To investigate the effects of intranasal dexmedetomidine hydrochloride nasal spray combined with lidocaine aerosol on anesthesia induction compliance, hemodynamics, stress response, and postoperative outcomes in children undergoing general anesthesia for adenoidectomy.

The pediatric patients who underwent adenoidectomy were divided into control group and treatment group based on their preoperative anesthesia protocol. Pediatric patients in the control group received intranasal dexmedetomidine hydrochloride nasal spray 2 μg·kg^-1 30 minutes before surgery. The control group received intranasal dexmedetomidine, while the treatment group received intranasal dexmedetomidine hydrochloride nasal spray 2 μg·kg^-1 combined with lidocaine aerosol 2 mg·kg^-1 30 minutes before surgery. A comparison was made between the two groups regarding preoperative anxiety, induction compliance, hemodynamic parameters, stress response markers, emergence agitation and pain, anesthesia recovery indices, and length of hospital stay, along with the incidence of adverse reactions.

A total of 82 pediatric patients were enrolled, with 39 cases in control group and 43 cases in treatment group. At anesthesia induction, the modified Yale Preoperative Anxiety Scale (m-YPAS) scores in the control and treatment groups were (26.56±5.13) and (23.14±4.91) points, respectively; the induction compliance checklist (ICC) scores were (0.81±0.26) and (0.69±0.12) points, respectively; the anesthesia induction time were (5.16±1.28) and (4.48±1.01) min, respectively. At T1, the heart rates (HR) in the control and experimental groups were (94.37±8.63) and (90.15±8.82) beats·min^-1, respectively, and the mean arterial pressures (MAP) were (72.63±5.81) and (69.58±5.75) mmHg, respectively; at T2, the HR values were (101.26±10.76) and (95.87±10.35) time·min^-1, respectively, and the MAP values were (78.94±7.44) and (74.23±6.72) mmHg, respectively; at T4, the HR values were (98.58±10.08) and (94.13±9.14) beats·min^-1, respectively, and the MAP values were (77.85±7.24) and (73.92±6.98) mmHg, respectively. Postoperative day 1, the serum cortisol (Cor) levels in the control and experimental groups were (331.67±48.47) and (309.42±45.87) ng·mL^-1, respectively; serotonin (5-HT) levels were (1.54±0.33) and (1.37±0.29) μmol·L^-1, respectively; norepinephrine (NE) levels were (195.73±20.35) and (184.67±21.42) ng·L^-1, respectively; glutamate (Glu) levels were (5.62±0.87) and (5.15±0.82) mmol·L^-1, respectively. At 30 minutes after extubation, the pediatric anesthesia emergence delirium scale (PAED) scores in the control and treatment groups were (4.06±1.37) and (3.28±1.13) points, respectively; the Face, Legs, Activity, Cry, Consolability Scale (FLACC) scores were (3.24±0.85) and (2.79±0.74) points, respectively; and the incidence of emergence agitation was 20.51% (8 cases/39 cases) and 4.65% (2 cases/43 cases), respectively. The comparisons of the above indicators showed statistically significant differences (all P<0.05). The adverse drug reactions in the control group and the experimental group mainly included cough, nausea and vomiting, laryngospasm, and bradycardia and the total incidence of adverse events was 12.82% (5 cases/39 cases) and 9.30% (4 cases/43 cases), respectively (P>0.05).

The intranasal administration of dexmedetomidine hydrochloride nasal spray combined with lidocaine aerosol for general anesthesia in pediatric adenoidectomy effectively alleviates preoperative anxiety, improves cooperation during induction, maintains hemodynamic stability, reduces surgical stress response, and decreases the incidence of emergence agitation and postoperative pain, with a good safety profile, demonstrating significant clinical promotion value.

To explore the clinical efficacy and safety of tiotropium bromide powder for inhalation combined with salmeterol xinafoate powder for inhalation in patients with stable chronic obstructive pulmonary disease (COPD).

Patients with stable COPD in our hospital were divided into control group and experimental group by random number table method. The control group was given salmeterol fluticasone inhalation powder, 1 inhalations per time, twice a day; the treatment group was additionally treated with tiotropium bromide powder for inhalation, 1 tablet per time, once a day. Both groups were treated continuously for 8 weeks. The clinical efficacy, forced vital capacity, respiratory condition, serum elafin level, and adverse drug reactions were compared between the two groups.

A total of 102 patients were enrolled. There were 51 cases in each group. Throughout the treatment period, 2 participants in the control group were lost to follow-up, and 1 case in the treatment group withdrew due to withdrawal of informed consent. Ultimately, control group had 49 cases and treatment group had 50 cases. After treatment, the treatment group (92.00%, 46 cases/50 cases) exhibited a superior total clinical effective rate (75.51%, 37 cases/49 cases), respectively; and the difference was statistically significant (P<0.05). After treatment, the percentage of predicted value (FEV₁%) in the treatment group and the control group was (57.64±5.88)% and (54.78±5.61)%, respectively; FVC was (2.58±0.40) and (2.14±0.32) L, respectively; peak expiratory flow rate (PEF) was (1.43±0.31) and (1.31±0.21) L·s^-1, respectively; the treatment group showed significantly higher levels of the above indicators compared with the control group (all P<0.05). After treatment, the modified British Medical Research Council respiratory questionnaire (mMRC) scores of the treatment group and the control group were (1.05±0.11) and (1.15±0.18) points, respectively; The serum elafin levels of the treatment group and the control group were (10.28±1.95) and (9.34±1.20) pg·mL^-1, respectively; the secretory leukocyte protease inhibitor (SLPI) levels were (56.39±6.54) and (52.15±6.04) ng·mL^-1, respectively; the levels of growth differentiation factor-15 (GDF-15) were (867.44±108.50) and (930.16±121.39) ng·mL^-1, respectively; there were statistically significant differences in the above indicators between the two groups(all P<0.05). In the treatment group, adverse drug reactions such as arrhythmia, gastrointestinal reactions, and joint pain, while those in the control group included arrhythmia, gastrointestinal reactions, joint pain, and dry mouth. The total incidence rates of adverse drug reactions in the treatment group and the control group were 22.00% (11 cases/50 cases) and 26.53% (13 cases/49 cases), respectively; there was no statistically significant difference between the two groups (P>0.05).

Tiotropium bromide power for inhalation combined with salmeterol fluticasone power for inhalation has outstanding efficacy in the treatment of stable COPD, which can improve forced vital capacity, respiratory status and elafin level, and has a good safety profile.

To establish a high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) method for simultaneous determination of calcitonin salmon in human plasma.

Precipitate plasma samples using organic reagents, then centrifuge and collect the supernatant, proceed with concentration, reconstitution, and sample injection, and a phenomenex Jupiter^® C4-300A column (2.1 mm×50.0 mm, 5.0 μm) was used for chromatographic separation. The mobile phase was 0.1% formic acid water (phase A) -0.1% formic acid acetonitrile (phase B); gradient elution with a flow rate of 0.50 mL·min^-1, column temperature 50 ℃, injection volume 20 μL. A custom-labeled isotopic compound was used as the internal standard, scanning was carried out by means of multi reaction monitoring (MRM) in the positive ionization mode with an electric spray ionization source(ESI). Examine the specificity, standard curve, lower limit of quantification (LLOQ), precision, accuracy, recovery rate, matrix effect, and stability of the method.

The method showed a good specificity results of the method, and there is no interference between the analyte and the internal standard. The linear range of the standard curves for the tested substances was 2.00、4.00、10.00、50.00、100.00、200.00、360.00、400.00 pg·mL^-1, The standard curve was y=2.98×10^-2x+5.30×10^-3 (R²=0.997 4) and the lower limit of quantification(LLOQ) is 2.00 pg·mL^-1. The intra-day and inter day relative standard deviation (RSD) were both less than 15%, extraction recovery rates ranging from 60.13% to 75.39% (RSD<15%), and matrix effects ranging from 97.45% to 109.72% (RSD<10%). The stability of the matrix samples was verified by placing them at room temperature for 24 hours, repeatedly freezing and thawing at -20 ℃ and -70 ℃ for 5 times, freezing at -20 ℃ and -70 ℃ for 49 days, and placing the processed samples in an automatic sampler for 333 hours, with accuracy ranging from 97.03% to 108.64%, all stable.

The established HPLC-MS/MS method is simple, rapid, highly sensitive, and specific, and can be used for the detection of plasma samples in pharmacokinetic studies.

To analyze the bioequivalence and safety of the test and reference formulations of erlotinib hydrochloride tablets in healthy Chinese subjects under fasting conditions following a single oral dose.

The study was conducted as a randomized, open-label, two-period crossover trial. A total of 60 healthy subjects were assigned to two sequences by randomization. Under fasting conditions, subjects received a single 150 mg oral dose of either the test or reference formulation, with a 12-day washout period between doses. The plasma concentrations of erlotinib were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and the pharmacokinetic parameters were calculated for bioequivalence evaluation using Phoenix WinNonlin software (version 8.3).

After a single oral administration of the test or reference formulation under fasting conditions, the main pharmacokinetic parameters of erlotinib hydrochloride were as follows: maximum concentration (C_max) was (1 649.48±567.44) and (1 548.15±529.59) ng·mL^-1, AUC_0-last were (28 830.12±11 507.57) and (29 396.47±11 121.61) h·ng·mL^-1, AUC_0-inf were (30 759.13±13 789.60) and (31 132.78±12 912.53) h·ng·mL^-1. The 90% confidence intervals for the geometric mean ratios of C_max, AUC_0-last, and AUC_0-inf for the two formulations were 92.44%-117.31%, 87.65%-103.90% and 87.66%-104.37%, respectively, all of which were within the bioequivalence acceptance range of 80.00%-125.00%. No serious adverse events, suspected unexpected serious adverse reactions, or adverse events leading to withdrawal occurred during the trial.

Under fasting conditions, the test erlotinib hydrochloride tablets were bioequivalent to the reference listed drug Tarceva^® in healthy Chinese subjects and the safety profile was favorable.

To investigate the effects of pachymic acid (Pac) on cholesterol metabolism in a gallstone (GS) model and its underlying molecular mechanisms.

A mouse model of GS was established by feeding a high-fat diet. Fifty healthy SPF male mice were randomly divided into five groups: Control group (fed a normal diet), model group (gallstone model), experimental-L group (model + 25 mg·kg^-1 Pac), experimental-H group (model+50 mg·kg^-1 Pac), and inhibitor group (model + 50 mg·kg^-1 Pac + 1 mg·kg^-1 GW9662). Gallstone grades were determined based on macroscopic cholesterol crystals or stones observed in bile. The expression of proteins in the peroxisome proliferator-activated receptor γ (PPARγ)/liver X receptor α (LXRα) pathway was detected by Western blot.

The gallstone grades in the control, model, experimental-L, experimental-H, and inhibitor groups were (0±0), (4.70±0.46), (3.70±0.64), (1.10±0.70), and (3.20±0.60) grades, respectively; The relative expression levels of PPARγ protein were 1.41±0.13, 0.32±0.02, 0.48±0.05, 1.39±0.15, and 0.80±0.07, respectively; The relative expression levels of LXRα protein were 0.99±0.07, 0.33±0.03, 0.42±0.02, 1.00±0.09, and 0.73±0.05, respectively. Statistically significant differences were observed when comparing the model group with the control, experimental-L, and experimental-H groups, as well as when comparing the inhibitor group with the experimental-H group (all P<0.05).

Pachymic acid effectively prevents high-fat diet-induced cholesterol gallstone formation in mice. Its protective mechanism is associated with the activation of the PPARγ/LXRα signaling pathway, leading to the restoration of cholesterol metabolic homeostasis.

To investigate the clinical efficacy and safety of somatostatin injection combined with ulinastatin injection in patients with severe acute pancreatitis (SAP).

Patients with SAP were divided into control group and experimental group by random number table method. Both groups received routine basic treatment. On this basis, the control group was additionally given somatostatin injection (6 mg once daily). The experimental group was treated with ulinastatin injection by intravenous infusion at a dose of 100 000 units three times a day on the basis of the control group. Both groups continued to receive treatment for 7 days. Compare the clinical efficacy, inflammatory factor levels, symptom relief time, intestinal mucosal function [D-lactate, diamine oxidase (DAO), and Endotoxin] of the two groups, and conduct a safety evaluation.

A total of 160 patients were enrolled in this study, both the treatment group and the control group included 80 cases. The total effective rates in the treatment group and the control group were 91.25% (73 cases/80 cases) and 75.00% (60 cases/80 cases), respectively, with statistically significant difference (P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α) in the treatment group and the control group were (22.46±5.90) and (28.85±6.37) pg·L^-1, respectively; the levels of interleukin-6 (IL-6) were (92.03±20.22) and (122.78±27.59) pg·L^-1, respectively; the levels of Presepsin were (1.25±0.54) and (1.55±0.58) μg·L^-1, respectively; the levels of D-lactate were (5.31±0.75) and (8.19±0.93) mg·L^-1, respectively; the levels of DAO were (4.29±0.88) and (9.84±1.05) U·L^-1, respectively; the levels of endotoxin were (0.63±0.18) and (1.21±0.25) EU·L^-1, respectively; the duration of abdominal pain relief was (3.14±0.42) and (4.98±0.51) d, respectively; the time for amylase to return to normal was (4.32±0.46) and (5.37±0.56) d, respectively. All these differences of the aforementioned indicators were statistically significant in both groups (P<0.05). The incidence of adverse drug reactions during treatment in the control group and the treatment group was 6.25% (5 cases/80 cases) and 6.25% (5 cases/80 cases), respectively, and the incidence of complications was 3.75% (3 cases/80 cases) and 2.50% (2 cases/80 cases), respectively. There were no statistical differences between the two groups (P>0.05).

Ulinastatin combined with somatostatin in the treatment of SAP patients can effectively reduce the levels of inflammatory factors, alleviate inflammatory response, promote the recovery of intestinal mucosal function, and has better curative effect, without increasing the occurrence of adverse reactions, with certain safety and effectiveness.

To discuss the effects of sauchinone on myocardial fibrosis and inflammatory injury in rats with acute myocardial infarction by adjusting the sonic hedgehog/glioma-associated oncogene homolog 1 (Shh/Gli1) signaling pathway.

A rat model of acute myocardial infarction was established by ligation of the left anterior descending coronary artery. A total of 72 rats were randomly divided into six groups: sham group (thoracotomy and suture without ligation), model group, experimental-L group (5 mg·kg^-1 sauchinone), experimental-M group (10 mg·kg^-1 sauchinone), experimental-H group (25 mg·kg^-1 sauchinone) and activator group [25 mg·kg^-1 sauchinone + 10 mg·kg^-1 purmorphamine (PUR)], with 12 rats in each group. Each group received the corresponding drug by gavage or intraperitoneal injection for 7 consecutive days. After the final administration, inflammatory cytokine levels were measured using enzyme-linked immunosorbent assay (ELISA); myocardial infarct size was assessed by 2,3,5-triphenyltetrazolium chloride (TTC) staining; myocardial tissue changes were observed using hematoxylin-eosin (HE) staining; apoptotic cells were detected by one-step terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining; superoxide anion levels were measured using dihydroethidium; collagen deposition was examined by Masson staining; and the protein expressions of Shh, Gli1 and α-smooth muscle actin (α-SMA) were detected by Western blot.

The serum levels of interleukin (IL)-6 in the sham group, model group, experimental-H group, and activator group were (56.31±9.21), (113.05±12.03), (59.67±9.67) and (103.71±11.68) pg·mL^-1, respectively; tumor necrosis factor (TNF)-α levels were (136.25±16.92), (220.16±22.14), (153.67±17.40) and (208.77±21.65) pg·mL^-1, respectively; IL-1β levels were (28.59±4.10), (52.07±5.38), (30.61±4.31) and (46.22±5.17) pg·mL^-1, respectively; myocardial infarct sizes were (0±0)%, (28.86±3.42)%, (10.24±1.28)% and (26.94±2.98)%, respectively; inflammation scores were (0±0), (2.88±0.32), (1.34±0.15) and (2.76±0.29), respectively; myocardial apoptosis rates were (2.46±0.25)%, (36.38±3.95)%, (12.23±1.45)% and (34.14±3.73)%, respectively; relative dihydroethidium fluorescence intensity in myocardial tissue was (4.58±0.68)%, (39.65±4.27)%, (15.36±1.73)% and (37.31±3.96)%, respectively; the percentage of myocardial fibrosis area was (11.34±1.32)%, (65.83±6.98)%, (18.48±2.24)% and (61.95±6.36)%, respectively; Shh protein relative expression levels were 1.04±0.11, 3.46±0.38, 1.29±0.16 and 3.28±0.35, respectively; Gli1 protein relative expression levels were 1.02±0.11, 2.73±0.31, 1.19±0.14 and 2.64±0.29, respectively; and α-SMA protein relative expression levels were (1.03±0.13), (2.33±0.27), (1.14±0.15), and (2.15±0.23), respectively. Comparisons between the sham group and the model group, between the model group and the experimental-H group, and between the experimental-H group and the activator group were statistically significant for all the above indicators (all P<0.05).

Sauchinone may alleviate myocardial fibrosis and inflammatory injury in rats with acute myocardial infarction by inhibiting the Shh/Gli1 signaling pathway.

To explore the clinical efficacy and safety of losartan potassium and hydrochlorothiazide tablets in the treatment of male patients with H-type hypertension complicated with osteoporosis.

Male patients with H-type hypertension complicated with osteoporosis were prospectively and randomly divided into control group and treatment group according to the random number table method. Both groups received conventional basic treatment. The control group was given amlodipine tablets on the basis of basic treatment, with an initial dose of 5 mg once a day (qd). If the blood pressure was not controlled after 2 to 4 weeks of treatment, the dose was adjusted to 10 mg qd. The treatment group was given losartan potassium and hydrochlorothiazide tablets on the basis of basic treatment, with an initial dose of 1 tablet qd. If the blood pressure was not controlled after 2 to 4 weeks of treatment, the dose was adjusted to 2 tablets qd. Both groups were treated for 12 weeks. The blood pressure efficacy, blood pressure monitoring, serum homocysteine (Hcy), cystatin C (CysC), folic acid, bone mineral density, bone metabolism indicators, and inflammatory indicators of the two groups were compared, and safety was evaluated.

A total of 88 patients were included, with 44 patients in the treatment group and 44 patients in the control group. The total effective rates of the treatment group and the control group were 90.91% (40 cases/44 cases) and 86.36% (38 cases/44 cases), respectively (P>0.05). After treatment, the Hcy levels of the treatment group and the control group were (9.28±2.13) and (10.94±2.40) μmol·L^-1, respectively; the CysC levels were (1.24±0.33) and (1.41±0.28) mg·L^-1, respectively; the folic acid levels in the treatment group and control group were (17.64±2.41) and (16.51±2.82) μg·L^-1, the type I collagen C-terminal telopeptide levels were (0.69±0.10) and (0.73±0.11) μg·L^-1, respectively; the osteocalcin levels were (20.81±3.67) and (19.11±2.64) μg·L^-1, respectively; the bone-specific alkaline phosphatase levels were (17.85±2.68) and (16.62±3.03) μg·L^-1, respectively; the alkaline phosphatase levels were (102.56±16.80) and (95.10±16.07) U·L^-1, respectively; the high-sensitivity C-reactive protein levels were (10.45±1.31) and (11.64±1.82) mg·L^-1, respectively; the matrix metalloproteinase-2 levels were (296.23±33.59) and (319.23±42.70) pg·mL^-1, respectively; and the interleukin-10 levels were (19.21±2.79) and (17.42±2.96) ng·mL^-1, respectively. Except folic acid, the differences of above indexes were all statistically significant (P<0.05, P<0.01). In the treatment group, adverse drug reactions included headache, dizziness, nausea and diarrhea; in the control group, adverse drug reactions included lower limb edema, headache, dizziness and gingival swelling. The total incidence of adverse drug reactions in the treatment group and the control group was 11.36% (5 cases/44 cases) and 13.64% (6 cases/44 cases), respectively (P>0.05).

Losartan potassium and hydrochlorothiazide tablets and amlodipine tablets have comparable efficacy and safety. The former showed positive effects on bone metabolism indicators during short-term treatment, and presented a certain positive trend in regulating Hcy, CysC, and inflammatory levels, which may provide a reference for the selection of combined medication regimens for such patients.

To discuss the effect of baicalin on renal injury in nephrotic syndrome (NS) rats by regulating the high mobility group protein B1 (HMGB1)/Toll like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) pathway.

SD rats were divided into control group, model group, experimental group, HMGB1 inhibitor group and HMGB1 activator group, with 12 rats in each group. Except for the control group, rats in all other groups were injected with adriamycin via the tail vein to establish the nephrotic syndrome (NS) model. Twenty-four hours after successful modeling, the rats in the experimental group were administered 100 mg·kg^-1 baicalin by gavage; rats in the HMGB1 inhibitor group were administered 0.03 g·kg^-1 HMGB1 inhibitor glycyrrhizic acid by gavage; rats in the HMGB1 activator group were administered 100 mg·kg^-1 baicalin by gavage combined with intraperitoneal injection of 8 μg·kg^-1 HMGB1 activator recombinant HMGB1 protein (rHMGB1); rats in the model group and control group were administered 10 mL·kg^-1 normal saline by gavage and intraperitoneal injection. All treatments were administered once daily for 30 consecutive days. Measure 24-hour urinary protein, serum creatinine, blood urea nitrogen levels, renal pathology, and renal levels of interleukin-1β (IL-1β), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α (TNF-α). TUNEL staining was used to detect the apoptosis rate of cells in renal tissue. Western blot was used to detect renal caspase-3, p53, HMGB1, TLR4, and p-NF-κB p65 proteins.

In the model group, the renal tissue showed thickening of the glomerular basement membrane, glomerular atrophy, and extensive inflammatory cell infiltration; the 24 h urinary protein levels in the control group, model group, experimental group, HMGB1 inhibitor group, and HMGB1 activator group were (65.56±4.73), (212.19±12.26), (87.76±5.15), (95.53±6.11) and (138.87±8.25) mg·24 h^-1, respectively; the serum creatinine levels were (51.57±3.18), (128.86±7.25), (63.69±4.12), (70.75±4.06) and (95.73±5.29) μmol·L^-1, respectively; the serum blood urea nitrogen levels were (4.23±0.25), (10.68±0.61), (5.44±0.32), (6.18±0.39) and (8.78±0.53) mmol·L^-1, respectively; the renal tissue IL-1β levels were (37.65±2.18), (83.39±5.07), (44.55±2.56), (50.52±2.89) and (69.89±4.17) pg·mL^-1, respectively; the renal tissue MCP-1 levels were (156.69±8.12), (314.45±17.36), (181.54±10.21), (201.16±11.54) and (264.45±14.58) pg·mL^-1, respectively; the renal tissue TNF-α levels were (34.99±2.15), (90.81±5.63), (43.78±2.52), (51.19±3.15) and (67.11±3.89) pg·mL^-1, respectively; the renal tissue apoptosis rates were (4.67±0.31)%, (28.81±1.76)%, (7.08±0.39)%, (8.26±0.51)% and (18.22±1.03)%, respectively; the renal tissue Caspase-3 protein expression levels were 0.86±0.10, 2.37±0.16, 0.98±0.09, 1.21±0.18 and 1.85±0.17, respectively; the renal tissue tumor protein p53 (p53) protein expression levels were 0.15±0.02, 0.68±0.07, 0.24±0.03, 0.36±0.04 and 0.51±0.05, respectively; the renal tissue HMGB1 protein expression levels were 0.65±0.08, 2.04±0.17, 0.87±0.09, 0.95±0.08 and 1.34±0.13, respectively; the renal tissue TLR4 protein expression levels were 0.41±0.05, 1.68±0.16, 0.63±0.07, 0.79±0.08 and 1.09±0.11, respectively; the renal tissue p-NF-κB p65 protein expression levels were 0.23±0.03, 0.81±0.09, 0.37±0.05, 0.45±0.04 and 0.68±0.07, respectively. All differences between the control group and the model group, between the model group and the experimental group/HMGB1 inhibitor group, and between the experimental group and the HMGB1 activator group were all statistically significant (all P<0.05).

Baicalin may inhibit the inflammatory response and cell apoptosis in NS rats, and alleviate renal injury by suppressing HMGB1/TLR4/NF-κB pathway.