The effect of phytosterol intensive diet intervention in patients with type2 diabetes mellitus combined with nonalcoholic fatty liver / 中国实用护理杂志

Objectives To investigate the effects of phytosterol intensive diet intervention on blood glucose, blood lipid and liver function in patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease(NAFLD). Methods Patients with NAFLD admitted to the department of endocrinology, the Affiliated Hospital of Jiangsu University from January 2016 to June 2016 were recruited.We divided the groups according to the order of patient admission,with patients admitted from January to March who received conventional diabetes mellitus low-fat diet enrolled as control group,and patients admitted from April to June received extra phytosterol intensive diet on the basis of conventional diabetes mellitus diet as treatment group. The changes of blood glucose, blood lipid and liver function between two groups with a follow-up of six months before and after intervention were compared and analyzed. Results After intervention,the levels of fasting blood sugar(FPG)and blood glucose(2hPG), glycosylated hemoglobin (HbA1c), cholesterol (TG), triglyceride (TC), alanine aminotransferase (ALT) of patients in control group(11.13 ± 3.17)mmol/L,(18.65 ± 6.21)mmol/L,(9.82 ± 1.69)%,(2.81 ± 1.43) mmol/L、(5.40 ± 1.14)mmol/L,77.27%(51/66),which were lower than those before intervention((8.51 ± 2.83)mmol/L,(10.39 ± 3.62)mmol/L,(7.78 ± 1.46)%,(2.18 ± 1.13)mmol/L,(4.99 ± 1.04)mmol/L, 90.91%(60/66),P<0.05,and FPG,2 hPG,HbA1c,TG,TC,LDL-C,ALT and aspartate aminotransferase (AST) in the experimental group were(11.32 ± 3.64)mmol/L,(20.09 ± 4.83)mmol/L,(9.70 ± 2.12)%, (2.68 ± 1.74)mmol/L,(5.16 ± 1.10)mmol/L,(3.18 ± 0.92)mmol/L,(70.27)%(52/74),(86.49)%(64/74), which were significantly lower than those before intervention((7.37 ± 2.08)mmol/L,(9.20 ± 3.35)mmol/L, (6.75 ± 0.99)%,(1.86 ± 1.13)mmol/L,(4.69 ± 1.06)mmol/L,(2.67 ± 0.72)mmol/L, 91.89%(68/74), 98.65%(73/74), P<0.05, and the differences was statistically significant(t=4.584,9.329,7.349,2.823, 2.140,χ2=4.587, P<0.01 or 0.05 in control group;t=8.106,15.715, 10.826,3.393,2.651,3.755,P<0.01 in experimental group). The levels of FPG, 2 hPG and HbA1c were significantly lower in the experimental group compared with those in control group after intervention(P<0.05),and the positive-to-negative rate of fatty liver were found to be significantly higher (33.8%,25/74) than that (9.1%,6/66) in controls(P<0.05).There were not significantly differences in the level of TG,TC,high density lipoprotein(HDL-C), LDL-C, ALT and AST between the control group and experimental group(P>0.05). Conclusions Phytosterol intensive diet intervention can effectively reduce LDL-C,AST and the blood glucose level of type 2 diabetes patients with NAFLD, improving the positive-to-negative rate of fatty liver. Phytosterol intensive diet intervention can effectively reduce LDL-C, AST and the blood glucose level of type 2 diabetes patients with NAFLD,improve the positive-to-negative rate of fatty liver.

Evidence summary for risk assessment of PICC-related venous thrombosis / 中华护理杂志

Objective To retrieve,appraise and summarize the best evidence of risk assessment for PICC-related venous thrombosis and provide references for establishing relevant assessment tools.Methods British Medical Journal Best Practice,Cochrane Library,JBt Library,Registered Nurses' Association of Ontario (RNAO),National Guideline Clearinghouse (NGC),International Practice Guideline Registry Platform,China Guideline Clearinghouse (CGC),PubMed,EMbase,CNKI and CBM were searched from inception to March,2017,to collect literatures including clinical practice guideline,best practice information sheet,recommended practice and systematic review regarding risk assessment for PICC-related venous thrombosis.Results Eight studies were recruited,including five clinical practice guidelines,and three systematic reviews.Three categories (individual factors,iatrogenic factors,and catheterrelated factors)and totally 18 items of best evidence were summarized.Conclusion It is critical to perform individualized risk assessment for preventing PICC-related venous thrombosis before PICC placement.Medical institutions should establish principles,procedures and practice guidelines for PICC-related venous thrombosis assessment based on best evidence.

Theoretical investigation of the first-shell mechanism of acetylene hydration catalyzed by a biomimetic tungsten complex.

The reaction mechanism of the hydration of acetylene to acetaldehyde catalyzed by [W(IV)O(mnt)(2)](2-) (where mnt(2-) is 1,2-dicyanoethylenedithiolate) is studied using density functional theory. Both the uncatalyzed and the catalyzed reaction are considered to find out the origin of the catalysis. Three different models are investigated, in which an aquo, a hydroxo, or an oxo coordinates to the tungsten center. A first-shell mechanism is suggested, similarly to recent calculations on tungsten-dependent acetylene hydratase. The acetylene substrate first coordinates to the tungsten center in an η(2) fashion. Then, the tungsten-bound hydroxide activates a water molecule to perform a nucleophilic attack on the acetylene, resulting in the formation of a vinyl anion and a tungsten-bound water molecule. This is followed by proton transfer from the tungsten-bound water molecule to the newly formed vinyl anion intermediate. Tungsten is directly involved in the reaction by binding and activating acetylene and providing electrostatic stabilization to the transition states and intermediates. Three other mechanisms are also considered, but the associated energetic barriers were found to be very high, ruling out those possibilities.

Why iron? A spin-polarized conceptual density functional theory study on metal-binding specificity of porphyrin.

Heme is a key cofactor of hemoproteins in which porphyrin is often found to be preferentially metalated by the iron cation. In our previous work [Feng, X. T.; Yu, J. G.; Lei, M.; Fang, W. H.; Liu, S. B. J. Phys. Chem. B 2009, 113, 13381], conceptual density functional theory (CDFT) descriptors have been applied to understand the metal-binding specificity of porphyrin. We found that the iron-porphyrin complex significantly differs in many aspects from porphyrin complexes with other metal cations except Ru, for which similar behaviors for the reactivity descriptors were discovered. In this study, we employ the spin-polarized version of CDFT to investigate the reactivity for a series of (pyridine)(n)-M(ll)-porphyrin complexes-where M = Mg, Ca, Cr, Mn, Co, Ni, Cu, Zn, Ru, and Cd, and n = 0, 1, and 2-to further appreciate the metal-binding specificity of porphyrin. Both global and local descriptors were examined within this framework. We found that, within the spin resolution, not only chemical reactivity descriptors from CDFT of the iron complex are markedly different from that of other metal complexes, but we also discovered substantial differences in reactivity descriptors between Fe and Ru complexes. These results confirm that spin properties play a highly important role in physiological functions of hemoproteins. Quantitative reactivity relationships have been revealed between global and local spin-polarized reactivity descriptors. These results contribute to our better understanding of the metal binding specificity and reactivity for heme-containing enzymes and other metalloproteins alike.

DFT study of the asymmetric nitroaldol (Henry) reaction catalyzed by a dinuclear Zn complex.

We report the mechanism of asymmetric nitroaldol (Henry) reaction catalyzed by a dinuclear Zn complex using density functional theory. The experimentally proposed catalytic cycle is validated, in which the first step is the deprotonation of nitromethane by the ethyl anion of the catalyst, subsequently a C-C bond formation step, and then the protonation of the resulting alkoxide. Three mechanistic scenarios (differing in binding modes) have been considered for the C-C bond formation step. The origin of the enantioselectivity is discussed. Our calculations supported that the S configurations are the major products, which is in agreement with the experimental observations.

Dipeptide hydrolysis by the dinuclear zinc enzyme human renal dipeptidase: mechanistic insights from DFT calculations.

The reaction mechanism of the dinuclear zinc enzyme human renal dipeptidase is investigated using hybrid density functional theory. This enzyme catalyzes the hydrolysis of dipeptides and beta-lactam antibiotics. Two different protonation states in which the important active site residue Asp288 is either neutral or ionized were considered. In both cases, the bridging hydroxide is shown to be capable of performing the nucleophilic attack on the substrate carbonyl carbon from its bridging position, resulting in the formation of a tetrahedral intermediate. This step is followed by protonation of the dipeptide nitrogen, coupled with C-N bond cleavage. The calculations establish that both cases have quite feasible energy barriers. When the Asp288 is neutral, the hydrolytic reaction occurs with a large exothermicity. However, the reaction becomes very close to thermoneutral with an ionized Asp288. The two zinc ions are shown to play different roles in the reaction. Zn1 binds the amino group of the substrate, and Zn2 interacts with the carboxylate group of the substrate, helping in orienting it for the nucleophilic attack. In addition, Zn2 stabilizes the oxyanion of the tetrahedral intermediate, thereby facilitating the nucleophilic attack.

DFT study on the mechanism of Escherichia coli inorganic pyrophosphatase.

Escherichia coli inorganic pyrophosphatase (E-PPase) is a tetranuclear divalent metal dependent enzyme that catalyzes the reversible interconversion of pyrophosphate (PPi) and orthophosphate (Pi), with Mg(2+) conferring the highest activity. In the present work, the reaction mechanism of E-PPase is investigated using the hybrid density functional theory (DFT) method B3LYP with a large model of the active site. Our calculated results shed further light on the detailed reaction mechanism. In particular, the important residue Asp67, either protonated or unprotonated, was taken into account in the present calculations. Our calculations indicated that a protonated Asp67 is crucial for the reverse reaction to take place; however, it is lost sight of in the forward reaction. The bridging hydroxide is shown to be capable of performing nucleophilic in-line attack on the substrate from its bridging position in the presence of four Mg(2+) ions. During the catalysis, the roles of the four magnesium ions are suggested to provide a necessary conformation of the active site, facilitate the nucleophile formation and substrate orientation, and stabilize the trigonal bipyramid transition state, thereby lowering the barrier for the nucleophilic attack.

Theoretical studies on pyridoxal 5'-phosphate-dependent transamination of alpha-amino acids.

Density functional methods have been applied to investigate the irreversible transamination between glyoxylic acid and pyridoxamine analog and the catalytic mechanism for the critical [1,3] proton transfer step in aspartate aminotransferase (AATase). The results indicate that the catalytic effect of pyridoxal 5'-phosphate (PLP) may be attributed to its ability to stabilize related transition states through structural resonance. Additionally, the PLP hydroxyl group and the carboxylic group of the amino acid can shuttle proton, thereby lowering the barrier. The rate-limiting step is the tautomeric conversion of the aldimine to ketimine by [1,3] proton transfer, with a barrier of 36.3 kcal/mol in water solvent. A quantum chemical model consisting 142 atoms was constructed based on the crystal structure of the native AATase complex with the product L-glutamate. The electron-withdrawing stabilization by various residues, involving Arg386, Tyr225, Asp222, Asn194, and peptide backbone, enhances the carbon acidity of 4'-C of PLP and Calpha of amino acid. The calculations support the proposed proton transfer mechanism in which Lys258 acts as a base to shuttle a proton from the 4'-C of PLP to Calpha of amino acid. The first step (proton transfer from 4'-C to lysine) is shown to be the rate-limiting step. Furthermore, we provided an explanation for the reversibility and specificity of the transamination in AATase.

Water-assisted transamination of glycine and formaldehyde.

A computational study on the transamination reaction of molecular complexes that consist of NH2CH2COOH + CH2O + nH2O, where n = 0, 1, 2, is presented. This work has allowed the description of the geometries of all the intermediates and transition states of the reactions, which can be described by five steps: carbinolamine formation, dehydration, 1,3 proton transfer, hydrolysis, and carbinolamine elimination. Among the five steps of the reaction, hydrolysis and elimination occur with the existence of general acid catalysis related to the carboxylic group. The water molecules can be involved in the reaction by performing as a proton-transfer carrier and a stabilizing zwitterion. It can be predicted from our calculations that in the transamination between alpha-amino acids and alpha-keto acids, the carbinolamine is formed with small barrier or even barrierless while the dehydration occurs easily at room temperature. However, without heating the 1,3 proton transfer could not occur as the barrier is 26.7 kcal/mol relative to the reactant complex when including two water molecules. Our results are in good agreement with experimental conclusions.

Insights into the photochemical processes of ClC(O)SCl from ab initio calculations.

All possible unimolecular processes upon photolysis of ClC(O)SCl in the UV-visible region have been characterized in the present paper through the optimized stationary structures and computed potential-energy profiles of the S0, S1, T2, and S2 states with the MP2, B3LYP, CASSCF, and MR-CI methods in conjugation with the cc-pVDZ basis set. Upon photoexcitation in the range of 300-400 nm, the ClC(O)SCl molecules are excited to the S1 state. From this state, the dissociation into ClC(O)S + Cl takes place immediately and subsequently Cl2 and SCO are formed. The C-Cl and C-S bond fissions that start from the S2 state are the dominant channels upon photodecomposition of ClC(O)SCl in the gas and condensed phases in the wavelength range of 200-248 nm. The formed Cl, C(O)SCl, ClCO, and SCl radicals are very reactive, and the Cl2, SCO, CO, and SCl2 molecules are subsequently produced as stable products in the condensed phase.

Striving to understand the photophysics and photochemistry of thiophosgene: a combined CASSCF and MR-CI study.

The potential energy surfaces for Cl(2)CS dissociation into ClCS + Cl in the five lowest electronic states have been determined with the combined complete active space self-consistent field (CASSCF) and MR-CI method. The wavelength-dependent photodissociation dynamics of Cl(2)CS have been characterized through computed potential energy surfaces, surface crossing points, and CASSCF molecular dynamics calculations. Irradiation of the Cl(2)CS molecules at 360-450 nm does not provide sufficient internal energy to overcome the barrier on S(1) dissociation, and the S(1)/T(2) intersection region is energetically inaccessible at this wavelength region; therefore, S(1) --> T(1) intersystem crossing is the dominant process, which is the main reason S(1)-S(0) fluorescence breaks off at excess energies of 3484-9284 cm(-1). Also, the S(1) --> T(2) intersystem crossing process can take place via the S(1)-T(2) vibronic interaction in this range of excess energies, which is mainly responsible for the quantum beats observed in the S(1) emission. Both S(2) direct dissociation and S(2) --> S(3) internal conversion are responsible for the abrupt breakoff of S(2)-S(0) fluorescence at higher excess energies. S(2) direct dissociation leads to the formation of the fragments of Cl(X(2)P) + ClCS(A(2)A' ') in excited electronic states, while S(2) --> S(3) internal conversion followed by direct internal conversion to the ground electronic state results in the fragments produced in the ground state.

Photodissociation of acetic acid in the gas phase: an ab initio study.

Photodissociation of acetic acid in the gas phase was investigated using ab initio molecular orbital methods. The stationary structures on the ground-state potential energy surfaces were mainly optimized at the MP2 level of theory, while those on the excited-state surfaces were determined by complete active space SCF calculations with a correlation-consistent basis set of cc-pVDZ. The reaction pathways leading to different photoproducts are characterized on the basis of the computed potential energy surfaces and surface crossing points. The calculations reproduce the experimental results well and provide additional insight into the mechanism of the ultraviolet photodissociation of acetic acid and related compounds.

Theoretical studies on cycloaddition reactions between 1-aza-2-azoniaallene cation and olefins.

Density functional (B3LYP) calculations using the 6-31++g basis set have been employed to study the title reaction between the cationic 1,3-dipolar 1-aza-2-azoniaallene ion (H2C=N(+)=NH) and ethene. Our calculations confirmed that [3 + 2] cycloaddition reaction takes place via a three-membered ring intermediate. In addition, solvent effects and substituent effects were also studied. For the reactions involving tetrachloroethene, there are two attacking sites. One is on the NH group in the 1-aza-2-azoniaallene ion, another is on its terminal CH2 group, and they are competitive for both approaching positions. Electron-releasing methyl substituents on ethene favor the reaction, and the potential energy surface is quite different from the previous one.