To investigate prescription of semaglutide and analyzed status of semaglutide administration in China’s real-world.

The prescription including semaglutide were extracted from 9 cities across China in first quarter of 2023. We analyzed the current administration of semaglutide and risk factors of off-label use of semaglutide by multivariant logistic regression.

A total of 10 884 patients were included after data screening, about 70% patients were 34-64 years old. Endocrinology was the most common prescription department. Diabetes was diagnosed in 76.78% patients and 765 patients combined chronic complications of diabetes, of which diabetic neuropathy (470 cases, 4.32%) and diabetic nephropathy (248 cases, 2.28%) were the most common complications. Cardiovascular diseases and risk factors were diagnosed in 2 429 patients. Hypertension (1 379 cases, 12.67%) and hyperlipemia (1 342 cases, 11.31%) were the most common cardiovascular disease and risk factors. While 56.74% (6 176 cases) patients were treated by semaglutide singe-agent in general, 36.79% (3 075 cases/ 8 357 cases) patients with diabetes combined oral hypoglycemic drugs or insulin, and biguanides and sodium-dependent glucose transporters 2 inhibitors were used mostly. About 1/4 patients without diabetes off-label administrated semaglutide. According to the logistic regression, risk factors of off-label use were elder age, came from first-tier cities, prescription from endocrinology and a greater number of combined cardiovascular diseases and risk factors.

Semaglutide -based therapy regimens in patients with diabetes are fairly standardized according to clinical guidelines, while off-label use in patients without diabetes are supported by clinical evidence and guidelines to some extent.

To observe the clinical efficacy and safety of evolocumab injection combined with pitavastatin calcium tablets in the treatment of patients with acute coronary syndrome after percutaneous coronary intervention (PCI).

According to cohort method, the patients with acute coronary syndrome after PCI were divided into control group and treatment group. Two groups were treated with routine treatment (anti-platelet, anti-coagulation, reducing myocardial oxygen consumption, improving myocardial ischemia). On the routine treatment, control group was treated with pitavastatin calcium 2 mg per time, once a day, orally before bedtime. On the basis of control group, treatment group was given evolocumab 140 mg per time, once every 2 weeks, subcutaneous injection. Two groups were treated for 6 months. The clinical efficay, blood lipid, myocardial injury indexes, serum levels of amyloid A1 (SAA1) and Gla-rich protein (GRP), major adverse cardiovascular events (MACEs) and safety were compared between two groups.

Fifty-two patients were enrolled in the treatment group and 58 patients were enrolled in the control group. After treatment, the total effective rates of treatment and control groups were 94.23% (49 cases/52 cases) and 75.86% (44 cases/58 cases), and the difference was statistically significant (P<0.05). After treatment, the total cholesterol levels of treatment and control groups were (1.17±0.22) and (1.35±0.25) mmol·L^-1, triglyceride levels were (2.63±0.76) and (3.89±0.92) mmol·L^-1, high-density lipoprotein cholesterol levels were (1.41±0.30) and (1.26±0.28) mmol·L^-1, low-density lipoprotein cholesterol levels were (1.23±0.46) and (1.58±0.55) mmol·L^-1, cardiac troponin I levels were (0.03±0.01) and (0.05±0.02) ng·mL^-1, creatine kinase isoenzyme levels were (12.35±2.38) and (14.23±2.89) U·L^-1, SAA1 levels were (213.92±41.58) and (274.18±43.36) μg·mL^-1, GRP levels were (21.32±3.50) and (19.35±3.27) ng·mL^-1, incidences of MACEs were 9.62% and 24.14%, the differences were statistically significant between two groups (all P<0.05). The adverse drug reactions of two groups were fatigue, pruritus, abdominal pain and elevated aminotransferase. There was no significant difference in total incidences of adverse drug reactions between treatment group and control group (11.54% vs 13.79%, P>0.05).

Evolocumab injection combined with pitavastatin calcium tablets has a definitive clinical efficacy in the treatment of patients with acute coronary syndrome after PCI, which can effectively reduce the blood lipid levels, the incidence of MACEs and myocardial injury, regulate the serum levels of SAA1 and GRP, without increasing the incidence of adverse drug reactions.

To observe the clinical effect and safety of N-acetylcysteine combined with budesonide and terbutaline in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure (RF).

According to queuing method, patients with AECOPD and RF were divided into treatment group and control group. On basis of basic treatment, control group was given aerosol inhalation of budesonide suspension (1 mg/once, bid) and terbutaline solution (5 mg/once, bid), while treatment group was given aerosol inhalation of N-acetylcysteine solution (0.3 g/once, bid) on basis of control group. All patients were treated for 2 weeks. The clinical effect, pulmonary function indexes [forced vital capacity (FVC), peak expiratory flow (PEF)], dyspnea degree [modified version of British medical research council dyspnea scale (mMRC)], oxidative stress response indexes [superoxide dismutase (SOD)] and inflammatory response indexes [hypersensitive C-reactive protein (hs-CRP)] were compared between the two groups after treatment, and safety was evaluated.

There were 56 cases in control group and 64 cases in treatment group. After treatment, the total effective rate of the treatment group and the control group were 93.75% (60 cases /64 cases) and 82.14% (46 cases /56 cases), respectively, and the difference was statistically significant (P<0.05). After treatment, FVC in treatment group and control group were (2.41±0.59) and (2.08±0.54) L; PEF were (4.97±1.18) and (4.08±1.12) L·s^-1; mMRC scores were (1.86±0.39) and (2.67±0.56) points; SOD levels were (97.54±8.03) and (79.02±7.27) U·L^-1; hs-CRP levels were (5.09±1.42) and (8.63±2.13) mg·L^-1. Compared with control group, the above indexes in treatment group were statistically significant (all P<0.001). The adverse drug reactions in treatment group were mainly on vomiting, rash, palpitation and nausea, while in control group were mainly on fatigue, gastrointestinal reactions and rash. There was no significant difference in total incidence of adverse drug reactions between treatment group and control group [10.94% (7 cases/64 cases) vs 8.93% (5 cases/56 cases), P>0.05].

Curative effect of N-acetylcysteine combined with budesonide and terbutaline is significant in patients with AECOPD and RF, which can promote the recovery of pulmonary function, relieve dyspnea, oxidative stress and inflammatory response.

To analyze the clinical efficacy and safety of salmeterol fluticasone propionate combined with cetirizine hydrochloride and montelukast sodium tablet in the treatment of children with cough variant asthma.

The children with cough variant asthma were divided into control group and treatment group by random number table method. The control group was treated with oral montelukast sodium chewable tablets and cetirizine hydrochloride oral solution, both 10 mg every time, qd; the treatment group was treated with salmeterol fluticasone propionate inhalation powder inhalation, 1 inhalation/time, bid on the basis of the control group. Children in both groups continued treatment for 3 weeks. The clinical efficacy, pulmonary function, airway reaction status, immune function index, inflammatory index and adverse drug reactions were compared between the two groups.

In the treatment group, 50 cases were enrolled, 1 case was lost, and 49 cases were finally included in the statistical analysis. In the control group, 52 cases were enrolled, 3 cases were lost, and finally 49 cases were included in the statistical analysis. After treatment, the total effective rate of the control group and the treatment group were 77.55% (38 cases/49 cases) and 93.88% (46 cases/49 cases), respectively, and the difference were statistically significant (P<0.05). After treatment, the maximum expiratory flow were (4.68±0.56) and (5.07±0.62) L·s^-1 in the control and treatment groups; the vital capacity were (0.98±0.05) and (1.02±0.07) L; the forced expiratory volume in the first second were (75.72±7.24)% and (80.03±8.36)%; the forced vital capacity were (75.49±7.68)% and (79.97±6.72)%; the initial airway resistance were (7.33±0.75) and (7.01±0.73) cm H₂O·L^-1·s^-1; the minimum induced cumulative dose were (1.89±0.14) and (2.01 ± 0.25) mg·L^-1; the 35th percentile of specific airway conduction decrease were (5.24±0.52)% and (5.59±0.68)%. There were statistically significant differences in the above indexes between the treatment group and the control group (P<0.05, P<0.01, P<0.001). The adverse drug reactions of the control group and the treatment group were headache, palpitation and sleep difficulty, and the incidence of the total adverse drug reactions of the treatment group and the control group were 6.12% (3 cases /49 cases) and 12.24% (6 cases /49 cases), respectively, with no statistical significance (P>0.05).

Salmeterol fluticasone propionate, cetirizine hydrochloride and montelukast sodium tablet are effective and safe in the treatment of children with cough variant asthma.

To observe the clinical efficacy of nilapalil toluene sulfonate capsules, bevacizumab injection, and their combination therapy for ovarian cancer, and to assess their impact on serum biomarkers and ovarian blood flow parameters.

Ovarian cancer patients were divided into three groups according to a cohort methods: Control A group, control B group, and combined group. Control A group received nilapalil toluene sulfonate capsules, 300 mg once daily for 21 days per cycle. Control B group received bevacizumab injection 7.5 mg·kg^-1, administered every 3 days for 21 days per cycle. The combined group received both nilapalil toluene sulfonate capsules and bevacizumab injection following the same regimen as the control groups. All groups underwent 4 cycles of treatment. Clinical efficacy, serum tumor biomarkers, ovarian blood flow parameters, adverse drug reactions, and patient survival were compared across the three groups.

A total of 31 patients in control A group, 28 patients in control B group, and 41 patients in the combined group were included. After treatment, the total effective rates for control A group, control B group, and the combined group were 70.97% (22 cases/31 cases), 71.43% (20 cases /28 cases) and 92.68% (38 cases /41 cases), respectively. The combined group showed a significantly higher effective rate compared to both control A group and control B group (all P<0.05). After treatment, the serum levels of carcinoembryonic antigen (CEA) in control A group, control B group, and the combined group were (15.26±2.33), (14.89±2.34) and (9.74±1.21) μg·L^-1, respectively; and the pulsatility index (PI) were 1.35±0.24, 1.39±0.21 and 1.82±0.32, respectively. The combined group showed significant differences in these parameters compared to both control A group and control B group (all P<0.05). Adverse drug reactions in control A group mainly included gastrointestinal reactions, hair loss, and proteinuria; control B group had gastrointestinal reactions, hair loss, and muscle pain; and the combined group experienced gastrointestinal reactions, hair loss, proteinuria, and muscle pain. The overall adverse drug reaction rates in control A group, control B group, and the combined group were 25.81% (8 cases /31 cases), 25.00% (7 cases /28 cases) and 26.38% (11 cases /41 cases), respectively, with no significant difference between the groups (all P>0.05). After 12 months of follow-up, the survival rates for control A group, control B group, and the combined group were 70.97% (22 cases /31 cases), 67.86% (19 cases /28 cases) and 90.24% (37 cases /41 cases), respectively. The survival rate of the combined group was significantly higher than that of control A group and control B group (all P<0.05).

The combination of nilapalil toluene sulfonate capsules and bevacizumab injection in the treatment of ovarian cancer effectively reduces serum biomarker levels, improves ovarian blood flow parameters, has a low incidence of adverse drug reactions, high safety, and significantly improves patient survival.

To observe the effect and safety of dydrogesterone combined with estradiol valerate on preventing the intrauterine re-adhesion after intrauterine adhesion (IUA) surgery.

The patients after IUA surgery were divided into control group and treatment group according to the cohort method. The control group was given oral estradiol valerate tablets (2 mg every time, twice a day) immediately after surgery and stopped after 30 days of continuous oral administration, and on the basis of the control group; the treatment group received dydrogesterone tablets (10 mg each time, once a day) from the 20^th day until the next menstruation. Both groups were treated for 2 menstrual cycles. The efficacy, endometrial receptivity ultrasound parameters [endometrial thickness, endometrial volume, vascular index (VI), blood flow index (FI), vascular blood flow index (VFI)], sex hormones [estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH)], adverse reactions and occurrence of re-adhesion were compared between the two groups.

Forty-eight cases in treatment group and 44 cases in control group were finally included. After 2 menstrual cycles of treatment, the total effective rates in treatment group and control group were 95.83% (46 cases/48 cases) and 81.82% (36 cases/44 cases), respectively (P<0.05). After 2 menstrual cycles of treatment, the endometrial thicknesses in treatment group and control group were (7.88±1.02) and (7.12±0.86) mm; the endometrial volumes were (3.02±0.97) and (2.57±0.73) cm³; VI values were 1.21±0.59 and 0.88±0.57; FI values were 29.87±5.12 and 27.56±4.63; VFI values were 1.12±0.43 and 0.83±0.36; E2 levels were (239.62±25.47) and (168.91±20.12) pmol·L^-1; FSH levels were (8.94±2.02) and (10.63±2.14) U·L^-1; LH levels were (13.38±2.16) and (15.27±2.59) U·L^-1, respectively (all P<0.05). The adverse drug reactions in treatment group were mainly breast tenderness and digestive tract discomfort; and the adverse drug reactions in control group were mainly breast tenderness, digestive tract discomfort and headache. The total incidence rates of adverse drug reactions in treatment group and control group were 14.58% (7 cases/48 cases) and 11.36% (5 cases/44 cases), respectively (P>0.05). The incidence rates of re-adhesion in treatment group and control group were 6.25% (3 cases/48 cases) and 20.45% (9 cases/44 cases) (P<0.05).

Dydrogesterone combined with estradiol valerate has a significant effect on preventing intrauterine re-adhesion after IUA surgery, and it can effectively improve the endometrial receptivity and sex hormones levels of patients, and it has medication safety.

To observe the anesthetic effects and safety of remazolam injection combined with alfentanil injection in the treatment of patients with hysteroscopic surgery.

Patients scheduled for hysteroscopic surgery were randomly divided into control group and treatment group. The control group received intravenous 1.5-2.0 mg·kg^-1 propofol + 7-10 μg·kg^-1 alfentanil for anesthetic induction, during the surgery, continuously infused with 4-12 mg·kg^-1·h^-1 propofol + 0.05-0.20 μg·kg^-1·h^-1 remifentanil for anesthesia maintenance. The treatment group was given intravenous 0.3-0.5 mg·kg^-1 remimazolam + 7-10 μg·kg^-1 alfentanil for anesthetic induction, during the surgery, received 0.5-1.0 mg·kg^-1·h^-1remazolam+ 0.05-0.20 μg·kg^-1·h^-1 remifentanil for anesthesia maintenance. The hemodynamics, analgesic effects, cognitive function and safety were compared between the two groups.

Control group were enrolled 52 cases, 3 cases dropped out, and 49 cases were finally included in the statistical analysis. Treatment group were enrolled 53 cases, 4 cases dropped out, and 49 cases were finally included in the statistical analysis. At the end of the surgery, the mean arterial pressure of treatment and control groups were (73.98±7.41) and (60.10±6.84) mmHg, the heart rates were (68.43±7.32) and (63.92±7.36) beat·min^-1, the differences of above index were statistically significant between two groups (all P<0.05). One hour after operation, the visual analogue scale scores of treatment and control groups were (3.08±0.49) and (3.86±0.61) points, the mini-mental state examination scores were (22.65±2.41) and (18.24±2.38) points, the differences were statistically significant (all P<0.05). The adverse drug reactions of treatment group were nausea, while those in the control group were bradycardia, hypotension, respiratory depression and nausea. The total incidences of adverse drug reactions in the treatment and control groups were 2.04% and 14.29%, with statistically significant difference (P<0.05).

Remazolam injection combined with alfentanil injection can help to maintain hemodynamics of patients with hysteroscopic surgery, reduce the risk of postoperative pain and cognitive impairment, with good safety.