Rhodium-catalyzed annulation of hydrazines with vinylene carbonate to synthesize unsubstituted 1-aminoindole derivatives.

Herein, we describe rhodium-catalysed C-H bond activation for [3 + 2] annulation using hydrazide and vinylene carbonate, providing an efficient method for synthesising unsubstituted 1-aminoindole compounds. Characterised by high yields, mild reaction conditions, and no need for external oxidants, this transformation demonstrates excellent regioselectivity and a wide tolerance for various functional groups.

Risk factors and outcomes regarding the acute kidney injury after AngioJet thrombectomy for acute lower-extremity deep vein thrombosis.

OBJECTIVE: To investigate the risk factors and outcomes regarding acute kidney injury (AKI) after AngioJet thrombectomy for acute lower-extremity deep vein thrombosis (DVT). METHODS: Patients were divided into AKI and non-AKI groups according to whether AKI occurred postoperatively. The demographic data, pre-operative and post-operative laboratory data and surgical differences were compared between the two groups. Logistic regression and Wilcoxon signed-rank test were used to identify the AKI risk factors and outcomes, respectively. RESULTS: Among the 341 patients who met the inclusion criteria, 45 developed AKI (AKI group) and 296 had normal renal function (non-AKI group) post-surgery. There were significant differences between the two groups in the course (t = 10.885, P = 0.000); preoperative history of a major surgery within 3 months (3M-MS) (odds ratio [OR] = 5.492, P = 0.001); duration of aspiration thrombectomy (Z = -8.803, P = 0.000); volumes of aspiration (Z = -8.215, P = 0.000); contrast volume (Z = -3.204, P = 0.001) and pulmonary thrombectomy (OR = 18.200, P = 0.002); and preoperative complications of hypertension (OR = 4.637, P = 0.002), diabetes (OR = 18.088, P = 0.000), or pulmonary embolism (OR = 0.085, P = 0.011). Wilcoxon signed-rank test showed that the renal function of every patient in the AKI group returned to normal 3 months after the surgery. CONCLUSIONS: The course, preoperative complications of diabetes or hypertension, 3M-MS, contrast volume, duration and volume of aspiration thrombectomy, and pulmonary thrombectomy are risk factors for post-AngioJet-thrombectomy AKI, which is temporary.

Efficacy of endostatin combined with continuous transcatheter arterial infusion and chemoembolization on gastric cancer with liver metastasis and analysis of prognosis.

PURPOSE: To explore the efficacy and safety of Endostatin combined with continuous transcatheter arterial infusion (TAI) and transcatheter arterial chemoembolization (TACE) in the treatment of gastric cancer with liver metastasis, and analyze the prognosis. METHODS: 96 gastric cancer patients with liver metastasis treated in our hospital from September 2013 to September 2016 were collected and randomly divided into TAI+TACE group (n=48) and Endostatin+TAI+TACE group (n=48). The clinical efficacy, changes in the level of vascular endothelial growth factor (VEGF) before and after treatment, adverse reactions, postoperative tumor recurrence and patient survival were observed and recorded, and the possible influencing factors for prognosis were analyzed. RESULTS: In the Endostatin+TAI+TACE group and TAI+TACE group, the objective response rate (ORR) was 70.8% (34/48) and 47.9% (23/48), and the disease control rate (DCR) was 91.7% (44/48) and 83.3% (40/48), respectively. After treatment, the concentration of VEGF declined significantly in both groups compared with that before treatment, more obviously in the Endostatin+TAI+TACE group than in the TAI+TACE group. According to the follow-up results, both overall survival (OS) and progression-free survival (PFS) in the Endostatin+TAI+TACE group were evidently higher than those in the TAI+TACE group. The Cox regression analysis revealed that the grade of tumor differentiation and Endostatin combination therapy were independent factors influencing the prognosis of patients. CONCLUSION: Endostatin combined with TAI and TACE can obtain good short-term clinical efficacy in the treatment of gastric cancer with liver metastasis. Compared with those treated with chemotherapy alone, patients receiving Endostatin+TAI+TACE have significantly improved OS and PFS, a reduced level of VEGF and a lower incidence rate of adverse reactions, so Endostatin+TAI+TACE is worthy of clinical popularization and application.

Mid- and Short-Term Efficacy of Percutaneous Mechanical Thrombectomy in the Treatment of Acute Iliofemoral Deep Vein Thrombosis.

BACKGROUND: We aimed to evaluate the efficacy and safety of percutaneous mechanical thrombectomy (PMT) in treating acute iliofemoral deep vein thrombosis (DVT). METHODS: We retrospectively analyzed the clinical data of 82 acute iliofemoral DVT patients between November 2017 and December 2018. The therapeutic effects were evaluated based on the thrombus removal rate and circumference changes 10 cm above the affected knee. Incidence rates of pulmonary embolism were evaluated to determine the safety of the procedure. During follow-up, the incidence of postthrombotic syndrome (PTS) was evaluated using the Villalta score, whereas the patency rate of the iliac vein was evaluated via duplex ultrasonography and venography. RESULTS: The surgical success rate was 100%. We identified 48 patients with iliac vein compression syndrome (IVCS) intraoperatively: three of these underwent stent implantation and the others underwent percutaneous transluminal angioplasty (PTA). Grade II and III thrombus removal was achieved in 32.9% (27/82) and 67.1% (55/82) patients, respectively. Postoperative venography revealed that four patients had many floating thrombi under their inferior vena cava filters, which were not removed. The circumference 10 cm above the affected knee decreased from 50.3 ± 3.5 cm preoperatively to 46.3 ± 3.3 cm postoperatively (P < 0.05). During follow-up, a PTS incidence rate of 9.8% was observed. The patency rate of the iliac vein was 66.6% after stent implantation and 93.3% after PTA. CONCLUSIONS: PMT is feasible, safe, and effective for acute iliofemoral DVT. With regard to IVCS, we suggest PTA alone as a one-stage surgery, and the need of secondary stent implantation should be determined based on follow-up results.

Covered Stent-Assisted Open Surgery in the Treatment of an Extracranial Carotid Artery Pseudoaneurysm.

Extracranial carotid artery pseudoaneurysms (ECAPs) are rare vascular lesions that, if untreated, can lead to severe neurologic deficits and significant mortality. Although conservative therapy, surgical ligation or reconstruction, and endovascular techniques can be curative, the literature demonstrates that the best therapy remains controversial and consensus is lacking. We report a case of a 53-year-old patient who developed a giant ECAP on the left side of her neck, which had been presented for 10 years and was successfully treated by covered stent-assisted open surgery. During the 6 months of follow-up, computed tomography angiography confirmed complete occlusion of the ECAP and patency of the carotid artery. In addition to this report, a brief review of the literature is presented.