IL Groups Research Articles

376. COMPARISON OF POST-SURGICAL NUTRITIONAL STATUS BETWEEN IVOR-LEWIS ESOPHAGECTOMY AND PROXIMAL GASTRECTOMY

Abstract Background In our institution, the surgical approach for esophagogastric junction cancer (EG) is determined based on the tumor location and the extent of esophageal invasion, opting for either Ivor-Lewis esophagectomy (IL) or proximal gastrectomy (PG). Both procedures necessitate the mitigation of postoperative weight loss, with nutritional therapy using Elemental diet 300 kcal/day initiated postoperatively and nutritional guidance provided by dietitians before discharge, and at 1, 3, 6, and 12 pos-operative months (POM). Additionally, quality of life (QOL) assessment using the PGSAS-37 questionnaire is conducted, and feedback is provided to patients. Methods The aim of this study is to compare the weight changes up to 12 POM and the temporal changes in PGSAS-37 scores following IL and PG procedures in our institution. We analyzed 45 cases who underwent IL or PG in our institution between January 2019 and December 2022, excluding cases of early recurrence within 12 months and those without questionnaire responses. Patient demographics, postoperative complications, anastomotic strictures, duration of Elemental intake (months), percentage of body weight loss (BWL) at 1, 3, 6, and 12 POM, and PGSAS-37 scores were extracted from electronic medical records. Results There were 27 IL cases and 18 PG cases. Postoperative complications of Grade 3 or higher were observed in 3 of IL group and 1 of PG group. Anastomotic strictures were observed in 1 of IL group and 6 of PG group. Duration of Elemental intake (months) was 4.5 (0-39) in IL group and 0 (0-8) in PG group (p=0.001). Median BWL (%) at 1/3/6/12 POM was IL: 4.5/8.3/10.3/13.8 and PG: 3.8/8.5/8.7/10.6. Temporal changes in total symptom score were similar in both IL and PG groups, but esophageal reflux subscale at 12 POM was significantly better in PG group (p=0.04). Conclusion The questionnaire response rates were approximately 80% at 12 months for both groups, but below 12 months ranged from 22.2% to 50%, indicating difficulty in assessing temporal changes in QOL. At 12 months, the IL group exhibited a greater percentage of weight loss than the PG group (p=0.027), but QOL evaluations, except for reflux symptoms SS, were comparable between the two groups. Both IL and PG groups experienced rapid weight loss up to 3 POM, with continued decline up to 12 months. However, improving questionnaire response rates is deemed necessary for investigating the relationship with QOL.

Maternal Circulating Vitamin D Level, Targeted Supplementation, and Perinatal Outcomes in Twin Pregnancy.

Vitamin D deficiency is associated with several obstetric complications in singleton pregnancy. The aim of this study was to assess whether vitamin D levels affect the outcomes of twin pregnancy and if targeted supplementation can improve perinatal outcomes. The serum vitamin D levels of 143 women with twin pregnancies were measured during their first trimester. Those with insufficient (10-30 ng/mL; IL group) or severely deficient (<10 ng/mL, DL group) vitamin D levels were supplemented. In the third trimester, vitamin D levels were reassessed. Perinatal outcomes of the IL and DL groups were compared with those of patients with sufficient levels (>30 ng/mL, SL group) since the beginning of pregnancy. Women in the IL and DL groups had a higher incidence of hypertensive disorders of pregnancy (HDP) compared to the SL group (24.8% and 27.8% vs. 12.5%, p = 0.045): OR = 1.58 for the IL group and 1.94 for the DL group compared to the SL group. In patients whose vitamin D levels were restored after supplementation, HDP incidence was lower than in patients who remained in the IL or DL groups (23.4% vs. 27.3%) but higher than those who were always in the SL group (12.5%). Insufficient or severely deficient levels of vitamin D in the first trimester are associated with an increased risk of HDP in twin pregnancy. The beneficial effect of targeted vitamin D supplementation in reducing HDP seems limited.

Protein expression patterns and metal metabolites in a protogynous hermaphrodite fish, the ricefield eel (Monopterus albus)

BackgroundThe ricefield eel Monopterus albus undergoes a natural sex change from female to male during its life cycle, and previous studies have shown the potential mechanisms of this transition at the transcriptional and protein levels. However, the changes in protein levels have not been fully explored, especially in the intersexual stage.ResultsIn the present study, the protein expression patterns in the gonadal tissues from five different periods, the ovary (OV), early intersexual stage gonad (IE), middle intersexual stage gonad (IM), late intersexual stage gonad (IL), and testis (TE), were determined by untargeted proteomics sequencing. A total of 5125 proteins and 394 differentially expressed proteins (DEPs) were detected in the gonadal tissues. Of the 394 DEPs, there were 136 between the OV and IE groups, 20 between the IM and IE groups, 179 between the IL and IM groups, and 59 between the TE and IL groups. Three candidate proteins, insulin-like growth factor 2 mRNA-binding protein 3 isoform X1 (Igf2bp3), triosephosphate isomerase (Tpi), and Cu-Zn superoxide dismutase isoform X1 [(Cu-Zn) Sod1], were validated by western blotting to verify the reliability of the data. Furthermore, metal metabolite-related proteins were enriched in the IL vs. IM groups and TE vs. IL groups, which had close relationships with sex change, including Cu2+-, Ca2+-, Zn2+- and Fe2+/Fe3+-related proteins. Analysis of the combined transcriptome data revealed consistent protein/mRNA expression trends for two metal metabolite-related proteins/genes [LOC109953912 and calcium Binding Protein 39 Like (cab39l)]. Notably, we detected significantly higher levels of Cu2+ during the sex change process, suggesting that Cu2+ is a male-related metal metabolite that may have an important function in male reproductive development.ConclusionsIn summary, we analyzed the protein profiles of ricefield eel gonadal tissues in five sexual stages (OV, IE, IM, IL, and TE) and verified the plausibility of the data. After preforming the functional enrichment of metal metabolite-related DEPs, we detected the contents of the metal metabolites Zn2+, Cu2+, Ca2+, and Fe2+/Fe3+ at these five stages and screened for (Cu-Zn) Sod1 and Mmp-9 as possible key proteins in the sex reversal process.

Biochemical, histological and transcriptional response of intestines in Litopenaeus vannamei under chronic zinc exposure

Zinc (Zn) is an essential trace element for the normal physiological function of aquatic organisms, but it could become toxic to organisms when the concentration increased in water. As the first line of defense, the shrimp intestines are the most susceptible organ to environmental stress. In this study, the chronic toxicity of 0 (control, IC), 0.01(IL), 0.1(IM) and 1mg/L (IH) Zn in intestines of Litopenaeus vannamei was investigated from the perspectives of biochemical, histological and transcriptional changes after exposure for 30 days. The results showed that the intestinal tissue basement membrane is swollen in the IM and IH groups and detached in the IH group. The total antioxidant capacities (T-AOC) were reduced while the content of malondialdehyde (MDA) were increased significantly in IM and IH groups. The production of reactive oxygen species (ROS) was increased significantly in IH group. Many differentially expressed genes (DEGs) were identified in IL, IM and IH groups, respectively. GO and KEGG enrichment analyses were conducted on the DEGs to obtain the underlying biological processes and pathways. The gene modules related to the sample were identified by weighted gene co-expression network analysis (WGCNA), and genes in modules highly corelated with IH group were mainly enriched in immune related pathways. Nine DEGs were selected for validation by quantitative real time PCR (qRT-PCR) and the expression profiles of these DEGs kept a well consistent with the high-throughput data, which confirmed reliability of transcriptome results. Additionally, 10 DEGs were screened to detect the changes of expression level in different groups. All these results indicated that Zn exposure could damage the intestinal barrier, provoke oxidative stress, reduce the immune function, increase the susceptibility to bacterial infections of L. vannamei and cause inflammation, ultimately result in cell apoptosis. Our study provides more perspective on the stress response of crustacean under Zn exposure.

Association Between Initial Corticosteroid Regimen and Treatment Response Time in Acetylcholine Receptor Antibody–Positive Myasthenia Gravis

Background: Corticosteroids remain the cornerstone in the management of myasthenia gravis (MG). Initiation of corticosteroid treatment at a high dose and subsequently decreasing the dose or gradual escalation from a low dose is recommended. We aimed to investigate the association between the initial corticosteroid regimen and treatment response.Methods: A retrospective study was conducted on 234 acetylcholine receptor (AChR) antibody (Ab)–positive MG patients who visited our institution between January 2010 and February 2023. Patients were grouped based on prednisolone dosages received: initial high (IH, ≥50 mg/day) or initial low (IL, ≤20 mg/day). Time to initial improvement and the achievement of minimal manifestation (MM) status were the main outcomes.Results: Of the 234 patients, 135 were classified as IH and 99 as IL group. The IH group demonstrated a faster onset of improvement compared with the IL group (20.0 [16.0–29.0] vs. 40.0 [27.0–84.0] days), with the IH group being a significant prognostic factor for initial improvement (HR, 2.44; 95% CI, 1.76–3.39). However, the IH group had a higher incidence of steroid‐induced exacerbation (51.9% vs. 2.0%, p &lt; 0.001). No significant difference between the IH and IL groups was found in terms of the proportion of patients achieving MM or the time to achieve MM within the first year after treatment initiation.Conclusion: While an initial high dose of corticosteroid treatment accelerated the onset of therapeutic responses in patients with AChR Ab–positive MG, it was associated with a higher cumulative steroid dose and an increased risk of steroid‐induced exacerbations.

Effectiveness of vocal fold medialization surgery on the swallowing function of patients with unilateral vocal fold paralysis.

Vocal fold medialization surgery is generally considered a phonosurgical procedure for improvement of vocal function in patients with glottic insufficiency. However, the literature describing this procedure for the management of dysphagia is limited. This study aims to assess the effects of medialization surgery on swallowing function in patients with unilateral vocal fold paralysis (UVFP). We enrolled 32 patients with UVFP undergoing vocal fold medialization surgery (medialization laryngoplasty combined with arytenoid adduction [ML + AA], 12 cases; injection laryngoplasty [IL], 20 cases). We assessed the aerodynamic vocal function including maximum phonation time and mean flow rate to evaluate glottal closure status. The Hyodo score determined by flexible endoscopic evaluation and Functional Oral Intake Scale (FOIS) were evaluated pre- and postoperatively. Almost 60% of patients with UVFP had dysphagia, and one-third were at high risk for aspiration. Aerodynamic parameters effectively improved after IL and ML + AA. With regard to swallowing, both the FOIS and total Hyodo score were significantly improved postoperatively. We found a particularly significant improvement in pharyngeal clearance. However, patients with high vagal nerve paralysis and postoperative insufficient glottal closure showed poor swallowing benefits after the interventions. In patients with recurrent laryngeal nerve palsy, there were no significant differences in postoperative swallowing function between the ML + AA and IL groups. Vocal fold medialization surgery was effective in improving swallowing function in most cases with UVFP, except for those with high vagal paralysis and insufficient postoperative glottal closure. Both IL and ML + AA showed an equivalent effect on swallowing improvement. 3b.

Do patients with metastatic pancreatic adenocarcinoma to the lung have improved survival?

Pancreatic ductal adenocarcinoma (PDAC) is a genetically heterogeneous disease often diagnosed with synchronous metastatic disease involving the liver. Tumors with extra-abdominal spread that bypass the liver are thought to represent a unique molecular subgroup and those with isolated pulmonary metastatic disease are thought to have a more favorable clinical phenotype. We conducted a retrospective review of patients with pathologically confirmed PDAC treated between the years 2007 and 2020 at a Scripps Health hospital. The final study sample (N=205) included patients with isolated pulmonary metastasis (IL), isolated liver metastasis or synchronous liver and lung metastasis (LL), or metastasis to any site other than the liver or lung (NLL). Primary endpoint was overall survival (OS). Progression-free survival (PFS) and recurrence-free survival (RFS) were analyzed as secondary endpoints. Each survival outcome was analyzed using Cox proportional hazards tests. No statistically significant differences were seen between the three groups in OS, PFS, or RFS. Median OS for the IL group was 561 days, 341 days for the LL group, and 441 days for the NLL group. Median RFS was 748 days for the IL group, 574 days for the LL group, and 545 days for the NLL group. Median PFS was 307 for the IL group, 236 for the LL group, and 265 for the NLL group. When comparing only the IL and LL groups, a statistically significant difference in OS was seen favoring the IL group (HR1.59 LL vs IL [ref], CI 1.04-2.41, p= 0.031) CONCLUSION: Though statistically significant differences in survival outcomes were not seen in our population, there was a trend toward improved survival for patients with isolated lung metastases. When comparing only the IL to LL group, statistically significant overall survival favoring the IL group was seen. These findings highlight a potential prognostic indicator of metastatic PDAC.

Evaluation of active tactile sensibility in a single-tooth implant opposing a natural tooth with either an immediate or delayed functional loading protocol: A parallel design clinical study

Statement of problemHigh primary stability makes immediate loading more predictable, but immediately loaded implants are subjected to higher stresses and strains during the healing phase than implants that are left to heal for 3 months. Whether an earlier sensory-motor phenomenon with an immediate loading protocol helps to reduce the risk of overloading at the implant-bone interface is unclear. PurposeThe purpose of this concurrent parallel design clinical study was to evaluate and compare active tactile sensibility for a single-tooth implant opposing a natural tooth in the mandibular posterior region with either a delayed or immediate functional loading -protocol. Material and methodsIn this parallel group randomized trial, 2 test groups were formed: the DL group comprised 20 participants with the delayed loading protocol (loading after 3 months), and the IL group comprised 20 participants with the immediate loading protocol (loading within 2 days). Natural tooth-to-tooth contact on the side contralateral to the implant site (split mouth) in both test groups was used as a control to evaluate active tactile sensibility, which was evaluated in the test and control sites of both groups by using interocclusal articulating foils of varying thickness in maximum intercuspation. Active tactile sensibility was compared between the DL and IL groups at 3 and 6 months of follow-up. The nonparametric Mann-Whitney test was used for intergroup comparisons (P=.05). ResultsA significant difference was found for 8-μm- and 12-μm-thick articulating foil at 3 months and for 8-μm-thick foil at 6 months (P<.05), indicating a difference in active tactile sensibility between the DL and IL groups. No implant failure was recorded in this short clinical study. ConclusionsAn immediate loading protocol can be performed in implants with sufficient primary stability. Upon loading, the IL group has shown more active tactile perception than the DL group.

Three-dimensional evaluation of maxillary tooth movement in extraction patients with three different miniscrew anchorage systems: a randomized controlled trial

ObjectiveTo compare the three-dimensional (3-D) movement of maxillary teeth in response to three common miniscrew anchorage systems in extraction patients with maxillary dentoalveolar protrusion.Materials and methodsThe study employed a randomized controlled single-blinded design with three arms. Thirty extraction patients who required maximum anchorage to retract maxillary anterior teeth were included and randomly allocated into three treatment groups: space closure with direct miniscrew anchorage and low crimpable hooks (DL group), indirect miniscrew anchorage and low crimpable hooks (IL group), and direct miniscrew anchorage and high crimpable hooks (DH group). Cone beam computed tomography (CBCT) images of all included patients were obtained immediately before (T0) and after (T1) space closure. The outcomes were 3-D positional changes of maxillary central incisor, lateral incisor, canine, second premolar, and first molar. The repeated measures analysis of variance with post hoc LSD test was used to evaluate differences among groups.ResultsA significant intrusion (− 1.34 mm; 95% CI, − 1.60 mm, 1.08 mm) and buccal (− 6.92°; 95% CI, − 8.67°, − 5.13°) and distal (4.90°; 95% CI, 3.75°, 6.04°) inclination of the maxillary first molars were observed in the DL group, compared to the other two groups. The mesial movement (− 0.40 mm; 95% CI, − 0.83 mm, − 0.03 mm) of the maxillary first molars was found in the IL group, while the DL (0.44 mm; 95% CI, 0.15 mm, 0.73 mm) and IL (0.62 mm; 95% CI, 0.28 mm, 0.96 mm) groups exhibited distal movement. In the DH group, the lingual inclination changes of maxillary central incisor (5.04°; 95% CI, 2.82°, 7.26°) were significantly lower, which is indicative of good lingual root torque control of the maxillary anterior teeth.ConclusionThree miniscrew anchorage systems produced significantly different 3-D maxillary tooth movement. The maxillary first molars were significantly buccally and distally inclined and intruded in patients using direct miniscrew anchorages with low crimpable hooks. Direct miniscrew anchorages with high crimpable hooks could help to achieve better lingual root torque control of the maxillary incisors.Trial registration The trial was registered at www.chictr.org.cn (ChiCTR1900026960). Registered 27 October 2019.

Effect of gastroesophageal reflux disease on the clinical characteristics of patients with laryngopharyngeal reflux disease

Objective: To investigate the effect of gastroesophageal reflux disease (GERD) on the clinical characteristics of patients with laryngopharyngeal reflux disease(LPRD). Methods: The data of 141 patients with symptoms of LPRD, who were admitted to the Department of Pharyngology, Laryngology& Phonosurgery at the Sixth Medical Center of the PLA General Hospital from November 2020 to October 2021, were retrospectively analyzed.There were 118 males and 23 females, aged 28-75 (56.72±10.04) years old. The included patients underwent simultaneous 24-hour hypopharyngeal and esophageal multichannel intraluminal impedance pH monitoring (24h-HEMII-pH), salivary pepsin test at multiple times, Reflux Symptom Index (RSI), and Reflux Finding Score (RFS). One laryngopharyngeal reflux event on 24 h-HEMII-pH monitoring results was used as a diagnostic criterion for LPRD. And the duration of lower esophageal pH<4.0>4.0% at 24 h or DeMeester score>14.7 were used as diagnostic criteria for GERD. Among them, patients with both positive LPRD and GERD were classified as L&G group, patients with positive LPRD and negative GERD were classified as IL group, patients with negative LPRD and positive GERD were classified as IG group, and patients with both negative LPRD and GERD were classified as N group. The differences in the clinical characteristics of reflux and salivary pepsin assay in each group were statistically analyzed. SPSS 23.0 software was applied for statistical analysis. Results: According to the 24 h-HEMII-pH results, 116 (82.3%) patients were diagnosed with LPRD and 45 (31.9%) with GERD, including 82 (58.2%) in the IL group, 34 (24.1%) in the L&G group, 11 (7.8%) in the IG group, and 14 (9.9%) in the N group. Based on the salivary pepsin test, a total of 106 patients had positive results, and the L&G group had a significantly higher rate of positive total salivary pepsin test (94.1%) and positive morning test (70.6%) than the IL group (75.6%, 26.8%), IG group (63.6%, 27.3%) and N group (35.7%, 28.6%), with chi-square values of 19.01 and 20.81, both with P<0.001. The patients in the L&G group had a significantly higher RSI score (14.0) than the IL group (7.0), IG group (1.0) and N group (0), H=52.26,P<0.001. The difference in RFS between the L&G and IL groups was not statistically significant (Z=-0.92,P>0.05). Conclusion: Combined with GERD, LPRD patients have more obvious clinical symptoms and higher positive rate of pepsin test in saliva.

Cyclic loading regime considered beneficial does not protect injured and interleukin-1-inflamed cartilage from post-traumatic osteoarthritis

Injurious overloading and inflammation perturbate homeostasis of articular cartilage, leading to abnormal tissue-level loading during post-traumatic osteoarthritis. Our objective was to gain time- and cartilage depth-dependent insights into the early-stage disease progression with an in vitro model incorporating for the first time the coaction of (1) mechanical injury, (2) pro-inflammatory interleukin-1 challenge, and (3) cyclic loading mimicking walking and considered beneficial for cartilage health. Cartilage plugs (n = 406) were harvested from the patellofemoral grooves of young calves (N = 6) and subjected to injurious compression (50% strain, rate 100%/s; INJ), interleukin-1α-challenge (1 ng/ml; IL), and cyclic loading (intermittent 1 h loading periods, 15% strain, 1 Hz; CL). Plugs were assigned to six groups (control, INJ, IL, INJ-IL, IL-CL, INJ-IL-CL). Bulk and localized glycosaminoglycan (GAG) content (DMMB assay, digital densitometry), aggrecan biosynthesis (35S-sulfate incorporation), and chondrocyte viability (fluorescence microscopy) were assessed on days 3–12. The INJ, IL, and INJ-IL groups exhibited rapid early (days 2–4) GAG loss in contrast to CL groups. On day 3, deep cartilage of INJ-IL-CL group had higher GAG content than INJ group (p < 0.05). On day 12, INJ-IL-CL group showed more accumulated GAG loss (normalized with control) than INJ-IL group (average fold changes 1.97 [95% CI: 1.23–2.70]; 1.66 [1.42–1.89]; p = 0.007). Aggrecan biosynthesis increased in CL groups on day 12 compared to day 0. Despite promoting aggrecan biosynthesis, this cyclic loading protocol seems to be beneficial early-on to deep cartilage, but later becoming incapable of restricting further degradation triggered by marked but non-destructive injury and cytokine transport.

Microbial Diversity and Community Analysis of Dental Plaques in Orthodontic Patients Wearing Invisible Appliances and Fixed Appliances

To explore the microbial diversity and community structure of dental plaques in orthodontic patients with invisible appliances and fixed appliances and to study the differences. Ten orthodontic patients wearing invisible appliances (I) and ten wearing fixed appliances (F) were recruited. Dental plaques were collected from both buccal (B) and lingual (L) sides. Based on 16S rDNA, 40 dental plaque samples were analyzed after Illumina sequencing. The microbial diversity, abundance and evenness of the FB group were significantly higher than those of the IB and IL groups (P<0.05), while the FL group showed substantial individual differences. The community structures were generally similar among the four groups, but significant differences in the relative abundance of some bacteria were found. The IB group showed higher abundances of Actinomycetes and Rosella (P<0.05), which were considered to be involved in dental caries and periodontal diseases. Some key communities showing significant differences were significantly enriched in the FB group, including Coprobacillus, Bifidobacterium, Enterobacterium, Lactobacillus, etc.. Dental plaques in patients wearing invisible appliances and fixed appliances showed significantly different microbial abundance, diversity and composition, which may be involved in orthodontic complications such as dental caries and periodontal diseases. Orthodontic patients need strengthened measures for oral hygiene maintenance, no matter what kind of appliances they wear.

Rosin-based porous heterogeneous catalyst functionalized with hydroxyl groups and triazole groups for CO2 chemical conversion under atmospheric pressure condition

Development of efficient, green and recyclable heterogeneous catalysts for the chemical conversion of CO2 into cyclic carbonates with excellent yields under atmospheric pressure condition is still a very challenging task. Herein, a class of biomass-derived hyper-cross-linked porous heterogeneous catalysts MPAc-Br and MPAc-OH-Br, based on easily available and sustainable rosin, was synthesized by Friedel–Crafts polymerization and the further N-alkylation of triazole groups. Compared with MPAc-Br, the bifunctional catalyst MPAc-OH-Br (bearing triazole IL groups and -OH groups) exhibited higher catalytic activity for direct chemical conversion of CO2 into cyclic carbonates (up to 99% yields) under metal-, solvent-free and atmospheric pressure conditions. The rosin-based porous molecular structure and bifunctional groups on the surface of MPAc-OH-Br played a very important role in the promoting the cycloaddition of CO2 with epoxides under the optimal conditions. Furthermore, MPAc-OH-Br exhibited good stability and reusability (96% yield after 10 recycles).

Effect of eggshell temperatures on hatching performance, egg production, and bone morphology of laying hens

The present study aims to evaluate the effect of lower or higher eggshell temperatures from days 7 to 21 on hatching performance, bone and blood parameters, and egg production along with the age of laying chickens. A total of 3150 eggs obtained from a white egg-type breeder were divided randomly into 3 groups of 1050 eggs. From 7 to 21 days, eggs were incubated at one of three eggshell temperatures: Control (IC) 37.5 °C, low (IL) 36.9 °C, and high (IH) 38.5 °C. At hatch, chicks were weighed, and blood was collected to measure total Ca, inorganic P, and ALP level weights, dimensions, and ash contents of femur, humerus, and tibia were obtained. A total of 240 chicks from each incubation temperature were reared up to 58 weeks. The results showed that hatchability was similar among the eggshell temperature groups. The IL chicks had the heaviest chick weight and yolk free chick weight. The IH group had reduced chick weight compared to IL and IC but increased lengths of tibia and humerus, ash contents of tibia and femur, and blood Ca levels at the day of the hatch. Laying hens from the IH group had impaired body weight during the laying cycle. At 58 weeks, there was no effect of eggshell temperature on egg production, bone length, and width. IH hens had lower tibia ash and serum Ca but higher P and ALP levels compared to IL and IC groups. However, bone mineral content and mineral density were similar for hens from different eggshell temperature groups. In conclusion, it appeared that although chicks from the IH group had reduced chick weight, they had improved bone morphology and ash content of bones compared to IC and IL at hatch. However, IH hens could not maintain the higher ash content during the grow-out and laying periods. The results indicate that the positive effect of IH incubation temperature on bone morphological measurements and ash content of tibia would not be long term.

A Novel Method of Damage Control for Multiple Discontinuous Intestinal Injuries with Hemorrhagic Shock: A Controlled Experiment

Aim: In this study, we examined the effects of branched silicon tube (BST) and temporary closed circle (TCC) in a Beagle dog model of multiple transection of small intestine and discontinuities suspected intestinal necrosis with hemorrhagic shock. Materials and Methods: Ten male Beagle dogs were randomly divided into two groups. Hemorrhagic shock was induced by bleeding. Intestine was severed. Suspected intestinal necrotic model by ligating the mesenteric vessels was established, with a small tertiary mesenteric vessel reserved. Fracted intestines were ligated (IL group, n = 5) or reconnected with BST (IR group, n = 5). The abdominal cavity was temporarily closed with TCC. Definitive surgery was conducted after 24 h. Results: There was no statistical difference between two groups in the weight of dogs, their blood loss, fluid resuscitation, operation time of early emergency treatment (EET). After definitive surgery, all dogs in IR group and 3 dogs in IL groups were alive. 18 (90%) suspicious necrotic intestinal segments in IL group became necrotic, but 20 (80%) segments in IR group didn't develop obvious changes (p < 0.01). From 2 h after EET, the endotoxin concentration in IL group was significantly higher than that in IR group (133.87 ± 43.73 vs. 56.31 ± 24.70 pg/ml, p < 0.01). Microscopic examination revealed that much more severe damage occurred in the suspicious necrotic intestinal segments in IL group. Conclusion: Both reconnecting intestine with BST and temporary abdominal closure with TCC are viable methods of damage control for multiple discontinuous intestinal injuries.

Facile pyrolysis synthesis of ionic liquid capped carbon dots and subsequent application as the water-based lubricant additives

Carbon dots (CDs) were facilely synthesized by one-pot pyrolyzing a lactic acid-ionic liquid (IL) gel with a relatively high yield of 34.9 wt%. The CDs, with a mean particle size of 4.4 nm and high thermal stability, were almost amorphous and capped by IL groups. The CDs-IL in water exhibited an obvious excitation-, concentration-, pH-dependent and high salt-tolerant photoluminescence property. Specifically, the CDs-IL emitted the strongest blue fluorescence at 454 nm under 365 nm excitation with a quantum yield of 16%. In addition, the CDs-IL, as a kind of water-based lubricant additives, greatly improved the tribological properties of base liquid. The loading capability of base liquid for steel–steel pair increased from 50 N to at least 80 N when only 0.015 wt% of CDs-IL was added. Meanwhile, the mean friction coefficient and wear volume of base liquid reduced by 57.5% and 64% at the load of 40 N, respectively. In addition, the friction-reducing and antiwear performance of CDs-IL was far superior to the CDs and IL, reflecting a synergetic lubrication effect between the IL groups and carbon cores. Based on the worn surface analyses, the CDs were prone to be squeezed out of the rubbing surfaces during the boundary shear friction process, while the CDs-IL were prone to quickly form ordered absorption layers on rubbing surfaces by electrostatic interaction between the IL groups and steel surface, which is of key importance for the formation of effective lubrication film to largely reduce friction and wear.

Effect of emulsified isoflurane post-conditioning on mitochondrial function during lung ischemia-reperfusion in rats: an in vitro experiment

Objective To evaluate the effect of emulsified isoflurane post-conditioning on the mitochondrial function during lung ischemia-reperfusion (I/R) in rats in an in vitro experiment. Methods Twenty-four SPF healthy male Sprague-Dawley rats, weighing 250-300 g, were used in the study.After the animals were anesthetized, the lungs were removed, connected to the perfusion system and then divided into 4 groups (n=6 each) using a random number table: control group (group C), group I/R, emulsified isoflurane post-conditioning group (group EI) and intralipid post-conditioning group (group IL). After 20 min of equilibration, the lungs were continuously perfused for 105 min in group C, and the lungs were subjected to 45 min ischemia followed by 60 min reperfusion to establish the model of lung I/R injury in the other three groups.During the reperfusion period, the common perfusate was used in group I/R, the perfusate containing 1.68 mmol/L emulsified isoflurane was used in group EI, and the equal volume of perfusate containing 30% intralipid was used in group IL.At the end of the equilibration (T0), immediately after beginning of reperfusion (T1) and at 30 and 60 min of reperfusion (T2, 3), the arterial oxygen partial pressure (PaO2), airway resistance, pulmonary compliance and tidal volume (VT) were recorded.The right upper lobe of the lung was removed at T3 for determination of wet to dry weight ratio (W/D ratio). The right middle lobe of the lung was removed at T3 for pathologic examination with light microscope.The contents of reactive oxygen species (ROS), NAD+ and ATP in lung tissues were detected. Results Compared with group C, the PaO2, pulmonary compliance and VT were significantly decreased, and the airway resistance was increased at T1-3, and the W/D ratio and ROS content were increased, and NAD+ and ATP contents were decreased at T3 in I/R, EI and IL groups (P<0.05). Compared with I/R and IL groups, the PaO2, pulmonary compliance and VT were significantly increased, and the airway resistance was decreased at T2, 3, and the W/D ratio and ROS content were decreased, and NAD+ and ATP contents were increased at T3 in group EI (P<0.05). The pathologic changes of lungs were significantly attenuated in group EI as compared with group I/R. Conclusion The mechanism by which emulsified isoflurane post-conditioning attenuates lung I/R injury is related to decrease in mitochondrial dysfunction in rats in an in vitro experiment. Key words: Isoflurane; Fat emulsions, intravenous; Reperfusion injury; Lung; Mitochondrial; Ischemia post-conditioning

COSMO-descriptor based computer-aided ionic liquid design for separation processes. Part I: Modified group contribution methodology for predicting surface charge density profile of ionic liquids

When applying COSMO-based models in Computer-Aided Ionic Liquid Design (CAILD), the generation of surface charge density profiles (σ-profiles) and cavity volumes (VCOSMO) of ILs is particularly important but too computationally expensive with quantum chemical calculations. In this work, a modified group contribution methodology, the COSMO-GC-IL method, is proposed for quick prediction of IL σ-profiles and VCOSMO based on σ-profiles of IL groups in their reference states (COSMO descriptors), together with two modification parameters (stretch and translation parameters). The influence of molecular environment on target groups can be well described and IL isomers are thereby distinguishable. To verify the method, σ-profiles and VCOSMO generated from the present method and from the DMol3 database are employed to calculate activity coefficients of 28,644 binary systems and 3410 liquid-liquid equilibria of ternary mixtures. Their close results in most cases demonstrate the reliability of the COSMO-GC-IL method.

Serum creatine phosphokinase levels as an indicator of muscle injury following lumbar disc surgery: Comparison of fully endoscopic discectomy and microdiscectomy

ObjectiveThe aim of this study is to make a comparison between fully endoscopic lumbar discectomy (FELD) and conventional microdiscectomy (MD) by using pre- and postoperative serum creatine phosphokinase (CPK) levels in correlation with postoperative low-back pain. MethodsFortyfive consecutive patients who underwent surgery for lumbar disc herniation were allocated into three groups with 15 patients on each: (1) FELD with interlaminar approach (IL), (2) FELD with transforaminal approach (TF), (3) Conventional MD. Serum CPK levels pre- and 1, 6, 12 and 24h postoperatively, patients’ body mass index (BMI), operation duration and hospital stays were recorded. The low-back pain pre- and postoperatively was assessed with the use of the 100mm visual analog scale (VAS) and the “Oswestry Disability Index” (ODI). ResultsThere were 16 female (35.5%) and 29 male (64.5%) patients with a mean age of 44.1 years. CPK levels at 6th, 12th and 24th hours postoperatively were found significantly lower in TF and IL groups compared to MD group (p<0.004). Mean operation duration was significantly shorter in MD group (p: 0.014). There was a significant decrease in both the VAS and ODI scores after the surgery in all patient groups (p<0.001). Postoperative VAS scores were found significantly higher in MD group (p: 0.04). ConclusionMinimal invasive nature of FELD procedures compared to the MD was substantiated by serum CPK levels in this study. To draw definitive conclusions regarding pain relief, larger patient samples should be evaluated, although postoperative VAS scores were found in favor of FELD.

What are the consequences of enlarging the extraction site to exteriorize a large specimen during laparoscopic surgery for Crohn's enteritis?

The implications of extraction site enlargement for the removal of large specimens during laparoscopic surgery for Crohn's disease have not been clearly described; such a description is the aim of this study. An institutional database was queried to identify patients undergoing laparoscopic resection for Crohn's disease through midline incision between 1995 and 2013. Perioperative outcomes were compared among cases completed through their initial extraction site (L), completed after increasing the length of the initial extraction site (IL) for specimen exteriorization, and cases converted to open surgery (C). Univariate and multivariate statistical analyses were performed. Out of 309 patients, 52 required IL and 36 required C. Heavier, older, male patients were more likely to require IL or C. There were no differences in disease behaviour (P=0.260), procedures performed (P=0.12) or postoperative morbidity (P=0.33). IL and L groups had a comparable initial length of hospital stay (LOS), which was shorter than in the C group. While there were no significant differences in causes of readmission (P=0.31), IL had increased readmission rates compared with L [odds ratio (OR) 2.80, P=0.021] or C (OR 13.89, P=0.015). When combining initial and readmission LOS, C and IL groups had comparable overall LOS [median ratio (MR) 1.09, P=0.57], which was significantly longer than in the L group (MR 1.27, P=0.02). Extraction site enlargement during laparoscopic surgery for enteric Crohn's disease had no impact on primary LOS. However, the shorter initial LOS was offset by increased readmission rates when compared with formal conversion. The threshold to convert in case of anticipated difficulty due to a large specimen should be low.