Olverembatinib (HQP1351) is a tyrosine kinase inhibitor (TKI) that inhibits wild-type BCR-ABL1 and multiple BCR-ABL1 mutants, including the T315I mutation. In November 2021, olverembatinib was fi rst approved for marketing in China for the treatment of adult patients with chronic-phase chronic myeloid leukemia (CML) who are resistant and/or intolerant to fi rst- and second-generation TKIs, as well as adult patients with chronic-phase or accelerated-phase CML with a confi rmed T315I mutation who are resistant to any TKI. This article reviews the mechanism of action of olverembatinib, the results of phase Ⅰ and phase Ⅱ clinical trials, and its safety profile, and discusses its role in the treatment of patients with CML.

Objective: To assess potentially inappropriate medication (PIM) in the oldest-old using two different domestic and international criteria. Methods: Chronic medication data from 163 older adults aged ≥85 years were summarized. The 2023 American Geriatrics Society Beers Criteria (2023 AGS Beers Criteria) and the 2017 Chinese Criteria for Potentially Inappropriate Medication in Older Adults were used for assessment and analysis. Results: According to the 2023 AGS Beers Criteria, the prevalence of PIM was 72.39% (118/163, 317 instances). According to the Chinese PIM criteria, the prevalence of PIM was 73.01% (119/163, 322 instances). The prevalence of PIM in the oldest-old with polypharmacy exceeded 70% when assessed using either criterion, but the drugs involved and the potential risk points differed. Conclusion: Assessment using dual criteria can identify PIM more comprehensively and provide a basis and guidance for subsequent individualized medication interventions.

Objective: To investigate the short-term efficacy and hypoglycemia risk of insulin degludec/liraglutide injection combined with dapagliflozin tablets and metformin hydrochloride tablets in elderly patients with poorly controlled type 2 diabetes mellitus (T2DM), and to perform real-time continuous glucose monitoring. Methods: A total of 80 elderly patients with poorly controlled T2DM who visited the Department of Endocrinology of our hospital from April 2022 to December 2024 were selected and randomized by the random number table method into a control group and an observation group, with 40 patients in each group. Both groups received dapagliflozin tablets and metformin hydrochloride tablets as background oral hypoglycemic drug therapy. On this basis, the control group received insulin glargine solution for injection, and the observation group received insulin degludec/liraglutide injection. Both groups were treated for 12 weeks. Glycemic parameters [fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), and glycated hemoglobin (HbA1c)], β-cell function indicators [homeostasis model assessment of β-cell function (HOMA-β) and homeostasis model assessment of insulin resistance (HOMAIR)], lipid parameters [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)], and occurrence of adverse events were compared between the two groups. Real-time continuous glucose monitoring was also performed, including mean glucose, standard deviation of blood glucose (SDBG), and largest amplitude of glycemic excursion (LAGE). Results: After 12 weeks of treatment, FPG, 2hPG, HbA1c, TG, TC, and LDL-C were lower in the observation group than in the control group (P<0.05), and improvements in HOMA-β and HOMA-IR were greater in the observation group than in the control group (P<0.05). After treatment, HDL-C did not differ significantly between the two groups (P>0.05). The incidence of hypoglycemia did not differ significantly between the two groups (P=0.094), and no severe hypoglycemia occurred in either group. Real-time continuous glucose monitoring showed that mean glucose, SDBG, and LAGE were lower in the observation group than in the control group (P<0.05). Conclusion: Insulin degludec/liraglutide injection combined with dapagliflozin tablets and metformin hydrochloride tablets can improve short-term glycemic control, islet function, selected lipid parameters, and glycemic variability in elderly patients with poorly controlled T2DM without increasing the risk of hypoglycemia, indicating short-term clinical value.

Objective: To investigate the clinical outcomes of doxycycline (Dox) in children older than 8 years with azithromycin-resistant severe Mycoplasma pneumoniae pneumonia (SMPP). Methods: Data from 112 children with azithromycin-resistant SMPP admitted to our hospital from January 2023 to January 2025 were retrospectively collected. According to treatment strategy, patients were divided into group A (initial Dox administration, n=32), group B (azithromycin discontinued and switched to Dox, n=58), and group C (azithromycin used throughout treatment, n=22). Inflammation-related indicators, liver function, clinical outcomes, and adverse reactions were compared among the three groups. Results: After treatment, C-reactive protein, D-dimer, and lactate dehydrogenase, white blood cell count, levels decreased in all three groups and were lowest in group A (P<0.05). Alanine aminotransferase and aspartate aminotransferase levels after treatment did not differ significantly among the three groups (P>0.05). The 48 h and 72 h fever resolution rates, intensive care unit (ICU) length of stay, and methylprednisolone use rate differed significantly among the three groups (P<0.05), whereas chest X-ray improvement rate and bronchoalveolar lavage rate did not differ significantly (P>0.05). Pairwise comparisons showed that group A had the highest 48 h and 72 h fever resolution rates and the shortest ICU length of stay, as well as the lowest methylprednisolone use rate (P<0.05), whereas these indicators did not differ significantly between groups B and C (P>0.05). The overall incidence of adverse reactions did not differ significantly among the three groups (P>0.05). Conclusion: Dox in children older than 8 years with azithromycin-resistant SMPP can improve clinical outcomes and reduce inflammatory responses, with favorable drug safety.

Objective: To investigate the clinical efficacy of nebulized recombinant human interferon α1b combined with acetylcysteine in children with bronchopneumonia. Methods: A retrospective study was conducted on 100 children with bronchopneumonia admitted to our hospital from December 2022 to December 2024. They were divided into a control group [treated with N acetylcysteine (NAC) aerosol inhalation] and a study group (treated with recombinant human interferon α1b in addition to the NAC regimen) based on different treatment methods, with 50 cases in each group. The following parameters were compared between the two groups: C reactive protein (CRP) and fractional exhaled nitric oxide (FeNO) levels; immune function indicators, including immunoglobulin M (IgM), immunoglobulin A (IgA), and immunoglobulin G (IgG) levels; pulmonary function parameters, including the ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), tidal volume per kilogram of body weight (VT/kg), and the ratio of inspiratory to expiratory ratio (I/E); length of hospital stay and time to disappearance of clinical symptoms; as well as differences in clinical efficacy and adverse reactions. Results: After treatment, CRP and FeNO levels decreased in both groups, with the study group showing ignificantly lower values than the control group (P<0.05); both groups showed increases in TPTEF/TE, VT/kg, I/E, IgM, IgA, and IgG levels, with the study group having significantly higher values than the control group (P<0.05). The hospital stay and time to resolution of clinical symptoms in the study group were shorter than those in the control group (P<0.05); the total clinical efficacy rate in the study group (96.00%) was higher than that in the control group (82.00%, P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Recombinant human interferon α1b combined with NAC aerosol inhalation shows good therapeutic efficacy, can shorten the time to resolution of symptoms such as fever and cough, alleviate inflammatory responses, improve pulmonary function, and immune function, and does not increase the risk of adverse reactions.

Objective: To investigate the clinical effect of nebulized ambroxol (AMB) combined with N-acetylcysteine (NAC) in children with Mycoplasma pneumoniae pneumonia (MPP) complicated by bronchial mucus plugs. Methods: A total of 118 children with MPP complicated by bronchial mucus plugs admitted to our hospital from January 2023 to April 2025 were prospectively selected and randomized by the random number table method into a control group (nebulized NAC) and an observation group (nebulized AMB plus NAC), with 59 patients in each group. Changes in airway resistance indicators [airway resistance at 5 Hz (R5), airway resistance at 20 Hz (R20), and respiratory reactance at 5 Hz (X5)], serum inflammatory factors [interleukin-6 (IL-6) and macrophage inflammatory protein-2 (MIP-2)], and oxidative stress indicators [superoxide dismutase (SOD) and malondialdehyde (MDA)] before and after treatment were observed in the two groups. The time to symptom resolution, mucus plug clearance time, bronchoscopy intervention rate, and incidence of adverse reactions were compared between the two groups. Results: After treatment, R5, R20, IL-6, MIP-2, and MDA decreased in both groups and were lower in the observation group than in the control group (P<0.05), whereas X5 and SOD increased in both groups and were higher in the observation group than in the control group (P<0.05). The time to resolution of dyspnea and the mucus plug clearance time were shorter in the observation group than in the control group (P<0.05), and the bronchoscopy intervention rate was lower in the observation group (P<0.05). The overall incidence of adverse reactions did not differ significantly between the two groups (P>0.05). Conclusion: Nebulized NAC combined with AMB in children with MPP complicated by bronchial mucus plugs can further shorten mucus plug clearance time, reduce airway resistance, and help improve inflammatory and oxidative stress responses.

Objective: To observe the effects of sequential therapy with Qinggan Lidan Oral Liquid and Yinzhihuang Granules on bilirubin metabolism and liver function in neonates with hyperbilirubinemia. Methods: Clinical data from 134 neonates with hyperbilirubinemia admitted to our hospital from January 2023 to December 2024 were retrospectively analyzed. According to treatment method, they were divided into a control group (Yinzhihuang Granules) and a study group (sequential therapy with Qinggan Lidan Oral Liquid combined with Yinzhihuang Granules), with 67 neonates in each group. Liver function indicators [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)], bilirubin indicators [total bilirubin (TBIL), indirect bilirubin (IBIL), and direct bilirubin (DBIL)], clinical efficacy, and adverse reactions were compared between the two groups. Results: After 14 days of treatment, ALT and AST levels decreased in both groups and were lower in the study group than in the control group (P<0.05). After 7 days of treatment, TBIL, IBIL, and DBIL levels decreased in both groups (P<0.05), but there was no significant between-group difference (P>0.05). After 14 days of treatment, TBIL, IBIL, and DBIL levels in both groups were lower than before treatment and after 7 days of treatment (P<0.05), and these levels were lower in the study group than in the control group (P<0.05). The overall clinical response rate was higher in the study group than in the control group (97.01% vs 82.09%, P<0.05). The overall incidence of adverse reactions did not differ significantly between the two groups (P>0.05). Conclusion: Sequential therapy with Qinggan Lidan Oral Liquid combined with Yinzhihuang Granules has good efficacy in neonates with hyperbilirubinemia. It can effectively regulate bilirubin metabolism and improve liver function indicators without increasing the risk of adverse reactions.

Objective: To investigate the clinical effect of different doses of sacubitril/valsartan as adjunctive therapy in patients with acute exacerbation of chronic heart failure (AECHF). Methods: A total of 80 patients with AECHF admitted to our hospital from March 2021 to March 2024 were selected as the study participants. All patients were randomized by the random number table method into a low-dose group (sacubitril/valsartan sodium tablets 100 mg/day) and a highdose group (sacubitril/valsartan sodium tablets 200 mg/day), with 40 patients in each group. After 3 months of continuous treatment, cardiac function indicators [left ventricular ejection fraction (LVEF), left ventricular posterior wall thickness (LVPW), and diastolic interventricular septal thickness (IVST)], myocardial injury markers [creatine kinase-isoenzyme (CK-MB), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac troponin T (cTnT)], quality of life [Minnesota Living with Heart Failure Questionnaire (MLHFQ) score], clinical efficacy, and adverse reactions were compared between the two groups. Results: After treatment, LVPW, IVST, CK-MB, NTproBNP, and cTnT decreased in both groups and were lower in the high-dose group than in the lowdose group (P<0.05), whereas LVEF and MLHFQ scores increased in both groups and were higher in the high-dose group (87.50%) than in the low-dose group (67.50%, P<0.05). The total overall clinical response rate was higher in the high-dose group than in the low-dose group (P<0.05). The total incidence of adverse reactions did not differ significantly between the two groups (P>0.05). Conclusion: The high-dose sacubitril/valsartan showed a greater effect in improving cardiac function, reducing myocardial damage, and enhancing quality of life compared to the low-dose group. Moreover, its adverse reactions were similar to those of the low-dose sacubitril/valsartan regimen.

Objective: To investigate the therapeutic effect of tirofiban combined with conventional therapy on disease progression and prognosis in patients with acute progressive cerebral infarction (APCI). Methods: A total of 100 patients with APCI admitted to the Department of Neurology of our hospital from February 2024 to August 2025 were selected as the study participants and randomized by the random number table method into a control group and an observation group, with 50 patients in each group. The control group received conventional therapy, including antiplatelet therapy, plaque stabilization, and circulation-improving treatment, whereas the observation group received tirofiban hydrochloride concentrated solution for injection in addition to the treatment given to the control group. Both groups were treated for 14 days. Neurological deficit scores [assessed using the National Institutes of Health Stroke Scale (NIHSS)], serum neurological injury markers [neuronspecific enolase (NSE) and S100β protein], disease progression rate, 90 days post-treatment modified Rankin Scale (mRS) score, and adverse reactions were compared between the two groups. Results: After 7 and 14 days of treatment, NIHSS scores were lower in the observation group than in the control group (P<0.05). After 14 days of treatment, serum NSE and S100β protein levels were lower in the observation group than in the control group (P<0.05). The disease progression rate was lower in the observation group than in the control group (6.00% vs 20.00%, P<0.05). At 90 days post-treatment, the rate of favorable prognosis (mRS score ≤2) was higher in the observation group than in the control group (76.00% vs 54.00%, P<0.05). The overall incidence of adverse reactions did not differ significantly between the two groups (P>0.05). Conclusion: Tirofiban combined with conventional therapy can effectively prevent disease progression in patients with APCI, reduce neurological deficits, and improve prognosis, with a favorable safety profile.

Objective: To investigate the clinical efficacy of edaravone and dexborneol combined with butylphthalide in patients with acute cerebral infarction and its effect on inflammatory response. Methods: Clinical data of 96 patients with acute cerebral infarction admitted to our hospital from June 2021 to January 2026 were retrospectively collected. Patients were divided into the control group and the observation group according to treatment regimen, with 48 cases in each group. All patients received intravenous thrombolysis with alteplase for injection. The control group received butylphthalide soft capsules within 24–48 h after intravenous thrombolysis, while the observation group received edaravone and dexborneol concentrated solution for injection combined with butylphthalide soft capsules within 24–48 h after intravenous thrombolysis. Both groups were treated for 14 days. Clinical efficacy, inflammatory markers [white blood cell count (WBC) and high‑sensitivity C‑reactive protein (hs‑CRP)], prognosis at 3 months after treatment [assessed using the Simplified Modified Rankin Scale Questionnaire (smRSq)], and adverse reactions were compared between the two groups. Results: After 14 days of treatment, the total effective rate of treatment was higher in the observation group than in the control group (93.75% vs 75.00%, P<0.05). WBC and hs‑CRP levels decreased in both groups and were lower in the observation group than in the control group (P<0.05). At 3‑month follow‑up after treatment, the rate of favorable prognosis was higher in the observation group than in the control group (89.58% vs 72.92%, P<0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups during treatment (P>0.05). Conclusion: Edaravone and dexborneol combined with butylphthalide can significantly improve clinical efficacy in patients with acute cerebral infarction, reduce inflammatory response, and improve prognosis without increasing the risk of adverse reactions.

Objective: To analyze the clinical efficacy of ginkgolide injection combined with conventional therapy in patients with cerebral infarction. Methods: A total of 133 patients with cerebral infarction admitted to our hospital from November 2023 to October 2025 were selected and divided according to clinical treatment modality into a conventional group (n=68) and a combination group (n=65). The conventional group received conventional treatment, whereas the combination group received ginkgolide injection in addition to conventional treatment. Neurological function [assessed using the National Institutes of Health Stroke Scale (NIHSS)], clinical efficacy, quality of life [assessed using the Barthel Index (BI)], and adverse reactions were compared between the two groups. IBM SPSS Modeler 18.0 was used to analyze important indicators affecting clinical efficacy. Results: After 7 and 14 days of treatment, NIHSS scores decreased in both groups and were lower in the combination group than in the conventional group (P<0.05). After 14 days of treatment, the overall clinical response rate was higher in the combination group (92.31%) than in the conventional group (75.00%, P<0.05). At 30 and 90 days after treatment, BI scores increased in both groups and were higher in the combination group than in the conventional group (P<0.05). The overall incidence of adverse reactions did not differ significantly between the two groups (P>0.05). Feature selection based on IBM SPSS Modeler 18.0 showed that treatment modality (group), BI at 90 days after treatment, BI at 30 days after treatment, and age were key factors affecting clinical efficacy. Conclusion: Ginkgolide injection combined with conventional therapy has good clinical efficacy in patients with cerebral infarction, significantly improves neurological impairment, enhances activities of daily living, and has positive clinical value. Treatment modality (group), BI at 90 days after treatment, BI at 30 days after treatment, and age are key factors affecting clinical efficacy.

Objective: To investigate the effects of dapagliflozin (Dap) combined with metformin (Met) on glucose and lipid metabolism, islet function, and inflammatory markers in patients with type 2 diabetes mellitus (T2DM) and obesity. Methods: A total of 102 patients with T2DM and obesity admitted to our hospital from June 2021 to July 2024 were prospectively enrolled and randomly assigned, using a random number table method, to a control group and an observation group, with 51 patients in each group. Both groups received basic non‑drug treatment according to their symptoms. On this basis, the control group received metformin hydrochloride tablets, while the observation group received dapagliflozin tablets in addition to the control treatment. Both groups were treated for 3 months. Glucose and lipid metabolism markers [fasting plasma glucose (FPG), 2‑hour postprandial plasma glucose (2hPG), lipoprotein‑associated phospholipase A2 (Lp‑PLA2), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high‑density lipoprotein cholesterol (HDL‑C), and low‑density lipoprotein cholesterol (LDL‑C)], islet function‑related markers [homeostasis model assessment of insulin resistance (HOMA‑IR) and homeostasis model assessment of β‑cell function (HOMA‑β)], inflammatory markers [platelet‑to‑lymphocyte ratio (PLR) and neutrophil‑to‑lymphocyte ratio (NLR)], clinical efficacy, and treatment safety were compared between the two groups. Results: After 3 months of treatment, FPG, 2hPG, Lp‑PLA2, HbA1c, TC, TG, LDL‑C, HOMA‑IR, PLR, and NLR decreased in both groups and were lower in the observation group than in the control group (P<0.05). HDL‑C and HOMA‑β increased in both groups and were higher in the observation group than in the control group (P<0.05). The total effective rate of treatment was higher in the observation group than in the control group (96.08% vs 80.39%, P<0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P>0.05). Conclusion: Dap combined with Met has definite efficacy in patients with T2DM and obesity. It can effectively regulate glucose and lipid metabolism, improve insulin resistance, reduce the inflammatory markers NLR and PLR, and improve islet function without increasing the risk of adverse reactions.

Objective: To investigate the clinical value of dienogest after laparoscopic surgery in patients with adenomyosis. Methods: A total of 114 patients with adenomyosis who scheduled to undergo laparoscopic lesion resection at our hospital from October 2022 to June 2024 were prospectively enrolled and allocated by the random number table method to the control group (2 patients voluntarily withdrew from the trial; n=55) or the observation group (1 patient voluntarily withdrew from the trial and 2 patients were excluded because of poor compliance; n=54). The control group received postoperative leuprorelin acetate microspheres for injection, whereas the observation group received postoperative dienogest tablets. Both groups were treated continuously for 3 months and were followed up until 12 months. Changes in the Chinese version of the COX Menstrual Symptom Scale (CMSS) score and Pictorial Blood Loss Assessment Chart (PBAC) score were evaluated. Uterine volume and levels of carbohydrate antigen 125 (CA125), 8‑iso‑prostaglandin F2α (PGF2α), vascular endothelial growth factor (VEGF), prostaglandin E2 (PGE2), and hemoglobin (Hb) were measured in both groups. Adverse reactions were recorded. Results: After 3 and 12 months of treatment, CMSS score, PBAC score, CA125, VEGF, PGF2α, and PGE2 decreased in both groups (P<0.05), and CMSS score, CA125, VEGF, PGF2α, and PGE2 were lower in the observation group than in the control group (P<0.05). Uterine volume decreased in both groups and was smaller in the observation group than in the control group (P<0.05). Hb increased in both groups (P<0.05), with no significant difference between groups (P>0.05). The incidence of irregular vaginal bleeding was higher in the observation group than in the control group (P<0.05). No significant differences were observed between the two groups in hot flashes and sweating, mood changes, insomnia and irritability, musculoskeletal pain, or the overall incidence of adverse reactions (P>0.05). Conclusion: Dienogest after laparoscopic surgery in patients with adenomyosis is beneficial for relieving dysmenorrhea symptoms and regulating CA125, VEGF, PGF2α, and PGE2 expression, but it may increase the incidence of irregular vaginal bleeding.

Objective: To investigate the effect of a ropivacaine regional block‑based multimodal analgesia regimen in patients after laparoscopic hysterectomy. Methods: A total of 90 patients scheduled to undergo laparoscopic hysterectomy at our hospital from January 2023 to December 2024 were selected and randomized by the random number table method into a control group and an observation group, with 45 patients in each group. The control group received a conventional postoperative analgesia regimen, whereas the observation group received postoperative ropivacaine regional block‑based multimodal analgesia in addition to the treatment given to the control group. Pain intensity at rest and during movement at different postoperative time points [assessed using the Numerical Rating Scale (NRS)], postoperative recovery, analgesic medication use, and adverse reactions were compared between the two groups. Results: At 6, 12, 24, and 48 h after surgery, NRS scores at rest and during movement were lower in the observation group than in the control group (P<0.05). Compared with the control group, the observation group had shorter times to first ambulation and first flatus after surgery and a shorter hospital stay (P<0.05). Within 48 h after surgery, the observation group had fewer analgesic pump presses, a later time to first analgesic pump press, and a lower rate of rescue analgesic use (P<0.05). The overall incidence of adverse reactions was lower in the observation group than in the control group (6.67% vs 24.44%, P<0.05). Conclusion: Standardized application of a ropivacaine regional block‑based multimodal analgesia regimen for laparoscopic hysterectomy can effectively relieve postoperative pain, promote postoperative recovery, reduce postoperative opioid analgesic requirements, and lower the risk of adverse reactions, providing a reference for the safe and effective implementation of perioperative analgesia management.

Objective: To investigate the clinical value of dezocine combined with propofol in endoscopic interventional treatment of esophageal variceal bleeding (EVB). Methods: A total of 106 patients with EVB who were scheduled to undergo endoscopic polidocanol injection sclerotherapy for esophageal varices at our hospital from January 1, 2020 to October 31, 2024 were prospectively enrolled. They were allocated by the random number table method to the propofol group (1 patient who underwent esophageal variceal ligation during the procedure was excluded, n=52) or the dezocine group (2 patients who underwent esophageal variceal ligation during the procedure were excluded, n=51). The propofol group received anesthesia with target‑controlled infusion of propofol, whereas the dezocine group received dezocine induction before target‑controlled infusion of propofol. Hemodynamic parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and blood oxygen saturation (SpO₂)], propofol dose, anesthesia emergence time, rate of vasoactive drug use, liver function indices [alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL)], Mini‑Mental State Examination (MMSE) score, incidence of postoperative cognitive dysfunction (POCD), and adverse events were compared between the two groups. Results: SBP and DBP at endoscope insertion (T₁), endoscope withdrawal (T₂), and anesthesia emergence (T₃), and HR at T₁ and T₂, were higher in the dezocine group than in the propofol group (P<0.05). The dezocine group required a lower propofol dose and had a shorter anesthesia emergence time than the propofol group (P<0.05). The rate of vasoactive drug use did not differ significantly between the two groups (P>0.05). ALT and AST levels at 24 h postoperatively were lower in the dezocine group than in the propofol group (P<0.05). MMSE scores at 24 h and 48 h postoperatively were higher in the dezocine group than in the propofol group (P<0.05). The incidence of POCD and the overall incidence of adverse events did not differ significantly between the two groups (P>0.05). Conclusion: Dezocine induction combined with target‑controlled infusion of propofol in patients with EVB undergoing endoscopic polidocanol injection sclerotherapy for esophageal varices can stabilize hemodynamics, reduce the propofol dose, and promote postoperative recovery of cognitive function.

Objective: To observe the efficacy of Buyang Huanwu Decoction combined with alteplase intravenous thrombolysis in acute ischemic stroke. Methods: Prospective selection of 120 patients with acute ischemic stroke who received alteplase intravenous thrombolysis in our hospital from June 2022 to June 2024 was conducted as the research subjects. They were numbered according to the order of admission and divided into a control group and an experimental group using the odd‑even number grouping method, with 60 patients in each group. During the study, 3 patients dropped out from the control group, resulting in a final inclusion of 57 patients; 7 patients dropped out from the experimental group, and 4 were excluded, resulting in a final inclusion of 49 patients. The control group received conventional treatment after intravenous thrombolysis with alteplase, while the experimental group received Buyang Huanwu Decoction in addition to the treatment given to the control group. Neurological function [assessed using the National Institutes of Health Stroke Scale (NIHSS)], activities of daily living [assessed using the modified Barthel Index (mBI)], traditional Chinese medicine (TCM) syndrome score, serum apoptosis‑related markers [cysteinyl aspartate specific protease 3 (Caspase‑3), B‑cell lymphoma/leukemia‑2 (Bcl‑2), factor associated suicide (Fas), and Fas ligand (FasL)], and recurrence were compared between the two groups. Results: After treatment, NIHSS score, TCM syndrome score, Caspase‑3, Fas, and FasL decreased in both groups and were lower in the experimental group than in the control group (P<0.05). mBI score and Bcl‑2 increased in both groups and were higher in the experimental group than in the control group (P<0.05). The log‑rank test showed that the cumulative recurrence rate of ischemic stroke was lower in the experimental group than in the control group (9.43% vs 24.53%; χ²=4.197, P=0.041). Conclusion: Buyang Huanwu Decoction combined with alteplase intravenous thrombolysis can significantly improve neurological function, activities of daily living and TCM syndromes, inhibit apoptosis, and reduce the risk of stroke recurrence in patients with acute ischemic stroke.

Objective: To investigate the clinical efficacy of Zishen Huoxue Decoction in the treatment of infertility with diminished ovarian reserve of kidney deficiency and blood stasis pattern. Methods: The clinical data of 102 patients with infertility due to diminished ovarian reserve of kidney deficiency and blood stasis type, admitted to our hospital from February 2021 to February 2024, were retrospectively selected. These patients were divided into a control group and an observation group based on different treatment methods, with 51 cases in each group. The control group were given conventional western medicine treatment, while the observation group were given Zishen Huoxue Decoction on the basis of the treatment administered to the control group. Both groups were treated for 3 menstrual cycles. TCM syndrome score, sex hormone levels [follicle‑stimulating hormone (FSH) and estradiol (E₂)], ovarian reserve function [anti‑Müllerian hormone (AMH) and antral follicle count (AFC)], and ovarian arterial blood flow indices [peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI)] were compared between the two groups. Patients were followed up for 1 year, and pregnancy rates were recorded. Results: After treatment, TCM syndrome score, FSH, PI, and RI were lower in the observation group than in the control group (P<0.05), whereas E₂, AMH, AFC, and PSV were higher in the observation group than in the control group (P<0.05). After 1 year of follow‑up, the pregnancy rate was higher in the observation group than in the control group (70.59% vs 45.10%; χ²=6.795, P=0.009). Conclusion: Zishen Huoxue Decoction for infertility with diminished ovarian reserve of kidney deficiency and blood stasis pattern can relieve clinical symptoms, improve sex hormone levels, ovarian reserve function, and ovarian arterial blood flow, and increase the pregnancy rate.

Objective: To evaluate the effects of Xuandan Sanjie Decoction combined with a predefined basic Western medicine regimen on pain, menstrual blood loss, and quality of life in patients with adenomyosis, and to explore the statistical association pathways between treatment efficacy and changes in estrogen metabolism and macrophage inflammatory activation markers. Methods: A total of 98 patients with adenomyosis who attended our hospital from May 2023 to May 2025 were enrolled. After stratification according to the predefined basic Western medicine regimen (dienogest tablets, a levonorgestrel‑releasing intrauterine system, or combined short‑acting oral contraceptives), patients were randomized into a control group and a combination group, with 49 patients in each group. The control group received the predefined basic Western medicine regimen, and the combination group received Xuandan Sanjie Decoction in addition to the treatment given to the control group. Both groups were treated for 12 weeks. The Numerical Rating Scale (NRS) score, Pictorial Blood Loss Assessment Chart (PBAC) score, EuroQol Five‑Dimension Five‑Level Questionnaire (EQ‑5D‑5L) utility index, traditional Chinese medicine (TCM) syndrome score, uterine imaging parameters, clinical efficacy, rescue medication use, and adverse events were compared between the two groups after 12 weeks of treatment. Estrogen metabolism indicators [serum estradiol (E₂), 2‑hydroxyestrone/16α‑hydroxyestrone ratio (2‑OHE1/16α‑OHE1), and CYP1B1 mRNA expression in peripheral blood mononuclear cell (PBMC)] and macrophage inflammatory activation markers [peripheral blood M1/M2 ratio and plasma tumor necrosis factor‑α (TNF‑α)] were measured and compared. Analysis of covariance was used to evaluate the primary outcome, NRS score; predefined subgroup analyses were performed according to the basic Western medicine regimen; and exploratory serial mediation association analysis was used to evaluate the statistical association among the metabolic ratio, pro‑inflammatory burden index, and NRS score. Results: In the final analysis, 48 patients in the control group and 47 patients in the combination group completed the study. After 12 weeks of treatment, improvements in NRS score, PBAC score, EQ‑5D‑5L utility index, TCM syndrome score, uterine volume, endometrial thickness, maximum junctional zone (JZ) thickness, and JZ asymmetry difference were greater in the combination group than in the control group (P<0.05). E₂, CYP1B1 mRNA expression, M1/M2 ratio, and TNF‑α were lower in the combination group than in the control group, whereas 2‑OHE1/16α‑OHE1 was higher in the combination group (P<0.05). The overall clinical response rate was higher in the combination group than in the control group (91.49% vs 75.00%, P<0.05). Exploratory serial mediation association analysis showed that the total effect of treatment group on NRS score after 12 weeks of treatment was β=‑0.302 (95% CI: ‑0.453 to ‑0.151), and the summed indirect effect was β=‑0.131 (95% CI: ‑0.192 to ‑0.079). These findings suggest that the metabolic ratio and pro‑inflammatory burden index may be involved in the statistical association pathway related to efficacy, but the effect size was small and cannot replace mechanistic validation. The overall incidence of adverse events did not differ significantly between the two groups (P>0.05). Conclusion: Xuandan Sanjie Decoction combined with a predefined basic Western medicine regimen can improve pain, menstrual blood loss, and quality of life in patients with adenomyosis after 12 weeks of treatment without increasing obvious safety risks. The analgesic benefit was statistically associated with an increase in 2‑OHE1/16α‑OHE1 and a decrease in macrophage‑related pro‑inflammatory burden index. However, because NRS score, metabolic ratio and pro‑inflammatory burden index were all measured at the same 12‑week time point, the current findings cannot prove a strict temporal causal mechanism.

Objective: To analyze pharmacotherapy in a case of severe coagulation abnormality after the use of cefoperazone sodium and sulbactam sodium for injection. Methods: The clinical data of one patient with urinary tract infection who received intravenous infusion of cefoperazone sodium and sulbactam sodium (1.5 g, q12h) were retrospectively analyzed. Changes in coagulation function, clinical manifestations, and interventions after medication were recorded. Results: The patient developed hematuria after 8 days of medication. Laboratory tests indicated severe coagulation abnormality: prothrombin time (PT) 87.10 s, activated partial thromboplastin time (APTT) 64.80 s, and international normalized ratio (INR) 8.29. After 10 days of treatment, these parameters further worsened (PT 109.90 s, APTT 84.30 s, INR 10.55), while the platelet count remained normal. The suspected drug was discontinued immediately, and intramuscular vitamin K₁ and fresh frozen plasma infusion were administered. After 3 days of treatment, the patient's clinical symptoms were relieved and coagulation parameters returned to normal. The Naranjo assessment scale score was 5, suggesting that the adverse reaction was probably related to cefoperazone sodium and sulbactam sodium. Conclusion: Cefoperazone sodium and sulbactam sodium can cause severe and progressively worsening coagulation abnormality, which may occur even at routine doses and with a routine treatment course. Coagulation function should be closely monitored during clinical use. Once an abnormality occurs, the drug should be discontinued promptly and vitamin K₁ and coagulation factors should be supplemented; the condition is usually reversible after intervention.

Objective: To investigate the occurrence characteristics and key monitoring points of adverse drug reactions (ADRs) associated with Shengxuebao Mixture, and to provide a reference for safe clinical medication. Methods: Medical records of inpatients who received Shengxuebao Mixture at our hospital from July 2024 to October 2025 were retrospectively reviewed. ADRs associated with Shengxuebao Mixture were collected according to the Guidelines for the Collection and Reporting of Individual Adverse Drug Reactions and were statistically analyzed. Results: Among 1436 hospitalized patients who received Shengxuebao Mixture, 19 (1.32%) experienced ADRs. The incidence of ADRs was higher in female patients (1.91%) than in male patients (0.71%). Among patients with ADRs, older adults aged ≥65 years predominated (89.47%). ADRs mainly involved the gastrointestinal system (56.67%) and hepatobiliary system (23.33%) and mostly occurred within 3 days after administration (68.42%). Serious ADRs accounted for 10.53% (2/19). After drug withdrawal and symptomatic treatment, all patients had favorable outcomes. Conclusion: Shengxuebao Mixture shows overall good safety in clinical use; however, the risk of serious ADRs should not be overlooked. Medication monitoring should be strengthened, particularly in older and female patients, with close attention to gastrointestinal reactions and drug‑induced liver injury to ensure safe medication use.

Objective: To construct an indicator system for comprehensive clinical evaluation of immune checkpoint inhibitors (ICIs) combined with chemotherapy as first‑line treatment for advanced esophageal squamous cell carcinoma (ESCC), with reference to the Guidelines for the Management of Comprehensive Clinical Evaluation of Drugs (2021 Trial Version) and the Technical Guidelines for Comprehensive Clinical Evaluation of Antitumor Drugs (2022 Trial Version). Methods: A three‑level framework for comprehensive clinical evaluation was initially developed through literature analysis. Two rounds of Delphi expert consultation were conducted to determine the evaluation indicators, and the normalization method and analytic hierarchy process were used to determine the weight coefficient of each indicator, thereby establishing the indicator system for comprehensive clinical evaluation of ICIs combined with chemotherapy as first‑line treatment for advanced ESCC. Results: Through multidimensional and multimethod evidence synthesis, an indicator system comprising 6 first‑level indicators, 18 second‑level indicators, and 49 third‑level indicators was established. Conclusion: The constructed indicator system for comprehensive clinical evaluation of ICIs combined with chemotherapy as first‑line treatment for advanced ESCC has high scientific validity and applicability and may provide a reference for empirical studies on comprehensive clinical evaluation of ICIs and for drug selection.