Effect of Butylphthalide soft capsules on cognitive function and dementia-related factors in elderly patients with Parkinson's disease dementia during the COVID-19 pandemic.

OBJECTIVE: To observe the effect of Butylphthalide soft capsules on improving cognitive function, activity of daily living, and dementia-related factors of elderly patients with Parkinson's disease dementia (PDD) during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: The clinical data of 126 elderly patients with PDD admitted to the Second Affiliated Hospital of Zhengzhou University during the COVID-19 pandemic were analyzed retrospectively. Patients were assigned to a control group (conventional clinical treatment, n=50) and a research group (conventional clinical treatment combined with Butylphthalide soft capsules, n=76). The clinical response, clinical symptoms, cognitive function, activity of daily living (ADL), cerebral blood flow velocity, serum inflammatory factors, oxidative stress indices, neurotrophic factors, dementia-related factors, and drug safety were analyzed and compared between the two groups. RESULTS: The overall response rate was significantly higher in the research group than in the control group (97.37% vs. 84.00%, P=0.017). After treatment, the clinical symptom-based scores and levels of serum inflammatory factors, malondialdehyde, and Parkinson disease protein 7 were significantly lower in the research group than in the control group (all P<0.001); the cognitive function and ADL scores, cerebral blood flow velocities, and levels of catalase, glutathione peroxidase, superoxide dismutase, neurotrophic factors, and neurotrophin-3 were significantly higher in the research group (all P<0.001). The incidence of adverse reactions was comparable between the two groups (4.00% vs. 6.58%, P=0.825). CONCLUSION: Butylphthalide soft capsules have a definite effect and good safety in elderly patients with PDD during the COVID-19 pandemic.

The Accuracy of Point-of-Care Ultrasound in the Detection of Gallbladder Disease: A Meta-analysis.

RATIONALE AND OBJECTIVES: The aim of this meta-analysis was to systematically assess the diagnostic value of point of care ultrasound (POCUS) in the detection of gallbladder diseases. MATERIALS AND METHODS: Pubmed, Web of Science, Embase, and the Cochrane Library were searched for studies up to May 22, 2023. Pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio, diagnostic odds ratio, area under the curve of summary receiver operating characteristic were calculated using the bivariate model. Subgroup analysis based on cholecystitis and cholelithiasis was conducted. RESULTS: A total of seven studies with 1464 participants were identified in this meta-analysis. The pooled sensitivity of POCUS for the detection of gallbladder disease was 0.86 (95% CI: 0.75, 0.93) and the pooled specificity was 0.92 (95% CI: 0.87, 0.96). The pooled sensitivity and specificity of POCUS for the detection of acute cholecystitis were 0.73 (95% CI: 0.55, 0.86) and 0.93 (95% CI: 0.82, 0.98). The pooled sensitivity and specificity of POCUS for the detection of gallstones were 0.94 (95% CI: 0.91, 0.96) and 0.93 (95% CI: 0.91, 0.95). CONCLUSION: POCUS was a favorable modality for the detection of patients suspected of gallbladder disease, especially for cholelithiasis. Physicians are advised to use POCUS in clinical practice as a non-invasive test to detect gallbladder disease.

Predictive Value of FNA-Tg and TgAb in Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma.

Objectives: To analyze whether thyroglobulin (Tg) and anti-Tg antibody (TgAb) detection in fine-needle aspiration (FNA) of cervical lymph node (LN; LN-FNA-Tg and LN-FNA-TgAb) can predict LN metastasis and obtain the best cutoff value. Methods: The patients admitted to our hospital from January 2020 to March 2021 were prospectively enrolled. The LNs were sampled by FNA. All patients underwent thyroid surgery and neck dissection. LN-FNA-Tg, LN-FNA-TgAb, and blood Tg and TgAb were measured. The receiver operating characteristic curve analysis was used to determine the best cutoff points for positive LN. Results: There were 29 participants in the LN metastasis group and 42 in the nonmetastasis group. Compared with the nonmetastasis group, the participants in the metastasis group had higher LN-FNA-Tg (median: 1897 vs 7.74 ng/mL, P < .001), higher LN-FNA-TgAb (median: 15.65 vs 8.21 IU/mL, P < .001), and higher serum Tg (median: 25.4 vs 18.81 ng/mL); there were no differences in serum TgAb (median: 26.6 vs 28.6 IU/mL, P = .477). The best accuracy (87.5%) was observed with LN-FNA-Tg of >227.1 ng/mL, resulting in an area under the curve of 0.927, 84.5% sensitivity, and 89.5% specificity. LN-FNA-TgAb >10.85 IS/mL had an accuracy of 79.6%, sensitivity 64.8%, and specificity 89.5%. Serum Tg and TgAb had the lowest accuracy, with 64.2% and 57.4%, respectively, sensitivity of 53.5% and 67.6%, and specificity of 71.4% and 50.5%. Similar results were observed in first-operation participants and postoperative participants. Conclusions: LN-FNA-Tg has high accuracy, sensitivity, and specificity for detecting cervical LN in patients with papillary thyroid cancer.

Current care practices for patients with Duchenne muscular dystrophy in China.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has presented challenges in the care of patients with chronic diseases. We identified the challenges faced by Chinese patients with Duchenne muscular dystrophy (DMD) during the pandemic. METHODS: An online cross-sectional survey was conducted between March 27 and June 30, 2021. RESULTS: Of the 2105 valid questionnaire responses, 2,056 patients were from non-lockdown areas. In these areas, 42.8% reduced outside daily activities, 49.4% reduced rehabilitation service use, 39.7% postponed regular follow-ups, and 40.8% reported accelerated motor function decline. These figures generally increased for patients from lockdown areas-67.3% reduced outside daily activities, 44.9% reduced rehabilitation service use, 79.6% postponed regular follow-ups, and 55.1% reported accelerated motor function decline. Ambulation loss was most commonly reported in September and March before 2020; however, this trend was absent in 2020. Regarding the informed prices of disease-modifying drugs in Europe and the United States, 86.7% could afford a maximum of one-twentieth of the prices, 8.0% could afford one-tenth of the prices, and only 0.6% of the patients could afford the full prices. CONCLUSIONS: Implementation of standardized care for DMD in China is consistent with global practices, and the COVID-19 pandemic has affected the care of patients with chronic diseases worldwide, particularly in lockdown areas. Telemedicine is an effective model for providing healthcare to such patients. Healthcare workers should assist patients and establish more robust chronic disease management systems. Collaboration between governmental and non-governmental entities could address the cost of disease-modifying drugs in China and other developing countries.

A catalytic enantioselective approach to tetrol bearing vicinal all-carbon quaternary stereogenic centers.

The first highly enantioselective catalytic protocol for selective manipulation of tetrol benzylidene acetals through chiral phosphoric acid mediated oxidative desymmetrization is reported. This efficient approach provides a general access to vicinal all-carbon quaternary stereogenic center structural motifs, as well as structures containing vicinal tertiary and quaternary stereocenters enantioselectively. The synthetic utility has been furthermore demonstrated by transformations and gram-scale processes.

Mild arylboronic acid catalyzed selective [4 + 3] cycloadditions: access to cyclohepta[b]benzofurans and cyclohepta[b]indoles.

The first example of arylboronic acid catalyzed [4 + 3] cycloaddition reaction is reported. 3,5-Bis-(trifluoromethyl) phenylboronic acid is shown to be the best catalyst in this reaction. The method has also enabled the preparation of cyclohepta[b]benzofurans and cyclohepta[b]indoles in excellent yields.

Chiral phosphoric acid catalyzed highly enantioselective desymmetrization of 2-substituted and 2,2-disubstituted 1,3-diols via oxidative cleavage of benzylidene acetals.

A highly enantioselective catalytic protocol for the desymmetrization of a wide variety of 2-substituted and 2,2-disubstituted 1,3-diols is reported. This reaction proceeds through the formation of an "ortho ester" intermediate via oxidation of 1,3-diol benzylidene acetal by dimethyldioxirane (DMDO) and the subsequent proton transfer catalyzed by chiral phosphoric acid (CPA). The mechanism and origins of enantioselectivity of this reaction are identified using DFT calculations. The oxidation by DMDO is rate-determining, and the phosphoric acid significantly accelerates the proton transfer; the attractive interactions between the benzylidene part of the substrate and the 2,4,6-triisopropyl group of CPA are the key to high enantioselectivity.

Linear heterocyclic aromatic fluorescence compounds having various donor-acceptor spacers prepared by the combination of carbon-carbon bond and carbon-nitrogen bond cross-coupling reactions.

A family of novel linear 1,10-phenanthroline-based (A-D-A-D-A) and oligothiophene-based (A-D-D-D-(D)-A) heterocyclic aromatic fluorescence compounds having N-containing imidazole and pyridine tails with effective π-conjugated systems, prepared by the combination of carbon-carbon (C-C) bond and carbon-nitrogen (C-N) bond cross-coupling reactions, is described. They have molecular lengths of more than 2.30 nm in the cases of 4, 6, 9, and 26, various D-A spacers, and certain N-coordination sites (phen, imidazole, and pyridine). X-ray single-crystal structures of 13 compounds reveal a variety of trans and cis configurations with different dihedral angles between adjacent aromatic heterocycles. Synthetic, computational, and spectral studies have been made to reveal the differences between cross-coupling approaches on the C-C bond and C-N bond formation as well as band gaps and energy levels and optical and electrochemical properties for related compounds. The influences of introducing a ß-methyl group to the thiophene ring on reaction activity, solubility, and conformation of related compounds have also been discussed.