2- (2-thiophenyl) scopolamine glycolate is produced through an ester exchange reaction between scopine and methyl 2, 2-dithienylglycolate, and is used to synthesize tiotropium bromide. In this paper, the treatment process of 12 patients with acute 2- (2-thiophenyl) scopolamine glycolate poisoning was reviewed and their clinical data were analyzed. After a large amount of 2- (2-thiophenyl) scopolamine glycolate was absorbed through the respiratory tract, the poisoning patients presented with central nervous system injury as the main clinical manifestations, accompanied by symptoms such as blurred vision and irritability. After fluid replacement, ovulation induction and symptomatic supportive treatment, all patients improved and were discharged. The patients were followed up. After 6 months, only 3 patients had residual headache and dizziness. It is indicated that early intervention for acute 2- (2-thiophenyl) scopolamine glycolate poisoning has a good prognosis. Meanwhile, occupational protection should be strengthened to prevent the occurrence of poisoning.

2- (2-thiophenyl) scopolamine glycolate is produced through an ester exchange reaction between scopine and methyl 2, 2-dithienylglycolate, and is used to synthesize tiotropium bromide. In this paper, the treatment process of 12 patients with acute 2- (2-thiophenyl) scopolamine glycolate poisoning was reviewed and their clinical data were analyzed. After a large amount of 2- (2-thiophenyl) scopolamine glycolate was absorbed through the respiratory tract, the poisoning patients presented with central nervous system injury as the main clinical manifestations, accompanied by symptoms such as blurred vision and irritability. After fluid replacement, ovulation induction and symptomatic supportive treatment, all patients improved and were discharged. The patients were followed up. After 6 months, only 3 patients had residual headache and dizziness. It is indicated that early intervention for acute 2- (2-thiophenyl) scopolamine glycolate poisoning has a good prognosis. Meanwhile, occupational protection should be strengthened to prevent the occurrence of poisoning.

Objective:To explore the diagnosis and treatment of HIV infection complicated with acute lymphoblastic leukemia.Methods:The diagnosis and treatment of a patient with HIV infection and ALL who was admitted to Tianjin People's Hospital on February 13, 2021 were retrospectively analyzed, and the experience was summarized and the literature was reviewed.Results:The patient had a history of HIV infection for more than 3 years, and was diagnosed as acute lymphoblastic leukemia, and was treated with VCP (Vindesine 2 mg on days 1, 8, 15, 22, cyclophosphamide 600 mg on days 1-2, 15-16, dexamethasone 9 mg on days 1-14, 5 mg. 15-28 days) and died on the 8th day of chemotherapy. The cause of death was infection.Conclusion:Combined chemotherapy and hematopoietic stem cell transplantation on the basis of highly active antiretroviral therapy can improve the prognosis and survival rate of HIV-infected patients with acute lymphoblastic leukemia.

Objective:To investigate the clinical features of patients with epilepsy in Neurosurgery Outpatient and influencing factors for their seizure control.Methods:Six hundred and seventy-three epilepsy patients admitted to Neurosurgery Outpatient of 6 hospitals including Fifth Affiliated Hospital of Zhengzhou University from September 2017 to December 2022 were chosen. Clinical data (including general demographic data, education level, onset age, onset cycle and duration, course of onset, family annual income and seizure control) were collected using a questionnaire prepared by He'nan Epilepsy Systematic Diagnosis and Treatment Center to summarize the clinical features. Univariate and multivariate Logistic regressions were used to analyze the influencing factors for their seizure control.Results:(1) In these 673 epilepsy patients, 50 (7.4%), 78 (11.6%), 192 (28.5%), 100 (14.9%), 68 (10.1%), 72 (10.7%) and 113 (16.8%), respectively, were <1 year old (infant stage), 1-2 years old (children stage), 3-5 years old (preschool stage), 6-16 years old (juvenile stage), 17-39 years old (young stage), 40-64 years old (middle-aged stage) and ≥65 years old (elderly stage). In the past medical treatment history, 23.0% (155/673) patients did not receive intervention, 72.4% (487/673) received medication, and 4.6% (31/673) received surgical treatment; 55.9% (376/673) had good seizure control and 44.1% (297/673) had poor seizure control. (2) Secondary education ( OR=2.199, 95% CI: 1.037-15.221, P=0.033), primary education or below ( OR=3.544, 95% CI: 2.101-21.343, P=0.012), daily seizures ( OR=4.788, 95% CI: 1.369-33.103, P=0.011), each seizure lasted ≥3 min ( OR=4.179, 95% CI: 3.338-18.550, P=0.003), course of disease≥3 years ( OR=0.199, 95% CI: 0.077-0.602, P=0.001), course of disease for 1-3 years ( OR=0.379, 95% CI: 0.108-0.882, P=0.031), and currently taken antiepileptic drugs for 3 or more ( OR=6.237, 95% CI: 2.195-17.837, P=0.001) were independent risk factors for poor seizure control in epilepsy patients. Conclusion:In Neurosurgery Outpatient, children with diseases before childhood enjoy the largest proportion; drug therapy remains the main treatment; low education level, short seizure cycle, long duration of attack, long course of disease, and multiple drugs used in these patients imply poor anti-epileptic effecacy.

Methyltransferases (MTs) constitute a large group of enzymes that catalyze the transfer of a methyl moiety, most frequently from S-adenosyl-L-methionine, to their substrates. It plays an essential role in regulation of gene expression and synthesis of many natural compounds. Owing to its broad substrate spectrum, MTs make important contributions to diversify the spectrum of products through methylation modifications. Recently, great progress has been made in application of MTs for the biosynthesis of various natural products including phenylpropane compounds, fragrances, hormones and antibiotics, which is summarized in this review. Moreover, we highlighted the strategies of using MTs for efficient production and for expanding the diversity of these methylated natural products, and discussed the current challenges and future prospects in this area.
Biological Products ; Methylation ; Methyltransferases/metabolism*

[摘 要] 目的：探讨过表达miR-497靶向细胞周期蛋白E1（cyclin E1，CCNE1）对肺癌A549细胞上皮间质转化（epithelial-mesenchymal transition，EMT）的影响。方法：常规培养人肺癌A549细胞，细胞实验分为正常组（不加干预）、对照组（转染miR-497 mimics-NC）、实验组（转染miR-497 mimics）。采用Transwell小室实验、免疫荧光染色、qPCR、Western blotting法分别检测各组细胞迁移和侵袭能力、蛋白间质标志物α-SMA和上皮标志物E-cadherin的表达、miR-497和CCNE1的表达水平，荧光素酶基因基因报告实验验证miR-497和CCNE1的靶向关系。结果：与对照组和正常组相比，实验组A549细胞迁移和侵袭的数量明显减少（均P<0.05），细胞的间质标志物α-SMA的绿色荧光强度明显减弱[（36.95±5.81） vs （98.69±2.36）、（97.94±2.63），均P<0.05]，上皮标志物E-cadherin的绿色荧光强度明显增强[（388.41±10.93） vs （100.95±6.37）、（102.55±3.18），均P<0.05]，miR-497的表达明显升高（均P<0.05），CCNE1的表达均明显下降（均P<0.05）。miR-497能够靶向调控CCNE1的表达。结论：在肺癌A549细胞中miR-497能够靶向调控CCNE1的表达，上调miR-497的表达后能明显抑制A549细胞迁移和侵袭能力，影响EMT相关蛋白的表达。

Serum vitamin D level and vitamin D receptor (VDR) gene FokI polymorphisms were detected in 200 single full-term pregnant women who gave birth in our hospital during 2016 to 2018. The newborns with birth weight<2500 g were diagnosed as fetal growth restriction (FGR), there were 100 cases in FGR group and 100 cases in control group. The average level of vitamin D in pregnant women in FGR group was significantly lower than that of the control group [(30.1±10.9) vs. (36.1±15.8) nmol/L, P<0.05]. In the FGR group, the birth weight of infants in mother carrying ff genotype was significantly lower than that in mother carrying Ff and FF genotypes [(2073±90) g vs. (2242±122) g and (2349±96) g, P<0.05]. Pregnant women carrying Ff and FF genotypes had lower risk of FGR than those of carrying ff genotype (ORFf=0.31, 95％ CI: 0.17-0.76; ORFF=0.28, 95％CI: 0.11-0.46). The pregnant women with serum 25(OH)D level>30 nmol/L carrying F allele (FF+Ff) were set as reference, the risk of FGR in pregnant women with serum 25 (OH)D level ≤ 30 nmol/L carrying ff genotype was increased (OR=6.14, 95％CI: 2.13-13.23). The polymorphism of VDR gene FokI may be associated with the occurrence of FGR. In the case of vitamin D deficiency, the influence of ff genotype on FGR is more tangible.

Objective To study the effect of possible factors pre-operativly on recipient survival after heart transplantation among the dilated cardiomyopathy (DCM) patients.Methods 394 DCM recipients went through heart transplantation from June 2004 to October 2017 in our center,and the pre-operative NT-proBNP levels and risk factors influencing the post-operational survival reported by ISHLT retrospectively were analyzed.Kaplan Meier method was used to calculate the 1-10 years survival rate of the DCM patients and analyze the clinical data of the recipients and the donors,and the ROC method was applied to find the cutoff point of every pre-operation event.The recipients were divided into two groups according to the cutoff point:＜4 000 ng/L group (n =296) and ≥4 000 ng/ L group (n=73).COX regression curve was used to decide the hazard ratio and the Kaplan Meier curve was drawn.The result was verified by Log-rank.Results The cutoff point of the preoperative NT-proBNP level was 4000 ng/L.By analyzing the NT-proBNP levels between 2 groups,the relationship between them and the survival rate was acknowledged and the NT-proBNP level ≥4 000 ng/L was a risk factor (P =0.029,Kaplan Meier method).In the recipients whose pulmonary arterial systolic pressure (PASP) was more than 40 mmHg,the survival rate between ＜4 000 ng/L group (n =190) and ≥4 000 ng/L group (n =58)] showed significant difference (P =0.027),and there was no significant difference in the recipients whose PASP was less than 40 mmHg (P＞0.05).Conclusion The 1-,3-,5-,7-,and 10-year survival rate in our patients was 97.2％,94.5％,91.9％,88.0％ and 83.1 ％ respectively,which shows advantage over other international reports.The pre-operative NT-proBNP level ≥ 4 000 ng/L is a risk factor in the DCM patients who have pulmonary hypertension,so determination and dynamic monitoring of the pre-operative NT-proBNP level may be beneficial to the survival of cardiac transplantation,especially among the patients who have higher PASP level.

Objective To investigate the sleep quality state of people who did physical examination,and its correlation with brachial-ankle Pulse Wave Velocity (baPWV).Methods The indexes of Pittsburgh sleep quality index (PSQI) and baPWV were used.The people who did physical examination were divided into sleep disorders group (284 cases) and normal sleep group (608 cases) according to the results of PSQI survey.Results (1) There were 31.84％ of the people who had sleep quality problems.(2) The PSQI total score and the score of subjective sleep quality (SSQ),sleep duration (Sdu),daytime dysfunction (DD) of females were higher than males (t =6.71,3.46,2.45,3.96,P ＜0.05).The PSQI total score and the score of sleep latency (SL),habitual sleep efficiency (HSE),use of sleeping medication (USM) among different age groups were statistically analyzed (F =12.23,8.31,7.50,7.11,P ＜ 0.05).(3) The score of baPWV of sleep disorders group was higher than normal sleep group (t =5.14,P ＜ 0.05).There were significantly positive correlation between baPWV and total PSQI score,subjective sleep quality,sleep time,daytime dysfunction (r =0.28,0.45,0.30,0.36,0.35,P ＜ 0.05).Conclusions 1/3 of the physical examination people have sleep quality problems.Sleep quality of females is worse than males.There are different styles among different age groups.There is significantly positive correlation between sleep quality and baPWV.

Objective To study the curative effect of limited-acupotomy therapy on chronic lumbosacral osteo-fascial compartment syndrome. Methods 59 patients were randomly recruited into a control group (with 29 patients) and a treatment group (with 30 patients). The control group was treated with general-acupotomy therapy, and treatment group was treated with limited-acupotomy therapy. Evaluate the curative effects before the first and the second therapy, and 3 months after the therapy respectively, as well as VAS pain, JOA and CODI scores. Results The curative effect was 96.56% and 100% respectively in the control group and the treatment group 3 months after the treatment. The difference between the two groups was not statistically significant(χ2＝0.19,P＞ 0.05). As to VAS pain scores, JOA and CODI scores, the difference among the three stages of the treatment were significant (in control group F＝165.70, 99.90, 106.60 respectively, in treatment group F＝279.76, 154.34, 67.36 respectively, P＜0.01)in both groups respectively, but the difference between the two groups were not significant(P＞0.05) in each stage. Conclusion Limited-acupotomy therapy was safe and effective in treating chronic lumbosacral osteo-fascial compartment syndrome.