Background:Early-weaning of piglets is often accompanied by severe disorders,especially diarrhea.The gut microbiota and its metabolites play a critical role in the maintenance of the physiologic and metabolic homeosta...Background:Early-weaning of piglets is often accompanied by severe disorders,especially diarrhea.The gut microbiota and its metabolites play a critical role in the maintenance of the physiologic and metabolic homeostasis of the host.Our previous studies have demonstrated that oral administration of Lactobacillus frumenti improves epithelial barrier functions and confers diarrhea resistance in early-weaned piglets.However,the metabolic response to L.frumenti administration remains unclear.Then,we conducted simultaneous serum and hepatic metabolomic analyses in early-weaned piglets administered by L.frumenti or phosphatebuffered saline(PBS).Results:A total of 1006-day-old crossbred piglets(Landrace×Yorkshire)were randomly divided into two groups and piglets received PBS(sterile,2 m L)or L.frumenti(suspension in PBS,10~8 CFU/m L,2 m L)by oral administration once per day from 6 to 20 days of age.Piglets were weaned at 21 days of age.Serum and liver samples for metabolomic analyses were collected at 26 days of age.Principal components analysis(PCA)showed that L.frumenti altered metabolism in serum and liver.Numerous correlations(P<0.05)were identified among the serum and liver metabolites that were affected by L.frumenti.Concentrations of guanosine monophosphate(GMP),inosine monophosphate(IMP),and uric acid were higher in serum of L.frumenti administration piglets.Pathway analysis indicated that L.frumenti regulated fatty acid and amino acid metabolism in serum and liver.Concentrations of fatty acidβ-oxidation related metabolites in serum(such as3-hydroxybutyrylcarnitine,C4-OH)and liver(such as acetylcarnitine)were increased after L.frumenti administration.Conclusions:Our findings suggest that L.frumenti regulates lipid metabolism and amino acid metabolism in the liver of early-weaned piglets,where it promotes fatty acidβ-oxidation and energy production.High serum concentrations of nucleotide intermediates,which may be an alternative strategy to reduce the incidence of diarrhea in early-weaned piglets,were further detected.These findings broaden our understanding of the relationships between the gut microbiota and nutrient metabolism in the early-weaned piglets.展开更多
Forty piglets weaned at 21 days age were randomly assigned to one of two groups. The treatment group contained 1. 2% glutamine. The diets were calculated to be isonitrogenous and isoenergetic, each treatment contained...Forty piglets weaned at 21 days age were randomly assigned to one of two groups. The treatment group contained 1. 2% glutamine. The diets were calculated to be isonitrogenous and isoenergetic, each treatment contained five replicates of four piglets. Five piglets from each dietary treatment were killed at 35 days and 49 days age. The results showed that dietary glutamine supplementation increased jejunal DNA content of piglets in the treatment group at 35 days and 49 days age. There was no significant change of ileum DNA content and intestinal protein content between the treatment and control ones. Dietary glutamine supplementation increased mucosal thickness of piglets in treatment group markedly at 35 days age. The intestinal villus heights were significantly higher in treatment than that in control. The results of electron micrograph showed that dietary glutamine supplementation prevented deterioration of intestinal epithelium, and maintained normal intestinal microvillus structure. The results suggested that glutamine supplementation prevented villus atrophy, and had protective effect on intestinal structure.展开更多
Two experiments were conducted to study the effect of supplemental histamine in the diet of early-weaned piglets. In experiment A, 24 cross bred piglets with an average body weight of 6.10±0. 40 kg, weaned at the...Two experiments were conducted to study the effect of supplemental histamine in the diet of early-weaned piglets. In experiment A, 24 cross bred piglets with an average body weight of 6.10±0. 40 kg, weaned at the age of 28 days, were divided into four groups, fed with basal diet of low dietary copper without (control) or with supplemental histamine at 60, 120, 180μg kg-1 BW. During the two weeks and the third week after weaning, ADG(average daily gain) of piglets were increased by 15.8%(P<0. 05), 9.5%(P< 0.10) by addition of 60μg kg-1 BW histamine, but decreased by addition of 180μg kg-1BW histamine, which also increased the amount of E. coli in colon and the scour incidence. The secretion of gastric acid and pepsin were improved by both dose of supplemental histamine (60, 180μg kg-1BW) and gastric digesta pH were decreased by both. Addition of 60 μg kg-1 BW histamine improved the activities of trypsin, amylase in duodelum digesta. In experiment B, 12 cross bred piglets with an average body weight of 6. 85±0.35 kg, weaned at the age of 28 days, were divided into two groups, fed with basal diet of high dietary copper without (control) or with supplemental 60 μg kg-1 BW histamine. During the two weeks and the third week after weaning, ADG of piglets were increased by 9. 8% (P<0.05), 7. 0% (P<0. 10). The secretion of gastric acid, activities of trypsin and amylase in duodelum digesta, were also improved by addition of 60 μg kg-1BW histamine. The results showed that addition of histamine (60μg kg-1BW) in early weaned piglets could increase the secretion of gastric acid and pepsin, reduce gastric digesta pH and scour incidence, improve activities of trypsin, amylase in duodelum digesta, and the growing performance of early weaned piglets.展开更多
BACKGROUND Tracheostomy is commonly used in intensive care unit(ICU)patients who are expected to be on long-term mechanical ventilation or suffer from emergency upper airway obstruction.However,some studies have confl...BACKGROUND Tracheostomy is commonly used in intensive care unit(ICU)patients who are expected to be on long-term mechanical ventilation or suffer from emergency upper airway obstruction.However,some studies have conflicting findings regarding the optimal technique and its timing and benefits.AIM To provide evidence of practice,characteristics,and outcome concerning tracheostomy in an ICU of a tertiary care hospital.METHODS This was a retrospective cohort study including adult critical care patients in a single ICU for two consecutive years.Patients’demographic characteristics,severity of illness(APACHE II score),level of consciousness[Glasgow Coma Scale(GCS)],comorbidities,timing and type of tracheostomy procedure performed and outcome were recorded.We defined late as tracheostomy placement after 8 days or no tracheotomy.RESULTS Data of 660 patients were analyzed(median age of 60 years),median APACHE II score of 19 and median GCS score of 12 at admission.Tracheostomy was performed in 115 patients,of whom 63 had early and 52 late procedures.Early tracheostomy was mainly executed in case of altered level of consciousness and severe critical illness polyneuromyopathy,however there were no significant statistical results(47.6%vs 36.5%,P=0.23)and(23.8%vs 19.2%,P=0.55)respectively.Regarding the method selected,early surgical tracheostomy(ST)was conducted in patients with maxillofacial injuries(50.0%vs 0.0%,P=0.033),whereas late surgical tracheostomy was selected for patients with goiter(44.4%vs 0.0%P=0.033).Patients with early tracheostomy spent significantly fewer days on mechanical ventilation(15.3±8.5 vs 22.8±9.6,P<0.001)and in ICU in general(18.8±9.1 vs 25.4±11.5,P<0.001).Percutaneous dilatation tracheostomy(PDT)vs ST was preferable in older critical care patients in the case of Central Nervous System underlying cause of admission(62.5%vs 26.3%,P=0.004).ST was the method of choice in compromised airway(31.6%,vs 7.3%P=0.008).A large proportion of patients(88/115)with tracheostomy managed to wean from mechanical ventilation and were transferred out of the ICU(100%vs 17.4%,P<0.001).CONCLUSION PDT was performed more frequently in our cohort.This technique did not affect mechanical ventilation days,ventilator-associated pneumonia(VAP),ICU length of stay,or survival.No complications were observed in the percutaneous or surgical tracheostomy groups.Patients undergoing early tracheostomy benefited in terms of mechanical ventilation days and ICU length of stay but not of discharge status,presence of VAP,or survival.展开更多
Object:Early-life neglect has irreversible emotional effects on the central nervous system.In this work,we aimed to elucidate distinct functional neural changes in me-dial prefrontal cortex(mPFC)of model rats.Methods:...Object:Early-life neglect has irreversible emotional effects on the central nervous system.In this work,we aimed to elucidate distinct functional neural changes in me-dial prefrontal cortex(mPFC)of model rats.Methods:Maternal separation with early weaning was used as a rat model of early-life neglect.The excitation of glutamatergic and GABAergic neurons in rat mPFC was recorded and analyzed by whole-cell patch clamp.Results:Glutamatergic and GABAergic neurons of mPFC were distinguished by typi-cal electrophysiological properties.The excitation of mPFC glutamatergic neurons was significantly increased in male groups,while the excitation of mPFC GABAergic neurons was significant in both female and male groups,but mainly in terms of rest membrane potential and amplitude,respectively.Conclusions:Glutamatergic and GABAergic neurons in medial prefrontal cortex showed different excitability changes in a rat model of early-life neglect,which can contribute to distinct mechanisms for emotional and cognitive manifestations.展开更多
AIM: To evaluate the impact of sociodemographic/clinical factors on early virological response (EVR) to pegin-terferon/ribavirin for chronic hepatitis C (CHC) in clinical practice. METHODS: We conducted a multicenter,...AIM: To evaluate the impact of sociodemographic/clinical factors on early virological response (EVR) to pegin-terferon/ribavirin for chronic hepatitis C (CHC) in clinical practice. METHODS: We conducted a multicenter, cross-sectional, observational study in Hepatology Units of 91 Spanish hospitals. CHC patients treated with peginterferon α-2a plus ribavirin were included. EVR was defined as undetectable hepatitis C virus (HCV)-ribonucleic acid (RNA) or ≥ 2 log HCV-RNA decrease after 12 wk of treatment. A bivariate analysis of sociodemographic and clinical variables associated with EVR was carried out. Independent factors associated with an EVR were analyzed using a multiple regression analysis that included the following baseline demographic and clinical variables: age (≤ 40 years vs > 40 years), gender, race, educational level, marital status and family status, weight, alcohol and tobacco consumption, source of HCV infection, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and gamma glutamyl transpeptidase (GGT) (≤ 85 IU/mL vs > 85 IU/mL), serum ferritin, serum HCV-RNA concentration (< 400 000 vs ≥ 400 000), genotype (1/4 vs 3/4), cirrhotic status and ribavirin dose (800/1000/1200 mg/d).RESULTS: A total of 1014 patients were included in the study. Mean age of the patients was 44.3 ± 9.8 years, 70% were male, and 97% were Caucasian. The main sources of HCV infection were intravenous drug abuse (25%) and blood transfusion (23%). Seventyeight percent were infected with HCV genotype 1/4 (68% had genotype 1) and 22% with genotypes 2/3. The HCV-RNA level was > 400 000 IU/mL in 74% of patients. The mean ALT and AST levels were 88.4 ± 69.7 IU/mL and 73.9 ± 64.4 IU/mL, respectively, and mean GGT level was 82 ± 91.6 IU/mL. The mean ferritin level was 266 ± 284.8 μg/L. Only 6.2% of patients presented with cirrhosis. All patients received 180 mg of peginterferon α-2a. The most frequently used ribavirin doses were 1000 mg/d (41%) and 1200 mg/d (41%). The planned treatment duration was 48 wk for 92% of patients with genotype 2/3 and 24 wk for 97% of those with genotype 1/4 (P < 0.001). Seven percent of patients experienced at least one reduction in ribavirin or peginterferon α-2a dose, respectively. Only 2% of patients required a dose reduction of both drugs. Treatment was continued until week 12 in 99% of patients. Treatment compliance was ≥ 80% in 98% of patients. EVR was achieved in 87% of cases (96% vs 83% of patients with genotype 2/3 and 1/4, respectively; P < 0.001). The bivariate analysis showed that patients who failed to achieve EVR were older (P < 0.005), had higher ALT (P < 0.05), AST (P < 0.05), GGT (P < 0.001) and ferritin levels (P < 0.001), a diagnosis of cirrhosis (P < 0.001), and a higher baseline viral load (P < 0.05) than patients reaching an EVR. Age < 40 years [odds ratios (OR): 0.543, 95%CI: 0.373-0.790, P < 0.01], GGT < 85 IU/mL (OR: 3.301, 95%CI: 0.192-0.471, P < 0.001), low ferritin levels (OR: 0.999, 95%CI: 0.998-0.999, P < 0.01) and genotype other than 1/4 (OR: 4.716, 95%CI: 2.010-11.063, P < 0.001) were identified as independent predictors for EVR in the multivariate analysis. CONCLUSION: CHC patients treated with peginterferon-α-2a/ribavirin in clinical practice show high EVR. Older age, genotype 1/4, and high GGT were associated with lack of EVR.展开更多
BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a serious disease with a poor prognosis.Only a minority of patients undergo surgery due to the advanced stage of the disease,and patients with early-stage disease,wh...BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a serious disease with a poor prognosis.Only a minority of patients undergo surgery due to the advanced stage of the disease,and patients with early-stage disease,who are expected to have a better prognosis,often experience recurrence.Thus,it is important to identify the risk factors for early recurrence and to develop an adequate treatment plan.AIM To evaluate the predictive factors associated with the early recurrence of earlystage PDAC.METHODS This study enrolled 407 patients with stage I PDAC undergoing upfront surgical resection between January 2000 and April 2016.Early recurrence was defined as a diagnosis of recurrence within 6 mo of surgery.The optimal cutoff values were determined by receiver operating characteristic(ROC)analyses.Univariate and multivariate analyses were performed to identify the risk factors for early recurrence.RESULTS Of the 407 patients,98 patients(24.1%)experienced early disease recurrence:26(26.5%)local and 72(73.5%)distant sites.In total,253(62.2%)patients received adjuvant chemotherapy.On ROC curve analysis,the optimal cutoff values for early recurrence were 70 U/mL and 2.85 cm for carbohydrate antigen 19-9(CA 19-9)levels and tumor size,respectively.Of the 181 patients with CA 19-9 level>70 U/mL,59(32.6%)had early recurrence,compared to 39(17.4%)of 226 patients with CA 19-9 level≤70 U/mL(P<0.001).Multivariate analysis revealed that CA 19-9 level>70 U/mL(P=0.006),tumor size>2.85 cm(P=0.004),poor differentiation(P=0.008),and non-adjuvant chemotherapy(P=0.025)were significant risk factors for early recurrence in early-stage PDAC.CONCLUSION Elevated CA 19-9 level(cutoff value>70 U/mL)can be a reliable predictive factor for early recurrence in early-stage PDAC.As adjuvant chemotherapy can prevent early recurrence,it should be recommended for patients susceptible to early recurrence.展开更多
Preconditioned calves have greater marketvalue per unit weight than normal-weaned calves. Development of a low cost forage-based preconditioning system allows producers to add value to their calf-crop. This study eval...Preconditioned calves have greater marketvalue per unit weight than normal-weaned calves. Development of a low cost forage-based preconditioning system allows producers to add value to their calf-crop. This study evaluated calf performance in three forage-based weaning systems;early-weaned calves were backgrounded in legume/grass forage plots and supplemented with commercial preconditioning feed (Treatment 1) or an on-farm corn-mix (Treatment 2). Control (Treatment 3) calves suckled for an additional 45 days. Supplements provided2.17 kgTDN/calf/ day. Weights were collected on days -30, 0 and 45 with respect to early weaning, from135 inyear 1 and 150 calves in each of the two subsequent years. Effects of treatment, age of dam, sex of calf and their interactions on calf weight gain were analyzed by analysis of covariance using GLM procedures of SAS. Marginal effects of treatment and feed cost were used to evaluate economic feasibility. Sensitivity analyses were evaluated for anticipated market fluctuations in feed costs and calf premiums. Data are reported as least squares means. Calf weight gains differed (P < 0.001) among treatments and averaged 1.16, 1.03 and1.04 kg/calf/day for commercial supplement, corn-mix and controls, respectively. Calves from 2-year-old cows gained less (P < 0.001) weight compared to those from cows 3 - 4 and ≥5 years of age (44.8, 48.9 and51.5 kg, respectively). Steers calves gained more (P < 0.001) weight compared to heifer calves (51.2 vs.45.7 kg, respectively). Net returns for corn mix were greater than those for commercial feed ($1.48 vs. $1.35/kg weight gain, respectively). Sensitivity analyses indicated that selection of preconditioning treatment to a large degree was less sensitive to significant changes in market conditions due to the large gap in marginal costs between the two treatments. In conclusion, forage-based weaning systems can be utilized to precondition calves providing an economical means for calf weight gain and profit potential as long as feed costs are held within reasonable limits.展开更多
One hundred and three Hereford × Angus crossbred, spring-calving cows were used to determine the influence of early weaning performance of their male progeny and the need for cowherd winter supplementation. Treat...One hundred and three Hereford × Angus crossbred, spring-calving cows were used to determine the influence of early weaning performance of their male progeny and the need for cowherd winter supplementation. Treatments were early weaned (EW;115-d of age) and normal weaned calves (NW;220-d of age). Both intact and castrated male progeny were randomly allotted to early and normal weaning calf management treatments. Following summer grazing and weaning protocols, cows within each weaning group were randomly assigned to receive winter supplementation treatments of LOW (1.26 kg/hd/d) or HIGH (1.81 kg/hd/d) amounts of a protein supplement containing 450 g/kg CP (DM basis). Cows whose calves were weaned early gained more BW and BCS (P P P P = 0.04) BCS but similar (P = 0.74) BW when compared with cows with normally weaned calves that received 100% of their supplement (NWHIGH). Early weaning has the potential to reduce the amount of supplement required during the winter grazing period.展开更多
The relationship between Egypt and Palestine can be traced back to theChalcolithic Age thanks to the evidence of current excavations in the Nile Deltaand Sinal.Palestinian pottery and cast metal objects from the Delta...The relationship between Egypt and Palestine can be traced back to theChalcolithic Age thanks to the evidence of current excavations in the Nile Deltaand Sinal.Palestinian pottery and cast metal objects from the Delta sites of Maadi,Minshat Abu Omar,and elsewhere have proved contacts with Palestine inProtodynastic(Nagada Ⅱ-Ⅲ)times.The Egyptian Protodynastic Period andDynasty 1 were contemporary with the Palestinian EB Ⅰ and EB Ⅲ,and展开更多
目的分析严重呼吸衰竭患者早期肺康复后撤机失败的影响因素。方法选取2020年1月至2022年1月广西壮族自治区钦州市第一人民医院收治的135例严重呼吸衰竭患者作为研究对象,统计严重呼吸衰竭患者早期肺康复后撤机情况,分析影响撤机失败的...目的分析严重呼吸衰竭患者早期肺康复后撤机失败的影响因素。方法选取2020年1月至2022年1月广西壮族自治区钦州市第一人民医院收治的135例严重呼吸衰竭患者作为研究对象,统计严重呼吸衰竭患者早期肺康复后撤机情况,分析影响撤机失败的因素。结果与撤机成功严重呼吸衰竭患者比较,撤机失败患者ICU住院、带管、呼吸机使用时间较长,并发症发生率较高(P<0.05)。单因素分析所示,严重呼吸衰竭患者早期肺康复后撤机失败与性别、入住ICU时间、BMI、平均动脉压无关(P>0.05);严重呼吸衰竭患者早期肺康复后撤机失败与年龄、合并基础疾病、NYHA心功能分级、多器官衰竭、血清白蛋白、CK-MB、cTnI、机械通气时间、APACHEⅡ评分、SOFA评分、PETCO_(2)有关,≥65岁、合并基础疾病、NYHA心功能分级Ⅲ~Ⅳ级、多器官衰竭者、血清白蛋白<210×10^(9)/L、CK-MB≥6 U/L、cTnI≥120μg/L、机械通气时间≥10 d、APACHEⅡ评分≥20分、SOFA评分≥5分、PETCO_(2)≥40 mm Hg的严重呼吸衰竭患者早期肺康复后撤机失败发生率较高(P<0.05)。以严重呼吸衰竭患者早期肺康复后撤机情况为因变量(成功=0,失败=1),选择单因素分析中P<0.05的变量进行多因素Logistics回归分析,结果显示年龄、合并基础疾病、NYHA心功能分级、多器官衰竭、血清白蛋白、CK-MB、cTnI、机械通气时间、APACHEⅡ评分、SOFA评分、PETCO_(2)为影响严重呼吸衰竭患者早期肺康复后撤机失败的主要因素(P<0.05)。结论年龄、合并基础疾病、NYHA心功能分级、多器官衰竭、血清白蛋白、CK-MB、cTnI、机械通气时间、APACHEⅡ评分、SOFA评分、PETCO_(2)均为严重呼吸衰竭患者早期肺康复后撤机失败的影响因素。展开更多
基金supported by the National Key Research and Development Program of China(2017YFD0500503 and 2018YFD0500404)the Natural Science Foundation of China(31730090)Hubei Provincial Natural Science Foundation of China(2018CFA020).
文摘Background:Early-weaning of piglets is often accompanied by severe disorders,especially diarrhea.The gut microbiota and its metabolites play a critical role in the maintenance of the physiologic and metabolic homeostasis of the host.Our previous studies have demonstrated that oral administration of Lactobacillus frumenti improves epithelial barrier functions and confers diarrhea resistance in early-weaned piglets.However,the metabolic response to L.frumenti administration remains unclear.Then,we conducted simultaneous serum and hepatic metabolomic analyses in early-weaned piglets administered by L.frumenti or phosphatebuffered saline(PBS).Results:A total of 1006-day-old crossbred piglets(Landrace×Yorkshire)were randomly divided into two groups and piglets received PBS(sterile,2 m L)or L.frumenti(suspension in PBS,10~8 CFU/m L,2 m L)by oral administration once per day from 6 to 20 days of age.Piglets were weaned at 21 days of age.Serum and liver samples for metabolomic analyses were collected at 26 days of age.Principal components analysis(PCA)showed that L.frumenti altered metabolism in serum and liver.Numerous correlations(P<0.05)were identified among the serum and liver metabolites that were affected by L.frumenti.Concentrations of guanosine monophosphate(GMP),inosine monophosphate(IMP),and uric acid were higher in serum of L.frumenti administration piglets.Pathway analysis indicated that L.frumenti regulated fatty acid and amino acid metabolism in serum and liver.Concentrations of fatty acidβ-oxidation related metabolites in serum(such as3-hydroxybutyrylcarnitine,C4-OH)and liver(such as acetylcarnitine)were increased after L.frumenti administration.Conclusions:Our findings suggest that L.frumenti regulates lipid metabolism and amino acid metabolism in the liver of early-weaned piglets,where it promotes fatty acidβ-oxidation and energy production.High serum concentrations of nucleotide intermediates,which may be an alternative strategy to reduce the incidence of diarrhea in early-weaned piglets,were further detected.These findings broaden our understanding of the relationships between the gut microbiota and nutrient metabolism in the early-weaned piglets.
文摘Forty piglets weaned at 21 days age were randomly assigned to one of two groups. The treatment group contained 1. 2% glutamine. The diets were calculated to be isonitrogenous and isoenergetic, each treatment contained five replicates of four piglets. Five piglets from each dietary treatment were killed at 35 days and 49 days age. The results showed that dietary glutamine supplementation increased jejunal DNA content of piglets in the treatment group at 35 days and 49 days age. There was no significant change of ileum DNA content and intestinal protein content between the treatment and control ones. Dietary glutamine supplementation increased mucosal thickness of piglets in treatment group markedly at 35 days age. The intestinal villus heights were significantly higher in treatment than that in control. The results of electron micrograph showed that dietary glutamine supplementation prevented deterioration of intestinal epithelium, and maintained normal intestinal microvillus structure. The results suggested that glutamine supplementation prevented villus atrophy, and had protective effect on intestinal structure.
文摘Two experiments were conducted to study the effect of supplemental histamine in the diet of early-weaned piglets. In experiment A, 24 cross bred piglets with an average body weight of 6.10±0. 40 kg, weaned at the age of 28 days, were divided into four groups, fed with basal diet of low dietary copper without (control) or with supplemental histamine at 60, 120, 180μg kg-1 BW. During the two weeks and the third week after weaning, ADG(average daily gain) of piglets were increased by 15.8%(P<0. 05), 9.5%(P< 0.10) by addition of 60μg kg-1 BW histamine, but decreased by addition of 180μg kg-1BW histamine, which also increased the amount of E. coli in colon and the scour incidence. The secretion of gastric acid and pepsin were improved by both dose of supplemental histamine (60, 180μg kg-1BW) and gastric digesta pH were decreased by both. Addition of 60 μg kg-1 BW histamine improved the activities of trypsin, amylase in duodelum digesta. In experiment B, 12 cross bred piglets with an average body weight of 6. 85±0.35 kg, weaned at the age of 28 days, were divided into two groups, fed with basal diet of high dietary copper without (control) or with supplemental 60 μg kg-1 BW histamine. During the two weeks and the third week after weaning, ADG of piglets were increased by 9. 8% (P<0.05), 7. 0% (P<0. 10). The secretion of gastric acid, activities of trypsin and amylase in duodelum digesta, were also improved by addition of 60 μg kg-1BW histamine. The results showed that addition of histamine (60μg kg-1BW) in early weaned piglets could increase the secretion of gastric acid and pepsin, reduce gastric digesta pH and scour incidence, improve activities of trypsin, amylase in duodelum digesta, and the growing performance of early weaned piglets.
文摘BACKGROUND Tracheostomy is commonly used in intensive care unit(ICU)patients who are expected to be on long-term mechanical ventilation or suffer from emergency upper airway obstruction.However,some studies have conflicting findings regarding the optimal technique and its timing and benefits.AIM To provide evidence of practice,characteristics,and outcome concerning tracheostomy in an ICU of a tertiary care hospital.METHODS This was a retrospective cohort study including adult critical care patients in a single ICU for two consecutive years.Patients’demographic characteristics,severity of illness(APACHE II score),level of consciousness[Glasgow Coma Scale(GCS)],comorbidities,timing and type of tracheostomy procedure performed and outcome were recorded.We defined late as tracheostomy placement after 8 days or no tracheotomy.RESULTS Data of 660 patients were analyzed(median age of 60 years),median APACHE II score of 19 and median GCS score of 12 at admission.Tracheostomy was performed in 115 patients,of whom 63 had early and 52 late procedures.Early tracheostomy was mainly executed in case of altered level of consciousness and severe critical illness polyneuromyopathy,however there were no significant statistical results(47.6%vs 36.5%,P=0.23)and(23.8%vs 19.2%,P=0.55)respectively.Regarding the method selected,early surgical tracheostomy(ST)was conducted in patients with maxillofacial injuries(50.0%vs 0.0%,P=0.033),whereas late surgical tracheostomy was selected for patients with goiter(44.4%vs 0.0%P=0.033).Patients with early tracheostomy spent significantly fewer days on mechanical ventilation(15.3±8.5 vs 22.8±9.6,P<0.001)and in ICU in general(18.8±9.1 vs 25.4±11.5,P<0.001).Percutaneous dilatation tracheostomy(PDT)vs ST was preferable in older critical care patients in the case of Central Nervous System underlying cause of admission(62.5%vs 26.3%,P=0.004).ST was the method of choice in compromised airway(31.6%,vs 7.3%P=0.008).A large proportion of patients(88/115)with tracheostomy managed to wean from mechanical ventilation and were transferred out of the ICU(100%vs 17.4%,P<0.001).CONCLUSION PDT was performed more frequently in our cohort.This technique did not affect mechanical ventilation days,ventilator-associated pneumonia(VAP),ICU length of stay,or survival.No complications were observed in the percutaneous or surgical tracheostomy groups.Patients undergoing early tracheostomy benefited in terms of mechanical ventilation days and ICU length of stay but not of discharge status,presence of VAP,or survival.
基金CAMS Innovation Fund for Medical Sciences(CIFMS),Grant/Award Number:2021-I2M-1-034National Natural Science Foundation of China,Grant/Award Number:31970510Young Elite Scientist Sponsorship Program by CAST,Grant/Award Number:2019QNRC001。
文摘Object:Early-life neglect has irreversible emotional effects on the central nervous system.In this work,we aimed to elucidate distinct functional neural changes in me-dial prefrontal cortex(mPFC)of model rats.Methods:Maternal separation with early weaning was used as a rat model of early-life neglect.The excitation of glutamatergic and GABAergic neurons in rat mPFC was recorded and analyzed by whole-cell patch clamp.Results:Glutamatergic and GABAergic neurons of mPFC were distinguished by typi-cal electrophysiological properties.The excitation of mPFC glutamatergic neurons was significantly increased in male groups,while the excitation of mPFC GABAergic neurons was significant in both female and male groups,but mainly in terms of rest membrane potential and amplitude,respectively.Conclusions:Glutamatergic and GABAergic neurons in medial prefrontal cortex showed different excitability changes in a rat model of early-life neglect,which can contribute to distinct mechanisms for emotional and cognitive manifestations.
文摘AIM: To evaluate the impact of sociodemographic/clinical factors on early virological response (EVR) to pegin-terferon/ribavirin for chronic hepatitis C (CHC) in clinical practice. METHODS: We conducted a multicenter, cross-sectional, observational study in Hepatology Units of 91 Spanish hospitals. CHC patients treated with peginterferon α-2a plus ribavirin were included. EVR was defined as undetectable hepatitis C virus (HCV)-ribonucleic acid (RNA) or ≥ 2 log HCV-RNA decrease after 12 wk of treatment. A bivariate analysis of sociodemographic and clinical variables associated with EVR was carried out. Independent factors associated with an EVR were analyzed using a multiple regression analysis that included the following baseline demographic and clinical variables: age (≤ 40 years vs > 40 years), gender, race, educational level, marital status and family status, weight, alcohol and tobacco consumption, source of HCV infection, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and gamma glutamyl transpeptidase (GGT) (≤ 85 IU/mL vs > 85 IU/mL), serum ferritin, serum HCV-RNA concentration (< 400 000 vs ≥ 400 000), genotype (1/4 vs 3/4), cirrhotic status and ribavirin dose (800/1000/1200 mg/d).RESULTS: A total of 1014 patients were included in the study. Mean age of the patients was 44.3 ± 9.8 years, 70% were male, and 97% were Caucasian. The main sources of HCV infection were intravenous drug abuse (25%) and blood transfusion (23%). Seventyeight percent were infected with HCV genotype 1/4 (68% had genotype 1) and 22% with genotypes 2/3. The HCV-RNA level was > 400 000 IU/mL in 74% of patients. The mean ALT and AST levels were 88.4 ± 69.7 IU/mL and 73.9 ± 64.4 IU/mL, respectively, and mean GGT level was 82 ± 91.6 IU/mL. The mean ferritin level was 266 ± 284.8 μg/L. Only 6.2% of patients presented with cirrhosis. All patients received 180 mg of peginterferon α-2a. The most frequently used ribavirin doses were 1000 mg/d (41%) and 1200 mg/d (41%). The planned treatment duration was 48 wk for 92% of patients with genotype 2/3 and 24 wk for 97% of those with genotype 1/4 (P < 0.001). Seven percent of patients experienced at least one reduction in ribavirin or peginterferon α-2a dose, respectively. Only 2% of patients required a dose reduction of both drugs. Treatment was continued until week 12 in 99% of patients. Treatment compliance was ≥ 80% in 98% of patients. EVR was achieved in 87% of cases (96% vs 83% of patients with genotype 2/3 and 1/4, respectively; P < 0.001). The bivariate analysis showed that patients who failed to achieve EVR were older (P < 0.005), had higher ALT (P < 0.05), AST (P < 0.05), GGT (P < 0.001) and ferritin levels (P < 0.001), a diagnosis of cirrhosis (P < 0.001), and a higher baseline viral load (P < 0.05) than patients reaching an EVR. Age < 40 years [odds ratios (OR): 0.543, 95%CI: 0.373-0.790, P < 0.01], GGT < 85 IU/mL (OR: 3.301, 95%CI: 0.192-0.471, P < 0.001), low ferritin levels (OR: 0.999, 95%CI: 0.998-0.999, P < 0.01) and genotype other than 1/4 (OR: 4.716, 95%CI: 2.010-11.063, P < 0.001) were identified as independent predictors for EVR in the multivariate analysis. CONCLUSION: CHC patients treated with peginterferon-α-2a/ribavirin in clinical practice show high EVR. Older age, genotype 1/4, and high GGT were associated with lack of EVR.
文摘BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a serious disease with a poor prognosis.Only a minority of patients undergo surgery due to the advanced stage of the disease,and patients with early-stage disease,who are expected to have a better prognosis,often experience recurrence.Thus,it is important to identify the risk factors for early recurrence and to develop an adequate treatment plan.AIM To evaluate the predictive factors associated with the early recurrence of earlystage PDAC.METHODS This study enrolled 407 patients with stage I PDAC undergoing upfront surgical resection between January 2000 and April 2016.Early recurrence was defined as a diagnosis of recurrence within 6 mo of surgery.The optimal cutoff values were determined by receiver operating characteristic(ROC)analyses.Univariate and multivariate analyses were performed to identify the risk factors for early recurrence.RESULTS Of the 407 patients,98 patients(24.1%)experienced early disease recurrence:26(26.5%)local and 72(73.5%)distant sites.In total,253(62.2%)patients received adjuvant chemotherapy.On ROC curve analysis,the optimal cutoff values for early recurrence were 70 U/mL and 2.85 cm for carbohydrate antigen 19-9(CA 19-9)levels and tumor size,respectively.Of the 181 patients with CA 19-9 level>70 U/mL,59(32.6%)had early recurrence,compared to 39(17.4%)of 226 patients with CA 19-9 level≤70 U/mL(P<0.001).Multivariate analysis revealed that CA 19-9 level>70 U/mL(P=0.006),tumor size>2.85 cm(P=0.004),poor differentiation(P=0.008),and non-adjuvant chemotherapy(P=0.025)were significant risk factors for early recurrence in early-stage PDAC.CONCLUSION Elevated CA 19-9 level(cutoff value>70 U/mL)can be a reliable predictive factor for early recurrence in early-stage PDAC.As adjuvant chemotherapy can prevent early recurrence,it should be recommended for patients susceptible to early recurrence.
文摘Preconditioned calves have greater marketvalue per unit weight than normal-weaned calves. Development of a low cost forage-based preconditioning system allows producers to add value to their calf-crop. This study evaluated calf performance in three forage-based weaning systems;early-weaned calves were backgrounded in legume/grass forage plots and supplemented with commercial preconditioning feed (Treatment 1) or an on-farm corn-mix (Treatment 2). Control (Treatment 3) calves suckled for an additional 45 days. Supplements provided2.17 kgTDN/calf/ day. Weights were collected on days -30, 0 and 45 with respect to early weaning, from135 inyear 1 and 150 calves in each of the two subsequent years. Effects of treatment, age of dam, sex of calf and their interactions on calf weight gain were analyzed by analysis of covariance using GLM procedures of SAS. Marginal effects of treatment and feed cost were used to evaluate economic feasibility. Sensitivity analyses were evaluated for anticipated market fluctuations in feed costs and calf premiums. Data are reported as least squares means. Calf weight gains differed (P < 0.001) among treatments and averaged 1.16, 1.03 and1.04 kg/calf/day for commercial supplement, corn-mix and controls, respectively. Calves from 2-year-old cows gained less (P < 0.001) weight compared to those from cows 3 - 4 and ≥5 years of age (44.8, 48.9 and51.5 kg, respectively). Steers calves gained more (P < 0.001) weight compared to heifer calves (51.2 vs.45.7 kg, respectively). Net returns for corn mix were greater than those for commercial feed ($1.48 vs. $1.35/kg weight gain, respectively). Sensitivity analyses indicated that selection of preconditioning treatment to a large degree was less sensitive to significant changes in market conditions due to the large gap in marginal costs between the two treatments. In conclusion, forage-based weaning systems can be utilized to precondition calves providing an economical means for calf weight gain and profit potential as long as feed costs are held within reasonable limits.
文摘One hundred and three Hereford × Angus crossbred, spring-calving cows were used to determine the influence of early weaning performance of their male progeny and the need for cowherd winter supplementation. Treatments were early weaned (EW;115-d of age) and normal weaned calves (NW;220-d of age). Both intact and castrated male progeny were randomly allotted to early and normal weaning calf management treatments. Following summer grazing and weaning protocols, cows within each weaning group were randomly assigned to receive winter supplementation treatments of LOW (1.26 kg/hd/d) or HIGH (1.81 kg/hd/d) amounts of a protein supplement containing 450 g/kg CP (DM basis). Cows whose calves were weaned early gained more BW and BCS (P P P P = 0.04) BCS but similar (P = 0.74) BW when compared with cows with normally weaned calves that received 100% of their supplement (NWHIGH). Early weaning has the potential to reduce the amount of supplement required during the winter grazing period.
文摘The relationship between Egypt and Palestine can be traced back to theChalcolithic Age thanks to the evidence of current excavations in the Nile Deltaand Sinal.Palestinian pottery and cast metal objects from the Delta sites of Maadi,Minshat Abu Omar,and elsewhere have proved contacts with Palestine inProtodynastic(Nagada Ⅱ-Ⅲ)times.The Egyptian Protodynastic Period andDynasty 1 were contemporary with the Palestinian EB Ⅰ and EB Ⅲ,and
文摘目的分析严重呼吸衰竭患者早期肺康复后撤机失败的影响因素。方法选取2020年1月至2022年1月广西壮族自治区钦州市第一人民医院收治的135例严重呼吸衰竭患者作为研究对象,统计严重呼吸衰竭患者早期肺康复后撤机情况,分析影响撤机失败的因素。结果与撤机成功严重呼吸衰竭患者比较,撤机失败患者ICU住院、带管、呼吸机使用时间较长,并发症发生率较高(P<0.05)。单因素分析所示,严重呼吸衰竭患者早期肺康复后撤机失败与性别、入住ICU时间、BMI、平均动脉压无关(P>0.05);严重呼吸衰竭患者早期肺康复后撤机失败与年龄、合并基础疾病、NYHA心功能分级、多器官衰竭、血清白蛋白、CK-MB、cTnI、机械通气时间、APACHEⅡ评分、SOFA评分、PETCO_(2)有关,≥65岁、合并基础疾病、NYHA心功能分级Ⅲ~Ⅳ级、多器官衰竭者、血清白蛋白<210×10^(9)/L、CK-MB≥6 U/L、cTnI≥120μg/L、机械通气时间≥10 d、APACHEⅡ评分≥20分、SOFA评分≥5分、PETCO_(2)≥40 mm Hg的严重呼吸衰竭患者早期肺康复后撤机失败发生率较高(P<0.05)。以严重呼吸衰竭患者早期肺康复后撤机情况为因变量(成功=0,失败=1),选择单因素分析中P<0.05的变量进行多因素Logistics回归分析,结果显示年龄、合并基础疾病、NYHA心功能分级、多器官衰竭、血清白蛋白、CK-MB、cTnI、机械通气时间、APACHEⅡ评分、SOFA评分、PETCO_(2)为影响严重呼吸衰竭患者早期肺康复后撤机失败的主要因素(P<0.05)。结论年龄、合并基础疾病、NYHA心功能分级、多器官衰竭、血清白蛋白、CK-MB、cTnI、机械通气时间、APACHEⅡ评分、SOFA评分、PETCO_(2)均为严重呼吸衰竭患者早期肺康复后撤机失败的影响因素。