Objective To assess home medication adherence among elderly patients with chronic diseases in China,analyze influencing factors,and propose targeted intervention strategies.Methods A cross-sectional survey was conducted from October 2024 to March 2025,covering elderly patients(≥60 years)with chronic diseases across 31 provinces in China.Data were collected through face-to-face interviews by pharmacists,and binary logistic regression analysis was used to examine influencing factors and their interaction effects.Results A total of 6 692 valid questionnaires were collected(response rate:98.47%).The rate of optimal medication adherence was 36.86%(2 467 cases).Facilitators included:female sex(OR=0.869,P=0.040),higher education(junior high school:OR=0.690,P=0.001;senior high/vocational school:OR=0.782,P=0.014),regular disease monitoring(OR=1.443,P=0.033),awareness of medication indications(OR=0.662,P=0.025),ability to describe adverse drug reactions(OR=1.548,P﹤0.01),reviewing drug instructions before use(OR=1.384,P=0.015),and higher medication literacy(OR=0.980,P﹤0.01).Barriers included:larger household size(OR=1.058,P=0.001),employment status(OR=0.731,P=0.001),medical insurance coverage(OR=0.791,P=0.002),and drug-related problems(OR=1.899,P﹤0.01).Educational level plays a pivotal moderating role in the interaction effects.Conclusions Medication adherence among Chinese elderly chronic disease patients remains suboptimal and is influenced by multidimensional factors.Tailored,stratified interventions integrating medical,psychosocial,and pharmaceutical management strategies are warranted to achieve precision care.

Objective To assess home medication adherence among elderly patients with chronic diseases in China,analyze influencing factors,and propose targeted intervention strategies.Methods A cross-sectional survey was conducted from October 2024 to March 2025,covering elderly patients(≥60 years)with chronic diseases across 31 provinces in China.Data were collected through face-to-face interviews by pharmacists,and binary logistic regression analysis was used to examine influencing factors and their interaction effects.Results A total of 6 692 valid questionnaires were collected(response rate:98.47%).The rate of optimal medication adherence was 36.86%(2 467 cases).Facilitators included:female sex(OR=0.869,P=0.040),higher education(junior high school:OR=0.690,P=0.001;senior high/vocational school:OR=0.782,P=0.014),regular disease monitoring(OR=1.443,P=0.033),awareness of medication indications(OR=0.662,P=0.025),ability to describe adverse drug reactions(OR=1.548,P﹤0.01),reviewing drug instructions before use(OR=1.384,P=0.015),and higher medication literacy(OR=0.980,P﹤0.01).Barriers included:larger household size(OR=1.058,P=0.001),employment status(OR=0.731,P=0.001),medical insurance coverage(OR=0.791,P=0.002),and drug-related problems(OR=1.899,P﹤0.01).Educational level plays a pivotal moderating role in the interaction effects.Conclusions Medication adherence among Chinese elderly chronic disease patients remains suboptimal and is influenced by multidimensional factors.Tailored,stratified interventions integrating medical,psychosocial,and pharmaceutical management strategies are warranted to achieve precision care.

Objective To analyze the current state of medication literacy among elderly patients with chronic diseases in urban areas of Beijing,identify its key influencing factors,and propose targeted improvement measures.Methods From February 1 to June 30,2023,a questionnaire survey was conducted among elderly chronic disease patients in 193 communities across 15 districts of Beijing using a convenience sampling method.Data was collected through face-to-face interviews,with a total of 787 questionnaires distributed and 755 valid responses received.The logistic regression analysis model was employed to systematically identify and evaluate the factors affecting patients'medication literacy.Results Among the 755 valid questionnaires collected,53.25%(402 cases)of patients met the medication literacy criteria.Regression analysis results showed that multiple factors significantly influenced medication literacy among elderly patients with chronic diseases,including using rural cooperative medical care or self-payment methods(OR=1.669,P=0.039),retaining medication instructions(OR=0.519,P=0.038),checking medication instructions before use(OR=1.993,P<0.01),and possessing the ability to understand medication instructions(partial understanding OR=2.805,P=0.038;fully understanding OR=3.084,P=0.022)as positive influencing factors;whereas having 2 to 3 chronic diseases(OR=0.574,P=0.039),taking 3 to 5 medications(OR=1.845,P=0.015),and experiencing drug-related problems(OR=1.993,P<0.01)were identified as negative influencing factors.Conclusion Multiple factors influence medication literacy among elderly patients with chronic diseases.To ensure the safety and efficacy of their medication use,It is recommended to implement targeted measures.These include revising patient medication guidance leaflets tailored to age,enhancing patients'understanding of drug instructions,and strengthening medication guidance and social support systems.

Objective This study aims to provide an in-depth analysis of the effectiveness of blood pressure control and the influencing factors in elderly hypertensive patients in urban areas of Beijing,providing scientific support for developing more precise and effective home pharmaceutical intervention strategies.Methods Pharmacists conducted home visits and administered questionnaires to systematically investigate elderly hypertensive patients aged 60 and above in the urban areas of Beijing from February to June 2023.Binary logistic regression was used to identify key factors affecting blood pressure control.Results A total of 575 questionnaires were collected with 560 valid responses,achieving an effective recovery rate of 97.39%.Among the respondents,233 were male(41.61%)and 327 were female(58.39%),with a median age of 69.The proportion of patients with qualified blood pressure control was 33.39%(187 cases).Logistic regression analysis further revealed that smoking,the presence of comorbidities,and multiple comorbid conditions significantly impacted the control rate(P<0.05).Conclusion The blood pressure control rate among elderly hypertensive patients in urban areas of Beijing remains low.It is recommended to develop more targeted home pharmaceutical intervention measures for patients who smoke and have multiple comorbidities to enhance blood pressure control outcomes.

Objective To investigate the correlation between the level change of serum homocysteine (HCY) and vascular endothelial growth factor (VEGF) with the degree of the coronary artery stenosis in the patients with acute coronary syndrome (ACS) .Methods A total of 157 ACS patients were divided into the ST‐elevation myocardial infarction (STEMI) group ,non‐ST el‐evation myocardial infarction (NSTEMI) group and unstable angina pectoris(UA) group based on the symptoms ,cardiac enzymes level and electrocardiogram changes .The cases were induded into the mild ,moderate and severe stenosis lesion groups according to the coronary arteriography examination;meanwhile the enzyme‐linked immunosorbent assay (ELISA) was used to detect the change of the serum VEGF concentration .The HCY level was determined by enzymatic cycling methods with the biochemical analyzer (BXC800 ,Beckman ,USA) .The differences in the concentrations of VEGF and HCY compared among different groups .Results The VEGF level had statistical differences among the mild ,moderate and sever stenosis groups(F=39 .9 ,P=0 .00) ,and between the UA group with the NSTEMI group and STEMI group(F=123 .3 ,P=0 .00) .The HCY level had statistically significant differ‐ence between the severe stenosis group with the mild and moderate stenosis groups (F=39 .7 ,P=0 .00);the HCY level had statis‐tically significant difference among the UA group ,NSTEMI group and STEMI group(F=102 .65 ,P=0 .00) .The VEGF and HCY levels in the mild stenosis group ,different degrees of coronary stenosis groups and different clinical diagnosis groups were positively correlated with the Gensini scores(r=0 .723 ,0 .716) .Conclusion The serum VEGF and HCY levels are correlated with the degree of the coronary artery lesion and myocardial necrosis in ACS patients ,furthermore are related with the Gensini scores .

Objective To investigate the effect and mechanism of liver X receptor ( LXR ) agonist on expression of fatty acid synthase( FAS) in diabetic kidney. Methods In the part of in vivo study, immunostaining was used to detect the FAS protein expression in kidney. 16-week-old male db/db mice on C57BL/6 background were administered via gavage a LXR synthetic agonist, TO901317, at a dose of 3 mg · kg-1 · d-1 or vehicle ( 0. 5%Carboxymethyl Cellulose Sodium, CMC-Na) alone for 7 d;Quantitative RT-PCR and Western blot were used to detect mRNA and protein levels of FAS and SREBP-1. In the part of in vitro study, MCT cell(a mouse murine proximal tubule cell line)was treated with 10μmol/L TO901317 for 24 h or transfected with active SREBP-1c expression vector (SREBP-1cN). HEK293 cells(a human renal tubule cell line)were transfected with mFAS-(1. 7 kb)-luc, LXR expression vector or SREBP-1cN for 12 h. Quantitative RT-PCR and luciferase reproter assay were utilized to examine FAS mRNA level and FAS promoter activity. Results FAS was abundantly expressed in renal cortex, with low expresson in renal glomeruli. The mRNA and protein expressious of FAS in kidney of db/db mice were lowered compared with db/m mice. TO90137 treatment increased FAS mRNA expression by 1. 3-fold. TO901317 increased expression of SREBP-1 in kidneys of db/m and db/db mice by 5. 1-fold and 17-fold, respectively. TO901317 and overexpression of SREBP-1c increased expression of FAS in MCT cells by 1. 5-fold and 1. 8-fold. Transcription activity of FAS were induced by TO901317, LXR, and SREBP-1cN overexpressions in HEK293 cells. Conclusions Both direct(LXRE)and indirect(SREBP-1c)mechanisms may contribute to the up-regulation of FAS expression by LXR in renal proximal tubule cells.

Objective To evaluate the safety of new-generation of antidepressants and amitriptyline in the treatment of depression in patients with coronary heart disease (CHD). Methods A total of 194 patients with first-episode depression with CHD were divided into amitriptyline group(n=40), venlafaxine group(n=40), mirtazapine group(n=48)and escitalo?pram group(n=66). The blood routine test, liver function, blood lipids and blood glucose (GLU) were monitored after treat?ment for six weeks, and which were compared before and after treatment. Results The levels of white blood cells (WBC) and neutrophil count (NE) were significantly lower in amitriptyline group after 6-week treatment (P<0.05), but the levels of acid alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (T-CHO) and GLU were significant?ly increased after treatment than those before treatment (P<0.05). The levels of WBC, NE and GLU were significantly de?creased in venlafaxine group after 6-week treatment (P<0.05). The levels of ALT, AST, low density lipoprotein (LDL) were significantly increased in mirtazapine group after six-week treatment (P<0.05). In escitalopram group, the level of three ac?yl glycerin (TG) was significantly increased after six-week treatment than before treatment ( P<0.05). There was a signifi?cant difference in AST change after treatment between venlafaxine group and mirtazapine group (P<0.05). There was a sig?nificant decrease in WBC in amitriptyline group than that of mirtazapine group after six-week treatment ( P<0.05). There was a significant decrease in NE in amitriptyline group than that of mirtazapine group and escitalopram group ( P<0.05). The increase level of AST was significant higher in amitriptyline group than that of venlafaxine group (P < 0.05). Conclusion Three different kinds of new-generation of antidepressants have fewer influence in routine blood test, liver function, blood lipids and blood glucose than those of amitriptyline in the treatment of depression in patients with CHD.

Objective To evaluate the early diagnosis value of procalcitonin (PCT) in severe brain damage combined with pul‐monary infection .Methods The brain injury patients in the hospital from January to October 2014 were enrolled in the study and divided into infectious group whose infection had occurred within 5 days after admitting to hospital and non‐infectious group who had not suffered from infection .The blood samples of the patients were collected within 2 h and 3 days after admitting to hospital and detected for PCT concentration .The Early diagnosis value of PCT in brain damage combined with pulmonary infection was e‐valuated and compared with white blood cells (WBC) ,neutrophile granulocyte(N)and hypersensitive C‐reactive protein(hs‐CRP) . Results The incidence of pulmonary infection within 5 days of severe brain injury was 22 .9% (41/179) .There were statistically differences of PCT ,WBC ,N and hs‐CRP between infectious group and non‐infectious group(P< 0 .05) .The areas under curve (AUC) of PCT ,WBC ,N and hs‐CRP were 0 .83 ,0 .80 ,0 .78 and 0 .82 respectively .The combination of PCT+WBC+ hs‐CRP had the highest diagnostic value since its AUC was 0 .87 .PCT had a satisfied diagnostic veracity since it had good sensitivity ,specificity and positive predictive value in the diagnosis of brain damage combined with pulmonary infection .Conclusion PCT could be an ear‐ly diagnosis indicator in severe brain damage combined with pulmonary infection ,and the diagnostic veracity is higher when com‐bined with WBC and hs‐CRP .An antimicrobial treatment is recommended when PCT concentration of brain damage patient rises , especially when combined with WBC and hs‐CRP concentration elevating .

Objective To investigate the effect of hosphocreatine therapy on the plasma cardiotrophin-1(CT-1) and N terminal probrain natriuretic (NT-proBNP) in elderly hypertensive patients with heart failure. Methods A total of 76 hy-pertensive patients with heart failure, aged 65 or over, were randomly divided into treatment group and control group (n=38 for each group). The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 2 weeks. The plasma levels of CT-1 and NT-proBNP were determined in two groups. The plasma CT-1 level was measured by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The plasma level of NT-proBNP was tested by Rui Pu fluorescent dry quantitative analyzer. Results The plasma levels of CT-1 and NT-proBNP were significantly lower after treatment in two groups (P＜0.01). The plasma levels of CT-1 and NT-proBNP were significantly decreased in treatment group than those in control group (P＜0.05). The total effective rate was 89.47%in treatment group, which was significantly higher than that of control group (71.05%, P＜0.05). Symptoms of heart failure improved in one week (21 cases in treatment group/9 cases in control group) and in two weeks (13 cases in treatment group/18 cases in control group). Conclusion The conventional therapy plus creatine phosphate sodium can decrease the plasma CT-1 and NT-proBNP levels in elderly hypertensive patients with heart failure, which improves symptoms of heart failure in a shorter period of time.

Objective To investigate the expressions of B7-H1 and PD-1 on peripheral leukocytes from patients with Henoch-Schtmlein purpura(HSP)and their significance.Methods Peripheral leukocytes were obtained from 36 patients with HSP(HSP group)and 24 healthy human controls(control group).Immunofluorescent staining and flow cytometry were used to measure the expressions of B7-H1 and PD-1 on peripheral leukocytes.The expression of both two molecules was compared between the HSP group and control group as well as between patients with Henoch-Sch(o)nlein purpura nephritis(HSPN)(n=9)and those without(n=27).SPSS 12.0 for Windows was used for data analysis.Results The expression rate of B7-H1 on monocytes significantly increased(24.43%±25.79%vs 7.69%±8.31%,t=3.62,P＜0.011),while that of PD-1 decreased(0.84%±1.96%vs 2.28%±1.95%,t=2.78,P＜0.01)in HSP group compared with those in the control group.No significant difference was revealed in the expression of B7-H1 or PD-1 on lymphocytes between HSP group and control group(both P＞0.05).There was a significant increase in the expression of B7-H1 on monocytes(44.81%±12.36%vs 17.63%±25.63%,t=3.05,P＜0.01)and lymphocytes(8.78%±2.10%vs 5.65%±3.96%,t=2.25,P＜0.05)in patients with HSPN compared with those without.Conclusion There is a high expression of B7-H1.but low expression of PD-1 on peripheral blood monocytes from patients with HSP.suggesting that B7-H1 and PD-1 may play a certain role in the Dathogenesis of HSP.