Objective To establish an individualized nomogram model and evaluate its efficacy to provide a possible evaluation basis for the prognosis of lower third and abdominal part of oesophageal adenocarcinoma (EAC). Methods Lower third and abdominal part of EAC patients from 2010 to 2015 were chosen from the SEER Research Plus Database (17 Regs, 2022nov sub). The patients were randomly allocated to the training cohort and the internal validation cohort with a ratio of 7∶3 using bootstrap resampling. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) in EAC patients, which would be elected to construct the nomogram prediction model. C-index, calibration curve and receiver operating characteristic (ROC) curve were performed to evaluate its efficacy. Finally, the efficacy to evaluate the OS of EAC patients was compared between the nomogram prediction model and TNM staging system. Results In total, 3945 patients with lower third and abdominal part of EAC were enrolled, including 3475 males and 470 females with a median age of 65 (57-72) years. The 2761 patients were allocated to the training cohort and the remaining 1184 patients to the internal validation cohort. In the training and the internal validation cohorts, the C-index of the nomogram model was 0.705 and 0.713, respectively. Meanwhile, the calibration curve also suggested that the nomogram model had a strong capability of predicting 1-, 3-, and 5-year OS rates of EAC patients. The nomogram also had a higher efficacy than the TNM staging system in predicting 1-, 3-, and 5-year OS rates of EAC patients. Conclusion This nomogram prediction model has a high efficiency for predicting OS in the patients with lower third and abdominal part of EAC, which is higher than that of the current TNM staging system.

Objective:To investigate the alterations of individual metabolic brain network properties in patients with mild cognitive impairment (MCI) and their correlations with cognitive function.Methods:One hundred and five participants from Alzheimer's Disease Neuroimaging Initiative (ADNI) database enrolled from March 2012 to February 2016 were chosen, including 61 MCI patients and 44 normal controls (NC). Cognitive assessments, including mini-mental state examination (MMSE), auditory verbal learning test (AVLT), trail making test (TMT), and semantic verbal fluency (SVF) score, were performed in both groups; differences of above scores and clinical data between the participants from the two groups were compared. T1-weighted imaging and fluorodeoxyglucose positron emission tomography (FDG-PET) images were collected in both groups; individual metabolic brain networks were constructed based on differences in effect sizes between brain regions and network properties were calculated. Spatial correlation analysis was used to compare the correlations of metabolic brain networks at the individual and group levels. General linear model was employed to compare the differences in network properties between the two groups. Partial correlation analysis was used to examine the correlations of differential network properties with cognitive function in MCI patients. A support vector machine (SVM) classification model was constructed based on individual metabolic brain network properties, and receiver operating characteristic (ROC) curve was used to explore the diagnostic value of this SVM classification model in MCI.Results:(1) Compared with the NC group, the MCI group had significantly lower MMSE and AVLT-immediate recall scores, and longer TMT-A completion time ( P<0.05). (2) Spatial correlation analysis revealed a positive correlation between individual metabolic brain networks and group-level metabolic brain networks in patients of the MCI group ( r=0.825, P<0.001). No significant differences in global network properties were noted between the two groups ( P>0.05). Compared with the NC group, the MCI group significantly decreased degree centrality in the left A8vl, right A39c, and right V5/MT+ regions, increased degree centrality in the left anterior cuneus, decreased nodal efficiency in the left A8vl, right V5/MT+, and right caudal hippocampus regions, increased nodal shortest path length and nodal clustering coefficient in the left A8vl region ( P<0.05). (3) The degree centrality at the A8vl of ventral part of the left middle frontal gyrus and nodal efficiency in right caudal hippocampus region were positively correlated with AVLT-immediate recall scores ( r=0.331, P=0.010; r=0.282, P=0.030), nodal efficiency in the left A8vl region was negatively correlated with TMT-A completion time ( r=-0.470, P<0.001), and nodal efficiency in the left A8vl region was positively correlated with SVF score ( r=0.263, P=0.044). (4) Area under the curve of SVM classification model in diagnosing MCI was 0.880 (95% CI: 0.813-0.945, P<0.001), with an accuracy rate of 0.790. Conclusions:Patients with MCI have alterations in individual metabolic brain network properties, among which the degree centrality and nodal efficiency of some nodes are closely related to cognitive function changes. Models constructed based on individual metabolic brain network properties can help to effectively diagnose MCI.

Background Arsenic exposure has been demonstrated to induce apoptosis. The fibronectin type III structural domain 3B protein (FNDC3B) has been shown to promote cancer cell proliferation; however, its role in arsenic-induced apoptosis remains to be elucidated. Objective To investigate the effects of sodium arsenite (NaAsO₂) and its metabolites on the expression of FNDC3B gene in A549 cells and to understand the function of FNDC3B gene in A549 cells. Methods (1) A549 cells were exposed to varying final concentrations of NaAsO₂ and their optical density at 450 nm values were measured by Cell Counting Kit-8 (CCK-8) after 48 h. Survival curves were plotted, and a final exposure dose was selected according to the survival rate. Total protein and RNA were extracted by exposing A549 cells to high (30 µmol·L⁻¹), medium (20 µmol·L⁻¹), and low (10 µmol·L⁻¹) NaAsO₂ concentrations, high (30 µmol·L⁻¹) monomethylarsinic acid (MMA), and high (30 µmol·L⁻¹) dimethylarsinic acid for a period of 48 h. mRNA expression and the protein expression of the FNDC3B gene was detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot (WB), while the protein ubiquitination expression of the FNDC3B gene was detected by co-immunoprecipitation (CO-IP) and WB assay. (2) Knockdown of FNDC3B gene expression was achieved in A549 cells by siRNA interference. The si-FNDC3B fragment was transfected in A549 cells for 48 h. The mRNA and protein expression of FNDC3B gene was then detected by qRT-PCR and WB assay. Cell viability was determined through CCK-8 assay. Hoechst 33342/propidium iodide (PI) double staining and JC-1 mitochondrial membrane potential assay were employed to detect both early and late apoptosis, while cleaved caspase3 protein and P53 signalling pathway related protein expressions were evaluated by WB. Results (1) The CCK-8 results demonstrated a decline in the viability of A549 cells with an increase in NaAsO₂ concentration, with an inhibitory concentration at 50% of 38.12 µmol·L⁻¹. The qRT-PCR results demonstrated that compared to the control group, varying concentrations of NaAsO₂ (10, 20, and 30 µmol·L⁻¹) significantly upregulated the mRNA expression of FNDC3B gene (P<0.01). In contrast, MMA and DMA showed no significant effect on FNDC3B mRNA expression (P>0.05). The WB analysis revealed that the protein expression of FNDC3B was reduced in the NaAsO₂-treated group compared to the control, accompanied by elevated ubiquitination levels of FNDC3B protein, particularly at the K48 ubiquitination site. MMA and DMA exhibited no impact on FNDC3B protein expression. (2) Following the specific knockdown of FNDC3B expression in A549 cells, the CCK-8 assay demonstrated a significant reduction in cell viability in the silenced FNDC3B group (si-FNDC3B) compared to the control group. The JC-1 assay demonstrated that the mitochondrial membrane potential was diminished in the si-FNDC3B group relative to the control group. The Hoechst 33342/PI staining assay revealed that the si-FNDC3B group exhibited a notable degree of apoptosis. The si-FNDC3B group also displayed substantial apoptosis. The WB analysis indicated that the relative expressions of cleaved caspase3, P53, MDM2, Bad, and Bax proteins were elevated in the si-FNDC3B group in comparison to the control group. Conclusion The presence of NaAsO₂ is observed to promote the ubiquitination expression of the FNDC3B protein, which in turn reduces the expression of FNDC3B protein. However, the main metabolites DMA and MMA have no effect on the expression of FNDC3B. Furthermore, the silencing of FNDC3B is observed to inhibit the viability of A549 cells and promote apoptosis, a phenomenon related to the activation of P53 signaling pathway.

Objective:To explore the predictive value of the combined application of total prostate-specific antigen (TPSA), vascular endothelial growth factor A (VEGF-A), and interleukin (IL) in predicting postoperative biochemical recurrence in patients with prostate cancer.Methods:This study adopted a retrospective cohort research method. 202 male prostate cancer patients who visited Xi′an Gaoxin Hospital from April 2021 to January 2024 were selected as the research subjects. The age of the patients was 68(64, 71) years, and their postoperative conditions were classified into the non-recurrence group ( n=144) and the biochemical recurrence group ( n=58). The general clinical data and serumological test indicators SA, free prostate-specific antigen (FPSA), VEGF-A, IL-6, IL-17] were detected and compared between the two groups. Quantitative data with normal distribution were expressed as mean±standard deviation, and the comparison between groups was performed using the independent sample t-test; non-normal distribution quantitative data were expressed as M( Q1, Q3), and the comparison between groups was performed using the Mann-Whitney U test. The comparison between groups of count data was performed using the chi-square test. Through Spearman correlation analysis and multivariate Logistic regression analysis, the risk factors for biochemical recurrence after surgery in prostate cancer patients were screened out, and the efficacy of the combined prediction model based on TPSA, VEGF-A, and IL-17 was evaluated by receiver operating characteristic (ROC) curve, decision curve (DCA), and calibration curve. Results:The average tumor diameter, proportion of positive surgical margins, proportion of seminal vesicle invasion, and proportion of patients with Gleason score 3-5 in the biochemical recurrence group were significantly higher than those in the non-recurrence group ( P<0.05). The serumological indicators TPSA, VEGF-A, IL-6, IL-17 in the biochemical recurrence group were 44.28 (42.37, 48.57) ng/mL, (28.24±3.99) ng/mL, (39.14±2.95) ng/L and (66.64±6.04) pg/mL; those in the non-recurrence group were 41.25 (36.61, 43.56) ng/mL, (23.52±3.75) ng/mL, (37.19±4.19) ng/L, and (57.31±6.63) pg/mL. The biochemical recurrence group was higher than the non-recurrence group, and the difference was statistically significant ( P<0.05). Spearman correlation analysis and Logistic regression analysis found that TPSA, VEGF-A, and IL-17 were risk factors for biochemical recurrence after surgery in prostate cancer patients ( P<0.05); the DCA curve and calibration curve indicated that the combined prediction model based on TPSA, VEGF-A, and IL-17 had good accuracy (Hosmer-Lemeshow P=0.421), and the ROC curve suggested that the efficacy of the above indicators combined for predicting biochemical recurrence after surgery in prostate cancer patients was higher [AUC (95% CI)=0.899 (0.832-0.966)], and higher than the independent predictive efficacy of each indicator. Conclusion:Continuous monitoring of serum TPSA, VEGF-A, and IL-17 levels can effectively predict the risk of postoperative recurrence in prostate cancer patients and also provide biological markers for preventing disease recurrence.

Objective To study the clinical characteristics and medication patterns of Wangbi Tablets in treating patients with knee osteoarthritis(KOA)in the real world and to analyze the advantages and specific features of Chinese patent medicines in treating advantage disease.Methods A prospective case registry study was conducted,registering 3 000 patients from 30 TCM and Western medicine hospitals across China from April 2019 to December 2021.Data on gender,age,BMI,Chinese medicine staging(CMS),K-L grading,medication duration,VAS score,medical history and combined medication were collected for descriptive analysis.Comparisons were made between different stages and between single-use and combined-use groups.The Apriori algorithm was used for association analysis of combined medications.Results A total of 2 999 patients were included,with 2 063 females(68.79%)and 936 males(31.21%).The average age was(56.89±8.90)years.The average BMI was(23.80±2.88)kg/m2.The proportion of patients in CMS I was 512(17.07%),with a VAS median score of 8,while the proportion of patients in CMS Ⅱ was 2 181(72.73%),with a VAS median score of 6.The proportion of patients in CMS Ⅲ was 306(10.20%),with a VAS median score of 3;316 cases(10.54%)were classified as K-L grade I,2 477 cases(82.59%)as grade Ⅱ,204 cases(6.80%)as grade Ⅲ,and 2 cases(0.07%)as grade Ⅳ.Medication analysis indicated that the single-use group(1507 cases,50.25%)was larger than the combined-use group(1 492 cases,49.75%).In terms of the number of drugs used in combination,one(39.01%)and two(38.14%)were the main types;in terms of medication types,combination therapy with Western medicine(62.27%)and simultaneous use of Western medicine and other Chinese materia medica(26.14%)were the main methods;the top three drugs with the highest frequency of combination use were glucosamine capsules,imrecoxib tablets and sodium hyaluronate injection.The top three drug combinations with the highest support were"Huoxue Zhishang Powder+imrecoxib tablets","glucosamine capsules+imrecoxib tablets"and"glucosamine capsules+sodium hyaluronate injection".Inter-group comparisons showed that the medication duration for Wangbi Tablets in CMS I was longer than in CMS Ⅱ and CMS Ⅲ(P<0.01).The proportion of patients on monotherapy in CMS I(62.11%)was higher than in CMS Ⅱ(46.54%)and CMS Ⅲ(56.86%)(P<0.001).Among patients in CMS I(16.41%)and CMS Ⅲ(21.24%),the highest proportion used one combined medication,whereas in CMS Ⅱ,the highest proportion was for those using two combined medications(20.50%).In all three groups,CMS I(19.53%),CMS Ⅱ(33.70%)and CMS Ⅲ(30.72%),the highest proportion of combined medications was Western medicine.Conclusion More than half of the patients treated KOA with Wangbi Tablets alone.Approximately one-fifth of the patients were in CMS I,with a median pain score of 8.The average duration of medication for patients in CMS I,CMS Ⅱ and CMS Ⅲ decreases,and there is no obvious pattern in the medication method at different stages;combination therapy is represented by"Huoxue Zhishang Powder+imrecoxib tablets"and"glucosamine capsules+imrecoxib tablets".

Objective:To explore the RNA expression and alterations in brain structure in individuals who have experienced stressful life events (SLE), as well as the correlation patterns between them and their association with the occurrence of depression.Methods:Prospectively, a total of 80 SLE subjects were recruited from the psychiatry and psychology clinic of the Jiangsu University Affiliated Yixing Hospital between January 2021 and December 2022, with 16 normal controls (NC) enrolled concurrently. The 17 items Hamilton depression scale (HAMD-17) and social readjustment rating scale (SRRS) were used to assess depressive symptoms and stress levels. RNA sequencing information of peripheral blood and imaging data at baseline were collected. Based on whether depression occurred during the 2-year follow-up period, SLE subjects were divided into the SLE-depression group ( n=15) and the SLE-non-depression group ( n=65). Differentially expressed genes (DEGs) were screened using differential analysis and protein-protein interaction (PPI) networks. Fractional anisotropy (FA) of white matter tracts and gray matter volume (GMV) were extracted using tract-based spatial statistics and voxel-based morphometry.Using analysis of variance compared inter-group differences in gene expression, GMV and white matter FA values. Partial correlation analysis was used to explore correlations between DEGs, altered GMV and white matter microstructure. Gene set enrichment analysis (GSEA) was performed on key genes to identify potential biological pathways. Propensity score matching constructed sensitivity subgroups to verify result robustness. Results:The SLE-depression group showed significantly higher SRRS and HAMD-17 scores at baseline and at the end of follow-up compared to the SLE-non-depression group and the NC group ( H=47.773, 35.427, 41.114, all P<0.05). Expression levels of IL-10 (2.12±0.28, 2.43±0.44), EZH2 (2.11±0.43, 2.45±0.51), NCAM1 (3.60±0.30, 3.03±0.39), CD3E (4.95±0.37, 4.57±0.48), CCK (3.29±0.28, 3.02±0.42), and CX3CR1 (5.55±0.40, 5.91±0.34) were significantly different between the SLE-depression group and SLE-non-depression group( F=5.549~28.371, all P<0.05). Compared with the SLE-non-depression group, the SLE-depression group exhibited significantly lower FA values in the genu of the corpus callosum (0.29±0.04, 0.31±0.04) and the left uncinate fasciculus (0.31±0.02, 0.33±0.02), as well as significantly smaller GMV in the right hippocampus (0.29±0.07, 0.33±0.06), bilateral middle frontal gyrus (left: 0.27±0.05, 0.31±0.05; right: 0.28±0.06, 0.32±0.06), right insula (0.36±0.03, 0.38±0.04), and left precentral gyrus (0.19±0.04, 0.24±0.05) ( F=4.593-12.064, all P<0.05, FDR correction). GMV in the right anterior cingulate and paracingulate gyri was significantly larger than that in the SLE-non-depression group (0.34±0.05, 0.29±0.06) ( F=6.704, P=0.034, FDR correction). Partial correlation analysis revealed significantly stronger correlations between hub DEGs and altered brain regions in the SLE-depression group ( r=0.017-0.801) compared to the SLE-non-depression group ( r=0.002-0.382), with a statistically significant difference ( U=629, P<0.001; Cliff's Delta=0.454). GSEA indicated that the aforementioned genes were primarily involved in pathways including the ribosome, spliceosome, ribosome biogenesis in eukaryotes, and neuroactive ligand-receptor interaction. Sensitivity analysis confirmed that the above results remained statistically significant after balancing sample sizes (all P<0.05). Conclusion:The SLE-depression group showed specific RNA expression and brain structure alterations compared to the SLE-non-depression group, and the correlation between RNA and brain structure was significantly enhanced in the SLE-depression group. This suggests that the correlation between genes and brain structure in the SLE population may be related to their susceptibility to depression.

Objective To investigate the effect of dexmedetomidine combined with ropivacaine on postop-erative sleep quality in patients undergoing upper abdominal surgery following Oblique Subcostal Transversus Abdominis Plane Block(OSTAPB).Methods A total of 140 patients who underwent gastric surgery at the Affiliated Hospital of Xuzhou Medical University between September 2024 and November 2024 were enrolled.According to the random number table method,they were randomly allocated into two groups:the simple subcostal transversus abdominis plane block group(Group A)and the dexmedetomidine combined with subcostal transversus abdominis plane block group(Group B),with 70 patients in each group.The study compared the Asymptomatic Sleep Distur-bance Scale(AIS)scores and Self-rating Anxiety Scale(SAS)scores on the night before surgery,AIS scores on the night after surgery and the following day,the amount of remifentanil used during surgery,and the cumulative num-ber of patient-controlled analgesia(PCA)button presses within 3 days postoperatively.Additionally,the Numeric Rating Scale(NRS)pain scores at 2 h,6 h,12 h,24 h,and 48 h post-surgery,as well as the Quality of Recovery-15(QoR-15)scores on the night of surgery and the second day post-surgery,were evaluated.Results There were no significant differences in anxiety levels or subjective sleep quality scores between the two groups prior to the opera-tion(P>0.05).Additionally,there was no significant difference in the usage of remifentanil between Group A and Group B(P>0.05).The NRS scores for pain differed significantly between the two groups within the first 48 hours post-operation(P<0.05);however,no significant difference was observed in NRS scores between the two groups after 24 hours during rest.Furthermore,the number of patient-controlled analgesia(PCA)activations in Group B was significantly lower than that in Group A at 12 hours post-operation(P<0.05).Lastly,both the QoR-15 and sleep quality were significantly higher in Group B compared to Group A(P<0.05).Conclusion Dexmedetomidine combined with ropivacaine for subcostal transversus abdominis plane block not only provides superior postoperative analgesia compared to ropivacaine alone but also enhances patients' sleep quality and recovery quality on the night following surgery,thereby contributing to improved overall postoperative recovery.

Objective:To explore the RNA expression and alterations in brain structure in individuals who have experienced stressful life events (SLE), as well as the correlation patterns between them and their association with the occurrence of depression.Methods:Prospectively, a total of 80 SLE subjects were recruited from the psychiatry and psychology clinic of the Jiangsu University Affiliated Yixing Hospital between January 2021 and December 2022, with 16 normal controls (NC) enrolled concurrently. The 17 items Hamilton depression scale (HAMD-17) and social readjustment rating scale (SRRS) were used to assess depressive symptoms and stress levels. RNA sequencing information of peripheral blood and imaging data at baseline were collected. Based on whether depression occurred during the 2-year follow-up period, SLE subjects were divided into the SLE-depression group ( n=15) and the SLE-non-depression group ( n=65). Differentially expressed genes (DEGs) were screened using differential analysis and protein-protein interaction (PPI) networks. Fractional anisotropy (FA) of white matter tracts and gray matter volume (GMV) were extracted using tract-based spatial statistics and voxel-based morphometry.Using analysis of variance compared inter-group differences in gene expression, GMV and white matter FA values. Partial correlation analysis was used to explore correlations between DEGs, altered GMV and white matter microstructure. Gene set enrichment analysis (GSEA) was performed on key genes to identify potential biological pathways. Propensity score matching constructed sensitivity subgroups to verify result robustness. Results:The SLE-depression group showed significantly higher SRRS and HAMD-17 scores at baseline and at the end of follow-up compared to the SLE-non-depression group and the NC group ( H=47.773, 35.427, 41.114, all P<0.05). Expression levels of IL-10 (2.12±0.28, 2.43±0.44), EZH2 (2.11±0.43, 2.45±0.51), NCAM1 (3.60±0.30, 3.03±0.39), CD3E (4.95±0.37, 4.57±0.48), CCK (3.29±0.28, 3.02±0.42), and CX3CR1 (5.55±0.40, 5.91±0.34) were significantly different between the SLE-depression group and SLE-non-depression group( F=5.549~28.371, all P<0.05). Compared with the SLE-non-depression group, the SLE-depression group exhibited significantly lower FA values in the genu of the corpus callosum (0.29±0.04, 0.31±0.04) and the left uncinate fasciculus (0.31±0.02, 0.33±0.02), as well as significantly smaller GMV in the right hippocampus (0.29±0.07, 0.33±0.06), bilateral middle frontal gyrus (left: 0.27±0.05, 0.31±0.05; right: 0.28±0.06, 0.32±0.06), right insula (0.36±0.03, 0.38±0.04), and left precentral gyrus (0.19±0.04, 0.24±0.05) ( F=4.593-12.064, all P<0.05, FDR correction). GMV in the right anterior cingulate and paracingulate gyri was significantly larger than that in the SLE-non-depression group (0.34±0.05, 0.29±0.06) ( F=6.704, P=0.034, FDR correction). Partial correlation analysis revealed significantly stronger correlations between hub DEGs and altered brain regions in the SLE-depression group ( r=0.017-0.801) compared to the SLE-non-depression group ( r=0.002-0.382), with a statistically significant difference ( U=629, P<0.001; Cliff's Delta=0.454). GSEA indicated that the aforementioned genes were primarily involved in pathways including the ribosome, spliceosome, ribosome biogenesis in eukaryotes, and neuroactive ligand-receptor interaction. Sensitivity analysis confirmed that the above results remained statistically significant after balancing sample sizes (all P<0.05). Conclusion:The SLE-depression group showed specific RNA expression and brain structure alterations compared to the SLE-non-depression group, and the correlation between RNA and brain structure was significantly enhanced in the SLE-depression group. This suggests that the correlation between genes and brain structure in the SLE population may be related to their susceptibility to depression.

Objective To study the clinical characteristics and medication patterns of Wangbi Tablets in treating patients with knee osteoarthritis(KOA)in the real world and to analyze the advantages and specific features of Chinese patent medicines in treating advantage disease.Methods A prospective case registry study was conducted,registering 3 000 patients from 30 TCM and Western medicine hospitals across China from April 2019 to December 2021.Data on gender,age,BMI,Chinese medicine staging(CMS),K-L grading,medication duration,VAS score,medical history and combined medication were collected for descriptive analysis.Comparisons were made between different stages and between single-use and combined-use groups.The Apriori algorithm was used for association analysis of combined medications.Results A total of 2 999 patients were included,with 2 063 females(68.79%)and 936 males(31.21%).The average age was(56.89±8.90)years.The average BMI was(23.80±2.88)kg/m2.The proportion of patients in CMS I was 512(17.07%),with a VAS median score of 8,while the proportion of patients in CMS Ⅱ was 2 181(72.73%),with a VAS median score of 6.The proportion of patients in CMS Ⅲ was 306(10.20%),with a VAS median score of 3;316 cases(10.54%)were classified as K-L grade I,2 477 cases(82.59%)as grade Ⅱ,204 cases(6.80%)as grade Ⅲ,and 2 cases(0.07%)as grade Ⅳ.Medication analysis indicated that the single-use group(1507 cases,50.25%)was larger than the combined-use group(1 492 cases,49.75%).In terms of the number of drugs used in combination,one(39.01%)and two(38.14%)were the main types;in terms of medication types,combination therapy with Western medicine(62.27%)and simultaneous use of Western medicine and other Chinese materia medica(26.14%)were the main methods;the top three drugs with the highest frequency of combination use were glucosamine capsules,imrecoxib tablets and sodium hyaluronate injection.The top three drug combinations with the highest support were"Huoxue Zhishang Powder+imrecoxib tablets","glucosamine capsules+imrecoxib tablets"and"glucosamine capsules+sodium hyaluronate injection".Inter-group comparisons showed that the medication duration for Wangbi Tablets in CMS I was longer than in CMS Ⅱ and CMS Ⅲ(P<0.01).The proportion of patients on monotherapy in CMS I(62.11%)was higher than in CMS Ⅱ(46.54%)and CMS Ⅲ(56.86%)(P<0.001).Among patients in CMS I(16.41%)and CMS Ⅲ(21.24%),the highest proportion used one combined medication,whereas in CMS Ⅱ,the highest proportion was for those using two combined medications(20.50%).In all three groups,CMS I(19.53%),CMS Ⅱ(33.70%)and CMS Ⅲ(30.72%),the highest proportion of combined medications was Western medicine.Conclusion More than half of the patients treated KOA with Wangbi Tablets alone.Approximately one-fifth of the patients were in CMS I,with a median pain score of 8.The average duration of medication for patients in CMS I,CMS Ⅱ and CMS Ⅲ decreases,and there is no obvious pattern in the medication method at different stages;combination therapy is represented by"Huoxue Zhishang Powder+imrecoxib tablets"and"glucosamine capsules+imrecoxib tablets".

Objective To investigate the effect of dexmedetomidine combined with ropivacaine on postop-erative sleep quality in patients undergoing upper abdominal surgery following Oblique Subcostal Transversus Abdominis Plane Block(OSTAPB).Methods A total of 140 patients who underwent gastric surgery at the Affiliated Hospital of Xuzhou Medical University between September 2024 and November 2024 were enrolled.According to the random number table method,they were randomly allocated into two groups:the simple subcostal transversus abdominis plane block group(Group A)and the dexmedetomidine combined with subcostal transversus abdominis plane block group(Group B),with 70 patients in each group.The study compared the Asymptomatic Sleep Distur-bance Scale(AIS)scores and Self-rating Anxiety Scale(SAS)scores on the night before surgery,AIS scores on the night after surgery and the following day,the amount of remifentanil used during surgery,and the cumulative num-ber of patient-controlled analgesia(PCA)button presses within 3 days postoperatively.Additionally,the Numeric Rating Scale(NRS)pain scores at 2 h,6 h,12 h,24 h,and 48 h post-surgery,as well as the Quality of Recovery-15(QoR-15)scores on the night of surgery and the second day post-surgery,were evaluated.Results There were no significant differences in anxiety levels or subjective sleep quality scores between the two groups prior to the opera-tion(P>0.05).Additionally,there was no significant difference in the usage of remifentanil between Group A and Group B(P>0.05).The NRS scores for pain differed significantly between the two groups within the first 48 hours post-operation(P<0.05);however,no significant difference was observed in NRS scores between the two groups after 24 hours during rest.Furthermore,the number of patient-controlled analgesia(PCA)activations in Group B was significantly lower than that in Group A at 12 hours post-operation(P<0.05).Lastly,both the QoR-15 and sleep quality were significantly higher in Group B compared to Group A(P<0.05).Conclusion Dexmedetomidine combined with ropivacaine for subcostal transversus abdominis plane block not only provides superior postoperative analgesia compared to ropivacaine alone but also enhances patients' sleep quality and recovery quality on the night following surgery,thereby contributing to improved overall postoperative recovery.