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        Does Early Endoscopy Affect the Clinical Outcomes of Patients with Acute Nonvariceal Upper Gastrointestinal Bleeding? A Systematic Review and Meta-Analysis

        Bai Liyi,Jiang Wei,Cheng Rui,Dang Yan,Min Li,Zhang Shutian 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.4

        Background/Aims: In patients with acute nonvariceal upper gastrointestinal bleeding (ANVUGIB), the optimal timing of endoscopy is still a matter of dispute. We conducted a systematic review and meta-analysis to determine the clinical benefit of early endoscopy. Methods: A literature search of the MEDLINE, Embase, and Cochrane databases was conducted to identify publications from inception to March 1, 2022. Eligible studies included observational cohort studies and randomized controlled trials that reported clinical outcomes of endoscopy in patients with ANVUGIB. ANVUGIB patients who underwent endoscopy within 24 hours of admission were considered to have had an early endoscopy. The primary outcome was the mortality rate in ANVUGIB patients who had early or nonearly endoscopy. Results: The final analysis included five randomized controlled studies (RCTs) and 20 observational studies from the 1,206 identified articles. The mortality rate was not significantly reduced among patients who received endoscopy performed within 24 hours, whether in cohort studies nor in RCTs. For subgroup analysis, a higher mortality rate was found only among patients who received very early endoscopy within 12 hours (odds ratio, 1.66; p<0.001, I2=0) in cohort studies. No significant difference in mortality rates was found among patients at high risk of bleeding who received early versus nonearly endoscopy. Conclusions: Early endoscopy within 24 hours does not appear to significantly reduce the mortality rates of patients with ANVUGIB. Further well-designed studies are warranted to address if very early endoscopy within 12 hours can provide a clinical benefit for patients at high risk of bleeding.

      • KCI등재

        INFLUENCE OF INLET WATER INJECTION ON ENERGY CONSERVATION AND EMISSION OF GASOLINE ENGINE

        Xu Jiangtao,Zhou Zhiyuan,Jiang Liyi,Zhou Haojie,Zhang Chuan 한국자동차공학회 2023 International journal of automotive technology Vol.24 No.4

        Increased compression ratio of auto engine can effectively improve thermal efficiency. However, the risk of engine knock becomes higher when increasing the intake boosting. In this paper, the role of an inlet Water Injection (WI) system in improving the performance of a spark ignition engine was investigated, which was through a comparative study of Miller cycle with electromagnetic intake valve train (EMIT). The numerical simulation method was developed in AVL BOOST based on the engine test rig, and then the port water injection modelling was introduced. The results showed that when the engine speed was lower than 1800 r/min, the water spray scheme had a better effect on the engine performance as compared with the Miller cycle, and such advantage was increasingly significant with the decrease of the speed. This is due to the fact that the water injection takes into account the temperature reduction in the cylinder. When the engine speed was over 1800 r/min, it had a negative impact on engine performance with IWI due to the excessive suppression of combustion. This study provides a theoretical basis for design and research of gasoline engines

      • SCIESCOPUSKCI등재

        Effects of bamboo leaf extract on the production performance, rumen fermentation parameters, and rumen bacterial communities of heat-stressed dairy cows

        Li, Yi,Fang, Luoyun,Xue, Fuguang,Mao, Shengyong,Xiong, Benhai,Ma, Zhu,Jiang, Linshu Asian Australasian Association of Animal Productio 2021 Animal Bioscience Vol.34 No.11

        Objective: An experiment was conducted to evaluate the effects of bamboo leaf extract (BLE) on the production performance, rumen fermentation parameters, and rumen bacterial communities of heat-stressed dairy cows. Methods: The experiment comprised a 14-day adaptation period and a 21-day experimental period and was conducted in a high-temperature and humidity environment (daily mean ambient temperature = 33.5℃±1.3℃; daily mean relative humidity = 64.9%±0.8%, daily mean temperature-humidity index = 86.2±0.4). Twelve Holstein dairy cows were randomly allocated into two groups. A total mixed ration supplemented with BLE at 0 (CON) and 1.3 g/kg dry matter (DM) were fed, respectively. Feed intake and milk yield were recorded daily. Milk samples were collected on 1, 11, and 21 d of the experimental period to analyze milk performance. Rumen fluid samples were collected on 21 d of the experimental period to analyze rumen fermentation parameters and rumen bacterial communities. Results: Compared with the control group, supplementation of BLE increased milk yield (p<0.01), milk fat yield (p = 0.04), 4% fat-corrected milk (p<0.01) and milk fat content (p<0.01); reduced somatic cell count (p<0.01). No differences in DM intake and milk protein or lactose content were observed between two groups. Supplementation of BLE also increased the rumen total volatile fatty acid (p<0.01), acetate (p<0.01), butyrate (p<0.01), and valerate (p = 0.05) concentrations. However, no significant effects were observed on rumen pH, ammonia nitrogen, propionate, acetate/propionate ratio, isobutyrate, or isovalerate. Furthermore, BLE increased the rumen bacterial abundance and the diversity of the rumen bacterial community. The BLE reduced the Firmicutes/Bacteroidetes abundance ratio and increased the abundances of Butyrivibrio_2 (p<0.01) and Ruminococcus_2 (p<0.01). Conclusion: The BLE supplementation at 1.3 g/kg DM could improve production performance and rumen fermentation in dairy cows during heat stress.

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