(+)-Borneol, the main component of "Natural Borneol" in the Chinese Pharmacopoeia, is a high-end spice and precious medicine. Plant extraction cannot meet the increasing demand for (+)-borneol, while microbial biosynthesis offers a sustainable supply route. However, its production was extremely low compared with other monoterpenes, even with extensively optimizing the mevalonate pathway. We found that the key challenge is the complex and unusual dephosphorylation reaction of bornyl diphosphate (BPP), which suffers the side-reaction and the competition from the cellular dephosphorylation process, especially lipid metabolism, thus limiting (+)-borneol synthesis. Here, we systematically optimized the dephosphorylation process by identifying, characterizing phosphatases, and balancing cellular dephosphorylation metabolism. For the first time, we identified two endogenous phosphatases and seven heterologous phosphatases, which significantly increased (+)-borneol production by up to 152%. By engineering BPP dephosphorylation and optimizing the MVA pathway, the production of (+)-borneol was increased by 33.8-fold, which enabled the production of 753 mg/L under fed-batch fermentation in shake flasks, so far the highest reported in the literature. This study showed that rewiring dephosphorylation metabolism was essential for high-level production of (+)-borneol in Saccharomyces cerevisiae, and balancing cellular dephosphorylation is also helpful for efficient biosynthesis of other terpenoids since all whose biosynthesis involves the dephosphorylation procedure.

Danshen, the dried roots and rhizomes of Salvia miltiorrhiza Bunge (S. miltiorrhiza), is widely used in the treatment of cardiovascular and cerebrovascular diseases. Tanshinones, the bioactive compounds from Danshen, exhibit a wide spectrum of pharmacological properties, suggesting their potential for future therapeutic applications. Tanshinone biosynthesis is a complex process involving at least six P450 enzymes that have been identified and characterized, most of which belong to the CYP76 and CYP71 families. In this study, CYP81C16, a member of the CYP71 clan, was identified in S. miltiorrhiza. An in vitro assay revealed that it could catalyze the hydroxylation of four para-quinone-type tanshinones, namely neocryptotanshinone, deoxyneocryptotanshinone, and danshenxinkuns A and B. SmCYP81C16 emerged as a potential broad-spectrum oxidase targeting the C-18 position of para-quinone-type tanshinones with an impressive relative conversion rate exceeding 90%. Kinetic evaluations andin vivo assays underscored its highest affinity towards neocryptotanshinone among the tested substrates. The overexpression of SmCYP81C16 promoted the accumulation of (iso)tanshinone in hairy root lines. The characterization of SmCYP81C16 in this study accentuates its potential as a pivotal tool in the biotechnological production of tanshinones, either through microbial or plant metabolic engineering.
Humans ; Salvia miltiorrhiza/metabolism* ; Biosynthetic Pathways ; Quinones/metabolism* ; Plant Roots/metabolism* ; Gene Expression Regulation, Plant

Objective:To evaluate the clinical efficacy of autologous bone marrow nucleated cell transplantation on ovarian dysfunction-related diseases.Methods:From September 2020 to August 2021, we conducted a before-after study in Shanghai Institute of Planned Parenthood Research Hospital and Shanghai New Hongqiao International Medical Center. A total of 28 patients with premature ovarian insufficiency, perimenopausal syndrome or repeated assisted reproduction failure were treated with ultrasound-guided autologous bone marrow nucleated cell transplantation into the ovaries. Clinical efficacy was evaluated by comparing the patients' self-reported symptoms, endometrial thickness, bilateral ovarian volume, the number of bilateral ovarian follicles, the maximum diameter of bilateral ovarian follicles, and the level of plasma estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, prolactin, and testosterone.Results:After autologous bone marrow nucleated cell transplantation, the number of bilateral ovarian follicles and the maximum diameter of bilateral ovarian follicles statistically significantly increased by an average of 1.26±2.12 ( P=0.005) and (5.40±8.92) mm ( P=0.006), respectively. Endometrial thickness and bilateral ovarian volume increased after treatment although without statistically significance (all P>0.05). However, the ovarian volume, the number of follicles, and the maximum diameter of follicles with greater changes between the left and right sides of the treatment, were found to statistically significantly increase after treatment ( P=0.007, P<0.001, P=0.002). Besides, the levels of FSH, LH, progesterone, and prolactin decreased with no statistical significance (all P>0.05). The stratified analysis of disease types found that endometrial thickness, the number of bilateral ovarian follicles, and the maximum diameter of bilateral ovarian follicles after treatment tended to increase, but only the number of bilateral follicles and the maximum diameter of bilateral ovarian follicles in patients with perimenopausal syndrome showed statistical significance ( P=0.008, P=0.047). Conclusion:The present study suggested that autologous bone marrow nuclear cell therapy could improve ovarian function to some extent, and is expected to be a new treatment method for patients with premature ovarian insufficiency, perimenopausal syndrome, and repeated assisted reproduction failure. However, further studies with larger sample sizes are needed to corroborate the findings.

Objective:To evaluate the clinical efficacy of autologous bone marrow nucleated cell transplantation on ovarian dysfunction-related diseases.Methods:From September 2020 to August 2021, we conducted a before-after study in Shanghai Institute of Planned Parenthood Research Hospital and Shanghai New Hongqiao International Medical Center. A total of 28 patients with premature ovarian insufficiency, perimenopausal syndrome or repeated assisted reproduction failure were treated with ultrasound-guided autologous bone marrow nucleated cell transplantation into the ovaries. Clinical efficacy was evaluated by comparing the patients' self-reported symptoms, endometrial thickness, bilateral ovarian volume, the number of bilateral ovarian follicles, the maximum diameter of bilateral ovarian follicles, and the level of plasma estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, prolactin, and testosterone.Results:After autologous bone marrow nucleated cell transplantation, the number of bilateral ovarian follicles and the maximum diameter of bilateral ovarian follicles statistically significantly increased by an average of 1.26±2.12 ( P=0.005) and (5.40±8.92) mm ( P=0.006), respectively. Endometrial thickness and bilateral ovarian volume increased after treatment although without statistically significance (all P>0.05). However, the ovarian volume, the number of follicles, and the maximum diameter of follicles with greater changes between the left and right sides of the treatment, were found to statistically significantly increase after treatment ( P=0.007, P<0.001, P=0.002). Besides, the levels of FSH, LH, progesterone, and prolactin decreased with no statistical significance (all P>0.05). The stratified analysis of disease types found that endometrial thickness, the number of bilateral ovarian follicles, and the maximum diameter of bilateral ovarian follicles after treatment tended to increase, but only the number of bilateral follicles and the maximum diameter of bilateral ovarian follicles in patients with perimenopausal syndrome showed statistical significance ( P=0.008, P=0.047). Conclusion:The present study suggested that autologous bone marrow nuclear cell therapy could improve ovarian function to some extent, and is expected to be a new treatment method for patients with premature ovarian insufficiency, perimenopausal syndrome, and repeated assisted reproduction failure. However, further studies with larger sample sizes are needed to corroborate the findings.

Objective:To explore the application and influence of task-driven teaching in the internship of rehabilitation medicine among general medical students.Methods:A total of 256 students of the same grade from the fifth clinical college of Chongqing Medical University were included in this study. 128 students were selected as the experimental group to receive task-driven teaching, and another 128 students were selected as the control group to receive traditional teaching. Course design for students in the experimental group was evaluated, and the learning effects were compared between the two groups.Results:In the experimental group, more than 88% students were relatively satisfied with the tasks designed. The ability of self-study and independent thinking of students in the experimental groups was better than those in the control group ( P<0.05). In the aspect of problem solving, expression, cooperation, modern information utilization and creative thinking ability, students in the experimental group did a significantly better performance than those in the control group ( P=0.000), and students' learning motivation was significantly increased in the experimental group than in the control group ( P=0.000). Conclusion:In the internship of rehabilitation medicine, task-driven teaching was highly accepted among students and received fair satisfaction. It improves the learning effect of students majoring in general medicine and promotes the understanding for rehabilitation medicine, which lays a foundation for the work of primary hospitals in the future.

OBJECTIVE：To observe the ef fectiveness and safety of bosentan in the treatment of hypoxic pulmonary hypertension（HPH）in neonates. METHODS ：From Jan. 2014 to Mar. 2019，a total of 82 HPH neonates hospitalized in the department of neonatology of our hospital were selected as research subjects. According to whether or not receiving bosentan therapy，50 cases were included into bosentan group and 32 cases into non-bosentan group. Meanwhile ，another 25 non-HPH neonates with serum sample retention time and general information such as gestational age at birth and day age matching the HPH group were selected as the control group. All neonates with HPH were given continuous intravenous infusion of Dopamine hydrochloride injection 5 mg/（kg·min）until PASP was normal. On this basis, neonates in the bosentan group were additionally given Bosentan tablets 1 mg/kg（fed after dissolving with appropriate amount of water for injection ）for q 12 h，72 h. The relationship between serum ET- 1 levels of neonates with HPH and PASP was analyzed ，as well as PASP before and after treatment and therapeutic efficacy between bosentan and non-bosentan groups ，the changes of arterial blood gas indexes and ADR in 3 groups were compared. RESULTS ：Before treatment ，the serum ET- 1 levels of bosentan group was （164.3±115.3）pg/mL，which was significantly higher than （41.9±3.7）pg/mL of control group and positively correlated with PASP level （r＝0.864，P＜0.001）. Total response rate of bosentan group was 90.00％，which was significantly higher than 71.88％ of non-bosentan group （P＜0.05）. After 72 h of treatment ，PASP of 2 groups was decreased significantly ，compared with before treatment （P＜0.001），and the bosentan group was significantly lower than the non-bosentan group （P＜0.05）. The PaO 2，SaO2，PaCO2 and OI in 3 groups was significantly improved compared with that before treatment （P＜0.001），and the PaO 2，SaO2 and OI in the bosentan group was significantly higher than that in the non-bosentan group （P＜0.05）. During the treatment period of bosentan and within one week after drug withdrawal，there was no significant change in serum LDH ，AST，ALT and Scr levels in neonates. There was no statistically significant difference in the incidence of feeding intolerance ，anemia，reduced WBC and reduced PLT in 3 groups（P＞0.05）. CONCLUSIONS： Bosentan can improve the oxygenation status of neonates with HPH, reduce PA SP，and short-termmedication is safe. com

Objective To analyze the changes of serum hypoxia-inducible factor-1α(HIF-1α),vas-cular endothelial growth factor ( VEGF) and endothelin-1 ( ET-1) levels in neonates with hypoxia-induced pulmonary hypertension(HPH),and to explore the roles of three factors in the pathogenesis of HPH in neo-nates. Methods A total of 50 neonates with HPH in the neonatal intensive care unit as HPH group and an-other 25 non-HPH hospitalized neonates with similar clinical data in the same period as control group were enrolled from January 2014 to December 2017. The levels of serum HIF-1α,VEGF and ET-1 were deter-mined by enzyme linked immunosorbent assay when neonates were diagnosed as HPH and their pulmonary artery systolic blood pressure(PASP) decreased to 35 mmHg below respectively. The changes of three factors levels were analyzed and compared with those of control group at the same time point. Results (1) The levels of serum HIF-1α,VEGF and ET-1 of HPH group were significantly higher than those of the control group (F value were 151. 97,43. 31,and 129. 56 respectively,all P<0. 01). Furthermore,the more serious the grade of HPH,the higher the levels of three factors. The differences were statistically significant (all P<0. 01). (2) After PASP of neonates in HPH group decreased to 35 mmHg or below,the levels of serum HIF-1α,VEGF and ET-1 also significantly decreased,and the differences were statistically significant ( all P <0. 01). However,there were no statistically significant differences compared with those of the control group for the levels of serum HIF-1α and VEGF(both P>0. 05) in addition to serum ET-1 levels (F＝14. 98,P<0. 05). Conclusion High levels of HIF-1α,VEGF and ET-1 caused by hypoxia may play an important role in neonatal HPH.

OBJECTIVE:To investigate the omeprazole off-label use and provide reference for rational drug use in clinic. METHODS:In retrospective survey,1838 omeprazole prescriptions were selected from outpatient department during Jun. 2014 to May 2017 by random number table. According to the latest drug instruction,whether the off-label use or not was determined. Off-label use was determined by reviewing domestic and foreign guidelines,literatures and Micromedex database. RESULTS:Among 1838 pre-scriptions,there were 1750 prescriptions of off-label drug use (95.21％),involving 13 items and 3 types of off-label drug use. Main type of off-label drug use was over-indication medication,involving 1747 prescriptions (96.47％). There was no statistical significance in the incidence of off-label drug use between digestive department and non-digestive department or among physicians at different levels(P>0.05). Among 13 items of off-label drug use,7 items were supported by evidence-based medicine evidence of domestic and foreign guideline,expert consensus/suggestion or literature reports,etc.;among which 1 item of off-label drug use were included in Micromedex grading system and other 6 items had no evidence-based medicine evidence. CONCLUSIONS:The phenomenon of omeprazole off-label use is widespread in outpatient department of the hospital,and some off-label drug use are sup-ported by evidences. There are differences in the quality of those evidences. It is suggested to standardize the off-label drug use to avoid legal risks and guarantee the safety of drug use for patients.

Objective To better understand the clinical characteristics of Familial Idiopathic Basal Ganglia Calcifi?cation (FIBGC), including at the perspective of hereditary pattern, clinical test results, onset age, clinical heterogeneity and the volume of basal ganglia calcification (VBGC). Method 8 Eight FIBGC families were collected and draw family pedigrees were draw. Analysis of was conducted on the patient's clinical test results, head CT and MRI changes, onset ag?es, relationship of clinical manifestations with VBGC. Results No significant difference was found in serum calcium, alu?minum, arsenic, cobalt, magnesium, phosphorus, iron, parathyroid hormone and calcitonin concentration between the fam?ily members of patients and healthy controls (P>0.05). Family members from 8 FIBGC families including the two with consanguineous marriage manifested autosomal dominant heredity. The severity of , symptomatic s was correlated with VBGCpatients showed the same clinical manifestations in the dyskinesia family. The psychiatric symptoms was not asso? ciated with VBGC whereas patients with dyskinesia had a large VBGC. There was a significant difference in onset age be?tween patients with psychiatric symptoms and those with dyskinesia. P.atients with dyskinesia suffer larger VBGC, and is characterized by Patients with dyskinesia had relatively later onset age (43.95 ± 2.47 y) whereas those with. psychiatric symptoms hadsymptomatic patients with early onset age (31.32±10.16y). The comparison of the onset age (43.954±2.473 vs. 31.319±10.156 y, t=4.438, P=0.001) and VBGC (1.748±0.622 vs. 0.392±0.276 cm3, t=2.518, P=0.028) with symptom?atic patients between dyskinesia and psychogenic families was significant. Conclusions Eight FIBGC families manifested autosomal dominant heredity. Patients with dyskinesia suffer have a larger VBGC and are associated with a, and is char?acterized by relatively later onset age. In contrast, patients with psychiatric symptomspsychogeny is not related withhave a the small VBGC and showedand their age of onset is young. earlier onset age.