Gengzhen Chen

Purpose This study examined whether poor sleep quality at baseline predict the subsequent recurrence of peptic ulcer disease (PUD) in older patients after H. pylori eradication, and to investigate whether nonpharmacological treatment and sleeping pills play a role in this association. Method s Of 1,126 older Chinese patients with H. pylori-infected PUD from Eight Grade-A hospitals in the People’s Republic of China (PRC) recruited between 2010 and 2015, 1,028 obtained H. pylori eradication and healed PUD by the end of 2015, and 950 were followed for up to 36 months. PUD recurrence was confirmed with esophagogastroduodenoscopy. Sleep quality at baseline was measured by the Pittsburgh sleep quality index (PSQI). Information of use of pharmacological and non-pharmacological treatments was extracted from their medical and social service records. Results The results revealed that baseline poor sleep quality was associated with PUD recurrence during the 36-month follow-up period (HR 1.894 (1.007, 3.561)). However, older patients with poor sleep quality who consumed sleeping pills were more likely to experience PUD recurrence, compared to those with moderate-to-good sleep quality (HR 1.588 (1.126, 2.589)). No significant difference was noted between older patients with moderate-to- good sleep quality and those with poor sleep quality who used nonpharmacological sleep treatment alone (HR 1.395 (0.729, 2.669)) or who simultaneously used pharmacological and nonpharmacological sleep treatments (HR 1.162 (0.901, 2.286)). Conclusions Poor sleep quality is associated with a greater risk of PUD recurrence. However, using nonpharmacological sleep treatment may alter this trajectory.

To examine the longitudinal association between objective measure of sleep duration and subsequent recurrence of peptic ulcer disease (PUD) in older patients with mild cognitive impairment (MCI) and the potential influence of change in the severity of depression on this association. Older Chinese patients with MCI and Helicobacter pylori (H. pylori)-infected PUD (N = 2,208) were recruited from hospitals in the People's Republic of China between 2010 and 2014. H. pylori was eradicated and PUD cleared in 2,015 patients by the end of 2014; 1,866 of these were followed for up to 48 months. Sleep duration was measured using an accelerometer. The Kaplan-Meier method was used to assess how PUD recurrence in older patients, as confirmed with esophagogastroduodenoscopy, varied with the levels of sleep duration and change in depression. Multivariate Cox-proportional hazards models were calculated to examine the associations between sleep duration, depression, and PUD recurrence. The present results are based on no change, a decrease, or an increase in caregiver-assessed depressive symptoms. Multivariate analyses showed that short sleep duration was associated with PUD recurrence during the 48-month follow-up period (hazard ration [HR] = 2.685; 95% confidence interval [CI: 1.622, 4.538]). Sleep duration did not affect recurrence in patients without depression (HR = 1.325; 95% CI [.878, 1.998]) or with reduced depression (HR = 1.048; 95% CI [.695, 1.581]). However in patients with unchanged or increased depression, a higher risk of PUD recurrence was found in short sleepers (HR = 1.598; 95% CI [1.042, 2.451]; HR:HR = 2.668; 95% CI [1.720, 4.083], respectively) than in medium and long sleepers. Short sleep duration is associated with a greater risk of PUD recurrence, but decrease in depression or absence of depression may alter this relationship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

To examine the association between social isolation, change in the severity of depression, and subsequent recurrence of peptic ulcer disease (PUD) in older adults with mild cognitive impairment (MCI). Older adults (≥55 years) with MCI and H. pylori-infected PUD (N=2,208) were recruited between 2010 and 2014 from twelve hospitals in the People’s Republic of China. H. pylori was eradicated and PUD was cleared in 2,015 participants by the end of 2014; 1,900 of these were followed for up to 36 months. The Kaplan-Meier method was used to assess how PUD recurrence, varied with social engagement levels and changes in depression severity. Multivariate Cox-proportional hazard models were used to examine associations between social isolation, changes in depression severity, and PUD recurrence. PUD recurrence was more prevalent in socially isolated (10.8%) than in socially engaged participants (5.5%). However, the rates of PUD were lower in socially isolated individuals without (absence of) depression (7.2%) and those with decreased depression (8.2%), whereas socially isolated individuals with unchanged and increased depression had substantially higher rates of PUD (16.3% and 17.8%, respectively; the social isolation by depression group for PUD recurrence was significant (p<0.001). Specifically, although social isolation was associated with PUD recurrence during the 36-month follow-up period (HR:2.665 [1.602, 4.518]), it did not increase PUD recurrence risk in participants without depression or with reduced depression. However, in participants with unchanged or increased depression, PUD recurrence was more likely to occur in socially isolated (HR:1.587 [1.125, 2.588]; HR:1.886 [1.012, 3.522] respectively) than in socially engaged participants. Social isolation is associated with a greater risk of PUD recurrence; however, the absence of or decreased severity of depression may alter this relationship.

Commentary: Association between Poor Sleep Quality and Subsequent Peptic Ulcer Recurrence in Older Patients with Mild Cognitive Impairment: Examining the R

OBJECTIVE: To examine the effect of subjective and objective sleep quality on subsequent recurrence of peptic ulcer disease (PUD) among older patients after Helicobacter pylori eradication. SETTING: Eight grade A hospitals in China. PARTICIPANTS: Of 1689 older Chinese with H. pylori –infected PUD recruited between January 2011 and October 2014, H. pylori were eradicated and PUD was cleared in 1538 patients by the end of 2014; 1420 of these patients were followed up for up to 36 months. MEASUREMENTS: Using multiple measures at 6‐month intervals, PUD recurrence was determined with esophagogastroduodenoscopy. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. Objective sleep quality domains were measured using an accelerometer, including sleep onset latency, sleep efficiency, total sleep time, and number of awakenings. RESULTS: This study documented a 36‐month cumulative PUD recurrence of 8.3% (annual rate = 2.8%). Multivariate analyses showed that participants who reported poorer sleep quality were more likely to experience PUD recurrence during the 36‐month follow‐up period (hazard ratio [HR] = 1.895; 95% confidence interval [CI] = 1.008‐3.327). Regarding objective sleep quality domains, longer sleep onset latency (HR = 1.558; 95% CI = 1.156‐2.278) and more nighttime awakenings (HR = 1.697; 95% CI = 1.168‐2.665) increased the risk of PUD recurrence. However, a longer total sleeping time protected against PUD recurrence (HR = 0.768; 95% CI = 0.699‐0.885). CONCLUSIONS: Poor sleep quality predicts a greater risk of PUD recurrence. Accurate diagnosis and effective treatments should, therefore, be provided for older adults afflicted with poor sleep, particularly for those who previously had PUD. It is equally important to include sleep assessment as an integral part while dealing with these patients.

This study aims to examine whether perceived poor sleep quality predicts subsequent recurrence of peptic ulcer disease (PUD) in older patients with mild cognitive impairment following Helicobacter pylori eradication and to investigate whether social engagement status alters this association. Of 1,689 older patients with H. pylori-infected PUD recruited from eight Grade-A hospitals in the People’s Republic of China between 2011 and 2014, H. pylori was eradicated and PUD cleared in 1,538 patients by the end of 2014; 1,420 of these were followed for up to 36 months. The Kaplan–Meier method was used to compare the proportion of PUD recurrence, as confirmed with esophagogastroduodenoscopy, among older patients with different levels of sleep quality and social engagement statuses. Multivariate Cox-proportional hazards models were performed to examine the association between sleep quality and PUD recurrence, and the role of social engagement in altering this relationship. The results showed that PUD recurrence was more prevalent in poor (10.8%) compared with good sleepers (5.5%). However, increased and continued social engagement reduced the proportion to 7.2% and 8.2% among poor sleepers, respectively. Poor sleep quality was associated with subsequent PUD recurrence (hazard ratio [HR] 1.965 (1.002, 3.518)). However, no significant difference was observed between good and poor sleepers who reported increased (HR 1.428 (0.736, 2.380)) and continued (HR 1.273 (0.915, 2.492)) social engagement, suggesting that increased and continued social engagement prevented the effect of poor sleep quality on PUD recurrence. To conclude, poor sleep quality is associated with subsequent PUD recurrence. However, increased and continued social engagement may moderate this association.

Impact of an Information Leaflet on Knowledge of Hepatocellular Carcinoma and Hepatitis B among Chinese Youth Primary liver cancer;hepatocellular carcinoma;hepatitis B;information leaflet;knowledge; Background: To assess the effect of an information leaflet on the level of Chinese youth's knowledge about hepatitis B and hepatocellular carcinoma (HCC), the most common type of primary liver cancer (PLC). Materials and Methods: A total of 500 students, from two universities in the Chaoshan area of China, were randomly divided into an intervention group of 280 participants and a control group of 220. Baseline knowledge of HCC and hepatitis B was evaluated by questionnaire interview. Subsequently, only the intervention group was given an information leaflet of HCC and hepatitis B. Three months later, the two groups were contacted for a second interview. Changes in knowledge from baseline of HCC and hepatitis B were compared between the two groups. Results: There was no statistically significant difference in mean PRE-questionnaire scores between the intervention and control groups. However, the mean POST-questionnaire score was significantly higher in the intervention group after the intervention. The leaflet had the greatest effect on the participants' questionnaire score, and raised their level of knowledge about HCC and hepatitis B. Conclusions: The information leaflet intervention is significantly effective in improving the knowledge of HCC and hepatitis B among the youth.

Previous studies on surgical team composition have shown that surgical team size had an independent impact on surgical performance in US and Canadian hospitals. We aimed to investigate the impact of team composition on surgical performance in two Chinese hospitals.