Synthesis of isothiocyanato alkyl sulfides from alkenes using KSCN and DMTSM.

A method for the synthesis of isothiocyanato alkyl sulfides from KSCN and DMTSM under metal-free conditions has been developed. The features of this reaction are low-cost, readily accessible starting materials and the use of KSCN as nucleophiles for C-NCS bond formation. Alkenes with various substituted groups react smoothly and the desired products are obtained in moderate to good yields.

Efficacy and safety analysis of AcoStream thrombus aspiration device in the treatment of acute superior mesenteric artery embolism.

OBJECTIVE: Acute superior mesenteric artery embolism is a life-threatening disease caused by the abrupt interruption of mesenteric blood circulation, and the prognosis is very poor. Several studies have confirmed the efficacy and safety of percutaneous mechanical thrombectomy in acute superior mesenteric artery embolism, however, there are currently no literature reports on the latest percutaneous mechanical thrombectomy device-AcoStream™. In the present report, we summarize a series of cases and share our surgical experiences. METHODS: The clinical data of 10 patients (six men and four women, mean age 77.6 ± 7.4 years) with acute superior mesenteric artery embolism treated by AcoStream™ in our center from December 2022 to December 2023 were retrospectively analyzed. Based on the literature, we summarized the diagnosis, therapy, and surgical experience of acute superior mesenteric artery embolism. RESULTS: Percutaneous mechanical thrombectomy was performed for all the patients. The success rate of surgery reached 100% and no perioperative complications occurred. Abdominal pain was significantly relieved and the abdominal signs gradually disappeared in eight patients, while the other two patients still complained of abdominal pain during hospitalization, and eventually, they underwent resection of necrotic bowel. All the patients' symptoms were significantly relieved and they were smoothly discharged from the hospital. CONCLUSIONS: As shown in the present study, percutaneous mechanical thrombectomy using AcoStream™ is minimally invasive, safe, and efficient in the initial stage of acute superior mesenteric artery embolism. We believe that percutaneous mechanical thrombectomy can be a promising alternative in selected cases.

Percutaneous mechanical thrombectomy in the management of early acute superior mesenteric artery embolism.

PURPOSE: This study was performed to summarize our experience in the management of early-stage acute superior mesenteric artery embolism (ASMAE) by percutaneous mechanical thrombectomy (PMT). METHODS: The clinical data of 12 patients with early-stage ASMAE treated by PMT in our institution from November 2019 to September 2021 were retrospectively analyzed. The patients had no obvious evidence of bowel infarction as shown by peritoneal puncture and computed tomography angiography. Thrombectomy of the superior mesenteric artery was performed using a 6F AngioJet catheter. RESULTS: The emboli were completely removed in 10 (83.3%) patients. Six patients were treated only by the AngioJet device. The other six patients underwent combined treatment with a 6F multipurpose drainage catheter after PMT, including one patient who underwent simultaneous stent implantation. Two patients showed no significant improvement in their symptoms after the operation; one was found to have intestinal necrosis and underwent resection by exploratory laparotomy, and the other died of septic shock 3 days after PMT (further intervention had been discontinued because of complications with multiple underlying diseases). No other PMT-related complications occurred. Only one patient was found to have a pseudoaneurysm of the superior mesenteric artery 1 week after PMT and underwent resection by exploratory laparotomy. The 11 surviving patients were smoothly discharged from the hospital after their symptoms were relieved. At a mean follow-up of 13.2 months, computed tomography angiography showed smooth patency of the superior mesenteric artery. No patients developed serious symptoms during follow-up. CONCLUSIONS: PMT by the AngioJet device is a minimally invasive, safe, and effective technique to remove ASMAE. Early application of PMT can avoid acute intestinal necrosis. Combining the AngioJet device with a 6F multipurpose drainage catheter might be more helpful to remove residual emboli.

Deciphering a mitochondria-related signature to supervise prognosis and immunotherapy in hepatocellular carcinoma.

Background: Hepatocellular carcinoma (HCC) is a major public health problem in humans. The imbalance of mitochondrial function has been discovered to be closely related to the development of cancer recently. However, the role of mitochondrial-related genes in HCC remains unclear. Methods: The RNA-sequencing profiles and patient information of 365 samples were derived from the Cancer Genome Atlas (TCGA) dataset. The mitochondria-related prognostic model was established by univariate Cox regression analysis and LASSO Cox regression analysis. We further determined the differences in immunity and drug sensitivity between low- and high-risk groups. Validation data were obtained from the International Cancer Genome Consortium (ICGC) dataset of patients with HCC. The protein and mRNA expression of six mitochondria-related genes in tissues and cell lines was verified by immunohistochemistry and qRT-PCR. Results: The six mitochondria-related gene signature was constructed for better prognosis forecasting and immunity, based on which patients were divided into high-risk and low-risk groups. The ROC curve, nomogram, and calibration curve exhibited admirable clinical predictive performance of the model. The risk score was associated with clinicopathological characteristics and proved to be an independent prognostic factor in patients with HCC. The above results were verified in the ICGC validation cohort. Compared with normal tissues and cell lines, the protein and mRNA expression of six mitochondria-related genes was upregulated in HCC tissues and cell lines. Conclusion: The signature could be an independent factor that supervises the immunotherapy response of HCC patients and possess vital guidance value for clinical diagnosis and treatment.

Fruquintinib for refractory colorectal cancer in a pre-treated 82-year-old patient achieved a progression-free survival of 25 months: a case report.

Background: Chemotherapy was recommended as the 1st or 2nd line standard of care for patients with refractory or metastatic colorectal cancer (mCRC). Extra cautions are needed for elderly patients, because cytotoxic regimens may induce unexpected adverse effects due to their impaired physical condition and tolerability. Currently, there is no evidence for the treatment in elderly patients. This case reports a new ideas to the treatment of elderly mCRC patients. Case Description: An 82-year-old man was diagnosed with descending colon cancer and underwent radical operation revealed stage IIIB cancer (pT4aN1cM0) in June 2016, followed by adjuvant chemotherapy (6 cycles of XELOX). The disease relapsed in June 2018, and the patient was prescribed Tegafur for 6 months. In December 2018, he was admitted to hospital due to intestinal obstruction with performance status (PS) score of 3 and nutrition score (NRS2002) of 5. According to a multidisciplinary team (MDT) meeting: considering that the adverse effects of front-line treatment are dominated by myelosuppression, the general condition of the patient is currently poor. The patient received fruquintinib as the second-line treatment which was interrupted for one month due to grade 3 hypertension and proteinuria. The restarted dose was reduced from 5 to 3 mg/day and continued until the last follow-up. The disease did not progress during 25-months of Fruquintinib treatment. Unfortunately, the patient was bedridden for a long time after an accidental fall resulting in a pulmonary infection and finally died of respiratory failure in January 2021. Conclusions: CRC patients with advanced age and poor general condition require MDT meetings and individualized treatment. Despite of an advanced age, poor physical condition, and intense tumor burden, Fruquintinib as the second-line treatment achieved satisfactory disease control in this case. Adverse events could be relieved by dose reduction. Thus, fruquintinib could be a treatment option in refractory elderly CRC patients.

Application of Kissing Technique for the Treatment of Superior Vena Cava Syndrome.

BACKGROUND: Superior vena cava syndrome is a series of symptoms caused by compression of the superior vena cava and its main branches. Endovascular therapy is now widely accepted because it offers rapid, safe and effective relief of clinical symptoms. Few reports have described the application of kissing technique for the treatment of superior vena cava syndrome. In this report, we review a series of cases in which superior vena cava syndrome was treated by kissing technique and we share our experience. METHODS: Our institute treated 22 patients with SVCS by endovascular intervention from November 2016 to June 2021; among them, the kissing technique was used in 10 cases and achieved satisfactory results. This is a retrospective evaluation and analysis of 10 patients with superior vena cava syndrome who were treated by endovascular intervention using the kissing technique from May 2018 to April 2021 in Hwa Mei Hospital, University of Chinese Academy of Sciences. Based on literatures, we summarize the diagnosis, treatment, and surgical experience. RESULTS: All patients underwent the implantation of the kissing stents, and the technical success rate was 100%. The symptoms and signs of intravenous obstruction in all patients were alleviated or disappeared within 1-3 days after the procedure. During the follow-up period, 9 patients remained free from any clinical signs or symptoms, and 1 patient died 1 month after the procedure due to the progression of malignant tumors. CONCLUSIONS: As a palliative intervention, the kissing technique for the treatment of superior vena cava syndrome caused by malignant tumors is safe, rapid, and effective. Successful endovascular therapy can quickly relieve symptoms, improve the patient's quality of life, and provide more opportunities for subsequent antitumor treatment.

Acute Pancreatitis: A Rare Complication After Percutaneous Mechanical Thrombectomy of Portal Vein Thrombosis.

BACKGROUND: Acute pancreatitis caused by Percutaneous Mechanical Thrombectomy treatment is extremely rare, and so far, no clinical report involving portal veins has been reported. In the article, we summarize this unusual case and share our experience. METHODS: Percutaneous mechanical thrombectomy was performed for the patient who was diagnosed with portal vein thrombosis. Postoperatively, the patient was complicated by acute pancreatitis and received a series of medical treatments. RESULTS: During the first month of follow-up, the patient was free of any clinical symptoms or signs. CONCLUSIONS: When performing percutaneous mechanical thrombectomy therapy, it is crucial to grasp the time limit strictly, strengthen perioperative rehydration and urine alkalinization to prevent massive hemolysis and subsequent complications. Early detection and the early administration of therapy for this potentially severe complication are essential for obtaining a good prognosis.

Docosahexaenoic acid inhibits vascular smooth muscle cell migration and proliferation by decreasing microRNA­155 expression levels.

Vascular smooth muscle cell (VSMC) hyperplasia is a common cause of carotid restenosis. In the present study, the potential protective effects of docosahexaenoic acid (DHA) in carotid restenosis and the underlying mechanism of its effects were examined. VSMCs were treated with DHA, a polyunsaturated ω­3 fatty acid. Cell migration and proliferation were assessed using wound healing and Cell Counting Kit­8 assays and by measuring Ki­67 protein levels. Additionally, the expression levels of microRNA­155 were determined by reverse transcription­quantitative PCR (RT­qPCR). The involvement of microRNA­155 in the regulation of migration and proliferation was evaluated by transfecting VSMCs with microRNA mimics and inhibitors. Moreover, the reversal of migration and proliferation after transfection of VSMCs with the microRNA mimics and subsequent treatment with DHA was investigated. A target gene of microRNA­155 was identified using RT­qPCR and luciferase assays. The migration and proliferation of VSMCs, as well as the expression of microRNA­155 was inhibited by DHA stimulation. MicroRNA­155 regulated the migration and proliferation of VSMCs. Finally, proliferation and migration of VSMCs were reduced following DHA treatment, which was mediated by an increase in the expression levels of microRNA­155. Suppressor of cytokine signalling 1 (Socs1) was the target gene of microRNA­155. In conclusion, DHA inhibited VSMC migration and proliferation by reducing microRNA­155 expression. This effect may be caused by the microRNA­155 target gene Socs1.

Spontaneous Spinal Subdural Hematoma after Percutaneous Mechanical Thrombectomy Combined with Catheter-Directed Thrombolysis for Deep Venous Thrombosis: A Case Report.

BACKGROUND: Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis is one of the most important methods for deep venous thrombosis treatment. Spontaneous spinal subdural hematoma is a remarkably rare complication in the thrombolysis process with catastrophic consequences, as shown in this case report. METHODS: Percutaneous mechanical thrombectomy, percutaneous angioplasty, and catheter-directed thrombolysis were performed for the patient. Postoperatively, the patient was diagnosed with spontaneous spinal subdural hematoma and received a series of medical treatments and surgical interventions. RESULTS: The patient was still paraplegic and incontinent at the postoperative 7-month follow-up. CONCLUSIONS: Neurologic symptoms must be monitored carefully both during and after the thrombolysis procedure. The onset of spinal neurologic deficits in any patient must raise the suspicion that a spinal subdural hematoma has occurred. Surgical decompression beyond 24 hr may cause permanent neurological damage.

Development of a simple LC-MS/MS method for determination of rebamipide in human plasma and its application to a bioequivalence study.

The purpose of this study was to design a simple and rapid liquid chromatography-tandem mass spectrometric (LC-MS/MS) method for a rebamipide bioequivalence study in healthy Chinese male volunteers. In this method, sample pretreatment involved simple protein precipitation with venlafaxine as the internal standard. Analysis was achieved on a ZORBAX SB-C18 column with a concentration range of 6-1200 ng/mL. Rebamipide tablets from Yuanlijian (test, Hangzhou, China) and from Otsuka (reference, Hangzhou, China) were evaluated following a single 300 mg oral dose to 20 healthy volunteers. Bioequivalence was determined by calculating 90% confidence intervals (90% CI) for the ratio of Cmax, AUC(0-t) and AUC(0-infinity) values for the test and reference products, using logarithmic transformed data. The 90% confidence intervals for the ratio of Cmax (83.7-118.4%), AUC(0-t) (91.1-113.4%) and AUC(0-infinity) (90.6-113.2%) values for the test and reference products were within the interval (80.0-125.0% for AUC, and 70-143% for Cmax), proposed by State of Food and Drug Administration [SFDA, 2005. China]. It was concluded that the two rebamipide tablets were bioequivalent in their rate and extent of absorption and the method met the principle of quick and easy clinical analysis.

Relative bioavailability and pharmacokinetic comparison of two different enteric formulations of omeprazole.

In order to comply with the requirements for a drug listed in China, the study was developed to compare the pharmacokinetics and relative bioavailability of two different enteric formulations of omeprazole (OPZ) in healthy Chinese subjects. A total of 32 volunteers participated in the study. Plasma concentrations were analyzed by nonstereospecific liquid chromatography/tandem mass spectrometric (LC-MS/MS) method. After administration of a single 40-mg dose of the two OPZ formulations, the comparative bioavailability was assessed by calculating individual AUC(0‒t) (the area under the concentration-time curve from time zero to the last measurable concentration), AUC(0‒∞) (the area under the concentration-time curve extrapolated to infinity), C(max) (the maximum observed concentration), and T(peak) (the time to C(max)) values of OPZ, 5-hydroxyomeprazole (OH-OPZ), and omeprazole sulfone (OPZ-SFN), respectively. The 90% confidence intervals (CIs) of AUC(0‒t), AUC(0‒∞), and C(max) were 85.4%‒99.0%/88.8%‒98.6%/87.6%‒99.4%, 85.5%‒99.2%/89.0%‒98.6%/88.5%‒101.3%, and 72.3%‒87.6%/79.6%‒91.1%/88.4%‒99.1% for OPZ/OH-OPZ/OPZ-SFN, respectively, and T(peak) values did not differ significantly. In this study, the test formulation of OPZ in fasting healthy Chinese male volunteers met the Chinese bioequivalance standard to the reference formulation based on AUC, C(max), and T(peak).