A preoperative prediction model based on Lymphocyte-C-reactive protein ratio predicts postoperative anastomotic leakage in patients with colorectal carcinoma: a retrospective study.

BACKGROUND & AIMS: Lymphocyte-C-reactive Protein Ratio (LCR) has been demonstrated as a promising new marker for predicting surgical and oncological outcomes in colorectal carcinoma (CRC). However, anastomotic leakage (AL) is also likely related to this inflammatory marker. Herein, we aimed to identify preoperative predictors of AL and build and develop a novel model able to identify patients at risk of developing AL. METHODS: We collected 858 patients with CRC undergoing elective radical operation between 2007 and 2018 at a single center were retrospectively reviewed. We performed univariable and multivariable analyses and built a multivariable model that predicts AL based on preoperative factors. Propensity adjustment was used to correct the bias introduced by non-random matching of the LCR. The model's performance was evaluated by using the area under the receiver operator characteristic curves (AUROCs), decision curve analysis (DCA), Brier scores, D statistics, and R2 values. RESULTS: Age, nutrition risk screening 2002 (NRS2002) score, tumor location and LCR, together with hemoglobin < 90 g/l, were independent predictors of AL. The models built on these variables showed good performance (internal validation: c-statistic = 0.851 (95%CI 0.803-0.965), Brier score = 0.049; temporal validation: c-statistic = 0.777 (95%CI 0.823-0.979), Brier score = 0.096). A regression equation to predict the AL was also established by multiple linear regression analysis: [Age(≥ 60 year) × 1.281] + [NRS2002(≥ 3) × 1.341] + [Tumor location(pt.) × 1.348]-[LCR(≤ 6000) × 1.593]-[Hemoglobin(< 90 g/L) × 1.589]-6.12. CONCLUSION: Preoperative LCR is an independent predictive factor for AL. A novel model combining LCR values, age, tumor location, and NRS2002 provided an excellent preoperative prediction of AL in patients with CRC. The nomogram can help clinical decision-making and support future research.

Dietary L-tryptophan supplementation with reduced large neutral amino acids enhances feed efficiency and decreases stress hormone secretion in nursery pigs under social-mixing stress.

Tryptophan (Trp), the rate-limiting substrate of serotonin [5-hydroxytryptoamine (5-HT)] synthesis in the brain, competes with large neutral amino acids (LNAA) to cross the blood-brain barrier. This study was designed to evaluate the effect of L-Trp supplementation on nursery pigs experiencing social-mixing stress and fed diets varying in LNAA concentrations. Forty-eight individually housed barrows at 6 wk of age were randomly allotted to 4 dietary treatments based on a 2 × 2 factorial arrangement, with L-Trp supplementation (0 or 0.6%) and LNAA concentrations (4.5 or 3.8%) as the 2 main factors. Pigs were fed the diets for 7 d. On d 4, pigs within a treatment were paired in a new pen to create social-mixing stress and behavior was recorded for 24 h. Body weight was measured on d 0, 4, 5, and 7. Saliva and blood were collected on d 4 and 7. On d 7, pigs were killed to obtain hypothalami. During the entire period excluding the mixing day (d 5), L-Trp supplementation improved (P < 0.01) feed efficiency of pigs and lowering the LNAA further enhanced (P < 0.05) the effects of L-Trp. Supplementation of 0.6% L-Trp increased (P < 0.001) hypothalamic 5-HT and 5-hydroxyindoleacetic acid. The salivary cortisol concentration was reduced (P < 0.05) by lowering the LNAA. Collectively, lowering the LNAA further enhanced the improvement of feed efficiency by L-Trp supplementation of nursery pigs under social-mixing stress in association with reduced stress hormones, indicating that reducing LNAA in the diet can facilitate the effect of L-Trp on the stress response of pigs.

Physiological Effects of Deoxynivalenol from Naturally Contaminated Corn on Cerebral Tryptophan Metabolism, Behavioral Response, Gastrointestinal Immune Status and Health in Pigs Following a Pair-Feeding Model.

This study investigated the impact of deoxynivalenol (DON) from naturally contaminated feed on pig growth, immune status, organ health, brain serotonin (5-Hydroxytryptamine, 5-HT) and behavior. Sixteen individually housed pigs (25.57 ± 0.98 kg, age 9 weeks) were randomly allotted to two dietary treatments: without DON (CON) or with 3.8 mg/kg of DON (MT). Pigs were pair-fed to eliminate differences in feed intake (equal tryptophan (Trp) intake). Pigs fed CON received a daily ration based on the ad libitum feed consumption of their MT pair-mate. Performance was determined over 21 days and blood collected for immunological and oxidative stress parameters. Behavior was recorded for 12 h on days 0, 7, 14 and 21. After 21 days, pigs were euthanized to collect tissues for immune parameters, gut morphology and brain serotonin levels. Overall, pigs fed MT had greater weight gain compared with CON. Immunological and oxidative stress parameters were unaffected, but pigs fed MT had reduced villus height, crypt depth and villus-to-crypt ratio in the jejunum. Pigs consuming MT had reduced concentration of 5-HT and increased 5-HT turnover in the hypothalamus. Mycotoxin-fed pigs spent more time lying and sitting, and less time standing and drinking. In conclusion, consumption of DON impacted gastrointestinal tract structure, altered behavior and changed Trp metabolism through increasing 5-HT turnover in hypothalamus.

Improving efficiency of sow productivity: nutrition and health.

This reviews research focused to understand the nutrient requirement and balance to meet the needs of fetal growth, mammary growth, and milk production. This summary will handle how feeding strategies can be adjusted according to the nutrient needs for a sow to enhance productivity and health. Most research data used in this summary are based on the studies conducted by the authors between 1996 and 2013. Nutrient requirements of sows are affected by stage of gestation and parity of sows. Dietary antioxidant concentrations need to be re-evaluated for its sufficiency in sow diets especially to prevent excessive oxidative stress during late gestation and lactation. When feeding sows, consideration of phase feeding of gestating sows and parity feeding of lactating sows could enhances production longevity and health of sows. Use of selected nutrients and additives seems to help productivity and health of sows.