目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭（HFrEF）患者的疗效，并分析其对中医证候积分、心功能的影响。方法 选取2024年8月～2025年8月于本院诊治的150例HFrEF患者进行回顾性分析，依据治疗方案不同将其分为对照组、观察组，其中采取恩格列净治疗的75例患者作为对照组，采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验（6MWT）、心衰因子[心肌肌钙蛋白I（cTnI）、可溶性人基质裂解素2（sST2）、N末端B型利钠肽原（NT-proBNP）]、血流动力学、炎症因子[白细胞介素-6（IL-6）、C反应蛋白（CRP）、白细胞介素-1β（IL-1β）、正五聚蛋白-3（PTX-3）]、氧化应激指标[谷胱甘肽过氧化物酶-3（GPX-3）、丙二醛（MDA）、超氧化物歧化酶（SOD）、脂质过氧化物（LPO）、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组（P＜0.05）；观察组治疗后中医证候积分、Lee氏心衰积分低于对照组（P＜0.05）；观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组，LVEF、6MWT高于对照组（P＜0.05）；观察组治疗后血流动力学改善程度优于对照组（P＜0.05）；治疗后，与对照组比较，观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低，GPX-3、SOD、总抗氧化能力水平升高（P＜0.05）；观察组再住院率低于对照组（P＜0.05），且两组不良反应比较无明显差异（P＞0.05）。结论 活血通络汤联合恩格列净治疗HFrEF患者，可提高治疗效果，改善临床症状、心功能，调节血流动力学，并可降低炎症反应，抑制氧化应激反应，减少再住院的发生，且具有一定安全性。

Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.

目的 探讨腔镜下双平面假体植入乳房重建术在乳腺癌患者乳房重建中的临床价值。方法 回顾性分析2023年1月至2025年1月于我院行手术治疗的126例乳腺癌患者病例资料，根据术中乳房重建方式分为两组，将采用胸肌前假体植入乳房重建的63例患者纳入对照组，采用腔镜下双平面假体植入乳房重建的63例患者纳入研究组。比较两组围手术期指标、患侧乳房体积、创面瘢痕[温哥华瘢痕量表（VSS）评分]、乳房美观度、生活质量[中文版乳腺癌患者生命质量测定量表（FACT-B）评分]及并发症情况。结果 研究组手术时间长于对照组，术中出血量高于对照组（P＜0.05）。两组术后引流量、住院天数比较无显著差异（P＞0.05）；术后3个月研究组患侧乳房体积大于对照组，VSS评分低于对照组（P＜0.05）；研究组乳房美观度优良率95.24%高于对照组80.95%（P＜0.05）；术后3个月，研究组FACT-B总评分高于对照组（P＜0.05）；两组并发症总发生率比较无显著差异（P＞0.05）。结论 乳腺癌患者采用腔镜下双平面假体植入乳房重建术虽在一定程度增加手术时间及术中出血量，但能改善乳房形态，提升美观满意度，改善患者生活质量，且不增加并发症风险。

目的：探讨利多卡因复合艾司氯胺酮对肺部手术患者苏醒质量及认知功能的影响。方法：选取2023年7月至2025年6月本院收治的100例拟行肺部手术患者，按随机数字表法分为观察组和对照组，各50例。对照组采用常规麻醉方案维持麻醉，观察组在常规麻醉基础上复合利多卡因及艾司氯胺酮辅助麻醉。比较两组患者苏醒质量[拔管后30min Riker镇静躁动评分（SAS）、苏醒时间、拔管时间]、认知功能[术前及术后1d、3d简易精神状态检查表评分（MMSE）]、围术期血流动力学指标[麻醉药物输注前（T0）、气管插管时（T1）、拔管后5min（T2）平均动脉压（MAP）、心率（HR）]及术后72h不良反应发生率。结果：观察组拔管后30min SAS评分、术后1d、3d的MMSE评分高于对照组，苏醒时间、拔管时间低于对照组；观察组T0、T1、T2各时间点MAP、HR无显著差异（P>0.05）；对照组T1、T2时MAP、HR高于T0（P<0.05）；两组不良反应发生率无显著差异（P>0.05）。结论：利多卡因复合艾司氯胺酮应用于肺部手术，可提升患者苏醒质量、保护术后认知功能，维持围术期血流动力学稳定，且安全性良好。

Objective : To investigate the effect of lidocaine combined with esketamine on recovery quality and cognitive function in patients undergoing lung surgery. Methods : A total of 100 patients receiving pulmonary resection at our hospital between July 2023 and December 2025 were enrolled and randomized via a random number table into two equal arms (n=50 per group): observation and control. The control group was treated with routine anesthesia to maintain anesthesia, and the observation group was treated with lidocaine and esketamine on the basis of routine anesthesia. The recovery quality [ Riker sedation agitation score ( SAS ) at 30 min after extubation, recovery time, extubation time ], cognitive function [ simple mental state examination score ( MMSE ) before operation and 1 d, 3 d after operation ], perioperative hemodynamic indexes [ mean arterial pressure ( MAP ), heart rate ( HR ) before anesthesia drug infusion ( T0 ), tracheal intubation ( T1 ), 5 min after extubation ( T2 ) ] and the incidence of adverse reactions at 72 h after operation were compared between the two groups. Results : In the observation group, the SAS score measured 30 minutes post-extubation and the MMSE scores at 1 day and 3 days post-operation were significantly higher than those in the control group. Conversely, both recovery and extubation times were shorter in the observation group compared to the control group. No significant differences in MAP and HR were observed at T0, T1, and T2 within the observation group (P > 0.05). In contrast, within the control group, MAP and HR at T1 and T2 were notably elevated compared to T0, with the differences being statistically significant (P < 0.05). Conclusion : The application of lidocaine combined with esketamine in lung surgery can improve the quality of recovery, protect postoperative cognitive function, maintain perioperative hemodynamic stability, and has good safety.

目的 探讨穴位推拿联合稳定肌训练对颈椎病患者的康复效果。方法 回顾性选取我院收治的102例颈椎病患者（选例时间：2025年1月-2026年3月）为研究对象，根据干预方案分为参照组（51例，给予稳定肌训练）、联合组（51例，给予穴位推拿联合稳定肌训练）。对比两组临床疗效，干预前、后颈椎功能障碍指数（NDI）评分、视觉模拟量表（VAS）评分、中医证候积分、颈椎活动度、基底动脉血流动力学指标［基底动脉舒张期血流速度（EDV）、收缩期血流速度（PSV）、血管搏动指数（PI）、血流平均速度（Vm）］、健康调查简表（SF-36）评分。结果 联合组总有效率为94.12%，高于参照组的78.43%（P＜0.05）；与参照组相比，干预后联合组各中医证候积分均较低（P＜0.05）；联合组干预后VAS、NDI评分较参照组低（P＜0.05）；联合组干预后颈椎活动度较参照组大（P＜0.05）；干预后联合组基底动脉EDV、PSV、Vm较参照组大，PI值较参照组小（P＜0.05）；联合组干预后SF-36评分高于参照组（P＜0.05）。结论 穴位推拿联合稳定肌训练可提高颈椎病患者康复效果，减轻临床症状、疼痛程度，改善颈椎功能与血流动力学，提高生活质量。

目的 探讨超声引导双侧眶下神经阻滞对鼻中隔偏曲矫正术患者术后镇痛效果、麻醉苏醒质量的影响。方法 回顾性选取2021年8月至2025年8月我院收治的行鼻中隔偏曲矫正术治疗的患者120例，按麻醉方案不同，分为全麻组和眶下神经阻滞组，各60例。全麻组进行气管插管全身麻醉和术后镇痛泵镇痛，眶下神经阻滞组在全麻基础上进行超声引导双侧眶下神经阻滞+术后镇痛泵镇痛。比较两组麻醉前、拔管即刻、拔管后5 min血流动力学（心率、平均动脉压）水平、术后麻醉苏醒质量（苏醒时间、苏醒期躁动发生情况）、术后24 h按压镇痛泵次数、术后3 h、6 h、12 h、24 h镇痛效果[数字分级评分（NRS）]及麻醉前、拔管后5 min时血清应激指标水平及不良反应发生情况。结果 拔管即刻、拔管后5 min，眶下神经阻滞组平均动脉压、心率均低于全麻组（P＜0.05）；眶下神经阻滞组躁动发生率、术后24 h按压镇痛泵次数低于全麻组（P＜0.05）；术后3 h、6 h、12 h，眶下神经阻滞组NRS评分均低于全麻组（P＜0.05）；拔管后5 min，眶下神经阻滞组血清皮质醇（Cor）、去甲肾上腺素（NE）水平低于全麻组（P＜0.05）；两组麻醉相关不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论 超声引导双侧眶下神经阻滞可有效减轻患者鼻中隔矫正术后循环波动、术后疼痛及应激反应，减少麻醉药物用量，降低躁动发生率。

Objective To investigate the clinical application value of novel light-cured TheraCal LC pulp capping agent in children receiving deciduous teeth pulpotomy. Methods A retrospective study was performed on clinical data of 90 children who underwent deciduous teeth pulpotomy from August 2023 to May 2025. Subjects were divided according to different capping materials: 45 cases using TheraCal LC as study group, another 45 cases treated with iRoot BP Plus as control group. The treatment success rate, pain score, masticatory efficiency, gingival crevicular fluid inflammatory factors [interleukin-6 (IL-6), matrix metalloproteinase-3 (MMP-3)], root resorption, dentin bridge formation and adverse reactions were compared between two groups. Results There was no significant difference was found in treatment success rate at 12 months after operation between groups (P>0.05). At postoperative 3 months, the study group had lower pain score and higher masticatory efficiency than the control group (P<0.05), whereas no intergroup differences were observed at 6 and 12 months (P>0.05). The levels of gingival crevicular fluid IL-6 and MMP-3 in study group were significantly lower at 3, 6 and 12 months postoperatively (P<0.05). There was no significant difference in root resorption degree and dentin bridge formation rate at postoperative 12 months (P>0.05). No pulp inflammation, tooth discoloration or secondary caries occurred in either group. Conclusion The novel light-cured TheraCal LC shows favorable overall efficacy and safety in deciduous teeth pulpotomy; it can effectively suppress early gingival inflammation, relieve early postoperative pain and improve early masticatory function.

目的 探讨基于围手术期的口服营养补充（ONS）管理方案对胃癌手术患者的影响。方法 选取2020.1-2025.12本院收治的80例胃癌手术患者，分为观察组和对照组，每组40例。对照组实施围手术期常规膳食指导及肠外营养支持，观察组在对照组基础上实施规范化口服营养补充管理，比较相关指标。结果 术后7d，观察组总蛋白、白蛋白、前白蛋白水平均高于对照组（P<0.001）；观察组术后CRP及IL-6水平低于对照组（P<0.001）。观察组术后首次排气时间及住院天数短于对照组（P<0.001）；观察组术后并发症总发生率为7.50%，显著低于对照组的25.00%（P<0.05）。结论 胃癌围手术期实施口服营养补充管理，对营养状况的改善，炎症反应的减轻，胃肠功能的恢复，住院时间的缩短，降低并发症风险。

目的 探讨基于围手术期的口服营养补充（ONS）管理方案对胃癌手术患者的影响。方法 选取2020.1-2025.12本院收治的80例胃癌手术患者，分为观察组和对照组，每组40例。对照组实施围手术期常规膳食指导及肠外营养支持，观察组在对照组基础上实施规范化口服营养补充管理，比较相关指标。结果 术后7d，观察组总蛋白、白蛋白、前白蛋白水平均高于对照组（P<0.001）；观察组术后CRP及IL-6水平低于对照组（P<0.001）。观察组术后首次排气时间及住院天数短于对照组（P<0.001）；观察组术后并发症总发生率为7.50%，显著低于对照组的25.00%（P<0.05）。结论 胃癌围手术期实施口服营养补充管理，对营养状况的改善，炎症反应的减轻，胃肠功能的恢复，住院时间的缩短，降低并发症风险。

目的 探讨基于围手术期的口服营养补充（ONS）管理方案对胃癌手术患者的影响。方法 选取2020.1-2025.12本院收治的80例胃癌手术患者，分为观察组和对照组，每组40例。对照组实施围手术期常规膳食指导及肠外营养支持，观察组在对照组基础上实施规范化口服营养补充管理，比较相关指标。结果 术后7d，观察组总蛋白、白蛋白、前白蛋白水平均高于对照组（P<0.001）；观察组术后CRP及IL-6水平低于对照组（P<0.001）。观察组术后首次排气时间及住院天数短于对照组（P<0.001）；观察组术后并发症总发生率为7.50%，显著低于对照组的25.00%（P<0.05）。结论 胃癌围手术期实施口服营养补充管理，对营养状况的改善，炎症反应的减轻，胃肠功能的恢复，住院时间的缩短，降低并发症风险。

摘要：目的 探讨心力衰竭患者住院期间容量管理成效及影响因素。方法 选取2024年1月—2025年12月我院收治的666例心力衰竭患者为调查对象，根据其成效将其分为有效组（n=612）和无效组（n=54）。统计两组患者临床资料及监测指标，采用单/多因素Logistic分析心力衰竭患者住院期间容量管理成效的影响因素。结果 本研究中，心力衰竭患者住院期间容量管理的有效率为91.89%（612/666）。两组年龄、病程、心功能分级及下肢水肿发生率比较（P＜0.05）；性别、体重指数、文化程度、吸烟史、饮酒史、基础疾病比较无明显差异（P＞0.05）。干预前及干预后，两组左室射血时间、左心室做功指数、左心室做功、每搏输出量、心脏指数、心输出量及脑钠肽比较（P＜0.05）。自变量设置为一般资料中对比有差异的指标包括年龄、病程、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、每搏输出量、心脏指数、心输出量及脑钠肽，因变量为心力衰竭患者住院期间容量管理成效，进行单因素Logistic回归分析，结果显示，心力衰竭患者住院期间容量管理成效的影响因素是年龄、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、每搏输出量、心脏指数、心输出量及脑钠肽。校正年龄、性别等混杂因子，将单因素方差中对比有差异的数据纳入多因素Logistic回归分析，结果显示，心力衰竭患者住院期间容量管理成效的影响因素是年龄、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、心输出量及脑钠肽。结论 心力衰竭患者住院期间容量管理成效较好，心力衰竭患者住院期间容量管理成效的影响因素为年龄、心功能分级及下肢水肿发生率、左室射血时间、左心室做功指数、左心室做功、心输出量及脑钠肽。