Constraints of digestion on swimming performance and stress tolerance vary with habitat in freshwater fish species.

Limited aerobic scope (AS) during digestion might be the main constraint on the performance of bodily functions in water-breathing animals. Thus, investigating the postprandial changes in various physiological functions and determining the existence of a shared common pattern because of possible dependence on residual AS during digestion in freshwater fish species are very important in conservation physiology. All species from slow-flow habitats showed impaired swimming speed while digesting, whereas all species from fast-flow habitats showed strong swimming performance, which was unchanged while digesting. Only two species from slow-flow habitats showed impaired heat tolerance during digestion, suggesting that whether oxygen limitation is involved in the heat tolerance process is species-specific. Three species from slow- or intermediate-flow habitats showed impaired hypoxia tolerance during digestion because feeding metabolism cannot cease completely under hypoxia. Overall, there was no common pattern in postprandial changes in different physiological functions because: (1) the digestion process was suppressed under oxygen-limiting conditions, (2) the residual AS decreased during digestion, and (3) performance was related to residual AS, while digestion was context-dependent and species-specific. However, digestion generally showed a stronger effect on bodily functions in species from slow-flow habitats, whereas it showed no impairment in fishes from fast-flow habitats. Nevertheless, the postprandial change in physiological functions varies with habitat, possibly due to divergent selective pressure on such functions. More importantly, the present study suggests that a precise prediction of how freshwater fish populations will respond to global climate change needs to incorporate data from postprandial fishes.

A Randomized Multicenter Clinical Trial of RPH With the Simplified Milligan-Morgan Hemorrhoidectomy in the Treatment of Mixed Hemorrhoids.

PURPOSE: To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids. METHODS: This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. RESULTS: The efficacy rate was the highest in patients who received RPH+sMMH and decreased in the following order: patients who received RPH alone, MMH alone, procedure for prolapse and hemorrhoids (PPH) alone, and PPH+sMMH ( P < .05). The operation time was the shortest in patients who received RPH alone and increased in the following order: patients who received RPH+sMMH, PPH alone, MMH alone, and PPH+sMMH ( P < .01). The duration of postoperative hospitalization stay was the shortest in patients who received RPH alone and increased in the following order: PPH alone, RPH+sMMH, PPH+sMMH, and MMH alone ( P < .01). The incidence of postoperative hemorrhage, uroschesis, anal fissure, crissum hematoma or thrombosis, and anorectal stenosis was significantly lower in patients who received RPH+sMMH than in patients who received the other 4 types of surgical treatments ( P < .05, P < .01). No significant differences in postoperative rectovaginal fistula and anal incontinence were observed between the 5 groups of patients. CONCLUSIONS: RPH with or without simplified MMH can reduce the incidence of postoperative complications and improve the curative efficacy in the treatment of patients with mixed hemorrhoids.

[Treatment of Mixed Hemorrhoids by RPH with the Simplified Milligan-Morgan Surgery: a Multi-center, Randomized, Controlled Clinical Trial].

Objective To observe the safety and efficacy of RPH with the simplified. Milligan-Mor- gan(M-M) surgery on mixed hemorrhoids. Methods Totally 1 200 patients with mixed hemorrhoid were assigned to the control group(600 cases) and the treatment group(600 cases) according to randomized, parallel controlled,multi-center trial design. Patients in the control group received PPH with the simplified M-M surgery, and patients in the treatment group received RPH with the simplified M-M surgery. Postop- erative complications, operation time,the postoperative hospitalization days and the efficacy were ob- served. Results Compared with the control group, the numbers of postoperation hemorrhage, postop- erative uroschesis, anal fissure and anorectal stenosis in treatment group were decreased(P <0. 01 , P < 0. 05), operation time and the postoperative hospitalization days were decreased (P <0. 01 , P <0. 05 ), the cure rate for 3 and 12 months after operation were increased (P <0. 01, P <0. 05). Conclusions RPH with the simplified M-M surgery could reduce the incidence of postoperative complications,improve the clinical cure rate and the curative effect in treatment of mixed hemorrhoids.