老年良性前列腺增生病人用药依从性及影响因素的横断面调查研究

目的:了解老年良性前列腺增生(BPH)病人用药依从性,分析影响用药依从性的影响因素.方法:采用横断面调查的方法,调查BPH病人用药依从性现状,并采用多因素logistic回归方法分析用药依从性的影响因素.结果:共纳入406例BPH病人,仅47.3%病人用药依从性良好.病人年龄、教育程度、婚姻状况、国际前列腺症状评分(IPSS)、服药种类和合并其他疾病间用药依从性差异均有统计学意义(P<0.01),多因素logistic回归分析结果显示,影响用药依从性的因素为教育程度、婚姻状况、IPSS评分和服药种类和合并其他疾病(P<0.01),多因素logistic回归分析结果显示,影响用药依从性的因素为教育程度、婚姻状况、IPSS评分和服药种类(P<0.05~P<0.01).结论:BPH病人服药依从性差,教育程度、婚姻状况、IPSS评分和服药种类影响病人用药依从性.建议开展健康教育、加强病人心理护理和建立用药依从性随访制度以提高用药依从性.     

影响肺结核患者化疗依从性的相关因素分析

目的 探讨肺结核患者化疗依从性影响因素.方法 回顾性分析180例肺结核患者的临床资料,对依从性影响因素进行单因素和logistic回归分析.结果 180例化疗患者中依从性佳124例(68.9%),依从性差56例(31.1%).单因素分析结果显示,患者服药依从差与年龄大、文化程度低、收入低、服药种类多、服药次数多、病程长、缺乏对肺结核疾病知识、医患关系一般、自费支付医疗费用、药物副作用等11个因素有关;logistic回归分析结果显示认知程度差、年龄大、自费支付医疗费用、药物副作用等4个因素是影响肺结核化疗依从性主要因素.结论 影响肺结核化疗依从性有诸多因素,通过开展健康教育,加强老年患者管理,正确及时处理药物不良反应,降低医疗费用,以提高患者治疗依从性.     

冠脉血运重建术后抗血小板药物依从性影响因素分析

目的探讨冠心病患者行冠脉介入术后抗血小板药物服药依从性的影响因素。方法收集262例冠脉血运重建术后患者的有关资料,采用自制调查问卷进行服药依从性调查,比较术后不同时间点患者服用药物的依从性差异。采用多因素logistic回归模型分析与影响服药依从性的因素。结果调查显示患者冠脉血运重建术后6个月患者服药依从性为51.1%,明显高于术后12个月的37.1%(P<0.05)。多因素logistic回归分析显示:婚姻状况、文化程度、经济状况、医疗付费方式、住院次数是影响服药依从性的危险因素(P<0.05)。结论患者术后1年服用药物的依从性明显下降;婚姻状况、文化程度、经济状况、医疗付费方式以及住院次数是影响冠脉血运重建术后患者服用抗血小板聚集药物的服药依从性的主要因素。     

抑郁症患者服药依从性现状及影响因素分析

目的探究抑郁症患者服药依从性的影响因素,提高其服药依从性。方法采用随机调查的方法,选择2020年4月到2020年9月在滨州医学院附属医院心理门诊就诊的200名抑郁症患者作为调查对象,采用一般资料调查表及自制的服药依从性调查量表进行调查评价。采用χ²检验、logistic回归分析,探究抑郁症患者服药依从性的影响因素。结果在收集到的195名患者中,服药依从性得分(1.91±1.37)分,而服药依从性好的有59例(总得分为0分),仅占30.26%。职业(医药类/非医药类)、月收入、服药时长、对疾病的认识、对医生的满意度以及既往有无出现药物不良反应对患者服药依从性的影响有统计学意义(P<0.05)。logistic回归分析结果显示,职业、服药时长、月收入、对疾病的了解情况以及对医生的满意度都是抑郁症患者服药依从性的影响因素。结论抑郁症患者的服药依从性情况不容乐观。职业、服药时长、月收入、对疾病了解情况以及对医生的满意度都会对服药依从性造成影响。     

2型糖尿病患者用药特征及服药依从性的相关性研究

目的 探究2型糖尿病患者口服用药特征与服药依从性的关系。方法 采用方便抽样法选取2021年1月至4月在中国科学技术大学附属第一医院内分泌科就诊的286例2型糖尿病(T2DM)患者,利用一般资料问卷、用药特征问卷及Morisky药物依从性量表进行资料收集;根据服药依从性得分将依从性分为依从性正常组和依从性差组。采用多因素logistic回归分析探讨T2DM患者服药依从性的影响因素。结果 T2DM患者服药依从性得分平均为(5.8±1.5)分,服药依从性差占总人数的38.5%。多因素logistic回归分析结果显示年龄＜60岁、有糖尿病慢性并发症、每日服用治疗糖尿病相关用药片数≥5片是T2DM患者服药依从性的危险因素(P＜0.05)。结论 T2DM患者服药依从性仍有待提高;年龄、糖尿病慢性并发症及每日服用治疗糖尿病相关用药片数是T2DM患者服药依从性的影响因素。     

强直性脊柱炎患者治疗依从性现状及影响因素研究

目的 了解强直性脊柱炎患者治疗依从性现状及其影响因素.方法 对2011年3月-2012年3月在我院风湿免疫科门诊就诊的200例强直性脊柱炎患者建立门诊健康档案,同时进行治疗依从性测评,并对不依从原因进行调查.结果 200例强直性脊柱炎患者中依从性良好者54例(占27%),依从性差或不依从者146例(占73%).单因素分析结果显示,依从性良好者和依从性差或不依从者在性别、婚姻、职业、家庭人均月收入方面,差异有统计学意义(P＜0.05);对强直性脊柱炎患者治疗依从性的影响因素进行Logistic回归分析结果显示,性别及职业进入回归方程.依从性差的原因排序为治疗因素、自身因素、知识缺乏、医患关系欠和谐、家属不支持.结论 AS患者治疗依从性低,其依从性高低与诸多因素有关,医务人员应针对患者的具体情况,实施有针对性的干预措施以提高其依从性.     

基于倾向性评分法评估耐药肺结核患者疾病感知与服药依从性的相关性

目的 耐药肺结核(MDR-TB)患者的服药依从性问题已引起高度重视,本研究采用倾向性评分法(PSM)探讨疾病感知与服药依从性的相关性。方法 选取2019年6月—2022年10月丽水市中医院结核病科收治的172例MDR-TB患者,依据Morisky服药依从性量表(MMAS-8)分成依从性良好组(103例)和依从性较差组(69例)。比较组间相关资料和简易疾病感知问卷(BIPQ)量表评分,采用logistic回归分析研究MDR-TB患者服药依从性的影响因素。PSM法按照1∶1的比例进行组间均衡匹配,比较PSM匹配后组间资料。分析PSM匹配前后MDR-TB患者MMAS-8、BIPQ量表评分的相关性。结果 PSM匹配前,依从性良好组年龄<60岁、病程<2年、高中及以上文化水平、家庭月收入≥6 000元、家人督导服药的比例高于依从性较差组(均P<0.05),医疗自费、有药物不良反应的比例和BIPQ量表评分低于依从性较差组(均P<0.05)。年龄、病程、文化水平、家庭经济水平、医疗支付方式、药物不良反应、BIPQ量表评分是MDR-TB患者服药依从性的独立影响因素(均P<...     

美沙酮维持治疗依从性及其影响因素分析

目的:分析美沙酮维持治疗依从性及其影响因素。方法:选取2015年1月-2018年1月于本中心门诊接受美沙酮维持治疗的48例患者为研究对象。根据《Morisky服药依从性问卷》调查结果分为依从性良好组和依从性差组。比较两组患者基本情况、家庭功能以及社会支持。结果:48例患者中,依从性良好者34例,占70.83%,依从性差者14例,占29.17%;依从性良好组文化程度高于依从性差组(P0.05),但两组性别、年龄、职业、婚姻状况比较差异均无统计学意义(P0.05);依从性良好组多药物滥用史、吸毒频次以及吸毒剂量均高于依从性差组(P0.05),两组吸毒方式、初吸年龄以及吸毒时间比较,差异均无统计学意义(P0.05);依从性良好组家庭功能以及社会支持中的主观支持和支持利用度均高于依从性差组(P0.05),但两组社会支持中的客观支持比较差异无统计学意义(P0.05)。结论:文化程度、家庭功能以及社会支持等均是美沙酮维持治疗患者治疗依从性的影响因素,相关部门应针对各项因素采取综合措施,提前干预。     

中老年高血压患者服药依从性的影响因素调查及对策

目的:探讨中老年高血压患者服药依从性的影响因素及对策。方法:采用自编问卷的方法对328例中老年高血压患者进行用药依从性的随访调查。结果:实际回收问卷320份,服药依从性良好占35%,服药依从性差占65%。依从性差的影响因素有:主观因素、不良反应、联合用药多、经验因素、经济因素、擅自停药、忘记服药等。服药依从性良好的患者血压控制较好,与依从性差的患者的血压下降幅度比较差异有统计学意义(P<0.01)。服药依从性差患者有3例发生心脑血管并发症。结论:中老年高血压患者服药依从性差,应加强健康宣传教育,提高其用药依从性。     

原发性高血压患者服药依从性及护理对策研究

目的 本研究调查原发性高血压患者服药依从性的影响因素及提高患者服药依从性的策略.方法 选择2006年1月至2007年6月在我院住院治疗的符合高血压诊断标准的原发性高血压患者100例,使用自行编制的高血压患者服药依从性问卷收集资料,资料分析使用SPSS 110.软件.结果 服药依从性好的患者40例,占40.8%;文化程度、家庭人均月收入(P<0.01)、病情分级(P<0.05)是影响高血压患者服药依从性的主要因素;导致高血压患者服药依从性差的原因,主要为忘记服药、认为疾病好转而停药,第三为不知道高血压病需长期服药.结论 原发性高血压患者服药依从性差,护理人员应加强对其的用药指导,培养患者正确的健康信念,以提高患者的服药依从性.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.