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.

Humans ; Cardiovascular Diseases/chemically induced* ; East Asian People ; Risk Factors ; Heart Disease Risk Factors ; Lipids ; Anticholesteremic Agents/adverse effects* ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Treatment Outcome

Tuberculous meningitis (TBM) is one of the most serious and lethal diseases in neurology. The early diagnosis and treatment of TBM still faces severe challenges. Acid-fast staining of cerebrospinal fluid and culture of Mycobacteriumtuberculosis are the "gold standard" for the diagnosis of TBM, but lack sensitivity. With the application of metagenomic next-generation sequencing technology, significant advances have been made in the early diagnosis of TBM. The optimal treatment regimen for TBM remains to be further explored and studied. This article intends to provide an overview of the pathogenesis, pathology, clinical manifestations, diagnosis and treatment advancement of TBM, and provide guidance for clinical practice.

Objective:Using data of health information system (HIS) of medical institutions to study epidemiological characteristics of herpes zoster in Xicheng district of Beijing.Methods:To collect data of outpatient herpes zoster cases of all 42 medical institutions in 2019 based on HIS. After distinguishing the reduplicated cases, we organized these data for descriptive epidemiological analysis.Results:A total of 3 982 primary outpatient cases were investigated, the estimated incidence was 3.38‰ (3 982/1 178 999). The incidence was 2.90‰ (1 655/570 320) for males and 3.82‰ (2 327/608 679) for females and with increasing trends with age. Herpes zoster occurred from January to December. These cases mainly visited tertiary hospitals, with central departments as dermatology and traditional Chinese medicine involved. For the first identified cases, the average age was (60.48±15.43) years old. The ages of disseminated herpes zoster patients was (74.00±8.98) years old, while the age of herpes zoster in the outer ear was (54.32±15.73) years old. The top three diseases were herpes zoster, post-herpetic neuralgia, and Herpes zoster with other neurological complications, with proportions as 82.65% (3 291/3 982), 10.37% (413/3 982), and 4.37% (174/3 982), respectively.Conclusions:Most herpes zoster cases were more than 50 years old in Xicheng district of Beijing, with females have seen more than males. Complications commonly occurred among individuals more than 50 years old and with the most widely seen complication as post-herpetic neuralgia.

Objective To investigate the clinical features,diagnosis,treatment and prognosis of Dementia with Lewy Body (DLB) in order to improve doctors' understanding and experience.Methods Thirteen cases of clinicall diagnosed DLB were analyzed.The clinical manifestations,neurological examination,laboratory tests,treatment and prognosis were analyzed.Results All of 13 patients had fluctuating dementia.Among them,11 were diagnosed with probable DLB,and 2 were diagnosed with possible DLB.There were 8 cases (8/13) with volatility cognitive impairment,8 cases (8/13) with Parkinson's syndrome,8 casess (8/13) with visual hallucinations,13 cases (13/13) with memory loss,4 patients with limb tremor (4/13),5 cases with delirium (5/13),3 cases with increased sleep (3/ 13),1 case with silence (1/13),9 cases with anxiety and depression (9/13),one case with dizziness (1/13),6 cases with abnormal dysplasia (6/13),and one case with abnormal sensitive to diazepam (1/13).The cognitive function fluctuated,the condition deteriorated and two patients died during the follow-up from 6 months and 5 years.Conclusions Lewy body dementia is an irreversible and progressive neurodegenerative disease.Comprehensive understanding of its clinical features is helpful for the early diagnosis and treatment,which may in turn improve the prognosis.

Objective:To investigate the clinical effects of stellate ganglion block(SGB) on the stress ulcer in burn patients and explore the underlying mechanisms.Methods:40 patients with burn injury induced stress ulcer were randomized to two groups:SGB group (n=20) and Control group (n=20).SGB group was treated with conventional symptomatic therapy,SGB group underwent SGB every two days for 1 week on the basis of Control group.And the levels of plasma ET-1 and NO were detected using ELISA before and after therapy.And the clinical efficacy of the two groups was observed after the treatment.Results:Compared with the Control group,the levels of plasma ET-1 and NO were markedly lower in the SGB group (P＜0.05),while the clinical efficacy was higher(P＜0.05).Conclusion:SGB could enhance the clinical efficacy stress ulcer in bum patients,which might be related to the decrease of plasma ET-1 and NO levels.

Objective To explore the feasibility of reduction by using cone beam computed tomography (CBCT) before intensity modulated radiation therapy(IMRT) in the patients with nasopharyngeal carcinoma.Methods Twenty-three patients with nasopharyngeal carcinoma (NPC) undergoing IMRT were included in this study.The reverse IMRT plan with CBCT verification was prepared with location center coordinates origin as the planned central point.Before therapy,the CBCT reduction was adopted,the CBCT scanning was performed before the second and third radiotherapies.The registering data in 3 times were analyzed and summarized.Results In CBCT reduction,the absolute value at any direction≤3 mm accounted for 89.9％ (62/69),＜5 mm accounted for 98.6 ％ (68/69),and the deviation value at every direction was (0.6 ± 2.1)mm;in the second and third CBCT,the absolute value at any direction ≤3 mm accounted for 92.8％ (128 q38),＜5 mm accounted for 99.3％ (137/138),and the deviation value at every direction was (0.4 ± 2.0) mm:the difference between the two sets of data had no statistically significant difference (P＞ 0.05).Conclusion In formulating the nasopharyngeal carcinoma IMRT plan withthe location center coordinates origin as the planned central point,adopting the CBCT reduction is intuitional,convenient,practicable and feasible.

Objective To study the correlation between the risk factors of coronary slow flow phenomenon ( CSF) and the level of plasma D-dimer in patients with ACS ( acute coronary syndrome) after emergency percutaneous coronary intervention ( PCI) .Methods A total of 297 patients with ACS after PCI were enrolled for retrospective analysis.All patients were divided into CSF group and control group in the light of corrected thrombolysis in myocardial infarction (TIMI) frame count method (cTFC).Multivariate analysis for evaluating clinical predictors of CSF was carried out using Logistic regression test and Pearson analysis to find the correlation between plasma D-dimer and cTFC.The predictive value of D-dimer level in the occurrence of coronary slow flow was determined by using receiver operating characteristic ( POC) curve analysis.Results CSF was observed in 59 cases (19.8%).The plasma D-dimer was significantly higher in the coronary slow flow group compared with the control group ( P <0.05 ) .Multivariate regression analysis and Logistic regression test showed that the level of plasma D-dimer ( OR =1.276, 95%CI:1.132-3.224, P=0.012), thrombus score (OR =1.108, 95%CI: 1.085-2.103, P =0.018) and target lesion length of culprit vessel ( OR =1.436, 95%CI: 0.635-1.382, P =0.037 ) were the risk factors of CSF.Correlation analysis showed that plasma D-dimer were positively associated with CSF. Receiver operating characteristic ( ROC ) curve analysis showed that D-dimer cutoff point at 515.3 ng/ml had a good judgment significance ( AUC 0.783, OR =1.502, 95%CI: 1.324-2.531, P =0.005). Conclusions The increased D-dimer level is a risk factor and plays an important role in the ACS patients with the CSF phenomenon, thereby predicting no-reflow phenomenon after primary PCI in these patients.

Objective: To evaluate the impact of anemia on prognosis of elder patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).
Methods: A total of 908 consecutive ACS patients elder than 60 years of age with PCI in our hospital from 2010-06 to 2012-06 were studied. According to WHO deifnition of anemia (HB<12.0 g/dL in female and HB<13.0 g/dL in male), the patients were classiifed as Anemia group, n=283 and Non-anemia group, n=625. The patients were followed-up for 1 year. The basic clinical characteristics, incidences of mortality and major adverse cardiovascular and cerebravascular events (MACCE) were compared between 2 groups by cardiac death, myocardial re-infarction, worsening of cardiac function, target vessel revascularization, cerebral hemorrhage and cerebral infarction.
Results: There were 31%of patients suffering from anemia. Anemia group had more patients with the elder age, female gender, diabetes, hypertension, chronic kidney disease, decreased LVEF, more patients with 3 vessel-disease, and higher mortality at 1 year after PCI, higher rate of MACCE than those in Non-anemia group, all P<0.05. Multiple regression analysis indicated that anemia is the independent predictor for mortality in elder ACS patients at 1 year after PCI, P<0.05.
Conclusion: Anemia may increase the incidences of mortality and MACCE in elder ACS patients after PCI for a long-term.