Background: Imported malaria has been an important challenge for China. Fatality rates from malaria increased in China, particularly in Henan Province, primarily due to malpractice and misdiagnoses in healthcare institutions, and the level of imported malaria. This study aims to investigate the relationship between the state of diagnosis and subsequent complications among imported malaria cases at healthcare institutions, based on malaria surveillance data in Henan Province from 2012 to 2017. Methods: A retrospective descriptive analysis was performed using data from the Centre for Disease Control and Prevention, Zhengzhou City, the capital of Henan Province. A decision tree method was exploited to provide valuable insight into the correlation between imported malaria cases and healthcare institutions. Results: From 2012 to 2017, there were 371 imported malaria cases, mostly in males aged between 20 and 50 years, including 319 Plasmodium falciparum cases. First visits of 32.3%, 19.9% and 15.9% malaria cases for treatment were to provincial, municipal and county healthcare institutions, respectively. The time interval between onset and initial diagnosis of 284 cases (76.5%) and the time interval between initial diagnosis and final diagnosis of 197 cases (53.1%) was no more than 72 h. An apparent trend was found that there were notably fewer patients misdiagnosed at first visit to healthcare institutions of a higher administrative level; 12.5% of cases were misdiagnosed in provincial healthcare institutions compared to 98.2% in private clinics, leading to fewer complications at healthcare institutions of higher administrative level due to correct initial diagnosis. In the tree model, the rank of healthcare facilities for initial diagnosis, and number of days between onset and initial diagnosis, made a major contribution to the classification of initial diagnosis, which subsequently became the most significant factor influencing complications developed in the second tree model. The classification accuracy were 82.2 and 74.1%, respectively for the tree models of initial diagnosis and complications developed. Conclusion: Inadequate seeking medical care by imported malaria patients, and insufficient capacity to diagnose malaria by healthcare institutions of lower administrative level were identified as major factors influencing complications of imported malaria cases in Henan Province. The lack of connection between uncommon imported malaria

The adequate data indicated that ADSC therapy recovered erectile function and regenerated cavernous structures in ED rats, and ADSCs modified by some growth and neurotrophic factors accelerated the recovery of erectile function and cavernous structures in ED rats.

A high incidence of DM and IFG was detected in Chinese HIV-infected patients receiving combination antiretroviral therapy. Clinicians should be aware of the potential for an increased risk of glycemic disorders in Chinese HIV-infected patients, particularly those of advanced age, with hepatitis B virus coinfection or high baseline fasting glucose.

Herein, we report the development of a method for highly regio-, stereo-, and enantioselective BÀ H bond insertion reactions of α-silylcarbenes generated from 1-silylcyclopropenes in the presence of a chiral copper(I)/bisoxazoline catalyst for the construction of chiral γ,γ-disubstituted allylic gem-silylboranes, which cannot be prepared by any other known methods. This reaction is the first highly enantioselective carbene insertion reaction of α-silylcarbenes ever to be reported. The method shows general applicability for various 3,3disubstituted silylcyclopropenes and exclusively affords E-products. The novel chiral γ,γ-disubstituted allylic gem-silylborane products are versatile allylic bimetallic reagents with high stability and have great synthetic potential, especially for the construction of complex molecules with continuous chiral centers.Carbenes are important intermediates with diverse reactivities. α-Silylcarbenes are a class of functionalized carbene species with relatively good stability, [1] and their asymmetric transfer reactions constitute a promising tool for facilely introducing the silyl-methylene moiety and preparing structurally diverse chiral organosilanes. [2] α-Carbon carbenes were broadly utilized in the enantioselective carbene transfer reactions; [3] however, the analogue carbene transfer reactions of α-silylcarbenes are much underdeveloped probably owing to the restricted source of α-silylcarbene precursors [4] and the lack of efficient catalytic protocols (Scheme 1a). Dirhodium or copper-catalyzed asymmetric cyclopropanation reactions of α-silylcarbenes derived from corresponding α-silyl diazocompounds provided a reliable access to chiral silylcyclopropanes, [5] yet highly enantioselec-tive insertion reactions of α-silylcarbenes are basically unknown. [6] Recently, our group developed a method of coppercatalyzed BÀ H insertion reaction of cyclopropene-derived αvinylcarbenes. [7] We hypothesized that 1-silylcyclopropenes might serve as a suitable precursor for α-silyl-αvinylcarbene, [8] which could undergo enantioselective BÀ H insertion to afford chiral gem-silylboranes (Scheme 1b). To achieve this transformation, at least the following three challenges need to be addressed. ( 1) We needed to regioselectively cleave the C1-C3 bond to form an α-silyl-α-vinyl metal carbene intermediate in the ring-opening process. [9] (2) We need to control the stereoselectivity of the C=C bond if R 1 and R 2 were different. (3) We needed to achieve efficient chiral induction to control the enantioselectivity of the BÀ H bond insertion. [10] By using a Cu I /chiral bisoxazoline complex, we established a method for highly regio-, stereo-, and enantioselective BÀ H bond insertion reactions of α-silyl-α-vinylcarbenes derived from 1-silylcyclopropenes, representing the first highly enantioselective XÀ H bond insertion reaction of αsilyl-substituted carbenes. This protocol affords chiral allylic[*] M.