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BackgroundImported malaria has been an important challenge for China. Fatality rates from malaria increased in China, particularly in Henan Province, primarily due to malpractice and misdiagnoses in healthcare institutions, and the level of imported malaria. This study aims to investigate the relationship between the state of diagnosis and subsequent complications among imported malaria cases at healthcare institutions, based on malaria surveillance data in Henan Province from 2012 to 2017.MethodsA retrospective descriptive analysis was performed using data from the Centre for Disease Control and Prevention, Zhengzhou City, the capital of Henan Province. A decision tree method was exploited to provide valuable insight into the correlation between imported malaria cases and healthcare institutions.ResultsFrom 2012 to 2017, there were 371 imported malaria cases, mostly in males aged between 20 and 50 years, including 319Plasmodium falciparumcases. First visits of 32.3%, 19.9% and 15.9% malaria cases for treatment were to provincial, municipal and county healthcare institutions, respectively. The time interval between onset and initial diagnosis of 284 cases (76.5%) and the time interval between initial diagnosis and final diagnosis of 197 cases (53.1%) was no more than 72 h. An apparent trend was found that there were notably fewer patients misdiagnosed at first visit to healthcare institutions of a higher administrative level; 12.5% of cases were misdiagnosed in provincial healthcare institutions compared to 98.2% in private clinics, leading to fewer complications at healthcare institutions of higher administrative level due to correct initial diagnosis. In the tree model, the rank of healthcare facilities for initial diagnosis, and number of days between onset and initial diagnosis, made a major contribution to the classification of initial diagnosis, which subsequently became the most significant factor influencing complications developed in the second tree model. The classification accuracy were 82.2 and 74.1%, respectively for the tree models of initial diagnosis and complications developed.ConclusionInadequate seeking medical care by imported malaria patients, and insufficient capacity to diagnose malaria by healthcare institutions of lower administrative level were identified as major factors influencing complications of imported malaria cases in Henan Province. The lack of connection between uncommon imported malaria cases and superior medical resources was found to be the crucial challenge. A web-based system combined with WeChat to target imported malaria cases was proposed to cope with the challenge.

Publisher's version (útgefin grein), Interaction of riociguat with human serum albumin (HSA) is extremely important in understanding the drug's disposition and efficiency. In the current study, the binding of riociguat to HSA was explored using spectroscopic methods and molecular docking. The quenching constant, the binding constant, the number of binding sites, thermodynamic parameters, and the secondary structure of protein were determined. A fluorescence study revealed that riociguat quenched HSA fluorescence via static quenching with a binding constant of 1.55 × 104 L mol-1 at 298 K. The calculated thermodynamic parameters indicated that the binding process was spontaneous and that the main interaction force was hydrophobic interaction. Site marker competitive binding experiments and molecular docking studies suggested that riociguat was inserted into the subdomain IIA (site I) of HSA. Alterations in the protein secondary structure after drug complexation were predicted. Results indicated that the protein a-helix structure increased with an increasing concentration of riociguat. This indicated that a riociguat-HSA complex was formed and that the protein secondary structure was altered by the addition of riociguat., This work was supported by the Natural Science Foundation of China (81502921 and 81503251), the Key Research and Development Program of Shandong Province (2017GSF218049), and Young Scholars Program of Shandong University (2015WLJH50).

A new dihydroisocoumarin derivative, R-(−)-heteroscyphide (1), together with three known terpenoid derivatives (2–4), were isolated from the liverwort Heteroscyphus coalitus. Their structures were elucidated by spectroscopic methods and the biogenetic pathway of compound 1 was proposed. Cytotoxic test revealed that they exhibited moderate inhibitory activity to three human tumor cell lines.

Three undescribed cis -clerodane lactones, scapanialides A–C ( 1–3 ), and a new cis -clerodane furano-diterpenoid, scaparvin F ( 4 ), were isolated from the Chinese liverwort Scapania parva Steph. Scapanialide B ( 2 ) is the first cis -clerodane diterpenoid with a bicyclo[5.4.0]undecane skeleton from liverworts. Their structures including the absolute configurations were determined by extensive analysis of multidimensional NMR spectroscopy and TDDFT CD calculations, together with crystal X-ray diffraction measurements. The cytotoxicity of compounds 1–4 was preliminary tested against the Hela and MCF-7 cell lines.

Four new rearranged abietane diterpenoid hydroquinones, ajudecumins A–D (1–4), together with two known rearranged abietane diterpenoids, three neo-clerodane diterpenoids, four megastigmane derivatives, two flavonoids as well as a bisabolene sesquiterpenoid were isolated from the aerial parts of Ajuga decumbens. Their structures were established on the basis of extensive spectroscopic analysis and the stereochemistry of 1 was confirmed by single-crystal X-ray diffraction analysis. Among the diterpenoids, compounds 1 and 3 exhibited moderate inhibitory activity on the proliferation of human breast cancer MCF-7 cells.

7′-Hydroxyriccardin C (1) and marchantin E (2), two macrocyclic bisbibenzyls with a stereogenic center at the ethylene bridge from Chinese liverworts, were investigated stereochemically. Compound 1 was found to be optically active and occurred as a pair of dynamically interchangeable atropisomers at room temperature due to the low barrier of rotation around the biaryl bond, while 2 was a racemic mixture, which was successfully resolved by chiral HPLC into two enantiomers. Their absolute configurations were unequivocally assigned by analysis of temperature-dependent NMR spectra, X-ray crystallographic diffraction, and comparison of experimental and calculated ECD data.

Chemical investigation of the fungus Phellinus baumii has resulted in characterization of five previously undescribed hispidin derivatives, phellibaumins A-E (1-5), as well as two pairs of new non-equivalent epimeric benzyl dihydroflavones, methylphelligrin A (9), epi-methylphelligrin A (10), methylphelligrin B (11), and epi-methylphelligrin B (12), together with five known compounds, interfungin B (6), phelligridin H (7), phelligridimer A (8), phelligrin A (13), and epi-phelligrin A (14). Phellibaumin A (1) was a novel hispidin derivative with a unique 3,4-dihydroxybenzofuran unit. These compounds exhibited NF-κB inhibitory activity with IC(50) values of 52.96 μM (1), 41.40 μM (2), 52.92 μM (5), 36.44 μM (9 and 10), and 22.46 μM (11 and 12), respectively.

Four new phenolic glycosides, named rebouosides A–D (1–4, resp.), along with three known ones 2-(3,4-dihydroxyphenyl)ethyl 2-O-α-L-rhamnopyranosyl-β-D-allopyranoside (5), 2-(3,4-dihydroxyphenyl)ethyl β-D-allopyranoside (6), 2-(3,4-dihydroxyphenyl)ethyl β-D-glucopyranoside (7), and a nucleoside, inosine (8), were isolated from Chinese liverwort Reboulia hemisphaerica. Their structures were elucidated by acidic hydrolysis and extensive spectroscopic methods, including 2D-NMR techniques.

A new diterpene, (7α,11β,14β,16R)-7,11,14-trihydroxy-ent-kaur-15-one (1), and a new sesquiterpene, polyanthuslide (2), were isolated from the Chinese liverwort Chiloscyphus polyanthus. Their structures were determined on the basis of extensive spectroscopic analyses, and the configuration of 2 was established by X-ray crystallographic analysis.

Aim To study the chemical constituents of the Chinese liverwort Porella acutifolia subsp. tosana . Methods The compounds were isolated and purified with column chromatography and their structures were determined on the basis of 1D- and 2D-NMR analysis. Results Three compounds were obtained and identified as guaian-3-en-2α, 14-6α, 12-diolide ( 1 ), (20 R )-6β-hydroxystigmasta-4, 22-dien-3-one ( 2 ), and (20 R )-3β-hydroxystigmasta-5, 22-dien-7-one ( 3 ). Conclusion Compound 1 is a new guaiane-type sesquiterpene lactone. Compounds 2 and 3 are known steroids.

Aim To study the chemical constituents of Lepidozia reptans (L.) Dumont. Methods The chemical constituents were isolated and purified with column chromatography and their structures were elucidated on the basis of 1D and 2D NMR analysis. Results Three compounds were obtained and identified as 5α-hydroxy-9α,10α-epoxycadinan-3-en-2β,14-olide ( 1 ), abieslactone ( 2 ), and 24, 25-dihydroabieslactone ( 3 ). Conclusion Compound 1 is a new cadinane sesquiterpenoid lactone, and compounds 2 and 3 have been isolated from this genus for the first time.

One undescribed 6,7-secofusicoccane-type diterpene, albifolione (1), and one new aromadendrane-type sesquiterpenoid ketone, methyl 2-oxoaromadendra-1(10),3-dien-12-oate (2), along with four known compounds, δ-cuparenol (3), fusicoauritone (4), chiloscyphenols A and B (5 and 6, resp.), were isolated from the liverwort Bazzania albifolia Horik. The structures and relative configurations of 1 and 2 were established unequivocally on the basis of spectroscopic data analysis. Preliminary bioassay revealed that compound 5 showed quite strong cytotoxicity against the human tumor cell line MCF-7, with an IC(50) value of 5.6 μM.

Nine new compounds, five hispidin-derived polyphenols, phellibaumin A (III), B (II), C (IV), D (Ia), and E (Ib) benzyl dihydroflavones methylphelligrin A (Vb) and B (Va) and their epimers are isolated from the fruit body of P.

Scaparvin A (I) is isolated together with the analogues scaparvin B (IIa), C (IIb), D (IIc) and E (III).

A novel caged cis-clerodane diterpenoid, scaparvin A, possessing an unprecedented C-6/C-11 bond and a ketal ring, as well as four new cis-clerodane derivatives, scaparvins B−E, were isolated from the Chinese liverwort Scapania parva. Their absolute structures were elucidated by analysis of NMR and CD data coupled with electronic circular dichroism (ECD) calculations. It was proposed that an enzymatic intramolecular aldol reaction was the key step in the biogenetic pathway of scaparvin A.

Four undescribed labdane diterpenoids, 1,2-dehydro-3,7-dioxo-manoyl oxide (1), 1,2-dehydro-7 beta-hydroxy-3-oxo-manoyl oxide (2), 3,7-dioxo-manoyl oxide (3), and 3beta-hydroxy-7-oxo-manoyl oxide (4) together with three known diterpenoids (5-7) and four highly methoxylated bibenzyls (8-11) were isolated from the liverwort Frullania inouei. The absolute structures of 1-4 were established by combined analysis of NMR data, CD data coupled with TDDFT CD calculations, and single-crystal X-ray diffraction measurement. Cytotoxicity tests to human tumor KB, KB/VCR, K562 or K562/A02 cells showed bibenzyls 8-11 inhibited cell proliferation with ID(50) values ranging from 11.3 to 49.6 microM and overcame the multidrug resistance (MDR) with the reversal fold (RF) values ranging from 3.19 to 10.91 (5 microM) for vincristine-resistant KB/VCR and RF values from 4.40 to 8.26 (5 microM) for adriamycin-resistant K562/A02 cells, respectively. However, none of the diterpenoids were found to be active (ID(50)>50 microM).

A new trinortriterpenoid, diospyrolide acetate (1) and a new diphenylmethane derivative, pulcherrimumin (12), together with ten known pentacyclic triterpenoids (2–11) and four aromatic compounds (13–16), were isolated from the liverwort Ptilidium pulcherrimum. Their structures were established on the basis of extensive analysis of NMR data and by chemical methods. The cytotoxicity of compounds 1–16 was evaluated against the PC3, MDA-MB-231, and Hela cells lines. Ursane triterpenoids 8–10 exhibited moderate cytotoxicity against PC3 cells with IC50 values ranging from 10.1 to 39.7 μM.

Two undescribed dimeric ArC2 derivatives, cis- and trans-1,2-bis(3,4-dimethoxyphenyl)cyclobutane (1 and 2), one new monoterpenes esters, 2α,5β-dihydroxybornane-2- cis-cinnamate (3), along with eight known compounds, 2α,5β-dihydroxybornane-2- trans-cinnamate (4), perrottetin E (5), isoriccardin C (6), marchantin A (7), marchantin E (8), marchantin C (9), and isomarchantin C (10) were isolated from the liverwort Conocephalum japonicum. All the structures were established by extensive spectroscopic analysis. The isolated compounds 3–10 were evaluated for their cytotoxicity against the human KB cell line with IC50 values ranging from 16.5 to 50.2 μM.