The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients.

Background: Post-operative chylous leakage (CL) is the pathologic leakage of chylomicron fluid after surgery. This retrospective study was performed to evaluate a uniform oral nutrition management strategy on the post-operative CL. Methods: We retrospectively reviewed patients who developed post-operative CL and received consultation from a clinical nutritionist in seven departments of the Second Affiliated Hospital of Dalian Medical University from May 2020 to April 2022. We designed the oral nutrition intervention program which mainly standardized the type and amount of foods contained in the medium-chain triglyceride (MCT) diet. The influencing factors of curative efficacy were analyzed. Finally, binary logistic regression analysis was conducted to observe the relationship between curative efficacy and potentially predictive variables, including post-operative albumin, post-operative hemoglobin, surgical procedure, and drainage volume at consultation. Results: Sixty-three patients with post-operative CL were included in this analysis. Of this number, 58 patients were cured successfully without other treatments. Three patients had a significantly prolonged recovery period, and the remaining two cases were treated by reoperation therapy. The leakage volume at the initiation of enteral intervention had no statistically significant difference in seven surgical departments and surgical sites (left, right, median, and bilateral). The length of stay (LOS) of patients with CL after the intervention was not significantly increased in cardiac, hepatobiliary, gastrointestinal, and urological surgeries. Patients with CL had longer LOS than those without CL in gynecology (P=0.044) and thyroid surgery departments (P=0.008). Each unit increase in post-operative hemoglobin would increase the probability of an effective outcome by 8%, which was statistically significant (P = 0.037). Conclusion: In treating patients with post-operative CL, we recommend the MCT diet and EN as the first option, rather than fasting, parenteral nutrition (PN), or octreotide.

Effect of Deposition Temperature on Long-Term Residual Stress Evolution of Au Films.

To increase the residual stress stability of Au films while reducing the residual stress level, the effect of deposition temperature on long-term residual stress evolution of Au films under different conditions were studied. Au films with a thickness of 360 nm were deposited using e-beam evaporation on fused silica under different temperatures. Observations and comparisons were made of the microstructures of Au films deposited under different temperatures. Results showed that by increasing the deposition temperature, a more compact microstructure of Au film was obtained, which was manifested in increased grain size and reduced grain-boundary voids. After deposition, a combined process consisting of natural placement and 80 °C thermal holding was conducted on the Au films, and the residual stresses were monitored using the curvature-based technique. Results showed that the initial tensile residual stress of the as-deposited film decreased with the deposition temperature. The Au films with higher deposition temperatures showed better residual stress stability, maintaining low stress levels in the subsequent long-term combination of natural placement and thermal holding. The mechanism was discussed based on the differences in microstructure. Comparisons were made between post-deposition annealing and increased deposition temperature.

Electronic cigarette use among residents aged 15 years and older in Tongzhou District, Beijing Municipality / 预防医学

Objective @#To investigate the prevalence of electronic cigarette use among adult residents at ages of 15 years and older in Tongzhou District, Beijing Municipality, so as to provide insights into formulation of tobacco control interventions. @*Methods@#Permanent residents at ages of 15 years and older were sampled using a stratified multi-stage cluster random sampling method in Tongzhou District from September to October, 2021, and subjects' demographics, electronic cigarette use, and exposure to electronic cigarette advertising were investigated using the 2021 Questionnaire for Adult Tobacco Survey in Beijing. The awareness of electronic cigarette knowledge, prevalence of electronic cigarette use, route of acquiring electronic cigarette knowledge and route of exposure to electronic cigarette advertising were analyzed among residents in Tongzhou District, and factors affecting electronic cigarette uses were identified using a multivariable logistic regression model.@*Results@#A total of 1 196 questionnaires were allocated, and 1 166 valid questionnaires were recovered, with an effective recovery rate of 97.49%. The respondents included 532 men (45.63%) and 634 women (54.37%), with a mean age of (57.05±15.04) years. The awareness of electronic cigarette knowledge was 67.58%, and the prevalence of electronic cigarette uses and current electronic cigarette uses was 3.94% and 0.34%, respectively. Multivariable logistic regression analysis showed a higher possibility of electronic cigarette uses among men (OR=28.492, 95%CI: 6.873-118.106), residents at ages of 15 to 44 years (OR=3.219, 95%CI: 1.584-6.539), enterprise workers/businessmen/service industry workers (OR=3.599, 95%CI: 1.527-8.482), and public institution workers/public servants/students (OR=4.403, 95%CI: 1.758-11.026). The main route of acquiring electronic cigarettes was presented by others (43.48%), and the main cause of electronic cigarette use was quitting smoking (30.43%), followed by thinking little harmlessness of electronic cigarette use (26.09%), while the main route of exposure to electronic cigarette advertising was television (59.09%), followed by internet (45.45%). @*Conclusions@#There is a low prevalence rate of electronic cigarette uses among residents at ages of 15 years and older in Tongzhou District, and men and residents at ages of 15 to 44 years are main electronic cigarette users. Health education pertaining to the harmlessness of electronic cigarette uses and supervision of electronic cigarette advertising are required to be reinforced.

The Role of Hydrogen Sulfide in the Development and Progression of Lung Cancer.

Lung cancer is one of the 10 most common cancers in the world, which seriously affects the normal life and health of patients. According to the investigation report, the 3-year survival rate of patients with lung cancer is less than 20%. Heredity, the environment, and long-term smoking or secondhand smoke greatly promote the development and progress of the disease. The mechanisms of action of the occurrence and development of lung cancer have not been fully clarified. As a new type of gas signal molecule, hydrogen sulfide (H2S) has received great attention for its physiological and pathological roles in mammalian cells. It has been found that H2S is widely involved in the regulation of the respiratory system and digestive system, and plays an important role in the occurrence and development of lung cancer. H2S has the characteristics of dissolving in water and passing through the cell membrane, and is widely expressed in body tissues, which determines the possibility of its participation in the occurrence of lung cancer. Both endogenous and exogenous H2S may be involved in the inhibition of lung cancer cells by regulating mitochondrial energy metabolism, mitochondrial DNA integrity, and phosphoinositide 3-kinase/protein kinase B co-pathway hypoxia-inducible factor-1α (HIF-1α). This article reviews and discusses the molecular mechanism of H2S in the development of lung cancer, and provides novel insights for the prevention and targeted therapy of lung cancer.

Characteristics of Gastric Microbiota in GK Rats with Spontaneous Diabetes: A Comparative Study.

BACKGROUND: The Goto-Kakizaki (GK) rat, developed from repeated inbreeding of glucose-intolerant Wistar rats, has been widely used to explore the development of spontaneous type-2 diabetes mellitus (T2DM). However, the gastric microbiota of GK and Wistar rats are still unclear. This study aimed to understand the gastric microbiota characteristics of GK rats by comparing it with non-diabetic Wistar rats. MATERIALS AND METHODS: Male Wistar rats and GK rats were housed in specific pathogen-free (SPF) environment for 12 weeks with free access to sterilized food and water. Body weight and random blood glucose (BG) levels were determined. At the end of the experiment, the gastric contents of the rats were collected for the identification of gastric microbiota using 16S rRNA gene sequencing. RESULTS: The richness of gastric microbiota in GK rats was similar to that of Wistar rats (P > 0.05). The results of Shannon, Simpson, beta diversity indices, and ANOSIM analysis showed that alpha and beta diversity of gastric microbiota in GK rats were significantly lower than that of Wistar rats (P < 0.01). Firmicutes (96.0%), Proteobacteria (1.9%) and Cyanobacteria (0.8%) were the dominant gastric microbiota in GK rats accounting for 72.9%, 14.7% and 10.9%, respectively. Linear discriminant analysis effect size (LEfSe) revealed that phylum Firmicutes and four genera (Anaerovibrio, Collinsella, Prevotellaceae_UCG_001, and Lactobacillus) were significantly abundant in the stomachs of GK rats. In contrast, seven genera (unidentified_Chloroplast, Porphyromonas, Neisseria, Rubrobacter, Veillonella, Lachnospiraceae_UCG_005, and unidentified_Erysipelotrichaceae) were significantly abundant in the stomachs of Wistar rats. Blood glucose was positively correlated with Anaerobibrio and Lactobacillus, and negatively correlated with four genera (Porphyromonas, Rubrobacter, Lachnospiraceae_UCG_005, and unidentified_Erysipelotrichaceae). In addition, chemoheterotrophy and fermentation were the most important functions of gastric microbiota. CONCLUSION: The gastric microbiota of GK rats with spontaneous T2DM showed the typical characteristics of low diversity and significant enrichment of Firmicutes phylum and four genera (Anaerovibrio, Collinsella, Prevotellaceae_UCG_001, and Lactobacillus) compared with gastric microbiota of Wistar rats.

Probing Thermalization through Spectral Analysis with Matrix Product Operators.

We combine matrix product operator techniques with Chebyshev polynomial expansions and present a method that is able to explore spectral properties of quantum many-body Hamiltonians. In particular, we show how this method can be used to probe thermalization of large spin chains without explicitly simulating their time evolution, as well as to compute full and local densities of states. The performance is illustrated with the examples of the Ising and PXP spin chains. For the nonintegrable Ising chain, our findings corroborate the presence of thermalization for several initial states, well beyond what direct time-dependent simulations have been able to achieve so far.

Enteral nutrition provided within 48 hours after admission in severe acute pancreatitis: A systematic review and meta-analysis.

BACKGROUND: Whether to conduct enteral nutrition in patients with severe acute pancreatitis (SAP) during the active phase of intestinal stress or to feed during remission remains controversial. This study was aimed to evaluate the efficacy and safety of enteral nutrition within 48 hours after admission in the patients with SAP or predicted severe acute pancreatitis (pSAP). METHODS: We searched PubMed, EMBASE, Web of Science, and the Cochrane Library before December 2017. Randomized controlled trials of early enteral nutrition (starting within 48 hours after admission) versus late enteral nutrition or total parental nutrition in severe acute pancreatitis or predicted severe acute pancreatitis were selected. RESULTS: Ten randomized controlled trials containing 1051 patients were included. Comparing early enteral nutrition to late enteral nutrition or total parental nutrition in SAP or pSAP, the pooled risk ratios were 0.53 (95% confidence interval [CI] 0.35-0.81, P = .003) for mortality, 0.58 (95% CI 0.43-0.77, P = .0002) for multiple organ failure (MOF), 0.50 (95% CI 0.33-0.75, P = .0008) for operative intervention, 0.75 (95% CI 0.61-0.93, P = .009) for systemic infection, 0.42 (95% CI 0.26-0.69, P = .0005) for local septic complications, 0.84 (95% CI 0.74-0.96, P = .01) for gastrointestinal symptoms. 0.87 (95% CI 0.74-1.02, P = .08) for systemic inflammatory response syndrome (SIRS), and 1.24 (95% CI 0.66-2.31, P = .50) for other local complications. CONCLUSIONS: Enteral nutrition within 48 hours after admission is efficient and safe for the patients with SAP or pSAP.

Dai-Huang-Fu-Zi-Tang Alleviates Intestinal Injury Associated with Severe Acute Pancreatitis by Regulating Mitochondrial Permeability Transition Pore of Intestinal Mucosa Epithelial Cells.

OBJECTIVE: The aim of the present study was to examine whether Dai-Huang-Fu-Zi-Tang (DHFZT) could regulate mitochondrial permeability transition pore (MPTP) of intestinal mucosa epithelial cells for alleviating intestinal injury associated with severe acute pancreatitis (SAP). METHODS: A total of 72 Sprague-Dawley rats were randomly divided into 3 groups (sham group, SAP group, and DHFZT group, n = 24 per group). The rats in each group were divided into 4 subgroups (n = 6 per subgroup) accordingly at 1, 3, 6, and 12 h after the operation. The contents of serum amylase, D-lactic acid, diamine oxidase activity, and degree of MPTP were measured by dry chemical method and enzyme-linked immunosorbent assay. The change of mitochondria of intestinal epithelial cells was observed by transmission electron microscopy. RESULTS: The present study showed that DHFZT inhibited the openness of MPTP at 3, 6, and 12 h after the operation. Meanwhile, it reduced the contents of serum D-lactic acid and activity of diamine oxidase activity and also drastically relieved histopathological manifestations and epithelial cells injury of intestine. CONCLUSION: DHFZT alleviates intestinal injury associated SAP via reducing the openness of MPTP. In addition, DHFZT could also decrease the content of serum diamine oxidase activity and D-lactic acid after SAP.

Automatic characterization of classic choroidal neovascularization by using AdaBoost for supervised learning.

PURPOSE: To provide a computer-aided visualization tool for accurate diagnosis and quantification of choroidal neovascularization (CNV) on the basis of fluorescence leakage characteristics. METHODS: All image frames of a fluorescein angiography (FA) sequence are first aligned and mapped to a global space. To automatically determine the severity of each pixel in the global space and hence the extent of CNV, the system matches the intensity variation of each set of spatially corresponding pixels across the sequence with the targeted leakage pattern, learned from a sampled population graded by a retina specialist. The learning strategy, known as the AdaBoost algorithm, has 12 classifiers for 12 features that summarize the variation in fluorescence intensity over time. Given a new sequence, the severity map image is generated using the contribution scores of the 12 classifiers. Initialized with points of low and high severity, regions of CNV are delineated using the random walk algorithm. RESULTS: A dataset of 33 FA sequences of classic CNV showed the average accuracy of CNV delineation to be 83.26%. In addition, the 30- to 60-second interval provided the most reliable information for differentiating CNV from the background. Using eight sequences of multiple visits of four patients for evaluation of the postphotodynamic therapy (PDT), the statistics derived from the segmented regions correlate closely with the clinical observed changes. CONCLUSIONS: The clinician can easily visualize the temporal characteristics of CNV fluorescence leakage using the severity map, which is a two-dimensional summary of a complete FA sequence. The computer-aided tool allows objective evaluation and computation of statistical data from the automatic delineation for surgical assessment.