Treatment adherence among sputum smear-positive pulmonary tuberculosis patients in Xinjiang,China: a prospective study

Background: Despite great effort to control tuberculosis (TB), low treatment adherence threatens the success of drug therapy, increases the risk of TB transmission, and leads to the development of drug resistance. The present study assessed anti-TB treatment adherence in sputum smear-positive TB patients and examined the risk factors for poor patient adherence to identify targets for intervention. Methods: We monitored and followed up TB patients who were diagnosed between July 2014 and June 2015 in Xinjiang, China. A total of 8289 sputum smear-positive TB patients were included in this study. All patients registered their information during the first hospital visit or with the Centers for Disease Control, had regular follow-up visits, and accepted the anti-TB treatment. Insufficient re-examination adherence was defined as undergoing fewer than the recommended three sputum smear examinations during the treatment course. Results: Among 8289 patients, 3827 men (84.4% of male patients) and 3220 women (85.7% of female patients) had good adherence during treatment follow-up. 1242 patients (15.0%) did not complete regular follow-up. 332 (4.0%) patients lost contact. An adjusted logistic regression model showed that ethnicity, household address, treatment classification, patient source, and the actual management were significantly associated with non-adherence. Conclusion: The Xinjiang TB epidemic situation remains grim. Smear-positive patients had a higher proportion of non-adherence, which increased treatment difficulties and the risk of death from TB. Relevant medical departments should strengthen their supervision and interventions during the TB treatment process to improve patient adherence to anti-TB treatment.

Background: Despite great effort to control tuberculosis (TB), low treatment adherence threatens the success of drug therapy, increases the risk of TB transmission, and leads to the development of drug resistance.     

新疆地区胃蛋白酶原与慢性萎缩性胃炎相关性探讨

目的目前全球范围内胃癌的发病率和病死率仍居高不下。由于进展期胃癌的预后差,早期筛查、诊断和干预胃肠化生、萎缩性胃炎和早期癌变对提高患者的生存率至关重要。本文旨在介绍胃蛋白酶原及其在筛查萎缩性胃炎和胃癌中的作用探讨血清胃蛋白酶原（pepsinogen,PG）与慢性萎缩性胃炎的相关性,并评估其临床价值。方法选择在新疆维吾尔自治区人民医院消化内镜中心行胃镜检查的106例患者,其中慢性浅表性胃炎患者34例,慢性萎缩性胃炎患者72例,并设正常对照11例,采用时间分辨荧光免疫分析法法检测血清PGⅠ、PGⅡ和水平。采用SPSS 13.0统计软件处理数据的系统分析。结果与正常对照组相比,慢性萎缩性胃炎组PG I、PGⅠ/PGⅡ水平下降,慢性浅表性胃炎组差异无统计学意义（P〉0.05）。结论通过检测血清PGⅠ、PGⅡ浓度可评价胃黏膜萎缩的程度,对胃癌进行早期诊断,具有一定诊断价值。     

维医异常黑胆质载体动物模型下丘脑-垂体-肾上腺轴组织超微结构的改变

目的：探讨异常黑胆质载体动物模型下丘脑、垂体、肾上腺组织细胞的变化。方法：选用ICR小鼠，在阴凉环境下采用干寒性饲料饲养、慢性电击等多因素复合，建立维吾尔医学异常黑胆质载体动物模型，透射电镜观察其下丘脑、垂体、肾上腺的变化。结果：与正常对照组相比，模型组小鼠下丘脑、垂体、肾上腺细胞的超微结构可见明显改变。结论：维医异常黑胆质病证与下丘脑-垂体．肾上腺组织细胞的变化有密切关系。     

新疆4个地区240例HIV感染者直接经济负担研究

目的探讨新疆4个地区HIV感染者个人直接经济投入的差异。方法对新疆乌鲁木齐、哈密、伊犁、喀什4个地区240例HIV感染者家庭收入和医疗费用支付方式进行调查;分析各地区HIV感染者的门诊费用(诊疗费、交通费)、住院费用(住院费、交通费、食宿费、营养费)等存在的差异。结果乌鲁木齐与其他地区相比HIV门诊就诊率和住院率均比较高,且各项直接医疗费用与非直接医疗费用也较其他地区高。结论经济发达地区,交通业较为便利,医疗服务较为齐全,医疗服务投入较多。而经济发展较为缓慢地区,其各种医疗服务较为匮乏,人民获得各种医疗服务较为困难,并且由于个人收入较低,居民受教育程度也较低,HIV感染者各项医疗投入也较低。     

新疆和田地区维吾尔族和汉族人群糖脂代谢的流行病学调查分析

目的:采用流行病学调查,比较和田地区维吾尔族和汉族的糖脂代谢特点.方法:采用整群抽样,按国际糖尿病联盟(IDF)MS的诊断标准,调查分析新疆和田地区维吾尔族和汉族人群糖脂代谢指标及代谢异常人群的百分数.40岁以上的健康人群糖尿病筛查总人数1 017例其中维吾尔族684例,汉族433例.结果:维吾尔族体重(WT),腰围(WC)、甘油三脂(TG)明显高于汉族组(P<0.01),维吾尔族组的平均体质指数(BMI)为(29.39±16.08)kg/m2.如按IDF的腹型肥胖的腰围标准.维吾尔族男性有78.8%,女性有74.6%腰围超标.而汉族易出现胆固醇(TC)的升高,维吾尔族组的空腹血糖(FPG)胆固醇低于汉族组,甘油三脂(TG)高密度脂蛋白胆固醇(HDL-C)高于汉族组,维吾尔族更须关注TG水平,本研究还发现汉族组如拟FPG≥5.6 mmol/L为糖代谢异常标准时有43.6%的异常,如拟FPG≥6.1 mmol/L为糖代谢异常标准时只有23.3%的异常,差异显著.结论:维吾尔族较汉族存在较严重的肥胖和代谢综合征.     

Pyridoxal phosphate prevents progression of diabetic nephropathy.

BACKGROUND: We have demonstrated that pyridoxal 5'-phosphate (PLP), an active form of vitamin B6, inhibits formation of advanced glycation end-products (AGEs) by trapping 3-deoxyglucosone. The present study aimed to clarify if PLP could exert beneficial effects on nephropathy in diabetic rats. METHODS: Streptozotocin (STZ)-induced diabetic rats were treated by oral administration of PLP or pyridoxamine (PM), another active form of vitamin B6, at a dose of 600 mg/kg/day for 16 weeks. AGEs [imidazolone, N(epsilon)-(carboxymethyl)lysine (CML) and N(2)-carboxyethyl-2'-deoxyguanosine (CEdG)], transforming growth factor-beta1 (TGF-beta1), type 1 collagen and fibronectin were detected in the kidneys using immunohistochemistry. Gene expression of TGF-beta1 and receptor for AGEs (RAGEs) in the kidneys was determined using real-time quantitative polymerase chain reaction. RESULTS: Administration of PLP significantly inhibited albuminuria, glomerular hypertrophy, mesangial expansion, and interstitial fibrosis as compared with diabetic rats. PLP markedly inhibited accumulation of AGEs such as imidazolone, CML and CEdG, a DNA-linked AGE, in glomeruli. PLP significantly inhibited expression of TGF-beta1, type 1 collagen, fibronectin and RAGE in the kidneys. PLP was superior to PM in inhibiting accumulation of AGEs, expression of TGF-beta1, type 1 collagen, and fibronectin, and the development of diabetic nephropathy. CONCLUSIONS: PLP prevented progression of nephropathy in STZ-induced diabetic rats by inhibiting formation of AGEs. PLP is considered a promising active form of vitamin B6 for the treatment of AGE-linked disorders such as diabetic nephropathy.     

新疆公立医院对护理毕业生需求行为的影响因素分析

目的：了解影响新疆公立医院选拔录用护理专业学生的主要因素并对护理专业毕业生专业水平能力进行评价。方法对新疆部分公立医院382名护理部主任、护士长和护理部管理干部等进行问卷调查,用Epidate3．0进行数据录入,采用 SPSS16．0软件数据处理,选择向前逐步回归法对有关因素进行非条件 logistic 回归分析。结果思想道德修养、学历及毕业院校等变量分别被选入回归模型。毕业生的心理素质、思想道德修养、面试综合表现、专业知识操作技能是影响医院对护理毕业需求行为的重要因素。毕业护生专业水平能力主要为临床工作能力、心理素质、评判性思维及创新能力。结论新疆公立医院对毕业生“临床工作能力”的要求也越来越高。     

P-糖蛋白表达与维吾尔族、汉族宫颈癌新辅助化疗疗效相关性研究

目的:探讨耐药基因产物P-糖蛋白(P-glycoprotein,P-gp)的表达与维吾尔族(维族)、汉族宫颈癌新辅助化疗疗效的相关性.方法:62例宫颈癌患者(宫颈癌组)中汉族40例,维族22例,均接受新辅助化疗;50例宫颈组织正常者(对照组)中汉族30例,维族20例.应用免疫组织化学SP法检测2组P-gP的表达情况,并进行比较.结果:2组P-gp的表达在维、汉2个民族间差异无统计学意义(P>0.05);宫颈癌组P-gP表达水平明显高于对照组,差异有统计学意义(P<0.05).新辅助化疗有效率P-gp表达阳性患者(72.5%)明显低于表达阴性患者(100.0%)(P<0.05),新辅助化疗疗效在维、汉2个民族间差异无统计学意义(P>0.05);P-gp表达与民族、新辅助化疗疗效、临床分期、分化程度及淋巴结转移均无相关性(P>0.05).结论:P-gp的表达可能与宫颈癌发生、发展相关,P-gp的表达不仅在宫颈癌耐药机制中发挥重要作用,且与化疗疗效密切相关.     

醒脾养儿颗粒治疗小儿肺炎继发性腹泻的临床疗效

目的：探究并分析醒脾养儿颗粒治疗小儿肺炎继发性腹泻的临床疗效。方法随机选取该院自2013年12月—2014年12月收治的60例肺炎继发性腹泻患儿,采用随机数字表法分成试验组和对照组,每组30例患儿。对照组患儿采用常规的治疗方案,试验组患儿采用在常规治疗的基础上加用醒脾养儿颗粒的治疗方案,分别观察两组患儿经不同方式治疗后总有效率及呕吐、腹泻、发热及治愈时间的对比情况。结果试验组总有效率为93.33%,对照组总有效率为60.00%,试验组总有效率明显高于对照组,差异有统计学意义（P＜0.05）。试验组患者呕吐改善时间、腹泻改善时间及治愈时间明显短于对照组患者,差异有统计学意义（P＜0.05）。结论采用醒脾养儿颗粒治疗小儿肺炎继发性腹泻可提高总有效率,减轻患儿的痛苦,值得临床推广。