ABSTRACT
Objective:To investigate the current situation of medication belief, compliance and asthma control level of elderly patients with asthma, and to analyze the influencing factors of asthma control level, so as to provide theoretical reference for improving asthma control level of elderly patients with asthma.Methods:Using the convenient sampling method, 325 elderly patients with asthma were selected from the respiratory clinic of Jilin Central Hospital and the Affiliated Hospital of Beihua University from June to December 2019. The general information, medication belief, compliance and the level of asthma control in elderly patients with asthma were evaluated by general information questionnaire, the specific medication beliefs scale (BMQ-S), Chinese bronchus Asthma medication adherence scale (MARS-A) and Asthma Control Test scale (ACT).Results:The scores of BMQ-S, MARS-A and ACT were (2.82±8.36), (3.67±0.85) and (17.96±5.10) respectively. Regression results showed that age, education level, medication belief and compliance were important influencing factors of asthma control level in elderly patients with asthma ( P<0.05 or 0.01), which could explain 77.9% of variation. The total score of asthma control level was positively correlated with the total score of belief in taking medicine and the total score of compliance ( r values were 0.704, 0.775, P<0.05). The structural equation model fit index between the necessity of medication belief, the concern of medication belief, the compliance and the level of asthma control was high, the path coefficient significantly ( P<0.05), compliance had a mediating effect between the necessity of medication belief and the level of asthma control. The direct and indirect effects of the necessity of medication belief on the level of asthma control in elderly asthmatics were 0.320 and 0.389 respectively, and the direct effect of medication belief concern on the level of asthma control was-0.089. Conclusions:The medication belief necessity and medication belief concern have a direct predictive effect on asthma control level in elderly patients with asthma, and compliance has a mediating effect between medication belief necessity and asthma control level.
ABSTRACT
Objective The aim of this study was to investigate the predictive value of p53 protein expression in postmenopa-usal hormone receptor(HR)positive and HER-2 positive postoperative breast cancer patients with adjuvant endocrine drugs. Meth-ods A total of 172 cases of postoperative breast cancer patients were collected in Harbin Medical University Cancer Hospital from January 2005 to December 2011. All patients were postmenopausal,including 84 patients received aromatase inhibitors(AI)treatment and 88 patients received tamoxifen(TAM)treatment. The median follow-up time was 68 months(4~131 months). χ2test was used to analyze the relationship between p53 protein expression and the clinicopathological features of breast cancer. Kaplan-Meire analysis, Log-rank test and Cox regression model were used for survival analysis. Results The expression of p53 protein was not correlated with tumor size,lymph node status,histological grade,ER and PR expression. Cox univariate analysis showed that p53 protein was re-lated to lymph node status(χ2=46. 602;P<0. 001)and radiation therapy(χ2=9. 617;P=0. 002). But p53 expression was not asso-ciated with DFS in breast cancer patients(χ2=0. 002,P=0. 968). Cox multivariate analysis showed that DFS was only associated with lymph node metastasis in breast cancer patients(HR=2. 121,95% CI:1. 630 ~2. 760,P<0. 001). Subgroup analysis showed that DFS in patients with p53-positive was superior to patients with p53-negative in oral TAM(χ2=4. 695,P=0. 030). In patients with oral AI,DFS in with p53-negative patients was superior to p53-positive patients(χ2= 5. 995,P=0. 014). Conclusion The posi-tive expression of p53 protein is a predictor of effective treatment of TAM,while the negative expression of p53 protein is a predictor of effective treatment of AI.