Monoterpenoid Indole Alkaloids from Inadequately Dried Leaves of Alstonia scholaris

Six new indole alkaloids,named alstoniascholarines L–Q(1–6),together with nineteen known analogues were isolated from the inadequately dried leaves of Alstonia scholaris.Their structures were elucidated on the basis of extensive analysis of spectroscopic data and by comparison of their physical and spectroscopic data with the literature values.In addition,the new alkaloids were tested for their cytotoxic and neurite outgrowth-promoting activities.

Efficacy of 0.5-L vs 1-L polyethylene glycol containing ascorbic acid as additional colon cleansing methods for inadequate bowel preparation as expected by last stool examination before colonoscopy

BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods, which negatively affects the efficacy and quality of colonoscopy. The most ideal and reasonable rescue option involves early suspicion and identification of patients with inadequate preparation before sedation, additional oral ingestion of a suitable preparation formulation, and same-day colonoscopy.AIM To compare 0.5-L and 1-L polyethylene glycol containing ascorbic acid(PEG +Asc) as additional bowel cleansing methods after a 2-L split-dose PEG + Asc regimen in patients with expected inadequate bowel preparation before colonoscopy.METHODS Individuals with expected inadequate bowel preparation based on last stool form, such as turbid liquid, particulate liquid, or liquid with small amounts of feces, were randomized to either a 0.5-L PEG + Asc group or a 1-L PEG + Asc group. The primary endpoint was bowel preparation as assessed using the Aronchick bowel preparation scale(ABPS) and Boston bowel preparation scale(BBPS) scores. The secondary endpoints were cecal intubation time, withdrawal time, polyp detection rate(PDR), adenoma detection rate(ADR), individual compliance with additional PEG + Asc, and patient satisfaction.RESULTS Initially, 98 patients were included, but 8 were later excluded due to withdrawal of consent to participate in the study. Adequate bowel preparation(as assessed by ABPS) was observed in 80.9%(38/47) of subjects in the 0.5-L group and in88.4%(38/43) of subjects in the 1-L group(P = 0.617). Mean total BBPS was 6.7 points in the 0.5-L group and 7.0 points in the 1-L group(P = 0.458). ADRs and PDRs were similar in the two groups, and cecal intubation and withdrawal times were not significantly different. However, mean patient satisfaction score was significantly higher in the 0.5-L group(P = 0.041).CONCLUSION The bowel cleaning efficacy of additional 0.5-L PEG + Asc was not inferior to that of 1-L PEG + Asc. Additional 0.5-L PEG + Asc is worthwhile when inadequate bowel preparation is expected before colonoscopy.

The Discovery of Deep High-Resistivity Block and Inadequately Consolidated Magma Chambers in Gaoligongshan Oblique Collisional Orogen and its Tectonic Implications

Objective The Gaoligongshan oblique collisional orogen is located in the southern section of the Hengduan Mountains, and belongs to one of the main Late Yanshanian-Himalayan oblique collisional orogens in the Sanjiang area. Many researchers have studied the geology, geochemistry and geophysics of this region, and many research achievements have been obtained from deep geophysical exploration of the region, especially using the magnetotelluric （MT） sounding technique. However,

Conquering China＇s Unbalanced and Inadequate Development： Macroeconomic Outlook, Policy Simulations, and Reform Implementation--A Summary of Annual SUFE Macroeconomic Report （2017-2018）

Leaving year 2017 China＇s macroeconomy is continuously characterized by unbalanced and inadequate development. Whereas some aggregate indicators have shown improvement over the year, the cumulative growth rates in consumption and fixed asset investment have continued theirdownward trajectories. Worsening income inequality and resource misallocations, both between secondary and tertiary industries, and within the latter, pose serious challenges, let alone the systemic risk associated with the flourishing shadow banking system, rapid credit growth and debt overhang that weigh on the Chinese economy like the Sword of Damocles. This summary report highlights both the status quo and the consequences of the unbalanced and inadequate development embodied in China＇s persistently distorted economic structure, and the role of deepening reforms of the institutions and governance in resolving the problems. Our analyses based on IAR-CMM model provide a unified framework for addressing China＇s short-, medium-, and long-term issues ir~ an internally coherent manner. Looking into year 2018, our benchmark projection of real GDP growth rate is 6.7% （6.41% using more reliable rather than the official data）. Alternative scenario analyses and policy simulations are conducted to reflect various aspects of the economic challenges in the short to long runs. Through the lens of these analyses we conclude that rule-of-law based and market-oriented structural reforms should continue to hold a center stage in China＇s transition from a phase of high-speed but unbalanced growth, to a stage of balanced and adequate high-quality development.

Predictive factors predicting inadequate ST-segment resolution in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

Objective To survey ST-segment resolution in STEMI patients undergoing emergency percutaneous coronary intervention(PCI)and to find the specific clinical features of patients with inadequate ST-segment resolution.Methods A total of 198 patients were divided into two groups according to the ratio of ST-segment resolution:relatively adequate ST-segment resolution group(】50%)and inadequate ST-segment resolution group(【50%).

Analysis of the Implementation of Integrated Healthcare Management in Preoperative Preparation

Objective:To strengthen preoperative preparation management and reduce preoperative preparation defects.Methods:We set up a special medical care management team to investigate the preoperative preparation in surgical departments,analyze the causes of the shortcomings in preoperative preparation,and propose countermeasures.The medical staff jointly formulated plans related to preoperative preparation management including clear outline of responsibilities,strengthening of training,integrated medical care,timely feedback,and continuous improvement.Besides,the preoperative preparation of patients before and after the improvement measures were compared using statistical analysis.Results:The rate of inadequate preoperative preparation was 11.14 per thousand before the integrated management model was implemented.After the implementation of the integrated management model,the rate of inadequate preoperative preparation decreased to 2.99 per thousand,and the difference was statistically(P<0.05).Conclusion:The integrated management of preoperative preparation can help reduce the rate of preoperative complications and ensure the safety of surgery.

DNTF的核磁表征及理论研究

为了完善3,4-双(4'-硝基呋咱-3'-基)氧化呋咱(DNTF)的核磁表征,采用NMR实验与GIAO-NMR理论计算相结合的方法区分并归属13C和15N的化学位移。采用二甲基亚砜(DMSO-d6)、丙酮(Acetone-d6)和氯仿(CDCl3)为溶剂,进行了DNTF的一维13CNMR和15NNMR实验,并在DMSO-d6中获得DNTF的所有核磁信号。采用二维INADEQUATE实验完成了13CNMR的归属。采用高斯09程序,在DFT-B3LYP/6-311+G(2d,p)水平上优化了DNTF结构,用GIAO方法在不同基组上计算了13CNMR和15NNMR的化学位移,计算结果与实验值一致性较好。结果表明,受氧化呋咱环上氧原子O(22)吸电子作用的影响,C(9)与C(13)的化学位移出现较大的差别,与C(13)相比,C(9)出现在高场。

Type 2 diabetes mellitus and Alzheimer's disease

Epidemiological and biological evidences support a link between type 2 diabetes mellitus(DM2) and Alzheimer's disease(AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Futuretrials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes.

Combination could be another tool for bowel preparation?

Optimal bowel preparation increases the cecal intubation rate and detection of neoplastic lesions while decreasing the procedural time and procedural-related complications. Although high-volume polyethylene glycol(PEG) solution is the most frequently used preparation for bowel cleansing, patients are often unwilling to take PEG solution due to its large volume, poor palatability, and high incidence of adverse events, such as abdominal bloating and nausea. Other purgatives include osmotic agents(e.g., sodium phosphate, magnesium citrate, and sodium sulfate), stimulant agents(e.g., senna, bisacodyl, and sodium picosulfate), and prokinetic agents(e.g., cisapride, mosapride, and itopride). A combination of PEG with an osmotic, stimulant, or prokinetic agent could effectively reduce the PEG solution volume and increase patients' adherence. Some such solutions have been found in several published studies to not be inferior to PEG alone in terms of bowel cleansing quality. Although combination methods showed similar efficacy and safety, the value of these studies is limited by shortcomings in study design. New effective and well-tolerated combination preparations are required, in addition to rigorous new validated studies.

AURICULOACUPUNCTURE THERAPY—A TRADITIONAL CHINESE METHOD OF TREATMENT

Auriculoacupuncture is a branch ofacupuncture that makes use of acupoints onthe auricles in the treatment of diseases.Stimulation on the auriculoacupoints is be-lieved to have the effects of dredging thechannels and collateral to facilitate flow ofqi and invigorate blood circulation while itregulates endocrines and functions of thenervous system to combat morbid condi-

Food Sources and Intake of Calcium in a Representative Sample of Spanish Adults

The present study aimed to assess calcium intake, dietary sources of this nutrient and its adequacy with respect to the dietary reference intake (DRI) in a representative sample of Spanish adults. In this study 418 adults (18 to 60 years) from 15 Spanish provinces were studied. Energy and nutrient intake was determined using a 24-hour recall questionnaire for two days. Adequacy of calcium intake was assessed using the established DRI for calcium. Anthropometric data (weight and height) were measured and the body mass index was calculated. Seventy eight percent of the participants in the study did not meet the DRI for calcium. Additionally, 33.7% of the participants did not meet the 67% of the DRI. The daily intake of calcium was 916.6 ± 288.1 mg/day, which represented the 81.3% of the DRI of calcium. Interestingly, subjects who had higher intake of calcium were taller. Additionally, it has been observed that individuals with normal body weight (BMI 2) had higher intakes of dairy products in comparison with overweight and obese individuals (BMI ≥ 25 kg/m2). The main food sources of calcium were dairy products (58.7% of calcium), cereals (13.6%) and vegetables (6.5%). Less than 1% (0.5%) of the calcium intake came from dietary supplements. It was observed that individuals who met the DRI for calcium had a significantly higher intake of dairy products (551.3 ± 240.4 g/day) than individuals who did not meet the DRI of calcium (305.0 ± 150.3 g/day). Calcium intake was inadequate in this sample of the adult Spanish population. Therefore, an increase in the consumption of dairy products, as well as cereals, vegetables and food items fortified with calcium seems to be necessary to achieve an adequate intake of calcium and to prevent diseases caused by calcium deficiency.

Quantitative Assessment of the Risk Linked to the Consumption of Braised Beef Meat “<i>Choukouya</i>” Contaminated with Pathogenic <i>Clostridium perfringens</i>in Côte D’Ivoire

Inadequate handling, processing and sales of meat products have resulted in microbial contamination responsible for most infectious human food-borne illness. The study conducted a stochastic assessment of the risk of infection linked to the consumption of braised beef meat “Choukouya” contaminated by Clostridium perfringens in C?te d’Ivoire. We conducted “Choukouya” consumers (n = 900) and vendors (n = 300) survey to characterize the actors behavior. 189 samples of “Choukouya” were collected and microbiologically analyzed according to French standard protocols NF V 08-061 and XPV 08-061. A risk model was developed and the risk of infection linked to the consumption of “Choukouya” was estimated by Monte Carlo simulation procedure. The consumer’s surveys showed that the percentage of population consuming “Choukouya” was 74.4%, with an average consumption of 114.3 ± 0.5 g/person/intake. The microbiological analysis revealed the isolation of 70% of Clostridium perfringens in the vegetative form and 60.3% in sporulated form with an average loading of 3.7 ± 2.6 log10·cfu/g and 1.1 ± 1.0 log10·cfu/g respectively. The probability of ingesting a dose greater than 109 bacteria of Clostridium prefringens varied between 7.36% and 7.93%. The braised beef meat “Choukouya” sold in the streets of cities in C?te d’Ivoire represents a real risk of infection, and Clostridium perfringens is one of the causes. This risk could be mitigated by the establishment of good hygiene practices and adequate handling processes in this informal sector.

Professional Staffing Practice of Academic Anesthesia Departments in the United States

Background: Academic anesthesia departments are under increasing financial pressure. Many struggle to integrate the priorities of their academic and clinical missions. Previous studies have documented increasing need for monetary institutional support of academic anesthesia departments. In view of current economic and legislative circumstances, it is arguable that the need for support will grow. This survey demonstrates that staffing issues, which are most likely engendered by financial circumstances, have impacted academic anesthesia departments in the United States to the point of having deleterious effects upon clinical safety and resident education.Methods: After IRB approval, we electronically solicited the anonymous response to a 23 question survey from all 133 chairpersons of academic anesthesia departments in the United States. Results: Sixty-two responded electronically, for an overall response rate of 46.6%. Conclusion: The results of this survey suggest that academic anesthesia departments are being financially stressed to the point that education and patient care are affected.

Development Imbalances in China:An Integrated Analysis with the Tsinghua China Balanced Development Index

The principal contradiction facing the Chinese society has evolved to be that between imbalanced and inadequate development and the people’s ever-growing needs for a better life.Given China’s vision for achieving moderate prosperity,it is relevant to conduct theoretical and empirical studies on the nation’s development imbalances.As a quantitative index,the Tsinghua China Balanced Development Index measures the extent to which development is uneven and insuf ficient across regions,re flecting the progress and shortfalls in China’s efforts to promote balanced development.Our findings provide implications for how policymakers may help people’s expectations for a better life materialize by spurring balanced economic,social,environmental and livelihood development across regions.

Monitoring Passive Transfer of Immunity in Neonatal Calves by Measuring Levels of IgG in Blood Using Immunoassay Method and Refractometer Measures of Serum and Colostrum

IgG Check calf test has been used in this study to identify if a failure of passive transfer occurs in neonatal calves by measuring the level of IgG in blood. An adequate level of IgG measured in all calves at 48 hours, 7 days and 14 days after birth showed level of IgG 1000 mg/dl. This level indicated that they have good passive transfer of immunity. Also, in this study colostrum quality fed to calves was detected using Brix Refractometer. The colostrum is of high quality as it contains 50 mg/ml of IgG. This Brix refractometer can be used on the farm level to estimate colostrum IgG content and monitoring colostrum feeding practices. Colostrum with high quality IgG could provide calves with enough IgG to attain successful passive transfer of immunity. Brix and Obione refractometers provide simple, rapid method for estimating IgG concentration on calf serum, thus considered to be the most common method for determining passive transfer failure.

Changes in Alveolar Bone Width Following Bone Expansion

The placement of implants in edentulous areas is often compromised because of atrophic alveolar ridges. Several techniques have been suggested in the literature to increase inadequte bone width which includes bone grafting, distraction osteogenesis and bone expansion. Bone expansion technique is one of the most widely used methods which can also be utilized to increase the width of alveolar ridge and to provide sufficient bone volume for implant placement. The purpose of this study, is to measure the increase of the width of alveolar ridge after bone expansion following implant placement. Between 2013-2016, 30 consecutive, healthy, non-smoking, adult patients with atrophy of the maxilla and mandibula had 149 implants inserted. There were 18 women and 12 men, mean age 51.34 years (range 34 - 67). The initial width of the alveolar ridge measured from 2.5 to 3 mm (mean 2.83 ± 0.2) with Cone beam computed tomography (CBCT). The mean increase of bone width was achieved 1.25 mm (between 0.64 mm and 1.73 mm). Before prosthetic rehabilitation, width of expanded alveolar bone was calculated from 3.50 to 4.75 mm with CBCT. During follow-up, 140 implants survived and 9 implants failed. The rate of implant survival was 93.95% after average 5 years follow-up. In conclusion, we suggest that, bone expansion is useful for managing the unsufficient ridges for implant placement.

Sexuality of Repartnered Men and Women in France: Sexual Behaviors, Perceptions, Expectations and Sexual Dysfunctions

Introduction. Although many epidemiological studies on sexuality have been published, none have specifically addressed male and female sexuality in repartnered couples. Aim. To investigate men and women’s sexual behaviors, perceptions and expectations, and the frequency of their sexual dysfunctions, with a focus on repartnered couples, i.e, subjects living with a partner in a stable relationship after divorce or widowhood (including both remarried couples and cohabitating unmarried couples). Methods. Analysis of telephone survey data collected from 1,002 French subjects (483 men, 519 women) ≥35years. Of these, 748 were living with their partner as part of a heterosexual couple. For these subjects, the sexuality of 149 repartnered subjects was compared to that of the other 599 subjects. Main Outcome Measures. A 39-item questionnaire assessing subjects' perceptions, expectations, sexual behaviors and dysfunctions. Results. Compared with other subjects, men and women in repartnered couples had more active sexuality and more interest in sexuality (men 93% vs 80%, P < 0.01, women 73% vs 65%, P < 0.05). They were generally more sensitive to feelings and emotions linked to their sexuality, and these feelings seemed to increase steadily with age. Their sexuality was more attuned to their partner’s pleasure (men 79% vs. 59% P < 0.001, women 50% vs. 34% P < 0.01). Concern for the future of the relationship and for sexuality was equally present for both groups, although repartnered couples were more often concerned about potential inadequacy and conflicts between the two partners. Although repartnered men seemed to be less affected by diminished desire, they had slightly higher rates of premature ejaculation and erectile dysfunction, and considered their quality of life to be more affected by these problems. Conclusion. The sexuality of repartnered couples remains poorly studied, but seems to differ from that of non-repartnered couples. Our findings open interesting avenues of research on the diagnosis and management of repartnered couples.

How does the New Generation of Information Technology Support the Urban Transparent Geology?

1 BACKGROUND China has opened a new era in which the society begins to face new principal contradiction between unbalancedinadequate development and the people’ s ever-growing needs for a better life. To achieve this better life, the livability and safety of cities are two most important issues.

WINTER TEMPERATURE CHANGES DURING THE LAST 500 YEARS IN SOUTH CHINA

The characteristics of the winter temperature changes in eight regions south of the Qinling Mountains and the Huai River in China during the last 500 years, based on the winter temperature indices or severe winter sequences, have been discussed in this paper.

Comparative study on efficacy and safety between premixed insulin aspart 30 regimens of twice daily versus injection,triple-daily regimen in treatment of serious type 2 diabetes

Objective To compare the efficacy and safety between twice- and triple-daily subcutaneous injection of premixed insulin aspart 30 ( BIAsp30) in serious T2DM patients with failure of oral anti-diabetic drugs(OADs) . Methods Fifty-six patients with inadequate control of hyper-glycemia by OADs were randomized into two