Serum Total Protein Research Articles

Clinical Implications and Risk Factors of Dilatation of Remnant Pancreatic Duct at 1 Year after Pancreatoduodenectomy: A Prospective, Japanese, Multicenter, Observational Cohort Study (DAIMONJI Study).

To determine the precise frequency of main pancreatic duct (MPD) dilatation within the remnant pancreas at 1 year after pancreatoduodenectomy (PD) and its clinical implications, a prospective multicenter cohort study was performed in patients without MPD dilatation before PD (registry number: UMIN000029662). Between October 2017 and July 2020, patients with an MPD diameter less than 3 mm who were planned to undergo PD for periampullary lesions at 21 hospitals were enrolled. The primary endpoints were frequency of MPD dilatation at 1 year after PD, and the relationship between MPD dilatation and pancreatic endo- and exocrine function, nutritional status, and fatty liver. Secondary endpoints were risk factors for MPD dilatation at 1 year after PD and time-course change in MPD diameter. Of 200 registered patients, 161 patients were finally analyzed. Pancreatic fistula was the most frequent complication (76; 47.2%). MPD dilatation (MPD > 3 mm) at 1 year after PD was seen in 35 patients (21.7%). Pancreatic exocrine function, assessed by steatorrhea, was significantly impaired in patients with MPD dilatation. However, endocrine function, nutrition status, and fatty liver development were comparable between the 2 groups. In multivariate analysis, the serum total protein level 7.3 g/dL or more was an independent predictor for MPD dilatation at 1 year after PD (odds ratio 3.12, 95% CI 1.31 to 7.15). A mean MPD diameter significantly increased at 6 months after PD and kept plateau thereafter. MPD dilatation at 1 year after PD was seen in 21.7% of patients and significantly associated with exocrine function impairment but not with endocrine function, nutrition status, or development of fatty liver.

Association of regular plasmapheresis donation with serum protein and electrolyte levels: a multicentre cross-sectional study in China

BackgroundChina’s plasmapheresis donation policy differs from that of Western countries. The association between regular plasmapheresis donation and donor health in China is still unknown.ObjectivesTo investigate the association of regular plasmapheresis...

Differences Between Serum and Plasma: An Indirect Approach to Derive a Combined Reference Interval for Total Protein, Albumin, and Globulin

Abstract The objective of our study is to derive reference intervals (RI) for total protein (TP), albumin and globulin that are appropriate for both plasma and serum samples by applying statistical analyses to retrospective patient data. Both plasma and serum are acceptable matrices for these tests at our institution, with a single RI that applies to all specimens. The widespread shortage of lithium heparin (LH) tubes that occurred as a consequence of the pandemic prompted our lab to switch the primary tube type for comprehensive metabolic panels (CMPs) from LH to serum separator tubes (SST) in October 2021. The primary tube type reverted to LH in October 2023, and no adjustments were made to RIs at either time. To determine how well our RIs align with the accepted matrices, we used R Statistical Programing version 4.3.1 to apply an indirect, nonparametric statistical approach to data extracted from the laboratory information system (LIS) between July 2018 and December 2023. All orders for TP, albumin and globulin were queried to include the following components in the analysis: TP, albumin, globulin, serum TP, serum albumin and serum globulin. The records were divided into 3 epochs based on the primary tube type for CMP on the order date, with epochs 1 and 3 reflecting LH and epoch 2 reflecting SST. We attempted to identify a subset of serum and plasma samples in healthy individuals by applying exclusion criteria based on inpatient status, age, and draw station at which the specimen was collected. For each component, a resampling bootstrap method was used to calculate the RIs and corresponding 95% confidence intervals by epoch. Our results show that the RI of TP, albumin and globulin changed significantly between the epochs, reflecting the difference in primary matrix. The components serum TP, serum albumin, and serum globulin did not see a significant change in values over the epochs. A verification study looking at plasma and serum samples in 20 healthy individuals support these results. Based on these findings, our reference intervals were updated from 6.6-8.7 g/dL to 5.9-8.3 g/dL for TP, from 3.6-4.9 g/dL to 3.6-5.1 g/dL for albumin and from 2.3-3.5 g/dL to 1.5-3.9 g/dL for globulin. We show that there are statistically and potentially clinically significant differences in the reference intervals of TP, albumin and globulin in serum compared to plasma. This study demonstrates a big data analytics approach to derivation of RIs and emphasizes the importance of RI assessment and adjustment for patient population and acceptable specimen type.

Comparative Analysis of Newcastle Disease Seroprevalence in Different Breeds of Pigeon Populations in Chattogram Bangladesh

This study was performed to determine the antibody against Newcastle disease and serum protein level in pigeons of Chattogram, Bangladesh. The results were evaluated in pigeons of different groups of age, sex, and breed by applying the hemagglutination inhibition (HI) test. A total of 90 pigeons were selected for this research. Antibody titer against Newcastle Disease virus was analyzed according to the different age groups, sex, breeds and clinical signs of ND infection of pigeons by X2 test. Incase of less than 6 month age pigeons 73% (n=22) were HI titer positive whereas more than 6 months but less than 1 year 56% (n=32) were HI negative. There was no significant variation among different sex. In both male and female pigeon groups, the percentage of HI titer-positive pigeons in females and males was 51.7% and 57.4% respectively. There was significant variation among the different breeds and equal percentages of HI titer positive and negative pigeons were found in Giribaj and local breeds whereas 100% were found in King and Owl breeds and 80% were found in the Siraji breed. There was significant variation among NDV-infected and non-infected pigeons and equal percentage of HI titer negative and positive pigeons were found in ND non- infected, whereas (80.8%) were found in ND infected pigeons. A paired test was done between HI titer and total serum protein. There was a significant (t<0.0) difference among the group. In the case of HI titer mean was about 23 titer and the standard error was 0.28. In the case of total serum protein mean was 4.45 and the standard error was 0.19.

Impact of enhanced recovery after surgery (ERAS) on surgical site infection and postoperative recovery outcomes: a retrospective study of 1276 cases

This retrospective observational study aimed to evaluate the incidence of surgical site infection (SSI) in the era of enhanced recovery after surgery (ERAS) and the effect of ERAS on postoperative outcomes. Totally 1,276 patients (565 in ERAS group and 711 in non-ERAS group) who underwent operations at the department of general surgery during 2017–2021 were included. Risk factors were identified via logistic regression analysis and meta-analysis of all relevant published studies was performed. Subsequently, propensity score matching was used to match different risk factors. Overall, 40 patients were diagnosed with SSI, and the pooled incidence of SSI was 3.13%. In total, 14 (2.48%) and 26 (3.66%) patients in the ERAS and non-ERAS groups, respectively, were diagnosed with SSI (P = 0.230). Among patients for whom the ERAS protocol was adopted, 7 independent risk factors of SSI were identified. After propensity score matching, in patients without SSI, the number of hospital days was significantly lower in the ERAS group than in the non-ERAS group (2 [2, 5] vs. 3 [2, 7], P = 0.005), whereas in patients with SSI, the number of hospital days was similar between the ERAS and non-ERAS groups. ERAS had no effect on the incidence of SSI but could significantly accelerate the discharge of uninfected patients. In the era of ERAS, SSI incidence was affected by the type of surgery; number of postoperative hospital days; type of incision; serum hemoglobin, total protein, and albumin levels; and antibiotic prophylaxis. Furthermore, these results will significantly affect the implementation of the ERAS protocol and optimal preoperative management.

Comparative Analysis of Newcastle Disease Seroprevalence in Different Breeds of Pigeon Populations in Chattogram, Bangladesh

This study was performed to determine the antibody against Newcastle disease and serum protein level in pigeons of Chattogram, Bangladesh. The results were evaluated in pigeons of different groups of age, sex, and breed by applying the hemagglutination inhibition (HI) test. A total of 90 pigeons were selected for this research. Antibody titer against Newcastle Disease virus was analyzed according to the different age groups, sex, breeds, and clinical signs of ND infection of pigeons by X2 test. In the case of fewer than 6 months of age pigeons, 73% (n=22) were HI titer positive whereas more than 6 months but less than 1 year 56% (n=32) were HI negative. There was no significant variation among the different sexes. In both male and female pigeon groups, the percentage of HI titer-positive pigeons in females and males was 51.7% and 57.4% respectively. There was significant variation among the different breeds and equal percentages of HI titer positive and negative pigeons were found in Giribaj and local breeds whereas 100% were found in King and Owl breeds and 80% were found in the Siraji breeds. There was significant variation among NDV-infected and non-infected pigeons and an equal percentage of HI titer negative and positive pigeons were found in ND non-infected, whereas (80.8%) were found in ND-infected pigeons. A paired test was done between HI titer and total serum protein. There was a significant (t<0.0) difference among the groups. In the case of HI titer mean was about 23 titer and the standard error was 0.28. In the case of total serum protein mean was 4.45 and the standard error was 0.19.

Effects of Chitosan-Based Additive on Rumen Fermentation and Microbial Community, Nutrients Digestibility and Lactation Performance in Goats.

Recently, the potential of using chitosan (CHI) as a feed additive to enhance ruminal fermentation and improve animal performance has gained increasing attention in ruminant nutrition. This study was undertaken to investigate the effect of dietary supplementation with increasing doses of CHI on rumen fermentation attributes and microbial composition, digestibility and milk performance in Dhofari goats. Twenty-four lactating goats (27 ± 1.8 kg of initial live body weight) were fed a control diet comprising of Rhodes grass hay plus a concentrate feed mixture. Goats were assigned to one of three experimental treatments (n = 8 per treatment) as: (1) control diet with no supplement (CTRL), (2) control diet with 0.300 g/day CHI (CHI0.3) and (3) control diet supplemented with 0.600 g/day CHI (CHI0.6) for a 45-day experimental period. Dietary supplementation with increasing doses of CHI decreased (p < 0.05) linearly ruminal pH (p = 0.023), total short chain fatty acids concentrations (p = 0.011), acetate (p = 0.013) and butyrate (p = 0.042) proportions, acetate to propionate ratio (p < 0.001), estimated methane (CH4) production (p < 0.001), ammonia nitrogen concentrations (p = 0.003) and protozoa abundance (p = 0.003). However, the ruminal propionate proportion augmented (p = 0.002) linearly with increasing doses of CHI in the diet. Increasing doses of CHI linearly increased the abundance of the ruminal propionate-producing bacteria, while diminished acetate and CH4-producing bacteria (p < 0.05). Serum total protein (p = 0.037) and glucose (p = 0.042) levels linearly increased as CHI doses increased in the diet. However, serum UREA levels decreased linearly (p = 0.002) by 21% with increasing CHI amounts in the diet. The digestibility of organic matter, crude protein and neutral detergent fibre increased linearly with the increasing CHI doses (p < 0.05). Neither linear nor quadratic responses (p > 0.05) were observed in daily milk yield and feed efficiency by supplementing the diet with CHI. In conclusion, supplementing the diet with CHI at a dose of 0.600 g/day as a feed additive for dairy goats reduced estimated CH4 generation and improved fibre and protein digestion, with no influence on feed intake, milk yield or composition.

A study on subcutaneous infection model of colibacillosis in broilers: Selected immunological and hematological aspects

Colibacillosis is still a major challenge to poultry industry. This study examined selected immune and hematological features of broilers experimentally infected with E. coli via subcutaneous (sc) route. Fifty-one 5-week-old chickens were randomly assigned to three groups: two controls (NC and SCC) and one experimental (SC) group. The SC group was inoculated by O2 E. coli suspension via sc route in the inguinal region. Three days after inoculation, blood sampling was performed. Bacterial count of liver was determined. Histopathological samples of liver, lung, spleen, thymus, and bursa were also collected. Serum total protein and globulin significantly increased in birds of SC group as compared to control birds (P < 0.05). Birds in SC group also showed decreased albumin/globulin ratio. Serum levels of IL-6, IL-10, and IFN-γ remained statistically the same among groups. Lymphocytosis, monocytosis, thrombocytosis and heterophilia were present in SC group. Heterophils/lymphocytes ratio increased in SC birds. Left shift was observed in SC group with cells showing vacuolated cytoplasm that contained toxic granules. Histologically, lung involvement was less severe than liver. Lymphoid depletion was present in all examined lymphoid organs. E. coli growth was observed in liver samples from SC group but not in control birds. In conclusion, using sc route for induction of colibacillosis was associated with a systemic inflammatory response in broilers and histopathological lesions of thymus, bursa, and spleen three days post-infection. It seems that detection of changes in serum cytokine levels (IL-6, IL-10, and IFN-γ) should be performed in earlier hours of the disease in this model.

Effect of Gestational Direct-Fed Microbials Supplementation on the Metabolic Profile in Periparturient Dairy Cows.

This study was conducted at a commercial dairy farm in Queensland, Australia to evaluate the effects of feeding a lactic acid bacteria-based direct-fed microbial (DFM) during gestation on the metabolic profile of periparturient dairy cows and its effects on milk production and body weight. A total of 150 multiparous Holstein cows were randomly selected based on parity (2.3) and days in milk (130 DIM) and divided into two groups of 75 cows each (control and DFM). The control cows were assigned to a basal diet consisting of a silage-based partial mixed ration (PMR), concentrate fed in the dairy twice a day, and ad libitum pasture. The DFM group received the same basal diet supplemented with three strains of Lactobacillus top-dressed in the feed. The DFM supplementation continued during both the dry period and the subsequent lactation. A subset of 82 cows (40 control and 42 DFM) were monitored during the calving season (March to July 2022) to assess the metabolic profile and postpartum performance. Blood samples were collected during the periparturient period (-4 to -2 w prepartum, around calving, and at weeks 1, 3, and 6 postpartum) to measure the levels of metabolites, enzymes, and minerals. Overall, the serum glucose, NEFA, and chloride levels were higher, while protein and urea were lower in cows supplemented with the DFM (p < 0.005). The pre-calving levels of glucose were higher and the total bilirubin, urea, and BHB were lower in cows supplemented with DFM than in the control (p < 0.05). The post-calving levels of glucose and Mg were also higher in the DFM cows than in the control cows (p < 0.05). Average milk production at 110 DIM was significantly higher in the DFM cows compared to control cows (p = 0.03). Although the total milk production over 305 days was numerically greater in the DFM cows, the difference was not statistically significant (p = 0.3), whereas the milk protein percentage was higher in the control cows (p = 0.03). The body weight of the DFM cows was greater during the periparturient period (p = 0.001) than that of the control cows. In the DFM cows, glucose levels had a positive correlation (r = 0.16) with milk yield, at 110 DIM, while serum total protein had a positive correlation with body weight (r = 0.32) (p < 0.05). In conclusion, feeding Lactobacillus-based DFM during gestation can positively influence the metabolic profile of periparturient cows, which, in turn, may affect the milk production and body weight of postpartum dairy cows.

Nutritional Innovation Using Green Seaweed (Ulva sp.) and Garlic Powder Extracts for White-Leg Shrimp (Litopenaeus vannamei) Challenged by Vibrio harveyi.

This study aimed to determine the antimicrobial effects of ethanolic extracts of Ulva sp. and garlic (Allium sativum) powder ethanolic extracts against Vibrio harveyi in vitro. The stimulatory effects of Ulva sp. extract (UE) and garlic powder extract (GPE) on the growth performance and innate immune responses of white-leg shrimp, Litopenaeus vannamei, and their challenge against V. harveyi infection were also investigated. A commercial shrimp diet (36.1% protein) was enriched with 0.5, 1.0 and 2.0gUE/kg diet and 2, 4 and 6gGPE/kg diet, whereas the control group was free of any supplement. Health juveniles of L. vannamei (average weight 2-3g) were distributed in 21 fiberglass reinforced plastic (FRP) tanks (500-L capacity) at a stocking density of 300 animals/tank to represent each treatment in triplicate. The animals were fed ad libitum on the experimental diets up to satiety four times daily for 60 days. The phytochemical analysis of ethanolic extracts of Ulva sp. and garlic powder evoked their richness of several bioactive compounds showing significant antibacterial activity against V. harveyi. The GPE exhibited a higher inhibition zone than that of the UE. The supplemented diets did not significantly affect weight gain %, final weight, feed conversion ratio, specific growth rate and survival rates of white shrimp compared to those fed on the control diet. Significant increases were observed in total haemocyte count, phagocytosis and phagocytic index of all treatments compared with the control group. There were significant increases in serum total protein, acid phosphatase activity, alkaline phosphatase, lysosomal enzyme activity, phenoloxidase activity and superoxide dismutase activity with offered diets with increasing the levels of ethanolic extracts of Ulva sp. and garlic powder up to 2.0gUE/kg diet and 6gGPE/kg diet, respectively. The ethanolic extraction of Ulva sp. and garlic powder-supplemented diet groups, particularly at treatments of 2.0 and 6gGPE/kg diet, respectively, significantly reduced the shrimp mortality induced by V. harveyi infection when compared with the control group. The net results evoked that ethanolic extraction of Ulva sp. (2.0gUE/kg) and garlic powder (6gGPE/kg diet) enhanced the immune response and disease resistance of the white-leg shrimp, L. vannamei. It is also noted that the GPE is more efficient than the UE in vitro and in vivo investigations.

Inland saline culture of GIFT (Oreochromis niloticus) juveniles: effect of graded levels of lipid on growth and haemato-biochemical responses.

60-days trial was performed to study the effect of inland saline water (ISW) at 10ppt salinity on lipid requirement of Genetically Improved Farmed Tilapia (GIFT) juveniles. Six purified iso-nitrogenous (37% crude protein) and hetero-caloric (380-430 Kcal DE/100g) diets having graded levels of dietary lipid viz., 4, 6, 8, 10, 12 and 14% were prepared. Two hundred and seventy acclimated GIFT juveniles (1.90 ± 0.1g) were randomly distributed (15 fish per 300L tank) into six different treatments viz., T4, T6, T8, T10, T12 and T14 in triplicates. The increase in dietary lipid resulted in an increase in body lipid and a diminution in moisture levels in fish. There was a significant (p < 0.05) increase in weight gain (g), percent weight gain (WG%), protein efficiency ratio (PER) and feed efficiency ratio (FER) with increasing dietary lipid level up to 8% and decreased thereafter, but an opposite trend was noted in the feed conversion ratio (FCR). The serum glucose level linearly elevated with the rise in dietary lipid level, but higher lipid (beyond 8%) fed groups showed significantly (p < 0.05) more total protein in serum. Though there was a significant (p < 0.05) difference in cholesterol levels, no clear trend was observed; while other parameters viz., body indices (VSI and HSI), serum albumin, globulin and A-G ratio was not showed any significant (p > 0.05) variation with varying dietary lipid level. Based on regression models, it was observed that the optimum lipid level required for GIFT in ISW (10ppt) is in the range of 8.35-9.05%.

Relationship between morphometric measurements and blood parameters in horses with varying adiposity levels and physiological conditions.

Understanding and finding the correlation between morphometric measurements and horse blood parameters is crucial for predicting equine metabolic issues. This study aims to analyse morphometric measurements and blood samples in horses with varying adiposity levels. Cross-sectional observational. A total of 50 horses were included in the study and categorized into groups based on their body condition score (BCS) and cresty neck score (CNS). The insulin concentration was significantly higher in overweight horses (p=0.022). Female horses exhibited higher cortisol concentrations (p=0.025) and girth circumference at the withers (p=0.004) compared to males. Lactating mares exhibited higher concentrations of serum total protein (p=0.012) and globulin (p=0.003). A positive correlation was observed between BCS and insulin concentrations (r=0.290, p=0.041). Negative correlations were found between neck circumference to height at withers and glucose (r=-0.309, p=0.029), CNS and glucose (r=-0.315, p=0.026) as well as between crest diameter and cortisol (r=-0.360, p=0.01). Increasing the sample size and conducting longitudinal studies would enhance the study's validity and reliability. Although insulin, glucose and cortisol concentrations have predictive capabilities based on signs and certain morphometric measurements, their correlations are not always strong. Therefore, this study challenges the notion that all overweight horses are unhealthy, as overweight horses can still have good metabolic health. Conversely, lean horses may also experience metabolic issues. Hence, relying solely on visual cues is insufficient to diagnose the metabolic status of horses. Other factors must also be considered to assess their health status accurately.

Palygorskite improves growth performance and prevents liver damage in avian pathogenic Escherichia coli-challenged broiler chickens at an early age.

Avian pathogenic Escherichia coli (APEC) is a major bacterial infection that causes economic losses in the global poultry industry. Palygorskite (PAL) has been shown to enhance growth performance while improving antioxidative and anti-inflammatory properties of broilers. This study evaluated the protective effects of PAL on growth performance and liver function in broilers subjected to APEC challenge. A total of 320 one-day-old male Arbor Acres chicks were divided into four groups with eight replicates of ten birds each, based on a 2×2 factorial arrangement (basal diet or 5g/kg PAL-supplemented diet) and inoculation (bacterial culture medium or APEC). PAL increased body weight gain (BWG) prior to APEC challenge (P < 0.05). However, APEC caused losses in BWG, feed intake (FI), and feed efficiency, along with increased relative hepatic weight, hepatic pathology scores, and hepatic-cell apoptosis rate (P < 0.05). Compared to normal birds, APEC increased interleukin (IL)-1β, interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), and nitric oxide (NO) levels, as well as lysozyme (LZM) and myeloperoxidase (MPO) activities, while decreasing total antioxidant capacity (T-AOC) and IL-10 levels, and total superoxide dismutase (T-SOD) and catalase (CAT) activities in both serum and liver, APEC also raised alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, but reduced total protein (TP), albumin (ALB), immunoglobulin (Ig) A, IgG, and IgM levels in serum (P < 0.05). Moreover, APEC increased hepatic mRNA level of IL-1β, IFN-γ, TNF-α, nuclear factor kappa B, and inducible nitric oxide synthase (iNOS), while inhibited mRNA level of IL-10 (P < 0.05). In contrast, PAL increased BWG and FI, alleviated hepatic-cell apoptosis rate during the challenge period (P < 0.05). An incorporation of PAL reduced triglyceride and NO contents, ALT and AST activities, while increasing TP, ALB, IL-10, IgG, and IgM levels in serum, enhancing serum T-SOD and CAT activities, elevating hepatic T-AOC and CAT activities, inhibiting hepatic MDA accumulation, and reducing IL-1β levels and LZM activity in both liver and serum (P < 0.05). An interactive effect was found for hepatic TNF-α and iNOS mRNA expression, in which PAL inhibited their mRNA expression in APEC-challenged birds (P < 0.05). Overall, PAL addition partially mitigated the negative impact of APEC challenge on growth performance and liver function of broiler chicks at an early age.

Expedient measurement of total protein in human serum and plasma via the biuret method using fiber optic probe for patient samples and certified reference materials.

The biuret method is currently recognized as a reference measurement procedure for serum/plasma total protein by the Joint Committee for Traceability in Laboratory Medicine (JCTLM). However, as the reaction involved in this method is highly time-dependent, to ensure identical measurement conditions for calibrator and samples for high accuracy, a fast and simple measurement procedure is critical to ensure the precision and trueness of this method. We measured serum/plasma total protein using a Cary 60 spectrophotometer coupled with a fiber optic probe, which was faster and simpler than the conventional cuvette method. The biuret method utilizing alkaline solutions of copper sulfate and potassium sodium tartrate was added to the sample and calibrator (NIST SRM 927e) incubated for 1h before measurement. A panel of samples consisting of pooled human serum, single donor serum, and certified reference materials (CRMs) from three sources were measured for method validation. Sixteen native patient samples were measured using the newly developed biuret method and compared against clinical analyzers. Additionally, the results of three cycles of a local External Quality Assessment (EQA) Programme submitted by participating clinical laboratories were compared against the biuret method. Our biuret method using fiber optic probe demonstrated good precision with within-day relative standard deviation (RSD) of 0.04 to 0.23% and between-day RSD of 0.58%. The deviations between the obtained values and the certified values for all three CRMs ranged from -0.38 to 1.60%, indicating good method trueness. The routine methods using clinical analyzers were also found to agree well with the developed biuret method using fiber optic probe for EQA samples and native patient samples. The biuret method using a fiber optic probe represented a convenient and reliable way of measuring serum total protein. It also demonstrated excellent precision and trueness using CRMs and patient samples, which made the method a simpler candidate reference method for serum protein measurement.

A-136 Icteric Interference is not Resolved with Sample Dilution in Serum Creatinine and Total Protein Assays

Abstract Background Icterus is a common endogenous interference that can cause falsely low results for serum creatinine and total protein. It can be defined by elevated unconjugated (indirect) and conjugated (direct) bilirubin levels and is most commonly associated with liver dysfunction. Recent literature suggests that dilutions can be a reliable method to reduce bilirubin interference. The purpose of this study was to determine whether the vendor’s on-board sample dilution can eliminate icteric interference with creatinine and total protein. Methods Creatinine (enzymatic) and total protein interference studies were performed on an automated chemistry analyzer (Roche Diagnostics, cobas c702). Low, mid, and high sample pools for each analyte were divided into four equal volumes. To achieve an icterus index (II) of approximately 40 (approximately 40 mg/dL of bilirubin), one sample pool was spiked with unconjugated bilirubin, and one pool was spiked with conjugated bilirubin. An equal amount of diluent was added into each control pool and remained at an II of approximately 0. The icteric and control samples were measured for conjugated and unconjugated bilirubin, serum indices, and the target analyte. Using the on-board dilution function, the icteric creatinine and total protein pools were diluted using a 1:4 and 1:3 dilution, respectively. All samples were analyzed in triplicate. Percent variance was found by calculating the difference between the average dilution result and control result and then dividing by the average control result. Results Conclusions Only modest alleviation of icteric interference was noted with dilution. The average bias was 10% for creatinine and 24% with total protein, after dilution. The on-board sample dilution is not effective in eliminating icteric interference when measuring both creatinine and total protein.

B-089 Pseudo-clonal Increased IgG4 with Polyclonal Distribution Demonstrated by MALDI-TOF-MS in a Pediatric Patient with Tricho-Hepato-Enteric Syndrome (THES)

Abstract Background THES is a rare autosomal recessive syndromic enteropathy caused by pathogenic variants in two genes, the Tetratricopeptide Repeat Domain 37 (TTC37) and Ski2 Like RNA Helicase (SKIV2L), that encode components of the human SKI complex involved in RNA degradation. This disease is characterized by several clinical features with variable penetrance including intractable congenital diarrhea, wooly hair abnormalities, intrauterine growth restriction, facial dysmorphism, immune dysfunction, liver abnormalities, and skin hyperpigmentation. Hypogammaglobulinemia with low IgG and normal to low IgM levels have been described in these cases which may require intravenous immunoglobulin (IVIG) replacement therapy. Some cases have a reduced population of switched memory B cells, T cells with reduced IFN-γ secretion, and hyporesponsive NK cells. Our patient is a 4-year-old female reported to have a homozygous TTC37 mutation with clinical manifestations of TPN dependence, liver fibrosis with portal hypertension, splenomegaly, developmental delay, thrombocytopenia and anemia requiring transfusion, and a history of hypogammaglobinemia requiring IVIG replacement. Patient would go on to develop elevated immunoglobin levels leading to additional testing described below. Methods Serum total protein analysis performed using the using Siemens Atellica CH Total Protein II test (Weichselbaum method using biuret reagent). Serum immunoglobin (IgA, IgG and IgG), IgG subclass, and kappa/lambda free light chain level analysis performed by turbidimetric photometry assay using a Binding Site Optilite analyzer. Serum protein electrophoresis and immunotyping performed using CAPILLARYS 2 capillary zone electrophoresis and immunosubtraction with antisera. Serum protein immunofixation performed using Sebia Hydrasys 2 with Hydragel 9 IF Maxi kit. Confirmation and final determination of serum immunoproteins performed at our reference laboratory using MASS-FIX (MALDI-TOF MS) matrix-assisted laser desorption/ionization-time of flight mass spectrometry after patient serum applied to 5 separate immunoaffinity resins specific to immunoglobulin G, A, M, K, and L for purification. Results Initial testing showed a broadly migrating beta-gamma region IgG kappa monotypic restriction measuring 1.7 g/dL, with predominantly kappa subtraction and trivial lambda subtraction by immunosubtraction; serum free kappa/lambda light chain ratio was increased at 22.94. Serum immunoglobins and free light chains measured (mg/dL): IgA 738 (15 - 160), IgM 48 (50 - 240), IgG 2,805 (405 - 1,160), free kappa 20.42 (0.33 - 1.94), and free lambda 0.89 (0.57 - 2.63). IgG subclasses measured (mg/dL): IgG1 533 (320 - 950), IgG2 174 (50 - 340), IgG3 16.9 (10.0 - 120.0), IgG4 1,221.1 (2.0 - 110.0). Additional serum protein values included (g/dL): total protein 8.10 (6.00 - 8.30), albumin 2.97 (3.43 - 4.84), alpha-1 0.32 (0.21 - 0.44), alpha-2 0.52 (0.54 - 0.97), beta globulin 3.42 (0.65 - 1.03), and gamma globulin 0.87 (0.70 - 2.30). The polyclonal nature of the IgG4 spike was later demonstrated by the MASS-FIX mass spectrograph. Conclusions MASS-FIX is a useful addition to the toolset used in the diagnosis of possible monoclonal gammopathies and protein disorders, especially where broad monotypic restrictions are observed or in patients with abnormal presentations for monoclonal gammopathies. Using current standard techniques, the above case could have been incorrectly classified as a monoclonal process resulting in unnecessary cost and incorrect treatment.

Impact of Silver Nanoparticles (Ag-NPs) as a Dietary Supplement on Growth Performance, Carcass Traits, Blood Metabolites, Digestive Enzymes, and Cecal Microbiota of Growing Rabbits

Abstract The present study investigated the impact of silver nanoparticles (Ag-NPs) on growth performance, carcass traits, liver and kidney functions, immunity and antioxidant indicators, digestive enzymes, and cecum bacteriology of growing rabbits. One hundred 5-week-old New Zealand White (NZW) male rabbits were randomly divided into 5 equal groups and fed for 8 weeks on the basal diet only or on the basal diet supplemented with different levels of Ag-NPs (0.25, 0.50, 0.75, or 1.00 mg/kg diet). Animals in each group were randomly distributed in 10 cages (replicates), with two rabbits each. Different dietary concentrations of Ag-NPs significantly increased live body weight (LBW) and feed conversion ratio (FCR). Also, body weight gain (BWG) increased dramatically during all experimental periods except 11–13 weeks of age. Levels of 0.25 and 1 mg of Ag-NPs/kg diet showed the highest increase in LBW, BWG, and FCR. All studied carcass traits, except liver %, were not affected by Ag-NPs levels. Rabbits fed diet supplemented with 1 mg Ag-NPs had the highest liver %. Serum total protein, albumin, and globulin levels were increased (P&lt;0.05) in groups treated with 0.25 and 0.75 mg Ag-NPs. In contrast, serum values of aspartate transaminase (AST) and alanine transaminase (ALT), urea and creatinine were significantly reduced with the supplementation of Ag-NPs up to 0.75 mg/kg diet. The immunoglobulins M, G, and A (IgM, IgG, and IgA), complement 3 (C3) and lysozyme activity were improved with the inclusion of nano-silver in the rabbit feeds, particularly at the level of 0.25 mg Ag-NPs/kg feed. The inclusion of Ag-NPs in rabbit diets at different concentrations increased the total antioxidant capacity and the activities of superoxide dismutase, catalase, and glutathione peroxidase. Growing rabbits fed on diets supplemented with Ag-NPs had higher levels of digestive enzymes than the control group. The addition of Ag-NPs reduced the load of E. coli, Salmonella spp. and coliform in the rabbit cecum. Overall, the inclusion of 0.25–1 mg Ag-NPs/kg to NZW rabbit diets has shown beneficial effects on health and performance.

How enteral nutrition modes influence nasopharyngeal carcinoma survivors with late dysphagia after radiotherapy: a randomized controlled study.

Palliation to late dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC) continues to be a challenge. Intermittent oro-esophageal tube feeding (IOE) is an emerging enteral nutrition mode that can address nutrition and quality of life issues related to nasogastric tube feeding (NGT). This study aims to investigate the effect of IOE versus NGT in late dysphagia after radiotherapy for NPC. This randomized controlled study included 82 NPC survivors with late dysphagia after radiotherapy. The subjects were randomized divided into the IOE and NGT groups (n1 = n2 = 41). Both groups received standard-of-care rehabilitation. Enteral nutrition supports were administered through IOE or NGT accordingly. This study lasted 2weeks for each participant. The primary outcome was nutritional status including albumin, hemoglobin, total serum protein, and body mass index. The secondary outcomes were (i) the functional oral intake scale (FOIS), (ii) the penetration-aspiration scale (PAS), (iii) oral transit time (OTT), (iv) hyoid pause time (HPT), (v) pharyngeal transport time (PTT), and (vi) swallowing-quality of life (SWAL-QoL). Three cases quitted the study halfway and there were no significant baseline differences between the IOE (n = 40) and NGT (n = 39) groups. Both time and group effects were significant in all nutritional indicators. The time effect was significant in the FOIS levels, OTT and PTT, while the group effect was not. Either time or group effect were insignificant in the PAS levels and HPT. Both group and time effects were significant in the SWAL-QoL total scores (zGroup = 5.080, P < 0.001; zTime = 18.005, P < 0.001). The significance of time and group effects varied across different dimensions of the SWAL-QoL. Rehabilitation interventions can improve swallowing function among NPC survivors with late dysphagia after radiotherapy. In this population who received standard-of-care rehabilitation, IOE is more conducive to the improvement of nutritional status, and swallowing-related quality of life. ClinicalTrials.gov Identifier: NCT06301763.

Effect of Dietary Moldavian Balm (Dracocephalum moldavica L.) on Growth Performance, Antioxidant Status, Immune Response, and Gene Expression of Common Carp (Cyprinus carpio)

Abstract Chemical compounds used to prevent and control fish disease often cause environmental hazards; thus, alternative approaches as new and effective strategies are needed. The current investigation was performed with the aim of exploring the effects of dietary Moldavian balm (MB, Dracocephalum moldavica L.) on the growth, immune parameters, and antioxidant status of common carp (Cyprinus carpio). Fish (n=300, w=3.80±0.02 g) in four groups in triplicates were supplemented with 0%, 0.5%, 1%, and 2% MB. After 42 days, it was found that feed supplements increased final weight (FW), weight gain (WG), and specific growth rate (SGR) and decreased the food conversion ratio (FCR) (P&lt;0.05). In addition, fish supplemented with 2% MB significantly showed higher serum total protein (TP), alternative complement pathway (ACH50), and glutathione peroxidase (GPx) (P&lt;0.05). The 0.5% MB-supplemented fish represented higher levels of LYZ, alkaline phosphatase (ALP), total Ig, and ACH50 in their skin mucus in comparison with the unsupplemented fish (P&lt;0.05). The results also indicated that 2% MB resulted in a significantly higher expression level of intestinal tumor necrosis factor (TNF- α) (P&lt;0.05); however, the level of LYZ, interleukin-1β (IL-1 β), and TLRs decreased in supplemented fish. CAT and SOD expressions were increased in 0.5% MB supplement. In conclusion, MB could be recommended as an efficient feed additive to boost common carp’s growth, immunity, and health status.

Effects of Yishentongluo Recipe on Nrf2 and HO-1 pathway activation leading to reduction of oxidative stress and kidney fibrosis in membranous nephropathy rat model

This study investigated Yishentongluo Recipe (YSTLF) effects on renal oxidative stress and fibrosis in membranous nephropathy (MN) rats. MN was induced by cationized bovine serum albumin injection. Rats were divided intocontrol, MN, YSTLF, and benazepril groups. After four weeks of treatment, urine protein levels (UTP), serum total cholesterol (TC), triglycerides (TG), total protein (TP), and albumin (ALB) were assessed. Kidney microstructure, IgG immune complex deposition, and protein expressions of superoxide dismutase (SOD), malondialdehyde (MDA), transforming growth factor β1 (TGF-β1), collagen I (Collagen-I), α-smooth muscle actin (α-SMA), nuclear factor E2-related factor (Nrf2), haem oxygenase 1 (HO-1), and NADPH oxidase 4 (NOX4) were evaluated. YSTLF and BNPL treatments reduced UTP, TC, TG, increased TP and ALB levels, downregulated TGF-β1, Collagen-I, and α-SMA, and upregulated Nrf2, HO-1, and NOX4. YSTLF partially reversed SOD reduction and MDA elevation, suggesting its efficacy in alleviating renal oxidative stress and fibrosis in MN rats via Nrf2/HO-1 signaling pathway activation.