Objective To analyze temporal trends in infectious disease burden among Chinese elderly(≥60 years)using data from the Global Burden of Disease Study(GBD 2021),evaluate age-period-cohort effects on disease burden,predict trends through 2045,and propose evidence-based medication management strategies.Methods We conducted a threefold analysis of infectious disease burden from 1990 to 2021 using Joinpoint regression to identify temporal trends,Age-Period-Cohort(APC)modeling to disentangle epidemiological effects,and Nordpred projections for 2045 disease burden estimates.Results Over 32 years,all infectious disease categories except HIV/AIDS and sexually transmitted infections demonstrated significant declines.Enteric infections showed the most rapid reductions in mortality(AAPC=-7.85,P﹤0.001)and disability-adjusted life year rates(DALYR;AAPC=-7.18,P﹤0.001).We also found a significant decrease in the incidence of tropical diseases and malaria(AAPC=-6.77,P﹤0.001).APC analysis found that the age effect was mostly negative in terms of the annual percentage change in mortality and DALYR for each disease,except for HIV/AIDS,with an overall decline in period risk over time,and a generally higher risk of morbidity and mortality for the early birth cohort,and an overall decline in the risk of each disease as the year of birth progressed,but the risk of HIV/AIDS death and DALY period and cohort risks trended upward.While the overall risk for certain diseases was slightly higher in males compared to females,the trends were largely consistent across both sexes.In terms of projections,the absolute prevalence of respiratory infections and tuberculosis in terms of number of cases and age-standardized rates,and the growth of the disease burden of HIV/AIDS were particularly prominent,making them important health challenges for the future.The burden of disease in the elderly often results in issues such as potential polypharmacy,which must be addressed to improve medication management.Conclusions China has achieved remarkable progress in reducing infectious disease burdens among older adults,though HIV/AIDS and sexually transmitted infections present an escalating public health threat.These findings advocate for enhanced surveillance systems,age-specific prevention strategies,and precision medication protocols to optimize therapeutic outcomes in geriatric populations.

Objective To analyze temporal trends in infectious disease burden among Chinese elderly(≥60 years)using data from the Global Burden of Disease Study(GBD 2021),evaluate age-period-cohort effects on disease burden,predict trends through 2045,and propose evidence-based medication management strategies.Methods We conducted a threefold analysis of infectious disease burden from 1990 to 2021 using Joinpoint regression to identify temporal trends,Age-Period-Cohort(APC)modeling to disentangle epidemiological effects,and Nordpred projections for 2045 disease burden estimates.Results Over 32 years,all infectious disease categories except HIV/AIDS and sexually transmitted infections demonstrated significant declines.Enteric infections showed the most rapid reductions in mortality(AAPC=-7.85,P﹤0.001)and disability-adjusted life year rates(DALYR;AAPC=-7.18,P﹤0.001).We also found a significant decrease in the incidence of tropical diseases and malaria(AAPC=-6.77,P﹤0.001).APC analysis found that the age effect was mostly negative in terms of the annual percentage change in mortality and DALYR for each disease,except for HIV/AIDS,with an overall decline in period risk over time,and a generally higher risk of morbidity and mortality for the early birth cohort,and an overall decline in the risk of each disease as the year of birth progressed,but the risk of HIV/AIDS death and DALY period and cohort risks trended upward.While the overall risk for certain diseases was slightly higher in males compared to females,the trends were largely consistent across both sexes.In terms of projections,the absolute prevalence of respiratory infections and tuberculosis in terms of number of cases and age-standardized rates,and the growth of the disease burden of HIV/AIDS were particularly prominent,making them important health challenges for the future.The burden of disease in the elderly often results in issues such as potential polypharmacy,which must be addressed to improve medication management.Conclusions China has achieved remarkable progress in reducing infectious disease burdens among older adults,though HIV/AIDS and sexually transmitted infections present an escalating public health threat.These findings advocate for enhanced surveillance systems,age-specific prevention strategies,and precision medication protocols to optimize therapeutic outcomes in geriatric populations.

Objective To investigate the medication and blood glucose control of type 2 diabetes patients under chronic diseases management in Xi'an chain pharmacies,and provides reference for improving the management policy of diabetes at grassroots level.Methods A number of chain pharmacies in the sixth district of Xi'an were selected by random sampling method,and on-site interviews were conducted by questionnaire survey to patients with type 2 diabetes under the management of chronic diseases.The basic information of patients,medication status(medication plan,drug adherence,etc.),diabetes-related conditions(blood glucose status,family history,course and complications,etc.)were collected.Multivariate logistic regression was used to analyze the relevant factors of blood glucose control in patients.Results A total of 403 patients were surveyed,the largest number of patients use oral hypoglycemic drugs alone(53.4％),followed by insulin medication(including insulin only and insulin in combination with oral hypoglycemic drugs)(35.7％),and the differences between disease course and glycemic control among patients with different drug regimens were statistically significant(P＜0.05).Only 43.7％of patients had good medication compliance.In addition,the patient's fast plasma glucose compliance rate was only 39.2％.The results of multivariate logistic regression analysis showed that good medication compliance(OR=1.744,95％CI 1.104 to 2.754,P=0.017)were independent influencing factors for achieving glycemic control.Conclusion The medication compliance of type 2 diabetes patients with poor blood glucose control in chronic disease management of chain pharmacies in Xi'an needs to be strengthened.Pharmacies should emphasize and give full play to the professional and service advantages of pharmacists to realize the functional role of pharmacies and strengthen diabetes management.

Objective To investigate the current awareness of pharmaceutical service fees among pharmacists in hospitals of Shaanxi province to provide a theoretical basis and decision-making framework for establishing such fees in hospitals of various provinces and cities in the future.Methods A questionnaire survey was conducted among 47 representative hospitals and 53 pharmacists within these hospitals in Shaanxi province.The results were analyzed using differential analysis.Results In most hospitals of Shaanxi province,pharmaceutical services are not provided or not charged for,indicating a lack of practical experience in the establishment of pharmaceutical service fees.Among hospitals that provide and charge for pharmaceutical services,there remains a need for uniformity in specific service content and fee standards,clear regulatory policy support,and a unified evaluation system.Significant differences exist among hospitals of different levels and types in terms of their capacity to provide pharmaceutical services and the forms in which they are offered.There is inconsistency among pharmacists within hospitals regarding crucial aspects of establishing pharmaceutical service fees,and further enhancement is needed in their awareness of relevant policies and the latest guidelines.Conclusions There is considerable room for improvement in establishing pharmaceutical service fees in hospitals of Shaanxi province.Stakeholders should promptly establish and standardize the fee establishment model,differentiate the fee standards for various services,enhance the publicity and dissemination of relevant document requirements to support the smooth implementation of pharmaceutical service fee policies.

Objective:To evaluate the safety and efficacy of intravenous tirofiban in stent-assisted embolization of acute ruptured intracranial aneurysms.Methods:A total of 286 patients with acute ruptured intracranial aneurysms who received stent-assisted embolization in Department of Neurosurgery, Linyi People's Hospital from January 2020 to September 2022 were enrolled. According to different preoperative antiplatelet regiments, they were divided into aspirin combined with double resistant group (preoperatively taking orally loading dose of aspirin and clopidogrel, n=167) and tirofiban group (intravenously injecting tirofiban, n=119). Propensity score matching (PSM) was used to adjust for potential differences in age, gender, Hunt-Hess grading, hypertension history, diabetes history, smoking history, aneurysm location, aneurysm neck, aneurysm body-neck ratio, and stent types; incidences of perioperative hemorrhagic and ischemic complications, and neurological recovery status at discharge (scores of modified Rankin scale [mRS]≤2 as good recovery) were compared between the two groups. Results:After 1:1 PSM, 96 patients were included in each group. No significant difference in incidence of hemorrhagic complications was noted between the double resistant group (2.1%) and tirofiban group (0.0%, P>0.05). No significant difference in incidence of ischemic complications was noted between the double resistant group (9.3%, including 8 with intraoperative thrombosis and 1 with postoperative infarction) and tirofiban group (7.2%, including 6 with intraoperative thrombosis and 1 with postoperative infarction, P>0.05). No significant difference in good recovery rate at discharge was noted between double resistant group (86.4%) and tirofiban group (90.6%, P>0.05). Conclusion:In stent-assisted embolization therapy for acute ruptured intracranial aneurysms, preoperative intravenous tirofiban enjoys the same safety and efficacy compared with preoperative oral loading dose of aspirin and clopidogrel.

Objective: To explore the key technique and outcome of transoral radiofrequency ablation microsurgery for early stage of glottic carcinoma with anterior commissure involvement (ACI). Methods: A retrospective analysis was conducted on 31 patients, who were diagnosed as early stage glottic carcinoma during January 2010 to March 2016 in ENT Department. According to whether the anterior commissure was involved or not, two groups were divided. There were eleven cases with ACI (stages T1a, T1b, and T2). Twenty cases without ACI (stages Tis, T1a, and T2). All the patients received transoral radiofrequency ablation microsurgery and followed up closely.Only one case received radiotheraphy after surgery. SPSS19.0 software was used to analyze data. Results: The follow-up time was 12-67 months, and the median follow-up time was 30 months. Nine among 11 cases with ACI obtained good oncologic outcomes, initial local recurrence was identified in 2/11 cases, including 2 cases of T2. Two cases ultimately required salvage total laryngectomy. Meanwhile, initial local recurrence was identified in 2/20 cases without ACI, including 1 case of T1a and 1 case of T2. One case underwent elective neck dissection, and another one received salvage total laryngectomy.Compared to the patients without ACI, it seemed that the cases with ACI always accomponied with a little higher initial local recurrence and lower overall laryngealpreservation, but the difference had no significance (P>0.05). Conclusions Transoral radiofrequency ablation microsurgery is an effective treatment for glottic carcinoma with ACI. Its advantages, such as more flexibility and deformability, make it more feasible to operate at the narrow space of anterior commissure assisted with laryngeal endoscopy.Good oncologic outcomes can be obtained by this technique with lower initial local recurrence as well as higher overall laryngeal preservation rate.

Objective To study the effects of microemulsion/ethosomes on transdermal absorption properties and efficacy of Huoxue Zhitong Cataplasm. Methods The improved Franz diffusion cells were used for the in-vitro permeation experiment with rat skins as the barriers, which was used to evaluate the transdermal absorption properties. In the erxeriment, the contents of paeonol, eugenol and methyl salicylate were used as markers, and detected by ultra performance liquid chromatography to evaluate the transdermal absorption effects. The anti-inflammatory and analgesia activity were evaluated through the writhing plate experiments. Results The cumulative release rate of paeonol in Huoxue Zhitong Cataplasm, Microemulsion Huoxue Zhitong Cataplasm and Ethosomes Huoxue Zhitong Cataplasm were, in order, 65.30%, 61.30%and 60.20%in 24 h;eugenol were, in order, 51.08%, 54.71% and 55.66% in 24 h; methyl salicylate were, in order, 49.20%, 65.17% and 72.15% in 24 h. Furthermore, Microemulsion Huoxue Zhitong Cataplasm high-dose group and Ethosomes Huoxue Zhitong Cataplasm medium-dose group had good effects on reducing the inflammatory exudate of peritoneal capillary and capillary permeability (P<0.05) in animal models. Conclusion Huoxue Zhitong Cataplasm based on microemulsion/ethosomesnano-technology has good transdermal absorption properties and efficacy.

Objective To provide an comprehensive evaluation of the correlation between sleep apnea hypopnea syn?drome (SAHS) and nonalcoholic fatty liver disease (NAFLD). Methods The various case-control studies on the relation?ship between SAHS and NAFLD were retrieved from all kinds of large-scale databases at home and abroad (including Web of science, EMbase, Pubmed, Springer Link, EBSCO Databases, CNKI, CQVIP, Wanfang Data). The quality evaluation of in?cluded studies was made by two independent researchers. RevMan 5.1 and stata 12.0 software were used for meta-analysis. Results A total of 11 qualified documents were included in this study. Meta analysis showed that the relative risk of NAFLD was increased in SAHS patients than non-SAHS patients (RR=2.82, 95%CI:2.03-3.92, P<0.01). The serum ala?nine aminotransferase (ALT) increased in SAHS patients (SMD=0.53, 95% CI:0.02-1.05, P < 0.05). Compared with non-SAHS patients, the apnea-hypopnea index (AHI) was significantly higher in SAHS patients combined with severe NAFLD than those combined with mild NAFLD (SMD=1.42, 95%CI:0.12-2.72, P < 0.05). Conclusion The risk of NAFLD in?creases in SAHS patients. The severity of NAFLD is relatively higher with the severity of intermittent hypoxia.

Objective To study the effects of health management on blood pressure and lifestyle of hypertensive outpatients.Methods A total of 319 hypertensive outpatients were randomly assigned to the control group (n =160) or the health management group (n =159).Pharmacologic therapy was given to the control group,while in the health management group,intensive health management combined with pharmacologic therapy was conducted.Blood pressure,height,body weight (BW),total cholesterol (TC),and fasting blood glucose (FBG) of the participants were measured and compared at baseline and 12 months.Results There were no significant differences of clinical characteristics between two groups at baseline.After 12 months' intervention,more significant decrease of systolic blood pressure and diastolic blood pressure was found in the health management group (t values were 2.701 and 2.306,respectively;both P ＜ 0.05).There were statistically significant differences of body mass index (BMI) and serum TC levels between the control and the health management group (t values were 2.111 and 2.227,respectively ;P ＜ 0.05).After the intervention,two groups showed no significant difference in current cigarette smoking (x2=2.787,P ＞ 0.05).The participants in the health management group showed improved physical exercises,diet,and adherence to treatment at the end of the observation (x2 values were 59.459,52.018,6.321 and 5.392,respectively; all P ＜ 0.05).Conclusion Compared with pharmacologic therapy,health management combined with pharmacologic therapy could significantly improve clinical parameters and life style of hypertensive patients.

ObjectiveTo study the effects of health management on elderly patients with metabolic syndrome and lower extremity arterial disease.Methods A total of 118 metabolic syndrome( MS ) patients with ankle-brachial index (ABI) ＜ 0.9 and no intermittent claudication were randomly assigned to the control group( n =60,receiving pharmacologic therapy ) or health management group ( n =58,receiving intensive health management + pharmacologic therapy).Blood pressure,ABI,total cholesterol (TC),and fasting blood glucose(FBS) were tested before and 12 after the intervention.Results Clinical data were comparable between the two groups at baseline.After 12-months' intervention,systolic blood pressure(SBP) and FBS in both groups were significantly decreased,especially in the health management group[SBP:(141 ± 10)mm Hg(1 mm Hg=0.133 kPa) vs(146±11) mm Hg,t =2.581,P=0.011; FBS:(5.32 ±1.33) mmol/L vs ( 5.92 ± 1.61 ) mmol/L,t =2.231,P =0.028].TC ( 5.51 ± 0.51 ) mmol/L vs ( 5.11 ± 0.49 ) mmol/L,(t=4.307,P=0.000) and ABI(0.77 ±0.17 vs 0.84 ±0.19,t=2.091,P=0.039) of the health management group were significantly improved at 12 months.Patients in the health management group also showed higher SF-36 scores than those in the control group( physical functioning:72.2 ± 12.4 vs 65.2 ±20.1,t =2.268,P =0.025 ; emotion:73.9 ± 18.0 vs 65.6 ± 21.1,t =2.295,P =0.023 ; mental health:63.9 ± 13.3vs 58.3 ± 12.5,t =2.358,P =0.020 ).Conclusion Compared with medication,health management and pharmacologic therapy could significantly improve clinical parameters and quality of life of elderly MS patients combined with peripheral arterial disease.