Diabetes onset at an earlier age and high HbA1c levels as risk factors of diabetic retinopathy

AIM:To assess the effect of age at diabetes onset and uncontrollable high Hb A1 c levels on the development of diabetic retinopathy(DR)among Chinese type 2 diabetes mellitus(DM)patients.METHODS:This was a cross-sectional survey of diabetic patients in Subei district,China.Data covering physical measurements,fasting blood-glucose(FBG),glycosylated hemoglobin(Hb A1 c),blood lipid,urinary albumin/creatinine ratio(UACR),ocular fundus examination,and diabetes treatment records were collected.An independent sample t-test were used to analyze differences.A Logistic regression analysis was applied to study the independent risk factors of DR.RESULTS:A total of 1282 patients with type 2 DM were enrolled,and 191 cases had DR(14.9%).The age at diabetes onset,education level,alcohol consumption,Hb A1 c level,UACR level,and hypoglycemic drugs were independent influencing factors for DR.The older the onset of diabetes,the less likely to develop DR(OR:0.958,95%CI:0.942-0.975,P=0.000).Patients were then divided in terms of age at diabetes onset as follows:<50 y,50-59 y,60-69 y,and≥70 y.Compared with diabetes onset age<50 y,50-59 y(OR:0.463,95%CI:0.306-0.699,P=0.000),60-69 y(OR:0.329,95%CI:0.203-0.535,P=0.000)and≥70 y(OR:0.232,95%CI:0.094-0.577,P=0.002)were at a lower risk of DR.The prevalence of DR was highest in patients with diabetes onset age<50 y(29.5%,P<0.05).The Hb A1 c level(8.67±1.97)%and proportion of insulin injection(52.5%)in patients with diabetes onset<40 y were higher than in patients with older diabetes onset age(P<0.05).CONCLUSION:Diabetes onset at an earlier age and uncontrollable high Hb A1 c level could be independent risk factors for DR.

康柏西普联合25G玻璃体手术及小梁切除术治疗继发于PDR伴VH的NVG

目的:比较不同围手术时期给予玻璃体腔内注射康柏西普联合25G微创玻璃体手术(PPV)及小梁切除术治疗继发于增生型糖尿病视网膜病变(PDR)伴玻璃体积血(VH)的新生血管性青光眼(NVG)的手术效果及并发症。方法:前瞻性随机对照临床试验。纳入2016-11/2019-04在我院确诊的PDR伴VH的Ⅲ期NVG患者28例30眼。所有患者均接受25G PPV联合小梁切除术。将其随机分为两组:第1组12例14眼患者于术前3d玻璃体腔内注射康柏西普,第2组16例16眼于25G玻璃体手术及小梁切除术毕玻璃体腔内注射康柏西普(IVC)0.5mg/0.05mL。比较两组患者手术时间、术中出血及术后并发症的发生率。观察术后疼痛缓解、虹膜新生血管(INV)消退和最佳矫正视力(BCVA)以及眼压(IOP)控制率情况。结果:第1、2组均完成手术并分别随访12.40±2.21mo和12.23±2.11mo(P>0.05)。第1组术中出血和术后早期前房出血发生率(29%、14%)低于第2组(75%、56%,均P<0.05)。两组患者手术时间、浅前房、脉络膜脱离、玻璃体再出血的发生率无差异(P>0.05)。术后3d所有患者疼痛缓解。第1组IVC后3d(即手术日)93%的INV完全消退,第2组PPV术后7d 94%INV完全消退。末次随访两组患者各有1眼残余少许萎缩的INV。术后1wk,1、3、6mo IOP控制率,第1组依次为93%、79%、64%、57%,第2组依次为94%、75%、50%、44%,两组患者各时间段比较无差异(P>0.05)。两组术后不同时间点IOP与术前相比均明显降低(P<0.05)。末次随访时第1、2组IOP分别为20.45±10.55和22.63±7.24mmHg,与术前42.21±9.11和44.88±11.83mmHg相比明显降低(P<0.05)。两组术后不同随访时间点BCVA与术前相比无差异(P>0.05)。结论:术前IVC预处理与术毕IVC联合25G PPV及小梁切除术治疗继发于PDR伴VH的NVG相比,术中出血和术后早期前房出血的发生率较低。两种方法IOP控制率相当,虽然随着时间逐渐减低,但是经过及时处理最终可以获得较好的疗效。

Ypsiyunnosides A-E,Five New Cholestanol Glycosides from Ypsilandra yunnanensis

Phytochemicalinvestigation onthe whole plants of Ypsilandra yunnanensiswas carried out forthe firsttime andledtothe isolation of five new cholestanol glycosides,ypsiyunnosides A–E(1–5),and one known analogue.Their structures were determined mainly by detailed spectroscopic analysis,including extensive 1D and 2D NMR,MS and UV,as well as chemical methods.Among them,compound 1 possessed a rare 6/6/6/5/5 fused-rings cholestanol sketelon,which was identified as(23R,25R)-3β,16α,26-triol-16,23-cyclocholest-5,17(20)-dien-22-one.Their induced platelet aggregation activities and cytotoxicities were evaluated.Graphical Abstract Five new cholestanol glycosides,ypsiyunnosides A–E(1–5),were isolated from the whole plants of Ypsilandra yunnanensis.Compound 1 possessed a rare 6/6/6/5/5 fused-rings cholestanol sketelon.Their structures were elucidated by a combination of 1D and 2D NMR,MS and chemical analysis.

Steroidal and pregnane glycosides from Ypsilandra thibetica

The whole plants of Ypsilandra thibetica have been analyzed as part of a systematic study on saponin constituents of medicinal plants.This has resulted in the isolation of two new bisdesmosidic furostanol saponins,named ypsilandroside P(1)and ypsilandroside Q(2),and one new pregnane glycoside,named ypsilandroside R(3),together with nine known steroidal glycosides.Their structures were elucidated on the basis of extensive spectroscopic analysis,including that of 2D NMR data,and the results of acidic hydrolysis.Ypsilandroside P(1)was cytotoxicity against two human tumor cell lines.

Two New Highly Oxygenated Spirostanol Saponins from Paris polyphylla var.stenophylla

Phytochemical investigation of the rhizomes of Paris polyphylla var.stenophylla led to the isolation of two new highly oxygenated spirostanol saponins,named paristenosides A(1)and B(2),together with seven known compounds.Their structures were established mainly on the base of NMR spectroscopic techniques and mass spectrometry,as well as chemical methods.In addition,the cytotoxicity of the two new saponins was tested.Graphical Abstract Two new highly oxygenated spirostanol saponins,paristenosides A(1)and B(2),were isolated from the rhizomes of Paris polyphylla var.stenophylla.Their structures were established mainly based on NMR spectroscopic techniques and mass spectrometry,as well as chemical methods.

Two New Steroidal Saponins from Ypsilandra thibetica

Two new monosaccharide steroidal saponins,named ypsilandroside S(1)and ypsilandroside T(2),have been isolated from the whole plants of Ypsilandra thibetica.Their structures were elucidated as heloniogenin 3-O-b-D-apiofuranoside(1)and pregna 5,16-dien-3b,12a-diol-20-one-3-O-b-D-apiofuranoside(2)by spectroscopic techniques(1D and 2D NMR,MS).Compounds 1 and 2 were tested for their inhibitory effects on lipopolysaccharide-induced nitric oxide production in RAW 264.7 cells.

Perioperative massive cerebral stroke in thoracic patients:Report of three cases

BACKGROUNDPerioperative stroke is a rare but devastating complication. The risk factors formassive cerebral stroke in surgical patients include older age, male sex, priorcerebrovascular disease, hypertension, renal failure, smoking, diabetes mellitus,and atrial fibrillation.CASE SUMMARYWe describe two cases of perioperative massive cerebral stroke following thoracicsurgery and one case following bronchoscopy. Neurologic symptoms, includingchanges in mental status and hemiplegia, occurred within 10 h after surgery in thethree patients. All three patients died after the surgery.CONCLUSIONPerioperative massive cerebral stroke may be more likely to occur in thoracicsurgical patients if there are pre-existing factors including previous stroke,hypotension, and hypoxemia. Sufficient pain control after surgery and timelyneurology consultation and management are helpful for the diagnosis and controlof stroke in high-risk patients.

Untiring Researches for Alternative Resources of Rhizoma Paridis

Rhizoma Paridis(RP,M®),a traditional Chinese medicine,is the rhizoma of Paris polyphylla var.yunnanensis(PPY)or P.polyphylla var.chinensis which are widely used as important raw materials for several Chinese patent drugs.However,the wild resources of these herbs have become less and less due to their slow-growing characteristics and previously excessive excavation.This review covers untiring investigations on alternative resources of RP by our research group over the past decades,including non-medicinal parts of PPY as well as other plants of Liliaceae and Liliflorae families.The arial parts of PPY and the whole plants of Trillium kamtschaticum might be alternative resources for RP based on the fact that they shared the same or similar saponins and bioactivities.

Structurally Diverse Polymethylated Phloroglucinol Meroterpenoids from Baeckea frutescens

Phytochemical investigation of the MeOH extract of twigs and leaves of Baeckea frutescens led to the isolation of seven new polymethylated phloroglucinol meroterpenoids(PPMs),named baeckfrutones M-S(1-7).Their structures and absolute configurations were determined by spectroscopic analyses,chiral-phase HPLC analysis,and electronic circular dichroism(ECD)calculations.PPM 1 is a novel meroterpenoid possessing a 6/6/5/3 tetracyclic skeleton in PPMs,whereas 3 and 4 are the first hydroxytasmanone type phloroglucinol-monoterpene hybrids.(+)-2 and 7 displayed potent antiinflammatory activity with IC50 values of 20.86±0.60 and 36.21±1.18 lL,respectively.

胸部肿瘤螺旋断层放疗系统setup功能位置矫正与误差来源分析

目的探讨螺旋断层放疗(helical tomotherapy,HT)系统setup功能矫正位置误差的作用并分析误差的来源。方法分析36例胸部肿瘤患者兆伏级计算机断层扫描图像信息,收集首次放疗常规复位和第二次放疗setup功能复位扫描的图像,并分别记录与千伏级计算机断层扫描图像配准的位置误差。比较2次复位误差间差异,构建重复测量混合线性回归模型分析可能的误差来源。结果除左右方向平移误差外,setup功能复位后误差均值总体上均小于首次复位,尤其在前后方向上,setup功能复位后误差显著小于首次复位(0.17±1.14 vs.5.04±2.43,P<0.001)。多因素分析发现,体质量指数(BMI)对胸部肿瘤前后方向平移误差和Roll旋转误差存在影响,回归系数β分别为0.191(P=0.001)和0.034(P=0.040)。此外,前后方向平移误差还受到分次剂量和治疗次数的影响。未发现性别、年龄和疾病类型对位置误差有明确影响。结论setup功能能够矫正位置误差,尤其前后方向平移误差。BMI、分次剂量和治疗次数影响胸部肿瘤放疗前后方向位置精准性。

Terpenoids from Chloranthus elatior

Two new eudesmane-type sesquiterpenoid lactones,named chlorelactone A(1)and chlorelactone B(2),and one new labdane-type diterpenoid,named elatiorlabdane(3),along with seven known sesquiterpenoids and one known disesquiterpenoid were isolated from the whole plants of Chloranthus elatior.Their structures and relative configurations were established on the basis of extensive spectroscopic analysis.

Ypsilandrosides U-Y,five new steroidal saponins from Ypsilandra thibetica

Phytochemical reinvestigation on the whole plants of Ypsilandra thibetica obtained four new spirostanol glycosides,named ypsilandrosides U-X(1-4),and one new cholestanol glycoside,named ypsilandroside Y(5).Their structures have been established by extensive spectroscopic data and chemical methods.Among them,compound 4 is a rare spirostanol glycoside which possesses a novel 5(6→7)abeo-steroidal aglycone,while compound 1 is a first spiro-stanol bisdesmoside attached to C-3 and C-12,respectively,isolated from the genus Ypsilandra.The induced platelet aggregation activity of the isolates was tested.

Cytotoxic Acylphloroglucinol Derivatives from Callistemon salignus

Callisalignenes G–I(1–3),three new meroterpenoids of b-triketone and monoterpene,along with two known analogues(4 and 5),were isolated from Callistemon salignus.Their structures and absolute configurations were unambiguously established by a combination of NMR and MS analysis and electronic circular dichroism(ECD)evidence.Callisalignenes H(2)and I(3)have a rare sec-butyl moiety at C-7.Meroterpenoids 1–3 exhibited cytotoxicity against HCT116 cells with IC50 values of 8.51±1.8,9.12±0.3,and 16.33±3.3 lM,respectively.

Correction to:Structurally Diverse Polymethylated Phloroglucinol Meroterpenoids from Baeckea frutescens

Correction to:Natural Products and Bioprospecting(2018)8:431–439 https://doi.org/10.1007/s13659-018-0189-3 In the original publication,two errors have occurred.The corrected texts are provided below:1.The author,Xu-Jie Qi,should read as Xu-Jie Qin among the author group.2.The reference 9 should be cited as X.J.Qin,Y.E.Zhi,H.Yan,Y.Zhang,H.Liu,Q.Yu,S.Wang,Q.Zhao,L.He,X.Ma,L.K.An,H.Y.Liu,Tetrahedron 74,6658–6666(2018).

A sample of metal-poor galaxies identified from the LAMOST spectral survey

We present a sample of 48 metal-poor galaxies at z 〈 0.14 selected from 92 510 galaxies in the LAMOST survey. These galaxies are identified by their detection of the auroral emission line[OⅢ]λ4363 above the 3σ level, which allows a direct measurement of electron temperature and oxygen abundance. The emission line fluxes are corrected for internal dust extinction using the Balmer decrement method. With electron temperature derived from [OⅢ]λλ4959, 5007/[OⅢ]λ4363 and electron density from [SⅡ]λ6731/[SⅡ]λ6717, we obtain the oxygen abundances in our sample which range from 12 ＋ log（O/H） = 7.63（0.09 Z_⊙） to 8.46（0.6 Z_⊙）. We find an extremely metal-poor galaxy with 12 ＋ log（O/H） = 7.63 ± 0.01. With multiband photometric data from FUV to NIR and Hαmeasurements, we also determine the stellar masses and star formation rates, based on the spectral energy distribution fitting and Hα luminosity, respectively. We find that our galaxies have low and intermediate stellar masses with 6.39 ≤ log（M/M_⊙） ≤ 9.27, and high star formation rates（SFRs） with-2.18 ≤ log（SFR/M_⊙yr^（-1）） ≤ 1.95. We also find that the metallicities of our galaxies are consistent with the local T_e-based mass-metallicity relation, while the scatter is about 0.28 dex. Additionally,assuming the coefficient of α = 0.66, we find most of our galaxies follow the local mass-metallicity-SFR relation, but a scatter of about 0.24 dex exists, suggesting the mass-metallicity relation is weakly dependent on SFR for those metal-poor galaxies.

Risk assessment of malignancy in solitary pulmonary nodules in lung computed tomography:a multivariable predictive model study

Background:Computed tomography images are easy to misjudge because of their complexity,especially images of solitary pulmonary nodules,of which diagnosis as benign or malignant is extremely important in lung cancer treatment.Therefore,there is an urgent need for a more effective strategy in lung cancer diagnosis.In our study,we aimed to externally validate and revise the Mayo model,and a new model was established.Methods:A total of 1450 patients from three centers with solitary pulmonary nodules who underwent surgery were included in the study and were divided into training,internal validation,and external validation sets(n=849,365,and 236,respectively).External verification and recalibration of the Mayo model and establishment of new logistic regression model were performed on the training set.Overall performance of each model was evaluated using area under receiver operating characteristic curve(AUC).Finally,the model validation was completed on the validation data set.Results:The AUC of the Mayo model on the training set was 0.653(95%confidence interval[CI]:0.613–0.694).After re-estimation of the coefficients of all covariates included in the original Mayo model,the revised Mayo model achieved an AUC of 0.671(95%CI:0.635–0.706).We then developed a new model that achieved a higher AUC of 0.891(95%CI:0.865–0.917).It had an AUC of 0.888(95%CI:0.842–0.934)on the internal validation set,which was significantly higher than that of the revised Mayo model(AUC:0.577,95%CI:0.509–0.646)and the Mayo model(AUC:0.609,95%CI,0.544–0.675)(P<0.001).The AUC of the new model was 0.876(95%CI:0.831–0.920)on the external verification set,which was higher than the corresponding value of the Mayo model(AUC:0.705,95%CI:0.639–0.772)and revised Mayo model(AUC:0.706,95%CI:0.640–0.772)(P<0.001).Then the prediction model was presented as a nomogram,which is easier to generalize.Conclusions:After external verification and recalibration of the Mayo model,the results show that they are not suitable for the prediction of malignant pulmonary nodules in the Chinese population.Therefore,a new model was established by a backward stepwise process.The new model was constructed to rapidly discriminate benign from malignant pulmonary nodules,which could achieve accurate diagnosis of potential patients with lung cancer.

High-mobility patternable MoS_(2) percolating nanofilms

Fabrication of large-area and uniform semiconducting thin films of two-dimensional(2D)materials is paramount for the full exploitation of their atomic thicknesses and smooth surfaces in integrated circuits.In addition to elaborate vapor-based synthesis techniques for the wafer-scale growth of 2D films,solution-based approaches for high-quality thin films from the liquid dispersions of 2D flakes,despite underdeveloped,are alternative cost-effective tactics.Here,we present layer-by-layer(LbL)assembly as an effective approach to obtaining scalable semiconducting films of molybdenum disulfide(MoS_(2))for field-effect transistors(FETs).LbL assembly is achieved by coordinating electrochemically exfoliated MoS_(2) with cationic poly(diallyldimethylammonium chloride)(PDDA)through electrostatic interactions.The PDDA/MoS_(2) percolating nanofilms show controlled and self-limited growth on a variety of substrates,and are easily patterned through lift-off processes.Ion gel gated FETs are fabricated on these MoS_(2) nanofilms,and they show mobilities of 9.8 cm^(2)·V^(−1)·s^(−1),on/off ratios of 2.1×10^(5) with operating voltages less than 2 V.The annealing temperature in the fabrication process can be as low as 200℃,thereby permitting the fabrication of flexible FETs on polyethylene terephthalate substrates.The LbL assembly technique holds great promise for the large-scale fabrication of flexible electronics based on solution-processed 2D semiconductors.

Appended corrole manganese complexes:Catalysis and axial-ligand effect

A series of N-base appended corroles and their manganese complexes were synthesized and their binding constants with three different nitrogenous ligands, triethylamine, N-methylimidazole and pyridine, were evaluated by spectroscopy. Kinetic studies indicated that the presence of appended N- donor ligands may cause a significant enhancement of the rate of oxygen atom transfers （OAT） from （oxo）manganese（V） corrole to alkene, and the stronger axial ligand binding has impact on the rate of the oxidation reaction. Turnover frequency （TOF） for the catalytic oxidation of alkenes by appended manganese corroles varies with the following ligand order： acetamido 〈 pyridyl 〈 imidazolyl. The influence of the external axial ligands on the catalytic epoxidation was investigated by using appended acetamido manganese corrole as catalyst, with the results revealing that N-methylimidazole gave the best enhancement on the yields of total oxidation products among the investigated nitrogenous ligands.

Solvent effects on oxygen atom transfer reaction between manganese(V)-oxo corrole and alkene

Pseudo-first order reaction rate constants of 5,10,15-tris（pentafluorophenyl）corrole Mn（V）-oxo （F_（15）CMn（V）-oxo）,5,15-bis（pentafluorophenyl）-10-（phenyl）corrole Mn（V）-oxo（F_（10）CMn（V）-oxo）,5,15- bis（phenyl）-10-（pentafluorophenyl）corrole Mn（V）-oxo（F_5CMn（V）-oxo） and 5,10,15-tris（phenyl）corrole Mn（V）-oxo（F_0CMn（V）-oxo） with a series of alkene substrates in different solvents were determined by UV-vis spectroscopy.The results indicated that the oxygen atom transfer pathway between Mn（V）-oxo corrole and alkene is solvent-dependent.

β-Octafluorinated tetrakis(ethoxycarbonyl)porphyrin

Tetrakis（alkoxycarbonyl）porphyrin and its β-octafluoro-substituted derivatives were synthesized via Lindsey method and transformed to their zinc complexes. Single crystal X-ray structures of corresponding Zn（II） porphyrins revealed that β-octafluorination will give more compactness of porphyrin moieties in the crystal structure owing to the hydrogen bonding interactions involving β- fluorine atoms. An unusual six-coordinated Zn（II） was found via intramolecular coordination of oxygen atom of meso-substituents with central Zn（II）.