Search

Aim: The commonly recommended endotracheal tube cuff pressure is 20–30 cmH2O. However, some patients require a cuff pressure of >30 cmH2O to prevent air leakage. The study aims to determine the risk factors that contribute to the endotracheal tube cuff pressure of >30 cmH2O to prevent air leakage. Design: A multi‐centre prospective observational study. Methods: Eligible patients undergoing mechanical ventilation in the intensive care unit of three hospitals between March 2020 and July 2022 were included. The endotracheal tube cuff pressure to prevent air leakage was determined using the minimal occlusive volume technique. The patient demographics and clinical information were collected. Results: A total of 284 patients were included. Among these patients, 55 (19.37%) patients required a cuff pressure of >30 cmH2O to prevent air leakage. The multivariate logistic regression results revealed that the surgical operation (odds ratio [OR]: 8.485, 95% confidence interval [CI]: 1.066–67.525, p = 0.043) was inversely associated with the endotracheal tube cuff pressure of >30 cmH2O, while the oral intubation route (OR: 0.127, 95% CI: 0.022–0.750, p = 0.023) and cuff inner diameter minus tracheal area (OR: 0.949, 95% CI: 0.933–0.966, p < 0.001) were negatively associated with the endotracheal tube cuff pressure of >30 cmH2O. Therefore, a significant number of patients require an endotracheal tube cuff pressure of ＞30 cmH2O to prevent air leakage. Several factors, including the surgical operation, intubation route, and difference between the cuff inner diameter and tracheal area at the T3 vertebra, should be considered when determining the appropriate cuff pressure during mechanical ventilation. [ABSTRACT FROM AUTHOR]

A facile protocol for the synthesis of quinoline formaldehydes via direct oxidative C--H bonds functionalization of methyl-azaheteroarenes in the presence of [I.sub.2]--DMSO has been described. This method is metal-free and easy to operate. This reaction provided a convenient route for the preparation of a range of important quinoline formaldehydes. Key words: metal free, oxidative functionalization, methyl-azaheteroarenes, quinoline formaldehydes, iodine. Nous decrivons une methode de synthese facile pour preparer des formaldehydes derives de la quinoline par fonctionnalisation directe de methylazaheteroarenes via l'oxydation de liaisons C--H en presence d'un melange d'I2 dans le DMSO. Cette methode, simple a realiser, fonctionne sans metaux. La reaction constitue une voie d'acces pratique a une variete de formaldehydes de quinoline importants. [Traduit par la Redaction] Mots-cles : sans metaux, fonctionnalisation oxydante, methylazaheteroarenes, formaldehydes de quinoline, iode., Introduction (Hetero)aryl aldehydes ketones are integral parts of various natural products, and they are widely employed as key synthetic intermediates in pharmaceuticals and organic synthesis. (1) In particular, quinoline formaldehyde [...]

Objective To compare the repair effects of different doses of human umbilical cord mesenchymal stem cells (hUC-MSCs) on white matter injury (WMI) in neonatal rats. Methods Two-day-old Sprague-Dawley neonatal rats were randomly divided into five groups: sham operation group, WMI group, and hUC-MSCs groups (low dose, medium dose, and high dose), with 24 rats in each group. Twenty-four hours after successful establishment of the neonatal rat white matter injury model, the WMI group was injected with sterile PBS via the lateral ventricle, while the hUC-MSCs groups received injections of hUC-MSCs at different doses. At 14 and 21 days post-modeling, hematoxylin and eosin staining was used to observe pathological changes in the tissues around the lateral ventricles. Real-time quantitative polymerase chain reaction was used to detect the quantitative expression of myelin basic protein (MBP) and glial fibrillary acidic protein (GFAP) mRNA in the brain tissue. Immunohistochemistry was employed to observe the expression levels of GFAP and neuron-specific nuclear protein (NeuN) in the tissues around the lateral ventricles. TUNEL staining was used to observe cell apoptosis in the tissues around the lateral ventricles. At 21 days post-modeling, the Morris water maze test was used to observe the spatial learning and memory capabilities of the neonatal rats. Results At 14 and 21 days post-modeling, numerous cells with nuclear shrinkage and rupture, as well as disordered arrangement of nerve fibers, were observed in the tissues around the lateral ventricles of the WMI group and the low dose group. Compared with the WMI group, the medium and high dose groups showed alleviated pathological changes; the arrangement of nerve fibers in the medium dose group was relatively more orderly compared with the high dose group. Compared with the WMI group, there was no significant difference in the expression levels of MBP and GFAP mRNA in the low dose group (P>0.05), while the expression levels of MBP mRNA increased and GFAP mRNA decreased in the medium and high dose groups. The expression level of MBP mRNA in the medium dose group was higher than that in the high dose group, and the expression level of GFAP mRNA in the medium dose group was lower than that in the high dose group (P<0.05). Compared with the WMI group, there was no significant difference in the protein expression of GFAP and NeuN in the low dose group (P>0.05), while the expression of NeuN protein increased and GFAP protein decreased in the medium and high dose groups. The expression of NeuN protein in the medium dose group was higher than that in the high dose group, and the expression of GFAP protein in the medium dose group was lower than that in the high dose group (P<0.05). Compared with the WMI group, there was no significant difference in the number of apoptotic cells in the low dose group (P>0.05), while the number of apoptotic cells in the medium and high dose groups was less than that in the WMI group, and the number of apoptotic cells in the medium dose group was less than that in the high dose group (P<0.05). Compared with the WMI group, there was no significant difference in the escape latency time in the low dose group (P>0.05); starting from the third day of the latency period, the escape latency time in the medium dose group was less than that in the WMI group (P<0.05). The medium and high dose groups crossed the platform more times than the WMI group (P<0.05). Conclusions Low dose hUC-MSCs may yield unsatisfactory repair effects on WMI in neonatal rats, while medium and high doses of hUC-MSCs have significant repair effects, with the medium dose demonstrating superior efficacy. [ABSTRACT FROM AUTHOR]

A total synthesis strategy was developed for the synthesis of luotonin A, B and their analogues using synergistic FeCl3/KI‐catalyzed oxidative cyclization. This protocol utilizes cheap and widely available N‐propargyl 2‐methyl‐quinazolinones and arylamines under mild conditions, and it has a wide substrate scope and high atom economy. Different natural products (luotonin A, B and derivatives) can be synthesized via a unique switchable approach. Further transformations from luotonin B to luotonin E and structural modification of natural products demonstrate the potential applications of this method. Moreover, camptothecin can also be modified with the reported protocol to afford the hydroxyl‐substituted product. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the management of early mobilization (EM) in Chinese intensive care units (ICUs).

A cascade 6-endo-dig cyclization reaction was developed for the switchable synthesis of halogen and non-halogen-functionalized pyrazolo[3,4-b]pyridines from 5-aminopyrazoles and alkynyl aldehydes via C≡C bond activation with silver, iodine, or NBS. In addition to its wide substrate scope, the reaction showed good functional group tolerance as well as excellent regional selectivity. This new protocol manipulated three natural products, and the arylation, alkynylation, alkenylation, and selenization of iodine-functionalized products. These reactions demonstrated the potential applications of this new method. [ABSTRACT FROM AUTHOR]

A concise and efficient strategy has been proposed to synthesize indolizine derivatives from easily available aryl or heteroaryl methyl ketones, pyridines, and acrylonitriles. The mechanistic pathway involved the integration of iodination, pyridinium ylide synthesis, and 1,3-dipolar cycloaddition. The protocols were found to be highly efficient in terms of high yields, operational simplicity, mild reaction conditions, and easy workup. This method has provided an important supplement for the synthesis of indolizine derivatives via a novel tandem synthesis. Key words: indolizine derivative, iodination, pyridinium ylide synthesis, 1;3-dipolar cycloaddition, tandem synthesis. On a propose une strategie concise et efficace de synthese des derives de l'indolizine en partant d'aryl- ou d'heteroarylmethyl-cetones, pyridines et acrylonitriles faciles a obtenir. Le chemin reactionnel comprenait l'integration de l'iodation, de la synthese de l'ylure de pyridinium et de la cycloaddition 1,3-dipolaire. Les protocoles se sont averes hautement efficaces comme l'indiquent les rendements eleves, la simplicite operatoire, les conditions douces de reaction et la facilite du traitement final. Cette methode apporte un supplement important a la synthese des derives de l'indolizine sous la forme d'une nouvelle synthese par reaction tandem. [Traduit par la Redaction] Mots-cles: derives de l'indolizine, iodation, synthese de l'ylure de pyridinium, cycloaddition 1;3-dipolaire, synthese par reaction tandem., Introduction Indolizines represent a significant class of nitrogen-fused heterocylces and are highly abundant in many natural products and biologically active compounds. (1-4) They are also known for their intriguing molecular [...]