Objective To explore the efficacy of progressive exercise training based on the modified Medical Research Council dyspnea scale (mMRC) grading in respiratory rehabilitation for patients with chronic obstructive pulmonary disease (COPD) at a primary healthcare setting. Methods A total of 106 patients with COPD admitted to Zhuanqiao Community Health Service Center in Shanghai from Aug.1, 2022 to Jul. 30, 2024 were selected as research subjects. They were randomly divided into a study group and a control group in a 1∶1 ratio, with 53 patients in each group. The control group received conventional treatment, while the study group received conventional treatment combined with progressive exercise training. After 4 weeks of continuous treatment, the changes in the 6-minute walk test (6MWT), COPD assessment test (CAT) score, mMRC grading, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading and pulmonary function were compared between the two groups. Results Patients in both groups showed improvements in 6MWT distance, CAT score, mMRC grading, GOLD grading, and pulmonary function compared to baseline (P＜0.05). Moreover, the study group had better improvements in 6MWT distance, CAT score, mMRC grading, GOLD grading, and pulmonary function than the control group (P＜0.05). Conclusions Conventional treatment combined with progressive exercise training based on mMRC grading can enhance the effect of respiratory rehabilitation in patients with COPD, particularly in improving pulmonary function and exercise tolerance.

Six new ent-abietane diterpenoids, abientaphlogatones A-F (1-6), along with two undescribed ent-abietane diterpenoid glucosides, abientaphlogasides A-B (7-8) and four known analogs were isolated from the aerial parts ofPhlogacanthus curviflorus (P. curviflorus). The structures of these compounds were determined using high-resolution electrospray ionization mass spectrometry (HR-ESI-MS), one-dimensional and two-dimensional nuclear magnetic resonance (NMR) spectroscopy, electronic circular dichroism (ECD) spectra, and quantum chemical calculations. Notably, compounds 5 and 6 represented the first reported instances of ent-norabietane diterpenoids from the genus Phlogacanthus. In the β-hematin formation inhibition assay, compounds 2, 4, 7-10, and 12 displayed antimalarial activity, with IC₅₀ values of 12.97-65.01 μmol·L^-1. Furthermore, compounds 4, 5, 8, and 10 demonstrated neuroprotective activity in PC12 cell injury models induced by H₂O₂ and MPP⁺.
Abietanes/pharmacology* ; Antimalarials ; Hydrogen Peroxide ; Biological Assay ; Plant Components, Aerial

Objective To observe the clinical curative effect of unilateral biportal endoscopy(UBE)in the treatment of extreme lateral lumbar disc herniation(ELLDH).Methods From June 2019 to June 2022,25 patients with ELLDH were treated with UBE-guided discectomy,including 16 males and 9 females.The age ranged from 26 to 62 years with a mean of(53.67±17.45)years.History ranged from 3 d to 10 years.There were 9 cases of internal foraminal type(type Ⅰ),13 cases of external foraminal type(type Ⅱ)and 3 case of mixed type(type Ⅲ).There were 8 cases of L4/5 space and 17 cases of L5/S1 space.All the patients underwent anterior and lateral lumbar X-rays,CT and MRI scans before surgery.The visual analogue scale(VAS)pain score and Oswestry disability index(ODI)assessed lower limb and lower back pain and functional recovery before surgery and at 3 d and 3 months after surgery,respectively.Macnab criteria evaluated the immediate surgical outcome.Results The UBE technique was used to treat ELLDH.The operative time was(79.79±23.97)min,the intraoperative bleeding volume was 40～80 mL,with an average of(55.80±10.74)mL.Follow-up time was(7.02±4.26)months.Preoperative VAS of lower limb was(7.04±0.92),lower back VAS was(3.49±1.52),ODI was(35.03±2.97)%.Compared with the preoperative results,the lower limb VAS was(2.17±0.61),lower back VAS was(1.48±0.43),and ODI was(18.77±3.15)%on day 3 after surgery,lower limb VAS was(1.38±0.65),lower back VAS was(1.03±0.48)and ODI was(6.05±1.80)%on the 3 months after surgery were improved(P＜0.05).The excellent and good rate was 96.0%(excellent 20,good 4,fair 1),and no obvious complications were observed during the follow-up.Conclusion UBE is effective,with little trauma,clear intraoperative visual field,good intraoperative experience,and less traumatic and safe in the treatment of ELLDH.

Circular RNAs are a group of novel non-coding RNA molecules, which form covalently closed continuous loop structures, lacking the terminal 5′ and 3′ ends. They are abundant in eukaryotes and have recently become an increasing area of research in the field of RNA. Circular RNAs have many functions, such as abundant expression, cell- or tissue-specific expression, and high resistance to RNase-induced degradation. They are closely related to tissue development and the occurrence and development of diseases, play an important role in the pathogenesis and development of a variety of diseases, and can be used as a novel molecular marker of some diseases. Therefore, this review summarizes the latest research progress of circular RNAs in the regulation of endocrine diseases to better understand the biological mechanisms underlying endocrine diseases.

Otamixaban is a potent (Ki ? 0.5 nM) fXa inhibitor currently in late-stage clinical develop-ment at Sanofi for the management of acute coronary syndrome. Being unproductive in obtaining a suitable crystal of Otamixaban, the required enantiomeric characterization has been accomplished using vibrational circular dichroism (VCD) spectroscopy. Selected by a spectrum similarity index, the calculated spectra of several higher energy conformers were found to match well with the observed spectra. The characteristic IR bands of these conformers were also identified and attributed to the solvation effect. Combined with both the single crystal x-ray diffraction results for an intermediate and the proton NMR study, the absolute configuration of Otamixaban is unambiguously determined to be (R,R).

Objective To observe the safety and efficacy of the posterior spinal instrumentation (PSI) with preserving of the intraspinal rib head in neurologically intact patients with scoliosis secondary to Neurofibromatosis type 1 (NF1).Methods The clinical and radiographic data of nine NF1 scoliosis patients with rib head protrusion into the spinal canal,who had undergone PSI from August 1998 to March 2012,were retrospectively investigated.The average age of these patients (4 males,5 females) was 15.4±7.6 years,and their neurological status all were Frankel grade E preoperatively.The intraspinal rib head was not resected in all patients intraoperatively.The following parameters,including the magnitude of rib head penetration into the spinal canal (MRPC),the angle between the bilateral rib (ABR),the angle between the dislocated rib and the posterior vertebral wall (ARV),the coronal Cobb angle and the sagittal Cobb angle,were measured before and after surgery.Results The follow-up period was 0.5 to 4.8 years.The average MRPC decreased from preoperative 32.8％±9.9％ to postoperative 16.8％±15.2％ (P=0.026); the average ARV increased from preoperative 34.7°±16.4° to postoperative 47.8°±17.5° (P=0.001); the average ABR decreased from preoperative 83.0°±19.5° to postoperative 67.9°±13.3° (P=0.009); the average coronal Cobb angle decreased from preoperative 70.7° ±17.7° to 35.4°±17.0° immediately after operation (P=0.000) and the sagittal Cobb angle decreased from preoperative 59.7°±17.6° to 24.7°±10.8° immediately after operation (P=0.001).The coronal Cobb angle and sagittal Cobb angle had no significant change during follow-up period.The neurological status was Frankel grade E in all patients immediately after operation and at final follow-up.Conclusion For NF1 scoliosis patients with rib head penetration into the spinal canal without impingement of the spinal cord and neurological deficits,the deformity can be corrected safely and effectively without resecting the intraspinal rib head.