Metabolic disorders and immunosuppression exist in peripartal cows,and glutamine(GLN)has the potential efficacy to improve the negative energy balance(NEB)and the function of neutrophil(polymorphonuclear granulocyte,PMN)in peripartal cows.The aim of the present study was to investigate the effects of supplementation with rumen-protected GLN on the metabo-lism and the phagocytosis function of PMN in peripartal cows.Twenty Chinese Holstein cows with similar age,parity,body condition score and expected date of delivery were selected and divided into CON(n=10,fed basal diet)and GLN groups(n=10,supplemented with 180 g/d of rumen-protected GLN).During the test period of 42 d,blood samples were collected at-21,-14,-7,0,7,14 and 21 d.Milk production was recorded at 7,14 and 21 d,respectively.The results showed that:serum GLN concentrations in peripartal cows continued to decrease until they increased after 7 d postpartum,suggesting that peripartal cows may be in a state of GLN deficiency.The serum GLN content of the cows increased significantly(P＜0.05)from-7 to 21 d after GLN supple-mentation,indicating that supplementation was effective.The blood glucose concentration of peri-partal cows increased on the day of parturition but decreased postpartum,and the concentrations of non-esterified fatty acid(NEFA)and β-hydroxybutyrate(BHBA)in the blood increased postpar-tum,which indicated that peripartal cows had a physiological NEB.Blood glucose concentration in-creased significantly(P＜0.01)at-7,14 and 21 d after GLN supplementation,and blood concen-trations of NEFA and BHBA decreased significantly(P＜0.01)postpartum,suggesting that peri-partal cows had a NEB alleviated by GLN supplementation.Serum malondialdehyde(MDA)con-centration of periparturient cow peaked on the day of parturition but declined postpartum,and the concentration of MDA reached a peak on the day of delivery but declined postpartum,and the total antioxidant capacity(T-AOC)level continued to decline until it increased on the day of parturi-tion,indicating that peripartal cows were in a state of oxidative stress.Serum MDA concentration significantly decreased(P＜0.05)and serum T-AOC level significantly increased(P＜0.05)after GLN supplementation,indicating that antioxidant capacity of peripartal cows was improved by GLN supplementation.The concentration of serum pro-inflammatory factor IL-β peaked on the day of parturition and then decreased,the concentration of TNF-α peaked on the day of parturition and then decreased,and the concentration of anti-inflammatory factor IL-10 continued to decrease,which indicated that there was an inflammatory reaction in the cows during the periparturient peri-od.However,the levels of IL-1β on the day of delivery and postpartum decreased significantly(P＜0.01),the levels of TNF-α decreased(P＜0.05),and the levels of IL-10 increased significantly(P＜0.01)throughout the peripartum period,which indicated that GLN supplementation im-proved the anti-inflammatory ability of periparturient dairy cows.The phagocytosis function of PMN in peripartal cows was significantly reduced from-14 d to the day of parturition(P＜0.01),and the phagocytosis function of neutrophils was significantly enhanced after GLN supple-mentation at-14(P＜0.05),14 and 21 d(P＜0.01),which indicated that intrinsic immune func-tion of peripartal cows was enhanced by supplementation of GLN.GLN supplementation did not significantly affect milk production of cows at three weeks postpartum.In conclusion,supplemental rumen-protected GLN alleviated NEB,alleviated systemic oxidative stress and inflammatory re-sponse,and enhanced phagocytosis of PMN in peripartal cows,which has some potential for clini-cal application.

Metabolic disorders and immunosuppression exist in peripartal cows,and glutamine(GLN)has the potential efficacy to improve the negative energy balance(NEB)and the function of neutrophil(polymorphonuclear granulocyte,PMN)in peripartal cows.The aim of the present study was to investigate the effects of supplementation with rumen-protected GLN on the metabo-lism and the phagocytosis function of PMN in peripartal cows.Twenty Chinese Holstein cows with similar age,parity,body condition score and expected date of delivery were selected and divided into CON(n=10,fed basal diet)and GLN groups(n=10,supplemented with 180 g/d of rumen-protected GLN).During the test period of 42 d,blood samples were collected at-21,-14,-7,0,7,14 and 21 d.Milk production was recorded at 7,14 and 21 d,respectively.The results showed that:serum GLN concentrations in peripartal cows continued to decrease until they increased after 7 d postpartum,suggesting that peripartal cows may be in a state of GLN deficiency.The serum GLN content of the cows increased significantly(P＜0.05)from-7 to 21 d after GLN supple-mentation,indicating that supplementation was effective.The blood glucose concentration of peri-partal cows increased on the day of parturition but decreased postpartum,and the concentrations of non-esterified fatty acid(NEFA)and β-hydroxybutyrate(BHBA)in the blood increased postpar-tum,which indicated that peripartal cows had a physiological NEB.Blood glucose concentration in-creased significantly(P＜0.01)at-7,14 and 21 d after GLN supplementation,and blood concen-trations of NEFA and BHBA decreased significantly(P＜0.01)postpartum,suggesting that peri-partal cows had a NEB alleviated by GLN supplementation.Serum malondialdehyde(MDA)con-centration of periparturient cow peaked on the day of parturition but declined postpartum,and the concentration of MDA reached a peak on the day of delivery but declined postpartum,and the total antioxidant capacity(T-AOC)level continued to decline until it increased on the day of parturi-tion,indicating that peripartal cows were in a state of oxidative stress.Serum MDA concentration significantly decreased(P＜0.05)and serum T-AOC level significantly increased(P＜0.05)after GLN supplementation,indicating that antioxidant capacity of peripartal cows was improved by GLN supplementation.The concentration of serum pro-inflammatory factor IL-β peaked on the day of parturition and then decreased,the concentration of TNF-α peaked on the day of parturition and then decreased,and the concentration of anti-inflammatory factor IL-10 continued to decrease,which indicated that there was an inflammatory reaction in the cows during the periparturient peri-od.However,the levels of IL-1β on the day of delivery and postpartum decreased significantly(P＜0.01),the levels of TNF-α decreased(P＜0.05),and the levels of IL-10 increased significantly(P＜0.01)throughout the peripartum period,which indicated that GLN supplementation im-proved the anti-inflammatory ability of periparturient dairy cows.The phagocytosis function of PMN in peripartal cows was significantly reduced from-14 d to the day of parturition(P＜0.01),and the phagocytosis function of neutrophils was significantly enhanced after GLN supple-mentation at-14(P＜0.05),14 and 21 d(P＜0.01),which indicated that intrinsic immune func-tion of peripartal cows was enhanced by supplementation of GLN.GLN supplementation did not significantly affect milk production of cows at three weeks postpartum.In conclusion,supplemental rumen-protected GLN alleviated NEB,alleviated systemic oxidative stress and inflammatory re-sponse,and enhanced phagocytosis of PMN in peripartal cows,which has some potential for clini-cal application.

Objective To explore the efficacy and prognosis of robot-assisted percutaneous pedicle screw(PPS)in the treatment of thoracic and lumbar spine fracture.Methods A total of 84 patients with thoracolumbar fracture were selected from Xuzhou Renci Hospital from November 2018 to November 2022,and divided into study group(42 cases with robot-assisted PPS)and control group(42 cases with free-hand PPS)according to random number rank method.Perioperative indexes,nail placement accuracy,prognostic indexes(VAS score,Cobb Angle,relative height of anterior vertebra)and incidence of postoperative complications were compared between the two groups.Results Less intraoperative blood loss,shorter fluoroscopy time,fluoroscopy times,operative time,single nail placement time and radiation exposure time,and higher nail placement accuracy were observed in the study group(P<0.05).VAS score and Cobb Angle of the injured vertebrae were lower in the postoperative 3 d and the last follow-up,and the relative height of the injured vertebrae was higher than that before surgery in the two groups(P<0.05).Conclusion Robot-assisted PPS in the treatment of thoracolumbar fracture has a good application effect,which can shorten the operation time,reduce the intraoperative fluoroscopy times,improve the accuracy of nail placement,and have good safety.

Objective: We previously found that the incidence of sarcopenia increased with declining glucose metabolism of muscle in patients with treatment-naïve diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the relationship between sarcopenia and muscle glucometabolism using 18 F-FDG PET/CT at baseline and end-of-treatment, analyze the changes in these parameters through treatment, and assess their prognostic values. Materials and Methods: The records of 103 patients with DLBCL (median 54 years [range, 21–76]; male:female, 50:53) were retrospectively reviewed. Skeletal muscle area at the third lumbar vertebral (L3) level was measured, and skeletal muscle index (SMI) was calculated to determine sarcopenia, defined as SMI < 44.77 cm 2 /m 2 and < 32.50 cm 2 /m 2 for male and female, respectively. Glucometabolic parameters of the psoas major muscle, including maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), were measured at L3 as well. Their changes across treatment were also calculated as ΔSMI, ΔSUVmax, and ΔSUVmean; Δbody mass index was also calculated. Associations between SMI and the metabolic parameters were analyzed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified. Results: The incidence of sarcopenia was 29.1% and 36.9% before and after treatment, respectively. SMI (P = 0.004) was lower, and sarcopenia was more frequent (P = 0.011) at end-of-treatment than at baseline. The SUVmax and SUVmean of muscle were lower (P < 0.001) in sarcopenia than in non-sarcopenia at both baseline and end-of-treatment. ΔSMI was positively correlated with ΔSUVmax of muscle (P = 0.022). Multivariable Cox regression analysis showed that sarcopenia at end-of-treatment was independently negatively associated with PFS (adjusted hazard ratio [95% confidence interval], 2.469 [1.022–5.965]), while sarcopenia at baseline was independently negatively associated with OS (5.051 [1.453–17.562]). Conclusion Sarcopenic patients had lower muscle glucometabolism, and the muscular and metabolic changes across treatment were positively correlated. Sarcopenia at baseline and end-of-treatment was negatively associated with the prognosis of DLBCL.

Objective To investigate the optimization of therapeutic regimen through the adjustment of the minimum sub-field area in intensity-modulated radiotherapy (IMRT) for cervical cancer,under the premise of no influence on the dose to target volume or organs at risk.Methods A total of 12 patients with pathologically confirmed cervical cancer were enrolled,and the prescribed dose to the planning target volume (PTV) was 50 Gy in 25 fractions.The Pinnacle 8.0m treatment planning system was used for all patients,and 16 IMRT plans were developed for each patient,with the application of 9 evenly distributed fixed incidence directions (0°,40°,80°,120°,160°,200°,240°,280°,and 320°),a minimum sub-field number of 80,and a minimum sub-field hop count (MU) of 5 MU.The range of sub-field area was 2-81 cm2.Direct machine parameter optimization was used for inverse-planned optimization calculation,and all the plans met the requirements of the clinical prescribed dose.The dose-volume histogram was used to evaluate the dose distribution in target volume and organs at risk.Results With the sub-field area increasing from 2 cm2 to 81cm2,the total hop count of IMRT plan was reduced from (1405±170) MU to (490±47) MU (P=0.000),and when the sub-field area increased above 6 cm×6 cm,the total hop count was reduced significantly (P=0.000).In the IMRT plan with a minimum sub-field area of 2-49 cm2,there was no significant difference in dose between the target volume and the organs at risk (P＞0.05).The dose to the rectum,the bladder,and both femoral heads showed no significant differences across the IMRT plans with different minimum sub-field areas (P＞0.05).Conclusions When the Pinnacle 8.0m treatment planning system is used to develop IMRT plans for cervical cancer,the requirements for clinical dose can still be met with a minimum sub-field area reaching 7 cm×7 cm,and there are significant reductions in sub-field hop count and total hop count.