Low-protein diets supplemented with casein hydrolysate favor the microbiota and enhance the mucosal humoral immunity in the colon of pigs

Background:High-protein diets can increase the colonic health risks.A moderate reduction of dietary crude-protein(CP)level can improve the colonic bacterial community and mucosal immunity of pigs.However,greatly reducing the dietary CP level,even supplemented with all amino acids(AAs),detrimentally affects the colonic health,which may be due to the lack of protein-derived peptides.Therefore,this study evaluated the effects of supplementation of casein hydrolysate(peptide source)in low-protein(LP)diets,in comparison with AAs supplementation,on the colonic microbiota,microbial metabolites and mucosal immunity in pigs,aiming to determine whether a supplementation of casein hydrolysate can improve colonic health under very LP level.Twenty-one pigs(initial BW 19.90±1.00 kg,63±1 days of age)were assigned to three groups and fed with control diet(16%CP),LP diets(13%CP)supplemented with free AAs(LPA)or casein hydrolysate(LPC)for 4 weeks.Results:Compared with control diet,LPA and LPC diet decreased the relative abundance of Streptococcus and Escherichia coli,and LPC diet further decreased the relative abundance of Proteobacteria.LPC diet also increased the relative abundance of Lactobacillus reuteri.Both LP diets decreased concentrations of ammonia and cadaverine,and LPC diet also reduced concentrations of putrescine,phenol and indole.Moreover,LPC diet increased total short-chain fatty acid concentration.In comparison with control diet,both LP diets decreased protein expressions of Toll-like receptor-4,nuclear factor-κB,interleukin-1βand tumor necrosis factor-α,and LPC diet further decreased protein expressions of nucleotide-binding oligomerization domain protein-1 and interferon-γ.LPC diet also increased protein expressions of G-protein coupled receptor-43,interleukin-4,transforming growth factor-β,immunoglobulin A and mucin-4,which are indicators for mucosal defense activity.Conclusions:The results showed that supplementing casein hydrolysate showed beneficial effects on the colonic microbiota and mucosal immunity and barrier function in comparison with supplementing free AAs in LP diets.These findings may provide new framework for future nutritional interventions for colon health in pigs.

Low crude protein diets supplemented with casein hydrolysate enhance the intestinal barrier function and decrease the pro-inflammatory cytokine expression in the small intestine of pigs

To reduce nitrogen excretion and lower feeding costs,low crude protein(CP)diets are sometimes pro-posed,however,a great reduction of dietary CP concentration(>4%reduction vs.recommended con-centration),even supplemented with essential and nonessential amino acids(AA)can detrimentally affect small intestinal barrier function and immunity,possibly due to the excessive lack of peptides.Here we hypothesize that with an extremely low CP concentration diet,protein-derived peptides,rather than AA supplementation,can improve intestinal barrier development and health.To test this hypothesis,21 growing pigs(19.90±1.00 kg body weight)were randomly assigned to 3 treatments with control diet(16%CP),or low CP diets(13%CP)supplemented with AA(LCPA)or casein hydrolysate(LCPC)for 28 days.In comparison with the control diet,the LCPA diet decreased the protein expression level of jejunal barrier factor zonula occludens-1(ZO-1)and stem cell proliferation factor leucine-rich repeat-containing G-protein-coupled receptor-5,whereas the LCPC diet enhanced intestinal barrier function by increasing the protein expression level of jejunal occludin and ZO-1 and ileal mucin-2.The LCPA diet reduced Lactobacillus counts,whereas the LCPC diet increased Lactobacillus counts and reduced Escherichia coli counts in the ileum.The LCPA diet also increased protein expression levels of pro-inflammatory cytokine interleukin-6(IL-6)and IL-22,whereas the LCPC diet decreased protein expression levels of pro-inflammatory IL-1β,IL-17A and tumor necrosis factor-αin the ileum.Collectively,the casein hydroly-sate supplementation of low CP diets showed beneficial effects on the small intestinal barrier,bacterial community,and immunity in pigs,pointing to the important role of protein-derived peptides in small intestinal health in cases of low crude protein diets.

COVID-19疫情期间江苏省某三甲综合医院急诊救治疾病谱与2019年同期比较分析

目的分析江苏省南通市某三甲综合医院2020年1至7月急诊救治患者的疾病谱构成情况,并与2019年同期进行比较分析,为当地政府及医疗部门提供疾病防控的方向和常态化疫情管控期间的管理策略。方法选取该医院2019年及2020年1至7月急诊收治的101443例患者为研究对象,其中男性52025例,女性49418例;年龄1~97岁,平均(46.37±5.31)岁。采用SPSS 23.0对资料进行整理分析,分别对两年同期急诊患者疾病谱构成情况、年龄分布及性别构成情况进行比较。结果(1)共调查了急诊收治患者101443例,疾病顺位前8位分别是呼吸系统疾病、发热、创伤、消化系统疾病、神经系统疾病、循环系统疾病、泌尿系统疾病和妇产科疾病。(2)2年同期呼吸系统疾病始终排在第一位,2020年呼吸系统疾病、发热患者占比有所上升,创伤患者占比减少,(P<0.01)。(3)2020年17岁及以下患者有明显增加,由2019年23.74%上升至2020年的34.09%,(P<0.01)。(4)急诊救治患者男性稍多于女性,(P<0.05)。结论在COVID-19疫情期间,呼吸系统疾病、发热、创伤是主要救治病种,呼吸系统疾病居首位,积极完善相关制度与流程,加强急诊队伍相应专业的业务水平与急救能力建设,确保疾病谱前三位的患者得到专业、及时、有效的救治。

Cs_(3)Bi_(2)l_(9)-hydroxyapatite composite waste forms for cesium and iodine immobilization

Perovskite-based ceramic composites were developed as potential waste form materials for immobilizing cesium(Cs)and iodine(I)with high waste loadings and chemical durability.The perovskite Cs_(3)Bi_(2)I_(9)has high Cs(22 wt%)and I(58 wt%)content,and thus can be used as a potential host phase to immobilize these critical radionuclides.In this work,the perovskite Cs_(3)Bi_(2)I_(9)phase was synthesized by a cost effective solution-based approach,and was embedded into a highly durable hydroxyapatite matrix by spark plasma sintering to form dense ceramic composite waste forms.The chemical durabilities of the monolithic Cs_(3)Bi_(2)I_(9)and Cs_(3)Bi_(2)I_(9)-hydroxyapatite composite pellets were investigated by static and semi-dynamic leaching tests,respectively.Cs and I are incongruently released from the matrix for both pure Cs_(3)Bi_(2)I_(9)and composite structures.The normalized Cs release rate is faster than that of I,which can be explained by the difference in the strengths between Cs-I and Bi-I bonds as well as the formation of insoluble micrometer-sized BiOI precipitates.The activation energies of elemental releases based on dissolution and diffusion-controlled mechanisms are determined with significantly higher energy barriers for dissolution from the composite versus that of the monolithic Cs_(3)Bi_(2)I_(9).The ceramic-based composite waste forms exhibit excellent chemical durabilities and waste loadings,commensurate with the state-of-the-art glass-bonded perovskite composites for I and Cs immobilization.

区域性中毒协同救治体系建设的探索与实践

区域协同救治体系是一种囊括院内和院外周边的无障碍通道,相较于传统的绿色急救通道,将管理的范围拓展至院外,也将救治的时间从患者入院后提前到患者首次诊断,从空间和时间两个维度对患者展开及时的救治[1]。区域协同救治体系有利于医疗资源的合理配置和利用,实现医疗资源再分配,使目前有限的医疗资源发挥最大的社会效益,为提高区域内急危重症患者的整体救治水平带来了新的前景[2,3]。中国胸痛中心的建设及其认证体系建设虽然近几年才开始发展,但已显示出了其在急性胸痛救治中的巨大价值[4,5]。如何让区域性协同救治体系在中毒救治中发挥重要作用,笔者做出了一些探索与实践。现报告如下。

Analysis of the clinical characteristics and neonatal outcomes of seven cases of pregnancy luteoma discovered incidentally at cesarean section

Objective:In this study,we summarize the clinical characteristics and neonatal outcomes of patients with pregnancy luteomas that were identified incidentally at cesarean section in our hospital.We also provide a review of the existing literature relating to this condition.Methods:A total of seven cases of pregnancy luteoma were enrolled from our hospital into this retrospective study between March 2013 and February 2018.We then evaluated the clinical characteristics and neonatal outcomes of these patients.Results:All seven patients with pregnancy luteomas found incidentally during Cesarean sections at term as a result of obstetric indications.These masses were unilateral and ranged from 2 to 10 cm in size.All patients underwent partial ovariectomies or oophorocystectomy due to presumptive benign ovarian tumors.Two patients had gestational diabetes and one patient had gestational hypertension.One patient developed hirsutism and a deepened voice.Of the seven newborns,three were girls and four were boys.Physical examinations of the newborns were normal and no virilization was detected among the infant girls.Conclusion:Pregnancy luteoma may be more common than expected.Better strategies are now needed to educate obstetricians about the clinical features of pregnancy luteoma so that they can avoid unnecessary surgery.