PBD in patients undergoing surgery for obstructive jaundice is associated with similar mortality but increased serious morbidity compared with no PBD. Therefore, PBD should not be used routinely.

Introduction Helicobacter pylori eradication therapy may lead to the perturbation of gut microbiota. We aim to investigate the impact of probiotics on eradication rate and gut microbiota during eradication therapy. Methods A total of 162 patients receiving bismuth quadruple therapy were enrolled and randomly assigned to groups given probiotics ( n = 83) or placebo ( n = 79) for 4 weeks. Fecal samples were collected before treatment and 2, 4, 6, and 8 weeks after eradication therapy. Gut microbiota was analyzed by 16S rRNA high-throughput sequencing. Results The eradication rates in the placebo and probiotics group were 82.43% and 87.01%, respectively ( P > 0.05). Compared with baseline, alpha and beta diversity was significantly altered 2 weeks after eradication in both groups, which was restored at week 8. There were no significant differences in diversity between the two groups. H. pylori eradication therapy resulted in enrichment of some detrimental bacteria taxa such as Shigella , Klebsiella , and Streptococcus , while probiotics supplementation could rapidly restore these taxa levels after eradication and increase the taxa of Bacillus and Lactobacillales. Functional analysis revealed that lipopolysaccharide biosynthesis and polymyxin resistance pathways were significantly enriched after eradication, while probiotics supplementation mainly enriched the cofactors and vitamins metabolism pathways. Increased relative abundances of Roseburia and Dialister were associated with the positive eradication outcome. Conclusions Probiotics supplementation might help to construct a beneficial profile of gut microbiota after eradication therapy. Specific bacteria taxa are associated with H. pylori eradication outcome. These findings may be of value in rational use of probiotics during H. pylori eradication. Trial Registration Chinese Clinical Trial Registry, ChiCTR1900022116. Electronic supplementary material The online version of this article (10.1007/s40121-020-00372-9) contains supplementary material, which is available to authorized users.

The aim of this study is to explore the survival rate and risk factors of mortality in patients with late-onset systemic lupus erythematosus (SLE) in a large cohort. Clinical presentations, disease activity, organ damage scores, autoantibody profile, and mortality data were obtained retrospectively from late-onset SLE patients (onset age ≥50 years) diagnosed between 1995 and 2009. The risk factors of organ damage were evaluated by the chi-square test and logistic regression. The cumulative rate of survival was calculated by Kaplan-Meier method, and factors predictive of mortality were studied by Cox proportion hazard regression model. A total of 158 patients (132 female and 26 male) were studied. The average onset age was 58.66 ± 6.38 years and mean disease duration was 63.85 ± 48.17 months. One hundred and four patients had organ damage at the time of data analysis. Hematological system and kidney involvement were most common. Central nervous system involvement was relatively rare. In univariate logistic analysis, associations were found between SLE disease activity index (SLEDAI) at diagnosis (OR = 1.133, P = 0.001); renal involvement (OR = 2.441, P = 0.009) and edema (OR = 2.812, P = 0.003) were associated with organ damage. And SLEDAI at diagnosis (OR = 1.103, P = 0.034) was independent factor for organ damage in multivariate logistic regression. During the follow-up, 64 patients (51 female and 13 male) died. Five-, 10-, and 15-year survival rates were 80.4, 56.5, and 31.7 %, respectively. Median survival time was 123 months. The analysis of Cox proportion hazard regression model showed that age at disease onset (OR = 1.069, P = 0.002), compliance of medical care (OR = 3.282, P = 0.001), and SLEDAI at diagnosis (OR = 1.091, P = 0.003) were independent risk factors of mortality. Late-onset SLE has a poor long-term prognosis. Infection is the major cause of death in patients with late-onset lupus. Disease activity, medical care, and onset age are strongly related to death of late-onset SLE.

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Using a low toxic agent that potentially with anti-inflammatory proprieties, minocycline, we conducted Phase II randomized placebo controlled trial and observed positive effect of reducing fatigue and other symptoms in patients undergoing CRT for NSCLC.Purpose: In patients with non-small cell lung cancer (NSCLC), concurrent chemoradiation therapy (CRT) exacerbates a cluster of difficult-to-manage symptoms, especially cancer-related fatigue. Minocycline is a readily available, low-cost antibiotic with antiinflammatory properties. We conducted a phase 2 randomized, doubleblinded, placebo-controlled trial to investigate the effect of minocycline in reducing CRT-symptom burden in NSCLC. Methods and Materials: Patients with NSCLC scheduled to receive CRT provided consent and were randomized to receive either minocycline (100 mg twice daily) or a matching placebo during 6 to 7 weeks of CRT. Patient-reported fatigue and other symptoms were assessed on MD Anderson Symptom Inventory weekly from the start of CRT for 12 weeks. The primary outcome was 12-week (AE2 days) area under the curve for symptom burden, which was compared between treatment groups. Results: Forty of 49 enrolled patients (80%) were evaluable (19 on minocycline and 21 on placebo). There were no grade 3 þ adverse events related to the study medication. Fatigue was significantly reduced in the minocycline group compared with placebo group during the 12-week trial period (area under the curve Z 31.2 AE 14.2 vs 45.0 AE 20.9, P Z .011), with a large effect size (Cohen's d Z 0.77). Pain (Cohen's d Z 0.54) and shortness of breath (Cohen's d Z 0.55) were also significantly reduced in the minocycline group (all P < .05).