Advancements in the application of natural extracts for atopic dermatitis treatment

Atopic dermatitis,a common chronic inflammatory skin disease,has an unclear etiology and may involve multiple factors such as genetic predisposition,immune abnormalities,and impaired skin barrier function.Currently,there is no specific medication available for the complete cure of atopic dermatitis.The current treatment approaches mainly focus on symptom relief and control rather than curative treatment.Some commonly used medications for atopic dermatitis,such as topical corticosteroids and immunosuppressants,may have certain adverse reactions and side effects.This review summarizes the research progress on natural extracts in the treatment of atopic dermatitis,aiming to provide a foundation for the development of safe and side-effectfree medications.

Lid scrubbing with a gel combining natural extracts for dry eye treatment

AIM:To evaluate the effect of lid scrubbing using a gel combining different natural extracts on ocular signs and symptoms of dry eye patients.METHODS:A retrospective study was performed on 19 dry eye patients(51.1±16.0y).Non-invasive tear break-up time,tear meniscus height,meibomian gland loss,lipid layer thickness,conjunctival redness,corneal staining,ocular surface disease index(OSDI),and ocular pain intensity were measured before(baseline),1wk,and 2mo after lid scrubbing with a gel containing different natural extracts(okra extract,aloe vera leaf juice,hydrolysed soy protein,caffeine,citrus unshiu peel extract,and raspberry seed oil).RESULTS:Compared with the baseline,there was a statistically significant improvement in both first(P=0.048)and average(P=0.026)non-invasive tear break-up time 2mo after treatment,as well as in corneal staining(P=0.043,0.012),OSDI(P<0.001),and ocular pain intensity(P<0.001)after 1wk and 2mo.In addition,there was no correlation between ocular signs and symptoms.CONCLUSION:The lid scrubbing with a gel combining different natural extracts show beneficial effects on tear film stability,corneal damage,and ocular symptoms,which is the reason why this therapeutic procedure is proposed as an alternative for dry eye management.However,it is not possible to attribute this beneficial effect solely to the presence of the natural extracts in the gel,primarily due to the absence of a negative control group.

Effect of natural extract eye drops in dry eye disease rats

AIM:To investigate the therapeutic effect of natural extract eye drops containing bee venom,musk,and deer antlers in dry eye disease(DED)animal models.METHODS:Scopolamine-injected DED rats and lacrimal gland-excised rats were allocated into control,saline,and natural extract groups respectively and a normal group(lacrimal gland excision was not performed)in lacrimal gland-excised rats.After eye drop instillation 4 times a day for 5 d,corneal fluorescein staining(CFS)scores,tear MUC5AC levels,and tear lactic dehydrogenase(LDH)levels were measured.RESULTS:In scopolamine-injected rats,the natural extract-treated group had significantly lower CFS scores(1.7±0.5,4.7±1.4,3.8±1.9,P=0.006)and tear LDH levels(0.10±0.01,0.19±0.01,0.16±0.08 OD,P=0.014)but higher tear MUC5AC levels(12.9±3.7,7.9±2.0,9.7±3.6 ng/m L,P=0.041)compared with the control and saline-treated groups.There were no significant differences between the control and saline-treated groups.In lacrimal gland-excised rats,the natural extract-treated group also had lower CFS scores(4.3±1.2,11.5±2.3,9.0±1.9,P<0.001,P=0.001)and tear LDH levels(0.30±0.08,0.48±0.12,0.39±0.05 OD,P<0.05)but higher tear volume(4.3±0.9,1.9±0.7,2.8±1.1 mm,P=0.005,P=0.124)and tear MUC5 AC levels(8.2±2.0,2.9±1.2,5.4±2.2 ng/m L,P<0.001,P=0.047)compared with the control and saline-treated groups.There were no significant differences in the CFS scores,tear MUC5AC level,and tear LDH level between the normal and natural extracttreated groups.CONCLUSION:The natural extract consisting of bee venom,musk,and deer antlers may have effectiveness in DED treatment by restoring the damaged ocular surface,increasing tear volume,and recovering the tear mucin layer in DED rats.

A review of rat models of periodontitis treated with natural extracts

Objective:To review treatment methods using natural extracts applied in rat models of periodontitis to establish a direction for the design of future experiments.Methods:An electronic search of PubMed was carried out using the keywords“periodontitis,”“natural”,“extracts”,“herb*”,“plants”and“rats.”Articles were screened against inclusion and exclusion criteria by two independent researchers.Data describing the characteristics of rats,method of periodontitis inducement,extract administration,and outcome measures were extracted and analyzed by more than two authors manually.Results:Of the 864 articles identified,33 studies were included.The use of SpragueeDawley rats(51.2%)and male rats(90.9%)was preferred.The most common experimental methods were ligature placement(72.7%)and oral administration(66.7%).Alveolar bone loss was evaluated mainly by photography(51.5%)and micro-computed tomography(39.4%).Factors related to bone remodeling and inflammatory processes,such as interleukin-1b,tumor necrosis factor-a,receptor activator of nuclear factor-kB,and osteoprotegerin,were also measured.Conclusion:Many diverse experimental periodontitis models have been used.However,few articles observed bone formation,immune responses,antibacterial effects,and toxicity.Future studies to assess natural extracts for the treatment of periodontitis should be robust and well-designed.

Robotic natural orifice specimen extraction surgery I-type F method vs conventional robotic resection for lower rectal cancer

BACKGROUND Robotic resection using the natural orifice specimen extraction surgery I-type F method(R-NOSES I-F)is a novel minimally invasive surgical strategy for the treatment of lower rectal cancer.However,the current literature on this method is limited to case reports,and further investigation into its safety and feasibility is warranted.AIM To evaluate the safety and feasibility of R-NOSES I-F for the treatment of low rectal cancer.METHODS From September 2018 to February 2022,206 patients diagnosed with low rectal cancer at First Affiliated Hospital of Nanchang University were included in this retrospective analysis.Of these patients,22 underwent R-NOSES I-F surgery(RNOSES I-F group)and 76 underwent conventional robotic-assisted low rectal cancer resection(RLRC group).Clinicopathological data of all patients were collected and analyzed.Postoperative outcomes and prognoses were compared between the two groups.Statistical analysis was performed using SPSS software.RESULTS Patients in the R-NOSES I-F group had a significantly lower visual analog score for pain on postoperative day 1(1.7±0.7 vs 2.2±0.6,P=0.003)and shorter postoperative anal venting time(2.7±0.6 vs 3.5±0.7,P<0.001)than those in the RLRC group.There were no significant differences between the two groups in terms of sex,age,body mass index,tumor size,TNM stage,operative time,intrao-perative bleeding,postoperative complications,or inflammatory response(P>0.05).Postoperative anal and urinary functions,as assessed by Wexner,low anterior resection syndrome,and International Prostate Symptom Scale scores,were similar in both groups(P>0.05).Long-term follow-up revealed no significant differences in the rates of local recurrence and distant metastasis between the two groups(P>0.05).CONCLUSION R-NOSES I-F is a safe and effective minimally invasive procedure for the treatment of lower rectal cancer.It improves pain relief,promotes gastrointestinal function recovery,and helps avoid incision-related complications.

Natural products and extracts from plants as natural UV filters for sunscreens:A review

Although solar exposure is necessary for human health,phototoxicology induced by excessive UVB and UVA radiation,which involves sunburns,skin aging and even tu-morigenesis,has been widely researched.Sunscreen is one of the most important ways to protect skin from UV phototoxic damage.As well as inorganic and organic UV filters,some natural products or plant extracts with aromatic rings in their structures,such as flavonoids or polyphenols,can absorb UV to reduce sunburn,acting as a natu-ral UV filter;they also show antioxidant or/and anti-inflammatory activity.This could explain why,although there are no officially approval natural commercial sun-filters,more and more commercial sunscreen products containing plant extracts are avail-able on the market.Here we summarize articles focusing on natural UV filters from plant published in the last 6 years,selecting the most significant data in order to better understand the photoprotective activity of natural products and extracts from plants,including their major constituents and main biological effects,methods for evaluating UV radiation resistance,anti-UV radiation experimental models and anti-UV radiation mechanisms.

Perioperative outcomes of transvaginal specimen extraction laparoscopic total gastrectomy and conventional laparoscopicassisted total gastrectomy

BACKGROUND Natural orifice specimen extraction surgery(NOSES)has emerged as a promising alternative compared to conventional laparoscopic-assisted total gastrectomy(LATG)for treating gastric cancer(GC).However,evidence regarding the efficacy and safety of NOSES for GC surgery is limited.This study aimed to compare the safety and feasibility,in addition to postoperative complications of NOSES and LATG.METHODS Dual circular staplers were used in Roux-en-Y digestive tract reconstruction for transvaginal specimen extraction LATG,and its outcomes were compared with LATG in a cohort of 51 GC patients with tumor size≤5 cm.The study was conducted from May 2018 to September 2020,and patients were categorized into the NOSES group(n=22)and LATG group(n=29).Perioperative parameters were compared and analyzed,including patient and tumor characteristics,postoperative outcomes,and anastomosis-related complications,postoperative hospital stay,the length of abdominal incision,difference in tumor type,postoperative complications,and postoperative survival.RESULTS Postoperative exhaust time,operation duration,mean postoperative hospital stay,length of abdominal incision,number of specific staplers used,and Brief Illness Perception Questionnaire score were significant in both groups(P<0.01).In the NOSES group,the postoperative time to first flatus,mean postoperative hospital stay,and length of abdominal incision were significantly shorter than those in the LATG group.Patients in the NOSES group had faster postoperative recovery,and achieved abdominal minimally invasive incision that met aesthetic requirements.There were no significant differences in gender,age,tumor type,postoperative complications,and postoperative survival between the two groups.CONCLUSION The application of dual circular staplers in Roux-en-Y digestive tract reconstruction combined with NOSES gastrectomy is safe and convenient.This approach offers better short-term outcomes compared to LATG,while long-term survival rates are comparable to those of conventional laparoscopic surgery.

Laparoscopic natural orifice specimen extraction-colectomy: A systematic review

Over the last 20 years, laparoscopic colorectal surgery has shown equal efficacy for benign and malignant colorectal diseases when compared to open surgery. However, a laparoscopic approach reduces postoperative morbidity and shortens hospital stay. In the quest to optimize outcomes after laparoscopic colorectal surgery, reduction of access trauma could be a way to improve recovery. To date, one method to reduce access trauma is natural orifice specimen extraction(NOSE). NOSE aims to reduce access trauma in laparoscopic colorectal surgery. The specimen is delivered via a natural orifice and the anastomosis is created intracorporeally. Different methods are used to extract the specimen and to create a bowel anastomosis. Currently, specimens are delivered transcolonically, transrectally, transanally, or transvaginally. Each of these NOSEprocedures raises specific issues with regard to operative technique and application. The presumed benefits of NOSE-procedures are less pain, lower analgesia requirements, faster recovery, shorter hospital stay, better cosmetic results, and lower incisional hernia rates. Avoidance of extraction site laparotomy is the most important characteristic of NOSE. Concerns associated with the NOSE-technique include bacterial contamination of the peritoneal cavity, inflammatory response, and postoperative outcomes, including postoperative pain and the functional and oncologic outcomes. These issues need to be studied in prospective randomized controlled trials. The aim of this systematic review is to describe the role of NOSE in minimally invasive colorectal surgery.

Complete laparoscopic resection of the rectum using natural orifice specimen extraction

AIM: To investigate how complete laparoscopic anterior resection with natural orifice specimen extraction (NOSE), as a novel minimally invasive surgery, compares to conventional laparoscopic surgery.

Transanal natural orifice specimen extraction for laparoscopic anterior resection in rectal cancer

AIM: To investigate whether transanal natural orifice specimen extraction (NOSE) is a better technique for rectal cancer resection.METHODS: A prospectively designed database of a consecutive series of patients undergoing laparoscopic low anterior resection for rectal cancer with various tumor-node-metastasis classi?cations from March 2011 to February 2012 at the First Affiliated Hospital of Sun Yat-Sen University was analyzed. Patient selection for transanal specimen extraction and intracorporeal anastomosis was made on the basis of tumor size and distance of rectal lesions from the anal verge. Demographic data, operative parameters, and postoperative outcomes were assessed.RESULTS: None of the patients was converted to laparotomy. Respectively, there were 16 cases in the low anastomosis and five in the ultralow anastomosis groups. Mean age of the patients was 45.4 years, and mean body mass index was 23.1 kg/m2. Mean distance of the lower edge of the lesion from the anal verge was 8.3 cm. Mean operating time was 132 min, and mean intraoperative blood loss was 84 mL. According to the principle of rectal cancer surgery, we performed D2 lymph node dissection in 13 cases and D3 in eight. Mean lymph nodes harvest was 17.8, and the number of positive lymph nodes was 3.4. Median hospital stay was 6.7 d. No serious postoperative complication occurred except for one anastomotic leakage. All patients remained disease free. Mean Wexner score was 3.7 at 11 mo after the operation.CONCLUSION: Transanal NOSE for total laparoscopic low/ultralow anterior resection is feasible, safe and oncologically sound. Further studies with long-term outcomes are needed to explore its potential advantages.

Safety and survival outcomes of transanal natural orifice specimen extraction using prolapsing technique for patients with middle-to low-rectal cancer

Objective:The transanal approach to specimen collection,combined with the prolapsing technique,is a wellestablished and minimally invasive surgery for treating rectal cancer.However,reports on outcomes for this approach are sparse.We compared short-and long-term outcomes of conventional laparoscopic surgery(CLS)vs.transanal natural orifice specimen extraction(NOSE)using the prolapsing technique for patients with middle-to low-rectal cancer.Methods:From January 2013 to December 2017,we enrolled consecutive patients with middle-to low-rectal cancer undergoing laparoscopic anterior resection.Totally,50 patients who underwent transanal NOSE using the prolapsing technique were matched with 50 patients who received CLS.Clinical parameters and survival outcomes between the two groups were compared.Results:Estimated blood loss(29.70±29.28 vs.52.80±45.09 mL,P=0.003),time to first flatus(2.50±0.79 vs.2.86±0.76,P=0.022),time to liquid diet(3.62±0.64 vs.4.20±0.76 d,P<0.001),and the need for analgesics(22%vs.48%,P=0.006)were significantly lower for the NOSE group compared to the CLS group.The incidences of overall complications and fecal incontinence were comparable in both groups.After a median follow-up of 44.52 months,the overall local recurrence rate(6%vs.5%,P=0.670),3-year disease-free survival(86.7%vs.88.0%,P=0.945)and 3-year overall survival(95.6%vs.96.0%,P=0.708),were not significantly different.Conclusions:For total laparoscopic rectal resection,transanal NOSE using the prolapsing technique is effective and safe,and associated with less trauma and pain,a faster recovery,and similar survival outcomes compared to CLS.

Natural orifice specimen extraction with laparoscopic radical gastrectomy for distal gastric cancer: A case report

BACKGROUND This article introduces the surgical method and early experience in performing totally laparoscopic radical gastrectomy with transrectal specimen extraction for gastric cancer, and we evaluate the short-term effects and feasibility of this new procedure for gastric cancer in a 64-year-old male patient. This approach may provide new possibilities for gastric natural orifice specimen extraction(NOSE)surgery. In addition, we believe that this new procedure may further relieve pain,speed up recovery, and cause minimal physiological and psychological impact.CASE SUMMARY We performed NOSE gastrectomy in a male patient. Tumor resection, digestive tract reconstruction, and lymph node dissection were performed totally laparoscopically;the specimen was extracted from the natural orifice of the rectum-anus. This procedure reduced damage to the abdominal wall and decreased postoperative pain. We successfully performed radical gastrectomy without conversion and complications. Total operative time and blood loss were 176 min and 50 m L, respectively. The patient resumed normal activities of daily living on day 1 without pain, and passed flatus within 48 h. Postoperative hospital stay was 10 d. The number of resected lymph nodes was 0/43. During the follow-up, no stricture or anastomotic leakage was detected. Three months postoperatively, colonoscopy showed full recovery of the rectum without stricture or scar contracture. Computed tomography and laboratory test results showed no signs of tumor recurrence. There was no visible scar on the abdominal wall.CONCLUSION It is safe and reliable to perform totally laparoscopic radical gastrectomy with transrectal specimen extraction for distal gastric cancer patients.

Development and future perspectives of natural orifice specimen extraction surgery for gastric cancer

In recent years,natural orifice specimen extraction surgery(NOSES),a novel minimally invasive surgical technique,has become a focus in the surgical field,and has been initially applied in gastric surgery in many national medical centers worldwide.In addition,this new surgical technique was launched in major hospitals in China.With an increasing number of patients who have accepted this new surgical technique,NOSES has provided new prospects for the treatment of gastric cancer(GC),which may achieve a better outcome for both patients and surgeons.More and more experts and scholars from different countries and regions are currently paying close attention to NOSES for the treatment of GC.However,there are only a few reports of its use in GC.This review focuses on the research progress in NOSES for radical gastrectomy in recent years.We also discuss the challenges and prospects of NOSES in clinical practice.

Morphological Assessment of the Small Intestine of Broilers Fed Dietary Natural Zeolite Including Plant Extract

Many kinds of feed additives （e.g., probiotics, prebiotics, antibiotics, etc.） can be used in chicken diets to stimulate intestinal morphological maturation and, consequently, intestinal function. The aim of this trial was to investigate the possibility that natural zeolite including plant extract （ZEM） could encourage the hypertrophy of intestinal villi and the absorptive function of epithelial cells in broiler chickens. At 7 days old, 64 male Marshall Chunky broilers were divided into four groups, each with four replicates of four chickens. The birds were fed a basal mash diet supplemented with ZEM at 0% （control）, 0.05%, 0.1%, and 0.2% for 42 days. At 49 days old, four chickens from each treatment were killed to obtain intestinal samples. Morphological intestinal assessment was conducted using both a light and a scanning electron microscope. A tendency to increased villus height and cell area could be observed throughout the intestinal segments of the broilers fed ZEM. Particularly, the villus height in the duodenum was significantly increased （P 〈 0.05） in the 0.05% ZEM group when compared with the control group. The area of the villus cells tended to be higher in the ZEM groups in all intestinal regions and showed a significant increase （P 〈 0.05） in the ileal part of the 0.2% ZEM group. Also, the assessment of cells mitosis in the intestinal crypts showed significantly higher numbers （P 〈 0.05） in all levels of ZEM groups in the duodenum and a tendency to increase in value in the jejunum and ileum, as compared with the control group. More protuberated cells and multi-cell clusters were found in the ZEM groups than in the control group, resulting in a rough cellular surface. In conclusion, the present study might suggest that the intestinal villi and epithelial cells on the villus apical surface are hypertrophied in the ZEM groups, and that intestinal villi adapt to enhance their absorption capacity by increasing the absorptive surface area. These results are indicated that ZEM can provide effective nutritive value when used as a feed additive.

Outcomes after natural orifice extraction vs conventional specimen extraction surgery for colorectal cancer: A propensity scorematched analysis

BACKGROUND Natural orifice specimen extraction(NOSE)via the anus or vagina replaces conventional transabdominal specimen retrieval via the transabdominal route through a limited mid-line laparotomy or Pfannenstiel incision.Reducing the number of laparoscopic ports further decreases operative abdominal wall trauma.These techniques reduce the surgical wound size as well as the risk of incisionrelated morbidity.AIM To compare short-term outcomes following 3-port NOSE surgery with a matched cohort of conventional non-NOSE colorectal cancer surgery.METHODS Patients who underwent elective 3-port laparoscopic colorectal NOSE surgery between February to October 2021 were identified.Selection criteria for NOSE surgery was adapted from the 2019 International Consensus on Natural Orifice Specimen Extraction Surgery for colorectal cancer.Patients with clinical T4 or N2 tumors on staging computed tomography were also excluded.The propensity score-matched cohort was identified amongst patients who underwent conventional laparoscopic colorectal surgery from January 2019 to December 2020.Matching was performed in the ratio of 1:4 based on age,gender,type of resection,and p-tumor node metastasis staging.RESULTS Over the eight-month study duration,14 consecutive cases(nine female,five male)of elective 3-port laparoscopic surgery with NOSE were performed for colorectal cancer.Median age and body mass index were 70(range 43-82)years and 24.1(range 20.0-31.7)kg/m2 respectively.Six patients underwent transanal NOSE and eight had transvaginal NOSE.Median operative time,intraoperative blood loss and postoperative length of stay were 208(range 165-365)min,30(range 10-150)mL and 3(range 2-6)d respectively.Two(14%)suffered minor postoperative compilations not attributable to the NOSE procedure.Median follow-up duration was 12(range 8-15)mo.No instances of mortality,local or distant disease recurrence were recorded in this cohort.Compared to the conventional surgery cohort of 56 patients,the 3-port NOSE cohort had significantly quicker mean return of bowel function(2.6 vs 1.2 d,P<0.001),reduced postoperative pain and patientcontrolled analgesia use,and decreased length of hospital stay(6.4 vs 3.4 d,P<0.001).There were no statistical differences in surgical duration and perioperative complication rates between the NOSE and non-NOSE cohorts.CONCLUSION 3-port laparoscopic colorectal surgery with NOSE is a feasible technique,augmenting the minimally invasive nature of surgery and producing good outcomes.Appropriate patient selection and expertise in conventional laparoscopy are required.

Effects of Some Materials Extracted from Ajuga Species on the Larvae of Hyphantria cunea and its Natural Enemies

Six kinds of cxtracts drawn from Ajuga multiflora and .A. multliflora var. brevispicala and A. multiflora var.serotina using methanol and acetone were used in this experiment to test their killing activity to the second instar larvae ofHypantria cunea and their influence on its natural enemics. The average death rate caused by those extracts on the secondinstar larvae was 85.70%. The mortality rate caused by the extracts drawn with methanol was from 88.89% to 96.33%,which was significal1tly l1igl1er tl1a11 tl1at caused by acetol1e extracts. 'I11osc extracts were satt to TrchogranInIa `Ie)uI,xiIinIi,Coccinella septempunctata, the natural enelnies of H. cunea. We did not found any evidence shown that those extracts hadany influence the emergence and the devclopment of T. dendrolimi. Those methanolic extracts gotten from A. multiflora andA. multiflora var. brevispicata had no significant effects on the mortality of the larvae and adults of C. septenrpunctala.Those eXtracts could be used in the control of H cunea sattly.

Analysis of the Results of Rectal Cancer Treatment via 3D Laparoscopic Natural Orifice Specimen Extraction Surgery (NOSES IV)

Objective:To investigate the effect of 3D laparoscopic natural orifice specimen extraction surgery as rectal cancer treatment.Methods:The study was carried out in Shaanxi Provincial People’s Hospital from July 2021 to July 2022.80 rectal cancer patients were selected and divided into two groups which are the experimental group and control group.The experimental group was given 3D laparoscopic surgery while the control group was given 2D laparoscopic surgery.The results were compared and analysed.Results:The patients in the experimental group had shorter operative and evacuation times,less intraoperative bleeding,and a lower rate of complications.Conclusion:The clinical application of 3D laparoscopic radical surgery for rectal cancer via natural lumen extraction is more effective,which can promote patients'recovery and reduce the incidence of adverse events.

International guideline on natural orifice specimen extraction surgery(NOSES)for colorectal cancer(2023 version)

Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many questions remain open for discussion.The aim of this guideline is to provide more evidence for the promotion of NOSES.Methods This guideline has been prepared by the CACA Committee of Colorectal Cancer Society and the International NOSES Alliance,based on the latest evidence.Results The guideline on NOSES for colorectal cancer include the definition,classification,technology requirement,indications,technical difficulties and clinical research.Conclusion The guideline provides a full introduction of the theoretical and technical aspects of NOSES for colorectal cancer which will beneficial to development of NOSES.

Natural capsicum extract replacing chlortetracycline enhances performance via improving digestive enzyme activities,antioxidant capacity,anti-inflammatory function,and gut health in weaned pigs

The objective of this study was to investigate the effects of natural capsicum extract(NCE,containing 2%natural capsaicin,the rest is carrier)replacing chlortetracycline(CTC)on performance,digestive enzyme activities,antioxidant capacity,inflammatory cytokines,and gut health in weaned pigs.A total of 108 weaned pigs(Duroc×[Landrace×Yorkshire],initial body weight-8.68±1.34 kg;weaned on d 28)were randomly allotted into 3 treatments with 6 replicate pens per treatment(3 barrows and 3 gilts per pen).The treatments include a corn-soybean meal basal diet as a control group(CON),a CTC group(basal diet+CTC at 75 mg/kg),and a NCE group(basal diet--NEC at 80 mg/kg).Compared with CON and CTC,NCE had increased(P<0.05)average daily gain in phase 2(d 15 to 28)and overall(d 1 to 28),and higher(P<0.05)apparent total tract digestibility of gross energy,dry matter,crude protein,and organic matter in phase 1(d 1 to 14).These pigs also had increased(P<0.05)pancrelipase activity in pancreas,α-amylase,lipase and protease activities in the jejunal mucosa,and lipase activity in the ileal mucosa on d 28.Moreover,NCE had increased(P<0.05)the contents of growth hormone,β-endorphin,5-hydroxytryptamine,total antioxidant capacity,total superoxide dismutase,catalase,and IL-10,as well as decreased(P<0.05)contents of malondialdehyde,tumor nuclear factor-a,interferon-y,and interleukin-6 in serum on d 28 compared with CON and CTC.NCE showed higher(P<0.05)propionic acid,butyric acid and total volatile fatty acids(VFA)contents,and increased(P<0.05)relative abundance of Faecalibacterium in colon,as well as higher(P<0.05)propionic acid and total volatile fatty acids in cecum on d 28 compared with CON.In conclusion,NCE replacing CTC could enhance performance via improving digestive enzyme activities,antioxidant capacity,anti-inflammatory function,gut VFA composition and microbiota community in weaned pigs,and it could be used as a potential target for the development of feed additives.

International consensus on natural orifice specimen extraction surgery(NOSES)for colorectal cancer

In recent years,natural orifice specimen extraction surgery(NOSES)in the treatment of colorectal cancer has attracted widespread attention.The potential benefits of NOSES including reduction in postoperative pain and wound complications,less use of postoperative analgesic,faster recovery of bowel function,shorter length of hospital stay,better cosmetic and psychological effect have been described in colorectal surgery.Despite significant decrease in surgical trauma of NOSES have been observed,the potential pitfalls of this technique have been demonstrated.Particularly,several issues including bacteriological concerns,oncological outcomes and patient selection are raised with this new technique.Therefore,it is urgent and necessary to reach a consensus as an industry guideline to standardize the implementation of NOSES in colorectal surgery.After three rounds of discussion by all members of the International Alliance of NOSES,the consensus is finally completed,which is also of great significance to the long-term progress of NOSES worldwide.