Background. Although the neutrophil percentage‐to‐albumin ratio (NPAR) has proven to be a robust systemic inflammation‐based predictor of mortality in a wide range of diseases, the prognostic value of the NPAR in critically ill patients with cardiogenic shock (CS) remains unknown. This study aimed at investigating the association between the admission NPAR and clinical outcomes in CS patients using real‐world data. Methods. Critically ill patients diagnosed with CS in the Medical Information Mart for Intensive Care‐III (MIMIC‐III) database were included in our study. The study endpoints included all‐cause in‐hospital, 30‐day, and 365‐day mortality in CS patients. First, the NPAR was analyzed as a continuous variable using restricted cubic spline Cox regression models. Second, X‐tile analysis was used to calculate the optimal cut‐off values for the NPAR and divide the cohort into three NPAR groups. Moreover, multivariable Cox regression analyses were used to assess the association of the NPAR groups with mortality. Results. A total of 891 patients hospitalized with CS were enrolled in this study. A nonlinear relationship between the NPAR and in‐hospital and 30‐day mortality was observed (all P values for nonlinear trend<0.001). According to the optimal cut‐off values by X‐tile, NPARs were divided into three groups: group I (NPAR < 25.3), group II (25.3 ≤ NPAR < 34.8), and group III (34.8 ≤ NPAR). Multivariable Cox analysis showed that higher NPAR was independently associated with increased risk of in‐hospital mortality (group III vs. group I: hazard ratio [HR] 2.60, 95% confidence interval [CI] 1.72‐3.92, P < 0.001), 30‐day mortality (group III vs. group I: HR 2.42, 95% CI 1.65‐3.54, P < 0.001), and 365‐day mortality (group III vs. group I: HR 6.80, 95% CI 4.10‐11.26, P < 0.001) in patients with CS. Conclusions. Admission NPAR was independently associated with in‐hospital, 30‐day, and 365‐day mortality in critically ill patients with CS.

Background: Despite pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is a minimally invasive treatment for pancreatic stones, complications exist.Case presentation: A 37-year-old male was diagnosed with chronic pancreatitis and admitted to our hospital for recurrent acute pancreatitis. After the first P-ESWL session, the patient complained of a new type of pain different from the previous pain pattern. Computerized tomography and colonoscopy were arranged and colonic hematoma was found. Since the patient had stable vital signs, no special treatment was given focusing on the colonic hematoma. Five days later, P-ESWL treatment was repeatedly performed for four consecutive days. Two days after the last P-ESWL session, the patient underwent endoscopic retrograde cholangiopancreatography. At the three-month follow up visit, the colonic hematoma disappeared and pancreatic stones decreased significantly.Conclusions: To the best of our knowledge, colonic hematoma after P-ESWL for pancreatic stones has never been reported. Here, we present the only case of colonic hematoma after P-ESWL, which was coincidentally found in more than 6000 P-ESWL sessions in our hospital. As the symptoms of colonic hematoma are mild, we believe the incidence of colonic hematoma has been underestimated. Many people with colonic hematoma after P-ESWL may be undiagnosed or misdiagnosed. Treatment for colonic hematoma depends on whether there is severe clinical state. Exploration of more precise location method for pancreatic stones may reduce the probability of P-ESWL complication.

Acute pancreatitis (AP) is a common digestive disease encountered in Emergency Departments that carries a heavy socioeconomic burden. This study was conducted to determine the global status of AP research. Articles related to AP published in 1999 to 2018 were retrieved from the Web of Science (WOS) database and the 20 highest-output countries or regions were determined based on the total number of publications. Correlation analysis of AP research output and the gross domestic product (GDP) of each country or region was conducted. The quantity and quality of research of these 20 highest-output countries were compared to the total output, outputs per capita, and average impact factor (IF). All annual data were analyzed using time-trend analysis. A keyword co-occurrence analysis was conducted to determine the highlights in AP research. In total, 17,698 publications were retrieved, and 16,461 papers (93.0%) of them were from the 20 highest-output countries. A significantly positive correlation was identified between AP research output and the GDP (R = 0.973, P < .001). The 5 highest-output countries were the USA (24.9%), China (12.3%), Germany (7.5%), Japan (6.7%), and the UK (6.1%). Finland ranked 1^st in the number of publication per capita, the USA had the highest accumulated IF (25,432.758) and total citations (104,592), Switzerland had the highest average IF (6.723), and Netherland had the highest average citations (51.90). Genetic research and AP-related hyperglycemia were research highlights. Analysis of the global output of research of AP research showed signs of growth. Research output was positively correlated with GDP. For the most productive countries, research quality was stable. Although developing countries lagged behind in output per capita and quality, great progress has been made in the past 2 decades.

Objective: The aim of the study was to investigate the global research levels in chronic pancreatitis (CP) fields. Methods: The term “chronic pancreatitis” was used to retrieve articles published between 2009 and 2018 from the Web of Science database. The 15 highest-output countries' gross domestic product was retrieved to analyze the correlation between output and economic development. The 5 top-ranking countries were compared in quantity and quality. The frequently used terms of all articles were retrieved to conduct co-occurrence analysis to reveal research highlights for CP. Results: There were 6094 articles included and 6007 articles were from 15 highest-output countries. There was a positive correlation between output and gross domestic product (r = 0.928, P < 0.001). The United States, China, and Japan had increasing trends in total output (P = 0.022, P < 0.001, and P = 0.021, respectively). China and Japan had increasing trends in output per capita (P < 0.001 and P = 0.023). However, in average impact factor, all 5 countries did not show increasing trends (all P > 0.05). For research highlights, mass lesion and autoimmune pancreatitis were the notable aspects. Conclusions: The global output for CP will continue increasing and research quality will be stable.