Clinical effectiveness of sodium bicarbonate therapy on mortality for septic patients with acute moderate lactic acidosis.

Objective: This study aimed to explore the effectiveness of sodium bicarbonate (SB) administration on mortality in septic patients with acute moderate lactic acidosis (MLA). Methods: The large ICU database (MIMIC-IV) was retrospectively analyzed. Patients with sepsis and acute MLA were identified. Propensity score analysis (PSA) was performed to explain baseline differences in the probability of accepting or not accepting SB. The edge structured cox model (MSCM) was used to adjust for baseline and time-varying confounding variables. The primary outcome was the ICU and hospital mortality. The subgroup of septic shock was also investigated. Results: A total of 512 septic patients with acute MLA were identified in this study, including 160 in the SB group and 352 in the non-SB group. In the PSA, SB administration was associated with reduced ICU (HR .58, 95% CI 0.38-.89; p <.05) and hospital (HR .67, 95% CI 0.47-.95; p <.05) mortality in septic patients with acute MLA. In the subgroup, the results were similar with septic patients. In the MSCM, SB administration could also improve the ICU (HR .35, 95% CI 0.16-.75; p <.01) and (HR .50, 95% CI 0.28-.88; p <.05) mortality on septic patients. However, In the subgroup, SB administration could only be found associated with improved hospital (HR .44, 95% CI 0.20-.97; p <.05) survival in septic shock. Conclusion: SB administration treatment could reduce ICU and hospital mortality of septic patients with acute MLA. Meanwhile, it could also improve hospital survival in the subgroup of septic shock patients with acute MLA.

CT-US fusion imaging increases the feasibility of early ultrasound-guided percutaneous intervention of local drug therapy in pancreatic contusion and laceration.

BACKGROUND: Multimodal fusion imaging (MMFI) was usually used to assist percutaneous procedures for difficult lesions, with most applications occurring with hepatic and prostatic interventions. This paper aimed to evaluate the precision and effectiveness of computed tomography-ultrasound (CT-US) fusion imaging (CUFI)-assisted US-guided percutaneous intervention (UGPI) in early local drug therapy for pancreatic contusion and laceration (PCL). METHODS: A total of 12 pigs with PCL were randomly divided into a CUFI-assisted UGPI (MU) group (n=6) and a single UGPI (SU) group (n=6). The MU group underwent CUFI-assisted UGPI of locally applied medical protein glue (1 mL) injection while the SU group received the same therapy using two-dimensional UGPI. The duration and accuracy of each procedure were observed in the 2 groups. RESULTS: In the MU group, the overall time of the procedure for locking the plane was 1.85±0.06 minutes. Less time was spent in the selection of the pathway and puncture site in the MU group compared with the SU group (6.56±0.42 vs. 7.61±0.44 minutes, P<0.01). The duration of puncturing and drug injection was also shorter in the MU group than in the SU group (3.41±0.30 vs. 4.20±0.20 minutes, P<0.01) and the MU group had a higher accuracy of medical protein glue injection than the SU group (100% vs. 50%, P<0.05). CONCLUSIONS: CUFI could increase the precision and effectiveness of early UGPI in the delivery of local drug therapy in PCL.

Retracted Publications in the Biomedical Literature from Open Access Journals.

The number of articles published in open access journals (OAJs) has increased dramatically in recent years. Simultaneously, the quality of publications in these journals has been called into question. Few studies have explored the retraction rate from OAJs. The purpose of the current study was to determine the reasons for retractions of articles from OAJs in biomedical research. The Medline database was searched through PubMed to identify retracted publications in OAJs. The journals were identified by the Directory of Open Access Journals. Data were extracted from each retracted article, including the time from publication to retraction, causes, journal impact factor, and country of origin. Trends in the characteristics related to retraction were determined. Data from 621 retracted studies were included in the analysis. The number and rate of retractions have increased since 2010. The most common reasons for retraction are errors (148), plagiarism (142), duplicate publication (101), fraud/suspected fraud (98) and invalid peer review (93). The number of retracted articles from OAJs has been steadily increasing. Misconduct was the primary reason for retraction. The majority of retracted articles were from journals with low impact factors and authored by researchers from China, India, Iran, and the USA.

Therapeutic effect of ultrasound interventional perirenal catheter-assisted early peripancreatic lavage of protease inhibitor on severe acute pancreatitis in miniature pigs.

OBJECTIVES: To study the therapeutic effect of early peripancreatic lavage of ulinastatin on severe acute pancreatitis(SAP). METHODS: Sixteen pigs were divided into 4 groups: model(SAP), saline lavage(SL), ulinastatin lavage(UL), intravenous ulinastatin(IU). UL and SL group were given peripancreatic lavage of ulinastatin by ultrasound-guided perirenal catheterization and IU group was intravenously instilled with ulinastatin. The multi-organ functions and the inflammatory factors were observed. RESULTS: UL group has the best therapeutic effect. The changes of multi-organ functions and the inflammatory factors were compared with SAP group as follows. In time window of treatment: amylase (p < 0.01), lipase (p < 0.01), ALT (p > 0.05), AST (p < 0.05), CR (p < 0.01), UR (p < 0.01), IL-6 (p < 0.01), IL-10 (p < 0.01). In post-treatment phase: amylase (p < 0.01), lipase (p < 0.01), ALT (p < 0.01), AST (p < 0.01), CR (p < 0.05), UR (p > 0.05), IL-6 (p < 0.01), IL-10 (p < 0.01). CONCLUSIONS: Early peripancreatic lavage of ulinastatin in SAP could effectively improve the multi-organ functions and inflammatory response.