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A photoredox-catalyzed regio- and stereoselective trifluoroethylation reaction of enamides using commercially available 2,2,2-trifluoroethyl iodide as trifluoroethylating agents has been developed,...

Sequential invasive-noninvasive ventilation (NIV) improves the outcomes of patients with respiratory failure caused by acute exacerbation of chronic obstructive pulmonary disease (AECOPD); however, there is no clear consensus on the optimal timing of the switch to sequential invasive-NIV in these patients. In the present study, a potential role for the modified Glasgow Coma Scale (GCS) score to guide sequential weaning was investigated. Patients with AECOPD and respiratory failure were prospectively recruited from three study centers (Wenling Hospital Affiliated to Wenzhou Medical University, the First Affiliated Hospital of Wenzhou Medical University and Changsha Central Hospital) between January 1st 2016 and December 31st 2018. Patients were randomly assigned to group A and B, with the switching point for sequential weaning strategy in the two groups being a modified GCS score ≥13 and 10 points, respectively. Each group included 240 patients. Baseline demographic characteristics were comparable in the two groups. The duration of invasive mechanical ventilation (IMV) in group A was significantly shorter than that in group B. However, there were no significant between-group differences with respect to the incidence of re-intubation, ventilator-associated pneumonia, in-hospital mortality or the length of hospital stay. Use of a modified GCS score ≥13 as the switching point for sequential invasive-NIV may help decrease the duration of IMV in patients with AECOPD and respiratory failure.

A photoredox-catalyzed regio- and stereoselective trifluoroethylation reaction of enamides using commercially available 2,2,2-trifluoroethyl iodide as trifluoroethylating agents has been developed, furnishing geometrically defined and synthetically and physiochemically pivotal β-trifluoroethylated enamides bearing a diverse range of functional groups.

A straightforward and efficient C(sp2)-H acylation of enamides with aldehydes via transition-metal-free photoredox catalysis is demonstrated. The transformation proceeded smoothly without resorting to expensive and potentially toxic iridium or ruthenium polypyridyl-based photocatalysts under mild conditions, furnishing a diverse range of synthetically crucial, geometrically defined β-acylated enamides in a stereoselective and regioselective manner. This journal is We gratefully acknowledge the financial support from the National Natural Science Foundation of China (21801129), the Natural Science Research Projects in Jiangsu Higher Education Institutions (18KJB150018), the National Students’ Platform for Innovation and Entrepreneurship Training Program (201910291012Z) and Nanjing Tech University (Start-up Grant No. 39837137, 39837101 and 3827401739).