Theoretical comparison of fructose with methylglucoside for the production of formate and levulinate catalyzed by Brønsted acids in a methanol solution.

For the conversion of fructose/methylglucoside (MG) into both methyl formate (MF) and methyl levulinate (MLev), the C-source of formate [HCOO]- remains unclear at the molecular level. Herein, reaction mechanisms catalyzed by [CH3OH2]+ in a methanol solution were theoretically investigated at the PBE0/6-311++G(d,p) level. For the conversion of fructose into MF and MLev, the formate [HCOO]- comes from the C1-atom of fructose, in which the rate-determining step lies in the reaction of 5-hydroxymethylfurfural (HMF) with CH3OH to yield MF and MLev. The reaction of fructose with CH3OH kinetically tends to generate HMF intermediates rather than yield (MF + MLev). When MG is dissolved in a methanol solution, its O2, O3, and O4 atoms are closer to the first layer of the solvent than O1, O5, and O6 atoms. For the dehydration of MG with methanol into MF and MLev, the formate [HCOO]- stems from the dominant C1- and secondary C3-atoms of MG. Kinetically, MG is ready to yield (MF + MLev), whereas fructose can induce the reaction to remain at the HMF intermediate, inhibiting the further conversion of HMF with CH3OH into MF and MLev. If MG isomerizes into fructose, the reaction will be more preferable for yielding HMF rather than (MF + MLev).

The Treatment Satisfaction in Patients and Their Partners Treated with Low-Intensity Extracorporeal Shock Wave Therapy and Sildenafil: A Prospective Non-Randomized Controlled Study.

Background: Phosphodiesterase 5 inhibitors (PDE5Is) and other more invasive options merely provide symptomatic relief rather than a permanent improvement in erectile dysfunction (ED), whereas the long-term improvement in ED via low-intensity extracorporeal shockwave therapy (Li-ESWT) has been confirmed. So far, no comparative study of sildenafil versus Li-ESWT has been conducted with respect to treatment satisfaction. Objective: In this study, we aim to compare erectile function status and satisfaction rates in patients who received sildenafil or Li-ESWT for ED. Methods: Patients complaining of ED were considered candidates. Participants chose to enter one of two active treatment groups according to their treatment intention-either a 9-week Li-ESWT regimen or 100 mg on-demand sildenafil. The erectile function was evaluated using the erectile function domain of the International Index of Erectile Function questionnaires (IIEF-EF), while the treatment satisfaction was evaluated using the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaires (EDITS). Results: We enrolled 72 participants in the study (42 in the Li-ESWT group and 30 in the sildenafil group). Patients in both groups were young men. Four weeks after the last session, the IIEF-EF score for Li-ESWT and sildenafil was 16.3± 5.5 and 18.3± 6.5 (P > 0.05), respectively. The total EDITS index of the patient version and the partner version were similar in the two groups. Among EDITS questions measuring overall satisfaction and efficacy duration, the score was higher in the Li-ESWT group. Conclusion: We found that Li-ESWT may have better satisfaction than on-demand sildenafil for young ED patients. However, further studies are needed to determine the factors influencing satisfaction.

De novo urothelial carcinoma in kidney transplantation patients with end-stage aristolochic acid nephropathy in China.

INTRODUCTION: Aristolochic acid contained in Chinese herbs has been proved to be nephrotoxic and carcinogenic. Immunosuppression is associated with an increased risk of developing malignancies. What will be the result if these two significant risk factors are concomitantly present in transplanted patients with aristolochic acid nephropathy (AAN)? PATIENTS AND METHODS: A 2-center cohort of 1,612 renal transplant recipients was studied retrospectively from January 1998 to December 2006. We performed an evaluation of the database and review of the charts and pathology reports of these recipients. RESULTS: Kidney transplantations were performed in 17 patients with AAN. Nine (52.9%) of these recipients developed urothelial carcinoma (UC), compared with a 0.46% prevalence of urinary tract tumors among kidney-transplanted patients in China. Eight cases (88.9%) involved the upper urinary tract (bilateral, 3 cases, 37.5%; unilateral, 5 cases, 62.5%). All patients underwent surgical treatment. Six patients (75%) had recurrence during the follow-up period. Three patients died within a mean of 20 months after tumor excision. CONCLUSIONS: The risk for UC is distinctly increased in patients with AAN after transplantation. Regular screening for early detection of malignancy is mandatory.

[Efficacy of Hushen Gujing (HSGJ) in preventing chronic allograft nephropathy in rats].

OBJECTIVE: To evaluate the effect of HSGJ on chronic allograft nephropathy (CAN) using standard rat model of CAN. METHOD: Renal transplantation was performed with Fisher rats as donors and Lewis rats as recipients. All the recipients were randomly divided into control group and medication groups (high and low dosage of HSGJ, fed every other day). After 16 weeks of treatment, renal function and the histological alteration of CAN were measured. The expression of the TGFbeta1 mRNA in the allograft was evaluated by real-time PCR. RESULT: The content of 24 h urine protein and the level of serum creatinine in the medication groups were significantly decreased (P < 0.01) as compared with control group, whereas the creatinine clearance was increased (P < 0.01). The degree of glomerular sclerosis and the Banff score of medication groups were lower than the control group respectively (P < 0.01), in consistent with decreased expression of the TGF 1mRNA. CONCLUSION: HSGJ can prevent the chronic allograft nephropathy and the mechanism may be related with its influence on the expression of the TGFbeta1.