糖尿病视网膜病变患者家庭关怀度与治疗依从性关联研究

目的调查2型糖尿病合并视网膜病变患者家庭关怀度、视功能损伤程度（以矫正视力、视网膜病变为评价指标）与治疗依从性之间的关系,为完善糖尿病视网膜病变的临床治疗提供依据.方法对127例糖尿病视网膜病变患者分别进行矫正视力、视网膜病变检查,并采用APGAR家庭关怀度指数问卷和糖尿病治疗依从性问卷分别评定家庭关怀度和治疗依从性情况,并分析以上各项与糖尿病患者治疗依从性的关系.结果糖尿病视网膜病变患者家庭关怀度指数与正常对照组存在显著差异,家庭关怀度总分、家庭适应度、情感度、亲密度三个维度评分及视力损伤程度与治疗依从性呈显著相关性,视网膜病变与治疗依从性无显著相关性.结论家庭关怀度总分、适用度、情感度、亲密度与治疗依从性相关,糖尿病患者依从性与家庭支持呈正相关.     

Ageing in rural China: Impacts of increasing diversity in family and community resources

The majority of China's population lives in rural areas and a pattern is emerging of very uneven provision of support for rural elderly people. Local economic conditions and broad demographic trends are creating diversity in the ability both of rural families to care for their elderly kin and in the capacity of communities to support their elderly residents and family carers. In part as a consequence of China's population policy and the 'one-child policy', future Chinese families will have fewer members and be 'older', but they will continue to be regarded emotionally and in policy as the main source of economic and social support for the elderly. The increasing involvement of women in the paid workforce and the changing geographical distribution of family members resulting from work-related migration, are reducing the ability of families to care for their elderly relatives. The availability of resources other than the family for the care of older persons therefore becomes a key issue. Communities in more prosperous, modernising rural areas are often able to provide their elderly residents with welfare and social benefits previously found almost exclusively in urban areas. However, in poorly developed rural areas, provision is either very patchy or non-existent and the local economy cannot support expansion or improvement. A case study in Zhejiang Province illustrates the favourable provision for ageing in a prosperous modernising rural community, in which entitled elderly residents are provided with an impressive array of financial and social benefits. The paper concludes with a consideration of the policy implications of the growing differentiation of the social and economic capacity of rural communities to support their elderly members.     

Public beliefs and use of antibiotics for acute respiratory illness

OBJECTIVE: To better understand public beliefs and use of antibiotics for acute respiratory illnesses. DESIGN: Cross-sectional telephone survey. PARTICIPANTS: Three hundred eighty-six adult members (aged 18 years or older) of a group-model HMO in the Denver metropolitan area. MEASUREMENTS AND MAIN RESULTS: Two hundred seventy-three (70%) of the respondents reported that antibiotics were beneficial for bacterial respiratory illnesses, 211 (55%) reported that antibiotics were beneficial for viral respiratory illnesses, and 82 (21%) reported that antibiotics were beneficial for bacterial but not for viral illness. Multivariate regression analysis identified consulting an advice nurse (odds ratio [OR] 2.9; 95% confidence interval [CI] 1.7, 5.3), ever being told by a provider that antibiotics were not needed for a respiratory illness episode (OR 2.0; 95% CI 1.2, 3.6), having a chronic medical condition (OR 2.0; 95% CI 1.0, 3.9), and believing antibiotics to be helpful for viral (OR 2.5; 95% CI 1.3, 4.7) or bacterial (OR 2.6; 95% CI 1.2, 6.7) respiratory illnesses to be independently associated with antibiotic use for respiratory illnesses during the previous year. There was a trend toward lower previous antibiotic use among those believing antibiotics to be helpful for bacterial illness but not for viral illness. CONCLUSIONS: A lack of understanding about antibiotic effectiveness exists in the community. Increased previous antibiotic use among those believing antibiotics to be effective for viral illnesses suggests that improvements are needed in communications to patients and the public about antibiotic appropriateness.     

The first abortion - and the last? A study of the personality factors underlying repeated failure of contraception

The causes leading to a second abortion were outlined in a psychological study comparing 30 women expecting a second abortion with 29 women who had successfully prevented conception after a first abortion. It was found that both groups improved their contraceptive practices after the first abortion. However, while the latter group continued with their improved practices, the former group went back to the earlier inefficient or non-existent contraceptive behavior. The inability to improve contraception in the long run was not related to differences in educational level or knowledge about contraceptive techniques but to the developmental level of personality structures. The women expecting their second abortion rated lower in control of impulsivity, emotional balance, realism, self-esteem and stability of life as well as capacity for more integrated personal relationships. The differences in personality development and consequently in the capacity for long-term contraception were found to be due to growth conditions in childhood.     

A robust structure-activity relationship (SAR) model for esters that cause skin irritation in humans.

A structure-activity relationship (SAR) model has been developed to discriminate skin irritant from nonirritant esters. The model is based on the physicochemical properties of 42 esters that were tested in humans for skin irritation. Nineteen physicochemical parameters that represent transport, electronic, and steric properties were calculated for each chemical. Best subsets regression analysis indicated candidate models for further analysis. Regression analyses identified significant models (p < 0.05) that had variables that were also significant (p < 0.05). These candidate models were evaluated using linear discriminant analysis to determine if the irritant esters could be discriminated from nonirritant esters. The stability of the model was evident from the consistency of parameters among ten submodels generated using multiple random sampling of the database. The sensitivity of the ten models, evaluated by "leave-one-out" cross-validation, ranged from 0. 846 to 0.923, with a mean of 0.885 +/- 0.025 (95% CI). The specificity ranged from 0.615 to 0.923, with a mean of 0.738 +/- 0.06 (CI). Compared with nonirritant esters, irritant esters had lower density, lower water solubility, lower sum of partial positive charges, higher Hansen hydrogen bonding parameter, and higher Hansen dispersion parameter. The results indicate that physicochemical features of esters contribute to their ability to cause skin irritation in humans, and that chemical partitioning into the epidermis and intermolecular reactions are likely important components of the response. This model is applicable for prediction of human irritation of esters yet untested.     

Serum antibodies against gliadin and reticulin in a family study of coeliac disease

The familial occurence of coeliac disease is well known. In every day practice, however, diagnosis of coeliac disease is not frequently established in the relatives of patients. As it did not seem practicable to biopsy all relatives, several tests were investigated in selecting individuals for intestinal biopsy in a family study. 55 index patients out of 54 families with biopsy-proven coeliac disease and 165 of their first grade relatives underwent the study. Immunofluorescent gliadin and reticulin antibodies were determined, and additionally laboratory tests were done. These included haemoglobin, serum iron, serum protein and albumin, serum immunoglobulins and blood xylose. The immunofluorescent gliadin antibody assay using red cells coated with gliadin proved to be superior to the other methods. False negatives came to 8.7%, and false positives 10.9%, in healthy relatives. Gliadin antibodies could be found five times more frequently in healthy relatives than in normal controls. This finding indicates a genetic predisposition to the formation of gliadin antibodies in coeliac families.Ninety-one percent of index coeliac children had IgG-antigliadin in their sera while on a normal diet. During gluten-free diet, and in adult patients, results were less convincing. All relatives with antigliadin titres greater than 8 have been biopsied, and all with titres above 64 were shown to have coeliac disease. The prevalence of coeliac disease found in this study was 5.5%. In the active state of coeliac disease in children, gliadin antibody determination thus is a valuable diagnostic tool but in selecting relatives for biopsy there are limitations to the wide application of the test. Although reticulin antibodies are more specific for coeliac disease than gliadin antibodies, determination of antireticulin proved to be much less sensitive.Supported by Deutsche Forschungsgemeinschaft Gr 278/6 and Ste 305/1     

Hemihypertrophy in a boy with renal polycystic disease: Varied patterns of presentation of renal polycystic disease in his family

Hemihypertrophy is a condition that has been described in association with a variety of other malformations and diseases; quite often these have had a renal origin. — It is the purpose of this paper to record and discuss the occurrence of polycystic disease in a family, to note that the disease was manifest as either the adult or the infantile form, and detail the fact that one member of the family who had infantile type polycystic disease also had hemihypertrophy. —The pattern of inheritance of renal polycystic disease, its age at presentation and the variation in the boy of its manifestation with the passage of time are discussed. The need for caution in offering a prognosis and genetic counselling is stressed.     

喹诺酮类抗菌剂抗分支杆菌的QSAR研究——C-7位结构变化对活性的影响

用分子连接性指数法对一系列喹诺酮类化合物抗结核病分支杆菌的定量构效关系进行了研究。设计了４个新的化合物,预测它们具有高的抗菌活性。     

Evaluation of Prediction Accuracy for Volume of Distribution in Rat and Human Using In Vitro,In Vivo,PBPK and QSAR Methods

Volume of distribution at steady state (V_ss) is an important pharmacokinetic parameter of a drug candidate. In this study, V_ss prediction accuracy was evaluated by using: (1) seven methods for rat with 56 compounds, (2) four methods for human with 1276 compounds, and (3) four in vivo methods and three Kp (partition coefficient) scalar methods from scaling of three preclinical species with 125 compounds. The results showed that the global QSAR models outperformed the PBPK methods. Tissue fraction unbound (f_u,t) method with adipose and muscle also provided high V_ss prediction accuracy. Overall, the high performing methods for human V_ss prediction are the global QSAR models, Øie-Tozer and equivalency methods from scaling of preclinical species, as well as PBPK methods with Kp scalar from preclinical species. Certain input parameter ranges rendered PBPK models inaccurate due to mass balance issues. These were addressed using appropriate theoretical limit checks. Prediction accuracy of tissue Kp were also examined. The f_u,t method predicted Kp values more accurately than the PBPK methods for adipose, heart and muscle. All the methods overpredicted brain Kp and underpredicted liver Kp due to transporter effects. Successful V_ss prediction involves strategic integration of in silico, in vitro and in vivo approaches.