[Impact of obesity on the incidence of postoperative pulmonary complications following laparoscopic colorectal surgery]

Objective: To evaluate the effects of obesity on the incidence of postoperative pulmonary complications (PPCs) following laparoscopic colorectal surgery. Methods: A total of 150 patients with pathological diagnosis of colorectal cancer who accepted laparoscopic colorectal excision from January to May 2023 were retrospectively recruited. All the patients scored 26 points or more in the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) model, making them all in intermediate to high risks of PPCs. Patients were divided into obesity group and non-obesity group depending on whether they were obese or not. Propensity score matching (1∶1) was performed to achieve the balance of clinicopathological characteristics with the matching factors of age, sex, respiratory complications and ARISCAT score. A total of 96 patients were eventually enrolled, with 48 patients in obesity group and 48 patients in non-obesity group. Besides, the patients were divided into 25°-30° Trendelenburg subgroup and ±10°-15° Trendelenburg subgroup according to surgical sites for further analysis. The incidence of PPCs, the intraoperative airway pressure and blood biomarker expression of lung injury, including soluble receptor for advanced glycation end products (sRAGE) and angiopoietin-2 (ANG2) at postoperative day (POD) 1 and POD3 between the two groups were compared. The relationship between obesity and incidence of PPCs within 30 postoperative days were analyzed with unifactorial Cox proportional hazard model. Results: The obesity group was comprised of 35 males and 13 females with a median age of 60 (49, 69) years, and the non-obesity group was comprised of 35 males and 13 females with a median age of 60 (52, 67) years. The incidence of PPCs was 50.0% (24/48) in the obesity group, which was higher than 20.8% (10/48) in the non-obesity group and the incidence of grade Ⅰ PPCs and microatelectasis were 31.3% (15/48) and 33.3% (16/48), higher than the 12.5% (6/48) and 12.5% (6/48) of the non-obesity group (all P<0.05). The peak airway pressure (Ppeak) and plateau airway pressure (Pplat) of patients in obesity group were 34.0(31.5, 36.5) and 30.0(27.0, 32.0) cmH2O(1 cmH2O=0.098 kPa), which were significantly higher than the 26.0 (24.0, 29.5) and 22.0 (21.0, 26.5) cmH2O of the non-obesity group (all P<0.001). The ANG2 level of the obesity group at POD3 was 11.9 (8.4, 16.5) μg/L, which was higher than 9.2 (6.0, 12.3) μg/L of the non-obesity group (P=0.045). In 25°-30°Trendelenburg subgroup, the incidence of PPCs in obese patients were significantly higher than that of non-obese patients [41.4% (12/29) vs 11.4% (4/35), P=0.005]. In ±10°-15°Trendelenburg subgroup, no significant difference was found in PPCs incidence between obese and non-obese patients [63.2% (12/19) vs 46.2% (6/13), P=0.215]. The unifactorial Cox proportional hazard model analysis showed that obesity was a risk factor of PPCs in 30 postoperative days (HR=3.015, 95%CI: 1.438-6.321, P=0.001). Conclusion: In patients undergoing laparoscopic colorectal surgery with intermediate to high risk of PPCs, obesity raises intraoperative airway pressure and aggravates intraoperative lung endothelial injury. Obesity is a risk factor of PPCs in 30 postoperative days.

Comparison of greenhouse gas emissions from sheep measured using both respiration and portable accumulation chambers

Methane (CH4) is a potent gas produced by ruminants, and new measurement techniques are required to generate large datasets suitable for genetic analysis. One such technique are portable accumulation chambers (PAC), a short-term sampling method. The objectives of the current study were to explore the relationship between CH4 and carbon dioxide (CO2) output measured using both PAC and respiration chambers (RC) in growing lambs, and separately investigate the relationship among CH4, CO2 and measured ad libitum DM intake (DMI). Methane, CO2 and DMI were measured on 30 Suffolk and 30 Texel ewe lambs (age 253 ± 12 days) using the RC and PAC sequentially. The experiment was conducted over a 14-day period, with DMI measured from days 1 to 14; measurements in RC were conducted from days 10 to 12, while measurements in PAC were taken twice, the day immediately prior to the lambs entering the RC (day 9; PAC Pre-RC) and on the day lambs exited the RC (day 13; PAC Post-RC). Greater CH4 and CO2 output was measured in the RC than in the PAC (P < 0.01); similarly mean CH4 yield was greater when measured in the RC (15.39 ± 0.452 g CH4/kg DMI) compared to PAC (8.01 ± 0.767 g CH4/kg DMI). A moderate correlation of 0.37 was found between CH4 output measured in PAC Pre-RC and the RC, the corresponding regression coefficient of CH4 output measured in the RC regressed on CH4 output measured in PAC Pre-RC was close to unity (0.74; SE 0.224). The variance of CH4 and CO2 output within the measurement technique did not differ from each other (P > 0.05). Moderate to strong correlations were found between CH4 and CO2 per kg of live weight and CH4 and CO2 yield. Results from this study highlight the suitability of PAC as a ranking tool to rank animals based on their gaseous output when compared to the RC. However, repeated measurements separated by several days may be beneficial if precise rankings are required. Given the close to unity regression coefficient of CH4 output measured in the RC regressed on CH4 output measured in PAC Pre-RC suggests that PAC could also be potentially used to estimate absolute CH4 output; however, further research is required to substantiate this claim. When DMI is unknown, CH4 and CO2 per kg of live weight are a suitable alternative to the measurement of CH4 and CO2 yield.

[Relationship between gut microbiota and its metabolite dysregulation and postoperative cognitive dysfunction in elderly male C57BL/6J mice after laparotomy exploration]

Objective: To explore the relationship between gut microbiota and its metabolite dysregulation and postoperative cognitive dysfunction in elderly male C57BL/6J mice after laparotomy exploration. Methods: A total of 48 specific pathogen-free (SPF) male C57BL/6J mice, aged 16-17 months, were divided into two groups by random number table method: control group (n=24) and operation group (n=24). Mice in the operation group were induced with 1.4% isoflurane for 15 minutes, followed by a 10 minutes exploratory laparotomy anesthetized with 1.4% isoflurane and 100% oxygen, and anesthesia continued for 2 hours after surgery. Mice in control group were put in 100% oxygen for 2 hours. Feces and venous blood samples of both groups were collected 48 hours after surgery. Changes in the abundance and diversity of intestinal bacteria in the feces were detected by 16S rDNA gene sequencing. Functional changes of fecal metabolic profiles were detected by liquid chromatography tandem mass spectrometry (LC/MS) metabolomics and differential metabolite functions were analyzed. The serum level of interleukin (IL)-6, IL-1β and tumor necrosis factor-α (TNF-α) were detected by Enzyme-linked immunosorbent assay (ELISA). The cognitive function of the mice was detected by Morris water maze test 3 days after operation. Results: The postoperative escape latency of mice in control group and operation group was (22.0±4.9) and (35.0±5.1) s, and the target quadrant residence time was (26.0±3.7) and (16.0±2.9) s, respectively. Compared with the control group, the postoperative escape latency of mice in the operation group was prolonged (P=0.035), and the residence time in the target quadrant was reduced (P=0.006). The difference of intestinal flora between the two groups was comparable. The expression levels of Escherichia coli, shigella and clostridium in the operation group were up-regulated, while the expression levels of rumen bacteria and butyricobacteria were down-regulated. Fecal metabolic profiles of mice in control group and operation group were obtained by LC/MS, and 14 and 21 different metabolites were screened in positive and negative ion modes, respectively. The different metabolites in positive ion mode were glutamic acid, 2-indoleic acid, kynuuric acid and glyceraldehyde. The negative ion pattern differential metabolites are methionine, aspartic acid, L-threonine, tyrosyl-threonine and 5-hydroxyindole-3-acetic acid. The identified differential metabolite pathways are mainly involved in amino acid, fatty acid and tryptophan metabolism and nucleotide synthesis. There were no significant differences in serum levels of IL-1β, IL-6 and TNF-α between the two groups (all P>0.05). Conclusion: The dysregulated changes of gut microbiota and its metabolites are correlated with the occurrence of postoperative cognitive dysfunction in elderly male C57BL/6J mice. Anesthesia and surgery alter the structure of mice intestinal bacteria on the level of abundance, and change the metabolic balance and feces metabolomic phenotype.

[The effect of deep neuromuscular block combined with low pneumoperitoneum pressure on postoperative pain in patients undergoing laparoscopic radical colorectal surgery]

Objective: To investigate the effect of deep neuromuscular blockade (DNMB) combined with low pneumoperitoneum pressure anesthesia strategy on postoperative pain in patients undergoing laparoscopic colorectal surgery. Methods: This study was a randomized controlled trial. One hundred and twenty patients who underwent laparoscopic colorectal surgery at Cancer Hospital of Chinese Academy of Medical Sciences from December 1, 2022 to May 31, 2023 were selected and randomly divided into two groups by random number table method. Moderate neuromuscular blockade [train of four stimulations count (TOFC)=1-2] was maintained in patients of the control group (group C, n=60) and pneumoperitoneum pressure level was set at 15 mmHg(1 mmHg=0.133 kPa). DNMB [post-tonic stimulation count (PTC)=1-2] was maintained in patients of the DNMB combined with low pneumoperitoneum pressuregroup (group D, n=60) and pneumoperitoneum pressure level was set at 10 mmHg. The primary measurement was incidence of moderate to severe pain at 1 h after surgery. The secondary measurements the included incidence of moderate to severe pain at 1, 2, 3, 5 d and 3 months after surgery, the incidence of rescue analgesic drug use, the doses of sufentanil in analgesic pumps, surgical rating scale (SRS) score, the incidence of postoperative residual neuromuscular block, postoperative recovery [evaluated with length of post anesthesia care unit (PACU) stay, time of first exhaust and defecation after surgery and length of hospital stay] and postoperative inflammation conditions [evaluated with serum concentration of interleukin (IL)-1β and IL-6 at 1 d and 3 d after surgery]. Results: The incidence of moderate to severe pain in group D 1 h after surgery was 13.3% (8/60), lower than 30.0% (18/60) of group C (P<0.05). The incidence of rescue analgesia in group D at 1 h and 1 d after surgery were 13.3% (8/60) and 4.2% (5/120), respectively, lower than 30.0% (18/60) and 12.5% (15/120) of group C (both P<0.05). The IL-1β level in group D was (4.1±1.8)ng/L at 1 d after surgery, which was lower than (4.9±2.6) ng/L of group C (P=0.048). The IL-6 level in group D was (2.0±0.7)ng/L at 3 d after surgery, which was lower than (2.4±1.1) ng/L of group C (P=0.018). There was no significant difference in the doses of sufentanil in analgesic pumps, intraoperative SRS score, incidence of neuromuscular block residue, time spent in PACU, time of first exhaust and defecation after surgery, incidence of nausea and vomiting, and length of hospitalization between the two groups (all P>0.05). Conclusion: DNMB combined with low pneumoperitoneum pressure anesthesia strategy alleviates the early-stage pain in patients after laparoscopic colorectal surgery.

Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A

The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10  TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60  TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.

Different sedation profiles with ciprofol compared to propofol represented by objective sedation level assessments by BIS and its acute hemodynamic impact in 3 escalated doses of ciprofol and propofol in healthy subjects: a single-center, open-label, randomized, 2-stage, 2-way crossover trial

OBJECTIVE

To compare the sedation profiles and the pharmacokinetic, pharmacodynamic and safety characteristics of ciprofol and propofol at 3 escalated dose levels in healthy Chinese male subjects.

PATIENTS AND METHODS

Eighteen subjects were planned to be enrolled into 3 dose groups in turn: group 1 (ciprofol-0.4 mg/kg vs. propofol-2.0 mg/kg), group 2 (ciprofol-0.6 mg/kg vs. propofol-3.0 mg/kg) and group 3 (ciprofol-0.8 mg/kg vs. propofol-4.0 mg/kg). They were randomly assigned into a ciprofol or propofol group in a ratio of 1:1, with sequences of ciprofol-propofol or propofol-ciprofol, separated with a washout period of at least 48 h.

RESULTS

A total of 19 subjects were enrolled and 18 completed the trial. The median time to being fully alert after induction by ciprofol was longer than for propofol. The bispectral index (BIS) recovered significantly slower with ciprofol than with propofol 5 min and 10 min after reaching its lowest points. Systolic blood pressure (group 1: p=0.041; group 2: p=0.015; group 3: p=0.004) and mean arterial pressures (group 1: p=0.026; group 2: p=0.015; group 3: p=0.004) measured by the area under the curve below the baseline during the 2 min after induction were significantly less for ciprofol compared to propofol, but a significant change in diastolic blood pressure was only observed in group 3 (p=0.002). Eighteen (100.0%) subjects experienced 47 ciprofol-related treatment emergent adverse events (TEAEs) and 17 (94.4%) subjects had 54 propofol-related TEAEs, which were mainly hypotension, involuntary movements, respiratory depression, and pain at the injection site with severity of grade 1 or 2.

CONCLUSIONS

Ciprofol may be well tolerated at higher doses in the clinical practice and exhibited significantly different sedation profiles to propofol.

A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst

Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.

[Double-edged sword of opioids in the treatment of cancer pain: hyperalgesia]

Hyperalgesia is an occult complication during the treatment of cancer pain, not only related to opioids, but also pertaining to the tumor itself and cancer therapeutic drugs. Yet it is often ignored by clinicians. Patients with cancer pain who were treated with opioids often have sensory abnormalities presented with reduced pain threshold and increased sensitivity to nociceptive stimuli. This phenomenon is clinically called opioid-induced hyperalgesia (OIH). However, due to the complexity of pathogenesis and the lack of clinical diagnostic criteria, the pain management of cancer patients is still facing great challenges. Therefore, this article focuses on the clinical diagnosis, pathogenesis, prevention and treatment of hyperalgesia related to cancer pain treatment, in order to provide a basis for optimal use of opioids in the future.

Effects of dietary crude protein concentration on animal performance and nitrogen utilisation efficiency at different stages of lactation in Holstein-Friesian dairy cows

Nitrogen (N) excretion from livestock production systems is of significant environmental concern; however, few studies have investigated the effect of dietary CP concentration on N utilisation efficiency at different stages of lactation, and the interaction between dietary CP levels and stages of lactation on N utilisation. Holstein-Friesian dairy cows (12 primiparous and 12 multiparous) used in the present study were selected from a larger group of cows involved in a whole-lactation study designed to examine the effect of dietary CP concentration on milk production and N excretion rates at different stages of lactation. The total diet CP concentrations evaluated were 114 (low CP), 144 (medium CP) and 173 (high CP) g/kg DM, with diets containing (g/kg DM) 550 concentrates, 270 grass silage and 180 maize silage. During early (70-80 days), mid- (150-160 days) and late (230-240 days) lactation, the same 24 animals were transferred from the main cow house to metabolism units for measurements of feed intake, milk production and faeces and urine outputs. Diet had no effect on BW, body condition score, or milk fat, protein or lactose concentration, but DM intake, milk yield and digestibilities of DM, energy and N increased with increasing diet CP concentration. The effect of diet on milk yield was largely due to differences between the low and medium CP diets. Increasing dietary CP concentration significantly increased urine N/N intake and urine N/manure N, and decreased faecal N/N intake, milk N/N intake and manure N/N intake. Although increasing dietary CP level significantly increased urine N/milk yield and manure N/milk yield, differences in these two variables between low and medium CP diets were not significant. There was no significant interaction between CP level and stage of lactation on any N utilisation variable, indicating that the effects of CP concentration on these variables were similar between stages of lactation. These results demonstrated that a decrease in dietary CP concentration from high (173 g/kg DM) to medium level (144 g/kg DM) may be appropriate for Holstein-Friesian dairy cow to maintain milk production efficiency, whilst reducing both urine N and manure N as a proportion of N intake or milk production.

[Effects of myocardial fibrosis on ischemic preconditioning against myocardial ischemia-reperfusion injury in type 2 diabetic rats]

Objective: To assess whether myocardial fibrosis affects the protective efficiency of ischemic preconditioning (IPC) against myocardial ischemia/reperfusion injury (MIRI) in type 2 diabetic rats. Methods: Type 2 diabetic rat model was established. Fifty-four normal and 54 diabetic spragus-dawley (SD) rats were equally divided into 6 groups (n=18) using the random number table method: (1) Control group (C group); (2) Ischemia reperfusion injury (IRI) control group (IRI group); (3) IPC group; (4) Diabetic control group (DC group); (5) Diabetic IRI group (DIRI group); (6) Diabetic IPC group (DIPC group). After the reperfusion, blood samples were obtained for measuring serum concentrations of creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) using enzyme-linked immunosorbent assay (ELISA). The myocardial infarction size (IS) was assessed by double staining method with Evan's blue and Triphenyl tetrazolium chloride (TTC), and the myocardial collagen volume fraction (CVF) and perivascular collagen area (PVCA) were assessed by Masson staining. Results: A stable and effective rat model with long-term diabetes was established in the current study. Compared with the normal rat groups, the CVF and PVCA significantly increased (all P<0.05) in the diabetic rat groups. The levels of CK-MB, cTnI and IS in the IPC group were (6.6±0.8) ng/ml, (0.5±0.1) ng/ml and (25.1±4.7) %, which showed significant decrease compared with (12.3±1.1) ng/ml, (1.2±0.3) ng/ml and (52.3±8.1) % in IRI group (all P<0.05). Among the diabetic rat groups, the CK-MB and cTnI levels in DIPC group were (11.5±0.9) and (1.1±0.1) ng/ml, apparently lower than the levels of (16.6±2.2) and (1.4±0.3) ng/ml in the DIRI group (both P<0.05). Compared with the IPC group, the IS, CK-MB and cTnI levels significantly increased in the DIPC group (all P<0.05). Conclusion: Myocardial fibrosis exists in rats with long-term type 2 diabetes, which weakens the protective effect of IPC on diabetes MIRI.

[Application of the enhanced milieu teaching model in language intervention of children with language developmental delay in outpatient child healthcare clinic]

Objective: To explore the role of the enhanced milieu teaching (EMT) model in early intervention of children with language developmental delay (LDD) in outpatient child healthcare clinic. Methods: Case-control study design was adopted. Twenty-eight children aged 2.5 to 4.0 years who were diagnosed with LDD from June 2019 to June 2020 at the Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were recruited as the intervention group, and participated in one-on-one EMT model language rehabilitation sessions for 3 months (12 sessions). Another 27 children with LDD who attended the Division of Child Healthcare around the same period of time were recruited as control group, all of whom did not attend any types of language intervention in the subsequent three months. Both groups were followed up three months later. Gesell developmental scale (GDS) and diagnostic receptive and expressive assessment of Mandarin-comprehensive (DREAM-C) standardized language test were used to evaluate and compare children's development level at the first and follow-up visit, with the treatment effect of the EMT model being evaluated with independent sample t-test. Results: The language development quotient of GDS of the intervention group (22 boys and 6 girls) at the follow-up visit was significantly higher than that of at the first visit (64±21 vs. 52±17,t=4.960, P<0.01). The Dream-C test scores of total language (89±16 vs. 77±14, t=5.061, P<0.01), receptive language (90±16 vs. 77±15, t=5.301, P<0.01), semantics (93±20 vs. 79±19, t=5.06, P<0.01), and syntax after training (84±14 vs. 76±11, t=3.209, P<0.01) were significantly higher than those at the first visit. In the control group (19 boys and 8 girls), the only improvement was found in the Dream-C semantics score (82±26 vs. 71±18, t=2.330, P<0.05). There was no significant difference in any domains in GDS at the first and follow-up visit (all P>0.05). Conclusions: Early language rehabilitation training based on the EMT model has a significant effect on all domains of language development for children with LDD. Therefore, EMT model is a language intervention model compatible in the child healthcare outpatient clinic settings.

Molecular Simulations Guided Polymer Electrolyte towards Superior Low-Temperature Solid Lithium-Metal Batteries

Low-temperature operation is a challenge for solid-lithium-metal batteries (LMBs), and insufficient ionic conductivity is the main obstacle. Herein, guided by the molecular dynamics simulations (MDS), a solid polymer electrolyte (SPE) based on poly(1,3-dioxolane) (PDOL) with sufficient ionic conductivity at low temperature is reported. In situ X-ray diffraction (XRD) and differential scanning calorimetry (DSC) tests reveal that the PDOL-based SPE could well maintain amorphous nature at low temperatures, contributing to excellent ionic transport. The MDS analysis of the Li-O coordination environment indicates that more oxygen atoms bonded with Li⁺ in PDOL than in poly(ethylene oxide) (PEO) at low temperatures, thus we could envision the preponderance of PDOL as a better polymer matrix of SPE for low-temperature solid LMBs. It delivers a high capacity of 103 mAh g^-1 and 85% retention for 200 cycles for Li||LiFePO₄ at -20 °C, showing great potential for application in low-temperature solid LMBs in cold climates.

An off-pump biatrial mini-maze procedure for treatment of long-standing persistent atrial fibrillation

Background

Surgical treatment has assumed a more prominent role in the therapy of atrial fibrillation (AF) with favorable efficiency and acceptable safety during the last decades. The traditional Cox-Maze procedure and Wolf Mini-Maze procedure focused on left atrial ablation. However, it is ubiquitous that patients with long-standing persistent atrial fibrillation (LSPAF) typically suffer from biatrial electrical and structural remodeling. The left atrial procedures are still not enough in patients with LSPAF.

Purpose

Herein, we aimed to introduce a modified biatrial off-pump ablation procedure based on the Wolf Mini-Maze procedure and to detect the safety and efficacy of the surgery for patients with LSPAF.

Methods

Between January 2016 and September 2020, 102 patients of LSPAF underwent our modified Mini-Maze procedure using bipolar radiofrequency ablation. Those patients firstly underwent a Mini-Maze procedure using Dallas lesion set, including video-assisted bilateral mini-thoracotomy, left atrial appendage excision, bilateral pulmonary vein isolation, ganglionic plexi evaluation and destruction, left atrial roof connecting lesion, and a linear lesion connecting this roofline to the root of the aorta at the junction of the left coronary and the non-coronary cusp. Secondly, a purse-string suture was performed on the right atrium, and then four ablation lesions were made to the superior vena cava, to the inferior vena cava, to the appendix of the right atrium, and to the tricuspid valve annulus from the purse-string suture point by the bipolar radiofrequency clamp. After the operation, the patients were followed up at an interval of 3, 6, 12 months, and every 1 year after that.

Results

No mortality

No surgical re-exploration for bleeding. No permanent pacemaker implantation. 99 patients were free from LSPAF upon discharge. A follow-up at interval of 3, 6, 12, 24, 36, and 48 months showed a success rate free from LSPAF was 95.1% (97/102), 94.4% (85/90), 94.8% (73/77), 91.5% (54/59), 90.3% (28/31) and 100% (9/9), respectively

Conclusions

The modified biatrial Mini-Maze suggested a safe and feasible procedure. Early follow-up demonstrated an acceptable success rate free from AF. It might have the potential to become another option for clinical treatment of LSPAF.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): General Program of the National Natural Science Foundation of China Schematic of the procedure

Determination of maintenance energy requirement and responses of dry ewes to dietary inclusion of lucerne versus concentrate meal

An accurate value for metabolizable energy (ME) requirement for maintenance (ME_m) is essential to enable sheep husbandry practice to reach its potential. The objectives of the study were to use calorimetry chamber data of dry ewes (Hu × thin-tail Han F1 crossbred) to develop updated ME_m, examine effects of substituting concentrate feed with lucerne hay on energy partitioning, and explore the relationships between energy utilization and fasting heat production (FHP). Data were collected from three experiments. In Exps. 1, 2a and 2b, lucerne hay was used to replace concentrates in three levels (0:40%, 15:25% and 30:10%), with diets containing 60% maize stover (Exp. 1), fresh rye forage (Exp. 2a) or dry rye forage (Exp. 2b). Within each experiment, diets were isoenergetic (digestible energy, DE) and isonitrogenous. Exp. 3 aimed at evaluating effects of three BW levels on nutrient utilization of dry ewes offered diets containing 60% maize stover, 15% lucerne hay and 25% concentrates. Energy metabolism data were measured using the respiration calorimeter chamber technique in all three experiments, followed by the measurement of FHP in Exps. 1, 2b and 3. The ME_m derived from the linear regression between energy balance (EB) and ME intake was 0.440 MJ/kg BW^0.75. The average FHP was 0.326 MJ/kg BW^0.75. The fasting metabolism, net energy requirement for maintenance (NE_m) and ME_m were estimated to be 0.336, 0.359 and 0.511 MJ/kg BW^0.75, respectively, through adjustment of FHP using fasting urinary energy output, activity allowance and efficiency of ME use for maintenance. The FHP was negatively correlated to EB/metabolic BW, ME/gross energy (GE), ME/DE, EB/GE intake and EB/ME intake, while positively correlated to HP/GE intake, HP/ME intake and CH₄-E/GE intake. Compared to zero lucerne hay diet, the 15% lucerne hay intake decreased HP (MJ/d), and had no negative effects on EB (MJ/d) or energy utilization efficiencies. The results indicate that nutrient requirement standards currently used across the world are likely to underestimate ME_m for dry ewes, and the selection of low FHP ewes for breeding has the potential to improve sheep production efficiency.

The use of an upgraded GreenFeed system and milk fatty acids to estimate energy balance in early-lactation cows

Measurements of energy balance (EB) require the use of respiration chambers, which are quite expensive and laborious. The GreenFeed (GF) system (C-Lock Inc.) has been developed to offer a less expensive, user friendly alternative. In this study, we used the GF system to estimate the EB of cows in early lactation and compared it with EB predicted from energy requirements for dairy cows in the Finnish feeding standards. We also evaluated the association between milk fatty acids and the GF estimated EB. The cows were fed the same grass silage but supplemented with either cereal grain or fibrous by-product concentrate. Cows were followed from 1 to 18 wk of lactation, and measurements of energy metabolism variables were taken. Data were subjected to ANOVA using the mixed model procedure of SAS (SAS Institute Inc.). The repeatability estimates of the gaseous exchanges from the GF were moderate to high, presenting an opportunity to use it for indirect calorimetry in EB estimates. Energy metabolism variables were not different between cows fed different concentrates. However, cows fed the grain concentrate produced more methane (24.0 MJ/d or 62.9 kJ/MJ of gross energy) from increased digestibility than cows fed the by-product concentrate (21.3 MJ/d or 56.5 kJ/MJ of gross energy). Nitrogen metabolism was also not different between the diets. Milk long-chain fatty acids displayed an inverse time course with EB and de novo fatty acids. There was good concordance (0.85) between EB predicted using energy requirements derived from the Finnish feed table and EB estimated by the GF system. In conclusion, the GF can accurately estimate EB in early-lactating dairy cows. However, more data are needed to further validate the system for a wide range of dietary conditions.

MicroRNA-328-3p inhibits the tumorigenesis of bladder cancer through targeting ITGA5 and inactivating PI3K/AKT pathway

OBJECTIVE

Previous studies have shown that microRNA-328-3p (miR-328-3p) is involved in tumorigenesis of many human cancers. However, the specific function of miR-328-3p remains unclear in bladder cancer (BC). Therefore, this research was designed to investigate the role of miR-328-3p in BC.

PATIENTS AND METHODS

Expressions of miR-328-3p and integrin α5 (ITGA5) were measured by quantitative Real-time polymerase chain reaction (qRT-PCR). MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and transwell assays were used to explore the function of miR-328-3p in BC. The expression of the corresponding genes was observed via Western blot and immunocytochemical assays. The dual luciferase assay was applied to verify the relationship between miR-328-3p and ITGA5. Tumor growth was measured via xenograft tumor formation assay.

RESULTS

Downregulation of miR-328-3p was identified in BC tissues, which predicted poor prognosis in BC patients. Moreover, miR-328-3p suppressed cell proliferation, migration and invasion in BC through targeting ITGA5. Furthermore, miR-328-3p inhibited epithelial-mesenchymal transition (EMT) and inactivated PI3K/AKT pathway in BC. Besides that, miR-328-3p was found to inhibit tumor growth of BC.

CONCLUSIONS

MiR-328-3p inhibited tumorigenesis of BC through targeting ITGA5 and inactivating the PI3K/AKT pathway.

Between-cow variation in the components of feed efficiency

A meta-analysis based on an individual-cow data set was conducted to investigate between-cow variations in the components and measurements of feed efficiency (FE) and to explore the associations among these components. Data were taken from 31 chamber studies, consisting of a total of 841 cow/period observations. The experimental diets were based on grass or corn silages, fresh grass, or a mixture of fresh grass and straw, with cereal grains or by-products as energy supplements, and soybean or canola meal as protein supplements. The average forage-to-concentrate ratio across all diets on a dry matter basis was 56:44. Variance component and repeatability estimates of FE measurements and components were determined using diet, period, and cow within experiment as random effects in mixed procedures of SAS (SAS Institute Inc., Cary, NC). The between-cow coefficient of variation (CV) in gross energy intake (GE; CV = 0.10) and milk energy (El) output as a proportion of GE (El/GE; CV = 0.084) were the largest among all component traits. Similarly, the highest repeatability estimates (≥0.50) were observed for these 2 components. However, the between-cow CV in digestibility (DE/GE), metabolizability [metabolizable energy (ME)/GE], methane yield (CH4E/GE), proportional urinary energy output (UE/GE), and heat production (HP/GE), as well as the efficiency of ME use for lactation (kl), were rather small. The least repeatable component of FE was UE/GE. For FE measurements, the between-cow CV in residual energy-corrected milk (RECM) was larger than for residual feed intake (RFI), suggesting a greater possibility for genetic gain in RECM than in RFI. A high DE/GE was associated with increased CH4E/GE (r = 0.24), HP/GE (r = 0.12), ME/GE (r = 0. 91), energy balance as a proportion of GE (EB/GE; r = 0.35), and kl (r = 0.10). However, no correlation between DE/GE and GE intake or UE/GE was observed. Increased proportional milk energy adjusted to zero energy balance (El(0)/GE) was associated with increases in DE/GE, ME/GE, EB/GE, and kl but decreases in UE/GE, CH4E/GE, and HP/GE, with no effect on GE intake. In conclusion, several mechanisms are involved in the observed differences in FE among dairy cows, and reducing CH4E yield (CH4E/GE) may inadvertently result in reduced GE digestibility. However, the selection of dairy cows with improved energy utilization efficiencies offers an effective approach to lower enteric CH4 emissions.

Analysis of clinical features and imaging signs of COVID-19 with the assistance of artificial intelligence

OBJECTIVE

To explore the CT imaging features/signs of patients with different clinical types of Coronavirus Disease 2019 (COVID-19) via the application of artificial intelligence (AI), thus improving the understanding of COVID-19.

PANTIENTS AND METHODS

Clinical data and chest CT imaging features of 58 patients confirmed with COVID-19 in the Fifth Medical Center of PLA General Hospital were retrospectively analyzed. According to the Guidelines on Novel Coronavirus-Infected Pneumonia Diagnosis and Treatment (Provisional 6th Edition), COVID-19 patients were divided into mild type (7), common type (34), severe type (7) and critical type (10 patients). The CT imaging features of the patients with different clinical types of COVID-19 types were analyzed, and the volume percentage of pneumonia lesions with respect to the lung lobes (where the lesion was located) and to the whole lung was calculated with the use of AI software. SPSS 21.0 software was used for statistical analysis.

RESULTS

Common clinical manifestations of COVID-19 patients: fever was found in 47 patients (81.0%), cough in 31 (53.4%) and weakness in 10 (17.2%). Laboratory examinations: normal or decreased white blood cell (WBC) counts were observed in 52 patients (89.7%), decreased lymphocyte counts (LCs) in 14 (24.1%) and increased C-reactive protein (CRP) levels in 18 (31.0%). CT imaging features: there were 48 patients (94.1%) with lesions distributed in both lungs and 46 patients (90.2%) had lesions most visible in the lower lungs; the primary manifestations in patients with common type COVID-19 were ground-glass opacities (GGOs) (23/34, 67.6%) or mixed type (17/34, 50.0%), with lesions mainly distributed in the periphery of the lungs (28/34, 82.4%); the primary manifestations of patients with severe/critical type COVID-19 were consolidations (13/17, 76.5%) or mixed type (14/17, 82.4%), with lesions distributed in both the peripheral and central areas of lungs (14/17,82.4%); other common signs, including pleural parallel signs, halo signs, vascular thickening signs, crazy-paving signs and air bronchogram signs, were visible in patients with different clinical types, and pleural effusion was found in 5 patients with severe/critical COVID-19. AI software was used to calculate the volume percentages of pneumonia lesions with respect to the lung lobes (where the lesion was located) and to the whole lung. There were significant differences in the volume percentages of pneumonia lesions for the superior lobe of the left lung, the inferior lobe of the left lung, the superior lobe of the right lung, the inferior lobe of the right lung and the whole lung among patients with different clinical types (p<0.05). The area under the ROC curve (AUC) of the volume percentage of pneumonia lesions for the whole lung for the diagnosis of severe/critical type COVID-19 was 0.740, with sensitivity and specificity of 91.2% and 58.8%, respectively.

CONCLUSIONS

The clinical and CT imaging features of COVID-19 patients were characteristic to a certain degree; thus, the clinical course and severity of COVID-19 could be evaluated with a combination of an analysis of clinical features and CT imaging features and assistant diagnosis by AI software.

The effects of energy metabolism variables on feed efficiency in respiration chamber studies with lactating dairy cows

The objective of the present study was to investigate factors related to variation in feed efficiency (FE) among cows. Data included 841 cow/period observations from 31 energy metabolism studies assembled across 3 research stations. The cows were categorized into low-, medium-, and high-FE groups according to residual feed intake (RFI), residual energy-corrected milk (RECM), and feed conversion efficiency (FCE). Mixed model regression was conducted to identify differences among the efficiency groups in animal and energy metabolism traits. Partial regression coefficients of both RFI and RECM agreed with published energy requirements more closely than cofficients derived from production experiments. Within RFI groups, efficient (Low-RFI) cows ate less, had a higher digestibility, produced less methane (CH₄) and heat, and had a higher efficiency of metabolizable energy (ME) utilization for milk production. High-RECM (most efficient) cows produced 6.0 kg/d more of energy-corrected milk (ECM) than their Low-RECM (least efficient) contemporaries at the same feed intake. They had a higher digestibility, produced less CH₄ and heat, and had a higher efficiency of ME utilization for milk production. The contributions of improved digestibility, reduced CH₄, and reduced urinary energy losses to increased ME intake at the same feed intake were 84, 12, and 4%, respectively. For both RFI and RECM analysis, increased metabolizability contributed to approximately 35% improved FE, with the remaining 65% attributed to the greater efficiency of utilization of ME. The analysis within RECM groups suggested that the difference in ME utilization was mainly due to the higher maintenance requirement of Low-RECM cows compared with Medium- and High-RECM cows, whereas the difference between Medium- and High-RECM cows resulted mainly from the higher efficiency of ME utilization for milk production in High-RECM cows. The main difference within FCE (ECM/DMI) categories was a greater (8.2 kg/d) ECM yield at the expense of mobilization in High-FCE cows compared with Low-FCE cows. Methane intensity (CH₄/ECM) was lower for efficient cows than for inefficient cows. The results indicated that RFI and RECM are different traits. We concluded that there is considerable variation in FE among cows that is not related to dilution of maintenance requirement or nutrient partitioning. Improving FE is a sustainable approach to reduce CH₄ production per unit of product, and at the same time improve the economics of milk production.

AB0048 THE EXPRESSION OF T LYMPHOCYTE SUBSETS IN PERIPHERAL BLOOD OF PATIENTS WITH AUTOIMMUNE UVEITIS AND THE SHORT-TERM EFFICACY AND SAFETY EVALUATIONS OF LOW-DOSE IL-2 COMBINED THERAPY

Background:

Autoimmune uveitis is a group of inflammatory diseases that affect the uveal tract such as iris, cilia and choroid. In addition to diabetic retinopathy and age-related macular degeneration, uveitis is one of the main causes of blindness in developed countries[1].The disease is autoimmune-mediated, and abnormal immune responses are induced by pathogenic antigens such as retinal soluble antigens and retinal interphotoreceptor retinoid-binding protein (IRBP), and autoimmune inflammation is caused by specific cytotoxic effects, immune complex responses and delayed hypersensitivity reactions.It has been found that the disorder of lymphocyte subsets, mainly due to the number and function defects of regulatory T cells (Tregs), may be involved in the development of uveitis.IL-2 is a key cytokine in T cell differentiation. As a new type of immunomodulator, IL-2 has achieved preliminary efficacy in the treatment of systemic lupus erythematosus, ankylosing spondylitis, Sjogren’s syndrome and other diseases[2-4], but there is no clinical evidence of IL-2 in the treatment of autoimmune uveitis.The purpose of this study was to investigate the expression of T lymphocytes in patients with autoimmune uveitis and the effect of low dose IL-2 on their immune status.

Objectives:

To investigate the expression of peripheral blood lymphocyte in patients with autoimmune uveitis and evaluate the short-term efficacy and safety of low-dose IL-2 combined with methylprednisolone.

Methods:

A total of 108 patients with autoimmune uveitis and 93 healthy subjects who visited our hospital from January 2016 to April 2019 were collected.Twenty-three patients were treated with a low dose of IL-2 (50WIU/ day for 5 consecutive days) on the basis of conventional treatment (methylprednisolone and/or DMARDs), and the changes in the patients’ condition and lymphocyte subsets were observed. The t-test of two independent samples was used when the measurement data conformed to the normal distribution and the variance was homogeneous, and Manil-Whitney rank sum test was used when the measurement data did not conform to the normal distribution.

Results:

Among 108 patients, 58 were males and 50 were females, with an average age of 41 + 14 years. Compared with the normal control group, total T cells, total B cells, Th cells, Ts cells, Th1 cells, Th17 cells, Th1/Th2, Th17/Treg in patients with autoimmune uveitis were higher than those in healthy control group (P < 0.05), while Th1 cells and Treg cells were lower than those in healthy control group (P < 0.05). After IL-2 treatment, the number of Treg cells increased from 21.90±15.29 /ul to 51.54±41.86 /ul (P < 0.05), the Th17/Treg ratio decreased back from 0.44±0.27 to 0.33±0.23 (P < 0.05), and both serum sedimentation rate and CRP decreased compared with before treatment (P < 0.05).

Conclusion:

Treg cells are involved in the pathogenesis of autoimmune uveitis. Low dose of IL-2 selectively elevates Treg cells, regulates Th17/Treg balance and improves the condition of the disease.

References:

[1]Durrani OM, Meads CA, Murray PIJO. Uveitis: A Potentially Blinding Disease[J]. 2004, 218(4): 223-236.

[2]He J, Zhang X, Wei Y, et al. Low-dose interleukin-2 treatment selectively modulates CD4(+) T cell subsets in patients with systemic lupus erythematosus[J]. 2016, 22(9): 991-993.

[3]An H, Li X, Li F, et al. The absolute counts of peripheral T lymphocyte subsets in patient with ankylosing spondylitis and the effect of low-dose interleukin-2[J]. 2019, 98(15): e15094.

[4]Miao M, Hao Z, Guo Y, et al. Short-term and low-dose IL-2 therapy restores the Th17/Treg balance in the peripheral blood of patients with primary Sjögren’s syndrome[J]. 2018: annrheumdis-2018-213036.

Disclosure of Interests:

None declared

Circular RNA_LARP4 inhibits cell migration and invasion of prostate cancer by targeting FOXO3A

OBJECTIVE

The importance of circular RNAs in malignant tumors causes more attention in researchers. Circular RNA_LARP4 is identified as a tumor suppressor in gastric cancer, but the role of circular RNA_LARP4 in prostate cancer (PCa) remains unclear. Our work aims to uncover whether and how circular RNA_LARP4 functions in the PCa development.

PATIENTS AND METHODS

Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) was utilized to determine the level of circular RNA_LARP4 in PCa tissues and cell lines. The patients' prognosis was analyzed. Circular RNA_LARP4 lentivirus was constructed for transfection of PCa cells. Cell migrated and invaded ability was detected through wound healing assay and transwell assay. Western blot assay was performed to analyze the protein level of FOXO3A.

RESULTS

The low circular RNA_LARP4 expression was associated with poor prognosis of PCa patients. The circular RNA_LARP4 was lowly expressed in PCa tissues compared with adjacent samples. The expression of circular RNA_LARP4 was downregulated in PCa cell lines. The cell migrated and invaded ability of PCa cells was inhibited after circular RNA_LARP4 was overexpressed. Furthermore, FOXO3A expression was increased via the overexpression of circular RNA_LARP4.

CONCLUSIONS

Circular RNA_LARP4 could suppress cell migration and invasion of PCa by upregulating FOXO3A.

Effects of Bacillus subtilis and antibiotic growth promoters on the growth performance, intestinal function and gut microbiota of pullets from 0 to 6 weeks

The development of digestive organs and the establishment of gut microbiota in pullets play an important role throughout life. This study was conducted to investigate the effects of Bacillus subtilis (BS) on growth performance, intestinal function and gut microbiota in pullets from 0 to 6 weeks of age. Hy-line Brown laying hens (1-day-old, n = 504) were randomly allotted into four diets with a 2 × 2 factorial design: (1) basal diet group (control); (2) antibiotics group (AGP), the basal diet supplemented with 20 mg/kg Bacitracin Zinc and 4 mg/kg Colistin Sulphate; (3) BS group, the basal diet supplemented with 500 mg/kg BS and (4) mixed group, the basal diet supplemented with both AGP and BS. As a result, when BS was considered the main effect, BS addition (1) reduced the feed conversion ratio at 4 to 6 weeks (P < 0.05); (2) decreased duodenal and jejunal crypt depth at 3 weeks; (3) increased the villus height : crypt depth (V : C) ratio in the duodenum at 3 weeks and jejunal villus height at 6 weeks and (4) increased sucrase mRNA expression in the duodenum at 3 weeks as well as the jejunum at 6 weeks, and jejunal maltase and aminopeptidase expression at 3 weeks. When AGP was considered the main effect, AGP supplementation (1) increased the V : C ratio in the ileum at 3 weeks of age; (2) increased sucrase mRNA expression in the duodenum at 3 weeks as well as the ileum at 6 weeks, and increased maltase expression in the ileum. The BS × AGP interaction was observed to affect average daily feed intake at 4 to 6 weeks, and duodenal sucrase and jejunal maltase expression at 3 weeks. Furthermore, dietary BS or AGP addition improved caecal microbial diversity at 3 weeks, and a BS × AGP interaction was observed (P < 0.05) for the Shannon and Simpson indexes. At the genus level, the relative abundance of Lactobacillus was found to be higher in the mixed group at 3 weeks and in the BS group at 6 weeks. Moreover, Anaerostipes, Dehalobacterium and Oscillospira were also found to be dominant genera in pullets with dietary BS addition. In conclusion, BS could improve intestinal morphology and change digestive enzyme relative expression and caecum microbiota, thereby increasing the efficiency of nutrient utilization. Our findings suggested that BS might have more beneficial effects than AGP in the study, which would provide theoretical evidence and new insight into BS application in layer pullets.

Prediction of Metabolizable Energy Concentrations of Herbage in the Qinghai-Tibetan Plateau Using Tibetan Sheep Digestibility Data

Simple Summary

Robust prediction of herbage nutritive value is critical to improve grazing efficiency and to maintain a sustainable environment in the Qinghai–Tibet Plateau. A range of prediction equations were developed in the present study using sheep digestibility data which can produce an accurate estimation of herbage nutritive value. The adaptation of the present equations is expected to benefit local farmers with higher economical return and to improve the fragile ecological systems the Qinghai–Tibet Plateau.

Abstract

Due to its extremely harsh environment, including high altitude, hypoxia, long cold season, and strong ultraviolet radiation in the Qinghai–Tibet Plateau (QTP), herbage species and nutritional value of the pasture may differ considerably from elsewhere across the world. The aim of the present study was to develop biologically relevant equations for estimating the metabolizable energy (ME) value of fresh native herbages in the QTP using digestibility variables and chemical concentrations in the herbage offered to Tibetan sheep at the maintenance level. A total of 11 digestibility trials (6 sheep/trial) were performed in different grazing seasons from 2011 to 2016. The herbage was harvested daily in the morning and offered to sheep at the maintenance feeding level. Thirty-seven equations were developed for the prediction of herbage digestible energy (DE) and ME energy values. The mean prediction error for ME was the lowest when using herbage gross energy digestibility as a sole predictor. When using other digestibility variables (e.g., dry matter and organic matter) as primary predictors, addition of herbage nutrient concentration reduced the difference between predicted and actual values. When DE was used as the primary explanatory variable, mean prediction error was reduced with the addition of ash, nitrogen (N), diethyl ether extract (EE), neutral detergent fiber (NDF), and acid detergent fiber (ADF) concentrations. The internal validation of the present equations showed lower prediction errors when compared with those of existing equations for prediction of DE and ME concentrations in the herbage. Equations developed in the current study may thus allow for an improved and accurate prediction of metabolizable energy concentrations of herbage in practice, which is critical for the development of sustainable grazing systems in the QTP.

[Effect of mobile platform in improving compliance and efficacy of subcutaneous immunotherapy in children with allergic rhinitis]

Objective:To explore effect of mobile platform in improving compliance and efficacy of subcutaneous immunotherapy（SCIT） in children with allergic rhinitis（AR）. Method:From January to June 2018, 86 children diagnosed with AR and receiving SCIT were selected as research objects. According to the random sequence generated by the computer, the research objects were randomly assigned to the experimental group and the control group, with 43 cases in each group. The control group received conventional SCIT management, while the experimental group received mobile platform SCIT management relying on smart phones and computers. The SCIT shedding rate at the initial stage and the time taken to reach the maintenance period were compared between the two groups, as well as the visual simulation scale of rhinitis symptoms, four-point score and rhinoconjunctivia-related quality of life scores before and at the 6th month after the intervention. Result:There was no statistically significant difference in the initial SCIT shedding rate between the two groups（P>0.05）, and the average duration of the maintenance period of the experimental group was shorter than that of the control group, with statistically significant difference（P<0.05）. At the 6th month after intervention, there was no statistically significant difference in the scores of rhinitis symptoms by the four-point method between the two groups（P>0.05）, and there were statistically significant differences in the visual simulation scale of rhinitis symptoms and the scores of children's rhinoconjunctivia-related quality of life（P<0.05）. Conclusion:This study confirmed that the application of a mobile platform is of great significance for improving compliance and the treatment effects of SCIT in children with AR.

Field bean inclusion in the diet of early-lactation dairy cows: Effects on performance and nutrient utilization

The European livestock sector has a significant deficit of high-quality protein feed ingredients. Consequently there is interest in using locally grown protein grain crops to partially or completely replace imported protein feeds in dairy cow rations. Field bean (FB; Vicia faba) has been identified as a locally grown crop with significant potential. The current study was designed to examine the effects of FB on cow performance and nutrient utilization in the diet of early-lactation dairy cows, including high levels of FB (up to 8.4 kg/cow per day). The experiment used 72 dairy cows in a 3-treatment continuous design (from calving until wk 20 of lactation). All cows were given ad libitum access to a mixed ration comprising grass silage and concentrates [45:55 on a dry matter (DM) basis]. Concentrates offered contained either 0, 349, or 698 g of FB/kg of concentrate (treatments FB0, FB-Low, and FB-High, respectively), with FB completely replacing soybean meal, rapeseed meal, maize gluten, and wheat in the concentrate for the FB-High treatment. Following completion of the 20-wk experiment, ration digestibility, nutrient utilization, and methane (CH4) production were measured using 4 cows from each treatment. Neither silage DM intake, total DM intake, nor milk yield were affected by treatment. Cows on FB0 had a higher milk fat content than those on FB-High, and cows on FB0 and FB-Low had higher milk protein contents than did those on FB-High. Field bean inclusion increased the degree of saturation of milk fat produced. Milk fat yield, milk protein yield, and milk fat plus protein yield were higher with FB0 than with either FB-Low or FB-High. Treatment had no effect on the digestibility of DM, organic matter, nitrogen (N), gross energy, or neutral detergent fiber, whereas digestibility of acid detergent fiber was higher with FB0 than with FB-High. Neither the efficiency of gross energy or N utilization, nor any of the CH4 production parameters examined, were affected by treatment. Similarly, none of the fertility or health parameters examined were affected by treatment. The reduction in milk fat observed may have been due to the higher starch content of the FB-High diet, and the reduction in milk protein may have been due to a deficit of methionine in the diet. It is likely that these issues could be overcome by changes in ration formulation, thus allowing FB to be included at the higher range without loss in performance.

[Relationship between liver controlled attenuation parameters and body fat mass and its distribution]

Objective: To explore the relationship between liver controlled attenuation parameters (CAP) and body fat mass and its distribution. Methods: From May to December 2018, 978 adult patients visited at the fatty liver center of the Third People's Hospital of Changzhou were treated. The patient's liver controlled attenuation parameters were measured by transient elastography and the body fat mass and its distribution were measured by bioelectrical impedance technology. Pearson's correlation coefficient was adopted to describe the correlation between liver CAP value and body mass index (BMI), body fat mass index (BFMI), trunk fat mass index (TFMI), limbs fat mass index (LFMI) and visceral fat area (VFA). Receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate BMI, BFMI, TFMI, LFMI and VFA to differentiate the cut-off points and efficacy of CAP for diagnosing grading of fatty liver changes in S0-1 and S2-3. Results: In 653 cases of male, S0 ~ S3 accounted for 4.90%, 3.37%, 22.36% and 69.37%, respectively, and in 325 cases of females, S0 ~ S3 accounted for 7.38%, 6.46%, 13.23% and 72.92%, respectively. Female patients had more visceral, trunk and limbs fat than male (P < 0.01). Body mass, body fat mass, body fat percentage, BMI, BFMI, TFMI, LFMI, and VFA were increased in male and female patients with increasing liver fat grade (P < 0.01). CAP values ​​of male and female patients were positively correlated with BMI, BFMI, TFMI, LFMI and VFA. Percentage of body fat mass increased with increasing liver fat grade (male: F = 13.42, P < 0.001; female: F = 3.22, P = 0.023); while limb fat mass percentage did not increase with liver fat grade (Male: F = 1.13, P = 0.34; female: F = 1.05, P = 0.37). Hepatic steatosis grading (S0 ~ 1 or S2 ~ 3) diagnosed with CAP were distinguished through BMI, BFMI, TFMI, LFMI and VFA. AUC was 0.80 ~ 0.82 in males (P < 0.01), and 0.75 ~ 0.78 in females (P < 0.01). Conclusion: The liver CAP value is positively correlated with the body's limbs, trunk and visceral fat, and has a strong correlation with trunk and visceral fat. BMI, BFMI, TFMI, LFMI and VFA up to some extent can identify the CAP diagnosis of grading of fatty liver changes in S0-1 and S2-3.

Effects of different diets on the intestinal microbiota and immunity of common carp (Cyprinus carpio)

AIMS

An 8-week trial was performed to evaluate the differences in the intestinal microbiota and immune function of common carp (Cyprinus carpio)-fed different diets.

METHODS AND RESULTS

The fish (initial weight 492·6 ± 30 g, n = 270) were randomly divided into three groups with three replicates and were fed earthworms (group A), earthworms + duckweed (group M) or duckweed (group P) respectively. The diversity and dominant microbiota of the intestinal bacteria were detected by denaturing gradient gel electrophoresis, and the abundance of dominant bacteria was quantified by qPCR. Additionally, the activities of some nonspecific immune enzymes and antioxidant enzymes were determined. The results showed that higher diversity and abundance of intestinal microbiota were observed in group M and group P (P < 0·05). Based on the intestinal microbiota, Cetobacterium was only detected in the intestines of common carp in group A, and Bacillus was identified in groups M and P. Additionally, a higher abundance of Bacteroidetes and Firmicutes was also found in the intestine in group P than in group A (P < 0·05). Interestingly, the higher activities of immune enzymes were detected in intestine of common carp in group M, such as acid phosphatase, phosphatase (AKP), lysozyme, total antioxidant capacity, superoxide dismutase, catalase, glutathione peroxidase. In addition, the lower level of metabolites were also detected, such as nitric oxide and malondialdehyde.

CONCLUSIONS

Our results indicate that the intestinal microbiota and intestinal immunity of common carp were affected by diet. Meanwhile, the results show that a mixed diet can promote and improve the immune function of the omnivorous carp intestine, which suggests that paddy fields might be more suitable for the intestinal health and animal welfare of omnivorous fishes because they contain plant and animal diets.

SIGNIFICANCE AND IMPACT OF THE STUDY

As an ecological aquaculture strategy, the rice-fish mode has attracted attention among farmers, researchers and even consumers, especially for the cultivation of common carp in paddy fields. In paddy fields, fish can eat plant- and animal-based diets. However, it is not clear whether common carp feeding on a mixed diet in paddy fields have better intestinal health. This experiment is one of only a few studies performed from the perspective of intestinal micro-organisms and immunity to successfully study the effects of different natural diets on adult common carp. This study also provides a theoretical basis for healthy breeding of common carp in paddy fields.

Response of AMP-activated protein kinase and lactate metabolism of largemouth bass (Micropterus salmoides) under acute hypoxic stress

To study adaptation of largemouth bass (Micropterus salmoides) to hypoxic stress, we investigated physiological responses and lactate metabolism of the fish under acute hypoxia. The objectives of this study were to (a) observe changes in glucose, glycogen, and lactate content; (b) detect the activity of lactate dehydrogenase (LDH) in serum, brain, heart, and liver tissues; and (c) quantify the dynamic gene expression of AMP activated protein kinase alpha (AMPKα), hypoxia-inducible factor-1 alpha (HIF-1α), monocarboxylate transporter 1 (MCT1), monocarboxylate transporter 4 (MCT4), and lactate dehydrogenase-a (LDHa) following exposure to hypoxia. The fish were subjected to two hypoxia stresses (dissolved oxygen [DO] 1.20 ± 0.2 mg/L and 3.50 ± 0.3 mg/L, respectively) for 24 h. Our results showed that hypoxic stress significantly increased the decomposition of liver glycogen and significantly increased the concentration of blood glucose; however, the muscle glycogen content was not significantly decreased, which indicates that liver glycogen was the main energy source under acute hypoxia. Moreover, hypoxia led to accumulation of a large amount of lactic acid in tissues, possibly due to the activity of lactic acid dehydrogenase, but this process was delayed in the heart and brain relative to the liver. Additionally, hypoxia induced the expression of AMPKα, HIF-1α, MCT1, MCT4, and LDHa, suggesting that glycometabolism had switched from aerobic to anaerobic. Our results contribute to a better understanding of the molecular mechanisms of the response to hypoxia in largemouth bass.

Computational correction of spatially variant optical aberrations in 3D single-molecule localization microscopy

3D single-molecule localization microscopy relies on fitting the shape of point-spread-functions (PSFs) recorded on a wide-field detector. However, optical aberrations distort those shapes, which compromises the accuracy and precision of single-molecule localization microscopy. Here, we employ a computational phase retrieval based on a vectorial PSF model to quantify the spatial variance of optical aberrations in a two-channel ultrawide-field single-molecule localization microscope. The use of a spatially variant PSF model enables accurate and precise emitter localization in x-, y- and z-directions throughout the entire field of view.

The effect of silage type on animal performance, energy utilisation and enteric methane emission in lactating dairy cows

The present study aimed to investigate the effect of silage type on dry matter (DM) intake, nutrient digestibility, energy utilisation and methane (CH4) emission. Six late lactating Holstein dairy cows were used in a replicated 3 × 3 Latin square design study with three treatments (grass silage (GS), maize silage (MS) and whole-crop wheat silage (WCWS)) and three periods (3 weeks/period). All animals were offered forage ad libitum and 5.55 kg/day of a concentrate supplement, which contained (DM basis) 66.0% rapeseed meal, 28.3% soyabean meal and 5.7% a mineral/vitamin supplement. During each period, animals were subject to digestibility, CH4 and heat production measurements during the final 6 days using calorimeter chambers. The results demonstrated that total DM intake for MS and WCWS diets were higher (P &lt; 0.001) than for the GS diet. Faecal energy and heat production loss for the GS diet were lower (P &lt; 0.01) than for MS and WCWS diets. In contrast, cows fed the GS diet had higher (P &lt; 0.05) urine energy loss compared with MS and WCWS diets. In comparison with the GS and MS diets, WCWS diet produced a lower CH4 loss per kg DM and organic matter intake (P &lt; 0.01), and CH4 energy output as a proportion of gross energy and metabolisable energy intake (P &lt; 0.05). The present study demonstrates that choice of forage types affects energy utilisation and CH4 emission in dairy cows.

[Effect of different anesthetic techniques on the prognosis of hepatocellular carcinoma after hepatectomy]

Objective: To investigate the influence of different anesthetic techniques on the prognosis of hepatocellular carcinoma (HCC)after hepatectomy. Methods: A total of 185 consecutive patients with HCC confirmed underwent surgery in Cancer Hospital, Chinese Academy of Medical Sciences were recruited from January 2006 to January 2008. The patients were assessed as American Society of Anesthesiologists (ASA)Ⅰ-Ⅲ, with body mass index (BMI) (22.8±4.6)kg/m(2). There were 169 males, with an average age of 56 years old and 16 females, with an average age of 53 years old. According to the different anesthesia methods, 185 patients were divided into two groups: total intravenous anesthesia group (TIVA) (n=53) and intravenous-inhalation combined anesthesia group (n=132). Postoperative pain and adverse reactions were compared in recent follow-up, prognosis were compared in long-term follow-up. Results: Recent follow-up showed that the NRS scores 2 hours after operation in TIVA group was 2.0 (0-2.0), whereas those in intravenous-inhalation combined anesthesia group was 3.0 (1.0-3.0). The pain in TIVA groups was significantly lower than that in intravenous-inhalation combined anesthesia group (Z=-3.261, P=0.001). But for 24 hours after operation, the NRS scores in these two groups were 3.0 (2.0-5.0) and 3.0 (3.0-4.0), respectively. There was no significant difference in the two groups (Z=-0.035, P=0.972). In addition, there was no significant difference between the two groups in the incidence of sedation, nausea/vomiting, restlessness and other adverse reactions (all P>0.05). Long-term follow-up indicated that anesthetic techniques have no correlation with HCC prognosis in Kaplan-Meier analysis and Cox's regression analysis. Conclusion: There is no significant effect of two anesthesia methods on the long-term prognosis of HCC.

[Diagnostic value of serum chitinase-3-like protein 1 in chronic liver disease of significant fibrosis and cirrhosis]

Objective: To study the correlation between the level of serum Chitinase-3-like protein 1 (CHI3L1) and the significant liver fibrosis and liver cirrhosis in patients with chronic liver disease, and to evaluate its diagnostic value. Methods: 165 patients with chronic liver disease were selected, liver histopathological examination was performed to detect serum CHI3L1 concentration. Four indexes of hepatic fibrosis (type III procollagen, collagen IV, laminin, hyaluronic acid), aspartate aminotransferase/platelet ratio index (APRI) and FIB-4 (fibrosis- 4) scores were based on the pathological findings of liver biopsy and compared the advantages and disadvantages of serum CHI3L1 with other methods for the diagnosis of hepatic fibrosis and liver cirrhosis. A multivariate regression analysis model was created, and receiver operating characteristic curve was analyzed. Results: The level of serum CHI3L1 increased with increase of fibrosis stage and was highest in liver cirrhosis stage. In the period of S0 to 1, the levels of S2 to 3 and S4 were 62.82 (41.40 ~ 87.20), 70.94 (48.47 to 122.60) and 141.06 (78.18 ~ 197.40), and there were statistically significant differences between the groups (P < 0.001). The area under the curve for the diagnosis of significant liver fibrosis was 0.68 (0.60 to 0.77), and 0.74 (0.65 to 0.83) for cirrhosis in CHI3L1. Multivariate regression analysis showed that CHI3L1 was an independent predictor of significant fibrosis and cirrhosis. The combined diagnostic model based on CHI3L1, collagen IV and FIB-4 scores further improved the diagnostic value. The area under the curve for the diagnosis of significant fibrosis and cirrhosis was 0.79 (0.72 to 0.86) and 0.80 (0.73 to 0.87), respectively. Conclusion: CHI3L1 has a good diagnostic value in patients with chronic liver disease with significant fibrosis and liver cirrhosis. The diagnostic model in combination with other markers like Collagen IV and FIB-4 scores could further improve the diagnostic value and is worthy of further study.

Municipal Wastewater as a Microbial Surveillance Platform for Enteric Diseases: A Case Study for Salmonella and Salmonellosis

Municipal wastewater (MW) contains a conglomeration of human enteric microbiota from a community and, hence, represents a potential surveillance tool for gastrointestinal infectious disease burden at the community level. To evaluate this, the concentration of Salmonella in MW samples from Honolulu, Hawaii, was monitored over a 54-week period, which showed positive and significant linear and rank correlation with clinical salmonellosis case numbers over the same period. Salmonella isolates were obtained from the MW samples and then compared with clinical isolates obtained by the Hawaii Department of Health State Laboratories over the same period. The MW isolate collection contained 34 serotypes, and the clinical isolate collection contained 47 serotypes, 21 of which were shared between the two isolate collections, including nine of the 12 most commonly detected clinical serotypes. Most notably, nine Salmonella strains, including one outbreak-associated Paratyphi B strain and eight other clinically rare strains, were shared and concurrently detected between the MW and the clinical isolate collections, indicating the feasibility of using enteric pathogens in the MW as a timely indication of community enteric disease activity.

Thermionic cooling devices based on resonant-tunneling AlGaAs/GaAs heterostructure

We study by means of full quantum simulations the operating principle and performance of a semiconductor heterostructure refrigerator combining resonant tunneling filtering and thermionic emission. Our model takes into account the coupling between the electric and thermal currents by self-consistently solving the transport equations within the non-equilibrium Green's function framework and the heat equation. We show that the device can achieve relatively high cooling power values, while in the considered implementation, the maximum lattice temperature drop is severely limited by the thermal conductivity of the constituting materials. In such an out-of-equilibrium structure, we then emphasize the significant deviation of the phonon temperature from its electronic counterpart which can vary over several hundred Kelvin. The interplay between those two temperatures and the impact on the electrochemical potential is also discussed. Finally, viable options toward an optimization of the device are proposed.

Effects of forage types on digestibility, methane emissions, and nitrogen utilization efficiency in two genotypes of hill ewes

Thirty-six nonpregnant hill ewes (18 pure Scottish Blackface and 18 Swaledale × Scottish Blackface) aged 18 mo and weighing 48 ± 4.8 kg were allocated to 3 forage treatments balanced for genotype and BW. Each genotype was offered 3 forages (pelleted ryegrass, fresh lowland grass, and fresh hill grass) ad libitum with 6 ewes for each of the 6 genotype × diet combination treatments. Pelleted ryegrass was sourced from a commercial supplier (Drygrass South Western Ltd, Burrington, UK). Fresh lowland grass was harvested daily in the morning from a third regrowth perennial ryegrass () sward. Fresh hill grass was harvested from a seminatural hill grassland every 2 d and stored in plastic bags at 4 to 5°C until offered. The animals were individually housed in pens and offered experimental diets for 14 d before being transferred to 6 individual respiration chambers for a further 4 d, during which feed intake, fecal and urine outputs, and CH emissions were measured. There was no interaction between genotype and forage types on any variable measured. In a comparison of effects of the 3 forages, pelleted ryegrass had the greatest ( < 0.001) values in DMI, GE intake, CH emissions, N intake (NI), and fecal N (FN), urine N (UN), and manure N (MN) outputs, whereas hill grass had the lowest ( < 0.001) values in DMI, energy (GE, DE, and ME) intake, CH emissions, NI, UN, and MN. However, pelleted ryegrass had the lowest ratio in CH emissions per unit DMI ( = 0.022) or GE intake ( = 0.026) or UN excretion as a proportion of NI or MN ( < 0.001). Lowland grass had a greater ( < 0.001) digestibility of DM, OM, CP, NDF, ADF, and GE and a greater ( < 0.001) ME:GE ratio or retained N:NI ratio than pelleted ryegrass and hill grass. Genotypes of sheep had no effect on any variable in feed intake, digestibility, CH emissions, or N utilization. The CH conversion factors (CH energy/GE) for pelleted ryegrass, lowland grass, and hill grass were 4.4, 5.7, and 5.6%, respectively. All data were then pooled to develop regression equations between CH and DMI or between N excretions (FN, UN, and MN) and NI. Methane emissions and N excretions were positively related to DMI and NI ( < 0.001), respectively. However, increasing DMI could reduce CH emissions per kilogram DMI. These equations add new information in predicting enteric CH emissions and N utilization efficiency and can be used to quantify the environmental footprint of hill sheep production systems.