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Electroconvulsive therapy is an important somatic treatment for severe mental disorders with established efficacy and safety. However, data on the relationship between ECT and the readmission rate of patients with schizophrenia are scarce. This study will explore the association between the administration of ECT and readmission rates using a machine learning method. Inpatient medical records from the year of 2016 in one large psychiatric hospital in Beijing, China, were analyzed using a machine learning algorithm to determine the most important variables affecting readmission of patients with schizophrenia. The medical records of 2131 inpatients with schizophrenia were reviewed. 1099 patients were followed up within 3 months of their index admission (642 ECT cases and 457 non-ECT cases) and 1032 patients were followed up within 6 months (596 ECT cases and 436 non-ECT cases) after discharge. The 3- and 6-month readmission rates in the ECT group (11.37% and 17.94%, respectively) were significantly lower than that of the patients who did not receive ECT (18.79% and 29.36%, respectively, both p < 0.001). The risk of readmission was significantly associated with male sex, older age, being married, having a lower income, a shorter inpatient length of stay, and receiving specific antipsychotic medications including olanzapine, paliperidone, clozapine, and haloperidol during the index admission. In the ECT group, patients who received 9 or more treatments were significantly less likely to be readmitted. Receiving ECT may be associated with a lower risk of readmission in patients with schizophrenia. • Receiving ECT treatment during the index admission was associated with significantly lower readmission rates within 3 and 6 months in patients with schizophrenia. • The risk of readmission was significantly associated with male sex, older age, being married, having a lower income, a shorter inpatient length of stay, and receiving some specific antipsychotic medications including olanzapine, paliperidone, clozapine, and haloperidol during the index admission. • Among patients received ECT treatment, patients who received 9 or more treatments were significantly less likely to be readmitted. [ABSTRACT FROM AUTHOR]

An unprecedented organocatalytic asymmetric Michael/Hemiketalization/retro-aldol cascade sequence catalyzed by bifunctional amino-squaramides is described. The corresponding adducts were generally obtained in high yields (up to 97%) with moderate diastereo- (up to 79:21 dr) and good enantioselectivities (up to 90% ee). [ABSTRACT FROM AUTHOR]

Abstract: A highly efficient enantioselective Michael reaction of 2-oxindole-3-carboxylate esters with N-maleimides catalyzed by commercially available cinchonidine was described. The desired adducts, containing a quaternary center at the C3-position and a vicinal tertiary center, were obtained in excellent yields (up to 99%), good enantioselectivities (up to 85% ee), and diastereoselectivities (dr>90:10) in the presence of 0.05–5 mol % catalyst loading. [Copyright &y& Elsevier]

An efficient catalyst-free direct nitration of the aliphatic hydrocarbon bonds of tertiary β-keto ethers using tert- butyl nitrite as a nitrating reagent is described. This radical nitration protocol tolerants diverse functional groups, leading to the preparation of linear and cyclic α-nitro-β-keto ester derivatives in good to excellent yields under mild conditions. In addition, the nitration product 3a was applied to the concise synthesis of α-quaternary α-amino acid ether 4 in the presence of zinc power and acetic acid. [Display omitted] An efficient catalyst-free direct nitration of the C H bonds of tertiary β-keto esters using tert- butyl nitrite as a nitrating reagent is described. This radical nitration protocol tolerants diverse functional groups, leading to the preparation of linear and cyclic α-nitro-β-keto ester derivatives in good to excellent yields under mild conditions. In addition, the nitration product 3a was applied to the concise synthesis of α-quaternary α-amino acid 4 in the presence of zinc power and acetic acid. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Tongxinluo (TXL), which is a Chinese medicine rooted from traditional used herbs, has been used in clinic to treat cardiovascular and cerebrovascular diseases. However, it remains unknown whether TXL alleviates low pressure hypoxic pulmonary hypertension. Aim of the study Here, we aimed to observe the influence of TXL on pulmonary hypertension in a rat model that exposed to high altitude environment characterized by low pressure hypoxia. Materials and methods A total of 32 male Sprague-Dawley rats were divided into four groups: control group (normal pressure and normoxia), pulmonary hypertension group (PAH, the parameter is equal to that in altitude 5000 m), TXL group (rats living in environment equal to that at altitude of 5000 m received TXL treatment), vardenafil group (VDNF, rats living in environment equal to that altitude of 5000 m received vardenafil treatment). The high altitude environment was created in chamber by adjusting the inner pressure and oxygen content concomitantly. Before entering the chamber, the TXL group was given TXL (1.2 g kg −1 d −1 ) for 28 days, and the VDNF group was given VDNF (0.1 g kg −1 d −1 ) for 28 days. After 28 days, the mean pulmonary artery pressure (mPAP) and right ventricular pressure was measured using right heart catheterization. The weight of the right ventricle (RV), left ventricle (LV) and interventricular septum (IVS) was measured, and the right ventricular mass index was calculated. Lung tissue was subjected to hematoxylin and elastic fiber staining, and the medial wall thickness (MT), medial wall cross-sectional area (MA), MT%, and MA% were measured. Proliferative activity within the pulmonary arteries was quantified by Ki67staining. Results After 28 days, as compared with that in normal control group, animals living in the chamber (PAH group) showed a significant increase in mPAP( 47.5 mmHg versus 18 mmHg), RV/LV+IVS (0.45 versus 0.21) and MA% (78% versus 44%), respectively. Administration of TXL resulted in a significant decrease of 20 mmHg in mPAP, returning of RV/LV+IVS to 0.27, and a 40% reduction in MT% compared with that in PAH group. In the VDNF group, RV/LV+IVS and MT% was 0.268 and 38.77, significantly lower than that in PAH group. While, mPAP increased by 12.5 mmHg with treatment by VDNF. In contrast to the PAH group, alpha- Smooth Muscle Actin (α-SMA reduced by 19% in the TXL group (p=0.005) and 16% in the VDNF group (p=0.01). Ki67 expression in the VDNF group was significantly lower than the PAH group (P<0.01). Ki67 expression in the TXL group was significantly lower than the PAH group (P<0.01). Compared with the VDNF group, the indexes above reduced in the TXL group. Our results indicate that TXL significantly reduces pulmonary artery pressure, right ventricular hypertrophy, pulmonary small artery wall thickness, and luminal stenosis. In addition, smooth muscle proliferation markedly decreased and muscular artery decreased. However, TXL was unable to restore parameters to control levels. Conclusions The automatic-adjusted low pressure hypoxic chamber was capable of establishing a pulmonary hypertension rat model at an altitude of 5000 m. Compared with VDNF, TXL decreased mPAP and right ventricular hypertrophy index (RVHI) in the pulmonary hypertension rat model, and prevented vascular remodeling by reducing small pulmonary artery thickening, smooth muscle thickening and proliferation. Thus, TXL may be a potential treatment for pulmonary hypertension. [ABSTRACT FROM AUTHOR]

Abstract: Organocatalytic Michael–aldol–dehydration domino reaction of 3-(1-hydroxyethylidene)benzofuran-2(3H)-ones and enones catalyzed by Cinchona-based primary amine has been developed. The desired chiral spirocyclic benzofuranones were obtained in excellent stereoselectivities (dr>20:1 and up to 96% ee) and moderate to excellent yields (up to 98%). [Copyright &y& Elsevier]

Abstract: Simple chiral tertiary amines with a special imide skeleton were first successfully applied to catalyze the enantioselective D–A reaction of anthrone and maleimides in excellent yields (up to 96%) and enantioselectivities (up to 95% ee). [Copyright &y& Elsevier]

Abstract: The first K2CO3-catalyzed 1,3-dipolar cycloaddition/dehydrogenation of azodicarboxylates with azomethines was developed and a wide range of unsaturated 1,2,4-triazolines have been successfully prepared in good yields (up to 93%). [Copyright &y& Elsevier]

Abstract: Cinchona alkaloids were first successfully reported to promote enantioselective Phospho-Aldol reaction of diphenyl phosphite to a variety of N-alkylated isatin derivatives in good to excellent yields (up to 99%) and moderate to good enantioselectivities (up to 73% ee) almost in no time. [Copyright &y& Elsevier]

Abstract: In our recent published Letter entitled ‘Highly effective and enantioselective Phospho-Aldol reaction of diphenyl phosphite with N-alkylated isatins catalyzed by quinine’, there was an inaccurate structural determination of the final product. We report here the correction of the structure via X-ray diffraction of the single crystal. The product should be α-oxindole-phosphonate, which was derived from the subsequent phospha-Brook rearrangement of the normal phospho-Aldol product. [Copyright &y& Elsevier]