Fabricating an adsorbent and micro-nano bubble catalyst through confining maghemite in the ß cage of NaY zeolite.

This work reports the ion exchange fabrication of maghemite (γ-Fe2O3) modified NaY zeolite (Fe2O3@Y) with bifunction of adsorption and catalysis. The Fe3+ successfully replaced the Na+ in the ß cage of zeolite in the ion exchange process and coordinated with framework oxygens to form magnetic γ-Fe2O3. Therefore, most of the γ-Fe2O3 particles were confined in the ß cages, which resulted in the high dispersal and stability of the catalyst. The Fe2O3@Y could remove methylene blue (MB) model pollutants up to 59.02 and 61.47% through the adsorption and catalysis process, respectively. The hydrogen bond between the OH- ions around the Fe2O3@Y surface and the N and O presented in the MB molecules enabled the chemical adsorption to MB, which accorded with the pseudo-second-order kinetic model. Further, the H+ existed in the solution and the ß cage of zeolite promoted the collapse of micro-nano bubbles (MNBs). Then, the γ-Fe2O3 catalyst would be activated by high temperature and oxidated OH- to produce hydroxyl radicals for pollutant degradation. Thus, pollutant removal was attributed to the combined effects of adsorption and catalysis in the Fe2O3@Y + MNB system. In this work, the Fe2O3@Y was demonstrated as a potentially magnetic adsorbent or MNB catalyst for wastewater treatment.

Helicoselective Synthesis of Indolohelicenoids through Organocatalytic Central-to-Helical Chirality Conversion.

We report the helicoselective and convergent construction of indolohelicenoids with excellent efficiency and stereocontrol. This reaction proceeds through a chiral-phosphoric-acid-catalyzed enantioselective cycloaddition and eliminative aromatization sequence, which can be finely controlled by adjusting the reaction temperature. Mechanistic studies reveal that the chiral phosphoric acid cooperatively serves as both a bifunctional and Brønsted acid catalyst, enabling one-pot central-to-helical chirality conversion. Additionally, the optical properties of the synthesized indolohelicenoids were characterized to explore their potential applications in organic photoelectric materials.

Simultaneous total occlusion due to spasm of 2 main coronary arteries: A case report.

RATIONALE: Coronary artery spasm (CAS) defined by severe reversible focal or diffuse vasoconstriction, plays an essential role in the pathophysiology of acute coronary syndrome but is not very common in the clinic. Due to its transience, it is difficult to diagnose CAS directly, many patients are diagnosed by clinical experience. Here, we report the diagnosis and treatment of a rare case of simultaneous total occlusion due to spasm of the two main coronary arteries by coronary angiography (CAG). PATIENT CONCERNS: A 47-year-old man with no medical history was admitted to our emergency room complaining of sudden-onset chest pain lasting 3 hours. Emergency CAG showed total occlusion of the proximal left anterior descending artery and right coronary artery. DIAGNOSES: Acute myocardial infarction caused by CAS was diagnosed, according to CAG findings and test results. INTERVENTIONS: Intracoronary injection of nitroglycerin and anti-spasm medication. OUTCOMES: The patient was discharged on the 8th day with complete resolution of symptoms and normalization of the electrocardiography findings. No ischemic events occurred during a follow-up for 27 months. LESSONS: This case highlights the significance of identifying CAS in patients with acute myocardial infarction and avoiding blind interventional stent therapy, which requires closer attention from clinicians.

Development and evaluation of machine learning models and nomogram for the prediction of severe acute pancreatitis.

BACKGROUND AND AIM: Severe acute pancreatitis (SAP) in patients progresses rapidly and can cause multiple organ failures associated with high mortality. We aimed to train a machine learning (ML) model and establish a nomogram that could identify SAP, early in the course of acute pancreatitis (AP). METHODS: In this retrospective study, 631 patients with AP were enrolled in the training cohort. For predicting SAP early, five supervised ML models were employed, such as random forest (RF), K-nearest neighbors (KNN), and naive Bayes (NB), which were evaluated by accuracy (ACC) and the areas under the receiver operating characteristic curve (AUC). The nomogram was established, and the predictive ability was assessed by the calibration curve and AUC. They were externally validated by an independent cohort of 109 patients with AP. RESULTS: In the training cohort, the AUC of RF, KNN, and NB models were 0.969, 0.954, and 0.951, respectively, while the AUC of the Bedside Index for Severity in Acute Pancreatitis (BISAP), Ranson and Glasgow scores were only 0.796, 0.847, and 0.837, respectively. In the validation cohort, the RF model also showed the highest AUC, which was 0.961. The AUC for the nomogram was 0.888 and 0.955 in the training and validation cohort, respectively. CONCLUSIONS: Our findings suggested that the RF model exhibited the best predictive performance, and the nomogram provided a visual scoring model for clinical practice. Our models may serve as practical tools for facilitating personalized treatment options and improving clinical outcomes through pre-treatment stratification of patients with AP.

Organocatalytic cycloaddition-elimination cascade for atroposelective construction of heterobiaryls.

The first chiral phosphoric acid (CPA) catalyzed cycloaddition-elimination cascade reaction of 2-naphthol- and phenol-derived enecarbamates with azonaphthalenes has been established, providing a highly atroposelective route to an array of axially chiral aryl-C3-benzoindoles in excellent yields with excellent enantioselectivities. The success of this strategy derives from the stepwise process involving CPA-catalyzed asymmetric formal [3 + 2] cycloaddition and subsequent central-to-axial chirality conversion by elimination of a carbamate. In addition, the practicality of this reaction had been verified by varieties of transformations towards functionalized atropisomers.

Stability Analysis: Rational Design of a Ag Nanoparticle/Polymer Brush for Fabricating Cu Coating on a PET Surface.

Excellent stability of a catalytic center would facilitate the prolongation of the cycle of a chemical plating bath and the reduction of environmental pollution. In this study, silane (3-aminopropyltriethoxysilane (KH550) and γ-(2,3-epoxypropoxy)propytrimethoxysilane (KH560)) was incorporated in AgNO3 solution to rationally prepare a Ag nanoparticle/polymer brush (Ag/PB) catalytic solution. The effects of the KH560 relative content on the Ag/PB structure and stability were studied. The epoxy group in the KH560 could react with an amino group in the KH550 through direct ring-opening reaction to form a secondary amino group and hydroxyl, which could coadsorb Ag nanoparticles by means of a chelating structure; hence, Ag/PB with superior Ag-adsorbed intensity was established on a polyethylene terephthalate (PET) surface. Ag particles on PB with 75% KH560 revealed the best stability of those measured, and the relative Ag surplus was 56.7% after stability testing. The generated Ag/PB that served as catalytic centers to catalyze the electroless copper plating resulted in a facile technology for preparing Cu/PET composite material. This means that the technology has potential application in a green process for preparing metal/polymer composite materials.

Measurement of the Equality of the Drug Welfare Induction Level of Chinese Patients With Chronic Diseases in Gansu, Sichuan, Hebei, and Zhejiang Based on the Bivariate Theil-T Index Method.

Objectives: This study aimed to measure the induction level of drug welfare in Chinese patients with chronic diseases using a bivariate Theil index. Design: The bivariate Theil-T index was used to hierarchically decompose the relevant survey data, and the contribution rate of the intragroup gap and the intergroup gap to the total gap was investigated to better understand the current drug welfare induction level of Chinese patients with chronic diseases. Setting: The study was based in Gansu, Sichuan, Hebei, and Zhejiang provinces in China. Participants: Survey data was from patients with chronic diseases in 20 hospitals in four provinces. Primary and secondary outcome measures: Data was collected through a questionnaire designed by the research team after expert consultation. Using the variables represented by the index system to decompose the Theil index from the two dimensions of the region and urban and rural areas. SPSS 22.0 was used for reliability and validity analysis and Theil index calculation. Results: The overall level of drug welfare induction in Chinese patients with chronic diseases had a high degree of equalization. The overall Theil index was 0.0003, but there were still some differences among groups. Conclusions: To improve the drug welfare equalization induction level of patients with chronic diseases in China, the government should start from western rural areas, and policy should target the provinces that were in a disadvantaged position within the region to promote the equalization of drug welfare induction level for patients with chronic diseases in China.

Application of CPI cutoff value based on parentage testing of duos and trios typed by four autosomal kits.

In this study, we analyzed the application of four autosomal kits and the sensitivity of the combined paternity index (CPI) cutoff value (CPI≥10000) in parentage testing. First, 1442 real trios and 803 real duos were tested using the Goldeneye 25A kit. The Goldeneye 25A kit covers the autosomal short tandem repeat (STR) loci of the other three kits, so we calculated the CPI value of every case for the four kits. Second, three complex close relative kinship cases were also analyzed to evaluate the application of the CPI cutoff value. The CPI values of all trio cases were higher than 10000 using the four kits; the CPI values of all duo cases were higher than 10000 using the Goldeneye 25A kit; and the CPI values of a portion of the duo cases were lower than 10000 using the other three kits. In the three complex close relative cases, the alleged father or mother was not excluded using 40 autosomal STRs. Adding X chromosome short tandem repeats (X-STR) and samples of biological fathers or mothers, the conclusions were confirmed. The four kits were adequate to draw conclusions in the trio cases; the Goldeneye 25A Kit was adequate to draw conclusions in the duo cases; and the other three kits were not sufficient for a portion of the duo cases. The CPI cutoff value was sensitive for real trio and duo cases. In complex close relative kinship cases, high CPI values may result in false conclusions.

Co-delivery of polyinosinic:polycytidylic acid and flagellin by poly(lactic-co-glycolic acid) MPs synergistically enhances immune response elicited by intranasally delivered hepatitis B surface antigen.

The aim of the present work was to investigate the synergistic effect between toll-like receptor (TLR) 3 ligand polyinosinic:polycytidylic acid (pI:C) and TLR5 ligand flagellin (FLN) on immune responses induced by nasally delivered hepatitis B virus surface antigen (HBsAg). Mannan and chitosan oligosaccharide-modified, pH-responsive poly(lactic-co-glycolic acid) (MC-PLGA) microparticles (MPs) containing HBsAg, FLN, pI:C or both ligands were prepared with a double-emulsion method. In vitro uptake experiments show that cellular uptake of MC-PLGA MPs by macrophages was through energy-dependent, receptor-mediated endocytosis mechanism. After uptake of MPs by macrophages, MC-PLGA MPs existed both in the endo-some and in the cytoplasm. FLN and pI:C in solution or MP formulation could synergize to activate macrophages and induce higher pro-inflammatory cytokines interleukin (IL)-6, IL-12, interferon-γ and anti-inflammatory cytokines IL-10 compared to single TLR ligand (P<0.05). In vivo immunogenicity studies indicated that co-delivery of FLN and pI:C within MC-PLGA MPs synergistically induced higher serum anti-HBsAg IgG levels and Th1 cytokine levels compared with MC-PLGA MPs encapsulated single TLR ligand plus MPs encapsulated HBsAg (P<0.05). These results suggest that synergic TLR3 and TLR5 stimulation might be a promising novel tool for nasally delivered HBsAg.

A Dy4 single-molecule magnet and its Gd(iii), Tb(iii), Ho(iii), and Er(iii) analogues encapsulated by an 8-hydroxyquinoline Schiff base derivative and ß-diketonate coligand.

Five new tetranuclear complexes based on an 8-hydroxyquinoline Schiff base derivative and the ß-diketone coligand, [Ln4(acac)4L6(µ3-OH)2]·CH3CN·0.5CH2Cl2 (Ln = Gd (1), Tb (2), Dy (3), Ho (4) and Er (5); HL = 5-(benzylidene)amino-8-hydroxyquinoline; acac = acetylacetonate) have been synthesized, and structurally and magnetically characterized. Complexes 1-5 have similar tetranuclear structures. Each LnIII ion is eight coordinated and its coordination polyhedra can be described as being in a distorted square-antiprismatic geometry. The magnetic studies reveal that 1 features the magnetocaloric effect (MCE) with the magnetic entropy change of -ΔSm(T) = 25.08 J kg-1 K-1 at 2 K for ΔH = 7 T, and 3 displays the slow magnetic relaxation behavior of Single Molecule Magnets (SMMs) with the anisotropic barrier of 86.20 K and the pre-exponential factor τ0 = 2.99 × 10-8 s.

Modulation of the relaxation dynamics of linear-shaped tetranuclear rare-earth clusters through utilizing different solvents.

Nine new tetranuclear centrosymmetric linear complexes, [RE4(dbm)8L2(DMF)2]·nCH2Cl2·mC2H3N (RE = Y (1), Tb (2), Dy (3), Ho (4), Er (5), Lu (6)) and [RE4(dbm)8L2(C2H5OH)2]·nCH3CN (RE = Tb (7), Dy (8), Ho (9)) (HL = 2-[(2-(hydroxyimino)propanehydrazide)methyl]-8-hydroxyquinoline and dbm = 1,3-diphenyl-1,3-propanedione) have been synthesized. Complexes 1-9 are tetranuclear complexes. Magnetic studies reveal that both DyIII-based complexes (3 and 8) exhibit single-molecule magnet (SMM) behavior under a zero dc field. Furthermore, complex 3 presents one relaxation process under a zero dc field, while application of an external dc field (1500 Oe) induces multi-relaxation signals of the ac magnetic susceptibility.

[Comparison of the efficacy of second line EGFR TKIs followed by third line pemetrexed or the reverse sequence in the treatment of advanced lung adenocarcinoma].

OBJECTIVE: To compare the efficacy of second-line EGFR-TKIs followed by third-line pemetrexed with second-line pemetrexed followed by third-line EGFR-TKIs in patients with advanced lung adenocarcinoma. METHODS: From March 2007 to August 2008, 83 patients with advanced lung adenocarcinoma who failed standard first-line chemotherapy were included in this study. The patients who received EGFR-TKIs as second-line therapy followed by third-line pemetrexed were designated as group A (n = 45). The patients who received pemetrexed as second-line therapy followed by third-line EGFR-TKIs were designated as group B (n = 38). PFS and MST were estimated with Kaplan-Meier analysis and the difference between groups were compared with Log-rank test. RESULTS: The progression-free survival (PFS) after second-line therapy in the groups A and B was 8.05 months (95% CI, 5.90 to 10.20) and 4.20 months (95% CI, 3.33 to 5.06), respectively (P = 0.001). The PFS after second-line therapy in smokers and non-smokers was 3.69 months (95% CI, 5.00 to 7.59) and 7.12 months (95% CI, 5.51 to 8.38), respectively (P = 0.007). The PFS of male and female patients was 5.56 months (95% CI, 4.02 to 7.10) and 6.85 months (95% CI, 4.98 to 7.58), respectively (P = 0.279). The PFS after third-line therapy in groups A and B was 6.88 months (95% CI, 5.07 to 8.69) and 7.60 months (95% CI, 5.59 to 9.12) respectively, (P = 0.899). The PFS after third-line therapy in smokers and non-smokers was 4.95 months (95% CI, 2.83 to 7.05) and 8.49 months (95% CI, 6.27 to 10.76), respectively (P = 0.050). The PFS after third-line therapy in male and female patients was 5. 96 months (95% CI, 4.02 to 7.91) amd 8.38 months (95% CI, 5.68 to 11.07), respectively (P = 0.176). The MST in groups A and B was 23.60 months (95% CI, 19.23 to 28.00) and 15.58 months (95% CI, 11.85 to 19.32), respectively (P = 0.021). The MST in smokers and non-smokers was 11.99 months (95% CI, 8.55 to 15.49) and 23.18 months (95% CI, 19.33 to 27.02), respectively (P = 0.001). The MST in male and female patients was 17.40 months (95% CI, 13. 19 to 21.61) and 22.74 months (95% CI, 18.29 to 27.19), respectively (P = 0.111). CONCLUSIONS: Second line EGFR TKIs followed by third line pemetrexed regimen improves the PFS and MST compared with the regimen second line pemetrexed followed by third line EGFR TKIs in patients with advanced lung adenocarcinoma. Smoking status is an independent prognostic factor. Survival is not influenced by gender. Prospective clinical trials are needed to confirm these findings.

[Efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs as second-line treatment for patients with advanced non-small-cell lung cancer].

OBJECTIVE: To compare the efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs in the second-line treatment for patients with advanced non-small cell lung cancer. METHODS: The clinical data of 170 patients with advanced non-small cell lung cancer who failed standard first-line chemotherapy were reviewed. Those who received docetaxol as second-line therapy were designated as group A (n = 60), those who received pemetrexed as second-line therapy were designated as group B (n = 49), and those who received EGFR-TKIs as second-line therapy were designated as group C (n = 61). PFS and MST were estimated by Kaplan-Meier method and the differences between groups were compared by log-rank test. RESULTS: The response rate in the groups A, B and C group was 15.0% (9/60), 24.5% (12/49) and 36.1% (22/61), respectively. The PFS after second-line therapy in the groups A, B and C was 5.49 months (95%CI: 4.03 - 6.95 months), 5.42 months (95%CI: 4.23 - 6.60 months) and 9.31 months (95%CI: 6.88 - 11.73 months), respectively (P = 0.045). The MST after second-line therapy in the groups A, B and C was 14.89 months (95%CI: 11.23 - 18.55 months), 15.81 months (95%CI: 12.11 - 19.52 months) and 17.47 months (95%CI: 13.38 - 21.56 months), respectively (P = 0.574). Regression analysis showed that the performance status score (PS) and response for second-line treatment are independent prognostic factors in each sub-group, and pathological type is an independent prognostic factor in the group C (P = 0.003). CONCLUSIONS: The safety of the three drugs used as second-line treatment for patients with advanced non-small-cell lung cancer, who failed standard first-line chemotherapy, is comparable, but the EGFR-TKIs group has the highest response rate, and the EGFR-TKIs group has the longest PFS with a statistically significant difference, while there is no significant difference in MST among the three groups. When patients receive second-line treatment, the performance status < 2 and the response rate for second-line treatment are independent prognostic factors. Furthermore, pathological type (adenocarcinoma) is also an independent prognostic factor for EGFR-TKIs as second-line treatment.

Polymorphism of vascular endothelial growth factor -1154G>A (rs1570360) with cancer risk: a meta-analysis of 16 case-control studies.

Published data on the association of vascular endothelial growth factor (VEGF) -1154G>A polymorphism with cancer risk is inconclusive. To derive a more precise estimation of association between VEGF -1154G>A polymorphism and the risk of cancer, we performed a meta-analysis of 7,071 cancer cases and 7,693 controls from 16 published case-control studies. Our meta-analysis didn't reveal an association between VEGF -1154G>A polymorphism and overall cancer risk (GG vs. AA: OR: 1.08, 95% CI: 0.96-1.20; GA vs. AA: OR: 1.04, 95% CI: 0.93-1.17; recessive model: GG+GA vs. AA: OR: 1.06, 95% CI: 0.95-1.18; dominant model: GG vs. GA+AA, OR: 1.11, 95% CI: 1.00-1.24). Nevertheless, for non-Caucasians, GG homozygote may have higher cancer risk compared with either A carriers (OR: 1.58, 95% CI: 1.12-2.23) or AA homozygote (OR: 1.43, 95% CI: 1.17-1.76). No significant heterogeneity was detected except in the dominant model and "prostate cancer" subgroup analysis. More studies with larger samples are warranted to confirm these findings.

Second-line epidermal growth factor receptor inhibitors followed by third-line pemetrexed or the reverse sequence: a retrospective analysis of 83 Chinese patients with advanced lung adenocarcinoma.

BACKGROUND: The optimal treatment sequence of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) and pemetrexed in previously treated advanced lung adenocarcinoma patients is currently unknown. METHODS: This retrospective study explored two sequential regimens incorporating EGFR TKIs and pemetrexed in advanced lung adenocarcinoma patients who had failed standard first-line chemotherapy. The medical records of 83 patients were carefully reviewed. 45 patients who received second-line EGFR TKIs followed by third-line pemetrexed were grouped as cohort A. 38 patients who received a strategy with the reverse sequence were grouped as cohort B. Progression-free survival, disease control duration and survival time were compared between the two cohorts. RESULTS: Median survival time is significantly longer in cohort A compared with cohort B (23.615 months vs. 16.269 months, HR: 0.549, 95% CI: 0.308-0.979, P = 0.042). Median disease control duration is 17.463 months in cohort A versus 11.587 months in cohort B (HR: 0.700, 95% CI: 0.409-1.196, P = 0.191). Median progression-free survival with second-line EGFR TKIs is significantly longer than second-line pemetrexed (8.056 months vs. 4.200 months, HR: 0.462, 95% CI: 0.281-0.758, P = 0.001). Median progression-free survival with third-line EGFR TKIs is 6.885 months versus 7.624 months with third-line pemetrexed (HR: 0.462, 95% CI: 0.605-1.767, P = 0.902). The rate of response to EGFR TKIs is higher in second-line setting than in third-line (44% vs. 34%). CONCLUSIONS: We hypothesized that for EGFR-mutated patients, second-line EGFR TKIs followed by third-line pemetrexed is preferable to the reverse sequence.