Research progress on diarrhoea and its mechanism in weaned piglets fed a high-protein diet.

In order to pursue faster growth and development of weaned piglets, increased dietary protein (CP) levels were favoured by the pig industry and the feed industry. The digestive organs of piglets were not fully developed at weaning, and the digestive absorption capacity of protein was limited. High-protein diets can cause allergic reactions in piglets, destroy intestinal structural integrity, reduce immunity, and cause intestinal flora imbalance. Undigested proteins were prone to produce toxic substances, such as ammonia and biogenic amines, after fermentation in the hindgut, which negatively affects the health of the intestine and eventually causes reduced growth performance and diarrhoea in piglets. This review revealed the mechanism of diarrhoea caused by high-protein diets in weaned piglets and provided ideas for preventing diarrhoea in weaned piglets.

Sugammadex enhances recovery after abdominal surgery in cancer patients: a real-world, observational study.

BACKGROUND: Sugammadex, a modified γ-cyclodextrin that selectively binds to muscle relaxants, is increasingly being used to reverse neuromuscular blockade after surgery, but the potential benefits for cancer patients in the real-world setting are obscure. METHODS: This was a real-world, retrospective study. Adult cancer patients (≥18 years) undergoing abdominal surgery at Jiangsu Cancer Hospital, a tertiary care cancer hospital in China, between 2 March 2018 and 25 November 2019, were included in the analysis. Patients received 2 mg/kg (maximally 200 mg) sugammadex based on the discretion of the attending anesthetists. Patients were extubated as soon as they were awake and able to follow commands. The endpoint measures included extubation time, bowel function recovery and length of hospital stay. RESULTS: A total of 1,615 patients were included in the analysis: 795 participants received sugammadex at a dosage of 2 mg/kg (maximum 200 mg) upon completion of surgery; the remaining 820 participants did not receive sugammadex or neostigmine (another antidote for neuromuscular blockade). Despite several biases that clearly favored patients not receiving sugammadex [younger, better American Society of Anesthesiologists (ASA) status, and fewer comorbidities], the extubation time was significantly shorter in patients receiving sugammadex [median: 14 (range, 0-121) vs. 30.5 (range, 0-183) min; P<0.001]. In multivariate linear regression analysis, sugammadex use was associated with a significantly shorter extubation time (P<0.05). Patients who received sugammadex also had accelerated bowel function recovery and shorter postoperative hospital stay. CONCLUSIONS: Sugammadex shortens extubation time and accelerates postoperative recovery in cancer patients undergoing abdominal surgery.

Futility stopping in clinical trials, optimality and practical considerations.

Stopping for futility is a useful tool in a clinical trial. It is widely used in single-arm trials in oncology and in many two-arm trials. We review three stopping rules for futility. We give recommendations for the optimal timing of futility looks in two-stage trials in terms of the information fraction and the probability of stopping under the alternative hypothesis. We discuss futility stopping in trials with substantial uncertainty about the variability of the outcome and in crossover trials.