Dietary non-phytate phosphorus requirements for optimal productive and reproductive performance, and egg and tibial quality in egg-type duck breeders.

Optimal dietary non-phytate phosphorus (NPP) is essential in poultry to maximise productive and reproductive performance, along with indices of egg and bone quality. This study aimed to establish the NPP requirements of egg-type duck breeders aged from 54 to 80 weeks on the following traits: egg production, egg incubation, egg quality, tibial characteristics, reproductive organ, plasma indices, and the expression of genes related to phosphorus absorption. Longyan duck breeders aged 54 weeks (n = 300) were randomly allotted to five treatments, each containing six replicates of 10 individually caged birds. Birds were fed corn-soybean meal-based diets containing 0.18, 0.25, 0.32, 0.38, and 0.45% NPP/kg for 27 weeks. The tested dietary NPP levels did not affect egg production or egg quality indices. The hatchling weight of ducklings increased (quadratic, P < 0.01) as dietary NPP level increased, and the highest value occurred with 0.25% NPP. The number of large yellow follicles (LYF), and the relative weights of LYF and ovary showed linear and quadratic responses to dietary NPP levels; the lowest number and relative weight of LYF occurred with 0.38% NPP, and the lowest ovarian weight was obtained with 0.25% NPP. There were no differences in tibial length, breaking strength, and mineral density in response to dietary NPP levels. In contrast, tibial content of Ca increased (linear, P < 0.01) with dietary NPP levels increasing from 0.18 to 0.45%, and the tibial content of P increased at 0.32% NPP and the higher dietary NPP levels. Plasma concentration of P showed a quadratic (P < 0.05) response to the dietary NPP levels, where the highest value was seen at 0.38% NPP. In conclusion, dietary NPP levels from 0.18 to 0.45% had no effects on egg production, and egg and tibial quality of duck breeders. The duck breeders fed a diet with 0.25% NPP showed the highest hatchling weight of their offspring, while those fed 0.38% NPP had the lowest number and relative weight of LYF. These results indicated that the diet with 0.25% NPP can be used in egg-type duck breeders to improve the hatchling weight of their offspring, without adverse effects on their productivity. The regression model indicated that the maximal hatchling weight of ducklings was obtained from duck breeders fed the diet with 0.30% NPP.

[Exploration of clinical pathway-oriented optimal management diagnosis and treatment model for rare diseases].

This study takes Cushing's syndrome, a rare disease, as a model, and adopts the path of "Plan, Do, Check, Action" (PDCA) to explore new methods to optimize the clinical path, can improve the quality and efficiency of diagnosis and treatment of rare diseases. After sorting out the problems existing in the previous diagnosis and treatment mode, our team optimizes the path in various ways and establishes a standard operation procedure (SOP) for the new path. In the evaluation of the optimized mode, 55 patients with Cushing's syndrome were admitted to the Department of Endocrinology, Peking Union Medical College Hospital, including 19 males and 36 females, aged (41.8±14.4) years (6-68 years). The pathway group (28 cases) and the control group (27 cases) were divided according to whether they were included in the new path management at the time of admission, and the effect of path optimization was assessed in terms of time, efficacy, safety and cost. The results showed that compared with the control group, the pathway group had a shorter time of hospitalization in the Department of Endocrinology and critical tests, such as blood cortisol rhythm, low-dose dexamethasone inhibition test, and bilateral inferior petrosal sinus sampling (all P<0.05). There was no significant differences in the decrease of total cortisol after operation, the incidence of postoperative complications, and hospitalization expenses (all P>0.05). The optimized path improves the medical efficiency while ensuring medical quality, safety and no increase in cost. This study proposes PDCA path optimization for complex diseases and establishes SOP process, which provides experience in management optimization for the patient-centered and clinical path-oriented diagnosis and treatment mode of rare diseases.

[The 499th case: Roux-en-Y gastric bypass, limb weakness, and ostealgia].

A 36-year-old woman was admitted to the Peking Union Medical College Hospital with a history of fractures for 2 years, limb weakness for 1 year, and ostealgia for 2 months. The patient's examination identified iron deficiency anemia, significantly decreased serum calcium and 25-hydroxyvitamin D3 levels, and increased alkaline phosphatase and parathyroid hormone levels. Imaging showed several typical signs of osteomalacia. Considering the history of Roux-en-Y gastric bypass surgery, the diagnosis was considered to be osteomalacia caused by a postoperative nutritional absorption disorder. The patient was supplemented with calcitriol, calcium, and vitamin D and gradually returned to normal physical activity. The bone metabolism indicators and bone density were significantly improved.

Effects of dietary substitution of peanut meal for soybean meal on egg production, egg quality, oxidative status, and yolk fatty acid profile in laying ducks.

There is an urgent need to evaluate and introduce alternatives for the unsustainable and traditional feed stuffs in poultry. This study evaluated the effects of graded replacement of soybean meal (SBM) by peanut meal (PNM) on egg production, egg quality, oxidative status, and yolk fatty acid profile in laying ducks. In total, 360 Longyan ducks aged 21 weeks were allocated to five treatments, each containing six replicates of 12 birds. Birds were fed the diets containing PNM replacing 0 (control), 25, 50, 75 or 100% of SBM for 16 weeks. With the increase of PNM level, egg production was improved (quadratic, P < 0.05), egg weight and feed consumption were decreased, feed conversion ratio and egg mass were impaired at 100% PNM, and yolk colour was enhanced (quadratic, P < 0.05). Plasma malondialdehyde concentration was increased at 100% PNM, while plasma glutathione concentration was decreased (quadratic, P < 0.01) as PNM substitution increased. Total cholesterol content in yolk decreased (P < 0.01) in response to increased PNM substitution. The contents of saturated fatty acids C20:0 and C22:0 in yolk increased (linear or quadratic, P < 0.05) with increased PNM substitution, but the contents of saturated fatty acid C18:0, monounsaturated fatty acid C22:1, and polyunsaturated fatty acids C18:3n-3 and C22:6n-3 in yolk were decreased (linear, P < 0.05) as PNM replacement increased. The contents in yolk of polyunsaturated fatty acid C18:2n-6, C20:2n-6, C20:3n-6, C20:4n-6, and total amount of polyunsaturated fatty acids increased with the highest contents obtained at 75% PNM substitution. The ratio between n-6 and n-3 increased (linear, P < 0.05) as PNM substitution increased. The transcript abundance in liver of peroxisome proliferators-activated receptors γ and fatty acid synthase showed quadratic (P < 0.05) responses with PNM replacement, with the highest expression of both genes being obtained with 75% substitution with PNM. Replacement of dietary SBM with 100% PNM decreased egg production and antioxidant capacity and increased the ratio of omega fatty acid in yolk between n-6 and n-3 in laying ducks. The obtained results indicate that PNM can be used to replace up to 75% of SBM in the diet of laying ducks without negative effects on the egg-laying production or egg quality. The regression model indicated that the maximal egg mass was obtained at no more than 67.6% replacement of SBM with PNM in the diet of laying ducks.

Effects of dietary inclusion of cassava starch-extraction-residue meal on egg production, egg quality, oxidative status, and yolk fatty acid profile in laying ducks.

This study was designed to evaluate the effects of different dietary levels of cassava starch extraction residue meal (CReM) on egg production, egg quality, oxidative status, egg yolk fatty acid profile, and hepatic expression of fatty acid metabolism-related genes. In total, 288 Longyan laying ducks aged 21 wk with similar BW were randomly assigned to 4 dietary treatments, each consisting of 6 replicates of 12 birds. The birds were fed a typical corn-soybean meal diet, which contained 0% (control), 5%, 10%, and 15% CReM, mainly replacing wheat bran, and the experiment lasted for 16 wk. The tested CReM levels did not show significant effects on the egg production, nonmarketable egg percentage, egg weight, daily egg mass, and FCR (g feed: g egg), but daily feed intake was reduced with increased CReM level (linear P < 0.001, quadratic P < 0.05). Yolk color increased (linear and quadratic, P < 0.01) with the increase in CReM level, but the Haugh unit, yolk proportion, albumen proportion, shell proportion, eggshell thickness, and eggshell strength were unaffected. Yolk contents of C11:0 and C12:0 (linear, quadratic, P < 0.01) and total saturated fatty acids increased, and the C22:1 level decreased (linear P < 0.01, quadratic P < 0.05) with the increase in CReM level, but the total monounsaturated fatty acids, the individual and total polyunsaturated fatty acids and n-6 and n-3 fatty acids, triglycerides, and total cholesterol in egg yolk were not affected. Hepatic gene expression revealed a significant increase in peroxisome proliferators-activated receptors γ (linear, quadratic, P < 0.001), but the expression of fatty acid synthase, sterol regulatory element binding protein 1 and apolipoprotein A1 genes were unaffected by CReM level. In conclusion, the results of the current study indicated that the CReM could be included up to 15% in laying duck diets without negative effects on the egg-laying rate, egg quality, and oxidative status. Dietary inclusion of CReM increased the yolk content of total saturated fatty acids and SOD activity in the liver.

The efficacy and safety of different doses of calcitriol combined with neutral phosphate in X-linked hypophosphatemia: a prospective study.

The present study was the first prospective cohort evaluated the efficacy and safety of different doses of calcitriol in XLH children. The results suggested that a dose of 40 ng/kg/day calcitriol, compared with 20 ng/kg/day, was more effective in relieving the rickets, with similar safety outcomes. Further investigations were expected to set more dose groups. INTRODUCTION: Dose recommended for calcitriol in X-linked hypophosphatemia (XLH) varies in different studies. Therefore, we aimed to compare the efficacy as well as the safety of 20 ng/kg/d and 40 ng/kg/d calcitriol in Chinese XLH pediatrics population. METHODS: A 2-year, randomized, open-label, prospective study recruited 68 XLH children, which were randomized to receive either 40 ng/kg/day or 20 ng/kg/day calcitriol. Efficacy endpoints were the total Thacher ricket severity score (RSS) change from baseline to month 12 and 24, the difference in serum TALP level, fasting serum phosphate level, body height Z-score, and frequency of dental abscess. Safety assessments were done using renal ultrasound nephrocalcinosis grades (0-4), fasting serum and 24 h urine calcium level, and the occurrence of hyperparathyroidism. RESULTS: The decrease in the total RSS from baseline was more significant in the high-dose group at 12 (difference 0.87, p = 0.049) and 24 month (difference 1.23, p = 0.011). The serum TALP level was significantly lower in the high-dose group at 6 months. Pi level, height Z-score change, frequency of dental abscess and ratio of de novo nephrocalcinosis were comparable. A lower incidence of secondary hyperparathyroidism was seen in the high-dose group (p < 0.0001). CONCLUSION: For the first time in this prospective cohort, 40 ng/kg/d calcitriol was shown to be the more effective therapy in XLH children than the 20 ng/kg/d. Moreover, 40 ng/kg/d calcitriol was not associated with increasing adverse events. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT 03,820,518.

Effects of maternal and progeny dietary selenium supplementation on growth performance and antioxidant capacity in ducklings.

This study evaluated the effects of selenium (Se) supplementation in maternal and offspring diets on performance and antioxidant capacity of ducklings aged from 0 to 2 wk. A total of 144 female Longyan duck breeders aged 22-wk were allotted into 2 treatments and fed a control diet or a 0.16 mg Se/kg supplemented diet. At 40-wk, 120 offspring from each treatment were divided into 2 groups, with 6 replicates of 10 birds. Using a 2 × 2 factorial design, ducklings from each maternal dietary treatment were assigned to a control diet or a 0.16 mg Se/kg supplemented diet from hatch to 2-wk. Compared with Se-deficient diet, maternal diet supplemented with 0.16 mg Se/kg increased the BW of hatchlings (P < 0.01). There were interactions between maternal and progeny diet with 0.16 mg Se/kg in BW of ducklings aged 2 wk and BW gain (BWG) as ducklings from maternal Se/progeny none treatment had the lightest BW and BWG (P < 0.01). Maternal diet with 0.16 mg Se/kg decreased plasma concentration of uric acid and insulin-like growth factor 1 (P < 0.01), and progeny diet supplemented with 0.16 mg Se/kg increased the activities of glutathione peroxidase 3 (GPx3) in plasma and glutathione peroxidase 1 in erythrocyte (P < 0.01). Maternal diet with 0.16 mg Se/kg increased (P < 0.05) the hepatic activity of total superoxide dismutase (T-SOD). Progeny diet supplemented with 0.16 mg Se/kg increased (P < 0.01) hepatic activity of GPx3 and decreased (P < 0.01) the hepatic concentration of malondialdehyde. Interactions were detected between maternal and progeny diet with 0.16 mg Se/kg in hepatic activity of T-SOD and maternal and progeny diet supplemented with Se displayed the highest hepatic activity of T-SOD (P < 0.05). Overall, Se supplementation in the diet of duck breeders and offspring increased the antioxidant capacity of ducklings. Maternal Se supplementation increased the BW of hatchlings, whereas maternal and progeny dietary Se supplementation did not affect the BWG of ducklings aged from 0 to 2 wk. Se supplementation with additional 0.16 mg/kg in the diet of duck breeders and offspring displayed beneficial effects particularly on the antioxidant capacity in ducklings.

Interventional treatments for prolapsing haemorrhoids: network meta-analysis.

BACKGROUND: Multiple treatments for early-moderate grade symptomatic haemorrhoids currently exist, each associated with their respective efficacy, complications, and risks. The aim of this study was to compare the relative clinical outcomes and effectiveness of interventional treatments for grade II-III haemorrhoids. METHODS: A systematic review was conducted according to PRISMA criteria for all the RCTs published between 1980 and 2020; manuscripts were identified using the MEDLINE, Embase, and CENTRAL databases. Inclusion criteria were RCTs comparing procedural interventions for grade II-III haemorrhoids. Primary outcomes of interest were: symptom recurrence at a minimum follow-up of 6 weeks, postprocedural pain measured on a visual analogue scale (VAS) on day 1, and postprocedural complications (bleeding, urinary retention, and bowel incontinence). After bias assessment and heterogeneity analysis, a Bayesian network meta-analysis was performed. RESULTS: Seventy-nine RCTs were identified, including 9232 patients. Fourteen different treatments were analysed in the network meta-analysis. Overall, there were 59 RCTs (73 per cent) judged as being at high risk of bias, and the greatest risk was in the domain measurement of outcome. Variable amounts of heterogeneity were detected in direct treatment comparisons, in particular for symptom recurrence and postprocedural pain. Recurrence of haemorrhoidal symptoms was reported by 54 studies, involving 7026 patients and 14 treatments. Closed haemorrhoidectomy had the lowest recurrence risk, followed by open haemorrhoidectomy, suture ligation with mucopexy, stapled haemorrhoidopexy, and Doppler-guided haemorrhoid artery ligation (DG-HAL) with mucopexy. Pain was reported in 34 studies involving 3812 patients and 11 treatments. Direct current electrotherapy, DG-HAL with mucopexy, and infrared coagulation yielded the lowest pain scores. Postprocedural bleeding was recorded in 46 studies involving 5696 patients and 14 treatments. Open haemorrhoidectomy had the greatest risk of postprocedural bleeding, followed by stapled haemorrhoidopexy and closed haemorrhoidectomy. Urinary retention was reported in 30 studies comparing 10 treatments involving 3116 participants. Open haemorrhoidectomy and stapled haemorrhoidopexy had significantly higher odds of urinary retention than rubber band ligation and DG-HAL with mucopexy. Nine studies reported bowel incontinence comparing five treatments involving 1269 participants. Open haemorrhoidectomy and stapled haemorrhoidopexy had the highest probability of bowel incontinence. CONCLUSION: Open and closed haemorrhoidectomy, and stapled haemorrhoidopexy were associated with worse pain, and more postprocedural bleeding, urinary retention, and bowel incontinence, but had the lowest rates of symptom recurrence. The risks and benefits of each treatment should be discussed with patients before a decision is made.

Estimation of dietary tryptophan requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, reproductive organ and ovarian follicle development and serum biochemical indices.

This study aimed to determine the dietary tryptophan (Trp) requirement for laying duck breeders. A total of 504 Longyan duck breeders (body weight: 1.20 ± 0.02 kg) aged 22 wk were randomly allocated to 6 treatments, each with 6 replicates of 14 ducks. During the next 16 wk, birds were fed the basal diet with total Trp contents of 1.00, 2.00, 3.00, 4.00, 5.00 and 6.00 g/kg, respectively. Dietary Trp levels increased egg production, egg mass and feed intake of duck breeders from 22 to 37 wk (P < 0.05), and there were linear and quadratic effects of Trp level (P < 0.05). The feed conversion ratio (FCR) quadratically decreased with dietary Trp levels (P < 0.05). Dietary Trp levels decreased (P < 0.05) egg albumen height and Haugh unit at wk 8 or 12, and the responses were linear and quadratic (P < 0.05). The body weight of breeders, absolute and relative weight of oviduct, number and total weight of preovulatory follicles (POF), and its proportion relative to ovarian weight were increased (P < 0.05), and the responses were linear (P < 0.01) and quadratic (P < 0.001). Ovarian weight increased quadratically (P < 0.05), and the mean weight of POF increased (P < 0.05), linearly and quadratically. The proportion of small yellow follicles relative to ovary weight decreased (P < 0.01) linearly and quadratically. At wk 16 of the trial period, the serum albumin content and alanine aminotransferase activity decreased (P < 0.05) and the creatinine content increased (P < 0.01) linearly and quadratically. The Trp requirements were estimated to be 3.14 g/kg for optimizing egg production, 2.93 g/kg for egg mass, and 2.92 g/kg for FCR. Overall, dietary Trp levels (1 to 6 g/kg) affected productive performance, egg quality, reproductive organ and ovarian follicle development, and serum biochemical indices of layer duck breeders, and a diet containing 2.9 to 3.1 g Trp per kg feed was adequate during the laying period (22 to 37 wk of age).

Effects of capsaicin on laying performance, follicle development, and ovarian antioxidant capacity in aged laying ducks.

The present study was conducted to evaluate the effects of dietary addition of capsaicin (CAP) on egg production performance, follicular development, and ovarian antioxidant capacity in laying ducks. Three hundred seventy eight 58-wk-old laying ducks were randomly divided into 3 treatments, each treatment consisted 6 replicates, with 12 individually caged laying ducks per replicate. Ducks fed a basal diet served as control, the other 2 groups of ducks were fed the same diet containing 150 mg/kg CAP but in the manner of feed restriction (pair-fed) or ad libitum fed. The experiment lasted for 8 wk. The results showed that the dietary supplementation with CAP under conditions of ad libitum feeding increased feed intake (P < 0.001) and tended (P < 0.1) to increase egg production and egg weight in laying ducks but had no effects on daily egg mass and feed conversion ratio. The relative weight of large yellow follicles from the 2 CAP-supplemented groups at 64 wk of age were significantly higher than that of the controls (P = 0.01). The relative weight of the small yellow follicles in the CAP free-fed group was significantly higher than that of the other 2 groups (P < 0.01). Capsaicin supplementation under ad libitum feding conditions tended to increase the number of dominant follicles in laying ducks (P = 0.06). The ovarian mRNA expression of genes related to calcium signaling (TRPV4, ATP2A2, ITPR1, and CaM) in the CAP ad libitum fed groups were significantly higher than those of the other 2 groups (P < 0.05). The ovarian mRNA expression of CDK1 in CAP free-fed ducks was significantly higher than that of the other 2 groups (P = 0.01). Capsaicin supplementation significantly increased the plasma glutathione peroxidase activity (P < 0.01) in comparison with the control group but reduced the malondialdehyde content in the ovaries of laying ducks (P < 0.01). The results of this study indicates that dietary supplementation of CAP increased feed intake and improved egg production performance probably by activating calcium signaling pathway and improving redox status.

The application of reduced dietary crude protein levels supplemented with additional amino acids in laying ducks.

This study was aimed at studying use of reduced dietary crude protein (CP) level supplemented with additional amino acids in laying ducks. A total of 720 Jingjiang ducks (50 wk) were randomly assigned to 5 treatments and fed 5 basal diets with CP levels at 17.5, 16.5, 15.5, 14.5, or 13.5%, with additional amino acids added to each diet for 12 wk. Each treatment had 6 replicates of 24 ducks each. Dietary CP levels affected (P < 0.05) egg production and mass of laying ducks, and there was a linear and quadratic decrease with decreasing CP levels (P < 0.05). Dietary CP levels did not affect egg weight and feed conversion ratio (FCR), but egg weight decreased linearly (P < 0.05); FCR increased linearly and quadratically (P < 0.05) with decreasing CP levels. There were no significant differences in egg quality among the different CP levels (P > 0.05). Ovarian weight, total and mean weight of preovulatory follicles, and total weight of small yellow follicles (SYF) were decreased by dietary CP levels (linear, P < 0.01 and quadratic, P < 0.05). The oviductal weight decreased linearly (P < 0.05), and the number of SYF decreased linearly and quadratically with decreasing CP levels (P < 0.05). The serum estradiol content decreased linearly with dietary CP levels (P < 0.05). The serum contents of luteinizing hormone, prolactin, and progesterone decreased (P < 0.05), linearly and quadratically (both P < 0.01) with decreasing CP levels. The serum contents of creatinine (CRE), triglycerides (TG), total cholesterol (TC), and alanine aminotransferase (ALT) activity were affected (P < 0.05) by different dietary CP levels. The total protein content increased linearly (P < 0.05), TC content increased quadratically (P < 0.05), and contents of albumin, CRE, TG, and phosphorus, and activities of aspartate aminotransferase and ALT increased linearly and quadratically (both P < 0.05) with decreasing CP levels. Overall, reduced dietary CP levels with addition of amino acids affected the laying performance, the development of reproductive organs and ovarian follicles, serum hormones, and biochemical indices of laying ducks. Dietary CP levels can be reduced to 14.5% with additional amino acid supplementation for 12 wk in laying ducks without negative effect on laying performance and egg quality.

Estimation of dietary manganese requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, tibial characteristics, and serum biochemical and antioxidant indices.

This study was aimed at estimating the dietary manganese (Mn) requirement for laying duck breeders. A total of 504 Longyan duck breeders (body weight: 1.20 ± 0.02 kg) aged 17 wk were randomly allocated to 6 treatments. The birds were fed with a basal diet (Mn, 17.5 mg/kg) or diets supplemented with 20, 40, 80, 120, or 160 mg/kg of Mn (as MnSO4·H2O) for 18 wk. Each treatment had 6 replicates of 14 ducks each. As a result of this study, dietary Mn supplementation did not affect the productive performance of laying duck breeders in the early laying period (17-18 wk), but affected egg production, egg mass, and feed conversion ratio (FCR) from 19 to 34 wk (P < 0.05), and there was a linear and quadratic effect of supplement level (P < 0.05). The proportion of preovulatory ovarian follicles increased (P < 0.01) linearly and quadratically, and atretic follicles (weight and percentage) decreased (P < 0.05) quadratically with dietary Mn supplementation. The density and breaking strength of tibias increased (quadratic; P < 0.05), the calcium content of tibias decreased (linear, quadratic; P < 0.01), and Mn content increased (linear, quadratic; P < 0.001) with increase in Mn. The addition of Mn had a quadratic effect on serum contents of estradiol, prolactin, progesterone, luteinizing hormone, and follicle-stimulating hormone (P < 0.001). Dietary Mn supplementation decreased serum contents of total protein (linear, P < 0.05), glucose (quadratic, P < 0.05), total bilirubin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and calcium (linear, quadratic; P < 0.05). The serum total antioxidant capacity and total and Mn-containing superoxide dismutase activities increased (linear, quadratic; P < 0.001), and malondialdehyde content decreased (linear, quadratic; P < 0.001) in response to Mn supplemental levels. The dietary Mn requirements, in milligram per kilogram for a basal diet containing 17.5 mg/kg of Mn, for Longyan duck breeders from 19 to 34 wk of age were estimated to be 84.2 for optimizing egg production, 85.8 for egg mass, and 95.0 for FCR. Overall, dietary Mn supplementation, up to 160 mg/kg of feed, affected productive performance, tibial characteristics, and serum biochemical and antioxidant status of layer duck breeders. Supplementing this basal diet (17.5 mg/kg of Mn) with 85 to 95 mg/kg of additional Mn was adequate for laying duck breeders during the laying period.

The effects of dietary Se on productive and reproductive performance, tibial quality, and antioxidant capacity in laying duck breeders.

This study evaluated the optimal concentrations of dietary Se for the productive and reproductive performance, tibial quality, and antioxidant status in duck breeders aged 23 to 49 wk. In total, 432 Longyan duck breeders aged 22 wk were allotted randomly to 6 treatments, each with 6 replicates of 12 individually caged birds. The experiment lasted for 27 wk, and birds were fed corn-soybean meal-based diets containing 0.11, 0.19, 0.27, 0.35, 0.43, or 0.51 mg Se/kg, respectively. The tested dietary Se levels did not affect egg production and tibial quality of duck breeders. The Se contents of the shell, yolk or albumin, whole egg, and the fertility of set eggs increased in a linear and quadratic manner (P < 0.05) in response to the increased dietary Se level, whereas the yolk malondialdehyde (MDA) and embryonic mortality decreased. The activities of glutathione peroxidase 3 (Gpx3) in plasma and Gpx1 in the erythrocytes and livers of breeder ducks increased in a linear and quadratic manner (P < 0.05) in response to increased dietary Se levels, whereas the total superoxide dismutase (T-SOD) activity increased and the MDA concentration decreased in the liver. The activity of Gpx3 in the plasma and Gpx1 in the erythrocytes and livers of newly hatched ducklings increased linearly (P < 0.01) with the increase in Se level, whereas the T-SOD activity and MDA concentration did not change. In conclusion, diets containing 0.27 mg Se/kg led to the highest egg fertility and hatchability in Longyan duck breeders, and using levels >0.19 mg Se/kg diet enhanced the antioxidant capacity in breeders and their offspring. The regression model indicated that dietary Se levels 0.19, 0.27, 0.28, 0.24, and 0.30 mg/kg are optimal levels to obtain maximum Se deposition efficiency in eggs, egg fertility, Gpx1 activity in erythrocytes and liver in duck breeders, and plasma activity of Gpx3 in newly hatched ducklings, respectively.

Estimation of dietary zinc requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, tibial characteristics, plasma biochemical and antioxidant indices, and zinc deposition.

This study evaluated the effects of different dietary zinc (Zn) levels on productive and reproductive performance, egg quality, tibial characteristics, plasma biochemical and antioxidant indices, and zinc deposition in laying duck breeders. A total of 504 Longyan duck breeders aged 21 wk were randomly allocated to 6 treatments and fed a basal diet (Zn, 27.7 mg/kg) or that basal diet supplemented with Zn (as ZnSO4·H2 O) at 10, 20, 40, 80, or 160 mg Zn per kg of feed for 20 wk. Each group had 6 replicates of 14 ducks each. Dietary Zn supplementation affected (P < 0.05) the egg production, FCR, and shell thickness of laying duck breeders from 21 to 40 wk, and there was a quadratic (P < 0.05) effect between them. Dietary Zn supplementation affected (P < 0.05) and quadratically (P < 0.001) increased the breaking strength, density, and dry defatted weight of tibias. Alkaline phosphatase, calcium, phosphorus, total superoxide dismutase, glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) activities or content in plasma were affected (P < 0.05), and quadratically (P < 0.01) changed by dietary Zn levels. Dietary Zn supplementation affected (P < 0.01) and increased the Zn deposition in egg yolk (linear, P < 0.05; quadratic, P < 0.001) and tibia (linear, P < 0.05). The dietary Zn requirements, in mg/kg for a basal diet containing 27.7 mg/kg Zn, for Longyan duck breeders from 21 to 40 wk of age were estimated to be 65.4 for optimizing egg production, 68.6 for FCR, 102 for hatchling BW, 94.7 for eggshell thickness, 77.2 for tibial breaking strength, 81.4 for tibial density, 78.9 for tibial dry defatted weight, 69.5 for plasma GSH-Px activity, 72.4 for plasma MDA content, and 94.6 for Zn content in tibia. Overall, dietary Zn supplementation, up to 160 mg/kg feed, affected the productive performance, eggshell thickness, tibial characteristics, plasma antioxidant status, and Zn deposition of layer duck breeders. Supplementing this basal diet (27.7 mg/kg Zn) with 70 to 80 mg/kg additional Zn was adequate for laying duck breeders during the laying period.

Promoting physical activity among children with cancer through an integrated experiential training programme with coaching: A qualitative study.

OBJECTIVE: The study aim was to investigate how the integrated experiential training programme with coaching could motivate children undergoing cancer treatment to adopt and maintain physical activity. METHODS: A descriptive phenomenological approach was used. A purposive sample of 23 children and their parents participated in one-to-one 25-30-minute semistructured interviews. Interviews were tape-recorded and transcribed. Colaizzi's method of descriptive phenomenological data analysis was used. RESULTS: The integrated programme motivated children with cancer by increasing children's and parents' knowledge of physical activity, enhancing confidence in physical activity and improving physical and psychological well-being. Moreover, the programme provided children with encouragement and psychological support through coach companionship. The programme also facilitated children's participation in physical activity and modified perceptions of physical activity. CONCLUSION: This study addressed a gap in the literature by exploring how an integrated programme promoted and maintained physical activity in childhood cancer patients. PRACTICE IMPLICATIONS: The integrated experiential training programme is feasible and can be easily sustained. Future studies could extend the programme beyond aspects of physical activity to help people change their health practices and maintain a healthy lifestyle.

[The establishment and influence of the Prescription Appraisal Committee of the Central National Physician Pavilion].

The Prescription Appraisal Committee of the Central National Physician Pavilion was established on November 8, 1935. It specializes in handling cases where the parties entrusted by the Court have applied for re-identification against the identification of the local Chinese Medicine branch or medical group.The statutes of the Prescription Appraisal Committee stipulate the entrusted appraisers, the scope of appraisal, the appraisers, the appraisal process, and the signing and service of the appraisal opinions for the re-identification of TCM cases. To a certain extent, it played a role in improving the medical service environment of Chinese medicine at that time, safeguarding the common interests of doctors and patients, and promoting the institutionalized development of appraisal of Chinese medicine lawsuits in the Republic of China. However, due to historical reasons and limitations, it also had inherent limitations such as the uneven geographical distribution of appraisal candidates, the lack of strict identification procedures, and the inconsistency of appraisal standards.

Effects of ${\rm \small L}$-methionine on growth performance, carcass quality, feather traits, and small intestinal morphology of Pekin ducks compared with conventional ${\rm \small {DL}}$-methionine.

The research studied the effects of l-methionine (l-Met) on growth performance, carcass quality, feather traits, and small intestinal morphology of Pekin ducks compared with conventional dl-methionine (dl-Met). A total of 1080, 1-day-old male Pekin ducks were randomly allotted to 9 groups with 6 replicate pens of 20 birds each. During the starter phase (1 to 14 d), ducks were fed a basal diet (Met, 0.30%) or that supplemented with dl-Met or l-Met at 0.05, 0.10, 0.15, or 0.20% of feed. During the grower phase (15 to 35 d), ducks were fed a basal diet (Met, 0.24%) or that supplemented with dl-Met or l-Met at 0.04, 0.08, 0.12, or 0.16% of feed. Compared with ducks fed the basal diet, supplementation with either dl-Met or l-Met increased the body weight (BW) of ducks at days 14 and 35, increased average daily gain (ADG) and average daily feed intake (ADFI), decreased F:G at the starter phase, and increased ADG over the whole 35-d period (P < 0.05). The efficacy of l-Met compared to dl-Met was 140.1% for 14-d BW, 137.6% for ADG and 121.0% for F:G for days 1 to 14. Ducks fed diets supplemented with l-Met had greater proportion of leg muscle, higher than in ducks provided with dl-Met (P < 0.05). The breast muscle proportion was enhanced with dl-Met rather than l-Met supplementation (P < 0.01). The back feathers score and fourth primary wing feather length were increased with dl-Met or l-Met supplementation (P < 0.01), and there was increased efficacy of l-Met relative to dl-Met for back feathers score (153.1%). Dietary dl-Met or l-Met supplementation increased villus height of ileal mucosa of ducks at days 14 and 35 (P < 0.01). Overall, dietary l-Met or dl-Met supplementation affected the growth performance of ducks during the starter phase, and improved the feather traits and small intestinal morphology. The efficacy of l-Met to dl-Met ranged from 120 to 140% for growth performance of young ducks (1 to 14 d) and was 153% for the feather traits of ducks (35 d).

Effects of dietary lysine on productivity, reproductive performance, protein and lipid metabolism-related gene expression in laying duck breeders.

This study investigated whether dietary lysine (Lys) affects productive performance and expression of genes related to protein and lipid metabolism in laying duck breeders. Longyan duck breeders (n = 540, 19 wk of age) were randomly assigned to 6 groups with 6 replicates of 15 birds each. Breeders were fed diets with 6 total Lys levels (6.4, 7.2, 8.0, 8.8, 9.6, and 10.4 g/kg) for 26 wk duration. Egg production, egg weight, egg mass, feed conversion ratio, hatchability, hatchling weight, albumen weight, eggshell weight, yolk weight, and yolk proportion increased with dietary Lys levels (P < 0.05). Dietary Lys level had a linear (P < 0.05) and quadratic (P < 0.05) effects on maternal hepatic expression of mechanistic target of rapamycin, eukaryotic translation initiation factor 4E binding protein 1, ubiquitin conjugating enzyme E2K (UBE2K), cathepsin B (CTSB), and quadratically (P < 0.05) increased the concentrations of plasma Lys, leucine, threonine, and tryptophan in duck breeders. In contrast, maternal dietary Lys suppressed expression of proteasome 26S subunit, UBE2K, and CTSB in the liver of hatchlings. Moreover, relative expression of peroxisome proliferator-activated receptors alpha, carnitine palmitoyltransferase 1A, and very low density apolipoprotein-II increased linearly (P < 0.05) and quadratically (P < 0.05), and that of VLDL receptor (VLDLR) decreased quadratically (P < 0.05) in the liver of duck breeders with increasing dietary Lys levels; hepatic triglyceride and cholesterol contents were reduced. Maternal dietary Lys suppressed hepatic expression of VLDLR in the hatchlings. A diet containing 8.6 g Lys/kg promoted protein turnover and lipid metabolism in laying duck breeders, which positively reflected in the productivity and reproductive performance.

Estimation of calcium requirements for optimal productive and reproductive performance, eggshell and tibial quality in egg-type duck breeders.

Optimizing the dietary calcium (Ca) level is essential to maximize the eggshell quality, egg production and bone formation in poultry. This study aimed to establish the Ca requirements of egg-type duck breeders from 23 to 57 weeks of age on egg production, eggshell, incubation, tibial, plasma and ovary-related indices, as well as the expression of matrix protein-related genes. Totally, 450 Longyan duck breeders aged 21 weeks of age were allotted randomly into five treatments, each with six replicates of 15 individually caged birds. The data collection started from 23 weeks of age and continued over the following 35 weeks. The five groups corresponded to five dietary treatments containing either 2.8%, 3.2%, 3.6%, 4.0% or 4.4% Ca. The tested dietary Ca levels increased (linear, P <0.01) egg production and egg mass, and linearly improved (P <0.01) the feed conversion ratio (FCR). Increasing the dietary Ca levels from 2.8% to 4.4% increased (P <0.01) the eggshell thickness and eggshell content. The tested Ca levels showed a quadratic effect on eggshell thickness and ovarian weight (P <0.01); the highest values were obtained with the Ca levels 4.0% and 3.6%, respectively. Dietary Ca levels affected the small yellow follicles (SYF) number and SYF weight/ovarian weight, and the linear response (P <0.01) was significant vis-à-vis SYF number. In addition, dietary Ca levels increased (P <0.05) the tibial dry weight, breaking strength, mineral density and ash content. Plasma and tibial phosphorus concentration exhibited a quadratic (P <0.01) response to dietary Ca levels. Plasma calcitonin concentration linearly (P <0.01) increased as dietary Ca levels increased. The relative expression of carbonic anhydrase 2 in the uterus rose (P <0.01) with the increment of dietary Ca levels, and the highest value was obtained with 3.2% Ca. In conclusion, Longyan duck breeders fed a diet with 4.0% Ca had superior eggshell and tibial quality, while those fed a diet with 3.6% Ca had the heaviest ovarian weights. The regression model indicated that the dietary Ca levels 3.86%, 3.48% and 4.00% are optimal levels to obtain maximum eggshell thickness, ovarian weight and tibial mineral density, respectively.

Dietary curcumin enhances intestinal antioxidant capacity in ducklings via altering gene expression of antioxidant and key detoxification enzymes.

The study investigated the effects of dietary curcumin supplementation on tissue distribution of curcumin and its metabolites, intestinal antioxidant capacity, and expression of detoxification-related genes in ducks. A total of 720 one-day-old male Cherry Valley Pekin ducklings (initial BW 58.6 ± 0.1 g) were randomly assigned to 4 dietary groups each with 6 replicates of 30 ducks using a single factorial arrangement design. Ducks in the control group were fed a basal diet and the remainder were fed the basal diet supplemented with 200, 400, or 800 mg/kg curcumin. The experiment lasted for 21 D. Curcumin was present at 13.12 to 16.18 mg/g in the cecal digesta, 75.50 to 575.40 µg/g in jejunal mucosa, 35.10 to 73.65 µg/g in liver, and 7.02 to 7.88 µg/mL in plasma. The jejunal and hepatic contents of curcumin increased significantly (P < 0.05) in response to supplementation with 400 and 800 mg/kg of curcumin respectively, compared with 200 mg curcumin/kg group. There was a linear (P < 0.001) effect of dietary curcumin on relative abundance of SOD1, GPX1, CAT, HO-1, and Nrf2 transcripts, and a quadratic (P < 0.001) increase in the activities of GSH-Px and T-AOC in jejunal mucosa. The expression of CYP1A4, CYP2D17 increased and CYP1B1, CYP2A6 decreased linearly (P < 0.001) with dietary curcumin concentrations. In addition, dietary curcumin increased gene expression of GST, MRP6, and ABCB1 in jejunal mucosa. In conclusion, dietary supplementation with 200 to 800 mg/kg curcumin enhanced the accumulation of curcumin and its metabolites in jejunum as well as increasing the antioxidant capacity and detoxification potential, which play major roles in the protection of duck intestines against damage.