To evaluate the relationship between blood glucose fluctuation and macrovascular dysfunction.Eighty-eight type 2 diabetes mellitus (T2DM) patients with or without coronary heart disease (CHD) and 30 healthy control subjects were recruited. Glycosylated hemoglobin A1c (HbA1c), fasting insulin (FIns), and C-reaction protein (CRP) and some other general clinical variables were measured. A 72-hour continuous glucose monitoring (CGM) and brachial artery endothelium-dependent flow-mediated dilation (FMD) assessment were performed. The glucose excursion, MAGE (mean amplitude of glycemic excursions), LAGE (largest amplitude of glycemic excursions), MPPGE (mean postprandial glycemic excursions), MODD (absolute means of daily differences), and IAUC70 (incremental area under the curve below 70 mg/dl) during the CGM were analyzed. Correlations between the various variables were analyzed.Enhanced blood glucose fluctuation was observed in T2DM patients with CHD as compared to other participants. And blood glucose fluctuation was correlated with FMD, CRP and HOMA-IR.Blood glucose fluctuation is an important factor that affects inflammatory response and possibly induces CHD in T2DM patients.
Summary We have studied nearly 100 patients with β thalassaemia major and 60 patients with Hb H disease who were attending the Haematology Clinic of Guangxi Medical College. Treatment of the patients was limited and only a few patients with β‐thalassaemia major received blood transfusion(s). As a result, the severe anaemia has led to early death at 3–4 years for β + ‐thalassaemia homozygotes, and 8–12 years for β + ‐thalassaemia homozygotes. Four β‐thalassaemia alleles are responsible for nearly 90% of all β‐thalassaemia chromosomes. This information has resulted in the initiation of a prenatal testing programme at the local level. The patients with Hb H disease maintained a haemoglobin level of 6–10 g/dl and early death was infrequently observed. The SEA deletion was the major type of α‐thalassemia‐1, while three smaller deletions (−2.7, −3.7 and −4.2 kb) and two nondeletional α‐thalassaemia determinants (Hbs Constant Spring and Quong Sze) were the α‐thalassaemia‐2 types.
Objective: To compare the clinical characteristics of patients with different type of laryngopharyngeal reflux disease in order to study the effect of non-acid reflux on laryngopharyngeal reflux disease. Methods: From January 2015 to January 2020, 349 inpatients or outpatients suspected of having laryngopharyngeal reflux underwent 24-hour multichannel intraluminal impedance pH monitoring (MII-pH). There were 303 male and 46 female patients, with an average age of 56.03 years old ranged from 25 to 81 years old. The reflux symptom index (RSI)and reflux findings score(RFS)were recorded before MII-pH monitoring. The number of acid reflux events and non-acid reflux events in hypopharynx were counted. It was defined mainly acid reflux type when the ratio of acid reflux to all reflux events was greater than 50%, mainly non-acid reflux type when the ratio of non-acid reflux to all reflux events was greater than 50%. The clinical characteristics of patients with different type of reflux were compared. SPSS 19.0 software was used for statistical analysis, and multiple independent samples were compared between groups. The quantitative data were analyzed by multivariate analysis of variance, and the counting data were analyzed by chi-square test, the difference was statistically significant when P<0.05. Results: The 24-hour MII-pH showed that there were 90 patients with no reflux events, 51 patients with mainly acid reflux type, 198 patients with mainly non-acid reflux type and 10 patients with equal acid reflux events and non-acid reflux events. Statistics showed that the RSI(10.72±4.40), RFS(7.70±2.73) and the average number of reflux events(0) in the group without reflux events were significantly lower than those in patients with mainly acid reflux type (RSI 13.16±6.62,RFS 10.08±3.03,average number of reflux events 5.33±3.15,P<0.05) and mainly non-acid reflux type(RSI 13.25±5.54,RFS 8.81±2.54,average number of reflux events 7.93±5.26, P<0.05). There was no significant difference in RSI between the mainly non-acid reflux type group and the mainly acid reflux type group, but the RFS of the mainly non-acid reflux type group was significantly lower than that of the mainly acid reflux type group. The average number of reflux events in the mainly non-acid reflux group was significantly higher than that in the mainly acid reflux type group (P<0.05). Conclusion: The results show that non-acid reflux plays a certain role in laryngopharyngeal reflux disease, but the effect of acid reflux is greater.
Purpose To establish a population pharmacokinetic (PK) model of esomeprazole (ESO), a proton-pump inhibitor, in 36 adult patients with gastroesophageal reflex disease (GERD) symptoms following an oral administration of 40 mg ESO (AstraZeneca study SH-QBE-0008). Methods Blood samples for ESO plasma concentration measurements were obtained from 0 to 8 hours post dosing. The absorption model of ESO was identified by a semi-parametric deconvolution approach with the input function represented by a piece-wise linear spline. Identification of the disposition model of ESO and covariate evaluation was performed by population PK analysis using NONMEM. Results A one-compartment open model with sequential zero-and first-order absorption described the data best. Estimated population means for apparent clearance, apparent volume of distribution, first order absorption rate constant, duration of zero order input and the absorption lag time are 8.66 (L/hr), 18.7 (L), 2.0 (1/hr), 0.32 (hr) and 0.46 (hr), respectively. Covariate evaluation indicated that apparent clearance in female was about 81% of that in male. Body weight exhibited a slight impact on the first-order absorption rate constant. Conclusions The absorption of 40 mg ESO in GERD patients could be described by a sequential zero- and first-order absorption model. Slight effects of gender on clearance and of body weight on the first order absorption rate constant are unlikely to be clinically significant. Clinical Pharmacology & Therapeutics (2005) 77, P92–P92; doi: 10.1016/j.clpt.2004.12.243