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Prednisolone therapy accelerates recovery of severe drug-induced liver injury: A prospective, randomized controlled study

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iLIVER 2023年第3期2卷 156-162页

作者： Fang-Jiao Song Hong-Ling Liu Ying Sun Tian-Jiao Xu Dong-Ze Li Hai-Bo Wang Shao-Jie Xin Yu-Dong Wang Gregory Cheng George Lau Sa Lv Shao-Li You Bing Zhu Senior Department of Hepatology Fifth Medical Center of Chinese PLA General HospitalBeijing 100005China Humanity and Health Clinical Trial Center Humanity&Health Medical GroupHong Kong SARChina Faculty of Health Science University of MacaoMacao SARChina

Background and aims:Drug-induced liver injury(DILI)is one of the most serious adverse drug reactions and its incidence has been increasing *** evidence suggests that immune activation and systemic inflammatory responses are very important in the progression of *** are often used in DILI,but their clinical usefulness remains *** therefore conducted a prospective,randomized controlled study to investigate whether corticosteroid therapy can accelerate recovery and reduce mortality in severe DILI(SDILI).Methods:SDILI patients with total bilirubin?171μmol/L who presented to the Fifth Medical Center of Chinese PLA General Hospital,Beijing from 2016 to 2019 were randomly allocated to prednisolone and control *** endpoints were resolution of SDILI,defined as a decrease in total bilirubin of at least 35μmol/L to<171μmol/L,and overall survival at 6 *** in the prednisolone group received prednisolone 60 mg/day therapy for the first 7 *** with a decrease in total bilirubin of more than 35μmol/L on day 8 continued on tapering doses of prednisolone;otherwise,prednisolone was ***:On day 8,50.75%(34/67)and 26.47%(18/68)of the participants in the prednisolone and control groups,respectively,achieved the primary endpoint(p¼0.002).However,there was no significant difference in overall survival at 6 months:95.52%(64/67)vs.91.18%(62/68)in the prednisolone and control groups,respectively(p¼0.3).All deaths in both groups occurred in patients who failed to achieve SDILI resolution on day ***:Prednisolone therapy may accelerate the recovery of SDILI.

关键词： randomized study Severe drug-induced liver injury Hepatotoxicity Prednisolone Efficacy Accelerated recovery

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Effect of probiotics on length of hospitalization in mild acute pancreatitis:A randomized,double-blind,placebo-controlled trial

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World Journal of Gastroenterology 2021年第2期27卷 224-232页

作者： You-Dong Wan Rui-Xue Zhu Zhong-Zheng Bian Tong-Wen Sun Integrated Intensive Care Unit The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Health Management Centre The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina Department of Emergency Medicine The Affiliated Hospital of Qingdao UniversityQingdao 266000Shandong ProvinceChina

BACKGROUND Acute pancreatitis is the leading cause of hospitalization for acute gastrointestinal disease *** effects of probiotics in mild acute pancreatitis have not been *** hypothesized that the administration of probiotics may accelerate the recovery of intestinal function and shorten the length of hospital stay(LOS)in patients with mild *** To investigate the value of probiotics in reducing the LOS in patients with mild acute *** We conducted a double-blind randomized clinical trial to evaluate the effects of probiotics administered to patients with mild acute pancreatitis at a tertiary medical *** patients were given probiotics capsules(a mixed preparation of Bacillus subtilis and Enterococcus faecium)or *** primary study endpoint was the *** secondary endpoints included time to abdominal pain relief,recurrent abdominal pain,and time to successful oral *** A total of 128 patients were included,with 64 patients in each *** severity of illness and the etiological distribution of disease were similar in the two *** was a significant reduction in the LOS in the probiotics treatment group vs the placebo group(5.36±0.15 vs 6.02±0.17 d,Pstudy results showed that the administration of probiotics capsules is associated with a shorter duration of hospitalization in patients with mild acute pancreatitis.

关键词： Acute pancreatitis Probiotics Length of hospitalization randomized study Placebo Mild

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Is a 7-day Helicobater pylori treatment enough for eradication and inactivation of gastric inflammatory activity?

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World Journal of Gastroenterology 2008年第18期14卷 2838-2843页

作者： Carlos Robles-Jara Carlos Robles-Medranda Manuel Moncayo Byron Landivar Johnny Parrales Gastroenterology Division Instituto Ecuatoriano de Enfermedades Digestivas y Pélvicas (IECED) Portoviejo 1301266 Ecuador Gastroenterology Division Instituto Ecuatoriano de Enfermedades Digestivas y Pélvicas (IECED) Portoviejo 1301266 Ecuador Gastroenterology Division Hpital Edouard Herriot Lyon 69003 France Gastroenterology Division Instituto Ecuatoriano del Seguro Social Portoviejo 1301266 Ecuador Epidemiology Division Hospital Oncológico Julio Villacreses Colmont Sociedad de Lucha contra el Cancer (SOLCA) or Registro Nacional de Tumores Portoviejo 1301266 Ecuador Laboratorio de Histopatologia (LABOPAT) Portoviejo 1301266 Ecuador

AIM: To compare the efficacy of a 7-d vs 10-d triple therapy regarding H pylori eradication, endoscopic findings and histological gastric inflammatory inactivation in the Ecuadorian population. METHODS: 136 patients with dyspepsia and H pylori infection were randomized in 2 groups (68 per group): group 1, 7-d therapy; group 2, 10-d therapy. Both groups received the same medication and daily dosage: omeprazole 20 mg bid, clarithromycin 500 mg bid and amoxicillin 1 g bid. Endoscopy was performed for histological assessment and H pylori infection status before and 8 wk after treatment. RESULTS: H pylori was eradicated in 68% of group 1 vs 83.8% of group 2 for the intention-to-treat analysis (ITT) (P = 0.03; OR = 2.48; 95% CI, 1.1-5.8), and 68% in group 1 vs 88% in group 2 for the per-protocol analysis (PP) (P = 0.008; OR = 3.66; 95% CI, 1.4-10). Endoscopic gastric mucosa normalization was observed in 56.9% in group 1 vs 61.2% in group 2 for ITT, with similar results for the PP, the difference being statistically not significant. The rate of inflammatory inactivation was 69% in group 1 vs 88.7% in group 2 for ITT (P = 0.007; OR = 3.00; 95% CI, 1.2-7.5), and 69% in group 1 vs96% in group 2 for PP (P = 0.0002; OR = 7.25; 95% CI, 2-26). CONCLUSION: In this Ecuadorian population, the 10-d therapy was more effective than the 7-d therapy for H pylori eradication as well as for gastric mucosa inflammatory inactivation.

关键词： Helicobater pylori treatment Helicobater pylon infection Gastric inflammatory inactivation Triple therapy eradication randomized study

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Has Coca-Cola treatment become the first-line therapy for gastric bezoars,both in general and specifically for western countries?

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World Journal of Gastrointestinal Endoscopy 2024年第5期16卷 237-243页

作者： Maria Delgado Galan Luis Ramon Rabago Department of Gastroenterology Hospital Severo OchoaLeganes 28914Spain Department of Gastroenterology Hospital San RafaelMadrid 28016Spain

Phytobezoars is a rare disease and less common in Western *** stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective ***,medical treatments using enzymatic and chemical agents,such as cellulase and Coca-Cola,aimed at dissolving the bezoars,have also been utilized,showing varying degrees of resolution ***,the oral dissolution treatment with Coca-Cola has emerged as a promising,simpler,and more costeffective *** study by Liu et al represents an important step in clinical research on this topic,despite some limitations that need addressing for a more comprehensive understanding of its *** considerations for future research include sample size calculation,endoscopic procedure details,outpatient *** treatment,and detailed cost *** study's exclusions,such as patients with upper gastric surgery,phytobezoars older than 14 d,and cases of gastroparesis,limit its applicability to broader populations,especially in Western *** the promising outcomes of the Coca-Cola treatment,it's advocated as a first-line therapy for ***,further research is essential to overcome these *** special situations such as perforation or small bowel obstruction will require surgical treatment.

关键词： Phytobezoars Endoscopic treatment Oral dissolution treatment with Coca-Cola randomized study Editorial

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