The study aims to develop and validate a predictive model for effectively predicting in-hospital mortality in patients admitted to the intensive care unit due to Gastrointestinal bleeding (GIB). A retrospective cohort study was conducted, including data from patients in the Electronic Intensive Care Unit Collaborative Research Database (eICU-CRD) and Medical Information Mart for Intensive Care-IV Database (MIMIC-IV) with a diagnosis of GIB. Patients from the eICU-CRD were randomly allocated into both development and validation sets, and those from MIMIC-IV were assigned as an external validation group. Multivariate logistic regression was employed to create a predictive model, which was depicted as a nomogram. This study included a total of 2929 patients with GIB from the eICU-CRD and 718 patients from the MIMIC-IV. To access the dynamic nomogram, please use the following link: https://kangzou.shinyapps.io/DynNomapp_GIB/ . The area under the receiver operating characteristic curve for the nomogram was 0.893 in the development set, 0.860 in the internal validation set, and 0.781 in the external validation set. The mortality rate was 25.7% in the high-risk group (nomogram scores > 101.974) and 2.8% in the low-risk group (nomogram scores ≤ 101.974). The nomogram exhibited excellent discrimination, calibration, and clinical utility in predicting in-hospital mortality among patients admitted to the intensive care unit with GIB.

BACKGROUND As a less invasive technique, peroral endoscopic myotomy (POEM) has recently been widely accepted for treating achalasia with an excellent safety profile, durability, and efficacy in adults. In pediatric and geriatric patients, the treatment is more difficult. AIM To discuss the clinical outcomes of POEM in pediatric and geriatric patients with achalasia. METHODS We conducted a comprehensive search of PubMed, Embase and Cochrane Library databases from inception to July 2024. The primary outcomes were technical and clinical success. Secondary outcomes of interest included adverse events and gastroesophageal reflux disease (GERD). The pooled event rates were calculated by comprehensive meta-analysis software. RESULTS A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this study. The pooled event rates of technical success, clinical success, GERD and adverse events of POEM for treating achalasia in pediatric patients were 97.1% [95% confidence interval (CI): 95.0%-98.3%; I ² = 0%; P < 0.000], 93.2% (95%CI: 90.5%-95.2%; I ² = 0%; P < 0.000), 22.3% (95%CI: 18.4%-26.7%; I ² = 43.874%; P < 0.000) and 20.4% (95%CI: 16.6%-24.8%; I ² = 67.217%; P < 0.000), respectively. Furthermore, in geriatric patients, the pooled event rates were 97.7% (95%CI: 95.8%-98.7%; I ² = 15.200%; P < 0.000), 93.2% (95%CI: 90.3%-95.2%; I ² = 0%; P < 0.000), 23.9% (95%CI: 19.4%-29.1%; I ² = 75.697%; P < 0.000) and 10.8% (95%CI: 8.3%-14.0%; I ² = 62.938%; P < 0.000], respectively. CONCLUSION Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.

Peroral endoscopic myotomy (POEM) has revolutionized the therapeutic strategy for achalasia with promising results. We conducted this meta-analysis to compare clinical outcomes between Eastern and Western countries. A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science and Cochrane Library databases to query for studies that assessed the efficacy of POEM for achalasia. All articles published from inception to December 31, 2021 were included. The primary outcome was the pooled clinical success rate. The secondary outcomes included the pooled technical success rate, incidence of adverse events, procedure time and hospital stay. Eighteen Eastern studies involving 5962 patients and 11 Western studies involving 1651 patients were included. The pooled clinical success rate and technical success rate for POEM was equal in the Eastern studies compared to Western studies. The pooled incidence of procedure adverse events for POEM was a little lower in the Eastern studies compared to Western studies (6.6% vs. 8.7%). Similarly, the incidence of reflux-related adverse events was lower in Eastern studies than that in Western studies. The pooled procedure time of POEM was shorter in Eastern studies compared to Western studies (61 minutes vs. 80 minutes), while the length of hospital stay was longer in Eastern studies compared to Western studies (5.8 days vs. 2.4 days). Overall, Eastern countries have the similar POEM outcomes compared to Western countries. However, Eastern countries still need to do more to reduce the length of hospital stay.

回顾性分析214例SAP患者的资料，构建5种SAP并发急性呼吸窘迫综合征(ARDS)的机器学习预测模型，并筛选出最优模型。结果显示，5种机器学习模型中，极端梯度提升(XGBoost)为最优模型。XGBoost在测试集中的AUC值为0.851(95% CI 0.739~0.963)，灵敏度为0.840，特异度为0.793，阳性预测值为0.842，阴性预测值为0.743。最重要的4个预测变量为呼吸频率、血清淀粉酶、年龄和总蛋白。表明机器学习模型能够很好地预测SAP相关ARDS的发生，为临床早期识别高危患者提供了思路。

Abstract Objectives: The effect of a retracted publication can be significant, especially in high-impact journals. We aimed to identify the characteristics of retracted articles in three high-impact clinical journals, including The Journal of the American Medical Association (JAMA), Lancet, and The New England Journal of Medicine (NEJM).Methods: The Retraction Watch database was searched from inception to March 21, 2021. Data collected for each article included title, article type, reasons for retraction, journal, publisher, publication year, retraction year, first author, country of origin, and times a retracted article was cited. Data analysis was performed by GraphPad Prism version 8.00 (La Jolla, CA, United States), and SPSS Statistics 26.0. Results: A total of 77 articles were retracted, of which 20 were from JAMA, 31 from Lancet, and 26 from NEJM. Over one-half of papers were retracted within the last decade (n=44, 57.1%). Since 2005, the number of retracted articles had increased dramatically. The United States (n=29, 37.7%) was the country with the highest number of retracted publications in the three journals, followed by the United Kingdom (n=9, 11.7%) and China (n=5, 6.5%). The most common reasons for retractions were “Error” (n=20, 26.0%), “Fraud” (n=19, 24.7%) and “Reliability” (n=18, 23.4%) in these three journals. The media number of citations was 79 (range 0-2677). The media time to retraction was 651 (range 2-8474) days. The time was longer when an article was retracted because of fraud than that because of error. Conclusions: By analyzing the features of retracted articles in the three high-impact journals, we could identify the reason for retraction more comprehensively and benefit in improving the quality of biomedical literature.

To evaluate the methodological and reporting quality of published meta-analyses (MAs) in four major gastrointestinal endoscopic journals, and identify the predicted factors for high quality. A systematic search was performed in PubMed to identify MAs from 1, January, 2016 to 31, December, 2020 in four major gastrointestinal endoscopic journals (including Digestive Endoscopy, Gastrointestinal Endoscopy, Surgical Endoscopy, and Endoscopy). We collected the characteristics of MAs after filtering unqualified articles, and assessed methodological and reporting qualities for eligible articles by AMSTAR tool and PRISMA checklist, respectively. Logistic regression was used for identifying predictive factors for high quality. A total of 289 MAs were identified after screening by predefined inclusion and exclusion criteria. The scores (mean ± SD) of AMSTAR and PRISMA were 7.73 ± 1.11 and 22.90 ± 1.85, respectively. In PRISMA checklist, some items had less than 50

ABSTRACT Background and objectives As an emerging minimally invasive technology, endoscopic ultrasound (EUS) has been reported to treat pelvic abscess instead of surgical or image-guided percutaneous drainage (PCD) under certain conditions. The aim of this study was to assess the efficacy and safety of EUS-guided drainage for patients with pelvic abscesses. Methods We conducted a comprehensive literature search on PubMed, Embase, Cochrane Library, and Web of Science databases (inception–March 2022). The main outcomes were technical success, clinical success, and complications. Comprehensive meta-analysis software was used to calculate the pooled event rate. Results Twelve studies containing 272 patients were included. These pelvic abscesses most frequently developed after abdominal and pelvic surgery (n = 180, 66.2%), inflammatory bowel disease (n = 32, 11.8%), and other inflammatory conditions. Respectively, the pooled technical and clinical success rate was 100% and 88.7% [95% confidence interval (CI): 83.8–92.2%, I2 = 1.0%, p < 0.001]. After excluding an individual study, the pooled rate of complications changed from 11.5% (95% CI: 7.4–17.4%, I2 = 38.8%, p < 0.001) to 8.2% (95% CI: 5.0–13.3%, I2 = 0, p < 0.001). Conclusions EUS-guided drainage of the pelvic abscess was feasible, effective, and safe. Further randomized-controlled studies with large-sample sizes were required in the future.

Objective:To evaluate the methodological quality and reporting quality of clinical practice guidelines or consensuses in the field of Chinese pancreatic diseases from 2016 to 2021, and provide reference for formulating clinical practice guidelines and consensuses in this field.Methods:VIP, Wanfang , CNKI and CBM databases were searched for articles published from January 2016 to March 2021. The main index terms were " pancreas" , " guideline" , " consensus" , and the supplementary index terms were " pancreatitis" , " pancreatic cancer" , " pancreatic head cancer" . Two researchers independently selected the literature. The appraisal of guidelines for research and evaluation (AGREE-China) was utilized to assess the methodological quality of the guidelines or consensuses, and the reporting items for practice guidelines in healthcare (RIGHT) tool was used to assess the reporting quality.Results:A total of 14 literature were included, including 7 literature on pancreatic cancer, 3 literature on acute pancreatitis, 1 literature on chronic pancreatitis and 3 literature on others. The results of the assessment by the AGREE-China tool showed that there were no document with a total score greater than or equal to 60.0 points, two with 40.0 to 59.9 points, eleven with 20.0 to 39.9 points, and one with less than 20.0 points. Among the results of RIGHT list, basic information was reported the highest(72.62%) and funding and declaration was the lowest(0).Conclusions:The methodological and reporting quality of the guidelines or consensuses on pancreatic disease in China from 2016 to 2021 are generally not high. In the process of developing domestic guidelines or consensuses on pancreatic diseases, the guideline developer should refer to AGREE-China and RIGHT to improve the quality of clinical practice guidelines or consensuses.

Background and objectives As an emerging minimally invasive technology, endoscopic ultrasound (EUS) has been reported to treat pelvic abscess instead of surgical or image-guided percutaneous drainage (PCD) under certain conditions. The aim of this study was to assess the efficacy and safety of EUS-guided drainage for patients with pelvic abscesses. Methods We conducted a comprehensive literature search on PubMed, Embase, Cochrane Library, and Web of Science databases (inception-March 2022). The main outcomes were technical success, clinical success, and complications. Comprehensive meta-analysis software was used to calculate the pooled event rate. Results Twelve studies containing 272 patients were included. These pelvic abscesses most frequently developed after abdominal and pelvic surgery (n = 180, 66.2%), inflammatory bowel disease (n = 32, 11.8%), and other inflammatory conditions. Respectively, the pooled technical and clinical success rate was 100% and 88.7% [95% confidence interval (CI): 83.8-92.2%, I-2 = 1.0%, p < 0.001]. After excluding an individual study, the pooled rate of complications changed from 11.5% (95% CI: 7.4-17.4%, I-2 = 38.8%, p < 0.001) to 8.2% (95% CI: 5.0-13.3%, I-2 = 0, p < 0.001). Conclusions EUS-guided drainage of the pelvic abscess was feasible, effective, and safe. Further randomized-controlled studies with large-sample sizes were required in the future.