A Multimodal Magnetic Resonance Imaging Study of Recovery of Consciousness in Severe Traumatic Brain Injury: Preliminary Results.

Accurate and reliable assessment of the conscious state of patients with severe traumatic brain injury (TBI) is vital for their future management. The purpose of the present study is to find an effective and accurate magnetic resonance imaging (MRI) method for predicting recovery of consciousness in patients with severe TBI. Multimodal MR techniques, including structural MRI, MR spectroscopy (MRS), diffusion tensor imaging (DTI), were used to evaluate brain damage in 58 patients with severe TBI. Statistical analysis compared imaging results and recovery over a relatively long period to find the most potent prognostic indicators and predictive method. A total 33 patients gained recovery of consciousness (RC), and 25 did not (NRC). Compared with the RC group, those in the NRC group had a significantly lower N-acetylaspartate to creatine (NAA/Cr) ratio of pons (1.43 ± 0.54 vs. 1.70 ± 0.42), more fiber lines (1046.3 ± 100.8 vs. 975.6 ± 128.1), less peripheral grey matter (pgrey) (579.23 ± 78.85 vs. 638.23 ± 61.16), lower fractional anisotropy (FA) of fibers (0.42 ± 0.04 vs. 0.45 ± 0.03), older age (43.08 ± 14.61 vs. 30.57 ± 12.89), and higher apparent diffusion coefficient (ADC) of fibers (0.99 ± 0.14 vs. 0.89 ± 0.06); all p < 0.05. Age, pgrey, ADC of fibers, NAA/Cr of pons were selected by logistic regression analysis to predict RC, with p values of 0.033 and 0.031, 0.035, 0.030, respectively. Age, pgrey, ADC of fibers, NAA/Cr of pons are effective indicators in the predictive model of RC.

[Relationship between jugular vein thrombosis and extremity vein thrombosis by vascular color Doppler ultrasound].

OBJECTIVE: To explore the relationship between jugular vein thrombosis and extremity vein thrombosis in cancer patients by vascular color Doppler ultrasound. METHODS: A total of 79 cases with malignant tumors complicated with venous thrombosis undergoing vascular color Doppler ultrasound were analyzed retrospectively. All cases were divided into the group of jugular vein thrombosis (n = 36) and the group of extremity vein thrombosis (n = 43). The thrombotic factors of PT (prothrombin time), APTT (activated partial thromboplastin time), FIB (fibrinogen), HCT (hematocrit), PLT (platelet), PCT (plateletcrit), PDW (platelet distribution width), MPV (mean platelet volume), pathologic type and thrombotic time were compared between two groups. RESULTS: Between two groups, significant differences existed in APTT, pathologic types and before or after therapy (P < 0.05). However the other factors were not significant (P > 0.05). CONCLUSION: The clinicians should pay great attention to malignant tumor complicated with venous thromboembolism (VTE). An early diagnosis is essential to prevent pulmonary embolism (PE) and improve patient survival. Vascular color Doppler ultrasound may be used as the first-line examination. Preoperative and postoperative prophylactic anticoagulant therapy can reduce the risk of VTE in patients with high-risk factors.

Synthesis and in vitro antibacterial activity of 7-(4-alkoxyimino-3-methyl-3-methylaminopiperidin-1-yl)quinolones.

To explore new agents of quinolone derivatives with high antibacterial activity, 7-(4-alkoxyimino-3-methyl-3-methylaminopiperidin-1-yl)quinolones were designed and synthesized, and their activity against gram-positive and gram-negative strains was tested in vitro. Sixteen target compounds were obtained. Their structures were established by 1H NMR, HRMS and X-ray crystallographic analysis. Compounds 14k and 14m-14o show good antibacterial activity against the tested five gram-positive strains and five gram-negative strains (MIC: 0.25-16 micromg x mL(-1)), of which the most active compound 14o is 8-fold more potent than levofloxacin against S. pneumoniae (MIC: 4 microg x mL(-1)), and comparable to levofloxacin against S. aureus, S. epidermidis, E. faecalis and E. coli (MIC: 0.25-1 microg x mL(-1)), but generally less potent than gemifloxacin.

Synthesis and in vitro antibacterial activity of 7-(4-alkoxyimino-3-amino-3-methylpiperidin-1-yl)fluoroquinolone derivatives.

A series of novel 7-(4-alkoxyimino-3-amino-3-methylpiperidin-1-yl)fluoroquinolone derivatives were designed, synthesized and characterized by (1)H NMR, MS and HRMS. These fluoroquinolones were evaluated for in vitro antibacterial activity against representative Gram-positive and Gram-negative strains. All of the title compounds have considerable activity against the twelve strains, and exhibit exceptional potency in inhibiting the growth of Staphylococcus aureus, Staphylococcus epidermidis and Klebsiella pneumoniae (minimum inhibitory concentration (MIC): 0.06-8 microg/mL). The most active compound 17 is 4-fold more potent than levofloxacin against S. aureus and S. epidermidis, 32-fold more potent than levofloxacin against Streptococcus pneumoniae, and 16-fold more potent than IMB against K. pneumoniae.

tert-Butyl 3-carbamoyl-4-methoxy-imino-3-methyl-piperidine-1-carboxyl-ate.

In the title compound, C(13)H(23)N(3)O(4), the piperidine ring adopts a chair conformation. An intra-molecular N-H⋯O hydrogen bond is observed between the carbamoyl and carboxyl-ate groups. In the crystal structure, mol-ecules form inversion dimers linked by pairs of N-H⋯O hydrogen bonds.