Medicine
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Microcirculatory changes and coagulation disturbances are thought to play a key role in sepsis. Some evidence suggests that the percentage of reticulated platelets (RP%) may be a valuable and cost-effective sepsis screening parameter. This was a prospective study in surgical patients to investigate the potential value of RP% as a predictor of mortality in septic shock patients. ⋯ This association was preserved in a multi-logistic regression analysis that included clinical confounders (P < 0.014). This prospective study demonstrates that increased RP% identifies septic shock patients who have a high risk of death. RP% has the potential to act as a marker for patient stratification in future clinical trials.
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Randomized Controlled Trial Multicenter Study
Probiotics for standard triple Helicobacter pylori eradication: a randomized, double-blind, placebo-controlled trial.
The primary objective in the study is determination of efficacy of probiotic preparation as a supportive therapy in eradication of Helicobacter pylori. The study was multicenter, prospective, randomized, placebo controlled, and double-blind. The subjects first filled out a specially designed questionnaire to assess the severity of the 10 symptoms, which can be related to eradication therapy to be monitored during the trial. ⋯ At 15 days postinclusion, probiotic treatment was found superior to placebo in 7 of 10 mentioned symptoms. Average intensity for symptoms potentially related to antibiotic therapy was significantly higher in the placebo group, 0.76 vs 0.55 (P < 0.001). Adding probiotics to the standard triple therapy for H pylori eradication significantly contributes to treatment efficacy and distinctly decreases the adverse effects of therapy and the symptoms of the underlying disease.
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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with an increased risk of death compared to general population. Although previous studies showed improvement in survival of SLE, the long-term prognosis has not been elaborated in China. This study aims to integrate the observational studies estimating current long-term survival of Chinese SLE patients and analyze the death-cause situation of SLE in China. ⋯ The overall survival rates for Chinese patients with SLE resembled previous publications in Asia-Pacific area. But the death causes of SLE in China were of some differences indicating relatively higher proportion of infection and lupus encephalopathy and lower cardiovascular disease. Ethnicity and more aggressive treatment might have contributed to the difference in death composition.
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The objective of the present study was to investigate cortical differences between chronic low back pain (CLBP) subjects and pain-free controls with respect to habituation and processing of stimulus intensity. The use of a novel event-related fixed-interval areas (ERFIA) multilevel technique enables the analysis of event-related electroencephalogram (EEG) of the whole post stimulus range at a single trial level. This technique makes it possible to disentangle the cortical processes of habituation and stimulus intensity. ⋯ By means of the ERFIA multilevel technique, habituation effects were found in a broad post stimulus range and were not solely limited to peaks. This study suggests that habituation may be a key mechanism involved in the transition process to chronic pain. Future studies with a longitudinal design are required to solve this issue.
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Laparoscopic gastrectomy with D2 lymph node (LN) dissection has not yet been widely adopted for advanced gastric cancer because it is technically complicated. Due to the high suprapancreatic lymph nodes metastasis rate (LMR) and the various vascular anatomies, the suprapancreatic LN dissection is a crucial and demanding procedure for radical resection of gastric cancer. To explore the anatomical basis of the proximal splenic artery (SA) approach for laparoscopic suprapancreatic LN dissection and its application in advanced gastric cancer. ⋯ The No. 11p LMR was lower than the Nos. 9, 7, 8a, 5, and 12a LMR (P < 0.01, each). Compared with the conventional approach, the proximal SA approach was associated with less blood loss (P < 0.05), significantly more retrieved total LNs and suprapancreatic LNs (P < 0.01, each). The proximal SA exhibits the most constant and maximum diameter, is located closer to the suprapancreatic border, and exhibits the lowest LMR; therefore, the proximal SA approach is the ideal approach for laparoscopic suprapancreatic LN dissection in advanced gastric cancer.