Abdominal Blood Research Articles

Does Far-Infrared Therapy Improve Peritoneal Function and Reduce Recurrent Peritonitis in Peritoneal Dialysis Patients?

The use of peritoneal dialysis in end-stage renal disease is increasing in clinical practice. The main purpose of this study was to evaluate the effect of far-infrared radiation therapy on inflammation and the cellular immunity of patients undergoing peritoneal dialysis. We recruited 56 patients undergoing peritoneal dialysis, and we included 32 patients for the experimental group and 24 patients from the control group in the final analysis. The experimental evaluation in our study was as follows: (1) We used abdominal computed tomography to explore the changes in abdominal blood vessels. (2) We compared the effects of peritoneal dialysis using blood glucose, HbAlC, albumin, urea nitrogen, creatinine, white blood cells, hs-CRP; peritoneal Kt/V of peritoneal function, and eGFR. (3) We compared the cytokines’ concentrations in the two groups while controlling for the other cytokines. Results and Discussion: (1) There was no significant difference in the abdominal blood vessels of the experimental group relative to the control group according to abdominal CT over the 6 months. (2) Our study demonstrates statistically significant effects of FIR therapy on the following parameters: creatinine (p = 0.039 *) and hs-CRP (p < 0.001 **) levels decreased significantly, and eGFR (p = 0.043 *), glucose (p < 0.001 **), and albumin (p = 0.048 *) levels increased significantly. Our study found that in the experimental group, creatinine and hs-CRP levels decreased significantly due to FIR therapy for 6 months. However, our study also found that the glucose level was significantly different after FIR therapy for 6 months. Peritoneal dialysis combined with FIR can reduce the side effects of the glucose in the dialysis buffer, which interferes with peritoneal inflammation and peritoneal mesothelial cell fibrosis. (3) In addition, we also found that no statistically significant difference in any inflammatory cytokine after FIR therapy. IFN-γ (p = 0.124), IL-12p70 (p = 0.093), IL-18 (p = 0.213), and TNF-α (p = 0.254) did not exhibit significant improvements after peritoneal dialysis with FIR treatment over 6 months. Conclusions: We found that the effectiveness of peritoneal dialysis was improved significantly with FIR therapy, and significant improvements in the peritoneal permeability and inflammatory response were observed.

A Bayesian Network Meta-Analysis of Complications Related to Breast Reconstruction Using Different Skin Flaps After Breast Cancer Surgery.

As the incidence of breast cancer rises, the number of mastectomy surgeries surges, so does the importance of postoperative breast reconstruction. The implementation of autologous flap restoration methods is becoming prevalent, although which is the best flap remains controversial. As a result, we performed a Bayesian network meta-analysis to compare the eight most common flap in the reconstruction processor of breast cancer surgery. Our findings may help surgeons decide which skin flaps to use for breast reconstruction. We searched PubMed, Medline, Embase, and the Cochrane library for relevant literature. For our Bayesian network meta-analysis, we scrutinized 37 papers and evaluated the postoperative complications of eight commonly used breast reconstruction procedures. We also registered this study on PROSPERO, with the number CRD42021251989. A total of 21,184 patients were included in this Bayesian network meta-analysis from 37 different studies. The results demonstrate that TRAM flaps are more prone to complications such as hernias in the abdominal wall and blood flow problems. Hematoma and seroma are more likely to follow LDP flaps. Combining LDP flaps with a prosthetic or autologous adipose tissue does not enhance the risk of postoperative problems appreciably. Fat liquefaction are relatively common in DIEP. After breast reconstruction, several skin flaps can be employed as clinical choices. TRAM flaps are not recommended for patients with a weak abdominal wall structure, although LDP flaps or SIEA flaps can be considered instead. We do not advocate LDP flaps for patients who have had breast surgery because of the higher risk of hematoma or seroma, but DIEP flaps or LAP flaps can be utilized instead. We do not propose DIEP flaps for individuals who are at a higher risk of postoperative fat liquefaction, but LDP flaps or SIEA flaps can be used instead. However, this Bayesian network meta-analysis has limitations, and further randomized controlled trials are needed to confirm its findings. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract P020: High Sensitivity C-reactive Protein Is Associated With Incidence Of Metabolic Syndrome Among Hispanic/Latino Participants Of The Hispanic Community Health Study/Study Of Latinos

Introduction: High Sensitivity C-reactive protein (HsCRP) is a non-specific marker of systemic inflammation. Elevated levels of HsCRP have been shown to be predictive of cardiovascular disease and cardiovascular related events. The relationship between HsCRP and longitudinal onset of metabolic syndrome (MetS) has not been fully elucidated, especially among U.S. Hispanics/Latinos, which is a growing diverse group in the U.S. Objectives: To determine whether HsCRP is associated with incident MetS among U.S. Hispanics/Latinos. Methods: The Hispanic Community Health Study/Study of Latinos is a longitudinal observational cohort assessing cardiovascular health among diverse U.S. Hispanics/Latinos. HsCRP was measured at visit 1 (2008-2011) using a Roche Modular Chemistry Analyzer. HsCRP was classified as low, moderate, or high, based on ACC/AHA guidelines. All MetS components (abdominal obesity, triglycerides, HDL cholesterol, blood pressure, and fasting glucose) were measured at visit 1 and visit 2 (2014-2017). MetS was defined as the presence of three or more components based on the definition from the Third Report of the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III). Participants free of MetS at visit 1 and with complete data on HsCRP and all MetS components were included (n=6,699 participants). We used Poisson regression analysis to determine whether HsCRP was associated with incident MetS after adjusting for age, follow-up time, sex, Hispanic/Latino background, income, education, marital status, employment, health insurance status, nativity, alcohol use, smoking, anxiety, CESD-10, physical activity, and diet. All analyses included sample weights and accounted for the complex survey design of the study. Results: Mean age was 38.2 years, 29.0% had less than a high school education, 59.7% had an income less than $30,000, and 48.4% were female. Average follow-up time was 6.1 years. In fully adjusted models, moderate vs. low HsCRP was associated with a 39% increased risk of MetS (IDR: 1.39, 95% CI: 1.13, 1.71), while high vs. low HsCRP was associated with a 109% increased risk of MetS (IDR: 2.09, 95% CI: 1.70, 2.57). Conclusions: Greater levels of HsCRP were associated with new onset of MetS in a diverse sample of U.S. Hispanics/Latinos. Results suggest that HsCRP may be an independent risk factor for, rather than a marker of MetS.

Acute Presentation of an unblocked Phaeochromocytoma with Small Bowel Ischaemia managed by Emergency Laparotomy and Adrenalectomy

Abstract Introduction A 50-year-old male presented as an emergency with acute abdominal pain, reduced consciousness and blood pressure of 230/136mmHg, having felt unwell for a year. CT scans showed a 9cm right adrenal mass, a 27mm left ventricular thrombus and emboli to the distal superior mesenteric artery. Echocardiography demonstrated a reduced ejection fraction of 25%. Methods Our regional multidisciplinary team (Endocrinologists, Anaesthetists, Intensivists, Biochemists and Surgeons) utilised their experience to manage this challenging emergency, with supra-regional expert consultation. Results In ICU, intravenous phentolamine and unfractionated heparin infusions were given, attempting to avoid surgery until alpha blockade was established. The following day sepsis and peritonitis developed: surgery could no longer be deferred and had to be undertaken without blockade. After anaesthetic induction a 12 minute asystolic arrest ensued, but circulation was restored with CPR and bolus noradrenaline. Intraoperative photographs demonstrate 150cm of infarcted small bowel being resected, and sequential adrenalectomy being undertaken to avoid further catecholamine crisis and anaesthetic, as discussed with supra-regional colleagues. Post-arrest targeted temperature management was instigated alongside empirical steroid replacement. Serum metadrenaline fell from 58,495pmol/L (&amp;lt;510pmol/L) to 174pmol/L and normetadrenaline from 78,731pmol/L (&amp;lt;1180pmol/L) to 330pmol/L post-resection. Histological assessment confirmed phaeochromocytoma with malignant features (PASS=6 and GAPP=5). The patient made a full recovery and ejection fraction improved to 55%. Conclusion This case adds to the controversial equipoise regarding pre-operative blockade. An experienced multidisciplinary adrenal team was crucial in managing this life threatening combination. Noradrenaline was effective during cardiac arrest whilst the circulation was unresponsive to adrenaline.

СРАВНИТЕЛЬНАЯ ОЦЕНКА КОНТРОЛИРУЕМОГО КЛИНИЧЕСКОГО ИСПЫТАНИЯ АППАРАТНОЙ ИНТРАОПЕРАЦИОННОЙ РЕИНФУЗИИ КРОВИ, СОБРАННОЙ ИЗ ПЛЕВРАЛЬНОЙ ПОЛОСТИ В УСЛОВИЯХ МЕДЛЕННОГО И БЫСТРОГО РЕЖИМОВ

Objective. An analysis of the study, in the mode of fast and slow blood exfusion, controlled clinical trials showed that the number of platelets was significantly reduced. Material and methods. We have conducted a series of researches in 44 patients with cavitary blood loss, which is 34.3% of the total number of the examined patients (n-128), for whom an IOBR apparatus technology was used. The studies were also conducted during the surgery in the first 2 hours. Results. Controlled clinical trials (CCT) have shown that blood exfusion after intraoperative blood reinfusion, the degree of destruction of erythrocytes and leukocytes with slow blood exfusion is 35%, and with fast - 48%. Osmotic resistance is reduced by 3 times. With rapid hardware exfusion, blood hemolysis is more than 28%, which should be taken into account when performing hardware intraoperative blood reinfusion. Controlled clinical trials have shown that the faster the machine exfusion is performed, the greater the decrease in protein and bilirubin content. In the blood collected in the mode of rapid apparatus exfusion, a higher concentration of K +, residual N and urea is noted. Controlled clinical trials have shown that platelet counts are significantly reduced, especially when using a rapid blood collection regimen. Against this background, the process of aggregation is reliably slowed down, and with a fast mode of blood collection - 2 times in comparison with the control. Plasma recalcification time is reliably reduced by 40% when using a high-speed blood collection mode in comparison with the control values, which is almost 3 times higher than when using slow blood aspiration. Conclusion. The article provides an analysis of scientific research, CCT, experimental control, clinical control and practical work. The work is interdisciplinary in nature, written at the intersection of surgery and anesthesiology, to increase the effectiveness of emergency surgery and anesthesiologyresuscitation in critical abdominal and luminal blood loss based on the optimization of intraoperative infusion-transfusion therapy

Establishment and evaluation of a specific antibiotic-induced inflammatory bowel disease model in rats.

Physical and chemical methods for generating rat models of enteritis have been established; however, antibiotic induction has rarely been used for this purpose. The present study aimed to establish and evaluate a rat model of inflammatory bowel disease (IBD) using antibiotics. A total of 84 Sprague-Dawley (SD) rats were divided into the following groups, according to the dosage and method of administration of the antibiotics: A, control; B, low-dose clindamycin; C, medium-dose clindamycin; D, high-dose clindamycin; E, low-dose clindamycin, ampicillin and streptomycin; F, medium-dose clindamycin, ampicillin and streptomycin; and G, high-dose clindamycin, ampicillin and streptomycin. Antibiotic administration was stopped on day 7; the modeling period covered days 1–7, and the recovery period covered days 8–15. Half of the animals were dissected on day 11, with the remaining animals dissected on day 15. Food and water intake, body weight and fecal weight were recorded. Intestinal flora was analyzed via microbial culture and quantitative PCR. The content of TNF-α, IL1-β, IL-6 and C-reactive protein (CRP) was assessed in abdominal aorta blood. Colonic and rectal tissues were examined pathologically via hematoxylin-eosin staining to assess leukocyte infiltration and intestinal mucosal changes as indicators of inflammation. Rat weight, food intake, water intake and 2-h fecal weight were significantly different across the experimental groups (P = 0.040, P = 0.016, P<0.001 and P = 0.009, respectively). Microbial cultures revealed no significant differences between group A and B,C (P = 0.546,0.872) but significant differences betwenn group A and the other experimental groups (all P<0.001). Furthermore, significant differences in the levels of Bacteroides, Faecalibacterium prausnitzii and Dialister invisus on day 4 between groups A, C and F (P = 0.033, P = 0.025 and P = 0.034, respectively). Significant differences were detected in the levels of TNF-α, IL1-β, IL-6 and CRP between the groups (all P<0.001). The colonic and rectal pathological inflammation scores of the experimental groups were significantly different compared with group A (B vs. A, P = 0.002; others, all P<0.001). These findings indicated that an antibiotic-induced IBD model was successfully established in SD rats; this animal model may serve as a useful model for clinical IBD research.

Hemodynamics and Wall Shear Stress of Blood Vessels in Aortic Coarctation with Computational Fluid Dynamics Simulation

The purpose of this study was to identify the characteristics of blood flow in aortic coarctation based on stenotic shape structure, stenosis rate, and the distribution of the wall load delivered into the blood vessels and to predict the impact on aneurysm formation and rupture of blood vessels by using a computational fluid dynamics modeling method. It was applied on the blood flow in abdominal aortic blood vessels in which stenosis occurred by using the commercial finite element software ADINA on fluid-solid interactions. The results of modeling, with an increasing stenosis rate and Reynolds number, showed the pressure drop was increased and the velocity was greatly changed. When the stenosis rate was the same, the pressure drop and the velocity change were larger in the stenosis with a symmetric structure than in the stenosis with an asymmetric one. Maximal changes in wall shear stress were observed in the area before stenosis and minimal changes were shown in stenosis areas. The minimal shear stress occurred at different locations depending on the stenosis shape models. With an increasing stenosis rate and Reynolds number, the maximal wall shear stress was increased and the minimal wall shear stress was decreased. Through such studies, it is thought that the characteristics of blood flow in the abdominal aorta where a stenosis is formed will be helpful in understanding the mechanism of growth of atherosclerosis and the occurrence and rupture of the abdominal aortic flow.

Clinical Features and Outcome of Saline Hydrostatic Reduction in Patients with Intussusception in a Tertiary Care Centre

Background: Intussusception is one of the most frequent causes of acute bowel obstruction in infants and toddlers. Abdominal sonogram is highly specific, accurate and is the first line diagnostic modality. The primary treatment options are non-operative hydrostatic or pneumatic reduction. In our institution, we use normal saline for reduction of intussusception under ultrasound guidance (USGR). The aim of the study is to analyse the clinical pattern and treatment outcome of intussusception. Methodology: Retrospective analysis of all cases admitted with intussusception in our department during 2014-2018 was done. Results: 785 cases (527 males: 258 females) with a mean age of 25 months and median of 16 months had abdominal pain (92.5%), vomiting (59%) and blood in stools (32%) as the predominant symptoms. 710/785 cases (90.4%) underwent successful USGR and 75/785 of the failed cases underwent surgery. Age group &lt; 12 months, presence of blood in stools irrespective of its duration and prolonged vomiting &gt;48 hours were found to be significant factors for failed USGR. Vomiting and blood in stools were found to be significantly higher in children &lt;12 months of age (p&lt;0.005), whereas pathological lead points were more frequent in children &gt;3 years of age. Conclusion: With a high success rate and no significant complication rate, USGR is an effective non-operative treatment modality for intussusception. Age group &lt;12 months, prolonged vomiting and presence of blood in stool were found to affect the success rate of hydrostatic reduction. Keywords: Intussusception, saline, ultrasound, hydrostatic reduction.

The Protective Effects of Preventive Atomisation Inhalation of Edaravone on the Lung Tissues of Rats with Smoke Inhalation Injury

Objective: To investigate the protective effects of the atomisation inhalation of edaravone on the lung tissues of rats with smoke inhalation injury. Methods: Forty male Sprague-Dawley (SD) rats were randomly divided into four groups of ten rats each: normal control group (group A), normal saline atomisation group (group B), edaravone aerosol group (group C) and edaravone atomisation prevention group (group D). Barring group A, the groups were used to create a model of severe smoke inhalation injury. However, before developing the model, group D rats were made to inhale edaravone (3.6 mg/mL) for 10 min. Six hours following smoke inhalation injury, abdominal artery blood samples were centrifuged, the lung tissue homogenate was prepared and carotid artery blood samples were used for blood gas analysis and oxygenation index (PaO2/FiO2) calculation. The levels of tumour necrosis factor alpha (TNF-α), interleukin (IL) 6 and IL-10 in serum and the levels of cysteine protease 3 (caspase-3), malondialdehyde (MDA), myeloperoxidase (MPO) and superoxide dismutase (SOD) in lung tissues were examined. The wet-dry ratio (W/D) and water content of the lung tissue were calculated, and the TUNEL method was used to determine the rate of lung tissue apoptosis in each group. Tissue specimens were obtained from the partial lung for histopathological examination. Results: Compared with those in group A, the water content of the lung tissue, the rate of lung tissue apoptosis, W/D and the caspase-3, TNF-α, IL-6, IL-10, MDA and MPO levels were significantly greater in other groups (P2/FiO2 were lower (P Compared with those in group B, the levels of W/D, the water content of the lung tissue, the rate of lung tissue apoptosis and the levels of caspase-3, TNF-α, IL-6, MDA and MPO were significantly low (P and the levels of IL-10, SOD and PaO2/FiO2 were significantly high in groups C and D (P The expression of the aforementioned factors was more evident in Group D (P Conclusions: The inhalation of edaravone can reduce smoke inhalation-induced lung injury. This may be related to the inhibition of apoptosis, the reduction of peroxidation injury and the production/release of inflammatory mediators/free radicals. It exerts a remarkable preventive effect.

Prospective Association of Circulating Adipokines with Cardiometabolic Risk Profile Among Women: The Rape Impact Cohort Evaluation Study.

Sexual violence is associated with poor cardiometabolic outcomes, yet the etiopathogenic pathways remain unclear. Adipokines may contribute to pathways in the development of cardiometabolic disease (CMD), including in vulnerable populations. Further investigation of adipokines among sexually traumatized individuals may inform cardiometabolic screening. This study aimed to investigate the association between circulating adipokines, metabolic syndrome (MetS), and longitudinal change in MetS components (namely abdominal obesity, blood pressure, lipid profile, and glycemic status) over a 1-year period in a cohort of rape exposed (RE) and rape unexposed (RUE) females. Seven hundred seventy-eight RE and 617 RUE black South African women aged 18-40 years were recruited for the Rape Impact Cohort Evaluation study. Nonfasting blood samples were analyzed for cardiometabolic variables and adipokine levels using enzyme-linked immunosorbent assay. Serum adiponectin was measured in both RE and RUE and resistin, leptin, and leptin/adiponectin (L/A) ratio in RE only. Associations between baseline serum adipokines, MetS, and its components were assessed at baseline and follow-up using adjusted linear and logistic regressions. In the RE group, adiponectin, leptin, and L/A ratio were significantly associated with MetS prevalence cross-sectionally (all p ≤ 0.001). No adipokine marker was related to incident MetS at 12-month follow-up. In the RE group, significant longitudinal associations with high-density lipoprotein cholesterol were shown for adiponectin (β = 0.146 [0.064], p = 0.022) and leptin (β = 0.001 [0.002], p = 0.012). Findings suggest that adipokines may have a potential role as biomarkers to identify RE individuals at high risk for CMD.

A study on correlation of sagittal abdominal diameter and blood pressure

A study on correlation of sagittal abdominal diameter and blood pressure

Variáveis clínicas consideradas fatores de risco para a síndrome metabólica: um estudo transversal

ABSTRACT Objective To identify the main risk factors for metabolic syndrome and its relationship with the perception of quality of life in Brazilian fishing colonies. Methods We included 77 participants aged &gt; 18 years. Metabolic syndrome and quality of life were the main study outcomes. We considered a significance level &lt; 0.05 and all procedures were approved by the ethics committee. Results Most participants are male, single, economic class D-E, working hours of 6 to 8 hours, length of service from 1 to 5 years, and dedicated exclusively to fishing. Conclusion Abdominal perimeter and blood pressures were the most frequent criteria and the greatest contribution to metabolic syndrome. Although quality of life had a higher score for the social relationship domain, in this study, the physical domain was the only one associated with another observation, in which we observed a significant correlation with systolic blood pressure.

Effects of low-dose oxygen ions on cardiac function and structure in female C57BL/6J mice

Purpose: Astronauts in space vehicles beyond low-Earth orbit will be exposed to high charge and energy (HZE) ions, and there is concern about potential adverse effects on the cardiovascular system. Thus far, most animal studies that assess cardiac effects of HZE particles have included only males. This study assessed the effects of oxygen ions (16O) as a representative ion of the intravehicular radiation environment on the heart of female mice. Materials and methods: Female C57BL/6 J mice at 6 months of age were exposed to 16O (600 MeV/n) at 0.25−0.26 Gy/min to a total dose of 0, 0.1, or 0.25 Gy. Cardiac function and abdominal aorta blood velocity were measured with ultrasonography at 3, 5, 7, and 9 months after irradiation. At 2 weeks, 3 months, and 9 months, cardiac tissue was collected to assess collagen deposition and markers of immune cells. Results: Ultrasonography revealed increased left ventricle mass, diastolic volume and diameter but there was no change in the abdominal aorta. There was no indication of cardiac fibrosis however, a 75 kDa peptide of left ventricular collagen type III and α-smooth muscle cell actin were increased suggesting some remodeling had occurred. Left ventricular protein levels of the T-cell marker CD2 was significantly increased at all time points, while the neutrophil marker myeloperoxidase was decreased at 2 weeks and 9 months. Conclusions: These results taken together suggest 16O ion exposure did not result in cardiac fibrosis or cardiac dysfunction in female mice. However, it does appear mild cardiac remodeling occurs in response to HZE radiation.

Peripheral serotonin lacks effects on endothelial adhesion molecule expression in acute inflammation

BackgroundPeripheral, non‐neuronal serotonin promotes the recruitment of neutrophils to sites of acute inflammation and tissue damage. Direct effects of serotonin on neutrophil function were shown to be involved. However, the influence of serotonin on the endothelial counterpart is unknown. ObjectivesTo investigate whether serotonin alters the function of endothelial cells in leukocyte recruitment during acute inflammation. MethodsWe used two murine models of acute inflammation: intraperitoneal lipopolysaccharide (LPS) injection and mesenteric ischemia/reperfusion injury (I/R). To study effects of peripheral serotonin, leukocyte recruitment and endothelial adhesion molecule expression were compared in wild type (WT) and tryptophan hydroxylase 1 deficient (Tph1−/−) mice, which are unable to synthesize peripheral serotonin. ResultsAs expected, neutrophil transmigration into the peritoneal cavity following LPS injection was impaired in Tph1−/− mice. Abdominal blood vessels, however, showed no difference in adhesion molecule expression. In the early reperfusion phase after mesenteric I/R, the number of rolling leukocytes was significantly lower in Tph1−/− compared to WT. In line with the LPS model, endothelial adhesion molecule expression was independent of serotonin. In vitro experiments using human umbilical vein endothelial cells (HUVECs) confirmed that serotonin does not affect endothelial adhesion molecules. ConclusionsThe inflammatory release of peripheral serotonin is dispensable for the regulation of endothelial adhesion molecules.

Cross-sectional Relationships Between Alternate Healthy Eating Index (AHEI) with General and Abdominal Obesity and Blood Pressure in Iranian Hospital Employees.

Due to the increasing prevalence of obesity and related disorders, there is an urgent need to examine the relationship between diet quality and public health. The Alternative Healthy Eating Index (AHEI) is one of the indices that is used to assess diet quality. Therefore, we investigated the relationship between AHEI and anthropometric measurements and blood pressure. In this cross-sectional study, 127 male and female hospital employees were examined. The AHEI was calculated by a 168 items Food Frequency Questionnaire. Body weight, height, Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR) and blood pressure were measured by skilled nutritionists. Physical activity level was also obtained by International Physical Activity Questionnaire (IPAQ). The mean total AHEI score in participants was reported as 47.1±6.9 (min=31.9, max=60.3). The mean differences of total AHEI score across the obese/non-obese employees were not statistically significant (P>0.05). Furthermore, there was no significant correlation between total AHEI score and BMI (r=0.019), WC (r=0.022), WHR (r=-0.102), systolic (r=-0.133) and diastolic blood pressure (r=-0.040) (P>0.05). The score of nuts and soybeans was inversely related to the WHR (P=0.008) and systolic blood pressure (P=0.030). Cereal fiber score had a negative relationship with BMI (P=0.02), WC (P=0.03), WHR (P=0.004) and systolic (P<0.001) and diastolic blood pressure (P=0.012). Consumption of nuts and soybeans -one serving per day- can be associated with WHR and systolic blood pressure reduction. More studies with a larger scale are needed to examine diet quality.

The Absorption, Distribution, and Excretion of 18 Elements of Tibetan Medicine Qishiwei Zhenzhu Pills in Rats with Cerebral Ischemia.

The aim of this study is to determine 18 elements in Tibetan medicine Qishiwei Zhenzhu pills (QSW) and their absorption, distribution, and excretion in rats with cerebral ischemia. Microwave digestion and inductively coupled plasma mass spectrometry (ICP-MS) were used to determine 18 elements of QSW in simulated gastrointestinal (GI) juice. Rats were given QSW (66.68 mg/kg) followed by middle cerebral artery occlusion (MCAO). Sham rats received saline and were not subjected to MCAO. ICP-MS was applied to determine the content of 18 elements in hepatic venous blood, abdominal aortic blood, brain, liver, kidney, hair, urine, and feces 24 h after MCAO. In vitro results showed that the extraction rate of Mn, Cu, Sr, Pb, Au, and Hg of QSW in gastric juice (1 h) was higher than that in water, and the contents of Cu, Au, Sr, and As were higher in intestinal juice (4 h) than in water. In vivo results showed that the contents of elements in the blood were quite low, and QSW increased Ni, Cr, Sr, Co, and V in artery blood and decreased V in venous blood. Elements in the tissues were also low, and QSW increased brain Li but decreased Cr and Cd; QSW increased kidney Ag and Cs and liver Mn but decreased liver Ni. QSW increased urinary excretion of Li, Sr, Hg, Cs, and V; QSW increased Hg content in hair but decreased Ni. Stool is the main excretion pathway of the elements in QSW, with Ba, Mn, Sr, Cd, V, Cu, Cs, Li, Pb, Ag, Hg, Cr, As, and Co the highest. In summary, this study examined the distribution of 18 elements in QSW-treated MCAO rats. The accumulation of these elements in blood and tissues was extremely low, and the majority was excreted in feces within 24 h, highlighting the importance of the gut-microbiota-brain axis in QSW-mediated brain protection.

Risk factors for perioperative complications in laparoscopic surgeries of retrorectal cystic lesions.

BACKGROUNDThe incidence of retrorectal lesions is low, and no consensus has been reached regarding the most optimal surgical approach. Laparoscopic approach has the advantage of minimally invasive. The risk factors influencing perioperative complications of laparoscopic surgery are rarely discussed.AIMTo investigate the risk factors for perioperative complications in laparoscopic surgeries of retrorectal cystic lesions.METHODSWe retrospectively reviewed the medical records of patients who underwent laparoscopic excision of retrorectal cystic lesions between August 2012 and May 2020 at our hospital. All surgeries were performed in the general surgery department. Patients were divided into groups based on the lesion location and diameter. We analysed the risk factors like type 2 diabetes mellitus, hypertension, the history of abdominal surgery, previous treatment, clinical manifestation, operation duration, blood loss, perioperative complications, and readmission rate within 90 d retrospectively.RESULTSSevere perioperative complications occurred in seven patients. Prophylactic transverse colostomy was performed in four patients with suspected rectal injury. Two patients underwent puncture drainage due to postoperative pelvic infection. One patient underwent debridement in the operating room due to incision infection. The massive-lesion group had a significantly longer surgery duration, higher blood loss, higher incidence of perioperative complications, and higher readmission rate within 90 d (P < 0.05). Univariate analysis, multivariate analysis, and logistic regression showed that lesion diameter was an independent risk factor for the development of perioperative complications in patients who underwent laparoscopic excision of retrorectal cystic lesions.CONCLUSIONThe diameter of the lesion is an independent risk factor for perioperative complications in patients who undergo laparoscopic excision of retrorectal cystic lesions. The location of the lesion was not a determining factor of the surgical approach. Laparoscopic surgery is minimally invasive, high-resolution, and flexible, and its use in retrorectal cystic lesions is safe and feasible, also for lesions below the S3 level.

Morbidity associated with Schistosoma mansoni infection in north-eastern Democratic Republic of the Congo.

BackgroundReducing morbidity is the main target of schistosomiasis control efforts, yet only rarely do control programmes assess morbidity linked to Schistosoma sp. infection. In the Democratic Republic of Congo (DRC), and particularly in north-eastern Ituri Province, little is known about morbidity associated with Schistosoma mansoni infection. For this reason, we aimed to assess intestinal and hepatosplenic morbidity associated with S. mansoni infection in Ituri Province.Methods/Principal findingsIn 2017, we conducted a cross-sectional study in 13 villages in Ituri Province, DRC. S. mansoni infection was assessed with a Kato-Katz stool test (2 smears) and a point-of-care circulating cathodic antigen (POC-CCA) urine test. A questionnaire was used to obtain demographic data and information about experienced intestinal morbidity. Each participant underwent an abdominal ultrasonography examination to diagnose hepatosplenic morbidity. Of the 586 study participants, 76.6% tested positive for S. mansoni. Intestinal morbidity reported in the two preceding weeks was very frequent, and included abdominal pain (52.7%), diarrhoea (23.4%) and blood in the stool (21.5%). Hepatosplenic morbidity consisted of abnormal liver parenchyma patterns (42.8%), hepatomegaly (26.5%) and splenomegaly (25.3%). Liver pathology (adjusted odds ratio [aOR] 1.20, 95% confidence interval [CI] 1.06–1.37, p = 0.005) was positively and significantly associated with S. mansoni infection. Hepatomegaly (aOR 1.52, 95% CI 0.99–2.32, p = 0.053) and splenomegaly (aOR 1.12, 95% CI 0.73–1.72, p = 0.619) were positively but not significantly associated with S. mansoni infection at the individual level. At the village level, S. mansoni prevalence was positively associated with the prevalence of hepatomegaly and splenomegaly. High-intensity S. mansoni infections were associated with diarrhoea, blood in the stool, hepatomegaly, splenomegaly, and liver parenchyma (C, D, E and F pathology patterns). Four study participants were diagnosed with ascites and five reported hematemesis.Conclusions/SignificanceOur study documents a high burden of intestinal and hepatosplenic morbidity associated with S. mansoni infection status in Ituri Province. The findings call for targeted interventions to address both S. mansoni infection and related morbidity.

Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a randomised controlled trial

BackgroundParastomal hernia is a common complication of an enterostomy and can have a significant impact on health-related quality of life. Currently used methods of repair have high recurrence rates and considerable risk for complications. We have developed a new technique for parastomal hernia repair that uses full-thickness skin graft as reinforcement.MethodsThis study protocol describes a multicentre randomised controlled trial on parastomal hernia repair comparing a new full-thickness skin graft technique with conventional synthetic composite mesh as reinforcement of the abdominal wall. Patients with a symptomatic parastomal hernia will be included and followed up at 3, 12 and 36 months, with surgical complication as the primary outcome. Secondary outcomes will be recurrence rate and health-related quality of life assessed with VHPQ, EORTC C30 and CR29. Tissue biology and collagen metabolism will be investigated pre- and postoperatively using biopsies of the abdominal wall fascia and blood samples.DiscussionParastomal hernia constitutes a major clinical problem where the prospects of a good result after hernia repair are presently poor. This new method of repair with full-thickness skin grafting could be a new alternative in our surgical toolbox, but before then, it must be evaluated properly.Trial registrationClinicalTrials.gov NCT03667287. Registered on September 12, 2018

Description of the arterial supply and venous drainage of the abdominal viscera in the puma (Puma concolor) (Linnaeus, 1771).

Detailed descriptions of the abdominal vasculature have not been reported on Puma concolor; thus, herein we provided a thorough description. Our findings include the following: a celiac artery branching into the hepatic and gastrolienal arteries, and this latter further branched into the left gastric, the left gastroepiploic, the lienal and three more arteries that supplied the greater omentum. We also found a cystic artery that derived from the right gastroduodenal artery; a right gastric artery that derived from the right hepatic artery; and an antimesenteric ileal artery that derived from the lateral cecal artery. The right gastric vein did not form the gastroduodenal vein as in other species, but it drained directly into the portal vein. Also, a middle pancreaticoduodenal vein was identified as the last branch of the cranial mesenteric vein. Finally, the left caudal phrenic vein drained into the left renal vein. The abdominal blood supply described herein corresponds to a single individual; further reviews are desirable to corroborate our observations and to detect potential intraspecific anatomical variations.