. However, the overall quality of evidence is low, lacking high-quality RCTs with rigorous design. Insufficient attention has been paid to the diagnostic criteria, objective evaluation of traditional Chinese medicine syndromes and long-term outcomes. Further post-marketing supplementary studies and reevaluations are still needed.

Objective: To investigate the efficacy of enoxaparin sodium in the treatment of recurrent spontaneous abortion (RSA) and its effects on uterine artery hemodynamics, sex hormones and T helper (Th)1/Th2 cytokines. Methods: Clinical data of 106 RSA patients treated in our hospital from January 2022 to December 2024 were retrospectively analyzed. According to treatment regimens, patients were divided into control group and experimental group, with 53 cases in each group. The control group received conventional treatment, and the experimental group was treated with enoxaparin sodium injection on the basis of conventional treatment. Clinical efficacy, uterine artery hemodynamic parameters [pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D)], sex hormone levels [progesterone (P), human chorionic gonadotropin (hCG), estradiol (E2)], Th1/Th2 cytokine levels [interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-10 (IL- 10)], pregnancy outcomes and adverse reactions were compared between the two groups. Results: The total clinical effective rate and full-term delivery rate in the experimental group were higher than those in the control group (94.34% vs 81.13%, 83.02% vs 50.94%), while the premature delivery rate and abortion rate were lower than those in the control group (11.32% vs 30.19%, 5.66% vs 18.87%, P<0.05). After treatment, PI, RI, S/D, IFN-γ and TNF-α in both groups were decreased, and those in the experimental group were lower than those in the control group (P<0.05); P, hCG, E2 and IL-10 were increased, and those in the experimental group were higher than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Enoxaparin sodium combined with conventional treatment can effectively optimize uterine artery blood perfusion, regulate sex hormone and Th1/Th2 cytokine levels, thus creating an internal environment conducive to embryonic development, significantly improving pregnancy outcomes without increasing the risk of adverse reactions in RSA patients.

Objective: To investigate the clinical efficacy of carbidopa and levodopa sustainedrelease tablets combined with levodopa and benserazide hydrochloride tablets in the treatment of Parkinson's disease. Methods: Clinical data from 60 patients with Parkinson's disease admitted to our hospital between February 2022 and December 2024 were retrospectively collected. Patients were divided according to treatment regimen into a control group (n=30; conventional treatment plus levodopa and benserazide hydrochloride tablets) and an observation group (n=30; conventional treatment plus levodopa and benserazide hydrochloride tablets, carbidopa and levodopa sustained-release tablets). Both groups received treatment for 6 months. Clinical efficacy, Parkinson's disease symptom scores [Unified Parkinson's Disease Rating Scale (UPDRS) and Non-Motor Symptom Scale (NMSS)], inflammatory markers [interleukin-1β (IL-1β) and interleukin-6 (IL-6)], homocysteine (Hcy) and brain-derived neurotrophic factor (BDNF) levels, and adverse reactions were compared between the two groups. Results: After treatment, the overall clinical response rate in the observation group was higher than that in the control group (93.33% vs 73.33%, P<0.05). The UPDRS score, NMSS score, and IL-1β, IL-6, and Hcy levels were lower in the observation group than in the control group, whereas the BDNF level was higher in the observation group (P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P>0.05). Conclusion: Carbidopa and levodopa sustained-release tablets combined with levodopa and benserazide hydrochloride tablets can improve clinical efficacy in patients with Parkinson's disease, alleviate motor and non-motor symptoms, reduce inflammatory marker levels, and improve Hcy and BDNF levels without increasing the risk of adverse reactions.

Objective: To compare the anesthetic effect and postoperative recovery quality of 0.33% ropivacaine in ultrasound-guided popliteal sciatic nerve block for ankle fracture surgery. Methods: A retrospective analysis was performed on 180 patients undergoing open reduction and internal fixation or ligament repair for ankle fracture from April 2020 to December 2022. Patients were divided into control group (0.50% ropivacaine, n=98) and observation group (0.33% ropivacaine, n=82). All patients received ultrasound-guided popliteal sciatic nerve block with 20 ml corresponding concentration of ropivacaine hydrochloride injection, followed by spinal anesthesia after satisfactory block. Baseline data, postoperative motor and functional recovery indexes, intraoperative anesthetic and block effect, postoperative analgesia indexes and complications were compared. Kaplan-Meier method and Log-rank test were used to compare the time to first analgesic requirement. Multivariate Logistic regression was used to analyze the influencing factors of 6-hour postoperative motor function recovery. Results: There was no significant difference in baseline data between the two groups (P>0.05). At 6 hours after operation, the proportion of active foot movement in the observation group was higher, and the time to first ambulation was shorter than that in the control group (P<0.05). The onset time and completion time of motor block in the control group were shorter (P<0.05), while no significant difference was found in sensory block onset time (P>0.05). The postoperative block duration and time to first analgesic requirement in the observation group were shorter, while 24-hour opioid consumption was higher (P<0.05). Log-rank test showed a significant difference in median time to first analgesic requirement (12.8 h vs 11.2 h, χ2=6.365, P=0.012). No significant difference was observed in the total incidence of complications (P>0.05). Multivariate Logistic regression showed that 0.33% ropivacaine was an independent protective factor for 6-hour postoperative motor function recovery (OR=2.160, 95%CI:1.112~4.195, P=0.023). Conclusion: In ultrasound-guided popliteal sciatic nerve block for ankle fracture surgery, 0.33% ropivacaine has equivalent intraoperative anesthetic efficacy to 0.50% ropivacaine. It can shorten postoperative block duration, accelerate motor function recovery, and does not increase the incidence of complications.

Objective: To explore the effects of propofol combined with sufentanil on immune function and neurological function in patients undergoing type A aortic dissection aneurysm surgery. Methods: A total of 104 patients with type A aortic dissection aneurysm admitted from February 2022 to January 2025 were randomly divided into control group (sevoflurane combined with cisatracurium and sufentanil, n=52) and observation group (propofol combined with cisatracurium and sufentanil, n=52). Immune function indexes [CD4+, natural killer cell (NK cell), CD19+, CD4+/CD8+), neurological function indexes[glial fibrillary acidic protein (GFAP), neuronspecific enolase (NSE), myelin basic protein (MBP) ]were detected before operation, 6 h and 24 h after operation; Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were evaluated before operation, 12 h and 24 h after operation; the incidence of adverse reactions was compared between the two groups. Results: There were significant inter-group, time-point and interaction effects on immune function indexes, neurological function indexes and cognitive function scores between the two groups (P<0.05). At 6 h after operation, CD4+, CD4+/CD8+, NK cell and CD19+ in the observation group were higher than those in the control group (P<0.05). The levels of GFAP, NSE and MBP at 6 h and 24 h after operation in the observation group were lower than those in the control group (P<0.05). The MMSE and MoCA scores at 12 h after operation in the observation group were higher than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Propofol combined with sufentanil can alleviate immune function suppression and reduce neurological and cognitive function damage in patients undergoing type A aortic dissection aneurysm surgery, with good safety.

Objective: To explore the effect of oxycodone-paracetamol on postoperative pain control in lung cancer patients undergoing thoracoscopic pulmonary segmentectomy. Methods: A total of 60 patients with lung cancer undergoing elective thoracoscopic pulmonary segmentectomy from August 2022 to June 2025 were prospectively enrolled and divided by envelope method into control group and observation group, with 30 cases in each group. The control group received routine postoperative analgesia, and the observation group was given oxycodone-paracetamol tablets on the basis of routine analgesia. Postoperative visual analogue scale (VAS) score, analgesic pump pressing times within 24 h after operation, total sufentanil dosage within 24 h after operation, pain mediators (substance P, β-endorphin, 5-hydroxytryptamine), inflammatory indicators [interleukin-6 (IL-6), high mobility group protein B1 (HMGB1)], sleep quality and adverse reactions were compared between the two groups. Results: The VAS scores at 12 h, 24 h and 48 h after operation in the observation group were lower than those in the control group (P<0.05). The total pressing times of analgesic pump within 24 h and total sufentanil dosage within 24 h after operation were less than those in the control group (P<0.05). At 24 h after operation, the levels of substance P, β-endorphin, 5-hydroxytryptamine, IL-6 and HMGB1 increased in both groups, with lower levels in the observation group (P<0.05). The total sleep time, deep sleep time and light sleep time were shortened in both groups, but longer in the observation group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Oxycodone-paracetamol has good effect on pain control after thoracoscopic pulmonary segmentectomy in lung cancer patients. It can inhibit the elevation of pain mediators and inflammatory indicators, reduce the impact on sleep quality, with good safety.

Objective: To investigate the effects of oxycodone combined with nerve block on postoperative analgesia, joint function recovery and early inflammatory factor levels in patients with hip fracture. Methods: A prospective clinical study was conducted on 100 patients with hip fracture scheduled for hip surgery in our hospital from February 2023 to April 2025. Patients were randomly divided into two groups using block randomization: group A (n=50) received nerve block anesthesia alone, and group B (n=50) received oxycodone combined with nerve block anesthesia. Dynamic and resting pain intensity [Visual Analogue Scale (VAS)], postoperative joint range of motion, postoperative functional recovery, early inflammatory factor levels and adverse reactions were compared between the two groups. Results: The dynamic VAS score at 24 h after operation and resting VAS score at 6 h after operation in group B were lower than those in group A (P<0.05). The flexion and abduction degrees at 48 h and 72 h after operation in both groups were higher than those at 24 h after operation (P<0.05), and those in group B were higher than those in group A at 24 h and 48 h after operation (P<0.05). The time to first straight leg raise ≥10 cm, time to first ambulation and timed up and go test (TUG) time at 72 h after operation in group B were shorter than those in group A (P<0.05). At 1 day after operation, interleukin-6 (IL-6), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in both groups were increased (P<0.05), but those in group B were lower than those in group A (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups during postoperative hospitalization (P>0.05). Conclusion: Oxycodone combined with nerve block can significantly enhance postoperative analgesia, promote early recovery of joint function, inhibit postoperative inflammatory response in patients with hip fracture, without increasing the risk of adverse reactions.

Objective: To explore the effects of Banxia Baizhu Tianma Decoction combined with atorvastatin calcium tablets on traditional Chinese medicine (TCM) syndrome score and blood ressure in patients with hypertension complicated with coronary heart disease (CHD). Methods: A total of 108 patients with hypertension complicated with CHD admitted to our hospital from April 2022 to September 2024 were selected and divided into control group and study group, with 54 cases in each group. The control group received atorvastatin calcium tablets on the basis of conventional antihypertensive treatment; the study group received Banxia Baizhu Tianma Decoction additionally on the basis of the control group. TCM syndrome score, blood pressure, blood lipid indicators [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C)], vascular endothelial function indicators [endothelin-1 (ET-1), nitric oxide (NO)], clinical efficacy and adverse reactions were compared between the two groups. Results: After treatment, the TCM syndrome score, systolic blood pressure, diastolic blood pressure, TG, TC, LDL-C and ET-1 levels in both groups decreased, and were lower in the study group than in the control group (P<0.05). The NO level increased in both groups and was higher in the study group (P<0.05). The total clinical effective rate of the study group was 92.59%, higher than 72.22% of the control group (P<0.05). No serious adverse reactions such as vomiting and dry mouth occurred in either group during treatment. Conclusion: Banxia Baizhu Tianma Decoction combined with atorvastatin calcium tablets has obvious clinical efficacy in the treatment of hypertension complicated with CHD. It can significantly reduce TCM syndrome score, regulate blood pressure and blood lipid, and improve vascular endothelial function.

Objective: To explore the clinical effect of Qilong Huoluo Formula combined with Wenyang Acupuncture in the treatment of cerebral infarction patients at recovery stage with qi deficiency and blood stasis syndrome. Methods: A total of 80 cerebral infarction patients at recovery stage with qi deficiency and blood stasis syndrome admitted from March to October 2025 were selected and divided into control group and observation group by random number table method, with 40 cases in each group. The control group received conventional treatment; the observation group was treated with Qilong Huoluo Formula combined with Wenyang Acupuncture on the basis of the control group, with continuous treatment for 4 weeks. Clinical efficacy, traditional Chinese medicine (TCM) syndrome score, motor function (evaluated by the Fugl-Meyer Assessment Scale), quality of life [evaluated by the Stroke-Specific Quality of Life (SS-QOL)], hemorheological indexes (plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity), neuro-related indicators[5-hydroxytryptamine (5-HT), brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE)] and adverse reactions were compared between the two groups. Results: The total effective rate of the observation group was 92.50%, higher than 70.00% of the control group (P<0.05). TCM syndrome score, plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity and serum NSE in the observation group were lower than those of the control group; Fugl-Meyer score (upper limb and lower limb), SS-QOL score, serum 5-HT and BDNF were higher than those of the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Qilong Huoluo Formula combined with Wenyang Acupuncture can improve clinical efficacy, reduce blood viscosity, regulate neurorelated indicators levels, and improve motor function and quality of life in cerebral infarction patients at recovery stage with qi deficiency and blood stasis syndrome.

Objective: To investigate the predictive value of serum β2-microglobulin (β2-MG) combined with absolute lymphocyte count (ALC) in survival and recurrence of patients with diffuse large B-cell lymphoma (DLBCL) in the era of rituximab. Methods: A total of 150 DLBCL patients diagnosed and treated in our hospital from March 2022 to March 2025 were retrospectively enrolled. All patients received standard rituximab combined with CHOP regimen (R-CHOP). Serum β2-MG and ALC were detected. The relationship between serum β2-MG, ALC and survival/recurrence was analyzed. The correlation between serum β2-MG and ALC, as well as their predictive value for survival and recurrence, were explored, and survival analysis was performed. Results: Serum β2-MG in surviving, progression-free and recurrence-free DLBCL patients was lower than that in dead, progressed and recurrent patients (P<0.05), while ALC was higher (P<0.05). Pearson analysis showed a negative correlation between serum β2-MG and ALC in DLBCL patients (r=-0.497, P<0.001). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of serum β2-MG, ALC and their combination for predicting survival were 0.849, 0.822 and 0.864; for predicting progression-free survival were 0.860, 0.681 and 0.866; for predicting recurrence were 0.852, 0.697 and 0.857, respectively. Kaplan-Meier curve analysis showed that overall survival (OS) and progression free survival (PFS) in the low β2-MG group were longer than those in the high β2-MG group (P<0.05), while OS and PFS in the low ALC group were shorter than those in the high ALC group (P<0.05). Conclusion: Serum β2-MG combined with ALC has certain predictive value for survival and recurrence in DLBCL patients in the era of rituximab.

Objective: To analyze the risk factors for the degree of liver injury in schizophrenia patients taking long-term second-generation antipsychotics, and to construct a risk prediction model for severe liver injury. Methods: Clinical data of 80 schizophrenia patients admitted to our hospital from January 2023 to December 2024 were retrospectively analyzed. According to the degree of liver injury, they were divided into mild group (n=41), moderate group (n=25) and severe group (n=14). Clinical data including gender, age, body mass index (BMI), disease duration, schizophrenia subtype, diabetes, hypertension, coronary heart disease, drinking history, smoking history, anemia, malnutrition and types of drugs were compared among the three groups. Indicators with statistical significance in univariate analysis were included in Logistic regression model. Receiver operating characteristic (ROC) curve was used to construct a risk prediction model for severe liver injury based on the combined data fitted by regression coefficients. Results: Univariate analysis showed that age, BMI, disease duration, drinking history, malnutrition and types of drugs were the main suspected risk factors affecting the degree of liver injury. Further Logistic regression analysis showed that BMI, malnutrition and types of drugs were independent risk factors for severe liver injury (P<0.05). ROC curve analysis of the combined model showed that the area under the curve (AUC) was 0.892, the prediction sensitivity was 99.2%, the specificity was 78.8%, the prediction accuracy was 50.0%, the recall rate was 99.5%, and the prediction probability was 0.82. Conclusion: Age, BMI, disease duration, drinking history, malnutrition and types of drugs are the main suspected risk factors for liver injury in schizophrenia patients taking longterm second-generation antipsychotics, among which BMI, malnutrition and types of drugs are independent risk factors for severe liver injury. Clinical monitoring and management of the above factors should be strengthened to reduce the occurrence of drug-induced liver injury.

Objective: To construct a comprehensive clinical evaluation index system for nicorandil tablets in the treatment of unstable angina pectoris (UAP), and evaluate its clinical application value, so as to provide reference and evidence support for rational clinical medication. Methods: Expert consultation and literature review were used to preliminarily establish the evaluation index system. Delphi method and analytic hierarchy process were adopted to screen indicators and determine their weights. Meta-analysis, real-world research and questionnaire survey were performed for comprehensive clinical evaluation. Experts scored nicorandil tablets and isosorbide mononitrate sustained-release tablets according to the evaluation results. Results: The constructed system included 6 primary indicators, 13 secondary indicators and 29 tertiary indicators. The comprehensive score of nicorandil tablets was 81.58 points, while that of isosorbide mononitrate sustained-release tablets was 77.20 points. Conclusion: This study established a multi-dimensional clinical evaluation system for nicorandil tablets. Integrated with expert consultation, Meta-analysis and real-world data, it is confirmed that nicorandil tablets are superior to isosorbide mononitrate sustained-release tablets in safety, efficacy and applicability. It provides evidence for rational medication and drug catalogue selection, and the established model is worthy of reference for similar studies.