ABSTRACT
<p><b>OBJECTIVE</b>To assess the efficacy and safety of bladder irrigation with amphotericin B for treatment of fungal infection in the urinary tract.</p><p><b>METHODS</b>All the available randomized controlled trials (published before March, 2018) examining bladder irrigation with amphotericin B for treatment of urinary tract fungal infection were searched in the Cochrane Central Register of Controlled Trials (Issue 12, 2017), PubMed, EMBase, Web of Knowledge Database, CNKI, CBM, Wanfang DATA and VIP information. Data were extracted from the selected trials for meta-analysis using RevMan 5.3 software.</p><p><b>RESULTS</b>A total of 96 studies were retrieved from the databases, and 9 trials involving 853 patients were included in the analysis. Meta-analysis results showed that compared with oral administration of fluconazole, bladder irrigation with amphotericin B was more effective in the treatment of fungal infection in the urinary tract (OR=1.66, 95%CI: 1.2-2.3, P=0.002) and was associated with less adverse reactions.</p><p><b>CONCLUSION</b>Bladder irrigation with amphotericin B can improve the curative effect of fungal infection in the urinary tract, but due to the small sample size of the included studies, this conclusion needs to be further validated by high-quality studies.</p>
ABSTRACT
2-[3-hydroxy-1-adamantyl]-2-oxoacetic acid [IV], a key intermediate of saxagliptin for type 2 diabetes mellitus [T2DM], was prepared from 1-adamantanecarboxylic acid[I] via oxidation by potassium permanganate[KMnO4] to afford 3-hydroxy-1-adamantanecarboxylic acid [II], which was treated with a one-pot method to give 1-acetyl-3-hydroxyadamantane [III] followed by oxidation. Some key steps were optimized and the overall yield was about 51%