Natural product elansolid A belongs to one type of polyketide macrolactone with promising antibiotic activity.Pre-viously,the first total synthesis of elansolid A in 28 longest linear sequence(LLS)and 41 steps in tota...Natural product elansolid A belongs to one type of polyketide macrolactone with promising antibiotic activity.Pre-viously,the first total synthesis of elansolid A in 28 longest linear sequence(LLS)and 41 steps in total has been achieved.Herein,the simplified analog of elansolid A,featured with a cyclohexyl-fused 19-memebered macrolactone,was proposed,and its asymmetric total synthesis based on a convergent strategy and key reactions exemplified by desymmetric alcoholysis of anhydride,Pd-catalyzed Stille coupling,Suzuki-Miyaura coupling as well as Mukaiyama macrolactonization was finished.展开更多
OBJECTIVE：To study the clinical curative effect,safety and mechanism of action of electroacupuncture combined with Zhizhukuanzhong capsules（ZZKZC） in treating gastroesophageal reflux disease（GERD）.METHODS：A tota...OBJECTIVE：To study the clinical curative effect,safety and mechanism of action of electroacupuncture combined with Zhizhukuanzhong capsules（ZZKZC） in treating gastroesophageal reflux disease（GERD）.METHODS：A total of 480 patients with confirmed GERD were randomly divided into four groups：the electroacupuncture group,the ZZKZC group,the combined therapy group,and the control group,with 120 cases in each group.Each case in the electroacupuncture group was treated with electroacupuncture on Zusanli（ST36）,Zhongwan（CV12）,Neiguan（PC6）,Taichong（LR3）and Gongsun（SP 4）once daily for 6 weeks.Each case in the ZZKZC group was treated with oral administration of 1.29 g ZZKZC three times daily.The combined therapy group had electroacupuncture and ZZKZC.The control group was given oral administration of 5 mg mosapride three times and 20 mg pantoprazole twice daily.The 24-hour intraesophageal total number of reflux episodes with pH 0.05）;however,these indices all significantly deteriorated in the ZZKZC and control groups（P〉0.05）.The short and long-term total efficacy rates in the combined therapy group showed significant superiority to those in the other groups（P〈0.05 or P〈0.01）.No serious adverse reactions were found in the four groups.CONCLUSION：Electroacupuncture and ZZKZC play an important role in inhibiting intraesophageal acid and bile reflux,decreasing the endoscopic grading score,and alleviating the symptoms of gastroesophageal reflux to improve the quality of life.However,the effect of combined treatment is more effective,with better security and long-term efficacy,and therefore,this combination treatment is appropriate for clinicaluse.展开更多
基金Project supported by the High-Level Talent Program of Yunnan Province(No.Y93D321261)the Regional Development Program for Young Scholars,Chinese Academy of Sciences(CAS)(No.E323521311)the Science and Technology Department of Yunan Province(Nos.202305AH34005,202401AS070096)。
文摘Natural product elansolid A belongs to one type of polyketide macrolactone with promising antibiotic activity.Pre-viously,the first total synthesis of elansolid A in 28 longest linear sequence(LLS)and 41 steps in total has been achieved.Herein,the simplified analog of elansolid A,featured with a cyclohexyl-fused 19-memebered macrolactone,was proposed,and its asymmetric total synthesis based on a convergent strategy and key reactions exemplified by desymmetric alcoholysis of anhydride,Pd-catalyzed Stille coupling,Suzuki-Miyaura coupling as well as Mukaiyama macrolactonization was finished.
文摘OBJECTIVE：To study the clinical curative effect,safety and mechanism of action of electroacupuncture combined with Zhizhukuanzhong capsules（ZZKZC） in treating gastroesophageal reflux disease（GERD）.METHODS：A total of 480 patients with confirmed GERD were randomly divided into four groups：the electroacupuncture group,the ZZKZC group,the combined therapy group,and the control group,with 120 cases in each group.Each case in the electroacupuncture group was treated with electroacupuncture on Zusanli（ST36）,Zhongwan（CV12）,Neiguan（PC6）,Taichong（LR3）and Gongsun（SP 4）once daily for 6 weeks.Each case in the ZZKZC group was treated with oral administration of 1.29 g ZZKZC three times daily.The combined therapy group had electroacupuncture and ZZKZC.The control group was given oral administration of 5 mg mosapride three times and 20 mg pantoprazole twice daily.The 24-hour intraesophageal total number of reflux episodes with pH 0.05）;however,these indices all significantly deteriorated in the ZZKZC and control groups（P〉0.05）.The short and long-term total efficacy rates in the combined therapy group showed significant superiority to those in the other groups（P〈0.05 or P〈0.01）.No serious adverse reactions were found in the four groups.CONCLUSION：Electroacupuncture and ZZKZC play an important role in inhibiting intraesophageal acid and bile reflux,decreasing the endoscopic grading score,and alleviating the symptoms of gastroesophageal reflux to improve the quality of life.However,the effect of combined treatment is more effective,with better security and long-term efficacy,and therefore,this combination treatment is appropriate for clinicaluse.
