ObjectiveTo investigate the clinical efficacy of oral/ gastric tube/ jejunal tube administration or retention enema of Qingjie Huagong Formula （清解化攻方， QHF） mirabilite abdominal bag external application combined with conventional western medicine in patients with acute pancreatitis （AP）. MethodsA prospective， randomized， double-blind， placebo-controlled trial was conducted. A total of 128 AP patients were enrolled and randomly assigned to a control group and a treatment group， with 64 cases in each group. The control group received placebo and conventional western medicine， while the treatment group additionally received oral/ gastric tube/ jejunal tube administration or retention enema of QHF， and mirabilite abdominal bag external application. Both groups received treatment from admission to discharge as one complete course， with the maximum treatment duration not exceeding 14 days.The primary outcome was the severity grading of AP. Secondary outcomes were clinical efficacy， laboratory indicators including white blood cell count （WBC）， C-reactive protein （CRP）， procalcitonin （PCT）， blood urea nitrogen （BUN）， lactate （Lac）， and D-dimer， gastrointestinal function recovery indicators including time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition， total fluid volume administered within 24 h after admission， intra-abdominal pressure， length of hospital stay， hospitalization costs， and incidence of complications. ResultsDuring the treatment period， 3 cases dropped out in the control group and 9 cases in the treatment group， leaving 116 cases for final analysis （55 in the treatment group and 61 in the control group）. After treatment， the markedly effective rate and overall effective rate in the treatment group were 69.09% （38/55） and 92.73% （51/55）， respectively， which was higher than 49.18% （30/61） and 80.33% （49/61） in the control group. The severity of the disease in the treatment group was significantly lower than that in the control group （P＜0.05）. Compared to the control group， the treatment group showed significantly reduced levels of WBC， CRP， PCT， BUN， Lac， and D-dimer； the time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition were significantly shortened； the fluid volume administered within 24 h after admission and intra-abdominal pressure were significantly reduced， as well as the length of hospital stay and hospitalization costs （P＜0.05 or P＜0.01）. The incidences of acute kidney injury， systemic inflammatory response syndrome， and infected pancreatic necrosis in the treatment group were significantly lower than those in the control group （P＜0.05）. ConclusionQHF combined with conventional western medicine can significantly improve the inflammatory status of AP patients， promote gastrointestinal function recovery， reduce intra-abdominal pressure and fluid resuscitation requirements， lower the risk of certain complications， and shorten the length of hospital stay.

ObjectiveTo investigate the clinical efficacy of oral/ gastric tube/ jejunal tube administration or retention enema of Qingjie Huagong Formula （清解化攻方， QHF） mirabilite abdominal bag external application combined with conventional western medicine in patients with acute pancreatitis （AP）. MethodsA prospective， randomized， double-blind， placebo-controlled trial was conducted. A total of 128 AP patients were enrolled and randomly assigned to a control group and a treatment group， with 64 cases in each group. The control group received placebo and conventional western medicine， while the treatment group additionally received oral/ gastric tube/ jejunal tube administration or retention enema of QHF， and mirabilite abdominal bag external application. Both groups received treatment from admission to discharge as one complete course， with the maximum treatment duration not exceeding 14 days.The primary outcome was the severity grading of AP. Secondary outcomes were clinical efficacy， laboratory indicators including white blood cell count （WBC）， C-reactive protein （CRP）， procalcitonin （PCT）， blood urea nitrogen （BUN）， lactate （Lac）， and D-dimer， gastrointestinal function recovery indicators including time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition， total fluid volume administered within 24 h after admission， intra-abdominal pressure， length of hospital stay， hospitalization costs， and incidence of complications. ResultsDuring the treatment period， 3 cases dropped out in the control group and 9 cases in the treatment group， leaving 116 cases for final analysis （55 in the treatment group and 61 in the control group）. After treatment， the markedly effective rate and overall effective rate in the treatment group were 69.09% （38/55） and 92.73% （51/55）， respectively， which was higher than 49.18% （30/61） and 80.33% （49/61） in the control group. The severity of the disease in the treatment group was significantly lower than that in the control group （P＜0.05）. Compared to the control group， the treatment group showed significantly reduced levels of WBC， CRP， PCT， BUN， Lac， and D-dimer； the time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition were significantly shortened； the fluid volume administered within 24 h after admission and intra-abdominal pressure were significantly reduced， as well as the length of hospital stay and hospitalization costs （P＜0.05 or P＜0.01）. The incidences of acute kidney injury， systemic inflammatory response syndrome， and infected pancreatic necrosis in the treatment group were significantly lower than those in the control group （P＜0.05）. ConclusionQHF combined with conventional western medicine can significantly improve the inflammatory status of AP patients， promote gastrointestinal function recovery， reduce intra-abdominal pressure and fluid resuscitation requirements， lower the risk of certain complications， and shorten the length of hospital stay.

Objective To investigate the influencing factors of treatment decision dilemma in the pa-tients with intracranial aneurysm.Methods A total of 210 patients with intracranial aneurysms hospitalized in the neurosurgery department of this hospital from January to December 2022 were selected as the research subjects.The questionnaire survey on the patients was conducted by using the general data questionnaire,De-cision Dilemma Scale (DDS),Perceptive Social Support Scale (PSSS) and Hospital Anxiety and Depression Scale (HADS).Results The scores of decisional dilemma,perceived social support,anxiety and depression of the patients with intracranial aneurysm were (38.08±14.05) points,(50.59±3.38) points,(11.12±3.46) points and (9.56±2.11) points respectively.The multiple linear regression analysis showed that the age,fam-ily per capita monthly income,aneurysm diameter,social support and anxiety were the main influencing fac-tors of treatment decision dilemma in the patients with intracranial aneurysm (P<0.05).Conclusion The de-cision-making dilemma in the patients with intracranial aneurysms is in a moderate level.Medical care staff should for-mulate the targeted decision support measures according to the patient' s age,economic status,aneurysm size,patient's social support and anxiety situation to help the patients to improve their decision-making level.