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BACKGROUND: Central nervous system involvement in chronic lymphocytic leukemia rarely occurs, and there is no standard therapy for central nervous system involvement in chronic lymphocytic leukemia. This article aims to analyze the diagnosis and treatment of central nervous system involvement in chronic lymphocytic leukemia. CASE PRESENTATION: It reports two cases of central nervous system involvement in chronic lymphocytic leukemia describing the clinical course, therapy, and prognosis. Case 1 is a 67-year-old Asian male patient, he experienced complications with central nervous system involvement after developing resistance to ibrutinib, bendamustine, and rituximab (BR) chemotherapies. The central nervous system lesion was controlled with high-dose methotrexate combined with pomalidomide, but Richter transformation occurred several months later. Case 2 is a 62-year-old Asian female patient, she had central nervous system involvement at initial diagnosis, and bone marrow and central nervous system lesions were controlled by ibrutinib therapy. CONCLUSION: Central nervous system involvement in chronic lymphocytic leukemia is rare and can be diagnosed on the basis of clinical features, cerebrospinal fluid testing, and radiographic evaluation. Ibrutinib, pomalidomide, and other drugs that can cross the blood-brain barrier may be effective for treating central nervous system involvement in chronic lymphocytic leukemia.
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Adenina , Leucemia Linfocítica Crónica de Células B , Piperidinas , Talidomida , Humanos , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Anciano , Masculino , Femenino , Persona de Mediana Edad , Adenina/análogos & derivados , Piperidinas/uso terapéutico , Talidomida/uso terapéutico , Talidomida/análogos & derivados , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/secundario , Neoplasias del Sistema Nervioso Central/diagnóstico por imagen , Pirazoles/uso terapéutico , Metotrexato/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Pirimidinas/uso terapéuticoRESUMEN
Bruton's tyrosine kinase inhibitors (BTKi) exhibit superior efficacy in relapsed/refractory primary central nervous system lymphoma (PCNSL), but few studies have evaluated patients with newly diagnosed PCNSL, and even fewer studies have evaluated differences in efficacy between treatment with BTKi and traditional chemotherapy. This study retrospectively analyzed the clinical characteristics of 86 patients with PCNSL and identified predictors of poor prognosis for overall survival (OS). After excluding patients who only received palliative care, 82 patients were evaluated for efficacy and survival. According to the induction regimen, patients were divided into the traditional chemotherapy, BTKi combination therapy, and radiotherapy groups; the objective response rates (ORR) of the three groups were 71.4%, 96.2%, and 71.4% (P = 0.037), respectively. Both median progression-free survival and median duration of remission showed statistically significant differences (P = 0.019 and P = 0.030, respectively). The median OS of the BTKi-containing therapy group was also longer than that of the traditional chemotherapy group (not reached versus 47.8 (32.5-63.1) months, P = 0.038).Seventy-one patients who achieved an ORR were further analyzed, and achieved an ORR after four cycles of treatment and maintenance therapy had prolonged OS (P = 0.003 and P = 0.043, respectively). In conclusion, survival, and prognosis of patients with newly diagnosed PCNSL are influenced by the treatment regimen, with the BTKi-containing regimen showing great potential.
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Chiral nanographenes (NGs) have garnered significant interest as optoelectronic materials in recent years. While helically chiral NGs have been extensively studied, axially chiral NGs have only witnessed limited examples, with no prior reports of axially chiral nonbenzenoid NGs. Herein we report an axially chiral nonbenzenoid nanographene featuring six pentagons and four heptagons. This compound, denoted as 2, was efficiently synthesized via an efficient Pd-catalyzed aryl silane homocoupling reaction. The presence of two bulky 3,5-di-tert-butylphenyl groups around the axis connecting the two nonbenzenoid PAH (AHR) segments endows 2 with atropisomeric chirality and high racemization energy barrier, effectively preventing racemization of both R- and S-enantiomers at room temperature. Optically pure R-2 and S-2 were obtained by chiral HPLC separation, and they exhibit circular dichroism (CD) activity at wavelengths up to 660 nm, one of the longest wavelengths with CD responses reported for the chiral NGs. Interestingly, racemic 2 forms a homoconfiguration π-dimer in the crystal lattice, belonging to the I222 chiral space group. Consequently, this unique structure renders crystals of 2 with a second harmonic generation (SHG) response, distinguishing it from all the reported axially chiral benzenoid NGs. Moreover, R-2 and S-2 also exhibit SHG-CD properties.
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Two-dimensional (2D) transition metal chalcogenides (TMCs) hold great promise as novel microwave absorption materials owing to their interlayer interactions and unique magnetoelectric properties. However, overcoming the impedance mismatch at the low loading is still a challenge for TMCs due to the restricted loss pathways caused by their high-density characteristic. Here, an interface engineering based on the heterostructure of 2D Cr5Te8 and graphite is in situ constructed via a one-step chemical vapor deposit to modulate impedance matching and introduce multiple attenuation mechanisms. Intriguingly, the Cr5Te8@EG (ECT) heterostructure exhibits a minimum reflection loss of up to - 57.6 dB at 15.4 GHz with a thin thickness of only 1.4 mm under a low filling rate of 10%. The density functional theory calculations confirm that the splendid performance of ECT heterostructure primarily derives from charge redistribution at the abundant intimate interfaces, thereby reinforcing interfacial polarization loss. Furthermore, the ECT coating displays a remarkable radar cross section reduction of 31.9 dB m2, demonstrating a great radar microwave scattering ability. This work sheds light on the interfacial coupled stimulus response mechanism of TMC-based heterogeneous structures and provides a feasible strategy to manipulate high-quality TMCs for excellent microwave absorbers.
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Non-benzenoid polycyclic aromatic hydrocarbons (PAHs) have received a lot of attention because of their unique optical, electronic, and magnetic properties, but their synthesis remains challenging. Herein, we report a non-benzenoid isomer of peri-tetracene, diazulenorubicene (DAR), with two sets of 5/7/5 membered rings synthesized by a (3+2) annulation reaction. Compared with the precursor containing only 5/7 membered rings, the newly formed five membered rings switch the aromaticity of the original heptagon/pentagon from antiaromatic/aromatic to non-aromatic/antiaromatic respectively, modify the intermolecular packing modes, and lower the LUMO levels. Notably, compound 2 b (DAR-TMS) shows p-type semiconducting properties with a hole mobility up to 1.27â cm2 â V-1 s-1 . Moreover, further extension to larger non-benzenoid PAHs with 19â rings was achieved through on-surface chemistry from the DAR derivative with one alkynyl group.
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Bio-oil can be used as a substitute for fossil fuels after it is upgraded. Bimetal-modified HZSM-5 catalysts with various Ni-to-Co ratios were prepared to address catalysis problems, including deactivation of the catalysts and low hydrocarbon yields. The catalytic performance of Ni-Co/HZSM-5 in upgrading the simulated bio-oil was investigated with a fixed-bed reactor, and the influence of the loaded duplex metal ratio was also discussed. The new moderately strong/strong acid sites of Ni-Co/HZSM-5 changed according to the Ni/Co loading ratios, which substantially affected the acidity, catalytic activity and selectivity of the Ni-Co/HZSM-5. However, incorporating Co and Ni into the zeolite did not alter the structure of the HZSM-5. The interactions of the loaded bimetallic oxides reached equilibrium in 6Ni-4Co/HZSM-5, in which moderately strong acid sites and strong acid sites were formed after loading with Co3O4 and NiO. With a suitable acid site ratio, 6Ni-4Co/HZSM-5 exhibited excellent performance, with a lower coke deposition of 3.29 wt% and stable catalytic activity, and the conversion remained at 83-73% during 360 min of uninterrupted catalysis. Periodic changes in the acid sites and interfacial protons were the critical factors that improved the properties of the 6Ni-4Co/HZSM-5 and enhanced its selectivity for aromatic compounds.
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Non-benzenoid acenes containing heptagons have received increasing attention. We herein report a heptacene analogue containing a quinoidal benzodi[7]annulene core. Derivatives of this new non-benzenoid acene were obtained through an efficient synthetic strategy involving an Aldol condensation and a Diels-Alder reaction as key steps. The configuration of this heptacene analogue can be modulated from a wavy to a curved one by just varying the substituents from a (triisopropylsilyl)ethynyl group to a 2,4,6-triisopropylphenyl (Trip) group. When mesityl (Mes) groups are linked to the heptagons, the resulting non-benzenoid acene displays polymorphism with a tunable configuration from a curved to a wavy one upon varying the crystallization conditions. In addition, this new non-benzenoid acene can be oxidized or reduced by NOSbF6 or KC8 to the respective radical cation or radical anion. Compared with the neutral acene, the radical anion shows a wavy configuration and the central hexagon becomes aromatic.
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A perylene five-membered ring diimide, PDI39, was developed as a new electron-deficient building block for n-type semiconductors. The π-expanded conjugated molecules containing azulenes were synthesized from PDI39. These conjugated molecules show helical geometry and near-infrared absorption up to 810 nm.
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BACKGROUND: Oral nutritional supplements (ONS) is a cost-effective nutritional therapy in patients with gastrointestinal cancer. However, information is lacking about adherence to ONS in general clinical settings. Figuring out adherence to ONS and related factors will provide evidence for the improvement of ONS usage practice. OBJECTIVE: The aim of this study was to survey adherence to ONS in gastrointestinal cancer patients with an ONS prescription and the factors associated with it. METHODS: A mixed-method prospective study was conducted. Multivariate analysis and semistructured interviews were performed to identify factors that affected patient adherence to ONS. RESULTS: Of 111 gastrointestinal cancer patients provided with an ONS prescription, the median of adherence to ONS was 50.00% (interquartile range, 28.57%-91.67%). Multivariate analysis indicated that participants with low weight showed higher adherence to ONS than those with normal weight (ß = -2.61, P = .011) or overweight (ß = -3.25, P = .002). Semistructured interviews on 14 participants suggested that factors related to adherence to ONS were needs perception and benefits, clarity of the target daily ONS intake, tolerance to ONS, the impact of disease or treatment, personal preference, and professional support. CONCLUSION: This study reveals poor adherence to ONS in patients with gastrointestinal cancer and factors related to it in current clinical settings. IMPLICATIONS FOR PRACTICE: Our findings could provide evidence for the development of strategies to improve ONS usage practice. It suggests that the practice in ONS should be improved from aspects of nutritional assessment, education, tolerance, and symptom management, as well as follow-up and monitoring of patients.
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Suplementos Dietéticos , Neoplasias Gastrointestinales , Neoplasias Gastrointestinales/complicaciones , Humanos , Evaluación Nutricional , Cooperación del Paciente , Estudios ProspectivosRESUMEN
AIM: To examine the incidence and risk factors for asymptomatic peripherally inserted central catheter-related thrombosis (PICC-RT). DESIGN: We performed a systematic review and meta-analysis following the PRISMA guidelines. METHODS: The review was registered in PROSPERO (CRD42020186732). A systematic search of EMBASE, CINAHL, PubMed, Web of Science and Cochrane was performed from inception to 4 June 2020. Meta-analysis was performed to determine the pooled incidence of asymptomatic PICC-RT. RESULTS: Ten studies comprising 1591 participants with 1592 PICCs were included in this meta-analysis. The pooled incidence of asymptomatic PICC-RT in adults was 22% (95% CI, 0.17-0.29). The pooled incidence of PICC-RT in cancer patients was 19% (95% CI, 0.13-0.26). Asymptomatic PICC-RT mainly occurred in superficial veins. Most asymptomatic thrombosis occurred 3-12 days after the PICC insertion. A higher Eastern Cooperative Oncology Group score (ECOG), slower blood flow velocity and left basilic vein were independent risk factors of asymptomatic thrombosis.
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Cateterismo Venoso Central , Cateterismo Periférico , Trombosis Venosa Profunda de la Extremidad Superior , Adulto , Cateterismo Venoso Central/efectos adversos , Cateterismo Periférico/efectos adversos , Catéteres , Humanos , IncidenciaRESUMEN
As ultralight and superelastic aerogels are quite desirable for pressure sensing and energy storage applications, superelastic and ultralight carbon nanofiber (CNF)/transition metal carbides and carbonitrides (MXenes) hybrid aerogels with anisotropic microchannels are thus fabricated by liquid nitrogen-assisted unidirectional-freezing followed by freeze-drying. The CNFs with high aspect ratios entangle and assemble into the interconnected scaffolds, while the MXene sheets enhance structural stability of the framework of CNFs and endow the aerogels with satisfactory electronic conductivities. Benefiting from the stable architecture with orientated microchannels, the CNF/MXene aerogel (CNF/MX) with an ultralow density of 4.87 mg cm-3 exhibits superb compressible resilience at the strain of 50% for at least 5000 cycles and a high strain of 95% for 500 cycles. Importantly, the outstanding strain- or pressure-responses endow the CNF/MX aerogel sensor with high sensitivity (65 kPa-1), ultralow detection limit (<5 Pa), rapid response (26 ms), large workable strain range (0-95%), and superb response stability. Furthermore, the presence of MXene with excellent electrochemical activity makes the binder-free CNF/MX electrode exhibit a high rate performance with 80% capacitance retention when the current density increases by 100 times and a high cycling stability with capacitance retention of 90% after 20,000 cycles at 5 A g-1.
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Although graphene fiber-based supercapacitors are promising for wearable electronic devices, the low energy density of electrodes and poor cold resistance of aqueous electrolytes limit their wide application in cold environments. Herein, porous nitrogen/sulfur dual-doped graphene fibers (NS-GFs) are synthesized by hydrothermal self-assembly followed by thermal annealing, exhibiting an excellent capacitive performance of 401â F cm-3 at 400â mA cm-3 because of the synergistic effect of heteroatom dual-doping. The assembled symmetric all-solid-state supercapacitor with polyvinyl alcohol/H2 SO4 /graphene oxide gel electrolyte exhibits a high capacitance of 221â F cm-3 and a high energy density of 7.7â mWh cm-3 at 80â mA cm-3 . Interestingly, solar-thermal energy conversion of the electrolyte with 0.1â wt % graphene oxide extends the operating temperature range of the supercapacitor to 0 °C. Furthermore, the photocatalysis effect of the dual-doped heteroatoms increases the capacitance of NS-GFs. At an ambient temperature of 0 °C, the capacitance increases from 0 to 182â F cm-3 under 1â sun irradiation because of the excellent solar light absorption and efficient solar-thermal energy conversion of graphene oxide, preventing the aqueous electrolyte from freezing. The flexible supercapacitor exhibits a long cycle life, good bending resistance, reliable scalability, and ability to power visual electronics, showing great potential for outdoor electronics in cold environments.
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BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) has recently proposed a consensus on the criteria to diagnose malnutrition. The validity of the new criteria to detect malnutrition is still being explored. Therefore, this study aimed to verify the validity of the GLIM criteria for malnutrition in hospitalized patients with gastric cancer (GC) using the Patient-Generated Subjective Global Assessment (PG-SGA) as a comparator. METHODS: This is a cross-sectional study involving 217 GC inpatients. Nutrition assessment was performed during their hospitalization with both the GLIM criteria and the PG-SGA. Consistency of the assessment results and their correlation with the quality of life in patients were evaluated. RESULTS: A moderate concordance (K = 0.483, P < 0.001) was founded between the two methods for malnutrition diagnosis. Spearman correlation analysis confirmed the significant association (P < 0.05) between most aspects of the quality of life and nutrition status regarding either the GLIM criteria or the PG-SGA. In multivariate linear regression, adjusted for confounding variables, the quality of life was significantly associated with nutrition status by the GLIM criteria (B = 5.63, 95% CI: 0.09-11.16, P = 0.046), and by the PG-SGA (B = 13.53, 95% CI: 7.78-19.27, P < 0.001). CONCLUSIONS: This study provides a new understanding of the validity of the GLIM criteria in hospitalized GC patients. In the study, we have found that the new GLIM criteria are of concurrent and clinical validity in GC inpatients, suggested by the comparison with the PG-SGA and its correlation with the quality of life.
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Desnutrición , Neoplasias Gástricas , Estudios Transversales , Humanos , Liderazgo , Desnutrición/diagnóstico , Desnutrición/etiología , Evaluación Nutricional , Estado Nutricional , Calidad de Vida , Neoplasias Gástricas/complicacionesRESUMEN
AIMS: The study aimed to explore factors contributing to body weight change over time in gastric cancer patients after gastrectomy, in order to find risk factors to implement nutritional intervention beforehand. METHODS: A cohort of gastric cancer patients who were treated with gastrectomy from January to March 2019 at a university affiliated hospital in Shanghai were consecutively identified in this study. Demographics, disease related information, nutrition knowledge, attitude, and practice score were collected before gastrectomy. In addition, body weight before surgery (T0), body weight at one month (T1), two months (T2), and three months (T3) after gastrectomy were recorded. Generalized estimation equation was used to describe body weight change and analyze factors contributing to body weight change after surgery. RESULTS: There were 49 patients recruited in the study. Patient body weight decreased by 9.2% at T1 (Wald χ = 271.173, P <0.001), 11.0% at T2 (Wald χ 2 = 277.267, P <0.001), and 11.4% at T3 compared to baseline at T0 (Wald χ = 284.076, P <0.001). The results of GEE for multivariable analysis showed that surgery type (Wald χ = 6.027, P = 0.014) and preoperative BMI (Wald χ = 12.662, P = 0.005) were contributing factors of body weight change. Compared with distal gastrectomy patients, total gastrectomy patients experienced greater body weight loss (ß = 2.8%, P = 0.014). Compared with patients with BMI&λτ; 18.5 kg/m2, patients with BMI ≥ 25 kg/m2experienced greater body weight loss (ß = 4.5% P = 0.026). CONCLUSION: Gastric cancer patients experienced significant weight loss during 3 months after gastrectomy. Total gastrectomy and BMI ≥ 25 kg/m2were risk factors to postoperative body weight loss for GC patients. The results suggested hinted that clinician should pay attention to postoperative nutrition status of patient undergoing total gastrectomy and obesity patients.
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The aim of this work was to compare the yields, proximate composition, structure and surface morphology of biochar derived from lignin, cellulose, hemicellulose and pine nut shell (PNS) at 400-700 â. PNS biochars obtained at different pyrolysis pressures in the range of 0.1-2.0 MPa were also studied. The results indicate that the interactions of lignin, cellulose and hemicellulose have smaller effects on the ash content, yield and higher heating value (HHV) of the biochar than they do on the fixed carbon and volatile matter contents. Increasing the pyrolysis temperature improves the HHV of the biochar, and increasing the pyrolysis pressure enhances the biochar yield, surface functional groups and combustion characteristics. The kinetic data for Pb2+ adsorption are best fitted by a pseudo-second-order model, indicating a chemisorption-controlled process. The PNSB550 and PNSB1.0 data are optimally fit by the Freundlich and Langmuir models, respectively. The maximum Pb2+ adsorption capacity is 237.3 mg/g.
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Nueces , Pirólisis , Adsorción , Biomasa , Carbón Orgánico , TemperaturaRESUMEN
High viscosity and low fluidity of heavy crude oils usually hinder their rapid diffusion into porous adsorbents, causing a low efficiency of oil spill remediation. Photothermal effect is thus adopted to rapidly reduce the viscosity of heavy crude oil by in situ solar light heating. Photothermal carbon nanotube/reduced graphene oxide (CNT/RGO) microspherical aerogels are synthesized by fabrication of graphene oxide (GO)-based microspherical aerogels with numerous radially orientated microchannels, followed by growing CNTs inside the microchannels and high-temperature reduction of the GO components. Thanks to the efficient photothermal conversion effect and the rough and oleophilic surface of the microchannels with large surface area, such aerogels facilitate the solar light absorption and hence enhance the crude oil adsorption. Furthermore, the CNTs grown on the RGO skeleton by a chemical vapor deposition approach promote the photothermal conversion efficiency by trapping and absorbing broadband solar light. Under 1 sun irradiation, the surface temperature of the aerogel quickly rises to 83 °C in 1 min, resulting in a sharp decrease in crude oil viscosity. The optimal microspherical aerogels deliver an extraordinary adsorption capacity of heavy crude oil, up to 267 g g-1 within 10 min, superior to those of other oil adsorbents reported so far.
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BACKGROUND: Gastrodia elata is a widely distributed achlorophyllous orchid and is highly valued as both medicine and food. Gastrodia elata produces dust-like seeds and relies on mycorrhizal fungi for its germination and growth. In its life cycle, G. elata is considered to switch from a specific single-fungus relationship (Mycena) to another single-fungus relationship (Armillaria). However, no studies have investigated the changes in the plant-fungus relationship during the growth of G. elata in the wild. In this study, high-throughput sequencing was used to characterize the fungal community of tubers in different growth phases as well as the soils surrounding G. elata. RESULTS: The predominant fungi were Basidiomycota (60.44%) and Ascomycota (26.40%), which exhibited changes in abundance and diversity with the growth phases of G. elata. Diverse basidiomycetes in protocorms (phase P) were Hyphodontia, Sistotrema, Tricholoma, Mingxiaea, Russula, and Mycena, but the community changed from a large proportion of Resinicium bicolor (40%) in rice-like tubers (phase M) to an unidentified Agaricales operational taxonomic unit 1(OTU1,98.45%) in propagation vegetation tubers (phase B). The soil fungi primarily included Simocybe, Psathyrella, Conocybe, and Subulicystidium. Three Mycena OTUs obtained in this study were differentially distributed among the growth phases of G. elata, accounting for less than 1.0% of the total reads, and were phylogenetically close to Mycena epipterygia and M. alexandri. CONCLUSIONS: Our data indicated that G. elata interacts with a broad range of fungi beyond the Mycena genus. These fungi changed with the growth phases of G. elata. In addition, these data suggested that the development of the fungal community during the growth of G. elata was more complex than previously assumed and that at least two different fungi could be involved in development before the arrival of Armillaria.