肺结核病人化疗依从性相关因素研究

目的研究影响肺结核病人治疗依从性的相关因素。方法对2004年3月1日至2006年6月30日在肺科住院的曾用过抗结核药品的肺结核病人采取问卷方式调查,了解病人规律服药情况及影响因素,评价患者对抗结核治疗依从性并总结分析。结果病人规则服药率为58.9%,影响病人服药依从性因素多为人为主观因素,并与病人年龄、结核病知晓情况及实行督导管理质量、药物不良反应相关。结论加强对结核病人及综合医院医生的防痨宣教,提高病人对结核病的知晓率,重视肺结核病人的督导管理,是提高结核病人治疗依从性的重要措施。     

昌吉市结核病患者治疗管理与健康教育

目的分析评价昌吉市结核病人在全程督导化疗过程中,对患者及家属进行必要的健康教育实施效果。方法对登记管理的痰涂片阳性肺结核患者及初治涂阴病人在提供免费抗结核药物治疗的同时,对每位患者及家属进行结核病防治知识的健康教育,提高患者治疗依从性及家属督促服药的责任心。结果健康教育工作,贯穿了整个治疗过程,实施有效的治疗管理,涂阳病人免费治疗率达100%,涂阳病人治愈率逐年稳步提高。结论建立长效的健康教育机制,提高了患者的治疗依从性,确保患者做到全程规律服药,提高了结核病防治工作质量,对提高治愈率起到了积极有效地促进作用。     

影响肺结核治疗转归的因素分析

目的 分析影响肺结核患者治疗转归的有关因素,为结核病防治提供理论依据.方法 收集1993-2001年世界银行贷款结核病控制项目期间涟源市卫生防疫站4 747份肺结核病历资料,对影响肺结核患者治疗转归的有关因素进行单因素分析和多因素非条件Logistic回归分析.结果 单因素分析表明,年龄、性别、疾病治疗之初有咯血症状(χ2=10.20,P=0.01)及临床症状超过3种、合并其他结核、就诊延误、既往用药、空洞、非全程督导管理方式、治疗2个月末痰菌阳性、初治涂阳病人不含链霉素治疗方案对肺结核患者的治疗转归有影响.多因素分析结果显示:治疗之初痰菌阳性及乏力症状为促进患者治愈的有利因素;治疗初相关临床症状及体征如发热、肺部空洞的存在非全程督导为影响肺结核患者治疗转归的不利因素.结论 加强宣传教育以减少患者的就诊延误现象,提高对结核病患者的全程督导率,提高患者正确服药依从性将有利于患者的预后.     

涡阳县农村地区肺结核病病人服药依从性影响因素分析

目的了解安徽省涡阳县农村地区肺结核病病人服药依从性情况及影响因素,为提高结核病病人服药依从性提供参考依据。方法抽取2016年2月1日—2016年6月30日登记的服药满一年的农村结核病病人为调查对象,面对面询问肺结核病病人服药情况。结果服药依从性佳者占70.73%(145/205),服药依从性差者占29.27%(60/205),服药依从性差的主要原因依次为忘记服药(29例)、症状好转或者自行停药(8例)、药物不良反应大(7例)、对自身疾病认识不足(6例)、经济原因(5例)、治疗方案了解不清(2例)、其他(2例)和就诊不方便(1例);年龄、文化程度与服药方式为影响服药依从性的主要因素(P0.05)。结论涡阳县肺结核病病人服药依从性相对较差,其中60岁及以上年龄组、文化程度低、家庭成员督导服药方式是影响服药依从性的主要原因;建议加强老年结核病病人的管理和关怀,加强公众结核病防治知识宣传力度以及对结核病定点医院门诊医生的培训,基层卫生机构应做好访视工作,切实落实"直视下服药"方式,加强病人管理,以提高结核病病人的服药依从性。     

肺结核病人规则服药依从性的探讨

目的 了解住院肺结核病人入院前服药依从性的情况及其影响因素。方法 对住院病人采用问卷方式，了解病人服药规律情况及相关因素。结果 住院病人在入院前服药规律者为48.7%，影响病人规律服药的因素主要与病人对结核病的知晓情况，病人年龄和病情等因素有关。结论 应该重视住院肺结核病人入院前的治疗管理工作，做好DOTS，特别对年龄较大、病情较重者，要加强宣传教育工作。     

影响肺结核治疗转归的因素分析

目的分析影响肺结核患者治疗转归的有关因素,为结核病防治提供理论依据。方法收集1993—2001年世界银行贷款结核病控制项目期间涟源市卫生防疫站4 747份肺结核病历资料,对影响肺结核患者治疗转归的有关因素进行单因素分析和多因素非条件Logistic回归分析。结果单因素分析表明,年龄、性别、疾病治疗之初有咯血症状(χ²=10.20,P=0.01)及临床症状超过3种、合并其他结核、就诊延误、既往用药、空洞、非全程督导管理方式、治疗2个月末痰菌阳性、初治涂阳病人不含链霉素治疗方案对肺结核患者的治疗转归有影响。多因素分析结果显示:治疗之初痰菌阳性及乏力症状为促进患者治愈的有利因素;治疗初相关临床症状及体征如发热、肺部空洞的存在非全程督导为影响肺结核患者治疗转归的不利因素。结论加强宣传教育以减少患者的就诊延误现象,提高对结核病患者的全程督导率,提高患者正确服药依从性将有利于患者的预后。     

三亚市肺结核患者治疗依从性特点及其相关影响因素分析

目的探讨三亚市肺结核患者的治疗依从性特点及其相关影响因素。方法对264例确诊的肺结核患者进行调查分析,根据其治疗依从性分为依从性好组(195例)和依从性差组(69例);分析肺结核患者治疗依从性的特点,比较两组患者的各因素分布,筛选可能影响肺结核患者治疗依从性的相关危险因素。结果三亚市结核门诊的治疗依从率为73.9%(195/264);影响治疗依从性的原因为主要为药物不良反应、病情明显好转或症状减轻、取药不方便等;而影响其治疗依从性的因素包括年龄(OR=2.000)、家庭经济情况(OR=2.524)、病情严重程度(OR=0.623)、服药督导情况(OR=4.204)及DOTS管理(OR=0.480)。结论肺结核患者的治疗依从性仍然较差,应充分考虑肺结核患者治疗依从性差的原因和高危因素,制定提高肺结核患者依从性的有效措施,为防治肺结核疾病提供依据。     

住院老年肺结核患者服药依从性的探讨

目的 探讨住院老年肺结核患者服药依从性的状况及影响因素。方法 采用方便抽样的方法，对住院老年肺结核患者采用问卷调查、访谈等方式，了解服药依从性情况及相关因素。结果 住院老年肺结核患者依从性较佳者为71．2％，影响因素主要与患者的性别、病情和掌握的特定结核病相关知识等有关。结论 应重视老年肺结核患者的服药依从性，特别是男病情较重、特定结核病相关知识欠佳者。     

肺结核合并人类免疫缺陷病毒感染患者服药依从性分析

肺结核合并人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染患者，其治疗效果与病人治疗依从性密切相关。目前由于受多种因素的影响，许多患者不能遵从医嘱，坚持规律、全程用药，直接影响治疗效果，造成初治失败，产生许多难／治、复治病例，严重影响结核病控制工作进程及增加对社会的危害性。为了解影响病人治疗依从性因素，提高抗结核的依从性，笔者对我院肺科门诊27例用抗结核药的肺结核合并HIV感染病人进行追踪调查分析，结果如下。     

老年肺结核患者治疗效果影响因素的Logistic回归分析

目的 探讨影响重庆市老年肺结核患者治疗效果的因素,为结核病的防治提供依据.方法 以重庆市2011年1月1日至12月31日期间60岁以上肺结核患者为研究对象,连续动态收集老年结核病患者的人口学基本信息、患病情况及治疗相关情况,利用非条件Logistic回归筛选影响肺结核治疗效果的因素.结果 研究纳入5 678例老年肺结核患者,患者治愈率为76.24％.单因素和多因素回归分析均显示,结核初治、2月末及5月末痰检结果阴性及全程督导管理模式是提高肺结核治愈率的关键因素,患有糖尿病和对结核常规治疗药物耐药是降低肺结核治愈率的主要因素.结论 深入贯彻“全程督导”模式,及时积极地参与治疗、有效地定期随访以及合理搭配用药有助于提高老年肺结核患者治愈率.     

Smoking, aging and the centenarians

The smoke of cigarettes represents an important accelerator of the aging process, both directly through complex mechanisms mediated prevalently by excessive formation of free radicals, and indirectly by favoring the appearance of various pathologies in which smoke is a recognized risk factor. This means that smoke compromises not only life expectancy, but also the quality of the life, favoring the occurrence of non-autosufficiency. Smoking is an important risk factor for many diseases, such as cancer, cardiovascular and respiratory diseases. These are also the main causes of death in the industrialized Countries, where the habit of smoking is also largely diffused. Non-smokers have a much higher life expectancy than smokers, and the suspension of smoking is accompanied, even in the elderly, by an increase in the survival time due to the reduction of smoke-induced biological damage. Therefore, cigarette smoking is opposing the longevity, particularly the extreme one, as it is confirmed by the observations obtained on centenarians. Among them, smoking is extremely rare, and even when it occurs among them, it is correlated almost exclusively to bad health conditions and non-autosufficiency, indicating that it compromises health status and the quality of life even in extremely long living subjects. Considering the demonstrated beneficial effects of suspension of smoking, all practitioners and geriatricians in particular, should promote the abstinence from smoking as a behavioral norm for a correct life style. Non-smokers can delay the appearance of diseases and of the aging process, thus attaining longevity; further, non-smoking habit allows genetically predisposed subjects to reach the extreme longevity and maintain an acceptable health status and autosufficiency.     

Aging-related changes in the thiol/disulfide redox state: implications for the use of thiol antioxidants

Genetic and biochemical studies suggest that free radical-derived reactive oxygen species play a key role in a common mechanism of aging in many or all animal species. This led to the hypothesis that the quality of life in old age may be improved by pharmacological or dietary thiol antioxidants. This review describes important details about how the organism deals with its own thiol antioxidants. Aging was found to be associated with an oxidative shift in the thiol/disulfide redox state (REDST) of the intracellular glutathione pool and of the plasma cyst(e)ine and albumin pools. There is also a decrease in plasma thiol (mainly cysteine) concentration. The oxidative shift in intracellular REDST was found to be typically associated with cellular dysfunctions. Studies in humans related to plasma REDST revealed correlations with aging-related pathophysiological processes, suggesting that oxidative changes in REDST play a key role in processes and diseases which limit the human life span. The age-related shift in plasma REDST is mediated, at least partly, by the decreasing capacity to remove dietary cysteine from the oxidative environment of the blood. Thiol antioxidants were found to ameliorate various aging-related processes but obviously ought to be used with caution in consideration of the oxidative environment of the blood.     

健脾片健脾功能的实验研究

目的研究健脾片运化水谷,健脾益气功能的作用机制.方法对正常及脾虚模型大小鼠胃酸分泌,胃蛋白酶含量,小肠推进运动,小肠D-木糖吸收率及主要免疫功能进行检测并设对照组.结果健脾片能增强正常大鼠胃蛋白酶活性;促进脾虚模型小鼠小肠D-木糖吸收功能,增加体重,减轻胸腺、脾脏萎缩;提高脾虚大鼠总蛋白、总胆固醇含量;对正常小鼠具有促进小肠推进运动,增加血清中异物清除率,凝集素值及促进DTH反应作用.结论健脾片确具健脾作用.     

Interplay between economic empowerment and sexual behaviour and practices of migrant workers within the context of HIV and AIDS in the Lesotho textile industry

Abstract

Economic empowerment brings with it a wide range of consequences, both positive and negative. The objective of this paper was to examine the relationship between economic empowerment and the sexual behaviour and practices of migrant workers within the context of HIV and AIDS in the Lesotho textile industry. Data for this paper were extracted from the findings of a larger study which had been conducted concerning HIV and AIDS in the textile industry in Lesotho. Using in-depth interviews, data were collected from 40 participants who were purposively selected from five factories which had been chosen randomly. Empowerment theory was used as a lens to provide meanings for the experiences of the participants. The findings show that the participants were empowered only in certain respects in terms of Kabeer's empowerment model of ‘power to’ and ‘power within’, on one hand, and in terms of Malhotra's comprehensive empowerment framework at the household level, on the other, as being employed in the industry enabled them to participate in the economy. Employment in the sector provided the participants with the means to be able to acquire basic needs and the ability to participate in household decision-making: for the female participants, the ability to make independent sexual decisions was also enhanced. These improvements were greeted enthusiastically, particularly by the female participants, given their previously disadvantaged status as a result of coming from rural patriarchal villages with gender-defined hegemonic notions of respectability. The findings also indicate that environmental factors and others, such as meagre salaries, encouraged some of the female workers to engage in transactional sex, while some of the male participants tended to increase their sexual relationships as a result of acquiring employment and income from the industry. It is the contention of the authors of this study that true empowerment requires both vital resources and individual and collective participation, particularly for the women, who are more vulnerable than men. Finally, we conclude that the opportunities provided by economic empowerment have given the participants a new social meaning for their situation and an awareness about their place in power relations.     

从JCEM的特色思考CJEM的发展方向

美国内分泌学会主办的《临床内分泌学与代谢杂志》是国际上特别受内分泌临床医师青睐的专业期刊,其特色是紧密结合临床实践,紧赶当代医学最先进的手段与最新发现,具有创新性、新颖性、科学性、实用性及可读性。相比之下,我们《中华内分泌代谢杂志》有许多不足之处,本文就对此差距进行剖析,并提出今后的发展方向。