目的 探讨顺行输尿管软镜治疗特殊类型输尿管中下段梗阻的临床疗效。方法　分析2024年1月至2026年5月广东省中西医结合医院收治了20例特殊类型输尿管中下段梗阻患者的临床资料，对患者手术时间、术前和术后的血红蛋白、肾积水及随访情况进行分析。结果　所有患者均一期完成手术，手术时间为（75.5±16.4）分钟，术前与术后第一天血红蛋白对比，有一定差异（t=6.141，P＜0.05），术前与术后1个月患侧肾积液对比，肾积液明显改善（t=3.937，P＜0.05）。结论　经皮肾通道顺行输尿管软镜治疗特殊类型输尿管中下段梗阻具有微创、安全、有效、并发症少、术后恢复快等优点，值得临床推广应用。

Objective To evaluate the clinical efficacy of antegrade flexible ureteroscopy in treating special types of middle and lower ureteral obstruction. Methods From January 2024 to May 2026, clinical data of 20 patients with special types of middle and lower ureteral obstruction admitted to Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine were analyzed. The operation time, preoperative and postoperative hemoglobin levels, hydronephrosis, and follow-up conditions of the patients were analyzed. Results All patients underwent successful single-stage surgery, with an average operative time of (75.5 ± 16.4) minutes. There was a significant difference in hemoglobin levels between preoperatively and on the first postoperative day (t = 6.141, P < 0.05). Hydronephrosis on the affected side showed marked improvement when comparing preoperative and one-month postoperative conditions (t = 3.937, P < 0.05). Conclusions Antegrade flexible ureteroscopy via percutaneous nephrostomy tract is a minimally invasive, safe, effective, and well-tolerated approach for treating special types of middle and lower ureteral obstruction, with few complications and rapid postoperative recovery, making it worthy of clinical promotion and application.

目的 探讨顺行输尿管软镜治疗特殊类型输尿管中下段梗阻的临床疗效。方法　分析2024年1月至2026年5月广东省中西医结合医院收治了20例特殊类型输尿管中下段梗阻患者的临床资料，对患者手术时间、术前和术后的血红蛋白、肾积水及随访情况进行分析。结果　所有患者均一期完成手术，手术时间为（75.5±16.4）分钟，术前与术后第一天血红蛋白对比，有一定差异（t=6.141，P＜0.05），术前与术后1个月患侧肾积液对比，肾积液明显改善（t=3.937，P＜0.05）。结论　经皮肾通道顺行输尿管软镜治疗特殊类型输尿管中下段梗阻具有微创、安全、有效、并发症少、术后恢复快等优点，值得临床推广应用。

Objective To evaluate the clinical efficacy of antegrade flexible ureteroscopy in treating special types of middle and lower ureteral obstruction. Methods From January 2024 to May 2026, clinical data of 20 patients with special types of middle and lower ureteral obstruction admitted to Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine were analyzed. The operation time, preoperative and postoperative hemoglobin levels, hydronephrosis, and follow-up conditions of the patients were analyzed. Results All patients underwent successful single-stage surgery, with an average operative time of (75.5 ± 16.4) minutes. There was a significant difference in hemoglobin levels between preoperatively and on the first postoperative day (t = 6.141, P < 0.05). Hydronephrosis on the affected side showed marked improvement when comparing preoperative and one-month postoperative conditions (t = 3.937, P < 0.05). Conclusions Antegrade flexible ureteroscopy via percutaneous nephrostomy tract is a minimally invasive, safe, effective, and well-tolerated approach for treating special types of middle and lower ureteral obstruction, with few complications and rapid postoperative recovery, making it worthy of clinical promotion and application.

乳腺癌化疗后骨髓抑制是临床常见不良反应，严重影响治疗依从性与疗效。中医药已形成系统防治体系，以“脾肾亏虚、气血不足”为核心病机，构建内治外治结合的诊疗模式。内治采用汤剂、中成药等，以健脾补肾、益气养血为法；外治依据经络理论，运用针刺、艾灸等手段，实现协同增效。本文梳理中医药治疗的理论与研究进展，旨在为临床应用与后续研究提供参考。

Bone marrow suppression after chemotherapy for breast cancer is a common clinical adverse reaction, which seriously affects the treatment compliance and efficacy. Traditional Chinese medicine has formed a systematic prevention and treatment system, with "spleen and kidney deficiency, qi and blood deficiency" as the core pathogenesis, and a diagnosis and treatment model that combines internal and external treatment. Internal treatment adopts decoction, traditional Chinese patent medicines and simple preparations, etc., with the method of strengthening spleen and kidney, supplementing qi and nourishing blood; External treatment is based on the theory of meridians, using acupuncture, moxibustion and other methods to achieve synergistic effects. This article reviews the theory and research progress of traditional Chinese medicine treatment, aiming to provide reference for clinical application and subsequent research.

目的 分析中药穴位贴敷、沙库巴曲缬沙坦联合治疗在慢性心力衰竭（CHF）中的应用效果。方法 选取我院CHF患者90例（2024-08—2026-01），依据随机数字表分成两组，每组45例。对照组接受沙库巴曲缬沙坦治疗，研究组接受中药穴位贴敷联合沙库巴曲缬沙坦治疗。观察两组疗效、6min步行距离、中医证候积分、心功能[心脏指数（CI）、每搏输出量（SV）、左室射血分数（LVEF）]、心肌指标[脑钠肽（BNP）、肌钙蛋白Ⅰ（cTnⅠ）]、安全性。结果 研究组治疗效果优于对照组（P＜0.05）；治疗后，研究组中医证候积分、BNP、cTnⅠ低于对照组，6min步行距离、LVEF、CI、SV高于对照组（P＜0.05）；两组治疗期间不良反应无显著差异（P＞0.05）。结论 中药穴位贴敷联合沙库巴曲缬沙坦治疗CHF效果显著，可减轻临床症状，改善心功能，减少心肌损伤。

Objective To analyze the clinical efficacy of combined therapy with traditional Chinese medicine acupoint application and sacubitril/valsartan in patients with chronic heart failure (CHF). Methods A total of 90 patients with CHF admitted to our Hospital from August 2024 to January 2026 were selected, and divided into two groups by random number table, with 45 cases in each group. The control group was treated with sacubitril/valsartan, while the study group received combined therapy of traditional Chinese medicine acupoint application and sacubitril/valsartan. The therapeutic efficacy, 6-minute walking distance, TCM syndrome score, cardiac function indexes [cardiac index (CI), stroke volume (SV), left ventricular ejection fraction (LVEF)], myocardial indicators [brain natriuretic peptide (BNP), cardiac troponin Ⅰ (cTnⅠ)] and safety were observed in both groups. Results The therapeutic efficacy of the study group was better than that of the control group (P<0.05). After treatment, the TCM syndrome scores, BNP and cTnⅠ levels in the observation group were lower, while the 6-minute walking distance, LVEF, CI and SV were higher compared with the control group (P<0.05). No significant between-group difference was found in adverse reactions during treatment (P>0.05). Conclusion Traditional Chinese medicine acupoint application combined with sacubitril/valsartan achieves remarkable efficacy in the treatment of CHF. It can relieve clinical symptoms, improve cardiac function and alleviate myocardial injury.

目的 探讨老年慢性阻塞性肺疾病急性加重期（AECOPD）患者应用十味龙胆花颗粒联合硫酸特布他林治疗的临床效果。方法 回顾性选取我院收治的116例老年AECOPD患者（选例时间：2024年1月~2026年2月）为研究对象，根据治疗方案将其分为参照组（58例，接受硫酸特布他林治疗）、联合组（58例，接受十味龙胆花颗粒联合硫酸特布他林治疗）。对比两组临床疗效、不良反应及治疗前后中医证候积分、慢性阻塞性肺疾病评估测试（CAT）评分、血气指标［动脉血二氧化碳分压（PaCO2）、血氧饱和度（SpO2）、动脉血氧分压（PaO2）］、免疫功能、炎症相关细胞因子［白细胞介素-8（IL-8）、分泌卷曲相关蛋白1（SFRP1）、肿瘤坏死因子-α（TNF-α）、趋化因子配体9（CXCL9）］水平。结果 联合组总有效率（94.83%）高于参照组（79.31%）（P＜0.05）；联合组治疗后各中医证候积分均较参照组低（P＜0.05）；与参照组相比，治疗后联合组CAT评分较低（P＜0.05）；联合组治疗后PaCO2水平较参照组低，SpO2、PaO2水平较参照组高（P＜0.05）；联合组治疗后CD3+、CD4+、CD4+/CD8+水平较参照组高，CD8+水平较参照组低（P＜0.05）；治疗后联合组血清IL-8、SFRP1、TNF-α、CXCL9水平均较参照组低（P＜0.05）；不良反应发生情况组间比较，无明显差异（P＞0.05）。结论 十味龙胆花颗粒联合硫酸特布他林可提高老年AECOPD患者治疗效果，减轻临床症状，改善肺功能、免疫功能及血气指标，降低机体炎症反应程度。

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.

目的 探究子午流注择时中药灌肠联合腹内压分级导向的早期肠内营养（EEN）护理方案对脓毒症胃肠功能障碍患者的影响。方法 选取92例脓毒症胃肠功能障碍患者，均在2025年1月～2026年2月收治于本院，按随机数字表法分为两组，各46例。对照组行腹内压分级导向的EEN护理，观察组在此基础上加用子午流注择时中药灌肠。对比两组中医证候积分、急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）、胃肠功能障碍评分（GIDS）、腹内压、喂养不耐受、7d内目标喂养量达成率、28d病死率。结果 干预7d，两组中医证候积分、APACHEⅡ评分、GIDS评分及腹内压均降低，观察组较低（P＜0.05）。观察组7d内目标喂养量达成率较高，喂养不耐受率较低（P＜0.05）。两组28d病死率无差异（P＞0.05）。结论 子午流注择时中药灌肠联合腹内压分级导向的EEN护理可以改善脓毒症胃肠功能障碍患者的健康状况与喂养情况，减轻胃肠功能障碍症状，降低腹内压，未显著降低28d病死率。

目的 探讨三维能量多普勒超声（3D-PDA）定量评估胎盘血管化参数与胎儿窘迫的相关性。方法 纳入2023年3月-2025年3月于固始县妇幼保健院建档且规律产检的106例孕产妇临床资料，均完善3D-PDA检查，获取胎盘血管化参数：血管化指数（VI）、血流指数（FI）、血管血流指数（VFI）。根据分娩过程中及娩出后是否发生胎儿窘迫分为发生组（n=30）、未发生组（n=76），比较两组孕产妇基线资料、胎盘血管化参数。Pearson相关性分析法评估胎盘血管化参数与胎儿窘迫缺氧评估指标相关性。多因素Logistic回归分析模型分析胎儿窘迫发生的独立影响因素。绘制受试者工作特征曲线（ROC）评估胎盘血管化参数联合对胎儿窘迫的诊断效能。结果 发生组、未发生组年龄、孕前体质指数、孕次等一般资料无明显差异（P＞0.05），胎盘厚度、脐动脉血pH值、新生儿5 min Apgar评分差异有统计学意义（P＜0.05）。发生组VI、FI、VFI值均显著低于未发生组（P＜0.05）。Pearson相关性分析结果显示，VI、FI、VFI与脐动脉血pH值均呈正相关（r=0.562、0.615、0.554，P＜0.05），与新生儿5 min Apgar评分均呈正相关（r=0.522、0.603、0.536，P＜0.05）。多因素Logstic回归分析结果显示，胎盘厚度厚（OR=1.652）、脐带血pH值低（OR=1.792）、新生儿5 min Apgar评分低（OR=1.848）、VI值低（OR=1.892）、FI值低（OR=2.125）、VFI值低（OR=1.885）是胎儿窘迫发生的独立影响因素（P＜0.05）。ROC曲线结果显示，胎盘血管参数（VI、FI、VFI）联合诊断胎儿窘迫的AUC为0.915，高于缺氧评估指标（胎盘厚度、脐动脉血pH值、新生儿5 min Apgar评分）联合（AUC=0.828）诊断效能（Z=2.998，P=0.023）。结论 胎盘血管化参数VI、FI、VFI与胎儿窘迫密切相关，且联合诊断胎儿窘迫的效能高于传统缺氧评估指标联合。

对比微创拔牙与传统拔牙在下颌阻生智齿治疗中的效果及并发症概率。方法：自2023年1月至2025年9月，选取110名下颌阻生智齿患者，采用随机数字列表法，将对象均衡地分为实验组（55人）与对照组（55人）。观察组行微创拔牙术（高速涡轮手机分牙+微创牙挺），对照组行传统拔牙术（骨凿劈冠+锤击增隙）。对比两组手术时间、术后疼痛程度、张口度及术中及术后并发症发生率。结果： 观察组施行手术的时间明显短于对照组[（25.38±5.47）min vs （31.65±6.83）min，P<0.001]；术后24h及7d的VAS评分均低于对照组[（3.52±1.21）分 vs （5.87±1.56）分，（0.89±0.65）分 vs （1.95±0.91）分，均P<0.001]，张口度大于对照组（均P<0.001）。观察组术中并发症总发生率（1.82%）显著低于对照组（14.55%）（P=0.009），术后并发症总发生率（3.64%）亦显著低于对照组（20.00%）（P=0.022）。结论：相较于常规拔牙方式，下颌阻生智齿的微创手术能显著减少治疗时间，减轻术后疼痛与张口受限，并显著降低术中及术后并发症风险，疗效与安全性俱佳，具备临床推广价值。

To compare the efficacy and complication rates of minimally invasive tooth extraction versus traditional extraction in treating impacted lower wisdom teeth. Methods: From January 2023 to September 2025,110 patients with impacted lower wisdom teeth were randomly assigned to an experimental group (55 cases) and a control group (55 cases) using a random number table. The experimental group underwent minimally invasive extraction (high-speed rotary mobile phone tooth splitting + minimally invasive tooth elevator), while the control group received traditional extraction (bone chisel splitting + hammer gap widening). The study compared operative time, postoperative pain (VAS score), mouth opening degree, and intraoperative/operative complications between the two groups. Results: The experimental group showed significantly shorter operative time [(25.38±5.47) min vs (31.65±6.83) min, P<0.001]. Postoperative VAS scores at 24h and 7d were significantly lower in the experimental group [(3.52±1.21) vs (5.87±1.56) points, (0.89±0.65) vs (1.95±0.91) points, both P<0.001], with greater mouth opening degree (P<0.001). The total intraoperative complication rate (1.82%) in the experimental group was significantly lower than the control group (14.55%) (P=0.009), and the postoperative complication rate (3.64%) was also significantly lower than the control group (20.00%) (P=0.022). Conclusion: Compared with traditional tooth extraction, minimally invasive tooth extraction can effectively shorten the operation time, reduce postoperative pain and limited mouth opening, and significantly reduce the risk of intraoperative and postoperative complications. The efficacy and safety are excellent, and it has the value of clinical promotion.

目的 基于Logistic多因素回归分析探讨糖尿病肾病（DKD）患者发生贫血的独立影响因素，并构建诊断模型。方法 回顾性选取2020年1月—2025年8月我院收治的200例DKD患者，依据贫血发生情况，将患者分为贫血组（80例）与非贫血组（120例）。比较2组临床资料，采用Logistic多因素回归分析DKD患者发生贫血的影响因素，并构建DKD患者发生贫血的联合诊断模型。结果 贫血组糖尿病病程、肾病分期G3~G4患者占比、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）、甘油三酯（TG）水平高于非贫血组，免疫球蛋白G（IgG）、免疫球蛋白M（IgM）、白蛋白（ALB）、低密度脂蛋白胆固醇（LDL-C）水平低于非贫血组，差异有统计学意义（P＜0.05）；糖尿病病程（OR=1.723，95%CI：1.317~2.254）、肾病分期（OR=5.202，95%CI：2.338~11.573）、TNF-α（OR=2.861，95%CI：1.636~5.001）、hs-CRP（OR=2.073，95%CI：1.440~2.985）、IgM（OR=0.470，95%CI：0.331~0.667）、ALB（OR=0.533，95%CI：0.378~0.753）、TG（OR=3.016，95%CI：1.833~4.962）均为DKD患者发生贫血的影响因素，差异有统计学意义（P＜0.05）；基于Logistic回归分析构建联合诊断模型：Logit（P）=-0.218+0.544×糖尿病病程+1.649×肾病分期+1.051×TNF-α+0.729×hs-CRP+（-0.756）×IgM+（-0.629）×ALB+1.104×TG，经校准曲线和决策曲线检验显示，该模型诊断结果与实际预测结果具有较高一致性，且具有较高净获益。结论 糖尿病病程、肾病分期、TNF-α、hs-CRP、IgM、ALB、TG水平是DKD患者发生贫血的影响因素，临床应关注上述影响因素，以早期预防患者贫血的发生。