Molecular genetics, therapeutics and RET inhibitor resistance for medullary thyroid carcinoma and future perspectives.

Medullary thyroid carcinoma (MTC) is a rare type of thyroid malignancy that accounts for approximately 1-2% of all thyroid cancers (TCs). MTC include hereditary and sporadic cases, the former derived from a germline mutation of rearrangement during transfection (RET) proto-oncogene, whereas somatic RET mutations are frequently present in the latter. Surgery is the standard treatment for early stage MTC, and the 10-year survival rate of early MTC is over 80%. While for metastatic MTC, chemotherapy showing low response rate, and there was a lack of effective systemic therapies in the past. Due to the high risk (ca. 15-20%) of distant metastasis and limited systemic therapies, the 10-year survival rate of patients with advanced MTC was only 10-40% from the time of first metastasis. Over the past decade, targeted therapy for RET has developed rapidly, bringing hopes to patients with advanced and progressive MTC. Two multi-kinase inhibitors (MKIs) including Cabozantinib and Vandetanib have been shown to increase progression-free survival (PFS) for patients with metastatic MTC and have been approved as choices of first-line treatment. However, these MKIs have not prolonged overall survival (OS) and their utility is limited due to high rates of off-target toxicities. Recently, new generation TKIs, including Selpercatinib and Pralsetinib, have demonstrated highly selective efficacy against RET and more favorable side effect profiles, and gained approval as second-line treatment options. Despite the ongoing development of RET inhibitors, the management of advanced and progressive MTC remains challenging, drug resistance remains the main reason for treatment failure, and the mechanisms are still unclear. Besides, new promising therapeutic approaches, such as novel drug combinations and next generation RET inhibitors are under development. Herein, we overview the pathogenesis, molecular genetics and current management approaches of MTC, and focus on the recent advances of RET inhibitors, summarize the current situation and unmet needs of these RET inhibitors in MTC, and provide an overview of novel strategies for optimizing therapeutic effects.

Porous Ga2 O3 Nanotubes Derived from Urease-Mediated Interfacially-Grown NH4 Ga(OH)2 CO3 for High-Efficient Hydrogen Evolution.

The authors proposed a novel template-free strategy, urease-mediated interfacial growth of NH4 Ga(OH)2 CO3 nanotubes at 20-50 °C, to fabricate the porous Ga2 O3 nanotubes. The subtlety of the proposed strategy is all the products from urea enzymolysis are utilized in formation of NH4 Ga(OH)2 CO3 precipitates, and the key for interfacial growth of NH4 Ga(OH)2 CO3 nanotubes is the dynamic match between the rate of CO2 bubble fusion and NH4 Ga(OH)2 CO3 precipitation. The proposed strategy works well for the doped porous Ga2 O3 nanotubes. As a proof-of-concept, the porous ß-Ga2 O3 and ß-Ga2 O3 :Cr0.001 nanotubes are used as photocatalysts or co-catalysts with Pt, for H2 evolution from water splitting. The H2 evolution rate of porous ß-Ga2 O3 nanotubes reach 39.3 mmol g-1 h-1 with solar-to-hydrogen (STH) conversion efficiency of 2.11% (Hg lamp) or 498 µmol g-1 h-1 with STH of 0.03% (Xe lamp) respectively, both about 3 times of ß-Ga2 O3 nanoparticles synthesized at pH 9.0 without urease. The Cr-doping enhances the in-the-dark H2 evolution rate pre-lighted by Hg lamp, and Pt co-catalysis further elevates the H2 evolution rate, for instance, the H2 evolution rate of Pt-loaded ß-Ga2 O3 :Cr0.001 nanotubes reaches 54.7 mmol g-1 h-1 with STH of 2.94% under continuous lighting of Hg lamp and 1062 µmol g-1 h-1 in-the-dark.

Comparison of 3 Treatment Methods for Distal Tibial Fractures: A Network Meta-Analysis.

BACKGROUND The choice of optimal internal fixation device for distal tibial fractures remains controversial. The purpose of our study was to evaluate the effectiveness and safety of open reduction and internal fixation, minimally invasive percutaneous osteosynthesis, and intramedullary nailing of distal tibial fractures in adults using network meta-analysis of data from clinical trials. MATERIAL AND METHODS The studies were abstracted from MEDLINE, EMBASE, CNKI, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials meeting inclusion and exclusion criteria were selected. Statistical analyses were conducted using Stata software, version 13.0 (Stata Corporation, College Station, Texas, USA). RESULTS Eleven randomized controlled trials were included. The total number of participants was 710 and the studies were published between 2005 and 2017. There were no significant differences in rates of delayed union, nonunion, or malunion among the various treatments (all p>0.05). The intramedullary nailing group had a lower incidence of wound complications than did the open reduction and internal fixation group and minimally invasive percutaneous osteosynthesis technique group. The SUCRA probabilities were 28.6% for ORIF, 98.4% for IMN, and 22.9% for MIPPO. CONCLUSIONS Given the superior results for intramedullary nailing in terms of wound complications, we recommend this procedure for treatment of distal tibial fractures. More RCTs focused on distal tibial fractures are needed to support the current evidence.

Synthesis of directly fused porphyrin dimers through Fe(OTf)3-mediated oxidative coupling.

An efficient and general Fe(OTf)3-mediated oxidative coupling method was developed for the synthesis of doubly or triply linked porphyrin dimers. Besides the central metal and peripheral substituent, regioselectivity of the oxidative coupling was found to be closely relevant to the onset oxidation potential of the porphyrin substrate, and the reactant with higher E(onset(ox)) tends to generate meso-ß doubly fused porphyrin dimer.

Clawlike tripodal porphyrin trimer: ion-controlled on­off fullerene binding.

A practical method for the preparation of novel tripodal tris(porphyrinato-urea) TP3 1 was readily achieved. Because of its appreciable preorganized triangular cone-shaped cavity resulting from the intramolecular hydrogen bonds of the tripodal tris-urea backbone, this porphyrin trimer host was found to have a high affinity toward fullerenes to form stable inclusion complexes in solution. A 120-fold binding selectivity toward C70 (Kassoc = 1.81 × 10(7) M(­1)) over C60 (Kassoc = 1.51 × 10(5) M(­1)) was further achieved in toluene. Moreover, the dissociation of such inclusion complexes can be easily realized by introducing H2PO4(­), and recapturing of the fullerene can be achieved after withdrawing H2PO4(­) by Ca(2+). A recyclable process for the inclusion and release of fullerene was therefore built by alternately feeding H2PO4(­) and Ca(2+). Benefiting from this approach, TP3 1 was sequentially applied to isolate C70 from the C60-enriched fullerene mixture successfully.

Metal-free iodine(III)-promoted synthesis of isoquinolones.

A metal-free oxidative cycloaddition reaction of substituted benzamides and alkynes has been developed for the synthesis of isoquinolones by using bis(trifluoracetoxy)iodobenzene (PIFA) and trifluoroacetic acid (TFA). Under mild conditions, a wide variety of isoquinolones were conveniently prepared via oxidative annulation of simple N-methoxybenzamide and diarylacetylene or aryl/alkyl acetylene derivatives in yields up to 87%.

Switchable regioselectivity in the PIFA-BF3·Et2O mediated oxidative coupling of meso-brominated Ni(II) porphyrin.

A simple and efficient method has been developed for the switchable synthesis of directly linked meso-brominated Ni(II) porphyrin dimers through PIFA-BF3·Et2O mediated oxidative coupling. The respective syntheses of meso-meso or meso-ß singly, doubly, and triply linked porphyrin dimers can be easily realized with the same reagent system.

Cr3+-ZnGa2O4@Pt for Light-Triggered Dark Catalytic Regeneration of Nicotinamide Coenzymes without Other Electron Mediators.

Photocatalysts for regeneration of reduced nicotinamide adenine dinucleotide (NADH) usually work with continuous lighting and electron mediators, which causes impracticability under dark conditions, risk of NADH reoxidation, and complex separation. To solve these problems, we present a new catalyst of tiny Pt nanoparticles photodeposited on chromium-doped zinc gallate (CZGO@Pt). Upon being light-triggered, the photogenerated electrons are stored in the traps of CZGO and then gradually released and transferred by Pt to directly reduce NAD+ after stoppage of illumination. Three lighting modes are compared to demonstrate the feasibility and advantage of this light-triggered dark catalysis. Within 4 h of reaction, the in-the-dark NADH yield reaches 75.0% under prelighting CZGO@5%Pt and it reaches 80.0% under prelighting CZGO@5%Pt and triethanolamine (TEOA). However, the NADH yield is only 53.5% under continuous lighting of CZGO@5%Pt, TEOA, and NAD+. Consequently, the light-triggered dark catalytic regeneration of NADH not only saves energy and operates easily but also significantly elevates the NADH yield. It thus would secure wide interests and applications in places where no light or only intermittent light is available.

Surface engineering of Al2O3 nanotubes by ureasolysis method for activating persulfate degradation of antibiotics.

Though ecofriendly, pure Al2O3 has never been used for activation of peroxodisulfate (PDS) to degrade pollutants. We report the fabrication of Al2O3 nanotubes by ureasolysis method for efficient activating PDS degradation of antibiotics. The fast ureasolysis in aqueous AlCl3 solution produces NH4Al(OH)2CO3 nanotubes, which are calcined to porous Al2O3 nanotubes, and the release of ammonia and carbon dioxide engineers the surface features of large surface area, numerous acidic-basic sites and suitable Zeta potentials. The synergy of these features facilitates the adsorption of the typical antibiotics ciprofloxacin and PDS activation, which is proved by experiment results and density functional theory simulation. The proposed Al2O3 nanotubes can catalyze 92-96% degradation of 10 ppm ciprofloxacin within 40 min, with chemical oxygen demand removal of 65-66% in aqueous, and 40-47% in whole including aqueous and catalysts. Ciprofloxacin at high concentration, other fluoroquinolones and tetracycline can also be effectively degraded. These data demonstrate the Al2O3 nanotubes prepared by the nature-inspired ureasolysis method has unique features and great potentials for antibiotics degradation.

Diastereoselective synthesis of chiral diporphyrins via intramolecular meso-meso oxidative coupling.

Diastereoselective syntheses of meso-meso linked diporphyrins were achieved via intramolecular chiral induction. The structures and conformations were analyzed by CD, UV, NMR, and computational calculations.

Study on nonlinear spectroscopy of tetraphenylporphyrin and dithiaporphyrin diacids.

The nonlinear absorption of two porphyrin diacids (H4TPP2+ and H2DSP2+), the diprotonated forms of free base tetraphenylporphyrin (H2TPP) and dithiaporphyrin (DSP), were studied in the wavelength range of 500-650 nm. The two porphyrin diacids exhibited perturbed static and dynamic characteristics and enhanced nonlinear absorption properties relative to their parent neutral complexes in solution. Furthermore, for the dithiaporphyrin diacid, the introduction of S-atoms into the porphyrin core makes it a better candidate for optical limiting relative to the simple porphyrin. Their photophysical parameters such as ground and excited states absorption cross-sections, together with fluorescence lifetime and intersystem crossing time, were determined.

Nonlinear absorption and nonlinear refraction of self-assembled porphyrins.

Nonlinear refraction and nonlinear absorption of self-assembled porphyrins in the nanosecond and picosecond regimes were studied at 532 nm by the Z-scan technique. First, a marked difference in nonlinear refraction was observed between self-assembled zinc porphyrins and free base porphyrins; however, the effects of self-assembly and metallization on nonlinear absorption are small. Second, an enhancement of nonlinear absorption was observed for the monomeric components of self-assembled structures by adding pyridine, while their nonlinear refractions remained almost unchanged as pyridine was added. It is expected that the metallization and addition of ligand can provide more convenient routes to alter the optical nonlinearities of porphyrins than the modifications of molecular structures of traditional covalent-bond organic materials.

DFT study on the geometric, electronic structure and Raman spectra of 5,15-diphenylporphine.

The ground state geometric, electronic structure and Raman spectra of 5,15-diphenylporphine (H(2)DPP) have been studied using B3LYP/6-31G(d) method and compared with that of well-studied free base porphine (H(2)P) and meso-tetraphenylporphine (H(2)TPP). Calculation shows that 5,15-substitution causes remarkable in-plane distortion, whereas the resulting out-of-plane distortion is negligible. The calculated electronic structure of H(2)DPP is consistent with the absorption spectra compared with H(2)P and H(2)TPP. The calculated vibrational frequencies of H(2)DPP scaled with a single factor of 0.971 agree well with experimental data (the rms error is 8.0 cm(-1)). The assignment of experimental Raman bands of H(2)DPP was discussed on the basis of theoretical calculation and the comparison with that of H(2)P and H(2)TPP. The splitting of some vibrational modes involving the motion of C(m) atom, such as nu(1), nu(8), and nu(10), was observed and was attributed to the diversification of the environment around C(m) atoms. As the shift of absorption peaks, the shift of some structure-sensitive Raman bands of H(2)DPP form that of H(2)TPP and H(2)P was attributed to the in-plane nuclear reorganization (IPNR) induced by phenyl-substitution, though the contribution of nonplanarity mechanism could not be excluded completely.

A meso-meso directly linked porphyrin dimer-based double D-π-A sensitizer for efficient dye-sensitized solar cells.

A novel double D-π-A branched dye () was synthesized and applied as a sensitizer for DSSCs. exhibited broader and stronger light absorption capability than the single D-π-A dye (). In the meantime, the orthogonal conformation of was found to be favorable for impeding intermolecular aggregation. Consequently, a power conversion efficiency of 5.33% was achieved under AM 1.5G conditions.

meso-2'-Linked porphyrin-BODIPY hybrids: synthesis and efficient excitation energy transfer.

Three meso-2'-linked porphyrin-BODIPY hybrids which contain one, two, and four BODIPY units (, , and ), respectively, were synthesized. Their photophysical properties were investigated by UV-vis and fluorescence spectroscopy, cyclic voltammetry, and femtosecond transient absorption spectroscopy, as well as by theoretical calculations. The electronic properties of the constituent chromophores were found to be largely retained in these hybrids. Meanwhile, efficient and rapid energy transfers from (1)* to were evaluated to be 1.2 × 10(11), 1.5 × 10(11), and 1.1 × 10(11) s(-1), respectively.

Benzo[a]carbazole-Based Donor-π-Acceptor Type Organic Dyes for Highly Efficient Dye-Sensitized Solar Cells.

A novel class of metal-free organic dyes based on benzo[a]carbazole have been designed, synthesized, and used in dye-sensitized solar cells for the first time. These types of dyes consisted of a cyanoacrylic acid moiety as the electron acceptor/anchoring group and different electron-rich spacers such as thiophene (JY21), furan (JY22), and oligothiophene (JY23) as the π-linkers. The photophysical, electrochemical, and photovoltaic properties, as well as theoretical calculations of these dyes were investigated. The photovoltaic performances of these dyes were found to be highly relevant to the π-conjugated linkers. In particular, dye JY23 exhibited a broad IPCE response with a photocurrent signal up to about 740 nm covering the most region of the UV-visible light. A DSSC based on JY23 showed the best photovoltaic performance with a Jsc of 14.8 mA cm(-2), a Voc of 744 mV, and a FF of 0.68, achieving a power conversion efficiency of 7.54% under standard AM 1.5 G irradiation.

Simple and catalyst-free synthesis of meso-O-, -S-, and -C-substituted porphyrins.

A simple and efficient method for the meso-functionalization of porphyrin has been developed. Kinetic studies of meso-fluoro-, -chloro-, -bromo-, -iodo-, and -nitro-substituted porphyrins (Ni) with phenol reveal that the reaction undergoes a typical aromatic nucleophilic substitution (SNAr) process. This catalyst-free method can be performed with meso-brominated porphyrins and oxygen-, sulfur-, and carbon-based nucleophiles to achieve a wide variety of meso-substituted porphyrins.

New donor-π-acceptor type triazatruxene derivatives for highly efficient dye-sensitized solar cells.

A new class of organic dyes based on triazatruxene have been designed and synthesized for dye-sensitized solar cells. The photoelectronic properties of these donor-π-acceptor dyes can be tuned by changing π-conjugated linkers. The best performance was found for triazatruxene dye TD1, wherein, with thiophene as the conjugated linker and cyanoacrylic acid as the acceptor, a power conversion efficiency up to 6.10% was achieved.

An efficient PIFA-mediated synthesis of a directly linked zinc chlorin dimer via regioselective oxidative coupling.

The synthesis of a directly linked zinc chlorin dimer was first achieved by a facile and efficient oxidative coupling of zinc chlorin monomers with phenyliodine bis(trifluoroacetate) (PIFA). The reaction shows high regioselectivity at the 20-position near the hydrogenated pyrrole ring producing selective dichlorin in 74% yield.

An efficient PIFA-mediated synthesis of fused diporphyrin and triply-singly interlacedly linked porphyrin array.

An efficient and metal-free oxidative method was reported for synthesis of triply linked diporphyrins with 2.5 equiv of phenyliodine bis(trifluoroacetate) (PIFA). This reaction showed high selectivity for Zn(II) porphyrins and had been successfully applied in the synthesis of a novel triply-singly interlacedly linked porphyrin array with lower energy gap.