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Dixon surgery for rectal cancer can lead to severe intestinal narrowing and blockage that is difficult to treat with open surgery or colonoscopy. The aim of the present study was to develop a minimally invasive approach for treating rectal anastomotic atresia based on three cases that were managed with transurethral prostate resection instrumentation. Preoperative imaging determined the distance from the anastomotic closure to the anal margin, the length of the anastomotic closure and the degree of proximal intestinal dilation for all cases. During the procedure, the anastomotic site was visualized, and a circular electrode was used to excavate and open the blockage. Membrane-like closures were directly incised to achieve satisfactory results, with an anastomotic diameter >20 mm. Those cases with tubular atresia required an initial incision using the prostate resectoscope to relieve the obstruction, followed by radial incisions until achieving an anastomotic diameter >20 mm. At 3-6 months post-dilation, two of the patients with anastomotic atresia >20 mm had satisfactory bowel movements, whereas the remaining patient experienced tumor recurrence at the anastomotic site and discontinued treatment. This case series demonstrates the potential of transurethral prostate resection instrumentation as a safe and effective minimally invasive approach for rectal anastomotic atresia. Given that prostate resection instrumentation is readily available in hospitals in China, this approach is widely accessible to most patients. Furthermore, the technique leverages existing surgical technology and practices, requiring only a shift in the surgical site. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) has become the most prevalent liver disease in China. Sinisan (SNS) is a traditional Chinese medicine formula that has been widely used in treating chronic liver diseases, including NAFLD. However, its underlying biological mechanisms are still unclear. In this study, we employed a network pharmacology approach consisting of overlapped terms- (genes or pathway terms-) based analysis, protein-protein interaction (PPI) network-based analysis, and PPI clusters identification. Unlike the previous network pharmacology study, we used the shortest path length-based network proximity algorithm to evaluate the efficacy of SNS against NAFLD. And we also used random walk with restart (RWR) algorithm and Community Cluster (Glay) algorithm to identify important targets and clusters. The screening results showed that the mean shortest path length between genes of SNS and NAFLD was significantly smaller than degree-matched random ones. Six PPI clusters were identified and ten hub targets were obtained, including STAT3, CTNNB1, MAPK1, MAPK3, AGT, NQO1, TOP2A, FDFT1, ALDH4A1, and KCNH2. The experimental study indicated that SNS reduced hyperlipidemia, liver steatosis, and inflammation. Most importantly, JAK2/STAT3 signal was inhibited by SNS treatment and was recognized as the most important signal considering the network pharmacology part. This study provides a systems perspective to study the relationship between Chinese medicines and diseases and helps to discover potential mechanisms by which SNS ameliorates NAFLD. [ABSTRACT FROM AUTHOR]

Abstract: A new isocoumarin, 7-hydroxyl-4-methyl isocoumarine (1), together with three known monoterpenes, (3R, 4R, 6S)-3, 6-dihydroxy-1-menthene (2), (+)-(1R, 3S, 4R, 6S)-6-hydroxymenthol (3) and 4-isopropyl-1-methylcyclohex-2-ene-1, 6-diol (4), was isolated from the methanol extract of Brickellia rosmarinifolia. The structures were determined by spectroscopic means. Compounds 1, 2, 3 and 4 showed antifungal activities against Colletotrichum musae and Peronophythora litchii in vitro. [Copyright &y& Elsevier]

The article offers information on Turpinia arguta Seem., which belongs to the family Staphyleaceae, and abundantly found in southern area of China. It is stated that leaves of Turpinia arguta are used in traditional Chinese medicine for the treatment of pharyngitis, amygdalitis and tonsillar abscess and pharmacological studies suggest that extracts of plant possess potent anti-inflammatory effects.

The fruit of Clausena lansium (wampee) is popular in southern China and warm areas of the world. Our chemical study on the fruit yielded three jasmonoid glucosides, 12-β- d -glucopyranosyloxy-6- epi -7-isocucurbic acid-1,6-lactone ( 1 ), 12-β- d -glucopyranosyloxyjasmonic acid ( 2 ) and 12-hydroxyjasmonic acid ( 3 ), two sesquiterpenes, (+)-curcumen-12-oic acid ( 4 ) and (+)-( E )-α-santalen-12-oic acid ( 5 ), two coumarins, xanthotoxol ( 6 ) and indicolactone ( 7 ), in addition to 3,4-dihydroxybenzoic acid ( 8 ), 5-hydroxymethylfuraldehyde ( 9 ), isopropyl β- d -glucopyranoside ( 10 ) and stigmasterol ( 11 ). Their structures were determined by spectroscopic methods. Compound 1 was a new metabolite and the others excluding 6 were reported from the species for the first time. Compounds 1 – 7 were evaluated for antioxidant and antibacterial activities. Among them, compound 6 showed antioxidant activity in ferric reducing antioxidant power (FRAP) and DPPH radical scavenging assays as well as antibacterial activity against Staphyloccocus aureus and Shigella dysenteriae , while compound 5 was active against Bacillus cereus . [ABSTRACT FROM AUTHOR]

Abstract: Preliminary evidence in support of fruit intake for the prevention of cardiovascular disease in patients with type 2 diabetes mellitus (T2DM) is still limited. The objective of this study was to evaluate the association between fruit consumption and cardiovascular risk factors such as carotid intima-media thickness (CIMT) and high-sensitive C-reactive protein (hsCRP) in patients with T2DM. In this cross-sectional study, 407 patients with T2DM were recruited from August 2007 to December 2009. Dietary assessment based on 3-day 24-hour recall interviews, hsCRP levels, and CIMT were examined. Participants were categorized into three tertiles based on fruit intake. Comparisons of the participants'' clinical characteristics among the three categories were performed using either one-way analysis of variance or analysis of covariance. In patients with type 2 diabetes with CIMT ≥1 mm, the intake of fruit was lower (P=0.001), whereas the serum hsCRP level was higher (P<0.001) compared with patients showing CIMT <1 mm. Results of the multivariable logistic regression analysis showed that the odds ratios of CIMT and hsCRP were 8% and 31% lower, respectively, in participants in the top tertile compared with those in the lowest tertile (P=0.018 and P<0.001, respectively) after adjustment for potential confounders. Hence, a reduction in hsCRP concentration and CIMT were found to be associated with an increase in fruit intake. Sufficient daily intake of fruits should, therefore, be considered as an important component of a medical nutritional therapy strategy for the prevention of cardiovascular diseases in patients with T2DM. [Copyright &y& Elsevier]

Abstract: The first stilbene possessing a γ-aminobutyric acid lactam function, artocarpene (1), and a new flavanone, 2-hydroxynaringenin 4′-O-β-d-glucopyranoside (2), were isolated from the stems of Artocarpus nitidus subsp. lingnanensis along with four known compounds, 2-hydroxynaringenin (3), oxyresveratrol (4), 3,4′,5-trihydroxy-3′-prenylstilbene (5) and norartocarpetin (6). Their structures were elucidated on the basis of spectroscopic data. Compounds 1 exhibited weak antioxidant activity and 2 displayed weak cytotoxicity against human lung cancer A549 cell line. [Copyright &y& Elsevier]

Abstract: 3,12-Dihydroxy-cis-3,4-methylenedodecanoic acid 3-O-β-d-glucopyranoside, trivially named litchioside C (1), the first cyclopropyl-containing fatty acid glycoside, was isolated along with three previously uncharacterized galactosylacylglycerols from the seeds of Litchi chinensis. Its structure was established on the basis of spectroscopic analysis including HRESIMS and 2D NMR spectra. Its antioxidant and antibacterial activities were evaluated and its biogenetic pathway was discussed. [Copyright &y& Elsevier]

Introduction: Postoperative delirium is one of the most common postoperative complications among elderly patients (65 years old or older). However, there are no effective treatments for this condition. Recent research suggests that continuous theta burst stimulation (cTBS), a non-invasive brain stimulation, can reduce pain level, improve cognitive function and affective symptoms in multiple diseases or dysfunctions, including anxiety disorders, major depressive disorder, sleep disorders and pain. But the potential benefits of cTBS in reducing postoperative delirium have not been investigated. Therefore, we propose determining whether cTBS can prevent and/or treat postoperative delirium in senior patients., Methods and Analysis: The study will be a double-blind, randomised controlled trial. Participants (65 years old or older) undergoing scheduled orthopaedic surgery (≥2 hours, general anaesthesia) will be randomised to receive either cTBS or sham stimulation with a focal figure-of-eight coil over the right dorsolateral prefrontal cortex at 80% of the resting motor threshold. Every patient will receive 2-3 sets of stimulations during postoperative days (40 s per session, 3 sessions per set, 1 set per day). Participants will be assessed twice daily by a research assistant blinded to allocation. The primary outcome will be the incidence of postoperative delirium measured by the Confusion Assessment Method on postoperative days 1, 2 and 3. The secondary outcomes will be the severity and duration of postoperative delirium, cognitive function, pain, sleep quality, activities of daily living, length of hospital stay, discharge-to-facility or home, and rate of complication and mortality during the hospital stay., Ethics and Dissemination: Ethical approval has been obtained from the ethics committee of Shanghai 10th People's Hospital. The principal investigator will submit a research progress report to the ethics committee regularly. All participants will provide written informed consent. Study results will be published in a peer-reviewed journal., Trial Registration Number: NCT04661904., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Formicapyridine-type racemates, streptovertidines A ( 1 ) and B ( 2 ), a 7,24- seco -fasamycin, streptovertidione ( 3 ), and the fasamycin-type streptovertimycins I-T ( 4 - 15 ), together with 13 known fasamycin congeners ( 16 - 28 ), were isolated from soil-derived Streptomyces morookaense SC1169. Their structures were elucidated by extensive spectroscopic analysis and theoretical computations of ECD spectra. The fasamycin-type compounds 5 , 8 - 12 , 14 , and 15 exhibited activity against the drug-resistant bacteria MRSA and VRE (MIC: 1.25-10.0 μg/mL). All isolates, except 3 , 4 , 10 , and 24 , displayed cytotoxicity against at least one of the human carcinoma A549, HeLa, HepG2, and MCF-7 cells (IC 50 < 10.0 μM), of which some were also cytotoxic to the noncancerous Vero cells. Taken together, the activity data demonstrated that the fasamycin-type compounds were more selective to the tested bacteria over the mammalian cells. Structure-activity relationship analysis suggested that chlorination at C-2 in antibacterial fasamycin-type compounds improves the activity and selectivity to the bacteria. Theoretical simulations of reaction paths and chemical reactions for conversion of 3 to 1 were carried out and supported that the pyridine ring formation in formicapyridines proceeds nonenzymatically via 1,5-dicarbonyl condensation with ammonia.

Five new cytochalasans, diaporthichalasins D-H (1-5), along with five known cytochalasans (6-10) were isolated from solid cultures of the endophytic fungus Diaporthe sp. SC-J0138 isolated from the leaves of Cyclosorus parasiticus. Their structures were elucidated by analysis of spectroscopic data and theoretical calculations of electronic circular dichroism spectra. Compounds 1 and 5 showed noticeable cytotoxicity against human carcinoma A549, HeLa, and HepG2 cells. The structure-activity relationships in cytotoxicity were discussed for this group of compounds., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Averrhoa carambola L. (Oxalidaceae) was widely cultivated for fruits (star fruit), whereas the value of leaves remains to be discovered. Our study on the leaves yielded five flavan-3-ols (1-5) and two 2-diglycosyloxybenzoates. Their structures were determined by spectroscopic and chemical methods. Epicatechin-(5,6-bc)-4β-(p-hydroxyphenyl)-dihydro-2(3H)-pyranone (1) and benzyl 2-β-d-apiofuranosyl-(1 → 6)-β-d-glucopyranosyloxybenzoate (6) were new structures. 6-(S -2 -Pyrrolidinone-5-yl)epicatechin (4) and 6-(R-2-pyrrolidinone-5-yl)epicatechin (5) were obtained as monomeric diastereomer for the first time and their absolute configurations were determined by electronic circular dichroism (ECD) computation. Epicatechin-(7,8-bc)-4α-(p-hydroxyphenyl)-dihydro-2(3H)-pyranone (2), epicatechin-(7,8-bc)-4β-(p-hydroxyphenyl)-dihydro-2(3H)-pyranone (3), and methyl 2-β-d-apiofuranosyl-(1 → 6)-β-d-glucopyranosyloxybenzoate (7) were not previously reported from the genus Averrhoa. Compounds 1-5 showed more potent 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) (ABTS) radical cation and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activities and ferric reducing antioxidant power (FRAP) than l-ascorbic acid. Meanwhile 1 and 3 exhibited lipase and α-glucosidase inhibitory activities, respectively. The results clarified the structures of flavan-3-ols and 2-diglycosyloxybenzoates in the leaves and their antioxidant, lipase, and α-glucosidase inhibitory activities., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Four new aromatic butenolides, asperimides A-D (1-4), together with a known analogue, butyrolactone I (5), were isolated from solid cultures of a tropical endophytic fungus Aspergillus terreus. The structures of these compounds were elucidated on the basis of spectroscopic methods and electronic circular dichroism calculations. Compounds 1-4 represent the first examples of butenolides with a maleimide core isolated from Aspergillus sp. Inhibitory effects of the isolated compounds on nitric oxide production were investigated in lipopolysaccaride (LPS)-mediated RAW 264.7 cells. Compounds 3 and 4 exhibited potent anti-inflammatory with IC 50 values of 0.78 ± 0.06 and 1.26 ± 0.11 μM, respectively., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Falandi is a common strawberry (Fragaria × ananassa Duch.) cultivar in southern China. Further study of the chemical constituents in Falandi fruit led to the isolation of nine norsesquiterpenoids and three triterpenoids. Falandioside D (1) and falandins A (2) and B (3) were new norsesquiterpenoids, and the others excluding tormentic acid (11) were found in strawberry for the first time. Compounds 1 and 11 exhibited potent α-glucosidase inhibitory activity with the half maximal inhibitory concentration (IC50) values of 565.0 and 27.4 μM in comparison to acarbose (619.9 μM). Compounds 3, 7 (blumenol C glucoside), and 11 showed cytotoxicity against human nasopharyngeal carcinoma cell line CNE1 with the IC50 values of 57.6, 56.4, and 36.0 μM, respectively. Among new compounds, 1 showed 2,2'-azinobis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) radical cation scavenging capacity (IC50=36.2 μM). These results suggested that non-phenolic constituents were also involved in the antidiabetic, antitumour, and antioxidant effects of strawberry fruit., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is a member of the TNF superfamily, and has been identified as a novel mediator of fatty liver disease (FLD). The aim of our study was to further investigate the relationship between TRAIL and FLD. We found that soluble TRAIL (sTRAIL) concentrations in non-alcoholic FLD (NAFLD) patients were significantly higher than those of controls, and that sTRAIL levels positively correlated with triglyceride concentrations in NAFLD patients. Our results also indicated that the AA/TT genotypes of TRAIL at 1525/1595 engendered a lower risk of FLD attack and a less severe form of steatosis for NAFLD patients in Chinese population. This study provides a means to test for susceptibility to FLD and may assist in the diagnosis of FLD. In addition, we found that 1525G/A and 1595C/T sites were in complete linkage disequilibrium in Chinese population. This might indicate a haplotype with high genetic frequency of TRAIL.

A new acetogenin, polyporolide (1), was isolated from the mycelial solid cultures of a Polyporus basidiomycete. Its structure was elucidated as 4-hydroxy-5-(1-hydroxyhexyl)-dihydrofuran-2-one by spectroscopic methods. Its toxicity to brine shrimps was assessed.

Two new grayanane diterpenoids, rhodomolins A (1) and B (2), together with two known diterpenoids, rhodomolleins I and rhodojaponin III, were isolated from the flowers of Rhododendron molle. The structures of 1 and 2 were elucidated on the basis of interpretation of spectroscopic data. All compounds were evaluated for cytotoxic activity against the Spodoptera frugiperda cell line Sf-9 and gave IC(50) values in the range 12-80 microg/mL.

Four new sesquiterpene dilactones, mikamicranolide (1), 11 beta,13-dihydromikamicranolide (2), 3 alpha-hydroxy-11 beta,13-dihydrodeoxymikanolide (3), and 2 beta,3 beta-dihydroxy-11 beta,13-dihydrodeoxymikanolide (4), were isolated from the whole plants of Mikania micrantha. Their structures were elucidated on the basis of spectroscopic analysis. Compounds 1 and 2 possess an unusual rearranged 12,8-germacranolide sesquiterpene skeleton.