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Defense against ultraviolet (UV) radiation exposure is essential for survival, especially in high-elevation species. Although some specific genes involved in UV response have been reported, the full view of UV defense mechanisms remains largely unexplored. Herein, we used integrated approaches to analyze UV responses in the highest-elevation frog, Nanorana parkeri. We show less damage and more efficient antioxidant activity in skin of this frog than those of its lower-elevation relatives after UV exposure. We also reveal genes related to UV defense and a corresponding temporal expression pattern in N. parkeri. Genomic and metabolomic analysis along with large-scale transcriptomic profiling revealed a time-dependent coordinated defense mechanism in N. parkeri. We also identified several microRNAs that play important regulatory roles, especially in decreasing the expression levels of cell cycle genes. Moreover, multiple defense genes (i.e., TYR for melanogenesis) exhibit positive selection with function-enhancing substitutions. Thus, both expression shifts and gene mutations contribute to UV adaptation in N. parkeri. Our work demonstrates a genetic framework for evolution of UV defense in a natural environment.
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Anuros , Raios Ultravioleta , Animais , Anuros/genética , Pele , Perfilação da Expressão Gênica , AntioxidantesRESUMO
BACKGROUND: Amphibians, particularly anurans, display an enormous variation in genome size. Due to the unavailability of whole genome datasets in the past, the genomic elements and evolutionary causes of anuran genome size variation are poorly understood. To address this, we analyzed whole-genome sequences of 14 anuran species ranging in size from 1.1 to 6.8 Gb. By annotating multiple genomic elements, we investigated the genomic correlates of anuran genome size variation and further examined whether the genome size relates to habitat types. RESULTS: Our results showed that intron expansions or contraction and Transposable Elements (TEs) diversity do not contribute significantly to genome size variation. However, the recent accumulation of transposable elements (TEs) and the lack of deletion of ancient TEs primarily accounted for the evolution of anuran genome sizes. Our study showed that the abundance and density of simple repeat sequences positively correlate with genome size. Ancestral state reconstruction revealed that genome size exhibits a taxon-specific pattern of evolution, with families Bufonidae and Pipidae experiencing extreme genome expansion and contraction events, respectively. Our result showed no relationship between genome size and habitat types, although large genome-sized species are predominantly found in humid habitats. CONCLUSIONS: Overall, our study identified the genomic element and their evolutionary dynamics accounting for anuran genome size variation, thus paving a path to a greater understanding of the size evolution of the genome in amphibians.
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Elementos de DNA Transponíveis , Genômica , Animais , Tamanho do Genoma , Elementos de DNA Transponíveis/genética , Anuros/genética , Evolução MolecularRESUMO
A. Baumannii is an opportunistic nosocomial pathogen which has severe antibiotic resistance. However, the epidemiology is less clearly understood in Jilin province and China. Thus, 89 A. baumannii isolates from a single hospital in Jilin province between 2013-2017 were performed by MLST. In order to better understanding of the epidemiology of Jilin isolates, Chinese strains originated from other domestic regions and worldwide isolates in MLST database were analyzed by silico phylogenetic tools together. A total of 22 STs in Jilin were identified, and 10 STs were found to be novel. The top three predominant sequence types are ST195 (n = 34, 38.2%), ST208 (n = 14, 15.7%) and ST540 (n = 13, 14.6%). ST369 is predicted to be group founder and ST195, ST540 are subgroup founders of the majority STs in Jilin Province. Some newly discovered singletons showed close relationship with strains from other countries, which suggest that nation-cross transmission is one of important origin of Jilin strains. The majority of Jilin STs showed clonality and close relationship with the majorities from other regions of China. But occupation of individual STs in Jilin were different from that of other domestic regions. The aggregation trend and genetic relationship proved that predominant Jilin STs continue to mutate during transmission. Drug resistance facilitated transmission of Jilin A.baumannii isolates because more than 94% of isolates are resistant to at least one carbapenem and the STs with strong resistance to carbapenems usually has more isolates. In conclusion, high diversity and different occupation of STs, and occupation of novel STs proved that epidemiology of A. baumannii in Jilin has special regional characteristics, and drug resistance facilitated transmission of domestic strains and foreign strains.
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Acinetobacter baumannii , Antibacterianos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , beta-Lactamases/genética , Tipagem de Sequências Multilocus , Filogenia , Epidemiologia Molecular , Carbapenêmicos/farmacologia , China/epidemiologia , Testes de Sensibilidade MicrobianaRESUMO
The lytic bacteriophage JC01 was isolated using a strain of Cronobacter sakazakii previously isolated from powdered infant formula (PIF). The complete genome sequence of phage JC01 was determined. The double-stranded DNA genome of phage JC01 is composed of 61,736 bp with a G + C content of 58.9%, and it contains 76 putative open reading frames (ORFs) without any tRNA genes. The predicted ORFs were classified into functional groups, including DNA manipulation, transcription, phage packaging, phage structure, host lysis, and hypothetical proteins. Based on overall nucleotide sequence comparisons, calculation of phage intergenomic similarities, and phylogenetic analysis, JC01 appears to be a novel bacteriophage infecting C. sakazakii.
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Bacteriófagos , Cronobacter sakazakii , Humanos , Lactente , Cronobacter sakazakii/genética , Filogenia , Genoma Viral , Genômica , Fases de Leitura Aberta , DNARESUMO
CD8 T cell differentiation is orchestrated by dynamic metabolic changes that direct activation, proliferation, cytotoxic function, and epigenetic changes. We report that the BTB-ZF family transcriptional repressor Zbtb20 negatively regulates CD8 T cell metabolism and memory differentiation in mice. Effector and memory CD8 T cells with conditional Zbtb20 deficiency displayed enhanced mitochondrial and glycolytic metabolism, and memory CD8 T cells had enhanced spare respiratory capacity. Furthermore, Zbtb20-deficient CD8 T cells displayed increased flexibility in the use of mitochondrial fuel sources. Phenotypic and transcriptional skewing toward the memory fate was observed during the CD8 T cell response to Listeria monocytogenes Memory cells mounted larger secondary responses and conferred better protection following tumor challenge. These data suggest that inactivation of Zbtb20 may offer an approach to enhance metabolic activity and flexibility and improve memory CD8 T cell differentiation, useful attributes for T cells used in adoptive immunotherapy.
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Metabolismo Energético/genética , Listeriose/imunologia , Neoplasias/imunologia , Linfócitos T Citotóxicos/imunologia , Fatores de Transcrição/metabolismo , Transferência Adotiva , Animais , Diferenciação Celular/genética , Diferenciação Celular/imunologia , Modelos Animais de Doenças , Metabolismo Energético/imunologia , Regulação Neoplásica da Expressão Gênica/imunologia , Glicólise/genética , Glicólise/imunologia , Humanos , Memória Imunológica/genética , Listeria monocytogenes/imunologia , Listeriose/microbiologia , Ativação Linfocitária , Camundongos , Camundongos Knockout , Mitocôndrias/metabolismo , Neoplasias/genética , Neoplasias/patologia , Neoplasias/terapia , Linfócitos T Citotóxicos/metabolismo , Fatores de Transcrição/genéticaRESUMO
Viviparous (live-bearing) vertebrates have evolved repeatedly within otherwise oviparous (egg-laying) clades. Over two-thirds of these changes in vertebrate reproductive parity mode happened in squamate reptiles, where the transition has happened between 98 and 129 times. The transition from oviparity to viviparity requires numerous physiological, morphological, and immunological changes to the female reproductive tract, including eggshell reduction, delayed oviposition, placental development for supply of water and nutrition to the embryo by the mother, enhanced gas exchange, and suppression of maternal immune rejection of the embryo. We performed genomic and transcriptomic analyses of a closely related oviparous-viviparous pair of lizards (Phrynocephalus przewalskii and Phrynocephalus vlangalii) to examine these transitions. Expression patterns of maternal oviduct through reproductive development of the egg and embryo differ markedly between the two species. We found changes in expression patterns of appropriate genes that account for each of the major aspects of the oviparity to viviparity transition. In addition, we compared the gene sequences in transcriptomes of four oviparous-viviparous pairs of lizards in different genera (Phrynocephalus, Eremias, Scincella, and Sphenomorphus) to look for possible gene convergence at the sequence level. We discovered low levels of convergence in both amino acid replacement and evolutionary rate shift. This suggests that most of the changes that produce the oviparity-viviparity transition are changes in gene expression, so occasional reversals to oviparity from viviparity may not be as difficult to achieve as has been previously suggested.
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Evolução Molecular , Oviparidade/genética , Transcriptoma/genética , Viviparidade não Mamífera/genética , Animais , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Genômica , Lagartos/genética , Lagartos/crescimento & desenvolvimento , Filogenia , Placentação/genética , Gravidez , Reprodução/genética , Serpentes/genética , Serpentes/crescimento & desenvolvimentoRESUMO
BACKGROUND: The incidence of ultrasound seromas has significantly increased after large hernial sac surgery. Several methods are available for preventing ultrasound seromas, but the clinical results are poor. It has also been demonstrated that hernial sac stump fenestration during laparoscopic incisional hernia repair surgery can significantly decrease the incidence of ultrasound seromas. MATERIALS AND METHODS: Ninety patients aged 18-75 years who were treated in our hospital for primary Type III indirect inguinal hernia from March 2017 to March 2018 were randomised to a preventive fenestration group and a control group. All patients underwent transabdominal preperitoneal repair. The number of ultrasound seromas in the inguinal regions and ultrasound seroma volume on day 6 and months 1 and 3 after surgery in the two groups were compared. The secondary outcomes included length of surgery, urinary retention, acute pain, chronic pain, length of hospitalisation, recurrence rate and other complications. RESULTS: There were no significant differences in demographic characteristics. Ultrasound seroma incidence and ultrasound seroma volume on day 6 and months 1 and 3 after surgery were significantly lower in the preventive fenestration group than that in the control group. There were no significant differences in the length of hospitalisation or incidence of acute pain or urinary retention between the two groups. CONCLUSIONS: Hernial sac stump fenestration after hernial sac transection in inguinal hernia repair surgery is a simple method that can effectively reduce post-operative ultrasound seromas.
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Escherichia coli O157:H7 is an important foodborne pathogen that has become a major worldwide factor affecting the public safety of food. Bacteriophage has gradually attracted attention because of its ability to kill specific pathogens. In this study, a lytic phage of E. coli O157:H7, named FEC14, was isolated from hospital sewage. Transmission electron microscopy analysis showed that phage FEC14 had an isometric head 80 ± 5 nm in diameter and a contractile tail whose terminal spikes present an umbrella-like structure. Phage FEC14 revealed 158,639 bp double-stranded DNA, with the G+C content of 44.6%, 209 ORFs and four tRNAs. Genome DNA of FEC14 could not be digested by some endonucleases. Many of the features of phage FEC14 are very similar to those of the newly classified genus "Kuttervirus", including morphology, genome size and organization, etc. Phage FEC14 is proposed to be a new isolate of genus "Kuttervirus" within the family Ackermannviridae, moreover, the endonuclease resistance of phage FEC14, has priority over other genera of bacteriophages for its use in biocontrol of foodborne pathogens.
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Bacteriófagos , Escherichia coli O157 , Genoma Viral , Bacteriófagos/classificação , Bacteriófagos/isolamento & purificação , Composição de Bases , Escherichia coli O157/virologia , Genômica , Fases de Leitura AbertaRESUMO
Although many cases of genetic adaptations to high elevations have been reported, the processes driving these modifications and the pace of their evolution remain unclear. Many high-elevation adaptations (HEAs) are thought to have arisen in situ as populations rose with growing mountains. In contrast, most high-elevation lineages of the Qinghai-Tibetan Plateau appear to have colonized from low-elevation areas. These lineages provide an opportunity for studying recent HEAs and comparing them with ancestral low-elevation alternatives. Herein, we compare four frogs (three species of Nanorana and a close lowland relative) and four lizards (Phrynocephalus) that inhabit a range of elevations on or along the slopes of the Qinghai-Tibetan Plateau. The sequential cladogenesis of these species across an elevational gradient allows us to examine the gradual accumulation of HEA at increasing elevations. Many adaptations to high elevations appear to arise gradually and evolve continuously with increasing elevational distributions. Numerous related functions, especially DNA repair and energy metabolism pathways, exhibit rapid change and continuous positive selection with increasing elevations. Although the two studied genera are distantly related, they exhibit numerous convergent evolutionary changes, especially at the functional level. This functional convergence appears to be more extensive than convergence at the individual gene level, although we found 32 homologous genes undergoing positive selection for change in both high-elevation groups. We argue that species groups distributed along a broad elevational gradient provide a more powerful system for testing adaptations to high-elevation environments compared with studies that compare only pairs of high-elevation versus low-elevation species.
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Adaptação Fisiológica , Altitude , Evolução Molecular , Animais , Sequenciamento de Nucleotídeos em Larga Escala , Lagartos/genética , Lagartos/fisiologia , Ranidae/genética , Ranidae/fisiologia , Análise de Sequência de RNA , Especificidade da Espécie , TibetRESUMO
Underwater wireless sensor networks (UWSNs) have emerged as a promising technology to monitor and explore the oceans instead of traditional undersea wireline instruments. Traditional routing protocols are inefficient for UWSNs due to the specific nature of the underwater environment. In contrast, Opportunistic Routing (OR) protocols establish an online route for each transmission, which can well adapt with time-varying underwater channel. Cross-layer design is an effective approach to combine the metrics from different layers to optimize an OR routing in UWSNs. However, typical cross-layer OR routing protocols that are designed for UWSNs suffer from congestion problem at high traffic loads. In this paper, a Cross-Layer-Aided Opportunistic Routing Protocol (CLOR) is proposed to reduce the congestion in multi-hop sparse UWSNs. The CLOR consists of a negotiation phase and transmission phase. In the negotiation phase, the cross-layer information in fuzzy logic is utilized to attain an optimal forwarder node. In the transmission phase, to improve the transmission performance, a burst transmission strategy with network coding is exploited. Finally, we perform simulations of the proposed CLOR protocol in a specific sea region. Simulation results show that CLOR significantly improves the network performances at various traffic rates compared to existing protocols.
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OBJECTIVE: The management of the hernia sac is the core step of laparoscopic indirect inguinal hernioplasty. In this study, a randomized controlled trial was conducted to evaluate the clinical effect of laparoscopic total extraperitoneal inguinal herniorrhaphy (TEP) with hernia sac transection and complete sac reduction. METHOD: From May 2017 to May 2018, 70 patients aged 18-75 with primary indirect inguinal hernia in our hospital were randomly divided into a transected sac group (TS) and a completely reduced sac group (RS). The primary outcomes compared between the two groups were the hernia sac treatment time, operation time, and the incidence of seroma formation after operation. Secondary outcomes included acute pain, chronic pain (pain which lasted for at least 3 months), hospital stay, recurrence rate, and other complications. RESULT: There were no significant differences in baseline demographic characteristics including age, sex, hernia type, size of hernia defect, and follow-up time between the two groups. The times required for hernia sac separation and operation in the TS group were significantly shorter than in the control group (6.1 ± 2.3 vs. 25 ± 5.8 min for hernia sac separation, p < 0.01; and 35.10 ± 3.50 vs. 54.40 ± 4.20 min for operation, p < 0.01). There was no significant difference in hospitalization time, incidence of acute pain, seroma formation, or urinary retention between the two groups. During the 12-month follow-up period, chronic pain, early recurrence, and other complications were not found in either group. CONCLUSION: Both the hernia sac transection technique and the complete sac reduction technique are safe and reliable. The hernia sac transection technique is a simple and effective hernia sac treatment method. It reduces the operation time and does not increase seroma or acute or chronic pain. It is valuable and likely to be popularly applied.
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Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Laparoscopia/métodos , Adolescente , Adulto , Idoso , Feminino , Herniorrafia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Seroma/etiologia , Adulto JovemRESUMO
Phage PA-YS35 is a novel lytic Pseudomonas aeruginosa phage belonging to the Myoviridae family and was isolated from the sewage of the First Hospital of Jilin University. The biological properties testing indicated that phage PA-YS35 is stable between - 20 and 60 °C and pH 4-9. The one-step growth curve shows that the latent period of PA-YS35 was 9 min, and the burst period was about 21 min by the size of approximately 380 progeny phages per host cell. The genome of phage PA-YS35 is linear double-stranded DNA with a size of 93,296 bp and a GC content of 49.35%. The results from RAST gene annotation analysis showed that the PA-YS35 genome contains 172 open reading frames (ORFs); the function of 41 ORFs can be predicted, whereas the product of remaining 131 ORFs are hypothetical proteins. According to phylogenetic tree of RNA ligase encoding sequence, phage PA-YS35 has a close evolutionary relationship with Pseudomonas phage PAK P1 because both of them are located on the same branch. The study of phage PA-YS35 genome will provide useful information for further research on the interaction between phages and their hosts.
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Genoma Viral/genética , Fagos de Pseudomonas/genética , Composição de Bases/genética , Concentração de Íons de Hidrogênio , Microscopia Eletrônica de Transmissão , Fases de Leitura Aberta/genética , FilogeniaRESUMO
Summary: FasParser is a graphical platform for manipulating sequences and alignments in a batch mode. It is particularly useful for biologists handling large datasets of sequences, even without an experience in programming. Here, I present an updated version 'FasParser2', featuring numerous improvements with sets of novel functions that can facilitate sequence manipulation. Its main additional features include (i) re-designed graphical interface which greatly improves its capability for batch processing, (ii) a trimming function to strip poorly-aligned regions in multiple sequence alignments, (iii) a series of functions that can identify as well as remove 'bad' sequence (either too short or too divergent sequences), (iv) an Editor tool for viewing and editing of biological sequences and (v) interfaces (with other programs) for detection of positive selection as well as primer design. Availability and implementation: The compiled Windows binary is freely available at https://github.com/Sun-Yanbo/FasParser/releases.
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Visualização de Dados , Alinhamento de Sequência , Análise de Sequência de DNA/métodos , SoftwareRESUMO
BACKGROUND: Inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair is an alternative surgical procedure. We present our experience and outcome of the way. METHODS: We performed a retrospective analysis of 230 patients who received anterior tension-free hernia repair between May 2016 to May 2017. Among these cases, 120 were performed using the traditional transinguinal preperitoneal (TTIPP) technique while 100 were performed using the vascular anatomic landmark transinguinal preperitoneal (VALTIPP) technique. Between these two groups, we compared the operation time, length of hospital stay, complication rates, and the visual analog scale (VAS) for pain at 2 days, 3 months, and 6 months after surgery. RESULTS: Surgery was well-tolerated in both groups with no significant hemorrhage or complications. The operation times for the VALTIPP and TTIPP groups were 42.52 ± 9.15 and 53.84 ± 10.64 min (P < 0.05), respectively. Ten patients in the VALTIPP group and 17 patients in the TTIPP group reported sensations of foreign bodies (P < 0.05). The VAS pain score in VALTIPP patients at 2 days (4.0 ± 0.5), 3 months (1.0 ± 0.3), and 6 months (0.9 ± 0.3) were significantly lower when compared with those of TTIPP patients (5.3 ± 0.9 at 2 days, 1.8 ± 0.4 at 3 months, and 1.1 ± 0.1 at 6 months, p < 0.05). No statistically significant differences were found in age, gender, BMI, hernia type and location, follow-up period, incidence of post-operative seromas, recurrence rate, or length of hospital stay. CONCLUSION: Anterior inguinal hernia repair using inferior epigastric vascular anatomical landmarks may lead to reduced operation times, reduced sensations of foreign bodies, and reduced post-operative pain. This technique is simple, practical, and effective in the management of inguinal hernias.
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Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Complicações Pós-Operatórias/epidemiologia , Idoso , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Dor Pós-Operatória/epidemiologia , Recidiva , Estudos Retrospectivos , Seroma/epidemiologiaRESUMO
The development of efficient sequencing techniques has resulted in large numbers of genomes being available for evolutionary studies. However, only one genome is available for all amphibians, that of Xenopus tropicalis, which is distantly related from the majority of frogs. More than 96% of frogs belong to the Neobatrachia, and no genome exists for this group. This dearth of amphibian genomes greatly restricts genomic studies of amphibians and, more generally, our understanding of tetrapod genome evolution. To fill this gap, we provide the de novo genome of a Tibetan Plateau frog, Nanorana parkeri, and compare it to that of X. tropicalis and other vertebrates. This genome encodes more than 20,000 protein-coding genes, a number similar to that of Xenopus. Although the genome size of Nanorana is considerably larger than that of Xenopus (2.3 vs. 1.5 Gb), most of the difference is due to the respective number of transposable elements in the two genomes. The two frogs exhibit considerable conserved whole-genome synteny despite having diverged approximately 266 Ma, indicating a slow rate of DNA structural evolution in anurans. Multigenome synteny blocks further show that amphibians have fewer interchromosomal rearrangements than mammals but have a comparable rate of intrachromosomal rearrangements. Our analysis also identifies 11 Mb of anuran-specific highly conserved elements that will be useful for comparative genomic analyses of frogs. The Nanorana genome offers an improved understanding of evolution of tetrapod genomes and also provides a genomic reference for other evolutionary studies.
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Anuros/genética , Evolução Molecular , Genoma/genética , Animais , Sequência de Bases , Galinhas/genética , Cromossomos/genética , Elementos de DNA Transponíveis/genética , Feminino , Humanos , Família Multigênica , Sintenia/genética , TibetRESUMO
OBJECTIVES: The aim of this study was to compare the effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty with or without mesh fixation on chronic pain and quality of life of patients. METHODS: One hundred patients with a simple oblique inguinal hernia were included and treated at the Second Affiliated Hospital of Kunming Medical University from July of 2015 to July of 2016. Patients were randomly assigned to TAPP inguinal hernioplasty with mesh fixation (fixation group, n = 50) or without mesh fixation (non-fixation group, n = 50). Observation indices such as mean operative time, time to ambulation, hospitalization expense, and complications were recorded. The visual analog scale (VAS) was adopted for pain evaluation 2 days, 3 months, and 6 months postoperatively. The 36-item short-form health survey (SF-36) was adopted for life quality scoring 3 months postoperatively. RESULTS: No recurrence or incisional infections were observed during follow-up in either group. The mean operative time, time to ambulation, and hospitalization expense of the non-fixation group were all significantly reduced compared to those of the fixation group. The VAS score 2 days, 3 months, and 6 months postoperatively of the non-fixation group were significantly lower than in the fixation group. The physical function, role physical, bodily pain, and general health in the non-fixation group were each significantly higher than in the fixation group. In contrast, vitality, social function, role emotional, and mental health showed no significant differences across groups. CONCLUSIONS: For patients with primary unilateral oblique inguinal hernia with a defect size less than 4.0 cm in diameter, TAPP inguinal hernioplasty without mesh fixation was safe and effective. Furthermore, this shortened the operative time, promoted early ambulation, decreased hospitalization expenses, alleviated postoperative pain, and improved quality of life.
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Dor Crônica , Hérnia Inguinal/cirurgia , Herniorrafia , Laparoscopia , Dor Pós-Operatória , Telas Cirúrgicas , Adulto , Idoso , Dor Crônica/etiologia , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Hérnia Inguinal/fisiopatologia , Hérnia Inguinal/psicologia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/fisiopatologia , Dor Pós-Operatória/psicologia , Estudos Prospectivos , Qualidade de Vida , Telas Cirúrgicas/efeitos adversos , Resultado do Tratamento , Escala Visual AnalógicaRESUMO
BACKGROUND & AIMS: Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition. METHODS: Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness. RESULTS: One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P < 0.05). The median postoperative length of stay in the multimodal EON group was 8 days (6, 12) versus 10 days (7, 18) in the conventional care group (P < 0.001). The total cost of treatment and nutritional support were also less in the multi-modal early oral nutrition group (P < 0.001). The effectiveness was 84.9 and 79.9% in the multimodal EON and conventional care group, respectively (P = 0.475). However, the cost-effectiveness ratio was USD 537.6 (506.1, 589.3) and USD 637.8 (593.9, 710.3), respectively (P < 0.001). CONCLUSION: The multi-modal early oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery. TRIAL REGISTRATION: Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014.
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Abdome/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório , Apoio Nutricional , Cuidados Pós-Operatórios/métodos , Idoso , Colectomia , Análise Custo-Benefício , Defecação/fisiologia , Determinação de Ponto Final , Feminino , Gastrectomia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Tamanho da Amostra , Método Simples-CegoRESUMO
With L band frequency allocations for satellite navigation getting more crowded, S band (2483.5-2500 MHz) is already allocated for navigation services, where Globalstar broadcasts downlink communications to user terminals. The Indian Regional Navigation Satellite System (IRNSS) is transmitting navigation signals and Galileo exploits some potential signals in S band. Also, several candidate S band signals based on binary offset carrier (BOC), binary phase shift keying (BPSK), continuous phase modulation (CPM) and minimum shift keying-BOC (MSK-BOC) are suggested for BeiDou system (BDS). In quite narrow S band, mutual interference among these systems is inevitable, thus the compatibility issue is particularly significant for S band signal design. To explore desired S band signals for BDS, the paper firstly describes a comprehensive compatibility evaluation methods based on effective carrier-to-noise ratio degradation for acquisition and code tracking. Then a real simulation is established using space constellations, modulation schemes and received power. Finally, the worst mutual interference of BDS candidate signals with Galileo, IRNSS and Globalstar is calculated and compared. The results indicate that CPM signal is easier to allow peaceful coexistence of other systems with minimal mutual interference in S band compared to other BDS candidates.
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OBJECTIVE: To investigate the impact of nutritional support on clinical outcomes in patients at nutritional risk who receive nutritional support that meets guideline standards and those who do not. METHODS: This prospective cohort study enrolled hospitalized patients from the Second Affiliated Hospital of Kunming Medical University from February 2010 to June 2012. The research protocols were approved by the university's ethics committee, and the patients signed informed consent forms. The clinical data were collected based on nutritional risk screening, administration of enteral and parenteral nutrition, surgical information, complications, and length of hospital stay. RESULTS: During the study period, 525 patients at nutritional risk were enrolled in the cohorts. Among patients who received nutritional support that met the guideline standards (Cohort 1), the incidence of infectious complications was lower than that in patients who did not meet guideline standards (Cohort 2) (17.1 % vs. 26.9 %, P = 0.01). Subgroup analysis showed that individuals who received a combination of parenteral nutrition (PN) and enteral nutrition (EN) for 7 or more days had a significantly lower incidence of infectious complications (P = 0.001) than those who received only PN for 7 or more days or those who received nutritional support for less than 7 days or at less than 10 kcal/kg/d. Binary logistic regression analysis showed that, after adjusting for confounding factors, nutritional support that met guideline standards for patients with nutritional risk was a protective factor for complications (OR: 0.870, P < 0.002). CONCLUSIONS: In patients at nutritional risk after abdominal surgery, nutritional support that meets recommended nutrient guidelines (especially regimens involving PN + EN ≥ 7 days) might decrease the incidence of infectious complications and is worth recommending; however, well-designed trials are needed to confirm our findings. Nutritional support that does not meet the guideline standards is considered clinically undesirable.
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Política Nutricional , Apoio Nutricional , Cuidados Pós-Operatórios , Abdome/cirurgia , Idoso , China/epidemiologia , Estudos de Coortes , Nutrição Enteral/métodos , Feminino , Humanos , Infecções/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Apoio Nutricional/normas , Nutrição Parenteral/métodos , Complicações Pós-Operatórias/epidemiologia , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
Dissipative particle dynamics simulations are employed to study the self-assembly of block copolymers on a template modified with ordered posts. Templates with hexagonally arranged and rectangularly arranged posts are both studied. For the systems with hexagonally arranged posts, morphologies with bending alignments are seen most often. We find that the different kinds of patterns, which can be directly observed in experiments, are substantially induced by the pattern of the bottom layer. In the simulations with a template modified with rectangularly arranged posts, by finely adjusting the distances between neighboring posts in both x and y directions, mesh-shaped structures with different angles between the bottom and the sub-bottom layers can be obtained. These results shed light on the better design of lithographically patterned materials on the scale of 10 nm via the directed self-assembly of BCPs by templating.