Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the t...Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the type of fluid are conflicting and generally come from small single-center randomized controlled trials(RCTs).We therefore conducted a systematic review and meta-analysis to compare the effect of balanced solutions(BS)versus NS on patient-centered clinical outcomes in AP.Methods:From four databases searched up to October 2024,we included only RCTs of adult patients with AP that compared the use of BS(including LR,acetate Ringer’s,etc.)with NS.The primary out-come was the disease advances from AP to moderately severe and severe AP(MSAP/SAP).Trial sequential analyses(TSA)were conducted to control for type-I and type-II errors and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)was used to assess the quality of evidence.Results:Six RCTs were identified and included,involving 260 patients treated with BS and 298 patients with NS.Patients who received the BS had less MSAP/SAP[odds ratio(OR)=0.50,95%confidence in-terval(CI):0.29 to 0.85,P=0.01,I^(2)=0%;5 studies,299 patients],reduced the need of ICU admission(OR=0.60,95%CI:0.39 to 0.93,P=0.02,I^(2)=0%;5 studies,507 patients)and shorter length of hospital stay[mean difference(MD)=-0.88,95%CI:-1.48 to-0.28,P=0.004,I^(2)=0%;6 studies,558 patients;confirmed by TSA with high certainty]compared with those who received NS.The evidence for most of the clinical outcomes was rated as moderate to low due to the risk of bias,imprecision and inconsistency.Conclusions:BS,compared with NS,was associated with improved clinical outcomes in patients with AP.However,given the moderate to low quality of evidence for most of the outcomes assessed,further trials are warranted.展开更多
Background:Infected pancreatic necrosis(IPN)is a highly morbid local complication following necrotizing pancreatitis.Early enteral nutrition has been proven to be effective in preventing IPN.This study aimed to assess...Background:Infected pancreatic necrosis(IPN)is a highly morbid local complication following necrotizing pancreatitis.Early enteral nutrition has been proven to be effective in preventing IPN.This study aimed to assess the association between the trajectory of prealbumin(PAB)during the early phase of acute pancreatitis(AP)and the incidence of IPN and other clinical outcomes.Methods:This retrospective,dual-centered study screened patients with AP admitted to the Center of Acute Pancreatitis,Jinling Hospital and the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022.The PAB levels during the first week after admission were collected.The primary outcome was the incidence of IPN within 90 days after AP onset.Group-based trajectory modelling was performed to describe the trajectory of PAB levels over time.A Cox proportional hazard model was used to facilitate the interpretation of the time-varying hazard ratio(HR)between PAB and outcomes.Fine-Gray sub-distribution hazard model was adopted for sensitivity analysis.Results:A total of 373 patients were included,of whom 82(22.0%)were diagnosed with IPN within 90 days.The trajectory model assigned 232 patients to the low-level PAB(L-PAB)group and 141 to the high-level PAB(H-PAB)group.The incidence of 90-day IPN in the L-PAB group was significantly higher than that in the H-PAB group(26.7%vs.14.2%,P=0.005).The multivariate Cox regression model showed that a high PAB trajectory was associated with a lower incidence of IPN(HR=0.52,95%CI:0.30-0.89;P=0.017)after adjustment for potential confounders.In the sensitivity analysis,taking death as a com-peting risk,high PAB trajectory remained significantly associated with a lower incidence of IPN in the Fine-Gray model(HR=0.55,95%CI:0.33-0.92;P=0.022).Conclusions:A high PAB trajectory within the first week of AP was significantly associated with a lower incidence of IPN within 90 days after AP onset.Dynamic monitoring of PAB levels in the early phase of AP may play an important role in stratifying patients at high risk of developing IPN.展开更多
Objective:This study tests whether long-term intake of Allium tuberosum(AT)can alleviate pulmonary inflammation in ovalbumin(OVA)-induced asthmatic mice and evaluates its effect on the intestinal microbiota and innate...Objective:This study tests whether long-term intake of Allium tuberosum(AT)can alleviate pulmonary inflammation in ovalbumin(OVA)-induced asthmatic mice and evaluates its effect on the intestinal microbiota and innate lymphoid cells(ILCs).Methods:BALB/c mice were divided into three groups:phosphate buffer saline,OVA and OVA+AT.The asthmatic murine model was established by sensitization and challenge of OVA in the OVA and OVA+AT groups.AT was given to the OVA+AT group by oral gavage from day 0 to day 27.On day 28,mice were sacrificed.Histopathological evaluation of lung tissue was performed using hematoxylin and eosin,and periodic acid-Schiff staining.The levels of IgE in serum,interleukin-5(IL-5)and IL-13 from bronchoalveolar lavage fluid(BALF)were measured by enzyme-linked immunosorbent assay.The ILCs from the lung and gut were detected by flow cytometry.16 S ribosomal DNA sequencing was used to analyze the differences in colon microbiota among treatment groups.Results:We found that long-term intake of AT decreased the number of inflammatory cells from BALF,reduced the levels of IL-5 and IL-13 in BALF,and IgE level in serum,and rescued pulmonary histopathology with less mucus secretion in asthmatic mice.16 S ribosomal DNA sequencing results showed that AT strongly affected the colonic bacteria community structure in asthmatic mice,although it had no significant effect on the abundance and diversity of the microbiota.Ruminococcaceae and Desulfovibrionaceae were identified as two biomarkers of the treatment effect of AT.Moreover,AT decreased the numbers of ILCs in both the lung and gut of asthmatic mice.Conclusion:The results indicate that AT inhibits pulmonary inflammation,possibly by impeding the activation of ILCs and adjusting the homeostasis of gut microbiota in asthmatic mice.展开更多
Bimetallic clusters have aroused tremendous interest because the property changes like structure,size,and composition have occurred.Herein,a structural search of the global minimum for anionic LiMg_(n)^(-)(n=2-11) clu...Bimetallic clusters have aroused tremendous interest because the property changes like structure,size,and composition have occurred.Herein,a structural search of the global minimum for anionic LiMg_(n)^(-)(n=2-11) clusters is performed using an efficient crystal structure analysis by particle swarm optimization(CALYPSO) structural searching program with subsequent density functional theory(DFT) calculations.A great variety of low energetic isomers are converged,and the most stable ones are confirmed by comparing their total energy of each size.It is found that the LiMg_(n)^(-)clusters are structurally consistent with corresponding Mg clusters anions except for LiMg_(5)^(-)and LiMg_(7)^(-).In all the doped clusters,the Li atom prefers to occupy the convex position.Simulated photoelectron spectra(PES),Infrared(IR),and Raman spectra of LiMg_(n)^(-)could be used as an essential evidence for identifying cluster structures experimentally in the future.Stability study reveals that a tower-like structure of LiMg_(9)^(-)has prominent stability and can be identified as a magic number cluster.The reason might be that there are both closed-shell 1S^(2)1P^(6)1D^(10)2S^(2) electronic configurations and stronger Li-Mg bonds caused by sp hybridization in the LiMg_(9)^(-)cluster.展开更多
文摘Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the type of fluid are conflicting and generally come from small single-center randomized controlled trials(RCTs).We therefore conducted a systematic review and meta-analysis to compare the effect of balanced solutions(BS)versus NS on patient-centered clinical outcomes in AP.Methods:From four databases searched up to October 2024,we included only RCTs of adult patients with AP that compared the use of BS(including LR,acetate Ringer’s,etc.)with NS.The primary out-come was the disease advances from AP to moderately severe and severe AP(MSAP/SAP).Trial sequential analyses(TSA)were conducted to control for type-I and type-II errors and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)was used to assess the quality of evidence.Results:Six RCTs were identified and included,involving 260 patients treated with BS and 298 patients with NS.Patients who received the BS had less MSAP/SAP[odds ratio(OR)=0.50,95%confidence in-terval(CI):0.29 to 0.85,P=0.01,I^(2)=0%;5 studies,299 patients],reduced the need of ICU admission(OR=0.60,95%CI:0.39 to 0.93,P=0.02,I^(2)=0%;5 studies,507 patients)and shorter length of hospital stay[mean difference(MD)=-0.88,95%CI:-1.48 to-0.28,P=0.004,I^(2)=0%;6 studies,558 patients;confirmed by TSA with high certainty]compared with those who received NS.The evidence for most of the clinical outcomes was rated as moderate to low due to the risk of bias,imprecision and inconsistency.Conclusions:BS,compared with NS,was associated with improved clinical outcomes in patients with AP.However,given the moderate to low quality of evidence for most of the outcomes assessed,further trials are warranted.
基金supported by a grant from the National Natural Science Foundation of China(82470680).
文摘Background:Infected pancreatic necrosis(IPN)is a highly morbid local complication following necrotizing pancreatitis.Early enteral nutrition has been proven to be effective in preventing IPN.This study aimed to assess the association between the trajectory of prealbumin(PAB)during the early phase of acute pancreatitis(AP)and the incidence of IPN and other clinical outcomes.Methods:This retrospective,dual-centered study screened patients with AP admitted to the Center of Acute Pancreatitis,Jinling Hospital and the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022.The PAB levels during the first week after admission were collected.The primary outcome was the incidence of IPN within 90 days after AP onset.Group-based trajectory modelling was performed to describe the trajectory of PAB levels over time.A Cox proportional hazard model was used to facilitate the interpretation of the time-varying hazard ratio(HR)between PAB and outcomes.Fine-Gray sub-distribution hazard model was adopted for sensitivity analysis.Results:A total of 373 patients were included,of whom 82(22.0%)were diagnosed with IPN within 90 days.The trajectory model assigned 232 patients to the low-level PAB(L-PAB)group and 141 to the high-level PAB(H-PAB)group.The incidence of 90-day IPN in the L-PAB group was significantly higher than that in the H-PAB group(26.7%vs.14.2%,P=0.005).The multivariate Cox regression model showed that a high PAB trajectory was associated with a lower incidence of IPN(HR=0.52,95%CI:0.30-0.89;P=0.017)after adjustment for potential confounders.In the sensitivity analysis,taking death as a com-peting risk,high PAB trajectory remained significantly associated with a lower incidence of IPN in the Fine-Gray model(HR=0.55,95%CI:0.33-0.92;P=0.022).Conclusions:A high PAB trajectory within the first week of AP was significantly associated with a lower incidence of IPN within 90 days after AP onset.Dynamic monitoring of PAB levels in the early phase of AP may play an important role in stratifying patients at high risk of developing IPN.
基金supported by the National Natural Science Foundation of China(No.81473656)Fundamental Research Funds for Central Universities(No.2019-JYB-TD014)。
文摘Objective:This study tests whether long-term intake of Allium tuberosum(AT)can alleviate pulmonary inflammation in ovalbumin(OVA)-induced asthmatic mice and evaluates its effect on the intestinal microbiota and innate lymphoid cells(ILCs).Methods:BALB/c mice were divided into three groups:phosphate buffer saline,OVA and OVA+AT.The asthmatic murine model was established by sensitization and challenge of OVA in the OVA and OVA+AT groups.AT was given to the OVA+AT group by oral gavage from day 0 to day 27.On day 28,mice were sacrificed.Histopathological evaluation of lung tissue was performed using hematoxylin and eosin,and periodic acid-Schiff staining.The levels of IgE in serum,interleukin-5(IL-5)and IL-13 from bronchoalveolar lavage fluid(BALF)were measured by enzyme-linked immunosorbent assay.The ILCs from the lung and gut were detected by flow cytometry.16 S ribosomal DNA sequencing was used to analyze the differences in colon microbiota among treatment groups.Results:We found that long-term intake of AT decreased the number of inflammatory cells from BALF,reduced the levels of IL-5 and IL-13 in BALF,and IgE level in serum,and rescued pulmonary histopathology with less mucus secretion in asthmatic mice.16 S ribosomal DNA sequencing results showed that AT strongly affected the colonic bacteria community structure in asthmatic mice,although it had no significant effect on the abundance and diversity of the microbiota.Ruminococcaceae and Desulfovibrionaceae were identified as two biomarkers of the treatment effect of AT.Moreover,AT decreased the numbers of ILCs in both the lung and gut of asthmatic mice.Conclusion:The results indicate that AT inhibits pulmonary inflammation,possibly by impeding the activation of ILCs and adjusting the homeostasis of gut microbiota in asthmatic mice.
基金Project supported by the National Natural Science Foundation of China(Grant No.11404008)the Innovation Training Program for College Students of Shanxi Province of China(Grant No.S201910721061)the Innovation Training Program for College Students of Baoji University of Arts and Sciences(Grant No.20191XJ087)。
文摘Bimetallic clusters have aroused tremendous interest because the property changes like structure,size,and composition have occurred.Herein,a structural search of the global minimum for anionic LiMg_(n)^(-)(n=2-11) clusters is performed using an efficient crystal structure analysis by particle swarm optimization(CALYPSO) structural searching program with subsequent density functional theory(DFT) calculations.A great variety of low energetic isomers are converged,and the most stable ones are confirmed by comparing their total energy of each size.It is found that the LiMg_(n)^(-)clusters are structurally consistent with corresponding Mg clusters anions except for LiMg_(5)^(-)and LiMg_(7)^(-).In all the doped clusters,the Li atom prefers to occupy the convex position.Simulated photoelectron spectra(PES),Infrared(IR),and Raman spectra of LiMg_(n)^(-)could be used as an essential evidence for identifying cluster structures experimentally in the future.Stability study reveals that a tower-like structure of LiMg_(9)^(-)has prominent stability and can be identified as a magic number cluster.The reason might be that there are both closed-shell 1S^(2)1P^(6)1D^(10)2S^(2) electronic configurations and stronger Li-Mg bonds caused by sp hybridization in the LiMg_(9)^(-)cluster.
