Chronic rhinosinusitis (CRS) requires long-term intranasal corticosteroid (INCS) therapy, yet comparative data on adherence, symptom control, and recurrence are scarce. This study compared beclomethasone dipropionate (BDP) and mometasone furoate (MFNS) nasal sprays over 18 months. We included patients with non-acute CRS (January 2019-January 2024) who initiated 18-month INCS monotherapy. We obtained data from electronic medical records. Using 1:1 propensity score matching on the initial prescription, we assigned 250 patients to each group. Outcome measures comprised: overall and stage-specific adherence over 18 months; Visual Analog Scale (VAS), Sino-Nasal Outcome Test-22 (SNOT-22), and Chronic Rhinosinusitis Patient-Reported Outcomes (CRS-PRO) scores before treatment and at 6, 12, and 18 months. We assessed clinical recurrence (VAS >= 5), local adverse event rates, and recurrence risk factors using multivariate logistic regression. After propensity score matching (PSM), baseline characteristics were comparable between groups (all p>0.05). The BDP group showed significantly higher cumulative adherence over 18 months and a greater percentage of high adherers during months 10-18 (p<0.05). At 12 and 18 months, BDP achieved superior VAS, SNOT-22, and CRS-PRO scores (p<0.05). Clinical recurrence rates were also significantly lower with BDP at these time points (p<0.05). Multivariate analysis identified treatment type, nasal polyps, and diabetes as independent predictors of recurrence (p<0.05). Adverse events did not differ significantly between the two groups (p>0.05). In this retrospective study, BDP was associated with better adherence, symptom control, quality of life, and lower recurrence versus MFNS, with comparable safety.
This study examined the effect of early recumbent cycling on postoperative gastrointestinal recovery in patients undergoing surgery for ma-lignant gynecological tumors. Between January 2024 and February 2025, we se-lected 80 patients undergoing surgery for malignant tumors in the Gynecology Department of the Second Affiliated Hospital of Wenzhou Medical University using convenience sampling. We randomly assigned participants using block randomization to the cycling intervention group (n=40) or the control group receiving conventional care (n=40). The control group received routine post-operative care, while the intervention group began recumbent cycling six hours after regaining consciousness from anesthesia. We assessed the following out-comes: time to return of bowel sounds, first flatulence, first bowel movement, the score of eating - nausea - vomiting - physical examination-symptom duration (I-FEED) and the recovery quality score (QOR-15). Seventy-seven participants completed the study (intervention: n=39; control: n=38). The intervention group had earlier onset of flatulence, earlier defecation, and faster recovery of bowel sounds. The I-FEED score was significantly lower (p<0.001), and the QOR-15 score was significantly higher (p<0.001) in the intervention group. In conclusion, early recumbent cycling is an effective non-pharmacological inter-vention that promotes postoperative gastrointestinal recovery in patients with malignant gynecological tumors.
This pilot study aimed to determine the median effective con-centration (EC50) of ropivacaine for continuous adductor canal block analgesia after total knee arthroplasty (TKA). Twenty-five patients undergoing TKA under spinal anesthesia were enrolled. All patients received local infiltration analgesia around the joint at the end of surgery, followed by ultrasound-guided adductor canal catheter placement. The initial analgesic dose was 15 mL of 0.33% ropi-vacaine. The nerve block catheter was then connected to a portable infusion pump. The ropivacaine concentration in the infusion pump was adjusted us-ing the up-and-down sequential method, with a starting concentration of 0.2% and a step ratio of 1.1. The study ended after six up-and-down cycles. The EC50of ropivacaine and its 95% confidence interval (CI) were calculated using the Dixon-Massey formula. The EC50 of ropivacaine in continuous adductor canal block for analgesia after total knee arthroplasty was 0.096%, with a 95% CI of 0.088%-0.105%. This concentration may reduce the risk of motor block and falls while maintaining adequate analgesia.
Erythropoietin is a hormone with both hematopoietic and tissue-protective effects. Epoetin alpha is a derivative of erythropoietin that crosses the blood-brain barrier. Epoetin alpha has neuroprotective effects in models of neurological disease. Although erythropoietin-related compounds have shown neuroprotective and antidepressant-like effects in previous preclinical studies, the effects of chronic epoetin alpha administration on depression-like behaviors and depression-related molecular markers remain insufficiently characterized. We aimed to investigate the effect of chronic epoetin alpha on depression-like behaviors. Adult female Wistar Albino rats (n = 24) were divided into a control, 1000 U epoetin alpha and 2000 U epoetin alpha groups. We administered epoe-tin alpha intraperitoneally once a week for four weeks. We examined locomotor activity in the open field test and depression-like behavior in the forced swim-ming test. The serotonergic marker tryptophan hydroxylase 2 (TPH2) mRNA, the norepinephrine transporter (NET) mRNA, and brain-derived neurotrophic factor (BDNF) mRNA levels were analyzed in the brain. We used ANOVA and Tukey tests for statistical analysis. Epoetin alpha displayed remarkably antide-pressant-like effects without dose dependence. Furthermore, this treatment did not alter locomotor activity. TPH2, NET, and BDNF mRNA levels increased with epoetin alpha administration. The present study found beneficial effects of epo-etin alpha on depression-like behaviors and also regulated key molecules for the pathophysiology of depression. Further investigations on the impact of deriva-tives of the erythropoietin hormone on depression-like behaviors are needed.
We aimed to explore risk factors for the development of adenomatous intestinal polyps and to establish a clinical prediction model. Subjects (280 in total) were retrospectively recruited from patients who underwent colonoscopy from March 2022 to June 2024 and were assigned to an occurrence group (n=119, with adenomatous intestinal polyps based on pathological examinations) or a non-occurrence group (n=161, without obvious abnormalities based on colonoscopy). Their clinical data and serum indicators were collected. Gender (male), age >= 60 years, gallstones, fatty liver, and high regulator of G-protein signaling (RGS19) expression were risk factors for the occurrence of adenomatous intestinal polyps (p<0.05). Decision curve analysis showed awide threshold probability range, indicating high predictive value for adenomatous intestinal polyps. Calibration curve analysis showed good predictive discrimination. The area under the receiver operating characteristic curve, sensitivity, and specificity of the model for predicting the occurrence of adenomatous intestinal polyps were 0.878 (95% confidence interval: 0.834-0.922), 89.57%, and 90.65%, respectively, suggesting high accuracy. The model constructed based on these risk factors had high predictive value for the occurrence of adenomatous intestinal polyps, which is conducive to accurate assessment.
