比较恩那度司他片与罗沙司他胶囊治疗肾性贫血的临床疗效与安全性。 方法 采用前瞻性队列研究设计，选取2025年1月-2025年12月就诊于我院肾内科使用恩那度司他片与罗沙司他胶囊的非透析肾性贫血患者，比较两者治疗4周后红细胞计数（RBC）、血红蛋白（Hb）、红细胞压积（HCT）水平。通过JADER数据库调取与恩那度司他和罗沙司他相关的药物不良事件（ADE）报告，采用报告比值比法（ROR）和比例报告比值法（PRR）进行信号挖掘，对比分析两者的不良事件信号。 结果 共纳入恩那度司他组18例、罗沙司他组27例。治疗4周后，恩那度司他组Hb、RBC、HCT水平均较治疗前显著升高（P＜0.05），两组间治疗后Hb、RBC、HCT水平比较差异无统计学意义（P＞0.05）。JADER数据库共提取恩那度司他相关ADE报告65例，挖掘得到13个阳性信号；罗沙司他相关ADE报告3542例，挖掘得到135个阳性信号。两组重叠信号11个，主要为血栓栓塞事件（深静脉血栓形成、肺栓塞、分流道阻塞等）和代谢异常（高钾血症）。恩那度司他组检出的高血压（5例，ROR=8.63）未在罗沙司他组中出现。 结论 恩那度司他治疗肾性贫血疗效确切，与罗沙司他疗效相当。安全性方面，恩那度司他相关的血栓事件、高钾血症等信号需引起关注，同时需动态监测血压水平。

To compare the clinical efficacy and safety of Enarodustat Tablets and Roxadustat Capsules in the treatment of renal anemia. METHODS A prospective cohort study design was used to select patients with non-dialysis renal anemia who were treated with Enarodustat Tablets and Roxadustat Capsules in the Department of Nephrology of our hospital from January 2025 to December 2025. The levels of Red Blood Cell count ( RBC ), Hemoglobin ( Hb ) and Hematocrit ( HCT ) were compared between the two groups after 4 weeks of treatment. The adverse drug events ( ADE ) reports related to Enarodustat and Roxadustat were retrieved from the JADER database. The report odds ratio method ( ROR ) and the proportional report ratio method ( PRR ) were used for signal mining, and the adverse event signals of the two were compared and analyzed.RESULTS A total of 18 cases in the Enarodustat group and 27 cases in the Roxadustat group were included. After 4 weeks of treatment, the levels of Hb, RBC and HCT in the Enarodustat group were significantly higher than those before treatment ( P < 0.05 ),and there was no significant difference in Hb, RBC and HCT levels between the two groups after treatment ( P > 0.05 ). A total of 65 ADE reports related to Enarodustat were extracted from JADER database, and 13 positive signals were mined. A total of 3542 cases of Roxadustat-related ADE were reported, and 135 positive signals were mined. There were 11 overlapping signals in the two groups, mainly thromboembolic events ( deep vein thrombosis, pulmonary embolism, shunt obstruction, etc. ) and metabolic abnormalities ( hyperkalemia ). Hypertension ( 5 cases, ROR = 8.63 ) was not detected in the Roxadustat group.CONCLUSION Enarodustat is effective in the treatment of renal anemia, which is equivalent to Roxadustat. In terms of safety, signals such as thrombotic events and hyperkalemia related to Enarodustat need to be paid attention to, and blood pressure levels need to be dynamically monitored.

探讨手术联合辅助放化疗治疗老年口腔颌面部肿瘤的疗效与安全性。方法：选取2023年1月至2025年9月收治的110例老年口腔颌面部肿瘤患者，采用随机分组分为联合治疗组与单纯手术组，各55例。单纯手术组行根治性肿瘤切除术；联合治疗组在相同手术后接受辅助放化疗。比较两组1年、2年总生存率（OS）与无进展生存率（PFS）、肿瘤控制情况（局部复发、区域淋巴结及远处转移）及治疗相关不良反应。结果：联合治疗组1年、2年OS及PFS均显著高于单纯手术组（均P<0.05）。联合治疗组局部复发率、区域淋巴结转移率及远处转移率均显著更低（均P<0.05）。在安全性方面，联合治疗组因接受了标准化的预防性止吐与支持治疗，其≥3级恶心（5.45% vs 14.55%）、呕吐（3.64% vs 12.73%）发生率显著低于单纯手术组（P<0.05），其他不良反应发生率组间无统计学差异；长期随访显示，联合治疗组张口受限（9.09% vs 21.82%）及吞咽功能异常（7.27% vs 18.18%）发生率亦显著更低（P<0.05）。结论：在精细化支持治疗与先进放疗技术支持下，手术联合辅助放化疗可提升老年口腔颌面部肿瘤患者生存率与肿瘤控制率，不增加治疗相关毒副反应，还能更好保留长期功能，表明该综合治疗方案兼具疗效与安全性。

目的：评估血细胞分离机单采制备自体富血小板血浆（PRP）治疗雄激素性脱发（AGA）的疗效及安全性。方法：纳入31例AGA患者，采用单采技术制备血小板浓度803~1669×10?/L的自体PRP，激活后行头皮注射治疗3次（间隔1个月）。于基线（T1）及每次治疗后1、2、3个月（T2~T4）评估毛发密度与不良反应。结果：患者均为男性。毛发密度由T1的（111.77±12.00）根/cm2升至T4的（133.74±16.34）根/cm2（均P＜0.001）。医师评估有效率80.6%，患者满意率74.2%。主要不良反应为注射部位出血、肿痛及灼热感，均自行缓解；1例出现额部及眼睑明显水肿，5 d后消退。结论：单采自体PRP治疗AGA疗效确切且安全。规范控制PRP制备质量及血小板浓度有助于优化疗效。

Objective: To evaluate the clinical efficacy and safety of autologous platelet-rich plasma (PRP) prepared via apheresis using a blood cell separator for the treatment of androgenetic alopecia (AGA). Methods: A total of 31 patients with AGA who completed the study were enrolled. Autologous PRP with a platelet concentration of 803-1669×10?/L was prepared using apheresis technology. After activation, the PRP was administered via intralesional scalp injections for a total of 3 sessions at 1-month intervals. Hair density changes and adverse reactions were evaluated at baseline (T1) and at 1, 2, and 3 months after the initial treatment (T2-T4). Results: All included patients were male. Hair density significantly increased from (111.77±12.00) hairs/cm2 at baseline to (133.74±16.34) hairs/cm2 at T4 (all P<0.001). The clinician-evaluated effective rate was 80.6%, and the patient satisfaction rate was 74.2%. The primary adverse reactions included hemorrhage, swelling, burning sensation, and transient pain at the injection site, all of which resolved spontaneously. Notably, 1 patient developed marked edema in the forehead and eyelids, which subsided spontaneously after approximately 5 days. Conclusion: Autologous PRP prepared via apheresis is effective and safe for the treatment of AGA. Standardized quality control of PRP preparation and platelet concentration may contribute to further optimizing the therapeutic outcomes.

【摘要】目的：探讨器械护士术中分区精细化器械管理对心脏瓣膜置换术（HVR）手术效率及安全性的影响。方法：研究对象包括2024年6月~2026年5月至我院行HVR治疗的110例心脏瓣膜病（VHD）患者，以及同期参与手术的22名器械护士，采用随机数字表法将入组患者及护士分别列为常规组（55例患者、11名护士）、试验组（55例患者、11名护士），常规组内护士术中实施常规器械管理，试验组内护士术中实施分区精细化器械管理。比较两组患者的手术效率、围手术期安全事件，以及两组护士所参与手术的工作效率、术中器械管理情况。结果：在不同器械管理模式下，试验组内患者的主动脉阻断时间、体外循环时间、术中非必要等待时间、手术总耗时均低于常规组（t=8.817，5.730，20.609，9.632；P＜0.05）。试验组内患者的围手术期安全事件发生率9.09%（5/55）低于常规组25.45%（14/55）（x2=5.153；P＜0.05）。试验组内护士的器械摆台时间、器械传递反应时间、手术中断次数、器械整理时间、器械移交时间均低于常规组（t=3.347，6.505，5.971，3.795，5.838；P＜0.05）。试验组内护士的器械管理差错率低于常规组（x2=5.238；P＜0.05）。结论：器械护士术中分区精细化器械管理能提高HVR患者的手术效率并降低围手术期安全事件发生风险，对提高器械护士的器械管理质量、预防器械管理差错有积极影响

[Abstract]Objective:To explore the impact of refined intraoperative instrument management by operating room nurses on the efficiency and safety of HVR surgery.Methods:The study subjects included 110 patients with VHD who underwent HVR treatment at our hospital from June 2024 to May 2026, along with 22 instrument nurses who participated in the surgeries synchronously. Using the random number table method, the enrolled patients and nurses were divided into a control group (55 patients, 11 nurses) and an experimental group (55 patients, 11 nurses). Nurses in the conventional group implemented routine instrument management during surgery, while nurses in the experimental group implemented zoned and refined instrument management during surgery. The surgical efficiency, perioperative safety events of the two groups of patients, as well as the work efficiency and intraoperative instrument management of the surgeries participated by the nurses in the two groups were compared.Results:Under different instrument management modes, the aortic occlusion time, extracorporeal circulation time, intraoperative non-essential waiting time, and total surgical time of patients in the experimental group were all lower than the control group (t=8.817，5.730，20.609，9.632; P<0.05). The incidence of perioperative safety events in the experimental group was 9.09% (5/55) lower than that in the control group 25.45% (14/55) (x2=5.153; P<0.05). The instrument placement time, instrument delivery response time, number of surgical interruptions, instrument sorting time, and instrument handover time of nurses in the experimental group were lower than those in the control group (t=3.347，6.505，5.971，3.795，5.838; P<0.05). The error rate of nurses in the experimental group was lower than the control group (x2=5.238; P < 0.05).Conclusion:Refined intraoperative zone-specific instrument management by instrument nurses enhances surgical efficiency for HVR patients and reduces the risk of perioperative safety incidents, thereby positively impacting the quality of instrument care provided by nurses and preventing instrument-related adverse events.

【摘要】目的：探讨超声骨刀与高速涡轮手机在颌骨囊肿患者外科手术中的应用效果及安全性。方法：研究选择2024年1月~2025年6月至我院行囊肿刮治术治疗的100例颌骨囊肿患者，通过隐藏信封法将入组患者随机列为常规组、试验组，每组50例。常规组术中应用高速涡轮手机去骨，试验组术中应用超声骨刀去骨，比较两组患者的手术情况，术后疼痛肿胀情况及住院期间并发症发生情况。术毕随访半年，比较两组患者神经损伤情况及骨愈合情况。结果：试验组的术中出血量、术后24h引流量、切骨精度偏差分别为（30.59±5.24）mL、（20.55±5.28）mL、（0.18±0.05）mm，均低于常规组[（40.19±7.33）mL、（30.46±6.45）mL、（0.59±0.12）mm]（t=7.534，8.407，22.301；P＜0.05）；手术耗时与常规组比较，差异无统计学意义（P＞0.05）。试验组术后24h、48h、72h的视觉模拟疼痛量表（VAS）评分，肿胀评分均低于常规组（t=4.403，3.354，12.986，4.610，2.911，14.888；P＜0.05）。试验组住院期间的并发症发生率4.00%（2/50）低于常规组18.00%（9/50）（x2=5.005；P＜0.05）。试验组随访第1个月、第3个月、第6个月的神经传导速度（NCV）均高于常规组，两点辨别觉（TPD）均低于常规组（t=4.598，5.784，6.322，3.194，3.595，3.501；P＜0.05）。截至随访结束时，试验组的成骨率分别为（75.27±8.14）%高于常规组（68.18±5.27）%]，骨缺损面积、创面愈合时间、骨吸收量分别为（55.29±5.42）%、（3.22±0.47）月、（1.25±0.36）mm，均低于常规组[（62.44±7.51）%、（5.08±1.33）月、（2.49±0.32）mm]（t=5.170，5.459，9.324，18.204；P＜0.05）。结论：与高速涡轮手机相比，超声骨刀可降低颌骨囊肿患者术中出血风险并实现精准去骨，在减轻术后疼痛、肿胀程度同时能一定程度减轻术后神经损伤，对促进患者骨愈合也有积极影响。

[Abstract]Objective:To explore the application effect and safety of ultrasound bone scalpel and high-speed turbine mobile phone in surgical procedures for patients with jaw cysts.Methods:A total of 100 patients with maxillary cysts who underwent curettage surgery in our hospital from January 2024 to June 2025 were selected for the study. The enrolled patients were randomly divided into a control group and an experimental group using the hidden envelope method, with 50 patients in each group. The conventional group used high-speed turbine mobile phones for bone removal during surgery, while the experimental group used ultrasonic bone knives for bone removal during surgery. The surgical conditions, postoperative pain and swelling, and incidence of complications during hospitalization were compared between the two groups of patients. Follow up for six months after surgery to compare the nerve damage and bone healing between the two groups of patients.Results:The intraoperative bleeding volume, postoperative 24-hour drainage volume, and bone cutting accuracy deviation of the experimental group were (30.59 ± 5.24) mL, (20.55 ± 5.28) mL, and (0.18 ± 0.05) mm, respectively, all lower than those of the control group [(40.19 ± 7.33) mL, (30.46 ± 6.45) mL, and (0.59 ± 0.12) mm] (t=7.534，8.407，22.301; P<0.05); The surgical time of the experimental group was similar to the control group (P>0.05). The VAS scores and swelling scores of the experimental group at 24, 48, and 72 hours after surgery were lower than the control group (t=4.403，3.354，12.986，4.610，2.911，14.888；; P<0.05). The incidence of complications during hospitalization in the experimental group was 4.00% (2/50) lower than the control group 18.00% (9/50) (x2=5.005; P<0.05).The NCV of the experimental group was higher than the control group at the1,3,6 months of follow-up, and TPD was lower than the control group (t=4.598，5.784，6.322，3.194，3.595，3.501; P<0.05). As of the end of follow-up, the osteogenic rate of the experimental group was (75.27 ± 8.14)% higher than the control group (68.18 ± 5.27)%. The bone defect area, wound healing time, and bone resorption were (55.29 ± 5.42)%, (3.22 ± 0.47) months, and (1.25 ± 0.36) mm, lower than the control group [(62.44 ± 7.51)%, (5.08 ± 1.33) months, and (2.49 ± 0.32) mm] (t=5.170，5.459，9.324，18.204; P<0.05).Conclusion:Compared with high-speed turbo phones, ultrasonic bone scalpel can reduce the risk of intraoperative bleeding in patients with jaw cysts and achieve precise bone removal. It can alleviate postoperative pain and swelling while greatly avoiding postoperative nerve damage, and has a positive impact on promoting bone healing in patients.

晚期癌痛所带来的疼痛症状是持久且严重的，这十分影响患者的生活质量与身心健康，并阻碍肿瘤治疗方案的顺利实施，进而影响患者治疗效果。阿片类药物是治疗中重度癌痛的主要方式，具有明确的镇痛效果，但是，吗啡、芬太尼等具有代表性的传统阿片类药物也存在一定的应用局限性，其主要通过激活μ-阿片受体下游的G蛋白信号通路以发挥镇痛作用，这会在一定程度上激活β-arrestin通路，进而增加呼吸抑制、严重便秘、过度镇静等副作用的发生情况，因此，该类药物不具有临床广泛应用性[1-2]。在此背景下，奥赛利定作为新型阿片类药物应运而生，其可选择性激活G蛋白通路，且不会显著激动β-arrestin通路效应，能够在实现强效镇痛的同时，还可降低由β-arrestin通路激活所介导的不良反应发生率，这十分适合应用在无法耐受传统阿片镇痛药物副作用的患者群体之中[3-4]。基于此，本研究进一步探究奥赛利定注射液治疗晚期癌痛的临床疗效与安全性，如下。

目的：对比季德胜蛇药片不同用药方式分别与阿昔洛韦结合，在带状疱疹治疗中的价值。方法： 将74例于我院诊治带状疱疹患者随机分为外涂组（37例，季德胜蛇药片外涂结合阿昔洛韦治疗）与口服组（37例，季德胜蛇药片口服结合阿昔洛韦治疗）。对治疗7天后两组的症状程度、病情转归时间、整体疗效及用药安全性展开对比。结果：治疗后，外涂组VAS评分、皮损评分均低于口服组（P＜0.05）；治疗后，外涂组止疱时间、疼痛减轻时间、结痂时间均短于口服组（P＜0.05）；外涂组97.30%的总有效率较口服组的83.78%高（P＜0.05）；外涂组5.41%的药物副反应发生率较口服组的21.62%低（P＜0.05）。结论：在带状疱疹治疗中，季德胜蛇药片外涂结合阿昔洛韦治疗，相比于季德胜蛇药片口服结合阿昔洛韦治疗，可获得更好整体疗效，患者症状改善更明显，病情转归更快，用药安全性更高。

目的：对比季德胜蛇药片不同用药方式分别与阿昔洛韦结合，在带状疱疹治疗中的价值。方法： 将74例于我院诊治带状疱疹患者随机分为外涂组（37例，季德胜蛇药片外涂结合阿昔洛韦治疗）与口服组（37例，季德胜蛇药片口服结合阿昔洛韦治疗）。对治疗7天后两组的症状程度、病情转归时间、整体疗效及用药安全性展开对比。结果：治疗后，外涂组VAS评分、皮损评分均低于口服组（P＜0.05）；治疗后，外涂组止疱时间、疼痛减轻时间、结痂时间均短于口服组（P＜0.05）；外涂组97.30%的总有效率较口服组的83.78%高（P＜0.05）；外涂组5.41%的药物副反应发生率较口服组的21.62%低（P＜0.05）。结论：在带状疱疹治疗中，季德胜蛇药片外涂结合阿昔洛韦治疗，相比于季德胜蛇药片口服结合阿昔洛韦治疗，可获得更好整体疗效，患者症状改善更明显，病情转归更快，用药安全性更高。

目的 探讨紫芪补肾汤联合达格列净治疗脾肾阳虚型糖尿病肾病（DKD）患者的临床疗效，并分析其对糖代谢、肾功能的影响。方法 选取2024年9月～2025年9月于本院就诊的106例DKD患者为研究对象，按照随机数字表法将其分为对照组、研究组，各53例。对照组予以达格列净治疗，研究组予以紫芪补肾汤联合达格列净治疗，连续治疗2个月。统计对比两组临床疗效、不良反应及治疗前后中医证候积分、血糖及糖代谢指标[空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、糖原合酶激酶-3β（GSK-3β）、缺氧诱导因子-1α（HIF-1α）]、肾功能相关指标[血尿素氮（BUN）、血肌酐（SCr）、尿微量白蛋白排泄率（UAER）、估算的肾小球滤过率（eGFR）、同型半胱氨酸（Hcy）、胱抑素C（CysC）、碳水化合物反应元件结合蛋白（ChREBP）]、炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、肿瘤坏死因子1型受体（TNFR1）、趋化因子配体9（CXCL9）]、血管内皮功能[血管生成抑制蛋白-1（VASH-1）、血管内皮生长因子（VEGF）、内皮素-1（ET-1）、一氧化氮（NO）、血栓素B2（TXB2）]。结果 研究组总有效率为90.57%，明显高于对照组的73.58%（P＜0.05）；研究组治疗后中医证候积分低于对照组（P＜0.05）；研究组治疗后FPG、2 h PG、HbA1c、GSK-3β、HIF-1α水平低于对照组（P＜0.05）；研究组治疗后BUN、SCr、UAER、Hcy、CysC、ChREBP水平低于对照组，eGFR高于对照组（P＜0.05）；研究组治疗后血清TNF-α、IL-1β、TNFR1、CXCL9水平低于对照组（P＜0.05）；研究组治疗后VASH-1、NO水平高于对照组，VEGF、ET-1、TXB2水平低于对照组（P＜0.05）；两组不良反应比较无明显差异（P＞0.05）。结论 紫芪补肾汤联合达格列净治疗DKD患者的疗效显著，可降低血糖水平，改善肾功能，抑制炎症反应，减轻血管内皮损伤，且具有一定安全性。

【摘要】目的：探讨不同剂量右美托咪定对老年骨科手术患者术后谵妄的预防作用。方法：回顾性选取2022年11月至2025年11月本院收治的116例老年骨折手术患者为研究对象，根据右美托咪定维持剂量不同分为0.2μg/(kg·h)的小剂量组（58例）和0.4μg/(kg·h)的大剂量组（58例）。比较两组不同时间点[麻醉诱导前（T0）、麻醉诱导后30 min（T1）、术闭即刻（T2）]的血压（收缩压、舒张压）、心率、应激反应指标[皮质醇（COR）、肾上腺素（E）、去甲肾上腺素（NE）]；采用简易智力状态检查量表（MMSE）评估两组患者术前、术后12 h、术后24 h、术后48 h的认知功能水平；统计两组患者术后谵妄及围术期不良反应发生情况。结果：小剂量组T1、T2时收缩压、舒张压和心率均高于大剂量组（P<0.05）。小剂量组T1、T2时COR、E和NE均低于大剂量组（P<0.05）。小剂量组术后12h、术后24h、术后48h的MMSE评分均高于大剂量组（P<0.05）。小剂量组术后谵妄发生率8.62%（5/58）显著低于大剂量组22.41%（13/58）（χ2=4.209，P=0.040）。小剂量组不良反应总发生率12.07%（7/58）与大剂量组20.69%（12/58）对比无显著差异（P>0.05）。结论：与0.4μg/(kg·h)的大剂量右美托咪定相比，0.2μg/(kg·h)的小剂量在老年骨科手术麻醉中应用效果更佳，能有效维持血流动力学稳定、减轻应激反应、保护认知功能，对术后谵妄具有更好的预防作用，且安全性良好，值得在临床推广应用。