[Arrhythmias and electrocardiographic characteristics in cancer patients treated with immune checkpoint inhibitors].

Objective: To evaluate the incidence of arrhythmias and electrocardiographic (ECG) characteristics in cancer patients treated with immune checkpoint inhibitors (ICIs). Methods: This was a cohort study conducted in the Fourth Hospital of Hebei Medical University. Cancer patients initiating ICIs treatments from November 2020 to September 2022 were included in this study. Baseline 12-leads ECG before ICIs initiation and post-treatment ECG were analyzed. An abnormal ECG was defined as the presence of any of the following changes: sinus arrhythmias, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, ventricular tachycardia, premature contractions, conduction disorder, and ST-T changes. Results: A total of 87 patients were enrolled, aged 63 (57, 68) years, with 66 (75.9%) males. And 44.8% (39/87) of patients presented with at least one confirmed cardiovascular disease or cardiovascular risk factor at baseline. The incidence of abnormal ECG increased from 31.0% (27/87) at baseline to 65.5% (57/87) after receiving (5.0±2.7) cycles of ICIs treatment (P<0.001). The incidence of sinus arrhythmias was significantly increased after ICIs treatment (23.0% (20/87) vs. 9.2% (8/87), P=0.023), of which only the incidence of sinus tachycardia was significantly increased (11.5% (10/87) vs. 2.3% (2/87), P=0.039). There was also a significantly increased incidence of ST-T changes after ICIs treatment (31.0% (27/87) vs. 17.2% (15/87), P=0.012), which mainly attributed to the T wave changes (29.9% (26/87) vs. 13.8% (12/87), P=0.001). The incidence of premature contractions was also significantly increased after ICIs treatment (9.2% (8/87) vs. 0, P=0.008). Additionally, compared with baseline, the P wave axis was significantly increased after ICIs treatment ((56.94±21.01)° vs. (52.00±22.69)°, P=0.043). After ICIs treatment, the heart rate was significantly increased ((79.07±15.37) beats/min vs. (75.64±13.37) beats/min, P=0.029). Sokolow-Lyon index ((2.21±0.81)mV vs. (2.33±0.75)mV, P=0.138), QTc interval ((431.44±36.04)ms vs. (428.00±30.05)ms, P=0.415) all showed signs of change after treatment, but did not reach the traditional significant level. Conclusions: The incidence of abnormal ECG is significantly increased after ICIs treatment, especially for sinus tachycardia, premature contractions and T wave changes; the P wave axis and heart rate is also significantly increased after treatment. It is important to perform regular ECG monitoring in patients receiving ICIs treatment.

[Associations between risk factor control and survival among cancer patients].

Objective: This study aimed to evaluate the associations between the number of cardiovascular risk factor goals achieved with all-cause mortality, atherosclerotic cardiovascular diseases (ASCVD)-related mortality, and cancer-related mortality amongst cancer patients. Methods: From 2006 to 2020, a total of 2 079 individuals with newly diagnosed cancer, free of ASCVD, were enrolled in this study from the Kailuan cohort. Patients were classified into three groups (group 1,≤1 risk factor at goal, n=407; group 2, 2 risk factors at goal, n=865; group 3,≥3 risk factors at goal, n=807) according to the control status of blood pressure, fasting blood glucose, low-density lipoprotein cholesterol and high-sensitivity C-reactive protein, using health checkup results of the latest survey after cancer diagnosis. Multivariable Cox regression analyses were performed to examine the associations between the number of risk factors at goals with all-cause mortality, ASCVD-related mortality, and cancer-related mortality. Results: The mean age at diagnosis was (60.4±10.4) years, and 71.2% were male. During a median follow-up of 2.95 (1.38, 5.12) years, 600 cases of all-cause mortality, 63 cases of ASCVD-related mortality, and 314 cases of cancer-related mortality were observed. After adjusting for age, gender, education level, smoking status, alcohol consumption, salt intake, physical activity, body mass index, triglyceride, high-density lipoprotein cholesterol, family history of cardiovascular diseases, antihypertensive drugs, hypoglycemic drugs, lipid-lowering drugs, and anti-cancer medications, compared with cancer patients achieving ≤1 risk factor goal, those achieving ≥3 risk factor goals showed significantly decreased risk of all-cause mortality, ASCVD mortality, and cancer mortality, with HR (95%CI) of 0.68 (0.54-0.86), 0.35 (0.16-0.77), and 0.60 (0.43-0.82), respectively (all P values <0.05). Significant relationships between the number of risk factor goals achieved and decreased mortality of all kinds were observed (all P values for trend<0.05). Results of the subgroup analyses suggested that the associations between the number of risk factor goals achieved and lower mortality of all kinds were more prominent among individuals who were ≥60 years, male, and those with respiratory and reproductive cancers (all P values <0.05). Conclusions: This study suggested a significant association between the number of cardiovascular risk factor goals achieved and survival in cancer patients, especially amongst those who were older, male, with respiratory cancers and reproductive cancers.

[Benefits and risks of prolonged dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent in patients with stable coronary artery disease and diabetes].

Objective: To compare the efficacy and safety of prolonged dual antiplatelet therapy (DAPT>1 year) in patients with stable coronary artery disease (CAD) and diabetes who were event-free at 1 year after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in a large and contemporary PCI registry. Methods: A total of 1 661 eligible patients were selected from the Fuwai PCI Registry, of which 1 193 received DAPT>1 year and 468 received DAPT ≤1 year. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE) and Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding, MACCE was defined as a composite of all-cause death, myocardial infarction or stroke. Multivariate Cox regression analysis and inverse probability of treatment weighting (IPTW) Cox regression analysis were performed. Results: After a median follow-up of 2.5 years, patients who received DAPT>1 year were associated with lower risks of MACCE (1.4% vs. 3.2%; hazard ratio (HR) 0.412, 95% confidence interval (CI) 0.205-0.827) compared with DAPT ≤1 year, which was primarily caused by the lower all-cause mortality (0.1% vs. 2.6%; HR 0.031, 95%CI 0.004-0.236). Risks of cardiac death (0.1% vs. 1.5%; HR 0.051, 95%CI 0.006-0.416) and definite/probable ST (0.3% vs. 1.1%; HR 0.218, 95%CI 0.052-0.917) were also lower in patients received DAPT>1 year than those received DAPT ≤ 1 year. No difference was found between the two groups in terms of BARC type 2, 3, or 5 bleeding (5.3% vs. 4.1%; HR 1.088, 95%CI 0.650-1.821). Conclusions: In patients with stable CAD and diabetes who were event-free at 1 year after PCI with DES, prolonged DAPT (>1 year) provides a substantial reduction in ischemic cardiovascular events, including MACCE, all-cause mortality, cardiac mortality, and definite/probable ST, without increasing the clinically relevant bleeding risk compared with ≤ 1-year DAPT. Further well-designed, large-scale randomized trials are needed to verify the beneficial effect of prolonged DAPT in this population.

Temperature-Induced Lifshitz Transition and Possible Excitonic Instability in ZrSiSe.

The nodal-line semimetals have attracted immense interest due to the unique electronic structures such as the linear dispersion and the vanishing density of states as the Fermi energy approaching the nodes. Here, we report temperature-dependent transport and scanning tunneling microscopy (spectroscopy) [STM(S)] measurements on nodal-line semimetal ZrSiSe. Our experimental results and theoretical analyses consistently demonstrate that the temperature induces Lifshitz transitions at 80 and 106 K in ZrSiSe, which results in the transport anomalies at the same temperatures. More strikingly, we observe a V-shaped dip structure around Fermi energy from the STS spectrum at low temperature, which can be attributed to co-effect of the spin-orbit coupling and excitonic instability. Our observations indicate the correlation interaction may play an important role in ZrSiSe, which owns the quasi-two-dimensional electronic structures.

The giant planar Hall effect and anisotropic magnetoresistance in Dirac node arcs semimetal PtSn4.

Topological semimetals (TSMs) present intriguing quantum states and have attracted much attention in recent years because of exhibiting various anomalous magneto-transport phenomena. Theoretical prediction shows that some novel phenomena, such as negative magnetoresistance (MR) and the planar Hall effect (PHE), originate from the chiral anomaly in TSMs. In this work, high-field (33 T) Shubnikov-de Haas (SdH) oscillations are obtained to reveal the topology of PtSn4. Giant PHE and anisotropic magnetoresistance (AMR) are observed in Dirac node arcs of semimetal PtSn4. First, a non-zero transverse voltage can be acquired while tilting the in-plane magnetic field. Moreover, the amplitude of PHE sharply increases at T * ∼ 50 K with decreasing temperature, which is suggested to be related to the Fermi surface reconstruction observed in PtSn4. Subsequently, the field-dependent amplitudes of the PHE show an abnormal behavior around 50 K, which is thought to stem from the complex correlation between the chiral charge and electric one in PtSn4 driving the system into different coupling states due to the complicated band structure. On the other hand, the relative AMR is negative and up to -98% at 8.5 T. Our work proves that the PHE measurements are a convincing transport fingerprint feature to confirm the chiral anomaly in TSMs.

Critical behavior in tetragonal antiperovskite GeNFe3 with a frustrated ferromagnetic state.

Tetragonal GeNFe3 has a second-order ferromagnetic (FM) to paramagnetic transition at 76 K. Our integrated investigations indicate that the ground FM state is frustrated and the tetragonal symmetry is retained below 550 K based on the results of variable temperature X-ray diffraction. Critical behavior was analyzed by a systematic bulk magnetization study. The estimated critical exponents by three different methods (modified Arrott plot, the Kouvel-Fisher method, and critical isotherm analysis) conformably suggest that long-range magnetic coupling described by mean-field (MF) theoretical model is dominant in GeNFe3. The experimental M-T-H data collapse into two independent branches according to the scaling equations m = f±(h) with the renormalized magnetization m = ε-ßM(H, ε) and the magnetic field h = Hε-(ß+γ). The exchange distance is estimated as J(r) ∼ r-4.8 on the basis of the ß and γ values, which lies between the long-range MF model (r-4.5) and the short-range 3D Heisenberg (3DH) model (r-5). Our results indicate that the competition between local magnetic moments of iron 3d electronic state and itinerant covalent interactions of N-Fe bonds should be responsible for critical behavior in this system.

Large Positive Thermal Expansion and Small Band Gap in Double-ReO3-Type Compound NaSbF6.

Double-ReO3-type structure compound NaSbF6 undergoes a low-temperature rhombohedral to high-temperature cubic phase between 303 and 323 K, as revealed by temperature-dependent X-ray diffractions. Although many double-ReO3-type fluorides exhibit either low thermal expansion or negative thermal expansion (NTE), NaSbF6 exhibits positive thermal expansion (PTE) with a large volumetric coefficient of thermal expansion, αv = 62 ppm/K, in its cubic phase. Raman spectroscopy reveals that the low-frequency transverse vibration of fluorine atoms is stiffened in NaSbF6, compared with the typical NTE compound CaZrF6 with the same structure. The related weak contraction associated with the polyhedral rocking would be overcome by the notable elongation of the Na-F bond length on heating, thus leading to the large volumetric PTE. Unlike ScF3 and CaZrF6 which are insulators with a wide band gap, a relative small band gap of 3.76 eV was observed in NaSbF6. The small band gap can be attributed to the hybridization between the Sb 5s and F 2p orbitals.

Pressure Induced Stripe-Order Antiferromagnetism and First-Order Phase Transition in FeSe.

To elucidate the magnetic structure and the origin of the nematicity in FeSe, we perform a high-pressure ^{77}Se NMR study on FeSe single crystals. We find a suppression of the structural transition temperature with pressure up to about 2 GPa from the anisotropy of the Knight shift. Above 2 GPa, a stripe-order antiferromagnetism that breaks the spatial fourfold rotational symmetry is determined by the NMR spectra under different field orientations and with temperatures down to 50 mK. The magnetic phase transition is revealed to be first-order type, implying the existence of a concomitant structural transition via a spin-lattice coupling. Stripe-type spin fluctuations are observed at high temperatures, and remain strong with pressure. These results provide clear evidence for strong coupling between nematicity and magnetism in FeSe, and therefore support a universal scenario of magnetic driven nematicity in iron-based superconductors.

Spin-orbit coupling enhanced superconductivity in Bi-rich compounds ABi3 (A = Sr and Ba).

Recently, Bi-based compounds have attracted attentions because of the strong spin-orbit coupling (SOC). In this work, we figured out the role of SOC in ABi3 (A = Sr and Ba) by theoretical investigation of the band structures, phonon properties, and electron-phonon coupling. Without SOC, strong Fermi surface nesting leads to phonon instabilities in ABi3. SOC suppresses the nesting and stabilizes the structure. Moreover, without SOC the calculation largely underestimates the superconducting transition temperatures (Tc), while with SOC the calculated Tc are very close to those determined by measurements on single crystal samples. The SOC enhanced superconductivity in ABi3 is due to not only the SOC induced phonon softening, but also the SOC related increase of electron-phonon coupling matrix elements. ABi3 can be potential platforms to construct heterostructure of superconductor/topological insulator to realize topological superconductivity.

Effects of tryptophan supplementation on cashmere fiber characteristics, serum tryptophan, and related hormone concentrations in cashmere goats.

This study was designed to investigate the effects of tryptophan (Trp) supplementation on cashmere fiber characteristics and on serum Trp, melatonin (MEL), prolactin (PRL), insulin-like growth factor 1 (IGF-1), triiodothyronine (T3), and thyroxine (T4) concentrations in cashmere goats during the cashmere fast-growth period. Thirty-six Liaoning cashmere wether goats were stratified on the basis of body weight (28±0.8 kg) and assigned randomly to 1 of the following 4 rumen-protected Trp treatments: 0, 2.0, 4.0, and 6.0 g per goat per day. The experimental period lasted 137 d. Blood samples were collected monthly during the daytime (8:00 AM) and at night (8:00 PM). Tryptophan supplementation improved cashmere growth rates, cashmere weight, and body weight (P=0.001) and increased serum Trp levels, nighttime MEL concentrations, IGF-1, and T3 and T4 concentrations (P<0.05). Across the treatments and sampling months, a highly positive correlation between cashmere growth rate and nighttime serum MEL concentrations was observed (r=0.879, P=0.001). A moderately negative correlation between cashmere growth rates and serum PRL concentrations during the day and at night (rday=-0.645, P=0.007; rnight=-0.583, P=0.018) was observed. A moderately positive correlation between the cashmere growth rate and the daytime serum IGF-1 concentration (r=0.536, P=0.032) was observed, and no correlation was found between the cashmere growth rate and the other serum hormone concentrations. These data indicate that changes in serum concentrations of MEL, IGF-1, and PRL are related to cashmere growth in Liaoning cashmere goats during the cashmere fast-growth period. Under the experimental conditions of the current trial, we suggest that Trp may promote cashmere growth by increasing daytime IGF-1 and nighttime MEL secretion.

Assessment of Cu (II)-bearing montmorillonite on Cd adsorption.

The abilities of montmorillonite (MMT) and Cu (II)-bearing montmorillonite (Cu-MMT) for adsorption of Cd from aqueous solutions have been studied at different optimized conditions of shaking time, pH value, and initial concentration, respectively. The results showed that the adsorbability of Cu-MMT onto Cd is stronger than the MMT. The amount of Cu-MMT necessary to remove Cd from solution was about 0.5 g for 100-200 mg/L Cd solution at a pH of 4.0. The maximum adsorption (94%) was 20 min of shaking time using Cu-MMT as adsorbent. The maximum adsorption of Cd = 95% at a pH of 4.0. By increasing the initial concentration, the adsorption amount of Cd onto Cu-MMT increased. Animal experiment of this study indicated that the addition of Cu-MMT to the Cd-contaminated diet of pigs reduced significantly the Cd levels in tissues (p < 0.05) and increased contents in feces (p < 0.01), improving the safety of animal products. Thus, the overall results established the use of Cu-MMT as a heavy metal adsorbent in animal's diets, implying a potential protective role against heavy metal toxicities.

Observation of the large magnetocaloric effect in an orbital-spin-coupled system MnV(2)O(4).

The magnetocaloric effect (MCE) in an orbital-spin-coupled spinel vanadate MnV(2)O(4) is investigated by magnetization measurement. MnV(2)O(4) has ferrimagnetic ordering occurring at T(C) = 57 K. The maximum magnetic entropy change reaches 14.8 and 24.0 J kg(-1) K(-1) for field changes of 0-2 and 0-4 T, respectively. The maximum adiabatic temperature is about 2.9 K for a magnetic field change of 2 T. Except for the spin entropy change, the observed giant MCE is suggested to be related to the orbital entropy change due to the change of the orbital state of V(3+) induced by an applied magnetic field around T(C).

Critical behavior of double perovskite La(2)NiMnO(6).

The critical behavior of the double perovskite La(2)NiMnO(6) was investigated by measurement of the magnetization around the Curie temperature T(C). The magnetic data were analyzed in the critical region using the Kouvel-Fisher method to yield the critical exponents of ß = 0.408 ± 0.011 with T(C) = 270.50 (from the temperature dependence of the spontaneous magnetization below T(C)) and γ = 1.295 ± 0.015 with T(C) = 271.10 (from the temperature dependence of the inverse initial susceptibility above T(C)). The critical magnetization isotherm M(T(C),H) gives δ = 4.139 ± 0.090. The critical exponents obtained by this method obey the Widom scaling relation δ = 1+γ/ß, implying the critical exponents are reliable. The values of critical exponents are close to those predicted by the three-dimensional (3D) Heisenberg model with short-range interactions.

The prevalence and awareness of hypertension and the relationship between hypertension and snoring in the Korean population.

BACKGROUND: Hypertension is the most important, and yet modifiable, risk factor for cardiovascular diseases. But in many countries, hypertension remains poorly controlled. Moreover, sleep apnea syndrome has shown that it is correlated with hypertension. The purpose of this study was to investigate the prevalence, awareness and control of hypertension among the Korean people and to evaluate the relationship between hypertension and snoring. METHODS: A total of 640 subjects living in Ansan, a regional city in Korea, were selected randomly, and trained nursing students investigated their age, sex, medical history, blood pressure, body mass index (BMI) and snoring score. Blood pressures were measured three times with a 10-minute interval and then averaged. The degree of snoring was estimated using a questionnaire. We divided the subjects into hypertensive (BP > or = 140/90 mmHg) versus normotensive group and snorer versus non-snorer group, and correlated hypertension with snoring. RESULTS: Of 640 subjects, 311 were male. The mean age was 39.7 +/- 14.6 years (18-77 years), the mean BMI (body mass index) was 22.4 +/- 3.0 kg/m2. The mean systolic and diastolic blood pressure was 121 +/- 15.7 mmHg and 79.5 +/- 11.6 mmHg. The prevalence and awareness of hypertension were 22.2% and 16.9%, respectively, and the prevalence of snoring was 35.2%. With the increment of age, in the male, the prevalence of hypertension and snoring were higher, and the snorer group showed a higher risk of hypertension than the non-snorer group (Odds ratio 2.32, CI = 1.56-3.39, p = 0.0001). CONCLUSION: In Korea, the prevalence of hypertension was similar to that in the western countries, but the awareness of hypertension was much lower compared with western countries. The prevalence of hypertension was higher in the snorer group, so more research on the correlation between the two conditions should be advanced in the future.

Assessment of coronary flow reserve with transthoracic Doppler echocardiography: comparison with intracoronary Doppler method.

To evaluate the feasibility and usefulness of transthoracic Doppler echocardiography (TTDE) as a non-invasive method in recording distal anterior descending (LAD) coronary flow velocity, we compared coronary flow reserve (CFR) measured by TTDE with measurements by intracoronary Doppler wire (ICDW). Twenty-one patients without LAD stenosis were studied. ICDW performed at baseline and after intracoronary injection of 18 microg adenosine. TTDE was performed at baseline and after intravenous adenosine (140 microg/kgmin for 2 min). Adequate Doppler recordings of coronary flow velocities during systole were obtained in 14 of 21 study patients (67%) and during diastole in 17 (81%) patients. Baseline and hyperemic peak diastolic flow velocities measured by TTDE were significantly smaller than those obtained by ICDW (p<0.05). However, diminishing trends of diastolic and systolic velocity ratio after hyperemia were similarly observed in both methods. CFR obtained by TTDE (3.0+/-0.5), was higher than the value calculated by ICDW (2.5+/-0.4). There were significant correlations between the values obtained by the two methods (r=0.72, p<0.01). It is concluded that TTDE is a feasible method in measuring coronary flow velocity and appears to be a promising non-invasive method in evaluating CFR.

Microvascular integrity as a predictor of left ventricular remodeling after acute anterior wall myocardial infarction.

The purpose of this study was to investigate the relation of microvascular integrity and ventricular remodeling after acute myocardial infarction. Twenty-six patients with first acute anterior myocardial infarction were studied before discharge with myocardial contrast echocardiography (MCE). Opacification index (OI) and wall motion index were calculated in the left anterior descending artery territory and left ventricular diastolic volume was measured at baseline and during a 9-month follow-up. In total 26 patients, the regional wall motion improved but the left ventricular volume and global function was not changed significantly at follow-up. When the patients were divided into 3 groups according to opacification index (> or = 0.75, 0.5 approximately 0.75, < or = 0.5) at baseline, functional recovery was not observed and significant left ventricular dilatation was developed in patients with < or = 0.5 OI. Among the baseline echo-parameters such as ejection fraction, wall motion score, left ventricular volume and opacification index, the best predictor for long term left ventricular dilatation was the opacification index by multivariate analysis. In patients with acute anterior wall infarction the assessment of microvascular integrity by MCE at acute stage provides useful information regarding recovery of dysfunctional regional wall motion and ventricular remodeling.

Neurosurgical aspects of sedimentation levels in acute intracerebral haematoma.

We describe the neurosurgical aspects of sedimentation levels that are rarely found in acute intracerebral haematomas (ICH). We had four patients with acute ICH whose cerebral computed tomography revealed sedimentation levels. Two patients had received thrombolytic therapy for ischaemic heart disease and one for ischaemic stroke. Another patient, who was diagnosed later as having a coagulation disorder, did not have any medical history on admission. All patients had emergency ICH drainage under local anaesthesia. In the immediate postoperative period, we observed dramatic improvement in all the patients, without surgical complications. The sedimentation level in an ICH should be identified as a specific indicator of a coagulation defect and a thorough search for possible underlying coagulopathy is warranted. We believe that simple ICH drainage should be performed as the haematoma is in a liquid form.