This review focuses on the clinical application of anti-amyloid β-protein (Aβ) monoclonal antibodies in Alzheimer's disease (AD). Following an overview of the disease characteristics and current therapeutic landscape, it examines the drug profiles, clinical efficacy, patient selection, adverse event management, and individualized dosing strategies of these agents. The approval of the anti-Aβ monoclonal antibodies lecanemab and donanemab marks a major breakthrough in etiology-directed treatment for AD. The 2 drugs can effectively clear cerebral Aβ deposits and delay cognitive decline. In clinical practice, patients should undergo indication screening and risk assessment before treatment to ensure efficacy and safety. Management of adverse reactions should focus on monitoring for amyloid-related imaging abnormalities and infusion-related reactions. Individualized treatment requires comprehensive consideration of comorbidities, characteristics of special populations, and concomitant medications. At present, the clinical application of anti-Aβ monoclonal antibodies continues to face challenges, including the need for further verification of efficacy and safety, a limited eligible population, and high treatment costs. Future efforts should optimize dosing regimens and diagnostic and treatment approaches and explore novel therapeutic targets and nonpharmacological interventions to promote a more diversified approach to AD treatment.

Objective: To investigate the effects of enalapril combined with felodipine on blood pressure variability (BPV) and advanced oxidation protein products (AOPP) levels in patients with essential hypertension and coronary heart disease (CHD). Methods: A total of 110 patients with essential hypertension and CHD who were treated at our hospital between July 2021 and December 2023 were enrolled. Using a random-number table method, patients were assigned to a control group (felodipine) or an observation group (enalapril plus felodipine), with 55 patients in each group. The following outcomes were compared between the two groups: BPV parameters, including mean daytime (d), nighttime (n), and 24-hour systolic blood pressure(SBP), diastolic blood pressure(DBP), systolic blood pressure coefficient of variation(SCV), and diastolic blood pressure coefficient of variation (DCV); AOPP levels; clinical efficacy; and adverse reactions. Results: After treatment, dSBP, nSBP, 24 h SBP, dDBP, nDBP, 24 h DBP, dSCV, nSCV, 24 h SCV, dDCV, nDCV, 24 h DCV, and AOPP levels decreased in both groups and were significantly lower in the observation group than in the control group (P<0.05). The overall response rate was significantly higher in the observation group than in the control group (94.55% vs. 81.82%, P<0.05). The total incidence of adverse reactions did not differ significantly between the two groups (P > 0.05). Conclusion: Enalapril combined with felodipine was effective in patients with essential hypertension and CHD, can reduce the expression levels of BPV and AOPP, and there was no increase in the risk of adverse reactions.

Objective: To investigate the efficacy of ezetimibe combined with metoprolol for acute myocardial infarction (AMI) and its effects on coronary blood flow velocity in the epicardium, patients with AMI treated at our hospital from January 2021 to December 2024 were enrolled. Using a random number table method, the patients were assigned to a control group receiving metoprolol or an observation group receiving ezetimibe plus metoprolol, with 58 patients in each group. Coronary blood flow velocity in the epicardium [thrombolysis in myocardial infarction test (TIMI) grades]; levels of factors related to ventricular remodeling [secreted frizzled-related protein 2 (SFRP2), cysteinyl aspartate specific proteinase 3 (CASP3)]; HRV indices [standard deviation of all normal sinus RR intervals (SDNN), root mean square of successive differences between adjacent normal RR intervals (RMSSD), and standard deviation of the average of normal sinus RR intervals in all 5-minute segments (SDANN)]; and cardiac function parameters [left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV)] were compared between the groups before and after treatment. Clinical efficacy and adverse reactions were also assessed. Results: After treatment, the TIMI grades of both groups of patients were better than those before treatment, and the observation group was better than the control group (P<0.05). SDNN, RMSSD, SDANN and LVEF all increased, and the values in the observation group were higher than those in the control group (P<0.05); SFRP2, CASP3 and LVEDV all decreased, and the values in the observation group were lower than those in the control group (P<0.05). The overall clinical response rate was higher in the observation group (93.10%) than in the control group (74.14%, P<0.05). The overall incidence of adverse reactions did not differ significantly between the groups (P > 0.05). Conclusion: Ezetimibe combined with metoprolol in the treatment of AMI can improve therapeutic efficacy and the blood flow velocity of epicardial coronary arteries, reduce the levels of factors related to ventricular remodeling, correct abnormal HRV, and enhance cardiac function in patients with AMI without increasing the risk of adverse reactions.

Objective: To investigate the effects of evolocumab combined with rosuvastatin on lipid metabolism indices and cardiac function in patients with coronary heart disease (CHD) and hyperlipidemia. Methods: This prospective randomized controlled trial enrolled 124 patients with CHD and hyperlipidemia treated at a hospital from July 2022 to July 2024. Using a random number table method, the patients were assigned to a control group receiving rosuvastatin or an observation group receiving evolocumab plus rosuvastatin, with 62 cases in each group. Changes from before to after treatment in serum lipid parameters [low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC)], lipid metabolism indices [apolipoprotein (Apo) A1 and ApoB], and cardiac function parameters [left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD)], as well as the incidences of major adverse cardiovascular event (MACE) and adverse reactions were compared between the groups. Results: After treatment, LDL-C, TC, ApoB, and LVEDD were decreased in both groups and were lower in the observation group than those in the control group (P<0.05). HDL-C, ApoA1, and LVEF were increased in both groups and were higher in the observation group compared with those in the control group (P<0.05). No statistical differences were exhibited in the overall incidence of MACE and overall incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Evolocumab combined with rosuvastatin effectively improves serum lipids and lipid metabolism indices and further improves cardiac function in patients with CHD and hyperlipidemia without increasing the risk of adverse drug reactions.

Objective: To investigate the effects of progressive resistance training (PRT) combined with type A botulinum toxin (BTX-A) on lower-limb muscle spasticity and motor ability in children with spasticity cerebral palsy(SCP). Methods: This prospective study included 80 children with SCP treated at our hospital from January 2021 to December 2023. They were randomly divided into a control group (BTX-A) and an observation group (PRT combined with BTX-A) using a random number table method, with 40 cases in each group. Lower-limb muscle spasticity [Modified Ashworth Scale (MAS) score], gait parameters (step width, step length and walking speed), motor ability [Gross Motor Function Measure-88 (GMFM-88) scores], and adverse reactions were observed before and after treatment in both groups. Results: After treatment, MAS scores decreased in both groups and were lower in the observation group than in the control group (P<0.05). Step width decreased and was shorter in the observation group than in the control group (P<0.05); step length increased and was longer in the observation group than in the control group (P<0.05); walking speed increased and was faster in the observation group than in the control group (P<0.05). GMFM-88 dimension D and E scores and their combined total score increased and were higher in the observation group than in the control group (P<0.05). There was no statistically significant difference in the incidence of injection-site pain between the two groups (P > 0.05). The incidence of transient muscle weakness was lower in the observation group (42.50%) than in the control group (65.00%, P<0.05). Conclusion: PRT combined with BTX-A can alleviate lower-limb muscle spasticity, correct abnormal gait, improve motor ability, and reduce the incidence of transient muscle weakness in children with SCP.

Objective: To explore the clinical efficacy of sivelestat sodium combined with ulinastatin and its influence on the survival rate of patients with sepsis-induced acute respiratory distress syndrome (ARDS). Methods: A total of 102 patients with sepsis-induced ARDS admitted from February 2022 to February 2025 were prospectively selected and randomly divided into control group and observation group by random number table method, with 51 cases in each group. The control group received ulinastatin monotherapy; the observation group received sivelestat sodium combined with ulinastatin. The severity of disease [evaluated by Sequential Organ Failure Assessment (SOFA) score, Murray Lung Injury Score (MLIS)], mechanical ventilation duration, pulmonary oxygenation indicators [arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), extravascular lung water index (ELWI)], inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP)], serum markers [soluble urokinase plasminogen activator receptor (suPAR), endothelial cell-specific molecule-1 (ESM-1), procalcitonin (PCT)] were compared, and the 14-day survival rate was counted. Results: There were no significant differences in mechanical ventilation duration, suPAR, ESM-1 and PCT between the two groups after 7 days of treatment (P > 0.05). After 7 days of treatment, SOFA score, MLIS score, ELWI, IL-6, TNF-α and CRP of the observation group were lower than those of the control group, while PaO2/FiO2 was higher (P<0.05). The 14-day survival rate of the observation group was higher than that of the control group (98.04% vs 86.27%, Log-rank χ2 = 4.867, P = 0.027). Conclusion: Sivelestat sodium combined with ulinastatin can significantly improve pulmonary oxygenation, inhibit inflammatory response, and increase short-term survival rate in patients with sepsis-induced ARDS.

Objective: To preliminarily evaluate the effects of mecobalamin combined with neuromuscular electrical stimulation (NMES) on pain intensity, nerve conduction, and joint mobility in patients with joint pain associated with peripheral nerve injury. Methods: A single-center, randomized, open-label, outcome assessor-blinded, controlled clinical study was conducted. A total of 86 patients with joint pain associated with peripheral nerve injury who presented to our hospital between January 2023 and January 2025 were assigned in a 1:1 ratio to a control group or an observation group using a random number table method, with 43 patients in each group. Both groups received basic rehabilitation therapy. The control group additionally received NMES, while the observation group received mecobalamin in addition to the control-group regimen. Both groups were treated for 4 weeks. Pain intensity [assessed using the Visual Analogue Scale (VAS)], nerve conduction [motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV)], joint mobility [range of motion (ROM)], clinical efficacy, and the incidence of adverse events were compared between the groups. Results: After 4 weeks of treatment, VAS scores decreased from baseline in both groups, with a greater reduction in the observation group than in the control group (P<0.05). MNCV, SNCV, and ROM increased from baseline in both groups, with greater increases in the observation group than in the control group (P<0.05). The overall clinical response rate was higher in the observation group than in the control group (93.02% vs 74.42%, P<0.05). No serious adverse events occurred in either group during treatment. Adverse events, including local skin erythema, dizziness, and nausea, were mild, and the overall incidence of adverse events did not differ significantly between the groups (P > 0.05). Conclusion: Mecobalamin combined with NMES alleviated joint pain associated with peripheral nerve injury and improved nerve conduction and joint mobility, with acceptable short-term safety.

Objective: To compare the anesthetic efficacy and safety of alfentanil combined with propofol target-controlled infusion (TCI) and fentanyl combined with propofol TCI during transvaginal ultrasound-guided oocyte retrieval. Methods: A total of 116 patients scheduled for transvaginal ultrasound-guided oocyte retrieval from January to December 2024 were prospectively enrolled and divided into control group and observation group by random number table method, with 58 cases in each group. The control group received intravenous anesthesia with fentanyl plus propofol TCI; the observation group received intravenous anesthesia with alfentanil plus propofol TCI. Operation time, time to loss of consciousness, recovery time, propofol dosage, postoperative pain condition [evaluated by Visual Analogue Scale (VAS)], vital signs at different time points and adverse reactions were compared between the two groups. Results: There were no significant differences in operation time, time to loss of consciousness, propofol dosage and VAS score between the two groups (P > 0.05). The recovery time of the observation group was shorter than that of the control group (P<0.05). At 3 min after anesthesia induction, heart rate (HR) and peripheral oxygen saturation (SpO2) in the observation group were higher than those of the control group (P<0.05). At 5 min after operation initiation, mean arterial pressure (MAP) and HR in the observation group were higher than those of the control group (P<0.05). The incidence of respiratory depression, nausea and vomiting in the observation group was lower than that in the control group (P<0.05). Conclusion: Compared with fentanyl combined with propofol TCI, alfentanil combined with propofol TCI has more advantages for transvaginal ultrasound-guided oocyte retrieval. It can maintain stable hemodynamics and shorten recovery time, with lower incidence of respiratory depression, nausea and vomiting.

Objective: To explore the effects of Shugan Jieyu capsules combined with fluoxetine hydrochloride capsules on brain-derived neurotrophic factor (BDNF), neurotransmitters and heart rate variability in the treatment of adolescent depression disorder. Methods: A total of 120 adolescents with depressive disorder who were hospitalized in our hospital from October 2024 to October 2025 were enrolled. Using a random number table method, the patients were assigned to a control group receiving fluoxetine hydrochloride capsules or an observation group receiving Shugan Jieyu capsules combined with fluoxetine hydrochloride capsules, with 60 patients in each group. The 24-item Hamilton Depression Rating Scale (HAMD-24) and Ottawa Self-Injury Inventory (OSI) scores; BDNF; neurotransmitter levels [norepinephrine (NE), 5-hydroxytrptamine (5-HT), and dopamine (DA)]; and heart rate variability indices [standard deviation of all normal sinus RR intervals (SDNN), normalized high-frequency (nHF), and normalized low-frequency (nLF)] were compared between the groups before and after treatment. Adverse reactions and suicide behavior events during treatment were also assessed. Results: Repeated measures analysis of variance showed that there were statistically significant differences in the time-point effects, group effects and interaction effects of the HAMD-24 and OSI scores between the two groups of patients (P<0.05). From the T1 (2 weeks of treatment) to the T3 (6 weeks of treatment) time points, the HAMD-24 and OSI scores of the observation group were lower than those of the control group (P<0.05). At the T3 time point, BDNF, NE, 5-HT, DA, SDNN, nHF, and nLF in both groups of patients increased, and the observation group were higher than those of the control group (P<0.05). During the treatment period, there were no statistically significant differences in the incidence of adverse reactions among the two groups of patients (P>0.05), and no suicide behavior events occurred. Conclusion: Shugan Jieyu capsules combined with fluoxetine hydrochloride capsules increases BDNF and neurotransmitter levels, and improves heart rate variability in adolescents with depressive disorder without increasing the risk of adverse reactions.

Objective: To investigate the clinical efficacy of Zhuifeng Tougu Capsules combined with imrecoxib tablets in the treatment of cervical spondylotic radiculopathy (CSR). Methods: This prospective study enrolled 90 patients with CSR admitted to the Department of Pain Medicine of our hospital between May 2022 and January 2026. Using a random number table method, the patients were assigned to a control group or an observation group, with 45 patients in each group. The control group received imrecoxib tablets, whereas the observation group received Zhuifeng Tougu Capsules in addition to imrecoxib tablets. Both groups were treated continuously for 4 weeks. Pain intensity [Visual Analogue Scale (VAS) score], levels of pain mediators [prostaglandin E2 (PGE2), tumor necrosis factor-α (TNF-α), and substance P (SP)], clinical efficacy, and neck function [Neck Disability Index (NDI)] were compared between the groups, and safety was assessed. Results: After treatment, VAS scores, PGE2, TNF-α, SP, and NDI scores decreased in both groups and were lower in the observation group than in the control group (P<0.05). The overall clinical response rate and overall radiographic improvement rate were higher in the observation group than in the control group (95.56% VS 77.78% and 91.11% VS 73.33%, respectively; P<0.05). During treatment, the overall incidence of adverse reactions did not differ significantly between the groups (P > 0.05). Conclusion: Combination therapy with Zhuifeng Tougu Capsules and imrecoxib tablets more effectively relieves pain, improves neck function, and inhibits the release of PGE2, TNF-α, and SP in patients with CSR without increasing the risk of adverse reactions.

Objective: To investigate the efficacy and safety of modified Danggui Buxue Decoction combined with calcium dobesilate capsules in patients with diabetic nephropathy. Methods: A total of 120 patients with diabetic nephropathy admitted to our hospital from January 2021 to December 2022 were prospectively enrolled and randomly assigned using a random number table method to a control group and an observation group, with 60 patients in each group. The control group received calcium dobesilate capsules, whereas the observation group received modified Danggui Buxue Decoction in addition to the control treatment. Both groups were treated for 3 months. Clinical efficacy, renal function parameters [urinary albumin excretion rate (UAER), serum creatinine (SCr), β2-microglobulin (β2-MG), and 24-hour urinary protein quantitation (24 h PRO)], blood glucose indicators [fasting plasma glucose (FPG)], and adverse reactions were compared between the two groups. Results: After treatment, the overall clinical response rate was higher in the observation group than in the control group (93.33% vs 78.33%, P<0.05). UAER, SCr, β2-MG, 24 h PRO and FPG decreased in both groups and were lower in the observation group than in the control group (P<0.05). During treatment, the incidences of nausea, gastric discomfort, loss of appetite, and burning sensation did not differ significantly between the two groups (P > 0.05). Conclusion: Modified Danggui Buxue Decoction combined with calcium dobesilate capsules has favorable efficacy in patients with diabetic nephropathy, improves renal function, and lowers blood glucose without increasing the risk of adverse reactions.

Objective: To analyze the clinical efficacy of modified Sangbaipi Decoction combined with acupoint application as adjuvant therapy for children with pneumonia of phlegm-heat obstructing lung syndrome. Methods: This was a prospective randomized controlled trial. A total of 86 children with pneumonia of phlegm-heat obstructing lung syndrome admitted to our hospital from October 2023 to January 2025 were selected and divided into control group and observation group by random number table method, 43 cases in each group. After follow-up loss, withdrawal and incomplete treatment, 40 cases were finally included in each group. The control group received conventional Western medicine treatment, and the observation group was given modified Sangbaipi Decoction combined with acupoint application on the basis of conventional Western medicine. Both groups were treated continuously for 10 days. traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, inflammatory indicators [C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT)], blood gas indicators [arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of oxygen (PaO2), oxygenation index (OI)], disappearance time of clinical symptoms and adverse reactions were compared between the two groups. Results: After 10 days of treatment, the total clinical effective rate of the observation group was higher than that of the control group (95.00% vs 77.50%, P<0.05). The TCM syndrome scores (main symptoms, secondary symptoms, total score), CRP, IL-6, PCT and PaCO2 in the observation group were lower than those in the control group (P<0.05). The PaO2 and OI of the observation group were higher than those of the control group (P<0.05). The disappearance time of fever, cough and pulmonary moist rales in the observation group was shorter than that in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups during treatment (P > 0.05). Conclusion: Modified Sangbaipi Decoction combined with acupoint application has remarkable adjuvant therapeutic effect on children with pneumonia of phlegm-heat obstructing lung syndrome, can inhibit the expression of inflammatory factors, improve blood gas indicators, promote the regression of clinical symptoms, and does not increase the risk of adverse reactions.

Objective: To systematically analyze adverse event signals and clinical characteristics of drug-related hyperhomocysteinemia (HHcy) based on the Food and Drug Administration Adverse Event Reporting System (FAERS), and to identify potential drug safety risks. Methods: Reports related to HHcy in the FAERS database from the first quarter of 2004 to the second quarter of 2025 were retrieved. Data were cleaned using the deduplication method recommended by the FDA, and signal mining was performed using the reporting odds ratio (ROR), proportional reporting ratio (PRR), and information component (IC) methods. Patient demographic characteristics, drug distribution, outcomes, time to onset (TTO), and event duration were analyzed, and TTO data were fitted using a Weibull distribution model. Results: A total of 249 valid reports were obtained. The sex distribution was balanced (45.0% male and 42.6% female), and patients aged 18-64 years accounted for the largest proportion (55.0%). Hospitalization accounted for 35.7%, and serious outcomes (life-threatening events, disability, and death) accounted for 10.8%. 16 drugs with HHcy risk signals were identified, involving 8 anatomical therapeutic chemical classes. Nitrous oxide (ROR=1679.54), guvisorin (ROR=853.11), and rofecoxib (ROR=47.56) showed the strongest associations. Notably, HHcy was not listed as an adverse reaction in the prescribing information for several drugs. TTO analysis showed a mean TTO of 89.1 days, consistent with an early failure-type risk curve. The mean duration of adverse events was 47.7 days, and 74.4% resolved within 30 days. Conclusion: Multiple drugs were statistically associated with HHcy, and some associations have not yet been documented in the prescribing information, suggesting potential new drug safety signals. Clinicians should pay attention to the risks associated with nitrous oxide, guvisorin, rofecoxib, and related drugs; strengthen early monitoring of plasma homocysteine levels; and provide folic acid or vitamin B12 intervention when necessary. Future prospective studies and mechanistic investigations are needed to further clarify the causal relationship between these drugs and HHcy.

Objective: To understand the application status and changing trends of medications for chronic diseases, so as to provide reference for rational clinical medication and chronic disease management. Methods: Hospital information system (HIS) was used to collect annual sales amount and consumption quantity of chronic disease drugs from 2021 to 2023. Defined daily doses (DDDs) analysis method was adopted to calculate relevant medication indexes. Results: The varieties and total sales amount of chronic disease drugs increased year by year from 2021 to 2023. Drugs for cardiovascular and cerebrovascular diseases and hypoglycemic agents accounted for more than 70.00% of total sales of chronic disease medications. Five drug varieties ranked top 10 in sales volume for three consecutive years, including nifedipine controlled-release tablets, irbesartan hydrochloride thiazide tablets, compound danshen tablets, isosorbide mononitrate tablets and acarbose tablets. Eight varieties that have ranked in the top 10 for DDDs for three consecutive years are all classified as cardiovascular, cerebrovascular, or hypoglycemic agents. The defined daily cost (DDC) of most drugs was less than 1 yuan within three years, and the sales amount/DDDs ratio (B/A) of most varieties was greater than 1.0. Conclusion: The medication situation of chronic diseases in this hospital is generally rational with a steady growth trend. Drug selection follows the principles of safety, efficacy, economy and suitability. Patients with cardiovascular, cerebrovascular diseases and diabetes take the highest proportion among chronic disease populations, which should be given priority in clinical work.

Objective: To establish criteria and methods for drug use evaluation of moxifloxacin for tuberculosis treatment, evaluate the rationality of its clinical use in tuberculosis treatment, and provide a reference for rational clinical medication and pharmaceutical intervention. Methods: Based on the prescribing information for moxifloxacin, authoritative guidelines, and the latest literature, drug use evaluation indicators and criteria for moxifloxacin in tuberculosis treatment were developed. The attribute Hierarchy Model (AHM) was used to assign weights to the evaluation indicators, and the weighted Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method was then applied to evaluate the rationality of discharged medical records involving moxifloxacin for anti-tuberculosis treatment in our hospital from July to December 2024. Results: The established evaluation criteria included 10 primary indicators and 18 secondary indicators. Among the 334 reviewed medical records included in the evaluation, 120 cases (35.92%) had a relative closeness to the optimal solution (Ci) of 0.8≤Ci≤1.0, 122 cases (36.53%) had 0.6≤Ci<0.8, and 92 cases (27.54%) had Ci<0.6. The top three evaluation indicators with the highest inappropriate-use rates were electrocardiographic monitoring (43.41%), drug susceptibility testing (29.64%), and incompatibility (26.35%). Conclusion: The weighted TOPSIS method is highly operable for evaluating the rationality of moxifloxacin use in tuberculosis treatment and can provide a reference for rational clinical medication. In our hospital, inappropriate use of moxifloxacin in tuberculosis treatment remains in adverse drug reaction monitoring and premedication assessment; therefore, management should be further strengthened.

Objective: By participating in the care of a patient with type 2 diabetes mellitus complicated by pulmonary tuberculosis and hepatitis C virus infection, clinical pharmacists focused on managing polypharmacy-related drug interactions and developing personalized treatment plans to optimize medication safety and efficacy for similar patients. Methods: Given the patient's concurrent conditions of Mycobacterium tuberculosis infection, suboptimal glycemic control and abnormal liver function, pharmaceutical care was carried out to help clinicians adjust and refine the treatment plan. Results: Adjustments were made to the patient's hypoglycemic and anti-tuberculosis regimens, which reduced the risk of liver injury. Stable glycemic control was achieved while effective anti-tuberculosis therapy was maintained simultaneously. Conclusion: High attention should be paid to drug-drug interactions in patients with multiple coexisting chronic diseases, and individualized medication strategies should be formulated via pharmaceutical care.

Objective: To investigate the etiology and clinical characteristics of human parainfluenza virus (HPIV) infection in children admitted to a hospital in Beijing. Methods: A retrospective study was conducted on throat swab specimens of 1630 children with respiratory tract infection hospitalized from July 1, 2024 to June 30, 2025. Detection of seven respiratory pathogens using multiplex real-time fluorescent reverse transcription polymerase chain reaction technology. A total of 45 HPIV-positive children were enrolled for statistical analysis. Results: Among the 45 HPIV-positive children, there were 28 males (62.22%) and 17 females (37.78%), with no significant difference in positive rate between genders (P > 0.05). The HPIV positive rates of age groups < 1 year, 1~2 years, 3~4 years and ≥5 years were 48.89%, 22.22%, 17.78% and 11.11% respectively (P<0.05). A total of 34 cases of HPIV-3 (75.56%) and 11 cases of HPIV-1 (24.44%) were detected, and the difference was statistically significant (P<0.05). There were 10 cases of upper respiratory tract infection (22.22%) and 35 cases of pneumonia (77.78%), among which 9 cases were severe pneumonia (25.71%), all HPIV-3 positive. All 10 children with upper respiratory tract infection received interferon nebulization alone. Among 35 pneumonia patients, 3 received interferon nebulization alone, 17 were combined with cephalosporin antibiotics, 7 added methylprednisolone sodium succinate, 7 underwent bronchoalveolar lavage, and 1 was supplemented with human immunoglobulin. All 45 children achieved clinical cure after treatment. Conclusion: HPIV infection shows no obvious gender difference and occurs most frequently in children under 1 year old. HPIV-3 is the predominant subtype, and HPIV-3-related pneumonia tends to be more severe. Interferon nebulization achieves definite efficacy for children with upper respiratory tract infection; pneumonia patients can be clinically cured after comprehensive treatment including anti-infection therapy, glucocorticoids, bronchoalveolar lavage and immune support according to disease conditions.

Objective: To investigate the relationship between serum levels of CC chemokine ligand 2 (CCL2) and CC chemokine ligand 8 (CCL8) and the prognosis of children with severe Mycoplasma pneumoniae pneumonia (SMPP) after treatment with acetylcysteine bronchoalveolar lavage. Methods: A total of 196 children with SMPP who received treatment at our hospital from January 2023 to January 2025 were prospectively selected as study subjects and divided into a control group and an observation group using a random number table method, with 98 cases in each group. The control group received 0.9% sodium chloride injection for alveolar lavage therapy on the basis of conventional treatment, while the observation group received acetylcysteine for alveolar lavage therapy on the basis of conventional treatment. The evaluation value of serum CCL2 and CCL8 for the deterioration of children with SMPP after undergoing acetylcysteine alveolar lavage therapy was analyzed. Results: After 5 days of treatment, the improvement rate in the observation group was significantly higher than that in the control group (75.51% vs 59.18%, χ2 = 5.939, P = 0.015). Serum levels of CCL2 and CCL8 in the observation group were significantly lower than those in the control group (P<0.05). Based on prognosis during 21-day follow-up after admission, children in the observation group were divided into the improvement group (n = 74) and deterioration group (n = 24). Multivariate logistic regression analysis showed that CCL2 [OR (95%CI)=1.548 (1.101~2.177)], CCL8 [OR (95%CI)=1.865 (1.209~2.875)], and Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score [OR (95%CI)=1.234 (1.026~1.483)] were independent risk factors for deterioration after bronchoalveolar lavage with acetylcysteine. ROC curve analysis showed that the area under the curve (AUC) of the combination of serum CCL2 and CCL8 for predicting deterioration was 0.863. Conclusion: Acetylcysteine bronchoalveolar lavage has good efficacy in children with SMPP, but some patients still experience disease progression. Early detection of serum CCL2 and CCL8 may help predict the prognosis and guide treatment optimization.

Objective: To explore the effects of different administration time of compound polyethylene glycol electrolyte powder (IV) on bowel preparation quality and patient tolerance during colonoscopy, so as to provide reference for optimizing clinical bowel preparation schemes. Methods: A total of 150 patients scheduled for colonoscopy in the Endoscopy Department of our hospital from January 2023 to January 2026 were prospectively selected and divided into group A (taken at 18:00 the day before examination), group B (taken at 20:00 the day before examination) and group C (taken at 04:00 on the day of examination) by random number table method, with 50 cases in each group. The total dosage of compound polyethylene glycol electrolyte powder (IV) was 2000 ml (2 bags), administered in a divided limited-time regimen: the first 1000 ml was taken within 45 min, followed by a 30-minute interval, then the remaining 1000 ml was finished within 60 min. Observation indicators include total Boston Bowel Preparation Scale (BBPS) score, adequate bowel preparation rate, defecation-related indicators, medication compliance rate and incidence of adverse reactions. Results: The total BBPS score, adequate bowel preparation rate and medication compliance rate of group B were higher than those of group A and group C (P<0.05). The initial defecation time of group B was later than group A and earlier than group C; the total defecation frequency of group B was higher than group A and group C; the interval from last defecation to colonoscopy in group B was shorter than group A and longer than group C (P<0.05). The total incidence of adverse reactions in group B was lower than that in group A and group C (P<0.05). No severe adverse reactions occurred in all three groups. Conclusion: Taking compound polyethylene glycol electrolyte powder (IV) at 20:00 the day before colonoscopy can effectively improve bowel preparation quality, increase patient compliance, and does not increase the risk of adverse reactions. It is worthy of clinical promotion.

Objective: To investigate the effects of lanthanum carbonate combined with low-calcium dialysate on calcium and phosphorus metabolism in older patients receiving maintenance hemodialysis (MHD) and to develop a risk prediction model for serum phosphorus levels during treatment. Methods: The clinical data of 70 older patients receiving MHD who were admitted to our hospital between January 2024 and January 2025 were retrospectively analyzed. All patients received lanthanum carbonate combined with low-calcium dialysate. The effects of this treatment on calcium and phosphorus metabolism were assessed. According to serum phosphorus levels, patients with levels >1.78 mmol/L were assigned to the hyperphosphatemia group, whereas those with levels ≤1.78 mmol/L were assigned to the non-hyperphosphatemia group. Clinical data were compared between the two groups. Logistic regression analysis was performed on variables showing between-group differences to identify factors independently associated with serum phosphorus levels in older patients receiving MHD. A risk prediction model was developed, and its predictive value was evaluated using receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC), and the Hosmer-Lemeshow goodness-of-fit test. Results: A total of 70 older patients receiving MHD were included. After 3 months of continuous treatment, serum calcium, serum phosphorus, and the calcium-phosphate product were significantly lower than before treatment (P<0.05). Of the 70 patients, 21 (30.00%) had serum phosphorus levels >1.78 mmol/L and were included in the hyperphosphatemia group, whereas 49 (70.00%) had serum phosphorus levels ≤1.78 mmol/L and were included in the non-hyperphosphatemia group. Univariate analysis showed significant between-group differences in Nutritional Risk Screening 2002 (NRS2002) score, hemoglobin (Hb), intact parathyroid hormone (iPTH), and serum creatinine (SCr) (P<0.05). The proportion of patients with an NRS2002 score ≥3 and the Hb, iPTH, and SCr levels were higher in the hyperphosphatemia group than in the non-hyperphosphatemia group. Logistic regression analysis showed that NRS2002 score and Hb, iPTH, and SCr levels were independent factors associated with serum phosphorus levels in older patients receiving MHD, with odds ratios (OR) of 7.987, 1.158, 1.019, and 1.009, respectively (P<0.05). The AUC of the risk prediction model was 0.926 (95% CI: 0.857 - 0.995). The Hosmer-Lemeshow test indicated good model fit (χ2 = 7.404, P = 0.494). Conclusion: Lanthanum carbonate combined with low-calcium dialysate effectively reduced serum calcium, serum phosphorus, and the calcium-phosphate product in older patients receiving MHD. Serum phosphorus levels were associated with NRS2002 score and Hb, iPTH, and SCr levels. The resulting prediction model showed good predictive performance and may provide a useful clinical reference.