ABSTRACT
Background:The prevalence rate of diabetes mellitus ( DM ) associated with gastroesophageal reflux disease ( GERD)is increasing recently,and the relationship between DM and GERD has become a research hotspot. Aims:To study clinical features and influential factors of therapeutic efficacy of reflux esophagitis( RE)in elderly patients with type 2 DM(T2DM). Methods:Two hundred elderly patients with RE diagnosed by gastroscopy from March 2011 to October 2013 were enrolled,and divided into T2DM associated with RE( T2DM)group and RE group. The clinical features, endoscopic findings and therapeutic efficacy of the two groups were analyzed,and the influences of DM course and control of blood glucose on efficacy of RE were also analyzed. Results:The main manifestations of RE were extraesophageal symptoms,typical esophageal symptoms were less common. The overall efficacy rate decreased with the increase of endoscopic grade of RE,however,extraesophageal symptoms improved significantly. With the prolonging of DM course,the endoscopic grade of RE was increased,and the control of blood glucose was worse. The overall therapeutic efficacy was significantly reduced with the prolonging of DM course in patients with well controlled blood glucose. Conclusions:Extraesophageal symptoms are common,endoscopic grade of RE is worse and blood glucose is difficult to control in elderly T2DM patients associated with RE. DM course and status of blood glucose control have influences on the therapeutic efficacy of RE.
ABSTRACT
Objective To study the changes and significance of CD4+CD25+ regulatory T cells and C-reactive protein(CRP) in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Methods Flow cytometry was used to detect the frequency of CD4+CD25+ regulatory T cells in peripheral blood from 36 patients with acute exacerbation of COPD( COPD group) and 36 patients with clinical stability of COPD(control group one)and 36 normal individuals(control group two). The level of CRP was detected routinely. Results The ratio of CD4+CD25+ regulatory T cells number in peripheral blood of COPD group to the total number of CD4+T cell was (2.56±1.83 )%, and it was significantly decreased compared to the other two groups (P all<0.01 ). The level of CRP in COPD group was markedly higher than that in the other two groups (P all<0.01 ). The level of CD4+CD25+ regulatory T cells in patients with acute exacerbation of COPD had negative relation with CRP. Conclusions CD4+CD25+ regulatory T cells participate in inflammatory response. The proportion of CD4+CD25+ regulatory T cells decreases in patients with acute exacerbation of COPD, and it may result in maladjustment of cytoimmunity.