Objective To explore the effects on self-efficacy and health behavior change in elderly patients with chronic diseases in community by motivational interviewing and to provide the basis for the health behavior management of elderly patients with chronic diseases in community.Methods The study was based on a cross-section investigation by random cluster sampling which included a sample of 287 elderly patients.The questionnaire was localized good life club questionnaire of Australia,including demographic data,prevalence of chronic diseases,health-related indicators,self-health assessment,psychological pressure measurement,life satisfaction scale and assessment of behavior change stage.A total of 265 valid questionnaires were effective,and the effective rate was 92.3％.Results The scores of self-reported symptoms and life satisfaction of patients with chronic diseases after motivational interviewing were significantly higher than before (F=8.527,7.697; P＜0.05),the scores of stress scale and behavior change stages were significantly lower than before (F=229.483,91.613; P＜0.01).The score differences with health self-assessment,functional status and social function evaluation were not statistically significant(F=0.222,2.084,P＞0.05).The number of patients who believed their health are better rose from 102 to 114,the number of patients whose life satisfaction were moderate and above rose from 255 to 265,and the number of high risk of psychological stress reduced from 5 to 1.In the stages of behavior change,the number of people in the action stage rose from 1 to 20,and the number of people in the preparation stage rose from 138 to 215 after the intervention.Conclusion Motivational interviewing can strengthen the self-efficacy in elderly patients with chronic diseases in community significantly and promote healthy behavior change.It is necessary to provide ongoing support for motivational interviewing to consolidate its behavior change outcomes,because of the complexity of the development process of behavior change stages.

OBJECTIVE To evaluate the clinical effectiveness and safety of domestic generic and imported original clopidogrel for antiplatelet therapy in patients with acute coronary syndrome （ACS）. METHODS The clinical data of ACS patients in Nanjing Drum Tower Hospital of China Pharmaceutical University from January 2020 to June 2021 were retrospectively collected by using electronic medical record system， and the patients were divided into original drug group （321 cases） and generic drug group （328 cases） according to the drug use. Both groups were given dual antiplatelet therapy with clopidogrel and aspirin. The effectiveness and safety outcomes of the two groups were followed up for 12 months and compared， the related influential factors were analyzed. RESULTS Major adverse cardiovascular events （MACE） occurred in 16 and 22 patients in original drug group and generic drug group respectively， including nonfatal myocardial infarction （4 and 5 cases）， stroke （2 and 4 cases）， revascularization （8 and 3 cases）， cardiovascular related death （2 and 4 cases）， and all-cause death （4 and 6 cases）. There were 12 and 7 patients with major bleeding events， 38 and 29 patients with minor bleeding events， and 33 and 21 patients with non-bleeding adverse events. There was no statistically significant difference in the cumulative incidence of related events （P values of Log-Rank tests were all greater than 0.05）. Cox regression analysis showed that the use of generic clopidogrel did not increase the risk of MACE and major bleeding events in ACS patients [hazard ratio of 1.305 and 0.416， 95% confidence interval of （0.678， 2.512） and （0.155， 1.117）， respectively， P＞0.05]， and the combination of proton pump inhibitors （PPI） could reduce the risk of major bleeding events [hazard ratio of 0.196， 95% confidence interval of （0.063， 0.611）， P＜0.05]. CONCLUSIONS Compared with imported original drug， domestic generic clopidogrel has similar clinical effectiveness and good safety. Combined use of PPI may be a beneficial factor to reduce the occurrence of major bleeding events in patients.