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Objective:To observe and compare the clinical characteristics between post-chronic pancreatitis diabetes mellitus(PPDM-C)patients and type 2 diabetes mellitus(T2DM).Methods:Data of 142 cases of CP patients confirmed in Shanghai Pudong New Area Gongli Hospital from January 2018 to December 2021 were collected, all the patients were divided into CP group without diabetes mellitus ( n=60) and PPDM-C group with diabetes mellitus ( n=82) based on whether with or without diabetes mellitus. And 82 cases T2DM without CP (T2DM group, n=82) hospitalized simultaneously were collected as control group. The age, sex, body mass index, onset characteristics, laboratory examination indicators at admission (fasting blood glucose, glycosylated hemoglobin, blood creatinine, and alanine transaminase), imaging characteristics of the pancreas (pancreatic atrophy, multiple calcifications of the pancreas, pancreatic duct stones, pancreatic duct dilation, and pancreatic duct obstruction), and treatments and efficacy of diabetes were recorded. Results:Compared with T2DM group, PPDM-C group had lower body mass index (22.2 kg/m 2vs 24.6 kg/m 2), and glycosylated hemoglobin levels (7.34% vs 9.20%) (all P values <0.001), higher alanine transaminase levels (33.00 U/L vs 18.65 U/L, P =0.021). And they had more upper abdominal pain, nausea, vomiting, weight loss and diarrhea symptoms. In addition, they had less use of combination of insulin and hypoglycemic drugs to control blood glucose. And compared with CP group, PPDM-C group had higher body mass index (22.06 kg/m 2vs 21.18 kg/m 2), higher glycosylated hemoglobin levels (7.34% vs 5.70%), higher fasting blood-glucose levels (7.91 mmol/l vs 5.31 mmol/l), higher alanine transaminase levels (33.00 U/L vs 26.50U/L), and their differences were statistically significant (all P values <0.05). And they had higher incidence of pancreatic atrophy, multiple calcifications in the pancreatic duct and pancreatic duct obstruction (all P values <0.05). Conclusions:PPDM-C patients are more likely to experience digestive system symptoms such as abdominal pain than T2DM patients, while their pancreatic malfunction is more likely to occur compared to CP patients. More attentions to PPDM-C associated clinical manifestations, biochemical and imaging changes could identify patients at potential risk for early diagnosis and treatment earlier.
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Objective:To explore the safety and efficacy of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) in treating painful chronic pancreatitis patients with pancreatic stones.Methods:The painful chronic pancreatitis patients receiving P-ESWL alone or P-ESWL combined with ERCP at Shanghai Pudong New Area Gongli Hospital from August 2019 to December 2021 were retrospectively analyzed. The success rate of stone fragmentation following P-ESWL, occurrence of postoperative complications, stone clearance rate of the main pancreatic duct and degree of pain relief in the follow-up were evaluated.Results:Among 113 patients, 7 patients were treated with P-ESWL alone and 106 patients were treated by P-ESWL combined with ERCP. The success rate of stone fragmentation was 98.2%. The occurrence of P-ESWL complications was 6.2%. Complete clearance of the main pancreatic duct stones was achieved in 75.2% of patients. With the mean follow-up of 17.5(3-31) months, complete pain relief was achieved in 84.1% of patients. The pain frequency and VAS score of patients treated with P-ESWL alone and P-ESWL combined with ERCP were obviously lower than those before treatment, and the body weight and body mass index were significantly higher than those before treatment, all with statistically significant differences (all P value <0.01). Conclusions:P-ESWL is safe and effective for the management of painful chronic pancreatitis patients with main pancreatic duct stones.
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Objective:To investigate the effects of self-made Hezhong-Jianpi Decoction on gastrointestinal motility and level of inflammatory cell factors in patients with reflux esophagitis. Methods:A total of 102 patients with reflux esophagitis who met the inclusion criteria in our hospital from May 2016 to September 2018 were divided into two group according to the random number table method, 51 cases in each group. The control group was treated with conventional western medicine. The intervention group was treated with self-made Hezhong-Jianpi Decoction based on the control group. Both groups were treated for 8 weeks. The levels of serum gastrin (GAS) and motilin (MTL) were detected by radioimmunoassay, the levels of TNF-α, IL-6 and IL-17 were detected by ELISA, the adverse reactions during the treatment were recorded, and the clinical efficacy was evaluated. Results:The total effective rate of the experimental group was 92.1% (47/51) and that of the control group was 72.5% (37/51). The difference between the two groups was statistically significant ( χ2=6.746, P=0.009). After the treatment, the levels of serum GAS (152.93 ± 26.85 ng/L vs. 134.30 ± 29.88 ng/L, t=3.312), MTL (291.58 ± 29.75 ng/L vs. 262.40 ± 38.71 ng/L, t=4.268) in the intervention group were significantly higher than those in the control group ( P<0.05), and serum TNF-α, IL-6, IL-17 levels were significantly lower than those in the control group ( t value were 4.653, 5.362, 4.759, respectively, all Ps<0.01). During the treatment, the incidence of adverse reactions was 9.8% (5/51) in the control group and 12.0% (6/51) in the intervention group, and there was no significant difference between the two groups ( χ2=0.102, P=0.750). Conclusions:The self-made Hezhong-Jianpi Decoction combined with the conventional western medicine can promote the gastrointestinal motility of patients with reflux esophagitis, reduce the inflammatory reaction and improve the clinical efficacy.