ABSTRACT
FUT8, the sole glycosyltransferase responsible for N-glycan core fucosylation, plays a crucial role in tumorigenesis and development. Aberrant FUT8 expression disrupts the function of critical cellular components and triggers the abnormality of tumor signaling pathways, leading to malignant transformations such as proliferation, invasion, metastasis, and immunosuppression. The association between FUT8 and unfavorable outcomes in various tumors underscores its potential as a valuable diagnostic marker. Given the remarkable variation in biological functions and regulatory mechanisms of FUT8 across different tumor types, gaining a comprehensive understanding of its complexity is imperative. Here, we review how FUT8 plays roles in tumorigenesis and development, and how this outcome could be utilized to develop potential clinical therapies for tumors.
Subject(s)
Carcinogenesis , Cell Transformation, Neoplastic , Fucosyltransferases , Humans , Carcinogenesis/genetics , Cell Transformation, Neoplastic/genetics , Immunosuppression Therapy , Fucosyltransferases/geneticsABSTRACT
(1) Background: The best method to assess discretionary salt intake in population surveys has not been established. (2) Methods: This secondary analysis compared three different methods of measuring sodium intake from discretionary salt in a convenience sample of 109 adults in New Zealand. Participants replaced their household salt with lithium-tagged salt provided by researchers over eight days. Baseline 24 h urine was collected, and two further 24 h urine and 24 h dietary recalls were collected between days six and eight. Discretionary salt was estimated from the lithium-tagged salt, focused questions in the 24 h dietary recall, and the 'subtraction method' (a combination of 24 h urine and 24 h dietary recall measures). (3) Results: Around one-third of estimates from the 'subtraction method' were negative and therefore unrealistic. The mean difference between 24 h dietary recall and lithium-tagged salt estimates for sodium from discretionary salt mean were 457 mg sodium/day and 65 mg/day for mean and median, respectively. (4) Conclusions: It is possible to obtain a reasonable estimate of discretionary salt intake from careful questioning regarding salt used in cooking, in recipes, and at the table during a 24 h recall process to inform population salt reduction strategies.
Subject(s)
Sodium Chloride, Dietary , Sodium, Dietary , Adult , Humans , Sodium , Lithium , Sodium Chloride , Antimanic AgentsABSTRACT
BACKGROUND: The use of iodized salt is a key strategy to increase iodine intake worldwide. In many countries, including New Zealand, females of reproductive age are still at risk of being mildly iodine deficient. OBJECTIVE: This study aimed to determine the level of iodization of salt needed to ensure that females aged 18 to 40 y have an adequate intake of iodine in 2 scenarios: current discretionary salt intake and reduced discretionary salt intake. METHOD: Data from nonpregnant, nonlactating females aged 18 to 40 y (n = 795) who took part in the 2008/09 New Zealand Adult Nutrition Survey and completed a 24-h dietary recall were used. Iodine intake was determined from all foods except bread and discretionary salt, which are fortified with iodine. Iodine from bread and salt was estimated at different levels of salt iodization, starting at 25 mg iodine/kg salt and increasing incrementally by 5 mg/kg, and added to calculate total iodine intake. The simulation concluded when the appropriate iodine content in salt was found using the estimated average requirement (EAR) cut-point method. RESULTS: In the 2 scenarios, current discretionary salt intake (i.e., 400 mg/d) and reduced discretionary salt intake (i.e., 304 mg/d), the iodine concentration of salt is required to be 55 mg/kg and 70 mg/kg for no more than 2% of females to have an iodine intake below the EAR of 100 µg of iodine/d, respectively. In both scenarios and at all levels of iodine concentration, no one was above the upper level of intake of iodine of 1100 µg/d. CONCLUSIONS: This study found that females of reproductive age need to consume iodized salt at the higher end of the legislated range of 25 to 65 mg/kg. If strategies to reduce sodium intake were adopted, the range would need to increase, or iodized salt would need to be included in a wider range of staple foods.
Subject(s)
Iodine , Sodium Chloride, Dietary , Humans , Female , Diet , SodiumABSTRACT
Existing fault prediction algorithms based on deep learning have achieved good prediction performance. These algorithms treat all features fairly and assume that the progression of the equipment faults is stationary throughout the entire lifecycle. In fact, each feature has a different contribution to the accuracy of fault prediction, and the progress of equipment faults is non-stationary. More specifically, capturing the time point at which a fault first appears is more important for improving the accuracy of fault prediction. Moreover, the progress of the different faults of equipment varies significantly. Therefore, taking feature differences and time information into consideration, we propose a Causal-Factors-Aware Attention Network, CaFANet, for equipment fault prediction in the Internet of Things. Experimental results and performance analysis confirm the superiority of the proposed algorithm over traditional machine learning methods with prediction accuracy improved by up to 15.3%.
ABSTRACT
To clarify the structural characteristics, phylogeny, biological function and regulation of 4-coumarate-CoAligase (4CL) in anthocyanin synthesis, the 4CL gene family members in apples were identified and bioinformatic analysis was performed. qRT-PCR was used to analyze the expression levels of this gene family members in different apple varieties, and the role of the 4CL gene in apple anthocyanin synthesis was preliminaries clarified, which provided a certain theoretical basis for the regulatory network of apple anthocyanin synthesis. The results showed that a total of 69 members of the 4CL gene family were identified in the apple (Malus domestica Brokh.), encoding amino acids ranging from 97 to 2310 with theoretical isoelectric points ranging from 5.28 to 9.84. The 69 4CL family members were distributed on 17 chromosomes in the apple, among which chromosome 17 had the largest distribution (9 members), followed by chromosome 9 (7 members), chromosomes 16 and 14 (6 members each), and chromosomes 15 and 13 (5 members each). The subcellular localization prediction showed that apple 4CL gene family members were mainly expressed in cytoplasm, chloroplast, nucleus and cell membrane, with a small amount of expression in mitochondria, vacuoles, peroxisomes, cytoskeleton, golgi and cell matrix, but not in endoplasmic reticulum. The secondary structures are mainly α-helices and irregular coils. Microarray expression profile analysis showed that the expression levels of each member in apple were related to fruit variety and tissue structure, and the expression levels were mainly higher in fruit, flower and leaf. Real-time PCR analysis showed that the expression level of each member was directly proportional to the degree of fruit coloring and anthocyanin accumulation. The expression levels of Md4CL10 and Md4CL23 in 'Astar' (G4) apple fruit skin with the highest anthocyanin content were 516, 20 and 2 times higher than those in 'Chengji NO.1' (G1), 'Golden Delicious' (G2) and 'Ruixue' (G3), respectively.
Subject(s)
Malus , Malus/genetics , Malus/metabolism , Anthocyanins , Fruit/genetics , Fruit/metabolism , Gene Expression , Genomics , Gene Expression Regulation, Plant , Plant Proteins/genetics , Plant Proteins/metabolismABSTRACT
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by oxidative stress that triggers motor neurons loss in the brain and spinal cord. However, the mechanisms underlying the exact role of oxidative stress in ALS-associated neural degeneration are not definitively established. Oxidative stress-generated phospholipid peroxides are known to have extensive physiological and pathological consequences to tissues. Here, we discovered that the deficiency of glutathione peroxidase 4 (GPX4), an essential antioxidant peroxidase, led to the accumulation of phospholipid peroxides and resulted in a loss of motor neurons in spinal cords of ALS mice. Mutant human SOD1G93A transgenic mice were intrathecally injected with neuron-targeted adeno-associated virus (AAV) expressing GPX4 (GPX4-AAV) or phospholipid peroxidation inhibitor, ferrostatin-1. The results showed that impaired motor performance and neural loss induced by SOD1G93A toxicity in the lumbar spine were substantially alleviated by ferrostatin-1 treatment and AAV-mediated GPX4 delivery. In addition, the denervation of neuron-muscle junction and spinal atrophy in ALS mice were rescued by neural GPX4 overexpression, suggesting that GPX4 is essential for the motor neural maintenance and function. In comparison, conditional knockdown of Gpx4 in the spinal cords of Gpx4fl/fl mice triggered an obvious increase of phospholipid peroxides and the occurrence of ALS-like motor phenotype. Altogether, our findings underscore the importance of GPX4 in maintaining phospholipid redox homeostasis in the spinal cord and presents GPX4 as an attractive therapeutic target for ALS treatment.
Subject(s)
Amyotrophic Lateral Sclerosis , Glutathione Peroxidase , Neurodegenerative Diseases , Phospholipids , Animals , Humans , Mice , Amyotrophic Lateral Sclerosis/genetics , Amyotrophic Lateral Sclerosis/metabolism , Amyotrophic Lateral Sclerosis/pathology , Glutathione Peroxidase/genetics , Glutathione Peroxidase/metabolism , Mice, Transgenic , Motor Neurons/metabolism , Motor Neurons/pathology , Neurodegenerative Diseases/genetics , Neurodegenerative Diseases/pathology , Peroxides , Superoxide Dismutase/genetics , Superoxide Dismutase/metabolism , Superoxide Dismutase-1/genetics , Superoxide Dismutase-1/metabolism , Phospholipids/metabolismABSTRACT
[Abstract] Oligodendroglial lineage cells (OLGs) are important cell reserves for myelination and remyelination. Recent studies of central nervous system (CNS) indicated that besides traditional CNS immune cells like microglia, primitive cells of oligodendroglial lineage, oligodendrocyte progenitor cells (OPCs) can also actively participate immune responses. Simulated by physiological or pathological factors, OPCs can express a series of receptors,signaling and/ or regulatory molecules et al, in this way,OPCs can play a critical role in both development and maintenance of the blood-cerebrospinal fluid barrier (BCB), and most essentially, in initial stage for recruitment of peripheral immune cells and initial immune activation. Besides, in neurological disorders, recent research has revealed that OPCs can transform to disease-specific cell states, characterized by activation of immune cell exclusive genes. These findings may provide the basis for a new insight into the therapeutic strategy of neuron disorders and neurovascular diseases by effectively regulating OPCs.
ABSTRACT
The timely detection of equipment failure can effectively avoid industrial safety accidents. The existing equipment fault diagnosis methods based on single-mode signal not only have low accuracy, but also have the inherent risk of being misled by signal noise. In this paper, we reveal the possibility of using multi-modal monitoring data to improve the accuracy of equipment fault prediction. The main challenge of multi-modal data fusion is how to effectively fuse multi-modal data to improve the accuracy of fault prediction. We propose a multi-modal learning framework for fusion of low-quality monitoring data and high-quality monitoring data. In essence, low-quality monitoring data are used as a compensation for high-quality monitoring data. Firstly, the low-quality monitoring data is optimized, and then the features are extracted. At the same time, the high-quality monitoring data is dealt with by a low complexity convolutional neural network. Moreover, the robustness of the multi-modal learning algorithm is guaranteed by adding noise to the high-quality monitoring data. Finally, different dimensional features are projected into a common space to obtain accurate fault sample classification. Experimental results and performance analysis confirm the superiority of the proposed algorithm. Compared with the traditional feature concatenation method, the prediction accuracy of the proposed multi-modal learning algorithm can be improved by up to 7.42%.
Subject(s)
Internet of Things , Algorithms , Internet , Neural Networks, ComputerABSTRACT
In order to investigate the characteristics of typical pesticide residues in farmland soil of different plant types in Shaya County and to evaluate the level of human health risk and ecological risk caused by pesticide residues, a total of 55 samples of plants, soil, and water from nine areas of Shaya county were collected on September 29, 2020. The occurrence levels of 47 typical pesticides in the samples were analyzed using gas chromatography-mass spectrometry (GC-MS). The results showed that a total of 23 pesticides were detected in three environmental media, and the maximum concentrations of pesticides in soil, plants, and water were 70.58 µg·kg-1, 1832.18 µg·kg-1, and 188.53 µg·L-1, respectively. The levels of pesticide residues in the three environmental media in Shaya county were characterized as plants>water>soil. From the detection of pesticides in different plant types, P1, P2, P6, and P8 in the center of the county were the most seriously polluted. The plants with a high pesticide load level in the corresponding areas were cotton, walnut, red jujube, and poplar, and the pesticides with a high concentration contribution were hexachlorocyclohexanes, chlorpyrifos, cyhalothrin, fluvalinate, metalaxyl, difenoconazole, and procymidone. The human health risks of adults and children caused by oral intake, skin contact, and respiratory inhalation were evaluated. The results showed that oral intake was the main exposure route, and the risk level of children was significantly higher than that of adults but was within the acceptable range. The ecological risk level of earthworms in soil was subsequently evaluated. The results showed that the potential ecological risk level of a single pesticide was low, and the potential ecological risk level of bifenthrin was the largest. The calculation of the total ecological risk of mixed pesticides showed that areas P1, P4, P7, and P9 were at moderate risk, whereas other areas were at low risk. Therefore, the use of some pesticides in Shaya County should be restricted.
Subject(s)
Pesticide Residues , Pesticides , Child , Farms , Humans , Pesticide Residues/analysis , Pesticides/analysis , Risk Assessment , Soil/chemistry , Water/analysisABSTRACT
BACKGROUND: In recent decades, the incidence of early-onset colorectal cancer (EOCRC) has reportedly increased in several developed countries, whereas that of late-onset colorectal cancer (LOCRC) has decreased continuously. The trends, clinicopathological features, surgical treatment patterns, and prognoses of EOCRC and LOCRC in China remain unclear. MATERIALS AND METHODS: This retrospective cohort study was performed in China using data from our pathology registry collected in 2000-2021. Pathologically confirmed cases of colorectal cancer (CRC) were analyzed. The average annual percentage change (AAPC) was estimated to quantify the secular trends. Clinicopathological features, surgical treatment patterns, and prognoses were compared between the two groups. Multivariate Cox regression analyses were performed for disease-free survival and overall survival. RESULTS: A total of 34,067 cases of CRC were included, with 6,369 cases of EOCRC and 27,698 cases of LOCRC. Overall, the numbers of EOCRC (AAPC = 8.4%), LOCRC (AAPC = 11.6%), and CRC (AAPC = 11.0%) cases increased significantly from 2000 to 2021. Compared to the LOCRC group, the EOCRC group had fewer men, comorbidities, concomitant cancers, polyps, and KRAS mutations; more symptoms, rectal cancers, multiple primary CRCs, deficient mismatch repair tumors, poorly differentiated, mucinous adenocarcinoma or signet ring cell carcinoma, advanced TNM stage, vascular invasion, perineural invasion; less laparoscopic surgery and sphincter-preserving surgery; more extended radical resection, perioperative chemoradiotherapy and targeted therapy; and similar disease-free and overall survival rates. CONCLUSION: The numbers of EOCRC and LOCRC cases have continuously increased over the last two decades. The EOCRC group has more aggressive features, advanced TNM stage, intensified surgical treatment and perioperative treatment than the LOCRC group, but similar disease-free and overall survival rates. More CRC screening programs are recommended for younger adults to combat the rapidly increasing trend of EOCRC.
Subject(s)
Colorectal Neoplasms , Adult , DNA Mismatch Repair , Early Detection of Cancer , Humans , Male , Prognosis , Retrospective StudiesABSTRACT
The World Hypertension League Science of Salt health outcomes review series highlights high-quality publications relating to salt intake and health outcomes. This review uses a standardised method, outlined in previous reviews and based on methods developed by WHO, to identify and critically appraise published articles on dietary salt intake and health outcomes. We identified 41 articles published between September 2019 to December 2020. Amongst these, two studies met the pre-specified methodological quality criteria for critical appraisal. They were prospective cohort studies and examined physical performance and composite renal outcomes as health outcomes. Both found an association between increased/higher sodium intake and poorer health outcomes. Few studies meet criteria for high-quality methods. This review adds further evidence that dietary salt reduction has health benefits and strengthens evidence relating to health outcomes other than blood pressure and cardiovascular disease. We observe that most studies on dietary sodium do not have adequate methodology to reliably assess sodium intake and its association with health outcomes.
Subject(s)
Hypertension , Sodium, Dietary , Humans , Blood Pressure/physiology , Hypertension/diagnosis , Hypertension/epidemiology , Hypertension/prevention & control , Outcome Assessment, Health Care , Prospective Studies , Sodium Chloride , Sodium Chloride, Dietary/adverse effectsABSTRACT
Parabens are widely used as preservatives, which have been found to affect thyroid function in toxicological studies. However, population studies on whether they are associated with thyroid tumors remain unclear. This study aims to investigate the relationship between environmental paraben exposure and thyroid cancer and benign nodules. We recruited participants from the Department of Thyroid and Breast Surgery at Wuhan Central Hospital, Wuhan, China. The detectable percentages of methyl paraben, ethyl paraben, and propyl paraben in the urinary samples of 425 study subjects were 99.1%, 95.3%, and 92.0%, respectively. All uncorrected and creatinine-corrected parabens were moderately correlated with one another. After adjusting for possible confounders, all three parabens were associated with an increased risk of thyroid cancer. Furthermore, the mixture pollutant analysis of parabens found positive associations with risk of thyroid cancer (OR = 0.24, 95% CI: 0.18, 0.31) and benign nodules (OR = 1.33, 95% CI: 0.86, 1.80). We observed that individual exposure to paraben mixtures may be associated with the risk of thyroid cancer and benign nodules.
Subject(s)
Environmental Pollutants , Thyroid Neoplasms , Adult , Creatinine/analysis , Environmental Exposure/analysis , Environmental Pollutants/analysis , Humans , Parabens/analysis , Thyroid Neoplasms/chemically induced , Thyroid Neoplasms/epidemiologyABSTRACT
Improving productivity to reduce the cost of biologics manufacturing and ensure that therapeutics can reach more patients remains a major challenge faced by the biopharmaceutical industry. Chinese hamster ovary (CHO) cell lines are commonly prepared for biomanufacturing by single cell cloning post-transfection and recovery, followed by lead clone screening, generation of a research cell bank (RCB), cell culture process development, and manufacturing of a master cell bank (MCB) to be used in early phase clinical manufacturing. In this study, it was found that an additional round of cloning and clone selection from an established monoclonal RCB or MCB (i.e., re-cloning) significantly improved titer for multiple late phase monoclonal antibody upstream processes. Quality attributes remained comparable between the processes using the parental clones and the re-clones. For two CHO cells expressing different antibodies, the re-clone performance was successfully scaled up at 500-L or at 2000-L bioreactor scales, demonstrating for the first time that the re-clone is suitable for late phase and commercial manufacturing processes for improvement of titer while maintaining comparable product quality to the early phase process.
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Purpose: The incidence of early-onset rectal cancer (EORC) has been increasing since the past decade, while its underlying cause remained unknown. This study was aimed at clarifying the relationship between perirectal fat area (PFA) and EORC. Patients and Methods. All patients with rectal cancer who received radical excision between January 2016 and December 2017 at our hospital were included. The fat series images of pelvic magnetic resonance imaging scans were obtained and PFA at the ischial spine level was calculated using the ImageJ software. Results: A total of 303 patients were finally included and divided into two groups according to the median PFA: Group 1 (<20.2 cm2, n = 151) and Group 2 (≥20.2 cm2, n = 152). PFA positively correlated with body weight and body mass index. PFA increased with invasion depth, lymph node metastasis, TNM stage, tumor deposits, and vascular invasion. Patients with EORC had higher PFA than those with late-onset rectal cancer (LORC; P = 0.009). Among patients with stage I-III rectal cancers, those in Group 2 had significantly shorter disease-free survival (P = 0.010) and overall survival (P = 0.034) than those in Group 1, and PFA was an independent predictor of disease-free survival (OR: 1.683 [1.126-3.015], P = 0.035) and overall survival (OR: 1.678 [1.022-2.639], P = 0.046). Conclusions: Patients with EORC had significantly higher PFA than those with LORC. PFA is positively correlated with T stage, N stage, TNM stage, tumor deposit, and vascular invasion and is an independent predictor of disease-free survival and overall survival. Therefore, perirectal fat may be involved in the carcinogenesis and development of EORC.
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PURPOSE: To simulate the potential impact of the HeartSAFE 2020 programme, a food reformulation initiative by the New Zealand (NZ) Heart Foundation, on sodium intake in the NZ adult population. METHODS: A representative sample of NZ adults aged 15 years and older completed a 24-h diet recall survey, with 25% of participants completing a second diet recall, in the 2008/09 New Zealand Adult Nutrition Survey (n = 4721). These data were used to estimate sodium intakes of participants. The effect of altering the sodium content of 840 foods in 17 categories and 35 sub-categories included in the NZ HeartSAFE 2020 programme was simulated. The simulated sodium intake reductions in each food sub-category for the entire sample were calculated. Using sampling weights, simulated reductions in population sodium intake and by sociodemographic subgroups were also analysed. RESULTS: Sodium intake from foods included in the HeartSAFE 2020 programme was 1307 mg/day (95% CI 1279, 1336) at baseline. After applying the HeartSAFE 2020 targets, potential sodium intake was 1048 mg/day (95% CI 1024, 1027). The absolute sodium reduction was 260 mg/day (95% CI 252, 268), corresponding to 20% sodium reduction for the foods included in the NZ HeartSAFE programme. CONCLUSION: Current sodium targets featured in the NZ HeartSAFE programme will not meet the 30% sodium intake reduction set out by the WHO Global Action Plan. A more comprehensive strategy consistent with the WHO SHAKE Technical Package is needed to advance the goal of sodium intake reduction.
Subject(s)
Sodium, Dietary , Sodium , Adult , Diet , Goals , Humans , New Zealand , World Health OrganizationABSTRACT
Earlier studies have suggested that exposure to phthalates (PAEs) may induce spermatozoa apoptosis. Sperm protamine as a molecular biomarker during spermatozoa apoptotic processes may mediate the association between PAE exposure and spermatozoa apoptosis. This study aimed to explore whether sperm protamine mediates the association of PAE exposure with spermatozoa apoptosis. We determined sperm protamine levels, 8 PAE metabolite concentrations in seminal plasma, and 3 spermatozoa apoptosis parameters among 111 men from an infertility clinic. The associations of PAEs as individual chemicals and mixtures with sperm protamine were determined. The mediating roles of protamine in the associations between PAEs and spermatozoa apoptosis parameters were examined by mediation analysis. After adjusting for confounders, we observed positive correlations between seminal plasma concentrations of mono(2-ethylhexyl) phthalate (MEHP) and sperm protamine-1 and protamine ratio. Estimates comparing highest vs. lowest quartiles of MEHP concentration were 4.65% (95% CI: 1.47%, 7.82%) for protamine-1 and 25.86% (95% CI: 3.05%, 53.73%) for protamine ratio. The quantile g-computation models showed that the adjusted protamine-1 per quartile increase in PAE mixture was 9.42% (95% CI: 1.00, 20.92) with MEHP being the major contributor. Although the joint association between PAE mixture and protamine ratio was negligible, MEHP was still identified as the main contributor. Furthermore, we found that protamine-2 and protamine ratio levels in the highest quartiles exhibited a decrease of 43.45% (95% CI: 60.54%, -19.75%) and an increase of 122.55% (95% CI: 60.00%, 209.57%) in Annexin V+/PI- spermatozoa relative to the lowest quartiles, respectively. Mediation analysis revealed that protamine ratio significantly mediated 55.6% of the association between MEHP and Annexin V+/PI- spermatozoa elevation (5.13%; 95% CI: 0.04%, 10.52%). Our findings provided evidence that human exposure to PAEs was associated with increased protamine levels which may mediate the process of spermatozoa apoptosis.
Subject(s)
Mediation Analysis , Phthalic Acids , Apoptosis , Humans , Male , Phthalic Acids/analysis , Protamines/metabolism , Spermatozoa/metabolismABSTRACT
Objective: To investigate the safety and efficacy of pelvic peritoneal reconstruction and its effect on anal function in laparoscopy-assisted anterior resection of low and middle rectal cancer. Methods: A prospective cohort study was conducted. Consecutive patients with low and middle rectal cancer who underwent laparoscopy-assisted transabdominal anterior resection at Naval Military Medical University Changhai Hospital from February 2020 to February 2021 were enrolled. Inclusion criteria: (1) the distance from tumor to the anal verge ≤10 cm; (2) laparoscopy-assisted transabdominal anterior resection of rectal cancer; (3) complete clinical data; (4) rectal adenocarcinoma diagnosed by postoperative pathology. Exclusion criteria: (1) emergency surgery; (2) patients with a history of anal dysfunction or anal surgery; (3) preoperative diagnosis of distant (liver, lung) metastasis; (4) intestinal obstruction; (5) conversion to open surgery for various reasons. The pelvic floor was reconstructed using SXMD1B405 (Stratafix helical PGA-PCL, Ethicon). The first needle was sutured from the left anterior wall of the neorectum to the right. Insertion of the needle was continued to suture the root of the sigmoid mesentery while the Hemo-lok was used to fix the suture. The second needle was started from the beginning of the first needle, after 3-4 needles, a drainage tube was inserted through the left lower abdominal trocar to the presacral space. Then, the left peritoneal incision of the descending colon was sutured, after which Hemo-lok fixation was performed. The operative time, perioperative complications, postoperative Wexner anal function score and low anterior resection syndrome (LARS) score were compared between the study group and the control group. Three to six months after the operation, pelvic MRI was performed to observe and compare the pelvic floor anatomical structure of the two groups. Results: A total of 230 patients were enrolled, including 58 who underwent pelvic floor peritoneum reconstruction as the study group and 172 who did not undergo pelvic floor peritoneum reconstruction as the control group. There were no significant differences in general data between the two groups (all P>0.05). The operation time of the study group was longer than that of control group [(177.5±33.0) minutes vs. (148.7±45.5) minutes, P<0.001]. There was no significant difference in the incidence of perioperative complications (including anastomotic leakage, anastomotic bleeding, postoperative pneumonia, urinary tract infection, deep vein thrombosis, and intestinal obstruction) between the two groups (all P>0.05). Eight cases had anastomotic leakage, of whom 2 cases (3.4%) in the study group were discharged after conservative treatment, 5 cases (2.9%) of other 6 cases (3.5%) in the control group were discharged after the secondary surgical treatment. The Wexner score and LARS score were 3.1±2.8 and 23.0 (16.0-28.0) in the study group, which were lower than those in the control group [4.7±3.4 and 27.0 (18.0-32.0)], and the differences were statistically significant (t=-3.018, P=0.003 and Z=-2.257, P=0.024). Severe LARS was 16.5% (7/45) in study group and 35.5% (50/141) in control group, and the difference was no significant differences (Z=4.373, P=0.373). Pelvic MRI examination 3 to 6 months after surgery showed that the incidence of intestinal accumulation in the pelvic floor was 9.1% (3/33) in study group and 46.4% (64/138) in control group (χ(2)=15.537, P<0.001). Conclusion: Pelvic peritoneal reconstruction using stratafix in laparoscopic anterior resection of middle and low rectal cancer is safe and feasible, which may reduce the probability of the secondary operation in patients with anastomotic leakage and significantly improve postoperative anal function.
Subject(s)
Humans , Anastomotic Leak/surgery , Intestinal Obstruction/surgery , Laparoscopy , Postoperative Complications/surgery , Prospective Studies , Rectal Diseases/surgery , Rectal Neoplasms/surgery , Retrospective Studies , Syndrome , Treatment OutcomeABSTRACT
Introduction: Discretionary salt (added in cooking at home or at the table) is a source of sodium and iodine in New Zealand. The amount of discretionary salt consumed in a population has implications on policies regarding sodium and iodine. Sodium intake from discretionary salt intake has not been quantified in New Zealand. The aim of this study was to estimate the proportion of total sodium that comes from discretionary salt in adults using the lithium-tagged salt method. Methods: A total of 116 healthy adults, who were not pregnant or breastfeeding, regularly consume home-cooked meals and use salt during cooking or at the table, aged 18-40 years from Dunedin, New Zealand were recruited into the study. The study took place over a 9-day period. On Day 1, participants were asked to collect a baseline 24-h urine to establish their normal lithium output. From Day 2 to Day 8, normal discretionary salt was replaced with lithium-tagged salt. Between Day 6 and Day 8, participants collected another two 24-h urine samples. A 24-h dietary recall was conducted to coincide with each of the final two 24-h urine collections. Urinary sodium was analysed by Ion-Selective Electrode and urinary lithium and urinary iodine were analysed using Inductively Coupled Plasma Mass Spectrometry. The 24-h dietary recall data was entered into Xyris FoodWorks 10. All statistical analysis were conducted using Stata 17.0. Results: A total of 109 participants with complete 24-h urine samples were included in the analysis. From the 24-h urine collections, the median urinary excretion of sodium and iodine was 3,222 mg/24 h (25th, 75th percentile: 2516, 3969) and 112 µg/24 h (82, 134). The median estimated sodium intake from discretionary salt was 13% (25th, 75th percentile: 7, 22) of the total sodium intake or 366 mg/24 h (25th, 75th percentile: 186, 705). Conclusion: The total sodium intake was higher than the suggested dietary target of 2,000 mg/day. In this sample of healthy adults 18 to 40 years old, 13% of total sodium intake derived from discretionary salt. Discretionary salt is an additional source of iodine if iodised salt is used. Policies to reduce sodium intake is recommended to include a range of strategies to target discretionary and non-discretionary sources of salt and will need to take into account the contribution of iodine from discretionary salt intake.