AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and cros...AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and crosssectional study,H.pylori cultures were successfully obtained from 371 and 950 patients(never receiving eradication) during 2009-2010 and 2013-2014,respectively.Resistance to amoxicillin,clarithromycin,metronidazole,levofloxacin,tetracycline,and rifampicin was determined by Epsilometer test.RESULTS:The resistance rates of isolates obtained during 2009-2010 were 66.8%,39.9%,34.5%,15.4%,6.7%,and 4.9% to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin and tetracycline,respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%,52.6%,54.8%,18.2%,4.4% and 7.3%,respectively.The resistance rates to clarithromycin and levofloxacin were significantly increased after four years.In 2009-2010,14.6% of H.pylori isolates were susceptible to all tested antibiotics,with mono(33.7%),double(28.3%),triple(16.7%),quadruple(6.2%),quintuple(0.3%) and sextuple resistance(0.3%) also being detected.In 2013-2014,9.4% were susceptible to all tested antibiotics,and mono(27.6%),double(28.4%),triple(24.9%),quadruple(7.3%),quintuple(2.3%) and sextuple resistance(0.1%) was also observed.More multiple resistant H.pylori isolates were found during 2013-2014.Gender(to levofloxacin and metronidazole),age(to levofloxacin) and endoscopic findings(to clarithromycin) were independent factors influencing antibiotic resistance.CONCLUSION:H.pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.展开更多
About 30% of patients with cirrhosis have diabetes mellitus(DM).Nowadays,it is a matter for debate whether type 2 DM in the absence of obesity and hypertriglyceridemia may be a risk factor for chronic liver disease.DM...About 30% of patients with cirrhosis have diabetes mellitus(DM).Nowadays,it is a matter for debate whether type 2 DM in the absence of obesity and hypertriglyceridemia may be a risk factor for chronic liver disease.DM,which develops as a complication of cirrhosis,is known as "hepatogenous diabetes".Insulin resistance in muscular and adipose tissues and hyperinsulinemia seem to be the pathophysiologic bases of diabetes in liver disease.An impaired response of the islet β-cells of the pancreas and hepatic insulin resistance are also contributory factors.Non-alcoholic fatty liver disease,alcoholic cirrhosis,chronic hepatitis C(CHC) and hemochromatosis are more frequently associated with DM.Insulin resistance increases the failure of the response to treatment in patients with CHC and enhances progression of fibrosis.DM in cirrhotic patients may be subclinical.Hepatogenous diabetes is clinically different from that of type 2 DM,since it is less frequently associated with microangiopathy and patients more frequently suffer complications of cirrhosis.DM increases the mortality of cirrhotic patients.Treatment of the diabetes is complex due to liver damage and hepatotoxicity of oral hypoglycemic drugs.This manuscript will review evidence that exists in relation to:type 2 DM alone or as part of the metabolic syndrome in the development of liver disease;factors involved in the genesis of hepatogenous diabetes;the impact of DM on the clinical outcome of liver disease;the management of DM in cirrhotic patients and the role of DM as a risk factor for the occurrence and exacerbation of hepatocellular carcinoma.展开更多
基金Supported by National Science and Technology Pillar Program during the Twelfth Five-year Plan Period,No.2012BAI06B02the Capital Health Research and Development of Special,No.2011-4032-02
文摘AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and crosssectional study,H.pylori cultures were successfully obtained from 371 and 950 patients(never receiving eradication) during 2009-2010 and 2013-2014,respectively.Resistance to amoxicillin,clarithromycin,metronidazole,levofloxacin,tetracycline,and rifampicin was determined by Epsilometer test.RESULTS:The resistance rates of isolates obtained during 2009-2010 were 66.8%,39.9%,34.5%,15.4%,6.7%,and 4.9% to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin and tetracycline,respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%,52.6%,54.8%,18.2%,4.4% and 7.3%,respectively.The resistance rates to clarithromycin and levofloxacin were significantly increased after four years.In 2009-2010,14.6% of H.pylori isolates were susceptible to all tested antibiotics,with mono(33.7%),double(28.3%),triple(16.7%),quadruple(6.2%),quintuple(0.3%) and sextuple resistance(0.3%) also being detected.In 2013-2014,9.4% were susceptible to all tested antibiotics,and mono(27.6%),double(28.4%),triple(24.9%),quadruple(7.3%),quintuple(2.3%) and sextuple resistance(0.1%) was also observed.More multiple resistant H.pylori isolates were found during 2013-2014.Gender(to levofloxacin and metronidazole),age(to levofloxacin) and endoscopic findings(to clarithromycin) were independent factors influencing antibiotic resistance.CONCLUSION:H.pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.
文摘About 30% of patients with cirrhosis have diabetes mellitus(DM).Nowadays,it is a matter for debate whether type 2 DM in the absence of obesity and hypertriglyceridemia may be a risk factor for chronic liver disease.DM,which develops as a complication of cirrhosis,is known as "hepatogenous diabetes".Insulin resistance in muscular and adipose tissues and hyperinsulinemia seem to be the pathophysiologic bases of diabetes in liver disease.An impaired response of the islet β-cells of the pancreas and hepatic insulin resistance are also contributory factors.Non-alcoholic fatty liver disease,alcoholic cirrhosis,chronic hepatitis C(CHC) and hemochromatosis are more frequently associated with DM.Insulin resistance increases the failure of the response to treatment in patients with CHC and enhances progression of fibrosis.DM in cirrhotic patients may be subclinical.Hepatogenous diabetes is clinically different from that of type 2 DM,since it is less frequently associated with microangiopathy and patients more frequently suffer complications of cirrhosis.DM increases the mortality of cirrhotic patients.Treatment of the diabetes is complex due to liver damage and hepatotoxicity of oral hypoglycemic drugs.This manuscript will review evidence that exists in relation to:type 2 DM alone or as part of the metabolic syndrome in the development of liver disease;factors involved in the genesis of hepatogenous diabetes;the impact of DM on the clinical outcome of liver disease;the management of DM in cirrhotic patients and the role of DM as a risk factor for the occurrence and exacerbation of hepatocellular carcinoma.
