Clinical significance of cellular immunity function and inflammatory factors assays in alveolar lavage fluid for severe COVID-19 pneumonia.

In this study, we aimed to investigate the changes of lymphocyte subsets (CD3+ , CD4+ , CD8+ ) and inflammatory factors (interleukin-6 [IL-6], hypersensitive C-reactive protein [HS-CRP], and procalcitonin [PCT]) of alveolar lavage fluid in patients with severe corona virus-2019 (COVID-19) pneumonia and their clinical impact on the assessment of disease severity and prognosis. Twenty-four patients with severe COVID-19 pneumonia were admitted to the intensive care unit (ICU) of the Ezhou Central Hospital from February 1 to March 22, 2020. According to the 28-day prognosis, they were assigned to a death group and a survival group. On the 3rd day of ICU admission, peripheral blood and alveolar lavage fluid were collected for examination of lymphocyte subsets and inflammatory factors by flow cytometry and immunoturbidimetry, respectively. The CD3+ , CD4+ , and CD8+ cell counts in alveolar lavage fluid and serum were significantly higher in the survival group than those of the death group (p < .05). The levels of IL-6, HS-CRP, and PCT in the alveolar lavage fluid and serum of the death group were statistically higher than those of the survival group (p < .05); The CD3+ , CD4+ cell count, and IL-6 level were negatively correlated with Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II scores, respectively (p < .05). The CD4+ cell and SOFA score have a regression relationship for the prognosis of COVID-19 severe patients. The CD3+ , CD4+ , CD8+ cells, and IL-6 levels are valuable in determining the prognosis of severe COVID-19 pneumonia and are strongly correlated with the severity of the disease; the CD4+ cell is an independent risk factor affecting the prognosis of COVID-19 pneumonia.

[Establishment of An Improved Rat Model of Sepsis Induced by Cecal Ligation and Puncture].

Objective To establish an improved animal model of sepsis induced by cecal ligation and puncture(CLP). Methods Ninety-six male Sprague-Dawley rats were randomly divided into sham operation group(n=24),intubation group(n=24),CLP group(n=24),and CLP+intubation group(n=24).The mortality rate,abdominal cavity condition,pathological changes and pathological scores of heart,lungs,liver,and kidneys of rats in each group were observed after modeling.Blood samples were obtained from the inferior vena cava for measuring the whole blood cells(WBC)and platelets(PLT)counts and analyzing serum interleukin(IL)-6,tumor necrosis factor(TNF)-α,serum troponin T(cTnT),creatine kinase-MB(CK-MB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),creatinine(CREA),and blood urea nitrogen(BUN)levels.Blood gas analysis of the aorta was also performed. Results The mortality rates 24 h after modeling were 0 in sham operation group and intubation group,20.8% in CLP group,and 54.2% in CLP+intubation group.Pathologically,swelling and inflammatory cell infiltration in the heart,lungs,liver,and kidneys were seen in the CLP+intubation group,inflammatory cell infiltration in a single organ was seen in most rats in the CLP group,and no obvious swelling and infiltration of inflammatory cells was observed in the sham-operation group and intubation group.The myocardial histopathology score,lung tissue injury pathology score,and kidney tissue injury pathology score in both the sham-operation group and the intubation group were significantly lower than those in the CLP group and the CLP+intubation group(all P=0.000).TNF-α,PaO2,CK-MB,cTnT,AST,TBIL,BUN,and CREA were significantly different between sham-operation group and intubation group/CLP group/CLP+intubation group and between intubation group and CLP group/CLP+intubation group(all P=0.000).The pH level was significantly different between sham operation group and intubation group/CLP group,between intubation group and CLP group/CLP+intubate group(all P=0.000). Conclusions Although both CLP and CLP+intubation can well mimic the pathophysiological mechanism of sepsis in rats,multiple organ dysfunction occurs in the latter.Thus,CLP+intubation can establish animal models of multiple organ dysfunction caused by sepsis induced by clinically effective abdominal infection.

Asymmetric Cycloaddition of ortho-Hydroxyphenyl-Substituted para-Quinone Methides and Enamides Catalyzed by Chiral Phosphoric Acid.

A BINOL-based chiral phosphoric acid was employed as an efficient catalyst in enantioselective cycloaddition of ortho-hydroxyphenyl-substituted para-quinone methides and enamides, which gave rise to acetamido-substituted tetrahydroxanthenes with three adjacent stereogenic centers in high yields (up to 99%) and excellent stereoselectivities (up to >99:1 diastereomeric ratio and up to 98% ee).

Anacardic acid suppresses fibroblast-like synoviocyte proliferation and invasion and ameliorates collagen-induced arthritis in a mouse model.

Anacardic acid, which is abundant in nutshell of Anacardium occidentale, has multiple pharmacological activities. In this study, we examined the therapeutic potential of anacardic acid in treating rheumatoid arthritis (RA). We explored the effects of anacardic acid on collagen-induced arthritis (CIA) in mice and on the proliferation and invasion of RA fibroblast-like synoviocytes (RA-FLSs). The underlying molecular mechanism was investigated. Anacardic acid treatment markedly suppressed paw swelling, joint destruction, and arthritis scores in CIA mice. The serum levels of tumor necrosis factor alpha (TNF- α) and interleutkin-1beta (IL- 1ß) were significantly lowered by anacardic acid. In vitro assays demonstrated that anacardic acid impaired the proliferation and invasion abilities of RA-FLSs in the presence of TNF- α or IL- 1ß. Western blot analysis revealed the reduction of Akt protein expression and phoshporylation in RA-FLSs by anacardic acid. However, the mRNA level of Akt remained unchanged. Anacardic acid treatment significantly increased the expression of miR-633 in RA-FLSs. Akt was identified as a novel target of miR-633. Overexpression of miR-633 significantly inhibited the proliferation and invasion of RA-FLSs, which was rescued by enforced expression of Akt. Depletion of miR-633 prevented anacardic acid-mediated suppression of proliferation and invasion of RA-FLSs, which was accompanied by increased expression of Akt protein. In conclusion, anacardic acid may serve as a promising agent in the treatment of RA.

N-tert-Butyl Sulfinyl Squaramide Receptors for Anion Recognition through Assisted tert-Butyl C-H Hydrogen Bonding.

A series of novel N-tert-butyl sulfinyl squaramide receptors have been designed and synthesized. Their interactions with a range of inorganic anions were studied in solution by 1H NMR spectroscopy. This new type of squaramide displayed better anion-binding abilities over conventional diphenyl squaramides. The single crystal analysis and DFT calulations implied the role of the tert-butyl C-H protons in binding Cl-. The energies of C-H···Cl- interactions were estimated to be 1.4-1.6 kcal/mol in solution.

Neutrophil CD64 combined with PCT, CRP and WBC improves the sensitivity for the early diagnosis of neonatal sepsis.

BACKGROUND: The aim of this study was to determine whether neutrophil CD64 (nCD64) combined with procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC) can increase the sensitivity and accuracy of neonatal sepsis diagnosis. METHODS: The serum levels of nCD64, CRP, PCT and WBC were detected in 60 patients with neonatal sepsis and 60 patients with non-sepsis. Sensitivity, specificity, positive and negative predictive values, receiver operating characteristic (ROC) area under the curve (AUC), and logistic regression analysis were performed to evaluate the diagnostic value of these markers on neonatal sepsis. RESULTS: Serum levels of nCD64, PCT, CRP and WBC were higher in the sepsis group than non-sepsis group (p<0.001). The sensitivities of nCD64, PCT, CRP and WBC at the recommended cut-off level for all infants were 79.5%, 68.2%, 38.6% and 52.3%, respectively. The best combination was nCD64 and PCT, which obtained sensitivity of 90.9%, largest AUC of 0.922, and a negative predictive value of 89.2%. However by using an optimal cut-off value, the sensitivities of all four biomarkers for the diagnosis of neonatal sepsis were increased to 95.5%. Except for WBC, the birth weight and gestational age had no effects on the diagnostic value of these serum biomarkers. CONCLUSIONS: nCD64 and PCT are better diagnostic biomarkers for early diagnosis of neonatal sepsis as compared to CRP. With the help of optimal cut-off value based on ROC curve and logistic regression analysis, the combination of these biomarkers could improve the sensitivity for the diagnosis of suspected late-onset neonatal sepsis based on common serum biomarkers.

Albumin Supplement Affects the Metabolism and Metabolism-Related Drug-Drug Interaction of Fenoprofen Enantiomers.

The influence of albumin towards the metabolism behavior of fenoprofen enantiomers and relevant drug-drug interaction was investigated in the present study. The metabolic behavior of fenoprofen enantiomers was compared in a phase II metabolic incubation system with and without bovine serum albumin (BSA). BSA supplement increased the binding affinity parameter (Km) of (R)-fenoprofen towards human liver microsomes (HLMs) from 148.3 to 214.4 µM. In contrast, BSA supplement decreased the Km of (S)-fenoprofen towards HLMs from 218.2 to 123.5 µM. For maximum reaction velocity (Vmax), the addition of BSA increased the Vmax of (R)-fenoprofen from 1.3 to 1.6 nmol/min/mg protein. In the contrast, BSA supplement decreased the Vmax value from 3.3 to 1.5 nmol/min/mg protein. Andrographolide-fenoprofen interaction was used as an example to investigate the influence of BSA supplement towards fenoprofen-relevant drug-drug interaction. The addition of 0.2% BSA in the incubation system significantly decreased the inhibition potential of andrographolide towards (R)-fenoprofen metabolism (P < 0.001). Different from (R)-fenoprofen, the addition of BSA significantly increased the inhibition potential of andrographolide towards the metabolism of (S)-fenoprofen. BSA supplement also changed the inhibition kinetic type and parameter of andrographolide towards the metabolism of (S)-fenoprofen. In conclusion, albumin supplement changes the metabolic behavior of fenoprofen enantiomers and the fenoprofen-andrographolide interaction.

Description of Atrocalopteryx fasciata spec. nov. from Yunnan, China (Odonata: Calopterygidae).

Atrocalopteryx fasciata Yang, Hämäläinen & Zhang, spec. nov. (holotype ♂, from China, Yunnan, Dehong, Yingjiang, deposited at Odonata Collection of College of Agriculture and Life Sciences, Dali University, Dali, Yunnan, China) is described and illustrated from the male sex. It is compared with Atrocalopteryx laosica (Fraser, 1933).

Descriptions of the last instar larvae of Anotogaster chaoi Zhou, 1998 and Neallogaster annandalei (Fraser, 1923) from Erhai Lake Basin, Yunnan, China (Odonata: Cordulegastrids).

The exuviae of Anotogaster chaoi Zhou, 1998 and Neallogaster annandalei (Fraser, 1923) are described and illustrated for the first time from Erhai Lake Basin, Yunnan Province, China, based on the final stage larvae reared in a laboratory. Diagnostic differences between the larvae of congeneric A. chaoi, A. gregoryi Fraser, 1923, as well as N. annandalei and N. hermionae (Fraser, 1927) are discussed, and notes on their habitats are provided.

The roles of liquidity and delay in financial markets based on an optimal forecasting model.

We investigate the roles of liquidity and delay in financial markets through our proposed optimal forecasting model. The efficiency and liquidity of the financial market are examined using stochastic models that incorporate information delay. Based on machine learning, we estimate the in-sample and out-of-sample forecasting price performances of the six proposed methods using the likelihood function and Bayesian methods, and the out-of-sample prediction performance is compared with the benchmark model ARIMA-GARCH. We discover that the forecasting price performance of the proposed simplified delay stochastic model is superior to that of the benchmark methods by the test methods of a variety of loss function, superior predictive ability test (SPA), Akaike information criterion (AIC), and Bayesian information criterion (BIC). Using data from the Chinese stock market, the best forecasting model assesses the efficiency and liquidity of the financial market while accounting for information delay and trade probability. The rise in trade probability and delay time affects the stability of the return distribution and raises the risk, according to stochastic simulation. The empirical findings show that empirical and best forecasting approaches are compatible, that company size and liquidity (delay time) have an inverse relationship, and that delay time and liquidity have a nonlinear relationship. The most efficient have optimal liquidity.

[The value of assay of (1, 3)-ß-D-glucan in bronchoalveolar lavage fluid for detection of invasive pulmonary fungal infection in critically ill patients in intensive care unit].

OBJECTIVE: To evaluate the value of (1, 3)-ß-D-glucan (G test) in bronchoalveolar lavage fluid (BALF) in diagnosing and determining the therapeutic effects among the critically ill patients suspected with invasive pulmonary fungal infection (IPFI). METHODS: Study was conducted between February 2010 and August 2011 in medical intensive care unit (MICU) of the Affiliated Hospital of Guiyang Medical College. Patients suspected of suffering from IPFI were enrolled. G tests of BALF and serum, and culture and microscopic examination of BALF were performed twice weekly.Clinical feature, mycological evidence and the results of G test were recorded. The results of IPFI were defined as "proven", "probable", "possible" and "non-IPFI". G test in BALF and serum was done with tachypleus amebocyte lysate. Positive G test was defined as cut-off index ≥20 ng/L in two consecutive measurements. Furthermore, the patients with positive G test received preemptive antifungal therapy with fluconazole or itraconazole. G tests of BALF and serum were respectively done on 7th day and 14th day of treatment. RESULTS: Ninety-eight patients were included. Among them, 10 patients were "proven" in whom the positive rate of BALF G test was 90.0%; 29 patients the results were considered as "probable" in whom the positive rate of BALF G test was 82.8%; in 32 patients the results were "possible" IPFI in whom the positive rate of BALF G test was 71.9%, 27 patients were "non-IPFI" in whom the positive rate of BALF G test was 7.4%. The positive rate of BALF G test was 84.6% (33/39), the positive rate of serum G test was 59.0% (23/39), the positive rate of culture of BALF was 41.0% (16/39), the positive rate of microscopic examination of BALF was 38.5% (15/39) in "proven" cases and "probable" cases. G test (cut-off ≥20 ng/L) of BALF had shown to have sensitivity, specificity, positive predictive value (PPV) of 84.6% (33/39), 92.6% (25/27), 94.3% (33/35), respectively, and negative predictive value (NPV) of 80.7% (25/31). The G test detection (cut-off ≥20 ng/L) in serum had shown to have sensitivity, specificity, PPV of 58.9% (23/39), 88.9% (24/27), 88.5%(23/26), respectively, and NPV of 60.0% (24/40), and the differences in sensitivity were statistically significant (P < 0.05). BALF G test assay tended to become positive earlier than the culture for 2-8 days with mean of (5.35 ± 2.26) days.Forty out of 56 G test positive patients were given preemptive antifungal therapy for 2 weeks, and there was a good response in 31 patients, but no response in 9 cases with 22.5% mortality. After treatment, the result of G test (ng/L) was lowered in patients with a good response in treatment group (BALF: 245.13 ± 43.84, 174.00 ± 13.01, 28.52 ± 7.38; serum: 93.26 ± 18.75, 72.15 ± 12.90, 37.37 ± 10.45, all P < 0.05). On the other hand, an elevated value suggested an unsatisfactory result in ineffective group (BALF: 267.58 ± 54.63, 309.71 ± 82.47, 486.72 ± 98.21; serum: 101.58 ± 12.75, 98.07 ± 27.45, 112.07 ± 19.21, all P < 0.05). There were significantly differences in the results of G tests on 7th day and 14th day between BALF G test and serum G test in both groups (all P < 0.05). CONCLUSIONS: It is suggested that BALF G test may be an useful test for early diagnosis of IPFI. Moreover, the dynamic change in G test values could be useful for assessing therapeutic response.

First description of the larva of Archineura incarnata (Karsch, 1891) with notes on the biology (Odonata: Calopterygidae).

The final instar larva of the genus Archineura Kirby, 1894 is described for the first time, based on a specimen of the Chinese endemic species Archineura incarnata (Karsch, 1892) collected from Mt. Nankunshan, Guangdong Province, China. The larva is distinguished by several characters, including its moderately slender build combined with the distinctive extremely long legs, long, narrow, uniquely spined outer caudal appendages, a mask strongly expanded anteriorly with a relatively small median cleft, and robust spines at the apex of the labial palp. The mask is most similar to larvae of Echo Selys, 1853, Mnais Selys, 1853 and Psolodesmus MacLachlan, 1870 which are considered its nearest relatives based on molecular analysis, but from which it differs in other characters. The biology of Archineura larvae is discussed briefly.

[Effects of high positive end-expiratory pressure combined with recruitment maneuvers in patients with acute respiratory distress syndrome].

OBJECTIVE: To investigate the clinical effects and safety degree of high positive end-expiratory pressure (PEEP) combined with lung recruitment maneuver (RM) in patients with acute respiratory distress syndrome (ARDS). METHODS: Thirty-eight patients in medical intensive care unit (MICU) of Affiliated Hospital of Guiyang Medical College suffering from ARDS admitted from June 2008 to May 2010 were enrolled in the study. With the envelope method they were randomized into RM group and non-RM group, with n=19 in each group. All patients received protective ventilation: pressure support ventilation (PSV) with plateau pressure limited at 30 cm H(2)O (1 cm H(2)O=0.098 kPa) or lower. PEEP was set at the minimum level with fraction of inspired oxygen (FiO(2)) <0.60 and partial pressure of arterial oxygen (PaO(2)) kept between 60 and 80 mm Hg (1 mm Hg=0.133 kPa). RM was conducted by regulating FiO(2) to 1.00, support pressure to 0, PEEP increased to 40 cm H(2)O and maintained for 30 seconds before lowering, and this maneuver was repeated every 8 hours for a total of 5 days. Base status, ventilation parameters, blood gas analysis and vital signs were obtained at baseline and for the next 5 days. Oxygenation status and lung injury indexes were compared between RM group and non-RM group, the adverse effects of RM and incidence of barotrauma were recorded. RESULTS: ¹ There were no significant differences of base status and ventilation parameters between RM group and non-RM group. ²PaO(2) and oxygenation index (PaO(2)/FiO(2)) were both increased in RM group and non-RM group, but the values were higher in RM group [PaO(2)(mm Hg) 2 days: 85.8±21.3 vs. 73.5±18.7, 3 days: 88.6±22.8 vs. 74.3±19.8, 4 days: 98.8±30.7 vs. 79.3±19.3, 5 days: 105.5±29.4 vs. 84.4±13.8; PaO(2)/FiO(2) (mm Hg) 4 days: 221.8±103.5 vs. 160.3±51.4, 5 days: 239.6±69.0 vs. 176.8±45.5, all P<0.05]. ³ Hydrogen peroxide (H(2)O(2)) and interleukin-6 (IL-6) concentration in exhaled breath condensate (EBC) decreased in both groups but lower in RM group with significant difference [5 days H(2)O(2) (µmol/L): 0.04±0.02 vs. 0.10±0.03; IL-6 (ng/L): 4.12±2.09 vs. 9.26±3.47, both P<0.05]. (4) Barotrauma and arrhythmia did not occur in both groups. No significant changes in heart rate were found during RM. Central venous pressure and mean arterial pressure remained unchanged after RM. CONCLUSION: High level PEEP combined with RM can improve gas exchange and oxygenation, decrease ventilator associated lung injury (VALI). RM was safe and had good tolerance, no hypoxemia, barotrauma and hemodynamic instability were observed.

Descriptions of larvae of Caliphaea angka Hämäläinen, 2003 and Mnais gregoryi Fraser, 1924 (Odonata: Calopterygidae).

The larvae of Caliphaea angka Hämäläinen, 2003 and Mnais gregoryi Fraser, 1924 are described and illustrated for the first time from Erhai lake Basin, Yunnan Province, China. Notes on their habitat are provided. This paper represents the first verified description of the larva of Caliphaea Hagen in Selys, 1859.

Asymmetric synthesis of N-N axially chiral compounds via organocatalytic atroposelective N-acylation.

Compared with the well-developed C-C and C-N axial chirality, the asymmetric synthesis of N-N axial chirality remains elusive and challenging. Herein we report the first atroposelective N-acylation reaction of quinazolinone type benzamides with cinnamic anhydrides for the direct catalytic synthesis of optically active atropisomeric quinazolinone derivatives. This reaction features mild conditions and a broad substrate scope and produces N-N axially chiral compounds with high yields and very good enantioselectivities. Besides, the synthetic utility of the protocol was proved by a large scale reaction, transformation of the product and the utilization of the product as an acylation kinetic resolution reagent. Moreover, DFT calculations provide convincing evidence for the interpretation of stereoselection.

[Bidirectional regulation of acupuncture: a subgroup analysis of multicenter randomized controlled trial of acupuncture with Tiaoshen Jianpi for irritable bowel syndrome].

OBJECTIVE: To explore the bidirectional regulation of acupuncture based on a subgroup analysis of multicenter randomized controlled trial of acupuncture with Tiaoshen Jianpi for irritable bowel syndrome (IBS). METHODS: A total of 519 patients were included in the analysis, including 137 patients with constipation type irritable bowel syndrome (IBS-C) (92 cases in the acupuncture group and 45 cases in the polyethylene glycol [PEG] group), and 382 patients with diarrhea type irritable bowel syndrome (IBS-D) (252 cases in the acupuncture group and 130 cases in the pinaverium group). The patients in the acupuncture group were given acupuncture at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) once every other day, 3 times a week. The patients in the PEG group received polyethylene glycol 4000 powder orally, and the pinaverium group received pinaverium bromide tablets orally. All were treated for 6 weeks. The IBS symptom severity score (IBS-SSS) was assessed at baseline, treatment period (2, 4, 6 weeks of treatment) and 12 weeks of follow-up, and the IBS quality of life (IBS-QOL) score was evaluated at the baseline period, 6 weeks of treatment and 12 weeks of follow-up. RESULTS: The total IBS-SSS scores of the two groups of IBS-C patients at 2, 4, 6 weeks of treatment and follow-up of 12 weeks were lower than those in the baseline period (P<0.01). The total IBS-SSS score in the IBS-C acupuncture group was lower than that in the PEG group at 12 weeks of follow-up (P<0.05). The total IBS-SSS scores of the two groups of IBS-D patients at 2, 4, 6 weeks of treatment and 12 weeks of follow-up were lower than those in the baseline period (P<0.01). The total IBS-SSS scores in the IBS-D acupuncture group were lower than those in the pinaverium group at 2, 4, 6 weeks of treatment and 12 weeks of follow-up (P<0.05). The total IBS-QOL scores at 6 weeks of treatment and 12 weeks of follow-up were higher than those in the baseline period in both groups of patients with IBS-C (P<0.01). The total IBS-QOL scores at 6 weeks of treatment and 12 weeks of follow-up were higher than those in the baseline period in both groups in patients with IBS-D (P<0.01). The total IBS-QOL score in the IBS-D acupuncture group was higher than that in the pinaverium group at 18 weeks of follow-up (P<0.05). CONCLUSION: Acupuncture with Tiaoshen Jianpi can improve the clinical symptoms and quality of life of patients with IBS-C and IBS-D, which can regulate different functional states (constipation and diarrhea) of the same disease (irritable bowel syndrome), reflecting the bidirectional regulation of acupuncture.

[Correlation between curative effect and 5-HTTLPR polymorphism in treatment of diarrhea-predominant irritable bowel syndrome with acupuncture for regulating shen and strengthening spleen].

OBJECTIVE: To compare the curative effect on diarrhea-predominant irritable bowel syndrome (IBS-D) between acupuncture for regulating shen and strengthening spleen and pinaverium bromide, and explore the relevant mechanism of curative effect of acupuncture in view of polymorphism of 5-hydroxytryptamine transporter gene-linked polymorphic region (5-HTTLPR). METHODS: A total of 231 patients with IBS-D were randomized into an acupuncture group (154 cases) and a western medication group (77 cases) at the ratio of 2 to 1. In the acupuncture group, acupuncture was applied to acupoint regimen for regulating shen and strengthening spleen, i.e. Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37) and Zusanli (ST 36), etc. The treatment was given once every 2 days, 3 times a week. In the western medication group, pinaverium bromide was prescribed for oral administration, 50 mg each time, 3 times daily. The duration of treatment was 6 weeks in each group. Separately, before treatment, after treatment and in 3-month follow-up, the IBS symptom severity scale (IBS-SSS) and IBS quality of life scale (IBS-QOL) scores were adopted in assessment. After treatment, the curative effect and safety were compared between the two groups. Before treatment, 5-HTTLPR genotypes were determined in the patients. RESULTS: After treatment and in follow-up, the total scores of IBS-SSS in the patients of the two groups were all reduced as compared with those before treatment (P<0.01) and the scores in the acupuncture group were lower than those in the western medication group (P<0.01). After treatment and in follow-up, the total scores of IBS-QOL in the two groups were all increased as compared with those before treatment (P<0.01) and the score in the acupuncture group was higher than the western medication group in follow-up (P<0.01). The total effective rate was 79.2% (122/154) in the acupuncture group, higher than 58.4% (45/77) in the western medication group (P<0.01). There was no severe adverse reaction found in the two groups. The difference in the total score of IBS-SSS before and after treatment in the patients with LS and SS genotypes was greater than that in the patients with LL in the acupuncture group (P<0.01). The difference in the total score of ISB-SSS before and after treatment in the patients with SS genotype was greater than that in the patients with LL in the western medication group (P<0.01). The difference in the total score of IBS-SSS before and after treatment in the patients with LS and SS genotypes in the acupuncture group was greater than that in the patients with the same genotypes in the western medication group (P<0.01). CONCLUSION: Acupuncture for regulating shen and strengthening spleen achieves the more curative effect on IBS-D as compared with pinaverium bromide. The acupuncture regimen effectively relieves the clinical symptoms and improves the quality of life in patients as well as presents a satisfactory long-term effect and safety. The clinical curative effect of acupuncture is correlated with 5-HTTLPR polymorphism, in which, the curative effect of acupuncture may be more effective in the patients with LS and SS genotypes.

[The monitoring and its clinical significance of the hydrogen peroxide and interleukin-6 levels in exhaled breath condensate of chronic obstructive pulmonary diseases patients undergoing mechanical ventilation].

OBJECTIVE: To explore the relationship of inflammatory response of the respiratory tract and prognosis of chronic obstructive pulmonary diseases (COPD) patients undergoing mechanical ventilation (MV) in respiratory intensive care unit (RICU). METHODS: Thirty patients with COPD undergoing MV were involved in the study, and divided into survival group (n=16) and non-survival group (n=14). Exhaled breath condensate (EBC) was collected on day 1, 3, 5, 7 after MV. The concentration of hydrogen peroxide (H2O2) in EBC was measured fluorimetrically. The content of interleukin-6 (IL-6) in EBC was measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: (1) The significantly lower H2O2 and IL-6 levels in the survival group were observed on days 3, 5 and 7 compared with those of day 1 after MV [H2O2 (micromol/L): 0.10+/-0.03 , 0.06+/-0.03, 0.04+/-0.03 vs. 0.19+/-0.14, IL-6 (ng/L): 11.11+/-2.39, 10.35+/-2.09, 8.89+/-2.63 vs. 14.45+/-6.03, all P<0.05]. A significantly lower H2O2 level was observed on day 7 compared with that of day 3 (P<0.05). (2) A significantly higher H2O2 level in the non-survival group was observed on days 5 and 7 compared with that of day 1 (0.16+/-0.15, 0.25+/-0.16 vs. 0.05+/-0.03, both P<0.05). A significantly higher IL-6 level was observed on days 3, 5 and 7 compared with that of day 1 (9.36+/-2.38, 10.55+/-2.33, 14.05+/-4.23 vs. 6.87+/-3.47, all P<0.05). The significantly higher H2O2 and IL-6 levels in non-survival group were observed on day 7 compared with those of days 3 and 5 (all P<0.05). (3) The significantly lower H2O2 and IL-6 levels in non-survivors were observed on day 1 after MV compared with survivors (both P<0.05). There were no marked differences in levels of H2O2 and IL-6 between non-survivors and survivors on day 3 (both P>0.05). A significantly higher H2O2 level in non-survivors was observed compared with survivors on day 5 (P<0.05). In addition, the significantly higher H2O2 and IL-6 levels in non-survivors were observed on day 7 compared with survivors (both P<0.05). (4) The levels of H2O2 and IL-6 in EBC in survivors and non-survivors undergoing MV showed no correlation with acute physiology and chronic health evaluation II (APACHEII) and APACHEIII scores (both P>0.05). CONCLUSION: The findings suggest that the levels of H2O2 and IL-6 in EBC are correlated with prognosis of patients undergoing MV, and it may prove to be useful in monitoring inflammatory response in the airway after MV as a guidance of therapy and prognosis in COPD patients undergoing MV.

Access to P-chiral phosphine oxides by enantioselective allylic alkylation of bisphenols.

A novel biscinchona alkaloid-catalyzed highly enantioselective desymmetrization reaction of bisphenol compounds with achiral Morita-Baylis-Hillman carbonate agents was developed. Through the asymmetric allylic alkylation strategy, a broad range of optically active P-stereogenic phosphine oxides were generated with excellent to good yields (up to 99%) and high enantioselectivities (up to 98.5 : 1.5 e.r.). The reaction was further investigated by the linear free energy relationship (LFER) analysis. A possible transition state was proposed and furthered verified by theoretical calculations.

[Determination of the hydrogen peroxide level in exhaled breath condensate of patients under mechanical ventilation].

OBJECTIVE: To determine hydrogen peroxide (H(2)O(2)) content in condensate of exhaled breath (EBC) in order to explore its relation with intensify of inflammation of the respiratory tract and prognosis of the patients under mechanical ventilation in respiratory intensive care unit (RICU). METHODS: Thirty-six patients undergoing mechanical ventilation were studied. EBC was collected on the 1,3,5,7 days after mechanical ventilation. H(2)O(2) in EBC was measured fluorimetrically. RESULTS: A significantly lowered H(2)O(2) level in the survivors was observed on day 3 [(0.105+/-0.032)micromol/L], day 5 [(0.072+/-0.034)micromol/L] and day 7 [(0.047+/-0.029)micromol/L] compared with day 1 [(0.192+/-0.135) micromol/L] after mechanical ventilation (all P<0.05). A significantly lowered H(2)O(2) level was observed on day 7 compared with day 3 (P<0.05) after mechanical ventilation. There was no difference in the H(2)O(2) level on day 7 compared with day 5 (P>0.05). A significant lower H(2)O(2) level was observed in non-survivors on day 1 [(0.055+/-0.029)micromol/L], and day 3 [(0.088+/-0.040)micromol/L] and day 5 [(0.150+/-0.134)micromol/L] compared with day 7 [(0.234+/-0.152)micromol/L] after mechanical ventilation (all P<0.05). A significantly lower H(2)O(2) level was observed on day 1 compared with day 5 (P<0.05) after mechanical ventilation. There was no difference in the H(2)O(2) level on day 1 compared with day 3 (P>0.05). A significantly lower H(2)O(2) level in non-survivor compared with survivors on day 1 after mechanical ventilation (P<0.05);There was no difference in the H(2)O(2) level between non-survivors and survivors on day 3 after mechanical ventilation (P>0.05).A significantly higher H(2)O(2) level in non-survivors compared with that of survivors on day 5 and day 7 after mechanical ventilation (P<0.05, respectively). The levels of H(2)O(2) in EBC in survivors and non-survivors undergoing mechanical ventilation showed no correlation with acute physiology and chronic health evaluation II (APACHE II) and APACHE III scores (both P>0.05). CONCLUSION: The findings suggest that the level of H(2)O(2) in EBC is correlated with severity of patients under mechanical ventilation, and it may prove to be useful in monitoring of inflammatory reaction in the airway after mechanical ventilation to be used as a guidance of therapy and prognosis in patients under mechanical ventilation.