经腹联合经阴道彩超在评估凶险型前置胎盘合并胎盘植入中的应用价值

本文对经腹联合经阴道彩超在评估凶险型前置胎盘(PPP)合并胎盘植入中的应用价值进行了探讨。选取我院2017年6月~2019年6月PPP患者172例,所有患者均给予经腹彩超、经阴道彩超检查,以产后病理结果为对照,分析经腹彩超、经阴道彩超,以及二者联合,对PPP合并胎盘植入的评估价值。产后病理结果显示,172例PPP患者中,有合并胎盘植入患者120例(69.77%)、无合并胎盘植入患者52例(30.23%)。对PPP合并胎盘植入的敏感度、特异度、准确度进行评估,结果显示,经腹彩超其值分别为76.67%、73.08%、75.58%,经阴道彩超分别为83.33%、80.77%、82.56%,经腹联合经阴道彩超则分别为96.67%、96.15%、96.51%,二者联合明显高于经腹彩超、经阴道彩超,差异有统计学意义(P<0.05)。证实经腹、经阴道彩超是评估PPP合并胎盘植入的有效检查方法,且二者联合的评估价值更高,值得临床推广。     

经直肠超声联合前列腺特异抗原密度诊断前列腺癌的临床应用价值研究

为探讨经直肠超声与前列腺特异抗原密度(PSAD)联合检查诊断前列腺癌的临床应用价值,选取本院2013年9月~2018年9月期间内接收的97例血清前列腺特异性抗原(PSA)患者实施研究。所有患者均行经直肠超声与前列腺特异抗原密度(PSAD)联合检查,并与手术病理结果进行对比。观察PSAD检查结果,分析经直肠超声与PSAD联合检查的诊断符合率,并对比病理结果与经直肠超声和PSAD联合检查的准确率、灵敏性、特异性情况,分析前列腺癌患者经直肠超声检查的影像学特征及内部回声情况。与病理结果对比,经直肠超声与PSAD联合检查对前列腺癌、移行细胞癌、黏液腺癌检出率均稍低(P>0.05);经直肠超声与PSAD联合检查的准确率、灵敏性、特异性较病理检查均稍低(P>0.05)。经直肠超声检查后根据图像表现可将疾病分为弥漫性、结节型、无结节型3型,不同类型的影像学特征及内部回声情况表现不同,表明经直肠超声与PSAD联合诊断前列腺癌准确性较高,并且可清晰地对不同疾病类型的内部回声作出反映,临床实用价值较高,值得加以推广。     

合成双醋瑞因的新方法

以芦荟素为原料,经脱苷、氧化反应得到大黄酸(4);4经三氟甲磺酸锌催化的乙酰化反应合成了双醋瑞因,总收率86.2%,其结构经1H NMR,IR和MS确证。     

L-亮氨酸衍生物手性氨基醇的合成与应用

以N,N-二甲基苯胺为原料,经对位溴化、邻位甲酰化得到5-溴-2-(二甲氨基)苯甲醛;L-亮氨酸经酯化、格氏反应得到二齿手性氨基醇;将5-溴-2-(二甲氨基)苯甲醛与上述氨基醇经缩合、还原得到三齿手性氨基醇;产物经红外光谱(IR)、质谱(MS)及核磁共振氢谱(1H-NMR)表征,考察了二齿手性氨基醇和三齿手性氨基醇作为...     

白鲜碱的合成

以苯胺为原料经取代、关环、甲基化、还原、消除反应合成了呋喃喹啉类生物碱白鲜碱,总收率17%,其结构经1H NMR,13C NMR和MS确证.     

盐酸左布诺洛尔的合成工艺改进

以回收的盐酸左布诺洛尔废料为原料,经NaOH碱化,HBr水解得5-羟基-α-萘满酮(2);2经醚化、氨化、用右旋酒石酸拆分得到盐酸左布诺洛尔,其结构经1H NMR和IR确证。2的回收率90%,总收率80.6%。     

高危良性前列腺增生的术式探讨

目的探讨经尿道前列腺剜除术与经尿道双极等离子前列腺电切术治疗高危良性前列腺增生的临床疗效。方法选取高危良性前列腺增生患者86例,随机分为实验组和对照组,两组患者分别应用经尿道前列腺剜除术、经尿道双极等离子前列腺电切术治疗,对比两组患者的手术效果。结果两组患者的临床疗效及不良反应均无明显差异(P>0.05),但实验组患者的手术时间、膀胱冲洗时间及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.01)。结论经尿道前列腺剜除术与经尿道双极等离子前列腺电切术治疗高危良性前列腺增生均安全有效,但经尿道前列腺剜除术的手术时间、膀胱冲洗时间及住院时间更短,术中出血量更少。     

2-氯烟酸绿色合成工艺

以烟酸为原料,经双氧水氧化制得N-氧化烟酸（2）; 2经氯化、水解并精制得2-氯烟酸,总收率76.8%,纯度≥99.5%,其结构经¹H NMR和¹³C NMR确证。     

三元环氨基酸的合成工艺改进

以甘氨酸乙酯盐酸盐为原料,经酰氨化、脱水、成环、水解反应合成了三元环氨基酸,总收率达50.4%。其结构经1HNMR,13CNMR,IR和EI-MS确证。     

β-胡萝卜素的合成工艺改进

以呋喃为原料,经水解、原位水解-Wittig反应、还原、氧化四步反应合成了β-胡萝卜素的关键中间体2,7-二甲基-2,4,6-辛三烯-1,8-二醛(5);5与季鏻盐经Wittig反应合成了β-胡萝卜素,总收率43%,其结构经1H NMR确证。     

α-Amino acid derived enaminones and their application in the synthesis of N-protected methyl 5-substituted-4-hydroxypyrrole-3-carboxylates and other heterocycles

A new and simple synthesis of novel N-protected methyl 5-substituted-4-hydroxypyrrole-3-carboxylates, which exist in equilibrium with their 4-oxo tautomers, has been developed in two steps starting from N-protected α-amino acids. The key intermediates are enaminones, which can also be isolated, characterized, and used for the construction of other functionalized heterocycles, before they spontaneously decompose to pyrrole products. 4-Hydroxypyrroles are prone to partial aerial oxidation but can be efficiently alkylated or reduced to stable polysubstituted pyrrolidine derivatives.     

Specific intramolecular aromatic CH insertion of diazosulfonamides

The chemoselectivity in the intramolecular CH insertion of various diazosulfonamides has been experimentally studied. The results reveal that the aliphatic 1,4-, 1,5-, or 1,6-C(sp³)?H insertions of diazosulfonamides are not accessible, while the aromatic 1,5-C(sp²)?H insertion can be realized specifically by adjusting the diazo-adjacent group. In addition, the general chemoselectivities in the intramolecular CH insertions of diazosulfonyl compounds are summarized. Generally, diazosulfones undergo both aromatic 1,5-C(sp²)?H and aliphatic 1,5- and 1,6-C(sp³)?H insertions, while diazosulfonates undergo aliphatic 1,5- and 1,6-C(sp³)?H insertions. However, diazosulfonamides only undergo aromatic 1,5-C(sp²)?H insertion.     

N-Heterocyclic carbene-palladacyclic complexes: synthesis,characterization and their applications in the C-N coupling and α-arylation of ketones using aryl chlorides

N-Heterocyclic carbene-palladacyclic complexes 3 were successfully achieved in a one-pot procedure under mild conditions. The structure of 3a was unambiguously confirmed by X-ray single crystal diffraction and it was an active catalyst in the Buchwald-Hartwig amination and α-arylation of ketones even at very low catalyst loadings (0.01?mol%).     

Iodine-mediated oxidative Pictet-Spengler reaction using terminal alkyne as the 2-oxoaldehyde surrogate for the synthesis of 1-aroyl-β-carbolines and fused-nitrogen heterocycles

An efficient iodine-mediated oxidative Pictet-Spengler reaction in dimethyl sulphoxide (DMSO) using terminal alkynes as the 2-oxoaldehyde surrogate for the synthesis of aryl (9H-pyrido[3,4-b]indol-1-yl)methanones is described. The scope of the protocol includes the total synthesis of Fascaplysin, Eudistomins Y₁ and Y₂. The methodology is extended for preparing pyrrolo[1,2-a]-quinoxaline and indolo[1,5-a]quinoxaline derivatives. The utility of 1-aroyl-β-carbolines was demonstrated by performing palladium-catalyzed β-carboline directed ortho-C(sp2)-H functionalization of the phenyl ring with thiomethyl (SMe) group using DMSO as source and for accessing 4-aryl-canthin-6-ones.     

Facile synthesis of bicyclic 1-arylpyrazol-5-ones

In this Letter, we described a facile method for constructing fused bicyclic 1-arylpyrazol-5-one ring system. We employed various methylene-containing carboxylic acids as the substrates and proved that the pyrazolone ring closure requires activated methylene group in intermediate II. Accordingly, a series of structurally diversified, fused bicyclic 1-arylpyrazol-5-ones was prepared in moderate to high yields using the requisite substrates.     

A carbanion induced synthesis of highly congested pyrazole and imidazole containing heterocycles

An efficient approach to the synthesis of highly congested di, penta and hexacyclic pyrazoles as well as imidazole fragment containing novel heterocyclic molecule has been developed through a carbanion induced transformation of suitably functionalized 2H-pyran-2-ones, benzo[h]chromene and thiochromeno[4,3-b]pyrans. Due to the presence of fluorescence, we report their prime application metal sensor as off/on switching in ferric ions.     

Synthesis of pyrrolo[1,2-a]pyrazines and pyrazino[1,2-a]indoles by Curtius reaction in Morita-Baylis-Hillman derivatives

Synthesis of substituted pyrrolo[1,2-a]pyrazines and pyrazino[1,2-a]indoles from the Morita-Baylis-Hillman derivatives of acrylates via saponification followed by Curtius reaction is described.     

Selective synthesis of 4,5-dihydroimidazo- and imidazo[1,5-a]quinoxalines via modified Pictet–Spengler reaction

An efficient tandem approach for the selective synthesis of 4,5-dihydroimidazo[1,5-a]quinoxalines 6a–g and imidazo[1,5-a]quinoxalines 7a–h by the reaction of 2-imidazolyl anilines 4a–c with aryl aldehydes 5a–k under mild reaction conditions is described. Introduction of electron releasing alkyl groups in substrates 4a–b was found to be instrumental for the success of the reaction.     

Understanding the Diels-Alder reactivity of 1,2-azaborine analogues

The Diels-Alder reactivity of 1,2-heteroborines (H₄C₄B(H)X, X?=?NH, PH, AsH; O, S, Se) has been computationally explored by means of Density Functional Theory (DFT) calculations. The influence of the HB?=?X fragment on the reactivity of the system has been quantitatively analyzed in detail by means of the so-called Activation Strain Model (ASM) of reactivity. It is found that the interaction between these species and the dienophile is significantly stronger than that computed for their all-carbon isoelectronic counterpart, benzene. In addition, the strain energy plays a key role in the observed reactivity trends. The role of the aromaticity strength of these heteroarenes on the reactivity is also assessed.