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1.
Bone Res ; 11(1): 1, 2023 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-36588108

RESUMO

Subclassification of tumors based on molecular features may facilitate therapeutic choice and increase the response rate of cancer patients. However, the highly complex cell origin involved in osteosarcoma (OS) limits the utility of traditional bulk RNA sequencing for OS subclassification. Single-cell RNA sequencing (scRNA-seq) holds great promise for identifying cell heterogeneity. However, this technique has rarely been used in the study of tumor subclassification. By analyzing scRNA-seq data for six conventional OS and nine cancellous bone (CB) samples, we identified 29 clusters in OS and CB samples and discovered three differentiation trajectories from the cancer stem cell (CSC)-like subset, which allowed us to classify OS samples into three groups. The classification model was further examined using the TARGET dataset. Each subgroup of OS had different prognoses and possible drug sensitivities, and OS cells in the three differentiation branches showed distinct interactions with other clusters in the OS microenvironment. In addition, we verified the classification model through IHC staining in 138 OS samples, revealing a worse prognosis for Group B patients. Furthermore, we describe the novel transcriptional program of CSCs and highlight the activation of EZH2 in CSCs of OS. These findings provide a novel subclassification method based on scRNA-seq and shed new light on the molecular features of CSCs in OS and may serve as valuable references for precision treatment for and therapeutic development in OS.

2.
Eur J Endocrinol ; 188(1)2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36651157

RESUMO

OBJECTIVES: The saline suppression test (SST) serves to confirm the diagnosis of primary aldosteronism (PA), while adrenal vein sampling (AVS) is used to subtype PA as unilateral or bilateral. Criteria that can accurately identify those with bilateral PA based on SST results could reduce the need for AVS. We previously demonstrated that a combination of plasma aldosterone concentration (PAC) < 300 pmol L-1 and a reduction in aldosterone-to-renin ratio (ARR) following recumbent SST had high specificity for predicting bilateral PA in an Australian cohort of 92 patients with PA who have undergone AVS. We sought to validate our predictive criteria in larger, independent cohorts of patients with PA. DESIGN: An international, multi-centre cohort study. METHODS: Data from 55 patients at Monash Health, Victoria, Australia, 106 patients from the First Affiliated Hospital of Chongqing Medical University, China, and 105 patients from Nihon University Itabashi Hospital, Japan were analysed. RESULTS: A combination of PAC <300 pmol L-1 and a reduction in ARR following recumbent SST predicted bilateral PA with specificities of 88.2%, 97.0%, and 100.0% in Australian, Chinese, and Japanese cohorts, respectively. This criterion could allow 22%-38% of patients with PA to bypass AVS and proceed directly to medical treatment. CONCLUSION: In patients undergoing the recumbent SST, a post-saline PAC <300 pmol L-1 together with a reduction in ARR can predict bilateral PA with high specificity and may allow targeted treatment to be commenced without AVS in up to a third of patients.


Assuntos
Aldosterona , Hiperaldosteronismo , Humanos , Estudos de Coortes , Austrália , Solução Salina , Estudos Retrospectivos , Glândulas Suprarrenais/irrigação sanguínea
3.
Phys Rev Lett ; 130(2): 023201, 2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36706400

RESUMO

Random motion of spins is usually detrimental in magnetic resonance experiments. The spin diffusion in nonuniform magnetic fields causes broadening of the resonance and limits the sensitivity and the spectral resolution in applications like magnetic resonance spectroscopy. Here, by observation of the parity-time (PT) phase transition of diffusive spins in gradient magnetic fields, we show that the spatial degrees of freedom of atoms could become a resource, rather than harmful, for high-precision measurement of weak signals. In the normal phase with zero or low gradient fields, the diffusion results in dissipation of spin precession. However, by increasing the field gradient, the spin system undergoes a PT transition, and enters the PT symmetry broken phase. In this novel phase, the spin precession frequency splits due to spatial localization of the eigenmodes. We demonstrate that, using these spatial-motion-induced split frequencies, the spin system can serve as a stable magnetometer, whose output is insensitive to the inevitable long-term drift of control parameters. This opens a door to detect extremely weak signals in imperfectly controlled environments.

4.
J Am Chem Soc ; 144(48): 22281-22288, 2022 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-36475403

RESUMO

The selective introduction of perfluoro-tert-butyl group (PFtB, the bulkier analogue of CF3 group) into arenes has long been sought after but remains a formidable task. We herein report the first general synthetic protocol to realize aromatic perfluoro-tert-butylation. The key to the success is the identification of PFtB phenyl sulfone as a new source of PFtB anion, which reacts with arynes in a highly regioselective manner to afford perfluoro-tert-butylated arenes in high yields. The application of the method is demonstrated by the preparation of sensitive 19F-labeled NMR probes with an extraordinary resolving ability.

5.
Angew Chem Int Ed Engl ; : e202217088, 2022 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-36517973

RESUMO

We have developed a new strategy for controllable single and double difluoromethylene (CF2 ) formal insertions into C-H bonds of aldehydes with nearly full selectivity under transition-metal-free conditions. The key to the success of controllable CF2 insertions lies in the well-defined formation of 2,2-difluoroenolsilyl ether and 2,2,3,3-tetrafluorocyclopropanolsilyl ether intermediates using difluorocarbene reagent TMSCF2 Br (TMS=trimethylsilyl). These two intermediates can react with various electrophiles including proton sources and various halogenation reagents, allowing for the access to diverse arrays of ketones containing difluoromethylene (CF2 ) and tetrafluoroethylene (CF2 CF2 ) units. The first synthesis of relatively stable 2,2,3,3-tetrafluorocyclopropanolsilyl ethers has been achieved, which offers a new platform to explore other unknown chemical space.

6.
Angew Chem Int Ed Engl ; : e202213646, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36315428

RESUMO

The transition-metal-catalyzed carbonylation reaction is a useful approach for ketone synthesis. However, it is often problematic to use exogenous carbonyl reagents, such as gaseous carbon monoxide. In this manuscript, we report a novel palladium-catalyzed coupling reaction of gem-difluoroalkenes and aryl boronic acids that yields bioactive indane-type ketones with an all-carbon α-quaternary center. Characterization and stoichiometric reactions of the key intermediates RCF2 PdII support a water-induced defluorination and cross-coupling cascade mechanism. The vinyl difluoromethylene motif serves as an in situ carbonyl precursor which is unprecedented in transition-metal-catalyzed coupling reactions. It is expected to raise broad research interest from the perspectives of ketone synthesis, fluoroalkene functionalization, and rational design of new synthetic protocols based on the unique reactivity of difluoroalkyl palladium(II) species.

7.
Front Endocrinol (Lausanne) ; 13: 995028, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36246918

RESUMO

Backgrounds: Ectopic fat deposition is closely related to chronic kidney disease (CKD). Currently, there are few population studies that have been conducted to determine the relationship between renal parenchyma fat deposition and the risk of CKD among patients with type 2 diabetes mellitus (T2DM). Therefore, we employed magnetic resonance imaging (MRI) to detect renal parenchyma fat content in individuals with T2DM, expressed as renal fat fraction (FF), to explore whether renal FF is an important risk factor for CKD in patients with T2DM. Methods: In this cross-sectional study, 189 subjects with T2DM were enrolled. CKD was defined as the estimated glomerular filtration rate (eGFR)<60 mL/min/1.73m2. Measurement of the renal FF was performed on a 3.0-T MRI (MAGNETOM Skyra, Siemens, Erlangen, Germany). Binary logistic regression was used to determine the association between tertiles of renal FF and risk of CKD. Receiver-operator characteristic (ROC) curves were constructed to evaluate the sensitivity and specificity of renal FF in detecting CKD in T2DM patients. Results: The patients were divided into three groups according to tertiles of the renal FF level (2.498 - 7.434). As renal FF increases, patients tend to be older, and more abdominally obese, with a decreased eGFR (p<0.05). After adjustment for potential confounders, patients in the highest tertile of renal FF had a significantly increased risk of CKD than those in the lowest tertile (odds ratio (OR) = 3.98, 95% confidence interval (CI) = 1.12 - 14.09, p = 0.032), and the area under the ROC curve for this model was 0.836 (0.765-0.907). Conclusions: The renal FF is significantly independently associated with CKD in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Insuficiência Renal Crônica , Estudos Transversais , Diabetes Mellitus Tipo 2/patologia , Taxa de Filtração Glomerular , Humanos , Rim/diagnóstico por imagem , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico
8.
Oxid Med Cell Longev ; 2022: 8441676, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36254233

RESUMO

Background: Ferroptosis has gained significant attention from oncologists as a vital outcome of oxidative stress. The aim of this study was to develop a prognostic signature that was based on the ferroptosis-related genes (FRGs) for osteosarcoma patients and explore their specific role in osteosarcoma. Methods: The training cohort dataset was extracted from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database. Different techniques like the univariate Cox regression, least absolute shrinkage and selection operator (LASSO) regression, multivariate Cox regression analyses, and the Kaplan-Meier (KM) survival analyses were utilized to develop a prognostic signature. Then, the intrinsic relationship between the developed gene signature and the infiltration levels of the immune cells was further investigated. An external validation dataset from the Gene Expression Omnibus (GEO) database was employed to assess the predictive ability of the developed gene signature. Subsequently, the specific function of potential FRG in affecting the oxidative stress reaction and ferroptosis of osteosarcoma cells was identified. Results: A prognostic signature based on 5 FRGs (CBS, MUC1, ATG7, SOCS1, and PEBP1) was developed, and the patients were classified into the low- and high-risk groups (categories). High-risk patients displayed poor overall survival outcomes. The risk level was seen to be an independent risk factor for determining the prognosis of osteosarcoma patients (p < 0.001, hazard ratio: 7.457, 95% CI: 3.302-16.837). Additionally, the risk level was associated with immune function, which might affect the survival status of osteosarcoma patients. Moreover, the findings of the study indicated that the expression of ATG7 was related to the regulation of oxidative stress in osteosarcoma. Silencing the ATG7 gene promoted the proliferation and migration in osteosarcoma cells, suppressing the oxidative stress and ferroptosis process. Conclusions: A novel FRG signature was developed in this study to predict the prognosis of osteosarcoma patients. The results indicated that ATG7 might regulate the process of oxidative stress and ferroptosis in osteosarcoma cells and could be used as a potential target to develop therapeutic strategies for treating osteosarcoma.


Assuntos
Proteína 7 Relacionada à Autofagia , Neoplasias Ósseas , Ferroptose , Osteossarcoma , Humanos , Proteína 7 Relacionada à Autofagia/genética , Neoplasias Ósseas/genética , Perfilação da Expressão Gênica , Estimativa de Kaplan-Meier , Osteossarcoma/genética , Estresse Oxidativo/genética
9.
Molecules ; 27(20)2022 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-36296584

RESUMO

Graphite anodes are well established for commercial use in lithium-ion battery systems. However, the limited capacity of graphite limits the further development of lithium-ion batteries. Hard carbon obtained from biomass is a highly promising anode material, with the advantage of enriched microcrystalline structure characteristics for better lithium storage. Tannin, a secondary product of metabolism during plant growth, has a rich source on earth. But the mechanism of hard carbon obtained from its derivation in lithium-ion batteries has been little studied. This paper successfully applied the hard carbon obtained from tannin as anode and illustrated the relationship between its structure and lithium storage performance. Meanwhile, to further enhance the performance, graphene oxide is skillfully compounded. The contact with the electrolyte and the charge transfer capability are effectively enhanced, then the capacity of PVP-HC is 255.5 mAh g-1 after 200 cycles at a current density of 400 mA g-1, with a capacity retention rate of 91.25%. The present work lays the foundation and opens up ideas for the application of biomass-derived hard carbon in lithium anodes.


Assuntos
Grafite , Lítio , Lítio/química , Grafite/química , Carbono/química , Taninos , Eletrodos , Íons/química , Eletrólitos
10.
Molecules ; 27(20)2022 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-36296670

RESUMO

A reagent-controlled highly stereoselective reaction between (S)-difluoromethyl phenyl sulfoximine 1 and imines is reported, and this synthetic method provides a variety of enantiomerically enriched α-difluoromethyl amines. The main pros of this approach include high efficiency, high stereoselectivity, and a broad substrate scope, which is probably achieved through a non-chelating transition state.


Assuntos
Aminas , Iminas , Indicadores e Reagentes , Estereoisomerismo
11.
Metabolism ; 136: 155307, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36058288

RESUMO

BACKGROUND: The association between fat mass and mortality has been equivocally shown to be linear, J-shaped, and U-shaped. We aimed to clarify this relationship based on Mendelian randomization (MR) analysis and lifestyle modification. METHODS: This prospective analysis included 449,831 participants from UK Biobank. Linear MR analysis was used to estimate the linear relationship between fat mass and mortality. We assessed whole body fat mass by bioimpedance analysis at baseline and categorized subjects into five equal groups based on fat mass index (FMI). The association between FMI and mortality were investigated among whole population and in subgroups stratified by individual lifestyle factors, including diet, physical activity, smoking, alcohol, sleep and psychological health. FINDINGS: Linear MR analyses indicated a positive association between genetically predicted fat mass and all-cause mortality (HR 1.10, 95 % CI 1.08-1.12, P < 0.001). The association between FMI and all-cause mortality was manifested as J-shaped (HRs across FMI categories: 1.04, 1.00, 1.07, 1.21, 1.54), which was significantly modified by the number of low-risk lifestyle factors (P for interaction<0.001). When evaluating individual lifestyle factors, we observed a nonlinear relationship between FMI and all-cause mortality among participants who had high-risk lifestyle factors, while a linear relationship was observed among participants who had low-risk lifestyle factors, especially for those with adequate physical activity (HRs across FMI categories: 0.95, 1.00, 1.05, 1.17, 1.44) and who never smoked (0.96, 1.00, 1.03, 1.14, 1.51). INTERPRETATION: Genetically determined fat mass is causally and linearly associated with mortality. The J-shape association between anthropometric FMI and mortality is caused by high-risk lifestyle factors.


Assuntos
Estilo de Vida , Análise da Randomização Mendeliana , Antropometria , Índice de Massa Corporal , Dieta , Humanos
13.
Diabetes ; 71(12): 2739-2750, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36095260

RESUMO

Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease. Neutrophil extracellular traps (NETs) are a network structure composed of loose chromatin and embedded with multiple proteins. Here, we observed increased NETs deposition in the glomeruli of DKD patients and diabetic mice (streptozotocin-induced or db/db mice). After NETs were degraded with DNase I, diabetic mice exhibited attenuated glomerulopathy and glomerular endothelial cells (GECs) injury. We also observed alleviated glomerulopathy and GECs injury in peptidylarginine deiminase 4-knockout mice with streptozotocin-induced diabetes. In vitro, NETs-induced GECs pyroptosis was characterized by pore formation in the cell membrane, dysregulation of multiple genes involved in cell membrane function, and increased expression of pyroptosis-related proteins. Strengthening the GECs surface charge by oleylamine significantly inhibited NETs-induced GECs pyroptosis. These findings suggest that the GECs charge-related pyroptosis is involved in DKD progression, which is promoted by NETs.


Assuntos
Diabetes Mellitus Experimental , Nefropatias Diabéticas , Armadilhas Extracelulares , Camundongos , Animais , Armadilhas Extracelulares/metabolismo , Nefropatias Diabéticas/metabolismo , Células Endoteliais/metabolismo , Diabetes Mellitus Experimental/metabolismo , Estreptozocina , Piroptose , Neutrófilos/metabolismo , Camundongos Knockout , Camundongos Endogâmicos C57BL
14.
Ann Intern Med ; 175(10): 1383-1391, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36095315

RESUMO

BACKGROUND: With the widespread use of advanced imaging technology, adrenal tumors are increasingly being identified. OBJECTIVE: To investigate the prevalence and characteristics of adrenal tumors in an unselected screening population in China. DESIGN: Cross-sectional study. (ClinicalTrials.gov: NCT04682938). SETTING: A health examination center in China. PATIENTS: Adults having an annual checkup were invited to be screened for adrenal tumors by adrenal computed tomography. MEASUREMENTS: The participants with adrenal tumors had further evaluation for malignancy risk and adrenal function. RESULTS: A total of 25 356 participants were screened, 351 of whom were found to have adrenal tumors, for a prevalence of 1.4%. The prevalence increased with age, from 0.2% in participants aged 18 to 25 years to 3.2% in those older than 65 years. Among 351 participants with adrenal tumors, 337 were diagnosed with an adrenocortical adenoma, 14 with another benign nodule, and none with a malignant mass. In 212 participants with an adenoma who completed endocrine testing, 69.3% were diagnosed with a nonfunctioning adenoma, 18.9% with cortisol autonomy, 11.8% with primary aldosteronism, and none with pheochromocytoma. Proportions of nonfunctioning adenomas were similarly high in various age groups (72.2%, 67.8%, and 72.2% in those aged <46, 46 to 65, and ≥66 years, respectively). LIMITATION: Only 212 of 337 participants with an adrenocortical adenoma had endocrine testing. CONCLUSION: The prevalence of adrenal tumors in the general adult screening population is 1.4%, and most of these tumors are nonfunctioning regardless of patient age. Cortisol and aldosterone secretion are the main causes of functional adenomas. PRIMARY FUNDING SOURCE: National Key Research and Development Program of China and National Natural Science Foundation of China.


Assuntos
Adenoma , Neoplasias das Glândulas Suprarrenais , Adenoma Adrenocortical , Adenoma/diagnóstico , Adolescente , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/epidemiologia , Adulto , Aldosterona , Estudos Transversais , Humanos , Hidrocortisona , Prevalência , Pesquisa , Adulto Jovem
15.
Carbohydr Polym ; 296: 119900, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36087968

RESUMO

The biodegradable hydrogels with a 3D network structure have potential applications in bone tissue engineering. Here, inspired by natural bone, the novel organic-inorganic composites (GelMPC-x) with high compressive strength are designed via adding magnesium oxide/calcium dihydrogen phosphate (MPC) powders into the oxidized dextran/gelatin (OD/Gel) hydrogel. GelMPC-x composites can trigger the gelation of OD/Gel hydrogel through an acid-alkaline reaction between magnesium oxide and calcium dihydrogen phosphate, thus forming an organic-inorganic double network. The cross-linked network between oxidized dextran and gelatin, and the multiple weak interactions between OD/Gel hydrogel and MPC enable the composites to have remarkable compressive strength (77-652 kPa) at the strain of 44 %. More importantly, the composites with appropriate MPC content possess superior injectability, high porosity, and excellent cytocompatibility. This work provides guidelines for the preparation of oxidized dextran-based composite hydrogels with enhanced mechanical performance.


Assuntos
Gelatina , Hidrogéis , Cálcio , Dextranos , Gelatina/química , Hidrogéis/química , Óxido de Magnésio
16.
Front Nutr ; 9: 918576, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938107

RESUMO

Background: Individual lifestyle varies in the real world, and the comparative efficacy of lifestyles to preserve renal function remains indeterminate. We aimed to systematically compare the effects of lifestyles on chronic kidney disease (CKD) incidence, and establish a lifestyle scoring system for CKD risk identification. Methods: Using the data of the UK Biobank cohort, we included 470,778 participants who were free of CKD at the baseline. We harnessed the light gradient boosting machine algorithm to rank the importance of 37 lifestyle factors (such as dietary patterns, physical activity (PA), sleep, psychological health, smoking, and alcohol) on the risk of CKD. The lifestyle score was calculated by a combination of machine learning and the Cox proportional-hazards model. A CKD event was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2, mortality and hospitalization due to chronic renal failure, and self-reported chronic renal failure, initiated renal replacement therapy. Results: During a median of the 11-year follow-up, 13,555 participants developed the CKD event. Bread, walking time, moderate activity, and vigorous activity ranked as the top four risk factors of CKD. A healthy lifestyle mainly consisted of whole grain bread, walking, moderate physical activity, oat cereal, and muesli, which have scored 12, 12, 10, 7, and 7, respectively. An unhealthy lifestyle mainly included white bread, tea >4 cups/day, biscuit cereal, low drink temperature, and processed meat, which have scored -12, -9, -7, -4, and -3, respectively. In restricted cubic spline regression analysis, a higher lifestyle score was associated with a lower risk of CKD event (p for linear relation < 0.001). Compared to participants with the lifestyle score < 0, participants scoring 0-20, 20-40, 40-60, and >60 exhibited 25, 42, 55, and 70% lower risk of CKD event, respectively. The C-statistic of the age-adjusted lifestyle score for predicting CKD events was 0.710 (0.703-0.718). Conclusion: A lifestyle scoring system for CKD prevention was established. Based on the system, individuals could flexibly choose healthy lifestyles and avoid unhealthy lifestyles to prevent CKD.

17.
Org Lett ; 24(32): 5982-5987, 2022 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-35939038

RESUMO

ß-Fluorinated amine is highly desirable for biological and pharmaceutical science, because replacing a C-H bond with a C-F bond can change the physical and chemical properties of the parent molecule to a large extent but not significantly alter its overall geometry. Herein, the highly stereoselective nucleophilic monofluoromethylation of imines have been developed. It is proposed that the chelated transition state enables the chiral induction by the dynamic kinetic resolution of the chiral α-fluoro carbanions.


Assuntos
Aminas , Iminas , Aminas/química , Ânions/química , Iminas/química , Cinética , Estereoisomerismo
18.
Chem Commun (Camb) ; 58(72): 10024-10027, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-35983787

RESUMO

Trifluoromethyl phenyl sulfone is traditionally a nucleophilic trifluoromethylating agent. Herein, we report the first example of the use of trifluoromethyl phenyl sulfone as a trifluoromethyl radical precursor. Arylthiolate anions can form electron donor-acceptor (EDA) complexes with trifluoromethyl phenyl sulfone, which can undergo an intramolecular single electron transfer (SET) reaction under visible light irradiation, thus realizing the S-trifluoromethylation of thiophenols under photoredox catalyst-free conditions. Similar S-perfluoroethylation and S-perfluoro-iso-propylation of thiophenols are also achieved using the corresponding perfluoroalkyl phenyl sulfones.

19.
J Am Chem Soc ; 144(27): 12202-12211, 2022 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-35786906

RESUMO

The selective difluoromethylene insertion into a C-Cu bond is a challenging task and is currently limited to either a single CF2 insertion into CuCF3 or double CF2 insertions into CuC6F5 (or (Z)-CF3CF = CFCu). Achieving both selective single and double CF2 insertions into the same C-Cu bond is even more difficult. Herein, highly controllable single and double CF2 insertions into CuCF2H species with a TMSCF2Br reagent have been described, affording two previously unknown fluoroalkylcopper species "Cu(CF2)nCF2H" (n = 1 and 2) independently under different reaction conditions. This work represents the first example of both single and double CF2 insertions into the same C-Cu bond in a highly selective manner. The synthetic value of the obtained "Cu(CF2)nCF2H" (n = 1 and 2) species is demonstrated by their reactions with aryl iodides, halogenation agents, and cinnamyl chloride, which enables the direct transfer of HCF2CF2 and HCF2CF2CF2 moieties into organic molecules. The key to controllable fluorocarbon chain elongation from C1 to C2 and from C1 to C3 is presumably attributed to the different reactivities of "Cu(CF2)nCF2H" species (n = 0, 1, 2 and 3) and the loading of the TMSCF2Br reagent.


Assuntos
Cobre , Iodetos , Cobre/química , Halogênios/química , Hidrocarbonetos Fluorados , Iodetos/química
20.
J Hypertens ; 40(9): 1692-1701, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35881462

RESUMO

CONTEXT: Current guidelines recommend adrenal venous sampling (AVS) to identify unilateral primary aldosteronism (UPA) before offering adrenalectomy. However, AVS is costly and technically challenging, limiting its use to expert centres. OBJECTIVE: To establish a model to predict UPA, and therefore, bypass the need for AVS prior to surgery. DESIGN AND SETTING: The model was developed in a Chinese cohort and validated in an Australian cohort. Previously published prediction models of UPA were also tested. PARTICIPANTS: primary aldosteronism patients with a definite subtyping diagnosis based on AVS and/or surgery. MAIN OUTCOME MEASURE: Diagnostic value of the model. RESULTS: In the development cohort (268 UPA and 88 bilateral primary aldosteronism), combinations of different levels of low serum potassium (≤3.0 or 3.5 mmol/l), high PAC (≥15-30 ng/dl), low PRC (≤2.5-10 µIU/ml) and presence of unilateral nodule on adrenal CT (>8-15 mm in diameter) showed specificity of 1.00 and sensitivity of 0.16-0.52. The model of serum potassium 3.5 mmol/l or less, PAC at least 20 ng/dl, PRC 5 µIU/ml or less plus a unilateral nodule at least 10 mm had the highest sensitivity of 0.52 (0.45-0.58) and specificity of 1.00 (0.96-1.00). In the validation cohort (84 UPA and 117 bilateral primary aldosteronism), the sensitivity and specificity of the model were 0.13 (0.07-0.22) and 1.00 (0.97-1.00), respectively. Ten previous models were tested, and only one had a specificity of 1.00 in our cohorts but with a very low sensitivity [0.07 (0.04-0.10) and 0.01 (0.00-0.06) in our development and validation cohorts, respectively]. CONCLUSION: A combination of high PAC, low PRC, low serum potassium and unilateral adrenal nodule could accurately determine primary aldosteronism subtype in 13-52% of patients with UPA and obviate the need for AVS before surgery.


Assuntos
Hiperaldosteronismo , Glândulas Suprarrenais , Adrenalectomia , Aldosterona , Austrália , Humanos , Potássio , Estudos Retrospectivos
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