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Cross-dialkylation of unactivated alkenes represents a significant challenge due to competitive β-hydride elimination and associated selectivity issues. Herein, a Ni-catalyzed reductive 1,2-dialkylation of unactivated aliphatic alkenes has been developed using two different alkyl bromides. The reaction proceeds smoothly under mild conditions to install two C

The research is to analyse the immunohistochemical reaction of orthodontic force on the periodontium reformed by nanobiphasic calcium phosphate ceramics (nBCP). Two third incisors were selected randomly and operated as experimental groups in 2 Beagle dogs. In the labial aspects of the third incisors, alveolar bone defects were surgically made and implanted with NBCP. The contralateral teeth in the same jaw did not receive any treatment as control. After 24 weeks, all the third incisors were moved labially. The dogs were euthanized 4 weeks later. The expression levels of osteocalcin were detected by immunohistochemical staining. Positive osteocalcin expressions in regenerated periodontium were observed and compared with the normal periodontium in the control groups. There were no significant differences within and between them. It means the periodontium regenerated by nBCP can bear orthodontic forces with a normal function. Based on these findings, we concluded that nBCP may offer a new bone graft choice for periodontic disease patients who have demands for orthodontic treatment.

Noninvasive measurement of myocardial work (MW) incorporates left ventricular (LV) pressure, and, therefore, allows correction of global longitudinal strain for changing afterload conditions. We sought to investigate MW as a tool to detect early signs of LV dysfunction in primary systemic hypertension patients, particularly with different predictive indices.None left ventricular hypertrophy (NLVH) and left ventricular hypertrophy (LVH) patients established were all primary systemic hypertension with preserved ejection fraction. Forty in NLVH and forty in LVH according to left ventricular end-diastolic mass index (LVEDmassI) were prospectively enrolled. The following indices of MW were assessed: global work index, global constructive work, global wasted work (GWW), and global work efficiency (GWE). Both global work index (P=0.348) and global constructive work (P=0.225) were increased in NLVH and decreased in LVH, and GWW (P0.001) was increased significantly in NLVH and increased more in LVH, while GWE (P0.001) was decreased significantly in NLVH and decreased more in LVH. The clinical utility of GWW (95% CI: 0.802-0.951) and GWE (95% CI: 0.811-0.950) were verified by receiver-operating characteristic curve analysis showing larger net benefits as evaluated with LVH and control comparisons. In multivariate linear regression analysis, 4-dimenaional LVEDmassI was independently associated with GWE (P=0.018) in systemic hypertension patients. Assessment of intraobserver and interobserver variability in the MW echocardiographic data documented good interclass correlation coefficients (all0.85).GWW and GWE derived from MW are more accurate, sensitive, and reproducible predictors to detect early LV dysfunction in primary systemic hypertension patients, especially in distinguishing the potential functional abnormality of NLVH and LVH, even though the ejection fraction is preserved.

Testicular choriocarcinoma is a relatively rare malignancy with a highly aggressive nature. Timely diagnosis and treatment can help prolong the survival of patients and even cure them. This case reports a 29-year-old male who presented to the clinic for a month with epigastric pain without complaints of discomfort in the reproductive system. On examination, only a massive mass of approximately 9*10 cm could be palpated in the upper abdomen. When asked about his previous history, the patient only described a history of a right inguinal hernia that had been repaired 12 years earlier without knowing that a testicular descending fixation had been performed at the same time (we only found out afterward by asking his parents). The admission diagnosis was considered the retroperitoneal tumor, which was found to have metastasized to the liver and lungs after the completion of relevant tests. We then performed a CT-guided puncture biopsy of the lung tissue. The biopsy pathology suggested only a tiny heterotypic cell mass, and metastatic cancer was considered. As the symptoms of tumor compression gradually worsened, we nevertheless performed surgical treatment (retroperitoneal tumor resection + partial duodenal resection + enteroanastomosis). The postoperative pathology was choriocarcinoma. It was at this point that we pursued the patient's medical history in detail and, at the same time, performed a testicular ultrasound which revealed a substantial occupation of the right testicle. The diagnosis of testicular choriocarcinoma was finally considered (without pathological confirmation). We wanted to start salvage chemotherapy as soon as possible after surgery. However, the patient's postoperative condition was poor, with rapid progression of hepatopulmonary metastases and gradually increased thyrotoxicosis, and we started salvage chemotherapy (EP regimen: etoposide and cisplatin) on postoperative day 12. However, the patient was forced to stop due to a severe chemotherapy reaction and eventually died of respiratory and cardiac arrest in hospital. For men presenting with a large retroperitoneal mass without reproductive system-related complaints, a detailed history of the inguinal testicle should still be inquired with a detailed physical examination. Meanwhile, laboratory and image tests should be performed to rule out the possibility of a genital tumor to avoid a missed diagnosis that could lead to delayed treatment.

Background: Family with sequence similarity three member (FAM3) plays a crucial role in the malignant development of various cancers of human. Our study aimed to investigate the role of FAM3 family genes in prognosis, immune subtype, tumor immune microenvironment, stemness score, and anticancer drug sensitivity of pan-cancer. Methods: The expression, survival, immune subtype, tumor microenvironment, stemness score, and anticancer drug sensitivity analysis data of FAM3 family genes associated with pan-cancer from UCSC Xena GDC and CellMiner databases. Furthermore, we investigated the tumor cellular functions and clinical prognostic value FAMC3 in pancreatic cancer (PAAD) using cellular experiments and tissue microarray. Results: The results revealed that FAM3 family genes are significantly differential expression in tumor and adjacent normal tissues in 7 cancers (CHOL, HNSC, KICH, LUAD, LUSC, READ, and STAD). The expression of FAM3 family genes were negatively related with the RNAss, and robust correlated with immune type, tumor immune microenvironment and drug sensitivity. Meanwhile, overexpression FAM3C promoted PAAD cell proliferation, migration, invasion and suppressed PAAD cell apoptosis. While knockdown of FAM3C triggered opposite results. High FAM3C expression was associated with duodenal invasion, differentiation and liver metastasis. Conclusion: This study provided a new perspective on the potential therapeutic role of FAM3 family genes in pan-cancer. In particular, FAM3C may be a new marker for PAAD, providing a new idea for the treatment of PAAD.

Remote arylation of amines via C–C bond functionalization has not been reported yet. Herein, we develop the γ-transarylation of amines through the cleavage of unstrained C–C bond enabled by copper ...

A strategy for the synthesis of well defined poly(ethylene glycol)-block-poly(methyl methacrylate) diblock copolymers containing trityl ether acid cleavable junctions is demonstrated. This approach is achieved by using a combination of poly(ethylene glycol) macroinitiator containing a trityl ether end group, which is susceptible to acid cleavage, and atom transfer radical polymerization technique. The trityl ether linkage between blocks can be readily cleaved in solution or in solid phase under very mild acid condition, which has been confirmed by 1H NMR. These diblock copolymers have been used to successfully fabricate nanoporous thin films by acid cleavage of trityl ether junction followed by complete removal of poly(ethylene glycol) block. The fabricated nanoporous thin films may have a wide range of application such as Recessed Nanodisk-array electrode (RNE) or as a template to fabricate nanoelectrode array for senor applications.

Lung injury is a severe complication of sepsis, which brings great threats and challenges to human health. CircVMA21 has exhibited powerful anti- inflammation capacity. However, its underlying molecule mechanism remains blurry.Lipopolysaccharide (LPS) was used to treat mice and WI-38 cells to establish models of lung injury caused by sepsis. Lung injury was evaluated using HE staining. Cell apoptosis was tested by TUNEL and flow cytometry. Levels of inflammatory cytokines were detected using ELISA assay. CircVMA21 and SOCS3 expression was measured using RT-qPCR. The ROS, MDA, SOD and GSH production were monitored by commercial kits. The protein expression was examined with western blot. The correlations among circVMA21, SOCS3 and TAF15 were confirmed using RIP and RNA-pull down.The expression of circVMA21 and SOCS3 was downregulated in LPS-induced lung injury of mice and WI-38 cells. Overexpressing circVMA21 or SOCS3 assuaged LPS-induced cell injury through repressing the levels of inflammatory factors, oxidative stress and cell apoptosis. NF-κB signaling pathway was inactivated by circVMA21 or SOCS3 overexpression. circVMA21 enhanced the stabilization of SOCS3 mRNA via interplaying with TAF15. SOCS3 knockdown destroyed the beneficial impacts of circVMA21 overexpression on LPS-induced cell injury.CircVMA21 suppressed LPS-induced the levels of inflammatory factors, oxidative stress and cell apoptosis and improved LPS-induced lung injury by mediating TAF15/SOCS3/NF-κB axis.

To explore the clinical effect of the modified Topping-off technique in the treatment of multiple lumbar degenerative diseases.From October 2019 to May 2020, 42 patients who underwent modified Topping-off operation (modified Topping-off group) and 42 patients who underwent multilevel total laminectomy and interbody fusion with screw rod system internal fixation (whole laminectomy group) were observed and analyzed. There were 15 males and 27 females in the modified Topping-off group, aged from 28 to 80 years old, with an average of (59.57±11.85)years old. There were 14 males and 28 females in the whole laminectomy group, aged from 45 to 82 years old, with an average of (64.26±9.19) years old. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were evaluated before operation, 1 week, 6 weeks and 12 weeks after operation. The intraoperative blood loss, incision length, operation time, postoperative drainage, weight-bearing time, hospitalization time, intervertebral space height, intervertebral foramen height and lumbar mobility were statistically analyzed.All patients were followed up for 12 weeks. The intraoperative blood loss and postoperative drainage in the modified Topping-off group were significantly less than those in the whole lamina group (The application of modified Topping-off technique in the treatment of multi segmental lumbar degenerative diseases can reduce the total length of fusion segments, avoid or slow down the degeneration of adjacent segments, and has a positive effect on maintaining the normal movement of the spine.

Allergic rhinitis (AR) is a noninfectious inflammatory disease seriously affecting the quality of life. This study aimed to assess the efficacy of the Tuomin Zhiti decoction in allergic rhinitis and to provide a reference for clinical treatment. One hundred patients with AR treated in the Department of Otolaryngology of our hospital from January 2019 to December 2020 were recruited and assigned via a random number table method (1 : 1) to receive either oral loratadine and mometasone nasal spray (control group) or the Tuomin Zhiti decoction plus oral loratadine and mometasone nasal spray (study group). The total clinical efficacy was 86% (43/50) in the study group, which was significantly higher than that of 64% (32/50) in the control group. After treatment, the Total Nasal Symptoms Scores (TNSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores between the two groups were similar, but 12 weeks after treatment, the study group had significantly lower TNSS and RQLQ scores than the control group. After treatment, the study group obtained lower levels of interleukin (IL)-4 and higher levels of interferon-γ (IFN-γ) than the control group. Significantly lower post-treatment peripheral blood eosinophil count (EOS) and eosinophil cationic protein (ECP) levels were observed in the study group in contrast to those of the control group. The Tuomin Zhiti decoction for the treatment of AR patients alleviates their clinical symptoms, reduces the inflammatory responses, enhances the immune function of patients by regulating IL-4 and IFN-γ, and lowers the long-term recurrence rate.

Background No clinical study has investigated the use of ceftazidime-avibactam combination schemes with an in vitro non-susceptible antimicrobial that could be superior to ceftazidime-avibactam monotherapy against carbapenem-resistant Klebsiella pneumoniae. Methods We performed a retrospective cohort study at two tertiary hospitals in China for patients with carbapenem-resistant Klebsiella pneumoniae infection treated with ceftazidime-avibactam for at least 72 h. A Cox proportional hazards regression model was used to evaluate covariates that potentially affected 30-day mortality. Results Sixty-two patients were eligible for our study; 41 (66.1%) received ceftazidime-avibactam combination therapy and 21 (33.9%) received ceftazidime-avibactam monotherapy. The overall 30-day mortality was 33.9% (21 patients): 24.4% (10/41) and 47.6% (11/21), P = 0.028, in combination and monotherapy groups, respectively. Combination therapy was significantly associated with lower 30-day mortality (Hazard ratio, 0.167; 95% Confidence Interval, 0.060–0.465, P = 0.001). At the same time, a higher APACHE II score, use of vasoactive drugs and comorbidity of organ transplantation were considered factors that increased mortality. The propensity score showed no significant alterations with other variables after adding it to the final model. In the subgroup analysis, the protective effect was revealed when combined with carbapenems, tigecycline or fosfomycin were applied, and in the following subgroups of patients: with sepsis, with creatinine clearance > 50 mL/min, stayed in the intensive care unit ≤ 30 days or underwent mechanical ventilation. Conclusions Ceftazidime-avibactam combined with another in vitro non-susceptible antimicrobial, especially carbapenems, fosfomycin and tigecycline, could significantly decrease the 30-day mortality rate for critically ill patients with carbapenem-resistant Klebsiella pneumoniae infection. Further investigation should be carried out to confirm this conclusion and identify autofit antimicrobials in ceftazidime-avibactam combination schemes.

Background: There is no clinical study investigating if using CAZ-AVI combination schemes with an in vitro non-susceptible antimicrobial could be superior to CAZ-AVI monotherapy against CRKP clinically. Methods: We performed a retrospective, cohort study at two tertiary hospitals in China for patients with CRKP infection who treated by CAZ-AVI at least 72 hours. A Cox-proportional hazards regression model was set up to evaluate covariates which potentially affected 30-day mortality. Results: Sixty-two patients were eligible in our study, 41 (66.1%) received CZA-AVI combination therapy and 21 (33.9%) received CZA-AVI monotherapy. The overall 30-day mortality was 33.9% (21 patients): 24.4% (10/41) and 47.6% (11/21), P=0.028, in combination and monotherapy groups, respectively. Combination therapy was significantly associated with lower 30-day mortality (HR 0.167, 95%CI 0.060-0.465, P=0.001), while higher APACHE II score, use of vasoactive drug and comorbidity of organ transplantation were considered as factors on increasing mortality. The propensity score showed no significant alteration with other variables after adding it into the final model. In the subgroup analysis, the protective effect revealed when combination with carbapenems, tigecycline or fosfomycin were applied, and in the following subgroups of patients: with sepsis, with CrCl > 50 mL/min, stayed in ICU ≤30 days or underwent mechanical ventilation. Conclusions: CAZ-AVI combination with another in vitro non-susceptible antimicrobial, especially carbapenems, fosfomycin and tigecycline, could significantly decrease 30-day mortality rate for critically ill patients with CRKP infection. Further investigation should be carried out to confirm this conclusion and find out the autofit antimicrobials in CAZ-AVI combination schemes.

Routes to efficient construction of fully aliphatic substituted tertiary chiral centers are highly challenging and desirable. Herein, a Ni-catalyzed enantioselective hydroalkylation of unactivated alkenes at room temperature is described, providing a general and practical access to tertiary stereogenic carbon centers with three alkyl substituents. This reaction involves the regio- and stereoselective hydrometalation of unactivated alkenes with Markovnikov selectivity, followed by coupling with unactivated alkyl electrophiles to access tertiary chiral centers with full alkyl substituents. The mild and robust conditions enable the use of terminal and internal unactivated alkenes as well as primary and secondary unactivated alkyl, benzyl, propargyl halides for the construction of diverse trialkyl tertiary stereogenic carbon centers with broad functional group tolerance.

Chiral dialkyl amines and alcohols are ubiquitous in pharmaceuticals, pesticides, natural products and fine chemicals, yet difficult to access due to the challenge to differentiate between the spatially and electronically similar alkyl groups. Herein, we report a nickel-catalyzed enantioselective reductive hydroalkylation of enamides and enolates with alkyl halides to afford enantioenriched α-branched aliphatic amines and alcohols in good yields with excellent levels of enantioselectivity. The operationally simple protocol provides a straightforward access to chiral dialkyl amine and alcohol derivatives from simple starting materials with great functional group tolerance.

Chiral dialkyl amines and alcohols are ubiquitous in pharmaceuticals, pesticides, natural products and fine chemicals, yet difficult to access due to the challenge to differentiate between the spatially and electronically similar alkyl groups. Herein, we report a nickel-catalyzed enantioselective reductive hydroalkylation of acyl enamines and enol esters with alkyl halides to afford enantioenriched α-branched aliphatic amines and alcohols in good yields with excellent levels of enantioselectivity. The operationally simple protocol provides a straightforward access to chiral dialkyl amine and alcohol derivatives from simple starting materials with great functional group tolerance.

A method based on stratified measurement and inverse fitting is proposed to measure and analyze the intensity of power in solid medium aiming at the problem of power ultrasonic intensity measurement in solid. The thickness of the typical solid medium is determined according to the sound pressure distribution on the acoustic axis of the simulated sound field, and the surface acoustic field is measured separately to obtain the change of the sound intensity in the radial direction. Then the measurements of different thicknesses are fitted based on a fractional linear fit algorithm. Finally, the distribution of the power ultrasonic field in the solid is obtained by using the fitting equation. This paper also compares the experimental measurement results with the COMSOL simulation results. The two have a high degree of similarity in the trend of change, indicating that the measurement scheme is feasible.

Colorectal cancer (CRC) is one of the most lethal and prevalent malignancies world-wide. Currently, surgery, radiotherapy and chemotherapy are clinically applied as common approaches for CRC patients. Cisplatin is one of the most frequently used chemotherapy drugs for diverse cancers. Although chemotherapeutic strategies have improved the prognosis and survival of cancer patients, development of cisplatin resistance has led to cancer recurrence. Curcumin, isolated from turmeric, has been used as an effective anti-cancer agent. However, the molecular mechanisms for curcumin-mediated cisplatin sensitivity of CRC have not been elucidated. This study aimed to investigate the effects of curcumin treatment on cisplatin-resistant CRC cells.Expression levels of miRNAs and mRNAs were determined by qRT-PCR. Protein expression levels were detected by Western blotting. Cell responses to curcumin treatments were evaluated by MTT assay, Clonogenic assay and Annexin V apoptosis assay. The glutamine metabolism of colon cancer cells was assessed by glutamine uptake and glutaminase (GLS) activity. The binding of miR-137 on 3' UTR of GLS was validated by Western blotting and luciferase assay.Results demonstrated that curcumin significantly synergized with cisplatin (combination index1) to suppress proliferation of colon cancer cells compared with curcumin or cisplatin alone. Moreover, from the established cisplatin-resistant cell line (HT-29), glutamine metabolism was remarkedly elevated in cisplatin-resistant CRC cells that displayed a glutamine addictive phenotype. Furthermore, curcumin treatments attenuated glutamine metabolism in colon cancer cells. Under low glutamine supply, colon cancer cells showed less sensitivity to curcumin. Using a microRNA (miRNA) microArray assay, miR-137, a tumor suppressor in colon cancer, was significantly induced by curcumin treatments in CRC cells. Bioinformatics analysis and a luciferase assay illustrated miR-137 directly targeted the 3' UTR of GLS mRNA. Rescue experiments demonstrated that miR-137-induced cisplatin sensitization was through targeting of GLS. Finally, curcumin treatment overcame cisplatin resistance through miR-137-mediated glutamine inhibition.Collectively, these results indicate that curcumin could be clinically applied as an anti-chemoresistance approach against CRC by modulating miR-137-inhibited glutamine metabolism.

Background and purpose The MRI-assessed tumor regression grade (mrTRG) is limited due to its subjectivity and poor consistency on pathological tumor regression grade (pTRG). A new MRI criterion was established to predict the prognosis of locally advanced rectal cancer (LARC). Materials and methods The new MRI criterion magnetic resonance imaging tumor response score (mrTRS) was based on the retrospective sample of 214 LARC patients (unpublished data). Subsequently, 878 LARC patients were enrolled for a prospective, multicenter study. Baseline and postoperative MRI were obtained, and imaging features were measured by collecting the pathological, clinical and follow-up data. Kaplan-Meier method with log-rank estimate and multivariate cox regression model was used to determine the prognosis of mrTRS in LARC patients with neoadjuvant chemoradiotherapy (NACRT). The predictive capability of 3-year prognosis between mrTRS and mrTRG was determined by time-dependent ROC curves. Results The results demonstrated that mrTRS acted as an independent predictor of survival outcomes. mrTRS stratified by good and moderate responders showed significantly lower risk of death (HR = 0.04, 95%CI 0.01–0.31; HR = 0.35, 95%CI 0.23–0.52), distant metastasis (HR = 0.25, 95%CI 0.13–0.52; HR = 0.42, 95%CI 0.30–0.58), and local recurrence when compared with poor responders(HR = 0.01 95%CI 0.23–0.52;HR = 0.38, 95%CI 0.16–0.90). In contrast, no significant difference was observed among mrTRG stratified groups. Excellent and substantial interobserver agreement for mrTRS and mrTRG evaluation was observed (κ = 0.92 and 0.62), respectively. Conclusion mrTRS can serve as an effective predictor for assessing tumor regression grade in LARC patients with NACRT.

Objective: To explore the anesthetic effect of dexmedetomidine (Dex) in different doses in combined with propofol on the painless colonoscopy in the elder patients. Methods: A total of 60 elder patients who were admitted in our hospital from November 2016 to October 2017 for selective painless fiber colonoscopy were included in the study and divided into the low dose group and high dose group according to Dex dose. The micro-infusion pump was used to inject Dex 10 min before examination. The load capacity in the low dose group was 0.25 μg/ kg, while in the high dose group was 0.75 μg/kg. The pump injection was completed within 10 min, then a continuous pump injection was performed in a speed of 0.5 μg/kg/h until the check off. After the completion of Dex pumping, propofol (1-1.5 mg/kg) was slowly injected. MAP, HR, and SpO2 before medication (T0), 5 min after inserting the endoscope (T1), and the time after the examination being finished (T2) were recorded, respectively. The bioelectrical impedance technique was used to continuously monitor SV, CO, and SVR. The awakening time, propofol dose, and discharge time were recorded. Results: The comparison of MAP, HR, and SpO2 at T0 between the two groups was not statistically significant. MAP, HR, SV, CO, and SVR at T1 and T2 were significantly lower than those at T0, while the comparison of SpO2 was not significantly changed. MAP at T1 in the high dose group was significantly higher than that in the low dose group, while HR at T1 and T2 was significantly lower than that in the low dose group. SV, CO, and SVR at T1 and T2 in the high dose group was significantly higher than those in the low dose group. The awakening time in the high dose group was significantly shorter than that in the low dose group, and the propofol dose was significantly less than that in the low dose group, while the comparison of discharge time was not significantly different. Conclusions: Application of Dex in a high dose in the painless colonoscopy in the elder patients can reduce the propofol dose, and will not increase the inhibiting effect on respiration and circulation.

The host-guest properties of cucurbit[7]uril (Q[7]) and bispyridinium ethylene derivatives have been studied by 1 H NMR spectroscopy, UV–vis absorption spectra, and fluorescence emission analysis. The proton shifts associated with the guest encapsulated by the host suggested that the Q[7]-based [2] pseudo rotaxane behaves like a fast molecular shuttle along the bispyridinium ethylene axle of the guest upon protonation and deprotonation of the terminal carboxylates. In particular, the distinct fluorescent response signals indicated that the bispyridinium ethylene moiety not only behaves as the axle component for the pseudo rotaxane system, but also acts as an optical reporting unit during the host–guest complexation.

Objective: To investigate the effect of dexmedetomidine combined with propofol on stress response and early cognitive function in hypertensive patients undergoing painless gastroscopy. Methods: A total of 70 cases of hypertensive patients undergoing painless gastroscopy from March 2016 to March 2017 were selected as the subjects. They were randomly divided into the observation group and the control group. The control group was injected with physiological saline before injection and injected with propofol 2 mg/kg. The observation group was injected with propofol 0.4 g/kg before injection, and 1 mg/kg by intravenous injection of propofol. 2 groups of patients before administration (T0), after administration (T1), gastroscopy (T2), gastroscope examination at the end of the 10 min (T3) collected venous blood, plasma epinephrine by radioimmunoassay (E), norepinephrine (NE), cortisol (COR) levels of T0 records; T1, T2, T3 at the time of breathing (HR), mean arterial pressure (MAP); after 5 min, 30 min, 3 h, 6 h was evaluated with mini mental state examination (MMSE) to evaluate the cognitive function in early stage. Results: 2 groups of patients with T1, NE, COR levels of plasma E and T0 no significant difference, T2, T3, NE, COR and plasma E levels higher than the T0 level, the observation group T2, T3, NE, plasma E COR levels lower than the control group, there was statistical significance the difference between the 2 groups; the control group T1 HR is slower than T0, MAP less than T0, T2, T3 HR faster than T0, MAP is higher than T0, and the observation group HR and MAP each time point did not change significantly between the 2 groups was statistically significant the difference; after 5 min and 30 min compared with the preoperative MMSE score decreased 1 D, 3 h after operation, the 6 h gradually increased, but the observation group after 3 h MMSE score higher than the control group, the difference was statistically significant. Conclusion: Dexmedetomidine combined with propofol can reduce the stress reaction of patients with hypertension during painless gastroscopy, and reduce the early understanding of the occurrence of dysfunction, which is worthy of clinical promotion.

Objective: To investigate the effects of different doses of dexmedetomidine on inflammatory factors and T lymphocyte subsets in elderly patients undergoing laparoscopic surgery. Methods: from June 2016 to June 2017 in our hospital for laparoscopic surgery of 120 cases of elderly patients, were randomly divided into A group, B group, C group, D group of 30 cases, all patients underwent intravenous inhalational anesthesia, A, B, C in three groups were given dexmedetomidine before induction of anesthesia. Fixed loading dose of 0.5 μg/ kg, after intubation respectively with dexmedetomidine 0.2 μg/(kg.h), 0.5 μg/(kg.h), 0.8 μg/ (kg.h) after continuous infusion to surgery, D group at the same time with the same volume of physiological saline. Before induction of anesthesia (T0), 24 h after operation (T1), 72 h after operation (T2) of venous blood interleukin-1 were measured beta (IL-1 beta), interleukin -2 receptor (sIL-2R) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and T lymphocyte subsets (CD3+ , CD4+ , D8+ ). Results: the T1 of the 4 groups of sIL-2R, IL-6, IL-1 beta, TNF-alpha and T0 levels were significantly higher than, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference; group IL-1, sIL-2R, IL-6, TNF-beta and alpha level of T1 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference. T1 of the 4 groups of CD3+ , CD4+ , D8+ , CD4+ /CD8+ and T0 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference; T2 D group CD3+ , CD4+ , D8+ , CD4+ /CD8+ lower than T1, and A group, B group, C group, CD3+ , CD4+ , D8+ , CD4+ /CD8+ higher than that of D group, B group, C group, CD3+ CD4+ , D8+ , CD4+ /CD8+ higher than that of A group, B group, C group no significant difference. Conclusion: Dexmedetomidine can inhibit the inflammatory reaction and improve the immune function in elderly patients undergoing laparoscopic surgery, and the effect of middle and high dose is more significant.

Objective: To investigate the effect of dexmedetomidine on inflammatory factors and immune function in elderly patients undergoing laparoscopic radical resection of colorectal cancer. Methods: From April 2016 to April 2017, 86 cases of elderly laparoscopic radical resection of colorectal cancer in our hospital were selected and randomly divided into the observation group and the control group. 2 groups of patients were open venous access, oxygen mask, monitoring heart rate (HR), blood pressure (BP), electrocardiogram (ECG), oxygen saturation (SpO2), bispectral index (BIS), after induction of anesthesia, the observation group was given dexmedetomidine 0.4 g/kg to 20 mL of normal saline control. Group of 20 mL saline, 15 min infusion is completed, and the observation group of dexmedetomidine in 0.4 g/kg - h continuous infusion of normal saline control group, continuous infusion, until the end of surgery. Before induction of anesthesia (T0), 2 h after operation beginning (T1), at the end of operation (T2), 24 h after operation (T3) in venous blood, using ELISA method for the determination of serum interleukin-2 receptor (sIL-2R) and interleukin-6 (IL-6), tumor necrosis factor alpha (the level of TNF-alpha); on preoperative and postoperative 4 h, 12 h, 24 h after operation in venous blood serum epinephrine ELISA method (E), norepinephrine (NE), endothelin-1 (ET-1) level; on preoperative and postoperative 4 h, 12 h after surgery, 24 h venous blood flow cytometry determination of CD3 +, CD4 +, CD8 +, CD4 +/CD8 +. Results: compared with before operation, the observation group after 4 h, 12 h, 24 h NE, and the lower control group E, NE and ET-1 increased, the observation group after 4 h, 12 h, 24 h E, NE, ET-1 lower than that of the control group; compared with T0, 2 patients in group T2, T3 sIL-2R, IL-6, TNF-alpha were increased, the observation group T2, T3 sIL-2R, IL-6, TNF- were lower than that of the control group; compared with the preoperative, 2 group after 4 h, 12 h, 24 h CD3 +, CD4 +, CD8 + and CD4 +/CD8 + decreased, the observation group after 4 h, 12 h, 24 h CD3 +, CD4 +, CD8+, CD4 +/CD8 + higher than those in the control group. Conclusion: Dexmedetomidine has a good analgesic effect on elderly patients undergoing laparoscopic radical resection of colorectal cancer. It can effectively relieve the stress reaction and inflammatory reaction during perioperative period, and effectively improve the immune function of the patients.

Three new biphenyl derivatives ( 1 – 3 ), together with five known compounds, were isolated from the leaves and twigs of Garcinia multiflora . Their structures were determined by extensive spectroscopic techniques including NMR spectroscopy and mass spectrometry. All eight isolates showed weak cytotoxicity on five human tumor cell lines. In addition, the three biphenyl derivatives showed moderate anti-oxidant activity with IC 50 values ranging from 7.78 to 8.78 μ M.

BACKGROUND Hepatocellular carcinoma (HCC) is one of the most common tumors. Transarterial chemoembolization (TACE) is the first choice of treatment for intermediate HCC and an important treatment option for advanced HCC. This retrospective study compared the prognosis between patients showing coagulative necrosis and patients showing liquefactive necrosis after the first TACE procedure. MATERIAL AND METHODS We divided 171 patients with Barcelona Clinic Liver Cancer (BCLC) Stage B or C HCC into 2 groups; a coagulative necrosis group (79 patients) and a liquefactive necrosis group (92 patients). The coagulative and liquefactive necroses were identified by computed tomography after the first TACE procedure. Kaplan-Meier analysis was used to identify the differences in the overall survival (OS) and progression-free survival (PFS) between the 2 groups, and the associated risk factors and safety of TACE were analyzed. RESULTS The median OS durations were 23.27±1.40 months and 8.83±2.15 months (P=0.004) and the median PFS durations were 9.33±0.96 months and 3.70±0.44 months (P=0.002) in the coagulative necrosis and liquefactive necrosis groups, respectively. Intrahepatic in situ progression, new intrahepatic metastasis, and extrahepatic progression occurred significantly earlier in the liquefactive necrosis group (P

This study was aimed at determining whether late gadolinium enhancement (LGE) in conjunction with Galectin-3 (Gal-3) level offered more precise prognosis of non-ischemic cardiomyopathy (NICM) in comparison to LGE alone. Results of LGE and Gal-3 expression in 192 patients with NICM, including 85 subjects with dilated cardiomyopathy (DCM) and 107 with hypertrophic cardiomyopathy (HCM), were examined. As suggested by the characteristics of LGE and Gal-3 levels, patients were divided into four groups: LGE positive + low Gal-3 (n = 10 for DCM, n = 15 for HCM), LGE positive + high Gal-3 (n = 25 for DCM, n = 51 for HCM), LGE negative + low Gal-3 (n = 32 for DCM, n = 29 for HCM), LGE negative + high Gal-3 (n = 18 for DCM, n = 12 for HCM). Primary endpoints over the follow-up period included major adverse cardiac events (MACEs). Kaplan–Meier survival analysis and univariate Cox proportional hazard models were used to analyze the survival status of patients with NICM. The optimal cut-off value of Gal-3 level for two types of NICM was determined by receiver operating characteristic analysis (13.38 U/L for DCM and 14.40 U/L for HCM). The combination of LGE and Gal-3 levels offered a more significant prognostic value than using LGE alone for both DCM and HCM (DCM P = 0.001