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Three isostructural transition metal-organic frameworks, [M(bta) 0.5 (bpt)(H 2 O) 2 ]·2H 2 O (M = Co ( 1 ), Ni ( 2 ), Zn ( 3 ), H 4 bta = 1,2,4,5-benzenetetracarboxylic acid, bpt = 4-amino-3,5-bis(4-pyridyl)-1,2,4-triazole), were successfully constructed using different metal cations. These frameworks exhibit a three-dimensional network structure with multiple coordinated and lattice water molecules within the framework, contributing to high stability and a rich hydrogen-bond network. Proton conduction studies revealed that, at 333 K and 98% relative humidity, the proton conductivities (σ) of MOFs 1-3 reached 1.42 × 10 -2 , 1.02 × 10 -2 , and 6.82 × 10 -3 S cm -1 , respectively. Compared to the proton conductivity of the initial ligands, the σ values of the complexes increased by 2 orders of magnitude, with the activation energies decreasing from 0.36 to 0.18 eV for 1 , 0.09 eV for 2 , and 0.12 eV for 3 . An in-depth analysis of the correlation between different metal centers and proton conduction performance indicated that the varying coordination abilities of the metal cations and the water absorption capacities of the frameworks might account for the differences in conductivity. Additionally, the potential of 1 as a supercapacitor electrode material was assessed. 1 exhibited a specific capacitance of 61.13 F g -1 at a current density of 0.5 A g -1 , with a capacitance retention of 82.4% after 5000 cycles, making it a promising candidate for energy storage applications.

Polyoxometalates (POMs) are a class of anionic metal-oxygen clusters with versatile biological activities. Over the past decade, an increasing number of POMs, especially Sb-rich POMs, have been proven to exert antitumor activity. However, the antitumor effects and mechanisms of POMs in the treatment of non-small cell lung cancer (NSCLC) remain largely unexplored. This study employed a Sb-rich {Sb 21 Tb 7 W 56 } POM (POM-1) for NSCLC therapy and investigated its mechanism of action. Our results demonstrated that POM-1 exhibited cytotoxicity against H1299 and A549 cells with IC 50 values of 3.245 μM and 3.591 μM, respectively. The migration and invasion were also inhibited by 28.05% and 76.18% in H1299 cells, as well as 36.88% and 36.98% in A549 cells at a concentration of 5 μM. In a tumor xenograft mouse model, POM-1 suppressed tumor growth by 76.92% and 84.62% at doses of 25 and 50 mg kg -1 , respectively. Transcriptomic analysis indicated the alteration of ferroptosis and apoptosis signaling pathways in POM-treated NSCLC cells. Subsequent experimentation confirmed the induction of ferroptosis, evidenced by 5.6-fold elevated lipid peroxide levels with treatment of 5 μM POM-1, alongside increased expression of ferroptosis-associated proteins. Additionally, the apoptosis induced by POM-1 was also validated by the 19.67% and 30.1% increase in apoptotic cells in H1299 and A549 cells treated with 5 μM POM-1, respectively, as well as the upregulated activation of caspase-3. In summary, this study reveals, for the first time, ferroptosis as the antitumor mechanism of Sb-rich POM, and that synergism with ferroptosis and apoptosis is a highly potent antitumor strategy for POM-based antitumor therapy., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Objective: To assess the efficacy and safety of Bufei Jiedu (BFJD) ranules as adjuvant therapy for patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB)., Methods: A large-scale, multi-center, double-blinded, and randomized controlled trial was conducted in 18 sentinel hospitals in China from December 2012 to December 2016. A total of 312 MDR-PTB patients were randomly assigned to BFJD Granules or placebo groups (1:1) using a stratified randomization method, which both received the long-course chemotherapy regimen for 18 months (6 Am-Lfx-P-Z-Pto, 12 Lfx-P-Z-Pto). Meanwhile, patients in both groups also received BFJD Granules or placebo twice a day for a total of 18 months, respectively. The primary outcome was cure rate. The secondary outcomes included time to sputum-culture conversion, changes in lung cavities and quality of life (QoL) of patients. Adverse reactions were monitored during and after the trial., Results: A total of 216 cases completed the trial, 111 in the BFJD Granules group and 105 in the placebo group. BFJD Granules, as an adjuvant treatment, increased the cure rate by 13.6% at the end of treatment, compared with the placebo (58.4% vs. 44.8%, P=0.02), and accelerated the median time to sputum-culture conversion (5 months vs. 11 months). The cavity closure rate of the BFJD Granules group (50.6%, 43/85) was higher than that of the placebo group (32.1%, 26/81; P=0.02) in patients who completed the treatment. At the end of the intensive treatment, according to the 36-item Short Form, the BFJD Granules significantly improved physical functioning, general health, and vitality of patients relative to the placebo group (all P<0.01). Overall, the death rates in the two groups were not significantly different; 5.1% (8/156) in the BFJD Granules group and 2.6% (4/156) in the placebo group., Conclusions: Supplementing BFJD Granules with the long-course chemotherapy regimen significantly increased the cure rate and cavity closure rates, and rapidly improved QoL of patients with MDR-PTB (Registration No. ChiCTR-TRC-12002850)., (© 2024. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

In this work, a novel organodiphosphate-containing inorganic-organic hybrid polyoxoniobate (PONb) ring {(PO 3 CH 2 CH 2 PO 3 H) 4 Nb 8 O 16 } 4- ( Nb 8 P 8 ) has been achieved by a one-pot hydrothermal method. The ring is constructed from a tetragonal {Nb 8 O 36 } motif and four {PO 3 CH 2 CH 2 PO 3 H} ligands. Interestingly, Nb 8 P 8 can be joined together via K-H 2 O clusters {K 2 (H 2 O) 4 (OH) 2 } to form one-dimensional chains {[K 2 (H 2 O) 4 (OH) 2 ] Nb 8 P 8 } n and further linked by {Cu(en) 2 } 2+ (en = ethylenediamine) complexes, resulting in a three-dimensional supramolecular framework {[Cu(en) 2 ] 2 [K 2 (H 2 O) 4 (OH) 2 ] Nb 8 P 8 }·3en·H 2 O ( 1 ). 1 exhibits good chemical and thermal stability and has a high water vapor adsorption capacity of ≤224 cm 3 g -1 (22.71 mol·mol -1 ) at 298 K, outperforming most of the known polyoxometalate-based materials. Impedance measurements prove that 1 can transfer protons with moderate conductivity. This study not only contributes to the structural diversity of organodiphosphate-containing PONbs and PONb rings but also provides a reference for the development of PONb-based materials with unique performance.

Two isostructural Co(Cd)-antimony-oxo tartrate cluster-based compounds with a one-dimensional (1-D) belt-like structure, namely H 9.2 [Co(H 2 O) 6 ]{ M 0.5 (H 2 O) 3.5 { M '(H 2 O) 4 [Sb V O 6 [Co 4.2 (H 2 O) 5 SbIII6(μ 3 -O) 2 (tta) 6 ]]}} 2 · n H 2 O ( M = Co, M ' = Co, n = 9 (1); M = Cd 0.39 /Co 0.61 , M ' = Cd 0.24 /Co 0.76 , n = 7 (2); H 4 tta = tartaric acid), have been synthesized by solvothermal methods. It is noteworthy that the relatively rare mixed-valence Sb(III,V) exists in the structures. The anionic clusters in both compounds appear to be in a sandwich configuration; the top and bottom layers are based on {Sb 3 (μ 3 -O)(tta) 3 } brackets, and the intermediate layer is occupied by {Sb V O 6 [Co 4.2 (H 2 O) 5 ]}. The title compounds have been characterized by single-crystal X-ray diffraction, powder X-ray diffraction, elemental analyses, thermogravimetric analyses, and UV-Vis spectroscopy. We chose compound 2 as a representative to test its proton conductivity, and the results show that the conductivity can reach 1.42 × 10 -3 S cm -1 at 85 °C under 98% relative humidity.

To investigate the etiology of multiple primary malignant neoplasms occurred in one patient. Retrospective analysis was performed on a 52-year-old female patient who was admitted to the Department of Endocrinology, the First Affiliated Hospital of Sun Yat-Sen University on October 7, 2021, due to "thyroid occupying lesion for one week". A complete systemic positron emission tomography examination of the patient indicated that the metabolic characteristics of the left thyroid nodules were consistent with medullary thyroid carcinoma, those of the right thyroid nodules were consistent with papillary thyroid carcinoma, and the metabolic characteristics of the T 6-7 level were consistent with meningioma, and teratoma was found in the right ovarian region. Intradural subdural mass resection was performed on October 20, 2021, and bilateral total thyroidectomy, isthmus thyroidectomy, bilateral central lymph node dissection and left cervical lymph node dissection were performed on November 2, 2021. The postoperative pathologic diagnosises were meningioma (WHO Grade 1), medullary thyroid carcinoma (left side), and papillary thyroid carcinoma (right side).Whole exon gene sequencing revealed the presence of mutations in the ACAN and FLNB genes, which are associated with dysplasia, as well as mutations in the DDX41 and JAK2 genes, which are linked to active pro-proliferation signaling and tumor susceptibility. In this study, a gene mutation pattern which could lead to multiple primary malignant neoplasms was found.

Functionalized crystalline solids based on metal-organic frameworks (MOFs) enable efficient luminescence detection and high proton conductivity, making them crucial in the realms of environmental monitoring and clean energy. Here, two structurally and functionally distinct zinc-based MOFs, [Zn(TTDPa)(bodca)]·H 2 O ( 1 ) and [Zn(TTDPb)(bodca)]·H 2 O ( 2 ), were successfully designed and synthesized using 3,6-di(pyridin-4-yl)thieno[3,2- b ]thiophene (TTDPa) and 2,5-di(pyridin-4-yl)thieno[3,2- b ]thiophene (TTDPb) as ligands, in the presence of bicyclo[2.2.2]octane-1,4-dicarboxylic acid (H 2 bodca). Both 1 and 2 display a three-dimensional (3D) structure with 5-fold interpenetration, and notably, 2 forms a larger one-dimensional pore measuring 17.16 × 10.81 Å 2 in size. Fluorescence experiments demonstrate that 1 and 2 can function as luminescent sensors for nitrofurantoin (NFT) and nitrofurazone (NFZ) with low detection limits, remarkable selectivity, and good recyclability. A comprehensive analysis was conducted to investigate the differing sensing effects of compounds 1 and 2 and to explore potential sensing mechanisms. Additionally, at 328 K and 98% relative humidity, 1 and 2 exhibit proton conductivity values of 2.13 × 10 -3 and 4.91 × 10 -3 S cm -1 , respectively, making them suitable proton-conducting materials. Hence, the integration of luminescent sensing and proton conductivity in monophasic 3D Zn-MOFs holds significant potential for application in intelligent multitasking devices.

Using enantiomerically pure bidentate and tridentate N-donor ligands ( 1 L R / 1 L S and 2 L R / 2 L S ) to replace two coordinated H 2 O molecules of Yb(tta) 3 (H 2 O) 2 , respectively, two eight- and nine-coordinated Yb III enantiomeric pairs, namely, Yb(tta) 3 1 L R /Yb(tta) 3 1 L S ( Yb- R -1 / Yb- S -1 ) and [Yb(tta) 3 2 L R ]·CH 3 CN/[Yb(tta) 3 2 L S ]·CH 3 CN ( Yb- R -2 / Yb- S -2 ), were isolated, in which Htta = 2-thenoyltrifluoroacetone, 1 L R / 1 L S = (-)/(+)-4,5-pinene-2,2'-bipyridine, and 2 L R / 2 L S = (-)/(+)-2,6-bis(4',5'-pinene-2'-pyridyl)pyridine. Interestingly, they not only present distinct degrees of chirality but also show large differences in near-infrared (NIR) photoluminescence (PL), circularly polarized luminescence (CPL), and second-harmonic generation (SHG). Eight-coordinated Yb- R -1 with an asymmetric bidentate 1 L R ligand has a high NIR-PL quantum yield (1.26%) and a long decay lifetime (20 μs) at room temperature, being more than two times those (0.48%, 8 μs) of nine-coordinated Yb- R -2 with a C 2 -symmetric tridentate 2 L R ligand. In addition, Yb- R -1 displays an efficient CPL with a luminescence dissymmetry factor g lum = 0.077, being 4 × Yb- R -2 (0.018). In particular, Yb- R -1 presents a strong SHG response (0.8 × KDP), which is 8 × Yb- R -2 (0.1 × KDP). More remarkably, the precursor Yb(tta) 3 (H 2 O) 2 exhibits a strong third-harmonic generation (THG) response (41 × α-SiO 2 ), while the introduction of chiral N-donors results in the switching of THG to SHG. Our interesting findings provide new insights into both the functional regulation and switching in multifunctional lanthanide molecular materials.

Herein, a giant Sb-rich polyoxometalate (POM) {Sb 21 Tb 7 W 56 } is reported, which contains the largest number of Sb atoms in a POM so far. The Sb-rich POM has many interesting structural features and is a rare example of a soluble and water-stable giant POM. Biomedical studies indicate that the Sb-rich POM exhibits broad-spectrum antitumor activity against various cancer cell lines by reactivating the P53-dependent apoptotic processes and disrupting the mitochondrial membrane. In addition, this Sb-rich POM was capable of suppressing the growth and metastasis of a breast cancer in vivo. This work demonstrates that Sb-rich POMs are promising candidates for the development of new anticancer drugs., (© 2022 Wiley-VCH GmbH.)

Objective: Refractory rifampicin-resistant/multidrug resistant/extensively-drug resistant tuberculosis (RR/MDR/XDR-TB) were defined as patients infected with Mycobacterium tuberculosis (MTB) resistant to rifampicin(RR-TB), or at least resistant to rifampicin and isoniazid (MDR-TB) or added resistant to fluoroquinolones (FQs) and one of second line injectable agents (XDR-TB), a patient for whom an effective regimen (fewer than 4 effective agents due to adverse events (AEs) or multiple drug resistances) cannot be developed. To compare the effectiveness and safety of bedaquiline (BDQ)-containing and BDQ-free regimens for treatment of patients with refractory RR/MDR/XDR-TB., Methods: Patients with refractory RR/MDR/XDR-TB receiving BDQ-containing regimens (BDQ group, n = 102) and BDQ-free regimens (non-BDQ group, n = 100) satisfied with included criteria were strictly included in this retrospective historical control study across East China. Culture conversion, treatment outcome, cavity closing rate, and AEs were compared between two groups., Results: The baseline characteristics involved all possible aspects of patients were well balanced between two groups (p > 0.05). Culture conversion rates in the BDQ group at month 3 (89.2% vs. 66.0%), month 6 (90.2% vs 72.0%), month 9 (91.2% vs. 66.0%), and month 12 (94.1% vs 65.0%) were all significantly higher than those in non-BDQ group (p < 0.001). Similar results were observed in the cavity closing rate at month 9 (19.6% vs 8.0%, p = 0.0) and month 12 (39.2% vs 15.0%, p < 0.001). Patients receiving BDQ-containing regimens had more treatment success than those receiving BDQ-free regimens (p < 0.001; cure rate, 69.6% vs. 45.0%; complete the treatment, 22.5% vs. 18.0%; treatment success, 92.2% vs. 63.0%); the use of BDQ and combined with Linezolid or Clofazimine or Cycloserine were identified as independent predictors of treatment success and no culture reversion (P < 0.05). AEs were similarly reported in 26.5% of patients in the BDQ group and 19.0% in the non-BDQ group (p = 0.2)., Conclusions: BDQ-containing regimens resulted in better treatment outcomes and similar safety relative to BDQ-free regimens for patients with refractory pulmonary RR/MDR/XDR-TB., (© 2022. The Author(s).)

A new dysprosium (III) coordination polymer [Dy(Hm-dobdc) (H 2 O) 2 ]·H 2 O ( Dy-CP ), was hydrothermal synthesized based on 4,6-dioxido-1,3-benzenedicarboxylate (H 4 m-dobdc) ligand containing carboxyl and phenolic hydroxyl groups. The Dy(III) center adopts an octa-coordinated [DyO 8 ] geometry, which can be described as a twisted square antiprism ( D 4d symmetry). Neighboring Dy(III) ions are interconnected by deprotonated Hm-dobdc 3- ligand to form the two-dimensional infinite layers, which are further linked to generate three-dimensional structure through abundant hydrogen bonds mediated primarily by coordinated and lattice H 2 O molecules. Magnetic studies demonstrates that Dy-CP shows the field-induced slow relaxation of magnetization and the energy barrier U eff / k B and relaxation time τ 0 are 35.3 K and 1.31 × 10 -6 s, respectively. Following the vehicular mechanism, Dy-CP displays proton conductivity with σ equal to 7.77 × 10 -8  S cm -1 at 353 K and 30%RH. Moreover, luminescence spectra reveal that H 4 m-dobdc can sensitize characteristic luminescence of Dy(III) ion. Herein, good magnetism, proton conduction, and luminescence are simultaneously achieved, and thus, Dy-CP is a potential multifunctional coordination polymer material., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Chen, Ge, Wu, Cui, Mu, Xiao, Li and Ge.)

Using Dy(dbm) 3 (H 2 O) and Dy(btfa) 3 (H 2 O) 2 to react with enantiopure N -donors, (-)/(+)-4,5-pinenepyridyl-2-pyrazine (L R /L S ), respectively, two pairs of chiral Dy III enantiomers, Dy(dbm) 3 L R /Dy(dbm) 3 L S ( R -1-Dy / S -1-Dy ) and Dy(btfa) 3 L R /Dy(btfa) 3 L S ( R -2-Dy / S -2-Dy ) were obtained, wherein one of the benzene rings of dbm - (dibenzoylmethanate) in R -1-Dy / S -1-Dy is displaced by the -CF 3 group of btfa - (4,4,4-trifluoro-1-phenyl-1,3-butanedionate) in R -2-Dy / S -2-Dy . Interestingly, this substitution results not only in giant differences in their single-ion magnetic (SIM) performances but also in their completely different nonlinear optical (NLO) responses. R -1-Dy presents a large effective energy barrier ( U eff = 265.47 K) under zero applied field, being more than 4 × R -2-Dy (61.40 K). The discrepancy on their magnetic performances has been further elucidated by ab initio calculations. Meanwhile, R -1-Dy/ S -1-Dy display the strongest third-harmonic generation responses (35/33 × α-SiO 2 ) among the known lanthanide NLO-active coordination compounds (CCs). On the contrary, R -2-Dy/ S -2-Dy exhibit moderate second-harmonic generation responses (0.65/0.70 × KDP). These results not only give the first example of the CCs with both SMM/SIM behavior and a THG response but also provide an efficient strategy for achieving the function regulation and switch in multifunctional CCs.

A multifunctional metal-organic framework, (Hdmbpy)[Dy(H 2 dobdc) 2 (H 2 O)]·3H 2 O ( Dy-MOF , H 4 dobdc = 2,5-dihydroxyterephthalic acid, dmbpy = 4,4'-dimethyl-2,2'-bipyridine), was synthesized and structurally characterized. The metal center Dy III is connected by four carboxyl groups to form the [Dy 2 (CO 2 ) 4 ] binuclear nodes, which are further interconnected by eight separate H 2 dobdc 2- ligands to form a three-dimensional (3D) framework including hydrophilic triangular channels and abundant hydrogen-bonding networks. Dy-MOF has good stability in aqueous solution as well as in harsh acidic or alkaline solutions (pH range: 2.0-12.0). Furthermore, the luminescence signal of Dy-MOF undergoes a visualized color change as the acidity of the solution alters, which is the typical behavior of pH ratiometric probe. At a 100% relative humidity, Dy-MOF exhibits a high proton conductivity σ (1.70 × 10 -4 S cm -1 at 303 K; 1.20 × 10 -3 S cm -1 at 343 K) based on the proton hopping mechanism, which can be classified as a superionic conductor with σ exceeding 10 -4 S cm -1 . Additionally, the ferromagnetic interaction and magnetic relaxation behavior are simultaneously achieved in Dy-MOF . Herein, the combination of luminescence sensing, magnetism, and proton conduction in a single-phase 3D MOF may offer great potential applications in smart multitasking devices.

A Yb(OTf) 3 catalyzed [1,3]-rearrangement of 3-alkenyl oxindoles was achieved, affording a variety of multifunctional 3-ylideneoxindoles with good yields and Z / E selectivities (64%-89% yield, 78 : 22->99 : 1 Z / E ). Importantly, an operationally simple, one-pot sequential catalytic synthesis of 3-ylideneoxindoles was also developed. Additionally, a cross [1,3]-rearrangement experiment and nonracemic transformation were also carried out, which indicated a concerted rearrangement mechanism of this methodology.

Methylprednisolone (MP) is widely used to treat clinical spinal cord injury (SCI). Treadmill training is also considered an important treatment after SCI to improve motor function in patients, resulting in an evident improvement. Therefore, the present study was designed to evaluate and contrast the effects of MP and treadmill training administered in combination or alone after SCI in adult rats. A rat spinal cord T10 contusion model was induced in Sprague-Dawley rats using an impact device. A total of 40 rats were divided into four groups (n=10 rats/group): the MP, MP + treadmill training, SCI and sham group. At 30 min after injury, MP sodium succinate was injected into the rats of the MP and MP + treadmill training groups. Treadmill training began on the second week post-trauma and was performed for 8 weeks. The results showed that MP therapy combined with treadmill training significantly ameliorated several parameters of hind limb function compared with those by MP treatment alone (all P<0.05). A significantly reduced immunopositive area of Nogo receptor and chondroitin sulfate proteoglycans and reduced relative expression of these mRNAs were found in the MP + treadmill training group (P<0.05) compared with the findings in the MP group. In conclusion, the present study indicated that combined MP and treadmill training treatment improved the recovery of hind limb function in rats with SCI, thus potentially representing a promising strategy to cure SCI., (Copyright © 2020, Spandidos Publications.)

The assembly of heterometallic cluster substituted polyoxometalates (POMs) remains a great challenge for inorganic synthetic chemistry up to now. Herein, a series of 5p-4f heterometallic cluster substituted POMs were successfully isolated by a facile one-step hydrothermal reaction method, namely H 17 (H 2 en) 3 [Sb III 9 Sb V Ln 3 O 14 (H 2 O) 3 ][(SbW 9 O 33 ) 3 (PW 9 O 34 )]·28H 2 O( 1-Ln , Ln = Ce, Sm, Eu, Gd, Tb, Dy) (en = ethylenediamine). Interestingly, by replacing en with imidazole, another series of 5p-4f heterometallic cluster substituted POMs H 13 (HIm) 4 K 2 Na 4 (H 2 O) 9 [Sb III 9 Sb V Ln 3 O 14 (H 2 O) 3 ][(SbW 9 O 33 ) 3 (PW 9 O 34 )]·26H 2 O ( 2-Ln , Ln = Sm, Eu, Gd, Tb, Dy, Im = imidazole) were obtained. Structural analyses indicate that both 1-Ln and 2-Ln are made up of an unprecedented 5p-4f heterometallic {Sb 10 Ln 3 O 14 (H 2 O) 3 } cluster stabilized simultaneously by mixed trilacunary heteropolyanions including {A-α-PW 9 O 34 } and {B-α-SbW 9 O 33 }. Impedance measurements indicate that both compounds exhibit different proton conduction properties, and the conductivity of 2 can reach up to 1.64 × 10 -2 S cm -1 at 85 °C under 98% relative humidity. Moreover, the fluorescence emission behaviors of both compounds have been studied.

One novel three-dimensional (3-D) copper(I)-thioarsenate(III) [Ni(en) 3 ]Cu 4 As 4 S 9 ( 1 , en = ethylenediamine) has been solvothermally prepared with the utilization of the in situ formation of [Ni(en) 3 ] 2+ complex as structure-directing agent (SDA). 1 contains cubane-like [Cu 8 S 12 ] 16- clusters and rare tetrameric [As 4 S 9 ] 6- units, which are interconnected to generate the first example of a 3-D anionic framework [Cu 4 As 4 S 9 ] n 2 n - , topologically identical to pyrite, and having large channels filled by [Ni(en) 3 ] 2+ complex cations. 1 is a potential wide-band-gap semiconductor with an energy gap of 1.91 eV that exhibits selectively photocatalytic degradation of methylene blue under visible-light irradiation. The density functional theory calculation, photocurrent response, and magnetic properties of 1 were also investigated.

We described a Ni-bidentate oxazoline catalyzed highly enantio- and diastereoselective decarboxylative aldol reaction of 2-oxotetrahydrofuran-3-carboxylic acid/2-oxochromane-3-carboxylic acid derivatives with different kinds of carbonyls. Under optimal reaction conditions, α-substituted β-hydroxy butyrolactones and dihydrocoumarins with an all-carbon quaternary stereocenter have been generated with high levels of functional-group compatibility. Furthermore, proficient transformations of products were also described, in which an aliphatic tertiary alcohol and a multi-substituted 1,4-diol were smoothly constructed through hydrogenation and ring-opening reaction, respectively.

Two homochiral EuIII and SmIII tris(β-diketonate) enantiomeric pairs, based on fluorinated β-diketone (Hbtfa) and enantiopure asymmetric N,N'-donor ligands (LR and LS), Λ-Eu(btfa)3LR (R-1-Eu)/Δ-Eu(btfa)3LS (S-1-Eu) and Λ-Sm(btfa)3LR (R-2-Sm)/Δ-Sm(btfa)3LS (S-2-Sm) (btfa- = 4,4,4-trifluoro-1-phenyl-1,3-butanedionate and LR/LS = (-)/(+)-4,5-pineno-2,2'-bipyridine) were synthesized. The electronic circular dichroism (ECD) spectra confirmed their enantiomeric nature. R-1-Eu/S-1-Eu and R-2-Sm/S-2-Sm exhibit intense characteristic emissions of EuIII (red) and SmIII (orange-red) ions both in the solid state and in DCM with long lifetimes and high luminescence quantum yields. For example, the overall quantum yields reach up to 61% and 53% along with very high sensitization efficiency values of 82 and 79 for R-1-Eu in the solid state and in DCM, respectively. Notably, the corresponding values are determined to be 6.5% (solid state) and 3.1% (DCM) for R-2-Sm, which are among the highest quantum yields for rare SmIII tris(β-diketonate) luminescent complexes reported to date. Furthermore, R-1-Eu and R-2-Sm show a strong triboluminescence (TL) phenomenon visible with the naked eye in daylight. Moreover, R-1-Eu/S-1-Eu and R-2-Sm/S-2-Sm show circularly polarized luminescence (CPL) properties. Particularly, the luminescence dissymmetry factors (glum) for R-2-Sm/S-2-Sm are larger than those for R-1-Eu/S-1-Eu despite the fact that SmIII complexes usually show poorer emission than EuIII homologues, which is very rare in the reported EuIII and SmIII CPL-active complexes.

The COVID-19 outbreak can be seen as a 'big test' for China; a summative assessment of its preparedness on multiple fronts, including medical education. Being intimately involved in the coordinated response, the First Affiliated Hospital of Sun Yat-sen University has been a first-hand witness to the strengths and weaknesses of the current medical education system in China. On the one hand, we believe that the distinguished contributions in disease containment efforts by healthcare professionals indicated that our medical education system has achieved its intended outcomes and is socially accountable. On the other hand, we have also identified three major issues that need to be addressed from an educational standpoint: insufficient emphasis on public health emergency preparedness; unsophisticated mechanisms for interdisciplinary cooperation; and inadequate guidance in medical ethics. Whilst these reflections might be seen in its summative form, we would suggest changing it to that of a formative process, where we learn from our assessment through observation and feedback of the gaps, upon which improvement of our present situation can be made. We hope that these lessons may be helpful to our colleagues in the rest of China and around the world, who are engaged in medical educational reform.

Background: China is the second highest pulmonary tuberculosis (PTB) burden country worldwide. However, retreatment of PTB has often developed resistance to at least one of the four first-line anti-TB drugs. The cure rate (approximately 50.0-73.3%) and management of retreatment of PTB in China needs to be improved. Qinbudan decoction has been widely used to treat PTB in China since the 1960s. Previously clinical studies have shown that the Qinbudan tablet (QBDT) promoted sputum-culture negative conversion and lesion absorption. However, powerful evidence from a randomized controlled clinical trial is lacking. Therefore, the aim of this study was to compare the efficacy and safety of QBDT as an adjunct therapy for retreatment of PTB., Methods: We conducted a multicenter, randomized, double-blind, placebo-controlled clinical trial in China. People diagnosed with PTB were enrolled who received previous anti-TB treatment from April 2011 to March 2013. The treatment group received an anti-TB regimen and QBDT, and the control group was administered an anti-TB regimen plus placebo. Anti-TB treatment options included isoniazid, rifampicin, pyrazinamide, ethambutol, streptomycin for 2 months (2HRZES), followed by isoniazid, rifampicin, ethambutol for 6 months (6HRE), daily for 8 months. Primary outcome was sputum-culture conversion using the MGIT 960 liquid medium method. Secondary outcomes included lung lesion absorption and cavity closure. Adverse events and reactions were observed after treatment. A structured questionnaire was used to record demographic information and clinical symptoms of all subjects. Data analysis was performed by SPSS 25.0 software in the full analysis set (FAS) population., Results: One hundred eighty-one cases of retreatment PTB were randomly divided into two groups: the placebo group (88 cases) and the QBDT group (93 cases). A total of 166 patients completed the trial and 15 patients lost to follow-up. The culture conversion rate of the QBDT group and placebo group did not show a noticeable improvement by using the covariate sites to correct the rate differences (79.6% vs 69.3%; rate difference = 0.10, 95% confidence interval (CI): - 0.02-0.23; F = 2.48, P = 0.12) after treatment. A significant 16.6% increase in lesion absorption was observed in the QBDT group when compared with the placebo group (67.7% vs 51.1%; rate difference = 0.17, 95% CI: 0.02-0.31; χ 2  = 5.56, P = 0.02). The intervention and placebo group did not differ in terms of cavity closure (25.5% vs 21.1%; rate difference = 0.04, 95% CI: - 0.21-0.12; χ 2  = 0.27, P = 0.60). Two patients who received chemotherapy and combined QBDT reported pruritus/nausea and vomiting., Conclusions: No significant improvement in culture conversion was observed for retreatment PTB with traditional Chinese medicine plus standard anti-TB regimen. However, QBDT as an adjunct therapy significantly promoted lesion absorption, thereby reducing lung injury due to Mycobacterium tuberculosis infection., Trial Registration: This trial is registered at ClinicalTrials.gov, NCT02313610.

Background: The pathogenic mechanism of antituberculous drug-induced liver injury (ATDILI) is associated with antioxidant enzymes. The objective of the present study was to investigate the associations of ATDILI susceptibility with genetic polymorphisms of antioxidant enzyme genes including nitric oxide synthase 2 (NOS2), thioredoxin reductase 1 (TXNRD1), superoxide dismutase 2 (SOD2), BTB domain and CNC homolog 1 (BACH1), and MAF bZIP transcription factor K (MAFK)., Methods: Thirty tag single nucleotide polymorphisms (tag-SNPs) from the all candidate genes were genotyped in a 2-stage cohort study including an initial discovery stage with 461 ATDILI patients and 466 controls and a replication stage with 216 ATDILI patients and 432 controls. The frequencies and distributions of genotypes and haplotypes were compared between the case and control groups. Three different genetic models including dominant, recessive, and additive models were used to determine the associations with susceptibility to ATDILI., Results: The SNPs rs9906835, rs944725, and rs3794764 of the NOS2 gene were significantly associated with an increased risk of ATDILI. The MAFK rs3735656 SNP was significantly associated with a decreased risk for ATDILI. The AAA haplotype of the NOS2 gene was associated with susceptibility to ATDILI. The treatment outcomes of patients with tuberculosis were further affected by genetic variants of the NOS2 and MAFK genes., Conclusions: Genetic polymorphisms of NOS2 and MAFK are associated with ATDILI susceptibility in Chinese patients with tuberculosis. The variants in NOS2 and MAFK affect treatment outcomes of tuberculosis patients. Further studies are needed to better understand the molecular mechanisms of ATDILI susceptibility via regulation of the expression of ATDILI-susceptibility genes and proteins., (© 2019 Pharmacotherapy Publications, Inc.)

Objective: To investigate the clinical characteristics and drug susceptibility test (DST) of patients infected with different nontuberculous mycobacteria (NTM). Methods: The patients with nontuberculous mycobacterial lung disease (NMLD) in Shanghai Pulmonary Hospital from March 2014 to March 2015 were studied retrospectively by analyzing the clinical characteristics, radiological features and DST results. A total of 201 NMLD patients [male 108, age(58±15) yrs] were enrolled into this study including 48 cases of M. Kansasii [male 13, age (52±16) yrs],46 cases of M. Abscess [male 46, age (57±16) yrs], 92 cases of M. Intracellulare [male 43, age (61±13) yrs], and 15 cases of M. Avium [male 6, age (67±10) yrs]. Clinical data were collected when the diagnosis was made and Chi-square test was used to compare the differences among 4 groups of patients. Bonferroni method was used for further pairwise comparisons. Results: There were significant differences among the 4 groups in the age(χ(2)=6.42, P< 0.001) and the gender(χ(2)=49.18, P< 0.001) of the patients. The history of bronchiectasis in the groups of M. Kansasii, M. Abscess , M. Intracellulare and M. Avium were 2/48, 31/46, 39/92 and 4/15 cases respectively(χ(2)=41.84, P< 0.001). For the Gamma-interferon release assays (ELISA) (IGRA), the positive rate of IGRA in the groups of M. Kansasii, M. Abscess, M. Intracellulare and M. Avium were 83%(40/48), 30%(14/46), 23%(21/92) and 33% (5/15) respectively(χ(2)=50.96, P< 0.001). The radiological features were significantly different in tree-in-bud(8/48, 35/46, 36/92 and 4/15 cases respectively, χ(2)=36.48, P< 0.001), pleural thickness or mild effusion (21/48, 36/46, 69/92 and 7/15 cases, χ(2)=19.54, P< 0.001), bronchiectasis (20/48, 39/46, 78/92 and 10/15 cases, P< 0.001) and cavities (38/48, 21/46, 63/92 and 10/15 cases, χ(2)=12.38, P< 0.001) among the 4 groups( M. Kansasii, M. Abscess, M. Intracellulare and M. Avium ). The drug resistance rates of M. Kansasii to rifampin, ethambutanol and ofloxacin were 10%(5/48), 8%(4/48) and 15%(7/48) respectively; the resistance rates of M.Intracellulare to ethambutanol was 45%(41/92), and the resistance rates of M.Abscess were all over 80% to all anti-TB drugs. The results of pairwise comparisons showed that the male proportion(46/48) and IGRAs positive rate(40/48) of patients with M. Kansasii were higher than those of other groups, and the incidence of bronchiectasis(20/48) and pleural changes(21/48) was lower than those of other groups. The female ratio(33/46), history of bronchiectasis (31/46) and tree-in-bud sign of patients(35/46) with M. Abscess were higher than those of other groups. Conclusions: There were differences in the clinical manifestations and imaging features of 4 common NMLD diseases, which were helpful for clinical differentiation. The patients with M. Kansasii infection were mainly male, with a high IGRA positive rate and fewer lesions of bronchiectasis or pleural changes. Most of the patients with M. Abscess were female, with a previous history of bronchiectasis, and with most of the lesions showing tree-in-bud signs. The NTM species had a high rate of resistance to anti-TB drugs except M. Kansasii.

A Ni-oxazoline complex-catalyzed asymmetric decarboxylative aldol reaction between malonic acid half-oxyesters and various carbonyls with carboxylate assistance was developed, affording structurally diverse β-hydroxy esters with good yields and enantioselectivities under mild conditions. Importantly, the broad substrate scope of this methodology enabled rapid accesses to several natural products and their analogues as exemplified by phenylpropanoid, phaitanthrin B, and phthalide.

Objective To investigate the 50% effective dose(ED 50 )and 95% effective dose(ED 95 )of dexmedetomidine(DEX)combined with 0.032 μg/(kg·h)sufentanil as well as its analgesic effect for patient-controlled intravenous analgesia(PCIA)after video-assisted thoracoscopic surgery(VATS).Methods Totally 25 patients undergoing elective VATS were enrolled. DEX and 0.032 μg/(kg·h)sufentanil were used for postoperative PCIA. The loading dose of DEX was 0.048 μg/(kg·h),and the dose difference between two adjacent patients was 0.008 μg/(kg·h). The DEX dose of a current patient was determined by whether the previous patient was satisfied with postoperative analgesic effect. If the previous patient was satisfied with postoperative analgesic effect,the DEX dose of the current patient was decreased by 0.008 μg/(kg·h);and if the previous analgestic effect was not satisfactory,DEX dose of the current patient was increased by 0.008 μg/(kg·h). The study endpoint was dexmedetomidine dose was<0.008 μg/(kg· h) within 7 upper and lower cycles in 7 consecutive cases. Finally,the probability unit regression was used to estimate the ED 50 and ED 95 of DEX and their 95% CI .Results When DEX combined with 0.032 μg/(kg·h) sufentanil was used for postoperative PCIA in young patients undergoing VATS,the ED 50 and ED 95 of DEX were 0.0346 μg/(kg· h)[95% CI :0.0283-0.0408 μg/(kg·h)] and 0.0459 μg/(kg·h)[95% CI :0.0400-0.0880 μg/(kg·h)],respectively. No adverse reaction such as vomiting,respiratory depression,or bradycardia occurred. The average Visual Analogue Scale(VAS)scores at rest( Z =-5.128, P =0.000)and cough(Z=-6.642, P =0.000)and the Ramsay sedation score(Z=-2.335, P =0.020)within 6 hours after surgery were higher than those after 6 hour.Conclusion DEX combined with 0.032 μg/(kg·h) sufentanil are effective for postoperative PCIA in patients undergoing VATS when the ED 50 and ED 95 are 0.0346 μg/(kg·h)and 0.0459 μg/(kg·h),respectively.

There has been increasing interest in the psycho-socio-relational and sexual disorders of infertility, as the risk of psychological burden among infertile men with sexual dysfunctions is significant. The purpose of this study was to develop and to validate a predictive model to estimate individual psychological burden among infertile men with sexual dysfunction and study the association between them. Comprehensive data were collected for infertile men (n = 480) who sought treatment for infertility in a reproductive medicine center between June 2012 and December 2013. Using independent predictors of psychological burden from the least absolute shrinkage and selection operator, univariable and multivariable analyses were developed into two models. Predictive accuracy was compared between the models. We explored the association between sexual dysfunction and psychological burden. A total of 480 patients were analyzed using 10-fold cross-validation. Independent predictors of psychological burden were incorporated into a model to measure anxiety (corrected-area under curve (AUC): 77.3%) and a model to measure depression (corrected-AUC: 70.2%). Anxiety and depression were both associated with erectile dysfunction (P < 0.05), with anxiety demonstrating the strongest association. Only anxiety was associated with premature ejaculation (P < 0.05). Premature ejaculation was not found to be associated with depression (P > 0.05). Predictive models for psychological burden among infertile men with sexual dysfunction are presented, and we found that there is an association between psychological burden and sexual dysfunction. According to the models, proper counseling and treatment of sexual dysfunction in infertile men may reduce the psychological burden, help attain natural pregnancy, and improve the quality of life., Competing Interests: None

A chiral phosphoric acid promoted enantioselective NMR analysis of atropisomeric quinazolinones was described, in which a variety of racemic arylquinazolinones such as afloqualone and IC-87114 were well recognized with up to 0. 21 ppm ΔΔδ value. With this method, the optical purities of different non-racemic substrates can be fast evaluated with high accuracy.

Background: Cardiovascular (CV) safety of one anti-diabetic medication over another remains partially delineated. We sought to assess the comparative effect on CV outcomes among novel anti-diabetic agents., Methods: This study was registered with the International Prospective Register of Systematic Reviews (CRD 42016042063). MEDLINE, EMBASE, and Cochrane Library Central Register of Controlled Trials were searched between Jan 1, 1980, and June 30, 2016. Randomized controlled trials comparing anti-diabetic drugs with other comparators in adults with type 2 diabetes were included. We used network meta-analysis to obtain estimates for the outcomes of interests. In addition, post hoc correlation analysis of severe hypoglycemia and primary outcome as per ranking order was conducted. Outcomes were major adverse cardiovascular events (MACE) and all-cause mortality., Results: A total of 170 trials (166,371 participants) were included. By class and by individual, sulfonylureas (SU) ranked last. Therefore, with SU as reference, categorically sodium-glucose co-transporter 2 inhibitor (SGLT2i), insulin (INS), glucagon-like peptide-1 receptor agonist, and dipeptidyl peptidase 4 inhibitor were significantly superior in term of MACE; as were SGLT2i and INS in term of all-cause mortality. Moreover, ranking orders of MACE and all-cause mortality were both positively correlated with that of severe hypoglycemia risk (by individual: R 2  = 0.3178, P = 0.018; by class: R 2  = 0.2574, P = 0.038)., Conclusions: Novel anti-diabetic agents possess favorable CV safety profile, despite small but robust differences between individuals. In addition, increase in CV risk was again shown to be partly attributable to a concomitant increase in the risk of severe hypoglycemia, for which SU performed the worst.

Background: Drug transporters and drug-metabolizing enzymes have been linked to drug-induced hepatotoxicity. Solute carrier organic anion transporter family member 1B1 (SLCO1B1), cytochrome P450 2E1 (CYP2E1), and UDP glucuronosyltransferase 1A1 (UGT1A1) were selected as candidate genes to explore their association with susceptibility to anti-tuberculosis drug-induced hepatotoxicity (ATDH)., Methods: Thirty-four tag single nucleotide polymorphisms (tagSNPs) in SLCO1B1, CYP2E1, and UGT1A1 with 10-kb expansion up- and down-stream were genotyped in 461 patients with ATDH and 466 patients without ATDH in a prospective 1:1 matched case-control study. The frequencies and distributions of genotypes and haplotypes were compared between the groups using three genetic models (dominant, recessive, and additive) to identify associations with susceptibility to ATDH., Results: Patients with the rs4149034 G/A, rs1564370 G/C, and rs2900478 T/A genotypes of SLCO1B1 had a significantly lower risk of ATDH, while those carrying the rs2417957 T/T and rs4149063 T/T genotypes had an increased risk. The rs4148323 A/A genotype of UGT1A1 was found to significantly reduce the risk of ATDH. Haplotype analysis showed the TGTG, TTTC, and GTTC haplotypes of SLCO1B1 were associated with an increased ATDH risk, whereas the GACC haplotype was related to a reduced risk. The ATG haplotype of UGT1A1 reduced the risk of ATDH. Moreover, treatment outcomes in tuberculosis patients were further affected by genetic variants of SLCO1B1., Conclusions: Genetic polymorphisms of SLCO1B1 and UGT1A1 were found to be associated with susceptibility to ATDH. Molecular identification of susceptibility genes provides a theoretical foundation for predicting the likelihood of ATDH and predicting treatment outcomes in tuberculosis patients.

Cervical cancer is the third most common cancer in women worldwide. Human papillomavirus (HPV) has been identified as an etiological factor for cervical cancer. Data on the prevalence and subtype distribution of HPV infection in Jiangxi Province are incomplete. In this study, we investigated HPV subtype distribution and prevalence in Jiangxi Province between August 1, 2010, and December 31, 2015. A total of 71,435 individuals ranging in age from 16 to 77 years were recruited. Cervicovaginal swabs were collected from each participant, and HPV screening was performed. Our results showed that the HPV prevalence was 22.49% in Jiangxi Province. Overall, 14.99% of individuals were positive for a single HPV type, and 7.49% were positive for multiple types. The most frequently detected low-risk genotypes were HPV-6, and high-risk genotypes were HPV-16, -18, -33, -52, and -58. The prevalence and type distribution of HPV infection exhibits regional and age differences; Yingtan had the highest incidence for high-risk HPV infection (32.00%), and peaks in the frequencies of HPV infections were seen for patients under 20 and over 60 years of age. In conclusion, we present data showing that the HPV prevalence varies significantly with age and regions in Jiangxi Province. These results can serve as valuable reference to guide Jiangxi cervical cancer screening and HPV vaccination programs., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

A chiral phosphoric acid promoted enantioselective NMR recognition and determination of indoloquinazoline alkaloids phaitanthrin A, cephalanthrin-A and their analogues was described, which conveniently reveals their optical purities with high accuracy. Besides, pyrazine type tertiary alcohols, cyclic amino alcohols and diamines can also be well resolved under optimal conditions. Importantly, this methodology was further employed in the direct analysis of reaction mixtures of amino acid metal salt catalyzed asymmetric synthesis of phaitanthrin A, providing access to the optimized reaction conditions in high efficiency.

The structures and properties of two mononuclear Dy(iii) enantiomeric pairs were dramatically controlled by crystallization temperature; the enantiomeric pair with coordinated chiral N,N'-donor ligands exhibits enhanced single-ion magnetic, ferroelectric and chiroptical properties with respect to the other one with protonated chiral N,N'-donor ligands.

Liraglutide is administered as glucagon-like peptide-1 (GLP-1) receptor agonist for diabetic patients and can protect pancreatic β-cells by inhibiting their apoptosis. MicroRNA-139-5p (miRNA-139-5p) participates in the regulation of cancer cell apoptosis. However, it is not clear whether miR-139-5p contributes to the anti-apoptotic effect of liraglutide in β-cells. The objective of the present study was to investigate the role of miR-139-5p on apoptosis of pancreatic β-cells. MicroRNA levels in pancreatic tissue from diabetic rats and INS-1 cells treated with liraglutide were measured by real-time quantitative RT-PCR. The role of miR-139-5p on apoptosis was studied by transfecting INS-1 cells with miR-139-5p mimics. The mRNA and protein expression of the target gene, insulin receptor substrate-1 (IRS1), were measured by qRT-PCR and Western blot, respectively. Apoptosis in rat pancreatic tissue and INS-1 cells was detected by TUNEL and annexin V/propidium iodide costaining. Apoptosis of pancreatic tissue from diabetic rats and INS-1 cells was decreased by administration of liraglutide. The expression of miR-139-5p increased in the pancreas of diabetic rats and decreased with liraglutide treatment. Incubation with liraglutide (100 nM) for 48 h attenuated the expression of miR-139-5p and increased the mRNA and protein levels of IRS1. Direct regulatory effects of miR-139-5p on IRS1 were found by a dual-luciferase reporter assay. Transfection of INS-1 cells with miR-139-5p mimics led to decreases in the mRNA and protein expression of IRS1. In conclusion, our observations suggest that decreased miR-139-5p expression contributes to the anti-apoptotic effect of liraglutide on the diabetic rat pancreas and INS-1 cells by targeting IRS1.

Objectives: Prostaglandin E2 (PGE2) is an important lipid mediator of the inflammatory immune response during acute and chronic infections. PGE2 modulates a variety of immune functions via four receptors (EP1-EP4), which mediate distinct PGE2 effects. Mice lacking EP2 are more susceptible to infection by Mycobacterium tuberculosis (M.tb), have a higher bacterial load, and increase size and number of granulomatous lesions. Our aim was to assess whether single nucleotide polymorphisms (SNPs) in EP2 increase the risk of tuberculosis., Methods: DNA re-sequencing revealed five common EP2 variants in the Chinese Han population. We sequenced the EP2 gene from 600 patients and 572 healthy controls to measure SNP frequencies in association with tuberculosis infections (TB) within the population., Results: The rs937337 polymorphism is associated with increased risk to tuberculosis (p=0.0044, odds ratio [OR], 1.67; 95% confidential interval,1.22-2.27). The rs937337 AA genotype and the rs1042618 CC genotype were significantly associated with TB. An estimation of the frequencies of haplotypes revealed a single protective haplotype GACGC for tuberculosis (p=0.00096, odds ratio [OR], 0.56; 95% confidential interval, 0.41-0.77). Furthermore, we determined that the remaining SNPs of EP2 were nominally associated with clinical patterns of disease., Conclusions: We identified genetic polymorphisms in EP2 associated with susceptibility to tuberculosis within a Chinese population. Our data support that EP2 SNPs are genetic predispositions of increased susceptibility to TB and to different clinical patterns of disease., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Purpose: Antituberculosis drug-induced liver injury (ATDILI) is one of the most deleterious side effects associated with chemotherapy against tuberculosis (TB). In this study, our objective was to determine the incidence, risk factors, and management of ATDILI and analyze its impact on the treatment outcome in patients receiving standard anti-TB chemotherapy., Methods: A prospective cohort study of ATDILI prevalence was conducted in 938 enrolled patients of the 1426 TB cases in Shanghai from March 2011 to September 2012. Patients were followed up until February 2014. Univariate and multivariate logistic regression analyses were used to determine the risk factors of ATDILI. Successful therapeutic outcome, rates of drug resistance conversion, sputum smear/culture conversion, and lung cavity closure were analyzed., Results: Hepatitis B surface antigen/hepatitis B e antigen-positive hepatitis B carriers, complicated with systemic lupus erythematosus, albumin ≤ 25 g/L, and chronic alcoholism were independent risk factors for ATDILI. Of the 121 cases with ATDILI (incidence rate of 12.9%), 84 (69.4%) used modified anti-TB therapy after recovery of liver function. Compared with the non-ATDILI group, patients with ATDILI exhibited remarkably decreased lung cavity closure rate (84.6% vs. 93.0%, P < 0.001) along with significantly reduced sputum smear/culture conversion rate (85.4% vs. 94.0%, P < 0.001)., Conclusions: Our findings indicated that 12.9% patients developed ATDILI during standard anti-TB therapy, resulting in poor therapeutic outcome. Hepatitis B carriers with systemic lupus erythematosus, albumin ≤ 25 g/L, and chronic alcoholism manifested increased risks for ATDILI. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Objective: In order to detect the in vitro synergistic effect of 4 drugs-pasiniazid (PA), moxifloxacin, rifabutin and rifapentini on multidrug-resistant mycobacterium tuberculosis (MDR-MTB) and extensively drug-resistant mycobacterium tuberculosis(XDR-MTB), which were core drugs of"The program of retreatment research of tuberculosis"., Method: The checkerboard method was used to detect the minimum inhibitory concentration (MIC) of antituberculosis drug combination schemes (moxifloxacin-PA, moxifloxacin-PA-rifabutin and moxifloxacin-PA-rifapentini) to 40 strains of clinical drug resistant MTB(20 strains of MDR-MTB and 20 XDR-MTB) and the standard strain H37Rv, by calculating the fractional inhibitory concentration index of joint action in vitro to judge the combined effect, with fractional inhibitory concentration index(FICI)≤0.5 and FICI≤0.75 as the basis of 2 drugs and 3 drugs showing synergy., Results: The FICI of moxifloxacin-PA scheme for DR-MTB was 0.125 to 1.000, only 5 strains with a FICI ≤0.5, showing synergistic effect. The FICI of moxifloxacin-Pa-rifabutin scheme with 20 strains of MDR-MTB ranged from 0.310 to 1.260, 10 strains with a FICI≤0.75, showing synergistic effect. The FICI of moxifloxacin-PA-rifabutin scheme with 20 strains of XDR-MTB ranged from 0.215 to 1.250, 11 strains with a FICI≤0.75, showing synergistic effect. The FICI of moxifloxacin-PA-rifapentini scheme with 20 strains of MDR-MTB ranged from 0.150 to 0.780, 19 strains with a FICI≤0.75, showing synergistic effect. The FICI of moxifloxacin-PA-rifapentini scheme with 20 strains of XDR-MTB ranged from 0.200 to 1.280, 16 strains with a FICI≤0.75, showing synergistic effect., Conclusions: The synergistic effect of moxifloxacin-PA scheme was poor, but showing better synergy when further combined with rifabutin or rifapentini. Rifabutin showed better effect than rifapentini, but the synergistic effect of moxifloxacin-PA-rifabutin combination scheme was poor than that of moxifloxacin-PA-rifapentini combination scheme.

A series of new 1-D organic hybrid lanthanoid thioarsenates [Ln(dap)2]2(μ-η(1):η(1):η(1):η(1)-AsS4)(μ-η(1):η(1)-As(V)S4)]n {Ln = Ce (Ia), Pr (Ib), Nd (Ic), and Sm (Id); dap = diaminopropane} have been prepared under solvothermal conditions and structurally characterized. Compounds Ia-d contain two [As(V)S4](3-) linkage modes, namely μ-η(1):η(1):η(1):η(1)-As(V)S4 and μ-η(1):η(1)-As(V)S4, which are linked alternately with [Ln(dap)2](3+) groups into 1-D neutral chains [Ln(dap)2]2(μ-η(1):η(1):η(1):η(1)-As(V)S4)(μ-η(1):η(1)-As(V)S4)]n, which represent the first examples of 1-D organic hybrid lanthanoid thioarsenates based on two [As(V)S4](3-) linkage modes. To learn more about the influence of lanthanide contraction on the formation of lanthanoid thioarsenates, five organic hybrid lanthanoid thioarsenates [Ln(dap)3As(V)S4] [Ln = Tb (IIa), Dy (IIb), Ho (IIIc), and Er (IIId)] and [Er(dien)2As(V)S4] (III, dien = diethylenetriamine) are also provided. Both II and III contain neutral lanthanide-centred complexes, where the tetrahedral anion [As(V)S4](3-) acts as a chelating ligand to the complex [Ln(dap)3](3+)/[Er(dien)2](3+) cation. Their optical properties have been characterized by UV-vis spectra, and the density functional theory calculation of Ia has been performed.

A series of lanthanide fumarates [Sm2(fum)3(H2fum)(H2O)2] (1, H2fum = fumaric acid), [Ln2(fum)3-(H2O)4]·3H2O {Ln = Tb (2a), Dy (2b)} and [Ln2(fum)3(H2O)4] {Ln = Y (3a), Ho (3b), Er (3c), Tm (3d)} were prepared by the hydrothermal method and their structures were classified into three types. The 3-D framework of compound 1 contains a 1-D infinite [Sm-O-Sm]n chain built up from the connection of SmO8(H2O) polyhedra sharing edges via three -COO group bridges of fumarate ligands, which is further constructed into a 3-D network structure with three kinds of fumarate ligands. Compounds 2a-b are isostructural and consist of a 3-D porous framework with 0-D cavities for the accommodation of chair-like hexameric (H2O)6 clusters. Compounds 3a-d are isostructural and have a 3-D network structure remarkably different from those of 1 and 2a-b, due to the different coordination numbers for the Ln(3+) ions and distinct fumarate ligand bridging patterns. A systematic investigation of seven lanthanide fumarates and five reported compounds revealed that the well-known lanthanide contraction has a significant influence on the formation of lanthanide fumarates. The magnetic properties of compounds 1, 2b and 3b-3d were also investigated.

Background: Large cohort studies provide conflicting evidence regarding the potential for oral macrolide antibiotics to increase the risk of serious cardiac events., Objectives: This study performed a meta-analysis to examine the link between macrolides and risk of sudden cardiac death (SCD) or ventricular tachyarrhythmias (VTA), cardiovascular death, and death from any cause., Methods: We performed a search of published reports by using MEDLINE (January 1, 1966, to April 30, 2015) and EMBASE (January 1, 1980, to April 30, 2015) with no restrictions. Studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of interest were included., Results: Thirty-three studies involving 20,779,963 participants were identified. Patients taking macrolides, compared with those who took no macrolides, experienced an increased risk of developing SCD or VTA (RR: 2.42; 95% CI: 1.61 to 3.63), SCD (RR: 2.52; 95% CI: 1.91 to 3.31), and cardiovascular death (RR: 1.31; 95% CI: 1.06 to 1.62). No association was found between macrolides use and all-cause death or any cardiovascular events. The RRs associated with SCD or VTA were 3.40 for azithromycin, 2.16 for clarithromycin, and 3.61 for erythromycin, respectively. RRs for cardiovascular death were 1.54 for azithromycin and 1.48 for clarithromycin. No association was noted between roxithromycin and adverse cardiac outcomes. Treatment with macrolides is associated with an absolute risk increase of 118.1 additional SCDs or VTA, and 38.2 additional cardiovascular deaths per 1 million treatment courses., Conclusions: Administration of macrolide antibiotics is associated with increased risk for SCD or VTA and cardiovascular death but not increased all-cause mortality., (Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Antituberculosis (TB) chemotherapeutic drugs may cause a variety of adverse drug reactions (ADRs). To assess the potential of drug-induced lymphocyte stimulation test (DLST) in screening ADRs in patients treated with anti-TB drugs, we performed DLST in 272 TB patients (176 cases with ADRs and 96 controls without ADRs) treated with anti-TB drugs isoniazid (INH), rifampicin (RFP), ethambutol (EMB), and pyrazinamide (PZA). The ADRs were diagnosed by drug provocation test based on clinical and laboratory examinations. The sensitivities of DLST in the diagnosis of INH-, RFP-, EMB-, or PZA-induced ADRs were 57.8%, 37.1%, 42.4%, and 23.1%, respectively, with the corresponding specificities being 93.4%, 94.0%, 97.5%, and 98.8%. DLST has high specificity and limited sensitivity in the diagnosis of anti-TB drug-induced ADRs. In combination with clinical observation and drug use history, DLST could have a predictive validity of ADRs, especially when a positive result is obtained., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A series of new lanthanoid thioarsenates [Ln(teta)(μ-η(1):η(2):η(1)-As(III)S3)]n {Ln = Ce (Ia), Pr (Ib), Nd (Ic), and Sm (Id); teta = triethylenetetramine} and [Ln(teta)(en)(μ-η(1):η(1):η(1)-As(V)S4)]n {Ln = La (IIa), Ce (IIb), Pr (IIc), and Nd (IId); en = ethylenediamine} were prepared by the solvothermal reaction of K3AsO3, S, LnCl3 and organic amines and structurally characterized. Compounds Ia–d crystallise in the orthorhombic space group Aba2 and display 1-D neutral chains [Ln(teta)(μ-η(1):η(2):η(1)-As(III)S3)]n, which represent the first examples of 1-D organic hybrid lanthanoid sulfides built up from trigonal-pyramidal [As(III)S3](3-) acting as tetradentate bridging ligands to interlink [Ln(teta)](3+) ions, while compounds IIa–d crystallise in the orthorhombic space group P2(1)2(1)2(1) and consist of other 1-D neutral chains [Ln(teta)(en)(μ-η(1):η(1):η(1)-As(V)S4)]n, which are built up from the linkages of the tetrahedral [As(V)S4](3-) ion and the [Ln(teta)(en)](3+) ion. To learn more about the influence of lanthanide contraction on the formation of lanthanoid thioarsenates, three organic hybrid lanthanoid thioarsenates [Ln(teta)(en)As(V)S4] [Ln = Dy (IIIa), Ho (IIIb), and Tm (IIIc)] with the neutral molecular structure type in the monoclinic centrosymmetric space group P2(1)/c are also presented. Their optical and magnetic properties have been investigated, and density functional theory calculations of Ia and IIa have also been performed.

A series of new lanthanoid selenidoantimonates(V) [Ln(en)(tepa)SbSe4] (Ln = La (Ia), Ce (Ib), Pr (Ic); en = ethylenediamine, tepa = tetraethylenepentamine) and [Ln2(tepa)2(μ-OH)2Cl2]-{[Ln(tepa)]2(μ-OH)2(SbSe4)2} (Ln = Y (IIa), Sm (IIb), Gd (IIc), Tb (IId), Dy (IIe), and Tm (IIf)) were solvothermally synthesized and structurally characterized. The structures of Ia-c consist of neutral molecules [Ln(en)(tepa)SbSe4], where the tetrahedral [SbSe4](3-) anion acts as a ligand to chelate the [Ln(en)(tepa)](3+) cation. The structures of IIa-f contain isolated dinuclear [Ln2(tepa)2(μ-OH)2Cl2](2+) cations built up from two [Ln(tepa)Cl](2+) ions linked by two -OH bridging groups and organic decorated {[Ln(tepa)]2(μ-OH)2(SbSe4)2}(2-) anions based on two [Ln(tepa)SbSe4] units bridged by two -OH groups. Although a few lanthanoid selenidoantimonates(V) under solvothermal conditions have been reported, their lanthanide complexes normally appear mononuclear. Hence, IIa-f are rare examples of lanthanoid selenidoantimonates based on dinuclear lanthanide complexes. A preliminary investigation of nine lanthanoid selenidoantimonates(V) shows that the well-known lanthanide contraction has a significant influence on the formation of lanthanoid selenidoantimonates(V) under solvothermal conditions. The absorption edges of all compounds have been investigated by UV-vis spectroscopy, and density functional theory calculations for Ia and IIc have also been performed.

The polymorphisms of toll-like receptor (TLR) have been hypothesized to affect the tuberculosis susceptibility. However, the direct evidence remains controversial. Here we performed a comprehensive meta-analysis to summarize the associations between TLR polymorphisms and tuberculosis susceptibility. We systematically searched the PubMed, Embase, Cochrane library, and Chinese National Knowledge Infrastructure up to April 25, 2014. Case-control studies investigating TLR polymorphisms and tuberculosis susceptibility were included in the meta-analysis. Pooled odds ratios and corresponding 95% confidence intervals were calculated for cases and controls. Stata 11.0 and Review Manager 5.1 were adopted to conduct statistical analysis. We included 29 studies, involving 17 804 individuals. The results revealed an obvious increase of tuberculosis risk in TLR2 2258AA, and decreased risk in TLR6 745TT and TLR8 rs3761624 GA genotypes. Meanwhile, different genetic models were performed. TLR8 rs3764879C, TLR8 rs3761624A and TLR8 rs3764880A alleles were associated with high susceptibility, while TLR6 745T and TLR8 rs3788935C alleles were protective. Other polymorphisms, including TLR9 1486C/T, did not show significant associations with tuberculosis infection. Finally, subgroup analysis in TLR8 rs3764880 according to gender found a slight elevated effect of A allele in males. The meta-analysis suggests significant associations between several TLR polymorphisms and tuberculosis, including TLR2 2258G/A, TLR6 745C/T, TLR8 rs3761624, TLR8 rs3764879, TLR8 rs3761624 and TLR8 rs3764880. This study serves as the framework for additional studies to determine further the role of TLRs in tuberculosis infection.

Setting: Four hospitals in China., Objective: To evaluate the clinical efficacy and safety of using bicyclol in conjunction with glucurolactone in preventing drug-induced liver injury (DILI) in tuberculosis (TB) patients suffering from underlying liver disease., Design: A total of 240 initially treated TB patients who were healthy hepatitis B carriers or had pure steatosis were randomised into two equal groups; both received an oral glucurolactone tablet 600 mg/day (200 mg three times daily) as basic liver protection. The test group also received 75 mg/day (25 mg three times daily) bicyclol tablets orally, while the control group received no other liver protection. The incidence of liver injury in the two groups, the adjustment or termination of anti-tuberculosis chemotherapy and any adverse reactions were assessed., Results: The incidence rate and level of severity of liver injury and the termination rate of anti-tuberculosis treatment in the test group were lower than that of the control group (P < 0.05). The overall time of occurrence of liver injury was significantly different between the two groups (P < 0.05)., Conclusion: Adding bicyclol to basic liver protectants may effectively and safely prevent the occurrence of anti-tuberculosis DILI in patients with underlying liver disease, and help simplify anti-tuberculosis treatment.

Unlabelled: To assess the clinical efficacy and safety of Silibinin in preventing drug-induced liver injury (DILI) in the general population (high-risk patients with non-drug induced liver injury)., Method: A prospective, multi-center, randomized, open-label and controlled trial was conducted with 568 patients undergoing primary treatment of pulmonary tuberculosis. The study included 277 patients in experimental group and 291 patients in control group. The patients in the two group were treated with conventional 2HREZ (S)/4HR for tuberculosis (TB), and additional Silibinin capsules (oral administration of 70 mg/time, 3 times/day for 8 weeks in experimental group. Outcomes of liver function, interruption of anti-TB treatment and therapeutic results, as well as adverse reactions were observed and analyzed., Results: At 2, 4 and 8 weeks of treatment, the incidences of liver injury in experimental group were 3.97%, 1.44% and 2.17%, respectively; the incidences in control group were 4.12%, 4.12% and 2.41%, respectively. Statistical analysis showed that there was no difference in the incidence between the two groups at each treatment period (P>0.05). At 8 weeks, the numbers of patients diagnosed of DILI were 18 (7.22%) and 27 (9.28%) in experimental and control groups, respectively (P>0.05). 34.30% and 27.49% of the patients in experimental and control groups had transient abnormal liver function or symptoms, respectively; similar percentages (3.25% and 6.19%) of the patients in two groups have liver function injury and symptoms, and were suspended for anti-TB treatment (P>0.05). The incidence of anorexia and nausea symptoms was lower in experimental group than in control group, and the differences were significant at 4 and 8 weeks (P<0.05). 8 weeks after the treatment, 98.30% of the sputum smear culture were negative in experimental group, which was significantly higher (P<0.01) than that in control group (92.98%)., Conclusion: Preventive hepatoprotective therapy in the general population may reduce drug discontinuation rate, improve patient's compliance and outcomes of anti-TB treatment.