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Purpose: To investigate the efficacy of the combination of amiodarone and atenolol in the treatment of patients with coronary artery disease (CAD) complicated with arrhythmia, and its effect on serum levels of CD-40L, TNF-a and IL-6. Methods: One hundred and twenty CAD patients with arrhythmia on admission in The First People's Hospital of Shuangliu District Chengdu, China were assigned to groups A and B, each having 60 patients. Amiodarone was administered to all the patients, while atenolol was additionally given to patients in group A. Levels of heart function indicators, inflammatory factors, blood pressure, heart rate, adverse reaction rate (ARR) and overall efficacy were evaluated for the two groups. Results: There were significantly improved levels of heart function indicators, and lower levels of CD40L, TNF-a and IL-6 in group A, when compared with group B (p < 0.001). Moreover, treatment effectiveness was higher in group A than in group B (p < 0.05). However, there was no significant difference (p > 0.05) in ARR between groups A and B. Conclusion: The combined use of amiodarone and atenolol improves heart function indicators in patients with CAD and arrhythmia, reduces the levels of inflammatory factors, normalizes blood pressure and heart rate, and lowers ARR. However, further clinical trials on this combined therapy are required prior to its use in clinical practice. [ABSTRACT FROM AUTHOR]

( S )-Atenolol (( S )-2-(4-(2-Hydroxy-3-(isopropylamino)propoxy)phenyl)acetamide) has been synthesized in >99% enantiomeric excess ( ee ) with the use of Candida antarctica lipase B from Syncozymes (Shanghai, China), in a kinetic resolution of the corresponding racemic chlorohydrin. A catalytic amount of base was used in deprotonation of the phenol building block. The enantiopurity of the chlorohydrin building block remained unchanged upon subsequent amination to yield the final drug. All four steps in the synthesis protocol have been optimized compared to previously reported methods, which makes this new protocol more sustainable and in accordance with green chemistry principles. The overall yield of ( S )-atenolol was 9.9%, which will be further optimized.

Although there has been a surge of interest in research focused on the presence of pharmaceuticals in the marine environment, study on the distribution and risks of pharmaceuticals in coastal waters remains inadequately documented due to the specific features of the marine environment, such as strong dilution, high salinity, and complex hydrodynamics. In this study, thirty pharmaceuticals with diverse physicochemical properties were analyzed in a coastal sea with low hydrodynamic energy caused by various artificial structures. The results indicate that 14 compounds were detected in seawater, with concentrations ranging from <1 to 201.4 ng L -1 , among which caffeine, metoprolol, and atenolol were detected at high levels. Statistical analysis reveals the prevalence of the most target pharmaceuticals with downward trends in concentrations from estuary to offshore region, demonstrating the significant impacts of riverine inputs on the coastal water. Nevertheless, the distribution patterns of caffeine and atenolol were intricate, suggesting that they may have also originated from other unknown sources. A newly-developed method combining risk quotient (RQ) and species sensitivity distribution (SSD) models was used in ecological risk assessment. The results indicate generally higher risks of target pharmaceuticals in the estuary compared to the offshore region, with caffeine, carbamazepine, and norfloxacin identified as the top three priority pollutants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

• First study on enantiomeric occurrence of chiral drugs and metabolites in surface water in China. • NODDV and α-hydroxymetoprolol were for the first time confirmed in domestic water. • The transformation products contributed to 60% of the total load of 11 compounds. • TPs could be transported substantial distances along the river with limited attenuation. • R-venlafaxine was more readily biotransformed than the S-form. The present work aimed to discuss the enantiomeric occurrence of chiral pharmaceuticals including 5 parent compounds (PCs) metoprolol, propranolol, atenolol, venlafaxine and fluoxetine as well as 6 of their transformation products (TPs) in surface water in Beijing. Among which, 9 out of 11 were detected during the two sampling campaigns with N-O -Didesmethylvenlafaxine (NODDV) and α-hydroxymetoprolol confirmed in the catchment for the first time. Metoprolol acid (MTPA) was the most abundant up to 1508 ng L−1, followed by metoprolol and O -desmethylvenlafaxine (ODV). Most compounds showed 100% detection frequency or nearly, while norfluoxetine (the main metabolite of fluoxetine) and 4-hydroxypropranololone (one TP of propranolol) were not detected. Metoprolol (MTP) and venlafaxine (VFX) did not vary significantly between two sampling periods with mean concentrations of 280.7 and 22.9 ng L−1, respectively. Enantiomeric enrichment was observed for venlafaxine, metoprolol and NODDV, where R-venlafaxine was preferentially biotransformed than the S-form through O -desmethylation. Risk assessment indicated that fluoxetine and atenolol could pose harmful effects to aquatic organisms. This work provides enantiospecific profiles of pharmaceutically active compounds (PhACs), and extended the concept of applying the ratio of TPs vs. parent compound plus their enantiomeric traits for quantitative assessment of in situ biodegradation. Due to the considerable contribution by TPs (64% in present study) as well as the unexpected impacts from enantiomeric existence, the stereoselectivity of chiral pollutants during environmental process should be taken into account in future study. To the best of the authors' knowledge, it is the first comprehensive evaluation of chiral pharmaceuticals and transformation products at enantiomeric level in aquatic environment in China, which would facilitate better understanding of their environmental fate. [ABSTRACT FROM AUTHOR]