[Traditional Chinese medicine may reduce the risk of readmission in patients with rheumatoid arthritis complicated with elevated platelet count: a matched cohort study].

OBJECTIVE: To evaluate the association of traditional Chinese medicine (TCM) treatment with the risk of readmission in patients with rheumatoid arthritis (RA) complicated with elevated platelet count. METHODS: We retrospectively collected the data of inpatients diagnosed with RA in our hospital from 2013 to 2021. The patients with elevated platelet count receiving TCM treatment were matched to those without TCM treatment using propensity score matching at the 1∶1 ratio, and the confounding factors were adjusted including gender, age, Chinese patent medicine, and external application. A Cox proportional hazard model was used to evaluate the hazard ratio (HR) of the risk of readmission, and a Kaplan-Meier curve was generated to assess the incidence of readmission in these patients. RESULTS: A total of 1176 RA patients with elevated platelet count were included in this study, including 842 patients in the TCM group and 334 patients in the non-TCM group, and after 1∶1 propensity score matching, 334 patients were included in each group. The Cox proportional hazards model showed that the readmission rate was significantly lower in TCM group than in non-TCM group (HR=0.59, 95% CI: 0.48-0.73, P<0.001), and TCM was a protective factor against readmission in RA patients with elevated platelet count. Kaplan-Meier curves demonstrated that long-term use of TCM helped to decrease the risk of readmission (Log-rank P<0.001). Association rules showed that the use of several Chinese herbal medicines and the Chinese patent medicine Xinfeng Capsule had a strong correlation with improvement of such clinical indicators as rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein. CONCLUSION: In RA patients with elevated platelet count, the use of TCM, as a protective factor against readmission, is strongly associated with a lowered risk of readmission with a long-term association.

Association between Elevated Magnesium Intake and Reduced Risk of Recurrent Falls and Frailty in Osteoarthritis: Data from the Osteoarthritis Initiative.

OBJECTIVES: The objective of this 8-year follow-up study was to investigate the relationship between magnesium intake and frailty, as well as recurrent falls, in individuals diagnosed with Osteoarthritis (OA) or those at a heightened risk for developing the condition. METHODS: This study utilized data from the Osteoarthritis Initiative (OAI) database and conducted a prospective cohort study with a 8-year follow-up period. Total magnesium intake from both food sources and supplements was assessed using a food frequency questionnaire (FFQ), while frailty and recurrent falls were evaluated through established criteria and self-report, respectively. To account for potential confounding factors, various covariates were considered, and statistical analyses, including generalized additive mixed models (GAMMs), were employed to examine the associations. RESULTS: Among the 4,667 participants with OA, those with lower total magnesium intake were characterized by younger age, a higher proportion of African American individuals, higher body mass index (BMI), and lower dietary fiber intake (P<0.001). Notably, this group exhibited higher odds of experiencing recurrent falls and frailty (P = 0.034 and 0.006, respectively). Controlling for various factors, the GAMMs consistently revealed negative correlations between magnesium intake and the likelihood of frailty and recurrent falls, with each 1 mg/1000 kcal increase in magnesium intake associated with a 0.5% reduced frailty risk (p < 0.001) and a 0.2% decreased risk of recurrent falls (p = 0.001). Subgroup analyses suggested that increased total magnesium intake from both food sources and supplements may exert a more pronounced preventive effect on recurrent falls and frailty in men, older adults, individuals with normal BMI, and those with higher dietary fiber intake. CONCLUSIONS: Elevated total magnesium intake from both food sources and supplements was found to be associated with a decreased risk of recurrent falls and frailty in individuals diagnosed with OA or those at risk of developing the condition. These findings imply that increased total magnesium intake might be beneficial in managing the risk of these outcomes, particularly within specific subgroups, including men, older adults, those with a normal BMI, and those with higher dietary fiber intake.

[Perioperative management and operative treatment of malignant tumor of anal canal merging severe abdominal protuberance].

Objective: To report the perioperative management and robot-assisted minimally invasive surgery results of one case with malignant tumor of anal canal combined with severe abdominal distention. Methods: A 66-year-old male suffer from adenocarcinoma of anal canal (T3N0M0) with megacolon, megabladder and scoliosis. The extreme distention of the colon and bladder result in severe abdominal distention. The left diaphragm moved up markedly and the heart was moved to the right side of the thoracic cavity. Moreover, there was also anal stenosis with incomplete intestinal obstruction. Preoperative preparation: fluid diet, intravenous nutrition and repeated enema to void feces and gas in the large intestine 1 week before operation. Foley catheter was placed three days before surgery and irrigated with saline. After relief of abdominal distention, robotic-assisted abdominoperineal resection+ subtotal colectomy+colostomy was performed. Results: Water intake within 6 hours post-operatively; ambulance on Day 1; anal passage of gas on Day 2; semi-fluid diet on Day 3; safely discharged on Day 6. Conclusion: Robotic-assisted minimally invasive surgery is safe and feasible for patients with malignant tumor of anal canal combined with severe abdominal distention after appropriate and effective preoperative preparation to relieve abdominal distention.

[Xanthoceras sorbifolium Bunge flower extract inhibits benign prostatic hyperplasia in rats].

OBJECTIVE: To assess the inhibitory effect of the extract of Xanthoceras sorbifolium Bunge flower against benign prostatic hyperplasia (BPH) and explore its possible mechanism. METHODS: MTT assay was used to examine the effect of the extract of Xanthoceras sorbifolium Bunge flower on proliferation of benign prostatic hyperplasia cells (BPH-1), and cell apoptosis and cell cycle changes following the treatment were analyzed using annexin V/PI double staining and flow cytometry. The protein expression levels of Bcl-2, Bax, caspase-3, PI3K and AKT in the treated cells were detected using Western blotting. A rat model of BPH established by subcutaneous injection of testosterone propionate was treated with the flower extract for 28 days, and pathological changes in the prostate tissue were observed with HE staining. The protein expression levels of Bcl-2, Bax, caspase3 and PI3K/AKT in the prostate tissue were detected with Western blotting. RESULTS: Within the concentration range of 125-1000 µg/mL, the flower extract of Xanthoceras sorbifolium Bunge significantly inhibited the proliferation of BPH-1 cells and caused obvious cell cycle arrest at G0/G1 phase; the apoptotic rate of the cells was positively correlated with the concentration of the flower extract (P < 0.05). Bcl-2, p-PI3K and p-AKT expression levels were significantly down-regulated and Bax and caspase-3 expression levels were significantly increased in the cells after treatment with the flowers extract (P < 0.05). In the rat models of BPH, the rats treated with the flowers extract at moderate and high doses showed obviously decreased expressions of p-AKT and Bcl-2 and an increased expression of Bax in the prostate tissue; a significantly lowered p-AKT expression was observed in the prostate tissue of rats receiving the low-dose treatment (P < 0.05). CONCLUSION: The flower extract of Xanthoceras sorbifolium Bunge has a inhibitory effect on BPH both in vitro and in rats, suggesting its potential value in the development of medicinal plant preparations for treatment of BPH.

[The academic sources of You Ke Tie Jing].

You Ke Tie Jing, as the most widely published Chinese pediatric work, first published in 1695. Its writing style was influenced by You Ke Bai Xiao Quan Shu in the Ming Dynasty. Its section of the Pediatric Tuina was related to You Ke Bai Xiao Quan Shu, Xiao Er An Mo Jing, Xiao Er Tuina Mi Zhi, and Xiao Er Tuina Mi Jue. The section of Pediatric Disease was based on You Ke Bai Xiao Quan Shu and the author's own identification of symptoms, such as febrile convulsion, fever, and umbilical wind. It documented seventy-five prescriptions of which 70 were the same as You Ke Bai Xiao Quan Shu. It can be inferred that You Ke Tie Jing was mainly based on You Ke Bai Xiao Quan Shu and also fully referred to Xiao Er An Mo Jing, Xiao Er Tuina Mi Zhi, and Xiao Er Tuina Mi Jue.

Analgesic and Anti-Inflammatory Activities of Sophocarpine from Sophora viciifolia Hance.

Sophora viciifolia Hance is an edible plant used in traditional Chinese medicine. Sophocarpine, a tetracyclic quinolizidine alkaloid, is one of the most abundant active ingredients in Sophora viciifolia Hance. Here, we study the analgesic and anti-inflammatory effects, as well as the acute toxicity of sophocarpine from Sophora viciifolia Hance in mice. Sophocarpine (20, 40, and 80 mg/kgbw) significantly prolonged the delay period before a hot plate reaction occurred (all P < 0.05), and the delay before a tail-flick response was induced by a warm bath (P < 0.05; P < 0.01). Sophocarpine (40, 80 mg/kg) resulted in dose-dependent inhibition of the writhing reaction induced by acetic acid in mice (P < 0.05; P < 0.001, respectively). Sophocarpine (80 mg/kg) reduced the total duration of a formalin-induced pain response (P < 0.05). Sophocarpine prolonged the foot-licking latency of mice after the hot plate reaction, and this effect was antagonized by calcium chloride and enhanced by verapamil. Sophocarpine (20, 40, and 80 mg/kg) significantly inhibited xylene-induced ear edema (P < 0.01; P < 0.001; P < 0.001, respectively) and the penetration of acetic acid-induced dye into the peritoneal cavity (P < 0.01; P < 0.01; P < 0.001, respectively). It also reduced the levels of proinflammatory cytokine interleukin (IL)-1ß, IL-6, and prostaglandin E2 (P < 0.05, P < 0.01, P < 0.001) and those of serum nitric oxide (P < 0.05). The results of this study suggest that sophocarpine possesses certain analgesic and anti-inflammatory activities, which may be related to calcium and inhibition of the secretion of inflammatory factors.

[A review on critics of Wenre Jingwei].

Wenre Jingwei(,Warp and Weft of Warm and Hot Disorders) is believed the masterpiece written by Wang Mengying, who was a famous physician in the Qing Dynasty. It represents the essence of Wang's theory in terms of Epidemic Febrile Diseases. It has been interpreted and analyzed by seven critics. However, these seven critics have not been widely known up to now. This paper introduces the life history of the critics and their medical achievements, in order to clarify their contributions to this book and enrich the content of medical history.

Research Note: Effects of polysaccharide-enriched Acanthopanax senticosus extract on growth performance, immune function, antioxidation, and ileal microbial populations in broiler chickens.

Acanthopanax senticosus (AS) is a well-known, highly effective traditional Chinese herbal medicine. Polysaccharides extracted from AS (ASPS) have multiple pharmacologic and biological activities with potential use as additives in broiler chicken feed. This trial evaluated the effects of dietary ASPS on growth performance, immune function, antioxidation, and ileal microbial populations in broiler chickens. A total of 240 1-day-old Arbor Acres male broiler chicks were randomly divided into 4 groups, with 10 replicates of 6 chicks and fed a corn- and soybean-based diet supplemented with 0, 1, 2, or 4 g/kg ASPS. Compared with the control group, supplementation with 1 g/kg ASPS increased ADG and ADFI in the finisher and overall periods and decreased the feed conversion ratio in the finisher period (both P < 0.05). Serum IgA and IgM were significantly increased by supplementation with 1 and 2 g/kg of ASPS (P < 0.05). Superoxide dismutase and glutathione peroxidase activities were increased and malondialdehyde concentration was decreased in birds fed ASPS-supplemented diets compared with those in the control group (P < 0.05). Polysaccharides extracted from AS supplementation increased Lactobacillus and decreased Escherichia coli and Salmonella counts in the ileal contents compared with the control diet (both P < 0.05). The results show that dietary ASPS improved growth performance, immune status, and antioxidant capacity and stimulated the growth of beneficial gut bacteria in broiler chickens. In conclusion, ASPS was effective as a natural additive in broiler chicken feed; 1 g/kg can be considered as the optimum dosage.

[Effects and mechanisms of Xuezhikang on preventing contrast-induced acute kidney injury in diabetic rats].

Objective: To explore the effects and mechanisms of Xuezhikang on preventing contrast-induced nephropathy (CIN) in diabetic rats. Methods: Streptozotocin (65 mg/kg) was injected intraperitoneally to establish a diabetes model in 7-week-old male Sprague-Dawley (SD) rats. After 4 weeks of modeling, 24 diabetic rats were randomly divided into 4 groups: sham group, CIN group, CIN+vehicle (Veh) group and Xuezhikang group. All animals were sacrificed at 24 hours after administration of contrast. Blood and kidney tissues were collected to detect biochemical, inflammation-related, oxidative stress-related and pathological indicators. Results: After administration of contrast agent, the renal function-related indicators were decreased in Xuezhikang group compared with CIN+Veh group [serum creatinine (SCr): (59.3±3.3) µmol/L vs (73.2±4.1) µmol/L; blood urea nitrogen (BUN): (13.8±0.5) mmol/L vs (16.3±0.6) mmol/L; serum neutrophil gelatinase-associated lipocalin (sNGAL): (41.4±2.0) ng/ml vs (54.9±4.4) ng/ml; urinary kidney injury moleculer-1 (uKIM-1): (11.1±0.5) ng/ml vs (16.6±0.5) ng/ml] (all P<0.05). Histological analysis showed that the severity of renal tubule dilatation, brush border loss and renal tubular cell necrosis in Xuezhikang group was better than that of CIN+Veh group. Additionally, the oxidative stress-related indicators of Xuezhikang group improved compared with those of CIN+Veh group [malondialdehyde (MDA): (12.1±0.7) nmol/mg vs (15.5±0.8) nmol/mg, superoxide dismutase (SOD): (35.0±2.2) U/mg vs (23.7±3.4) U/mg, renal nitrite: (1.7±0.1) nmol/mg vs (1.2±0.1) nmol/mg, all P<0.05]. Meanwhile, Xuezhikang pretreatment downregulated the mRNA and protein expression of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (both P<0.05). Conclusion: The current study suggests that Xuezhikang protects against CIN in diabetic rats by inhibiting oxidative stress and inflammation.

Progress of radiotherapy after breast-conserving surgery combined with silicone prosthesis reconstruction.

Breast cancer is the malignant tumor with the highest incidence in women. The standard treatment for early breast cancer is radical surgery combined with radiotherapy, but many studies have shown that adjuvant radiotherapy after breast-conserving surgery combined with silicone prosthesis reconstruction is gradually expected to become the new standard treatment because this method can obtain a good local tumor control rate, and has a cosmetic effect. Compared with myocutaneous flap reconstruction, silicone prosthesis implantation has the advantages of less trauma, simple operation, beautiful appearance, and no overlap of donor areas during reconstruction. It is a safe and feasible surgical method without worrying about necrosis and atrophy of myocutaneous flap. This emerging combination therapy may become the best mode of early breast cancer treatment.

Vitamin A with L-ascorbic acid sodium salt improves the growth performance, immune function and antioxidant capacity of weaned pigs.

Vitamin A is easily degraded by environmental factors. Therefore, it is very important to add antioxidants during Vitamin A production. In the past, ethoxyquin (EQ) was widely used, but recent studies have found that it has potential toxicity. Therefore, in this study, we evaluated the antioxidant activities of 4 antioxidants in vitro: EQ, butylated hydroxytoluene, α-tocopherol and L-ascorbic acid sodium salt (Vitamin C sodium). In vitro experiments showed that Vitamin C sodium had better antioxidant capacity. Then, we explored the effects of different antioxidant types of Vitamin A on the growth performance, immune function and antioxidant capacity of weaned pigs. In total, 288 weaned piglets with an initial mean BW of 8.34 ±â€¯0.02 kg at 30 days old were randomly divided into three groups with four replicates and 24 piglets per replicate for 35 days of feeding. The experimental diets were as follows: i) basal diet without external Vitamin A (NC); ii) basal diet supplemented with 12000 IU/kg EQ Vitamin A and iii) basal diet supplemented with 12000 IU/kg Vitamin C sodium Vitamin A. On day 36, two pigs from each replicate were selected to collect serum samples. The in vivo results showed that pigs in the EQ Vitamin A and Vitamin C sodium Vitamin A groups had significantly higher final weight and average daily gain (P < 0.05). During the trial, the levels of IgG and glutathione peroxidase in the EQ Vitamin A and Vitamin C sodium Vitamin A groups were significantly higher than those in the NC group (P < 0.05), and the malondialdehyde content was significantly lower (P < 0.05). On the 36th day, the levels of IgA and total antioxidant capacity in the Vitamin C sodium Vitamin A group were significantly higher than those in the EQ Vitamin A and NC (P < 0.05) groups. Thus, Vitamin C sodium Vitamin A can significantly improve the growth performance, antioxidant capacity and immune function of weaned pigs. Meanwhile, Vitamin C sodium may replace EQ as an antioxidant additive for Vitamin A.

Short communication: Effects of dietary deoiled soy lecithin supplementation on circulating choline and choline metabolites, and the plasma phospholipid profile in Holstein cows fed palm fat.

Dietary lecithin is a source of choline. Our objective was to evaluate the effects of dietary deoiled soy lecithin feeding on circulating choline, choline metabolites, and the plasma phospholipid profile in lactating dairy cows fed fractionated palm fatty acids. In a split-plot Latin square design, 16 Holstein cows (160 ± 7 d in milk; 3.6 ± 1.2 parity) were randomly allocated to a main plot receiving a corn silage and alfalfa haylage-based diet with palm fat containing either moderate or high palmitic acid content at 1.75% of ration dry matter (moderate and high palmitic acid containing 72 or 99% palmitic acid in fat supplement, respectively; n = 8/palm fat diet). Within each palm fat group, deoiled soy lecithin was top-dressed at 0, 0.12, 0.24, or 0.36% of ration dry matter in a replicated 4 × 4 Latin square design with 14-d experimental periods. A 14-d covariate period was used to acclimate cows to palm fat feeding without lecithin supplementation. Blood sampling occurred during the final 3 d of each experimental period. Plasma choline and choline metabolites were quantified using liquid chromatography and mass spectrometry. Plasma phospholipids were profiled using time-of-flight mass spectrometry. Whereas no effects of treatments were detected for plasma choline or methionine, lecithin feeding increased the plasma concentrations of choline metabolites trimethylamine N-oxide and dimethylglycine (24 and 11%, respectively). Plasma phosphatidylcholine (PC) and sphingomyelin (SM) concentrations increased with deoiled lecithin feeding (e.g., PC 16:0/22:6 and SM d18:1/18:3). Lecithin supplementation also increased plasma lysophosphatidylcholine (LPC) concentrations (e.g., LPC 18:0) while reducing plasma phosphatidylethanolamine (PE) concentrations (e.g., PE 16:0/20:5). Although increases in microbial-derived trimethylamine N-oxide suggest gastrointestinal lecithin degradation, elevations in plasma dimethylglycine, PC, LPC, and SM suggest that choline availability was improved by lecithin feeding in cows, thus supporting enhanced endogenous phospholipid synthesis.

[Research progress on the clinical features and mechanisms of COVID-19 combined with liver injury].

The highly contagious novel coronavirus pneumonia (COVID-19) that broke out in December 2019 has brought huge threats and losses to human society, so it has been the concern of every countries government. Presently, there are no specific drugs for COVID-19; however, a variety of potentially effective antiviral drugs, vaccines, cell therapies, traditional Chinese medicine and other methods are in clinical trials. Liver injury is a common complication of patients receiving COVID-19 treatment and its possible high incidence may affect the outcome of the disease. The pathogenesis of COVID-19 combined with liver injury in existing studies is still unclear, and relevant guidelines and expert consensuses are insufficient for clinical diagnosis and treatment. Therefore, the relevant progress and issues are now reviewed here.

[A probe into the editorial layout of the Pu Ji Ben Shi Fang].

The style of Fang Shu() has been developing and improving since it was established in the Qin and Han Dynasties, and it has reached a climax in the Song Dynasty. On the basis of prescriptions, the Pu Ji Ben Shi Fang (, Universal Benefit from My Prsactice) added Xu Shuwei's clinical cases and new experience. So it's called "Ben Shi" . This paper starts from the style of compiling febrile diseases in the Pu Ji Ben Shi Fang, taking the layout of prescription, medical record and medical theory as the research object, discusses the internal relationship between the expression of academic focus and the change of style and structure of works. The whole book is based on prescriptions, through medical cases and medical theories explained the prescription, expanding relevant content, integrating the three parts as a whole, combined with the clinical practice and theoretical analysis, further explanation and proof of the efficacy of the formula. Combined with the changes of the style of the Fang Shu, this paper expounds that the combination of case and theory supporting prescription is an important feature of the compilation style of Fang Shu.

Chicory fibre improves reproductive performance of pregnant rats involving in altering intestinal microbiota composition.

AIM: Chicory fibre (CF) is rich in fructan, which always functions as a quality dietary fibre source during mammalian pregnancy; however, its effect on reproductive performance remains unclear. METHODS AND RESULTS: 40 pregnant SD rats were randomly allotted to receive one of four diets: basal diet (control group), basal diet + 5% CF, basal diet + 10% CF, and basal diet + 15% CF, respectively. We found that CF significantly increased the number born alive and total litter birth weight (P < 0·05), increased the expression of intestinal tight junction proteins, mucins and antimicrobial peptides, accompanied by the increase of villi height and the decrease of crypts depth of pregnant SD rats (P < 0·05). We also observed that CF markedly increased the acetic acid, propanoic acid, butyric acid and total SCFAs concentrations in caecum contents and promoted the expression of SCFAs-related receptors (P < 0·05). Notably, rats fed CF increased the relative abundance of Bacteroidetes (P < 0·001), decreased the relative abundance of Firmicutes and Proteobacteria, while markedly lowered the Firmicutes/ Bacteroidetes ratio (F/B ratio) (P < 0·05). Intriguingly, the number born alive and total litter birth weight were positively correlated with some probiotics and negatively correlated with other harmful bacteria by Pearson correlation analysis. CONCLUSION: Collectively, CF can enhance intestinal barrier function and maintain intestinal health, and may improve reproductive performance by altering intestinal microbiota composition. SIGNIFICANCE AND IMPACT OF THE STUDY: Adding suitable dietary fibre to the diet can improve the reproductive performance of sows. Indeed, there exist various problems in the application of traditional dietary fibres, including high insoluble fibre content and anti-nutritional factor level, and mycotoxin contamination. This study demonstrates that dietary CF supplementation improves reproductive performance and intestinal health. Thus, CF can be applied in pregnancy animals as a new dietary fibre additive in animal husbandry.

[Effects of ω-3 polyunsaturated fatty acids from different sources on glucolipid metabolism in type 2 diabetic patients with dyslipidemia].

Objective: To determine the effects of ω-3 polyunsaturated fatty acids from different sources on glucolipid metabolism in type 2 diabetic patients with dyslipidemia. Methods: We recruited participants from the diabetes specialist clinic at the Guanlin hospital in Yixing city, Jiangsu Province from February 2017 to March 2017. A total of 180 subjects were randomly assigned to 3 g/day fish oil (FO), perilla oil (PO), or fish oil mixed with linseed oil (FLO) for 6 months. The basic conditions and fasting venous blood sample were obtained from each study subject at baseline, after 6 months of intervention. Serum glucose and lipid metabolism were investigated. Results: A total of 156 subjects aged (62.6±8.6) years completed the final follow-up after 6 months (FO,54 subjects; PO,52 subjects; FLO,50 subjects). Among them,59 patients (37.8%) were male. Serum glucose, glycated hemoglobin, C peptide, insulin and homeostasis model assessment-insulin resistance were not significantly different among the three groups after 6 months. Serum triglyceride decreased, whereas high-density lipoprotein cholesterol increased in FO [1.33 (1.05,1.93) mmol/L, (1.36±0.29) mmol/L, respectively] compared with PO [1.71 (1.23, 2.17) mmol/L, (1.23±0.22) mmol/L, respectively] and FLO [1.51 (1.12, 2.22) mmol/L, (1.29±0.30) mmol/L, respectively] (P<0.05). Serum low-density lipoprotein cholesterol and apolipoprotein B decreased in PO [(2.60±0.57) mmol/L,(0.96±0.23) g/L, respectively] compared with FO [(2.89±0.76) mmol/L, (1.07±0.30) g/L, respectively] (P<0.05). Serum lipoprotein(a) decreased in FLO [130.7 (63.3,270.6) mg/L] compared with FO [137.4 (58.7,333.2) mg/L] (P<0.05). Serum free fatty acid decreased in FLO [(0.43±0.15) mmol/L] compared with PO [(0.53±0.22) mmol/L] (P<0.05). Conclusion: The effects of ω-3 PUFA from different sources on glucose metabolism in type 2 diabetic patients with dyslipidemia are similar. Each of them has a good application prospect in improving lipid metabolism.

Effects of close-up dietary energy level and supplementing rumen-protected lysine on energy metabolites and milk production in transition cows.

The objective of this study was to investigate the effects of dietary energy levels and rumen-protected lysine supplementation on serum free fatty acid levels, ß-hydroxybutyrate levels, dry matter (DM) intake, and milk production and composition. Treatments were arranged in a 2 × 2 factorial design with 2 dietary energy levels [high net energy for lactation (NEL) = 1.53 Mcal/kg of DM vs. low NEL = 1.37 Mcal/kg of DM; HE vs. LE) fed either with rumen-protected lysine (bypass lysine; 40 g/cow per day) or without rumen-protected lysine (control). Sixty-eight third-lactation Holstein dairy cows entering their fourth lactation were randomly allocated to 4 treatments groups: HE with bypass lysine, HE without bypass lysine, LE with bypass lysine, and LE without bypass lysine. Groups were balanced based upon their expected calving date, previous milk yields, and body condition score. All cows were fed the same diet (NEL = 1.34 Mcal/kg of DM) during the dry period prior to the trial. Rumen-protected lysine was top-dressed on a total mixed ration to deliver 9.68 g/d of metabolizable lysine to pre- and postpartum cows. After calving, all cows received the same TMR (1.69 Mcal/kg of DM). Blood samples were collected at -21, -14, -7, 0, 3, 7, 14, and 21 d relative to calving, and free fatty acids and ß-hydroxybutyrate concentrations were measured. Amount of feed offered and orts were collected and measured for individual cows 4 d/wk. Milk samples were collected once per week following calving, and milk composition was analyzed. Feeding high NEL to close-up cows decreased the concentrations of free fatty acid and ß-hydroxybutyrate in prepartum cows but not in postpartum cows. Addition of rumen-protected lysine increased postpartum DM intake, and decreased serum free fatty acid and ß-hydroxybutyrate concentrations. Neither energy nor rumen-protected lysine supplementation nor their interaction affected milk yield or fat or lactose yields. However, cows in the group receiving HE with bypass lysine tended to produce more milk compared with other groups and had a lower blood ß-hydroxybutyrate concentration postpartum. These results indicate that feeding a high-energy diet together with rumen-protected lysine improved DM intake and lowered serum free fatty acid and ß-hydroxybutyrate concentrations in transition cows.

Acupuncture for patients with chronic functional constipation: A randomized controlled trial.

BACKGROUND: Acupuncture is used to treat chronic functional constipation (CFC) in China, despite limited evidence. We aim to assess the effectiveness and safety of acupuncture in managing CFC. METHODS: A multicenter randomized controlled trial was performed involving 684 patients with CFC; the patients were randomly allocated to receive He acupuncture (n = 172), Shu-mu acupuncture (n = 171), He-shu-mu acupuncture (n = 171), or oral administration of mosapride (n = 170). Sixteen sessions of acupuncture were given in the treatment duration of 4 weeks. The primary outcome was the change in spontaneous bowel movements (SBMs) at week 4 (at the end of treatment) compared to baseline. The secondary outcomes included stool consistency (Bristol scale), the degree of straining during defecation, and adverse events. KEY RESULTS: The SBMs increased in all the four groups at week 4, and the magnitude of increase was equivalent in the four groups (He acupuncture, 2.7 [95% CI, 2.3-3.1]; Shu-mu acupuncture, 2.7 [95% CI, 2.3-3.0]; He-shu-mu acupuncture, 2.2 [95% CI, 1.9-2.5]; and mosapride, 2.4 [95% CI, 2.0-2.9]; P = .226). However, the change in SBMs at week 8 was significantly smaller in mosapride group (1.4 [95% CI, 1.0-1.8]) than the three acupuncture groups (2.4 [95% CI, 2.1-2.7], 2.3 [95% CI, 1.9-2.7], 2.1 [95% CI, 1.7-2.5] in He, Shu-mu, and He-shu-mu group, respectively, P = .005). CONCLUSIONS & INTERFERENCES: The three acupuncture treatments were as effective as mosapride in improving stool frequency and stool consistency in CFC, but the magnitude of the treatment effect is unknown due to the lack of sham acupuncture control.

Effects of supplementing sow diets with fermented corn and soybean meal mixed feed during lactation on the performance of sows and progeny.

In the present study, two experiments were performed to study the effects of feeding fermented corn and soybean meal mixed feed (FMF) with Bacillus subtilis and Enterococcus faecium to lactating sows on the performance of the sows and their progeny. In experiment 1, 60 sows were allocated to the following three dietary treatments: 1) sows fed a corn and soybean meal basal diet (control) from day 3 before parturition to weaning, 2) sows fed a diet with 7.5% FMF, and 3) sows fed a diet with 15% FMF. Results indicated that feeding 15% FMF significantly improved (P < 0.05) the sows' ADFI, the individual piglet weaning weights, and piglet weight gain and reduced (P < 0.05) the backfat loss of sows compared with the control group. However, the 7.5% FMF treatment did not alter the performance of the sows or their progeny. Therefore, we considered the level of 15% FMF to be more efficient than 7.5% FMF. To verify the results of experiment 1, we performed experiment 2, in which 60 sows at 111 d of gestation were allocated into the following two dietary treatments: 1) sows fed a basal lactation diet (control) from d 111 of gestation to weaning and 2) sows fed a basal diet with 15% FMF. Compared with the control group, 15% FMF inclusion significantly increased (P < 0.05) the sows' ADFI, litter weight gain, and individual piglet weight gain during lactation and markedly decreased the backfat loss of sows (P < 0.05) and piglet diarrhea incidence (P < 0.05). Additionally, the milk yield and IgA contents of the milk in sows fed 15% FMF were greater (P < 0.05) than those of the control group. Furthermore, the apparent total tract digestibility of GE, DM, and total P of sows was increased (P < 0.05) with 15% FMF supplementation. Therefore, the present study indicates that supplementing sow diets with 15% FMF from parturition to weaning has the potential to 1) increase sow ADFI, milk production, milk IgA content, and nutrient digestibility and promote sow reproductive performance by shortening the weaning-to-estrous interval and 2) promote the growth performance of their progeny and decrease diarrhea incidence.