Objective To compare the clinical efficacy of low-molecular-weight heparin anticoagulant drugs in the treatment of venous thrombosis caused by viral pneumonia.Methods The clinical data of 355 patients diagnosed with viral pneumonia patients in the First People's Hospital of Yunnan Province from December 2022 to February 2023 were collected by retrospective analysis.The patients were classified into moderate group(n=1 14),severe group(n=116),and critical group(n=125)based on the severity of viral pneumonia.The changes in coagulation indicators of the patients after treatment with low molecular weight heparin sodium injection,low molecular weight heparin calcium injection,and enoxaparin sodium injection were compared among three groups.Results Compared with before treatment,there was no statistically significant difference in white blood cells count among three groups of patients after treatment(P＞0.05);The hypersensitive C-reactive protein levels of patients in moderate group and critical group decreased(P＜0.05);The levels of D-dimer decreased in severe group and critical group of patients(P＜0.05).After treatment with low-molecular-weight heparin calcium injection,the activated partial thromboplastin and prothrombin time of patients in severe group were shortened compared to before treatment,and the D-dimer levels of patients in severe group and critical group were reduced compared to before treatment,with statistical significance(P＜0.05);After treatment with low-molecular-weight heparin sodium and enoxaparin,only critical group showed a significant decrease in D-dimer levels(P＜0.05).Conclusion Low-molecular-weight heparin calcium injection has a stronger alleviating effect on blood hypercoagulability caused by elevated D-dimer levels than low-molecular-weight heparin sodium and enoxaparin,which is beneficial for relieving patients' hypercoagulability.

Erector spinae plane block(ESPB)is a fascia plane block technique that involves injecting local anesthetics between the erector spinae muscle and the transverse processes of the spine.It blocks the posterior branches of the spinal nerves to provide perioperative analgesia for spinal surgeries.In recent years,ESPB has been increasingly widely used in spinal surgery analgesia due to its relatively simple operation,high safety and significant clinical benefits.However,its mechanism of action and the best application strategy still need to be further explored.This article systematically reviews the anatomical basis,mechanism of action,op-eration methods,drug selection,analgesic effect in various spinal surgeries,comparative advantages with other commonly used analgesic methods,and potential complications of ESPB,aiming to provide a reference for the clinical application of ESPB.

Background and aims:Hepatocellular carcinoma(HCC)is a malignant tumor with a high mortality rate,but there are still no effective treatments.The aim of this study was to investigate the anticancer po-tential of the combined use of brefeldin A(BFA)and tunicamycin(TM)in HepG2 cells,as well as the underlying mechanisms.Methods:HepG2 cells were treated with different concentrations of BFA(0.1-2.5 mg/L)and TM(1-5 mg/L)for 24 h.DMSO(0.1％,v/v)was used as a vehicle control.Cell viability and cell migration were measured using MTT assay and scratch wound assay,respectively.Apoptosis was detected using flow cytometry and acridine orange(AO)staining.The protein and mRNA levels of various factors involved in apoptosis(poly(ADP-ribose)polymerase-1(PARP-1),caspase-12,caspase-3,and stearoyl-CoA desaturase 1)and endoplasmic reticulum(ER)stress(binding immunoglobulin protein(BiP),protein kinase R-like endoplasmic reticulum kinase(PERK),p-PERK,phosphorylation of eukaryotic translation initiation factor 2alpha(p-eIF2α),activating transcription factor(ATF)4,and C/EBP homologous protein(CHOP))were measured using Western blotting and qRT-PCR,respectively.Results:Both BFA and TM alone significantly reduced the viability of HepG2 cells in a dose-dependent way.The co-incubation with TM(1 mg/L)further significantly reduced the viability of HepG2 cells treated with BFA(0.25 mg/L)alone(P＜0.05).BFA significantly increased the protein and mRNA levels of caspase-3 and PARP-1(P＜0.05)compared to control and DMSO-treated cells,indicating that BFA induced apoptosis in HepG2 cells by increasing the expression of caspase-3 and PARP-1.The induction of apoptosis by BFA could be further significantly enhanced by co-incubation with TM.In addition,BFA significantly increased the mRNA levels of BiP,PERK and ATF4(P＜0.05)compared to control and DMSO-treated cells.After co-incubation of BFA and TM,the protein levels of BiP,p-PERK,p-eIF2α and CHOP were significantly increased,indicating that TM could enhance BFA-induced ER stress in HepG2 cells through the PERK-eIF2α-ATF4-CHOP pathway.Conclusions:BFA could induce apoptosis and ER stress,and TM could enhance the ability of BFA to induce apoptosis and ER stress in HepG2 cells through the PERK-eIF2α-ATF4-CHOP pathway.The findings highlight the therapeutic potential of the combined use of BFA and TM in treating HCC.

Objective To assess the clinical indications,efficacy,and safety of ertapenem for pediatric emergency infectious disea-ses,and to analyze factors guiding its use to inform rational medication choices.Methods A retrospective cohort study was performed on 538 pediatric patients with bacterial infections treated with ertapenem in the Emergency Department of the Capital Institute of Pediatrics from January to December 2023.Patient demographics,diagnoses,infection types,and treatment data were collected.Univariate and multivariate logistic regression analyses were used to identify risk factors for hospitalization.Results Ertapenem was broadly applied across all pediatric age groups,primarily for pneumonia(25.8％),suppurative tonsillitis(18.4％),and bronchitis(14.7％).Some patients with relatively common infections switched to ertapenem due to severe clinical presentations,poor response to initial antibiotics,or cephalosporin allergy.Key indications included cephalosporin allergy(48.4％),failure of prior antibiotics(37.2％),and moderate to severe infections(12.5％).Overall,80.9％of patients improved clinically;median time to defervescence was 2days,median time for inflammatory marker normalization was 4days,and median total treatment duration was 5days.The incidence of adverse events was 9.5％,mainly mild to moderate gastrointestinal disturbances(5.2％diarrhea,2.2％nausea/vomiting).Multivariate analysis identified pneumo-nia,lymphadenitis,urinary tract infection,and underlying diseases as independent risk factors for hospitalization.Conclusion Ertapen-em demonstrates good efficacy and a favorable safety profile in pediatric emergency infectious diseases,particularly for moderate to severe infections,cephalosporin allergy,and cases unresponsive to initial antibiotic therapy.

Objective To assess the clinical indications,efficacy,and safety of ertapenem for pediatric emergency infectious disea-ses,and to analyze factors guiding its use to inform rational medication choices.Methods A retrospective cohort study was performed on 538 pediatric patients with bacterial infections treated with ertapenem in the Emergency Department of the Capital Institute of Pediatrics from January to December 2023.Patient demographics,diagnoses,infection types,and treatment data were collected.Univariate and multivariate logistic regression analyses were used to identify risk factors for hospitalization.Results Ertapenem was broadly applied across all pediatric age groups,primarily for pneumonia(25.8％),suppurative tonsillitis(18.4％),and bronchitis(14.7％).Some patients with relatively common infections switched to ertapenem due to severe clinical presentations,poor response to initial antibiotics,or cephalosporin allergy.Key indications included cephalosporin allergy(48.4％),failure of prior antibiotics(37.2％),and moderate to severe infections(12.5％).Overall,80.9％of patients improved clinically;median time to defervescence was 2days,median time for inflammatory marker normalization was 4days,and median total treatment duration was 5days.The incidence of adverse events was 9.5％,mainly mild to moderate gastrointestinal disturbances(5.2％diarrhea,2.2％nausea/vomiting).Multivariate analysis identified pneumo-nia,lymphadenitis,urinary tract infection,and underlying diseases as independent risk factors for hospitalization.Conclusion Ertapen-em demonstrates good efficacy and a favorable safety profile in pediatric emergency infectious diseases,particularly for moderate to severe infections,cephalosporin allergy,and cases unresponsive to initial antibiotic therapy.

Objective To compare the clinical efficacy of low-molecular-weight heparin anticoagulant drugs in the treatment of venous thrombosis caused by viral pneumonia.Methods The clinical data of 355 patients diagnosed with viral pneumonia patients in the First People's Hospital of Yunnan Province from December 2022 to February 2023 were collected by retrospective analysis.The patients were classified into moderate group(n=1 14),severe group(n=116),and critical group(n=125)based on the severity of viral pneumonia.The changes in coagulation indicators of the patients after treatment with low molecular weight heparin sodium injection,low molecular weight heparin calcium injection,and enoxaparin sodium injection were compared among three groups.Results Compared with before treatment,there was no statistically significant difference in white blood cells count among three groups of patients after treatment(P＞0.05);The hypersensitive C-reactive protein levels of patients in moderate group and critical group decreased(P＜0.05);The levels of D-dimer decreased in severe group and critical group of patients(P＜0.05).After treatment with low-molecular-weight heparin calcium injection,the activated partial thromboplastin and prothrombin time of patients in severe group were shortened compared to before treatment,and the D-dimer levels of patients in severe group and critical group were reduced compared to before treatment,with statistical significance(P＜0.05);After treatment with low-molecular-weight heparin sodium and enoxaparin,only critical group showed a significant decrease in D-dimer levels(P＜0.05).Conclusion Low-molecular-weight heparin calcium injection has a stronger alleviating effect on blood hypercoagulability caused by elevated D-dimer levels than low-molecular-weight heparin sodium and enoxaparin,which is beneficial for relieving patients' hypercoagulability.