ABSTRACT
Objective:To analyze the efficacy and cost-effectiveness of probiotics in initial Helicobacter pylori ( H. pylori) eradication therapy. Methods:A total of 267 patients with positive H. pylori infection were randomly assigned to two groups, the control group ( n=133) received a 14-day bismuth agent quadruple therapy and the study group ( n=144) received conventional quadruple therapy plus probiotics from January 2020 to August 2021. Eradication status was assessed 4-12 weeks after treatment. The H.pylori eradication rate, adverse reactions, and cost-effectiveness were compared between the two groups. Results:The H.pylori eradication rate was higher in study group than that in the control group in intention-to-treat (ITT) (80.6%(108/134), 95% CI:73.8%-87.4% vs. 68.4%(91/133), 95% CI:60.4%-76.4%, P=0.022) and per-protocol (83.1%(108/130), 95% CI:76.5%-89.6% vs. 72.2%(91/126), 95% CI:64.3%-80.2%, P=0.037). The incidence of adverse effects in the study group was lower than that in the control group (8.2%(11/134) vs. 18.8%(25/133), χ 2=6.415, P=0.011). Cost-effectiveness analysis showed that compared with the control group, the incremental cost-effectiveness ratio (ICER) of the study group was 1 010.49 yuan. The single factor sensitivity analysis showed that the H.pylori eradication rate of the study group had a greater impact on the results, followed by that of the control group and the cost of bifidobacterium quadruplex viable tablets. The probability sensitivity analysis showed that when the willingness to pay value (WTP) was 2 500 yuan, the probability that the probiotics combined with the bismuth agent quadruple therapy group was more cost-effective than the simple bismuth agent quadruple therapy group was 91.2%. Conclusion:As initial Helicobacter pylori treatment, probiotics combined with the bismuth agent quadruple scheme has a higher eradication rate and a lower incidence of adverse events than the bismuth agent quadruple scheme.
ABSTRACT
Objective To explore the changes of elasticity in the large arteries and its clinical significance of sublingual administration of nitroglycerin in patients with elevated PWV,and mild and moderate essential hypertension.Methods Totally,779 patients with mild and moderate hypertension and PWV more than 1400 cm/s were selected and divided into four groups,one with simple hypertension,the second one with only one risk factor for it,the third one with two risk factors,and the fourth one with three risk factors or damage in their target organs.Sublingual administration of 0.5 mg nitroglycerin was administered and blood pressure and PWV were measured for all of them.and data were statistically compared and analyzed by groups and before and after nitroglycerin administration.Results Systolic blood pressure decreased to(135±20)mm Hg from(149±15)mm Hg,pulse pressure decreased to(50±11)mm Hg from(59±12)mm Hg,PwV decreased to(1329±288)cm/s from(1688±378)cm/s,respectively,after nitroglycerin treatment for hypertensive patients(t=3.036,2.473,3.885,all P＜0.05).Improvement of elasticity of the large arteries in them after nitroglycerin treatment inversely correlated with the number of risk factors for hypertension they had,with 89.1 percent,74.3 percent,72.6percent and 44.0 percent of improvement in PWV,respectively for those with simple hypertension,only one risk factor.two risk factors and three risk factors or with damage in target organs.Conclusions Systolic blood pressure and pulse pressure significantly correlated with elasticity of the large arteries in hypertensive patients,and their stifiness improved after sublingual administration of nitroglycerin due to decrease in systolic blood pressure and pulse pressure.The more risk factors the hypertensive patients had,the poorer elasticity of their large arteries and less sensitive to nitroglycerin treatment were.