Objective To compare the clinical effects of vancomycin, linezolid alone, and their separate combination with spleen polypeptide in the treatment of severe community-acquired pneumonia (CAP) in children with a history of recurrent respiratory infections. Methods A total of 296 children with severe CAP and a history of recurrent respiratory infections were selected as study subjects and randomly divided into four groups: vancomycin group (vancomycin alone), linezolid group (linezolid alone), combined group A (vancomycin combined with spleen polypeptide), and combined group B (linezolid combined with spleen polypeptide), with 74 patients in each group. The curative effects, recovery process (time to normalization of body temperature, time to improvement of cough, time to improvement of respiration, length of hospital stay), adverse reactions, and direct medical costs were compared among the four groups. Decision tree models and cost-effectiveness analysis were used to compare the economics of each treatment plan. Results The total effective rates in the linezolid group, combined group A, and combined group B were 83.78%, 86.49%, and 97.30%, respectively, which were all higher than 71.62% in the vancomycin group, and the combined group B had a higher effective rate than the linezolid group and combined group A (P < 0.05). The time to normalization of body temperature, improvement of respiration, improvement of cough, and length of hospital stay were shorter in the linezolid group, combined group A, and combined group B than in the vancomycin group, and were shorter in the combined group B compared to the linezolid group and combined group A (P < 0.05). There was no statistically significant difference in the occurrence of adverse reactions among the four groups (P>0.05). There were no statistically significant differences in treatment costs, examination/testing costs, and hospitalization costs among the four groups (P>0.05). The treatment costs and total costs were higher in the vancomycin group, combined group A, linezolid group, and combined group B in ascending order, with statistically significant between-group difference (P < 0.05). The cost-effectiveness ratios from high to low were combined group A (75.84), vancomycin group (73.22), linezolid group (32.87), and combined group B (32.69). Sensitivity analysis showed that the cost-effectiveness ratio analysis results were stable and reliable. Conclusion Among the four treatment options, the combination of linezolid and spleen polypeptide has the best therapeutic effect in severe CAP children with a history of recurrent respiratory infections, with the most significant clinical benefit and cost-effectiveness advantages.

Objective: To evaluate the efficacy and safety of low dose sublingual nifedipine dripping pills (5 mg) in treating moderate and severe hypertension in comparison with normal dose (10 mg) of sublingual nifedipine dripping pills. Methods: This study was designed as a randomized, double-blind, positive drug parallel controlled, multi-center, non-inferiority clinical trial. Patients with moderate and severe hypertension were enrolled by 14 clinical trial centers, randomly divided into the trial group (sublingual 5 mg nifedipine dripping pills) and the control group (sublingual 10 mg nifedipine dripping pills). The changes in blood pressure were monitored continuously within 2 hours after the initial administration, repeated the dose in 20 minutes interval after the initial administration for up to additional 3 doses (maximum 4 doses) if the antihypertensive efficacy was not satisfactory. The efficacy of antihypertensive therapy between the two groups was evaluated by repeated administration rates and blood pressure changes at 60 minutes post the initial administration, and the safety of treatment was evaluated by recording adverse event rate of the two groups. Results: The anti-hypertensive effective rates at 60 minutes after sublingual administration were 83.5% (202/242) and 86.7% (208/240) respectively between the trial group and control group (χ²=1.307, P=0.253) . On the aspect of antihypertensive effectiveness at 60 minutes after single dose of sublingual administration, the anti-hypertension effective rates of the trial group and the control group were 85.6% (154/180) and 87.2% (164/188) respectively (χ²=0.221, P=0.639). Prevalence of the repeated administration was also similar between the two groups (25.6%(62/242) in the trial group and 21.7% (52/240) in the control group, χ²=1.043, P=0.307). On the safety aspect, there was no adverse events/reactions in the trial group, but there were 15 cases of adverse events/reactions occurred in control group (6.25%, χ²=15.611, P<0.001). Conclusions In the treatment of moderate to severe hypertension, the antihypertensive efficacy of low dose nifedipine dripping pills is similar to that of conventional dosage, and the safety profile of low dose nifedipine dripping pills is better than that of the conventional dose.

Objective To explore medical equipment support in actual combat training to improve mobile medical unit in medical service support.Methods Combined with the characteristics of actual combat training,the problems and difficulty of medical equipment support were discussed in actual combat training.Results Some measures were put forward for medical equipment support such as cherishing of medical serviceman on equipment,equipment quality control and maintenance beforeutilization,effective protection and fixation,minimization of influence of instable power supply and plan preparation for loading and transport.Conclusion The study on medical equipment support in actual combat training contributes to enhancing medical support ability of mobile medical unit.