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1.
Blood glycated hemoglobin evaluation in sick dogs.   总被引:1,自引:0,他引:1       下载免费PDF全文
Blood glycated hemoglobin concentration reflects long-term serum glucose levels in dogs. In this study, the effects of several diseases on blood glycated hemoglobin levels have been evaluated. For this study, blood samples were drawn from 93 unhealthy dogs. The animals were distributed into 10 groups according to pathological process (group 1, digestive problems; group 2, leishmaniasis; group 3, anemia; group 4, dermatological disorders; group 5, urinary problems; group 6, cardiorespiratory problems; group 7, diabetes mellitus; group 8, insulinoma; group 9, general diseases; group 10, control group). Blood glucose and glycated hemoglobin concentrations and hemoglobin and hematocrit values were analyzed in all the animals. In diabetic dogs, a strong increase in blood glycated hemoglobin was observed when compared with the other groups (P < 0.01). In contrast, dogs with insulinoma showed a decrease in blood glycated hemoglobin, though significant differences were not reported in all cases. No change in blood glycated hemoglobin concentrations were reported in dogs affected by other diseases. So, we can suppose that only the chronic alterations in glucose metabolism (chronic hyper- or hypoglycemia) can induce significant changes on the blood glycated hemoglobin concentrations in dogs.  相似文献   

2.
Two experiments were conducted to evaluate the impact of housing density on the stomach morphology of growing pigs and determine whether there was an interaction between housing density and diet. All diets were corn-soybean meal based. In Exp. 1, 42 barrows (41.0+/-.95 kg BW) were allotted either individually or three pigs per pen to evaluate the effects of crowding on stomach lesions. Pen space per pig was 1.54 and .51 m2, respectively. All pigs were fed a finely ground and pelleted diet (610 microm) for 6 wk. The ADG decreased (P<.05) for the pigs housed three per pen during wk 4 to 6 only. There was no effect of housing density on feed intake or gain/feed ratio. Neither visual nor histological ulcer score differed between the two treatment groups. No stomachs were graded as normal. In Exp. 2, 80 barrows (39.8+/-.9 kg BW) were allotted either two or four pigs per pen. Pen space per pig was .77 and .39 m2, respectively. Half of the pigs in each housing situation were fed a coarse meal diet (1,050 microm), and half of the pigs were fed a finely ground and pelleted diet (577 microm) throughout the 49-d experimental period. Throughout the trial, pigs housed two per pen gained at a greater rate (P<.05) than pigs housed four per pen. From d 14 to the end of the trial, pigs consuming the finely ground and pelleted diet gained at a greater rate (P<.05) than pigs fed the coarse meal diet. The differences in ADG were reflected in final body weight. Stomach weight as a percentage of body weight was higher for animals on the coarse meal diet. Visual and histological ulcer scores were similar, and both were higher (P<.001) on the finely ground and pelleted diet, indicating greater damage. There was no effect of space restriction on stomach morphology. These data show the major effect of diet type on stomach lesions with no interaction with space restriction.  相似文献   

3.
The purpose of this work was to assess the clinical, haematological and biochemical responses of pigs experimentally inoculated with Trichinella spiralis. Groups of three pigs were inoculated per os with 100, 500 and 5000 T. spiralis muscle larvae, two pigs were used as control. Clinical evaluation of disease in pigs included daily examination, rectal temperature measurements and cardiac and respiration rates. Haematological studies included: hematocrit (%), hemoglobin (g/dl), and white cell, neutrophil, lymphocyte and eosinophil counts. Blood biochemistry included: bun (mg/dl), creatinine (mg/dl), AST (UI/l), ALT (UI/l), CPK (UI/l) and ALP (UI/l). No significant differences were observed in rectal temperature and in cardiac and respiration rates between inoculated animals and the control group (p> or =0.05). Significant differences were detected (p< or =0.05) in the values of % hemoglobin, and eosinophils, as well as in the values of CK, ALP, AST and ALT. The variations observed in some cases were related to the number of T. spiralis larvae inoculated and varied with the number of days post-infection. Inoculated pigs showed significant differences (p< or =0.05) in weight gain when compared with uninoculated controls. This study has clinical, haematological, and enzyme alterations in Trichinella infected pigs provides a better understanding of acute and chronic trichinellosis in pigs.  相似文献   

4.
The aim of the present study was to investigate the potential effects of different particle fractions in non‐pelleted (meal) and pelleted diets on the development of pre‐ulcerative gastric alterations. Furthermore, the effect of increased crude fibre supply (lignocellulose) on the integrity of gastric mucosa were investigated. For that purpose, 49 piglets were divided into eight feeding groups and fed pelleted diets differing in grinding intensity (very coarse/coarse/fine/very fine) and addition of lignocellulose (0/2.5%) for 6 weeks. A coarsely ground meal was used as control diet. Mucosal integrity of the pars non‐glandularis was characterised by macroscopical and histological score and basal epithelial conductance. Feed structure was assessed by sieve analysis (wet/dry). The use of coarsely ground meal (25% >2 mm, 29% <0.4 mm) had almost no negative effects on the gastric wall: three of seven pigs had slight histological and none had macroscopical lesions. Irrespective of the original grinding intensity before pelleting, offering pelleted diets led to mucosal changes similar in severity (one out of seven pigs fed coarsely ground and pelleted diets had no macroscopical alterations, whereas all pigs fed finely ground and pelleted diets showed altered tissues). Increasing the proportion of coarse particles in the pellet (from 25 to 29% >2 mm) did not show any ulceroprotective effect. An increase of crude fibre content (42–54 g/kg dm) by adding lignocellulose did not result in a decreased ulcerogenity. Unpelleted diets are recommended as more favourable for alleviating the problem of gastric ulcers in pigs as the pelleting process is equal to a secondary grinding process. According to our results, an upper level of fine particles seems to be reasonable (a minimum level of coarse particles is not ulceroprotective). In this study, an amount of 30% <0.4 mm resulted in higher risks for ulcerations.  相似文献   

5.
Pigs in four groups were fed fine non-pelleted (F-NP), fine pelleted (F-P), coarse non-pelleted (C-NP) or coarse pelleted (C-P) diets. DNA fingerprints, T-RFLP, revealed a strong dietary effect on bacterial community structure in the stomachs. Pigs fed the C-NP diet had the highest microbial diversity in stomach and the T-RFLP fingerprints suggested that bacteria tentatively identified as Lactobacillus delbrueckii, L. mucosae, L. reuteri, L. amylovorus/L. sobrius, Mitsuokella multiacida and Megasphera elsdenii were specifically stimulated. Lactobacilli may be responsible for the previously reported increase in stomach lactate levels of pigs fed the C-NP diet [Mikkelsen, L.L., Naughton, P.J., Hedemann, M.S., Jensen, B.B., 2004. Effects of physical properties of feed on microbial ecology and survival of Salmonella enterica serovar Typhimurium in the pig gastrointestinal tract. Appl. Environ. Microbiol. 70, 3485–3492.]. Moreover, earlier observations of butyrate and propionate accumulation in the stomach of pigs fed C-NP diets could be due to stimulation of M. elsdenii and S. ruminantium according to the T-RFLP fingerprints.  相似文献   

6.
The concentration of vitamin R12 in the blood was studied in five totally gastrectomized pigs followed for 10–18 months, and in four controls followed for 5¼–8 months. The concentration of vitamin B12 in the liver was investigated in three pigs of each group. The content of vitamin B12 in the blood was of the same magnitude in both groups. Thus, removal of the stomach does not compromise the normal presence of this vitamin in the blood. The B12 content in the liver was also unaffected by the operation, whereas it was increased after simultaneous administration of vitamin B6.  相似文献   

7.
An experiment was conducted to determine the energy content of oats and to investigate the effects of oat particle size on nutrient and energy balance in growing pigs. Eighteen barrows (23.56 ± 0.94 kg initial body weight) were randomly assigned to one of the three dietary treatments with six replicates per treatment. Whole oats were ground with a hammermill fitted with 4.8- and 3.2-mm screens to make coarse and medium particle size oats, respectively. Medium oats were further ground with a rotary steel cutting grinder fitted with a 2.0-mm screen, and the further ground oats were mixed with medium oats in a 1:3 ratio to make fine oats. Three experimental diets consisted of 96.3% of the coarse, medium, or fine oats as a sole source of energy were used. Pigs were fed diets for 16 d, including 10 d for adaptation and 6 d for total fecal and urine collection. Pigs were then moved into indirect calorimetry chambers to determine 24-h heat production and 12-h fasting heat production. All data were analyzed using the MIXED procedure of SAS with the individual pig as the experimental unit. The geometric mean particle sizes for coarse, medium, and fine oats were 765, 619, and 569 μm, respectively. Pigs fed the medium oats diet tended to have (P < 0.10) greater apparent total tract digestibility (ATTD) of starch, neutral detergent fiber, and gross energy than those fed coarse oats diet. The medium oats diet contained greater (P < 0.05) digestible energy (DE), metabolizable energy (ME), and net energy (NE) than the coarse oats diet. Pigs fed the fine oats diet had lower (P < 0.05) ATTD of Ca and P than those fed the coarse oats diet. The DE, ME, and NE contents of fine oats were comparable with those of coarse oats. The determined NE contents for coarse, medium, and fine oats were 2,335, 2,615, and 2,521 kcal/kg on a dry matter basis, respectively. The NE content in medium oats was greater (P < 0.05) than the NE values predicted using published equations. In conclusion, it was suggested to grind whole oats for 619 μm concerning energy utilization. Further grinding to 569 μm reduces Ca and P digestibility.  相似文献   

8.
The present study was undertaken to investigate the effect of Fasciola gigantica excretory secretory antigen (Fg-ESA) on rat hematological indices. Fg-ESA was prepared by keeping thoroughly washed 40 F. gigantica flukes in 100 ml phosphate buffer saline (PBS) for 2 h at 37℃, and centrifuging the supernatant at 12,000 g at 4℃ for 30 min. The protein content of Fg-ESA was adjusted to 1.8 mg/ml. The rats were randomly divided into two groups of six rats each. Rats in group A received 0.5 ml of Fg-ESA intraperitoneally (i.p.) for 7 days, whereas control rats in group B received 0.5 ml of PBS i.p. for 7 days. Hemograms of both groups were studied initially and on days 0, 2, 4, 14 and 21 after the final injection of Fg-ESA or PBS. Progressive and significant (p < 0.01) declines in the values of hemoglobin, hematocrit, and total erythrocyte count were observed without significant (p > 0.05) changes in the values of mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, or mean corpuscular volume in group A. Thus, we conclude that Fg-ESA induces normocytic normochromic anemia in rats.  相似文献   

9.
Pigs fitted with ileo-rectal anastomoses (IRA) and in parallel experiments intact (INT) pigs were used to estimate the influence of the different grinding fineness of barley and wheat (coarse, medium, fine) on the apparent and true precaecal and total digestibility resp. absorption of various N free and N containing nutrients, among them crude protein and the indispensable and dispensable amino acids. Coarse grinding (25 ... 50% of the particles greater than 2 mm) resulted in significantly lower digestibility values than medium and fine grinding--with more striking differences in barley than in wheat. Precaecally most nutrients and amino acids are distinctly less digestible than at the end of the total tract. The precaecal lysine absorption determined with IRA pigs is remarkably low. The results are discussed. In order to attain a good utilization of the protein contained in cereals grains should be ground in hammermills with maximal sieve meshes of 3 mm. It is proposed to tabulate crude protein and amino acids in future on the basis of a standardized true precaecal digestibility resp. absorption.  相似文献   

10.
Two experiments comprising a total of 80 Danish Landrace pigs in the period 20–90 kg live-weight were carried out to study the effect of dietary levels and ratios of Ca and P on serum values of Ca, inorg. P, and alkaline phosphatase and on the development of degenerative arthritis and atrophic rhinitis.In both experiments each kg feed (Table 1) was supplemented with 600 i. u. vitamin D3 and 80 p. p. m. Zn.In the first experiment the Ca:P ratio was 1.2 and the amount of Ca increased from 0.48 % to 1.20 % without influencing daily gain, feed conversion, carcass performance (Table 2) or frequency of atrophic rhinitis (Table 3). The Ca:P ratio in scapula was 2.15. Only when the diet was supplemented with 1.20 % Ga and 1.00 % P the bone quality was histomorphologically adequate (Figs. 1–4).In the second experiment various Ca:P ratios (ranging from 0.1 to 3.0) were compared with the recommended level and ratio of 0.72 % Ga and 0.60 % P. Performance of pigs on the normal level was better than for the other pigs (Table 4). Clinically, various degrees of leg-weakness and -deformation occurred, most pronounced in the high Ca — low P group. Very little lameness and no convulsions were observed. Marked hypocalcemia was not found. Unilateral high Ca intake increased serum Ca significantly, and serum alkaline phosphatase slightly, and decreased serum P (Figs. 5–7). Advanced pericytic osteolysis, poor mineralization and generalized osteodystrophia fibrosa were found in the low Ca groups (Figs. 8–13). The groups showed no differences in frequency of atrophic rhinitis (Table 5), and rickets was not observed.The incidence of degenerative joint lesions was not increased in pigs on the unfavourable Ca:P ratios, and depended apparently more on litters than on diets.  相似文献   

11.
The objective of this investigation was to study if different feeding strategies influence experimental infections of pigs with Lawsonia intracellularis, the causative agent of proliferative enteropathy. In three sequential trials, a total of 144 weaned pigs were fed five different diets all made from a standard diet based on wheat and barley as carbohydrate source and soybean as protein source. The five diets were: a standard diet (fine ground and pelleted), the standard diet fed as fermented liquid feed, the standard diet added 1.8% formic acid, the standard diet added 2.4% lactic acid and a diet similar to the standard diet (made from the same ingredients), but fed coarse ground. Twenty-four pigs on each diet were orally inoculated with L. intracellularis and growth performance and faecal excretion of bacteria were monitored. Twenty-four pigs fed the standard diet were included as not experimentally infected controls. Pigs in the first two trials were sacrificed 4 weeks post-inoculation, whereas animals in the third trial were sacrificed after 5 weeks. Pigs in all experimentally infected groups excreted L. intracellularis. The fermented liquid diet delayed the excretion of L. intracellularis and furthermore, pigs fed the standard diet supplemented with lactic acid had limited pathological lesions when the intestines were examined 4 weeks after inoculation. The growth performance was reduced in pigs experimentally challenged with L. intracellularis, however the prevalence and severity of diarrhea was limited.  相似文献   

12.
The epidemiologies of the most common diseases diagnosed in pigs at the Danish pig-breeding test stations were studied with special reference to possible genetic predisposition. The population under study comprised 9084 test pigs (corresponding to 3028 test groups) housed at nine test stations from September 1983 to September 1984. There were substantial differences between the four breeds in the study (Landrace, Yorkshire, Duroc and Hampshire) with the white breeds having higher clinical incidences of respiratory diseases and culling rates than the coloured ones. In only one of nine analyses was a significant sire effect found. However, significant differences were found between breeding centres of origin. There was a negative influence of clinical diseases on daily gain and feed conversion. Classifying respiratory disease in an ‘early’ form (at least one pig in the group was treated during the first 45 days of the test period) and a ‘late’ form (treatments were given after this period) showed that late infections resulted in a higher reduction of performance than early infections did. There were no associations between pathological findings at slaughter and growth rate.  相似文献   

13.
In a cohort study, 40 pig finishing herds were selected: twenty pig herds with a low and twenty pig herds with a high prevalence of several pathological lesions recorded at slaughter in a six-month period before the start of the study. Blood samples were taken from 20 pigs per herd at the end of the finishing period to investigate haematological and clinicochemical profiles. There was only a significant difference in serum albumin concentration between the low and high lesion prevalence groups. There were distinct differences in blood profiles between pig herds, but also between batches of pigs within a herd, housed in different compartments. Differences between castrated males and gilts were also demonstrated with respect to mean values of the blood variables haemoglobin, iron, copper, beta-globulin, eosinophils and segmented neutrophils. However, the differences were not of a biologically important magnitude. The mean values of the blood variables pepsinogen and lymphocytes differed significantly between pig herds from the two participating integration groups. Pigs with a higher albumin concentration, a lower gamma-globulin concentration, a higher copper concentration and a higher creatine kinase activity in serum showed a higher daily weight gain.  相似文献   

14.
本研究以洋姜治疗仔猪贫血,通过检测血清铁、血红蛋白、红细胞压积、转铁蛋白、网织红细胞数等指标的变化,验证该药对仔猪贫血的治疗效果。结果表明,饲喂洋姜7d后,试验组中血清铁和红细胞压积显著高于对照组(P0.05),试验组血红蛋白、转铁蛋白浓度与对照组相比,差异极显著(P0.01)。饲喂15d后,试验组仔猪血清铁、血红蛋白、红细胞压积、转铁蛋白浓度与对照组相比,差异极显著(P0.01)。而试验期内2组间网织红细胞数差异均不显著(P0.05)。说明洋姜能显著提高血液中铁离子、血红蛋白水平,有效增加转铁蛋白饱和度,对治疗仔猪贫血具有较好的效果。  相似文献   

15.
The aim of this study was to assess changes of Hsp70 and HSF-1 protein and mRNA expression in stress-sensitive organs of pigs during transportation for various periods of time. Twenty pigs were randomly divided into four groups (0 h, 1 h, 2 h, and 4 h of transportation). A significant increased activity of AST and CK was observed after 1 h and 2 h of transportation. Histopathological changes in the heart, liver, and stomach indicated that these organs sustained different degrees of injury. Hsp70 protein expression in the heart and liver of transported pigs did not change significantly while it increased significantly (p < 0.05) in the stomach. Hsp70 mRNA levels decreased significantly (p < 0.05) in the heart after 4 h of transportation. However, mRNA expression increased significantly in the liver after 1 (p < 0.05) and 4 h (p < 0.01) of transportation, and increased significantly in the stomach of the transported pigs after 1, 4 (p < 0.01), and 2 h (p < 0.05). HSF-1 levels were reduced at 1 and 4 h (p < 0.05) only in the hearts of transported pigs. These results indicate that Hsp70 mediates distinct stress-related functions in different tissues during transportation.  相似文献   

16.
This study was carried out to obtain basic information on the transmission of Oesophagostomum dentatum and Hyostrongylus rubidus in outdoor reared pigs in Denmark. Eighteen 10 weeks old worm-free pigs were allocated into 3 groups of 6 pigs each. In May, all pigs were turned out on the same parasitologi-cally naive pasture, and after 2 weeks the pigs in groups 2 and 3 were experimentally infected with 10,800 O. dentatum and 8,700 H. rubidus infective larvae, respectively. Pigs in group 1 served as non-infected controls. All pigs were reared together on the experimental pasture for further 134 days until slaughter in October. Strongyle egg counts, differentiation of infective larvae at species level, serum pepsinogen, and herbage larval infectivity were monitored at regular intervals throughout. Both strongyle species established in the originally parasite-free pigs (group 1) and cross infections were established in group 2 and 3. The pigs were exposed to steadily increasing herbage infectivity of both species of strongyles. At the end of the experiment, geometric mean worm burdens of O. dentatum in groups 1,2 and 3 were 1202, 6136 and 1431 respectively, the burden in group 2 being significantly higher (p<0.05) than that of the 2 other groups. The geometric mean worm burdens of H. rubidus in groups 1, 2 and 3 were 4907, 3679 and 5246 respectively, showing no significant differences between groups.  相似文献   

17.
Light and electron microscopical studies were carried out after experimental induced and spontaneous infection with African swine fever virus. The experimental infection was performed in 18 pigs divided into two groups consisting of 9 animals. The pigs of group I were inoculated with virulent isolate E 70, those of group II with attenuated isolate E 75. Two infected pigs of group I and one control animal were killed on days 3, 5 or 7 p.i., two pigs of group II and one control animal were killed on days 9, 11 or 13 p.i. Additionally 19 spontaneous infected and seropositive animals and two seronegative pigs without clinical signs were examined. Infection with African swine fever virus resulted in slight morphological alterations of the intestine. The pathological findings showed a more intense involvement of the large intestine, especially the caecum and colon, than the small intestine, where the ileum was mostly affected. In all three groups edema and vacuolisation could be observed in endothelial cells. In spite of beginning degenerative signs, especially after spontaneous infection, the fenestrated structure of the endothelium was conserved in most of the cases. In animals infected with virulent isolate the vascular lumina contained aggregations of fibrin, which was severe pronounced in the pigs of the other groups. In the area of these alterations disturbance of permeability with extravasation could be found. In all groups single virions or virus aggregates could be identified in concave depressions of the erythrocyte membrane or free within the blood plasma, in some cases enveloped by a plasma-like material.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

18.

Background

People donating blood more than twice annually are at risk of developing iron deficiency. Little is known about the iron status of dogs enrolled in blood donor programs.

Hypothesis

Dogs donating blood ≥6 times annually will show evidence of iron deficiency based on their reticulocyte indices.

Animals

Thirteen dogs enrolled in a blood donor program donating ≥6 times over the preceding 12 months and 20 healthy nondonor control dogs.

Methods

Prospective observational study. Mature red blood cell (RBC) indices, reticulocyte indices, serum iron, serum ferritin, and total iron‐binding capacity (TIBC) were compared between groups.

Results

Packed cell volume (median 47%, range 40–52%, < .01), hematocrit (median 46.4%, range 40.3–52.5%, < .01), and reticulocyte count (median 16,000/μL, range 9,000–38,000/μL, < .01) were significantly lower in the blood donor dogs. No statistically significant differences were noted in the mature RBC indices between groups. Both reticulocyte mean corpuscular volume (median 88.8 fL, range 83.4–95.5 fL, = .03) and reticulocyte hemoglobin content (median 24.6 pg, range 23.1–26.6 pg, < .01) were significantly lower in the blood donor group. Serum iron and ferritin were similar between groups; however, TIBC was significantly higher in the control group (median 403 μg/dL, range 225–493 μg/dL, = .02).

Conclusions

The findings in dogs donating ≥6 times annually suggest the presence of iron‐deficient erythropoiesis in this population.  相似文献   

19.
The measurement of serum pepsinogen concentrations by enzymatic method and immunoassay provides diagnostic values and should be helpful in the detection of gastric diseases related to a rise of blood pepsinogen. In the present study, the correlation between a conventional enzymatic method and a recently developed radioimmunoassay (RIA) for serum pepsinogen A was investigated. A total of 123 sera samples of porcine foetuses (n = 28), adult healthy pigs (n = 56), pigs with parakeratosis (n = 25) and pigs with ulceration of the pars oesophagea (n = 14) were tested. Overall, there was a slight correlation between the two methods (r = 0.60). In relation to individual animal groups, the correlations (r) were 0.39 (P>0.05), 0.74 (P<0.001), 0.19 (P>0.05) and 0.34 (P>0.05) in foetuses, healthy pigs, pigs with parakeratosis and pigs with ulcers, respectively. In both methods, pepsinogen concentrations (means+/-SE) were significantly higher (P<0.05) in pigs with parakeratosis (1778 +/- 86.00 mUTyr/L; 690 +/- 53.00 ng/mL) and in pigs with ulcers (2026 +/- 153.00 mUTyr/L; 1747 +/- 94.00 ng/mL) when compared to healthy pigs (935 +/- 58.00 mUTyr/L; 275 +/- 35.00 ng/mL). The proteolytic method gave a significant increased activity (P<0.05) in foetuses (1150 +/- 82.00 mUTyr/L) vs. (935 +/- 58.00 mUTyr/L) in healthy adult pigs, indicating an additional proteolytic activity in the sera of foetuses or neonates.  相似文献   

20.
Effects of probiotic bacteria on viral infections have been described previously. Here, two groups of sows and their piglets were fed with or without feed supplementation of the probiotic bacterium Enterococcus faecium NCIMB 10415. Shedding of enteric viruses naturally occurring in these pigs was analyzed by quantitative real-time RT-PCR. No differences between the groups were recorded for hepatitis E virus, encephalomyocarditis virus and norovirus. In contrast, astrovirus was exclusively detected in the non-supplemented control group. Rotavirus was shedded later and with lower amounts in the probiotic piglet group (p < 0.05); rotavirus-shedding piglets gained less weight than non-infected animals (p < 0.05). Serum titres of anti-rotavirus IgA and IgG antibodies were higher in piglets from the control group, whereas no difference was detected between sow groups. Phenotype analysis of immune cell antigens revealed significant differences of the CD4 and CD8β (p < 0.05) as well as CD8α and CD25 (p < 0.1) T cell populations of the probiotic supplemented group compared to the non-supplemented control group. In addition, differences were evident for CD21/MHCII-positive (p < 0.05) and IgM-positive (p < 0.1) B cell populations. The results indicate that probiotic bacteria could have effects on virus shedding in naturally infected pigs, which depend on the virus type. These effects seem to be caused by immunological changes; however, the distinct mechanism of action remains to be elucidated.  相似文献   

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