To analyze the clinical characteristics and distribution of pathogens in adult acute empyema.

Adult patients with acute empyema were divided into the control group (patients with community-acquired empyema) and the treatment group (patients with hospital-acquired empyema) according to cohort method. The general data, clinical manifestations, laboratory examinations, imaging data, antimicrobial drugs use, invasive treatment and outcomes of the two groups were collected and compared.

There were 59 cases in the treatment group and 102 cases in the control group. Compared with the control group, the proportion of lung abscess in the treatment group was lower (1.69% vs 10.78%, P<0.05), the proportion of pneumothorax, positive rates of pus culture and mixed infection were higher (47.46% vs 18.63%, 55.93% vs 24.51%, 27.12% vs 1.96%, all P<0.05). In the control group, 27 strains of pathogens were isolated, predominantly Gram-positive cocci (74.07%), with Streptococcus anginosus group being the most common (44.44%). In the treatment group, 52 strains were isolated, predominantly Gram-negative bacilli (67.31%), with Pseudomonas aeruginosa being the most common (21.15%). Streptococcus anginosus group was sensitive to penicilins and cephalosporins, while the multidrug resistance rate of Gram-negative bacilli was high, with Pseudomonas aeruginosa showing a 69.23% resistance to meropenem. Six patients in total died, all from the treatment group and receiving non-surgical treatment, due to malignant tumors or hospital-acquired pneumonia.

In adult acute empyema, non-parapneumonic empyema is common, and there were significant differences in the pathogenic distribution between community-acquired empyema and hospital-acquired empyema.

To observe the efficacy and safety of snake venom hemocoagulase injection combined with tranexamic acid injection and omeprazole sodium injection in the treatment of emergency patients with acute upper gastrointestinal bleeding.

Patients with acute upper gastrointestinal bleeding were divided into control group and treatment group according to the cohort method. Patients in the control group were administered with tranexamic acid injection 500 mg (iv; qd) combined with omeprazole sodium for injection 40 mg (bid); the treatment group was given snake venom hemocoagulase injection 0.5-1.5 kU (once in the morning and once in the evening) on the basis of the control group. All patients were treated for 3 d. The total effective rate, coagulation function [platelet (PLT), activated partial thromboplastin time (APTT), fibrinogen (Fib), plasma prothrombin time (PT)], hemodynamics [plasma viscosity (PV), erythrocyte sedimentation rate (ESR), whole blood high shear viscosity (WBVH) and hematocrit (HCT)], inflammatory stress response [C-reactive protein (CRP), cortisol (Cor) and neutrophil to lymphocyte ratio (NLR)], and adverse drug reactions were compared between two groups.

A total of 120 patients were enrolled in this trial, including 58 in the control group and 62 in the treatment group. After treatment, the effective rates of the control group and the treatment group were 79.31% (46 cases/58 cases) and 95.16% (59 cases / 62 cases), respectively, with statistical difference (P<0.05). After treatment, the PLT levels in the control and treatment groups were (170.18±10.86) and (180.18±9.83)×10⁹·L^-1, respectively; APTT values were (47.39±4.52) and (44.68±4.62), respectively; Fib levels were (2.98±0.33) and (3.21±0.28) g·L^-1, respectively; PT values were (19.21±3.76) and (17.01±2.62) seconds, respectively; PV levels were (1.98±0.36) and (2.38±0.43) MPa·s, respectively; ESR values were (53.69±4.52)% and (59.89±14.62)%, respectively; WBVH levels were (7.08±0.23) and (7.98±0.28) MPa·s, respectively; HCT levels were (49.21±5.62) and (52.01±8.62) L·L^-1, respectively; CRP levels were (8.63±1.36) and (6.38±0.93) mg·L^-1, respectively; Cor values were (323.69±14.82) and (315.86±14.62) mmol·L^-1, respectively; NLP levels were 4.08±0.43 and 2.98±0.48. All these differences were statistically significant (P<0.05). During the trial, the adverse drug reactions in the control group were mainly stomach distension, dizziness, headache and diarrhea, and the adverse drug reactions in the treatment group were mainly stomach distension, dizziness, headache and diarrhea. The total incidences of adverse drug reactions in the control group and the treatment group were 10.34% (6 cases / 58 cases) and 12.90% (8 cases / 62 cases), respectively, with no statistically significant difference (P>0.05).

Snake venom hemocoagulase injection combined with tranexamic acid injection and omeprazole sodium for injection has significant curative effect on emergency patients with acute upper gastrointestinal bleeding, with low adverse drug reactions.

To observe the clinical efficacy of medroxyprogesterone acetate and dinogestrel in the treatment of endometriosis (EMs) respectively.

EMs patients were divided into control group and treatment group according to cohort methods. Control group was given oral treatment with medroxyprogesterone acetate tablets, 10 mg each time, tid. Treatment group was given oral treatment with dinorgestrel tablets, 2 mg each time, qd. Patients in both groups continued to take the drug for 6 menstrual cycles. The levels of clinical efficacy, basal follicle-stimulating hormone (bF-SH), basal estradiol (bE₂), anral follicle count (AFC) and anti-mullerian hormone (AMH) before and after treatment were compared between the two groups.

In this trial, 38 cases were enrolled in the control group and 42 cases in the treatment group. After treatment, the total effective rates of the treatment group and the control group were 90.48% (38 cases / 42 cases) and 71.05% (27 cases / 38 cases), respectively, and the difference was statistically significant (P<0.05). After treatment, the levels of bF-SH in the treatment group and control group were (11.25±3.02) and (13.41±3.56) IU·L^-1, respectively; the bE₂ levels were (2.14±0.63) and (2.58±0.87) pmol·L^-1, respectively; the AFC levels were 7.80±1.69 and 6.97±1.63, respectively; the AMH levels were (1.12±0.14) and (1.03±0.21) ng·mL^-1, respectively; the above indexes were statistically significant (P<0.01,P<0.001). The adverse drug reactions of the treatment group mainly included abnormal vaginal bleeding, hot flashes and increased body weight, while the adverse drug reactions of the control group mainly included bleeding and hot flashes. The incidence of total adverse drug reactions in the treatment group and the control group was 11.90% (5 cases/42 cases) and 7.89% (3 cases/38 cases), respectively, and the difference was not statistically significant (P>0.05).

Dienogest tablets has a good effect in the treatment of EMs patients, which can effectively relieve pain symptoms, inhibit estrogen expression, improve uterine artery blood flow, and reduce the level of inflammation in the body, with low adverse drug reactions.

To observe the clinical efficacy of ulinastatin injection and thymalfasin for injection in the treatment of sepsis patients and their effects on peripheral blood T lymphocyte subsets.

Sepsis patients were divided into control group and treatment group according to the cohort method. The control group was treated with ulinastatin injection in addition to initial resuscitation, hemoperfusion, and antimicrobial therapy. The treatment regimen was intravenous infusion, 2.0×10⁵ U bid for 4 days, followed by intravenous pump infusion, 1.0×10⁵ U bid for 6 days. The treatment group received thymalfasin for injection on base of the control group’s treatment, subcutaneous injection, 1.6 mg twice a week, for 2 weeks. The clinical efficacy, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score, peripheral blood procalcitonin (PCT), lactate (Lac), D-dimer (D-D), and levels of T lymphocyte subsets were compared between the two groups, as well as 28-day mortality rate and safety were evaluated.

A total of 43 patients were enrolled in the control group and 37 patients in the treatment group. After treatment, the total effective rates in the treatment group and the control group were 94.59% (35 cases/37 cases) and 86.05% (37 cases/43 cases), respectively, with no significant difference statistically (P>0.05). After treatment, the SOFA scores in the treatment group and the control group were (5.46±1.20) and (6.71±1.33) points; the APACHE Ⅱ scores were (16.17±3.49) and (18.63±3.82) points; the peripheral blood PCT levels were (1.51±0.33) and (1.88±0.42) μg·L^-1; the Lac levels were (2.73±0.52) and (5.06±1.19) nmol·L^-1; the D-D levels were (0.85±0.27) and (1.02±0.33) mg·L^-1; the CD3⁺ levels were (38.98±4.36)% and (34.42±4.14)%; the CD4⁺ levels were (18.66±2.47)% and (13.17±1.96)%; the CD8⁺ levels were (12.35±1.42)% and (13.01±1.39)%; and the CD4⁺/CD8⁺ ratio were 1.49±0.24 and 1.04±0.22, respectively, all showing statistically significant differences (all P<0.05). The 28-day mortality rates in the treatment group and the control group were 18.92% (7 cases/37 cases) and 23.26% (10 cases/43 cases), respectively, with no significant difference statistically (P>0.05). No drug-related adverse reactions were observed in either group.

The clinical efficacy of thymalfasin for injection in the treatment of sepsis is more ideal than that of ulinastatin alone, as it can better reduce the levels of peripheral PCT, Lac, and D-D, regulate T lymphocyte subsets, demonstrating definite efficacy and safety.

To observe the anesthetic effect of esketamine injection combined with remimazolam injection in radical prostatectomy for prostate cancer.

The patients were divided into the control group and the treatment group according to cohort method. The control group was given anesthesia induction with remimazolam injection at 0.2 mg·kg^-1 combined with propofol injection at 1 mg·kg^-1. The treatment group was given anesthesia induction with esketamine injection at 0.5 mg·kg^-1 combined with remimazolam injection at 0.1 mg·kg^-1. Both groups underwent maintenance of anesthesia with propofol injection at 4-8 mg·kg^-1·h^-1 combined with remifentanil injection at 5-10 μg·kg^-1·h^-1. The analgesic effect, sedative effect, hemodynamics [before anesthesia (T0), tracheal intubation (T1), 30 min after the beginning of surgery (T2), 2 h after surgery (T3)], stress (T0~T3) and safety were compared between the two groups.

The control group and the treatment group were enrolled in 44 cases and 42 cases, respectively. At 3 h, 6 h, 12 h and 24 h after surgery, the Numerical Rating Scale (NRS) scores of the treatment groups were 2.71±0.46, 2.52±0.43, 2.24±0.32 and 2.25±0.29; the dosage of patient-controlled intravenous analgesia (PCIA) was (52.38±6.67) mL. At 3 h, 6 h, 12 h and 24 h after surgery, NRS scores of the control group were 3.49±0.52, 3.27±0.44, 2.73±0.41 and 2.54±0.39; the dosage of PCIA was (64.79±7.45) mL. For the treatment group, heart rate (HR) were (105.48±3.34), (102.67±3.45) and (100.29±1.93) beat·min^-1 from T1, T2, T3; serum cortisol (Cor) levels at T1 and T2 were (257.68±29.18) and (303.75±31.52) nmoL·L^-1; serum superoxide dismutase (SOD) levels at T2 and T3 were (425.85±50.45) and (422.96±50.21) U·L^-1. For the control group, HR were (95.38±2.26), (91.52±2.68) and (87.15±1.40) beats·min^-1 from T1, T2, T3; serum Cor levels at T1 and T2 were (307.36±32.11) and (322.38±33.45) nmoL·L^-1; serum SOD levels at T2 and T3 were (401.23±46.21) and (388.24±45.87) U·L^-1. The differences were statistically significant (all P<0.05). Adverse drug reactions in the treatment group mainly included emergence agitation, nausea and vomiting. Adverse drug reactions in the control group mainly included diplopia, emergence agitation, nausea and vomiting. The total incidence rates of adverse drug reactions in the treatment group and the control group were 13.64% (6 cases/44 cases) and 16.67% (7 cases /42 cases), without statistically significant difference (P>0.05).

Esketamine injection combined with remimazolam injection can achieve good anesthetic effect on patients undergoing radical prostatectomy for prostate cancer, which can effectively alleviate postoperative pain and physiological stress, and facilitate postoperative early functional recovery, with good safety.

To investigate the inhibitory effect of deoxyelephantopin on non-small cell lung cancer (NSCLC) and its potential mechanism.

Human lung adenocarcinoma H1975 cells were randomly divided into control group (routine culture), experimental-L group (1.0 μmol·L^-1 deoxyelephantopin), experimental-M group (2.0 μmol·L^-1 deoxyelephantopin), experimental-H group (5.20 μmol·L^-1 deoxyelephantopin), Vector group (transfected Vector plasmid +5.20 μmol·L^-1 deoxyelephantopin), epidermal growth factor receptor (EGFR) group (transfected with EGFR plasmid+5.20 μmol·L^-1 deoxyelephantopin). 5-ethynyl-2′-deoxyuridine(EdU) assay was used to detected cell proliferation; cell apoptosis were detected by TdT mediated dUDP nick end labeling(Tunel)and flow cytometry; Western blot assay was used to detect the proteins expression; and Transwell assay was used to detect cell migration and invasion.

The proliferation rates of cells in the control group and experimental-L, -M, -H groups were (40.64±2.70)%, (29.78±3.28)%, (23.59±1.98)% and (15.72±1.01)%, respectively; the rates of TUNEL-positive cells were (4.63±0.57)%, (10.18±0.88)%, (15.96±0.79)% and (24.73±3.70)%, respectively; the relative expression levels of phosphorylated epidermal growth factor receptor (p-EGFR) protein were 0.87±0.10, 0.60±0.05, 0.49±0.04 and 0.33±0.04, respectively. Comparisons between the experimental-L, -M, -H groups and the control group, as well as comparisons among the experimental-L, -M, -H groups, revealed statistically significant differences (all P<0.05). The relative expression levels of p-EGFR/EGFR protein in the control group, experimental-H group, Vector group, and EGFR group were 0.76±0.10, 0.49±0.07, 0.47±0.05 and 0.71±0.10, respectively; apoptosis rates were (4.11±0.39)%, (26.33±2.29)%, (25.40±1.58)% and (12.68±1.73)%, respectively; the number of migrating cells was 147.78±12.69, 87.11±9.65, 93.89±9.67 and 124.00±14.10, respectively. Statistical analysis showed significant differences in the above indices between the experimental-H group and the control group, as well as between the EGFR group and the Vector group (all P<0.05).

Deoxyelephantopin can degrade EGFR, inhibit related signaling pathways, inhibit proliferation and metastasis of lung cancer cells, and induce apoptosis.

To investigate the effects and mechanism of wogonoside on the malignant biological behavior of pancreatic cancer SW1990 cells.

Human pancreatic cancer cells SW1990 were cultured in vitro and randomly divided into control group (normal culture), miR-NC group (transfected with miR-NC), miR-573 group (transfected with miR-573 mimics), anti-miR-NC group (transfected with miR-NC + 20 μmol·L^-1 wogonoside), anti-miR-573 group (transfected with anti-miR-573 + 20 μmol·L^-1 wogonoside) and experimental -L, -M, -H groups (given 5, 10 and 20 μmol·L^-1 wogonoside, respectively). The ability of cell proliferation, migration and invasion were detected by methyl thiazolyl tetrazolium assay, plate cloning assay, scratch assay and Transwell assay, respectively; the expression level of microRNA (miR-573) was detected by real-time fluorescence quantitative polymerase chain reaction; Western blot were used to detect the expression levels of E-cadherin and N-cadherin protein.

The inhibition rates of experimental-H group, control group, miR-NC group, miR-573 group, anti-miR-NC group and anti-miR-573 group were (65.37±5.17)%, 0, (6.13±0.58)%, (51.94±4.99)%, (67.74±4.38)% and (28.23±2.47)%, respectively; the scratch healing rates were (27.33±2.52)%, (73.47±6.56)%, (74.27±6.86)%, (36.42±3.14)%, (25.91±2.53)% and (61.49±5.11)%, respectively; the number of invading cells were 58.05±5.46, 124.21±10.25, 126.77±11.89, 64.74±5.63, 56.65±4.79 and 103.94±10.68, respectively; the relative expression levels of miR-573 were 3.11±0.26, 1.00±0.00, 1.00±0.00, 3.96±0.37, 1.00±0.00 and 0.35±0.03, respectively; the relative expression levels of E-cadherin protein were 0.56±0.04, 0.16±0.02, 0.15±0.02, 0.50±0.04, 0.58±0.04 and 0.28±0.03, respectively; the relative expression levels of N-cadherin protein were 0.24±0.02, 0.66±0.04, 0.68±0.05, 0.31±0.03, 0.23±0.02 and 0.55±0.05, respectively. The differences of above indexes were statistically significant between the experimental -H group and the control group, between the miR-573 group and the miR-NC group, and between the anti-miR-573 group and the anti-miR-NC group (all P<0.05).

Wogonoside can decrease the proliferation, migration and invasion of pancreatic cancer cells by up-regulating the expression of miR-573, decreasing the expression of N-cadherin and increasing the expression of E-cadherin.