Electrolyte disorders are ERAS-associated in patients undergoing hepato-pancreato-biliary surgery.

PURPOSE: Emerging evidences have raised concerns about electrolyte disorders caused by restrictive fluid management in the enhanced recovery after surgery (ERAS) protocol. This study aims to investigate the morbidity and treatment of electrolyte disorders associated with ERAS in patients undergoing hepato-pancreato-biliary (HPB) surgery. METHODS: Clinical data from 157 patients under the ERAS program and 166 patients under the traditional (Non-ERAS) program after HPB surgery were retrospectively analyzed. Risk factors and predictive factors of postoperative electrolyte disorders were analyzed by logistic regression analysis and receiver operator characteristic (ROC) curve analysis, respectively. RESULTS: The average of intravenous fluid, sodium, chloride, and potassium supplementation after surgery were significantly lower in the ERAS group. Hypokalemia was the most common type of electrolyte disorders in the ERAS group, whose incidence was substantially increased compared to that in the Non-ERAS group [28.77% vs. 8.97%, p < 0.001, on postoperative (POD) 5]. Logistic regression analysis identified the ERAS program and age as independent risk factors of hypokalemia. ROC curve analysis identified serum potassium levels below 3.76 mmol/L on POD 3 (area under curve 0.731, sensitivity 58.54%, specificity 82.69%) as a predictive factor for postoperative hypokalemia in ERAS patients. Oral supplementation at an average of 35.41 mmol potassium per day was effective in restoring the ERAS-associated hypokalemia. CONCLUSIONS: ERAS procedures were particularly associated with a lower supplementation of potassium and a higher incidence of hypokalemia in patients after HPB surgery. Oral potassium supplementation could be an adopted ERAS program for the elderly undergoing HPB surgery.

Food Packaging: A Comprehensive Review and Future Trends.

Innovations in food packaging systems will help meet the evolving needs of the market, such as consumer preference for "healthy" and high-quality food products and reduction of the negative environmental impacts of food packaging. Emerging concepts of active and intelligent packaging technologies provide numerous innovative solutions for prolonging shelf-life and improving the quality and safety of food products. There are also new approaches to improving the passive characteristics of food packaging, such as mechanical strength, barrier performance, and thermal stability. The development of sustainable or green packaging has the potential to reduce the environmental impacts of food packaging through the use of edible or biodegradable materials, plant extracts, and nanomaterials. Active, intelligent, and green packaging technologies can work synergistically to yield a multipurpose food-packaging system with no negative interactions between components, and this aim can be seen as the ultimate future goal for food packaging technology. This article reviews the principles of food packaging and recent developments in different types of food packaging technologies. Global patents and future research trends are also discussed.

Metabolomic profiles delineate the effect of Sanmiao wan on hyperuricemia in rats.

A serum metabolomic method based on ultra-high-performance liquid chromatography coupled with mass spectrometry was developed to characterize hyperuricemia-related metabolic profiles and delineate the mechanism of Sanmiao wan (SMW), a traditional Chinese medicine (TCM), in treating hyperuricemic rats. With partial least-squares discriminant analysis for classification and selection of biomarkers, 13 potential biomarkers in mouse serum were identified in the screen, primarily involved in purine metabolism, arginine and proline metabolism, citrate cycle, phenylalanine metabolism, tryptophan metabolism and glycerophospholipid metabolism. Taking these potential biomarkers as screening indexes, SMW could reverse the pathological process of hyperuricemia through partially regulating the perturbed metabolic pathway except for glycerophospholipid metabolism. Our results showed that a metabolomic approach offers a useful tool to identify hyperuricemia-related biomarkers and provides a new methodological cue for systematically dissecting the underlying efficacies and mechanisms of TCM in treating hyperuricemia.