Electrochemical Arene Radical Cation Promoted Spirocyclization of Biaryl Ynones: Access to Alkoxylated Spiro[5,5]trienones.

Herein, a novel electrochemical arene radical cation promoted dearomative spirocyclization of biaryl ynones with alcohols is described, providing a conceptually novel transformation mode for producing diverse alkoxylated spiro[5,5]trienones. The catalyst- and chemical-oxidant-free spirocyclization protocol features broad substrate scope and high functional group tolerance. Mechanistic studies reveal that the generation of arene radical cation via anodic single-electron oxidation is crucial, with sequential 6-endo-dig cyclization, dissociation of hemiketal, anodic oxidation, and nucleophilic attack of alcohols.

Electrochemical 1,3-Alkyloxylimidation of Arylcyclopropane Radical Cations: Four-Component Access to Imide Derivatives.

Herein, a general electrochemical radical-cation-mediated four-component ring-opening 1,3-alkyloxylimidation of arylcyclopropanes, acetonitrile, carboxylic acids, and alcohols is described, providing a facile and sustainable approach to quickly construct structurally diverse imide derivatives from easily available raw materials in an operationally simple undivided cell. This metal-catalyst- and oxidant-free single-electron oxidation strategy offers a green alternative for the formation of highly reactive cyclopropane-derived radical cations, and this protocol features a broad functional group tolerance.

Evaluation of the Prognostic Value of Existing Scoring Systems for Nosocomial Infection in Patients with Decompensated Liver Cirrhosis.

BACKGROUND: Many scoring systems have been developed to evaluate the severity and survival of end-stage liver disorder patients. However, the conduction of these different predicting models has not been thoroughly verified in cirrhotic patients with nosocomial infections. This study ended to compare the predictive accuracy of various scoring systems. METHODS: During January 2015 and January 2020, liver cirrhosis patients with nosocomial infections were involved in this study. The clinical data, laboratory findings, and demographic characteristics of patients were collected during diagnosis. Patients were followed up for at least 6 months or till death. RESULTS: One hundred thirty-one patients meeting the criteria were enrolled and followed up for at least 6 months. The mortality rate at 30 days, 3 months, and 6 months was 23%, 35.1%, and 39.6%, respectively. The univariate analysis showed that all scoring systems indicated statistical significance between the surviving group and the non-surviving group at 6 months. Model for end-stage liver disease-Na showed excellent predictive accuracy in predicting the survival at 30 days, 3 months, 6 months, with the area under the curve of 0.807, 0.850, and 0.844, respectively. Model for end-stage liver disease-Na demonstrated sensitivities of more than 85%. In contrast, the child-turcotte-pugh and albumin-bilirubin scores showed a poorer predictive capability. CONCLUSION: All 5 models for end-stage liver disease-related scores (model for end-stage liver disease, model for end-stage liver diseaseto-serum sodium ratio, model for end-stage liver disease-Na, model for end-stage liver disease-Delta, snd integrated model for endstage liver disease) exhibited a reliable prediction for mortality of long-term prognosis and short-term prognosis of cirrhotic patients with nosocomial infections. Among them, the model for end-stage liver disease-Na score might be the best choice.

Clinical presentation, biochemical profile, and HLA haplotype frequency of celiac disease among adults in Northwest China.

OBJECTIVE: To evaluate the clinical characteristics, biochemical parameters and the distribution of HLA-DQ genotypes among adult patients with celiac disease (CD) in Northwest China. METHODS: This cross-sectional study retrospectively collected clinical, biochemical, and HLA-DQ genotype of patients with CD from a tertiary hospital in Xinjiang Uygur Autonomous Region, China between March 2016 and December 2021. Small intestinal biopsy and serum-specific antibodies were used to diagnose CD. RESULTS: Of the 102 CD patients, 63.7% were women (female: male = 1.76:1), and the mean age was 47.3 ± 14.7 years at diagnosis. Common gastrointestinal symptoms included abdominal pain (50.0%), diarrhea (39.2%), and abdominal distension (24.5%). While common extraintestinal manifestations were anemia (48.0%), osteopenia or osteoporosis (36.3%), and fatigue (35.3%). Approximately 34.3% of patients with CD had comorbidities, with the most common being thyroid diseases (18.6%). Biochemical profiles showed lower hemoglobin, higher platelet count, and 25-hydroxyvitamin D (25[OH]D) deficiency. HLA-DQ2/DQ8 was detected among all 53 patients who underwent genotype testing; the frequency of the HLA-DQ2.5, DQ2.2, and DQ8 haplotypes was 71.7%, 24.5%, and 3.8%, respectively. CONCLUSIONS: CD was more common among women. Clinical manifestations include primarily gastrointestinal symptoms, but extraintestinal manifestations were not uncommon. Lower hemoglobin level, higher platelet count, and 25[OH]D deficiency are the main biochemical manifestations. The HLA-DQ2.5 and DQ2.2 haplotypes are the most common genotypes in CD.

Epidemiological, clinical, and histological presentation of celiac disease in Northwest China.

BACKGROUND: Research on celiac disease (CD) in northwest China is still in its infancy. At present, large-sample data on the epidemiological, clinical, and pathological characteristics of CD are limited. AIM: To investigate the epidemiological, clinical, and pathological characteristics of CD in northwest China. METHODS: The clinical data of 2884 patients with gastrointestinal (GI) symptoms were retrospectively analyzed. Total immunoglobulin A (IgA) and anti-tissue transglutaminase (tTG) IgA levels were examined in all patients. Gastroscopy and colonoscopy were performed in patients with positive anti-tTG IgA and deficient total IgA levels. Atrophy of the duodenal and ileal villi was examined and histopathological examinations were performed. The modified Marsh-Oberhuber classification system was used to grade villous atrophy in the duodenum or distal ileum. The patients' Helicobacter pylori (H. pylori) infection status was compared in terms of clinical presentation and Marsh grade. Statistical analyses were performed using the t-test or chi-square test. RESULTS: Among the 2884 patients, 73 were positive for serum anti-tTG IgA, and 50 were diagnosed with CD. The CD detection rate was significantly higher in Kazakhs (4.39%) than in Uyghurs (2.19%), Huis (0.71%), and Hans (0.55%). The main symptoms of CD were chronic diarrhea, anorexia, anemia, fatigue, weight loss, sleep disorders, osteopenia, and osteoporosis. The body mass index of patients with CD was significantly lower than that of patients without CD. A total of 69 patients with positive serum anti-tTG IgA and two patients with deficient total IgA levels underwent GI endoscopy. Endoscopy revealed crypt hyperplasia and/or duodenal villous atrophy, mainly manifested as nodular mucosal atrophy, grooves, and fissures. The difference in H. pylori infection rates was not statistically significant between CD and non-CD patients but was significantly different among CD patients with different Marsh grades. CONCLUSION: Among the patients with GI symptoms in northwestern China, the prevalence of CD was more in the Uyghur and Kazakh populations. H. pylori infection may be associated with CD severity.