RESUMO
To date, few cases of concurrent acute myeloid leukemia (AML) and untreated chronic lymphocytic leukemia (CLL) have been reported. Due to the complexity of the pathogenesis and the absence of a uniform treatment regimen, the associated prognosis remains poor. The present study reports the case of a 58-year-old male with asymptomatic leukocytosis, who was previously healthy with no malignancies. Flow cytometry analysis revealed protocytosis, monocytosis and monoclonal B lymphocytosis in a bone marrow specimen. Results of a gene rearrangement assay demonstrated positive immunoglobulin heavy-chain variable region gene status in monoclonal B lymphocytes. Thus, the patient was diagnosed with AML with maturation (AML-M2) that co-existed with untreated CLL. The normative daunorubicin (40 mg/m2 on days 1-3) and cytarabine (80 mg/m2 on days 1-7) regimen combined with venetoclax (400 mg on days 1-7) and rituximab (375 mg/m2 on day 0) was used as induction chemotherapy. The patient achieved morphological complete remission in both AML and CLL following the first course of chemotherapy. In addition, the present study retrospectively analyzed the data of 22 patients with concurrent AML and untreated CLL, and the results demonstrated that the median age at the time of AML diagnosis was 69 years (range, 52-86 years). Moreover, the male:female ratio was 6.33:1 and AML-M2 was the most frequent subtype at diagnosis. The presence of a complex karyotype was associated with the poorest prognosis, and patients who received venetoclax often exhibited an improved prognosis. In conclusion, the combination of venetoclax and rituximab improves the prognosis of patients with concurrent AML and untreated CLL.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Compostos Bicíclicos Heterocíclicos com Pontes , Citarabina , Daunorrubicina , Leucemia Mieloide Aguda , Sulfonamidas , Humanos , Daunorrubicina/administração & dosagem , Citarabina/administração & dosagem , Citarabina/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Sulfonamidas/administração & dosagem , Sulfonamidas/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Compostos Bicíclicos Heterocíclicos com Pontes/uso terapêutico , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , AdultoRESUMO
The anchor drilling operations generate massive airborne dust particles in the tunnel heading face that raises the pneumoconiosis morbidity and explosion risk. In this paper, a full-scale tunnel physical model is constructed to study the effect of the wind velocity and drilling site position on the airborne dust regional pollution scope based on the actual anchor drilling craft. The research indicates that the four extensive vortex areas keep the dust suspension at 14 m from the heading face and make the deposition dust particle refloat. The average respirable dust rate reaches the maximum value at section 5 m and presents a gradual decline as the dust particle migrates along the outlet direction. Raising the wind velocity contributes to alleviating the airborne dust pollution in the anchor drilling operation. As the wind velocity increases from 3 to 24 m/s, the high dust concentration area and number higher than 200 mg/m3 pose overall decrease trends, and the average dust concentration displays a linear decrease until 26.14-58.65 mg/m3 around the anchor worker head. Moving the drilling site positions closer to the exhaust air duct aggravates the airborne dust pollution in the front breathing zone. As the anchor drilling operation switches from the return air side to the supply air side, the dust concentration area ascends by 59.4-84.4% in the personnel respiratory space.
Assuntos
Poluentes Ocupacionais do Ar , Exposição Ocupacional , Exposição Ocupacional/análise , Poluentes Ocupacionais do Ar/análise , Tamanho da Partícula , Poeira/análise , Monitoramento AmbientalRESUMO
BACKGROUND: Venetoclax (Ven) combined with intensive chemotherapy was proven effective in the management of acute myeloid leukemia (AML). However, the severe and prolonged myelosuppression remains a concern to worry about. To explore more appropriate combination regimens, we designed Ven combining daunorubicin and cytarabine (DA 2 + 6) regimen as induction therapy, aimed to evaluate the effectiveness and safety in adults de novo AML. METHODS: A phase 2 clinical trial was performed in 10 Chinese hospitals to investigate Ven combined with daunorubicin and cytarabine (DA 2 + 6) in patients with AML. The primary endpoints were overall response rate (ORR), comprising of complete remission (CR), complete remission with incomplete blood cell count recovery (CRi), and partial response (PR). Secondary endpoints included measurable residual disease (MRD) of bone marrow assessed by flow cytometry, overall survival (OS), event-free survival (EFS), disease-free survival (DFS), and the safety of regimens. This study is a currently ongoing trial listed on the Chinese Clinical Trial Registry as ChiCTR2200061524. RESULTS: Overall, 42 patients were enrolled from January 2022 to November 2022; 54.8% (23/42) were male, and the median age was 40 (range, 16-60) years. The ORR after one cycle of induction was 92.9% (95% confidence interval [CI], 91.6-94.1; 39/42) with a composite complete response rate (CR + CRi) 90.5% (95% CI, 89.3-91.6, CR 37/42, CRi 1/42). Moreover, 87.9% (29/33) of the CR patients with undetectable MRD (95% CI, 84.9-90.8). Grade 3 or worse adverse effects included neutropenia (100%), thrombocytopenia (100%), febrile neutropenia (90.5%), and one mortality. The median neutrophil and platelet recovery times were 13 (5-26) and 12 (8-26) days, respectively. Until Jan 30, 2023, the estimated 12-month OS, EFS, and DFS rates were 83.1% (95% CI, 78.8-87.4), 82.7% (95% CI, 79.4-86.1), and 92.0% (95% CI, 89.8-94.3), respectively. CONCLUSION: Ven with DA (2 + 6) is a highly effective and safe induction therapy for adults with newly diagnosed AML. To the best of our knowledge, this induction therapy has the shortest myelosuppressive period but has similar efficacy to previous studies.
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The atmospheric dust has a great negative impact on the societal harmonious development that starves for an efficient dust suppressant. This paper proposes a novel AES/polyacrylamide strengthen foam (APSF) to improve the dust trapping effectiveness. The APSF structure property and dust suppression capacity are studied and evaluated through the molecular dynamics simulation and experimental tests. The results express that APSF exhibits the stronger structure stability, superior water retention, and slower drainage performance than the traditional water-based foam (WBF). APSF dynamic simulation is studied by the relative concentration, radial distribution function, head group orientation, and mean square displacement. Research shows that APSF introduces water to thicken the hydration layer. The interaction strength between water and surfactant head groups is enhanced by 22.62 and 31.37% in the first and second hydrated water shells. APSF improves the sodium fatty alcohol ether sulfate (AES) orientation and weakens the diffusion of water molecules, which favors the foam stability. APSF exerts a better wettability on the coal dust through the wet settlement and contact angle tests. The APSF liquid film thickness reduces to 58.05 from 64.80 µm that is 3.14 times of WBF according to the foam liquid film decay experiment. Fourier transform infrared (FTIR) spectroscopy analysis indicates that there is an evident reinforcement on the coal surface absorption peak intensity of hydroxyl- and oxygen-containing functional groups treated by APSF. FTIR results are further determined by energy-dispersion spectrum analysis.
RESUMO
High dust concentration produced in the fully mechanized longwall mining face is a significant threat to the front-line workers. It is critical to discover the potential safety zone to ensure routine personnel operation. Fluent 2020 R1 is employed to reappear the spatial dust distribution based on the gas-solid coupling theory. The dust migration behavior and safety regional division are illuminated in the spatial longwall mining face. The formation of dust concentration trigonum is introduced with the particle diffusion force analyzed. The YZ plane safety zone area shows an increasing trend at X = 70-95 m. The respirable dust concentration decreases from the peak value to the safe value at sidewalk 4.0-4.6 m. The safety zone area and length both pose a linear growth with the increasing wind velocity. In the XY plane, the safety zone area and length extend by 1.26 times and 1.33 times, respectively. The horizontal plane creates a greater growth rate of safety zone than the vertical plane. The drum rotation creates a wind circumfluence that exerts an obvious effect on the dust distribution around the coal cutter. The sidewalk region mainly situates in the safety zone for the personal squat down, while it is gradually exposed to the dangerous dust pollution situation as the breathing height rises.
Assuntos
Minas de Carvão , Exposição Ocupacional , Carvão Mineral/análise , Poeira/análise , Humanos , Exposição Ocupacional/análise , VentoRESUMO
Foam is used as an efficient means of dust suppression in underground coal mines. The poor performance of conventional adding device of foaming agent restricts its wide application. The objective of this study is to propose and investigate a new parallel jet adding device (PJAD). Experimental results show that PJAD requires a greater water flow to produce negative pressure than the single stage jet adding device (SJAD) and is harder to generate cavitation. PJAD consumes a less pressure loss than SJAD and realizes any adding proportion below 1%, which is especially suitable for precision addition of foaming agent. A foaming system used for dust suppression is put forward with PJAD adding foaming agent. Field application indicates that foam achieves a far better dust suppression effect than the roadheader water spraying, and the foam cost is significantly reduced due to the low adding proportion of foaming agent. The marked dust suppression effect makes us believe that the proposed PJAD will greatly promote the large-scale application of foam technology used for dust suppression in underground coal mines.
Assuntos
Minas de Carvão/instrumentação , Minas de Carvão/métodos , Poeira/prevenção & controle , Invenções , Exposição Ocupacional/prevenção & controle , Substâncias Viscoelásticas/farmacologia , Poluentes Atmosféricos/farmacocinética , Poluição do Ar/prevenção & controle , Ar Comprimido , Desenho de Equipamento , Humanos , Prática Profissional , Substâncias Viscoelásticas/administração & dosagem , Substâncias Viscoelásticas/químicaRESUMO
Coal fires are a serious threat to the workers' security and safe production in open pit mines. The coal fire source is hidden and innumerable, and the large-area cavity is prevalent in the coal seam after the coal burned, causing the conventional extinguishment technology difficult to work. Foams are considered as an efficient means of fire extinguishment in these large-scale workplaces. A noble foam preparation method is introduced, and an original design of cavitation jet device is proposed to add foaming agent stably. The jet cavitation occurs when the water flow rate and pressure ratio reach specified values. Through self-building foaming system, the high performance foams are produced and then infused into the blast drilling holes at a large flow. Without complicated operation, this system is found to be very suitable for extinguishing large-scale coal fires. Field application shows that foam generation adopting the proposed key technology makes a good fire extinguishment effect. The temperature reduction using foams is 6-7 times higher than water, and CO concentration is reduced from 9.43 to 0.092 in the drilling hole. The coal fires are controlled successfully in open pit mines, ensuring the normal production as well as the security of personnel and equipment.