The influence of NHCs on C-Si and C-C reductive elimination: a computational study of the selectivity of Ni-catalyzed C-H activation of arenes with vinylsilanes.

Density functional theory calculations were performed to investigate the mechanism and origins of the NHC-controlled selectivity of Ni-catalyzed C-H activation of arenes with vinylsilanes. The key to the selectivity is the different impacts of NHCs on the C-Si/C-C reductive elimination of the square-planar/T-shaped intermediate.

Efficacy of patients' preferred exercise modalities in chronic obstructive pulmonary disease: A parallel-group, randomized, clinical trial.

INTRODUCTION: Physical exercise effectively improves health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). However, application of this medical intervention is problematic, due to poor adherence to the exercise program or unawareness of the significance of this intervention. OBJECTIVE: To determine whether COPD patients who adopted personal-preferred exercise modalities (PPEMs) for daily training would demonstrate sustained benefits due to improved adherence. METHODS: Stable COPD patients were randomly assigned to the daily PPEMs group or the control group (without extra exercise apart from daily life activities). All other treatments were similar. The primary outcome was the health-related quality of life (HRQoL), measured with St. George's Respiratory Questionnaire (SGRQ) score at 12 months. Other measures included the Borg dyspnea score, 6-min walking distance (6MWD) and lung function variables. RESULTS: The intention-to-treat (ITT) population included 94 patients, 68 of them completed the study protocol over 12 months (the PP-population). A greater decline of SGRQ score (improvement of HRQoL) in the PPEMs group than that in the controls was demonstrated over 12 months (-19.1 vs -9.0 in the ITT population and -19.1 vs -8.7 in the PP population, P ≤ .001 for all comparisons), the reduction exceeded the minimal clinically important difference of ≥ 4 points. The PPEMs group also showed a greater reduction than the control group in Borg score at 12 months in the ITT and the PP population as well (P < .01). No significant improvement was found in 6MWD or in lung function variables. CONCLUSIONS: COPD patients could benefit from extra daily PPEMs, and the gain may sustain at least for 1 year.

[Clinical application of tibial composite saphenous nervetissue flap for the treatment of traumatic bone-skin defect of leg].

OBJECTIVE: To investigate the effect of tibial composite saphenous nerve tissue flap in repairing traumatic bone-skin defect of leg. METHODS: From February 2009 to May 2015, 23 patients with focile skin defect caused by trauma were treated, including 18 males and 5 females, aged from 8 to 59 years old with an average age of 35.6 years old. Length of tibia bone cortex defect ranged from 4 to 12 cm, width ranged from 2 to 2.5cm, skin defect ranged from 8 cm× 3 cm to 18 cm× 11 cm, all the wound surfaces had purulent exudation. Cross shift and ipsilateral shift methods of tibial composite saphenous nerve tissue flap were used to reconstruct continuity of the injured limb tibial brace and repair wound surface. Cutting flap ranged from 9 cm× 4 cm to 20 cm × 12 cm, bone flap length was 6 to 15 cm, width was 1.5 to 2.5 cm. Fracture healing time and recovery of limb function were observed. RESULTS: At 3 to 5 months after operation, bone flap and area of affected area were healed with an average of 4.7 months. Twenty-three cases were followed up for 6 months to 5 years with an average of 30.3 months. Thirteen patients were able to walk without abnormal gait and could be engaged into original work. According to Enneking evaluation systems, 13 patients obtained excellent results, 8 moderate and 2 poor. CONCLUSIONS: With tibial composite saphenous nerve tissue flap transplantation at stage one to repair tibia and skin defects according to specific condition of affected limbs has a high rate of success and creates less damage to region of limb injury, which is an ideal method to repair skin defect of focile.