RESUMO
Objective To understand the status of type 2 diabetes mellitus (T2DM) patients′ trust in their family physicians, and to explore the role of the trust on patients′ medication adherence. Methods A total of 1078 patients with T2DM were recruited by cluster and systematic sampling method, from ten rural communities in Sanlong township in Yancheng city and five rural communities of Pingchao township in Nantong city, during February to April in 2018. The survey covered their trust behavior and attitude scale (PTBAS), and an 8-item Morisky medication adherence scale ( MMAS-8). Both measurement data and enumeration data were subject to descriptive analysis by mean ± SD and proportion respectively. Multiple linear regression was employed to explore the determinants of trust in physicians. Ordered logistic regression analysis was used to explore the relationship between patient-physician trust and medication adherence. Results The mean scoring of patients′ trust and medication adherence was 20. 16 ± 2. 13, 7. 07 ± 1. 54 respectively. 55. 40 percent of the patients had high medication compliance, 28. 53 percent of them had medium compliance and 16. 07 percent had poor compliance. Multiple linear regression analysis showed that the patient′s occupation, course of disease, self-reported health status and mental health status influenced their trust behavior (P < 0. 05). Ordered logistic regression analysis showed that each 1 point increase in patient′s trust in physicians, the medication compliance increased by 11. 0％ (OR = 1. 110, P < 0. 001). Medication adherence is also affected by age, employment status, course of illness, and mental health status. Conclusions Diabetes patients′ trust in their family physicians improves their medication adherence.
RESUMO
In present study,comparisons were carried out to develop and improve in vitro mauration(IVM) systems of goat oocytes. Oocytes were cultured in TCM-199 supplemented with(1)10% sera (either estrous goat serum (EGS) or fetal bovine serum(FBS)) + 20 mg/L luteinizing hormone (LH) + 10 mg/L follicle stimulating hormone (FSH) + 1 mg/L estradiol (E2); (2)10% EGS with different gonadotropins(LH: FSH) at a concentration of 5 mg/L: 0.5 mg/L or at 20 mg/L: 10 mg/L with0. 075 IU/mL human menopausal gonadotropin(HMG),1 mg/L estradiol 17β; (3)10% EGS+ 0. 075 mg/L HMG+10-20 μg/EGF. The culture was also performed by M199 supplemented with 10% EGS+0. 075 mg/L HMG+ 10-20 μg/L EGF into ultra-filtrated water which was derived either from self-producing or from purchased for use. The oocytes were cultured at 38 ℃,5% CO2 in air for 24 h,and the meterphase Ⅱ stage oocytes were examined under dissecting microscope. The results showed that EGS was better than FBS in supporting goat oocyte IVM. An addition of HMG in M199 could improve oocyte maturation and induce a higher percentage of metaphase Ⅱ oocytes compared to gonadotropins. 10-20 μg/L EGF improved goat oocyte maturation but the influence was not significant. Fresh,high quality water was vital for oocyte IVM. In conclusion,under our conditions with IVM ,the best result in maturation of goat oocyte has been M199 supplemented with 10% EGS+0.075 IU/mL HMG+10-20 μg/L EGF and prepared in fresh purified water.