To compare the effects of different doses of budesonide and formoterol fumarate powder for inhalation combined with montelukast sodium tablet in the treatment of cough variant asthma (CVA) and the improvement of airway function and inflammatory factors.

Elderly patients with cough variant asthma were randomly divided into group A and group B. Both groups of patients received budesonide and formoterol fumarate powder for inhalation combined with montelukast sodium tablet. Group A was given budesonide and formoterol fumarate powder for inhalation(Ⅱ), 2 inhalation per time, twice a day; Group B was given budesonide and formoterol fumarate powder for inhalation, 4 inhalation per time, twice a day; budesonide fumatrol inhalation powder mist for continuous treatment for 6 months, and montelukast sodium tablet 10 mg once a day for at least 3 months. The nighttime cough scores of the two groups were compared before treatment and after treatment. The percentage of forced expiratory volume in one second (FEV₁) in the predicted value, the maximum mid expiratory flow (MMEF), the fractional exhaled nitric oxide (FeNO), interleukin-5 (IL-5) and eosinophils were compared between the two groups. The incidence of adverse drug reactions and the recurrence rate within 1 year were compared between the two groups.

A total of 45 cases were enrolled in both the group A and the group B. At 9 months after treatment, the nocturnal cough scores of the group A and the group B were (0.93±0.42) and (0.65±0.29) points, respectively; the percentage of FEV₁ in the predicted value were (97.75±9.67)% and (100.93±11.06)%, respectively; the MMEF values were (2.81±1.04) and (3.08±1.09) L·s^-1, respectively; the FeNO values were (18.94±9.75) and (15.94±7.96) ppb, respectively; the IL-5 levels were (10.88±7.06) and (8.11±5.56) pg·mL^-1, respectively. The above indicators in group B showed statistically significant differences compared to group A (all P<0.05). The total incidence of adverse drug reactions in group A and group B were 8.89% (5 cases/45 cases) and 13.33% (6 cases/45 cases), respectively. The recurrence rates was 15.56% (7 cases/45 cases) and 13.33% (6 cases/45 cases), respectively. There was no statistically significant difference in the above indicators between group B and group A (all P>0.05).

For elderly patients with CVA, higher dose of budesonide and formoterol fumarate powder for inhalation combined with montelukast sodium tablet can better improve cough symptoms, reduce the level of airway hyperresponsiveness and inflammatory factors, reduce the recurrence rate, and the patients are well tolerated.

To observe the clinical efficacy and safety of vericiguat tablets combined with sacubitril valsartan sodium (Sac/Val) tablets in the treatment of patients with heart failure with reduced ejection fraction (HFrEF).

The HFrEF patients were divided into control group and treatment group according to the cohort method. The control group was treated with Sac/Val tablets 200 mg per time, bid, orally. On the basis of control group, the treatment group was treated with vericiguat tablets 2.5 mg per time, qd, taken with meal. Two groups were treated for 3 months. The clinical efficacy, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and end-systolic diameter (LVESD), levels of high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), nitric oxide (NO), N-terminal pro-brain natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN) and serum creatinine (SCr), and safety were compared between the two groups. During follow-up, the heart failure rehospitalization rates and major adverse cardiovascular events were compared between the two groups.

Treatment group was enrolled 53 patients, control group was enrolled 53 patients. After treatment, the total effective rates of treatment and control groups were 94.34% (50 cases / 53 cases) and 81.13% (43 cases / 53 cases) with statistical significant difference (P<0.05). After treatment, the LVEF of treatment and control groups were (48.02±5.20)% and (43.02±4.33)%, the LVEDDs were (52.85±6.30) and (55.63±6.88) mm, the LVESDs were (41.64±6.40) and (44.22±5.85) mm, the levels of hs-CRP were (10.22±2.63) and (14.60±2.98) mg·L^-1, the levels of IL-6 were (14.48±2.40) and (17.36±2.52) pg·mL^-1, the levels of NO were (102.60±20.16) and (92.16±16.33) μmol·L^-1, the levels of NT-proBNP were (898.74±102.20) and (1315.60±182.64) ng·L^-1, the levels of BUN were (12.02±2.28) and (13.45±2.33) mmol·L^-1, the levels of SCr were (82.22±5.89) and (85.64±6.03) μmol·L^-1, the heart failure rehospitalization rates were 5.66% and 13.21%, respectively; the differences were statistical significant between two groups (all P<0.05). The adverse drug reactions of treatment group were hyperkalemia, hypotension, renal dysfunction, dizziness and headache, while those in control group were renal dysfunction, hyperkalemia, and hypotension. The major adverse cardiovascular events of treatment group were angina pectoris and acute myocardial infarction, while those in control group were angina pectoris, acute myocardial infarction and atrial fibrillation. The incidences of total adverse drug reactions in treatment and control groups were 13.21% and 7.55%, the incidences of major adverse cardiovascular events were 5.66% and 13.21%, respectively, without statistically significant differences (all P>0.05).

Vericiguat tablets combined with Sac/Val tablets have a definitive clinical efficacy in the treatment of HFrEF patients, which can improve cardiac and endothelial function, reduce inflammatory response and readmission times, without increasing the incidences of adverse drug reactions.

To explore the cardiovascular protective effect of dapagliflozin on patients with heart failure with preserved ejection fraction (HFpEF) complicated with type 2 diabetes mellitus (T2DM).

Patients with HFpEF complicated with T2DM were divided into treatment group and control group according to cohort method. The control group was given 0.5 g of metformin hydrochloride tablet orally twice a day, while the treatment group was given 10 mg of dapagliflozin tablet orally once a day on the basis of treatment in the control group. Patients in both groups were continuously treated for 6 months. The clinical efficacy after treatment and blood glucose indicators [fasting blood glucose (FBG), 2 hours postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA1c)], echocardiographic left ventricular parameters [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular remodeling index (LVRI), left ventricular mass index (LVMI)] and serum N-terminal pro-brain natriuretic peptide (NT-proBNP), serum myocardial fibrosis indicators [matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1)] before and after treatment were compared between both groups, and the safety evaluation was performed.

Seventy-five cases in treatment group and 72 cases in control group were included. After treatment, the total effective rates in treatment group and control group were 93.33% (70 cases/75 cases) and 81.94% (59 cases/72 cases), respectively (P<0.05). After treatment, the levels of FBG, 2 h PBG, HbA1c, LVEF and LVEDD revealed no statistical differences between treatment group and control group (all P>0.05). After treatment, LVRI values in treatment group and control group were (2.17±0.41) and (2.54±0.46) g·mL^-2; LAMI values were (102.47±10.32) and (113.84±15.52) g·m^-2; serum NT-proBNP levels were (652.38±208.26) and (993.24±302.69) pg·mL^-1; MMP-9 levels were (142.52±21.67) and (168.73±25.88) mg·L^-1; TIMP-1 levels were (3.68±0.84) and (3.12±0.91) μg·L^-1, respectively (all P<0.05). The total incidence rates of adverse reactions in treatment group and control group were 14.67% (11 cases/75 cases) and 12.50% (9 cases/72 cases), respectively (P>0.05).

Dapagliflozin can improve ventricular remodeling and enhance cardiac function in patients with HFpEF complicated with T2DM, and it has a significant cardiovascular protective effect.

To observe the clinical efficacy and safety of dexamethasone injection combined with tranexamic acid injection in the treatment of patients with hyperfibrinolysis caused by bleeding after prostatic hyperplasia.

Patients with hyperfibrinolysis caused by hemorrhage after prostatic hyperplasia were randomly divided into control group and treatment group. The control group was given 1 g·d^-1 tranexamic acid intravenously. On the basis of the control group, the treatment group was given dexamethasone 10 mg, intravenous injection, q12 h. Both groups were treated continuously for 5 days. The clinical efficacy, coagulation factor level, quality of life (QOL) score, international prostate symptom score (IPSS), and safety were compared between the two groups.

In the treatment group, 52 cases were enrolled, 2 cases fell off, and finally 50 cases were included in the statistical analysis. In the control group, 51 cases were enrolled, 1 case fell off, and finally 50 cases were included in the statistical analysis. After treatment, the total effective rates of treatment group and control group were 94.00% (47 cases /50 cases) and 72.00% (36 cases /50 cases), respectively, and the difference was statistically significant (P<0.05). After treatment, the partial thromboplastin time of treatment group and control group were (35.12±4.38) and (49.14±5.61)s; the prothrombin time were (12.78±1.67) and (16.10±1.94) s; D-dimer levels were (350.42±25.90) and (380.90±37.10) μg·L^-1; QOL scores were (1.16±0.37) and (2.26±0.78) points, IPSS were (4.48±1.22) and (16.12±3.67) points, respectively. The differences of above indexes were statistically significant between two groups (all P<0.05). The adverse drug reactions of two groups were mainly abdominal pain, anemia and headache. The incidences of total adverse drug reactions in treatment group and control group were 6.00% and 16.00%, respectively, without statistical significance (P>0.05).

Dexamethasone injection combined with tranatemylic acid injection has a definitive clinical efficacy in the treatment of patients with bleeding induced hyperfibrinolytic hyperplasia after prostatic hyperplasia, which can significantly improve the coagulation function of patients, relieve symptoms, without increasing the incidence of adverse drug reactions.

To observe the clinical effect of live vaginal Lactobacillus capsule for vaginal use combined with nifuratel nystatin vaginal soft capsule on patients with recurrent vulvovaginal candidiasis (RVVC) and its influence on vaginal microecological environment of patients.

The RVVC patients were divided into the control group and the treatment group according to the cohort method. The patients in the control group were treated with one grain of vaginal embolization before going to bed with nifuratel nystatin vaginal soft capsule. The patients in the treatment group were treated with 0.25 g of vaginal live Lactobacillus capsule in the morning combined with one grain of vaginal embolization before going to bed with nifuratel nystatin vaginal soft capsule. The initial treatment time of the two groups lasted for 7 days. Initial treatment lasted for 7 days in both groups. Pathogenic bacteria culture was performed after 7 days of drug withdrawal. The negative patients were cured, and the cured patients were treated with nifuratel nysfungin vaginal suppository for consolidation treatment once a week for 6 months. The clinical therapeutic effect in the two groups was recorded. The changes in vaginal microecology and human β-defensin (HβD)-3, interleukin (IL)-1β and IL-8 in vaginal secretions were compared between the two groups before treatment and after 7 days of treatment, and the safety evaluation was carried out.

A total of 268 patients were enrolled in this study, including 136 in the treatment group and 132 in the control group. The mycological cure rates of initial treatment in the treatment group and the control group were 84.56% (115 cases/136 cases) and 73.48% (97 cases/132 cases), respectively; the mycological cure rates of consolidation treatment were 82.61% (95 cases/115 cases) and 70.10% (68 cases/97 cases), respectively; the differences were statistically significant (all P<0.05). The proportions of vaginal cleanliness grade Ⅲ-Ⅳ in treatment group and control group after 7 days of treatment were 24.26% and 36.36%; the proportions of vaginal flora density grade Ⅱ-Ⅲ were 79.41% and 68.18%; the proportions of vaginal flora diversity grade Ⅱ-Ⅲ were 77.94% and 65.91%; the proportions of dominant bacteria of Lactobacillus were 82.35% and 68.18%; the levels of HβD-3 in vaginal secretions were (129.65±11.51) and (135.87±10.46) pg·mL^-1; IL-1β levels were (65.48±9.27) and (72.46±10.38) pg·mL^-1; IL-8 levels were (159.36±12.50) and (176.30±13.19) pg·mL^-1 , and the differences were statistically significant (all P<0.05). The total incidence rates of adverse drug reactions in the treatment group and control group were 23.53% (32 cases/136 cases) and 18.38% (25 cases/132 cases), respectively (P>0.05).

Compared with nifuratel nysfungin vaginal soft capsule therapy, the combination of vaginal live Lactobacillus capsule can improve the vaginal microecology of RVVC patients, and the cure rate of vaginal fungal infection is higher, with better safety.

To explore the clinical efficacy and safety of alendronate sodium tablet combined with injection of recombinant teriparatide and calcium carbonate D₃ tablet in the treatment of postmenopausal osteoporosis (PMDP).

The patients with postmenopausal osteoporosis were divided into control group and treatment group according to the cohort method according to the treatment regimen. The control group was treated with calcium carbonate D₃ tablet (600 mg, 1 tablet a day) and alendronate sodium tablet (70 mg, once a week), while the treatment group was given injection of reacombinant teriparatide (200 U/20 μg, 20 μg every day) on the basis of the control group. Both groups were continuously treated for 6 months. The clinical efficacy was compared after 6 months of treatment. The bone mineral density (BMD) of lumbar spine, total hip and femoral neck and levels of bone metabolism indicators [osteocalcin (OCN), tartrate-resistant acid phosphatase-5b (TRAP-5b), procollagen type Ⅰ amino-terminal propeptide (PINP), C-terminal cross-linked peptide of type Ⅰ collagen (CTX-Ⅰ)]before treatment and after 6 months of treatment and bone pain [visual analogue scale (VAS)]and quality of life [European Foundation Osteoporosis Quality of Life Questionnaire (ECOS-16)]before treatment and after 3 and 6 months of treatment were recorded, and the adverse drug reactions within 6 months of treatment were compared.

Fifty-two cases in treatment group and 64 cases in control group were enrolled. After treatment, the total effective rates in treatment group and control group were 87.80% (36 cases/41 cases) and 68.29% (28 cases/41 cases), respectively (P<0.05). The BMD values of lumbar spine in treatment group and control group after treatment were (0.69±0.15) and (0.79±0.18) g·cm^-2; the BMD values of total hip were (0.70±0.11) and (0.77±0.15) g·cm^-2; the BMD values of femoral neck were (0.79±0.19) and (0.87±0.15) g·cm^-2, respectively; the OCN levels were (7.42±1.53) and (5.37±1.16) μg·L^-1; the PINP levels were (85.31±5.66) and (76.30±5.49) ng·mL^-1; the TRAP-5b levels were (3.27±0.46) and (5.16±0.72) U·L^-1; the CTX-I levels were (3.37±0.54) and (5.08±0.70) ng·mL^-1; the VAS scores were (1.48±0.13) and (2.07±0.24) points; the ECOS-16 scores were (24.84±4.62) and (32.71±6.07) points, and there were statistical differences in the above indicators between treatment group and control group (all P<0.05). The main adverse drug reactions in treatment group were rash, dizziness and limb pain, and the main adverse drug reactions in control group were rash, dizziness, nausea, and limb pain, and the total incidence rates of adverse reactions in treatment group and control group were 12.20% (5 cases/41 cases) and 19.51% (8 cases/41 cases) (P>0.05).

Alendronate sodium tablet combined with injection of recombinant teriparatide and calcium carbonate D₃ tablet has a significant short-term efficacy on PMOP patients, and it can help to enhance the bone mineral density, reduce the symptoms of bone pain, and relieve the osteoporosis.

To explore the clinical effects and influencing factors of recombinant human growth hormone (rhGH) treatment in pediatric patients with growth hormone deficiency.

The study subjects were pediatric patients with growth hormone deficiency, all of whom received a combination therapy of stanozolol tablets 2 mg (qd) and 0.1 U·kg^-1·d^-1 of recombinant human growth hormone injection for a continuous period of one year. After one year, the patients were divided into active group and invalid group based on clinical outcomes. Comparisons were made between the two groups in terms of height, annual growth velocity (GV) and height standard deviation score (HtSDS) before and after treatment, and safety evaluations were conducted. Multivariate Logistic regression analysis was used to identify factors that influenced the treatment outcomes in pediatric patients with growth hormone deficiency.

After one year of treatment, a total of 93 cases pediatric patients were included in the analysis, with 62 cases in the active group and 31 cases in the invalid group. The heights of the patients before and after treatment were (119.40±2.48) and (129.08±2.37) cm, respectively; the GV were (3.08±0.39) and (7.34±1.02) cm·year^-1, respectively; the HtSDS were -2.45±0.49 and -1.68±0.35, respectively, with statistically significant differences observed for all comparisons (all P<0.05). In the active and invalid groups, the proportions of patients with GV<3.0 cm·year^-1 before treatment were 32.26% and 58.06%, respectively; the proportions of patients with peak growth hormone (GH) levels <5.0 ng·mL^-1 before treatment were 30.65% and 54.84%, respectively; the average maternal heights were (158.83±5.76) and (155.48±6.58) cm, respectively, with statistically significant differences observed for all comparisons (all P<0.05). The results of the Logistic regression model showed that GV<3.0 cm·year^-1 before treatment, peak GH levels <5.0 ng·mL^-1 before treatment, and a shorter maternal height were independent risk factors for poor treatment outcomes with rhGH in pediatric patients with growth hormone deficiency (all P<0.05). No severe adverse reactions occurred during the treatment of any patient; seven patients experienced pain at the injection site, one patient had a slight increase in blood glucose, and five patients had mild decreased appetite. The total incidence of adverse drug reactions were 13.98% (13 cases/93 cases).

Treatment with rhGH for pediatric patients with growth hormone deficiency can significantly improve height development and has good safety, but it is influenced by factors such as growth velocity, peak GH levels, and maternal height.

To investigate the effect of subanesthetic dose esketamine hydrochloride injection combined with midazolam injection on hip replacement in elderly patients.

The elderly patients undergoing hip replacement were divided into control group and treatment group. The control group was given 0.02 mg·kg^-1 midazolam injection; the treatment group was given 0.02 mg·kg^-1 midazolam injection combined with 0.25 mg·kg^-1 esketamine hydrochloride injection. Anesthesia (sedation, analgesic effect), hemodynamic indexes, and safety evaluation.

There were 90 cases in the treatment group and 90 cases in the control group. The scores of sedation in the treatment group and the control group were (1.54±0.28) and (1.67±0.35) points, respectively; the scores of pain simulation at 2 h after operation were (3.16±0.47) and (3.38±0.59) points, respectively; at the end of the operation, the mean arterial pressure of the treatment group and the control group were (83.06±2.47) and (82.15±2.94) mmHg, respectively; the heart rate were (82.04±3.25) and (80.75±3.32) time·min^-1, respectively, and the difference was statistically significant (all P<0.05). The total incidence of adverse drug reactions in the treatment group and the control group was 8.89% (8 cases /90 cases) and 13.33% (12 cases /90 cases), respectively, with no statistical significance (P>0.05).

The subanesthetic dose of esketamine hydrochloride injection combined with midazolam hydrochloride injection can effectively stabilize the hemodynamic level of the body and reduce postoperative pain in elderly patients with hip replacement with good safety.