Cytopenia after CAR­T cell therapy: Analysis of 63 patients with relapsed and refractory B­cell non­Hodgkin lymphoma.

The present study aimed to determine the clinical characteristics of cytopenia in patients with relapsed and refractory B-cell non-Hodgkin lymphoma (B-NHL) who were treated with chimeric antigen receptor T-cell (CAR-T) therapy. Thus, a total of 63 patients with relapsed and refractory B-NHL who underwent CAR-T therapy between March 2017 and October 2021 were retrospectively selected for analysis. Neutropenia, anemia and thrombocytopenia at grade ≥3 occurred in 48 (76.19%), 16 (25.39%) and 15 (23.80%) cases, respectively. The results of a multivariate analysis demonstrated that the baseline absolute neutrophil count (ANC) and hemoglobin concentration were independent risk factors for grade ≥3 cytopenia. A total of 3 patients died early and were therefore excluded from the present study. Furthermore, cell recovery was examined at day +28 after infusion; 21 patients (35%) did not recover from cytopenia and 39 patients (65%) recovered. A multivariate analysis demonstrated that the baseline ANC <2.29×109/l, baseline hemoglobin <114.50 g/l and baseline IL-6 >21.43 pg/l were independent risk factors affecting hemocyte recovery. In conclusion, patients with relapsed and refractory B-NHL exhibited an increased incidence of grade ≥3 hematologic toxicity following CAR-T cell therapy, while baseline blood cell and IL-6 levels are independent risk factors for hemocyte recovery.

Pediatric Tuina for functional constipation in children: study protocol for a randomized controlled trail.

BACKGROUND: Functional constipation (FC) is a common functional gastrointestinal disorder, which brings many negative impacts to the children's daily life. Pediatric Tuina has been proved to be a potential therapy for FC. However, the evidence for its effectiveness and safety is insufficient due to the lack of high-quality study. This study aims to evaluate the efficacy and safety of pediatric Tuina for children with FC. METHODS/DESIGN: This study is a randomized, controlled, multicentre, clinical trial. We will include 176 children with FC from five hospitals. The participants will be randomly allocated into two groups: the pediatric Tuina group and the Medilac-Vita group. This study will include a 1-week actual treatment period and a 2-week follow-up period. Primary outcomes are weekly spontaneous bowel movements and weekly complete spontaneous bowel movements. The secondary outcomes are effective rate, stool form, distress sensation, and glycerine enema rate. The assessment will be performed each week. Adverse event will be monitored in the treatment period and follow-up period. DISCUSSION: This study is designed to evaluate the efficacy and safety of pediatric Tuina for children with FC, and we hypothesize that pediatric Tuina is more effective than probiotics. It will provide reliable evidence and support for the treatment of FC by pediatric Tuina. TRIAL REGISTRATION: This protocol was registered in the Chinese Clinical Trial Registry (ChiCTR2100046485). .

Effects of dietary fresh fermented soybean meal on growth performance, ammonia and particulate matter emissions, and nitrogen excretion in nursery piglets.

This study was conducted to investigate the effects of fresh fermented soybean meal (FSM) on the growth performance of nursery piglets, nitrogen excretion in feces, and the concentrations of ammonia (NH3) and particulate matter (PM) in the piggery. A total of 472 nursery piglets (Landrace×Yorkshire, (16.3±0.36) kg body weight) were randomly allocated into two treatments with 236 pigs in each treatment. The pigs were fed the basal diet without fresh FSM (control) or diet containing 10% (100 g/kg) fresh FSM (FSM group), and the crude protein content of the two groups was consistent. The feeding trial lasted for 28 d. The results showed that the pigs fed fresh FSM had increased (P<0.05) average daily gain (ADG) compared with the control. There was no significant difference (P>0.05) in feed to gain ratio (F:G) between the two groups. During the whole experiment, the concentration of NH3 in the piggery decreased (P<0.05) by 19.0%, and the concentrations of PM (PM10 and PM2.5) in the piggery decreased (P<0.05) by 19.9% and 11.6%, respectively, in the FSM group, compared with the control. The ammonia nitrogen and nitrite content in feces increased (P<0.05) by 32.9% and 28.4%, respectively, in the FSM group. The fecal pH declined (P<0.05) significantly in the FSM group compared with the control. At the end of experiment, total protein (TP) concentration was increased (P<0.05) significantly and blood urea nitrogen (BUN) concentration was decreased (P<0.05) for pigs fed the diet with fresh FSM. The results indicated that dietary fresh FSM not only improved the growth performance of nursery piglets, but also reduced the NH3 concentration in the piggery due to nitrogen conversion, and decreased the concentrations of PM10 and PM2.5 in the piggery.