Effects of different doses of metformin on bone mineral density and bone metabolism in elderly male patients with type 2 diabetes mellitus

BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely accepted that diabetes has an important impact on bone metabolism.Metformin is a commonly used and effective first-line treatment for type 2 diabetes.Some glucose-lowering agents have been found to have an effect on bone metabolism.The present study explored if different doses of metformin have an effect on bone mineral density(BMD)and bone metabolism in type 2 diabetes.AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019.They were randomly assigned to an experimental group and a control group with 60 patients in each group.Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk.Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk.The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.RESULTS There was no significant difference in the efficacy rate between the two groups(P>0.05).Before the treatment,there was no significant difference in BMD and bone metabolism between the two groups(P>0.05).However,after the treatment,BMD and bone metabolism were improved in the two groups.Moreover,BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group,and N-terminal/midregion andβ-isomerized Cterminal telopeptides were significantly lower in the experimental group than in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus.However,the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.

Central Venous Catheter-related Thrombosis in Senile Male Patients: New Risk Factors and Predictors

Central venous catheterization（CVC）-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases（6.17%） of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization（P〈0.01） and that in internal jugular vein catheterization（P〈0.05）. No statistically significant difference was found between femoral vein catheterization and internal jugular vein catheterization（P〉0.05）. Previous venous thrombosis history（P〈0.01）, high lactate dehydrogenase level（P〈0.01）, low high-density lipoprotein（HDL） level（P〈0.05）, and low albumin level（P〈0.05） were found as risk factors or predictors of CVC-related venous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

Clinical outcomes of COVID-19 in elderly male patients

Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)has spread throughout the world involving more than 200 countries with more than 3 million confirmed cases and over 200,000 deaths worldwide.[1]COVID-19 patients primarily present with respiratory symptoms showing abnormal lung changes on chest X-ray or computed tomography(CT)with typical imaging appearances of ground glass opacities and consolidation.

Analysis of semen quality of 38 905 infertile male patients during 2008- 2016 in Wenzhou, China

This study analyzed the trend in semen quality of infertile male patients in Wenzhou,China,based on the data obtained from 38905 patients during 2008-2016 in The First Affiliated Hospital of Wenzhou Medical University(Wenzhou,China).The results showed that only 24.9%of the patients had normal semen quality.For the semen quality of infertile male patients,that of the workers and 40-year-olds was significantly worse than the other occupational and age groups.For all the infertile patients,low semen volume,asthenozoospermia,and teratozoospermia accounted for 8.4%,50.5%,and 54.1%,respectively.During 2008-2016,the annual mean percentage of fast forward motile spermatozoa,percentage of total forward motile spermatozoa,and percentage of spermatozoa with normal morphology decreased linearly with slopes of-2.11,-2.59,and-0.70,respectively.The proportion of patients with asthenozoospermia and multi-abnormal spermatozoa increased during 2008-2016 with slopes of 4.70 and 4.87,respectively,while for low semen volume,it decreased with a slope of-0.47 in the same time period.The proportion of patients with teratozoospermia increased from 2008 to 2011 and from 2011 to 2016 with slopes of 17.10 and 2.09,respectively.In general,the deteriorating trend of semen quality of infertile male patients in Wenzhou was obvious.Future efforts should be made to reveal the adverse influences on semen quality,such as occupational exposure,environmental quality,and living habits.Furthermore,more pervasive reproduction health education is necessary.

Choroidal vascular occlusion in a young male patient with sickle cell trait

Dear Editor,Choroidal vascular occlusion is a rare finding. Choroidal perfusion disorders may range from focal infarction of the choriocapillaris to fibrinoid arteriolar necrosis. Vascular occlusion due to microembolism is more common in choroidal than in retinal vasculature. Due to its unique hemodynamic characteristics, which involve one of the highest rates of blood flow in the body and the fact that it is functionally an end artery system, the choroidal circulation is prone to platelet emboli associated with cardiovascular disease and other pathologies with increased risk of microembolismt.

Elevation of serum NT-proBNP level-A possible biomarker of malnutritiion in an elderly male patient

INTRODUCTION B-type natriuretic peptide （BNP） is a 32- amino acid polypeptide secreted by ventricular myocytes during period of increased ventricu- lar stretch and wall tension. It is believed that the peptide plays an important role in the reg- ulation of blood pressure, blood volume, and sodium balance. Because in vitro studies have reported that natriuretic peptides are directly released from cardiomyocytes in response to myocardial ischemia , it has been proposed that their circulating levels are relevant to sub- sequent risk of cardiovascular diseases （CVDs） other than heart failure.