Serum Alb Research Articles

Effects of dietary methionine supplementation on the growth performance, immune responses, antioxidant capacity, and subsequent development of layer chicks

Deficiencies or excesses of dietary amino acids, and especially of methionine (Met), in laying hens can lead to abnormal protein anabolism and oxidative stress, which affect methylation and cause cellular dysfunction. This study investigated the effects of dietary methionine (Met) levels on growth performance, metabolism, immune response, antioxidant capacity, and the subsequent development of laying hens. A total of 384 healthy 1-day-old Hyline Grey chicks of similar body weight were randomly allocated to be fed diets containing 0.31%, 0.38%, 0.43% (control group), or 0.54% Met for 6 wk, with 6 replicates of 16 chicks in each. The growth performance of the chicks was then followed until 20 wk old. The results showed dietary supplementation with 0.43% or 0.54% Met significantly increased their mean daily body weight gain, final weight, and Met intake. However, the feed:gain (F/G) decreased linearly with increasing Met supplementation, from 0.31 to 0.54% Met. Met supplementation increased the serum albumin, IgM, and total glutathione concentrations of 14-day-old chicks. In contrast, the serum alkaline phosphatase activity and hydroxyl radical concentration tended to decrease with increasing Met supplementation. In addition, the highest serum concentrations of IL-10, T-SOD, and GSH-PX were in the 0.54% Met-fed group. At 42 d of age, the serum ALB, IL-10, T-SOD, GSH-PX, T-AOC, and T-GSH were correlated with dietary Met levels. Finally, Met supplementation reduced the serum concentrations of ALP, IL-1β, IgA, IgG, hydrogen peroxide, and hydroxyl radicals. Thus, the inclusion of 0.43% or 0.54% Met in the diet helps chicks achieve superior performance during the brooding period and subsequently. In conclusion, Met doses of 0.43 to 0.54% could enhance the growth performance, protein utilization efficiency, antioxidant capacity, and immune responses of layer chicks, and to promote more desirable subsequent development during the brooding period.

Accuracy of Albumin, Globulin, and Albumin-Globulin Ratio for Diagnosing Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis.

Periprosthetic joint infection (PJI) is one of the most intractable orthopedic diseases, partly because of the difficulty in differentiating septic from aseptic conditions. We aimed to evaluate and consolidate the diagnostic accuracy of the quantitative assessment of serum albumin (Alb), globulin (Glb), and albumin-globulin ratio (AGR), alone or in combination with the inflammatory marker, C-reactive protein (CRP), for PJI. We searched the PubMed, CINAHL, and Cochrane Library databases for studies that quantitatively measured Alb, Glb, or AGR for the diagnosis of PJI up until the 30 April 2023. A total of 2339 patients were included from 10 studies, including 845 patients with a definitive diagnosis of PJI and 1494 with non-PJI. The pooled sensitivity, specificity, and area under the curve (AUC) in the summary receiver-operating characteristic curve were as follows: 0.625, 0.732, and 0.715 for Alb; 0.815, 0.857, and 0.887 for Glb; 0.753, 0.757, and 0.875 for AGR; 0.788, 0.837, and 0.876 for CRP; 0.879, 0.890, and 0.917 for the CRP-Alb ratio; and 0.845, 0.855, and 0.908 for the CRP-AGR ratio. Serum Alb, Glb, and AGR levels are feasible and accurate diagnostic markers for PJI, and the combination of these markers with CRP levels may potentially improve preoperative serum diagnostic accuracy. Future prospective studies are required to verify these findings because of the small numbers of included studies.

A real-world study and network pharmacology analysis of EGFR-TKIs combined with ZLJT to delay drug resistance in advanced lung adenocarcinoma

ObjectiveThis study aimed to explore the efficacy and safety of combining epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) with ZiLongJin Tablet (ZLJT) in delaying acquired resistance in advanced EGFR-mutant lung adenocarcinoma (LUAD) patients. Furthermore, we employed network pharmacology and molecular docking techniques to investigate the underlying mechanisms.MethodsA retrospective comparative study was conducted on stage IIIc/IV LUAD patients treated with EGFR-TKIs alone or in combination with ZLJT at the Second Affiliated Hospital of the Air Force Medical University between January 1, 2017, and May 1, 2023. The study evaluated the onset of TKI resistance, adverse reaction rates, safety indicators (such as aspartate aminotransferase, alanine aminotransferase, and creatinine), and inflammatory markers (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio) to investigate the impact of EGFR-TKI combined with ZLJT on acquired resistance and prognostic indicators. Additionally, we utilized the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, the Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine, PubChem, UniProt, and Swiss Target Prediction databases to identify the active ingredients and targets of ZLJT. We obtained differentially expressed genes related to EGFR-TKI sensitivity and resistance from the Gene Expression Omnibus database using the GSE34228 dataset, which included sensitive (n = 26) and resistant (n = 26) PC9 cell lines. The "limma" package in R software was employed to detect DEGs. Based on this, we constructed a protein‒protein interaction network, performed gene ontology and KEGG enrichment analyses, and conducted pathway network analysis to elucidate the correlation between the active ingredients in ZLJT and signaling pathways. Finally, molecular docking was performed using AutoDockVina, PYMOL 2.2.0, and Discovery Studio Client v19.1.0 software to simulate spatial and energy matching during the recognition process between predicted targets and their corresponding compounds.Results(1) A total of 89 patients were included, with 40 patients in the EGFR-TKI combined with ZLJT group (combination group) and 49 patients in the EGFR-TKI alone group (monotherapy group). The baseline characteristics of the two groups were comparable. There was a significant difference in the onset of resistance between the combination group and the monotherapy group (P < 0.01). Compared to the monotherapy group, the combination group showed a prolongation of 3.27 months in delayed acquired resistance. There was also a statistically significant difference in the onset of resistance to first-generation TKIs between the two groups (P < 0.05). (2) In terms of safety analysis, the incidence of adverse reactions related to EGFR-TKIs was 12.5% in the combination group and 14.3% in the monotherapy group, but this difference was not statistically significant (P > 0.05). There were no statistically significant differences in serum AST, ALT, CREA, TBIL, ALB and BUN levels between the two groups after medication (P > 0.05). (3) Regarding inflammatory markers, there were no statistically significant differences in the changes in neutrophil-to-lymphocyte Ratio(NLR) and Platelet-to-lymphocyte Ratio(PLR) values before and after treatment between the two groups (P > 0.05). (4) Network pharmacology analysis identified 112 active ingredients and 290 target genes for ZLJT. From the GEO database, 2035 differentially expressed genes related to resistant LUAD were selected, and 39 target genes were obtained by taking the intersection. A "ZLJT-compound-target-disease" network was successfully constructed using Cytoscape 3.7.0. GO enrichment analysis revealed that ZLJT mainly affected biological processes such as adenylate cyclase-modulating G protein-coupled receptor. In terms of cellular components, ZLJT was associated with the cell projection membrane. The molecular function primarily focused on protein heterodimerization activity. KEGG enrichment analysis indicated that ZLJT exerted its antitumor and anti-drug resistance effects through pathways such as the PI3K-Akt pathway. Molecular docking showed that luteolin had good binding activity with FOS (-9.8 kJ/mol), as did tanshinone IIA with FOS (-9.8 kJ/mol) and quercetin with FOS (-8.7 kJ/mol).ConclusionZLJT has potential antitumor progression effects. For patients with EGFR gene-mutated non-small cell LUAD, combining ZLJT with EGFR-TKI treatment can delay the occurrence of acquired resistance. The underlying mechanisms may involve altering signal transduction pathways, blocking the tumor cell cycle, inhibiting tumor activity, enhancing cellular vitality, and improving the bioavailability of combination therapy. The combination of EGFR-TKI and ZLJT represents an effective approach for the treatment of tumors using both Chinese and Western medicine.

Dietary Chinese herbal mixture supplementation improves production performance by regulating reproductive hormones, antioxidant capacity, immunity, and intestinal health of broiler breeders

Chinese herbs have been used as feed additives and are commonly utilized in domestic intensive livestock farming. However, their impact on the production performance and intestinal health of broiler breeders has yet to be thoroughly explored. This study aimed to evaluate the effects of a Chinese herbal mixture (CHM) on the production performance of broiler breeders in terms of reproductive hormones, antioxidant capacity, immunity, and intestinal health of broiler breeders. A total of 336 thirty-wk-old hens were randomly allotted to 4 groups with 6 replicates of fourteen hens each, which fed a basal diet supplemented with 0 (CON), 500 (CHM500), 1,000 (CHM1000), and 1,500 (CHM1500) mg/kg CHM for 56 days, respectively. Our results showed that dietary supplementation with CHM1000 increased the laying rate and number of SYF and decreased the feed conversion ratio (P < 0.05). All CHM groups increased oviduct and ovarian indexes, serum E2 and T-AOC levels, and decreased serum TG and MDA levels compared with CON (P < 0.05). In comparison to the CON group, the CHM1000 and CHM1500 groups increased serum ALB, IgM, and IL-10 levels, whereas the CHM1000 group also increased serum TP and SOD levels, and the CHM1500 group increased serum P and decreased serum TNF-α (P < 0.05). The addition of CHM increased FSHR expressions in the ovary, Claudin-1 expressions in the jejunum, and SOD1 expressions in the liver and ovary, but decreased the mRNA expressions of INH in the ovary as well as IL-2 and IL-6 expressions in the jejunum (P < 0.05). Moreover, CHM500 and CHM1000 groups increased CAT, GPx, and HO-1 expression in the ovary, and SOD1 and GPx expression in the jejunum, while decreasing IL-17A expression in the jejunum (P < 0.05). In addition, CHM1000 and CHM1500 groups increased villus height, VCR, and the mRNA expressions of Nrf2, HO-1, Occludin, and MUC2 in the jejunum, and IL-10 expression in the ovary, while decreasing IL-2 and IL-17A expression in the ovary, in addition to increasing GPx, Nrf2, HO-1, NQO1, and IL-10 expression in the liver (P < 0.05). Supplementation with CHM1000 increased ESR-α, ESR-β, GnRH, Nrf2, and NQO1 expression in the ovary, but decreased IFN-γ expression in the ovary as well as crypt depth in the jejunum (P < 0.05). Supplementing CHM1500 increased NQO1 and ZO-1 expression in the jejunum and decreased IL-2 in the liver (P < 0.05). The high-throughput sequencing results showed that dietary CHM1000 supplementation altered the composition of the intestinal microbiota, as evidenced by the regulation of the genera Lactobacillus, Faecalibacterium, and Phascolarctobacterium. PICRUSt analysis revealed that metabolic pathways of bacterial chemotaxis, butanoate metabolism, and synthesis and degradation of ketone bodies were enriched in the CHM1000 group. Spearman's correlation analysis indicated that the differentiated genera were significantly associated with the production performance, serum hormone, and gut barrier-related genes. Taken together, supplementation of CHM, especially at 1,000 mg/kg, could improve production performance by regulating reproductive hormones, antioxidant capacity, immunity, and intestinal health of broiler breeders, and maybe provide insights into its application as a potential feed additive to promote the performance of broiler breeders.

Evaluating Risk Factors for Developing Allergic Reactions during Plasma Exchange using Fresh-frozen Plasma: A Single-center Retrospective Study.

Objective Allergic reactions are a severe complication of plasma exchange (PEx). Few reports have analyzed allergic reactions during PEx using fresh-frozen plasma (FFP) as a replacement solution. We therefore clarified the relationship between risk and exacerbation factors that lead to the onset of PEx-related allergic reactions, particularly PEx, using FFP, and examined whether or not allergic reactions were predictable. Methods This retrospective study included 88 consecutive patients who underwent PEx with FFP as a replacement solution at Kitasato University Hospital. The patients were grouped according to the presence of allergic reactions and compared. Data were analyzed using the χ2 test, Mann-Whitney U test, and a binomial logistic analysis. Statistical analyses were performed using EZR software program, version 1.54, with p <0.05 considered statistically significant. Results There were 44 allergic reaction cases. The average time to the onset of an allergic reactions was 63.5 (45-93) min. The allergic reaction-onset group had significantly higher average albumin (Alb) levels than did the non-allergic reaction-onset group. The binomial logistic analysis identified Alb levels as independent risk factors for allergic reactions. The receiver operating characteristic analysis identified an Alb level ≥3.4 g/dL as a risk factor for allergic reactions (area under the curve: 0.731; 95% confidence interval: 0.622-0.84). Conclusion Allergic reaction onset occurred approximately one hour after PEx initiation in the critical period. A serum Alb level ≥3.4 g/dL was identified as a risk factor for predicting allergic reactions. Patients with Alb levels ≥3.4 g/dL at the first PEx should be monitored for allergic reaction symptoms.

Moringa oleifera leaf polysaccharide regulates fecal microbiota and colonic transcriptome in calves

This study investigated the effects of Moringa oleifera polysaccharide on growth performance indicators, serum biochemical indicators, immune organ indicators, colonic morphology, colonic microbiomics and colonic transcriptomics in newborn calves. 21 newborn calves were randomly divided into three groups of 7 calves per treatment group: control group (no Moringa oleifera polysaccharide addition); low-dose group (Moringa oleifera polysaccharide 0.5 g/kg); and high-dose group (Moringa oleifera polysaccharide 1 g/kg). This trial used gavage to feed MOP to calves. The test lasted 8 weeks. Calves were humanely electroshocked on the last day of the trial and slaughtered afterwards. Thymus, spleen, blood and colonic contents were collected for further testing. The results of this trial showed that MOP significantly increased the body weight of newborn calves and reduced the rate of calf diarrhea, thus promoting calf growth. Fecal scores showed a linear decrease with the addition of MOP. In terms of serum biochemistry, feeding MOP significantly increased serum ALB levels in a linear fashion. In terms of serum antioxidants, feeding MOP linearly increased CAT and T-AOC levels and decreased MDA concentrations, and in terms of serum immunity, feeding MOP linearly increased IgA, IgG, and IgM levels. At the same time, MOP regulated the abundance of Firmicutes and Bacteroidetes in the intestinal tract of calves, which reduced the occurrence of diarrhea. In addition, moringa polysaccharide could regulate genes related to inflammatory signaling pathways such as MAPK signaling pathway, TGF-beta signaling pathway, PI3K-Akt signaling pathway and TNF signaling pathway in calves' intestine to reduce the occurrence of intestinal inflammation. In conclusion, MOP can be used as a novel ruminant additive for the prevention of enteritis in calves.

The Effect of Lactobacillus sakei on Growth Performance and Intestinal Health in Dogs: Gut Microbiota and Metabolism Study.

The gut microbiota is the largest and most complex ecosystem consisting of trillions of microorganisms, which influenced by various external factors. As an important probiotic species, Lactobacillus helps to improve gut microbial diversity and composition, underlying potential efficacy in growth performance and disease prevention. However, limited studies have been investigated the relationship between Lactobacillus sakei and intestinal health in dogs. In this study, dogs in the two groups were fed a standard diet (group C, n = 8) and Lactobacillus sakei diet (group P, n = 8), respectively. The growth performance, serum biochemical indices, antioxidant capacity, gut microbiota, and metabolism of dogs in both groups were studied. Results from growth trials showed that L. sakei can significantly improve the growth performance of dogs, including increased weight gain (p < 0.05), serum biochemical indices, i.e., ALP, TP, and ALB (p < 0.05), and better antioxidant capacity, i.e., SOD and GSH-Px (p < 0.05). Significant changes in the gut microbial composition were detected in dogs fed Lactobacillus sakei, as evidenced by an increase in the level of Firmicutes, Spirochaetota, and Patescibacteria, all of them play an important role in maintaining intestinal health. Moreover, a decrease in the level of microorganisms that threaten health, such as Mucispirillum and Clostridium_sensu_stricto_13. The metabolic analysis showed that the Lactobacillus sakei enhanced metabolic pathways such as vitamin B6 metabolism, glutathione metabolism, retinol metabolism, and fatty acid degradation. Our findings suggested that Lactobacillus sakei supplementation had beneficial effects on the growth performance and health status of dogs by improving gut microbiota balance and promoting metabolism. There are an estimated 200 million dogs in China, and the population is continuing to grow at a rapid pace. It is essential to explore an effective way to promote health in dogs. Intestinal diseases, particularly colitis and diarrhea, are common clinical conditions in dogs and are associated with gut microbiota. Lactobacillus sakei, as an important species of probiotics, the relationship between L. sakei and intestinal health in dogs remains unclear. Our study suggests that L. sakei significantly promotes growth performance and health states involving weight gain, regulation of gut microbiota, and metabolism. Overall, our findings shed light on the potential role of L. sakei as an alternative in promoting health in dogs.

Differences of cerebral oxygen saturation in dialysis patients: a comparison of three principals of near infrared spectroscopy.

It has been reported that cerebral oxygen saturation (rSO2) measured by near infrared spectroscopy is low in dialysis patients. We compared the rSO2 values of dialysis patients before living donor kidney transplantation and their donors as controls by using three spectroscopes that utilize different principals, the INVOS 5100C (spatially resolved spectroscopy), FORE-SIGHT ELITE (modified Beer-Lambert law) and tNIRS-1 (time-resolved spectroscopy). Before induction of anesthesia, the sensors of one of the three spectroscopes were placed on the forehead and rSO2 values were recorded followed by the same measurement using the other two spectroscopes. The primary objective was to compare the rSO2 values of the dialysis patients and controls using the three spectroscopes by the unpaired t test. Then we compared the rSO2 values among the spectroscopes in both dialysis patients and controls by one-way ANOVA. Finally, we examined the relations between the rSO2 values and the physiological values by using the Pearson correlation coefficient. Fifteen pairs of dialysis patients and controls were studied. With the INVOS 5100C, the values of the dialysis patients (59.7 ± 9.7% (mean ± standard deviation) were 13% lower than those of the controls (73.3 ± 6.9%) (P < 0.01). With the tNIRS-1, the values were 57.8 ± 4.8% in the dialysis patients and 63.3 ± 3.5% in the controls (P < 0.01). Almost no differences were observed with the FORE-SIGHT ELITE (71.6 ± 4.9% [dialysis patients] vs. 70.8 ± 4.3% [Controls]) (P = 0.62). Among the spectroscopes, the values were significantly different in both dialysis patients and controls. For the INVOS 5100C and tNIRS-1, correlation coefficients between rSO2 values and blood Hb and serum Alb were more than 0.5. The rSO2 values for comparisons between the dialysis patients and the controls were different according to differences of the principles of the near infrared spectroscopes. In the INVOS 5100C and tNIRS-1, rSO2 values may be related to blood Hb and serum Alb.

361. THE IMPACT OF A PROGRAM TO IMPROVE PREOPERATIVE NUTRITION AND REHABILITATION FOR ESOPHAGEAL CANCER PATIENTS

Abstract Background Improvement of the preoperative inflammation, nutrition, and other systemic conditions may reduce surgical complications and improve the prognosis of cancer. The usefulness of preoperative nutritional therapy and rehabilitation has recently been discussed. We created a novel program of preoperative rehabilitation and nutritional support to improve postoperative outcomes. We examined the nutritional status and blood electrolyte predisposition before and after this program. Methods Thirty five patients who underwent esophagectomy for esophageal cancer. These patients performed muscle strengthening exercise and received jelly beverage containing branched-chain amino acids immediately after rehabilitation and immune-modulating liquid diets for 7 consecutive days before surgery. Nutritional guidance was provided by a dietitian, who set a daily energy target of 30 kcal/kg and a protein target of 1.2 g/kg. Upper and lower limb strength training was performed with a physical therapist. Blood biochemical data on nutrition such as serum Alb, PreAlb, CRP, levels were compared after preoperative support. Results Thirty five patients who underwent esophagectomy for esophageal cancer in this period and evaluate their blood and serum samples. The average age of the patients was 66 years, 29 men and 6 women. Serum Alb level was 4.01 ± 0.4 g/dl before admission and 3.74 ± 0.35 g/dl the day before surgery (p = 0.04), and serum transthyretin level was unchanged from 28.9 ± 5.5 mg/dl to 26.1 ± 4.75 mg/dl. Serum CRP level tended to decrease from O.23 ± 0.528 mg/dl before admission to 0.14 ± 0.23 mg/dl the day before surgery. Other index of nutritional status did not change significantly before or after the program. Improvements in preoperative inflammation and nutrition are expected to decrease surgical complications and contribute to cancer prognosis. Our study and intervention in the present study may have decreased inflammation, although it was not a clear objective improvement in nutritional status. The short duration of the intervention may have prevented a significant difference. A less prolonged hospitalization is not realistic and the most effective nutritional rehabilitation intervention should be devised in the future.

245. CONVERSION SURGERY AFTER DEINITIVE CHEMORADIOTHERAPY FOR THORACIC ESOPHAGEAL CANCER

Abstract Background Definitive chemoradiotherapy (dCRT) is an important treatment option for cStage III/IVa esophageal cancer. In our hospital, dCRT is the treatment of choice for cT4b. In this study, we investigated the technique, prognosis, and postoperative complications of salvage surgery after dCRT, with the aim of gaining knowledge to achieve both cure and safety. Methods The study included 36 patients who underwent conversion surgery after dCRT for thoracic esophageal cancer with suspected invasion of other organs between April 2012 and June 2021. The median age was 68 years (38–80 years). cT4b invasive organs were trachea and left main bronchus in 21 cases, aorta in 11 cases, and other organs in 4 cases. Thoracoscopic esophagectomy was performed in 13 patients. Reconstruction of the gastrointestinal tract via the posterior sternal route was the basic procedure. Resluts There was one case of death in hospital (3%). Postoperative complications (Clavien-Dindo Grade II or higher) were observed in 17 patients (47%), including pneumonia in 9 patients (25%) and suture failure in 5 patients (14%). The median postoperative hospital stay was 17 days. The incidence of postoperative pneumonia was lower in patients with higher preoperative serum Alb and preoperative PNI. The median recurrence-free survival was 14 months. Histopathologically, 7 patients (19%) showed cancerous remnants, and the prognosis was poor in patients with remnant disease, aortic invasion, or preoperative lymph node metastasis. Conclusion Perioperative outcomes were considered acceptable. Down staging is likely to be achieved after dCRT, but preoperative nutritional status should be improved. The prognosis is poor in patients with aortic invasion or lymph node metastasis, and the indication for chemoradiation should be carefully considered. Postoperative adjuvant therapy is an issue for the future.

Efficacy of polymethylmethacrylate membrane hemodiafilter Filtryzer® PMF™-21A in improving pruritus in hemodialysis patients: a prospective interventional study

BackgroundHemodialysis-associated pruritus (HAP) occurs in 60–80% of hemodialysis patients. This significant complication not only decreases quality of life through sleep disturbance and depression, but also leads to poor survival outcomes. The polymethylmethacrylate (PMMA) membrane was the first synthetic polymer membrane for the hollow-fiber artificial kidney created in 1977. PMMA membrane dialyzers have been reported to be effective for improving various complaints, including pruritus, and nutritional status. In Japan, a PMMA membrane hemodiafilter Filtryzer® PMF™-A (PMF-A) was launched in November 2021 and subsequently became available for online hemodiafiltration (OHDF). This study aimed to determine whether PMF-A effectively improves pruritus in hemodialysis patients.MethodsParticipants were 20 patients (median age 74.5 years) on predilution OHDF (pre-OHDF) or postdilution OHDF (post-OHDF) using an Asymmetric Triacetate Membrane® hemodiafilter (FIX-210E eco or FIX-210S eco), who were experiencing pruritus of “very mild” or higher severity based on the Shiratori severity score either during the daytime or nighttime. After switching to post-OHDF with PMF-21A (substitution flow rate: 10 L/session), the substitution flow rate was gradually increased according to results of pruritus evaluation every 2 weeks over 3 months. The primary endpoint was the severity of pruritus evaluated using visual analogue scale (VAS) and the Shiratori severity score. Secondary endpoints included white blood cell count (WBC), hemoglobin level (Hb), platelet count (Plt), serum albumin level (Alb), high-sensitivity C-reactive protein (hsCRP), IL-6, dry weight (DW), and solute removal performance.ResultsThe median VAS score was significantly decreased 2 weeks after switching compared with baseline (44 mm) and remained significantly decreased at Week 12 (22 mm; p < 0.01). From baseline to Week 12, 16 patients (80%) showed improvement in VAS score. The percentage of patients with mild to moderate daytime pruritus according to the Shiratori severity score decreased significantly from 80.0% to 45.0% (p < 0.05), whereas no significant change was observed for nighttime pruritus (p = 0.267). Pre-dialysis serum β2-MG levels were significantly higher at Week 12 compared with baseline. No significant changes were observed in WBC, Hb, Plt, serum Alb, hsCRP, IL-6, or DW.ConclusionsOHDF with PMF-21A may be more effective in improving HAP.

The characteristics of chest HRCT and pulmonary function tests in lung-onset primary sjogren's syndrome.

Interstitial lung disease (ILD) can manifest before the diagnosis of primary Sjögren's syndrome (pSS), however, the underlying mechanisms remain unclear. The aim of this study is to investigate the characteristics of lung-onset pSS using chest high-resolution computerized tomography (HRCT) and pulmonary function tests (PFTs). The data of 102 patients with pSS-ILD were retrospectively analyzed. The patients were divided into two groups: lung-onset group and the nonlung-onset group. The chest HRCT, PFTs, and clinical and laboratory data were evaluated and compared. Among the 102 patients with pSS-ILD, 59 (57.8%) were lung-onset and 43 (42.2%) were nonlung-onset. Chest HRCT in the lung-onset group showed higher percentage of usual interstitial pneumonia and nonspecific interstitial pneumonia, the difference did not reach statistical significance. The total HRCT score was higher in the lung-onset group, compared with the nonlung-onset group (2 [2, 3], vs. 2 [1, 2], p = .014). Total lung capacity (TLC) (%pred) [(75.4 ± 16.2) versus (82.8 ± 19.4), p = .049] and forced vital capacity (FVC) (%pred) [(82.2 ± 19.9) versus (91.6 ± 28.3), p = .050] were significantly lower in the lung-onset group, compared with the nonlung-onset group.Residual volume (RV)/TLC (%) significantly increased more than 40% in the lung-onset group (p = .015). Restricted ventilation disorder, small airway obstruction and reduced diffusing capacity of the lung for carbon monoxide/alveolar volume (%Pred) were more common in the lung-onset group (p = .038, p = .050, and p = .050, respectively). Correlation analysis showed that HRCT score was positively correlated with the interval between the onset of pulmonary symptoms and the diagnosis of ILD, serum CA125, and serum CEA. TCL (%pred), VC (%pred), FVC (%pred) were negatively correlated with serum CA125. Lung-onset is common in pSS patients with more severe lung function impairments. Serum biomarkers, such CA125, CEA, and ALB, were associated with the severity of lung damage.

Perilla frutescens (L.) Britt extract alleviating acute liver injury in mice induced by thioacetamide

Liver fibrosis is a significant public health concern and is one of the leading causes of death worldwide (2019). Perilla (Perilla frutescens (L.) Britt - PF) is a herb with potent anti-inflammatory and antioxidant properties extensively employed in traditional medicine. This study evaluated the hepatoprotective effects of perilla extract on mice with liver damage caused by Thioacetamide (TAA). Mice were induced liver damage by TAA and given perilla extract, then liver damage assessed through indicators: liver function (albumin index), liver enzymes (ALT, AST indices), liver necrosis and fibrosis by histological staining (H&amp;E and Sirius red staining) and expression levels of genes related to fibrogenesis, antioxidant system and inflammation. Acute liver injury mice treated with PF extract decreased WBC count, biochemical indices: AST, ALT; improved serum ALB level; reduced percentage of necrotic and fibrotic area; diminished expression of myofibroblast marker α-sma and inflammatory cytokine IL6; upregulated expression of gene related to antioxidant system GPx, bax. The result suggested that TAA 150 mg/kg caused hepatotoxicity and 100 mg/kg Perilla Frutescens (L.) has a hepaprotective effect that can attenuate liver damage.

#4596 ASSOCIATION OF LOW BLOOD SELENIUM CONCENTRATIONS WITH POOR MUSCLE MASS AND STRENGTH IN JAPANESE HEMODIALYSIS PATIENTS

Abstract Background and Aims Trace elements play an important role in muscle function and metabolism. Little information is available of a role of trace elements for sarcopenia (i.e. low muscle mass and strength) in patients on hemodialysis (HD). We aimed to investigate association between blood levels of trace elements and nutritional status or sarcopenia in HD patients. Method This cross-sectional study including patients undergoing HD at our center was conducted in June 2022. Clinical/demographic data and blood samples were collected before HD sessions at start of the week. Blood levels of zinc (Zn), copper (Cu), selenium (Se), and manganese (Mn), serum levels of creatinine (Cr), total cholesterol (Tch) and albumin (Alb) and body mass index (BMI) were measured. Handgrip strength, gait speed and muscle mass (skeletal muscle index: SMI) measured using dual-energy x-ray absorptiometry were analyzed. Sarcopenia was assessed by Asian Working Group for Sarcopenia (AWGS) and nutritional status by the Nutritional Risk Index-Japanese Hemodialysis (NRI-JH), which was calculated based on serum Cr, Tch, Alb and BMI (PLoS One. 2019, 14(3):e0214524). Peason's correlation coefficient test, multivariate logistic regression analyses were performed to evaluate the relationship between trace elements and nutritional indicators. Results Eighty-two patients (56 males and 26 females) were included, with a median dialysis vintage of 9.1±7.1 years and an average age of 68.7±12.2 years. Severe malnourished patients as defined by the NRI-JH and sarcopenia defined by AWGS accounted for 6.0% and 37.8% of enrolled patients, respectively. In all patients, the mean levels of Zn, Cu, Se, and Mn (in μg/dL) were 65.8±11.3, 84.1±22.2, 9.2±1.5 and, 1.2±0.6. respectively. The levels of Zn, Cu, Se and Mn were lower than normal levels in 72 cases (87.8%), 18 cases (22%), 57 cases (69.5%), and 13 cases (15.9%), respectively. There was an inverse correlation between the levels of Se and age (r = -0.298 p = 0.003) but not HD vintage. No significant correlation was found between the NRI-JH scores and blood levels of trace elements in all patients. Blood trace elements have been shown to be affected by gender. Thus, we next examined whether blood levels of trace elements and the relationship between blood trace elements and SMI and strength are different between male and female HD patients. The levels of Zn and Mn did not differ between males and females. The levels of Cu were lower in males (79.8±19.3 μg/dL) than females (93.0±25.4 μg/dL, p = 0.025). In contrast, the levels of Se were higher in males (9.5±1.5 μg/dL) than females (8.6±1.2 μg/dL, p = 0.0017). The multivariate logistic regression showed that higher blood levels of Zn and Se and lower Mn levels were independently associated with grip strength (p&amp;lt;0.01) but not gait speed in males. There was a significant positive correlation between Se and SMI (r = 0.305 p = 0.02) but not gait speed in males. In females, grip strength (r = 0.39, p = 0.048) and gait speed (r = 0.66, p&amp;lt;0.001) were independently associated with the Se levels but not Zn, Cu and Mn. However, there was no association between SMI and blood levels of Se, Zn and Mn in females. Conclusion Blood levels of Se were independently associated with grip strength and SMI in male HD patients. In female HD patients, the levels of Se were positively correlated with grip power and gait speed. Se may be implicated in muscle function and metabolism in HD patients.

Effects of Replacing Fish Meal with Enzymatic Cottonseed Protein on the Growth Performance, Immunity, Antioxidation, and Intestinal Health of Chinese Soft-Shelled Turtle (Pelodiscus sinensis).

The dietary effects of replacing fish meal with enzymatic cottonseed protein (ECP) on the growth performance, immunity, antioxidant, and intestinal health of Chinese soft-shelled turtles have not been explored. An eight-week feeding trial was conducted with a quadruplicated group of turtles (3.44 ± 0.01 g) that were randomly assigned to 16 cages (0.6 m × 0.6 m × 0.6 m) with 30 turtles that were stocked in each cage. Four dietary groups were fed with diets supplemented with 0, 2%, 4%, and 6% (ECP0 group (control group), ECP2 group, ECP4 group, ECP6 group) of enzymatic cottonseed protein replacing fishmeal. The present study illustrated that the final weight and WG in the ECP2 and ECP4 groups were significantly increased (P < 0.05) compared with the control group. The ECP2, ECP4, and ECP6 groups significantly reduced the feed coefficient (P < 0.05) and significantly increased the SGR (P < 0.05). The serum TP and ALB of the ECP4 group were significantly increased (P < 0.05). The ECP2, ECP4, and ECP6 groups significantly increased the activity of intestinal pepsin (P < 0.05), and the activity of intestinal lipase of the EPC4 group was significantly increased (P < 0.05). The intestinal villus height of the EPC4 group and EPC6 group, the villus width of the EPC2 group and EPC4 group, and the intestinal muscle thickness of the EPC4 group were significantly increased (P < 0.05). At the same time, replacing fishmeal with enzymatic cottonseed protein also affected the intestinal inflammation-related genes compared with the control group. Besides that, the expression of the IL-10 gene in the experimental group was significantly upregulated (P < 0.05). Nevertheless, the expression of TNF-α and IL-8 genes in the ECP2 group and TNF-α and IL-1β genes in the ECP4 group was significantly downregulated (P < 0.05). In summary, replacing fish meal with enzymatic cottonseed protein positively affects the growth, immunity, and intestinal health of Chinese soft-shelled turtles. The appropriate proportion of enzymatic cottonseed protein to replace fish meal in turtle feed is 4%.

Angiopoietin-like protein 3: a novel potential biomarker for nephrotic syndrome in children.

Angiopoietin-like 3 (ANGPTL3) is a secretory glycoprotein. It has been demonstrated that ANGPTL3 level was upregulated in minimal change nephrotic syndrome (MCNS) kidney tissues. Subsequently, our group found that ANGPTL3 level was closely correlated with nephropathy in vivo and in vitro. Hence, whether ANGPTL3 level could be correlated with the proteinuria level, and assessment of disease severity of nephrotic syndrome (NS) remained to be investigated. This study aimed to analyzed the correlation between the levels of ANGPTL3 in serum and urine of patients with nephrotic syndrome and proteinuria, and assessed the severity of the patients' disease. In future clinical translation, the level of ANGPTL3 in serum, urine will be used as a biomarker to better predict the development of nephrotic syndrome. A total of 200 NS patients and 80 healthy controls (age, 1-18 years) were admitted to our institution between 2021 and 2022. The etiology of NS included primary nephrotic syndrome (PNS, n = 144) and NS with other causes (n = 56). A total of 280 serum samples and 244 urinary samples were collected to determine ANGPTL3 level using enzyme-linked immunosorbent assay (ELISA). Serum ANGPTL3 and urinary ANGPTL3/Cre were remarkably elevated in NS patients compared with those in healthy controls. Furthermore, serum ANGPTL3 and urinary ANGPTL3/Cre were significantly correlated with proteinuria level. Additionally, multivariate linear regression analysis demonstrated that serum ALB was independently correlated with serum ANGPTL3 and PRO/CR was independently correlated with urinary ANGPTL3/Cre in NS patients. Serum ANGPTL3 and urinary ANGPTL3/Cre showed a promising performance in the diagnosis of NS, and served as novel potential noninvasive biomarkers to assess disease severity of NS. Further exploration of the role of ANGPTL3 level may shed a new light on the treatment of NS.

Danggui Shaoyaosan attenuates doxorubicin induced Nephrotic Syndrome through regulating on PI3K/Akt Pathway.

The study aimed to explore the role and the underlying mechanism of Danggui Shaoyaosan (DSS) in nephrotic syndrome (NS). NS rat model was induced by doxorubicin injection twice. After DSS treatment, inflammation and oxidative stress index were detected via ELISA. Western blot was used for the protein detection. Go and KEGG analysis was applied to evaluate target gene and signaling of DSS. MCP-5 cell was applied for the cell rescue experiments and mechanism exploration. The 24h urine protein levels of NS rats increased significantly, which was reduced by DSS treatment in a concentration-dependent manner. After DSS treatment, levels of BUN, SCr, TG and TC were also decreased, and serum ALB and TP levels were increased in rats. GO and KEGG pathway enrichment identified PI3K-Akt to be the candidate signaling of DSS in the treatment of NS, which was activated in NS rats. The recuse experiments in MCP-5 demonstrated that IGF-1, the agonist of PI3K/AKT, abolished the beneficial role of DSS in podocyte cell viability, apoptosis, inflammation and oxidative stress. In conclusion,DSS exerts a protective role against the development of NS. The mechanism is related to the improvement of podocyte injury and the inhibition of PI3K/Akt pathway-related proteins.

Impact of resting heart rate on cardiovascular mortality according to serum albumin levels in a 24-year follow-up study on a general Japanese population: NIPPON DATA80.

BackgroundElevated resting heart rate (RHR) is associated with an increased risk for cardiovascular disease (CVD) and all-cause mortality. However, the findings of cohort studies differed. Thus, the impact of RHR on CVD mortality might be different according to the background of the population. Therefore, we examined the relationship of RHR and CVD mortality according to serum ALB levels in a Japanese general population.MethodsIn total, 8363 individuals without a history of CVD were followed-up for 24.0 years. The participants were divided into four groups according to the quartiles of RHR (Q1-Q4), and they were further classified into the high and low ALB groups based on a median value of 44 g/L. We estimated the multivariable-adjusted hazard ratios (HRs) of CVD mortality in each RHR group based on ALB levels, and the interaction between RHR and ALB groups on CVD mortality was evaluated.ResultsWe found no significant association between RHR and CVD mortality. However, the Q4 of RHR was significantly associated with an increased risk for CVD mortality (HR: 1.27 [95% confidence interval, CI: 1.02-1.57]) in participants with a low ALB level. Meanwhile, the Q4 of RHR was significantly correlated with a decreased risk for CVD morality in those with a high ALB level (HR: 0.61 [95% CI: 0.47-0.79]) after adjusting for covariates. A significant interaction between RHR and ALB for CVD mortality was shown (p<0.001).ConclusionsThe impact of RHR on CVD mortality differed according to ALB levels in a general Japanese population.

The Interval of Two-Stage Bilateral Total Hip Arthroplasty under Enhanced Recovery Affects Perioperative Complications and Cost of Hospitalization: A Retrospective Study.

Perioperative enhanced recovery after surgery (ERAS) protocols can improve the quality of healthcare and reduce hospitalization for patients who underwent total hip arthroplasty (THA). The interval of staged bilateral THA under ERAS is still unclear. We attempt to ascertain the optimal interval of staged bilateral THA for reducing the perioperative complications and the cost of hospitalization. We retrospectively reviewed patients who received staged bilateral THA under ERAS performed at West China Hospital of Sichuan University from 2018 to 2021. The staged time was divided into two groups using four different cutoff points: (1) ≤3 months versus >3 months, (2) ≤4 months versus >4 months, (3) ≤5 months versus >5 months and (4) ≤6 months versus >6 months. Primary outcomes included the rate of perioperative complications and the cost of hospitalization. The secondary outcomes were the length of hospital stay (LOS), the rates of transfusion and albumin (Alb) administration, hemoglobin (Hb) decrease and serum Alb decrease. The categorical variables were compared using chi-squared and/or two-tailed Fisher's exact tests, whereas continuous variables were compared using two-tailed independent t-tests, the continuous variables which were asymmetrical distributions used a Kruskal-Wallis test. With the application of ERAS, the rate of perioperative complications in the >5 months group was significantly lower than that in the ≤5 months group (13/195 vs. 45/307, p < 0.05). Concerning the cost of hospitalization, the >5 monthly intervals spent significantly less than the ≤5 monthly intervals ($ 8695.91 vs. $ 8919.71, p < 0.05). However, no significant difference was found for secondary outcomes such as the rate of transfusions and Alb administrations or decreases of Hb and Alb in the 5 months threshold. More than 5 months maybe a reasonable period to perform the first contralateral THA under ERAS regarding the rate of perioperative complications and the cost of hospitalization. However, more high-quality research will include a larger sample size in the future to validate the appropriate time of staged bilateral THA.

High Protein Whole Food Snack and Albumin Outcomes in Patients With Dialysis-Dependent Chronic Kidney Disease

Protein-energy wasting is common among patients on hemodialysis (HD). This study sought to define effects that a novel, post-HD, high-calorie, high-protein whole food snack had on patients' serum albumin (serum alb), serum phosphorus and equilibrated normalized protein catabolic rate (enPCR). A 12-month (6months intervention, 6months pre/post data collection), single-center, unblinded study was conducted. Participants (n=67) consumed, ad libitum, a whole food snack post-HD for 6 treatments each month. Upon analysis, regression models identified relationships between serum alb and whole food snack consumption across follow up. Predefined effect size anticipated was + 0.2g/dL. Patients were stratified by high (≥4g/dL) or low (<4g/dL) mean serum alb during a 3-month baseline period. Paired t-tests compared mean per patient difference in serum alb, enPCR and serum phosphorus from baseline to each month of follow up, stratified by high (≥640 g) or low (<640 g) consumption of the whole food snack (a priori caloric estimation). Linear regression models showed positive associations between higher serum alb and enPCR with higher whole food snack consumption across follow up (all P<.05). Assessments from baseline to each follow-up month show some increases in serum alb, yet t test comparisons were not significant. No significant changes were seen in serum phosphorus levels during follow-up. Albeit the catabolic effects of HD are well-known, effective nutritional interventions are scarce. Results showed that providing a whole food snack post-HD to individuals with serum alb <4.0g/dL may be beneficial but further studies are recommended.