The pharmaceutical properties, including the physical and chemical properties, and the bioavailability are greatly influenced by their polymorphism. In this paper the polymer heteronuclei were used to produce the gabapentin polymorphs that were characterized by X-ray powder diffraction, FT-IR and DSC. The results indicated that the polymer heteronuclei are an effective method to control and select the gabapentin polymorphism. One new polymorph of gabapentin was found besides all known gabapentin polymorphs.

Objective:To investigate the effect of nucleolin on cardiac cell apoptosis in Type 2 diabetic cardiomyopathy mice.Methods:Mice were fed with high-fat and high-sugar food for 20 weeks (mice were injected intraperitoneally with 60 mg/kg streptozotocin in the 5th and 6th weeks) to establish a mouse model of Type 2 diabetes.The mice were divided into 4 groups:a wild type (WT) control group,a nucleolin transgenic (TG) control group,a WT diabetic group,a TG diabetic group.Diabetesrelated indicators were detected at the end of the 8th week.At the end of the 20th week,HE staining was used to observe myocardial morphological changes;TUNEL staining and caspase-3 activity were used to detect the extent of apoptosis of cardiac myocytes.Results:The level of fasting blood glucose was significantly increased in the diabetic group than that in the control group.In WT diabetic group,myocardial disarrangement,fragmentation and dissolution were observed (determined by HE staining);cellular apoptosis (determined by TUNEL staining and caspase-3 activity) also increased markedly in the WT diabetic group.Compared with the wild mice in the diabetic group,myocardial morphological changes and cardiac myocytes apoptosis were alleviated significantly.Conclusion:Nucleolin overexpression affectes the occurrence and development of diabetic cardiomyopathy through inhibition of cardiac myocyte apoptosis.

Objective To explore the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP) for elderly patients with periampullary diverticula accompanied with choledocholithiasis.Methods The retrospective cross-sectional study was conducted.The clinical data of 297 elderly patients with age ＞70 years and periampullary diverticula accompanied with choledocholithiasis who were admitted to the Zhongshan Hospital affiliated to Fudan University between January 2013 and January 2016 were collected.All the patients received lithotomy by ERCP after completion of preoperative preparation,and then underwent symptomatic treatment.Observation indicators included:(1) treatment results:cannulation time,success rate of cannulation and success rate of stones removed;(2) surgical complications:hemorrhage,perforation and pancreatitis;(3) follow-up results.All patients were followed up by outpatient examination and telephone interview up to December 2016.Follow-up included postoperative delayed perforation,patients' survival,further attack of acute cholangitis and reoperation for removing stones.Measurement data with normal distribution were represented as x ± s,and measurement data with skewed distribution were described as M (range).Results (1) Treatment results:all the 297 patients underwent successful lithotomy by ERCP,with a cannulation time of (5±4)minutes and a success rate of cannulation of 100.00％ (297/297).Of 297 patients,292 had one-off success of stones removed,with a one-off success rate of 98.32％ (292/297),and 5 received partial stones removed due to choledocholithiasis combined with acute cholangitis.(2) Surgical complications:4 patients were complicated with immediate hemorrhage during intraoperative endoscopic sphincterotomy (EST).Bleeding of 1 patient was cauterized by biopsy forceps,and 3 patients had simplex JHY-BAL compression hemostasis.Two patients with postoperative delayed hemorrhage had successful hemostasis by biopsy forceps with metal hemostatic clip under endoscope after emergency duodenoscopy.One patient with intraoperative perforation was cured by conservative treatment.Two patients with severe acute pancreatitis underwent continuous gastrointestinal decompression combined with maintenance therapy of somatostatin,and then received endoscopic ultrasound-guided puncture and drainage for pseudocyst around the pancreas,with a stable symptoms of pancreatitis after 4 weeks.(3) Follow-up results:all the 297 patients were followed up for 6-12 months,with a median time of 8 months.During follow-up,292 patients had healthy survival,without recurrences of cholangitis and bile duct stone,and no delayed perforation and death were detected.Five patients underwent the second time lithotomy by ERCP after 2-3 months postoperatively.Conclusion Lithotomy by ERCP is safe and effective in the treatment of elderly patients with periampullary diverticula accompanied with choledocholithiasis.

AIM: To investigate the effect of nucleolin on diabetic cardiomyopathy in mice.METHODS: A type II diabetic cardiomyopathy mouse model was prepared using a cardiac-specific nucleolin-overexpressing transgenic mice.The mice were divided into wild-type mouse control group, nucleolin transgenic mouse control group, wild-type mouse diabetes group and nucleolin transgenic mouse diabetes group.Wheat germ agglutinin (WGA) fluorescent dye, Masson staining and PowerLab system detection were used to further clarify the role of nucleolin on cardiac hypertrophy, fibrosis and cardiac function in type II diabetic cardiomyopathy mice.RESULTS: Compared with wild-type mouse control group, no significant increase in blood glucose level was found, while genetical myocardial cell hypertrophy was significantly attenuated in nucleolin transgenic mouse diabetes group.The collagen fibers were also significantly reduced, and hemodynamic indexes ± dp/dtmax, left ventricular end-diastolic pressure, left ventricular systolic pressure and heart rate were also improved.The above differences were statistically significant.CONCLUSION: Nucleolin may reduce the occurrence of myocardial hypertrophy and fibrosis, thus improving the cardiac function of diabetic cardiomyopathy mice.

ObjectiveTo evaluate the clinical efficacy and safety of nylon ligation combined with endoscopic high-frequency electric snare for the treatment of colorectal polyps.MethodsThe clinical data of 345 patients with colorectal polyps who received the treatment of nylon ligation combined with endoscopic high-frequency electric snare at the Zhongshan Hospital of Fudan University from January 2006 to January 2011 were retrospectively analyzed.Complications including bleeding and perforation were observed.Postoperative wound healing and local residual recurrence were assessed during follow-up.ResultsA total of 362 colorectal polyps were successfully removed.The mean diameter of the colorectal polyps was 2.7 cm (range,1.5-4.0 cm). Operative bleeding occurred in 1 patient,and perforation in 1 patient.The results of histological examination showed that 93.6％(339/362) colorectal polyps were adenoma,17 were hyperplastic polyps,5 were inflammatory polyps,and caneeration of colorectal polyps in 1 patient was detected.Endoscopic follow-up was completed in 334 patients at the first month after operation,and 9 patients with residual benign colorectal polyps received endoscopic resection.No residue or recurrence was found in the other patients.Endoscopic follow-up was completed in 308 patients at the second months after operation,and no residue or recurrence was found.The overall effective rate was 97.1％ (299/308).ConclusionEndoscopic nylon ligation combined with endoscopic high-frequency electric snare is effective and safe for the treatment of colorectal polyps.

Objective To evaluate the clinical efficacy and safety of metallic hemoclips in the treatment of gastric defects during endoscopic full-thickness resection. Methods Patients with submucosal tumors derived from the muscularis propria and adhesion of the gastric serosa diagnosed by EUS and CT were enrolled in the study.A total of 62 patients,22 males and 40 females,mean age 58.5 years,were recruited into the present study from June 2009 to December 2010,in which 37 patients were with tumors in gastric fundus,20 in gastric body and 5 in antrum.All patients were treated with endoscopic full-thickness resection.After the operation,metallic hemoclips were used to close the defects through endoscopic biopsy channel.The closure success rate with metallic hemoclips were assessed.The patients were followed up endoscopically for evaluation of efficacy and safety of the procedures.Results All patients underwent endoscopic full-thickness resection.Uncontrollable bleeding occurred in 1 patient,who subsequently underwent emergent laparoscopic surgery and was excluded from the study.Metallic hemoclips were applied to close defects in 57 patients,and metallic hemoclips combined with omentum obstruction in 4 patients.The overall success rate was 100％ in 61 patients.Endoscopic follow-up was completed in all patients in average of 4.4 months.The clinical wound healing rate was 100％.No complications such as fever,abdominal pain were found in 2months after the procedures.Conclusion Application of metallic hemoclips during endoscopic full-thickness resection for gastric defects is a safe and effective technique.

Objective To explore the clinical value of endoscopic ultrasonography (EUS) examination before esophageal achalasia (EA) patients treated by peroral endoscopic myotomy (POEM).Methods From August 2011 to November 2011,esophageal EUS examination was conducted in 34 EA patients scheduled for POEM treatment (EA group) and 30 cases accepted gastric EUS examination (control group) at endoscopic center,Zhongshan Hospital,Fudan University.The thickness of muscularis propria layer and the circular muscle layer was measured at cardia,5 cm,10 cm and 15 cm above cardia,and the proportion of circular muscle layer was calculated.The differences in groups and between groups were compared.The correlation between muscle thickness and complication after POEM treatment was analyzed.The data were analyzed by t test.Results There was no difference between EA group and control group in the thickness of the muscularis propria layer at same part (at cardia,5 cm,10 cm and 15 cm above cardia,t=1.210,1.116,0 and 0.292respectively; all P＞0.05 respectively).The thickness of the circular muscle layer of EA group at cardia,5 cm,10 cm and 15 cm above cardia was (1.72±0.49) mm,(1.86±0.81) mm,(1.56±0.47) mm and (1.41±0.48) mm respectively,those of control group was (1.06±0.50) mm,(1.40±0.33) mm,(1.05±0.37) mm and (0.78±0.12) mm respectively.At same part,the thickness of the circular muscle layer of EA group was significantly thicker than that of the control group (t =5.326,2.903,4.778 and 6.993 respectively,all P＜0.05).After POEM treatment,complication was high in EA cases with the thickness of muscularis propria layer less than 2 mm.Conclusion Before POEM treatment,EUS examination for EA patients has certain guiding significance.

Objective To evaluate the efficacy and the feasibility of peroral endoscopic myotomy (POEM) for achalasia (AC). Methods The clinical data of 8 patients diagnosed as having AC and receiving POEM at our center from August 2010 to December 2010 were reviewed. The patients were 16-62 years old, mean 43yr, whose disease courses lasted for 2-20 years, mean 8.4 years. The key procedures of POEM were as the following, esophageal mucosal incision, submucosal tunneling by endoscopic submucosal dissection ( ESD), endoscopic myotomy of the circular muscle and closure of mucosal entry by hemostatic clips. Results All the 8 patients underwent POEM successfully. The mean operation time was 68.5 min ( ranging 45-115 min). The mean submucosal tunneling length was 9.5 cm ( ranging 8-13 cm). The average length of endoscopic myotomy of inner circular muscle was 8.5cm ( ranging 7-11 cm). No severe complications related to POEM occurred. Patients were followed up for 1-4 months ( mean 2. 5 months). Dysphagia was relieved significantly during the follow-up in 7 patients. But dysphagia and vomiting re-occurred in one patient 15 days after the operation. Endoscopy revealed a submucosal fistula, which was managed by incision. Conclusion As a new minimally invasive therapy for AC, POEM is very effective to relieve dysphagia in a short term. However, further observation is needed to evaluate long-term efficacy and complications.

OBJECTIVETo investigate the impact of additional gastrectomy after endoscopic submucosal dissection(ESD) on the prognosis of early gastric cancer.

METHODSClinical data of 107 early gastric cancer patients undergoing additional gastrectomy after ESD (research group, n=44) or radical surgery (control group, n=63) from January 2008 to December 2014 in Zhongshan Hospital were retrospectively analyzed. The reasons for additional gastrectomy after ESD included positive resection margin (n=10), lymphovascular invasion (n=5), well-differentiated mucosal tumor with a diameter >3 cm (n=10), poor-differentiated mucosal tumor with a diameter >2 cm (n=4), submucosal tumor(sm1) with a diameter >3 cm (n=10), and submucosal tumor(sm2) (n=9). Operation time, length of stay, lymph node metastasis, tumor recurrence and disease-free survival rate were compared between two groups.

RESULTSBaseline data of two groups were not significantly different (all P>0.05). After evaluation, absolute and relative indications were identified in 19 cases (43.2%) and 25 cases (56.8%) of research group, and in 28 cases (44.4%) and 35 cases(55.6%) of control group without significant difference (P=0.897). Lymph node metastasis occurred in 6 patients (4.5%) after surgery in research group and 6.3% in control group (P=0.690). Operation time was (218.5±74.3) minutes in research group and (219.8±81.8) minutes in control group (P=0.932). Length of stay was (10.0±12.3) days in research group and (10.8±9.9) days in control group (P=0.687). Follow-up time was (35.5±15.0) months in research group and (29.5±18.1) months in control group (P=0.072). Tumor recurrence rate was 4.5% in research group and 9.5% in control group (χ(2)=0.928, P=0.229). Mortality was 4.5% in research group and 7.9% in control group (χ(2)=0.487, P=0.485). Besides, no significant differences of operation mode (P=0.164), lymphatic clearance mode (P=0.330), number of harvested lymph node (P=0.467), morbidity of postoperative infection or fever (P=0.923) were found. Three-year tumor-free survival rate was 95.5% and 89.2% in research and control group respectively without significant differences (P=0.571).

CONCLUSIONAdditional gastrectomy after endoscopic submucosal dissection has no negative influence on the prognosis of patients with early gastric cancer, whose efficacy is similar to simple radical gastrectomy.

Aged ; Disease-Free Survival ; Early Detection of Cancer ; Endoscopic Mucosal Resection ; Female ; Gastrectomy ; methods ; Gastric Mucosa ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Lymphatic Vessels ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Operative Time ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Survival Rate

It is of great significance to use biosynthesis to transform the inorganic substance formaldehyde into organic sugars. Most important in this process was to find a suitable catalyst combination to achieve the dimerization of formaldehyde. In a recent report, an engineered glycolaldehyde synthase was reported to catalyze this reaction. It could be combined with engineered D-fructose-6-phosphate aldolase, a "one-pot enzyme" method, to synthesize L-xylose using formaldehyde and the conversion rate could reach up to 64%. This process also provides a reference for the synthesis of other sugars. With the increasing consumption of non-renewable resources, it was of great significance to convert formaldehyde into sugar by biosynthesis.
Biocatalysis ; Formaldehyde ; chemistry ; Fructose-Bisphosphate Aldolase ; metabolism ; Xylose ; chemical synthesis