Aim: To improve the synthesis for 2, 5-anhydro-3,4, 6-tri-O-benzyl-D-glucitol. Methods: Dehydration of D-mannitol, followed by a reaction sequence of selective protection, benzylation, deprotection, tritylation, benzy-lation and removal of the trityl group, afforded the title compound. Results: Based on the improvement of the reported synthetic route, 2,5-anhydro-3,4,6-tri-O-benzyl-D-glucitol was synthesized in seven steps from D-mannitol with a total yield of 8. 3% . Conclusion: This new method features mild reaction conditions and facile work-up.

Objective The aim of this study was to investigate the relationship between serum C-reactive protein (CRP) and muscle strength, physical performance in the elderly. Methods A cross-sectional study was conducted in Hangu district of Tianjin from April to June in 2013. Totally 1 131 subjects aged 60 years or older completed the survey. Every subject filled out a standard questionnaire and underwent grip strength test, timed up and go test (TUGT). Serum CRP concentrations were determined using chemiluminescent immunoassay kits. Multivariate analysis was performed to determine the relationship between CRP and muscle strength, physical performance. Results After adjustment for potential confounding factors including age, BMI, smoking status, drinking status, hypertension, diabetes, cardiovascular disease, anemia, cancer and physical activity, the multiple linear regression analysis suggested that CRP levels were inversely related to handgrip strength (β'=-0.11, P<0.01), and the logistic regression analysis showed that compared with subjects in the lowest quintile, the odds ratios and 95%confidence interval of higher quintile of CRP were 1.09 (0.50, 2.39) and 2.70 (1.34, 5.66) (Ptrend<0.05) in males. However, the relationship between CRP and muscle strength, physical performance was not statistically significant in females. Conclusions In males, higher serum CRP levels were independently correlated with lower muscle strength and poor physical performance in older adults. These results suggested that inflammation-signaling pathways may play an important role in the progression of sarcopenia.

Objective·To identify the relationship between the estimated fetal weight (EFW) discordance and birth weight (BW) discordance, and evaluate the accuracy of ultrasonography in predicting birth weight discordance (△BW) of twin pregnancy. Methods·The ultrasound was used to detect the growth of twins at different gestational weeks and the data were analyzed to compare the difference between EFW discordance (△EFW) and ?BW. Results·About 15.9 percent of twins (totally 277 cases) had severe △BW (△BW ≥20%) in our study, and the percentages of dichorionic-diamniotic twin (DCDA) and monochorionic-diamniotic twin (MCDA) were 68.2% and 31.8%, respectively (P>0.01). Compared with △EFW in other gestational weeks,△EFW last time before parturition was most consistent of △BW. Furthermore, the negative predictive value of MCDA was highest (94%) at 22-24 gestational weeks. Conclusion·Twin △BW was relatively better predicted by △EFW last time before parturition. Twin pregnancy without severe △EFW (△EFW<20%), especially MCDA with △EFW<20% at 22-24 weeks, had low probability of selective intrauterine growth restriction in the future.

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Objective Through the research and analysis of guangdong medical college affiliated hospital orthopaedic hospitalized patients with a diagnosis of osteoporosis in Zhanjiang,this paper provide theoretical basis for the prevention of osteoporosis frac-ture.Methods The elderly aged over 40 years old,living in this area for a long time.Data was collected from August 2012 to Feb-ruary 2014,hospitalized patients in guangdong medical college affiliated hospital were diagnosed with osteoporosis.Contents include general situation survey,medical examination,venous blood tests and bone mineral density testing.Results Fracture group average age is older than the non fracture group;the fracture group lumbar spine bone mineral density(LSBMD)and femoral neck bone min-eral density(FNBMD)T value and Z value and serum calcium group is greater than the fracture and the differences were statistically significant(P <0.05).Fracture group in gender divided into two groups for comparison,in which women older than men,and the difference was statistically significant(P <0.05),male LSBMD T and Z values and FNBMD T value is greater than the female and the difference was statistically significant(P <0.05).According to the 10 year age group,Each age group compared with the frac-ture number and non fracture number,in the age group of 70-80 fracture number were the most;All age groups in LSBMD,FNB-MD,serum calcium(Ca)and VitD compared,non fracture group is most higher than that of fracture group.The influence factors of the fractures for non conditional Logistic regression analysis,age,LSBMD,FNBMD T value increased were risk factors for fracture, VitD,FNBMD,LSBMD T value increased were protective factors of fracture.Conclusion Need as soon as possible to prevent osteo-porosis,especially before the age of 40,try to improve the peak bone density,to prevent the occurrence of osteoporosis in the future.

Objective Neutrophil/lymphocyte ratio (NLR) is a simple and reliable inflammation biomarker but few studies have assessed the relationship between NLR and hypertension in Chinese population. In order to evaluate how NLR is related to the incidence of hypertension, we designed a large scale prospective cohort study in an adult population. Method Participants were recruited from Tianjin Medical University's General Hospital?Health Management Centre. Hypertension?free subjects (men, 13 638;women,15 212) were followed up for a median of 2.7 years. Adjusted Cox proportional hazards regression models were used to assess relationships between the quintiles of NLR and the incidence of hypertension. Result During the follow-up period, 1 348 subjects in men and 476 subjects in women developed hypertension. The hazard ratios of hypertension incidence were evaluated in increasing NLR quintiles both in men and women. In the final multivariate models, the hazard ratios (95% confidence interval) for hypertension across NLR quintiles were 1.00 (Reference), 1.05 (0.87, 1.26), 1.02 (0.85, 1.22), 1.07 (0.90, 1.29) and 1.22 (1.03, 1.45) (P for trend=0.01), in men;1.00 (Reference), 1.11 (0.82, 1.49), 0.79 (0.58, 1.08), 1.13 (0.85, 1.52) and 1.25 (0.94, 1.66) (P for trend=0.07), in women, respectively. Conclusion This study showed that the elevated NLR levels were significantly related to an increased risk of developing hypertension in men, but not in women.

Histone deacetylase 8(HDAC8)is a zinc-dependent class I histone deacetylase, closely related to human pathophysiology. HDAC8 involves in various critical signaling networks and is implicated as a therapeutic target in various diseases, including cancer, X-linked intellectual disability and parasitic infections. More and more selective HDAC8 inhibitors have been developed based on deepening study of its well-characterized crystal structure. They are mainly divided into several categories such as phenyl hydroxamic acids, indoles, ortho-aryl-N-hydroxycinnamides, azetidinones etc. . Current challenges remain in the development of potent selective inhibitors that would specifically target HDAC8 with fewer adverse effects compared with pan-HDAC inhibitors. Herein, we reviewed the progress in the study of structure and functions of HDAC8 as well as the development of selective HDAC8 inhibitors.

Clinical data of a child with acromesomelic dysplasia Maroteaux type (AMDM) treated in the Department of Pediatrics, Tianjin Medical University General Hospital at November 2018 was retrospectively analyzed.The female child aged 3 years and 3 months old with 83 cm height (-3.84 SD) had clinical manifestations of disproportionate short stature, disproportionate shortening of forearms and forelegs, and stubby fingers and toes.Gene sequencing identified compound heterozygous mutations, c.1640T>A(p.Val547Asp)/c.682G>A(p.Gly228Ser), in the NPR2 gene, which have not been reported in the Human Gene Mutation Database.Their protein function was predicted harmful.The child was diagnosed as AMDM.During the follow-up until 4 years and 8 months old, the child was 90 cm tall (-4.35 SD), with a growth velocity of 4.9 cm/year.She was treated with recombinant human growth hormone (rhGH) treatment for 9 months and regularly followed up.The child was now 98.2 cm height (-3.07 SD) and she had a growth velocity of 10.9 cm/year.This case report enriched the gene mutation spectrum of AMDM.Treatment with rhGH can effectively improve the height of the child, but the long-term effect needs further follow-up and observation.

Purpose: Little is known about the role of gut microbiota in the pathogenesis of erectile dysfunction (ED). We performed a study to compare taxonomic profiles of gut microbiota of ED and healthy males. Materials and Methods: A total of 43 ED patients and 16 healthy controls were enrolled in the study. The 5-item version of the International Index of Erectile Function (IIEF-5) with a cutoff value of 21 was used to evaluate erectile function. All participants underwent nocturnal penile tumescence and rigidity test. Samples of stool were sequenced to determine the gut microbiota. Results: We identified a distinct beta diversity of gut microbiome in ED patients by unweighted UniFrac analysis (R2=0.026, p=0.036). Linear discriminant analysis effect size (LEfse) analysis showed Actinomyces was significantly enriched, whereas Coprococcus_1, Lachnospiraceae_FCS020_group, Lactococcus, Ruminiclostridium_5, and Ruminococcaceae_UCG_002 were depleted in ED patients. Actinomyces showed a significant negative correlation with the duration of qualified erection, average maximum rigidity of tip, average maximum rigidity of base, tip tumescence activated unit (TAU), and base TAU. Coprococcus_1, Lachnospiraceae_FCS020_group, Ruminiclostridium_5, and Ruminococcaceae_UCG_002 were significantly correlated with the IIEF-5 score. Ruminiclostridium_5 and Ruminococcaceae_UCG_002 were positively related with average maximum rigidity of tip, average maximum rigidity of base, ΔTumescence of tip, and Tip TAU. Further, a random forest classifier based on the relative abundance of taxa showed good diagnostic efficacy with an area under curve of 0.72. Conclusions This pilot study identified evident alterations in the gut microbiome composition of ED patients and found Actinomyces was negatively correlated with erectile function, which may be a key pathogenic bacteria.

Objective:To evaluate the detective effect of double inversion recovery (DIR) sequence on cerebral white matter hyperintensities (WMH) in patients with acute ischemic stroke, and compare with those of T2WI and FLAIR sequences.Methods:Seventy-three acute ischemic stroke patients with WMH within 14 d of onset, admitted to Department of Neurology, Beijing Shijitan Hospital, Capital Medical University from November 2018 to March 2021, were chosen. MRI T2WI, FLAIR and DIR sequences were used to detect WMH. According to Fazekas scale, patients with periventricular white matter hyperintensities (PVWMH) or deep white matter hyperintensities (DWMH) were divided into mild group (score of 0-1) and moderate to severe group (scores≥2); the differences in WMH volume detected by T2WI, FLAIR and DIR sequences, and signal intensity, cross-sectional area and contrast of isolated lesions were compared.Results:(1) Seventy-three patients were with PVWMH (36 into the mild group and 37 into the moderate to severe group); in patients from the moderate to severe group, PVWMH volume detected by FLAIR sequence was statistically larger compared with that by DIR sequence, and PVWMH volume detected by T2WI sequence was significantly smaller compared with that by FLAIR sequence ( P<0.05). Fifty-seven patients were with DWMH (44 into the mild group and 13 into the moderate to severe group); the DWMH volume detected by FLAIR and T2WI sequences was significantly larger than that by DIR sequence ( P<0.05). (2) A total of 60 isolated lesions were detected, ranged 5.0-9.1 mm in length; isolated lesions enjoying significantly larger cross-sectional area, higher signal intensity, and lower contrast detected by FLAIR and T2WI sequences compared with those by DIR sequence ( P<0.05); isolated lesions enjoying significantly higher signal intensity and contrast detected by T2WI sequence compared with those by FLAIR sequence ( P<0.05). Conclusion:DIR sequence enjoys better effect in detecting WMH than FLAIR and T2WI sequences; the mismatch area of DIR sequence with FLAIR or T2WI sequences suggests WMH penumbra.