Comparison of gastrointestinal adverse events with different doses of metformin in the treatment of elderly people with type 2 diabetes.

WHAT IS KNOWN AND OBJECTIVE: Gastrointestinal discomfort is the most common adverse event of metformin treatment for type 2 diabetes, especially in elderly patients. The aim of this study was to compare gastrointestinal adverse events resulting from different doses of metformin used for the treatment of elderly people with type 2 diabetes. METHODS: A total of 361 elderly patients with newly diagnosed diabetes were randomly divided into three groups: metformin 1000 mg/d (N = 120), metformin 1500 mg/d (N = 121) and metformin 2000 mg/d (N = 120). Glycaemic control and gastrointestinal adverse events (abdominal pain, diarrhoea, nausea, vomiting, bloating and anorexia) were assessed and compared among the three groups after 12 weeks of treatment. RESULTS AND DISCUSSION: At baseline, there was no significant difference in gastrointestinal symptoms among the three groups. After 12 weeks of treatment with metformin, the change in HbA1c level was -0.7%, -0.9% and -1.0% for the 1000 mg/d, 1500 mg/d and 2000 mg/d groups, respectively (P < .0001). There was no significant difference in gastrointestinal adverse events among the three groups after treatment with metformin. In total, 62 people (17.2%) could not tolerate the adverse effects of metformin, and most of them stopped treatment in the first 4 weeks. Logistic regression analysis shows that female sex (OR = 2.660, 95%CI 1.692-4.183, P < .0001) and the concurrent use of organic cation transporter 1-inhibiting drugs (OR = 1.874, 95%CI 1.076-3.265, P = .027) are independent risk factors for adverse events. WHAT IS NEW AND CONCLUSIONS: Our data demonstrate that metformin doses of 1000 mg/d-2000 mg/d have similar adverse events but that 2000 mg/d of metformin yields the best glycaemic control in elderly people with diabetes. If elderly people can tolerate 1000 mg/d of metformin, we could gradually increase the dose to 2000 mg/d to achieve better glycaemic control.

Optimal Extraction of Zhiqian Capsule by Central Composite Design-Response Surface Method / 中国中医药信息杂志

Objective To optimize the extraction technology of Zhiqian Capsule;To provide evidence for researches on preparation into new Chinese medicine. Methods The main influential factors of extraction technology included the quantity of water, extraction time and immersion time. The extraction effect was evaluated with the content of aesculetin and the extract yield as indexes. The optimal extraction technology of Zhiqian Capsule was selected by single factor experiment and central composite design-response surface method. Results The best extraction conditions were as follows:reflux extraction for twice, the first time adding 10-fold of water and extraction for 2.5 h, the second time adding 8-fold of water and extraction for 2 h. Conclusion The optimal extraction technology of Zhiqian Capsule is efficient for extracting aesculetin, as well as economical, reasonable, easy and feasible.

Outcome of postoperative hypopituitarism and hormone replacement situation in 215 patients with pituitary adenoma / 中华内分泌代谢杂志

Objective To investigate the outcome of postoperative hypopituitarism and hormone replacement in patients with pituitary adenoma,and to analyze the potential factors related to postoperative hypopituitarism.Methods A total of 215 postoperative patients with pituitary adenoma were analyzed.Pituitary functions( including gonadal,thyroid,and adrenal axes ) were asessed by strict criteria.Data of surgery history and hormone replacement situation were collected for statistical analysis.Results The prevalence of hypopituitarism was 54.0％,including 36.7％ hypogonadism,32.6％ hypothyroidism,and 28.4％ hypoadrenalism.Replacements of gonadal steroid,glucocorticoid,and thyroxine were carried out in 25.6％,84.3％,and 80.6％ of the cases,respectively.Univariate analysis showed that male sex and large tumor were related to hypopituitarism. Conclusion After pituitary adenomectomy,approximately half of the patients present anterior pituitary dysfunction,while quite a number of them have not been treated appropriately.

Relationship between urinary iodine and prevalence of thyroid nodule in male workers of Qingdao area / 中华内分泌代谢杂志

Thyroid B-ultrasound and urinary iodine content were examined in 4390 male workers aged 18-62 years-old,who participated annual physical checkups in 2009 and 2010.The results suggest that there is no obvious relationship between the urinary iodine which represents the iodine intake within 24 hours and prevalence of thyroidnodale.However,the prevalence of thyroid nodules shows an upward trend with the advance of age.

Influence of tethered cord syndrome on the upper urinary tract and its etiology / 中华泌尿外科杂志

Objective To investigate the influence of tethered cord syndrome (TCS) on the up-per urinary tract and its etiology. Methods Forty patients with TCS diagnosed by spinal MRI were enrolled in this study. There were 21 males and 19 females with mean age of 23 years old. The course of disease ranged from 1 to 40 years. Urinalysis, mid-stream urine culture, serum creatinine(SCr), urinary system ultrasound, IVU, eystography and urodynamic study were carried out on all patients. Results Urinary tract infection was found in 17 patients and increased level of SCr was found in 6 pa-tients (251.64±98.5μmol/L). Of the 29 patients who underwent urinary system ultrasound examina-tion, 12 cases had hydronephroais and dilated upper ureter. Of the 30 patients who underwent IVU, 10(33.3%) had ureterectasia and hydronephrosis, 22 cases had bladder turriform or Christmas tree like deformity with diverticulum and trabeculum. Of the 22 patients accepted cystography, 17 cases had vesieoureteral reflux on 27 sides. Post-void residual (PVR) was evaluated in 35 patients and found increased in 31 cases. Cystometry had been done in 33 patients. The mean value of maximal detrusor pressure (Pdetmax) during filling phase was 41.2±20.9 cm H2O. The detrusor compliance was 22.35±18.8 ml/cm H2O. During voiding phase, detrusor-sphincter dyssynergia(DSD)was observed in 16 patients, detrusor areflexia was observed in 16 patients and detrusor underactivity was observed in 13 patients. Resting urethral pressure profilemetry was measured in 16 patients. Maximal urethral closure pressure (MUCP) was 76.1±33.1 cm H2O. The upper urinary tract deterioration was de-fined as increased SCr, hydronephrosis or vesicoureteral reflux. There were 20 patients diagnosed as upper urinary tract deterioration. The compliance of the upper urinary tract deteriorating group and the no-deteriorating group was 9.4±7.8 vs 19.3±15.8 ml/cm H2O, Pdetmax was 43.1±21.2 vs 24.0±11.9 cm H2O, PVR 189.0±138.0 vs 47.8±36.8 ml, MUCP 86.2±32.4 vs 46.8 5±20.8 cm H2O, incidence of damaged detrusor 100.0% vs 69.2% and DSD 65.0% vs 23.1%, respectively. There were significant differences between the 2 groups(P<0.05). And when comparing the VUR group with no VUR group, the incidence of urinary tract infection was 94.1%(16/17) vs 20.0%(1/ 5) (P=0.003). And when comparing urinary tract infection group with no infection group, the inci-dence of upper urinary tract deterioration was 88.2% (15/17) vs 21.7%(5/23)(P=0.000). Condn-sion Low compliance bladder, high Pdetmax during filling phase, increased PVR, high MUCP, damage of detrusor contractive function and DSD are the risk factors for upper urinary tract deteriora-tion in the TCS patients.

The differential expression of VEGF_(165)b in the transitional cell carcinoma of the bladder and normal bladder tissues and its clinical significance / 重庆医科大学学报

Objective:To investigate the differential expression of VEGF165b in the transitional cell carcinoma of the bladder (TCCB) and normal bladder tissues and its role in the development of TCCB. Methods: S-P immunohistochemistry was used to detect the expression of VEGF165b protein in 38 specimens of paraffin-embedded TCCB tissues and 36 specimens of paraffin-embedded normal bladder tissues. RT-PCR was performed to detect the expression of VEGF165b mRNA in 55 specimens of fresh TCCB tissues and 43 specimens of fresh normal bladder tissues. Results: Among 36 of normal bladder tissues, 35 specimens had positive expression of VEGF165b protein, with the positive rate of 97.22% (35/36) that was significantly higher than 21.05% (8/38) (P

The differential expression of VEGF165b in the renal cell carcinoma and normal renal tissues and its clinical significance / 重庆医科大学学报

Objective:To investigate the differential expression of VEGF165b in the renal cell carcinoma (RCC) and normal renal tissues and its role in the development of RCC. Methods: S-P immunohistochemistry was used to detect the expression of VEGF165b protein in 30 specimens of paraffin-embedded RCC tissues and 29 specimens of paraffin-embedded normal renal tissues. RT-PCR was performed to detect the expression of VEGF165b mRNA in 32 specimens of fresh RCC tissues and 30 specimens of fresh normal renal tissues. Results: Among 29 of normal renal tissues,28 specimens had positive expression of VEGF165b protein,with the positive rate of 96.55%(28/29) that was significantly higher than 20.00%(6/30)in RCC tissues(P