社区高血压患者管理依从性评估

目的：调查并评估高血压患者对社区管理的依从性,以提高患者治疗的有效性。方法：选取86例高血压患者在社区进行为期12个月的健康教育、行为干预、药物治疗等,观察患者接受程度。结果：本研究对86例高血压患者分析表明,在长达12个月的时间内,始终有90%以上的患者接受社区医生管理,平均血压降低明显（P〈0.01）。结论：在社区内对高血压患者进行长期治疗和管理是可行的,患者对社区管理较好的依从性,是保证患者形成健康的生活方式,使规范治疗率、血压控制率维持在较高水平的基础。     

Demographic features and compliance of children with allergic diseases receiving sublingual immunotherapy北大核心CSCD

目的探讨标准化舌下免疫治疗(sublingual immunotherapy,SLIT)过敏性疾病患儿的人口学特征,并分析依从性的影响因素。方法纳入江西省儿童医院2018年1月1日—2020年12月31日接受SLIT的1789例过敏性疾病患儿为研究对象,回顾性分析患儿的人口学特征和随访资料,分析SLIT的依从性及其影响因素。结果共1789例SLIT患儿,其中男性1271例(71.05%),女性518例(28.95%),年龄4~14岁;完全依从777例(43.43%);脱落1012例(56.57%),因自觉使用不便脱落354例(34.98%),因疗效欠佳脱落346例(34.19%),因症状改善自行停用253例(25.00%),因不良反应停用的59例(5.83%)。脱落主要集中在开始治疗后1~4个月(74.31%,752/1012)。女性患儿依从率低于男性患儿,患单一疾病者依从率低于患多种疾病者(P<0.05)。多因素分析结果显示,与男性相比,女性发生脱落的风险增加(OR=0.811,95%CI:0.658~0.998,P<0.05);相对于患多种疾病者,患单一疾病者发生脱落的可能性增加(OR=1.313,95%CI:1.005~1.715,P<0.05)。结论过敏性疾病患儿SLIT依从性不理想,与患儿性别、所患疾病数量等特征有关;主要脱落原因为自觉使用不便和疗效欠佳。     

Rectale Formalininstillation – eine praktikable und sichere Therapie der hämorrhagischen Proktitis

Zusammenfassung. H?morrhagische Proktitis ist eine seltene, aber ernstzunehmende Komplikation nach der Strahlentherapie von Tumoren des kleinen Beckens. Neben topischen Steroiden, Lasertherapie und nichtsteroidalen Antiphlogistica ist die Anwendung von 4 %iger Formalinl?sung ein ad?quates Therapiekonzept. In einem Hundemodell sollten die Ver?nderungen der rectalen Compliance, die Entzündungsreaktion der rectalen Mucosa und Submucosa sowie die Serumkonzentrationen von Formalin nach verschiedenen Applikationsformen untersucht werden. Methode: 21 Mischlingshunde wurden in 7 Gruppen randomisiert. Drei Tiere erhielten einen Bolus von 400 ml 4igem % Formalin rectal, der für 1 Std belassen wurde, w?hrend bei den übrigen 6 Gruppen sequentielle Volumina von 30 ml bis zu einem Gesamtvolumen von 400 ml appliziert wurden. 15, 30, 45, 60 und 180 min nach Instillation wurden die Formalinserumkonzentrationen gemessen und Mucosabiopsien der Rectumschleimhaut sofort sowie nach 1, 2 und 4 Wochen entnommen. Ergebnisse: In der Bolusgruppe wurden im Gegensatz zur sequentiellen Instillation toxische Werte im Serum nach 15 min gemessen. Die rectale Compliance und Mucosadicke waren in keiner Gruppe ver?ndert, w?hrend ein verringerter Angiogenesescore und eine milde Proktitis sofort und eine Woche nach Instillation diagnostiziert wurden.      

Good radiographic practice: The Nigerian experience and the CEC recommendations

A survey of 25 hospitals in Nigeria has been conducted to assess the level of compliance to the Commission for European Communities (CEC) criteria for good radiographic practice in four adult radiographic examinations. Chest, skull, abdominal and lumbar spine radiographic examinations were assessed. Using a simple scoring system of ‘0’ for unfulfilled and ‘1’ for fulfilled criteria, the results show an average compliance level of 50 ± 8% for chest, 57 ± 8% for skull, 56 ± 10% for abdomen and 51 ± 7% for lumbar spine radiography. Findings show that the level of compliance could be corrected by the adoption of quality control programmes in the country.     

Predictors of Compliance in Toddlers: Child Temperament, Maternal Personality, and Emotional Availability. Portions of the research were presented at the Conference on Human Development, Mobile, AL, March 6, 1998.

Fifty-one mother-toddler (15 to 31 months) dyads participated in a study on the predictors of compliance. Mothers completed two questionnaires: the Multidimensional Personality Questionnaire (Tellegen, 1982), a measure of maternal personality, and the Toddler Behavior Assessment Questionnaire (Goldsmith, 1987), a measure of child temperament. A free play period in the laboratory provided the observations for scoring the quality of the mother-toddler interactions with the Emotional Availability Scales (Biringen, Robinson, and Emde, 1993). The following clean-up task in which children were asked to help put the toys in the basket provided the observations for scoring compliance with maternal directives. Emotional availability was the strongest predictor of compliance, especially the maternal variables of sensitivity and structuring. Child temperament was also implicated, with high compliance toddlers perceived by their mothers to be less socially fearful and less prone to anger than their less compliant peers. The results are discussed in terms of the contribution of the mother-child emotional climate to the development of compliance.     

Use of new once-daily 5-aminosalicylic acid preparations in the treatment of ulcerative colitis： Is there anything new under the sun？

5-aminosalicylate （5-ASA） agents remain the mainstay treatment in ulcerative colitis （UC）. A number of oral 5-ASA agents are commercially available, including azo- bond pro-drugs, as well as delayed- and controlled- release forms of mesalazine. However, poor adherence due to frequent daily dosing and a large number of tablets has been shown to be an important barrier to successful management of patients with UC. Recently, new, once-daily formulations of mesalazine, including the unique multi-matrix delivery system and mesalazine granules, were proven to be efficacious in inducing and maintaining remission in mild-to-moderate UC, with a good safety profile comparable to that of other oral mesalazine formulations. In addition, they offer the advantage of a low pill burden and might contribute to increased long-term compliance and treatment success in clinical practice. This editorial summarizes the available literature on the short- and medium-term efficacy and safety of the new once-daily mesalazine formulations.     

Differential lung ventilation with a double-lumen tracheostomy tube in unilateral refractory atelectasis

Two patients with refractory hypoxemia due to unilateral lung atelectasis were treated with differential lung ventilation (DLV) through a Robertshaw-type, double-lumen tracheostomy tube. DLV was applied using two non-synchronized ventilators and maintained for 6 and 3 days, respectively. Ventilator settings were chosen in accord to the clinical, laboratory and chest X-rays results. Particularly, tidal volume and PEEP were set to avoid excessively high alveolar pressure and to obtain the highest possible value of compliance. We investigated the mechanical properties of the two lungs separately by measuring airway pressure and compliance of each lung before the beginning of DLV and at 0, 5, 24, and 48 h after. Initially we observed in both patients very low values of compliance (7–9 cm H₂O/I) and a significant level of PEEPi (12–8 cm H₂O) of the diseased lung, whereas PEEPi in the healthy lung was negligible. The clinical improvement was assessed by sequential chest X-rays and by significant improvement of arterial blood gas and PaO₂/FiO₂ ratios and was associated with a progressive increase of compliance (24–22 cm H₂O/I) and by a fall of PEEPi levels (5–4 cm H₂O) of the diseased lung. We also observed an improvement of S O₂, O₂AVI, PVRI and va/ t values (Case 1). The tracheostomy tube used to apply DLV was very reliable, allowing easy nursing care and selective bronchial aspirations. We conclude that DLV is a very useful technique in unilateral lung pathology, and it can be a life saving procedure in selected patients, by supplying volume and PEEP more efficiently to the affected lung.     

院外追踪健康教育对提高心血管疾病患者遵医行为的影响

目的 探讨院外追踪健康教育对心血管疾病患者遵医行为的影响.方法 将80例出院心血管疾病患者随机分为对照组和追踪组各40例.对照组只做出院指导,追踪组给予出院指导和院外追踪健康教育.追踪健康教育1年后对2组患者遵医行为包括治疗性生活方式改变及再次住院率、死亡率进行调查.结果 追踪组与对照组出院后1年内遵医行为及再次住院率、死亡率比较,差异有统计学意义.P＜0.01,P＜0.05,追踪组遵医行为显著好于对照组.结论 心血管疾病患者院外追踪健康教育是提高患者遵医行为的有力措施.     

The TCCS—A short measure to evaluate treatment-related coping and compliance in hospitalised childhood cancer patients and their primary caregivers

Goals This report describes the development and validation of a short rating system to assess treatment-related coping and compliance (TCC) in childhood cancer patients and their primary caregivers.Patients and methods The initial system contained 21 items referring to supportive parenting style of the caregiver, treatment-related attitudes and behaviour of both caregiver and child, communicative skills of the child and relationships with the health care team. This questionnaire was completed independently by a nurse, a nursery-school teacher, a psychologist and a physician who are all working full time at the oncology unit. The sample under study included 111 patients aged 3–18 years who were on treatment, as well as their caregivers (in most cases the mother).Results Using defined rules for item reduction, the questionnaire was reduced to 14 items, of which seven were referring to the TCC of the child and seven to the TCC of the caregiver. Cronbachs alpha coefficients ranged from 0.81 to 0.91 across the different assessments, indicating high internal consistency reliability. There was moderate to high agreement amongst observers (intra-class correlation coefficients ranged between 0.50 and 0.68). Construct validity was confirmed by a significant association between a global rating of TCC and the instruments summary scores in the four assessments.Conclusions Our system may be used for clinical trials and clinical monitoring. Further testing of psychometric properties is recommended.     

肝移植术后患者依从性及相关因素的调查研究

目的 评估肝移植术后患者的依从性及相关因素,为提高其依从性提供依据.方法 采用一般情况问卷和肝移植患者依从性调查表对54例肝移植术后超过6个月的患者进行随访和调查.结果 肝移植术后患者具有较好的免疫抑制药物依从性(3.67±0.51)分和良好生活习惯依从性(3.30±0.44)分,随访依从性(3.05±0.89)分和自我监测依从性(2.00±0.89)分较差.影响依从性的主要因素是家庭人均月收入(P<0.01)和术后时间(P<0.01).结论 应加强肝移植术后患者随访和自我监测的依从性教育,对家庭经济困难患者和术后时间较长患者的依从性应更加关注.