(S)-(+)-4-(Oxiran-2-ylmeth­oxy)-9H-carbazole

In the title compound, C15H13NO2, all atoms of the carbazole group are coplanar (r.m.s. deviation = 0.005 Å), and the dihedral angle between this plane and C—O—C plane of oxane group is 57.1 (4)°. The crystal packing is stabilized by an N—H⋯O hydrogen bond, resulting in infinite supra­molecular chains along [001]

Comparative efficacy of Chinese herbal medicines for dialysis patients with uremic pruritus: A systematic review and network meta-analysis

Introduction: Uremic pruritus is common in dialysis patients and reduces their quality of life. Chinese herbal medicine has been effective in patients with this condition.Methods: We conducted a random-effects network meta-analysis to compare the efficacies of different Chinese herbal medicine treatments for uremic pruritus. Outcome measures including the overall effective rates, visual analog scale scores, C-reactive protein levels, and adverse drug reactions were analyzed.Results: The network meta-analysis retrieved 25 randomized controlled trials. Compared with conventional treatments alone, combination treatments with Xiao-Yang-Ke-Li was the most effective intervention in decreasing visual analog scale scores (mean difference −2.98, 95% mean difference −5.05 to −0.91) and levels of C-reactive protein (mean difference −5.01, 95% mean difference −7.27 to −2.75). Conventional treatment combined with Si-Wu Tang was superior to other therapeutic combinations when overall effective rates were determined. The best visual analog scale scores and overall effective rates were achieved by adjunctive treatment with the Touxie-Jiedu-Zhiyang decoction followed by uremic clearance granules; these treatments were the most beneficial for uremic pruritis.Conclusion: Our network meta-analysis provided the relative efficacies of different adjunctive Chinese herbal formulas. Adjunctive treatment with the Touxie-Jiedu-Zhiyang decoction was the best treatment for improving overall effective rates and reducing visual analog scores of uremic pruritus in dialysis patients.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=357656; Identifier: CRD42022357656

Burkitt's Lymphoma Mimicking a Primary Gynecologic Tumor

SummaryObjectiveBurkitt's lymphoma (BL) occurs mostly in children; bilateral ovarian involvement mimicking a gynecologic malignancy in adults is extremely rare. Here, we report a patient with BL mimicking a gynecologic tumorCase ReportA 50-year-old Taiwanese woman presented with the complaint of persistent lower abdominal distension with dull pain, easy satiety, and progressively increasing abdominal girth for 2 weeks. Amenorrhea was also noted for about 2 months, and her review of systems was negative for the common “B” symptoms associated with lymphoma. At our hospital, imaging studies revealed a huge pelvic mass (10.8 ×8.7 cm), suggesting a large subserous myoma or an ovarian tumor. Under the impression of pelvic mass, she underwent exploratory laparotomy. Primary ovarian sex-cord malignancy with cecum involvement was impressed by the primitive intraoperative frozen section report. Subsequently, an optimal cytoreductive operation with right hemicolectomy was performed. However, final histopathologic report was an extranodal multifocal BL.ConclusionAlthough extranodal BL in ovaries is a rare condition, it should be noted in the differential diagnosis of pelvic gynecologic malignancies

Expanded CURB-65: A new score system predicts severity of community-acquired pneumonia with superior efficiency

Aim of this study was to develop a new simpler and more effective severity score for communityacquired pneumonia (CAP) patients. A total of 1640 consecutive hospitalized CAP patients in Second Affiliated Hospital of Zhejiang University were included. The effectiveness of different pneumonia severity scores to predict mortality was compared, and the performance of the new score was validated on an external cohort of 1164 patients with pneumonia admitted to a teaching hospital in Italy. Using age≥ 65 years, LDH>230u/L, albumin<3.5g/dL, platelet count<100×109/L, confusion, urea>7mmol/L, respiratory rate≥30/min, low blood pressure, we assembled a new severity score named as expanded-CURB-65. The 30-day mortality and length of stay were increased along with increased risk score. The AUCs in the prediction of 30-day mortality in the main cohort were 0.826 (95%CI, 0.807–0.844), 0.801 (95%CI, 0.781–0.820), 0.756 (95%CI, 0.735–0.777), 0.793 (95%CI, 0.773–0.813) and 0.759 (95%CI, 0.737–0.779) for the expanded-CURB-65, PSI, CURB-65, SMART-COP and A-DROP, respectively. The performance of this bedside score was confirmed in CAP patients of the validation cohort although calibration was not successful in patients with health care-associated pneumonia (HCAP). The expanded CURB-65 is objective, simpler and more accurate scoring system for evaluation of CAP severity, and the predictive efficiency was better than other score systems

Effect of Prunella vulgaris L extract on hyperprolactinemia in vitro and in vivo

Purpose: To investigate the anti-hyperprolactinemic activity of Prunella vulgaris L. extract (PVE) in vivo and in vitro.Methods: Rats were given intraperitoneal (i. p.) metoclopramide (MCP, 150 mg/kg daily) for 10 days to prepare hyperprolactinemia (hyperPRL) model. Bromocriptine was used as positive control drug. High (5.6 g/kg), medium (2.8 g/kg) and low (1.4 g/kg) doses of PVE were administered to hyperPRL rats. The effect of PVE on serum prolactin (PRL), estradiol (E2), progesterone (PGN), follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were investigated in the rats. MMQ cells derived from rat pituitary adenoma cells and GH3 cells from rat pituitary lactotropictumoral cells were used for in vitro experiments. The effect of PVE on PRL secretion were studied in MMQ cells and GH3 cells respectively.Results: Compared with the control group (446.21 ± 32.43 pg/mL), high (219.23 ± 10.62 pg/mL) and medium (245.47 ± 13.52 pg/mL) reduced PRL level of hyperPRL rats significantly (p 0.05). In MMQ cells, treatment with 5 mg/mL PVE or 10 mg/mL PVE) significantly suppressed PRL secretion and synthesis at 24h compared with controls (p &lt; 0.01). Consistent with D2- action, PVE did not affect PRL in rat pituitary lactotropic tumor-derived GH3 cells that lack the D2 receptor expression, compared with controls.Conclusion: PVE showed anti-hyperPRL activity and can potentially be used for the treatment of hyperprolactinemi, but further studies are required to ascertain this.Keywords: Prunella vulgaris, Hyperprolactinemia, Prolactin, Bromocriptin

Dimension Increase via Hierarchical Hydrogen Bonding from Simple Pincer-like Mononuclear complexes

A tetradentate symmetric ligand bearing both coordination and hydrogen bonding sites, N1,N3-bis(1-(1H-benzimidazol-2-yl)-ethylidene)propane-1,3-diamine (H2bbepd) was utilized to synthesize a series of transition metal complexes, namely [Co(H2bbepd)(H2O)2]·2ClO4 (1), [Cu(H2bbepd)(OTs-)]·OTs- (2),[Cu(bbepd)(CH3OH)] (3), [Cd(H2bbepd)(NO3)2]·CH3OH (4), [Cd(H2bbepd)(CH3OH)Cl]·Cl (5), and [Cd(bbepd)(CH3OH)2] (6). These complexes show similar discrete pincer-like coordination units, possessing different arrangements of hydrogen bonding donor and acceptor sites. With or without the aid of uncoordinated anions and solvent molecules, such mononuclear units have been effectively involved in the construction of hierarchical hydrogen bonding assemblies (successively via level I and level II), leading to discrete binuclear ring (complex 2), one-dimensional chain or ribbon (complexes 3, 4 and 6) and two-dimensional layer (complexes 1 and 5) aggregates

The Effectiveness and Safety of Total Glucosides of Paeony in Primary Sjögren's Syndrome: A Systematic Review and Meta-Analysis

Objective: To assess the effectiveness and safety of the total glucosides of paeony (TGP) on the treatment of primary Sjögren's syndrome (pSS) by conducting a meta-analysis.Methods: Eight databases were searched from their inception to December 10, 2018 for randomized controlled trials (RCTs). The Revman 5.3 software was used for this meta-analysis.Results: Nine RCTs which included 770 participants were identified. Pooled results showed that significant difference in Schirmer's test (P &lt; 0.00001) comparing TGP with placebo (PBO). However, the pooled results displayed significant differences in salivary flow rate, Schirmer's test, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), serum γ-globulin, immunoglobulin G (IgG), IgA, IgM, and effective rate (P ≤ 0.01) in the co-administration of TGP with immunosuppressant (IS) compared with IS alone. Subgroup analyses revealed both heterogeneities in ESR and serum γ-globulin were eliminated, showing combined intervention of TGP + IS being more advantageous than single usage of IS (P &lt; 0.00001). However, the advantage varied among three subgroups and showed a gradual weakening over time. Furthermore, our results showed statistical significance in Schirmer's test (P = 0.0006), when hydroxychloroquine (HCQ) was jointly applied, but not in the case of combined TGP with methotrexate (MTX) (P = 0.41). For the safety analysis, the most common adverse events (AEs) were diarrhea or gastrointestinal discomfort, and no severe AEs were reported in TGP group. Meanwhile, six trials showed statistically insignificant differences between TGP + IS and IS in AEs (P = 0.76).Conclusions: Improving the lacrimal gland secretion (Schirmer's test) is the prominent function of TGP compared with PBO. TGP + IS can improve the clinical symptoms, such as lacrimal and salivary gland secretion function (Schirmer's test, salivary flow rate), inflammatory indices (ESR, CRP, and RF) and immunoglobulins (γ-globulin, IgG, IgA, and IgM) on the basis of IS monotherapy. In addition, TGP has an acceptable safety profile and AEs were not increased when TGP combined with IS in pSS. Therefore, TGP can be considered to be a potentially valid and safe drug for the treatment of pSS in the clinic. In view of the limitations of the included trials, the potential beneficial effectiveness and safety of TGP need additional high-quality, multi-center, and large-scale RCTs to assess its use in pSS treatment

The promising immune checkpoint LAG-3 in cancer immunotherapy: from basic research to clinical application

LAG-3, a type of immune checkpoint receptor protein belonging to the immunoglobulin superfamily, is confirmed to be expressed on activated immune cells, mainly including activated T cells. LAG-3 can negatively regulate the function of T cells, exerting important effects on maintaining the homeostasis of the immune system under normal physiological conditions and promoting tumor cells immune escape in the tumor microenvironment. Given its important biological roles, LAG-3 has been regarded as a promising target for cancer immunotherapy. To date, many LAG-3 inhibitors have been reported, which can be divided into monoclonal antibody, double antibody, and small molecule drug, some of which have entered the clinical research stage. LAG-3 inhibitors can negatively regulate and suppress T cell proliferation and activation through combination with MHC II ligand. Besides, LAG-3 inhibitors can also affect T cell function via binding to Galectin-3 and LSECtin. In addition, LAG-3 inhibitors can prevent the FGL1-LAG-3 interaction, thereby enhancing the human body’s antitumor immune effect. In this review, we will describe the function of LAG-3 and summarize the latest LAG-3 inhibitors in the clinic for cancer therapy

An Analysis of Impact of Tariff Reduction in the Non-Agriculture Market Access Negotiations in the Wto Doha Round on the Fisheries Sector in Taiwan

Abstract only.Keywords: Fish and Aquaculture Sectors Development, Fisheries Economics, Contributions of Fisheries to Socioeconomic Wellbein