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Background: The third-generation streamlined liner of the pharynx airway (SLIPA-3G) is a new-generation supraglottic airway device (SAD) that is non-cuffed and disposable, with a sealing pressure that varies dynamically with the airway pressure. This study compared the SLIPA-3G with the laryngeal mask airway supreme (LMAS) in patients undergoing laparoscopic cholecystectomy. Methods: Two hundred and twenty patients scheduled for laparoscopic cholecystectomy were randomly allocated to either the SLIPA-3G group or the LMAS group. Data were collected on the patients' hemodynamic parameters at different time points, ease of insertion, fiberoptic view, oropharyngeal leak pressure (OLP) at different time points and SAD-related complications. Results: The mean OLP immediately after device placement in the LMAS group was significantly higher than that of the SLIPA-3G group (31.34 ± 6.99 cmH2O vs.28.94 ± 6.01 cmH2O, P = 0.008, 95% CI 0.62–4.17). The OLPs of the two groups were not significantly different after the induction of a pneumoperitoneum until the end of surgery. The OLP increased gradually through the course of the operation in the SLIPA-3G group (P value = 0.035) but not in the LMAS group (P value = 0.945). There was no significant difference between the two groups in hemodynamic parameters, insertion time and success rate, fiberoptic view and complication rate. Conclusions: The SLIPA-3G and LMAS were associated with comparable OLPs, hemodynamic parameters, ease of insertion, fiberoptic views and complication rates when used during laparoscopic cholecystectomy. The SLIPA-3G can be used as an effective alternative to the LMAS in patients undergoing laparoscopic surgeries. [ABSTRACT FROM AUTHOR]

Background: To investigate whether respectively radial extracoporeal shock wave therapy (rESWT) or a combination of rESWT, celecoxib and eperisone (rESWT + C + E) are superior in reducing pain in patients with chronic nonspecific low back pain (cnsLBP) compared to C + E alone (a standard treatment of this condition in China). Methods: 140 patients with cnsLBP were randomly allocated to rESWT (n = 47), rESWT + C + E (n = 45) or C + E alone (n = 48) for four weeks between November 2017 and March 2019. Outcome was evaluated using the Pain Self-Efficacy Questionnaire (PSEQ), Numerical Rating Scale (NRS), Oswestry Low Back Pain Disability Questionnaire and Patient Health Questionnaire 9, collected at baseline as well as one week (W1), W2, W3, W4 and W12 after baseline. Results: All scores showed a statistically significant improvement over time. The PSEQ and NRS scores showed a significant Time × Treatment effect. Patients treated with rESWT had significantly lower mean NRS values than patients treated with rESWT + C + E at W1 and W3, as well as than patients treated with C + E alone at W3 and W4. No severe adverse events were observed. Conclusions: rESWT may not be inferior to respectively rESWT + C + E or C + E alone in reducing pain in patients with cnsLBP. Level of Evidence: Level I, prospective, randomized, active-controlled trial. Trial registration: Clinicaltrials.gov Identifier NCT03337607. Registered November 09, 2017, https://www.clinicaltrials.gov/ct2/show/NCT03337607. Level of evidence: Level I; prospective, randomized, controlled trial. [ABSTRACT FROM AUTHOR]

Background: IgA nephropathy (IgAN) is one of the most common primary glomerular diseases worldwide, but effective therapy remains limited and many patients progress to end-stage renal disease (ESRD). Only angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin-receptor blockers (ARB) show a high level of evidence (1B level) of being of value in the treatment for IgAN according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. However, traditional Chinese medicine has raised attention in kidney disease research. Abelmoschus manihot, a single medicament of traditional Chinese medicine has shown therapeutic effects in primary glomerular disease according to the randomized controlled clinical trial that we have completed. Here, we conduct a new study to assess the efficacy and safety of Abelmoschus manihot in IgAN. Also, this study is currently the largest double-blind, randomized controlled registered clinical research for the treatment of IgAN.Methods: We will conduct a multicenter, prospective, double-blind, double-dummy randomized controlled study. The study is designed as a noninferiority clinical trial. Approximately 1600 biopsy-proven IgAN patients will be enrolled at 100 centers in China and followed up for as long as 48 weeks. IgAN patients will be randomized assigned to the Abelmoschus manihot group (in the form of a huangkui capsule, 2.5 g, three times per day) and the losartan potassium group (losartan potassium, 100 mg/d). The primary outcome is the change in 24-h proteinuria from baseline after 48 weeks of treatment. Change in estimated glomerular filtration rate (eGFR) from baseline after 48 weeks of treatment, the incidence of endpoint events (proteinuria ≥3.5 g/24 h, the doubling of serum creatinine, or receiving blood purification treatment) are the secondary outcomes. Twenty-four-hour proteinuria and eGFR are measured at 0, 4, 12, 24, 36 and 48 weeks.Discussion: This study will be of sufficient size and scope to evaluate the efficacy and safety of Abelmoschus manihot compared to losartan potassium in treating patients with IgAN. The results of this study may provide a new, effective and safe treatment strategy for IgAN.Trial Registration: ClinicalTrials.gov, identifier: NCT02231125 . Registered on 30 August 2014. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to compare glenopolar angle (GPA) and the functional outcomes of fixation of both the clavicle and the scapular neck, fixation of the clavicle alone, and conservative treatment for floating-shoulder injuries. Methods: A prospective stratified randomized study was performed in 39 adult patients who suffered floating-shoulder injuries and underwent fixation of both the clavicle and the scapular neck (group A), or fixation of the clavicle alone (group B), or conservative treatment (group C) between January 2005 and September 2011. The GPA, Disabilities of the Arm, Shoulder and Hand (DASH) score, and Constant-Murley Shoulder Outcome (Constant) score were compared between the three groups. Results: All 39 patients were followed up for more than 2 years. GPA after bony consolidation was significantly better in group A than in groups B and C (p = 0.015). Functional outcomes measured by DASH and Constant scores were significantly better in group A at final follow-up (p = 0.008 and 0.002, respectively). Both DASH and Constant scores were highly correlated with GPA after consolidation (p < 0.001, respectively). The receiver operating characteristic (ROC) analysis showed that of the two randomly selected DASH scores, the smaller DASH score would have a larger GPA than the larger DASH score. Similarly, the larger Constant score would have a larger GPA than the smaller Constant score. Conclusions: Fixation of both the clavicle and the scapular neck may correct GPA and improve functional outcomes for the treatment of floating-shoulder injuries. GPA after fracture consolidation is a useful prognostic indicator of a satisfactory clinical outcome as defined by either DASH score or Constant score. [ABSTRACT FROM AUTHOR]

Background: As inadequate pain communication contributes to difficulties in optimizing outcomes of outpatients, we investigated the effect of reinforced education using WeChat App to the opioid titration treatment of cancer-related pain in the outpatient setting.Methods: We conducted a prospective study to compare reinforced education using Wechat with care as usual from February to December 2019. Patients in the reinforced education group received reinforced education via Wechat, while those in the control group received care as usual. Effect measurements for both groups are carried out with questionnaires at the baseline and 3 days later. Questionnaires include pain intensity (NRS), treatment-related adverse events, cancer-related quality of life (QOL), sleep (PSQI), satisfaction, anxiety (GAD-7) and depression (PHQ-9). Number of patients whose NRS reduced to less than three points in 24 h was the primary outcomes. Secondary outcomes included treatment-related adverse events, cancer-related quality of life, sleep, satisfaction, anxiety and depression.Results: Although there was no significant difference regarding pain intensity (NRS) between the two groups at 72 h, the rate of NRS that reduced to less than three points in 24 h was significantly higher in the Wechat group than in the control group. Patients' satisfaction was significantly higher in the Wechat group than in the control group. There was no significant difference between the two groups regarding the other findings at 72 h, including pain intensity (NRS), cancer-related quality of life (QOL), anxiety (GAD-7), depression (PHQ-9), and sleep (PSQI). However, no significant difference was found between the two groups for constipation, nausea, vomiting, dizziness, somnolence, pruritus, loss of consciousness, and death.Conclusions: Our results indicated that receiving instructions delivered by Wechat resulted an increased number of patients with good pain control and better satisfaction. The study provided insight into the effectiveness of the reinforced education using a Wechat app delivered by a doctor to outpatients in the titration treatment of cancer-related pain.Trial Registration: This study was registered at chictr.org (Registration number: ChiCTR1900021150 , Date of Registration: January 30, 2019). [ABSTRACT FROM AUTHOR]