BACKGROUND: Stroke frequently results in oropharyngeal dysfunction (OD), leading to difficulties in swallowing and eating, as well as triggering negative emotions, malnutrition, and aspiration pneumonia, which can be detrimental to patients. However, routine nursing interventions often fail to address these issues adequately. Systemic and psychological interventions can improve dysphagia symptoms, relieve negative emotions, and improve quality of life. However, there are few clinical reports of systemic interventions combined with psychological interventions for stroke patients with OD.
OBJECTIVE: To explore the effects of combining systemic and psychological interventions in stroke patients with OD.
METHODS: This retrospective study included 90 stroke patients with OD, admitted to the Second Affiliated Hospital of Qiqihar Medical College (January 2022-December 2023), who were divided into two groups: regular and coalition. Swallowing function grading (using a water swallow test), swallowing function [using the standardized swallowing assessment (SSA)], negative emotions [using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS)], and quality of life (SWAL-QOL) were compared between groups before and after the intervention; aspiration pneumonia incidence was recorded.
RESULTS: Post-intervention, the coalition group had a greater number of patients with grade 1 swallowing function compared to the regular group, while the number of patients with grade 5 swallowing function was lower than that in the regular group (P < 0.05). Post-intervention, the SSA, SAS, and SDS scores of both groups decreased, with a more significant decrease observed in the coalition group (P < 0.05). Additionally, the total SWAL-QOL score in both groups increased, with a more significant increase observed in the coalition group (P < 0.05). During the intervention period, the total incidence of aspiration and aspiration pneumonia in the coalition group was lower than that in the control group (4.44% vs 20.00%; P < 0.05).
CONCLUSIONS: Systemic intervention combined with psychological intervention can improve dysphagia symptoms, alleviate negative emotions, enhance quality of life, and reduce the incidence of aspiration pneumonia in patients with OD.

BACKGROUND: Depression is a common, chronic, and recurrent mood disorder that has become a worldwide health hazard. Fluoxetine hydrochloride, a common treatment method, can inhibit 5-hydroxytryptamine (5-HT) recycling in the presynaptic membrane; however, the efficacy of a single drug is inadequate. At present, mild-to-moderate depression can be treated with acupuncture of ghost caves, but the clinical curative effect of combined therapy with fluoxetine hydrochloride has not been sufficiently reported.
OBJECTIVE: To evaluate the clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride in the treatment of mild-to-moderate depression.
METHODS: This retrospective study included 160 patients with mild-to-moderate depression who were admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated to Shanghai University of Traditional Chinese Medicine, between January 2022 and June 2023. Patients were separated into a single-agent group (fluoxetine hydrochloride treatment, n = 80) and a coalition group (fluoxetine hydrochloride treatment combined with acupuncture at ghost points, n = 80). Pre-treatment symptoms were recorded, and the clinical curative effect and adverse reactions [Asberg Antidepressant Side Effects Scale (SERS)] were assessed. Depression before and after treatment [Hamilton Depression Scale (HAMD)-24], neurotransmitter levels [5-HT, norepinephrine (NE), dopamine (DA)], oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were compared.
RESULTS: The total efficacy rate was 97.50% in the coalition group and 86.25% in the single-agent group (P < 0.05). After 2, 4, 6, and 8 wk of treatment, the HAMD, self-rating depression scale, and SERS scores of the coalition and single-agent groups decreased compared with pre-treatment, and the decrease was more significant in the coalition group (P < 0.05). After 8 wk of treatment, the levels of NE, DA, 5-HT, and SOD in the coalition and single-agent groups increased, while the levels of MDA decreased; the increases and decrease in the coalition group were more significant (P < 0.05). The PSQI scores of the coalition and single-agent groups decreased, and the decrease was more significant in the coalition group (P < 0.05).
CONCLUSIONS: Acupuncture at ghost points combined with paroxetine tablets can safely improve depressive symptoms and sleep disorders, regulate neurotransmitter levels, and reduce stress responses in patients with mild-to-moderate depression.

BACKGROUND: Currently, there is a scarcity of reliable biomarkers that can accurately forecast the outcome and prognosis of transarterial chemoembolization (TACE). In this study, we assessed the diagnostic efficacy of serum glutathione reductase (GR) as a biomarker for hepatocellular carcinoma (HCC) and its practicality in predicting TACE treatment response.
METHODS: The baseline positive rate and level of serum GR were analyzed and compared between HCC group and control group. Serum GR levels were assessed at three specific time points in 181 patients with unresectable HCC who underwent TACE (HCC-TACE). The correlation between serum GR levels and clinical pathological factors, tumor reactivity, and prognosis was investigated. The modified Response Evaluation Criteria in Solid Tumors (mRECIST) was utilized for assessing the treatment response to TACE. A nomogram for predicting the response to TACE treatment efficacy was developed.
RESULTS: Serum GR demonstrated superior diagnostic performance in HCC patients. The baseline levels of serum GR were associated with the patient\'s age, tumor size, BCLC staging, and tumor thrombi of the portal vein (TTPV) (p < 0.05). Elevated baseline levels of serum GR were also identified as independent prognostic factors for predicting lower overall survival (OS) and shorter time to radiological progression (TTP) (p < 0.001). Moreover, it is worth noting that non-responders group exhibited a substantial increase in median GR level in the fourth week following TACE treatment (p < 0.0001), whereas the median GR level of responders group did not display a significant augmentation (p > 0.05). Lastly, the changes in serum GRt1-t3 were negatively correlated with TTP (p < 0.001). The nomogram developed to predict the risk of mRECIST responsiveness in patients with HCC-TACE demonstrated excellent discriminatory ability.
CONCLUSIONS: Serum GR can serve as a valuable biomarker for the diagnosis of HCC and for predicting the therapeutic efficacy and prognosis of TACE treatment.

UNASSIGNED: Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing comprehensive treatment outcomes for depression.
UNASSIGNED: This study was a prospective, randomized, controlled, double-blind trial involving subjects and evaluators. One hundred eleven patients scheduled for ECT were randomly assigned to three groups. In Group P, propofol at 1mg/kg was administered intravenously. In Group P+E, propofol at a dosage of 0.5mg/kg and esketamine at a dosage of 0.5mg/kg was administered intravenously. Patients in Group P+SE received propofol at a dosage of 0.75mg/kg and esketamine at a dosage of 0.25mg/kg. The same anesthesia protocol was used for the same patient until the end of the last treatment. The primary outcome measures were the Hamilton depression scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9), the Columbia-Suicide Severity Rating Scale (C-SSRS), and the Digit symbol substitution test (DSST). Secondary outcomes included length of hospital stay, readmission rate, hemodynamic status, recovery, and adverse events.
UNASSIGNED: This study aimed to compare the effects of propofol combined with different doses of esketamine for ECT. The results may provide a better choice for ECT anesthesia.

UNASSIGNED: To evaluate the clinical efficacy and safety of baloxavir marboxil tablets in the treatment of influenza A.
UNASSIGNED: According to a random sequence generated by computer software, 200 patients with confirmed influenza A were divided into a study group and a control group with 100 cases in each group. Group allocation was concealed using sealed envelopes. The study group was treated with oral administration of baloxavir marboxil tablets, 40 mg once. The control group was given oral oseltamivir capsules, 75 mg twice a day, for five consecutive days. The therapeutic effects, symptom disappearance time and adverse drug reactions of the two groups after 5 days of treatment were compared.
UNASSIGNED: There was no significant difference in the total effective rate between the two groups (99% vs. 98%, p > 0.05). There was no significant difference in fever subsidence time (1.54 ± 0.66 d vs. 1.67 ± 0.71 d, p > 0.05), cough improvement time (2.26 ± 0.91 d vs. 2.30 ± 0.90 d, p > 0.05) and sore throat improvement time (2.06 ± 0.86 d vs. 2.09 ± 0.83 d, p > 0.05) between the two groups. There was no significant difference in the incidence of adverse drug reactions between the two groups (8% vs. 13%, p > 0.05).
UNASSIGNED: Baloxavir marboxil tablets can be effectively used in the treatment of patients with influenza A and have a similar efficacy and safety profile as oseltamivir capsules.

The aim of the present study was to investigate the possibility of reducing the damage to the donor site while preserving the functional recovery of the dorsum of the hand following burn injury. An attempt was made to analyze the effect of a phased surgery approach on inflammatory indicators. A two-phase treatment was administered on a total of 64 patients with deep second-degree burns on the dorsum of the hand who were admitted to Guangzhou Red Cross Hospital between January 2020 and March 2023. During phase I treatment, the wounds were covered with xenogeneic (porcine) skin, followed by the application of autologous thin intermediate thickness skin grafts for wound repair in phase II treatment 1 week later. The surgical results, complications, patient satisfaction and inflammatory response indicators were then analyzed. The mean wound healing time of these patients was found to be 21.94 days without complications. The mean survival rate was 98.66%, and the overall satisfaction score of the patients was high. Finally, the white blood cell, C-reactive protein and IL-6 levels of these patients were continuously decreased 2 days preoperatively and 2 days postoperatively in phase I, and 2 days preoperatively and 2 days postoperatively in phase II. In combination, the effect of phased autologous skin grafting in patients with severe second-degree burns on the dorsum of the hand was ideal, as it significantly reduced inflammatory response and was beneficial to the functional recovery of the hand. Therefore, phased autologous skin grafting is worthy of wider application.

UNASSIGNED: This study aimed to investigate the curative effect of motherwort combined with ethinylestradiol-cyproterone acetate (EE/CPA) on dysfunctional uterine bleeding (DUB).
UNASSIGNED: Atotal of 68 patients with DUB were divided into a single medication group (treated with EE/CPA) and a combination medication group(treated with motherwort and EE/CPA). The clinical efficacy, uterine hemodynamic parameters, sex hormone levels, coagulation index levels, blood routine test levels, and adverse reactions of patients were evaluated.
UNASSIGNED: After three months of treatment, total treatment response rate of the combination medication group was significantly higher than that of the single medication group. Decreased uterine volume, endometrial thickness and resistance index (RI), increased pulsatility index(PI), average flow rate, and uterine artery blood flow, as well asreduced follicle-stimulating hormone (FSH), luteinizing hormone (LH),estradiol (E2), progesterone (P), activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen (FIB), thrombin time(TT), platelet count (PLT), red blood cell (RBC), and hemoglobin (Hb)levels were witnessed in patients of the two groups. In thecombination medication group, there exhibited reduced uterine volume, endometrial thickness and RI, elevated PI, average flow rate, and uterine artery blood flow, reduced P, E2, FSH, LH, aPTT, PT, FIB, TT,PLT, RBC, and Hb levels in comparison to the single medication group.
UNASSIGNED: The combination of motherwort and EE/CPA is clinically effective in the treatment of DUB.

BACKGROUND: Diabetes and thyroiditis are closely related. They occur in combination and cause significant damage to the body. There is no clear treatment for type-2 diabetes mellitus (T2DM) with Hashimoto\'s thyroiditis (HT). While single symptomatic drug treatment of the two diseases is less effective, combined drug treatment may improve efficacy.
OBJECTIVE: To investigate the effect of a combination of vitamin D, selenium, and hypo-glycemic agents in T2DM with HT.
METHODS: This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023. Fifty patients were assigned to the control group, test group A, and test group B according to different treatment methods. The control group received low-iodine diet guidance and hypoglycemic drug treatment. Test group A received the control treatment plus vitamin D treatment. Test group B received the group A treatment plus selenium. Blood levels of markers of thyroid function [free T3 (FT3), thyroid stimulating hormone (TSH), free T4 (FT4)], autoantibodies [thyroid peroxidase antibody (TPOAB) and thyroid globulin antibody (TGAB)], blood lipid index [low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triacylglycerol (TG)], blood glucose index [fasting blood glucose (FBG), and hemoglobin A1c (HbA1c)] were measured pre-treatment and 3 and 6 months after treatment. The relationships between serum 25-hydroxyvitamin D3 [25 (OH) D3] level and each of these indices were analyzed.
RESULTS: The levels of 25 (OH) D3, FT3, FT4, and LDL-C increased in the order of the control group, test group A, and test group B (all P < 0.05). The TPOAB, TGAB, TC, TG, FBG, HbA1c, and TSH levels increased in the order of test groups B, A, and the control group (all P < 0.05). All the above indices were compared after 3 and 6 months of treatment. Pre-treatment, there was no divergence in serum 25 (OH) D3 level, thyroid function-related indexes, autoantibodies level, blood glucose, and blood lipid index between the control group, test groups A and B (all P > 0.05). The 25 (OH) D3 levels in test groups A and B were negatively correlated with FT4 and TGAB (all P < 0.05).
CONCLUSIONS: The combination drug treatment for T2DM with HT significantly improved thyroid function, autoantibody, and blood glucose and lipid levels.

Background: Rheumatoid arthritis (RA) is an erosive-destructive inflammation of the joints, and the chronic, long-term stiffness and deformation induced by RA are some of the symptoms of arthritis that are difficult to treat. Dexamethasone (DEX) and melittin (MLT) are two interesting anti-inflammatory substances, both of which possess anti-inflammatory effects exerted through the suppression of the immune system. The purpose of this study was to explore the role of MLT in the treatment of RA by DEX as well as to clarify the influence of MLT on the efficacy and side effects of DEX. Method: The rats were injected with Complete Freund\'s Adjuvant (CFA) to induce arthritis, followed by treatment with different doses of DEX and/or MLT. The relevant indexes of paw inflammation were determined, and the appetite, growth status, arthritis status, cytokine levels, and organ coefficient of the rats were evaluated. In addition, the paraffin sections of the joint tissues were prepared to analyze the pathological changes. Result: DEX exhibited side effects, notably hindering feed intake and growth, and inducing immune organ lesions in the rats. MLT significantly reduced the side effects of DEX and promoted its efficacy. DEX in combination with MLT demonstrated a synergistic efficacy in RA treatment, showing advantages in detumescence reduction, pro-inflammatory cytokine inhibition, and joint internal pathological improvement. Conclusion: Thus, MLT promoted the efficacy of DEX in adjuvant RA treatment in rats, offering an approach to reduce the use dosage and side effects of DEX.

BACKGROUND: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopharyngeal, oropharyngeal, soft palate, and tongue base areas. The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation. Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation. Nevertheless, there is a lack of clinical application and imaging evidence.
OBJECTIVE: To investigate the clinical efficacy and mechanisms of a mid-frequency anti-snoring device in treating moderate OSAHS.
METHODS: We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023. They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep. Following the treatment, we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores. Additionally, we performed computed tomography scans of the oropharynx in the awake state, during snoring, and while using the mid-frequency anti-snoring device. Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas.
RESULTS: Compared to pretreatment measurements, patients exhibited a significant reduction in the apnea-hypopnea index, the percentage of time with oxygen saturation below 90%, snoring frequency, and the duration of the most prolonged apnea event. The lowest oxygen saturation showed a notable increase, and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved. Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state. Conversely, during mid-frequency anti-snoring device treatment, these areas increased compared to snoring.
CONCLUSIONS: The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS, thereby improving their quality of life and reducing daytime sleepiness. These therapeutic effects are attributed to the device\'s ability to ameliorate the narrowing of the oropharynx in OSAHS patients.