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1.
J Refract Surg ; 37(9): 616-622, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34506238

RESUMO

PURPOSE: To assess the precision of a new spectral-domain optical coherence tomographer (SD-OCT)/Placido topographer (MS-39; CSO) and its comparison with a swept-source OCT (SS-OCT) biometer (Argos; Movu, Inc) in patients with cataract. METHODS: Fifty-three right eyes from 53 patients were examined by two experienced operators three times using both devices randomly. Employing the within-subject standard deviation (Sw), test-retest variability, coefficient of variation, and intraclass correlation coefficient to evaluate intraoperator repeatability and interoperator reproducibility; the double-angle plots to analyze astigmatism; and Bland-Altman plots and 95% limits of agreement to verify the agreement between devices. RESULTS: The SD-OCT/Placido tomographer showed high precision, with coefficient of variation of 0.44% or less, intraclass correlation coefficient of 0.945 or greater for all parameters, test-retest variability of 4.21 µm or less for central corneal thickness (CCT), 0.03 mm or less for anterior chamber depth (ACD) and aqueous depth (AQD), and 0.25 diopters (D) or less for mean keratometry (Km), J0, and J45. The inter-device differences in Km, J0, and J45 were statistically insignificant, whereas the remaining were statistically but not clinically significant. The 95% limits of agreement of CCT, ACD, AQD, Km, J0, and J45 were -3.70 to 15.25 µm, -0.06 to 0.04 mm, -0.06 to 0.04 mm, -0.28 to 0.35 D, -0.27 to 0.26 D, and -0.27 to 0.21 D, respectively. The double-angle plot confirmed the high agreement in astigmatism. CONCLUSIONS: For CCT, ACD, AQD, Km, and astigmatism measurements in patients with cataract, the new SD-OCT/Placido tomographer has excellent precision and high agreement with the Argos SS-OCT biometer, and can be used interchangeably. [J Refract Surg. 2021;37(9):616-622.].


Assuntos
Catarata , Tomografia de Coerência Óptica , Comprimento Axial do Olho , Biometria , Catarata/diagnóstico , Córnea , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes
2.
Biomaterials ; 277: 121117, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34517277

RESUMO

Scaffolds functionalized with bone morphogenetic protein-2 (BMP-2) have shown great potential for bone regeneration. However, structural instability and the necessity for supra-physiological dose have thus far limited practical applications for BMP-2. Protein modification and site-specific covalent immobilization of BMP-2 to carrier materials might be optimal strategies to overcome these problems. Here, we report a broadly applicable strategy where the polyhistidine tag-T4 Lysozyme (His6-T4L) was genetically fused at the N-terminus of BMP-2 and used as a protein spacer, which on one hand enhanced protein solubility and stability, and on the other hand mediated site-specific covalent anchoring of BMP-2 upon binding to nickel-chelated nitrilotriacetic acid (Ni-NTA) microparticles (denoted as MPs-His6-T4L-BMP2) to further maximize its rescued activity. We also constructed a novel gelatin-based hydrogel that was crosslinked by transglutaminase (TG) and tannic acid (TA). This hydrogel, when incorporated with MPs-His6-T4L-BMP2, displayed excellent in-situ injectability, thermosensitivity, adhesiveness and improved mechanical properties. The effective loading mode led to a controlled and long-term sustained release of His6-T4L-BMP2, thereby resulting in enhancement of bone regeneration in a critical-sized bone defect. We believe that the protein modification strategy proposed here opens up new route not only for BMP-2 applications, but can be used to inform novel uses for other macromolecules.

3.
Inorg Chem ; 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34520176

RESUMO

The construction of a phase junction photocatalyst can significantly enhance the photocatalytic performance with high selectivity for CO2 reduction. In this study, an S-scheme junction Cd0.5Zn0.5S/CoWO4 semiconductor with the coupling of a twin crystal Cd0.5Zn0.5S homojunction and CoWO4 was designed through a hydrothermal method, which could convert CO2 to CO with high efficiency under visible-light illumination. Cd0.5Zn0.5S-10%CoWO4 exhibited the optimal performance and its CO yield and selectivity were up to 318.68 µmol·g-1 and 95.90%, respectively, which were 4.54 and 1.62 times higher than that of twin crystal Cd0.5Zn0.5S. Moreover, the Cd0.5Zn0.5S homojunction with a zinc-blende and wurtzite phase and the S-scheme phase junction of Cd0.5Zn0.5S/CoWO4 enhanced the property of CO2 adsorption and accelerated the detachment of photogenerated carriers. The combination of photogenerated holes in Cd0.5Zn0.5S and the electrons of CoWO4 can retain the reduction sites to improve photocatalytic performance. This study provides a neoteric concept and reference for the construction of the S-scheme phase junction.

4.
BMC Infect Dis ; 21(1): 951, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521370

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted. METHODS: In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020. RESULTS: Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19. CONCLUSIONS: The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.

5.
Drug Des Devel Ther ; 15: 3765-3772, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34522082

RESUMO

Purpose: Treatment of spinal anesthesia-induced hypotension in patients with severe preeclampsia assumes special concern as hypotension may further reduce placental perfusion. Phenylephrine is still the first-line vasopressor for treating spinal anesthesia-induced hypotension. However, the optimal dose of phenylephrine used as intravenous (IV) boluses in patients with severe preeclampsia has not been clearly determined. We aim to calculate the 90% effective dose (ED90) of phenylephrine as IV boluses for treating spinal anesthesia-induced hypotension in patients with severe preeclampsia undergoing cesarean delivery. Patients and Methods: Forty patients with severe preeclampsia were enrolled in this prospective sequential allocation dose-finding trial. Using the biased coin up-and-down (BCUD) method, all patients in our study received an IV bolus phenylephrine of either 40, 50, 60, 70, or 80 µg when the mean arterial pressure (MAP) decreased to less than 80% of the baseline level and the ED90 was determined. The primary outcome was the success of the assigned phenylephrine bolus to maintain the MAP at or above 80% of baseline value between the induction of spinal anesthesia and delivery of the fetus. Secondary outcomes included hypertension, nausea, vomiting, bradycardia, upper sensory level of anesthesia, umbilical blood gases, and Apgar score. Estimating of the ED90 with 95% confidence interval (CI) was achieved by isotonic regression method. Results: The ED90 of phenylephrine was estimated as 62.00 µg (95% CI=50.00-67.40 µg) using the isotonic regression method. No patients enrolled in our study experienced bradycardia and those patients who developed hypertension were all observed at the dose level 70 µg. Conclusion: For clinical practice, we recommend that phenylephrine 60 µg may be both effective and safe for treatment of spinal anesthesia-induced hypotension in severe preeclampsia during cesarean delivery.

6.
Int J Med Sci ; 18(15): 3437-3451, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34522170

RESUMO

Aurora-A has attracted a great deal of interest as a potential therapeutic target for patients with CRC. However, the outcomes of inhibitors targeting Aurora-A are not as favorable as expected, and the basis behind the ineffectiveness remains unknown. Here, we found that signal transducer and activator of transcription 1 (STAT1) was highly expressed in colorectal cancer (CRC) xenograft mouse models that were resistant to alisertib, an Aurora-A inhibitor. Unexpectedly, we found that alisertib disrupted Aurora-A binding with ubiquitin-like with plant homeodomain and ring finger domain 1 (UHRF1), leading to UHRF1 mediated ubiquitination and degradation of DNA methyltransferase 1 (DNMT1), which in turn resulted in demethylation of CpG islands of STAT1 promoter and STAT1 overexpression. Simultaneous silencing Aurora-A and UHRF1 prevented STAT1 overexpression and effectively inhibited CRC growth. Hence, concomitant targeting Aurora-A and UHRF1 can be a promising therapeutic strategy for CRC.

7.
Inorg Chem ; 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34523334

RESUMO

The Pb-free hybrid-layered-double perovskites (HLDPs) have been proposed as green and stable semiconducting materials for optoelectronic devices, but the synthesized members are still limited. Here, we report the synthesis of three new HLDPs, (C8H20N2)2AgMBr8 (M = In, Sb, and Bi), by a solution method using 1,4-bis(ammoniomethyl)cyclohexane (C8H20N22+) as the organic spacing cation. All three of these HLDPs show ⟨100⟩-oriented layered structures with Ag and In/Sb/Bi order arranged in corner-sharing octahedral layers. The first-principle calculations indicate the indirect-gap nature of (C8H20N2)2AgInBr8 and (C8H20N2)2AgSbBr8, while their Bi counterpart shows a direct band gap after considering spin-orbit coupling. The band gaps obtained by diffuse-reflectance spectroscopy are 3.11, 2.60, and 2.70 eV for M = In, Sb, and Bi, respectively. (C8H20N2)2AgInBr8 shows a broadband red emission centered at 690 nm, and it is mainly attributed to the self-trapped-excitons mechanism. Our results not only provide a series of new "Pb-free" HLDPs with chemical diversity but also help us to further understand the structure-property relationships of HLDP materials.

8.
Acta Neurol Scand ; 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34523724

RESUMO

OBJECTIVES: The association between migraine and dementia has rarely been investigated, and available results are conflicting. Thus, the aim of this meta-analysis was to evaluate whether an association exists between migraine and dementia. MATERIALS & METHODS: We searched for cohort studies from databases including PubMed, EBSCO, Web of Science, and EMBASE database from inception to April 1, 2021, using subject and free words. RevMan 5.1 software was used to calculate the risk ratio (RR) of dementia in patients with migraine. Subgroup and sensitivity analyses were conducted to assess the source of heterogeneity. A random-effects model was used when heterogeneity was present. The Funnel plot and Egger's test were used to evaluate publication bias. RESULTS: Five published cohort studies covering a total of 249,303 individuals were identified. Pooled analysis showed that migraine was associated with increased risk of all-cause dementia (RR: 1.34, 95% CI: 1.13-1.59) and Alzheimer's disease (AD) (RR: 2.49, 95% CI: 1.16-5.32). However, we did not found any association between migraine and risk of vascular dementia (VaD) (RR: 1.51, 95% CI: 0.77-2.96). CONCLUSIONS: Our results revealed that migraine was a potential risk indicator for AD and all-cause dementia.

9.
Chemistry ; 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34523754

RESUMO

Lithium (Li) metal is regarded as an ultimate anode material for use in Li batteries due to its high theoretical capacity (3860 mA h g-1). However, the Li dendrites that are generated during iterative Li plating/stripping cycles cause poor cycling stability and even create vital safety risks, and thus severely handicap the commercial utility of Li metal anodes. Herein, we describe a graphene- and carbon nanotube (CNT)-based Li host material that features vertically aligned channels with attached ZnO particles (designated as ZnO@G-CNT-C) and show that the material effectively regulates Li plating and stripping. The ZnO@G-CNT-C is prepared from an aqueous suspension of Zn(OAc)2, CNTs, and graphene oxide using ice to template channel growth. ZnO@G-CNT-C was found to be mechanically robust and capable of guiding Li deposition on the inner walls of the channels without the formation of Li dendrites. When used as an electrode, the material exhibits relatively low polarization for Li plating, fast Li-ion diffusion, and high Coulombic efficiency, even over hundreds of Li plating/stripping cycles. Moreover, full cells prepared using ZnO@G-CNT-C as Li host and LiFePO4 as cathode exhibit outstanding performance in terms of specific capacity (155.9 mA h g-1 at 0.5 C), rate performance (91.8 mA h g-1 at 4 C), cycling stability (109.4 mA h g-1 at 0.5 C after 800 cycles). The methodology described can be readily adapted to enable the use of carbon-based electrodes with well-defined channels in a wide range of contemporary applications that pertain to energy storage and delivery.

10.
Orthop Surg ; 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34523790

RESUMO

OBJECTIVE: The study introduced uniportal-bichannel spinal endoscopic system (UBiSES) and explored the feasibility of applying UBiSES to conduct lumbar foraminoplasty in percutaneous endoscopic transforaminal discectomy (PETD). METHODS: This is a cohort study. 36 patients confirmed as L5/S1 lumbar disc herniation (LDH) in our hospital from March, 2019 to November, 2019 were enrolled. 36 patients were divided into two groups named the UBiSES group (n = 18, male: female = 8:10) and the TESSYS group (n = 18, male: female = 10:8). The average age of the UBiSES group and the TESSYS group were 40.94 ± 12.39 years old and 39.78 ± 13.02 years old respectively. PETD via uniportal-bichannel foraminoplasty assisted by UBiSES was adopted on the UBiSES group while PETD via conventional foraminoplasty was performed on the TESSYS group. One experienced surgeon with more than 4000 cases of lumbar surgery performed PETD on all patients. The demographic data, the duration of working cannula placement (minutes), decompression time (minutes), radiation exposure time (seconds), complications, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) scores and modified MacNab criteria were recorded and analyzed. The magnetic resonance imaging (MRI) and computed tomography (CT) were conducted to evaluate the radiographic improvement. RESULTS: PETD via lumbar foraminoplasty was successfully performed in all cases. The follow-up points were 3 months, 6 months, and 12 months. The average follow-up period of all patients was 15.78 ± 2.29 months. There was no statistic difference in age (P = 0.81), sex (P = 0.51) and follow-up (P = 0.14) between two groups. The duration of working cannula placement was 19.08 ± 2.30 min in the UBiSES group and 24.90 ± 4.71 min in the TESSYS group and there was significant difference between two groups (P < 0.05). There was no statistic difference in decompression time between the UBiSES group (44.18 ± 5.70 min) and the TESSYS group (47.46 ± 5.96 min) (P = 1.70). The radiation exposure time was 28.00 ± 4.70 s in the UBiSES group and 40.50 ± 5.73 s in the TESSYS group respectively, and has significant difference between two groups (P < 0.05). Furthermore, there was significant different in the duration of working cannula placement and radiation exposure time in male or female between the UBiSES group and the TESSYS group (P < 0.05). For male or female, no difference observed in decompression time and follow-up period between two groups. Postoperative VAS of low back and leg at every follow-up point (1 day, 3 months, 6 months, 12 months) was improved significantly in both groups compared with their preoperative VAS (P < 0.05). The postoperative ODI (3 months, 6 months, 12 months) has decreased significantly in both the UBiSES group and the TESSYS group compared with their preoperative ODI (P < 0.05). 94.44% patients received an excellent or good recovery in the UBiSES group and 88.89% for the TESSYS group. There was no poor result reported in both groups. The radiographic images showed satisfactory foraminoplasty and sufficient decompression of nerve in both groups. No postoperative complications were observed during follow-ups in the UBiSES group. Two patients in the TESSYS group experienced postoperative dysesthesia and the symptom was disappeared in 5 days and 7 days respectively with dexamethasone and neurotrophic drugs treatment. CONCLUSIONS: The original designed UBiSES could effectively and safely enlarge the foramen with an extensive surgical view and space under full-time and real-time visualization and get satisfactory efficacy.

11.
Artigo em Inglês | MEDLINE | ID: mdl-34524004

RESUMO

Background: We conducted a trial to evaluate the efficacy and safety of apatinib, a tyrosine inhibitor against vascular endothelial growth factor receptor 2, combined with neoadjuvant chemotherapy in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Materials and Methods: One hundred twenty six patients were randomized into two cycles of paclitaxel and cisplatin (TP) (n = 61) or combined with apatinib (Apa+TP) (n = 65), followed by surgery. The primary endpoint was objective response rate (ORR). Secondary endpoints included pathological complete response (pCR), safety, R0 resection rate, and operative complication rates. Results: Compared with TP chemotherapy alone, adding apatinib to neoadjuvant treatment significantly increased ORR (Apa+TP: 80.0% vs. TP: 54.1%, respectively; p = 0.004). Apa+TP achieved higher pCR rate compared with TP alone (15.4% vs. 4.92%, respectively; p = 0.101). Similar incidences of toxic effects were found between those two groups. No grade 3 or 4 adverse events (AEs) were observed. Meanwhile, apatinib-related AEs, including hypertension, proteinuria, and hand-and-foot syndrome, were mild. The R0 resection rate was 100% in both groups. No significant differences in operation time, intraoperative bleeding, and postoperative complications were observed, and no serious complications occurred. Conclusions: Adding apatinib to TP neoadjuvant chemotherapy significantly increased ORR, suggesting an advantage of anti-angiogenesis in ESCC. Clinical Trials.gov ID: ChiCTR-TRC-1800017662.

12.
Water Res ; 204: 117592, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34469809

RESUMO

As(III) species are the predominant form of arsenic found in groundwater. However, nanofiltration (NF) and reverse osmosis (RO) membranes are often unable to effectively reject As(III). In this study, we fabricate highly conducting ultrafiltration (UF) membranes for effective As(III) rejection. These membranes consist of a hydrophilic nickel-carbon nanotubes layer deposited on a UF support, and used as cathodes. Applying cathodic potentials significantly increased As(III) rejection in synthetic/real tap water, a result of locally elevated pH that is brought upon through water electrolysis at the membrane/water interface. The elevated pH conditions convert H3ASO3 to H2AsO3-/HAsO32- that are rejected by the negatively charged membranes. In addition, it was found that Mg(OH)2 that precipitates on the membrane can further trap arsenic. Importantly, almost all As(III) passing through the membranes is oxidized to As(V) by hydrogen peroxide produced on the cathode, which significantly decreased its overall toxicity and mobility. Although the high pH along the membrane surface led to mineral scaling, this scale could be partially removed by backwashing the membrane. To the best of our knowledge, this is the first report of effective As(III) removal using low-pressure membranes, with As(III) rejection higher than that achieved by NF and RO, and high water permeance.

13.
J Am Chem Soc ; 143(36): 14451-14457, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34477365

RESUMO

The first enantioselective copper-catalyzed cyanation of propargylic C-H bonds via radical relay was established using novel BoxOTMS ligands, providing an efficient and straightforward tool for the construction of structurally diverse chiral allenyl nitriles in good yields with excellent enantioselectivities. This reaction features high functional group tolerance and mild conditions. In addition, the chiral allene products can be readily converted to other chiral compounds via axis-to-center chirality transfer.

14.
Eur J Med Chem ; 225: 113815, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34479038

RESUMO

1, 2, 3, 4-Tetrahydro-ß-carboline (THßC) scaffold is widespread in many natural products (NPs) and synthetic compounds which show a variety of pharmacological activities. In this article, we reviewed the design, structures and biological characteristics of reported synthetic THßC compounds, and structure and activity relationship (SAR) of them were also discussed. This work might provide a reference for subsequent drug development based on THßC.

15.
Molecules ; 26(17)2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34500659

RESUMO

In this study, broilers were fed with heavy-metal-containing diets (Zn, Cu, Pb, Cr, As, Hg) at three rates (T1: 5 kg premix/ton feed, T2: 10 kg premix/ton feed and T3: 15 kg premix/ton feed) and Doxycycline (DOX) and Gatifloxacin (GAT) at low or high doses (T4: 31.2 mg DOX/bird/day and 78 mg GAT/bird/day, T5: 15.6 mg DOX/bird/day and 48 mg GAT/bird/day) to assess the accumulation of various heavy metals and the fate of two antibiotics in broiler manure after 35 days of aerobic composting. The results indicated that the two antibiotics changed quite differently during aerobic composting. About 14.96-15.84% of Doxycycline still remained at the end of composting, while Gatifloxacin was almost completely removed within 10 days of composting. The half-lives of Doxycycline were 13.75 and 15.86 days, while the half-lives of Gatifloxacin were only 1.32 and 1.38 days. Based on the Redundancy analysis (RDA), the concentration of antibiotics was significantly influenced by physico-chemical properties (mainly temperature and pH) throughout the composting process. Throughout the composting process, all heavy metal elements remained concentrated in organic fertilizer. In this study the Cr content reached 160.16 mg/kg, 223.98 mg/kg and 248.02 mg/kg with increasing premix feed rates, similar to Zn, which reached 258.2 mg/kg, 312.21 mg/kg and 333.68 mg/kg. Zn and Cr concentrations well exceeded the United States and the European soil requirements. This experiment showed that antibiotic residues and the accumulation of heavy metals may lead to soil contamination and pose a risk to the soil ecosystem.

16.
Nat Biotechnol ; 39(9): 1141-1150, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34504346

RESUMO

Clinical applications of precision oncology require accurate tests that can distinguish true cancer-specific mutations from errors introduced at each step of next-generation sequencing (NGS). To date, no bulk sequencing study has addressed the effects of cross-site reproducibility, nor the biological, technical and computational factors that influence variant identification. Here we report a systematic interrogation of somatic mutations in paired tumor-normal cell lines to identify factors affecting detection reproducibility and accuracy at six different centers. Using whole-genome sequencing (WGS) and whole-exome sequencing (WES), we evaluated the reproducibility of different sample types with varying input amount and tumor purity, and multiple library construction protocols, followed by processing with nine bioinformatics pipelines. We found that read coverage and callers affected both WGS and WES reproducibility, but WES performance was influenced by insert fragment size, genomic copy content and the global imbalance score (GIV; G > T/C > A). Finally, taking into account library preparation protocol, tumor content, read coverage and bioinformatics processes concomitantly, we recommend actionable practices to improve the reproducibility and accuracy of NGS experiments for cancer mutation detection.

17.
Talanta ; 235: 122796, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34517654

RESUMO

Bone metastasis of malignant solid tumors has become one of the most serious complications, especially in breast cancer, which was particularly challenging for early detection and treatment in clinical practice. In this work, we reported a new fluorescently labeled bisphosphonate for bone metastasis detection of breast cancer. The designed probes were based on Rhodamine B and bisphosphonate as recognition group, which can specifically target hydroxyapatite (HA) existed in bone tissue. After the osteoclasts were adsorbed on the bone surface, the surrounding microenvironment was acidified, causing the HA to locally dissolve. The probe bound to the HA was then released, and realized the fluorescence turn on under acidic conditions. In vitro experiments showed that G0 was more excellent than G2 owing to shorter connecting arm. Subsequently, we proved that G0 could combine with HA rapidly and exhibit excellent response in solid state. More importantly, we established a model of bone metastasis with MDA-MB-231 cells which was similar to the clinical cases and evaluated the theranostics value of G0 prospectively, which provide the potential application prospect in clinical.

18.
Artigo em Inglês | MEDLINE | ID: mdl-34519147

RESUMO

Chiral indoline-2-carboxylic acid has been identified to enable the first highly enantioselective Catellani-type annulation of (hetero)aryl, alkenyl triflate and conjugated vinyl iodides with 4-(bromomethyl)cyclohexanone, directly assembling a diverse range of chiral all-carbon bridged ring systems. Control experiments and DFT calculations suggest that the coordinating orientation of the chiral amino acid to the arylpalladium(II) center allows for high levels of stereochemical control.

19.
Obes Surg ; 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34519991

RESUMO

The purpose of this study was to compare bariatric surgery versus non-surgical treatment on blood pressure for patients with obesity. Nineteen RCTs (1353 total patients) were included. In the pooled analyses, bariatric surgery reduces more systolic blood pressure (WMD: - 3.937 mmHg, CI95%: - 6.000 to - 1.875, p < 0.001, I2 = 0%), diastolic blood pressure (WMD: - 2.690 mmHg, CI95%: - 3.994 to - 1.385, P < 0.001, I2 = 0%) and more antihypertensives. In subgroup analyses, patients after Roux-en-Y gastric bypass, with poor control of hypertension (BP > 130/80 mmHg) and diabetes mellitus (HbA1C > 7.0%, FPG > 7.0 mmol/L), elder patients (> 45 years), non-severe obesity (BMI < 40 kg/cm2, body weight < 120 kg), less waist circumference (< 115 cm) tend to decrease more blood pressure. Besides, patients after surgery also lost more weight (p < 0.001), decreased more waist circumference (p < 0.001), fasting plasma glucose (p < 0.001), glycosylated hemoglobin (p < 0.001), triglycerides (p < 0.001), hsCRP (p = 0.001), increased more high-density lipoprotein cholesterol (p < 0.001), and had better remission of metabolic syndrome (p < 0.001). Changes in total cholesterol, low-density lipoprotein cholesterol, renal function, resting heart rate, and 6-min walking test were not significantly different. Therefore, bariatric surgery is more effective than non-surgical treatment in controlling patients' blood pressure.

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