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Objective:To examine the relationship between fasting blood glucose(FBG)levels and H. pylori infection, as well as their impact on eradication and recurrence rates.Methods:A total of 1 584 patients with type 2 diabetes, ranging in age from 44 to 91 years old(mean age of 66.6±7.6 years), were included in this study conducted at the Physical Examination Center of the First Hospital of Lanzhou University between March 2010 and December 2019.Of the total participants, 1 063(67.1%)were male and 521(32.9%)were female.Logistic regression analysis was performed to investigate the impact of age, gender, fasting blood glucose, and H. pylori infection on the patients.In the study, 263 patients in the euglycemic control group(HbA1c<7%), 271 patients in the poor glycemic control group(HbA1c≥7%), and 269 patients in the control group underwent H. pylori eradication using bismuth-containing quadruple therapy, and the eradication efficacy, adverse reactions, and recurrence rates were compared after 1 year.Results:In patients with type 2 diabetes, the infection rate of H. pylori was found to be 48.2%.Further regression analysis revealed that poor glycemic control increased the risk of H. pylori infection( OR=1.611, 95% CI: 1.269~2.045, P<0.01). However, the constituent ratio and infection rate of different hypoglycemic drug groups did not show any significant statistical difference.The eradication rate of H. pylori was 90.9%, and there was no significant difference in the eradication rate among different blood glucose groups and control groups.However, after 1 year, the recurrence rate was 3.8%, with a higher rate observed in the poor glycemic control group compared to the euglycemic control group and the control group( P<0.05). There was a statistically significant difference in constipation as the main side effect of eradication therapy between the diabetic group and the control group[25.1%(134/253) vs.16.4%(44/269), P<0.01]. Conclusions:Diabetic patients with fasting hyperglycemia or poor glycemic control are at an increased risk of H. pylori infection.Additionally, these patients have a higher risk of recurrence after eradication.Therefore, it is important for clinicians to closely monitor and manage glycemic control in diabetic patients to reduce the risk of H. pylori infection and improve treatment outcomes.
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Objective:To examine the effect of helicobacter pylori(H.pylori)eradication on blood glucose and insulin levels in elderly patients with type 2 diabetes mellitus(T2DM).Methods:This was a prospective case-control study.Ninety-three diabetic elderly patients(≥ 80 years)under glycemic control and with H. pylori infection were selected as the DM group and eighty-nine elderly patients(≥ 80 years)without T2DM and with H. pylori infection were selected as the control group.Among them, bismuth quadruple was given to eradicate H. pylori.Levels of fasting blood glucose, insulin, glycated hemoglobin(HbA1c), gastrin, insulin resistance index(HOMA-IR), and insulin secretion index(HOMA-β)were compared before treatment and at 4, 8, 12 and 16 weeks after treatment.Rates of H. pylori eradication and adverse reactions were evaluated.Results:The eradication rate of H. pylori was similar between the DM group and the control group [73.1%(68 cases) vs.84.3%(75 cases), P>0.05]. There were no significant differences in levels of fasting blood glucose, insulin, HbA1c, gastrin, HOMA-IR, and HOMA- β before treatment and at 4, 8, 12, 16 weeks after treatment between the two groups( P>0.05). However, the incidence of constipation was significantly higher in the DM group than in the control group [25.8%(24 cases) vs.12.4%(11 cases), P<0.05]. Conclusions:The eradication of H. pylori has no significant effect on fasting blood glucose, insulin and HbA1c in elderly patients with or without T2DM.
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Objective:To analyze the differences in information needs of doctors, middle managers, and hospital leaders in tertiary public hospitals in the process of new technology access.Methods:From January to October 2018, 1 200 doctors and hospital administrators from 30 tertiary public hospitals in 8 provinces were selected. The importance scores of different positions for decision-making information demand of new technology introduction were collected through questionnaire survey, and the scores were analyzed by SPSS 25.0 software. Descriptive statistical analysis was performed.Results:1 032 valid questionnaires were obtained. Hospital-level leaders, middle-level managers, and doctors scored higher on the clinical application, safety, and effectiveness of technology at home and abroad(more than 4 points, maximum 5 points). Hospital-level leaders and middle-level managers had higher scores on effectiveness, evidence quality, possibility of being covered by medical insurance, ethics and relevant indicators of strategic level, while doctors had higher scores on health economics and organizational indicators.Conclusions:There are some differences in the information demand for new technology access among different positions in tertiary public hospitals. Understanding the decision-making needs of different positions is conducive to promoting the actual implementation of hospital-based health technology assessment standards in China′s public hospitals.
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Objectives To explore the effects of aging on midgastric transverse band(MTB)and gastric emptying.Methods In our prospective study,57 healthy volunteer were divided into young, middle and old-age groups.After taking test meal labeled by 99mTc-iethylenetriaminepentaacetic acid(99mTc-DTPA), the pictures were collected using double probe single photon emission computed tomography(SPECT).Stomach in each frame of the pictures was divided into proximal, midgastric transverse band(MTB)and distal parts.And half gastric emptying time,gastric remnant rate at 90 min, areas of different gastric parts were tested and calculated respectively.Results Half gastric emptying time of whole stomach was(43.24± 11.87)min,(42.07 ± + 9.31)min and(45.81 ± 10.73)min in young,middle and old-age groups, respectively, with P＞0.05.Among young, middle and oldage groups, half gastric emptying time was(38.09 ± 10.26)min,(37.33 ± 9.28)min and(26.74 ± 12.07)min in proximal stomach, and it was(38.35 ± 12.96)min,(37.73 ± 7.46)min and(46.41 ± 10.74)min in distal stomach,respectively.The half gastric emptying time was significantly reduced in proximal stomach and increased in distal stomach in old-age group(both P＜0.05).The gastric nuclide remnant rate at 90min in total stomach was(30.38 ± 19.32)％,(29.03 ± 10.36)％ and(31.92 ± 13.47)％ ,in young, middle and old-age groups, respectively, with P＞0.05.This rate in proximal stomach was(25.01 ± 12.35)％,(26.36± 15.29)％ and(19.54±8.47)％ among three group, respectively.The rate in proximal stomach was(42.25 ± 12.36)％,(41.56 ±± 9.33)％ and(56.05 ± 11.72)％ among three group,respectively.The gastric remnant rate at 90min was reduced in proximal stomach and was increased in distal stomach significantly in old-age group(both P＜0.05).Compared with young and middle-age group,the old-age group showed no difference in areas of total stomach in all the time, while the areas were reduced in proximal stomach and increased in distal stomach significantly from 30 min to 90 min(all P＜0.05).Total stomach versus proximal and distal stomach showed no difference in count/pixel ratio in all time,while a count/pixel ratio was reduced in proximal stomach and increased in distal stomach significantly from 30 min to 90 min(both P＜ 0.05).Both areas and count/pixel ratio of MTB at 60 min and 90 min were significantly increased in old-age group(both P＜0.05).Conclusions The total gastric emptying is not delayed along with aging, while the gastric emptying is increased in proximal stomach and reduced in distal stomach in the elderly.This abnormity of intragastric distribution of food might be related with larger area of midgastric transverse band.
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Objective To investigate the effect of combined Metformin and esomeprazole therapy on plasma levels of gastrin,blood glucose,glycosylated hemoglobin(HbA1c) and insulin in elderly patients with type 2 diabetes.Methods A randomized,double-blind,placebo-controlled study of 41 elderly patients with type 2 diabetes was conducted.Patients were randomly assigned into treatment group(combination therapy with Metformin 0.5 g,bid or tid and Esomeprazole 20 mg,qd,for 12 weeks)and placebo group(Metformin monotherapy 0.5 g,bid or tid,for 12 weeks).Fasting blood samples were taken from vein before and after treatment.Fasting serum levels of gastrin,glucose,HbA1c,insulin,lipids,liver and renal functions were compared between the two groups.The homeostasis model of assessment for insulin resistance index(HOMA-IR) and insulin secretion index (HOMA-β)were calculated,and complications were recorded.Results There were no significant differences in body mass index and waist circumference between the two groups.Serum gastrin level was slightly increased in the treatment group 12 weeks after treatment,but without statistically significance [(127.20±9.21)ng/L vs.(131.53±7.84)ng/L,P＞0.05],and serum gastrin level had no significant differences in the placebo group before and after treatment [(128.42±4.58)ng/L vs.(127.51±3.47)ng/L,P＞0.05].However,there were no significant differences in the changes of blood glucose,HbA1c,insulin,HOMA-β and HOMA-IR before versus after therapy,and between the two group(all P＞0.05).Conclusions Combined Metformin and insulin therapy cannot increase serum gastrin and insulin levels and has no significant effect on reducing blood glucose and HbA1c levels in elderly patients with type 2 diabetes.
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Objective To evaluate the therapeutic effects of low tension,anti-reflux Roux-y sigmoid neobladder. Methods Using modified ureterocolostomy and colorectostomy,low tension Roux-y sigmoid neobladders were formed on 12 cases of bladder cancer and 1 case of vesicovaginal fistula.The surgical procedures involved making an “inversive valve” into the bowel lumen about 1.5 cm above the Roux-y anastomotic stoma and anastomosing the ureter and colon by Leadbetter method;then the reservoir was made by detubularization of sigmoid.Postoperatively,blood electrolytes and acid-base balance, and urination were monitored. Results During the follow-up of 0.5~5 years,only 2 cases had occasional fever;no hydronephrosis, no disorder of acid-base balance occurred.The blood electrolytes were within the normal range.And no one had incontinence. Conclusions The low tension,anti-reflux Roux-y sigmoid neobladder is a surgical technique of less trauma and with less complications.