Efficacy of bismuth containing quadruple therapies on Helicobacter pylori eradication in patients with history of antibiotic treatment / 中南大学学报(医学版)

To investigate the efficacy of bismuth containing quadruple therapies on Helicobacter pylori (Hp) eradication in patients with history of antibiotic treatment. 
 Methods: Hp infected patients (n=327) were allocated into 3 groups. Group A (n=52), patients had no antibiotic history and they took medicine of proton pump inhibitors (PPI) and livzon triple (clarithromycin, tinidazole, and bismuth); group B (n=80), patients had the antibiotic history except for amoxicillin and clarithromycin, and they were treated with PPI, amoxicillin, clarithromycin, and bismuth; group C (n=195), patients suffered failures of Hp therapy or with history of antibiotic abuse, and they were treated with PPI, doxycycline, furazolidone, and bismuth.
 Results: Both the intention-to-treat (ITT) analysis (group A 63.5%, group B 76.2%, group C 82.6%, P<0.05) and the pre-protocol (PP) analysis (group A 76.7%, group B 92.4%, group C 96.4%, P<0.05) showed significant difference among the 3 groups, revealing higher elimination in group B and C. The side-effects (20.2%) were mild and tolerable (group A, 28.0%; group B, 10.7%; group C, 22.0%).
 Conclusion: Proton pump inhibitors together with the livzon triple regimen have a low rate of Hp eradication and a higher incidence of adverse reactions. The quadruple therapy containing clarithromycin and metronidazole drugs can achieve the satisfactory outcomes based on patient's antibiotic history. For patients with multiple antibiotics, the quadruple therapy containing furazolidone and doxycycline may achieve the satisfactory outcomes, but the adverse resction would be relatively higher.

Study on lifestyle in patients with gastroesophageal reflux disease / 中南大学学报(医学版)

Objective:To investigate the correlation between certain unhealthy lifestyles and the incidence of gastroesophageal reflux disease (GERD),thus to provide the lifestyle guidelines for GERD patients.Methods:Retrospective study were conducted for 402 GERD and 276 non-GERD out-patients in Department of Gastroenterology,Third Xiangya Hospital,Central South University from August,2014 to August,2015 based on questionnaire survey,then the correlation of unhealthy lifestyles with GERD were analyzed.Results:The top 10 common symptoms for GERD were as follows:reflux,acid regurgitation,postprandial fullness,heartburn,swallow obstruction or pain,epigastric burning sensation,paraesthesia pharynges,poststernal pain,chronic laryngopharyngitis,and chronic cough.The top 8 unhealthy habits closely related to GERD were as follows:fast-eating,over-eating,spicy preferred diet,sweets preferred diet,anxious,soup preferred diet,high-fat diet,and hot eating.Single-factor analysis showed that GERD was markedly correlated to gender (male),age (≥ 60 years),BMI,smoking,alcohol fast-eating,over-eating,hot-eating,spicy preferred diet,high-fat diet,acid preferred diet,sweets preferred diet,hard food preference,strong tea preference,coffee preference,immediately on bed after meal,difficult defecation,dyscoimesis,anxious,and too tight belt,respectively (P＜0.05).Logistic multiple regression analysis indicated that the largest risk factor for GERD was the fast-eating (OR=3.214,95％ CI 2.171 to 4.759,P＜0.001) followed by the overeating (OR=2.936,95％ CI 1.981 to 4.350,P＜0.001),elderly population (OR=2.047,95％ CI 1.291 to 3.244,P=0.002),too tight belt (OR=2.003,95％ CI 1.013 to 3.961,P=0.046),and hot-eating (OR=1.570,95％ CI 1.044 to 2.362,P=0.030).Conclusion:The elderly people are at high risk for GERD,and unhealthy habits like fast-eating,over-eating,too tight belt,and hot-eating is closely related to GERD.The lifestyles such as chewing food thoroughly,splitting the meals up,warm and cool diet,keeping patients out of the too tight belt are necessary for GERD patients.