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A visible light-promoted difluoroalkylation reaction of arenes or heterocycles, using triaryl phosphine as the catalyst and difluoroalkyl iodide as the alkylating agent, is presented. The strategy is highlighted by photocatalyst-free, mild reaction conditions and a broad substrate scope. Mechanistic experiments indicate that this reaction involves a radical-chain process that is initiated by an electron donor−acceptor complex formed from difluoroalkyl iodide and phosphine.

Four versions of Acute Physiology and Chronic Health Evaluation are limited in predicting hospital mortality for neurocritically ill patients. This prospective study aimed to develop and assess the accuracy of a modified APACHE II model in predicting mortality in neurologic intensive care unit (N-ICU). A total of 653 patients entered the study. APACHE II scores on admission, and worst 24-, 48-, and 72-h scores were obtained. Neurologic diagnoses on admission were classified into five categories: cerebral infarction, intracranial hemorrhage, neurologic infection, neuromuscular disease, and other neurologic diseases. We developed a modified APACHE II model based on the variables of the 72-h APACHE II score and disease category using a multivariate logistic regression procedure to estimate probability of death. We assessed the calibration and discrimination of the modified APACHE II model using the Hosmer-Lemeshow goodness-of-fit chi-squared statistic and area under the receiver operating characteristic curve (AU-ROC). The modified APACHE II model had good discrimination (AU-ROC = 0.88) and calibration (Hosmer-Lemeshow statistic: chi (2) = 3.707, P = 0.834). The discrimination of the 72-h APACHE II score for cerebral infarction, intracerebral hemorrhage, and neurologic infection was satisfactory, with AU-ROC of 0.858, 0.863, and 1.000, respectively, but it was poor in discriminating for the categories of other neurologic diseases and neuromuscular disease. The results showed that our modified APACHE II model can accurately predict hospital mortality for patients in N-ICU. It is more applicable to clinical practice than the previous model because of its simplicity and ease of use.

Background Circular RNAs (circRNAs) has emerged as vital regulator involved in various diseases. In this study, we identified and investigated the potential circRNAs involved in gestational diabetes mellitus (GDM). Methods High-throughput sequencing was used to collect the plasma circRNAs expression profiles of GDM patients. Quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR) was used to measure the expressions of circ_0008285 and circ_0001173 in the plasma specimens. The Pearson’s correlation test was employed to assess the correlation between 2 circRNAs expression and the clinicopathologic data. Two circRNAs expression was verified in high glucose (HG)-induced HTR-8/SVneo cells. MTS, transwell assay was used to evaluate the effects of circ_0008285 expression on HG-induced HTR-8/SVneo cells. The network of circ_0008285 was constructed using cytocape. Results In GDM patients, the expression of circ_0008285 was significantly upregulated, while that of circ_0001173 was decreased. Circ_0008285 was significantly correlated with the total cholesterol and LDL-C levels. Circ_0001173 was significantly correlated with glycated hemoglobin. HG promoted the proliferation, invasion, and migration in HTR-8/SVneo cells, while the knockdown of circ_0008285 exerted reverse effects. In addition, network construction exhibited that circ_0008285 had 45 miRNA binding sites, which correlated with 444 mRNA. Conclusions circ_0008285 plays an important role and provides a clue for the usage of therapeutic targets in the development of GDM.

BackgroundAppropriate classification of obesity is vital for risk assessment and complication prevention during pregnancy. We aimed to explore which pre-pregnancy BMI cut-offs of obesity, either BMI ≥ 25 kg/m2 as recommended by the WHO for Asians or BMI ≥ 28 kg/m2 as suggested by the Working Group on Obesity in China (WGOC), best predicts the risk of adverse maternal and perinatal outcomes.MethodsWe retrospectively reviewed 11,494 medical records for live singleton deliveries in a tertiary center in Guangzhou, China, between January 2013 and December 2016. The primary outcomes included maternal obesity prevalence, adverse maternal and perinatal outcomes. Data were analyzed using the Chi-square test, logistic regression, and diagnostics tests.ResultsAmong the study population, 824 (7.2%) were obese according to the WHO criteria for Asian populations, and this would be reduced to 198 (1.7%) based on the criteria of WGOC. Obesity-related adverse maternal and perinatal outcomes were gestational diabetes mellitus, preeclampsia, cesarean section, and large for gestational age (P < 0.05). Compared to the WGOC criterion, the WHO for Asians criterion had a higher Youden index in our assessment of its predictive value in identifying risk of obesity-related adverse outcomes for Chinese pregnant women. Women in the BMI range of 25 to 28 kg/m2 are at high risks for adverse maternal and perinatal outcomes, which were similar to women with BMI ≥ 28 kg/m2.ConclusionsA lower pre-pregnancy BMI cutoff at 25 kg/m2 for defining obesity may be appropriate for pregnant women in South China. If WGOC standards are applied to pregnant Chinese populations, a significant proportion of at-risk patients may be missed.

Kruppel-like factor 6 (KLF6) as a novel tumor suppressive gene participates in multiple biological behaviors and plays an important role in regulating tumor cell growth and invasion. However, the functions of KLF6 in hepatocellular carcinoma (HCC) remain poorly understood. The expression level of KLF6 was examined by immunohistochemical assay in human HCC tissues, and KLF6-overexpressed HCC cells (SMCC-7721 and HepG2) were used for evaluating cell proliferation and invasion by MTT and Transwell assays. A subcutaneous HCC tumor model was established for assessing tumor growth in vivo. Our results showed that the expression of KLF6 was significantly downregulated in HCC tissues compared with the adjacent non-cancerous tissues (50.0% vs. 72.0%, P = 0.034) and negatively associated with the lymph-vascular space invasion (LVSI) in HCC patients (P = 0.003). Furthermore, overexpression of KLF6 reduced cell proliferation and weakened the cell invasive potential followed with the decreased expression of PCNA and MMP-9 in HCC cells. The in vivo experiment indicated that KLF6 overexpression suppressed the xenograft tumor growth. Therefore, our findings show that KLF6 suppresses growth and invasion of HCC cells in vitro and in vivo, suggesting a tumor suppressive function in HCC and provides the potential therapeutic target for the treatment of HCC.