Objective To investigate risk factors of medication non-adherence in elderly patients with hypertension through Meta-analysis.Methods Literatures on medication non-adherence in elderly patients with hypertension were systematically reviewed across various databases,from inception to September 1st 2023,including CNKI,VIP,Wangfong Database,SinoMed,PubMed,Web of Science,Cochrane Library、EMbase.Meta-analysis was conducted using RevMan 5.4.Results A total of 19 articles were included,comprising a total of 18 220 patients in sample size.Meta analysis identified 10 risk factors,showed significant association(P<0.05)with:age[OR=1.36,95%CI=(1.00,1.86)],place of residence[OR=1.91,95%CI=(1.33,2.75)],method of payment for medical expenses[OR=1.60,95%CI=(1.38,1.86)],income level[OR=1.68,95%CI=(1.45,1.95)],occupational status[OR=1.79,95%CI=(1.37,2.36)],social support[OR=1.43,95%CI=(1.27,1.60)],comorbidity[CI=0.33,95%(0.19,0.58)],frequency of blood pressure measurement[CI=1.53,95%(1.14,2.05)],disease awareness[OR=1.70,95%CI=(1.44,2.00)]and dedication frequency[OR=1.44,95%CI=(1.16,1.79)].In addition,the number of influencing factors such as gender,marital status,depression,cognitive impairment,and complications was included in<3 articles,and only descriptive analysis was conducted.Conclusion Healthcare providers should focus on the identification and management of the risk factors associated with medication non-adherence in elderly patients with hypertension,therefore to reduce the incidence of medication non-adherence.

Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population. Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA). Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively). Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.

Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.

Drastic surges in intracellular reactive oxygen species (ROS) induce cell apoptosis, while most chemotherapy drugs lead to the accumulation of ROS. Here, we constructed an organic compound, arsenical N-‍(4-(1,3,2-dithiarsinan-2-yl)phenyl)acrylamide (AAZ2), which could prompt the ROS to trigger mitochondrial-dependent apoptosis in gastric cancer (GC). Mechanistically, by targeting pyruvate dehydrogenase kinase 1 (PDK1), AAZ2 caused metabolism alteration and the imbalance of redox homeostasis, followed by the inhibition of phosphoinositide-3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway and leading to the activation of B-cell lymphoma 2 (Bcl2)/Bcl2-associated X (Bax)/caspase-9 (Cas9)/Cas3 cascades. Importantly, our in vivo data demonstrated that AAZ2 could inhibit the growth of GC xenograft. Overall, our data suggested that AAZ2 could contribute to metabolic abnormalities, leading to mitochondrial-dependent apoptosis by targeting PDK1 in GC.
Humans ; Signal Transduction ; Stomach Neoplasms/drug therapy* ; Reactive Oxygen Species/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Apoptosis ; Proto-Oncogene Proteins c-bcl-2 ; Cell Line, Tumor

AIM: To observe the effects of rapamycin pregnancy intervention on cognitive function of autism model in rat offspring. METHODS: Fourteen pregnant rats were randomly divided into normal group (n = 3), model group (n = 4), rapamycin (RAPA) control group (n =3) and intervention group (n = 4). The model group and intervention group were i.p. injected with sodium valproate 600 mg/kg at embryonic day (E) 12.5 to establish autism model in rat offspring. RAPA control group and intervention group were i.g. given RAPA 4 mg/kg every day from the 13th day of gestation until the offspring rats were weaned at 23 days. After the birth of the above four groups of pregnant rats, 15, 27, 21 and 26 offspring male rats were selected to conduct behavioral tests to identify the model. Then, paw withdrawal mechanical threshold (PWMT), tail flick latency (TFL) evoked under different light intensity and learning and memory function of offspring rats were further detected. RESULTS: Rat offspring in the model group had lower growth and development indexes and exploratory behavior ability, but stronger repetitive stereotyped behavior compared with the normal group (P < 0.05), while the indexes between the intervention group and model group were reversed (P < 0.05). The model group had higher PWMT than normal group (P < 0.01) and the PWMT of intervention group was lower than that of model group (P < 0.01). The TFLs of rats in 4 groups showed a timed dose-response relationship (TDRR, P < 0.01), that is, TFLs were shortened with the increase of light intensity. The TDRR curve of model group shifted to right compared with normal group (P < 0.01) and intervention group shifted to left compared with model group (P < 0.01). At the light intensity of Focus 34, 51 and 76, the TFLs of model group were longer than those of normal group (P < 0.01) and intervention group had shorter TFLs compared with model group (P<0.01). In spatial probing trial of Morris water maze test, the platform crossover number in model group was less than that in normal group (P<0.01) and that in intervention group was more than model group (P < 0.05). CONCLUSION: RAPA intervention during pregnancy may alleviate behavior disorder, pain tolerance and memory function of autism model in rat offspring to some extent.

Secondary hyperparathyroidism (SHPT) is a common and serious complication in long-term dialysis patients, who often experience multiple symptoms and a poor quality of life. Parathyroidectomy (PTX) is the best choice for severe SHPT patients with poor drug treatment. At present, the follow-up after PTX has not received sufficient attention, and the assessment of patients' clinical symptoms and quality of life is not yet adequate. In view of this, we systematically combed the changes and influencing factors of patients' quality of life and related symptoms after surgery, in order to provide reference for the practice and research of symptom management of such patients in the future.

Background: and Purpose Patients with aortic disease might have an increased risk of intracranial aneurysm (IA). We conducted this research to assess the prevalence of IA in patients with aortopathy, considering the impact of gender, age, and cardiovascular risk factors. Methods: We searched PubMed and Scopus from inception to August 2019 for epidemiological studies reporting the prevalence of IA in patients with aortopathy. Random-effect meta-analyses were performed to calculate the overall prevalence, and the effect of risk factors on the prevalence was also evaluated. Anatomical location of IAs in patients suffered from distinct aortic disease was extracted and further analyzed. Results: Thirteen cross-sectional studies involving 4,041 participants were included in this systematic review. We reported an estimated prevalence of 12% (95% confidence interval [CI], 9% to 14%) of IA in patients with aortopathy. The pooled prevalence of IA in patients with bicuspid aortic valve, coarctation of the aorta, aortic aneurysm, and aortic dissection was 8% (95% CI, 6% to 10%), 10% (95% CI, 7% to 14%), 12% (95% CI, 9% to 15%), and 23% (95% CI, 12% to 34%), respectively. Gender (female) and smoking are risk factors related to an increased risk of IA. The anatomical distribution of IAs was heterogeneously between participants with different aortic disease. Conclusions According to current epidemiological evidence, the prevalence of IA in patients with aortic disease is quadrupled compared to that in the general population, which suggests that an early IA screening should be considered among patients with aortic disease for timely diagnosis and treatment of IA.

Antiangiogenic target therapy has been a hot topic in cancer treatment recently.Apatinib is a category 1.1 new medication developed domestically.It effectively inhibits angiogenic and exhibits promising anti-tumor activity in preclinical studies.Apatinib has been successfully applied in clinical trials of multiple malignancies,such as gastric cancer,lung cancer and breast cancer with satisfactory safety and efficacy profile.However,its mechanism of action is still not fully understood. Further researches should be carried on to improve its safety,effectiveness and marketability.This review summarized the mechanism of action,pharmacokinetics,clinical efficacy,safety and biomarkers,discussed the recent progress,hot issues and clinical prospects of apatinib,

This study aimed at exploring the economic operation and developing trend of county-level public TCM hospitals in Guangxi Province,promoting the comprehensive reform of county-level public hospitals with feasible countermeasures and suggestions.In this study,forty-seven county-level public TCM hospitals were involved in the analysis of their economic operations and benefits by constituent ratio analysis,ratio analysis and trend analysis.As a result,the average gross income of the hospitals exceeded the total expenditure with a slight surplus.Drug income contributed the biggest share of the medical income,while the ratio of Chinese drug income to the medical income was increasing year by year.The debt ratio increased from 38.7％ in 2009 up to 44.6％ in 2013,being over 30％ in this period.In conclusion,it was demonstrated that problems were found in the lack of financial assistance,the low efficiency of economic management and the increasing average medical charges,which should be addressed by increasing investments to TCM hospitals,strengthening the performance appraisal and adjusting the charges of TCM medical services.

Objective To study the demand of general doctors'professional skill in Guangxi Zhuang autonomaus region,and to enhance the professional skills and overall quality of general practitioners in Guangxi,thus to improve grassroots'health service capacity.Methods Through self -designed questionnaires and personal interviews,the author investigated the professional skills of general practitioners in rural township hospitals and urban community health service centers in Guangxi.Results The characteristics of the general practitioners in Guangxi were junior college degree,junior titles,youth and middle -aged.Part of the general practitioners thought that working with the guide of community health informationteaching abilityand the corresponding scientific research capabilitiesdid not belong to the scope of the general practitioners'professional skills demand,the percentage of these were 2%, 22%,26%.The teaching ability and the corresponding scientific ability of the general practitioner who were greater than 30 years,junior college degree and middle grade title and above,were better than the practitioners who were 20 -30 years,technical secondary degree,primary title(χ2 =12.886,1.945,57.473,53.276,30.458,29.141,all P <0.05).The general practitioners in Guangxi had a light awareness of teaching,scientific researching and other aspects.Conclusion We must emphasis on continuous medical education;establish and improve the system of general practitioners;establish and improve the two -way referral system.General practitioners must pay more attention on teaching and scientific researching.