BACKGROUND Enteral nutrition(EN)is essential for critically ill patients.However,some patients will have enteral feeding intolerance(EFI)in the process of EN.AIM To develop a clinical prediction model to predict the r...BACKGROUND Enteral nutrition(EN)is essential for critically ill patients.However,some patients will have enteral feeding intolerance(EFI)in the process of EN.AIM To develop a clinical prediction model to predict the risk of EFI in patients receiving EN in the intensive care unit.METHODS A prospective cohort study was performed.The enrolled patients’basic information,medical status,nutritional support,and gastrointestinal(GI)symptoms were recorded.The baseline data and influencing factors were compared.Logistic regression analysis was used to establish the model,and the bootstrap resampling method was used to conduct internal validation.RESULTS The sample cohort included 203 patients,and 37.93%of the patients were diagnosed with EFI.After the final regression analysis,age,GI disease,early feeding,mechanical ventilation before EN started,and abnormal serum sodium were identified.In the internal validation,500 bootstrap resample samples were performed,and the area under the curve was 0.70(95%CI:0.63-0.77).CONCLUSION This clinical prediction model can be applied to predict the risk of EFI.展开更多
BACKGROUND Mesenchymal stromal cell(MSC)-based therapy is currently under study to treat inflammatory bowel diseases.MSC bioactive products could represent a valid alternative to overcome issues associated with system...BACKGROUND Mesenchymal stromal cell(MSC)-based therapy is currently under study to treat inflammatory bowel diseases.MSC bioactive products could represent a valid alternative to overcome issues associated with systemic whole-cell therapies.However,MSC anti-inflammatory mechanisms differ between rodents and humans,impairing the reliability of preclinical models.AIM To evaluate the effect of conditioned medium(CM)derived from porcine vascular wall MSCs(pVW-MSCs)on survival and differentiation of porcine and guinea pig enteric ganglia exposed to lipopolysaccharide(LPS).METHODS Primary cultures of enteric ganglia were obtained by mechanic and enzymatic digestion of ileum resections from guinea pigs(Cavia porcellus)(GPEG)and pigs(Suus scrofa)(PEG).pVW-MSCs were derived by enzymatic digestion from vascular wall resections of porcine aorta and tested by immunoflowcytometry for MSC immune profile.Enteric ganglia were treated with increasing concentrations of LPS,CM derived by pVW-MSCs or a combination of CM and LPS 1μg/mL.Cell count and morphometric analysis of HuD positive neurons and glial fibrillary acidic protein positive glial cells were performed by immunofluorecent staining of cultured ganglia.RESULTS PEG showed a higher number of neurons compared to GPEG.Overall,CM exerted a protective role on LPS-treated enteric ganglia.CM in combination with LPS increased the number of glial cells per ganglion in both cultures evoking glial cells differentiation in porcine cultures.CONCLUSION These findings suggest an immunomodulating activity of pVW-MSCs mediators on the enteric nervous system in inflammatory conditions.展开更多
This experiment was carried out with 375 male broilers(Ross 308) from days 1 to 28 to evaluate the influence of crimped kernel maize silage(CKMS) on the manifestation of subclinical necrotic enteritis,microbiota count...This experiment was carried out with 375 male broilers(Ross 308) from days 1 to 28 to evaluate the influence of crimped kernel maize silage(CKMS) on the manifestation of subclinical necrotic enteritis,microbiota counts, organic acid production and relative weights of gastrointestinal segments. A necrotic enteritis disease model was applied. Birds were allocated into 3 different dietary treatments: a maizebased feed(MBF, control diet), and 2 diets supplemented with 15%(CKMS15) or 30%(CKMS30) of crimped ensiled kernel maize. The disease model involved a 10-time overdose of an attenuated live vaccine against coccidiosis given orally on day 17, followed by oral inoculation of Clostridium perfringens Type A(S48,10~8 to 10~9 bacteria/bird) twice daily on days 18,19, 20 and 21. Scoring of intestinal lesions was performed on days 22, 23, 25 and 28. Ileal and caecal digesta samples were collected for the quantification of selected bacterial groups and organic acids. The results showed that there was no effect of dietary treatments on small intestinal lesion scores(P> 0.05). Lesions scores peaked on days 23 and 25 and decreased again on day 28(P = 0.001). No effect of age on microbiota counts was observed, but feeding of CKMS30 reduced the number of coliforms in ileal contents(P = 0.01). Dietary treatments did not affect organic acid concentrations in ileum and caeca, but there was an effect of age; butyric acid was higher on days 22, 23 and 25 than on day 28(P = 0.04). Acetic acid and propionic acid concentrations in caeca were the highest on days 22 and 28 but the lowest on days 23 and 25. Relative gizzard and caeca weights were increased, and relative ileum weights were decreased when birds were fed CKMS30(P < 0.05). In conclusion, the inclusion of CKMS in broiler diets had no effects on the course of necrotic enteritis but had potential benefits in terms of inhibition of potentially harmful microorganisms.展开更多
目的系统评价重症监护病房患者肠内营养喂养不耐受风险预测模型的研究现况。方法检索Pub Med、EMbase、Web of Science、Cochrane Library、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统,检索时限为建库至2023年...目的系统评价重症监护病房患者肠内营养喂养不耐受风险预测模型的研究现况。方法检索Pub Med、EMbase、Web of Science、Cochrane Library、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统,检索时限为建库至2023年2月。由两名研究者独立筛选文献、提取资料,采用临床预测模型偏倚风险和适用性的评估工具对纳入的模型进行质量评价。结果共纳入10篇文献,包括14个预测模型,12个模型的受试者操作特征曲线下面积为0.60~0.94,其中9个模型准确度良好。模型偏倚风险评价结果显示研究整体呈现高的偏倚风险和良好的适用性。结论未来研究应集中于现有模型的外部验证与优化,或在规范化指导下开发新模型,以提高模型在临床应用的适用性和可行性。展开更多
文摘BACKGROUND Enteral nutrition(EN)is essential for critically ill patients.However,some patients will have enteral feeding intolerance(EFI)in the process of EN.AIM To develop a clinical prediction model to predict the risk of EFI in patients receiving EN in the intensive care unit.METHODS A prospective cohort study was performed.The enrolled patients’basic information,medical status,nutritional support,and gastrointestinal(GI)symptoms were recorded.The baseline data and influencing factors were compared.Logistic regression analysis was used to establish the model,and the bootstrap resampling method was used to conduct internal validation.RESULTS The sample cohort included 203 patients,and 37.93%of the patients were diagnosed with EFI.After the final regression analysis,age,GI disease,early feeding,mechanical ventilation before EN started,and abnormal serum sodium were identified.In the internal validation,500 bootstrap resample samples were performed,and the area under the curve was 0.70(95%CI:0.63-0.77).CONCLUSION This clinical prediction model can be applied to predict the risk of EFI.
基金Supported by Fondazione del Monte di Bologna e Ravenna(ID ROL:Fd M/3208)
文摘BACKGROUND Mesenchymal stromal cell(MSC)-based therapy is currently under study to treat inflammatory bowel diseases.MSC bioactive products could represent a valid alternative to overcome issues associated with systemic whole-cell therapies.However,MSC anti-inflammatory mechanisms differ between rodents and humans,impairing the reliability of preclinical models.AIM To evaluate the effect of conditioned medium(CM)derived from porcine vascular wall MSCs(pVW-MSCs)on survival and differentiation of porcine and guinea pig enteric ganglia exposed to lipopolysaccharide(LPS).METHODS Primary cultures of enteric ganglia were obtained by mechanic and enzymatic digestion of ileum resections from guinea pigs(Cavia porcellus)(GPEG)and pigs(Suus scrofa)(PEG).pVW-MSCs were derived by enzymatic digestion from vascular wall resections of porcine aorta and tested by immunoflowcytometry for MSC immune profile.Enteric ganglia were treated with increasing concentrations of LPS,CM derived by pVW-MSCs or a combination of CM and LPS 1μg/mL.Cell count and morphometric analysis of HuD positive neurons and glial fibrillary acidic protein positive glial cells were performed by immunofluorecent staining of cultured ganglia.RESULTS PEG showed a higher number of neurons compared to GPEG.Overall,CM exerted a protective role on LPS-treated enteric ganglia.CM in combination with LPS increased the number of glial cells per ganglion in both cultures evoking glial cells differentiation in porcine cultures.CONCLUSION These findings suggest an immunomodulating activity of pVW-MSCs mediators on the enteric nervous system in inflammatory conditions.
文摘This experiment was carried out with 375 male broilers(Ross 308) from days 1 to 28 to evaluate the influence of crimped kernel maize silage(CKMS) on the manifestation of subclinical necrotic enteritis,microbiota counts, organic acid production and relative weights of gastrointestinal segments. A necrotic enteritis disease model was applied. Birds were allocated into 3 different dietary treatments: a maizebased feed(MBF, control diet), and 2 diets supplemented with 15%(CKMS15) or 30%(CKMS30) of crimped ensiled kernel maize. The disease model involved a 10-time overdose of an attenuated live vaccine against coccidiosis given orally on day 17, followed by oral inoculation of Clostridium perfringens Type A(S48,10~8 to 10~9 bacteria/bird) twice daily on days 18,19, 20 and 21. Scoring of intestinal lesions was performed on days 22, 23, 25 and 28. Ileal and caecal digesta samples were collected for the quantification of selected bacterial groups and organic acids. The results showed that there was no effect of dietary treatments on small intestinal lesion scores(P> 0.05). Lesions scores peaked on days 23 and 25 and decreased again on day 28(P = 0.001). No effect of age on microbiota counts was observed, but feeding of CKMS30 reduced the number of coliforms in ileal contents(P = 0.01). Dietary treatments did not affect organic acid concentrations in ileum and caeca, but there was an effect of age; butyric acid was higher on days 22, 23 and 25 than on day 28(P = 0.04). Acetic acid and propionic acid concentrations in caeca were the highest on days 22 and 28 but the lowest on days 23 and 25. Relative gizzard and caeca weights were increased, and relative ileum weights were decreased when birds were fed CKMS30(P < 0.05). In conclusion, the inclusion of CKMS in broiler diets had no effects on the course of necrotic enteritis but had potential benefits in terms of inhibition of potentially harmful microorganisms.
文摘目的系统评价重症监护病房患者肠内营养喂养不耐受风险预测模型的研究现况。方法检索Pub Med、EMbase、Web of Science、Cochrane Library、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统,检索时限为建库至2023年2月。由两名研究者独立筛选文献、提取资料,采用临床预测模型偏倚风险和适用性的评估工具对纳入的模型进行质量评价。结果共纳入10篇文献,包括14个预测模型,12个模型的受试者操作特征曲线下面积为0.60~0.94,其中9个模型准确度良好。模型偏倚风险评价结果显示研究整体呈现高的偏倚风险和良好的适用性。结论未来研究应集中于现有模型的外部验证与优化,或在规范化指导下开发新模型,以提高模型在临床应用的适用性和可行性。
