Mycobacterium avium subsp. paratuberculosis (MAP) is responsible for Johne’s disease (JD), a contagious granulomatous gastroenteritis with global distribution. This study investigated the expression of miRNAs and their potential regulatory mechanisms in Canadian Holstein cows with different MAP infection status, including 4 infected (MAPI), 5 tolerant to MAP infection (MAPT) and 5 healthy controls (HC).Intestinal tissues, jejunum (JE), jejunal lymph node (JELN) and caecal Peyer’s patches (CPP) were collected for miRNA-sequencing, differential expression and functional analysis. A total of 318, 281 and 251 miRNAs were identified in JE, JELN, and CPP, respectively. Out of these, 28, 46, and 24 were highly expressed in JE, JELN and CPP, respectively, including 23 miRNAs highly expressed across all tissues. Their functional enrichment indicates overrepresentation in mostly immune related functions. More differentially expressed (DE) miRNAs were identified in CPP (39, 21 and 11) followed by the JELN (25, 8 and 13) and JE (9, 9 and 15) for the comparisons MAPI vs HC, MAPT vs HC, and MAPI vs MAPT, respectively. Six common DE miRNAs (bta-miR-125a, bta-miR-146a, bta-miR-146b, bta-miR-21-5p, bta-miR-320a, bta-miR-370) (FDR < 0.1) in the JELN and CPP of MAPI cows are implicated in the immune response, suggesting roles in MAP infection. Similarly, more functional annotations were recorded for the CPP (1284) than JELN (377) and JE (four). DE miRNAs in JELN and CPP were enriched in gene ontology (GO) terms (e.g. lymphocyte activation, lymphocyte homeostasis, leukocyte differentiation, regulation of cell differentiation, T cell receptor complex, alpha–beta T cell activation) and KEGG pathways (e.g. T/B cell receptor signaling pathways, Chemokine signaling pathway, Leukocyte transendothelial migration, Th17 cell differentiation, MAPK signaling pathway, etc.) with immune related functions indicative of participation in the regulatory mechanisms of the host immune response to MAP infection. The comparison MAPI vs HC revealed a more pronounced immune response in JELN and CPP indicative of a heightened immune response, but fewer DE miRNAs and less pronounced immune activation for MAPT vs HC indicative of the development of tolerance to MAP presence.MiRNA expression and functional enrichment in JE, JELN, and CPP highlightes tissue-specific regulation of immune pathways and cellular functions during JD. Moreover, largely a different set of DE miRNAs, biological processes and pathways were driving the MAPI and MAPT phenotypes. These findings underscore the complex interplay between miRNAs and MAP in the studied tissues and provide a foundation for further exploration of miRNAs as potential biomarkers for the management of JD.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12864-025-12304-3.

To quantify inter-center variation (ICV) in length of stay (LOS) among surviving infants with jejunal (JA) or ileal atresia (IA). Children's Hospitals Neonatal Consortium's database was used to identify infants with JA or IA. After excluding infants with abdominal wall defects, survivors' hospital LOS was modeled as a function of center using generalized linear models with log link for gamma distribution. There were 1134 and 808 infants with JA and IA, respectively. LOS had significant ICV in unadjusted (JA: 5.4 [IQR 3.7,9.9] weeks; IA: 4.3 [IQR 2.4,11.4] weeks) and multivariable analyses (JA: 4+ fold difference (6.5-31.5 week); p < 0.001 IA: 8+ fold difference (1.7-14.6 weeks); p < 0.001) with modifiable risk factors including cholestasis, ostomy creation, blood stream infection, and residual bowel length <55 cm. Risk-adjusted ICV in LOS was observed in infants with JA and IA, which exposes opportunities for improvements in outcomes for infants with intestinal atresia.

4018 Background: Small bowel adenocarcinoma (SBA) is a rare cancer with rising incidence and worse overall survival (OS) compared to other intestinal cancers. Clinical management of SBA is primarily extrapolated from colorectal cancer (CRC). Comprehensive genomic and transcriptomic profiling of SBA will facilitate development of disease-specific therapeutic strategies. We investigated molecular alterations and association with clinical outcomes in a large cohort of SBA pts. Methods: Tumors were analyzed using 592 gene next-generation sequencing of DNA (592 genes or WES), RNA (WTS) and IHC (Caris). Immune infiltration was calculated by QuantiSeq. OS was calculated from treatment start/tissue collection to last contact from insurance claims. Results: We analyzed 823 SBA tumors: 448 primary/312 metastases, 586 duodenal (DA)/95 jejunal (JA)/38 ileal (IA). Median age of JA pts was lower (57yo) than DA (67yo) and IA (68yo). Upon subsite comparison, HER2 overexpression (2.5%) and amplification (3.6%) was only seen in DA, while HER2 mutations (mts) were most common in JA (10%) and absent in IA. IA had the lowest rate of KRAS (30%) and APC (11%) mts and highest rate of DDR mts (37%). JAs were enriched in RSPO3 fusion (19%) and BRAF mts (21%). Among BRAF mts in SBA, class 3 comprised 53%, class 2 37% and class 1 10%. MSI/dMMR was seen in 8% SBA and TMB-H in 11% with no difference among subsites. Compared to 14000 CRC tumors, SBA had significantly higher immune infiltrates regardless of MSI status (p&lt;0.001), with highest fold change in myeloid dendritic cells (15.5), Tregs (9.4), neutrophils (3.6) and M2 Macrophages (3.5). When investigating clinical outcome of SBA pts (n=751), favorable prognostic markers included TMB³8 mts/Mb (HR: 0.65, 95%CI: 0.50-0.85), mts in APC (HR: 0.76, 95% CI: 0.62-0.93), MSH6 (HR: 0.45, 95% CI: 0.20-0.99), HNF1A (HR: 0.268, 95% CI: 0.11-0.65), PRKDC (HR: 0.45, 95% CI: 0.20-1.01) and ERBB3 (HR: 0.46, 95% CI: 0.26-0.82), while TP53 (HR: 1.32, 95% CI: 1.10-1.59) and CDKN2A (HR: 1.7, 95% CI: 1.25-2.3) mts and positive PD-L1 (HR: 1.44, 95% CI: 1.09-1.90) predicted worse OS. Among SBA pts treated with chemotherapy (n=258), DA had worse OS than IA/JA (HR: 1.44, 95% CI: 1.05-1.98), which had worse OS than left-sided [LS] (HR: 1.86, 95% CI: 1.39-2.46) and right-sided [RS] CRC pts (HR: 1.35, 95% CI: 1.01-1.79). DA pts had significantly worse OS compared to LS (HR=2.97, 95% CI: 1.73-5.08) and RS (HR=1.88, 95% CI: 1.08-3.24) CRC pts. Conclusions: This study represents the largest SBA cohort with comprehensive genomic and transcriptomic profiling. We identified subsite-specific enrichment in targetable alterations, including HER2 overexpression/amplification in DA, BRAF/HER2 mts and RSPO3 fusions in JA, and DDR mts in IA. SBAs harbor higher immune infiltrates than CRC, suggesting active immune modulation. DA is characterized by poor overall outcomes and decreased therapeutic benefit from chemotherapy compared to LS- and RS- CRCs.

Mycobacterium avium subsp. paratuberculosis (MAP) is the causative infectious agent of Johne’s disease (JD), an incurable granulomatous enteritis affecting domestic livestock and other ruminants around the world. Chronic MAP infections usually begin in calves with MAP uptake by Peyer’s patches (PP) located in the jejunum (JE) and ileum (IL). Determining host responses at these intestinal sites can provide a more complete understanding of how MAP manipulates the local microenvironment to support its long-term survival. We selected naturally infected (MAPinf, n=4) and naive (MAPneg, n=3) cows and transcriptionally profiled the JE and IL regions of the small intestine and draining mesenteric lymph nodes (LN). Differentially expressed (DE) genes associated with MAP infection were identified in the IL (585), JE (218), jejunum lymph node (JELN) (205), and ileum lymph node (ILLN) (117). Three DE genes (CD14, LOC616364 and ENSBTAG00000027033) were common to all MAPinf versus MAPneg tissues. Functional enrichment analysis revealed immune/disease related biological processes gene ontology (GO) terms and pathways predominated in IL tissue, indicative of an activated immune response state. Enriched GO terms and pathways in JE revealed a distinct set of host responses from those detected in IL. Regional differences were also identified between the mesenteric LNs draining each intestinal site. More down-regulated genes (52%) and fewer immune/disease pathways (n=5) were found in the ILLN compared to a higher number of up-regulated DE genes (56%) and enriched immune/disease pathways (n=13) in the JELN. Immunohistochemical staining validated myeloid cell transcriptional changes with increased CD172-positive myeloid cells in IL and JE tissues and draining LNs of MAPinf versus MAPneg cows. Several genes, GO terms, and pathways related to metabolism were significantly DE in IL and JE, but to a lesser extent (comparatively fewer enriched metabolic GO terms and pathways) in JELN suggesting distinct regional metabolic changes in IL compared to JE and JELN in response to MAP infection. These unique tissue- and regional-specific differences provides novel insight into the dichotomy in host responses to MAP infection that occur throughout the small intestine and mesenteric LN of chronically MAP infected cows.

Introduction: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) causes severe respiratory infection. Gastrointestinal symptoms have been reported in up to 10% of patients. Case Presentation: We here report a case of COVID-19-associated acute mesenteric ischemia in a patient presenting with fever and abdominal pain, deteriorating over a four-day period. The diagnosis was initially missed due to a low suspicion level. COVID-19 infection was confirmed by chest CT scan and RT-PCR. Then the patient underwent an emergency laparotomy showing segmental small bowel ischemia of about 2 meters (between the lower jejunum and upper ileum). Resection of the ischemic segment was performed by end-to-end anastomosis. He was then discharged from the hospital after recovering from COVID-19. Conclusions: The present case report highlights the importance of being vigilant about mesenteric ischemia symptoms in the patients with COVID-19, presenting with progressive abdominal pain for timely ordering appropriate diagnostic and therapeutic procedures.

Background Perforated duodenal ulcer (DU) is a dangerous and life-threatening condition, with associated high mortality, especially when there is releakage after initial repair with omental patch. There are multiple methods recommended by different studies for its management. These methods include cholecystoduodenoplasty, a jejunal serosal patch, triple-tube drainage, T-tube duodenostomy, and conservative methods. The aim of the study is to compare between triple-tube drainage and jejunal serosal patch as methods of management of releaked DU regarding the efficacy, failure, and mortality. Patients and methods This study included 20 patients presented with releaked perforated DU treated initially with pedicled omental patch technique. They were divided randomly into two groups: group A included 10 patients who were treated by triple-tube drainage and group B included 10 patients who were treated by jejuna serosal patch. Results The mean age of group A patients was 54 years, whereas for group B patients, it was 51 years. Most of the group A patients were males (80%) and also 90% of the group B patients were males. All patients (100%) of both groups were presented with manifestations of shock like hypotension and palpitation. The average length of hospital stay was 11 days (range, 8–15 days) for the group A patients and 13 days (range, 7–19 days) for group B patients. Conclusion Releaked perforated DU after initial omental patch repair is a life-threatening entity and needs urgent resuscitation and interference. There are several methods of its management, among them are triple-tube drainage and jejunal serosal patch. Both methods have nearly the same success, complications, and mortality rates.

THE SITE OF ABSORPTION OF CO58-LABELED VITAMIN B12 IN MAN. AN INVESTIGATION MADE BY INTESTINAL INTUBATION WITH POLYETHYLENE GLYCOL AS A MARKER SUBSTANCE.

To evaluate the value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint. A retrospective analysis was performed on the clinical data and capsule endoscopy findings of 93 children with hematochezia who were admitted to Children's Hospital of Fudan University from May 2015 to January 2019 and underwent capsule endoscopy. According to the capsule endoscopy findings of the jejunum and the ileum, they were divided into a positive lesion group with 39 patients and a negative lesion group with 54 patients. Related clinical data and the features of lesion on capsule endoscopy were analyzed for the two groups. There were no significant differences in age, sex, duration of capsule endoscopy, gastric transit time, and small intestinal transit time between the positive lesion and negative lesion groups (P>0.05). The positive lesion group had a significantly lower level of hemoglobin than the negative lesion group (P<0.05). Hemoglobin level was negatively correlated with the rate of positive lesions on capsule endoscopy (r=-0.342, P=0.001). Among the 39 patients with positive lesions on capsule endoscopy, the detection of Meckel's diverticulum was the highest (41%), followed by inflammatory bowel disease (21%). Capsule endoscopy has a certain value in detecting small intestinal diseases, especially diseases in the jejunum and the ileum, in children with lower gastrointestinal hemorrhage.

AIM: To provide a brief review of literature on intussusception due to inflammatory fibroid polyp (IFP). METHODS: A case report on inflammatory fibroid polyp presenting as ileo-colic intussusception made us review the literature on IFPs presenting as Intussusception, published in PubMed in English language. A comprehensive search of all case reports was done using keywords: intussusception due to IFP, intussusception and IFP, intussusception, IFP. The search covered all case reports from 2000 to 2020. RESULTS: 53 case reports with a total of 55 cases were analysed in this article, the range of age with such a presentation was from minimum10 years to maximum 79 yrs age, with median age of presentation 48years. 22 cases were males and 32 females, with one case gender not specified. Most common site of IFP presenting as intussusception was ileum (43cases), leading to ileo-colic intussusceptions, there were 11 case reports of jejunal intussusceptions also.

ABSTRACTThe purpose of this study was to assess the correlation between tissue volume and blood flow of the flap in an animal model. Using animal model, tissue volume can be attenuated, and precise change of blood flow could be evaluated. We further investigate the relationship between blood flow and vascular density in the tissue. In this study, we assessed flap conductance (ml/min/mm Hg) as to evaluate the conductivity of blood flow into the flap. Japanese white rabbit was used (n = 7) for this study. The amount of blood flow of jejunal and latissimus dorsi muscle (LD) flaps was measured while removing the distal portion of the flap sequentially. Conductance at each time was calculated from blood pressure and blood flow volume. The tissue volume at each time was also measured. The correlation between conductance and volume was analyzed using a linear mixed model. Immunohistochemical evaluation of microvessel densities (MVD) in these tissues was also performed for CD31/PECAM1 positive area. Conductance and tissue volume were significantly correlated in both jejunal and LD flaps. As the volume increases by 1 cm3, the conductance increased significantly by 0.012 ml/min/mm Hg in jejunum, and by 0.0047 ml/min/mm Hg in LD. Mean MVD was 1.15 ± 0.52% in the jejunum and 0.37 ± 0.29% in the LD muscle. In this study, we revealed that flap conductance is proportional to volume and proportional constant is different between the type of tissue. It suggests that the difference of MVD creates the unique conductance of each tissue.

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a classic bariatric and metabolic surgery, which is a combination of limiting intake and reducing absorption. LRYGB has a higher remission rate for type 2 diabetes, which may be related to the change of gastrointestinal hormone secretion and the effect of bypassing duodenum on the function of islet cells. LRYGB could be used as the first choice for obese patients or super obese patients with severe reflux esophagitis or metabolic syndrome. The main points of this operation include: ① A gastric pouch should be established under the cardia with isolated gastric fundus, ensuring a volume of < 30 ml; ② The total length of jejunum including biliopancreatic branch and food branch should be more than 200 cm; ③ Diameter of the GJ anastomosis should be < 1.5 cm; ④ Mesentery defect should be closed to prevent internal hernia. Key words: Laparoscopes; Gastric bypass; Bariatric and metabolic surgery

In this study, we aimed to determine the drug-drug interaction potential between atorvastatin (ATOR), and talinolol (TAL). Concentration-dependent effects of ATOR on the intestinal permeability of TAL were investigated by an in situ intestinal perfusion method. Dose-dependent effects of ATOR on TAL exposure were evaluated by measuring plasma concentrations after oral administration in rats. ATOR slightly changed the intestinal secretion of TAL in jejunum but not in colon. Plasma AUC levels of TAL were elevated by co-administration of ATOR at low and high doses whereas medium doses of ATOR resulted in a decrease in TAL bioavailability. However, these changes were not statistically significant. In our study, the pharmacokinetics of TAL were not affected by the concurrent use of ATOR in rats. In conclusion, it should be considered that complex interplay between the efflux and uptake transporters in the tissues and inhibition of these transporters by modulating agents may overshadow individual effects of each other.

Objective To investigate the clinical effect of intra-abdominal pressure monitoring on jejunal nutrition in critically ill patients. Methods From March 2017 to September 2018, 124 critically ill patients who needed early jejunal nutrition in ICU of our hospital were selected and randomly divided into observation group (63 cases) and control group (61 cases) according to the digital table.The observation group adjusted enteral nutrition according to IAP monitoring, while the control group was routinely observed and guided enteral nutrition.Intra-abdominal pressure was compared between the two groups.The changes of blood lactic acid, endotoxin and APACHE Ⅱ score were compared between the two groups. Results After treatment for 7 days and 14 days, the intra-abdominal pressure of the observation group[(14.28±2.36)mmHg, (12.08±1.78)mmHg] were lower than those of the control group [(16.05±2.55)mmHg and (15.21±2.11)mmHg] (t=4.013, 8.939, all P<0.05). After treatment for 14 days, the blood lactic acid, endotoxin, APACHE Ⅱ score in the observation group were (2.19±0.73)mmol/L, (0.71±0.21)U/L and (10.02±1.54), which were lower than those in the control group [(3.98±0.95)mmol/L, (0.92±0.23)U/L and (13.06±1.72)] (t=11.788, 5.313, 10.376, all P<0.05). The incidences of abdominal distension (9.52%) and gastric retention (7.94%) in the observation group were significantly lower than those in the control group (28.57%, 27.87%) (χ2=7.930, 8.437, all P<0.05). Conclusion Early jejunal nutrition under the monitoring of intra-abdominal pressure in critically ill patients can help to reduce intra-abdominal hypertension, promote the rehabilitation of patients, reduce the incidence of complications of jejunal nutrition and improve patients’ tolerance, which is worthy of clinical promotion. Key words: Enteral nutrition; Pressure; Abdominal cavity; Lactic acid; Endotoxins; APACHE Ⅱ score

Objective To investigate the transabdominal and left thoracoabdominal approach in treatment of Siewert Ⅱ/Ⅲ adenocarcinoma esophagigastric(AEG) junction. Methods A retrospective study was performed on 158 cases of patients with Siewert Ⅱ/Ⅲ AEG who were admitted from January 2016 to January 2019.113 males and 45 fenales were oged (66.78±6.54) years old, ranging from 39 to 85 years old.According to the different surgical methods, the patients were divided into the transabdominal group(n=76) and the left thoracoabdominal combined group(n=82). The intraoperative operative time, intraoperative hemorrhage, tumor length, abdominal esophageal involvement, digestive tract reconstruction(jejunum, gastric stump), pathological grading and postoperative complications in the two groups were compared and analyzed. Results The operative time[(144.93±31.89) min]in the transabdominal group was shorter than that in the left thoracoabdominal combined group[(183.66±31.63) min], intraoperative hemorrhage[(97.23±55.34) ml]was less than that in the left thoracoabdominal combined group[(126.83±59.42) ml], abdominal esophageal involvement[6.6%(5/76)]was lower than that in the left thoracoabdominal combined group[48.8%(40/82)], and esophageal jejunum[13.2%(10/76)]was higher than that in the left thoracoabdominal combined group[3.7%(3/82)]. Esophageal residual stomach[86.8%(66/76)]was lower than the left thoracoabdominal combined group[96.3%(79/82)], and the difference was statistically significant(P 0.05). There was no statistically significant difference(P=0.745) in the length of hospital stay[(16.78±3.78) d]between the patients in the transabdominal group and those in the left thoracoabdominal combined group[(16.51±6.07) d]. The incidence of postoperative complications in the transabdominal group[13.1%(10/76)]was lower than that in the left thoracoabdominal combined group[28.1%(23/82)], and the difference was statistically significant(P=0.021). Patients with postoperative pleural effusion and pulmonary infection are the most common, and can be cured and discharged after thoracopuncture and anti-infection treatment. Conclusion For SiewertⅡ/ⅢAEG, transabdominal or left thoracoabdominal combination can complete the operation well, and the choice of operation mode also has advantages and disadvantages.The transabdominal group is more simple and safe, and the left thoracoabdominal combined group is more conducive to ensure the negative cutting edge, however, the operation time is relatively long, and there are more intraoperative bleeding and postoperative complications. Key words: SiewertⅡ/Ⅲ adenocarcinoma esophagigastric junction; Thoracoabdominal approach; Left thoracoabdominal combination; Complications

The effects of Shirazi thyme as a medicinal plant on oxidant status (lipid peroxidation, protein oxidation, total antioxidant capacity, and catalase activity) and absorptive surface area were measured in three segments of the small intestine in cold-induced pulmonary hypertensive chickens. Birds were reared at four groups (thyme 0, 0.25, 0.50, and 1.00 % of diet) for 42 days. To induce pulmonary hypertension, the temperature was gradually decreased. The body weight was increased in thyme-0.25% birds compared to control ones, while it was decreased in thyme-1% of birds. The feed consumption was only increased in thyme-1.00% birds. The feed conversion ratio was lower in thyme-0.25% birds and higher in thyme-1.00% birds than control ones. The duodenal and jejunal villus surface area was lower in thyme-1.00% birds than control ones, while it was greater in the thyme-0.50% birds. The ileal villus surface area and duodenal lamina propria thickness were also greater in thyme-0.50% birds. Lipid peroxidation was only decreased in the duodenum and ileum of thyme-0.50% birds compared to control ones, whereas it was increased in the duodenum and jejunum of thyme-1.00% birds. Catalase activity was only elevated in the duodenum and jejunum of thyme-1.00% fed chickens. Total antioxidant capacity was increased in the duodenum, jejunum, and ileum of thyme-0.50% birds. It is concluded that the Shirazi thyme has beneficial effects on growth performance, intestinal absorptive surface area / secretory system, and pulmonary hypertension response at low doses (0.25 and 0.50% of diet), whereas high dose (1.00% of diet) of this plant may be toxic.

Objective To explore the feasibility, safety and effectiveness of Magnetic compression anastomosis (MCA) for gastrojejunostomy in rabbits. Methods 8 rabbits were subjected to gastric-jejunal anastomosis by magnetic compression according to the established surgical operation path. After 48 hours of magnet extubation, 4 rabbits were randomly selected to observe the anastomosis and cut its tissues for hematoxylin and eosin (HE) and Masson staining. The remaining 4 rabbits were performed pyloric ligation, and 14 days later, iodohexol angiography was performed to observe the patency and leakage of the anastomosis. Results All the 8 rabbits were successfully treated with gastric-jejunal anastomosis. The animals survived well and the magnets were discharged within 8-12 days. The anastomosis healed well, and the surrounding inflammatory reaction was mild without leakage. After ligation, 1 rabbit died due to anastomotic leakage, the rest survived well, and radiography showed good patency. Conclusion MCA can safely realize the anastomosis between stomach and jejunum and solve the problem of pyloric obstruction, which is expected to develop into a new anastomosis of digestive tract. Key words: Magnetic compression anastomosis; Gastrojejunostomy; Digestive tract reconstruction; Pyloric obstruction

The objective of this study was to evaluate the influence of viscosity-enhancing agents on oral absorption of metoprolol (MPL) and bisoprolol (BPL). Although the viscosity values were similar for MPL and BPL in hydroxypropyl methylcellulose (HPMC, 1.2 % (w/w)) and polyvinyl alcohol (PVA, 8.8 % (w/w)) solutions, the order of diffusion rate constants of the drugs in media were phosphate buffer solution (reference) > HPMC solution > PVA solution. In in vivo rat intestinal absorption experiments showed that the Cmax and AUC values of the drugs were lowest when they were administered into the rat jejunum in a PVA solution. In vitro binding studies showed that this may have been due to adsorption of the drugs to PVA molecules, resulting in decreased free fractions of the drugs. Our results indicated that intestinal absorption of the drugs in PVA solution was influenced both by decreased diffusion of the drugs and by interaction with PVA. Since various viscosity-enhancing agents are widely used as pharmaceutical and food additives, these findings may be of significance for understanding therapeutic efficacy and safety of oral drug products.

Objective To investigate the effect of jejunal interposition anastomosis in digestive tract reconstruction after total gastrectomy for proximal gastric cancer and its effect on digestive function of patients. Methods 80 patients with proximal gastric cancer who underwent radical total gastrectomy in our hospital from April 2016 to August 2018 were selected. 40 patients who underwent gastrointestinal reconstruction by jejunal interposition anastomosis were included in the observation group, and 40 patients who underwent gastrointestinal reconstruction by esophago-jejunal Roux-en-Y were included in the control group. All the data were analyzed by SPSS 16.0. The operation-related data and gastrointestinal hormone levels were described by (±s), the independent sample t test was used for comparison between the two groups, and the paired t test was used for comparison at different time. The counting data were compared by χ2 test; P<0.05 had statistical significance. Results There was no significant difference in operation time, intraoperative bleeding volume, number of lymph nodes dissected and length of hospital stay between the two groups (P>0.05). Three months after operation, the levels of serum gastrin (GAS), motilin (MTL) and somatostatin (SS) in the two groups were significantly lower than those before operation, and the decrease in the control group was more significant, the level of cholecystokinin (CCK) was significantly higher than that before operation, the differences were statistically significant (P<0.05). The complication rate of the observation group was 10.00%, which was lower than that of the control group of 27.50% (χ2=4.021, P=0.045). Conclusion Jejunal interposition anastomosis has less influence on digestive function and lower incidence of complications after radical total gastrectomy for proximal gastric cancer. Key words: Stomach neoplasms; Gastrectomy; Anastomosis, roux-en-Y; Digestion

Objective To evaluate the safety and efficacy of enchanced recovery plus transnasal placement of jejunal feeding tube for intestinal malrotation in neonates. Methods A prospective study was conducted for assessing the safety and efficacy of enhanced recovery after surgery (ERAS) plus transnasal placement of jejunal feeding tube for intestinal malrotation. A total of 51 surgical neonates aged from 1 day to 28 days with intestinal malrotation from January 2015 to March 2018 were recruited and divided into ERAS group (ERAS plus transnasal placement of jejunal feeding tube, n=31) and control group (n=20) according to the parental willingness on admission. The parameters of intraoperative blood loss, operative duration, preoperative hospital stay, time to initial defecation, time to initial enteral nutrition, time to total enteral nutrition time, postoperative stress and complications were compared. Postoperative recovery was tracked for 6 months. Results Significant inter-group differences existed in preoperative hospital stay [(1.78±0.33) vs. (2.28±0.74) days], operative duration [(139.16±7.03) vs. (74.30±5.92)min], time to first defecation [(1.80±0.33)vs.(2.25±0.54)days], time to initial enteral nutrition [(1.32±0.31) vs. (4.42±0.82) days] and time to total enteral nutriton [(7.55±0.66) vs. (8.40±0.75) days] (all P<0.05). There were also inter-group statistical differences (P<0.05) in stress parameters at 24h post-operation including c-reactive protein (CRP) [(9.29±1.81) vs.(20.45±4.31) mg/L], interleukin-6 [(2.76±0.21) vs. (7.10±1.02) pg/L] and cortisol [(86.75±32.77) vs.(156.75±35.59) nmol/L]. However, the difference of intraoperative blood loss was not statistically significant between two groups [(18.77±3.57) vs. (18.90±3.48) ml]. As for postoperative complications, there was no recurrence of volvulus in neither groups and no incision infection in ERAS group. However, two incision infections occurred in control group. The inter-group rates of respiratory tract infection and diarrhea were not statistically significant [9.6%(3/31) vs. 15.0%(3/20), 6.4%(2/31) vs. 10.0%(2/20)]. No postoperative re-hospitalization occurred during a 6-month follow-up period. Conclusions ERAS plus transnasal placement of jejunal feeding tube are both safe and feasible for intestinal malrotation in neonates. It may reduce stress injuries and enhance early recovery after surgery. Key words: Enteral Nutrition; Jejunum; Malrotation of intestine; Enhanced recovery after surgery

The influence of glutamine (Gln) on the intestinal function and health in broilers challenged with Salmonella pullorum was investigated. 240 one -day-old Arbor Acres broilers were divided into four groups in a completely randomized design, each of which included 6 replicates with 10 birds per replicate, for 21 days. The experimental groups were as follows: control group (CON), S. pullorum challenged control group (SCC), basal diet plus S. pullorum challenged plus 0.5 % Gln (Gln 1) or1.0 % Gln (Gln 2), The results showed that S. pullorum had significantly adverse effect on ADG, ADFI and feed to gain ratio (F: G) of broilers compared with the values measured for the CON during days 5 to 7. Moreover, compared with the characteristics of CON, S. pullorum showed significantly effects on the relative weight and length of small intestine at 7 d, the activities of sucrose, maltase and lactase in the jejunum mucosa at 4 d, or 7 d, the counts of Salmonella and Lactobacillus at 4, 7 and 21d and the molar proportion of isobutyric acid at 14 d. The inclusion of Gln significantly elevated the relative weight and length of small intestine, increased intestinal sucrose, maltase and lactase activities, decreased caecal Salmonella population and molar proportion of isobutyric acid at 14 d. These results suggested that Gln might exert a favorable effect on intestinal function and health in broilers.