Tropane alkaloids,such as hyoscyamine (or its more stable racemate atropine) and scopolamine,are remembered as the oldest drugs in medicine with wide pharmaceutical applications clinically for their mydriatic,antispasmodic,anticholinergic,analgesic and sedative properties.Presently,the supply of tropane alkaloids are entirely rested on their isolation from plant materials,yet the low contents of tropane alkaloids in plants raise the requirement to breed new varieties of high-yield tropane alkaloids and improving the production of tropane alkaloids in hairy root cultures or plants by biotechnology has be a research focus in the field of secondary metabolism.For the past decade,there have been important progresses on biosynthesis of tropane alkaloids and their molecular biology,some new pathway genes have been identified and many achievements have also been acquired in metabolic engineering of tropane alkaloids.This review summarized the recent advances in above aspects,and the problems and orientations of future research are also discussed and proposed.

A 50-year-old male of Indian descent presented with jaundice and right hypochondrium pain. Following a computed tomography (CT) scan of the abdomen, a segment 7 liver lesion was visualized, accompanied by extensive peritoneal tumour deposits. An ultrasound guided liver biopsy was performed and histology showed loose nests and sheets of tumour cells with a small blue round cell morphology. The tumour cells showed patchy strong immunopositivity for cytokeratins (AE1/3, CK7, CK19) and synaptophysin, while showing diffuse strong perinuclear positivity for desmin. Interphase fluorescence in-situ hybridization (FISH) study using EWSR1 breakapart probe was positive for EWSR1 gene rearrangement. Desmoplastic small round cell tumour is a rare but aggressive intra-abdominal mesenchymal tumour. While the primary sites of involvement are usually the peritoneum and omentum, visceral involvement can occur. We wish to highlight the importance of considering this entity when evaluating a liver biopsy especially in a less than classical clinical context.

Objective To compare the operation situation of pancreatico duodenectomy (PD) and pylorus‐preserving pancreatico duodenectomy (PPPD) ,and analyze the clinical efficacy of PPPD .Methods Data of 47 patients with periampullary carcinoma and pancreatic head carcinoma underwent pancreatico duodenectomy from January 2010 to December 2013 were retrospectively analyzed and divided into PPPD group (20 cases) and PD group (27 cases) according to different surgery method .Then compare the situa‐tion of intra‐operative and post‐operative situation in two groups of patients .Results The operation time of PPPD group was sig‐nificantly lower than that of PD group (P<0 .05);the incidence of postoperative complication rate of PPPD group was obviously lower than PD group (P< 0 .05);and postoperative infection rate of PPPD group was significantly lower than PD group (P<0 .05);there was no significant difference between two groups in pancreatic leakage ,bile leakage ,gastrointestinal leakage ,post oper‐ative bleeding ,mortality and the incidence of delayed gastric emptying after surgery (P>0 .05) .Conclusion PPPD operation could shorten the operation time ,promote post‐operative recovery ,lower complication rates and shorten hospitalization time ,and could al‐so help to improve the nutritional status of patients ,improve the postoperative quality of life of patients ,thus it should be further promoted .

Objective To explore the treatment effect of Zuogui pill (ZGP) on immune premature ovarian failure rats.Methods Female mice model of POF was established by multiple sites subcutaneous injection of zona pellucida 3,and treated with different dosage ZGP (low, middle and high),with prednisone and diaethylstilbestrol as positive control. We detecteed apoptosis rate of granulosa and oocyte of murine ovaries by tunel method and observd the change of sexual cycle and weight. Results Compared with the control group,the weight of model group rat in the third to eighth weeks was significant difference (P

Objective To observe the effect of somatostatin on liver function in patients after splenectomy combined with de-vascularization.Methods The clinical data of 48 patients with liver cirrhosis,portal hypertension and esophageal varices were retro-spectively analyzed,26 cases (somatostatin group)were used somatostatin after splenectomy combined with devascularization,and the other 22 cases (control group)were not used.The changes of serum albumin (Alb),alanine aminotransferase (ALT),aspartate transaminase (AST),prothrombin activity (PTA)and total bilirubin (TBIL)was observed.Results All patients recovered well af-ter surgery,and no deaths occurred.However,ALT,AST and TBIL of using somatostatin group were significantly reduced than those of control group(P <0.05),Alb and PTA were also improved significantly (P <0.05).Conclusion The combination of som-atostatin can not only reduce postoperative portal pressure,control of bleeding,but also to be significantly promote recovery of liver function.

Objective To evaluate the feasibility of strent-graft with Chimney technique in thoracic endovascular aortic repair (TEVAR) of thoracic aortic dissection left subclavian artery (LSA) disease and left common carotid artery (LCCA) disease without good landing zone. Methods A total of 21 patients with thoracic aortic diseases complicated by in-sufficient proximal anchoring area,who were presented in our hospital in recent years,were selected in this study. The clini-cal data were retrospectively analyzed. The thoracic aortic diseases included aortic dissection ( n=11), aortic pseudoaneurysm (n=2), aortic aneurysm(n=1) and penetrating ulcer(n=7). Among all 21 patients,lesion was located in distal to LSA in 18 pa-tients with distance to LSA anchoring less than15 mm,and the lesion was located between the LSA and LCCA in the rest 3 patients.Thoracic aortic stent-graft placement was carried out.The ostium of LSA was intentionally and completely cov-ered by thoracic aortic stent-graft and left subclavian artery or left internal carotid artery stent-graft placement was subse-quently performed. The patients were observed for symptoms of cerebral and upper limb ischemia. The postoperative com-plications such as endoleak and the patency of LSA were assessed with angiography. Results Thoracic aortic stent-graft placement was suceessfully carried out in all 21 patients. In addition,one“Chimney”stent was properly implanted in LSA or LICA in each patient. After the procedure,no complications of nervous system or severe ischemia of upper extremity was observed. Follow-up examinations between to 38 months after the treatment revealed that the aortic stent-graft remained in stable condition without type I endoleak. Meanwhile the blood flow in“chinney”stent was unobstructed. Conclusion Chimney technique can expand the applicability of TSGP with high tolerance. Chimney technique expand the applicability of TEVAR for patients with challenging anatomy. It is a safe,effective and microinvasive method to treat thoracic aortic lesions.

Objective To observe the changes in excitability of alpha-motoneuron responding to the muscle spindles afferent excitability in the model rats and explore whether the changes in this excitability to be changed as high frequency sinusoidal vibration acted on the soleus muscle.Methods The simulated weightlessness model was created by the tail-suspension.Mechanical vibrations at a frequency of 100 Hz with amplitude of 0.3 mm were acted on soleus muscle.The electromyogram of soleus muscle evoked by electrical stimulation of the sciatic nerve was recorded in control rats and HS rats.Results It was showed that HS and HFV did not influence the tendency of changes in amplitude of H reflex when the stimulation intensity increased.However,after 14-day HS,mean maximal motor response(Mmax)and mean maximal monosynaptic reflex/Mmax(Hmax/Mmax)both significantly decreased,respectively(P0.05).Conclusion It is suggested that HS should lead to the decrease in motoneurons excitability which is resulted from the reduction of muscle spindle afferent.HFV acted on soleus muscle of rats can improve the excitability of alpha-motoneurons in spinal cord during hindlimb suspension.

Objective To prospectively evaluate the feasibility and reliablity of low kilovoltage contrast-enhanced multi-slice CT(MSCT)to detect the myocardial viability in chronic myocardial infarcetion.with comparison to magnetic resonance(MR)myocardial perfusion and viability imaging.Methods Thirty-two patients with clinical diagnosed chronic myocardial infarction underwent the first pass and delayenhanced myocardial imaging with 64-slice MSCT and MR Left ventricle was divided into 16 segments.MSCT and MR images of all the patients were blindly analyzed.The size and extent of hypoenhanced regions in first pass phase and hyperenhanced regions in delayed phase were define.The Kappa test was used to assess the ability of identifying the viable myocardium between the two methods.Results In 32 patients with chronic myocardial infarction,MSCT showed hypoenhanced regions in 41 segments and normal in 471 segments during the first phase,while MRI revealed hypoenhanced regions in 47 segments and normal regions in 465 segments.The Kappa value was 0.650 and the concordance rate of the two techniques was 94.5%(484/512).MSCT showed 135 hyperenhanced regions which were non-transmural in 50 segments and transmural in 85 segments.And the other 377 normal segments showed no enhancement in the delayed phase.MRI revealed 120 hyperenhanced regions which were non-transmural in 56 segments and transmural in 64 segments.And the other 392 normal segments showed no enhancement in the delayed phase.The Kappa value of the two techniques was 0.609 and the concordance rate of the two techniques was 80.7% (413/512).Conclusion The study showed that low kilovolrage CE MSCT has a good concordance with MRI and has high feasibility and reliability in evaluating the myocardial viability in chronic myocardial infarction.The radiation dose is still the important aspect of MSCT application.

Objective: To evaluate the accuracy and clinical value of fractional lfow reserve (FFR) determined by CT coronary angiography (CTA) in relevant patients. Methods: A total of 43 patients treated in our hospitals from 2013-10 to 2015-10 were retrospectively studied. There were 29 (67.40%) with male gender, the average age was (60.2±10.1) years. The patients received CTA at 1 week prior coronary angiography (CAG), the interval between CTA and CAG was (5.4±1.6) days. FFR was measured by both CAG and CTA (FFRCT) in selected target vessel which was deifned as maximal diameter reduction 50% to 70%. The imaging data were recorded and compared, FFRCT was calculated. Results: 48 vessels from 43 patients were eligible for analysis as target vessels. FFRCT vas evaluated based on the gold criteria of FFR. FFRCT had the diagnostic accuracy at 83.3%, sensitivity 75.0%, speciifcity 89.3% and positive predictive value was 83.3%, negative predictive value was 83.3% respectively. FFR and FFRCT showed obvious correlation (r=0.704,P<0.001); Bland-Altman analysis presented good concordance with 95% limits of agreement for FFRCTand FFR value ranged from -0.12 to 0.16, and 95.8% of the points (46/48) fell in the 95% limit of agreement, Receiver operating characteristic curve indicated that AUC of FFRCT was 0.871 (95% CI 0.770-0.973). Conclusion: CTA could accurately assess FFR, and FFRCT might be used in guiding the treatment for patients with intermediate coronary stenosis in clinical practice.

Objective To systemically evaluate the effect of intravesical Botulinum toxin on pain of patientspain syndrom. Methods The following databases as Cochrane Library, PubMed, Web of Science, Embase, Springer, Wiley, Science Direct, OVID were searched to col-lect the randomized controlled trials (RCTs) with the treatment of intravesical Botulinum toxin vs. 0.9%sodium chloride for patients with bladder pain syndrome. Two reviewers screened the trials according to the inclusion and exclusion criterias, extracted the data, assessed the quality, and the changes of Visual Analogue Scales (VAS) before and after treatment were used to conduct Meta analysis with RevMan5.2 software. Results Five studies were included with a total of 218 patients, there were 127 cases in intravesical Botulinum toxin group and 91 cases in 0.9%sodium chloride group. Meta analysis showed that the pain relief effect of intravesical Botulinum toxin was better than that of 0.9%sodium chloride. Conclusion Intravesical Botulinum toxin can relieve the pain of patients with bladder pain syndrome.