Predictors and dynamic online nomogram for postoperative delayed hyponatremia after endoscopic transsphenoidal surgery for pituitary adenomas:a single-center,retrospective,observational cohort study with external validation

Background Postoperative delayed hyponatremia(PDH)is a major cause of readmission after endoscopic transsphenoidal surgery(eTSS)for pituitary adenomas(PAs).However,the risk factors associated with PDH have not been well established,and the development of a dynamic online nomogram for predicting PDH is yet to be realized.We aimed to investigate the predictive factors for PDH and construct a dynamic online nomogram to aid in its prediction.Methods We analyzed the data of 226 consecutive patients who underwent eTSS for PAs at the Department of Neurosurgery in Jinling Hospital between January 2018 and October 2020.An additional 97 external patients were included for external validation.PDH was defined as a serum sodium level below 137 mmol/L,occurring on the third postoperative day(POD)or later.Results Hyponatremia on POD 1-2(OR=2.64,P=0.033),prothrombin time(PT)(OR=1.78,P=0.008),and percentage of monocytes(OR=1.22,P=0.047)were identified as predictive factors for PDH via multivariable logistic regression analysis.Based on these predictors,a nomogram was constructed with great discrimination in internal validation(adjusted AUC:0.613-0.688)and external validation(AUC:0.594-0.617).Furthermore,the nomogram demonstrated good performance in calibration plot,Brier Score,and decision curve analysis.Subgroup analysis revealed robust predictive performance in patients with various clinical subtypes and mild to moderate PDH.Conclusions Preoperative PT and the percentage of monocytes were,for the first time,identified as predictive factors for PDH.The dynamic nomogram proved to be a valuable tool for predicting PDH after eTSS for PAs and demonstrated good generalizability.Patients could benefit from early identification of PDH and optimized treatment decisions.

Electro-reductive C-H cyanoalkylation of quinoxalin-2(1H)-ones

Herein,we report a practical electro-reductive protocol for the direct C-H cyanoalkylation of quinoxalin-2(1 H)-ones via iminyl radical-mediated ring opening.These mild reactions proceed under metal-,reductant-,and reagent-free conditions to provide synthetically useful cyanoalkylated quinoxalin-2(1 H)-ones.

Decatungstate as a direct hydrogen atom transfer photocatalyst for synthesis of trifluromethylthioesters from aldehydes

We have developed a versatile,mild protocol for trifluoromethylthiolation reactions of aldehydes with catalysis by a decatungstate hydrogen atom transfer photocatalyst under redox-neutral conditions.The protocol is highly selective,operationally simple,and compatible with a wide array of sensitive functional groups.It can be used for late-stage functionalization of bioactive molecules,which makes it convenient for drug discovery.

ROUTE DEVELOPMENT, ANTIVIRAL STUDIES, FIELD EVALUATION AND TOXICITY OF AN ANTIVIRAL PLANT PROTECTANT NK0238

It has previously been shown that tryptophan, the biosynthesis precursor ofPeganum harmala alkaloids, and its derivatives have anti-TMV activity bothin vitro and in vivo. Further exploration of this led to the identification of NK0238as a highly effective agent for the prevention and control of diseases caused byplant viruses, but the existing routes are unsuitable for its large-scale synthesis.This study optimized a route for two-step synthesis of this virucide candidate viareaction of L-tryptophan with triphosgene to produce L-tryptophan-N-carboxylicanhydride, which then reacts with n-octylamine to give NK0238 at up to 94%yield and nearly 97% HPLC purity. In addition, the route was used for thepreparation of NK0238 on a > 40 g scale permitting further assessment of itsantivirus activity in the greenhouse and field experiments, and toxicity tests.NK0238 exhibited useful antiviral activities against a variety of viruses both ingreenhouse and field experiments. The toxicity tests showed that NK0238 wasnot acutely toxic to birds, fish, honey bees and silkworms. The optimized routeprovides a solid foundation for its large-scale synthesis and subsequent efficacyand toxicity studies, its excellent activity and safety make NK0238 a promisingdrug candidate for further development.

Rh(Ⅲ)-catalyzed C8 arylation of quinoline N-oxides with arylboronic acids

Herein,we report the first Rh~Ⅲ-catalyzed regioselective C8 arylation of quinoline N-oxides with commercially available arylboronic acids as coupling partners.This procedure is simple,and the reaction shows perfect regioselectivity,a broad substrate scope,and isolated yields of up to 92%.We demonstrate the utility of the reaction by using it for late-stage functionalization of a fungicide.

SARS-CoV-2 Serological Survey of Cats in China before and after the Pandemic

Dear Editor,SARS-Co V-2 or COVID-19 has become pandemic and spread to more than 200 countries with over 24 million human infected cases(WHO 2020).The origin of SARSCo V-2 remains unknown,though bat,pangolin,and snake were reported to be the potential animal reservoirs(Ji et al).