Infantile hemangioma (IH) is the most prevalent benign vascular tumor in infancy, and propranolol is the first-line standard pharmacotherapy for high-risk IH. The clinically used formulation of propranolol is an equimolar 1:1 racemic mixture of two enantiomers, S-(−)-propranolol and R-(+)-propranolol. The traditional mechanistic hypothesis is centered on the β-adrenoceptor blockade pathway mediated by the S-enantiomer, yet this framework fails to fully explain the dose–response relationship and long-term involution effect of propranolol in IH treatment. Recent studies have revealed that R-(+)-propranolol, which exhibits negligible β-adrenoceptor blocking activity, exerts a remarkable and independent anti-IH effect, indicating the existence of a core β-adrenoceptor-independent mechanism of action. This review systematically integrates the preclinical evidence for the β-independent anti-IH activity of R-(+)-propranolol, elucidates the discovery logic of SOX18 as the core molecular target, identifies key translational gaps (zero clinical trials, lack of infant enantiomer-specific PK data, chiral formulation challenges), and proposes a dual-track model of propranolol action in IH. The authors further clarify the critical gaps in clinical translation in this field and provide a theoretical basis for the precision therapy of IH and the development of novel chiral pharmaceuticals.

Background:Totally implantable venous access ports (TIVAPs) are essential for long-term venous access in pediatric acute lymphoblastic leukemia (ALL). However, catheter-related calcified fibroblastic sheaths often make port removal difficult, and conventional traction may fail. Evidence regarding safe salvage surgery for calcified sheath-related stuck ports in children remains limited. This study aimed to investigate the etiology of difficult port removal and to evaluate the safety and feasibility of direct internal jugular vein (IJV) incision for fibroblastic sheath dissection and port extraction in pediatric patients with ALL. Case Description:This is a retrospective analysis of five pediatric ALL patients with difficult port removals due to calcified fibroblastic sheaths between January 2022 and December 2024. All patients had indwelling 6 Fr TIVAPs for 25-44 months and failed conservative traction attempts after 3-4 weeks of therapeutic low-molecular-weight heparin (LMWH). All underwent direct internal jugular vein (IJV) incision for fibroblastic sheath dissection and port extraction. All procedures were completed with complete removal of the sheath and catheter, and no perioperative complications occurred. Operative time was 35-60 minutes (mean 45.5±8.7 minutes), blood loss was 3-10 mL (mean 6.2±2.1 mL), and hospital stay was 2-3 days (mean 2.3±0.5 days). At 1-3 months of follow-up, all patients had patent IJV flow without sheath recurrence, full neck range of motion, no pain or neurologic deficits, and excellent cosmetic outcomes. Conclusions:Calcified adherent fibroblastic sheaths are the primary cause of difficult port removal in pediatric ALL. Direct IJV incision for fibroblastic sheath dissection appears to be a feasible and effective last-resort salvage procedure, offering a definitive solution for such complex cases.

We report a dual nickel and visible-light-driven dual catalytic system that enables the 1,4-diarylfunctionalization of 1,3-enynes with aryl iodides, providing access to polyaryl-substituted allenes with broad substrate scope. This method synergizes photoredox catalysis (4-CzIPN/DMAP) and nickel catalysis (Ni(DME)Br2/1,10-phenanthroline) under mild conditions using Zn as a terminal reductant

Herein, we report a heterogeneous, metal-free photocatalytic carbonylation of iodoalkanes using mesoporous graphitic carbon nitride under visible-light irradiation. This system efficiently converts a broad range of iodoalkanes and nucleophiles into diverse products under mild conditions. The catalyst demonstrates excellent functional group tolerance and can be readily recovered and reused for at least six cycles without significant loss of activity.

This work presents a visible-light-driven annulation protocol for synthesizing 6-silylphenanthridines from 2-isocyanobiaryls and silanes using mesoporous graphitic carbon nitride (mpg-CN) as a heterogeneous photocatalyst. The mpg-CN catalyst demonstrates exceptional recyclability, maintaining consistent activity over five consecutive cycles without loss of performance. Operating under ambient conditions without requiring precious metals or expensive organic photo redox catalysts, this method offers mild reaction conditions, cost efficiency, and operational simplicity. The protocol provides a scalable and sustainable approach to accessing 6-silyl-substituted phenanthridines, highlighting the potential of heterogeneous photocatalysis in organic synthesis.

ObjectiveTo compare the therapeutic outcomes of a modified Shehata surgery with a condensed 4-week interstage interval vs. conventional laparoscopic one-stage orchiopexy for intra-abdominal cryptorchidism.MethodsWe retrospectively analyzed 70 children with unilateral intra-abdominal cryptorchidism (July 2020–June 2022), allocated to modified Shehata (Group A, n = 35) or one-stage orchiopexy (Group B, n = 35). The modified procedure involved laparoscopic traction/fixation followed by second-stage orchiopexy at 4 weeks. Primary outcomes were testicular volume and blood flow (Doppler) assessed at 1, 3, and 6 months postoperatively. Secondary outcomes included serum testosterone (T), estradiol (E2), follicle-stimulating hormone (FSH) at 6 months, complication rates, success rate, and total treatment cost.ResultsBaseline characteristics were comparable. Group A demonstrated significantly larger testicular volume at all postoperative timepoints (P < 0.05) and superior blood flow at 6 months (97.1% vs. 77.1% ‘Rich’ flow, P = 0.032). Regarding secondary outcomes, Group A had more favorable 6-month hormonal profiles (higher T, lower FSH/E2, P < 0.05), a lower surgery-related complication rate (0% vs. 17.14%, P = 0.033), and a higher success rate (100% vs. 82.86%, P = 0.033), but incurred higher total cost (P < 0.001).ConclusionThe modified Shehata surgery with a 4-week interval yields superior testicular development, perfusion, endocrine function, and lower complications compared to one-stage orchiopexy, albeit at higher cost.

BackgroundSmall intestinal venous malformation is a rare vascular anomaly that most commonly presents with gastrointestinal bleeding. Its manifestation as acute bowel obstruction without hemorrhage is exceedingly uncommon, especially in children, posing a diagnostic dilemma.Case descriptionA previously healthy 9-year-old boy presented with acute abdominal pain and vomiting. Contrast-enhanced computed tomography revealed a homogeneously enhancing lesion with persistent enhancement on portal venous phase in the left pelvic small bowel, raising suspicion of a vascular malformation. Diagnostic laparoscopy was subsequently performed, identifying a 5 cm segment of small intestine with its serosal surface densely covered by tortuous vessels. Laparoscopic segmental resection with primary hand-sewn end-to-end anastomosis was performed. Immunohistochemistry revealed CD31 and CD34 positivity in lesional endothelial cells and GLUT-1 negativity, excluding infantile hemangioma. This immunoprofile, together with the characteristic morphology, supported the diagnosis of a venous malformation according to the International Society for the Study of Vascular Anomalies (ISSVA) classification. The patient recovered uneventfully and remained asymptomatic with no evidence of residual lesion or symptom relapse during a 6-month follow-up period.ConclusionsThis case suggests that a small intestinal venous malformation can rarely present as acute obstruction in the absence of bleeding. Contrast-enhanced CT with persistent enhancement pattern is a useful preoperative indicator, and laparoscopy appears to be a feasible approach for both diagnosis and minimally invasive resection. This integrated diagnostic and therapeutic strategy should be considered in select children with small bowel obstruction of uncertain etiology.

Sepsis-associated acute kidney injury (SA-AKI) represents a prevalent complication in critically ill patients, and its molecular mechanisms remain incompletely understood. Circular RNAs (circRNAs) have been increasingly implicated in the pathogenesis of multiple diseases; however, the function and mechanism of circGAB1 in SA-AKI remain largely unknown. Differentially expressed circRNAs in SA-AKI were identified from the Gene Expression Omnibus database (dataset GSE232404), and circGAB1 expression was confirmed by quantitative real-time polymerase chain reaction. Its stability and subcellular localization were assessed using RNase R digestion, actinomycin D assay, and fluorescence in situ hybridization. circGAB1 was knocked down with short hairpin RNA, and its effects on autophagy, cell viability, and apoptosis were evaluated using Cell Counting Kit-8, Western blot, monodansylcadaverine staining, lactate dehydrogenase release, and flow cytometry. Interactions among circGAB1, ELAV-like RNA-binding protein 1 (ELAVL1), and High Mobility Group Box 3 (HMGB3) were examined by RNA pull-down, RNA immunoprecipitation, and dual-luciferase reporter assays. In vivo, adenovirus-mediated knockdown or overexpression was employed to assess the role of the circGAB1/ELAVL1/HMGB3 axis in autophagy, the β-catenin pathway, and renal function. Analysis of the public GEO dataset revealed that circGAB1 was significantly upregulated in SA-AKI samples, and its high expression was also verified in SA-AKI model cells. Additionally, circGAB1 exhibited a nucleocytoplasmic subcellular localization pattern. In SA-AKI mice, knockdown of circGAB1 inhibited autophagy, reduced cellular damage, and improved renal function. Mechanistically, circGAB1 bound to ELAVL1 to enhance HMGB3 mRNA stability, thereby activating the β-catenin pathway and promoting autophagy. Overexpression of ELAVL1 or HMGB3 reversed the suppressive effects of circGAB1 knockdown on autophagy and the β-catenin pathway. circGAB1 enhances HMGB3 mRNA stability by binding to ELAVL1, thereby activating the β-catenin pathway and autophagy to promote SA-AKI. Targeting circGAB1 may provide a new strategy for SA-AKI treatment.

Solvent molecules in nanoporous catalysts are not passive media: they occupy pore volume, compete with reactants for active-site environments, and reshape adsorption thermodynamics. However, the structural rules that determine whether a solvent is expelled from a liquid-filled micropore or remains co-confined with a reactant are not well established. Here we show that zeolite topology switches solvent-reactant competition between two distinct regimes: solvent eviction in narrow MFI channels and solvent-reactant co-occupation in FAU supercages. Motion-sensitive in situ 2 H magic-angle-spinning NMR directly resolves confined and mobile decalin populations during cyclohexanol adsorption, revealing efficient displacement of decalin from MFI but persistent co-confinement in FAU. Liquid-phase adsorption isotherms and calorimetry show that cyclohexanol adsorption in MFI is enthalpy-dominated with a large entropy penalty, whereas FAU exhibits weaker enthalpic stabilization and a smaller entropy loss. Machine-learning-enhanced free-energy simulations rationalize this topology dependence by revealing an approximately 25 kJ mol − 1 preference for cyclohexanol over decalin at Brønsted acid sites (BAS) in MFI, while the larger FAU cages generate a broader landscape that permits co-adsorption. These results establish pore topology as a molecular switch that controls solvent participation in liquid-filled zeolite micropores, providing a mechanistic criterion for designing catalytic environments for liquid-phase chemistry.

Under ball-milling, continuous mechanical energy enables a TEMPO-mediated single-electron process, while inexpensive ferric nitrate serves as the nitrogen source for in situ diazotization. This method rapidly converts anilines into aryl halides with broad functional-group tolerance, avoiding hazardous diazonium salts, external heating, and bulk solvents. The approach improves operational simplicity, atom economy, and sustainability, highlighting the power of mechanochemistry to promote redox-driven transformations and providing a practical alternative to conventional solution-phase halogenation.

Iodo-substituted bicyclo[1.1.1]pentanes (iodo-BCPs) are valuable synthetic linchpins for the preparation of diverse BCP-containing bioisosteres. However, existing methods often require photocatalysts, specialized equipment, or large amounts of organic solvents. Herein, we report the first piezocatalytic mechanochemical radical iodination of [1.1.1]propellane (TCP) using recyclable tetragonal tet-BaTiO3 under ball-milling conditions. Mechanical energy promotes single-electron transfer, enabling efficient strain-release functionalization of TCP with pyridyl, benzyl, and α-carbonyl iodides. The protocol proceeds without photocatalysts and exhibits broad substrate scope. Mechanistic studies support a piezocatalytically initiated radical pathway. This sustainable method provides straightforward access to synthetically versatile iodo-BCPs for medicinal chemistry applications.

In recent years, heterogeneous manganese catalysis has emerged as a significant area of research in catalytic chemistry, leveraging manganese-based materials to facilitate a wide range of chemical transformations. This review explores the fundamental principles, recent advances, applications, and prospects of heterogeneous manganese catalysis in organic synthesis. These catalysts are widely employed in C-C bond formation, C-N bond formation, C-O bond formation, oxidation. Despite this, manganese catalysts have not received as much attention as other metals, such as iron and cobalt, often resulting in their excellent catalytic activity being overlooked. This review focuses on the mechanisms and capabilities of heterogeneous manganese catalysts in various aspects of organic synthesis, highlighting the latest research advancements.

Herein, we report the design and synthesis of m-bpy-MOF-PdCl2, a heterogeneous single-site palladium catalyst constructed via a mixed-linker metal-organic framework (MOF) strategy. In the carbonylation of iodobenzene, the catalyst exhibits exceptional activity under mild conditions without the need for a base. It also exhibits broad functional group tolerance, straightforward separation, and excellent recyclability over multiple cycles, with minimal loss of performance.

Herein, we report a sodium tert-butoxide-promoted reduction of N-heteroarenes using ammonia borane and dimethyl sulfoxide (DMSO) under mild reaction conditions. This method demonstrates broad functional group compatibility across diverse N-heteroarene substrates. Notably, substituting DMSO with deuterated DMSO-d6 enables the synthesis of C3-deuterated 1,2,3,4-tetrahydroquinolines with remarkable positional selectivity. Mechanistic investigations indicate that the protons are derived from both ammonia borane and DMSO. This strategy establishes a novel and environmentally benign approach for the synthesis of (deuterated) N-heterocycles, offering practical advantages in terms of operational simplicity and sustainable reaction conditions.

This study presents an efficient and concise methodology devised for effectuating the ortho-C-H amidation of phenols through the rearrangement of N-phenoxybenzamide derivatives. A variety of substrates, equipped with different electron-withdrawing and electron-donating functional groups, react smoothly under mild basic conditions or even without a base, eliminating the need for excessive use of strong acids, Lewis acids, or costly transition-metal catalysts (e.g., [Cp*RhCl2]2 or [Cp*Co(MeCN)3](SbF6)2) as previously delineated. Notably, the observed regioselectivity predominantly favors the ortho-position of the phenol rings. Mechanistic investigations suggest that C-H bond cleavage is likely not the rate-determining step and that an intramolecular rearrangement might be involved.

The Sandmeyer reaction is a key method for synthesizing aryl halides but often requires complex procedures and large solvent volumes. This study introduces a mechanoredox system using ball milling to activate piezoelectric BaTiO3, enabling solvent-minimized, metal-catalyst-free halogenation of aryl diazonium salts under air. The method features a broad substrate scope, scalability, and recyclable piezoelectric materials without significant activity loss. This sustainable approach overcomes the limitations of traditional Sandmeyer reactions, providing an efficient and practical alternative for aryl halide synthesis.

Arylthianthrenium salts have become key intermediates for late-stage functionalizations of drug-like molecules. Ruthenium-phosphine catalysts are now shown to enable their use as aryl sources in high-yielding ortho-C─H arylations of benzoic acids. The arylthianthrenium salts are converted chemo-selectively, leaving aryl halides and boronates untouched. The carboxylate groups are uniquely effective as directing groups, ensuring exclusive ortho-selectivity even in the presence of competing pyridine or amide groups. This makes the reaction orthogonal to cross-couplings and conventional C─H arylations. The carboxylate group can be removed via decarboxylation or serve as an anchor for downstream transformations. Mechanistic studies identify C─H ruthenation as the rate-limiting step and highlight the unique efficiency of P(Cy)₃ ligands.

The development of heterogeneous catalysis difunctionalization of olefins is of great significance because it can save costs in the industry. Here, we report the perfluoroalkyl carbonylation reaction of inactive olefins catalyzed by titanium dioxide under light, obtaining β-perfluoroalkylamide compounds. The catalyst has high activity and wide functional group tolerance and can maintain high activity after multiple cycles. This catalyst reduces the use of precious metals, avoids ligands, and can easily be separated from the reaction mixtures.

Esters are fundamental compounds in materials science, medicinal chemistry, and organic synthesis. Numerous synthetic methods have been developed to construct ester functional groups. The transition metal-catalyzed carbonylation of aryl halides with alcohols is well-established, with palladium catalysts being the most commonly used. However, the development of non-noble metal-based catalysts for carbonylation reactions has become attractive due to their cost-effectiveness. In this study, we report a novel homogeneous cobalt-catalyzed system for the carbonylation of aryl bromides and aryl chlorides with alkyl halides directly. Notably, this methodology efficiently prepares specialized esters using inexpensive alkyl halides, offering a more economical alternative to using the corresponding alcohols.

Mesoporous graphitic carbon nitride (mpg-CN) has been successfully employed as a highly efficient photocatalyst for the annulation of 2-isocyanobiaryls with ethers to synthesize 6-substituted phenanthridines. This method facilitates the preparation of a diverse range of 6-substituted phenanthridines, demonstrating a broad substrate scope under mild and environmentally benign reaction conditions. The versatility of this approach allows for the incorporation of various functional groups, making it a valuable tool for the synthesis of complex phenanthridine derivatives. Notably, this transition metal-free heterogeneous photocatalytic system offers significant advantages over traditional methods, which often rely on expensive precious metal catalysts. The system achieves reduced costs and enhanced sustainability by eliminating the need for such metals. Additionally, the recyclability of the mpg-CN catalyst is a key feature, as it can be reused for five consecutive cycles without significant loss of catalytic activity. This durability not only improves the economic feasibility of the process but also aligns with the principles of green chemistry by minimizing waste. The combination of mild conditions, cost-effectiveness, and recyclability positions this method as a practical and scalable alternative for the synthesis of 6-substitued phenanthridines.