P(NMe₂)₃‑Mediated Reductive (1 + 4) Annulation Reaction of Isatins with Nitroalkenes: An Access to Spirooxindolyl Isoxazoline <i>N</i>‑Oxides and Their Corresponding Isoxazolines

The reductive (1 + 4) annulation reaction of isatins and substituted nitroalkenes mediated by a trivalent phosphorus reagent has been realized for the first time, providing easy access to spirooxindolyl isoxazoline <i>N</i>-oxides in moderate to excellent yields with a flexible substrate scope. This reaction presumably proceeds through a Michael addition–intramolecular substitution sequence via active in situ generated Kukhtin–Ramirez zwitterions from isatins and P­(NMe₂)₃. It is also demonstrated that the spirooxindolyl isoxazoline <i>N</i>-oxides can be readily converted into the corresponding isoxazolines in good yields

P(NMe₂)₃‑Mediated Reductive (1 + 4) Annulation Reaction of Isatins with Nitroalkenes: An Access to Spirooxindolyl Isoxazoline <i>N</i>‑Oxides and Their Corresponding Isoxazolines

The reductive (1 + 4) annulation reaction of isatins and substituted nitroalkenes mediated by a trivalent phosphorus reagent has been realized for the first time, providing easy access to spirooxindolyl isoxazoline <i>N</i>-oxides in moderate to excellent yields with a flexible substrate scope. This reaction presumably proceeds through a Michael addition–intramolecular substitution sequence via active in situ generated Kukhtin–Ramirez zwitterions from isatins and P­(NMe₂)₃. It is also demonstrated that the spirooxindolyl isoxazoline <i>N</i>-oxides can be readily converted into the corresponding isoxazolines in good yields

Diastereoselective Synthesis of Functionalized Spirocyclopropyl Oxindoles via P(NMe₂)₃‑Mediated Reductive Cyclopropanation

A P­(NMe₂)₃-mediated reductive cyclopropanation reaction of α-keto esters or amides with isatin-derived alkenes has been developed, providing efficient and diastereoselective synthesis of highly functionalized spirocyclopropyl oxindoles bearing two all-carbon quaternary centers. This reaction also represents a complementary and nonmetal-involving protocol for the challenging cyclopropanation of electron-deficient alkenes

Longer time spent in bed attempting to sleep is associated with rapid renal function decline: the Dongfeng–Tongji cohort study

<p><b>Introduction:</b> Prospective evidence on the relation between time in bed and renal dysfunction remains limited. We aimed to investigate the association of time spent in bed attempting to sleep (TSBS) with renal function decline in a middle-aged and elderly Chinese population.</p> <p><b>Methods:</b> About 16,733 eligible participants with a mean age of 62.3 years at baseline were included. Rapid renal function decline was defined as (baseline eGFR − revisit eGFR)/years of follow-up ≥5 mL/min per 1.73 m²/year. A total of 1738 study participants experienced rapid renal function decline after a median 4.6-year follow-up. Logistic regression models were used for multivariate analyses.</p> <p><b>Results:</b> The adjusted odds ratio (OR) of rapid renal function decline was 1.18 (95% CI: 1.02, 1.37) for TSBS ≥9 h/night compared with TSBS 7 to <8 h/night. This association remained significant (OR = 1.19, 95% CI: 1.03, 1.38) after further adjustment for sleep quality, midday napping and usage of sleeping pills. Particularly, the association appeared to be prominent in individuals with diabetes.</p> <p><b>Conclusions:</b> Longer TSBS (≥9 h) was independently associated with an increased risk of rapid renal function decline. Our findings emphasized the importance to have optimal TSBS.Key messages</p><p>Our study firstly investigated the association between time spent in bed attempting to sleep (TSBS) and renal dysfunction in Chinese adults.</p><p>Compared with individuals TSBS 7 to <8 h, individuals with TSBS ≥9 h had 19% increased risk for rapid renal function decline after adjustment for multivariate confounders.</p><p>The association appeared to be prominent in individuals with diabetes.</p><p></p> <p>Our study firstly investigated the association between time spent in bed attempting to sleep (TSBS) and renal dysfunction in Chinese adults.</p> <p>Compared with individuals TSBS 7 to <8 h, individuals with TSBS ≥9 h had 19% increased risk for rapid renal function decline after adjustment for multivariate confounders.</p> <p>The association appeared to be prominent in individuals with diabetes.</p