Acid-related diseases (ARDs) are characterized by high incidence rates and significant disease burden. Excessive gastric acid secretion or heightened gastric acid sensitivity is the common pathogenesis of these conditions, leading to the widespread application of the principle of "treating different diseases with the same therapy" in medication management. With increasing concerns about the risks of inappropriate use of acid-suppressing drugs like proton pump inhibitors (PPIs), there is an urgent need to deepen the systematic understanding of medication therapy for acid-related diseases and to promote rational drug use. This consensus was developed by a multidisciplinary panel of experts in clinical medicine, pharmacy, and methodology. Based on evidence-based medicine, it provides a systematic elaboration on the classification of ARDs, therapeutic drugs, diagnostic methods, and pharmaceutical care services. Additionally, it offers consensus-based recommendations and management strategies for key clinical issues encountered in practice. The release of this consensus is of great significance for establishing a medication therapy management system and promoting rational drug use for acid-related diseases.
Background Sleep apnea is a high incidence sleep disorder disease in clinic.With the change of lifestyle,the incidence rate continues to rise,which can cause cardiovascular,metabolic and other multiple system damage.In recent years,it has been found that female sleep apnea patients often experience reproductive dysfunction such as menstrual disorders and infertility.However,the immune regulatory mechanism of sleep apnea induced damage to the female reproductive system,especially the abnormal immune response mediated by dendritic cells(DCs),still lacks in-depth analysis.Objective To study the effects of sleep apnea induced immune dysfunction on the reproductive system of female rats.Methods The research period was from January 2023 to December 2024.Thirty 4-6 month female SD rats(SPF grade)with regular estrous cycles were randomly divided into a blank control group,a short-term group,and a long-term group,with 10 rats in each group.The blank control group was fed normally for 6 weeks,the short-term group was fed for 3 weeks on the basis of preparing a sleep apnea model,and the long-term group was fed for 6 weeks on the basis of preparing a sleep apnea model.The estrous cycle of each group of rats,the expression levels of estrogen receptor alpha(ERα)and estrogen receptor beta(ERβ)subtypes in ovarian tissue,and the number of follicles in ovarian tissue were analyzed.The migration ability of DCs,the ability of DCs to stimulate homologous T lymphocyte proliferation response(MLR),and the changes in Toll-like receptor 4(TLR4)and RelB expression levels in DCs were observed.The fertility of each group and the growth and development of offspring mice were analyzed.Results Compared with the blank control group,the long-term groups showed an increased rate of dysregulation in the estrous cycle(P<0.017).Compared with the blank control group,the expression levels of ERα and ERβ in ovarian tissues were reduced in the short-term and long-term groups(P<0.05).Compared with the short-term group,the long-term group showed a decrease in the expression levels of ER α and ERβ in ovarian tissue(P<0.05).Compared with the blank control group,the number of primordial follicles,primary follicles,and antral follicles decreased in the short-term and long-term groups,while the number of blocked follicles increased(P<0.05).Compared with the short-term group,the long-term group showed a decrease in the number of primordial follicles,primary follicles,and antral follicles,and an increase in the number of blocked follicles(P<0.05).Compared with the blank control group,the migration rate of DCs decreased and the MLR increased in the short-term and long-term groups(P<0.05).Compared with the short-term group,the long-term group showed a decrease in the migration rate of DCs and an increase in MLR(P<0.05).Compared with the blank control group,the expression levels of TLR4 and RelB in DCs in both the short-term and long-term groups increased(P<0.05).Compared with the short-term group,the long-term group showed an increase in the expression levels of TLR4 and RelB in DCs(P<0.05).Compared with the blank control group,the pregnancy rate and live birth rate of long-term groups decreased(P<0.05).Three groups of live born offspring mice showed an increase in daily weight after 21 days of birth,but compared with the blank control group,the short-term and long-term groups showed growth retardation,especially the long-term group.Conclusion Sleep apnea can cause ovarian dysfunction and reduced fertility in female rats,suggesting that it may activate TLR4/RelB by altering the migration ability of DCs,leading to immune damage and reproductive system disorders.
Background Cervical cancer is the fourth most common malignant tumor among women worldwide,with persistent infection of high-risk human papillomavirus(HR-HPV)being its necessary cause.HPV vaccination can effectively prevent cervical cancer;however,the coverage rate of HPV vaccination in China remains far below the 90%target set by the WHO.Current research on factors influencing HPV vaccine coverage is insufficient.This study aims to contribute evidence to this field.Objective To explore the spatial relationships between HPV vaccine coverage and its influencing factors among the eligible population in China,and to provide a scientific basis for formulating region-specific HPV vaccination strategies tailored to the actual conditions of different provincial-level administrative regions.Methods The dependent variable was derived from the 2022 regional statistics on HPV vaccine coverage released by the Chinese Center for Disease Control and Prevention.Independent variables were obtained from the Seventh National Population Census,the China Statistical Yearbook 2022,and the National Bureau of Statistics,covering 10 continuous variables across two categories:socioeconomic level and health indicators.These included female junior high school,senior high school,and higher education rates;female illiteracy rate;female employment rate;proportion of ethnic minority women;proportion of rural women;per capita disposable income;per capita healthcare expenditure;and number of community health service centers(stations).All variables were included in the model in their original form.Data processing and general analysis were performed using R software,and a linear regression model was constructed.Global spatial autocorrelation analysis,geographically weighted regression(GWR)modeling,and hotspot analysis were conducted using ArcGIS software,with spatial distribution maps generated.Data collection and analysis were completed in April 2025.Results The HPV vaccine coverage rates across provinces ranged from 2.55%to 25.40%.Significant differences in coverage were observed among provincial-level administrative regions,exhibiting distinct spatial clustering characteristics(Moran's I index=0.198,P=0.007).Coverage was higher in southeastern regions and the Sichuan-Chongqing area,while relatively lower in western regions.HPV vaccine coverage was influenced by female education level,economic status,female sociodemographic characteristics,and the number of community health service centers(stations)(P<0.05),with varying degrees of impact across spaces.Conclusion HPV vaccine coverage in China demonstrates a pattern of higher rates in the southeast and lower rates in the northwest.Female higher education rate,per capita disposable income,and proportion of rural women are core factors contributing to this spatial disparity.A triple policy of"central government full funding,mobile vaccination units,and health education campaigns"could be implemented in western regions.Eastern regions should provide economic support for disadvantaged populations.Central regions could expand the eligibility for HPV vaccination subsidies and convert high health literacy into higher vaccination rates through behavioral incentives.Adopting precise,localized strategies will enhance HPV vaccine coverage and substantially advance the elimination of cervical cancer.
Background As China embarks on a new journey towards common prosperity, it is crucial to address the issue of preventing rural residents from falling back into poverty due to illness. This is a significant step towards achieving common prosperity. Objective This study aims to understand the distribution of health poverty vulnerability among rural out-migrant workers in Ningxia and identify the influencing factors, with the goal of providing policy recommendations for Ningxia to consolidate its poverty alleviation achievements and prevent poverty from returning due to illness. Methods Using field survey data collected by the research team in Haiyuan County, Yanchi County, Xiji County, and Pengyang County in Ningxia from June to July 2022, the study employed the three-stage feasible generalized least squares (FGLS) method to measure health poverty vulnerability. Logit regression analysis was used to identify the influencing factors. The study also used the marginal effect and Shapley value decomposition method to quantify the contribution of each factor. Results The proportion of health poverty vulnerable rural out-migrant workers in Ningxia is 4.5%. The logit model regression analysis results show that housing and kitchen separation, using electricity as living fuel, and participating in a health check in the past year can reduce the risk of health poverty vulnerability. Married status, borrowing money due to illness, and having a low level of education will increase the risk of health poverty vulnerability. The Shapley value decomposition results show that demographic characteristics contribute the most (55.93%), followed by family characteristics (16.46%) and health risk characteristics (15.34%). Conclusion The health poverty vulnerability among rural migrant workers in Ningxia is within a controllable range compared with the overall level in the western region. Having separate housing and kitchen areas, using electricity as a domestic fuel, participating in health check - ups within the past year, being in a married status, and borrowing money due to illness are key factors affecting the health poverty vulnerability of migrant workers from Ningxia. It is recommended that relevant departments establish an early warning system for the risk of returning to poverty due to illness, proactively adjust policies, and promote the effective implementation of health poverty prevention efforts.
Background Community pharmacy has significant advantages in curbing medication misuse and managing chronic diseases.Nevertheless,pharmacists encounter challenges such as complex job duties,inadequate professional knowledge,and low public awareness.Under the background of government support for innovating and expanding pharmacists'roles,the healthcare alliance has emerged as an ideal solution to the dilemma in community pharmacy.Objective This research devote to establish a community pharmacy studio to enhance the quality of community pharmacy services and the outcomes of chronic disease management based on the healthcare alliance model.Methods Three randomized controlled trials were implemented in three communities within a healthcare alliance from April 2023 to March 2024,while all control groups served as negative controls.In Trial one,254 healthcare professionals were randomly and equally divided into two groups.The experimental 1 group received pharmaceutical literacy training,after which the outcomes were compared with those of the control 1 group.In Trial two,540 residents were randomly divided into two groups,the experimental 2 group received services from the community pharmacy studio.Pharmaceutical literacy,medication adherence,pharmacist recognition,and service satisfaction were compared between the two groups.In Trial three,118 chronic disease patients were randomly divided into two groups.The experimental 3 group received individualized medication guidance,and the rates of chronic disease indicator control were compared between the two groups.Data were collected through questionnaires,interviews,and medical record reviews and analyzed by SPSS 24.0 software.Results Survey results indicated that the proportion of participants with high pharmaceutical literacy in the experimental 1 group(86.61%,110/127)was significantly higher than in the control 1 group(68.50%,87/127),showing a statistically significant difference(χ2=11.966,P<0.01).The research found that the experimental 2 group had a higher proportion of residents with high pharmaceutical literacy compared to the control 2 group(P<0.001),according to comprehensive assessment of community residents'pharmaceutical literacy and service satisfaction.Additionally,the proportion of community residents exhibiting high medication adherence was higher in the experimental 2 group compared to the control 2 group(P<0.05).Furthermore,respondents in the experimental 2 group were satisfied with the pharmacy studio,the degree of satisfaction was significantly higher than that in the control 2 group(P<0.001).Also,the experimental 2 group had a higher proportion of residents recognizing the professional the pharmacist team compared to the control 2 group(P<0.01).The experimental 3 group demonstrated a higher rate of achieving chronic disease control targets than the control 3 group,and a higher proportion of positive evaluations regarding the pharmacist's role compared to the control 3 group(P<0.05).Conclusion Supported by healthcare alliance,the community pharmacy studio model,effectively overcame the challenges of community pharmacy development,enhanced the quality of pharmacy services,improved outcomes of patient disease management,and set new standards for the future of community pharmacy.This model provides valuable insights and practical experience for the development and innovation of community pharmacy services in China.
