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Atractylodes macrocephala rhizome (called Bái-zhú in China) has a long history as a functional food and herbal medicine in East Asia, especially China. Sesquiterpenoids are one of the main active compounds of Atractylodes macrocephala rhizome. This study aimed to explore the unknown sesquiterpenoids of A. macrocephala rhizome using a molecular networking strategy. Two new nitrogen-containing sesquiterpenoids, atractylenolactam A (1) and atractylenolactam B (2), and 2 new sesquiterpene lactones, 8-methoxy-atractylenolide V (6) and 15-acetoxyl atractylenolide III (7), along with 12 known analogs (3-5 and 8-16) were discovered and isolated. All the structures were assigned based on detailed spectroscopic analyses. The absolute configurations of 1, 2, 6, and 7 were established by time-dependent density functional theory ECD (TDDFT-ECD) calculations. All these compounds had different degrees of concentration-dependent activating effects on nuclear-factor-E2-related factor-2 (Nrf2).

Four new briarane diterpenoids, junceellolides M–P (1–4), were isolated together with seven known analogs (5–11) from the South China Sea gorgonian, Junceella gemmacea. The structures of these compounds were elucidated by detailed spectroscopic analysis and comparison with the reported data. The absolute configuration of compounds 1–3 were determined based on an ECD experiment, while the absolute configuration of compound 4 was genetically determined. All the compounds were isolated for the first time from J. gemmacea. These compounds showed no growth inhibitory activity against A549, MG63 and SMMC-7721 cell lines in an in vitro bioassay.

Five new acylated aminooligosaccharides (1–5), together with one known related analogue (6), were isolated from Streptomyces sp. HO1518. Their structure was identified by extensive spectroscopic analysis, including 1D and 2D NMR data and high resolution electrospray ionization mass spectrometry (HRESIMS), and by comparison with those reported in the literature. All of the new compounds showed more promising porcine pancreatic α-amylase (PPA) inhibitory activities than the clinical drug acarbose, indicating them as potential pharmaceutical drug leads toward type II diabetes.

The purpose of this research study is to assess the potential using smartphone camera captured images for 3D model reconstruction by using Structure from Motion (SFM) photogrammetry technique, specifically in term of volumetric measurement. In past, the volumetric measurement of surface or object is by using Imaging Station or by professional Terrestrial Laser Scanner (TLS), however such approach is expensive in labour fees and instruments fee respectively. A cheaper alternative is necessary for researcher and industrial to construct 3D model with greater cost efficiency. The improvement of photography and computer vision has introduced the technique of SFM photogrammetry, an alternative in 3D model reconstruction other than TLS. Non-metric camera sensor mounted inside budget smartphone are used to capture images of stockpile and processed by Agisoft Metashape Professional (AMP) software to construct a 3D model. The volumetric measurement is executed and compare with the benchmark which is the model constructed from TLS. Statistics and tables are used to indicate the accuracy of Smartphone based SFM photogrammetry in intuitive manner. The result shows that the volumetric measurement by using smartphone SFM method has significant difference when compared with the benchmark, TLS solution. [ABSTRACT FROM AUTHOR]

Background End-stage renal disease ( ESRD) is associated with premature aging of the T-cell system. Nevertheless, the clinical significance of pre-transplant ESRD-related immune senescence is unknown. Methods We studied whether immune risk phenotype ( IRP), a typical feature of immune senescence, may affect post-transplant infectious complications. A total of 486 patients were prospectively studied during the first year post transplant. IRP was defined as positive cytomegalovirus serology with at least 1 of the following criteria: CD4/ CD8 ratio <1 and/or CD8 T-cell count >90th percentile. Results We found that 47 patients (9.7%) had pre-transplant IRP. IRP+ patients did not differ from IRP− patients for any clinical characteristics, but exhibited more pronounced immune senescence. Both opportunistic infections (43% vs. 6%, P < 0.001) and severe bacterial infection ( SBI) (40% vs. 25%, P = 0.028) were more frequent in IRP+ patients. In multivariate analysis, IRP was predictive of both opportunistic infection (hazard ratio [ HR] 2.97 [95% confidence interval { CI} 1.53-5.76], P = 0.001), and SBI ( HR 2.33 [95% CI 1.34-3.92], P = 0.008). Acute rejection rates were numerically much lower in IRP+ patients. A total of 418 patients (86%) had biological evaluation 1 year post transplant. Among 41 IRP+ patients, 35 (85%) remained IRP+ 1 year post transplant. Conclusion Pre-transplant IRP is associated with an increased risk of post-transplant infection. [ABSTRACT FROM AUTHOR]

The finding that 225 anti-CD4 receptor antibodies do not precisely mimic the binding of HIV-1 glycoprotein gp120 is questionable since intermediate steps in the characterizing of receptors may justify this method of obtaining anti-idiotypic antibodies. Moreover, more accurate testing procedures may detect usable mimics. However, the rebuttal view is that these antibodies are functional rather than structural mimics as is required. The actual occurrence of true mimics is too rare to be useful.

In a six-month, multicenter, open-label trial, de novo kidney transplant recipients at low immunological risk were randomized to steroid avoidance or steroid withdrawal with IL-2 receptor antibody (IL-2RA) induction, enteric-coated mycophenolate sodium (EC-MPS: 2160mg/day to week 6,1440mg/day thereafter), and cyclosporine. Results from a 30-month observational follow-up study are presented. Of 166 patients who completed the core study on treatment, 131 entered the follow-up study (70 steroid avoidance, 61 steroid withdrawal). The primary efficacy endpoint of treatment failure (clinical biopsy-proven acute rejection (BPAR) graft loss, death, or loss to follow-up) occurred in 21.4% (95% CI 11.8-31.0%) of steroid avoidance patients and 16.4% (95% CI 7.1-25.7%) of steroid withdrawal patients by month 36 (P = 0.46). BPAR had occurred in 20.0% and 11.5%, respectively (P = 0.19). The incidence of adverse events with a suspected relation to steroids during months 6-36 was 22.9% versus 37.1% (P = 0.062). By month 36, 32.4% and 51.7% of patients in the steroid avoidance and steroid withdrawal groups, respectively, were receiving oral steroids. In conclusion, IL-2RA induction with early intensified EC-MPS dosing and CNI therapy in de novo kidney transplant patients at low immunological risk may achieve similar three-year efficacy regardless of whether oral steroids are withheld for at least three months. [ABSTRACT FROM AUTHOR]

We present a case of an isolated pulmonary valve endocarditis in a 23-year-old woman with a history of heavy oxycodone abuse. She presented with fever and positive cultures for methicillin-sensitive Staphylococcus aureus . A transesophageal echocardiogram demonstrated a 3-cm vegetation of the pulmonary valve. Antibiotic therapy was started but she continued to have fever and the vegetation size did not change. In view of ongoing fever and risk of embolization, a left minithoracotomy was performed, and the pulmonary valve was replaced with a bioprosthesis using warm cardiopulmonary bypass, with a beating-heart technique. The patient had an uneventful postoperative course and was discharged home. To the best of our knowledge, this is the first case of a pulmonary valve replacement through this approach. [ABSTRACT FROM AUTHOR]

Objective: Thoracic epidural analgesia provides effective pain control after lung transplantation; however, the optimal timing of placement is controversial. We sought to compare pain control and pulmonary and epidural morbidity between patients receiving preoperative vs postoperative epidurals. Methods: Institutional records were reviewed for patients undergoing a bilateral lung transplant via a bilateral anterior thoracotomy with transverse sternotomy incision between January 2014 and January 2017. Pain control was measured using visual analog scale pain scores (0‐10). Pulmonary complications included a composite of pneumonia, prolonged intubation, and reintubation/tracheostomy. Results: Among 103 patients, 72 (70%) had an epidural placed preoperatively and 31 (30%) had an epidural placed within 72 hours posttransplant. There were no differences in the rates of cardiopulmonary bypass (3% vs 0%, P = 0.59); however, patients with a preoperative epidural were less likely to be placed on extracorporeal membrane oxygenation intraoperatively (25% vs 52%, P = 0.01). Pain control was similar at 24 hours (1.2 vs 1.7, P = 0.05); however, patients with a preoperative epidural reported lower pain scores at 48 (1.2 vs 2.1, P = 0.02) and 72 hours posttransplant (0.8 vs 1.7, P = 0.02). There were no differences in primary graft dysfunction (42% vs 56%, P = 0.28), length of mechanical ventilation (19.5 vs 24 hours, P = 0.18), or adverse pulmonary events (33% vs 52%, P = 0.12). No adverse events including epidural hematoma, paralysis, or infection resulted from epidural placement. Conclusion: Preoperative thoracic epidural placement provides improved analgesia without increased morbidity following lung transplantation. [ABSTRACT FROM AUTHOR]

Introduction L’ISRNM [1] retient le diagnostic de dénutrition protéino-énergétique (DPE) en dialyse si 1 critère est présent dans 3 des 4 catégories suivantes : marqueurs biologiques (1), évaluation de la masse corporelle (2), évaluation de la masse musculaire (3) et paramètres d’évaluation des ingesta (4). En pratique courante, l’albumine < 35 g/L (néphélémétrie) et la préalbumine < 300 mg/L, l’IMC < 23 kg/m 2 et la perte de poids (5 % en 3 mois ou 10 % en 6 mois), la créatinine au branchement < 10 mg/dL, et le nPCR <1 g/kg/j sont utilisés comme critères des variables (1), (2), (3) et (4) respectivement. Pour améliorer le diagnostic de DPE, nous avons utilisé la mesure de la circonférence musculaire brachiale (CMB), l’index de créatinine et la masse maigre estimée par impédancemétrie comme critères de la variable (3). Patients et méthodes Étude transversale prospective : 80 patients sont analysés. Au cours d’une dialyse de milieu de semaine sont recueillies : poids, albuminémie, transthyrétinémie, créatinine et urée avant et après dialyse, CRP, Kt/V, nPCR, CMB, Lean Tissu Index = Lean Tissu Mass/taille 2 (LTI) mesurée par impédancemétrie (BCM, fresenius). Une CMB < normale, un index de créatinine < 22 [2] et un LTI < 10 e percentile sont considérés comme critères de DPE (3). Résultats Les patients (66 ± 14 ans, H/F = 1,86) sont en hémodialyse (71 %) ou en hémodiafiltration (29 %), depuis 55 ± 40 mois. En utilisant la créatinine au branchement comme seul critère de la variable (3), 37 patients sont considérés comme dénutris (46 %), en y ajoutant une CMB < normale aucun patient supplémentaire n’est détecté dénutri. En revanche, quand l’index de créatinine ou le LTI < 10 e percentile sont des critères de la variable (3), 38 (47 %), et 43 (54 %) des patients sont considérés dénutris respectivement. Les patients diagnostiqués dénutris grâce au LTI sont plus jeunes, dialysent depuis moins longtemps et ont un Kt/V plus faible (48 ± 11 vs 70 ± 15 ans, p = 0,03 ; 34 ± 13 vs 63 ± 38 mois, p = 0,001 ; 1,4 ± 0,4 vs 1,86 ± 0,4, p = 0,04, respectivement). Discussion Les limites de l’étude sont le faible nombre de patients, l’influence de l’état d’hydratation sur les valeurs de masse maigre estimées par l’impédancemétrie et l’absence d’enquête diététique pour évaluer les ingesta. Conclusion Toutefois, notre étude montre que l’estimation de la masse maigre par impédancemétrie permet d’augmenter le nombre de diagnostics de DPE chez les patients hémodialysés. [ABSTRACT FROM AUTHOR]

The article describes the case of a 62-year-old female patient who was diagnosed with cardiac calcified amorphous tumour (CAT).

La dénutrition protéino-énergétique en hémodialyse a pour conséquence une augmentation de la morbi-mortalité. Le diagnostic de dénutrition est établi à l'aide de scores spécifiques validés par l'International Society of Renal Nutrition and Metabolism (ISRNM), et plus récemment par le groupe ARNOS. D'autre part, la baisse de la force de préhension (FP), même indépendamment d'une baisse de la masse maigre, altère le pronostic de ces patients. Nous avons analysé le lien entre FP et les différents paramètres d'évaluation de l'état nutritionnel, ainsi que leurs conséquences sur la mortalité dans une population d'adultes hémodialysés en centre lourd. Nous avons réalisé à l'occasion d'une séance de dialyse de milieu de semaine une mesure de la FP au membre dominant, une mesure de la composition corporelle par bioimpédencemétrie, et procédé à un recueil des données anthropométriques et biologiques. L'évaluation des apports protidiques quotidiens était effectuée par le calcul du « normalized Protein Nitrogen Appearance ratio » (nPNA). La survie a été recueillie à 2,5 ans de l'inclusion. Parmi les 96 patients dialysés chroniques du centre de dialyse, 80 patients ont été inclus dans notre étude. L'âge moyen était de 67,5 ± 12,3 ans, la durée de dialyse moyenne était de 4,9 ± 5,0 ans, et 37,5 % des patients étaient diabétiques. La FP était significativement plus faible en cas d'indice de masse maigre bas (< 11,6 kg/m2), d'albuminémie < 38 g/L ou de transthyrétine < 0,3 g/L. La FP était également abaissée en cas de dénutrition selon les scores de l'ISRNM et du groupe ARNOS. L'utilisation des seuils de FP proposés par le dernier consensus européen sur la sarcopénie (< 27 kg force pour les hommes et < 16 kg force pour les femmes), permettait de bien classer les patients dénutris ou non selon le score ISRNM. Pour le diagnostic de dénutrition selon le score ARNOS, les seuils de FP à 33,5 kg force pour les hommes et 25,5 kg force pour les femmes était plus performants. À 2,5 ans, la mortalité était de 28,8 %. Les facteurs associés à une augmentation de la mortalité étaient une transthyrétine < 0,3 g/L HR 5,05 (IC 1,98–12,84, p = 0,001), un rapport créatininémie sur surface corporelle < 520 μmol/L/m2 HR 0,318 (IC 0,108–0,937, p = 0,038) ou un nPNA ≤ 0,8 g/kg/j HR 4,918 (IC 2,096–11,541, p < 0,001). L'urée basse avant dialyse ou une CRP plus élevée était significativement reliée à la mortalité. On observait également une augmentation de la mortalité dans le groupe de patients avec FP pathologique selon les critères du dernier consensus européen sur la sarcopénie par rapport aux patients avec FP normale: HR 2,85 (IC 1,127–7,237, p = 0,028). En analyse multivariée prenant en compte les facteurs liés à une mortalité plus importante, seul le nPNA ≤ 0,8 g/kg/j reste significativement corrélé à la mortalité HR 3,76 (IC 0,570–4,452, p = 0,004). Notre étude a mis en évidence une corrélation entre la FP et la présence d'une dénutrition selon les scores de l'ISRNM et ARNOS. En hémodialyse, la FP est donc un marqueur utile pour l'évaluation de l'état nutritionnel, et en l'absence de dosages biologiques, un bon marqueur du risque de mortalité. [ABSTRACT FROM AUTHOR]