[Comparison of the effects and safety of dydrogesterone and medroxyprogesterone acetate on endometrial hyperplasia without atypia: a randomized controlled non-inferior phase Ⅲ clinical study]

Objective: To compare the effects and safety of dydrogesterone (DG) and medroxyprogesterone acetate (MPA) on the treatment in patients with endometrial hyperplasia without atypia (EH). Methods: This was a single-center, open-label, prospective non-inferior randomized controlled phase Ⅲ trial. From February 2019 to November 2021, patients with EH admitted to the Obstetrics and Gynecology Hospital of Fudan University were recruited. Enrolled patients were stratified according to the pathological types of simple hyperplasia (SH) or complex hyperplasia (CH), and were randomised to receive MPA or DG. Untill May 14, 2022, the median follow-up time after complete response (CR) was 9.3 months (1.1-17.2 months). The primary endpoint was the 6-month CR rate (6m-CR rate). The secondary endpoints included the 3-month CR rate (3m-CR rate), adverse events rate, recurrence rate, and pregnancy rate in one year after CR. Results: (1) A total of 292 patients with EH were enrolled in the study with the median age of 39 years (31-45 years). A total of 135 SH patients were randomly assigned to MPA group (n=67) and DG group (n=68), and 157 CH patients were randomly assigned to MPA group (n=79) and DG group (n=78). (2) Among 292 patients, 205 patients enrolled into the primary endpoint analysis, including 92 SH patients and 113 CH patients, with 100 patients in MPA group and 105 in DG group, respectively. The 6m-CR rate of MPA group and DG group were 90.0% (90/100) and 88.6% (93/105) respectively, and there were no statistical significance (χ²=0.11, P=0.741), with the rate difference (RD) was -1.4% (95%CI:-9.9%-7.0%). Stratified by the pathology types, the 6m-CR rate of SH patients was 93.5% (86/92), and MPA group and DG group were respectively 91.1% (41/45) and 95.7% (45/47); and the 6m-CR rate of CH patients was 85.8% (97/113), and MPA group and DG group were 89.1% (49/55) and 82.8% (48/58) respectively. The 6m-CR rates of the two treatments had no statistical significance either (all P>0.05). A total of 194 EH patients enrolled into the secondary endpoint analysis, including 88 SH patients and 106 CH patients, and 96 patients in MPA group and 98 in DG group, respectively. The 3m-CR rate of SH patients were 87.5% (77/88), while the 3m-CR rates of MPA group and DG group were 90.7% (39/43) and 84.4% (38/45), respectively; the 3m-CR rate of CH patients was 66.0% (70/106), and MPA group and DG group had the same 3m-CR rate of 66.0% (35/53). No statistical significance was found between the two treatments both in SH and CH patients (all P>0.05). (3) The incidence of adverse events between MPA group and DG group had no statistical significance (P>0.05). (4) A total of 93 SH patients achieved CR, and the cumulative recurrence rate in one year after CR were 5.9% and 0 in MPA group and DG group, respectively. While 112 CH patients achieved CR, and the cumulative recurrence rate in one year after CR were 8.8% and 6.5% in MPA group and DG group, respectively. There were no statistical significance between two treatment groups (all P>0.05). Among the 93 SH patients, 10 patients had family planning but no pregnancy happened during the follow-up period. Among the 112 CH patients, 21 were actively preparing for pregnancy, and the pregnancy rate and live-birth rate in one year after CR in MPA group were 7/9 and 2/7, while in DG group were respectively 4/12 and 2/4, and there were no statistical significance in pregnancy rate and live-birth rate between the two treatment groups (all P>0.05). Conclusions: Compared with MPA, DG is of good efficacy and safety in treating EH. DG is a favorable alternative treatment for EH patients.

From single atoms to self-assembled quantum single-atomic nanowires: noble metal atoms on black phosphorene monolayers

Transition metal (TM) nanostructures, such as one dimensional (1D) nanowires with/without substrates, usually possess drastically different properties from their bulk counterparts, due to their distinct stacking and electronic confinement. Correspondingly, it is of great importance to establish the dominant driving force in forming 1D single-metal-atom-wires (SMAWs). Here, with first-principles calculations, taking the black phosphorene (BP) monolayer as a prototype 2D substrate, we investigate the energetic and kinetic properties of all the 5d-TM atoms on the 2D substrate to reveal the mechanism of formation of SMAWs. In contrast to other 5d- and 4d-TMs, noble metal elements Pd and Pt are found to prefer to grow along the trough in an atom-by-atom manner, self-assembling into SMAWs with a significant magic growth behavior. This is due to distinct binding energies and diffusion barriers along the trough, i.e., zig-zag direction, as compared to other directions of the BP. The present findings are valuable in the fabrication and modulation of 1D nanostructures which can be anticipated to possess desirable functionalities for potential applications such as in nanocatalysis, nanosensors, and related areas.

Hydrothermal Synthesis, Crystal Structure and Properties of a Novel Phosphorus-containing 3D Metal- Organic Cd(II) Coordination Polymer

A metal-organic framework [Cd(dppip)]n (1) based on 5-(diphenylphosphino)isophthalic acid (H2dppip) has been synthesized hydrothermally and characterized by IR spectroscopy, elemental analysis, and X-ray crystallography. [Cd(dppip)]n shows a sheet structure owing to carboxylate bridging with windows with dimensions 10.692 x 9.325 Å2. The layers are further connected through P-Cd interactions to give a three-dimensional supramolecular network. The thermal analysis (DTA) of complex 1 exhibited an exceptionally high thermal stability (m. p. 452:8 °C). The compound shows fluorescence at ca. 418 nm upon excitation at 314 nm

Synthesis, crystal structure and luminescent properties of one 3D Cd(II) coordination polymer [Cd(H3BPTC)2(bpy)]n (H4BPTC = 1,1'-biphenyl-2,2',6,6'-tetracarboxylic acid, bpy = 4,4'-bipyridine)

A new 3D metal-organic coordination polymer [Cd(H(3)BPTC)(2)(bpy)](n) (1) (H(4)BPTC = 1,1'-biphenyl-2,2',6,6'-tetracarboxylic acid, bpy =4,4'-bipyridine) has been synthesized and characterized by single X-ray diffraction and IR spectroscopy. The one-dimensional metal-organic chains of the title complex, namely [Cd(H(3)BPTC)(2)](n), are held together through hydrogen bonding and bridging "second" ligand 4,4'-bpy to give a three-dimensional metal-organic network. The thermal stability of complex 1 was studied by thermal gravimetric (TG) and differential thermal analysis (DTA). Compound 1 exhibits photoluminescence with an emission maximum at ca. 380 nm upon excitation at ca. 251 nm.

Diaqua-(5-carb-oxy-benzene-1,3-dicarboxyl-ato-κO,O)(6,6'-dimethyl-2,2'-bipyridine-κN,N')nickel(II) hepta-hydrate

In the title compound, [Ni(C(9)H(4)O(6))(C(12)H(12)N(2))(H(2)O)(2)]·7H(2)O, the Ni(II) atom is six-coordinated by two O atoms from a chelating carboxyl-ate group of a 5-carb-oxy-benzene-1,3-dicarboxyl-ate ligand, two O atoms of two water mol-ecules and two N atoms from a 6,6'-dimethyl-2,2'-bipyridine ligand in a distorted octa-hedral geometry. The compound exhibits a three-dimensional supra-molecular structure composed of the complex mol-ecules and lattice water mol-ecules, which are linked together by inter-molecular O-H⋯O hydrogen bonds and partly overlapping π-π inter-actions between the pyridine and benzene rings [centroid-centroid distances = 3.922 (2) and 3.921 (2) Å]. One of the lattice water mol-ecules is disordered over two positions in an occupancy ratio of 0.521 (6):0.479 (6).

Poly[bis[μ-1,4-bis(imidazol-1-ylmethyl)benzene]dichloridomanganese(II)]

In the crystal structure of the title compound, [MnCl₂(C₁₄H₁₄N₄)₂]_n, the Mn^II atom, lying on an inversion center, is coordinated by four N atoms from four 1,4-bis­(imidazol-1-ylmeth­yl)benzene (bimb) ligands and two Cl⁻ anions in a distorted octa­hedral geometry. The bimb ligands bridge the Mn^II atoms, forming a two-dimensional polymeric complex, which is composed of a 52-membered [Mn₄(bimb)₄] ring with distances of 7.7812 (2) and 27.4731 (9) Å between opposite metal atoms. Weak C—H⋯π inter­actions are present in the crystal structure.

Poly[bis[μ-1,3-bis-(imidazol-1-ylmeth-yl)benzene-κN:N]bis-(nitrato-κO)cadmium]

A novel metal–organic framework based on 1,3-bis­(imidazol-1-ylmeth­yl)benzene (1,3-bimb), [Cd(NO₃)₂(C₁₄H₁₄N₄)₂]_n, has been synthesized hydro­thermally. The structure exhibits a two-dimensional metal–organic (4,4)-net composed of Cd^II atoms and bimb ligands, and such layers are further joined through inter­layer C—H⋯O hydrogen bonds to generate a three-dimensional supra­molecular structure.

Poly[[hexa-aqua-bis-(μ(3)-benzene-1,3,5-tricarboxyl-ato-κO:O:O)bis-(5,5'-dimethyl-2,2'-bipyridine-κN,N')trizinc] hexa-hydrate]

In the title compound, {[Zn(3)(C(9)H(3)O(6))(2)(C(12)H(12)N(2))(2)(H(2)O)(6)]·6H(2)O}(n), one Zn(II) atom, lying on an inversion center, is six-coordinated by two O atoms from two benzene-1,3,5-tricarboxyl-ate (btc) ligands and four water mol-ecules in a distorted octa-hedral geometry. The other Zn(II) atom is five-coordinated by two N atoms from a 5,5'-dimethyl-2,2'-bipyridine (dmbpy) ligand, two O atoms from two btc ligands and one water mol-ecule in a distorted trigonal-bipyramidal geometry. The compound features a one-dimensional ladder structure, with windows of ca 10.245 (1) × 15.446 (2) Å. The ladders are linked together by inter-molecular O-H⋯O hydrogen bonds and π-π inter-actions between the benzene rings and between the pyridine rings [centroid-to-centroid distances 3.858 (2) and 3.911 (3) Å, respectively] to form a three-dimensional supra-molecular structure. One of the lattice water molecules is disordered over two positions in a 0.592:0.408 ratio.

Diaqua-(5-carb-oxy-benzene-1,3-di-carboxyl-ato-κO)(4,4'-dimethyl-2,2'-bipyridine-κN,N')zinc

In the title compound, [Zn(C₉H₄O₆)(C₁₂H₁₂N₂)(H₂O)₂], the Zn^II atom is five-coordinated by two N atoms from a 4,4′-dimethyl-2,2′-bipyridine ligand, one O atom from a 5-carb­oxy­benzene-1,3-dicarboxyl­ate ligand and two water mol­ecules in a distorted trigonal–bipyramidal geometry. The complex mol­ecules are linked by inter­molecular O—H⋯O hydrogen bonds and partly overlapping π–π inter­actions [centroid–centroid distance = 4.017 (2) Å] into a three-dimensional supra­molecular network.

1-(2-Fluoro-benz-yl)quinolinium bis-(2-sulfanylidene-1,3-dithiole-4,5-dithiol-ato-κS,S')nickelate(III)

The crystal structure of the title compound, (C₁₆H₁₃FN)[Ni(C₃S₅)₂], consists of Ni^III complex anions and 1-(2-fluoro­benz­yl)quinolinium (fbq) cations. In the complex anion, the Ni^III cation is chelated by two 2-sulfanylidene-1,3-dithiole-4,5-dithiol­ate (dmit) dianions in a distorted square-planar geometry; the two dmit mean planes are twisted with respect to each other at a dihedral angle of 8.44 (3)°. In the fbq cation, the dihedral angle between the benzene ring and the quinoline ring system is 80.57 (14)°. The centroid–centroid distance of 3.860 (5) Å between benzene rings indicates π–π stacking between adjacent fbq cations. The distance of 3.4958 (18) Å between the S atom and the centroid of the pyridine ring suggests the existence of a lone-pair–aromatic inter­action between the anion and the cation. A short S⋯S contact [3.387 (2) Å] is also observed in the crystal structure.

Use of magnetic resonance imaging to measure facial soft tissue depth

OBJECTIVE

To investigate the feasibility of using magnetic resonance imaging to estimate facial tissue depth at standard anthropological facial landmarks.

DESIGN

Standard facial landmarks were marked with magnetic resonance imaging opaque markers on 10 normal subjects. Three observers estimated facial tissue depth at these landmarks on up to three separate occasions, and comparisons were made among the observers.

SETTING

The study was conducted with volunteers at the University of Alberta Biomechanical Engineering unit.

PARTICIPANTS

The volunteers were healthy individuals of both sexes between the ages of 18 and 30 years.

MAIN OUTCOME MEASURES

The technical error of measurement among observers was used as the main indicator of precision of measurement.

RESULTS

Measurements of tissue depth showed tolerable technical error of measurement and were precisely measured within and among observers.

CONCLUSIONS

Magnetic resonance images can be used to estimate tissue depth in human faces with precision.