Long-term risks of cardiovascular death among older patients with major hematological malignancies: a population-based cohort study from SEER database.

BACKGROUND: The objective of this study was to identify the risk of cardiovascular disease (CVD)-related death in older patients with major hematological malignancies (HM). METHODS: This study included 103,102 older patients diagnosed with 7 major types of HM between 1975 and 2018 (median follow-up: 2.7 years) from the Surveillance, Epidemiology, and End Result (SEER) database. The proportion of deaths, Fine-Gray sub-distribution hazards regression model, standardized mortality ratios (SMR) and absolute excess risk (AER) were used to evaluate the risk of CVD-related death. RESULTS: For older patients with HM, CVD-related death ranked as the second leading cause of death, surpassed only by primary malignancy. Compared to the general older population, older patients with HM had higher SMR and AER of CVD-related deaths (SMR: 1.16-1.81; AER: 41.24-308.99), heart disease-related deaths (SMR: 1.19-1.90; AER: 39.23-274.69), and cerebrovascular dis-ease-related deaths (SMR: 0.99-1.66; AER: -0.35 -24.15). The proportion of deaths and cumulative mortality increased with the passage of survival time, especially in Hodgkin lymphoma patients with stage I/II and those aged ≥85 years with chronic lymphocytic leukemia, surpassing primary malignancy. The risk of CVD-related death varied among different HM types. CONCLUSIONS: For older patients with HM, long-term cardiovascular risk management needs to be focused on while addressing the primary malignancy. IMPACT: Our results emphasize the need to manage long-term cardiovascular risk in older patients with HM, especially in those identified as high-risk cases.

Hemophagocytic lymphohistiocytosis caused by herpes simplex virus type 1 in a young adult: a case report with literature review.

Hemophagocytic lymphohistiocytosis is a severe hyperinflammatory syndrome that can be potentially life-threatening without appropriate treatment. Although viral infection is the most common trigger of hemophagocytic lymphohistiocytosis, cases of herpes simplex virus type 1-induced hemophagocytic lymphohistiocytosis are rare in adults. This study aims to provide a comprehensive overview of the clinical characteristics and treatment outcomes associated with HSV-1-induced HLH. We herein report an adult case of hemophagocytic lymphohistiocytosis caused by herpes simplex virus type 1, diagnosed on the basis of peripheral blood metagenomic next-generation sequencing results. The patient exhibited a favorable response to treatment, involving dexamethasone, intravenous immunoglobulin, and acyclovir. Notably, etoposide administration was deemed unnecessary, and there has been no recurrence of the disease within the year following treatment. Early and sensitive recognition, rapid and precise diagnosis, and timely and appropriate treatment facilitated the successful treatment of this case.

[Compositional Characteristics of Volatile Organic Compounds in Typical Industrial Areas of the Pearl River Delta: Importance of Oxygenated Volatile Organic Compounds].

Volatile organic compounds (VOCs) are key components of tropospheric chemistry, of which industrial emissions are an important source of atmospheric VOCs. In this study, online measurements of 74 VOCs were made in a typical industrial area of the Pearl River Delta in southern China during the early summer of 2021. The mean volume mixing ratio of total volatile organic compounds (TVOC) was (81.9±45.4)×10-9 during the campaign. Among them, oxygenated volatile organic compounds (OVOCs) accounted for the largest fraction of TVOC, with an average of 51.5%, followed by aromatics, accounting for 19.4% of TVOC. The proportion of OVOCs in TVOC gradually increased with the increase in TVOC concentration. Industry-related emissions were the main contributors to aromatics and OVOCs in this region. Aromatics and OVOCs were the two major contributors to the ozone formation potential (OFP), accounting for 56.4% and 26.7%, respectively. Furthermore, OVOCs also contributed 40.0% of the total ·OH reactivity from VOCs. Xylenes, toluene, acrolein, and ethyl acetate had a greater contribution to the formation of secondary pollution; thus, these species should be given priority for controlling secondary pollution. Our results underscore the severity of OVOCs pollution in industrial areas and the important roles of OVOCs in secondary pollution.

Allogeneic hematopoietic stem cell transplantation overcome the poor prognosis of patients with IKZF1plus CD20-a very high-risk subtype in B-cell acute lymphoblastic leukemia.

Genetic deletions of IKZF1 (IKZF1del) and IKZF1del plus other mutations (IKZF1plus) have been identified in B-cell acute lymphoblastic leukemia (B-ALL) with a poor prognosis. Herein, we investigated the combination of IKZF1del and CD20 immunotypes in adult patients with B-ALL in the PDT-ALL-2016 cohort. This study cohort consisted of 161 patients with B-ALL with detailed information on IKZF1del and CD20 expression. The independent cohort included 196 patients from the TARGET dataset. IKZF1del was detected in 36.0% of patients with 3-year event-free survival (EFS) of 37.1 ± 6.7% and overall survival (OS) of 51.5 ± 7.3%, compared to IKZF1 wild-type (IKZF1wt) with an EFS 55.3 ± 5.1% (P = 0.011) and OS 74.4 ± 4.5% (P = 0.013), respectively. CD20-positive (CD20+) was associated with inferior EFS compared to the CD20-negative (CD20-) group (P = 0.020). Furthermore, IKZF1del coupled with CD20+, IKZF1del/CD20+, comprised 12.4% of patients with a 3-year EFS of 25.0 ± 9.7%, compared with IKZF1wt/CD20- (P ≤ 0.001) and IKZF1del/CD20- (P = 0.047) groups. Multivariable analyses demonstrated the independence of IKZF1del/CD20+, with the highest predicted hazard ratio for EFS and OS. Furthermore, the prognostic panel of IKZF1del/CD20+ was confirmed in the TARGET cohort. Notably, neither the IKZF1del, CD20+, or IKZF1del/CD20+ groups were identified to have poor outcomes in the cohort of allogeneic hematopoietic stem cell transplantation (n = 81).Collectively, our data define IKZF1del/CD20+ as a very high-risk subtype in B-ALL, and allo-HSCT could abrogate the poor outcome of both IKZF1del and IKZF1del/CD20+ subsets.

Volatile organic compounds in wintertime North China Plain: Insights from measurements of proton transfer reaction time-of-flight mass spectrometer (PTR-ToF-MS).

The characteristics of wintertime volatile organic compounds (VOCs) in the North China Plain (NCP) region are complicated and remain obscure. VOC measurements were conducted by a proton transfer reaction time-of-flight mass spectrometer (PTR-ToF-MS) at a rural site in the NCP from November to December 2018. Uncalibrated ions measured by PTR-ToF-MS were quantified and the overall VOC compositions were investigated by combining the measurements of PTR-ToF-MS and gas chromatography-mass spectrometer/flame ionization detector (GC-MS/FID). The measurement showed that although atmospheric VOCs concentrations are often dominated by primary emissions, the secondary formation of oxygenated VOCs (OVOCs) is non-negligible in the wintertime, i.e., OVOCs accounts for 42% ± 7% in the total VOCs (151.3 ± 75.6 ppbV). We demonstrated that PTR-MS measurements for isoprene are substantially overestimated due to the interferences of cycloalkanes. The chemical changes of organic carbon in a pollution accumulation period were investigated, which suggests an essential role of fragmentation reactions for large, chemically reduced compounds during the heavy-polluted stage in wintertime pollution. The changes of emission ratios of VOCs between winter 2011 and winter 2018 in the NCP support the positive effect of "coal to gas" strategies in curbing air pollutants. The high abundances of some key species (e.g. oxygenated aromatics) indicate the strong emissions of coal combustion in wintertime of NCP. The ratio of naphthalene to C8 aromatics was proposed as a potential indicator of the influence of coal combustion on VOCs.

Body weight, CYP2C19, and P2Y12 receptor polymorphisms relate to clopidogrel resistance in a cohort of Chinese ischemic stroke patients with aspirin intolerance.

PURPOSE: Dual antiplatelet therapy (DAT) with clopidogrel and aspirin is not suitable for clopidogrel resistance (CR) patients with aspirin intolerance. To investigate the prevalence of CR in patients with aspirin intolerance after ischemic stroke (IS) and to assess the relationship between CR and CYP2C19, P2Y12 receptor genotypes in patients with aspirin intolerance after IS. METHODS: We enrolled 126 IS patients with aspirin intolerance from Han Chinese in Shangqiu from January 2016 to November 2018. All IS patients with aspirin intolerance were treated with clopidogrel for 7 days. Adenosine diphosphate-induced platelet inhibition rate was measured by thrombelastography (TEG) mapping assay. The SNPs CYP2C19*2, CYP2C19*3, and P2Y12 receptor (52 G >T) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Binary logistic regression analyses were performed using SPSS version 20.0. RESULTS: The prevalence of CR in patients with aspirin intolerance after IS was approximately 31.0%. Multivariate regression analysis showed that body weight (OR 1.091 (95% CI 1.031-1.155), p = 0.003), CYP2C19 phenotype intermediate metabolizer (IM) (OR 3.820 (95% CI 1.021-14.288), p = 0.046), and CYP2C19 phenotype poor metabolizer (PM) (OR 14.481 (95% CI 2.791-75.129), p = 0.001) significantly increased the risk of CR and P2Y12 receptors (52 G >T) (OR 3.498 [95% CI 1.251-9.784], p = 0.017) increased the risk of CR. CONCLUSIONS: The patients with high body weight, the CYP2C19 phenotypes, and P2Y12 receptor (52 G >T) variant alleles are at risk of CR during clopidogrel treatment in Chinese IS patients with aspirin intolerance. The higher body weight and relevant polymorphisms may help to predict CR in Chinese IS patients with aspirin intolerance.

Prevalence and Risk Factors of Cerebral Microbleeds in Patients with Nonvalvular Atrial Fibrillation: An Enhanced T2*-Weighted Angiography Imaging Study.

BACKGROUND/AIMS: Cerebral microbleeds (CMBs) may predict the occurrence of intracerebral hemorrhage (ICH). Warfarin use may cause ICH. It is still controversial whether warfarin increases CMBs in atrial fibrillation (AF) patients. The study aimed to investigate the prevalence of CMBs and risk factors in AF patient population. METHODS: This single retrospective center study included 113 patients with nonvalvular atrial fibrillation (NVAF) who were on outpatient treatment. CMBs were counted using 3D-enhanced T2*-weighted angiography (ESWAN) imaging. We compared clinical and radiological data between patients who used warfarin and not used warfarin with univariate analysis. The associations between clinical and radiological data and CMBs in NVAF population were analyzed with multivariate linear regression analyses. RESULTS: Among 113 NVAF patients, CMBs were found in 33 (29.2%) patients; there were 53 patients who used warfarin for thromboembolism prevention and 60 patients with similar demographic features who did not use warfarin. CMBs on ESWAN MRI showed no significant difference between the 2 groups (p = 0.061). Patients with CMBs were older than patients without CMBs (p = 0.046), and the frequency of smokers (p = 0.028), hypertension (p = 0.029), previous ICH (p = 0.000), and leukoaraiosis (p = 0.020) in patients with CMBs were significantly higher than patients without CMBs. In multivariate linear regression analyses, previous ICH (ß = 1.438, p = 0.000), age (ß = 0.082, p = 0.000), hypertension (ß = 0.956 p = 0.003), warfarin treatment (ß = 0.849, p = 0.006), and smokers (ß = 0.920, p = 0.016) were positive linear predictors of CMBs number levels in NVAF patients. CONCLUSION: The present data demonstrated that CMBs were associated with age, hypertension, warfarin treatment, smoking, and a history of ICH. We also found neither CHA2DS2-VASc score nor HAS-BLED score was associated with CMBs in patients with NVAF.

[Effects of ß-amyloid-induced microglial inflammatory supernatant on neuronal apoptosis].

OBJECTIVE: To study the effects of neuronal apoptosis under the induction of ß-amyloid inflammatory supernatant. METHODS: The neurons were intervened by ß-amyloid-induced inflammatory supernatant at the concentration of Aß1-42 at 125 nmol/L. And the expressions of Bcl-2, caspase-3, PARP and neuronal apoptosis were detected. RESULTS: The caspase-3 (14.2 ± 1.8), Bcl-2 (10.6 ± 0.8) positive cells of microglia inflammatory supernatant stimulated group were significantly elevated than the control (2.2 ± 0.6, 5.0 ± 0.3, P < 0.01). Nuclear chromatin was uniform yellow-green fluorescent. And there was significant difference of neuronal apoptosis between microglia inflammatory supernatant group and Aß1-42 directly stimulated group. CONCLUSION: Neuronal apoptosis is induced by caspase-3 in ß-amyloid inflammatory supernatant. One of the important causes is chronic inflammatory process of activated microglia by Aß.