1.Influencing factors for medication compliance in patients with comorbidities of chronic diseases: a meta-analysis
LIU Yudan ; ZHANG Caiyun ; GUO Mingmei ; ZHENG Yujuan ; JIA Ming ; YANG Jiale ; HOU Jianing ; ZHAO Hua
Journal of Preventive Medicine 2024;36(9):790-795,800
Objective:
To systematically evaluate the influencing factors for medication compliance in patients with comorbidities of chronic diseases, so as to provide the evidence for improving medication compliance.
Methods:
Literature on influencing factors for medication compliance in patients with comorbidities of chronic diseases were retrived from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and Embase from inception to January 20, 2024. After independent literature screening, data extraction, and quality assessment by two researchers, a meta-analysis was performed using RevMan 5.4 and Stata 16.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was assessed using Egger's test.
Results:
Initially, 7 365 relevant articles were retrieved, and 35 of them were finally included, with a total sample size of about 150 000 individuals. There were 30 cross-sectional studies and 5 cohort studies; and 11 high-quality studies and 24 medium-quality studies. The meta-analysis showed that the demographic factors of lower level of education (OR=2.148, 95%CI: 1.711-2.696), lower economic income (OR=1.897, 95%CI: 1.589-2.264), male (OR=0.877, 95%CI: 0.782-0.985), living alone (OR=2.833, 95%CI: 1.756-4.569) and unmarried (OR=2.784, 95%CI: 1.251-6.196); the medication treatment factors of polypharmacy (OR=1.794, 95%CI: 1.190-2.706), potentially inappropriate medication (OR=2.988, 95%CI: 1.527-5.847), low frequency of daily medication (OR=0.533, 95%CI: 0.376-0.754) and adverse drug reactions (OR=3.319, 95%CI: 1.967-5.602); the disease factors of long course of disease (OR=2.118, 95%CI: 1.643-2.730), more comorbidities (OR=1.667, 95%CI: 1.143-2.431) and cognitive impairment (OR=2.007, 95%CI: 1.401-2.874); and the psychosocial factors of poor belief in taking medication (OR=1.251, 95%CI: 1.011-1.547), poor self-rated health (OR=1.990, 95%CI: 1.571-2.522) and being guided by healthcare professionals (OR=0.151, 95%CI: 0.062-0.368) were the influencing factors for medication compliance in patients with chronic comorbidities.
Conclusion
The medication compliance in patients with comorbidities of chronic diseases is associated with demographic factors, pharmacological factors, disease factors and psychosocial factors, mainly including living alone, adverse drug reactions, course of disease, number of comorbidities and medication beliefs.
2.Application of growth hormone pretreatment in preimplantation genetic testing for aneuploidy
Haiyan ZHOU ; Caiyun WU ; Dehuan HUANG ; Yan HAO ; Dawei CHEN ; Menghan WANG ; Gang ZHAO ; Ping ZHOU
Acta Universitatis Medicinalis Anhui 2024;59(6):988-993
Objective To investigate the effect of growth hormone(GH)pretreatment on the improvement of eu-ploid and pregnancy outcome.Methods A prospective analysis was conducted on 134 patients undergoing preim-plantation genetic testing for aneuploidy(PGT-A),among whom 30 patients were self-controlled and 104 patients were inter-group controlled.According to whether GH was added,the patients were divided into GH pretreatment group and GH non-pretreatment group.GH pretreatment included subcutaneous injection of GH 2U/day for 4-6 weeks before the start of gonadotropin(Gn),and the dose was doubled on the day of Gn until the trigger day.GH non-pretreatment meant no GH treatment,GH pretreatment was given when the previous PGT-A cycle failed within one year when the PGT-A was performed again,forming the self-control group.The basic situation,blastocyst situa-tion and pregnancy outcome were compared between the groups by inter-group and self-control.Results No matter in the group control or self-controlled group,the endometrial thickness on the day of HCG,ovarian sensitivity index(OSI),number of oocytes obtained,MII oocytes,2PN number,2PN fertilization rate,available oocyte rate,num-ber of biopsy blastocysts,number of euploid blastocysts,euploid blastocyst rate,and at least one euploid rate sig-nificantly increased after GH pretreatment,with statistically significant differences(P<0.05).The total amount of Gn,Gn days,number of mosaic blastocysts,and mosaic blastocyst rate were not significantly changed after GH pretreatment,with no statistically significant differences.The implantation rate and clinical pregnancy rate in-creased after GH pretreatment,but with no statistically significant differences.Conclusion GH pretreatment can significantly improve the number and rate of euploid embryos in patients undergoing PGT-A,and has a tendency to improve pregnancy outcome.
3.Advances in the research and application of neurokinin-1 receptor antagonists
HONG XIANGYU ; MA JUNJIE ; ZHENG SHANSHAN ; ZHAO GUANGYU ; FU CAIYUN
Journal of Zhejiang University. Science. B 2024;25(2):91-105
Recently,the substance P(SP)/neurokinin-1 receptor(NK-1R)system has been found to be involved in various human pathophysiological disorders including the symptoms of coronavirus disease 2019(COVID-19).Besides,studies in the oncological field have demonstrated an intricate correlation between the upregulation of NK-1R and the activation of SP/NK-1R system with the progression of multiple carcinoma types and poor clinical prognosis.These findings indicate that the modulation of SP/NK-1R system with NK-1R antagonists can be a potential broad-spectrum antitumor strategy.This review updates the latest potential and applications of NK-1R antagonists in the treatment of human diseases and cancers,as well as the underlying mechanisms.Furthermore,the strategies to improve the bioavailability and efficacy of NK-1R antagonist drugs are summarized,such as solid dispersion systems,nanonization,and nanoencapsulation.As a radiopharmaceutical therapeutic,the NK-1R antagonist aprepitant was originally developed as radioligand receptor to target NK-1R-overexpressing tumors.However,combining NK-1R antagonists with other drugs can produce a synergistic effect,thereby enhancing the therapeutic effect,alleviating the symptoms,and improving patients'quality of life in several diseases and cancers.
4.Summary of best evidence on medication adherence interventions for patients with multiple chronic conditions
Yudan LIU ; Caiyun ZHANG ; Mingmei GUO ; Yujuan ZHENG ; Ming JIA ; Jiale YANG ; Jianing HOU ; Hua ZHAO
Chinese Journal of Modern Nursing 2024;30(30):4156-4162
Objective:To summarize the best evidence of medication adherence interventions for patients with multiple chronic conditions.Methods:According to the "6S" evidence model, literature on medication adherence in patients with multiple chronic conditions was retrieved from BMJ Best Clinical Practice, UpToDate, Medlive, National Institute for Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang data and so on. The search period was from establishing the database to August 30, 2023.Results:A total of 16 articles were included, including three guidelines, four expert consensus, seven systematic reviews, and two meta-analyses. Twenty-seven pieces of evidence were summarized from six aspects of compliance assessment, educational intervention, behavioral intervention, optimized treatment program, technical reminder intervention, and social-psychological-emotional intervention.Conclusions:The best evidence of medication adherence interventions for patients with multiple chronic conditions summarized provides a reference for medical and nursing staff to develop medication adherence interventions.
5.Influence of Spin-Lock Frequency on Quantitative Assessment of Myocardial T1ρ Mapping
Caiyun HAN ; Wei DENG ; Ren ZHAO ; Hongmin SHU ; Zhen WANG ; Jinxiu YANG ; Yongqiang YU ; Xiaohu LI
Chinese Journal of Medical Imaging 2024;32(7):731-735
Purpose To explore the influence of different spin-locking frequencies on T1ρ values based on a 3.0T MR system.Materials and Methods Thirty-eight healthy adult volunteers underwent cardiac magnetic resonance imaging at the First Affiliated Hospital of Anhui Medical University from July to September 2023.T1ρ mapping and short-axis cine imaging with steady-state free precession sequences were performed with 3.0T MR system.T1ρ mapping sequence in three short-axis slices with three spin-lock frequencies at the amplitude of 5 Hz,300 Hz,400 Hz,and 500 Hz was scanned,respectively.T1ρ relaxation times and myocardial fibrosis index were quantified for each slice and each myocardial segment,the difference in T1ρ of different spin-locking frequencies and myocardial fibrosis index was analyzed using one-way repeated-measures analysis of variance method.Results T1ρ of 5 Hz,300 Hz,400 Hz,and 500 Hz were(33.9±2.8)ms,(43.4±2.1)ms,(45.4±2.6)ms and(46.5±2.4)ms,respectively;and T1ρ values showed a significant progressive increase from the low spin-lock frequency to the high spin-lock frequency of the heart(300 Hz vs.400 Hz:P<0.001;300 Hz vs.500 Hz:P<0.001;400 Hz vs.500 Hz:P=0.043).In addition,the measured myocardial fibrosis index at 300 Hz,400 Hz and 500 Hz were(9.4±2.2)ms,(11.3±2.9)ms and(12.6±2.7)ms,respectively.Statistical analysis underscored significant variations among these measurements(300 Hz vs.400 Hz:P<0.001;300 Hz vs.500 Hz:P<0.001;400 Hz vs.500 Hz:P=0.033).Conclusion In this prospective study,myocardial T1ρ values for the specific cardiac magnetic resonance setting are provided,and we found that spin-lock frequency can affect the T1ρ values.
6.Cardiac Magnetic Resonance Tissue Tracking Technology in Biventricular Function Assessment of Patients with Chronic Kidney Disease
Shutian AN ; Wei DENG ; Hao QIAN ; Caiyun HAN ; Ren ZHAO ; Yongqiang YU ; Xiaohu LI
Chinese Journal of Medical Imaging 2024;32(11):1123-1128
Purpose To explore the changes in biventricular volume and mass in chronic kidney disease(CKD)patients with preserved ejection fraction using cardiac magnetic resonance(CMR),and evaluate cardiac function using tissue-tracking strain analysis.Materials and Methods The retrospective analysis of 40 CKD patients without symptoms of cardiovascular disease,diabetes and the estimated glomerular filtration rate<60 ml/(min·1.73 m2)who were treated at the First Affiliated Hospital of Anhui Medical University from October 2020 to June 2023 and 25 age-and gender-matched healthy volunteers.All participants underwent 1.5T CMR scans to calculate left and right ventricular function,myocardial strain and native T1 and T2 values,and differences in various imaging parameters between the two groups were compared.Results The native T1 value[(1 109.6±35.9)ms]and T2 value[(58.1±2.9)ms]of CKD patients were significantly higher than those in control group[(1 046.3±15.9)ms,(53.3±2.3)ms](t=8.296,6.916,both P<0.001).The left ventricular end-diastolic volume index,left ventricular end-systolic volume index,left ventricular mass index,right ventricular end-diastolic volume index,right ventricular end-systolic volume index and right ventricular mass index of CKD patients were significantly increased compared with the control group(t=3.233,3.350,5.751,7.746,5.937,2.363,all P<0.05),while the left and right ventricular strain parameters,left ventricular global longitudinal strain,left ventricular global circumferential strain,left ventricular global radial strain,right ventricular global longitudinal strain,right ventricular global circumferential strain and right ventricular global radial strain were significantly decreased(t=9.506,9.072,-10.603,10.496,11.574,-4.018,all P<0.001),and the estimated glomerular filtration rate exhibited significant correlations with left ventricular global longitudinal strain(r=-0.636),left ventricular global radial strain(r=0.688),right ventricular global longitudinal strain(r=-0.513),right ventricular global circumferential strain(r=-0.827)and right ventricular global radial strain(r=0.514)(all P<0.001).Conclusion CMR can quantitatively assess myocardial fibrosis and edema in patients with CKD,and tissue tracking strain analysis can detect myocardial motion abnormalities before changes in ventricular ejection fraction,offering value in the early detection of cardiac involvement in CKD patients..
7.The effect of salpingectomy with preservation of the mesosalpinx on ovarian reserve function
Bo LI ; Chuancui HU ; Da ZHAO ; Fangting LIN ; Yan GAO ; Caiyun LIN ; Xiaoli WANG
Journal of Clinical Medicine in Practice 2024;28(4):34-38
Objective To investigate the impact of salpingectomy with preservation of fallopian tube mesentery on ovarian reserve function. Methods A total of 281 patients with tubal disease who were admitted from January 2020 to March 2021 were collected as research objects. According to the different treatment methods, they were divided into traditional bilateral resection group (
8.Berberine Inhibits Atherosclerosis by Regulating Lipophagy Via Targeting Wnt5a/NPC1 Signaling Pathway
Caiyun YANG ; Qiwen LU ; Sang LUO ; Mengting TU ; Tong ZHAO ; Cuicui ZHENG ; Qiang WAN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(18):62-68
ObjectiveTo investigate the regulatory effect and molecular mechanism of berberine (BBR) on lipophagy in the prevention and treatment of atherosclerotic (AS) lesions in mice. MethodFifty apolipoprotein E-knockout (ApoE-/-) mice were randomly divided into an AS model group, an atorvastatin group (5 mg·kg-1), and low-, medium-, and high-dose BBR groups (2.5, 5, 10 mg·kg-1). Ten C57BL/6J mice were assigned to the control group. After 12 weeks, hematoxylin-eosin (HE) and oil red O staining were performed to assess the histopathological changes of AS plaques in the aorta. Biochemical analysis was used to measure serum lipid levels, and enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), oxidative stress marker reactive oxygen species (ROS), and serum lipophagy marker Beclin1 and microtubule-associated protein 1 light chain 3 Ⅱ (LC3Ⅱ). The xanthine oxidase method was used to measure serum superoxide dismutase (SOD) activity. Immunohistochemistry (IHC) was used to detect the distribution of wingless-type MMTV integration site family member 5a (Wnt5a) and Nieman Pick type C1 (NPC1) in the aorta, and Western blot was used to determine the protein expression of Wnt5a and NPC1 in the aorta. ResultCompared with the control group, the AS model group showed significant AS plaque formation, significantly elevated levels of serum total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), IL-6, TNF-α, and ROS, aortic Wnt5a distribution and protein expression (P<0.01), and significantly reduced levels of serum high-density lipoprotein cholesterol (HDL-C), SOD, Beclin1, LC3Ⅱ, and aortic NPC1 distribution and protein expression (P<0.01). Compared with the AS model group, the atorvastatin group, and high- and medium-dose BBR groups showed a significant reduction in AS plaque area (P<0.05, P<0.01), significantly decreased levels of serum TC, TG, LDL-C, IL-6, TNF-α, ROS, and aortic Wnt5a distribution and protein expression (P<0.05, P<0.01), and significantly increased levels of serum HDL-C, SOD, Beclin1, LC3Ⅱ, and aortic NPC1 distribution and protein expression (P<0.05, P<0.01). There was no statistically significant difference in the above indicators between the atorvastatin group and the medium-dose BBR group. ConclusionBBR can competitively bind to Wnt5a to activate NPC1 expression, upregulate lipophagy levels, reduce blood lipids, and inhibit the release of inflammatory mediators and oxidative stress damage, thereby exerting a preventive and therapeutic effect on AS.
9.Correlation analysis of bone mineral density, hemoglobin and serum albumin in healthy population
Caiyun WANG ; Kaiping ZHAO ; Xiaojuan ZHA ; Limei RAN ; Shuang CHEN ; Yan WU ; Guobin HONG ; Yong LU ; Yuqin ZHANG ; Xiao MA ; Jing LU ; Xigang XIAO ; Xiangyang GONG ; Zehong YANG ; Wei CHEN ; Lü YINGRU ; Jianbo GAO ; Shaolin LI ; Yuehua LI ; Xia DU ; Qiang ZENG ; Xiaoguang CHENG ; Jing WU ; Yongli LI
Chinese Journal of Health Management 2022;16(9):616-622
Objective:To use quantitative computed tomography (QCT) technology to measure the bone mineral density of the spine of the Chinese healthy population, and to explore its correlation with hemoglobin and serum albumin.Methods:The data in this study came from the China Health Quantitative CT Big Data Project (China Biobank). The spine bone density was measured by using QCT Pro Image Analysis System and all cooperating centers used the European spine phantom (NO.145) for quality control. Total of 50 053 healthy persons who met the criteria for entry were selected as the research subjects. The subjects were divided into 7 groups according to age. The general data, spine bone density, serum albumin, hemoglobin of the subjects were collected. The single-factor analysis of variance, Pearson correlation analysis and multi-classification logistic regression model were applied to analyze the correlation between bone density and hemoglobin and serum albumin.Results:The bone mineral density of healthy people decreased with age ( P<0.05), and there were significant differences in hemoglobin, serum albumin and body mass index (BMI) among different age groups (all P<0.05). Linear correlation analysis showed that there were positive correlation between bone mineral density and hemoglobin in healthy males in different age groups ( r=0.086, 0.101, 0.076, 0.090, 0.072, 0.123, 0.100, all P<0.01). There were negative correlation between bone mineral density and hemoglobin in certain age groups in women (40-49 years group: r=-0.027; 70-79 yearsgroup: r=-0.077; both P<0.05). And corelation were found between bone mineral density and serum levels of albumin in certain age groups of healthy subjects (among men, 30-39 years group: r=-0.048; 40-49 years group, r=-0.027; 70-79 years group, r=-0.051; among women, 30-39 years group: r=-0.044; 40-49 years group, r=-0.042; 50-59 years group, r=-0.086; 70-79 years group, r=-0.070; all P<0.05). After adjusting for age and BMI, the multi-category logistic regression analysis showed that the hemoglobin level was protective factor of normal bone density ( OR=1.022, 95% CI:1.017-1.027) and decreased bone density ( OR=1.012, 95% CI:1.007-1.016) in healthy males, and the serum albumin was risk factor for normal bone density ( OR=0.926, 95% CI:0.905-0.948) and decreased bone density ( OR=1.006, 95% CI:0.951-1.011) in healthy women. Conclusion:There is a correlation between bone mineral density and hemoglobin and serum albumin in Chinese healthy population. Hemoglobin is a protective factor for bone mineral density in men, and serum albumin is a risk factor for bone mineral densityin women.
10.Distribution of variants of 88 recessive genetic disease-related genes among 1314 individuals from Chenzhou, China.
Caiyun LI ; Yan ZHAO ; Haoqing ZHANG ; Yong GAO ; Yaqing LI ; Dongzhu LEI
Chinese Journal of Medical Genetics 2022;39(12):1319-1323
OBJECTIVE:
To determine the carrier rate for common recessive genetic diseases in Chenzhou region in order to provide a reference for carrier screening in this region.
METHODS:
Targeted capture and high-throughput sequencing were carried out to detect potential variants of 79 genes associated with 88 recessive genetic diseases. Couples at risk were provided with prenatal diagnosis upon their subsequent pregnancies.
RESULTS:
A total of 1314 individuals were enrolled, among whom 355 (27.02%) were found to be carrier for at least one disease. The carrier rates for 8 diseases have exceeded 1%, with the most common two including thalassemia (11.72%, 154/1314) and autosomal recessive deafness (5.48%, 72/1314). Ten couples were found to be at risk for producing affected offspring. Among these, five females were carriers for X-linked recessive genetic diseases. Following genetic counseling, seven couples had accepted prenatal diagnosis, and 3 affected fetuses were diagnosed.
CONCLUSION
The disease types and pathogenic variants of Chenzhou region have differed from previously reported. Further research is required to validate the above finding with a larger populations.
Female
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Pregnancy
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Humans
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China
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Prenatal Diagnosis
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Fetus
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Genetic Counseling
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Genetic Diseases, X-Linked


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