Incidence Of Adverse Reactions Research Articles

Analysis of the effectiveness and safety of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis: An observational study.

This study is for exploring the effectiveness and security of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis. This retrospective study collected 100 patients with gouty arthritis between February 2022 and February 2023. According to the different treatment methods, the data of patients were divided into control group and experimental group. The control group received routine treatment with benzbromarone, while the experimental group received additional treatment with Xuedu Xiezhuo Yishen Tang on the basis of the control group. The evaluation indicators for the effectiveness of treatment include serum levels of 8-hydroxydeoxyguanosine, 3-NT, interleukin-6, interleukin-10, interleukin-1β, tumor necrosis factor-α, C-reactive protein, erythrocyte sedimentation rate, urea nitrogen, creatinine, evaluation of knee joint function and pain level, traditional Chinese medicine syndrome score, and safety evaluation. After treatment, the overall treatment effect of the experimental group reached 98%, while the control group was 78%. After treatment, the differences in various indicators possessed statistical significance (SS) (P < .05). In the Lysholm score, the improvement in the experimental group was markedly more excellent than the control group, and the difference possessed SS (P < .05). In the NRS score, the experimental group's NRS score decreased from 8.39 to 1.08 before and after treatment, while the control group only decreased to 3.61. In addition, both groups of patients showed significant improvement in the joint score in the Traditional Chinese medicine syndrome sub-items. The experimental group was able to effectively improve symptoms such as joint pain, joint redness and swelling, joint fever, and limited joint mobility. After treatment, the incidence of adverse reactions in the experimental group was only 8%, while the incidence of adverse reactions in the control group was 24%. After statistical analysis of the incidence of adverse reactions during treatment among the participants, it was found that the difference possessed SS (P < .001). The combination treatment of Jiedu Xiezhuo Yishen Tang and benbromarone can effectively improve oxidative stress response and significantly reduce blood uric acid levels. Meanwhile, this combination therapy can effectively inhibit inflammatory reactions, significantly alleviate knee joint pain, and promote the recovery of knee joint function. This treatment regimen has lower toxic side effects and higher safety.

Exploration of the Optimal Dosage of Remimazolam in Painless Gastrointestinal Endoscopy and Analysis of Its Impact on Patient Comfort

Painless gastrointestinal endoscopy, as an important diagnostic technique in modern medicine, is crucial for patient comfort and examination quality. Remimazolam, as a novel sedative drug, has demonstrated promising applications in painless gastrointestinal endoscopy. This article aims to explore the optimal dosage of remimazolam in painless gastrointestinal endoscopy and analyze its impact on patient comfort..By comparing indicators such as sedation depth, recovery time, and incidence of adverse reactions under different dosages, we found that a certain dosage range can maximize patient comfort while ensuring the effectiveness of the examination.Finally, we conducted a thorough analysis of remimazolam within this dosage range, exploring its mechanism of improving patient comfort. The results showed that this dosage range of remimazolam can effectively alleviate patients' anxiety and fear, reduce discomfort during the examination, and thereby improve their overall satisfaction.

Transcatheter Hepatic Artery Embolization Versus Hepatic Artery Perfusion Chemoembolization in the Interventional Treatment of Primary Hepatocellular Carcinoma: Clinical Effect Observation

Objective: To investigate the clinical effect of transcatheter hepatic artery embolization and hepatic artery perfusion chemoembolization on the interventional treatment of primary liver cancer. Methods: Eighty-two primary hepatocellular carcinoma patients who came to the outpatient clinic for treatment from August 2020 to November 2023 were selected as the study subjects. Based on the retrospective analysis, they were divided into 45 cases in the embolization group and 37 cases in the chemoembolization group according to the difference of treatment methods. The embolization group was treated with transcatheter hepatic artery embolization, and the chemoembolization group was treated with hepatic artery perfusion chemoembolization. The clinical efficacy, survival rate, survival quality score, serum tumor markers, and incidence of adverse reactions were observed in the two groups. Results: The clinical efficacy, survival quality score, and serum tumor markers of the chemoembolization group were higher than that of the embolization group, and the incidence of adverse reactions was lower than that of the embolization group, with statistically significant differences (P &lt; 0.05). The survival rate of the chemoembolization group was not statistically significant when compared with that of the embolization group (P &gt; 0.05). Conclusion: In the treatment of primary hepatocellular carcinoma, hepatic artery perfusion chemoembolization is better than transcatheter hepatic artery embolization, which can effectively improve the quality of patients’ survival and reduce the incidence of adverse reactions, and it is worth further popularized in the clinic.

Safety of Pembroria® during non-medical switching from Keytruda® in patients with advanced malignant neoplasms of various localizations: the REFLECTION real-world study

Background. Post-registration observational studies with switching therapy from the original drug to a biosimilar for non-medical indications allow us to assess the safety and effectiveness of this type of switching in real clinical practice. Aim. Evaluation of the safety and effectiveness of non-medical switching from the original drug Keytruda® to the biosimilar drug Pembroria® in patients with various oncological pathologies in real clinical practice (REFLECTION). Materials and methods. A retrospective analysis of data from electronic medical records from 21 medical institutions of the Russian Federation for the period 2020–2023 was carried out. Data were included from patients with cancer of various locations who received at least 2 injections of Keytruda® followed by switching to Pembroria® for non-medical indications (at least 2 injections). Primary criteria: incidence of immune-mediated adverse reactions (ImARs) of any severity. Secondary indicators: incidence of ImARs of various degrees of severity and infusion reactions, frequency of objective response rate (according to RECIST 1.1 criteria). Results. The analysis included data from 382 patients (male/female 200/182, median age 62 years) with NSCLC (24.1%), RCC (23.3%), melanoma (20.4%) and cancer of other localization. Patients received Keytruda® on 1st and 2nd lines (54.2 and 25.4% of patients, respectively), on 3 or 4 lines (14.1%), or as part of adjuvant therapy (6.3%). 50.5% of patients received pembrolizumab as monotherapy. The median number of administrations was 7.0 and 5.0 for Keytruda® and Pembroria®, respectively. ImARs were registered in 44 (11.5%) patients (60 ImARs), including 40 ImARs in 35 (9.2%) patients while using Keytruda® and 20 ImARs in 17 (2.4%) patients with Pembroria®. The most common ImARs were hypothyroidism, hyperthyroidism, and hepatitis; the frequency of these ImARs was higher with Keytruda® (EAER for hypothyroidism 0.00422 and 0.00144, for hepatitis – 0.00124 and 0.00096, respectively). All 5 reported cases of hyperthyroidism in patients on Keytruda® (EAER 0.00124), were resolved before switching to Pembroria®. No infusion-related reactions or deaths due to ImARs have been reported. The objective response rate was comparable – 104 (32.6%) and 90 (29.2%) patients оn Keytruda® and Pembroria® therapy, respectively. Most patients maintained disease control after switching to Pembroria® [progression was recorded in 29 (9.4%) patients after switching to a biosimilar]. Conclusion. The safety profiles of Keytruda® and Pembroria® were satisfactory and comparable in this study. Switching from therapy with Keytruda® to Pembroria® is not accompanied by an increase in the frequency or severity of ImARs. Switching from Keytruda® to Pembroria® maintains disease control in most patients.

Efficacy and safety of acupuncture for cognitive impairment in Alzheimer's disease: a systematic review and meta-analysis.

To systematically evaluate the efficacy of acupuncture in the treatment of cognitive impairment in Alzheimer's disease (AD) by meta-analysis, in order to provide evidence-based evidence for the application of acupuncture therapy in the clinical process of AD. From the establishment of the database to December 31, 2022, China Biomedical Literature Database (CBM), China National Knowledge Network (CNKI), VIP database, WanFang Database, Pubmed, Embase and Cochrane Library Database were systematically searched. To collect published randomized controlled clinical trials (RCTS) of acupuncture in the treatment of cognitive impairment in AD. The subjects in the intervention group were given acupuncture alone or combined with other treatments the same as the control group; the control group received conventional Western medicine treatment. The main outcome indicators of the study were cognitive function assessment of subjects, including: Simple Mental State Examination Scale (MMSE), Assessment of daily Living Ability Scale (ADL), Alzheimer's Disease Cognitive Function Assessment Scale (ADAS-Cog), TCM syndrome score (SDSD), Montreal Cognitive Test (MoCA), Secondary outcome indicators were the occurrence of adverse reactions. Literature screening, data extraction, and quality evaluation of the included literature were performed independently by two researchers, according to bias risk assessment tools recommended in the Cochrane manual. Data were analyzed by RevMan5.3 software. Dichotomous variables were represented by risk ratio (OR) and 95% CI, and continuity variables were represented by mean difference (MD) and 95% CI. For heterogeneity analysis, when P > 0.1 and I 2 ≤ 50%, fixed effect model was applied. When P ≤ 0.1 and I 2 > 50%, the random effects model is applied. A total of 1,172 eligible subjects were included in 18 RCTS, including 595 in the intervention group and 577 in the control group. The results of meta-analysis are as follows: acupuncture intervention group improved MMSE [MD = 1.67, 95% CI (0.94, 2.41), P < 0.00001], ADL [MD = -1.18, 95% CI (-3.09, 0.72), P = 0.22], ADAS-Cog [MD = 3.31, 95% CI (5.84, 0.78), P = 0.01], SDSD [MD = 2.40, 95% CI (3.53, 1.26), P < 0.0001], MoCA [MD = 4.80, 95% CI (3.74, 5.86), P = 0.04] were better than the control group. No serious adverse reactions related to acupuncture were observed in the intervention group, and the incidence and severity of adverse reactions were lower than those in the control group, with statistical significance [OR = 0.17, 95% CI (0.04, 0.67), P = 0.01]. Existing data show that acupuncture therapy has certain advantages in improving cognitive dysfunction and improving self-care ability of patients with Alzheimer's disease. However, due to the small number of RCTS and cases evaluating the efficacy of acupuncture, and the possibility of measurement bias and selectivity bias in included studies, it is still unable to conduct high-intensity demonstration on its effectiveness. Further large-scale, high-quality randomized, double-blind controlled trials are needed to evaluate its efficacy. https://inplasy.com/inplasy-2021-12-0125/, identifier: INPLASY2021120125.

Effect of Ultrasonic Cleaning Combined with Antibacterial Polypeptide Periodontal Gel on Inflammatory Reaction and Incidence of Adverse Reactions in Patients with Chronic Gingivitis.

The purpose of this investigation was to evaluate the efficacy of ultrasonic subgingival curettage in conjunction with antibacterial polypeptide periodontal gel in the management of chronic periodontitis of moderate to severe severity. Methods included dividing 500 hospitalised patients with moderate to severe chronic periodontitis evenly between an observation group and a control group. Subgingival ultrasonic curettage was performed on the placebo group. The non-treatment group received ultrasonic subgingival curettage and a periodontal gel rinse containing polypeptides. Results were compared before and after treatment in terms of the periodontal index, inflammation in the gingival crevicular fluid, and occlusal and masticatory efficiency. Both groups saw significant reductions in occlusal duration and occlusal force balance after treatment compared to pre-treatment levels, though the observation group saw a more dramatic decrease in these indices than the control group with P ≤ 0.05. The treatment and observation groups both saw significant reductions in the masticatory efficiency standard deviation afterward, but the index in the observation group was significantly lower than that of the control group with P ≤ 0.05.The authors claim that moderate to severe chronic periodontitis can be effectively treated with a combination of polypeptide periodontal gel and ultrasonic subgingival curettage. Substantial decreases from pre-treatment levels for both groups, with the Observation Group's index being significantly lower than the Control Group's index (P ≤ 0.05). It is possible that this treatment will help reduce inflammation and improve your periodontal health. Biting strength and occlusion stability can both be improved at the same time to help patients improve their chewing efficiency. Therefore, this method can be used securely in real-world patient care settings.

Effectiveness and safety of multimodal analgesia in open gastrostomy in patients with end-stage head and neck cancer

Objective: To investigate the effectiveness and safety of multimodal analgesia in patients with end-stage head and neck cancer in open gastrostomy surgery. Methods: This was a randomized controlled trial. From June to December 2023, 50 patients with end-stage head and neck cancer who underwent elective open gastrostomy surgery in Beijing Tongren Hospital Affiliated to Capital Medical University were prospectively selected. The patients were divided into multimodal analgesia group and local anesthesia group using the random number table method according to different anesthesia methods, with 25 cases in each group. In multimodal analgesia group, a multimodal analgesia regimen was adopted: ultrasound-guided abdominal wall nerve block (rectus sheath block and transverse abdominis plane block)+intravenous injection of oxycodone+intravenous injection of flurbiprofen axetil and dexamethasone. In local anesthesia group, local infiltration anesthesia with ropivacaine was adopted. The main outcome measure was the incidence of intraoperative pain numeric rating scale (NRS) score>3 points in the two groups. The secondary observation indicators included NRS score and hemodynamic indexes [mean arterial pressure (MAP) and heart rate (HR)] at various time points during surgery [before anesthesia (T0), at the time of incision (T1), 10 minutes after surgery (T2), during gastric body traction (T3), and at the end of surgery (T4)], incidence of adverse reactions, postoperative patient satisfaction score, as well as the NRS scores at rest and activity (coughing) within 24 hours after surgery. Results: The multimodal analgesia group included 21 males and 4 females, aged (61.4±9.9) years. There were 19 males and 6 females in the local anesthesia group, aged (58.6±10.8) years. The incidence of intraoperative NRS score>3 points and the incidence of salvage analgesia in the multimodal analgesia group were both 12.0% (3/25), which were lower than 60.0% (15/25) in the local anesthesia group, and the differences were statistically significant (all P<0.001); The NRS score [M (Q1, Q3)] at T3 in the multimodal analgesia group was 2 (2, 3) points, which were lower than 5 (3, 6) points in the local anesthesia group (P<0.05). There were smaller variabilities in MAP and HR in the multimodal analgesia group than those in the local anesthesia group (all P<0.05). The incidence of intraoperative tachycardia, surgical traction reaction, and nausea in the multimodal analgesia group was lower than that in the local anesthesia group (all P<0.05). The postoperative satisfaction score of patients in the multimodal analgesia group was (9.25±0.71) points, which were higher than (7.33±0.87) points in the local anesthesia group (P<0.001). NRS score during postoperative activity within 24 hours in the multimodal analgesia group were (2.36±0.75) points, which were lower than (3.03±0.81) points of the local anesthesia group (P=0.005). No adverse reactions such as urinary retention, nausea, vomiting and dizziness occurred in both groups. Conclusion: Compared with local anesthesia, the multimodal analgesic strategy could provide better analgesic effect and longer duration, better hemodynamic stability, and fewer intraoperative adverse reactions in patients with end-stage head and neck cancer undergoing open gastrostomy.

The Clinical Effect and Safety of Dihuang Decoction in Henoch-Schönlein Purpura Compared With Different Traditional Programs: A Network Meta-Analysis.

This systematic review aims to evaluate the therapeutic efficacy of Dihuang decoction (DD), anti-inflammatory drugs (AIDs), blood circulation improvement drugs (BCIDs), and conventional therapy (CT) in the management of Henoch-Schönlein purpura (HSP)and to establish their comparative effectiveness rankings. Using the Population, Intervention, Comparison, Outcome, Study (PICOS) design framework, we developed a detailed search strategy. The literature search included databases such as PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, Weipu Journal Data, and the Chinese Biomedical Database, covering studies published up to June2024. We included randomized controlled trials that featured the DD as the experimental intervention, with three remaining treatments as comparators.Our analysis encompassed 63 studies with 5,435 participants, divided into 2,817 in the experimental group and 2,618 in the control group. The network meta-analysis suggested that theDD potentially surpasses AIDs, BCIDs, and CT in the management of HSP. This conclusion is supported by its superior SUCRA (Surface Under the Cumulative Ranking) scores across various measures, including the overall effective rate of medication, time to relief or disappearance of the rash, incidence of adverse reactions, time to relief or disappearance of abdominal pain, time to relief or disappearance of arthritic swelling or pain, IgA levels, and the relapse rate within six months (SUCRA scores: 100.0%, 88.3%, 79.8%, 94.4%, 99.9%, 88.3%, and 95.4%, respectively). In terms of overall effectiveness rate, the SUCRA efficacy rankings are as follows: DD > AIDs > AIDs+BCID > BCID > CT. Regarding rash relief and regression time, the SUCRA efficacy rankings are as follows: DD > CT > AIDs+BCID > AIDs. For the incidence rate of adverse reactions, the SUCRA efficacy rankings are as follows: DD > CT > AIDs > BCID > AIDs+BCID. For the relief and disappearance of abdominal pain, the SUCRA efficacy rankings are as follows: DD > CT > AIDs+BCID > AIDs. In terms of relief and disappearance of joint swelling and pain, the SUCRA efficacy rankings are as follows: DD > AIDs+BCID > AIDs. Regarding IgA changes, the SUCRA efficacy rankings are as follows: DD > CT > BCID > AIDs+BCID > AIDs. For the six-month recurrence rate, the SUCRA efficacy rankings are as follows: DD > AIDs > AIDs+BCID > CT. The DD appears to be a more effective alternative for treating HSP compared to AIDs, BCIDs, and CT.We hope that this study will provide better assistance to clinical practice.

Analysis of Therapeutic Options for Noise-Induced Hearing Loss: Retroauricular Injection of Methylprednisolone Sodium Succinate Combined with Hyperbaric Oxygenation.

To evaluate the clinical effect of retroaural injection of methylprednisolone sodium succinate combined with hyperbaric oxygen (HBO) on the treatment of noise-induced hearing loss. Case data of 220 patients with hearing loss treated at the Zhongda Hospital Southeast University from January 1, 2019 to August 1, 2023 were obtained. As per the treatment plan, the recruited patients were divided into two cohorts: 158 cases in the combined-treatment group (retroaural injection of methylprednisolone sodium succinate combined with HBO) and 62 cases in the single-hormone group (retroaural injection of methylprednisolone sodium succinate). Comparison of the clinical efficacies and postoperative complication rates of the two groups was performed after treatment. MS-Excel was used to build a database for all data, and SPSS26.0 was utilized in the statistical analysis of recorded data. For patients with low-frequency, high-frequency, and flat descending type, the combined-treatment group showed significantly higher clinical effective rate than the single-hormone group (P < 0.05). For patients with disease duration ≤7 days, the combined-treatment group attained a significantly higher clinical effective rate was than the single-hormone group (P < 0.05). The safety of patients in both groups was evaluated mainly through their adverse reactions. The total incidence of adverse reactions in the single-hormone group reached 9.68%, and that in the combined-treatment group was 8.23%. The two groups revealed no significant difference in terms of incidence of adverse reactions (P > 0.05). HBO combined with retroaural injection of methylprednisolone sodium succinate has good clinical efficacy and safety in the treatment of hearing loss.

Effect of Noise Management in Interventional Radiology Suites on Patients Undergoing Transarterial Chemoembolization: A Retrospective Study.

This study aims to evaluate the effect of noise management in interventional radiology suites on patients undergoing transarterial chemoembolization (TACE). A retrospective cohort study design was employed. The study included a total of 141 patients with hepatocellular carcinoma who underwent TACE surgery in interventional radiology suite of the First People's Hospital of Nantong from January 2022 to December 2022. The patients were divided into an observation group (received noise management, n = 70) and a control group (did not receive noise management, n = 71) on the basis of whether they received noise management. Patient demographics and surgical data were collected, and heart rate, blood pressure, and anxiety levels were assessed before, during and after surgery. Satisfaction and the incidence of adverse reactions were also documented. No significant differences were found in general characteristics. The comparison between the observation and control groups revealed statistically significant differences in noise levels (P < 0.001). Additionally, anxiety levels significantly differed between the two groups (P = 0.040) as well as across different time points (P < 0.001). However, no significant difference was found in the occurrence of adverse events between groups (P = 0.772). Furthermore, patient satisfaction was significantly higher in the observation group than that in the control group (P < 0.001). Although no significant differences were found in heart rate and systolic blood pressure between groups (P > 0.05), and a significant main effect of time was observed for both variables (P < 0.001). Noise management in the interventional radiology suite effectively alleviates intraoperative anxiety among patients with TACE and improves treatment satisfaction but has no significant effect on physiological changes and the incidence of adverse events.

Polypharmacy, Drug Interaction, and Their Consequences in Terms of Adverse Drug Reaction among Adults Receiving Cancer Chemotherapy in a Tertiary Care Hospital in Central India

Abstract Background: Noncommunicable diseases in India are calculated to account for 63% of total mortality, and cancer is one of the principle causes up to 9% of total deaths. Objective: The objective of the study was t collect and analyze data about drugs taken by patients, which were prescribed by the doctor to combat side effects and to determine the extent of polypharmacy in patients on cancer chemotherapy Materials and Methods: A cross-sectional study in a Tertiary Care Hospital of Central India in the adult population by giving questionnaire forms to assess polypharmacy usage. Necessary statistical tests were applied. Results: A total of 40 indoor patients receiving cancer chemotherapy were included in the study. Many potential interactions between two chemotherapeutic drugs and chemotherapeutic and adjuvant drugs were studied. Positive adverse drug reactions encountered by patients had a strong correlation with these interactions. Conclusion: Drug interactions during chemotherapy are a common occurrence. The judicious use of cancer chemotherapeutic medicines and their combination with adjuvants are required to decrease the incidence of adverse drug reactions and increase the efficacy of chemotherapy.

Chinese expert consensus on radiofrequency therapy for gastroesophageal reflux disease 2024

ObjectiveRadiofrequency (RF) therapy is a minimally invasive procedure used to treat gastroesophageal reflux disease (GERD). During the procedure, electrodes are meticulously inserted into the lower esophageal sphincter and cardiac muscle through a gastroscope. By applying heat at various layers and sites around the gastroesophageal junction, the treatment intends to augment the junction's pressure and reduce tissue compliance. This process may also desensitize the esophagus, thereby preventing reflux and relieving symptoms. RF therapy boasts a high success rate and a low risk of adverse effects, making it an increasingly popular choice. However, there is a lack of consensus regarding its indications, contraindications, and the evaluation processes for pre- and postoperative care. To enhance the precision of patient selection and the technical execution of RF therapy, it is imperative to consolidate and standardize its clinical application in China. This will ensure the therapy's safety and efficacy are optimized. MethodsBetween December 2022 and April 2024, a group of 25 Chinese endoscopists, each with experience in over 50 radiotherapy procedures, engaged in six rounds of consensus discussions. The discussions focused on several key aspects of the procedure. During these discussions, each item was put to a vote among the experts. A consensus was reached when an item received agreement from at least 80 ​% of the participants. ResultsThe expert group, comprising 25 specialists from 22 different institutions, had an average experience of over 50 RF procedures. These experts engaged in comprehensive discussions on a total of eight critical items, covering the full spectrum of the procedure, including indications, contraindications, basic working conditions and preparation, preoperative preparation, surgical process and technical skills, postoperative management, therapeutic effects, complications and prevention. The group successfully reached a consensus on all these items, ensuring a standardized approach to RF procedures. ConclusionThis consensus summarized and standardized the clinical application of anti-reflux RF therapy in China. Adoption of this consensus will improve the precision of patient selection and technical implementation, thereby enhancing the safety and effectiveness of anti-reflux radiofrequency therapy.

Tetracycline Three Times Daily Versus Four Times Daily in Bismuth-Containing Quadruple Therapy as the First-Line Treatment of Helicobacter pylori Infection: A Multicenter, Noninferiority, Randomized Controlled Trial.

Current guidelines recommend bismuth-containing quadruple therapy for patients newly diagnosed with Helicobacter pylori (H. pylori) infection. We aimed to compare the efficacy and safety of tetracycline administered three times daily versus four times daily in bismuth-containing quadruple therapy for first-line treatment of H. pylori infection. This multicenter, noninferiority, randomized controlled study, conducted in China, recruited treatment-naïve adults with H. pylori infection, randomized 1:1 into two treatment groups to receive either of the following bismuth-containing quadruple therapies: esomeprazole 20 mg twice-daily; bismuth 220 mg twice-daily; amoxicillin 1000 mg twice-daily; and tetracycline 500 mg three times daily (TET-T) versus 500 mg four times daily (TET-F). At least 6 weeks post-treatment, a 13C-urea breath test was performed to evaluate H. pylori eradication. In total, 406 patients were randomly assigned to the two treatment groups. Intention-to-treat eradication rates were 91.63% (186/203; 95% confidence interval [CI] 87.82%-95.44%) versus 90.15% (183/203; 95% CI 86.05%-94.25%) (p = 0.0005) and per-protocol eradication rates were 95.34% (184/193; 95% CI 92.36%-98.31%) versus 95.72% (179/187; 95% CI 92.82%-98.62%) (p = 0.0002) for the TET-T and TET-F group, respectively. TET-T-treated patients had a lower incidence of adverse effects than TET-F-treated patients (21.61% vs. 31.63%, p = 0.024), with no significant differences in compliance to treatment between the groups. As a first-line therapy for H. pylori infection, the eradication rate of the TET-T therapy was noninferior to that of the TET-F therapy while significantly reducing the incidence of adverse reactions. ClinicalTrials.gov identifier: NCT05431075.

Clinical application and effect evaluation of acupoint thread embedding therapy and traditional Chinese medicine treatment based on menstrual cycle characteristics in the management of breast hyperplasia: An observational study.

To evaluate the effectiveness of the combination of acupoint embedding therapy and traditional Chinese medicine dialectical treatment regimen in improving clinical symptoms, promoting tumor regression, controlling adverse reactions and complications, and enhancing patient satisfaction by comparing and analyzing the clinical data of 120 breast tumor patients. One hundred twenty patients with breast cancer were divided into a treatment group (60 cases) and a control group (60 cases) according to different treatment plans. Patients in the treatment group received a combination of acupoint embedding therapy and traditional Chinese medicine dialectical treatment based on different time points of the menstrual cycle. Including the proportion of reduction in the number of breast masses, the proportion of reduction in mass size, changes in pain severity scores, tumor regression rate, regression time, incidence of adverse reactions and complications, and patient satisfaction. Statistical software was used to analyze the data to evaluate differences between the 2 groups. In terms of clinical symptoms, the proportion of reduction in the number of breast masses in the treatment group averaged 50%, significantly higher than the 25% in the control group; the proportion of reduction in mass size averaged 40%, also higher than the 15% in the control group; and the improvement in pain severity scores was also superior to the control group. Regarding tumor regression, the tumor regression rate in the treatment group reached 85%, with an average regression time of 6.2 weeks, both significantly better than the 55% and 9.8 weeks in the control group. In terms of adverse reactions and complications, the incidence rate in the treatment group was relatively low, and no serious adverse events occurred. Patient satisfaction surveys showed that the treatment group had significantly higher satisfaction with treatment effectiveness, treatment process, and physician service attitude compared to the control group. Based on clinical data from 120 breast tumor patients, the results of this study indicate that breast tumor patients treated with a specific treatment regimen have significant advantages in improving clinical symptoms, tumor regression, controlling adverse reactions and complications, and patient satisfaction. This treatment regimen has high clinical application value and deserves further promotion.

Study on the therapeutic effect of sintilimab combined with modified DCF regimen on advanced gastric cancer and its impact on Th1/Th2 immune balance.

The aim of this study was to observe the therapeutic effect of sintilimab combined with a modified docetaxel + cisplatin + fluorouracil (DCF) regimen on advanced gastric cancer and its effect on Th1/Th2 immune balance. Ninety-eight cases of advanced gastric cancer patients who visited our hospital from April 2020 to May 2022 were selected and divided into 48 cases each in the conventional group and the research group by random number table method; the DCF regimen was adopted in the conventional group, and sintilimab combined with modified DCF regimen was adopted in the research group, and the therapeutic effects of the patients in the two groups and the changes of Th1/Th2 immune indexes were compared. CEA, CA199, CA242, CD168 AQ3, and IL-4 in the study group were lower than those in the conventional group at the end of three cycles of treatment, and the difference was statistically significant ( P < 0.001). The levels of IFN-γ and IL-4 in the study group at the end of three cycles of treatment were higher than those in the conventional group ( P < 0.001). The incidence of adverse reactions during treatment in the study group was lower than that in the conventional group ( P < 0.001), and the grading of adverse reactions in the study group was milder than that in the conventional group. Sintilimab combined with a modified DCF regimen in the treatment of advanced gastric cancer not only improves the therapeutic effect but also positively affects the Th1/Th2 immune balance, which provides better immune regulation for patients with advanced gastric cancer.

Perioperative impact of ultrasound-guided ilioinguinal and iliohypogastric nerve blocks in patients undergoing pelvic fracture surgery.

Pelvic fractures present a severe and complex clinical challenge. This study aimed to compare ultrasound-guided ilioinguinal (IIN) and iliohypogastric nerve (IHN) blocks with conventional general anesthesia (GA) in patients undergoing internal fixation surgery for pelvic fractures. A retrospective analysis was conducted on 100 patients equally divided into ultrasound-guided and control groups. The study monitored hemodynamics, intraoperative anesthesia drug usage, postoperative pain levels, and the incidence of adverse reactions between the 2 groups. The ultrasound-guided group underwent ultrasound-guided IHN and IIN blocks combined with GA. The ultrasound-guided group exhibited significant advantages for hemodynamic measurements at specific time points, lower consumption of Propofol and Remifentanil, and reduced pain intensity across all evaluated time intervals (P < .05). The incidence rate of adverse reactions was significantly lower in the ultrasound group (P = .016). Ultrasound-guided anesthesia is a superior alternative to conventional GA for managing pelvic fractures through internal fixation surgery. It offers advantages in terms of hemodynamic stability, drug consumption, postoperative pain management, and adverse reaction reduction.

Effect and mechanism of Qingre Huashi decoction on drug-resistant Helicobacter pylori.

Helicobacter pylori (HP), the most common pathogenic microorganism in the stomach, can induce inflammatory reactions in the gastric mucosa, causing chronic gastritis and even gastric cancer. HP infection affects over 4.4 billion people globally, with a worldwide infection rate of up to 50%. The multidrug resistance of HP poses a serious challenge to eradication. It has been de-monstrated that compared to bismuth quadruple therapy, Qingre Huashi decoction (QHD) combined with triple therapy exhibits comparable eradication rates but with a lower incidence of adverse reactions; in addition, QHD can directly inhibit and kill HP in vitro. To explore the effect and mechanism of QHD on clinically multidrug-resistant and strong biofilm-forming HP. In this study, 12 HP strains were isolated in vitro after biopsy during gastroscopy of HP-infected patients. In vitro, the minimum inhibitory concentration (MIC) values for clinical HP strains and biofilm quantification were determined through the E-test method and crystal violet staining, respectively. The most robust biofilm-forming strain of HP was selected, and QHD was evaluated for its inhibitory and bactericidal effects on the strain with strong biofilm formation. This assessment was performed using agar dilution, E-test, killing dynamics, and transmission electron microscopy (TEM). The study also explored the impact of QHD on antibiotic resistance in these HP strains with strong biofilm formation. Crystalline violet method, scanning electron microscopy, laser confocal scanning microscopy, and (p)ppGpp chromatographic identification were employed to evaluate the effect of QHD on biofilm in strong biofilm-forming HP strains. The effect of QHD on biofilm and efflux pump-related gene expression was evaluated by quantitative polymerase chain reaction. Non-targeted metabolomics with UHPLC-MS/MS was used to identify potential metabolic pathways and biomarkers which were different between the NC and QHD groups. HP could form biofilms of different degrees in vitro, and the intensity of formation was associated with the drug resistance of the strain. QHD had strong bacteriostatic and bactericidal effects on HP, with MICs of 32-64 mg/mL. QHD could inhibit the biofilm formation of the strong biofilm-forming HP strains, disrupt the biofilm structure, lower the accumulation of (p)ppGpp, decrease the expression of biofilm-related genes including LuxS, Spot, glup (HP1174), NapA, and CagE, and reduce the expression of efflux pump-related genes such as HP0605, HP0971, HP1327, and HP1489. Based on metabolomic analysis, QHD induced oxidative stress in HP, enhanced metabolism, and potentially inhibited relevant signaling pathways by upregulating adenosine monophosphate (AMP), thereby affecting HP growth, metabolism, and protein synthesis. QHD exerts bacteriostatic and bactericidal effects on HP, and reduces HP drug resistance by inhibiting HP biofilm formation, destroying its biofilm structure, inhibiting the expression of biofilm-related genes and efflux pump-related genes, enhancing HP metabolism, and activating AMP in HP.

Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid- to high-frequency sudden sensorineural hearing loss

BACKGROUND Sudden sensorineural hearing loss (SSNHL), characterized by a rapid and unexplained loss of hearing, particularly at moderate to high frequencies, presents a significant clinical challenge. The therapeutic use of methylprednisolone sodium succinate (MPSS) via different administration routes, in combination with conventional medications, remains a topic of interest. AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid- to high-frequency SSNHL. METHODS The medical records of 109 patients with mid- to high-frequency SSNHL were analyzed. The patients were divided into three groups based on the route of administration: Group A [intratympanic (IT) injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection], Group B (intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection), and Group C (single IT injection of MPSS). The intervention effects were compared and analyzed. RESULTS The posttreatment auditory thresholds in Group A (21.23 ± 3 .34) were significantly lower than those in Groups B (28.52 ± 3.36) and C (30.23 ± 4.21; P &lt; 0.05). Group A also exhibited a significantly greater speech recognition rate (92.23 ± 5.34) than Groups B and C. The disappearance time of tinnitus, time to hearing recovery, and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C (P &lt; 0.05). The total effective rate in Group A (97.56%) was significantly greater than that in Groups B and C (77.14% and 78.79%, χ 2 = 7.898, P = 0.019). Moreover, the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B (4.88%, 3.03% vs 2.57%, χ 2 = 11.443, P = 0.003), and the recurrence rate in Group A was significantly lower than that in Groups B and C (2.44% vs 20.00% vs 21.21%, χ 2 = 7.120, P = 0.028). CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS. This approach effectively improves patients' hearing and reduces the risk of disease recurrence.

Insights into Anti-Epileptic Drug Therapy: A Cross-Sectional Comparison of Adverse Drug Reactions in Monotherapy vs. Polytherapy at a Tertiary Care Hospital

Epilepsy, a widespread neurological disorder, poses significant challenges to effective treatment, often resulting in a diminished quality of life for affected individuals. Despite its prevalence, managing epilepsy remains a complex task, as many patients experience treatment non-compliance due to adverse effects or perceived lack of efficacy. The conventional approach to treatment involves monotherapy, wherein a single anti-epileptic drug (AED) is prescribed. However, this method often leads to adverse effects necessitating dose escalation, which can ultimately prompt treatment cessation. In recent years, polytherapy has emerged as an alternative strategy for managing epilepsy. Polytherapy involves combining multiple AEDs at reduced doses to mitigate adverse effects and enhance therapeutic efficacy. While monotherapy is favored for its simplicity and historical effectiveness, there is growing interest in exploring the comparative effectiveness and safety between monotherapy and polytherapy.1 Understanding the nuances of these treatment approaches is essential for clinicians and patients alike to make informed decisions regarding epilepsy management, considering factors such as seizure control, adverse effects, and overall quality of life. This review aims to provide a comprehensive analysis of the efficacy and safety profiles of monotherapy and polytherapy in epilepsy treatment. By evaluating existing evidence and clinical outcomes, this study offers valuable insights that can guide clinicians in tailoring treatment regimens to individual patient needs, ultimately improving outcomes and enhancing the overall quality of care for individuals living with epilepsy. Results from our study have established that out of the 563 patients included in our study, about 50% have developed some sort of adverse drug reaction (ADR). Of these 282 patients that have developed an ADR, about 62% of patients were on monotherapy and the remaining 38% were on polytherapy. Establishing the fact that monotherapy is more effective than polytherapy in reducing the incidence of adverse drug reactions.

Effects of tramadol hydrochloride preemptive analgesia in kyphoplasty of thoracolumbar osteoporotic fractures under local anesthesia

To explore preemptive analgesic effect of preoperative intramural tramadol injection in percutaneous kyphoplasty (PKP) of vertebrae following local anesthesia. From August 2019 to June 2021, 118 patients with thoraco lumbar osteoporotic fractures were treated and divided into observation group and control group, with 59 patients in each gruop. In observation group, there were 26 males and 33 females, aged from 57 to 80 years old with an average of (67.69±4.75)years old;14 patients on T11, 12 patients on T12, 18 patients on L1, 15 patients on L2;tramadol with 100 mg was injected intramuscularly half an hour before surgery in observation group. In control group, there were 24 males and 35 females, aged from 55 to 77 years old with an average of (68.00±4.43) years old;19 patients on T11, 11 patients on T12, 17patients on L1, 12 patients on L2;the same amount of normal saline was injected intramuscularly in control group. Observation indicators included operation time, intraoperative bleeding, visual analogue scale (VAS) evaluation and recording of preoperative (T0), intraoperative puncture(T1), and working cannula placement (T2) between two groups of patients, at the time of balloon dilation (T3), when the bone cement was injected into the vertebral body (T4), 2 hours after the operation (T5), and the pain degree at the time of discharge(T6);adverse reactions such as dizziness, nausea and vomiting were observed and recorded;the record the patient's acceptance of repeat PKP surgery. All patients were successfully completed PKP via bilateral pedicle approach, and no intravenous sedative and analgesic drugs were used during the operation. There was no significant difference in preoperative general data and VAS(T0) between two groups (P>0.05). There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). VAS of T1, T2, T3, T4 and T5 in observation group were all lower than those in control group(P<0.05), and there was no significant difference in T6 VAS (P>0.05). T6 VAS between two groups were significantly lower than those of T0, and the difference was statistically significant (P<0.05). There was no significant difference in incidence of total adverse reactions between two groups (P>0.05). There was a statistically significant difference in the acceptance of repeat PKP surgery (P<0.05). Half an hour before operation, intramuscular injection of tramadol has a clear preemptive analgesic effect for PKP of single-segment thoracolumbar osteoporotic fracture vertebral body under local anesthesia, which could increase the comfort of patients during operation and 2 hours after operation, and improve patients satisfaction with surgery.