Objective:To investigate the effectiveness of a free toe lateral ventral flap combined with metacarpophalangeal (MCP) osteotomy and tendon insertion reconstruction in treating severe lateral deviation in patients with postoperative duplicated thumb deformity.Methods:A retrospective analysis was conducted on the clinical data of children with severe lateral deviation after surgery for duplicated thumb deformity, treated at the Department of Pediatric Orthopaedics of the Ninth People’s Hospital of Wuxi City from January 2018 to June 2023. The children were divided into 2 groups: the control group underwent "MCP osteotomy and tendon insertion reconstruction", which included metacarpal (or phalangeal) osteotomy with internal fixation, interphalangeal joint (IPJ) and metacarpophalangeal joint (MCPJ) arthroplasty, as well as reconstruction of the insertion points of extensor and flexor tendons, collateral ligaments, abductor pollicis tendons, and joint capsules. The treatment group, in addition to the surgical steps performed in the control group, underwent reconstruction of the asymmetric nail fold using a free lateral toe flap and digital volume augmentation. The occurrence of postoperative complications was observed and recorded, and the circumference of the digit, joint lateral deviation angle, joint range of motion, and the postoperative scar conditions of the reconstructed thumbs of the 2 groups were compared. The appearance and function of the reconstructed thumbs were evaluated by using the Japanese Society for Surgery of the Hand (JSSH) score (total score of 20), the aesthetic scoring system (ASS) (total score of 18), and the modified Tada score (total score of 8). In all three scoring systems, the higher the score, the better the postoperative outcomes. The measurement data of normal distribution were expressed as Mean±SD, and independent sample t-test was used to compare the two groups. The count data were expressed as frequency, and χ2 test was used to compare the two groups. Results:A total of 41 children were enrolled, with 25 males and 16 females, aged 9 to 18 years (mean 11.3 years, ) with a time since initial surgery ranging from 6 to 16 years (mean 10.8 years). There were 25 cases in the control group and 16 cases in the treatment group. All surgeries were successfully completed, with no postoperative complications such as infection, skin or flap necrosis, or bone nonunion occurred. All children were followed up for 10-39 months (mean of 22.1 months). Preoperative comparison of the 2 groups in terms of gender, age, side of deformity, lateral deviation angle of MCPJ, lateral deviation angle of IPJ, and circumference of the digit was comparable with no statistically significant differences. At the final follow-up, there were no statistically significant differences between the two groups in MCPJ lateral deviation angle, IPJ lateral deviation angle, MCPJ range of motion, IPJ range of motion, Vancouver scar scale score, and modified Tada score (all P>0.05). However, in the treatment group, the ratio of reconstructed-side to healthy-side phalangeal circumference (1.05±0.04 vs. 0.76±0.03), JSSH score [(17.1±0.8) points vs. (15.2±0.6) points] and ASS score [(16.6±0.7) points vs. (14.5±0.7) points] were higher than those of the control group, and the differences were statistically significant (all P<0.01). Conclusion:The combination of a free lateral toe flap with MCP osteotomy and tendon insertion reconstruction for treating severe lateral deviation after surgery for duplicated thumb deformity fully leverages the technical advantages of microsurgery. The appearance of the lateral nail fold and the digital circumference are close to normal and can restore good thumb extension and flexion function.

Objective:To investigate the preventive efficacy of triamcinolone acetonide injection on esophageal stenosis after endoscopic submucosal dissection (ESD).Methods:From February 1, 2021 to October 31, 2023, 82 patients who underwent ESD for esophageal lesions at the Affiliated Cancer Hospital of Nanjing Medical University (Jiangsu Cancer Hospital) were enrolled. According to the treatment of the surface after ESD, the patients were divided into the triamcinolone acetonide group (49 cases) and the no-special-treatment group (33 cases). The patients of triamcinolone acetonide group received multiple injections of triamcinolone acetonide solution post-ESD (immediate), week 1, and week 4, while the patients of no-special-treatment group did not receive additional pharmacological intervention. The patients were followed up for 3 months after ESD. The occurrence of esophageal stenosis after ESD was observed under endoscopy. The incidence of esophageal stenosis and the improvement of dysphagia after ESD were compared between the triamcinolone acetonide group and no-special-treatment group. Univariate and multivariate logistic regression analyes were performed to identify influencing factors of esophageal stenosis after ESD. Chi-square test was used for statistical analysis.Results:The incidence of esophageal stenosis after ESD in the triamcinolone acetonide group was lower than that in the no-special-treatment group (16.3% (8/49) vs. 66.7% (22/33)), and the proportion of patients without dysphagia (Stooler′s grading score of 0) was higher than that in the no-special-treatment group (83.7% (41/49) vs. 33.3% (11/33)), and the differences were statistically significant ( χ2=19.42 and 24.31, both P<0.001). In 42 patients with circumferential esophageal lesions involving >75%, the incidence of esophageal stenosis in the triamcinolone acetonide group was lower than that in the no-special-treatment group (28.6% (6/21) vs. 85.7% (18/21)), and the proportion of patients without dysphagia (Stooler′s grading score of 0) was higher than that in the no-special-treatment group (71.4% (15/21) vs. 14.3% (3/21)), and the differences were statistically significant ( χ2=11.76 and 15.33, both P<0.001). There was no statistically significant differences in the incidence of adverse events between the triamcinolone acetonide group and no-special-treatment group (4.1% (2/49) vs. 0; χ2=0.20, P=0.656), and no serious adverse reactions occurred in 2 groups. The results of multivariate logistic regression analysis showed that the long distance from the proximal lesion margin to the incisors was a protective factor of whether esophageal stenosis occured or not after ESD ( OR=0.795, 95% confidence interval (95% CI): 0.652 to 0.947, P=0.014), while the incidence of esophageal stenosis increased in patients with circumferential lesions involving >75% ( OR=7.064, 95% CI: 1.893 to 32.408, P=0.006), and the incidence of esophageal stenosis effectively reduced after the use of triamcinolone acetonide post ESD ( OR=0.062, 95% CI: 0.013 to 0.229, P<0.001). Conclusion:After ESD, triamcinolone acetonide can reduce the incidence of esophageal stenosis and improve patients′ dysphagia.

Objective:To investigate the effectiveness of a free toe lateral ventral flap combined with metacarpophalangeal (MCP) osteotomy and tendon insertion reconstruction in treating severe lateral deviation in patients with postoperative duplicated thumb deformity.Methods:A retrospective analysis was conducted on the clinical data of children with severe lateral deviation after surgery for duplicated thumb deformity, treated at the Department of Pediatric Orthopaedics of the Ninth People’s Hospital of Wuxi City from January 2018 to June 2023. The children were divided into 2 groups: the control group underwent "MCP osteotomy and tendon insertion reconstruction", which included metacarpal (or phalangeal) osteotomy with internal fixation, interphalangeal joint (IPJ) and metacarpophalangeal joint (MCPJ) arthroplasty, as well as reconstruction of the insertion points of extensor and flexor tendons, collateral ligaments, abductor pollicis tendons, and joint capsules. The treatment group, in addition to the surgical steps performed in the control group, underwent reconstruction of the asymmetric nail fold using a free lateral toe flap and digital volume augmentation. The occurrence of postoperative complications was observed and recorded, and the circumference of the digit, joint lateral deviation angle, joint range of motion, and the postoperative scar conditions of the reconstructed thumbs of the 2 groups were compared. The appearance and function of the reconstructed thumbs were evaluated by using the Japanese Society for Surgery of the Hand (JSSH) score (total score of 20), the aesthetic scoring system (ASS) (total score of 18), and the modified Tada score (total score of 8). In all three scoring systems, the higher the score, the better the postoperative outcomes. The measurement data of normal distribution were expressed as Mean±SD, and independent sample t-test was used to compare the two groups. The count data were expressed as frequency, and χ2 test was used to compare the two groups. Results:A total of 41 children were enrolled, with 25 males and 16 females, aged 9 to 18 years (mean 11.3 years, ) with a time since initial surgery ranging from 6 to 16 years (mean 10.8 years). There were 25 cases in the control group and 16 cases in the treatment group. All surgeries were successfully completed, with no postoperative complications such as infection, skin or flap necrosis, or bone nonunion occurred. All children were followed up for 10-39 months (mean of 22.1 months). Preoperative comparison of the 2 groups in terms of gender, age, side of deformity, lateral deviation angle of MCPJ, lateral deviation angle of IPJ, and circumference of the digit was comparable with no statistically significant differences. At the final follow-up, there were no statistically significant differences between the two groups in MCPJ lateral deviation angle, IPJ lateral deviation angle, MCPJ range of motion, IPJ range of motion, Vancouver scar scale score, and modified Tada score (all P>0.05). However, in the treatment group, the ratio of reconstructed-side to healthy-side phalangeal circumference (1.05±0.04 vs. 0.76±0.03), JSSH score [(17.1±0.8) points vs. (15.2±0.6) points] and ASS score [(16.6±0.7) points vs. (14.5±0.7) points] were higher than those of the control group, and the differences were statistically significant (all P<0.01). Conclusion:The combination of a free lateral toe flap with MCP osteotomy and tendon insertion reconstruction for treating severe lateral deviation after surgery for duplicated thumb deformity fully leverages the technical advantages of microsurgery. The appearance of the lateral nail fold and the digital circumference are close to normal and can restore good thumb extension and flexion function.

Objective:To investigate the preventive efficacy of triamcinolone acetonide injection on esophageal stenosis after endoscopic submucosal dissection (ESD).Methods:From February 1, 2021 to October 31, 2023, 82 patients who underwent ESD for esophageal lesions at the Affiliated Cancer Hospital of Nanjing Medical University (Jiangsu Cancer Hospital) were enrolled. According to the treatment of the surface after ESD, the patients were divided into the triamcinolone acetonide group (49 cases) and the no-special-treatment group (33 cases). The patients of triamcinolone acetonide group received multiple injections of triamcinolone acetonide solution post-ESD (immediate), week 1, and week 4, while the patients of no-special-treatment group did not receive additional pharmacological intervention. The patients were followed up for 3 months after ESD. The occurrence of esophageal stenosis after ESD was observed under endoscopy. The incidence of esophageal stenosis and the improvement of dysphagia after ESD were compared between the triamcinolone acetonide group and no-special-treatment group. Univariate and multivariate logistic regression analyes were performed to identify influencing factors of esophageal stenosis after ESD. Chi-square test was used for statistical analysis.Results:The incidence of esophageal stenosis after ESD in the triamcinolone acetonide group was lower than that in the no-special-treatment group (16.3% (8/49) vs. 66.7% (22/33)), and the proportion of patients without dysphagia (Stooler′s grading score of 0) was higher than that in the no-special-treatment group (83.7% (41/49) vs. 33.3% (11/33)), and the differences were statistically significant ( χ2=19.42 and 24.31, both P<0.001). In 42 patients with circumferential esophageal lesions involving >75%, the incidence of esophageal stenosis in the triamcinolone acetonide group was lower than that in the no-special-treatment group (28.6% (6/21) vs. 85.7% (18/21)), and the proportion of patients without dysphagia (Stooler′s grading score of 0) was higher than that in the no-special-treatment group (71.4% (15/21) vs. 14.3% (3/21)), and the differences were statistically significant ( χ2=11.76 and 15.33, both P<0.001). There was no statistically significant differences in the incidence of adverse events between the triamcinolone acetonide group and no-special-treatment group (4.1% (2/49) vs. 0; χ2=0.20, P=0.656), and no serious adverse reactions occurred in 2 groups. The results of multivariate logistic regression analysis showed that the long distance from the proximal lesion margin to the incisors was a protective factor of whether esophageal stenosis occured or not after ESD ( OR=0.795, 95% confidence interval (95% CI): 0.652 to 0.947, P=0.014), while the incidence of esophageal stenosis increased in patients with circumferential lesions involving >75% ( OR=7.064, 95% CI: 1.893 to 32.408, P=0.006), and the incidence of esophageal stenosis effectively reduced after the use of triamcinolone acetonide post ESD ( OR=0.062, 95% CI: 0.013 to 0.229, P<0.001). Conclusion:After ESD, triamcinolone acetonide can reduce the incidence of esophageal stenosis and improve patients′ dysphagia.

Objective To identify factors associated with gastrointestinal heat retention in preschool children,and to provide a foundational understanding for future clinical investigations. Methods A case-control study was performed,which involved children from kindergartens in the Longgang District of Shenzhen City,Guangdong Province,from May to July 2021. Using the Children's Gastrointestinal Heat Retention Diagnostic Self-assessment Scale,subjects were allocated into a case group (children diagnosed with gastrointestinal heat retention) and a control group (children without this condition). An online survey was used to collect data on dietary behaviors,caregivers' feeding behaviors,early antibiotic use,daily routines,and birth conditions. SPSS 27.0 software was used to facilitate precise sociodemographic matching and paired logistic regression analysis to explore the association between gastrointestinal heat retention and the above factors. Results From the analysis of 51,252 matched cases,the study found that several factors contributed to an increased risk of gastrointestinal heat retention. These factors included reduced food intake compared to peers,reports of picky eating by caregivers,distractions during meals,pronounced dietary preferences,disinterest in food,meal durations ≥ 25 min,reluctance to sample new foods,consistent refusal of specific food types for over one month,irregular meal locations,coercive feeding practices,use of micronutrient supplements,allowing children too much freedom in food choice,persuading children to eat,infrequent encouragement to experiment with new foods,early antibiotic introduction,inadequate sleep,and premature birth (P<0.05). In contrast,exclusive breastfeeding in the first six months,engagement in moderate to massive physical activity,and regular napping patterns were associated with a reduced risk of gastrointestinal heat retention (P<0.05). Conclusion The suboptimal dietary habits,improper feeding practices,insufficient physical activity,inadequate sleep,and premature antibiotic exposure may be significant risk factors for gastrointestinal heat retention. Future research dedicated to unraveling the cause of gastrointestinal heat retention should prioritize these elements.

OBJECTIVE: To investigate the efficacy and safety of daratumumab in treatment of multiple myeloma (MM) patients with renal impairment (RI). METHODS: The clinical data of 15 MM patients with RI who received daratumumab-based regimen from January 2021 to March 2022 in three centers were retrospectively analyzed. Patients were treated with daratumumab or daratumumab combined with dexamethasone or daratumumab combined with bortezomib and dexamethasone and the curative effect and survival were analyzed. RESULTS: The median age of 15 patients was 64 (ranged 54-82) years old. Six patients were IgG-MM, 2 were IgA-MM,1 was IgD-MM and 6 were light chain MM. Median estinated glomerular filtration rate (eGFR) was 22.48 ml/(min·1.73 M₂). Overall response rate of 11 patients with MM was 91% (≥MR), including 1 case of stringent complete response (sCR), 2 cases of very good partial response (VGPR), 3 cases of partial response (PR) and 4 cases of minor response (MR). The rate of renal response was 60%(9/15), including 4 cases of complete response (CR), 1 case of PR and 4 cases of MR. A median time of optimal renal response was 21 (ranged 7-56) days. With a median follow-up of 3 months, the median progression-free survival and overall survival of all patients were not reached. After treatment with daratumumab-based regimen, grade 1-2 neutropenia was the most common hematological adverse reaction. Non-hematological adverse reactions were mainly infusion-related adverse reactions and infections. CONCLUSION Daratumumab-based regimens have good short-term efficacy and safety in the treatment of multiple myeloma patients with renal impairment.
Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Multiple Myeloma/drug therapy* ; Retrospective Studies ; Dexamethasone/therapeutic use* ; Antibodies, Monoclonal/therapeutic use* ; Bortezomib/therapeutic use* ; Renal Insufficiency/drug therapy* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*

OBJECTIVE: To establish a machine learning model based on extreme gradient boosting (XGBoost) algorithm for early prediction of severe acute pancreatitis (SAP), and explore its predictive efficiency. METHODS: A retrospective cohort study was conducted. The patients with acute pancreatitis (AP) who admitted to the First Affiliated Hospital of Soochow University, the Second Affiliated Hospital of Soochow University and Changshu Hospital Affiliated to Soochow University from January 1, 2020 to December 31, 2021 were enrolled. Demography information, etiology, past history, and clinical indicators and imaging data within 48 hours of admission were collected according to the medical record system and image system, and the modified CT severity index (MCTSI), Ranson score, bedside index for severity in acute pancreatitis (BISAP) and acute pancreatitis risk score (SABP) were calculated. The data sets of the First Affiliated Hospital of Soochow University and Changshu Hospital Affiliated to Soochow University were randomly divided into training set and validation set according to 8 : 2. Based on XGBoost algorithm, the SAP prediction model was constructed on the basis of hyperparameter adjustment by 5-fold cross validation and loss function. The data set of the Second Affiliated Hospital of Soochow University was served as independent test set. The predictive efficacy of the XGBoost model was evaluated by drawing the receiver operator characteristic curve (ROC curve), and compared it with the traditional AP related severity score; variable importance ranking diagram and Shapley additive explanation (SHAP) diagram were drawn to visually explain the model. RESULTS: A total of 1 183 AP patients were enrolled finally, of which 129 (10.9%) developed SAP. Among the patients from the First Affiliated Hospital of Soochow University and Changshu Hospital Affiliated to Soochow University, there were 786 patients in the training set and 197 in the validation set; 200 patients from the Second Affiliated Hospital of Soochow University were used as the test set. Analysis of all three datasets showed that patients who advanced to SAP exhibited pathological manifestation such as abnormal respiratory function, coagulation function, liver and kidney function, and lipid metabolism. Based on the XGBoost algorithm, an SAP prediction model was constructed, and ROC curve analysis showed that the accuracy for prediction of SAP reached 0.830, the area under the ROC curve (AUC) was 0.927, which was significantly improved compared with the traditional scoring systems including MCTSI, Ranson, BISAP and SABP, the accuracy was 0.610, 0.690, 0.763, 0.625, and the AUC was 0.689, 0.631, 0.875, and 0.770, respectively. The feature importance analysis based on the XGBoost model showed that the top ten items ranked by the importance of model features were admission pleural effusion (0.119), albumin (Alb, 0.049), triglycerides (TG, 0.036), Ca²⁺ (0.034), prothrombin time (PT, 0.031), systemic inflammatory response syndrome (SIRS, 0.031), C-reactive protein (CRP, 0.031), platelet count (PLT, 0.030), lactate dehydrogenase (LDH, 0.029), and alkaline phosphatase (ALP, 0.028). The above indicators were of great significance for the XGBoost model to predict SAP. The SHAP contribution analysis based on the XGBoost model showed that the risk of SAP increased significantly when patients had pleural effusion and decreased Alb. CONCLUSIONS A SAP prediction scoring system was established based on the machine automatic learning XGBoost algorithm, which can predict the SAP risk of patients within 48 hours of admission with good accuracy.
Humans ; Pancreatitis ; Acute Disease ; Retrospective Studies ; Hospitalization ; Algorithms

Objectives: This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade (R-SGB) as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy (NICM). Methods: This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1, 2021 and January 31, 2022. Lidocaine (5 ml, 1%) was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound, once per day for 7 days. Data including clinical characteristics, immediate and long-term outcomes, and procedure related complications were collected. Results: The mean age was (51.5±13.6) years. All patients were male. 5 patients were diagnosed as dilated cardiomyopathy, 2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy. The left ventricular ejection fraction was 37.8%±6.6%. After the treatment of R-SGB, 6 (75%) patients were free of electrical storm. 24 hours Holter monitoring showed significant reduction in ventricular tachycardia (VT) episodes from 43.0 (13.3, 276.3) to 1.0 (0.3, 34.0) on the first day following R-SGB (P<0.05) and 0.5 (0.0, 19.3) after whole R-SGB process (P<0.05). There were no procedure-related major complications. The mean follow-up was (4.8±1.1) months, and the median time of recurrent VT was 2 months. Conclusion: Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.
Humans ; Male ; Adult ; Middle Aged ; Aged ; Female ; Stroke Volume ; Stellate Ganglion/surgery* ; Ventricular Function, Left ; Cardiomyopathies/complications* ; Tachycardia, Ventricular/therapy* ; Treatment Outcome ; Catheter Ablation

OBJECTIVE: To investigate the clinical value of neutrophil CD64 index in hematological malignancies with pulmonary infection. METHODS: The cohort study method was used to retrospectively analyze the clinical data of 125 patients with hematological malignancies and pulmonary infections who were treated in The Third Affiliated Hospital of Soochow University. All the patients were divided into four stages according to the diagnosis and treatment process: non-infected stage (T1), the symptoms of infection had appeared before using antibiotics (T2), one week after anti-infective treatment (T3), and after stopping antibiotics (T4). CD64 index, C-reactive protein (CRP), blood cell count, and immune cell level were compared before and after infection (T1 vs T2), the correlation between CD64 index and other indicators were explored, the change trends of the significantly different indicators in the course of the disease were observed, and the diagnostic efficacy of CD64 index and CRP were compared. The surviving patients were followed up for whether reinfection occurred within 30 days after discharge, and the re-examination results of indices before discharge (in stage of T4) between reinfected and non-reinfected patients were compared to find the risk factors of reinfection. RESULTS: Before and after infection, the CD64 index, CRP, CD14⁺HLA-DR⁺, CD4⁺, and lymphocyte counts were significantly different (all P<0.05). There was a negative correlation of CD64 index with CD14⁺HLA-DR⁺ (r=-0.395, P<0.001), a negative correlation with CD3⁺ (r=-0.1.87, P=0.047), and a negative correlation with lymphocyte count (r=-0.230, P=0.006), while a positive correlation with CRP(r=0.313, P<0.001). The area under the curve of CD64 index, CRP, and CD64 index combined with CRP was 0.790 (95%CI: 0.711-0.868), 0.754(95%CI: 0.667-0.841), and 0.835(95%CI: 0.762-0.907), respectively; the sensitivity was 59.6%, 72.7%, and 74.7%, the specificity was 89.2%, 73.0%, and 78.4%, and the cut-off value was 0.488, 0.457, and 0.531, respectively. There were only two re-examination indexes showed significantly different before discharge between reinfected patients and non-reinfected patients: CD14⁺HLA-DR⁺ (F=8.524, P=0.004) and CD64 index (F=9.993, P=0.002). The increase of CD64 index was an independent risk factor for reinfection within 30 days after discharge from the hospital (HR=1.790, 95%CI: 1.343-2.386, P<0.001). CONCLUSION CD64 index has diagnostic value in patients with hematological malignancies and pulmonary infection, and its specificity is higher than that of CRP. The combination of the two indicators can improve the diagnostic sensitivity. CD64 index has a predictive value for reinfection within 30 days after infection treatment.
Anti-Bacterial Agents/therapeutic use* ; Biomarkers ; C-Reactive Protein/metabolism* ; Cohort Studies ; Hematologic Neoplasms/metabolism* ; Humans ; Neutrophils/metabolism* ; Receptors, IgG/metabolism* ; Reinfection ; Retrospective Studies

Objective:This paper aims to clone the cDNA sequence of limonene-3-hydroxylase（StL3OH） in Schizonepeta tenuifolia and analyze its sequence by bioinformatics. Method:Specific primers were designed based on sequences of StL3OH gene screened from transcriptome sequencing data of S. tenuifolia and the cDNA sequence of StL3OH gene was cloned by reverse transcription polymerase chain reaction （RT-PCR） and analyzed for its bioinformatics. Result:The StL3OH gene cDNA sequence length was 1 598 bp，containing a 1 497 bp long complete open reading frame which encoded 498 amino acids. StL3OH protein had a theoretical relative molecular mass of 56.40 kDa，with a hydrophilic and unstable nature. Bioinformatics analysis showed that StL3OH protein had no signal peptide but had a transmembrane domain which might be located in endoplasmic reticulum. Multiple sequence alignment and cluster analysis showed that the amino acid sequence of MsL3OH protein had a high similarity with StL3OH protein，both of which contained cytochrome P450 heme binding region，belonging to the D subfamily of cytochrome CYP71 family. Codon bias analysis showed that StL3OH gene preferred guanine/cytosine（G/C） ending codon，with 27 skewed codons， and Nicotiana benthamiana was proven to be the most suitable host for exogenous expression of StL3OH gene. Conclusion:The cDNA sequence of StL3OH gene was cloned from S. tenuifolia for the first time，which will provide a basis for further study on the structure and function of StL3OH protein and the regulation mechanism of StL3OH gene in the accumulation and biosynthesis of monoterpenes in S. tenuifolia.