Efficacy of cecal retroflexion observed on adenoma missing of ascending colon during colonoscopy: A prospective, randomized, pilot trial

BACKGROUND

Although colonoscopic retroflexion has been proved effective in reducing missed adenomas, there is still a lack of comprehensive and in-depth research focused on the ascending colon. We aimed to conduct a randomized controlled trial and tandem colonoscopy to investigate whether cecal retroflexion observed during colonoscopy can reduce missed adenomas in the ascending colon.

METHODS

Men and women required to be between 45 and 80 years of age were screened for enrollment in the trial. Patients were randomly assigned according to a 1:1 ratio to either the trial group or control group. Patients in the trial group underwent 2 forward examination and a cecal retroflexion observed in the ascending colon, while patients in the control group underwent only 2 forward examinations in the ascending colon. The primary outcome was adenoma miss rate. The secondary outcomes contained adenoma detection rate, polyp miss rate, polyp detection rate, insertion time and withdrawal time. Differences between groups in the primary outcome and in the other categorical indicators were tested using chi-squared test and Fisher exact test. For the comparison of continuous outcomes, the Student t test was applied.

RESULTS

A total of 60 subjects were eligible for the study between April to June 2020, of which 55 were randomized and eligible for analysis (26 to the control group and 29 to the trial group). The characteristics of patients were no significant differences statistically between the trial group and the control group. Similarly, the characteristics of the colonoscopy procedures included cecal insertion distance, the length of cecum and ascending colon, insertion time, withdrawal time, quality of bowel preparation, numerical rating scale for pain, polyps detected, and adenomas detected, and there were no significant differences statistically between the 2 groups (P = .864, P = .754, P = .700, P = .974, P = .585, P = .835, P = .373, P = .489). The characteristics of the polyps were also no significant differences statistically between the 2 groups.

CONCLUSION

This pilot trial failed to show benefit of cecal retroflexion observed on adenoma missing of ascending colon during colonoscopy; however, further conclusions require a prospective study with a higher level of evidence. (NCT03355443).

Re-recognition of BMPR1A-related polyposis: beyond juvenile polyposis and hereditary mixed polyposis syndrome

Background

Bone morphogenetic protein receptor type 1A (BMPR1A) is responsible for two individual Mendelian diseases: juvenile polyposis syndrome and hereditary mixed polyposis syndrome 2, which have overlapping phenotypes. This study aimed to elucidate whether these two syndromes are just two subtypes of a single syndrome rather than two isolated syndromes.

Methods

We sequenced the BMPR1A gene in 186 patients with polyposis and colorectal cancer, and evaluated the clinicopathological features and phenotypes of the probands and their available relatives with BMPR1A mutations.

Results

BMPR1A germline mutations were found in six probands and their three available relatives. The numbers of frameshift, nonsense, splice-site, and missense mutations were one, one, two, and two, respectively; two of the six mutations were novel. Typical juvenile polyps were found in only three patients. Two patients had colorectal cancer rather than any polyps.

Conclusions

Diseases in BMPR1A germline mutation carriers vary from mixed polyposis to sole colorectal cancer, and typical juvenile polyps do not always occur in these carriers. The variety of phenotypes reflected the features of BMPR1A-mutation carriers, which should be recognized as a spectrum of one syndrome. Genetic testing may be a good approach to identifying BMPR1A-related syndromes.

Fabrication and stabilization mechanisms of Pickering emulsions based on gliadin/arabinoxylan complexes

In the present work, the Pickering emulsions with enhanced oxidation stability were fabricated using gliadin (G)/arabinoxylan nanoparticles (GANPs). The influence of different G/AX ratios on the properties of GANPs and corresponding physicochemical characteristics of Pickering emulsions were investigated. Results indicated that the droplet size and ζ-potential of Pickering emulsions declined with the decrease of G/AX ratios. Pickering emulsion with the smallest G/AX ratio (1:4) exhibited excellent oxidative and coalescence stability due to the formation of viscoelastic gel network, which was supported by confocal laser scanning microscopy (CLSM) images. Furthermore, the increase of salt ions in a lower concentration (0-0.2 M) was conducive to the flocculation of the droplets, while further increasing the NaCl concentration impaired the emulsion stability. Such elements revealed that G/AX complex is a promising stabilizer of Pickering emulsions with prominent antioxidant activity, which have favorable potential applications in protecting the functional properties of polyunsaturated fatty acids (PUFAs).

Effect of freeze-thaw cycles on the physicochemical properties and frying performance of frozen Youtiao dough

The impact of freeze-thaw cycles on the physicochemical properties and frying performance of frozen Youtiao dough with chemical leavening agent was investigated. The specific volume of Youtiao made from frozen dough decreased by 66% after 4 freeze-thaw cycles. Meanwhile, the hardness and puncture force showed increasing trends, and the fibrous structure became unclear. The extensibility, storage modulus (G') and loss modulus (G'') of frozen Youtiao dough decreased during freeze-thaw cycles, while the creep compliance increased. Changes in rheological properties demonstrated that frozen Youtiao dough was more deformable and its strength was weakened. Moreover, the sodium dodecyl sulfate (SDS) extractable protein and free sulfhydryl content increased, revealing that protein was depolymerized. The loose structure with large pores and fractured protein network were observed by micromorphology. Freeze-thaw cycles had a detrimental effect on the Youtiao quality, which was related to the deterioration of rheological properties and protein structure of frozen Youtiao dough.

[Comparative study of CT relative enhancement value and subjective visual evaluation for intestinal ischemia in patients with closed loop obstruction]

Objective: To compare and evaluate the diagnostic performance of visual evaluation and CT maximal density relative enhancement value in the diagnosis of intestinal ischemia complication in patients with closed loop obstruction and to explore the feasibility of CT maximal density relative enhancement value in quantifying the degrees of intestinal ischemia. Methods: The clinical and CT imaging data of 82 patients, 46 males and 36 females, aged from 19 to 78(52±18) years, with closed loop obstruction were retrospectively analyzed in the First Affiliated Hospital of Zhengzhou University from July 2017 to July 2019. All patients were classified into three groups: necrosis group (28 cases), ischemia group (22 cases), non-ischemia group(32 cases) using clinicopathologic results as reference standard. CT visual evaluation was performed by two experienced radiologists. The sensitivity, specificity, positive and negative predictive values and accuracy of the two observers were calculated respectively. The inter-observer agreement was analyzed by kappa analysis. Maximal density relative enhancement value was defined as the difference CT value of an ROI at dilated obstructed loops between contrast-enhanced and unenhanced CT images. The differences among groups were compared by one-way analysis of variance. Diagnostic performances were evaluated by receiver operating characteristic (ROC) curve analysis. Results: The sensitivity, specificity, positive and negative predictive values and accuracy of observer1 were 62.0%, 87.5%, 88.6%, 59.6%, 72.0%, and 58.0%, 93.8%, 93.5%, 58.8%, 72.0%for observer2, respectively. The kappa value of inter-observer agreement was 0.747. The unenhanced CT value of necrosis group, ischemia group and non-ischemia group was (53.7±9.7), (45.7±7.2) and (44.7±7.0) HU, enhanced CT value was (60.5±10.1), (65.0±11.6) and (87.0±15.8) HU, relative enhancement value was(6.8±8.4), (19.2±12.4) and(44.7±16.2)HU, respectively. All had a statistical difference among three groups (all P<0.05). The unenhanced CT value of necrosis group was higher than that of ischemia group and un-ischemia group (both P<0.05). The enhanced CT value of non-ischemia group was higher than that of ischemia group and necrosis (both P<0.05). The relative enhancement value all had a significant difference between groups (all P<0.05). Taking maximal density relative enhancement value below 19.5 HU as diagnosis threshold, the sensitivity, specificity and area under curve(AUC) were 96.9%, 74.0% and 0.947, respectively. Taking enhanced CT value below 66.5 HU as diagnosis threshold, the sensitivity, specificity and AUC were 93.8%, 60.0% and 0.903, respectively; the sensitivity was higher than that of objective visual evaluation. Conclusion: Maximal density relative enhancement value can quantize the bowel wall enhancement, and is a more reliable way in the diagnosis of intestinal ischemia than visual evaluation.

The effects of extruded endogenous starch on the processing properties of gluten-free Tartary buckwheat noodles

The lack of gluten in Tartary buckwheat has always been the main limiting factor of their development. This paper explored how to improve the processing quality of gluten-free Tartary buckwheat noodles (GF-TBNs) by introducing extruded starch into Tartary buckwheat flour (TBF) and the underlying mechanism was also elucidated. Extruded Tartary buckwheat starch (ETBS) was obtained under different extrusion conditions. The thermal properties, molecular weight, and viscosity of ETBS were examined to determine the key parameters closely related to the water distribution and rheological properties of the dough sheet, and tensile properties of GF-TBNs. The results showed that ETBS with a low molecular weight and high viscosity contributed greatly to the GF-TBNs with good tensile properties. It is proposed that ETBS with a low molecular weight and high viscosity might form a gel-entrapped network inside GF-TBNs, which was confirmed by the morphology of GF-TBNs.

Changes of lipids in noodle dough and dried noodles during industrial processing

This study investigated the changes of lipids during the industrial preparation of noodle dough and dried noodles, including the hydration, sheeting, and drying processes. The results showed that industrial processing markedly influenced the stability of lipids during the preparation of dried noodles. The contents of total free fatty acids, polyunsaturated fatty acids, and free lipids were reduced, while peroxide values increased during the hydration and sheeting processes, showing the instability of lipids. The increase in lipid oxidation may have been due to the activation of lipoxygenase. Although its activity declined by 45.7% in the hydration process compared to that of the native wheat flour (198.5 ± 20.4 U/g/min), the residue activity should have been high enough to oxidize lipids. Interestingly, lipase activity remained relatively stable. In addition, an obvious increase of carbon-centered free radicals was observed during the entire processing. In conclusion, the industrial processing, especially the hydration process, markedly changed the lipid profile and promoted lipid oxidation during the preparation of dried noodles. PRACTICAL APPLICATION: The present study showed the positive relationship between endogenous lipid degrading enzymes and the degradation of lipids and elucidated the role of industrial processing on lipid stability in noodle dough and dried noodles. The results of the present study will also help us to understand more about the sensory quality of dried noodles during preparation, as well as to develop high quality of wheat-based food products.

Thermal-aggregation behavior of gluten in frozen dough induced by ε-poly-L-lysine treated yeast

ε-poly-L-lysine treated yeast (PTY) helps to enhance the freeze-thaw tolerance of frozen dough. This study explored the effect of PTY on the aggregation and the gas-retention of frozen dough after steaming for 2, 5, 10, and 20 min. Gas-cell images showed that PTY reduced the loss of gas-retention ability caused by 4 times of freeze-thaw. The results of sodium dodecyl sulfate extractability and subunit distribution of gluten showed that, after the same heat time, frozen dough with PTY has higher degree of covalent crosslinking with better aggregation ability of α-, γ-gliadin, and low molecular weight glutenin subunits than frozen dough with yeast. Chemical analysis and chain morphology results demonstrated that the levels of acidity, NH₂, and free sulfhydryl in dough were decreased, and the protein molecules aggregated into longer chains when using PTY instead of yeast, indicating that PTY reduced acid-mediated hydrolysis and increased the disulfide bonds-mediated gluten polymerization.

Influence of protein type, content and polymerization on in vitro starch digestibility of sorghum noodles

The impacts of protein type, content and polymerization on in vitro starch digestibility of cooked sorghum noodles were investigated. Results showed that addition of exogenous proteins decreased the starch hydrolysis rate. The noodles added wheat protein (WP) exhibited the highest amount of resistant starch, followed by whey protein isolate (WPI) and egg white protein (EWP). In each group, the hydrolysis kinetic parameters were the lowest when protein addition amounts were 5% WP, 3% EWP and 3% WPI, respectively. These changes were ascribed to the interactions of starch-proteins and protein-proteins, as proved by the enhancement of protein polymerization and starch short-range structure. The increase of protein polymerization degree induced by disulfide cross-links reduced the starch digestion rate of noodles. Additionally, the confocal laser scanning microscope observations demonstrated that the strengthening of protein network had a positive effect on decreasing starch digestibility by preventing the accessibility of enzymes to starch.

Influence of ε-poly-l-lysine treated yeast on gluten polymerization and freeze-thaw tolerance of frozen dough

The effects of ε-poly-l-lysine (ε-PL) treated yeast on gluten polymerization of frozen dough and quality of steamed bread after freeze-thaw cycles were investigated. Compared with steamed bread made from frozen dough containing ε-PL and untreated yeast (PUTY) or only untreated yeast, steamed bread made from frozen dough containing ε-PL treated yeast (PTY) had a larger specific volume, lower hardness and more porous. A dynamic rheological and scanning electron microscopic analysis demonstrated that using PTY instead of yeast could reduce dough elasticity and damage protein network after freeze-thaw cycles. Lower sodium dodecyl sulfate (SDS) soluble polymeric proteins and monomeric proteins, and higher SDS insoluble proteins were found in frozen dough containing PTY, which indicates a reduced depolymerization of gluten proteins after freeze-thaw cycles. After 4 freeze-thaw cycles, the lower glutathione and free sulfhydryl in dough containing PTY indicate that the interchain disulfide bonds between proteins were preserved.

Effects of tempering with steam on the water distribution of wheat grains and quality properties of wheat flour

In this study, the effects of tempering with steam on the water distribution of wheat grains and the microbial load in wheat flour were investigated, as well as the physicochemical properties of wheat flour. Results showed that when steam treatment time was 320 s, the total plate count (TPC), yeast and mold count (YMC), and mesophilic aerobic spores (MAS) in flour decreased by 1.74, 1.99 and 1.01 lgCFU/g, respectively. Nuclear magnetic resonance (NMR) results showed that tempering with steam accelerated the water distribution of grains and significantly (p < 0.05) shortened the tempering time. Moreover, flour yield, particle size, ash content, and damaged starch content of flour were all altered. Furthermore, after tempering with steam, proteins were aggregated and starches were partially gelatinized, which caused dough development time and stability of flour increasing. Collectively, our findings indicated steam tempering could shorten the tempering time and improve the qualities of flour partly.

Effect of thermal treatments on in vitro starch digestibility of sorghum dried noodles

Sorghum grains were pretreated by roasting, microwave, stir-frying and heat moisture treatment, which were effective to reduce the starch digestibility of cooked noodles.

A long-term follow-up study on the prognosis of endoscopic submucosal dissection for colorectal laterally spreading tumors

BACKGROUND AND AIMS

Colorectal laterally spreading tumors (LSTs) are divided into homogeneous (LST-G-H), nodular mixed (LST-G-M), flat elevated (LST-NG-F), and pseudodepressed (LST-NG-PD) subtypes. We hypothesized that based on the rates of advanced histology, the recurrence rates of the LST-NG-PD and LST-G-M groups may be higher than those of the other subgroups.

METHODS

Endoscopic submucosal dissection (ESD) was performed in 156 patients with a total of 177 LSTs. The clinicopathological features and long-term prognosis of ESD according to specific subtype were investigated.

RESULTS

LSTs were most commonly found in the rectum, and the highest percentage of rectal lesions was observed in the LST-G-M group (71.1% vs overall 55.4%, P = .032). The LST-G-M lesions were larger (60 ± 22 mm vs 40 ± 33 mm, P = .034) than the LST-G-H lesions. The LST-G-M group also demonstrated more high-grade intraepithelial neoplasias (32.2% vs 10.8%, P = .003) and submucosal carcinomas (13.6% vs 1.5%, P = .010) compared with the LST-G-H group. The LST-NG-PD group exhibited the highest incidence of submucosally invasive cancer (16.7%). The overall perforation rate was 2.3%. The perforation rate in the LST-NG group was higher than that in the LST-G group (5.7% vs 0.8%, P = .047). All recurrences (7.7%) were found by colonoscopy without any detection of cancers, and no difference was found among the subtypes.

CONCLUSIONS

No significant differences were observed among subgroups with 44.4 ± 16.3 months of follow-up. Considering that all recurrences were discovered by colonoscopy and most could be cured by repeated ESD, the LSTs of all subgroups require more intensive follow-up compared with smaller adenomatous lesions.

Expression of ZNF148 in different developing stages of colorectal cancer and its prognostic value: a large Chinese study based on tissue microarray

BACKGROUND

It has been speculated that zinc finger protein 148 (ZNF148) is a tumor suppressor. However, to the authors' knowledge, little is known about the clinical significance of ZNF148 expression in patients with colorectal cancer (CRC). The objective of the current study was to clarify the association between ZNF148 expression and the postoperative prognosis of patients with CRC.

METHODS

Tissue microarrays containing 56 normal mucosa, 51 adenoma, 742 CRC (TNM stage I-IV), 16 familial adenomatous polyposis, and 21 metastatic CRC specimens were examined immunohistochemically for ZNF148 expression.

RESULTS

Expression of ZNF148 was found to increase consecutively from normal mucosa to stage I CRC, and then decreased consecutively from stage I to stage IV CRC. Lower expression of ZNF148 in tumors was found to be significantly associated with lymph node metastases, advanced TNM disease stage, poor differentiation, higher rate of disease recurrence, worse overall survival (OS), and shorter disease-free survival. High expression of ZNF148 was also associated with improved OS (P = .025) and disease-free survival (P = .042) in patients with stages II to III CRC. On multivariate Cox analysis, lower ZNF148 expression in tumors, advanced TNM stage, colon cancer, and elevated serum carbohydrate antigen 19-9 (CA19-9) were found to be significant factors for a worse OS. In 16 patients with familial adenomatous polyposis, ZNF148 expression was upregulated at steps toward carcinogenesis. In 21 patients with metastatic CRC, although ZNF148 expression was higher in primary tumors compared with adjacent mucosa, its expression in metastatic tumors was significantly lower than that in primary tumors.

CONCLUSIONS

Although ZNF148 expression is related to colorectal carcinogenesis, high ZNF148 expression in patients with CRC appears to be inversely associated with malignant phenotypes and may serve as a significant prognostic factor after surgery for patients with CRC.

Antiserum to the recombinant truncated VP22 protein of herpes simplex virus type 1 that also recognizes full-length VP22

The herpes simplex virus type 1 (HSV-1) tegument protein VP22 encoded by the UL49 gene is essential for HSV-1 infection. However, its precise functions in the virus life cycle are unknown. A relatively important tool for disclosing these functions is an antiserum specifically detecting VP22 in the infected cell. To this end, a recombinant truncated VP22 protein consisting of C-terminal 45 aa fused to EYFP (enhanced yellow fluorescent protein) and His-tag was expressed in Escherichia coli, purified by the Ni2+-NTA affinity chromatography, and used for the preparation of antiserum in rabbits. Western blot and immunofluorescence assay showed that this antiserum specifically detected purified truncated VP22 as well as full-length VP22 in the HSV-1 infected cells. These results indicate that the prepared antiserum could serve as a valuable tool for further studies of VP22 functions.

Effects of maize grain and lucerne particle size on ruminal fermentation, digestibility and performance of cows in midlactation

This study evaluated the effects of, and interactions between, maize grain particle size (MPS) and lucerne particle size (LPS) on dry matter intake, milk production, milk composition, ruminal fermentation, microbial yield, chewing activity and nutrient digestibility in midlactation cows. Four multiparous Holstein cows with ruminal cannulas were assigned randomly to a 4 x 4 Latin square design, averaged 595 kg (SD = 52) of body weight and 121 days in milk (SD = 21) at the start of the experiment. Experimental periods were 21 days in length (14 days of treatment adaptation and 7 days of data collection). All diets were fed as total mixed ration and were formulated to meet or exceed the requirements of a 600 kg multiparous cow producing 20 kg milk/day with 4.0% fat. The ratio of concentrate to forage was 39:61 (dry matter basis). Treatments were arranged in a 2 x 2 factorial design; two levels of LPS (2.54 and 6.22 mm) were combined with concentrates based on either ground maize grain (711 mum) or cracked maize grain (1755 mum). Maize grain and LPS did not affect milk production and milk fat percentage. Milk protein percentage increased when MPS was decreased (p = 0.04). Milk urea nitrogen was lower for cows fed ground maize grain compared with cracked maize grain (118-134 mg/l, p = 0.05). Estimated microbial N supply increased 41.9 g/day for ground maize grain compared with cracked maize grain. Cows fed long lucerne (LL) hay spent more time ruminating compared with cows fed short lucerne (SL) hay ranging from 293 to 336 min/day (p < 0.001). Total time spent chewing by cows increased from 505 to 574 min/day (p = 0.002) for SL and LL respectively. Based on the results from this study, midlactation cows can be fed diets that contain ground maize grain and SL hay without leading to negative effects on ruminal pH and nutrient digestibility.

Effects of β-glucan extracted from Saccharomyces cerevisiae on growth performance, and immunological and somatotropic responses of pigs challenged with Escherichia coli lipopolysaccharide1

Three experiments were conducted to investigate the effects of beta-glucan supplementation on pig performance and immune function. In Exp. 1, 100 weaned pigs (8.65 +/- 0.42 kg of BW and 28 +/- 2 d of age) were used in a 35-d experiment to determine the effects of graded levels of beta-glucan. Pigs were randomly allotted to 1 of 5 treatments containing beta-glucan supplemented at 0, 25, 50, 100, or 200 ppm. Each treatment was replicated using 5 pens containing 4 pigs per pen. The ADG of pigs between d 14 to 28 and d 0 to 28 responded to dietary beta-glucan in a quadratic fashion (P < 0.05), whereas beta-glucan had no effect on ADFI and G:F in any period. In Exp. 2, 80 crossbred pigs (8.23 +/- 0.56 kg of BW and 28 +/- 2 d of age) were used in a 35-d experiment. Pigs were allotted to 1 of 2 dietary treatments (0 or 50 ppm of beta-glucan in the diet) using 10 pens with 4 pigs per pen. Pigs treated with beta-glucan had greater ADG in the 14- to 28-d (P = 0.05) and 0-to 28-d (P = 0.035) periods. The ADFI of pigs receiving beta-glucan was increased (P < 0.05) in the periods from 0 to 14, 0 to 28, and 28 to 35 d. The lymphocyte proliferation index in response to phytohemagglutinin (P = 0.051) and concanavalin A (P = 0.052) tended to decrease on d 14 in pigs supplemented with beta-glucan compared with pigs without supplementation. In Exp. 3, 24 barrows (8.89 +/- 0.20 kg of BW and 28 d of age) were used to investigate the immunological and somatotropic responses of pigs challenged with lipopolysaccharide (LPS). Experimental treatments were arranged in a 2 x 2 factorial, with the main effects of LPS challenge (saline vs. LPS) and dietary addition of beta-glucan (0 vs. 50 ppm). Pigs were raised individually in metabolic cages. Pigs were fed 0 or 50 ppm of beta-glucan for 28 d and then challenged with LPS (25 microg/kg of BW) or saline. After LPS injection, blood was obtained at 0, 1.5, 3, 4.5, 6, and 7.5 h to determine cytokine production and the somatotropic response. Dietary beta-glucan increased plasma interleukin-6 at 1.5, 3, and 4.5 h and tumor necrosis factor-alpha at 3 and 4.5 h and increased plasma interleukin-10 from 3 to 7.5 h after LPS challenge. The beta-glucan treatments had no effect on growth hormone. In conclusion, beta-glucan can selectively influence performance and partially offer benefits on somatotropic axis and immune function in weaned piglets challenged with LPS.

Effects of Feed Particle Size and Feed Form on Survival of Salmonella typhimurium in the Alimentary Tract and Cecal S. typhimurium Reduction in Growing Broilers

An in vitro experiment and an in vivo experiment were conducted to investigate the effects of feed particle size (coarse and fine) and feed form (mash and pellet) on the survival of Salmonella typhimurium (ST) in the alimentary tract, and the reduction of cecal ST in growing broilers in a 2 x 2 factorial design. All diets in the 2 trials were corn and soybean meal-based diets that differed only in physical characteristics. Diets were provided for birds from d 1 to 22 of age. In the in vitro trial, the relative gizzard weight was lower in birds that were fed the pellet diet (P < 0.01), whereas the relative weight of the cecum was higher in these birds (P < 0.01). Broilers receiving the pellet diet had enhanced concentrations of volatile fatty acids in contents from both the gizzards and the ceca. In addition, there was an increase in gizzard pH (P < 0.01) with the pellet diet, but a reduction in cecal pH (P < 0.05). Pellet-fed birds showed a significantly decreased and increased in vitro death rate of ST in the contents from gizzards (P < 0.01) and ceca (P < 0.05), respectively. A higher in vitro ST death rate in the gizzard was observed in birds given the coarse mash diet compared with those given the fine mash diet. In the in vivo experiment, cecal volatile fatty acid concentrations were increased, whereas cecal pH was decreased significantly (P < 0.05) when birds were fed the pellet diet compared with the mash diet. Furthermore, cecal ST concentrations were higher (P < 0.05) in broilers fed the pellet diet than in those fed the mash diet. Results indicated that the pellet diet increases the incidence of ST in gizzards and ceca in growing broilers and provide evidence demonstrating that the gizzard may play a critical role in reducing ST contamination in growing broilers.

Effects of salvianolic acids on erythrocyte deformability in oleic acid induced acute lung injury in rabbits

The present study was to investigate the protective effects of salvianolic acids (SA) on deformability of red blood cells (RBCs) and its mechanism during the development of acute lung injury (ALI) induced by oleic acid (OA) in rabbits. 32 rabbits were randomized into four groups, normal control group, OA-treated group (0.15 ml/kg), SA-treated group and OA+SA treated group. The blood samples were collected at 0, 10, 30, 60, 90, 120 and 180 min after OA injection. The RBC deformation index, Orientation index and small deformation index were measured by ektacytometry. The concentration of malondialdehyde (MDA) in RBCs was detected by the assay kit. Meanwhile, the pulmonary pathological examination and the blood gas analysis were also performed. The results showed that the deformation index, orientation index and small deformation index decreased during the early phase of ALI, while the concentration of MDA in RBCs increased during the course. Pre-treatment with SA increased the deformability and orientability of RBC significantly and decreased the concentration of MDA in RBCs compared with OA group. Meanwhile, the hypoxia and pulmonary pathological damage were much improved. These results suggest that there were erythrocyte deformability changes in the early phase of ALI. SA has the protective effects on erythrocyte deformability during the development of ALI induced by OA, which might be due to its antioxidant effect. These results are valid in rabbits and in a model of ARDS, it would be interesting to see the effects of SA in patients.

Effects of β-glucan obtained from the Chinese herb Astragalus membranaceus and lipopolysaccharide challenge on performance, immunological, adrenal, and somatotropic responses of weanling pigs1

A total of 108 crossbred piglets (7.75 +/- 0.24 kg of BW) weaned at 28 d was used to study the interactive effects of beta-glucan obtained from the Chinese herb Astragalus membranaceus (AM) and Escherichia coli lipopolysaccharide (LPS) challenge on performance, immunological, adrenal, and somatotropic responses of weaned pigs. The treatments were in a 2 x 3 factorial arrangement; main effects were level of Astragalus membranaceus glucan (AMG; 0, 500, or 1,000 mg/kg; as-fed basis) and presence of immunological challenge (with or without LPS). The experiment included six replicate pens per treatment and three pigs per pen. Lipopolysaccharide challenges were conducted on d 7 and 21 of the trial. Blood samples were obtained from the vena cava from one pig per pen at 3 h after LPS challenge to determine plasma responses. Weight gain and feed:gain ratio were unaffected by glucan. However, there was a quadratic effect on feed intake (P < 0.05): pigs fed 500 mg of glucan/kg had the highest feed intake. Immunological challenge with LPS decreased weight gain (P = 0.02). An interaction (P = 0.01 to 0.09) between AMG and LPS was observed for glucose, IL-1beta, PGE2, and cortisol. Astragalus membranaceus glucan had a quadratic effect on the plasma concentrations of glucose, IL-1beta, PGE2, and cortisol (P < 0.05) after both LPS challenges. Plasma concentrations of glucose, IL-1beta, PGE2, and cortisol (P < 0.05) were all increased in LPS-challenged pigs compared with the control pigs after both LPS challenges. The IGF-I concentrations were less for LPS-challenged pigs than for unchallenged pigs. The lymphocyte proliferation response of peripheral blood induced by 5 microg of concanavalin A/mL (P < 0.01) and IL-2 bioactivity (P < 0.05) increased linearly with increasing addition of glucan. Pigs challenged with LPS had greater T-lymphocyte proliferation (P = 0.06) and IL-2 bioactivity (P = 0.07) than unchallenged pigs after the first immunological challenge but not after the second. In conclusion, although glucan did not improve pig performance under the conditions of the present experiment, when included at 500 mg/kg, it decreased the release of inflammatory cytokine and corticosteroid and improved the lymphocyte proliferation response of weanling piglets via enhanced IL-2 bioactivity.

[Bowel control of elderly low rectal cancer patients after anus-retained operation]

BACKGROUND & OBJECTIVE

Though anus-retained operation has became the first choice in radical cure operation for rectal cancer, most surgeons whom fear of dissatisfied bowel control after operation recommend permanent bowel stoma in abdomen for elderly low rectal cancer patients rather than anus-retained operation. This study was to evaluate the bowel control of elderly low rectal cancer patients after anus-retained operation.

METHODS

A total of 80 elderly low rectal cancer patients were divided into > or =75-year old group (39 patients) and 60-74-year old group (41 patients). Clinical data and follow-up data of the 80 patients were analyzed; bowel function and continence of the 2 groups were compared.

RESULTS

The postoperative 18-month survival rate of all patients was 98.8%. The bowel control statuses of 76 patients were evaluable, of which 36 were in > or =75-year old group, 40 were in 60-74-year old group. Three months after operation, the bowel function was significantly poorer in > or =75-year old group than in 60-74-year old group (P<0.05), but the difference dissolved 6 months after operation (P>0.05). The time of recovering normal defecation frequency was slightly longer in > or =75-year old group than in 60-74-year old group (P>0.05). The prevalence of grade I incontinence 6 months after operation was significantly higher in > or =75-year old group than in 60-74-year old group (36.1% vs. 12.5%, P<0.05), but all symptoms of incontinence were relieved after treatment.

CONCLUSIONS

Most elderly low rectal cancer patients could maintain bowel control after anus-retained operation. Age alone should not be a contraindication to a restorative resection for low rectal cancer.

Effects of emulsification, fat encapsulation, and pelleting on weanling pig performance and nutrient digestibility

Two experiments were conducted to evaluate the effect of lysolecithin on performance and nutrient digestibility of nursery pigs and to determine the effects of fat encapsulation by spray drying in diets fed in either meal or pelleted form. In Exp. 1, 108 pigs (21 d of age; 5.96 +/- 0.16 kg BW) were allotted to one of four dietary treatments (as-fed basis): 1) control with no added lard, 2) control with 5% added lard, 3) treatment 2 with 0.02% lysolecithin, and 4) treatment 2 with 0.1% lysolecithin in a 35-d experiment. Added lard decreased ADG (P = 0.02) and ADFI (P < 0.06) during d 15 to 35 and overall. Lysolecithin improved ADG linearly (P = 0.04) during d 15 to 35 and overall, but did not affect ADFI or G:F. Addition of lard decreased the digestibility of DM (P = 0.10) and CP (P = 0.05) and increased (P = 0.001) fat digestibility when measured on d 10. Lysolecithin at 0.02%, but not 0.10%, tended to improve the digestibility of fat (P = 0.10). On d 28, digestibilities of DM, fat, CP, P, (P = 0.001), and GE (P = 0.03) were increased with the addition of lard, and lysolecithin supplementation linearly decreased digestibilities of DM (P = 0.003), GE (P = 0.007), CP, and P (P = 0.001). In Exp. 2, 144 pigs (21 d of age, 6.04 +/- 0.16 kg BW) were allotted to one of six treatments in a 3 x 2 factorial randomized complete block design. Factors included 1) level (as-fed basis) and source of fat (control diet with 1% lard; control diet with 5% additional lard; and control diet with 5% additional lard from encapsulated, spray-dried fat) and 2) diet form (pelleted or meal). Addition of lard decreased feed intake during d 0 to 14 (P = 0.04), d 15 to 35 (P = 0.01), and overall (P = 0.008), and improved G:F for d 15 to 35 (P = 0.04) and overall (P = 0.07). Encapsulated, spray-dried lard increased ADG (P = 0.004) and G:F (P = 0.003) during d 15 to 28 compared with the equivalent amount of fat as unprocessed lard. Pelleting increased ADG (P = 0.006) during d 0 to 14, decreased feed intake during d 15 to 35 (P = 0.01), and overall (P = 0.07), and increased G:F during all periods (P < 0.02). Fat digestibility was increased (P = 0.001) with supplementation of lard, and this effect was greater when diets were fed in meal form (interaction, P = 0.004). Pelleting increased the digestibility of DM, OM, and fat (P < 0.002). Results indicate that growth performance may be improved by lysolecithin supplementation to diets with added lard and by encapsulation of lard through spray drying.

Prolongation of xenograft survival using monoclonal antibody CD45RB and cyclophosphamide in rat-to-mouse kidney and heart transplant models

BACKGROUND

Intrigued by the finding that a monoclonal antibody (mAb) directed against the B exon of restricted CD45 (CD45RB mAb) induced renal allograft tolerance in the mouse model, we hypothesized that CD45RB mAb may prevent xenograft rejection. We explored the role of CD45RB mAb in preventing xenograft rejection in rat-to-mouse kidney and heart transplant models.

METHODS

Mice with rat kidney and heart xenografts were treated with a short course of mAb, cyclosporine, cyclophosphamide, or mAb + cyclophosphamide combination therapy. Untreated heart and kidney xenografts served as controls.

RESULTS

Untreated controls developed acute vascular and cellular rejection rapidly with a median survival time of only 6 days. Long-term kidney (median survival time = 70 days) and heart xenograft survival (median survival time = 65 days) was achieved using the combination therapy of mAb + cyclophosphamide. One-third of the kidney recipients with combination therapy survived 100 days. Immunohistochemistry and xenospecific-antibody analysis demonstrated that combination therapy remarkably reduced IgG and IgM deposition and also inhibited CD4+, CD8+, and Mac-1+ cell infiltration at early stages. This therapy, however, did not induce tolerance in this model as evoked xenoreactive antibodies and cellular responses may be the cause of late xenograft failure.

CONCLUSION

A short course of CD45RB mAb combined with cyclophosphamide effectively inhibits cellular and humoral immunoresponses and remarkably prolongs xenograft survival in rat-to-mouse heart and kidney transplant models.

Adoptively transferable tolerance induced by CD45RB monoclonal antibody

The phenomenon of rejection remains the most serious problem in transplantation. The ultimate goal in transplant immunology is to develop therapeutic strategies that lead to tolerance. It has been shown that two injections of a monoclonal antibody to CD45RB leads to indefinite acceptance of renal allografts in mice. Moreover, the CD45RB monoclonal antibody reverses acute rejection and still induces tolerance. The purpose of this study was to assess mechanisms that could underlie this therapeutic benefit. It was shown that splenic lymphocytes from tolerant animals augmented proliferation in allogeneic mixed lymphocyte reactions against donor alloantigens, and the serum of tolerant mice contained donor-specific antibodies, mainly of the IgG1 isotype, suggesting the presence of TH2 cytokines. Tolerance could not be broken by interleukin-2 infusion, but tolerance could be adoptively transferred by transfusion of tolerant mouse CD4+ splenic lymphocytes into naive allografted animals. These data suggest that an active immunoregulatory mechanism is partly responsible for the therapeutic effect. CD45RB-directed therapy may find clinical application in organ transplantation in human patients.

Suppression of dialysis patients' lymphocyte IL-2R expression by glucocorticoids and cyclosporine

Previous studies have shown interindividual heterogeneity in the suppressive effects of glucocorticoids and cyclosporine (CsA) on the proliferation responses of dialysis patients' peripheral blood mononuclear cells (PBMC). In addition, methylprednisolone (MP) was shown to be significantly more suppressive than prednisolone (P), and PBMC from patients on peritoneal dialysis (PD) were found to be more sensitive to both glucocorticoids than those from patients on haemodialysis (HD). In order to begin to explore the cellular mechanism(s) underlying these observations, the differential suppressive effects of these drugs on lymphocyte interleukin 2 receptor (IL-2R) expression by mitogen-stimulated PBMC from 23 PD and 30 HD were determined. The mean+/-SD concentrations (ng/ml) of steroid causing 50% inhibition (IC50) of cell proliferation was significantly lower for PD than HD PBMC with both P (94+/-93 vs 148+/-105, P<0.05) and MP (21+/-25 vs 35+/-31, P<0.05). MP was significantly (P<0.001) more suppressive than P of IL-2R expression in both PD and HD. PD IL-2R expression was significantly (P<0.05) more suppressed by CsA alone and by 400 ng/ml CsA+10(-7) MP than was HD IL-2R expression. CsA+10(-7) M MP was significantly (P<0.001) more suppressive of IL-2R expression than the other drugs, alone or in combination, in both groups of patients. In conclusion, these results support the notion that at least one mechanism underlying the significantly greater efficacy of MP compared to P in suppressing PBMC proliferation is its significantly greater suppression of lymphocyte IL-2R expression, either alone or in combination with CsA. Thus, use of MP following allograft transplantation may result in more effective immunosuppression for many recipients.

Differential glucocorticoid responsiveness of hemodialysis patients' lymphocytes

Acute allograft rejection remains a problem after renal transplantation, even in the cyclosporine era. Interindividual differences in the pharmacodynamic responses of the immune system to immunosuppressive agents might contribute to the vulnerability of some patients to rejection. Having previously demonstrated decreased sensitivity of hemodialysis patients' lymphocytes to glucocorticoid suppression of mitogen induced proliferation, the authors undertook a separate study to assess the suppressive effect of glucocorticoids on lymphocyte responsiveness to allogeneic cells and mitogenic stimulation. Lymphocytes were isolated from 32 hemodialysis patients in clinically stable condition for studies in both phytohemagglutinin (PHA) stimulated cultures and in one-way mixed lymphocyte (MLR) cultures. From the concentration-response relationships derived from stimulated cultures with 10 (-6), 10(-7), and 10(-8) M concentrations of prednisolone and methylprednisolone, the concentration of steroid required to achieve 50% inhibition (IC50) of lymphocyte proliferation was determined. A broad range of IC50 values was found in both PHA and MLR cultures, but within individual patients, the IC50 values for both steroids correlated significantly between PHA and MLR cultures. The inhibitory effect of methylprednisolone was significantly greater than that of prednisolone in both PHA and MLR cultures. These results demonstrate a heterogeneity of pharmacodynamic responsiveness to prednisolone and methylprednisolone that is consistent with individuals in two in vitro models of cellular immune response. Pretransplant evaluation by these methods may help identify patients at risk of suboptimal immunosuppression and assist in selecting the steroid component of the immunosuppressive regimen.

Suppression of lymphocyte interleukin-2 receptor expression by glucocorticoids, cyclosporine, or both

Although glucocorticoids and cyclosporine are frequently used to treat patients with various types of glomerulopathy, clinical responses to treatment vary considerably. Considerable interindividual heterogeneity in the suppressive effects of glucocorticoids on lymphocyte proliferation in vitro has been previously reported, suggesting that differences in the pharmacodynamic responsiveness of the immune system to these agents might be an important determinant of how well an individual patient responds to treatment. It also has been shown that methylprednisolone is significantly more suppressive than prednisolone. To identify cellular mechanisms by which these drugs act, a study of the suppressive effects of prednisolone, methylprednisolone, and cyclosporine on lymphocyte proliferation and the expression of the cell surface receptor for interleukin-2 (IL-2R) was conducted using phytohemagglutin-stimulated peripheral blood mononuclear cells (PBMCs) from 13 patients with glomerulopathy and 12 control subjects. Heterogeneity among individuals in both parameters of lymphocyte responsiveness to these drugs was again found, and the significantly greater suppressive effect of methylprednisolone was confirmed for both proliferation and IL-2R expression in patients and control subjects. Cyclosporine alone was moderately suppressive. For most individuals, the greatest degree of suppression occurred when cells were exposed to both cyclosporine and glucocorticoid. Further studies are being conducted to determine whether pretreatment assessment of in vitro lymphocyte responsiveness has any predictive value regarding therapeutic efficacy of each drug in individual patients and to identify of those patients likely to require a more intensive or multidrug immunosuppressive regimen.

Differential suppression of dialysis patients' lymphocyte IFN-gamma production by glucocorticoids and cyclosporine

IFN-gamma is a potent pro-inflammatory cytokine involved in the immunologic rejection of transplanted organs. Having previously demonstrated differential suppressive effects of methylprednisolone (MP), prednisolone (P) and cyclosporine (CsA) on dialysis patients' lymphocyte proliferative responses to phytohaemagglutinin (PHA), we studied the effects of these drugs on dialysis patients' lymphocyte IFN-gamma production during mitogenic and allogeneic (MLR) stimulation. The mean +/- SEM 50% inhibitory concentration (ng/ml) on cell proliferation was significantly lower for MP than P in PHA-stimulated haemodialysis (HD) patients' (35 +/- 7 vs 152 +/- 25, P < 0.001) and peritoneal dialysis (PD) patients' (35 +/- 11 vs 134 +/- 33, P = 0.001) cultures and in HD patients' MLR cultures (15 +/- 3 vs 48 +/- 9, P < 0.001). The mean +/- SEM fractional responses (PHA or MLR + drug/PHA or MLR) in culture supernatant IFN-gamma concentrations were significantly lower with 10(-7) M concentrations of MP than P in HD (0.19 +/- 0.05 vs 0.31 +/- 0.06, P = 0.01) and PD (0.30 +/- 0.11 vs 0.46 +/- 0.11, P < 0.05) PHA cultures and in HD MLR cultures (0.15 +/- 0.04 vs 0.28 +/- 0.07, P = 0.01). CsA (400 ng/ml) alone not only caused less than 50% inhibition of IFN-gamma production in 15/27 HD PHA, 6/14 PD PHA and 4/13 HD MLR cultures, but actually stimulated it in 9 HD and 5 PD PHA cultures. The results suggest that: (1) MP has greater immunosuppressive potential than P for renal transplant recipients; (2) the stimulation of IFN-gamma by CsA in some patients could be harmful in patients with initial allograft dysfunction; and (3) pre-transplant in-vitro assessment of recipients' PBMC responsiveness to glucocorticoids and CsA may help individualize the post-transplant immunosuppressive regimen.