A series of new coumarin-based benzotriazole derivatives were successfully synthesized via a multi-step sequence of cyclization, etherification and N-alkylation, and were confirmed by 1H NMR, IR, MS spectra as well as elemental analyses. All these synthesized coumarin compounds were evaluated for in vitro antimicrobial activities against four Gram-positive bacteria, four Gram-negative bacteria and three fungi by two fold serial dilution technique. The bioactive assay showed that all these prepared coumarin benzotriazoles could inhibit the growth of the tested bacterial and fungal strains. Title compounds 11a-11e and 13a-13c were more active than chloromycin on Proteus vulgaris ATCC 6896. Coumarin benzotriazoles 11a and 11b displayed comparable antibacterial efficacy against Staphylococcus aureus ATCC 25923 and Micrococcus luteus ATCC 4698 in comparison with reference drug chloromycin. Compared to fluconazole, compounds 11a-11d displayed stronger inhibition on Aspergillus fumigatus ATCC 96918. Moreover, coumarin-based benzotriazoles in combination with antibacterial chloromycin or antifungal fluconazole, showed notable antimicrobial efficacy with less dosage and broader antimicrobial spectrum. More importantly, fluconazole-insensitive A. fumigatus and methicillin-resistant Staphylococcus aureus N 315 (MRSA) were sensitive to these combined drugs.

BACKGROUND:Related studies have shown that after kyphoplasty with bone cement injection, the vertebral height restoration is closely related to the injury time. Surgical timing also has an important influence on the incidence of postoperative complications. OBJECTIVE:To compare the clinical efficacy of kyphoplasty with bone cement injection at 2 and 2-4 weeks after thoracolumbar vertebral compression fractures, and to investigate the best timing for kyphoplasty. METHODS:Eighty-two thoracolumbar fracture patients, aged 55-85 years old, were included. Thirty-nine cases were subjected to kyphoplasty with bone cement injection within 2 weeks after injury. Another 43 cases were subjected to kyphoplasty with bone cement injection within 2-4 weeks after injury. The visual analog scale score, restoration of anterior and central vertebral height, volume and leakage of bone cement after treatment were compared between two groups. At 6 months after treatment, the daily activities of patients in the two groups were evaluated using Oswestry disability index. RESULTS AND CONCLUSION:Immediately and at the 6th month after treatment, the scores on the visual analog scale and the Oswestry disability index were lower than those before treatment (P < 0.05). The visual analog scale score immediately after treatment in the treatment group within 2 weeks was higher than that in the treatment group within 2-4 weeks (P< 0.05). After 6 months of treatment, there was no significant difference in the restoration rate of anterior and central vertebral height between these two groups, but the loss rate of the anterior and central vertebral height in the treatment group within 2 weeks was lower than that in the treatment group within 2-4 weeks (P< 0.05). Bone cement injection volume and leakage rate had no significant differences between two groups. These results demonstrate that patients appeared to have obvious pain after percutaneous kyphoplasty with bone cement injection within 2 weeks, but the percutaneous kyphoplasty with bone cement injection had smal influence on the short-term loss rate of vertebral height. Therefore, percutaneous kyphoplasty with bone cement injection with 2 weeks after injury is the optimal treatment timing for patients with thoracolumbar compression fractures.

Objective To describe the incidence trend of leukemia in Shenzhen during 2001 to 2015, and to provide base data for designing prevention and treatment strategies on leukemia. Methods The leuke-mia incidence data and population data collected by Shenzhen Cancer Registry from 2001 to 2015 were used in our analysis. The crude incidence,age-standardized incidence rate by Chinese standard population (ASR China)and age-standardized incidence rate by world standard population (ASR world)were calculated. The annual percentage change (APC)of the incidence was analyzed by Joinpoint regression. Results Shenzhen Cancer Registry registered 2106 new cases of leukemia from 2001 to 2015. The crude incidence was 6. 31 per 100000,with 6. 75 per 100000 ASR China and 7. 15 per 100000 ASR world. Cumulative rate (0-74 years) was 0. 63％,and truncated rate (35-64 years)was 7. 03 per 100000. From the perspective of gender distribu-tion,the incidence of male was significantly higher than female,with a sex ratio of 1. 38 : 1. In terms of time trend,the incidence of leukemia was stable,and the Joinpoint regression showed that APC = - 0. 09％(95％ CI:- 1. 60％ -1. 41％,P = 0. 92). In terms of subtypes,acute myelocytic leukemia (AML)accounted for 17. 66％ of the total cases,and the incidence of AML has increased during 2001 to 2015 (APC = 13. 34％, 95％ CI:5. 71％ -21. 51％,P < 0. 01). The median age of leukemia patients was 36 years old,and the mean age was 37. 29 years old. The two peaks of the incidence were 1-4 and 80-84 age groups,and the ASR inci-dences were 9. 13 per 100000 and 39. 40 per 100000 respectively. Conclusion The incidence of leukemia is very high in Shenzhen. Children and the elderly are at high risk of leukemia. Government needs to guide insti-tutions to carry out research to reduce the incidence of leukemia.

Objective To compare the clinical effects of combined anterolateral and posterolateral approach,lateral incision via double intermuscular spatia approach,and posterolateral transfibular approach in the treatment of fractures of anterolateral and posterolateral columns of tibial plateau.Methods A retrospective analysis was done of the 18 patients with fracture of anterolateral and posterolateral columns of tibial plateau who had been treated at our hospital from January 2012 to January 2015.They were 10 men and 8 women,aged from 28 to 58 years (mean,35.5 years).They were divided into 3 equal groups.Group A was treated with combined anterolateral and posterolateral approach,group B with lateral incision via double intermuscular spatia approach and group C with posterolateral transfibular approach.Operation time,surgical blood loss and complications were recorded.At the final follow-ups,Rasmussen score was used to evaluate the fracture reduction and Hospital for Special Surgery (HSS) knee score to assess functions of the involved knees.Results The 18 patients were followed up for 10 to 18 months (average,13.3 months).No such early complications as incision infection or deep vein thrombosis occurred.The operation time (89.5 min and 79.3 min,respectively) and surgical blood loss (151.7 mL and 207.8 mL,respectively) for groups A and B were obviously less than those for group C (102.5 min;260.2 mL);the incision length for group A (10.5 cm) was shorter than that for group B (17.4 cm) and for group C (16.3 cm);group C had more cases of excellent reduction (6) than groups A and B (4 for both).There were no obvious differenc es between groups A,B and C in the Rasmussen score (16.8,17.0 and 16.3) or HSS score (86.3,86.0 and 85.7).One case of delayed incision healing due to partial necrosis occurred in group B.At the final follow-ups in group C,the varus stress test showed 2 cases of laxation of degree Ⅱ and 2 cases of laxation of degree Ⅰ.Conclusions In the treatment of fractures of anterolateral and posterolateral columns of tibial plateau,all the 3 approaches can lead to good exposure,fine reduction,rigid fixation and satisfactory outcomes.Although the combined anterolateral and posterolateral approach and lateral incision via double intermuscular spatia approach can lead to similar exposure ranges and fixation effects,the latter is easier in operation while the former exposes the anterior and posterior spatia more fully,allowing the anterior and posterior plates to be better positioned.The posterolateral transfibular approach can lead to the largest exposure range and more precise reduction,but it has risks of damage to the lateral ligamentous structure,greater invasion,postoperative lateral instability and injury to the common peroneal nerve.