1.Efficacy and safety of Xingnaojing as an adjuvant therapy for thrombolysis in the treatment of acute ischemic stroke: A meta-analysis
Journal of Apoplexy and Nervous Diseases 2026;43(3):219-226
Objective To systematically evaluate the effect of Xingnaojing injection on the levels of inflammatory factors in patients with acute ischemic stroke (AIS) as an adjuvant therapy for intravenous thrombolysis with alteplase, and to investigate the neuroprotective significance of Xingnaojing injection. Methods Chinese databases (CNKI, Wanfang Data, and VIP) and English databases (PubMed, Embase, and the Cochrane Library) were searched for studies on the serum levels of inflammatory factors in the treatment of AIS published up to August 2024, and the patients were divided into control group and experimental group based on the method of randomized controlled trial (RCT). The patients in the control group received intravenous thrombolysis with alteplase, while those in the experimental group received intravenous thrombolysis with alteplase combined with Xingnaojing injection. The Cochrane Collaboration Risk of Bias Tool was used to assess the methodological quality of the studies included for analysis, and RevMan 5.3 software was used to conduct a meta-analysis on NIHSS, response rate, C-reactive protein (CRP), TNF-α, IL-6, IL-8, IL-1, and adverse reactions for the experimental group and the control group. Results A total of 19 RCTs were included, involving 1 711 patients (856 in the experimental group and 855 in the control group). The meta-analysis showed that there were significant differences between the two groups in NIHSS (SMD=-2.12,95%CI -2.74 to -1.50, P<0.001), response rate (OR=5.22, 95%CI 3.44‒7.91, P<0.001), CRP (SMD=-1.27, 95%CI -1.74 to -0.79, P<0.001),TNF-α(SMD=-2.91, 95%CI -3.74 to -2.08, P<0.001), IL-6 (SMD=-6.74, 95%CI -9.06 to -4.41, P<0.001),IL-8 (SMD=-4.85,95%CI -6.49 to -3.20, P<0.001), IL-1 (SMD=-4.89,95%CI -6.86 to -2.92, P<0.001), and adverse reactions (OR=0.41, 95%CI 0.26-0.64, P<0.001). Conclusion As an adjuvant therapy for thrombolysis with alteplase, Xingnaojing injection significantly reduces the levels of inflammatory factors in AIS patients and exerts a neuroprotective effect on brain cells, with a high response rate and few adverse reactions, which provides a safe and reliable reference for clinical practice.
2.Research Progress on Assessment Tools for Medication Literacy in Chronic Disease Patients
Mingfen WU ; Aning SUN ; Teng LIU ; Xinchen LI ; Zhigang ZHAO
Herald of Medicine 2025;44(12):1927-1933
Medication literacy directly impacts the safety of drug therapy and clinical outcomes.Patients with low medication literacy demonstrate poorer medication adherence,higher medication risks,and inferior disease control outcomes.Chronic disease patients face significant medication safety hazards due to multimorbidity and polypharmacy.Accurately assessing medication literacy can quantify individual medication capabilities and promote safe medication management.This paper reviews the structure,methods,applicable population,current applications,advantages,and limitations of medication literacy assessment tools for chronic disease patients,both domestically and internationally.The aim is to provide references for developing and applying medication literacy assessment tools for patients in China,offering a basis for scientifically evaluating medication literacy levels and formulating medication safety intervention strategies.
3.Construction of Intervention Strategies for Medication Adherence in Patients with Chronic Diseases Based on the Delphi Method
Yujia YAN ; Zhigang ZHAO ; Li YANG ; Mingfen WU
Herald of Medicine 2025;44(12):1933-1939
Objective To develop an effective intervention strategy to improve medication adherence among chronic disease patients.Methods Based on the behavior change wheel theory and integrating literature analysis,questionnaire surveys,clinical practice experience,the initial draft of the intervention strategies was developed.The intervention strategies were revised and refined through two rounds of Delphi expert consultation.Results The effective response rates for the two rounds of expert consultation questionnaires were 95%and 100%,respectively.The expert authority coefficient was 0.91.The Kendall's coefficient of concordance for the importance of the first and second rounds of expert consultation was 0.224 and 0.202,while the Kendall's coefficient of concordance for feasibility was 0.172 in the second round of expert consultation.The differences were statistically significant(P﹤0.05).The coefficient of variation of entries was 0.00-0.23.Based on the experts'feedback,adjustments were made to several items,resulting in a final intervention strategy that includes 3 primary indicators,9 secondary indicators and 41 intervention measures.Conclusion This strategy demonstrates a high level of scientific rigor and practicality,making it applicable in clinical settings to enhance medication adherence among chronic disease patients effectively,thus providing robust support for patient management.
4.Home Medication Adherence and Its Influencing Factors Among Elderly Patients with Chronic Diseases in China:A National Cross-sectional Survey
Wei ZHAO ; Zhigang ZHAO ; Mingfen WU
Herald of Medicine 2025;44(12):1948-1955
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.
5.Analysis of Influential Factors on Chronic Disease Patients' Willingness to Participate in Home Pharmaceutical Care Based on Null Importance
Ke ZHAO ; Hongxin YANG ; Mingfen WU ; Hao GUO ; Zhigang ZHAO
Herald of Medicine 2025;44(8):1347-1351
Objective To investigate the key factors influencing the willingness of chronic disease patients to participate in home pharmaceutical services.Methods The study adopted the data from inner Mongolia and northeast China set of the drug aging system research for China.The Null Importance method was employed to identify key factors influencing the willingness of chronic disease patients to participate in home pharmaceutical services.The logistic regression model was constructed and evaluated the impact of feature selection through 5 fold cross-validation and accuracy and AUC values.Results 10 key factors were selected by the Null Importance method and the performance of the logistic regression model was improved after feature selection.The factors which significantly affected patients' willingness to accept home pharmaceutical services included the number of accessible information sources(OR=1.261,95%CI=1.182~1.345),medication therapeutic indication cognition(OR=1.342,95%CI=1.124~1.603),the presence the drug packaging or not(OR=1.218,95%CI=1.015~1.462),medication adherence(OR=0.881,95%CI=0.839~0.925),medication literacy(OR=0.631,95%CI=0.488~0.817),the degree of know of medication guidance services(OR=1.211,95%CI=1.017~1.442).Conclusion The logistic model refined by the Null Importance feature selection method demonstrated good performance and was conducive to analyzing the factors influencing the willingness of chronic disease patients to participate in home pharmaceutical care.
6.Research Progress on Assessment Tools for Medication Literacy in Chronic Disease Patients
Mingfen WU ; Aning SUN ; Teng LIU ; Xinchen LI ; Zhigang ZHAO
Herald of Medicine 2025;44(12):1927-1933
Medication literacy directly impacts the safety of drug therapy and clinical outcomes.Patients with low medication literacy demonstrate poorer medication adherence,higher medication risks,and inferior disease control outcomes.Chronic disease patients face significant medication safety hazards due to multimorbidity and polypharmacy.Accurately assessing medication literacy can quantify individual medication capabilities and promote safe medication management.This paper reviews the structure,methods,applicable population,current applications,advantages,and limitations of medication literacy assessment tools for chronic disease patients,both domestically and internationally.The aim is to provide references for developing and applying medication literacy assessment tools for patients in China,offering a basis for scientifically evaluating medication literacy levels and formulating medication safety intervention strategies.
7.Construction of Intervention Strategies for Medication Adherence in Patients with Chronic Diseases Based on the Delphi Method
Yujia YAN ; Zhigang ZHAO ; Li YANG ; Mingfen WU
Herald of Medicine 2025;44(12):1933-1939
Objective To develop an effective intervention strategy to improve medication adherence among chronic disease patients.Methods Based on the behavior change wheel theory and integrating literature analysis,questionnaire surveys,clinical practice experience,the initial draft of the intervention strategies was developed.The intervention strategies were revised and refined through two rounds of Delphi expert consultation.Results The effective response rates for the two rounds of expert consultation questionnaires were 95%and 100%,respectively.The expert authority coefficient was 0.91.The Kendall's coefficient of concordance for the importance of the first and second rounds of expert consultation was 0.224 and 0.202,while the Kendall's coefficient of concordance for feasibility was 0.172 in the second round of expert consultation.The differences were statistically significant(P﹤0.05).The coefficient of variation of entries was 0.00-0.23.Based on the experts'feedback,adjustments were made to several items,resulting in a final intervention strategy that includes 3 primary indicators,9 secondary indicators and 41 intervention measures.Conclusion This strategy demonstrates a high level of scientific rigor and practicality,making it applicable in clinical settings to enhance medication adherence among chronic disease patients effectively,thus providing robust support for patient management.
8.Home Medication Adherence and Its Influencing Factors Among Elderly Patients with Chronic Diseases in China:A National Cross-sectional Survey
Wei ZHAO ; Zhigang ZHAO ; Mingfen WU
Herald of Medicine 2025;44(12):1948-1955
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.
9.Analysis of Influential Factors on Chronic Disease Patients' Willingness to Participate in Home Pharmaceutical Care Based on Null Importance
Ke ZHAO ; Hongxin YANG ; Mingfen WU ; Hao GUO ; Zhigang ZHAO
Herald of Medicine 2025;44(8):1347-1351
Objective To investigate the key factors influencing the willingness of chronic disease patients to participate in home pharmaceutical services.Methods The study adopted the data from inner Mongolia and northeast China set of the drug aging system research for China.The Null Importance method was employed to identify key factors influencing the willingness of chronic disease patients to participate in home pharmaceutical services.The logistic regression model was constructed and evaluated the impact of feature selection through 5 fold cross-validation and accuracy and AUC values.Results 10 key factors were selected by the Null Importance method and the performance of the logistic regression model was improved after feature selection.The factors which significantly affected patients' willingness to accept home pharmaceutical services included the number of accessible information sources(OR=1.261,95%CI=1.182~1.345),medication therapeutic indication cognition(OR=1.342,95%CI=1.124~1.603),the presence the drug packaging or not(OR=1.218,95%CI=1.015~1.462),medication adherence(OR=0.881,95%CI=0.839~0.925),medication literacy(OR=0.631,95%CI=0.488~0.817),the degree of know of medication guidance services(OR=1.211,95%CI=1.017~1.442).Conclusion The logistic model refined by the Null Importance feature selection method demonstrated good performance and was conducive to analyzing the factors influencing the willingness of chronic disease patients to participate in home pharmaceutical care.
10.Global Research Trends and Hotspots Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Monoclonal Antibodies
Ning JIANG ; Wenshuang MENG ; Lina CHEN ; Yaodong YAN ; Mingfen WU
Herald of Medicine 2024;43(4):630-635
Objective To analyze the global research status,hotspots,and frontiers of proprotein convertase subtilisin/Kexin type 9(PCSK9)monoclonal antibodies,and to provide a reference for related scientific research and the rational drug use in clinical practice in China.Methods The research literature related to PCSK9 monoclonal antibody included in the Web of Science database was searched for the period from January 2011 to February 2022,and the literature included in the study was visually analyzed by the CiteSpace software.Results A total of 723 articles were included,and the annual number of publica-tions showed an overall upward trend.The top three countries were the United States,France,and the United Kingdom.Sanofi was the organization with the largest number of articles,and the organization with the highest citation of articles was Brigham and Women's Hospital.The hotspots of research mainly included the use of PCSK9 monoclonal antibody in the treatment of patients with hypercholesterolemia,patients who do not tolerate statins,patients with high cardiovascular risk,and the efficacy and safety of PCSK9 monoclonal antibody in lipid-lowering therapy combined statins;The frontiers of research in recent two years is the appli-cation of PCSK9 monoclonal antibodies in patients with acute coronary syndrome and the clinical benefits after reducing the level of lipoprotein(a).Conclusion A large number of studies have confirmed the efficacy and safety of PCSK9 monoclonal anti-bodies in reducing blood lipids,but there is still a lack of research on its economics and application in special populations,which should be the focus of future research.

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