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61.
Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma
Williams LK Pladevall M Xi H Peterson EL Joseph C Lafata JE Ownby DR Johnson CC 《The Journal of allergy and clinical immunology》2004,114(6):283-1293
BACKGROUND: Regular use of inhaled corticosteroids (ICSs) can improve asthma symptoms and prevent exacerbations. However, overall adherence is poor among patients with asthma. Objective To estimate the proportion of poor asthma-related outcomes attributable to ICS nonadherence. METHODS: We retrospectively identified 405 adults age 18 to 50 years who had asthma and were members of a large health maintenance organization in southeast Michigan between January 1, 1999, and December 31, 2001. Adherence indices were calculated by using medical records and pharmacy claims. The main outcomes were the number of asthma-related outpatient visits, emergency department visits, and hospitalizations, as well as the frequency of oral steroid use. RESULTS: Overall adherence to ICS was approximately 50%. Adherence to ICS was significantly and negatively correlated with the number of emergency department visits (correlation coefficient [ R ] = -0.159), the number of fills of an oral steroid ( R = -0.179), and the total days' supply of oral steroid ( R = -0.154). After adjusting for potential confounders, including the prescribed amount of ICS, each 25% increase in the proportion of time without ICS medication resulted in a doubling of the rate of asthma-related hospitalization (relative rate, 2.01; 95% CI, 1.06-3.79). During the study period, there were 80 asthma-related hospitalizations; an estimated 32 hospitalizations would have occurred were there no gaps in medication use (60% reduction). CONCLUSIONS: Adherence to ICS is poor among adult patients with asthma and is correlated with several poor asthma-related outcomes. Less than perfect adherence to ICS appears to account for the majority of asthma-related hospitalizations. 相似文献
62.
氨基胍对去卵巢大鼠主动脉晚期糖化终末产物及血脂的影响 总被引:2,自引:1,他引:2
将 6月龄雌性SD大鼠随机分为假手术组 (sham)、去卵巢组 (OVX)和去卵巢 +氨基胍组 (OVX +AG)。去除双侧卵巢 2周后用氨基胍治疗 13周。禁食 2 4h ,放血处死动物 ,取血和主动脉 ,分别测定主动脉AGEs、血脂和血清过氧化物含量。结果表明 ,与假手术组比较 ,去卵巢组主动脉AGEs、甘油三脂 (TG)、氧化低密度脂蛋白 (OX LDL)、丙二醛 (MDA)均明显升高 (分别为P <0 0 1,P <0 0 5 ,P <0 0 5和P <0 0 1) ;高密度脂蛋白 胆固醇 (HDL C)、载脂蛋白AⅠ (apo AⅠ )和超氧化物歧化酶 (SOD)活性均显著降低 (均P <0 0 1)。氨基胍组与病理组比较 ,主动脉AGEs、血清TG、MDA和OX LDL均明显降低 (分别为P <0 0 1,P <0 0 5、P <0 0 5和P <0 0 1) ;HDL C、apo AⅠ和SOD活性均显著升高 (均P <0 0 1)。提示氨基胍通过降低去卵巢大鼠主动脉AGEs含量 ,降低大鼠血清OX LDL和TG水平 ,升高HDL C、apo AⅠ水平和SOD活性 ,发挥其对心血管的保护作用 相似文献
63.
目的:探讨内皮细胞清除补体攻膜复合物(MAC)的途径及其清除动力学,方法:原代培养的人脐静脉内皮细胞以RH414荧光标记质膜双层,0℃组装亚溶剂量的MAC,37℃复苏后,LSCM实时监MAC沉积诱导的质膜囊泡化形成和胞吞,胞吐情况,流式细胞仪定量检测内皮细胞表面MAC抗原的清除情况,结果:MAC沉积后,内皮细胞有的质膜囊泡化形成,囊泡以胞吞和胞吐2种方式离开细胞,并以前者占优,37度条件下,内皮细胞清除表面MAC的半衰期约为5min。结论:内皮细胞可通过胞吞和胞吐2种机制清除细胞表面沉积的MAC,并以胞吞方式为主。 相似文献
64.
秦巴山区初中学生心理健康状况调查研究 总被引:11,自引:0,他引:11
目的 了解秦巴山区初中学生心理健康状况及其影响的主要因素。方法 采用 SCL-90临床症状自评量表随机对陕西省安康地区双溪乡初中学生进行心理健康测查。结果 秦巴山区双溪乡初中学生心理健康状况与全国初中学生心理健康常模比较 ,并未出现显著性差异 ;影响初中男生心理健康因素从大到小的顺序为 :抑郁 >躯体化 >焦虑 >强迫 >精神病性 >恐怖 >人际关系 >偏执 >其它 >敌对 ;影响女生心理健康因素从大到小的顺序为 :抑郁 >躯体化 >焦虑 >人际关系>强迫 >精神病性 >恐怖 >敌对 >其它 >偏执。结论 秦巴山区初中学生心理健康状况良好。影响秦巴山区初中学生心理健康的最主要因素为 :抑郁、躯体化和焦虑。 相似文献
65.
图像拼接能很好地解决显微镜高倍镜成像时视野减小的问题.我们在分析显微成像系统对医学显微图像灰度分布影响的基础上,提出了一个系统对图像灰度分布的影响函数.结合系统影响函数和精确匹配下的相关性方程,得到一个以最小平方和形式误差函数为基础的方程组.利用奇异值分解得到系统对图像灰度分布的影响的估计值,然后用估计值来补偿系统的影响,得到图像的原始灰度,再进行拼接.这种方法能在不影响拼接速度的前提下消除医学显微图像中存在的拼接缝和拼接痕迹. 相似文献
66.
ST2作为Th2细胞亚群标志以及其与支气管哮喘的关系的研究 总被引:2,自引:0,他引:2
各自主要分泌IFN γ和IL 4的Th1和Th2亚群 ,与临床疾病的关系十分密切。如何从表面标志上加以区分是一项迫切需要解决的问题。ST2是近年来提出的Th2细胞的稳定标志物。本工作在体外成功地诱导人脐带血T细胞向Th1或Th2分化的基础上 ,应用逆转录PCR分析了ST2mRNA的表达特点。证实ST2在人Th2细胞上的选择性表达。为了探索ST2、Th2与支气管哮喘的关系 ,本工作进一步检测了正常人和支气管哮喘患者外周血单个核细胞中 β actin、ST2以及IFN γ和IL 4的mRNA水平。结果显示 :支气管哮喘患者ST2mRNA水平升高 ,IL 4水平也明显升高 ,但IFN γ无变化。这提示ST2作为Th2细胞的标志物 ,有可能成为Th2极化性疾病如哮喘发病机制研究的一个参考性标志 ,至于ST2是否有可能作为治疗的靶分子 ,有待进一步探讨 相似文献
67.
目的探讨股骨远端骨折锁定钢板内固定失效的原因及防治措施。方法对2007年5月~2012年6月共14例应用锁定钢板固定失败的股骨远端骨折患者的临床资料进行分析,其中男9例,女5例,年龄27~68岁,平均39.2岁,骨折内固定术后1~8月(平均5.6个月)锁定钢板断裂。钢板断裂者均采用钢板螺钉取出术,5例予交锁髓内钉内固定,9例再次锁定钢板固定,均同时取自体髂骨移植植骨治疗。结果二次术后14例均获得随访,术后随访9~24月,平均14月,13例获得骨性愈合,1例二次锁定钢板固定患者于二次术后8月再次发生钢板断裂,予行钢板螺丝钉取出、交锁髓内钉固定治疗,再次手术后6月获骨性愈合。膝关节功能按Kolment评分标准:优4例,良9例,差1例。断裂原因具有多样性,5例钢板选择过短,9例存在螺钉置入密度过大,8例内侧皮质粉碎、缺失,4例因过早负重,2例因锻炼时摔伤而导致内固定失败。结论锁定钢板内固定失效的原因通常与对锁定钢板的适应证掌握不全,骨折端过度剥离、复位不良或内侧皮质存在缺损及术后功能锻炼不当有关。因此,选择合适的内固定物,注重植骨,加强术后康复指导、避免过早负重可有效预防及治疗股骨远端骨折钢板内固定失败。 相似文献
68.
The dispensable N-terminus of iso-1-cytochrome c (iso-1) in the yeast Saccharomyces cerevisiae was replaced by 11 different amphipathic structures. Rapid degradation of the corresponding iso-1 occurred, with the degree of degradation increasing with the amphipathic moments; and this amphipathic-dependent degradation was designated ADD. ADD occurred with the holo-forms in the mitochondria but not as the apo-forms in the cytosol. The extreme mutant type degraded with a half-life of approximately 12 min, whereas the normal iso-1 was stable over hours. ADD was influenced by the +/– state and by numerous chromosomal genes. Most importantly, ADD appeared to be specifically suppressed to various extents by deletions of any of the YME1, AFG3, or RCA1 genes encoding membrane-associated mitochondrial proteases, probably because the amphipathic structures caused a stronger association with the mitochondrial inner membrane and its associated proteases. The use of ADD assisted in the differentiation of substrates of different mitochondrial degradation pathways. 相似文献
69.
Hyperbaric oxygenation mitigates focal cerebral injury and reduces striatal dopamine release in a rat model of transient middle cerebral artery occlusion 总被引:16,自引:0,他引:16
Yang ZJ Camporesi C Yang X Wang J Bosco G Lok J Gorji R Schelper RL Camporesi EM 《European journal of applied physiology》2002,87(2):101-107
The usefulness of the administration of hyperbaric oxygen (HBO) in the treatment of acute focal cerebral ischemia remains
debatable. A significant association exists between focal cerebral injury and an excessive release of extracellular dopamine
(DA). In vivo microdialysis was used in the present study to examine the effect of HBO on DA release in the striatum during
ischemia and reperfusion in rats. The histological changes occurring were also evaluated. Focal cerebral ischemia was induced
by occlusion of the middle cerebral artery (MCA) using a surgically placed intraluminal filament. Control rats (n=8) were subjected to 1 h of ischemia, whilst the study rats (n=8) were in addition treated with HBO (2.8 atmospheres of absolute pressure 100% O2) during ischemia. Both groups were returned to breathing room air at normal pressure during reperfusion. Microdialysis samples
were continuously collected at 15 min intervals at 2 μl·min–1. The [mean (SE)] increase in release of striatal DA attained significance after 30 min of occlusion of MCA [170 (24)%], and
continued to increase [268 (26)% at 45 min] reaching a peak level at 60 min [672 (59)%] before returning to the baseline level
during the late reperfusion phase. There was no significant change in the level of DA in HBO treated rats during the period
of ischemia. A significant reduction in edema and neuronal shrinkage were observed by histological examination in HBO treated
rats when compared to the control rats. The results showed that HBO, when administered during ischemia, offered significant
neuroprotection in our experimental model of transient focal cerebral ischemia in the rat. The mechanism seems to imply, at
least in part, a reduced level of DA.
Electronic Publication 相似文献
70.
Mature T cells residing in peripheral lymphoid organs have frequent contact with antigen presenting cells (APC). Such contact may be required for T cell survival, but the degree to which signals in mature T cells are induced by TCR recognition of self peptide/MHC complexes is unclear. We have used induction of the early growth response gene 1 (Egr1) as an indicator of signal transduction in 3.L2 (I-Ek-restricted) T cells interacting with APC in the absence of exogenous antigen. The data show that Egr1 can be induced in 3.L2 T cells by TCR recognition of self peptides presented by I-Ek. However, a more transient induction of Egr1 can be induced in 3.L2 T cells interacting with dendritic cells derived from class II/beta2m double-deficient mice. Egr1 induction after T cell-APC contact was also observed in a freshly isolated polyclonal CD4 T cell population. The data suggest that self peptide/MHC recognition by the TCR induces a signal in T cells and that dendritic cells can also induce a more transient T cell signal by an MHC-independent mechanism. 相似文献