A Three-Year Retrospective Analysis: Do Nutritional and Immunological Indices Predict Postoperative Complications After Rectal Resection?

Background Nutritional and immunological indices, such as prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have been used as predictors of outcomes and survival in a few cancers. However, the literature is unclear about their usefulness in predicting postoperative complications in rectal cancer resection operations. Additionally, the prescribed cut-off values as well as the timing of the tests for these indices vary among studies. We aimed to determine the role of PNI, NLR, and PLR in predicting postoperative complications in patients undergoing rectal resection. Methods This is a retrospective analysis from a colorectal unit of a tertiary care teaching hospital. All consecutive patients undergoing rectal resection for rectal cancer between April 2018 and March 2021 were included. PNI, NLR, and PLR were calculated from preoperative blood tests, and all morbidity and mortality within 30 days of operation were considered. Results A total of 202 patients were included. Three patients who did not have the necessary preoperative blood test reports were excluded. Of the remaining 199, 142 (71.4 %) were males. The mean age was 47.3 years. Of the patients, 13.6% (n = 27) had major morbidity (Clavien-Dindo grade 3-5), including one mortality. The mean PNI, NLR, and PLR were 49.9, 4.3, and 230.5, respectively. The mean PNI between the groups (no complication vs. complication) was 49.6 vs. 50.1 (p = 0.46) and the mean NLR between the same groups was 4.7 vs. 3.8, (p = 0.06), and both were not significant. The mean PLR between the groups (256.3 vs. 203.4, p = 0.01) was found to be significant but significance was not elicited when only major complications were considered. Hence, none of the indices were a good predictor of postoperative complications in our study. Conclusion The role of nutritional and immunological indices (PNI, NLR, and PLR) is limited in predicting postoperative morbidity in rectal resection operations.

Increased Effect of Foot-and-Mouth Disease Virus Vaccine Structural Protein Antibody Positivity Rates in Piglets Orally Treated with Amino-Zinc Complex.

Foot-and-mouth disease (FMD) is a highly contagious animal disease that occurs in cloven-hoofed animals including pigs. To prevent FMD, vaccines and adjuvants are routinely used to induce an immune response; however, it requires an extended period of time to produce sufficient antibodies to prevent viral infection. In this study, we evaluated the increased effectiveness of the FMD vaccine structural protein (SP) antibody by administrating the Amino-Zn adjuvant to 100 pigs from 3 test pig farms in their feed. The FMD vaccine antibody titer and immunological index were analyzed using an enzyme-linked immunosorbent assay (ELISA) kit, and the hematological and blood biochemical parameters were analyzed using an automatic blood analyzer. The titer of the FMD vaccine SP antibodies in the 0.2% Amino-Zn-administered group was significantly increased compared to that of the positive control group only injected with FMD vaccine at 4 weeks after the first vaccination and at 4, 8, and 16 weeks after the second vaccination (p < 0.05). The FMD vaccine SP antibody positive rate was 100% until shipment. The IFN-γ and IgA levels were significantly increased by Amino-Zn administration 4 weeks after the first vaccination and 4 weeks after the second vaccination (p < 0.05). On the other hand, serum AST, and CPK (p < 0.001) were significantly decreased by Amino-Zn administration. These results show that the administration of Amino-Zn is effective in enhancing the antibody titer and immunogenicity of the FMD vaccine and can be used as an oral adjuvant (OrAd) to prevent viral diseases, such as FMD.

Comparative study on the efficacy of transumbilical single port and three port laparoscopic cholecystectomy in the treatment of calculous cholecystitis / 国际外科学杂志

Objective:To explore the efficacy of transumbilical single-port and three-port laparoscopic cholecystectomy (LC) in the treatment of calculous cholecystitis and its influence on immunological indicators and recovery of gastrointestinal function.Methods:One hundred and twenty patients with calculous cholecystitis who were treated in Suzhou Municipal Hospital of Anhui Province from June 2018 to June 2020 were prospectively selected as the research subjects, and the patients were randomly divided into single-hole group and three-hole group by random number table method. Group of 60 cases. The single port group used the transumbilical single port method LC, and the three port group used the transumbilical three port method LC. Compare the 24-hour pain VAS scores and the use of analgesics of the two groups of patients; compare the surgical indicators of the two groups of patients; compare the immunological indicators of the two groups before and after treatment; compare the two groups of patients The recovery of gastrointestinal function after operation; the occurrence of postoperative complications between the two groups was compared.Results:There was no statistically significant difference in intraoperative blood loss, hospitalization expenses, preoperative IgG, IgA, IgM levels, and postoperative complications between the two groups of patients ( P>0.05). The two groups of patients had significantly lower levels of IgG, IgA, and IgM after treatment ( P<0.05). In the single hole group, the pain VAS score, the use rate of analgesics, the time of hospitalization, the time of anal exhaust, the time of bowel sound returning to normal and the time of defecation were (4.65±0.61) points, 11.67%(7/60), (2.52±0.47) d, (13.65±3.72) h, (11.64±3.25) h and (20.31±4.12) h, respectively. The three-hole group were (6.87±0.58) points, 23.33% (14/60), (4.58±0.37) d, (17.36±4.12) h, (15.47±4.12) h and (26.48±4.25) h, respectively. It was significantly lower in the single-hole group than in the three-hole group ( P<0.05). In the single hole group, the operation time, abdominal wall cosmetology score and the levels of IgG, IgA, IgM after treatment were (76.36±4.58) min, (4.72±0.13) points, (1 108.48±42.65) mg/dL, (208.12±10.86) mg/dL, (154.65±8.72) mg/dL, respectively. The three-hole group were (51.37±5.25) min, (3.25±0.35) mg/dL, (1 072.39±28.42) mg/dL, (193.08±10.35) mg/dL and (145.28±8.42) mg/dL, respectively, and those in the single-hole group were significantly higher than those in the three-hole group ( P<0.05). Conclusion:Under the premise of proficiency in surgical operation techniques, the single-port method reduces pain, reduces the use of analgesics, has less impact on immunological indicators, recovers gastrointestinal function faster, and has better postoperative abdominal wall cosmetic effects.

Effects of feeding diets with processed Moringa oleifera stem meal on growth and laying performance, and immunological and antioxidant activities in laying ducks.

This study was conducted to determine the effect of Moringa oleifera stem (MOS) meal in ducks. A total of 225 ducklings at 1 D of age were randomly assigned to 3 dietary treatment groups with 3 replicates of 25 each. The growth experiment lasted 63 D . The egg experiment started from 23 to 27 wk of age. Ducks were randomly divided into 3 treatment groups with 3 replications of 15 each. The following dietary treatments were applied: 1) Control (CON), basal diet + 0% MOS meal; 2) basal diet + 2% MOS meal; 3) basal diet + 4% MOS meal. During 0 to 4 wk of age, ducks fed 2% MOS diet showed significantly increase in average daily feed intake (ADFI) and average daily gain (ADG; P < 0.05) and ducks fed 4% MOS diet had a significant improvement in feed conversion rate (FCR; P < 0.05). However, ADFI, ADG, and FCR were not affected significantly during 5 to 9 wk of age (P > 0.05). In egg production experiment, ADFI, average egg weight, laying rate, and FCR showed significant increase in 4% MOS diets (P < 0.05). Laying ducks fed 4% MOS diet had a higher egg shape index, whereas a lower yolk color compared with CON (P < 0.05). The proportion of broken shell eggs were zero in experimental diets, whereas 3% of which occurred in CON (P < 0.05). However, no significant effects in proportion of soft shell eggs, proportion of abnormal-shape eggs, albumen height, haugh unit, and eggshell thickness were observed among all treatments (P > 0.05). For serum biochemical parameters, total protein and albumin were increased in MOS diets during 0 to 4 wk of age, but decreased during 5 to 9 wk of age. For serum antioxidant index, superoxide dismutase and glutathione peroxidase values were increased whereas malondialdehyde values were decreased in MOS diets from 0 to 9 wk of age. The results suggest that MOS positively affects early growth performance and laying performane of duckling but partially affects egg quality. The antioxidative activity and immunological index may be improved.

Evaluation of single and combined effects of cadmium and micro-plastic particles on biochemical and immunological parameters of common carp (Cyprinus carpio).

The growing accumulation of microplastics (MPs) in aquatic environments is a global concern. MPs are capable to interact with other environmental contaminants, including heavy metals, altering their toxicity. The aim of the study was to investigate the sub-lethal effects of cadmium chloride (Cd) alone and in combination with MPs on common carp (Cyprinus carpio). Multi-biomarkers, including plasma biochemical parameters and intrinsic immunological factors, were measured after 30 days of exposure. Exposure to Cd or NPs reduced the plasma activities of acetylcholinesterase (AChE) and gamma-glutamyl-transferase (GGT) and increased aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and alkaline phosphatase (ALP). Exposure to both compounds enhanced the observed effects except for AST activity and ALP at the highest concentrations, whereas evidenced an antagonistic interaction in ALT. Plasma total protein, albumin, and globulin levels were decreased, and the levels of glucose, triglyceride, and cholesterol levels increased mainly in the Cd groups with no additional effects derived from the co-exposure to both stressors. Lysozyme and alternative complement (ACH50) activities and the levels of total immunoglobulins, and complement C3 and C4 in fish exposed to Cd and MPs were lower than those in the control group and this decrease was more significant by the mixture of both compounds. These findings showed that the exposure to Cd or MPs alone is toxic to fish altering the biochemical and immunological parameters. Moreover, these alterations are even greater when the Cd and the MPS are combined suggesting synergistic effects in increasing Cd toxicity and vice versa.