BackgroundTraditional Helicobacter pylori (H. pylori) eradication therapies have shown efficacies below 80% in several studies, and their use has been accompanied by antibiotic-related side effects. Some recent studies have reported that supplementing standard therapies with probiotics can improve the efficacy and tolerability of Helicobacter pylori eradication therapy.ObjectiveTo assess the effects of probiotic supplementation on the eradication rates and therapy-related adverse event rates of anti-Helicobacter pylori regimens.MethodsWe searched PubMed, Medline, the Cochrane Central Registry of Controlled Trials and the Chinese Biomedical Database for eligible randomized controlled trials published through July, 2015. Review Manager 5.3 was used for all statistical analyses.ResultsThirteen randomized controlled trials involving a total of 2306 patients were included in our analysis. Intent-to-treat (ITT) analysis performed using a fixed-effects model (test for heterogeneity I2 = 45%) showed that the pooled relative risk (RR) of eradication was significantly higher in the probiotic supplementation group than in the control group [RR 1.15, 95% confidence interval (CI): 1.10–1.20, P<0.00001]. The incidence of total antibiotic-related side effects was lower in the probiotic supplementation group than in the control group, and the pooled RR (studies n = 9) was 0.71 (95% CI: 0.54–0.94, P = 0.02), as determined using a random-effects model (heterogeneity test I2 = 59%). Certain adverse events, such as nausea and vomiting (RR = 0.58, 95% CI 0.35–0.95, P = 0.03), diarrhea (RR = 0.51, 95% CI: 0.31–0.84, P = 0.008) and constipation (RR = 0.47, 95% CI: 0.28–0.80, P = 0.005), were reported at lower rates in the probiotic supplementation group than in the control group. Subgroup analysis showed that eradication rates were significantly improved in both adults (RR = 1.14, 95% CI: 1.09–1.19, P<0.00001) and children (RR = 1.24, 95% CI: 1.05–1.47, P = 0.01) in the probiotic supplementation group and that no regional differences between Europe (RR = 1.17, 95% CI: 1.09–1.24, P<0.00001) and Asia were present (RR = 1.14, 95% CI: 1.06–1.22, P = 0.0002). However, the total adverse event rate was not decreased in the adult group (RR = 0.80, 95% CI: 0.61–1.04, P = 0.1) or the Asian group (RR = 0.68, 95% CI: 0.39–1.18, P = 0.17). Subgroup analyses examining therapy regimens and treatment durations showed that probiotic supplementation increased eradication rates in the triple-therapy (RR = 1.18, 95% CI: 1.12–1.25, P<0.00001), seven-day treatment (RR = 1.21, 95% CI: 1.12–1.31, P<0.00001) and fourteen-day treatment (RR = 1.13, 95% CI: 1.06–1.20, P = 0.0002) groups. The incidence of antibiotic-related side effects was significantly reduced in all groups, with the exception of the quadruple-therapy subgroup (RR = 1.13, 95% CI: 0.60–2.13, P = 0.07) and the fourteen-day therapy subgroup (RR = 0.96, 95% CI 0.61–1.51, P = 0.86). Supplementation with Lactobacillus alone (RR = 1.24, 95% CI: 1.12–1.38, P<0.0001) or multi-strain probiotics (RR = 1.12...

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Nonalcoholic fatty liver disease (NAFLD) is a common chronic disease that is associated with high serum uric acid (SUA) levels, although the effects of high SUA levels on NAFLD remission remain unclear. In addition, it is unclear whether obesity and high SUA levels have a combined effect on NAFLD remission. This retrospective cohort study evaluated male employees of seven Chinese companies and investigated the association between high SUA levels and NAFLD remission, as well as the potential combined effect of high SUA levels and obesity on NAFLD remission. The study followed 826 men with NAFLD for 4 years, and the NAFLD remission rate was 23.2% (192/826). Comparing to obese and non-obese individuals with normouricemia, individuals with hyperuricemia had significant higher values for total cholesterol, triglycerides, creatinine, and aspartate transaminase (all P < 0.05). Among non-obese individuals, hyperuricemia was associated with a lower NAFLD remission rate, compared to normouricemia (P < 0.001). However, no significant difference was observed between hyperuricemia and normouricemia among obese subjects (P > 0.05). Similar results were observed in the multivariate cox proportional hazard regression analyses. Compared to the normouricemia subjects, individuals with hyperuricemia had a significant lower likelihood of NAFLD remission (RR = 0.535, 95% CI: 0.312–0.916); and obese subjects had a significant lower likelihood of NAFLD remission than the non-obese individuals (RR = 0.635, 95% CI: 0.439–0.918). In addition, the interaction between hyperuricemia and obesity had a statistically significant effect on NAFLD remission (P = 0.048). In conclusion, hyperuricemia and obesity may be involved in NAFLD development and remission, with similar pathogenic mechanisms. Further studies are needed to confirm our findings and determine how to improve these individuals’ conditions.

Background The preoperative controlling nutritional status (CONUT) score and serum carbohydrate antigen 199 (CA199) levels are individually correlated with the prognosis of pancreatic ductal adenocarcinoma (PDAC). The objective of this study aimed to investigate the efficacy of CONUT score and CA199 (CONUT-CA199) combination in predicting the prognosis of PDAC patients undergoing radical surgery. Methods We retrospectively analyzed the preoperative CONUT scores and serum CA199 levels of 294 patients with PDAC who underwent radical resection at the Affiliated Hospital of Southwest Medical University between March 2012 and July 2019. Patients were divided into four groups on the basis of their preoperative CONUT scores and serum CA199 levels: CONUTlow/CA199low (1), CONUTlow/CA199high (2), CONUThigh/CA199low (3) and CONUThigh/CA199high (4). The prognostic effects were compared among the groups. Results CONUThigh was more frequent in patients with positive peripancreatic infiltration and Clavien–Dindo classification of ≥IIIa (P < 0.001). Kaplan–Meier analysis revealed obvious difference in overall survival (OS) and recurrence-free survival (RFS) among patients with PDAC having CONUT-CA199 scores of 1, 2, 3 and 4 (P < 0.001). Peripancreatic infiltration, lymph node metastasis, pTNM stage, CONUT score, serum CA199 levels and CONUT-CA199 classification were found to be the independent prognostic factors for OS and RFS in multivariate analyses. In time-dependent receiver operating characteristic (ROC) analyses, the area of the CONUT-CA199 score under the ROC curve (AUC) was higher than that of the preoperative CONUT score or serum CA199 levels for the prediction of OS and RFS. Conclusion CONUT-CA199 classification may be more effective in predicting the postoperative prognosis of PDAC patients.

Attenuated Salmonella typhi may represent a promising vector for in vivo administration of RNA interference therapy against malignant tumors.