Photocatalytic Bicyclization of Indole-Tethered 1,6-Enynes for Diastereoselective Synthesis of Pyrrolo[3,2,1-jk]carbazoles.

A visible-light-driven photocatalytic protocol is established for the diastereoselective synthesis of pyrrolo[3,2,1-jk]carbazoles via a radical-triggered multicomponent bicyclization reaction starting from readily available indole-tethered 1,6-enynes and α-benzyl-α-bromomalonates under mild conditions. This photocatalytic approach exhibits a wide substrate compatibility and excellent tolerability toward various functional groups and boasts the benefit of efficient ring formation and chemical bond creation.

Photocatalytic Thio/Selenosulfonylation-Bicyclization of Indole-Tethered 1,6-Enynes Leading to Substituted Benzo[c]pyrrolo[1,2,3-lm]carbazoles.

The photocatalyzed radical-triggered thio/selenosulfonylation-bicyclization of indole-tethered 1,6-enynes has been established for the first time, enabling the synthesis of various previously unreported thio/selenosulfonylated benzo[c]pyrrolo[1,2,3-lm]carbazoles with moderate to good yields under mild conditions. The reaction pathway was proposed, consisting of energy transfer, homolytic cleavage, radical addition, 5-exo-dig, radical coupling, and a Mallory reaction cascade. This approach exhibits a wide substrate compatibility and excellent tolerability toward various functional groups and is characterized by its remarkable efficiency in both bond formation and annulation.

Effect of Cobalt and Chromium Content on Microstructure and Properties of WC-Co-Cr Coatings Prepared by High-Velocity Oxy-Fuel Spraying.

To explore the Co/Cr ratio impact on the high-velocity oxygen fuel (HVOF)-sprayed WC-Co-Cr coatings microstructure and performances, three kinds of WC-Co-Cr coatings, namely WC-4Co-10Cr, WC-7Co-7Cr, and WC-10Co-4Cr, were prepared by using a high-velocity oxygen fuel (HVOF) spraying process. The three coatings' phase composition, microstructure, basic mechanical properties, abrasive wear, and corrosion resistance were investigated. The results show that all three WC-Co-Cr coatings comprise the main phase WC, minor W2C, and amorphous W-Co-Cr phase, besides the WC-4Co-10Cr coating containing a small amount of CrxCy phase. In addition, WC-7Co-7Cr coating exhibited the highest hardness and abrasive wear resistance, followed by WC-10Co-4Cr and WC-4Co-10Cr coatings. The corrosion resistance as a hierarchy was found to be WC-10Co-4Cr > WC-7Co-7Cr > WC-4Co-10Cr.

Clinical effect of short-term spinal cord stimulation in the treatment of patients with primary brainstem hemorrhage-induced disorders of consciousness.

Objective: Recently, short-term spinal cord stimulation (st-SCS) has been used in neurorehabilitation and consciousness recovery. However, little is known about its effects on primary brainstem hemorrhage (PBSH)-induced disorders of consciousness (DOC). In this study, we examined the therapeutic effects of st-SCS in patients with PBSH-induced DOC. Methods: Fourteen patients received a 2-week st-SCS therapy. Each patient's state of consciousness was evaluated using the Coma Recovery Scale-Revised (CRS-R). CRS-R evaluation scores were recorded at the baseline (before SCS implantation) and 14 days later. Results: Over 70% (10/14) of the patients (CRS-R score increased to ≥2 points) responded to the SCS stimulation after 14 days of st-SCS treatment. All items included in the CRS-R exhibited a significant increase post-treatment compared with pretreatment. After 2 weeks of st-SCS treatment, seven patients showed diagnostic improvement, resulting in a 50% (7/14) overall effective rate. Approximately 75% (3/4) of patients with minimally conscious state plus (MCS+) improved to emergence from MCS (eMCS), and 50% (1/2) of patients with vegetative state or unresponsive wakefulness syndrome (VS/UWS) improved to MCS+. Conclusion: In PBSH-induced DOC, st-SCS is a safe and effective treatment. The clinical behavior of the patients improved significantly following the st-SCS intervention, and their CRS-R scores markedly increased. This was most effective for MCS+.

Near-real-time daily estimates of fossil fuel CO2 emissions from major high-emission cities in China.

Cities in China are on the frontline of low-carbon transition which requires monitoring city-level emissions with low-latency to support timely climate actions. Most existing CO2 emission inventories lag reality by more than one year and only provide annual totals. To improve the timeliness and temporal resolution of city-level emission inventories, we present Carbon Monitor Cities-China (CMCC), a near-real-time dataset of daily CO2 emissions from fossil fuel and cement production for 48 major high-emission cities in China. This dataset provides territory-based emission estimates from 2020-01-01 to 2021-12-31 for five sectors: power generation, residential (buildings and services), industry, ground transportation, and aviation. CMCC is developed based on an innovative framework that integrates bottom-up inventory construction and daily emission estimates from sectoral activities and models. Annual emissions show reasonable agreement with other datasets, and uncertainty ranges are estimated for each city and sector. CMCC provides valuable daily emission estimates that enable low-latency mitigation monitoring for cities in China.

Surfactant-enhanced remediation of oil-contaminated soil and groundwater: A review.

Oil leakage, which is inevitable in the process of extraction, processing, transportation and storage, seriously undermines the soil and groundwater environment. Surfactants can facilitate the migration and solution of oil contaminants from nonaqueous phase liquid (NAPL) or solid phase to water by reducing the (air/water) surface tension, (oil/water) interfacial tension and micellar solubilization. They can effectively enhance the hydrodynamic driven remediation technologies by improving the contact efficiency of contaminants and liquid remediation agents or microorganism, and have been widely used to enhance the remediation of oil-contaminated sites. This paper summarizes the characteristics of different types of surfactants such as nonionic, anionic, biological and mixed surfactants, their enhancements to the remediation of oil-contaminated soil and groundwater, and examines the factors influencing surfactant performance. The causes of tailing and rebound effects and the role of surfactants in suppressing them are also discussed. Laboratory researches and actual site remediation practices have shown that various types of surfactants offer diverse options. Biosurfactants and mixed surfactants are superior and worth attention among the surfactants. Using surfactant foams, adding shear-thinning polymers, and combining surfactants with in-situ chemical oxidation are effective ways to resolve tailing and rebound effects. The adsorption of surfactants on soils and aquifer sediments decreases remediation efficiency and may cause secondary pollution, Therefore the adsorption loss should be noticed and minimized.

Comparison of surgical clipping and endovascular coiling in the treatment of oculomotor nerve palsy caused by posterior communicating artery aneurysm.

Oculomotor nerve palsy (ONP) caused by posterior communicating aneurysm (PcomAA) is mainly treated by surgical clipping or endovascular coiling. However, there are still some controversies about which treatment method could provide the more beneficial prognosis. This study aimed to compare ONP recovery rate between surgical clipping and endovascular coiling in patients diagnosed as PcomAA combined with ONP, and explore the potential risk factors of ONP recovery.The clinical data of 152 patients with ONP caused by PcomAA were retrospectively analyzed. Diameter of aneurysm, different treatment methods (surgical clipping or endovascular coiling), subarachnoid hemorrhage (SAH), degree of preoperative ONP, time from ONP onset to treatment, as well as degree of ONP symptom recovery were collected from medical records. All patients were followed up for at least 1 year.One hundred twelve patients underwent surgical clipping and 40 patients received endovascular coiling. There were no significant differences in age, gender, aneurysm diameter, hypertension, dyslipidemia, time from ONP symptom onset to treatment, SAH, and preoperative ONP degree between the 2 groups (all P > .05). Time to complete or partial recovery was 86.7 ±â€Š35.7 days for patients receiving surgical clipping and 132.6 ±â€Š37.5 days for patients receiving endovascular coiling, respectively (Log rank test, P < .001). The recovery rate was 94.6% in the surgical clipping group and 65.0% in the endovascular coiling group. The difference between the two groups was statistically significant (P < .001). Postoperative ONP recovery in the surgical clipping group was significantly superior to that of patients in the endovascular coiling group (HR, 2.625; 95% CI: 1.423-4.841; P = .002). Time from ONP symptom onset to treatment exerted the obvious effect on the ONP prognosis (HR, 0.572; 95% CI: 0.384-0.852; P = .006). In addition, the ONP recovery in patients with SAH before surgery was also independently associated with ONP prognosis (HR, 1.276; 95% CI, 1.043-1.562; P = .018). There was no treatment-related death in either group, and postoperative complications were within the manageable range.The recovery rate and recovery degree of ONP after surgical clipping was significantly better than that of endovascular coiling in PcomAA patients combined with ONP. The postoperative ONP recovery was associated with preoperative spontaneous SAH and time from ONP onset to treatment.

Beta amyloid-induced time-dependent learning and memory impairment: involvement of HPA axis dysfunction.

Aß aggregation is one of the pathological biomarkers of Alzheimer's disease (AD). However, the possible mechanism related to Aß-induced pathological signaling pathway is still unknown. In the present study, Aß1-42-induced time-dependent memory impairment and its possible relationship to hypothalamic-pituitary-adrenal (HPA) axis hyperactivity were examined. Aß1-42-treated mice significantly impaired acquisition activity in the learning curve at 10 days, 1 and 4 months in the Morris water-maze (MWM) task. This learning activity was back to normal at 8 months after Aß1-42 treatment. In the probe trial test, Aß1-42-treated mice needed longer latencies to touch the precious platform location and fewer numbers of crossing from 10 days to 4 months after microinjection. This Aß1-42 induced memory loss was consistent with the results of the step-down passive avoidance test. The HPA axis related parameters, such as corticosterone (CORT) level in the serum, glucocorticoid receptor (GR) and corticotropin-releasing factor receptor (CRF-R) expression in the frontal cortex and hippocampus increased in Aß1-42-treated mice from 10 days to 4 months. While the downstream molecules phosphorylation of cyclic AMP response element binding (pCREB) and brain-derived neurotrophic factor (BDNF) expression decreased during this time. These effects were back to normal 8 months after treatment with Aß1-42. Altogether, our results suggested that Aß1-42 induced significant learning and memory impairment, which is involved in HPA axis dysfunction.

A Clinical Comparative Analysis of Retroperitoneal Laparoscopic Tuberculous Nephrectomy and Open Tuberculous Nephrectomy.

Background: This study aimed to investigate the efficacy and safety of retroperitoneal laparoscopic tuberculous nephrectomy (RLTN) and open tuberculous nephrectomy (OTN). Materials and Methods: One hundred fifty-eight patients treated with RLTN were enrolled in the RLTN group. One hundred patients treated with OTN were enrolled in the control group. Surgical parameters and postoperative conditions were recorded to assess the effect of the operation, and complications were recorded throughout the follow-up time. The follow-up time was 2-72 months. Results: Eight cases in the RLTN group were moved to the OTN group due to intraoperative bleeding. There were significant differences in the diameter of the incision between the 2 groups (P < .01). The resumed time and length of hospitalization in the RLTN group were significantly shorter than those in the OTN group (P < .05). During surgery, 6 cases (3.79%) in the RLTN group presented pus overflow due to a rupture of the empyema space. The same happened to 3 cases (3.00%) in the OTN group. After surgery, there was 1 case of abdominal tuberculosis (TB) in the RLTN group. There was no tuberculous sinus or systemic disseminated TB during the follow-up period. Conclusions: Both treatment approaches were safe and effective, but RLTN presented more advantages. Therefore, RLTN can be used as a first-line method for tuberculous nephrectomy.

[Ginger-separated Snake Moxibustion Improves Yang Deficiency Constitution by Up-regulating Serum Adrenocorticotropic Hormone and Cortisol Levels in Yang Deficiency Constitution Volunteers].

OBJECTIVE: Yang deficiency constitution may bring with different types of illnesses in many people. The present study was designed to observe the effect of ginger-separated snake moxibustion on yang deficiency symptom, and serum adrenocorticotropic hormone (ACTH) and cortisol (CORT) contents in yang deficiency constitution subjects, so as to explore its mechanism underlying improvement of yang deficiency constitution. METHODS: Ninety subjects with yang deficiency type constitution were equally and randomly assigned to control A group (19 men and 26 women, 18－60 years in age) and moxibustion group (16 men and 29 women, 18－60 years in age) and 45 normal subjects with mild constitution (18 men and 27 women, 18－60 years in age) were assigned to control B group. An snake-like moxa-cone was placed at a moxa-holder covering the middle back of human body from Dazhui (GV 14) to Yaoshu (GV 2) after paving a layer (about 1 cm thick) of fresh ginger in the holder, and then ignited, followed by the next moxa-cone, 3 cones altogether every time for each participant. The treatment was conducted once a week, 12 times in total. The subjects' constitution was scored according to the "Classification and Evaluation of Constitution of Traditional Chinese Medicine" formulated by China Association of Chinese Medicine. The serum ACTH and CORT contents were measured by radioimmunoassay before and at the end of the treatment and 6 months after the treatment. RESULTS: The constitation scores of the moxibustion group and control A group were significantly higher than that of the control B group before treatment (P<0.01). At the end of the treatment, the constitution score was significantly decreased in the moxibustion group (P<0.01) rather than in the control A group relevant to its own pre-treatment (P>0.05). The serum CORT and ACTH contents were significantly decreased in both the moxibustion and control A groups in comparison to the control B group before treatment (P<0.01), and obviously increased at the end of treatment in the moxibustion group compared with its own pre-treatment (P<0.01). No significant differences were found among the three groups in the constitution score, and serum CORT and ACTH levels at the 6th month after the treatment compared with their own post-treatment (P>0.05)．. CONCLUSION: The ginger-separated snake moxibustion treatment may improve the constitution of yang deficiency participants by increasing the levels of serum ACTH and CORT, which may be helpful in resisting diseases.

[Different acupuncture and moxibustion methods at Heding (EX-LE 2) for knee osteoarthritis with yang-deficiency and cold-stagnation syndrome].

OBJECTIVE: To observe the differences for knee osteoarthritis (KOA) with yang-deficiency and cold-stagnation syndrome among acupuncture plus ginger moxibustion at Heding (EX-LE 2) on the affected side, simple acupuncture and simple ginger moxibustion at the same acupoint. METHODS: Ninety patients were randomly assigned into an acupuncture group, a ginger moxibustion group and a combination group, 30 cases in each one. Acupuncture was used in the three groups at bilateral Liangqiu (ST 34), Xuehai (SP 10), and Dubi (ST 35), Neixiyan (EX-LE 4), Yanglingquan (GB 34), Zusanli (ST 36), Yinlingquan (SP 9), Sanyinjiao (SP 6), Xuanzhong (GB 39), Taichong (LR 3) on the affected side. Acupuncture at the affected Heding (EX-LE 2) was applied in the acupuncture group; ginger moxibustion at the affected Heding (EX-LE 2) in the ginger moxibustion group; ginger moxibustion after acupuncture at Heding (EX-LE 2) in the combination group. The treatment was given once a day, and 10 treatments made one session. There were 2 days at the interval between 2 sessions. Before and after (22/30), which was significantly higher than 46.7% (14/30) of the acupuncture group and 20.0% (6/30) of the ginger moxibustion group (both P<0.05), and the rate of the acupuncture group was higher than that of the ginger moxibustion group (P<0.05). Conclusion Based on acupuncture, ginger moxibustion at the affected Heding (EX-LE 2) after acupuncture at the same acupoint are more effective than simple acupuncture at the affected Heding (EX-LE 2) and simple ginger moxibustion at the acupoint for KOA with yang-deficiency and cold-stagnation syndrome. two-session treatment, knee function scores, visual analogue scale (VAS) score, and present pain intensity (PPI) score were compared in the three groups. The clinic effects were evaluated too. RESULTS: After treatment, the knee function scores of the three groups were all higher than those before treatment (all P<0.05), and the VAS score and PPI score were lower (all P<0.05). The differences before and after treatment for knee function, VAS and PPI score of the combination group were higher than those of the other two groups (all P<0.05), and the differences of the acupuncture group were higher than those of the ginger moxibustion group (all P<0.05). The cured and remarkable effective rate of the combination group was 73.3% (22/30), which was significantly higher than 46.7% (14/30) of the acupuncture group and 20.0% (6/30) of the ginger moxibustion group (both P<0.05), and the rate of the acupuncture group was higher than that of the ginger moxibustion group (P<0.05). CONCLUSIONS: Based on acupuncture, ginger moxibustion at the affected Heding (EX-LE 2) after acupuncture at the same acupoint are more effective than simple acupuncture at the affected Heding (EX-LE 2) and simple ginger moxibustion at the acupoint for KOA with yang-deficiency and cold-stagnation syndrome.

Exploration of the sequential gene changes in epithelial ovarian cancer induced by carboplatin via microarray analysis.

The purpose of the current study was to explore the carboplatin­induced sequential changes in gene expression and screen out key genes, which were associated with effects of carboplatin on epithelial ovarian cancer (EOC). The microarray dataset GSE13525 was downloaded from the Gene Expression Omnibus database, including 6 EOC cell samples separately treated with carboplatin at 24, 30 and 36 h (case group), and 6 samples treated with phosphate­buffered saline at the same time points (control group). A total of 3 sets of differentially expressed genes (DEGs) were respectively identified in case samples at 24, 30 and 36 h compared with the control group via the Limma package, and separately recorded as DEG­24, DEG­30 and DEG­36. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the overlapped DEGs were performed via the Database for Annotation, Visualization and Integrated Discovery. The protein­protein interaction (PPI) network was constructed and analyzed by Cytoscape software. In addition, the survival curves were drawn to illustrate the association between the expression levels of certain critical genes and the prognosis of EOC. A total of 170, 605 and 1043 DEGs were separately obtained in DEG­24 DEG­30 and DEG­36, and 110 overlaps were identified. The overlaps were enriched in 77 GO terms and 3 KEGG pathways. A total of 152 pairs were involved in the PPI network, and the abnormal expression levels (high or low) of c­Jun and cyclin B1 (CCNB1) would reduce the survival time of patients with EOC. The study indicated that c­Jun and CCNB1 may be the prognostic biomarkers of EOC treated with carboplatin, and certain pathways (such as p53 signaling pathway, cell cycle and mitogen­activation protein kinase signaling pathway) may be involved in carbo-platin­resistant EOC.

[Application of "disharmony of stomach leads to insomnia" theory in acupuncture treatment for insomnia].

When looking back to the literature regarding insomnia, it is believed that "disharmony of stomach leads to insomnia" is an important mechanism for the attack of insomnia. This theory is widely accepted in clinical practices by ancient and modern acupuncturists, thus the method treating insomnia from the stomach is developed. But deeper research on its mechanism is still lacking. Through correlation between stomach meridian and heart meridian, spleen and stomach being the pivot of rise and decline of qi movement and yin-yang and being the pivot of five zang-viscera housing spirit, modern abdomen-brain theory and experimental research, the mechanism of treating insomnia from the stomach is discussed in this paper, so as to be better to guide clinical acupoint-selection and treatment.

[Efficacy observation on acupuncture prescription of regulating yin-yang and five viscera for intractable insomnia].

OBJECTIVE: To explore a more optimal therapy for intractable insomnia. METHODS: Seven hundred cases of intractable insomnia that were in accordance with the criteria were randomly divided into an observation group (368 cases) and a control group (332 cases). The acupuncture prescription of regulating yin-yang and five viscera was applied in the observation group, where Dazhui (GV 14), Shenmai (BL 62), Guanyuan (CV 4), Zhaohai (KI 6), Geshu (BL 17), etc. were selected. The acupuncture prescription of tranquilizing mind was applied in the control group, where Baihui (GV 20), Sishencong (EX-HN 1), Anmian (Extra), Shenmen (HT 7), Sanyin jiao (SP 6) were selected. The treatment was given once a day, ten times of which made a session. After the treatment for 4 sessions, the clinical efficacy and Pittsburgh sleep quality index (PSQI) were compared between two groups. RESULTS: The total effective rate was 92.6% (338/365) in the observation group, which was superior to 73.1% (242/331) in the control group (P < 0.05). The PSQI score was obviously decreased in two groups after the treatment (both P < 0.05), in which the decreasing in the observation group was superior to that in the control group (P < 0.05). CONCLUSION: The acupuncture prescription of regulating yin-yang and five viscera has better effect for intractable insomnia, which could be considered as a more optimal therapy.

[Observation on clinical efficacy of acute pain treated with the intervention of different time of needle retention].

OBJECTIVE: To compare the efficacy on acute pain treated under the different time of needle retention so as to provide the scientific evidence for the optimization of needle retention time for acupuncture analgesia. METHODS: Eighty cases of acute pain (acute lumbar sprain, stiffness of neck) were randomized into 4 groups. Acupuncture was applied to all the patients. After the arrival of needling sensation, the needles were retained for 20 min, 30 min, 45 min and 60 min in different groups separately. For acute lumbar sprain, Ashi (Extra), Houxi (SI 3) and Weizhong (BL 40) were the main points. For stiffness of neck, Ashi (Extra), Fengchi (GB 20) and Lieque (LU 7) were the main points. McGill pain scale, the internationally recognized pain description and measurement was adopted to observe the indexes and record the score changes of each item of pain symptoms before and 3 months after treatment. The immediate analgesic efficacy under different time of needle retention and the longterm efficacy in follow-up visit 3 months after treatment were compared and assessed among the groups. RESULTS: The scores of visual analogue scale (VAS) and present pain intensity (PPI) after treatment were all improved significantly as compared with those before treatment in the 4 groups (all P<0. 01), and the result in the 45 min group was superior to the other 3 groups (VAS: 2.90+/-0.87 vs 5. 52 +/-1.01, 4.45+/-0.81, 5.95+/-1.07; PPI: 1.40+/-0.21 vs 2.26+/-0.54, 2. 21+/-0. 43, 2. 28+/-0. 74, all P<0. 01). The total effective rate of the immediate analgesia was 95. 0% (19/20) in the 45 min group, which was better than that in each of the other 3 groups. CONCLUSION: The 45 min of needle retention achieves the best efficacy of acupuncture analgesia in treatment of acute pain.

[Expression and clinical significance of nuclear matrix protein 22 and cytokeratin 18 in transitional cell carcinoma of the bladder].

OBJECTIVE: To evaluate the expression and clinical significance of urinary nuclear matrix protein (NMP22) and cytokeratin 18 (CK18) for transitional cell carcinoma of the bladder. METHODS: Urinary NMP22 and CK18 levels of 293 patients with transitional cell carcinoma of the bladder, 400 patients with non-transitional cell carcinoma of the bladder, and 105 bladder benign disease were analysed by enzyme-linked-immunosorbent assay (ELISA). RESULTS: The levels of urinary NMP22 and CK18 in the patients with transitional cell carcinoma of the bladder (M = 17.3 U/ml, M(CK18) = 484.2 U/L) were significantly higher than those in the non-transitional cell carcinoma of the bladder (M = 6.8 U/ml, M(CK18) = 156.0 U/L) and the benign disease group (M(NMP22) = 2.3 U/ml, M(CK18) = 66.6 U/L) (P < 0.001). The sensitivity and specificity of urinary NMP22 and CK18 were 79.2%, 88.6% and 78.2%, 82.9%, respectively, for transitional cell carcinoma of the bladder before any treatment. The joint sensitivity of the two markers was 91.7%. The NMP22 and CK18 levels were significantly lower in the recovered patients after surgical operation (P < 0.01), while in patients with recurrence or metastasis the levels of the markers were significantly higher (P < 0.01). There was a significant relationship between NMP22 and CK18, (r = 0.689, P < 0.01). The levels of urinary nmp22 and CK18 were significantly different among pathological grade G1, G2, G3, and stage Ta, T1, T2, T3 (P < 0.01). CONCLUSION: NMP22 and CK18 are useful tumor marker for diagnosis of transitional cell carcinoma of the bladder and for monitoring the state of illness. The joint use of the two markers can improve the sensitivity of cancer detection. NMP22 and CK18 may become a new class of tumor markers, and to be the basis for development of a new assay with an increased efficacy for the detection and treatment of bladder cancer.