Objective:To explore the application of multimodal analgesia after hypospadias.Methods:Ninety children undergoing elective hypospadias,12～47 kg from April 2021 to December 2023,American Society of Anesthesiologists(ASA)grades Ⅰ～Ⅱ.Thirty patients were randomly assigned to each of the three groups that were used to create the random number table method.The three groups consisted of a control group,an experimental group 1,and an experimental group 2.The measures of postoperative pain level,changes in vital signs,complications,sleep quality,and satisfaction were compared in the three groups.Results:There were no significant differences in body quality,operation time and age among the three groups,P＞0.05;Compared with the group A,There were significant differences in postoperative pain scores between groups B and C at T2,T3,T4,T5,T6,and T7 time points,P＜0.05,B and C showed no significant,P＞0.05;no difference in SpO2 in the three groups,respiratory circulation between group B and C was relatively stable,compared with group A;group A was significantly more than group B and C,P＜0.05,no difference between group B and C;100％of the families of group B and C were better and better with the postoperative sleep quality,group A accounted for 30％and 70％.Conclusions:The application of multimodal analgesia after hypospadias can better maintain the vital signs of children,with significant analgesic effect and less complications,and the family members are satisfied with the sleep quality of children.

Objective:To analyze the medication pattern of traditional chinese medicine for pediatric mesenteric lymphadenitis,and to provide medication reference for clinical treatment of this disease.Methods:A total of 159 traditional chinese medicine prescriptions who were diagnosed with pediatric mesenteric lymphadenitis in the outpatient department of the Traditional Chinese Medicine Department of Chongqing Medical University Affiliated Children's Hospital from January 2020 to March 2024 were collected.A medication database was created by Excel software,and the high-frequency application of traditional chinese medicine,four qi of traditional chinese medicine,five flavors,meridian tropism,correlation analysis,and cluster analysis were analyzed by ancient and modern medical case cloud platform and SPSS software.Results:The top 10 drugs in terms of frequency were licorice,hawthorn,tangerine peel,corydalis yanhusuo,malt,white peony,magnolia officinalis,poria cocos,atractylodes macrocephala,and forsythia suspensa.The top three medicinal properties were warm,calm,and cold.The top three medicinal flavors were sweet,spicy,and bitter.The top three drugs classified by meridian were spleen,lung,and stomach.Association rule analysis identified four groups of core drugs.Cluster analysis divides high-frequency traditional Chinese medicine into four effective prescription groups.Conclusion:Traditional chinese medicine treatment for pediatric mesenteric lymphadenitis,association rule analysis has identified core drug combinations,including licorice,hawthorn,tangerine peel,etc;Cluster analysis divides high-frequency traditional chinese medicine into four groups of prescriptions,with the treatment methods of regulating qi and strengthening spleen,strengthening spleen and eliminating dampness,clearing heat and detoxifying,and promoting qi and blood circulation,providing reference for the rational application of traditional chinese medicine in the treatment of pediatric mesenteric lymphadenitis in clinical practice.

Objective:To investigate the clinical application of ultrasound-guided cervical plexus block combined with superior laryngeal nerve block in tracheotomy for burn patients.Methods:A total of 88 burn patients who underwent tracheotomy from January 2022 to December 2022 were divided into observation group(44 cases)and matched group(44 cases).The matched group received conventional general anesthesia,while the observation group underwent ultrasound-guided cervical plexus block combined with superior laryngeal nerve block.The operation time,anesthetic effect,intraoperative hemodynamic parameters,postoperative complications,and patient satisfaction were compared.Results:The surgery time in the observation group was shorter than that in the matched group(P＜0.05).The anesthetic effect in the observation group was superior to that in the matched group,with more stable intraoperative hemodynamics,and smaller fluctuations in heart rate and mean arterial pressure(P＜0.05).The incidence of postoperative cough reflex,hoarseness,postoperative pain score,and respiratory complications in the observation group were lower than those in the matched group(P＜0.05).Patient satisfaction in the observation group was higher than that in the matched group(P＜0.05).Conclusion:Ultrasound-guided cervical plexus block combined with superior laryngeal nerve block for tracheotomy in burn patients can effectively improve anesthetic effect,reduce operation time,stabilize intraoperative hemodynamics,reduce postoperative complications,and improve patient satisfaction,which is worthy of clinical application.

Objective:The purpose of this study is to explore the influencing factors of poor prognosis in henoch-schonlein purpura(HSP)children,and to construct a nomogram model and verify its validity through the analysis results of Logistic regression model.Methods:Collected the clinical data of 170 HSP children who were treated in Fuzhou Luoyuan County Hospital from January 2015 to May 2023 were retrospectively analyzed.They were divided into good prognosis group and poor prognosis group according to the prognosis after treatment.The clinical data and related biochemical indexes of different prognostic groups were compared.The factors of poor prognosis in HSP children were analyzed by Logistic regression model.A predictive model(nomogram)for poor prognosis in HSP children were constructed and evaluated its predictive performance.Prediction accuracy were evaluateed by receiver operating characteristic(ROC)curve.Results:170 HSP children,69 cases(40.59％)had poor prognosis and 101 cases(59.41％)had good prognosis.C-reactive protein(CRP),kidney injury at initial onset,platelet count(PLT),respiratory infection,recurrent rash,and immunoglobulin A(IgA)levels in poor prognosis group were higher than those in good prognosis group(P＜0.05).Multivariate logistic analysis showed that,recurrent rash,respiratory infection,elevated PLT,CRP and IgA levels were independent influencing factors of poor prognosis in HSP children(P＜0.05).The consistency index(C-index)of the column chart model established based on the results of multiple factor analysis was 0.798.The internal verification was carried out by Bootstrap self-sampling method,and the average absolute error of calibration curve was 0.017.ROC curve was drawn according to independent influencing factors and nomogram prediction probability,the area under the curve was 0.674(recurrent rash),0.649(respiratory infection),0.777(PLT),0.733(CRP),0.749(IgA)and 0.910(nomogram prediction probability)respectively.Conclusion:Recurrent rash,respiratory infection,PLT,CRP and IgA are independent factors affecting the prognosis of HSP children.The column chart prediction model constructed based on the above factors has certain predictive value for the poor prognosis in HSP children.

Objective:To observe the effect of sodium cantharidate assisted bevacizumab in the treatment of advanced non-small cell lung cancer patients.Methods:A total of 120 patients with advanced lung adenocarcinoma from January 2021 to December 2023 were divided into two groups,namely the experimental group and the matched group,each consisting of 60 cases.All patients were treated with AP(cisplatin+pemetrexed)chemotherapy,and bevacizumab(7.5 mg/kg)was administered intravenously at the same time as chemotherapy in the matched group,while sodium bengalate(0.5 mg)was added intravenously in the experimental group on the basis of the matched group,and the patients in the two groups were compared with each other in terms of the clinical efficacy of the two groups in a cycle of 21 d,and the changes in the indicators of the immune function,symptoms and scores of adverse reactions were also compared before and after the 4 consecutive cycles of treatment.After 4 consecutive cycles of treatment,we compared the clinical efficacy,immune function indexes,symptoms,and the incidence of adverse reactions.Results:There was no difference in disease control rate(P＞0.05),and the objective response rate was higher than the matched group(P＜0.05);Pretherapy,tthe levels of natural killer(NK)cells,CD4+/CD8+,immunoglobulin(Ig)G and IgA were different between the test and matched group(P＞0.05).Post-treatment,the levels of NK cells,CD4+/CD8+,IgG,and IgA in the experimental group increased,while there was no significant change in the matched group.The experimental group was higher than the matched group(P＜0.05);Pretherapy,there was no difference in VAS and BFI scores between the experimental group and the matched group(P＞0.05).Post-treatment,the scores of the Simplified Fatigue Scale(BFI)and Visual Analog Scale(VAS)in both groups decreased,and the experimental group was lower than the matched group(P＜0.05);The incidence of grade Ⅰ-Ⅱ gastrointestinal reactions,liver and kidney dysfunction,bone marrow suppression,leukopenia,and grade Ⅲ-Ⅳ bone marrow suppression in the experimental group were all lower than those in the matched group(P＜0.05).Conclusion:Sodium cantharidate assisted bevacizumab therapy has a significant effect on non-small cell lung cancer.Compared with single chemotherapy combined with bevacizumab,it can improve the objective remission rate of patients,improve their immune function level,alleviate pain and cancer-related fatigue symptoms,and assist in reducing the incidence of adverse reactions caused by bevacizumab and chemotherapy.

Objective:To explore the relationship between serum human epididymal secretory potein 4(HE4),carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)levels with clinicopathological characteristics and prognosis of uterine fibroid patients.Methods:87 patients who were diagnosed with uterine fibroids in Xiamen Maternal and Child Health Hospital during the period of January 2019 to January 2024 were selected as the observation group,and 87 women who underwent health checkups during the same period were selected as the control group.The serum HE4,CEA and CA199 levels were detected and compared between the two groups before and 1 month after surgery.The relationship between serum HE4,CEA and CA199 levels before surgery and their clinicopathological characteristics was analyzed.The patients with uterine fibroids were followed up for 1 year after surgery,and they were divided into recurrence group and non-recurrence group according to the recurrence status,influencing factors of postoperative recurrence were analyzed by multiple logistic regression model,the predictive value of CEA,HE4,and CA199 for postoperative recurrence was analyzed by receiver operating characteristic(ROC)curves.Results:Serum HE4,CEA and CA199 levels before surgery in the observation group were significantly higher than those in the control group(P＜0.05).Serum HE4,CEA and CA199 levels before surgery in uterine fibroids patients were significantly correlated with breast hyperplasia,the location of the fibroids,the number of tumors and the maximum diameter of the fibroids(P＜0.05).87 patients with uterine fibroids were followed up for 1 year after surgery,with a recurrence rate of 26.44％.Serum HE4,CEA and CA199 levels at 1 month after surgery in the recurrence group were significantly higher than those in the non-recurrence group(P＜0.05).Elevated HE4,elevated CEA and elevatedCA199 were independent risk factors for postoperative recurrence in uterine fibroids patients(P＜0.05).The area under the curve(AUC)of combined prediction of CEA,HE4,and CA199 for predicting postoperative recurrence of uterine fibroma patients was 0.880.Conclusion:Serum HE4,CEA,and CA199 in uterine fibroids patients are abnormally elevated,and closely related to their clinicopathological characteristics.Serum HE4,CEA,and CA199 levles are influencing factors for postoperative recurrence in uterine fibroids patients and have good predictive value for postoperative recurrence.

Objective:To observe the therapeutic effect of Edaravone Dexborneol combined with aspirin and clopidogrel in the treatment of acute ischemic stroke(AIS).Methods:82 AIS patients were randomly divided into control group(treated with aspirin and clopidogrel,n=41)and observation group(treated with Edaravone Dexborneol on the basis of control group,n=41)by random number table method.National Institutes of Health Stroke Scale(NIHSS),Montreal Cognitive Assessment Scale(MoCA),Barthel Index(BI),serum biochemical indicators[neuron specific enolase(NSE),superoxide dismutase(SOD),brain-derived neurotrophic factor(BDNF),malondialdehyde(MDA)],intracranial hemodynamic indicators[bilateral anterior cerebral artery(ACA),bilateral middle cerebral artery(MCA),bilateral posterior cerebral artery(PCA)],and incidence of adverse reactions during treatment were compared between the two groups.Results:The total clinical effective rate,MoCA,BI score,BDNF,SOD,and the average flow rates of ACA,MCA,and PCA in the observation group 14 d after treatment were higher than those in control group,NIHSS score,NSE,and MDA were lower than those in control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Edaravone Dexborneol combined with aspirin and clopidogrel in AIS treatment can significantly improve intracranial hemodynamics,regulate nerve factors,reduce nerve function damage,and has good safety.

Objective:To explore the evaluation value of blood routine derived indicators[derived neutrophil to lymphocyte ratio(dNLR),red blood cell distribution width to platelet ratio(RPR)]combine with serum C-reactive protein(CRP)and procalcitonin(PCT)detection for the clinical outcomes of children with Mycoplasma pneumoniae pneumonia(MPP).Methods:149 children with MPP who were admitted to our hospital from April 2022 to August 2024 were included,they were divided into good prognosis and poor prognosis groups based on their clinical outcomes 28 d after admission.The blood routine derived indicators,serum CRP,and PCT levels between the good prognosis group and the poor prognosis group were compared.The influencing factors of clinical outcomes in children with MPP were analyzed by Multiple logistic regression analysis,the value of blood routine derived indicators,serum CRP,and PCT testing alone and in combination to evaluate the clinical outcomes of children with MPP were analyzed by receiver operating characteristic(ROC)curves.Results:Among 149 children with MPP,113 had good prognosis and 36 had poor prognosis 28 d after admission,with a poor prognosis incidence rate of 24.16％(36/149).dNLR,RPR,CRP,and PCT levels in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).Univariate analysis showed that,the clinical outcome of children with MPP was related to pleural thickening,pleural effusion,severity disease and peak body temperature(P＜0.05).Multivariate Logistic regression analysis showed:Pleural thickening,pleural effusion,severity disease was severe,elevated dNLR,elevated RPR,elevated CRP and elevated PCT were risk factors for poor prognosis in children with MPP(P＜0.05).The area under the Curve(AUC)of dNLR,RPR,CRP and PCT combined to predict the prognosis of children with MPP was higher than that evaluated by the four indicators alone.Conclusion:Pleural thickening,pleural effusion,severe disease severity,elevated dNLR,elevated RPR,elevated CRP and elevated PCT are risk factors for poor prognosis in children with MPP.Moreover,the combined evaluate value of dNLR,RPR,CRP,and PCT is relatively high.

Objective:To investigate the correlation between choroidal thickness and sweep OCT angle parameters in primary angle-closure glaucoma(PACG)patients.Methods:72 patients(144 eyes)with PACG who were admitted to Longnan First People's Hospital from February 2022 to February 2024(PACG group)were selected,and 72 volunteers(144 eyes)with normal periodic angle eye examination at the same time were selected(control group).The choroidal thickness of the foveo-temporal side of the eyeball 2500 μm(T2.5),the foveo-naso-temporal side of the eyeball 2500 μm(N2.5)and the choroidal thickness of the macular subfoveal(SFCT)were compared between the two groups,nasal and temporal scanning OCT angle parameters:scleral abruptness(SSA500),angle opening distance(AOD500),angle recess area(ARA500),trabecular meshwork iris area(TISA500)were compared between the two groups.The correlation between choroidal thickness and nasal and temporal scanning OCT angle parameters were analyzed by Pearson analysis.Results:The choroidal thickness of T2.5,N2.5 and SFCT in PACG group were thicker than those in control group(P＜0.05).Nasal and temporal AOD500,TISA500,SSA500 and ARA500 in PACG group were lower than those in control group(P＜0.05).Pearson analysis showed that T2.5,N2.5 and SFCT were negatively correlated with nasal and temporal AOD500,TISA500,SSA500 and ARA500(P＜0.05).Conclusion:Patients with PACG have thick choroid and abnormal parameters of temporal and nasal scan OCT,and there is a significant correlation between choroid thickness and temporal and nasal scan OCT parameters.

Objective:To study genotype analysis and influence factors analysis of hepatitis B virus(HBV)deoxyribonucleic acid(DNA)positive samples of negative hepatitis B surface antigen(HBsAg)donors in blood donors without compensation in Nan'an area.Methods:A total of 62,000 HBsAg fast-screened blood donor samples from January 2021 to June 2024 were selected as the study objects.HBV infection,viral load and genotype of HBV DNA positive samples,single factor and influencing factor of HBV DNA positive samples were detected and analyzed.Results:Among the 62000 HBsAg fast-screened blood donor samples,the results were negative by HBsAg screening,moreover,285 cases(0.46％)were HBsAg positive and 61715 cases(99.54％)were negative.NAT positive 180 cases and 118 cases were positive for HBV DNA.The HBV DNA positive rate of HBsAg negative donors was 0.19％(118/62000).HBV DNA of the viral load of positive specimens with＜20 IU/mL was higher than those with 20 to 99 IU/mL and ≥ 100 IU/mL(P＜0.05).HBV DNA of C style of the genotype of positive specimens was higher than B style and unsamples(P＜0.05).Univariate analysis found that HBV DNA positivity was mainly related to the history of intravenous drug use and risky sexual behavior,as well as the history of hepatitis B vaccination and blood transfusion(P＜0.05).According to the Logistic regression analysis,history of intravenous drug use and risky sexual behavior,and blood transfusion were risk factors for positive HBV DNA(OR＞1,P＜0.05),vaccination of hepatitis B vaccine was a protective factor for HBV DNA positivity(OR＜1,P＜0.05).Conclusion:The proportion of HBsAg in Nan'an area is relatively high,but there are still a small number of positive samples,the main genotype was type C,and history of intravenous drug use and risky risk behaviors,as well as history of blood transfusion were all risk factors for positive HBV DNA,vaccination of hepatitis B vaccine is protective factor for HBV DNA positivity.