The aim of this study was to determine the efficacy of immunonutrition vs standard nutrition in cancer patients treated with surgery. Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, EBSCOhost, and Web of Science were searched. Sixty‐one randomized controlled trials were included. Immunonutrition was associated with a significantly reduced risk of postoperative infectious complications (risk ratio [RR] 0.71 [95% CI, 0.64–0.79]), including a reduced risk of wound infection (RR 0.72 [95% CI, 0.60–0.87]), respiratory tract infection (RR 0.70 [95% CI, 0.59–0.84]), and urinary tract infection (RR 0.69 [95% CI, 0.51–0.94]) as well as a decreased risk of anastomotic leakage (RR 0.70 [95% CI, 0.53–0.91]) and a reduced hospital stay (MD −2.12 days [95% CI −2.72 to −1.52]). No differences were found between the 2 groups with regard to sepsis or all‐cause mortality. Subgroup analyses revealed that receiving arginine + nucleotides + ω‐3 fatty acids and receiving enteral immunonutrition reduced the rates of wound infection and respiratory tract infection. The application of immunonutrition at 25–30 kcal/kg/d for 5–7 days reduced the rate of respiratory tract infection. Perioperative immunonutrition reduced the rate of wound infection. For malnourished patients, immunonutrition shortened the hospitalization time. Therefore, immunonutrition reduces postoperative infection complications and shortens hospital stays but does not reduce all‐cause mortality. Patients who are malnourished before surgery who receive arginine + nucleotides + ω‐3 fatty acids (25–30 kcal/kg/d) via the gastrointestinal tract during the perioperative period (5–7 days) may show better clinical efficacy.
BackgroundCatheter-related blood-stream infections (CRBSIs) are the most common complication when using central venous catheters (CVCs). Whether coating CVCs under bundles could further reduce the incidence of CRBSIs is unclear. We aimed to assess the effectiveness of implementing the use of bundles with antimicrobial-coated CVCs for preventing catheter-related blood-stream infections.MethodsIn this systematic review and network meta-analyses, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library in addition to the EMBASE, MEDLINE, CINAHL, and Web of Science databases for studies published before July 2017. The primary outcome was the rate of CRBSIs per 1000 catheter-days, and the secondary outcome was the incidence of catheter colonization.ResultsTwenty-three studies revealed significant differences in the rate of CRBSIs per 1000 catheter-days between antimicrobial-impregnated and standard CVCs (RR 0.70, 95% CI 0.53–0.91, p = 0.008). Thirty-three trials were included containing 10,464 patients who received one of four types of CVCs. Compared with a standard catheter, chlorhexidine/silver sulfadiazine- and antibiotic-coated catheters were associated with lower numbers of CRBSIs per 1000 catheter-days (ORs and 95% CrIs: 0.64 (0.40–0.955) and 0.53 (0.25–0.95), respectively) and a lower incidence of catheter colonization (ORs and 95% CrIs: 0.44 (0.34–0.56) and 0.30 (0.20–0.46), respectively).ConclusionsOutcomes are superior for catheters impregnated with chlorhexidine/silver sulfadiazine or other antibiotics than for standard catheters in preventing CRBSIs and catheter colonization under bundles. Compared with silver ion-impregnated CVCs, chlorhexidine/silver sulfadiazine antiseptic catheters resulted in fewer cases of microbial colonization of the catheter but did not reduce CRBSIs.Electronic supplementary materialThe online version of this article (10.1186/s13613-018-0416-4) contains supplementary material, which is available to authorized users.
With the trends of global warming, the extreme high temperature stress often happens during crop grain filling in the world. Heat stress has been an important factor limiting grain yield and quality. To determine the effects of heat stress on fresh kernel yield, quality and enzyme activities of sucrose metabolism, we carried out an experiment in artificial phytotron using two sweet corn cultivars (Xiatian 1 and Yuetian 16) with two typical temperature treatments (high temperature, HT and control, CK) during grain filling. The results indicated that the growth process of sweet corn was accelerated, but the weight and quality of kernel was decreased seriously under high temperature. The weight of 100-fresh-kernel and kernel water content were markedly reduced, but content of pericarp was increased. At the optimum harvest stage of fresh ear (with kernel water content 68%-74%), the fresh kernel weight of the two cultivars was reduced significantly by 20.8% (Xiatian 1) and 16.4% (Yuetian 16) under higher temperature respectively. The contents of soluble sugar and sucrose first increased and then decreased during the grain filling stage. High temperature was not favorable to sugar accumulation, resulting in sucrose content decrease and starch content increase. Sucrose phosphate synthetase (SPS) and sucrose synthetase (SS) play an important role in sucrose synthesis and degradation. SS catalyzes the interconversion of sucrose. Heat stress decreased the activities of SPS and SS (synthetic) and increased the activity of SS (cleavage), which inevitably leads to a depression in sucrose content and a reduction in kernel quality. The maximum SS (synthetic) activity in process of grain filling of two sweet corns appeared earlier under high temperature, while that of SPS activity appeared earlier in Xiatian 1 and did not in Yuetian 16.
There was insufficient evidence to definitively recommend the LAX, SAX, or OAX approach for patients undergoing ultrasound-guided vascular access cannulation.
Maize (Zea mays L.) contributes approximately 55% of China’s grain production. The effects of nitrogen (N) on maize grain morphology and starch granules remain elusive. In this study, a field experiment in clay loam soil was conducted using three maize hybrids (Suyu 30, Suyu 20, and Suyu 29) and four N levels (0, 360, 450, and 540 kg ha−1) in 2010 and 2012. The results indicated that increased grain length and width, starch granule number, surface area, and volume, was associated with the application of 450 kg ha−1 of N. Differences between superior (ear base) and inferior (apical) grains decreased under highest yield treatments. The effects of N levels on inferior grains was more than that on superior grains. The starch granules of superior grains showed more polygonal, and bigger shape than inferior grains. The results revealed that N levels affected size and morphology of starch granules and grains. The application of 450 kg N ha−1 resulted in larger-sized starch granules and less difference between superior and inferior grains.
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