Tropane alkaloids (TAs) are a class of anticholinergic drugs widely used in clinical practice and mainly extracted from plant, among which Atopa belladonna is the main commercial drug source. It is of great industrial value to obtain TAs in large quantities by plant metabolic engineering. In TAs pathway, cytochrome oxidase CYP82M3 catalyze the synthesis of tropinone and then tropinone reductase I (TRI) compete with TRII for tropinone to form tropine leading to the TAs synthesis (drainage). In this study, based on the "increasing flow and drainage" metabolic engineering strategy, two genes, namely HnCYP82M3 and DsTRI from Hyoscyamus niger and Datura stramonium, respectively, were overexpressed in the hair roots of A. belladonna, with a view to promote the TAs accumulation. The HnCYP82M3 gene was cloned from the root of H. niger, and it encoded amino acid with 91.7% sequence identity with AbCYP82M3 from A. belladonna. Overexpression of HnCYP82M3 alone did not affect the content of TAs in hair roots of A. belladonna, indicating that CYP82M3 was not a key enzyme in TAs biosynthesis. Simultaneous overexpression of HnCYP82M3 and DsTRI greatly promoted the accumulation of the three TAs, and the contents of hyoscyamine, anisodamine and scopolamine were 4.97 times, 2.83 times and 2.19 times that of the control, respectively, and the increase amplitude was greater than that of single overexpression of DsTRI. This study showed that the "increasing flow and drainage" strategy of enzyme genes co-expression at branch points was a promising metabolic engineering method to effectively improve the biosynthesis of TAs in A. belladonna, and laid a theoretical and technical foundation for the large-scale industrial acquisition of TAs.

The quality control of traditional Chinese medicine(TCM)is the core issue to ensure the modernization,industrialization and internationalization of TCM.Compared with other detection methods,electrochemical analysis method has many advantages such as high sensitivity,fast detection speed and low cost,making it an important means of quality control for TCM and having broad development prospects.This article reviewed the research progress of electrochemical methods in quality control of TCM in recent years,discussed the application of electrochemical fingerprinting technique in identification of TCM,and comprehensively summarized the application of electrochemical technology in analyzing effective components and harmful substances in TCM,including flavonoids,alkaloids,quinones,glycosides,heavy metals and pesticide residues.Finally,the development prospects of electrochemical methods in the field of quality control of TCM were discussed.

Objective To investigate the relationship between insomnia,gastrointestinal symptoms,and glycosylated hemoglobin(HbA1c)levels in individuals diagnosed with type 2 diabetes mellitus(T2DM),as well as the related influencing factors.Methods A total of 910 T2DM patients treated in our multicenter from January 2022 to December 2022 were enrolled in this study.General information(gender,age,smoking and drinking history,exercise,course of disease,treatment and complications),HbA1c,Athens Insomnia Scale(AIS)scores and Gastrointestinal Symptoms Rating Scale(GSRS)scores of patients were collected.The differences of sleep and gastrointestinal symptoms between groups were analyzed,and the correlation between the differences and HbA1c was analyzed.Furthermore,the risk factors for non-standard HbA1c were analyzed.Results The AIS score and GSRS score in the HbA1c control group were less than those in the non-standard group(P＜0.01).Insomnia was reported by 37.0％of T2DM patients,and the HbA1c level in the insomnia group was significantly higher than that in the non-insomnia group(10.00％±2.38％vs.8.26％±1.73％,P＜0.01).Gastrointestinal symptoms were present in 57.5％of T2DM patients,and the HbA1c levels in the group with gastrointestinal symptoms were significantly higher than those in the group without gastrointestinal symptoms(9.26％±2.23％vs.8.43％±1.98％,P＜0.01).Furthermore,26.3％of T2DM patients experienced both insomnia and gastrointestinal symptoms.Remarkably,the HbA1c levels in the group with both insomnia and gastrointestinal symptoms were significantly higher than those in the group without either condition(10.18％±2.44％vs.8.45％±1.86％,P＜0.01).Correlation analysis demonstrated a significant association between sleep quality,gastrointestinal function,and HbA1c levels(P＜0.01).The logistic regression analysis result revealed that age,GSRS score,AIS score,and the presence of insomnia combined with gastrointestinal symptoms were independent risk factors for predicting HbA1c≥6.5％(P＜0.01).Having both insomnia and gastrointestinal symptoms concurrently was the strongest risk factor for substandard HbA1c control,and the risk of blood sugar control may increase about 5 times when both appear together.Conclusion Insomnia and gastrointestinal symptoms are common comorbidities in T2DM patients,showing a cross-interfering relationship,and they appear together with poor blood sugar control,interact causally,and amplify each other.

Breast cancer is the most common cancer in women and one of the deadliest cancers worldwide.According to the distribution of tumor tissue,breast cancer can be divided into invasive and non-invasive forms.The cancer cells in invasive breast cancer pass through the breast and through the immune system or systemic circulation to different parts of the body,forming metastatic breast cancer.Drug resistance and distant metastasis are the main causes of death from breast cancer.Research on breast cancer has attracted extensive attention from researchers.In vitro construction of tumor models by tissue engineering methods is a common tool for studying cancer mechanisms and anticancer drug screening.The tumor microenvironment consists of cancer cells and various types of stromal cells,including fibroblasts,endothelial cells,mesenchymal cells,and immune cells embedded in the extracellular matrix.The extracellular matrix contains fibrin proteins(such as types Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅵ,and Ⅹcollagen and elastin)and glycoproteins(such as proteoglycan,laminin,and fibronectin),which are involved in cell signaling and binding of growth factors.The current traditional two-dimensional(2D)tumor models are limited by the growth environment and often cannot accurately reproduce the heterogeneity and complexity of tumor tissues in vivo.Therefore,in recent years,research on three-dimensional(3D)tumor models has gradually increased,especially 3D bioprinting models with high precision and repeatability.Compared with a 2D model,the 3D environment can better simulate the complex extracellular matrix components and structures in the tumor microenvironment.Three-dimensional models are often used as a bridge between 2D cellular level experiments and animal experiments.Acellular matrix,gelatin,sodium alginate,and other natural materials are widely used in the construction of tumor models because of their excellent biocompatibility and non-immune rejection.Here,we review various natural scaffold materials and construction methods involved in 3D tissue-engineered tumor models,as a reference for research in the field of breast cancer.

Objective:To determine the clinical application value of transcranial sonography (TCS) in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children.Methods:A total of 50 children aged 6-12 years diagnosed with ADHD (ADHD group) and 45 age-matched healthy children (control group) who presented to Suzhou Municipal Hospital and Children′s Hospital of Soochow University from August 2021 to August 2022 were prospectively enrolled for TCS examination. ADHD was diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-Ⅴ) criteria established by the American Psychiatric Association.Based on clinical symptom characteristics, ADHD was further classified into 3 subtypes, including 14 cases of predominantly inattentive, 3 cases of predominantly hyperactive/impulsive, and 33 cases of combined presentation. The substantia nigra(SN) hyperechoic area and the ratio of SN hyperechoic area to midbrain area (S/M) were measured and compared between the two groups. The examination of the correlation was performed between SN hyperechoic area, S/M ratio, and DSM-Ⅴ scores within the ADHD group.Results:Semi-quantitative analysis: the proportion of the SN grade Ⅲ or more in ADHD group was significantly higher than that in control group [96.00%(48/50) vs 13.3%(6/45), P<0.05]. Quantitative analysis: the area of SN hyperechogenicity and the ratio of S/M were significantly larger in ADHD group than in control group [0.32(0.22, 0.38)cm 2 vs 0.00(0.00, 0.00)cm 2, 7.08(5.11, 8.75)% vs 0.00(0.00, 0.00)%, all P<0.05]. Correlation analysis: The SN hyperechoic area and S/M ratio showed no significant correlations with DSM-Ⅴ scores in the ADHD group ( r=0.144, 0.142, all P>0.05). Conclusions:TCS can detect the SN echo enhancement of ADHD children, and the proportion of SN echo enhancement, SN hyperechoic area and S/M ratio are significantly higher than those of normal children, but the SN hyperecho area and S/M ratio are not significantly correlated with DSM-Ⅴ scores.

Robotic surgery is known as the"third technological revolution"in the field of surgery,and is an important milestone in the development of modern surgery.However,our country's innovative surgical robot industry is still in its early stages,and it is only being utilized in certain surgical fields.To explore the effectiveness of the application of do-mestic surgical robot in oral and maxillofacial surgery,the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot.The operation was successful,facial nerve function was preserved,and postoperative wound healing was good.

Objective:In order to construct a multisectoral cooperation evaluation index system for chronic disease prevention and control in the Healthy China strategy,so as to provide a reference for the evaluation and improvement of multisectoral cooperation work.Methods:The initial indicator system was constructed based on D'Amour's cooperative structure model.Fifteen public health experts were selected to refine the evaluation indicators through two rounds of expert consultation using the Delphi method.Then weights of indicators were assigned according to AHP.Results:Experts'positive coefficient,level of authority and coordination of opinions were confirmed.The finalized evaluation index system for multisectoral cooperation in chronic disease prevention and control contains 5 first-level indicators,12 second-level indicators and 34 third-level indicators.According to the weight,the indicators in first level were Shared Goals and Vision(0.222 8),Internalization(0.158 7),Formalization(0.252 3),Governance(0.154 5)and Cooperation effects(0.211 8).Conclusions:The evaluation index system applicable to multisectoral cooperation in the prevention and control of chronic diseases in counties(cities/districts)is preliminarily established,which is highly scientific and operable,and lays the foundation for the next step of application and promotion.

Objective To explore the correlations between self-esteem,social support and mental health status of patients with deep bums at special sites at different stages of the disease course.Methods A total of 36 inpatients who were admitted to Department of Burn Surgery of The First Affiliated Hospital of Naval Medical University(Second Military Medical University)between Jan.2020 and Sep.2023 were enrolled.The patients were assessed with self-rating anxiety scale(SAS),self-rating depression scale(SDS),post-traumatic stress disorder(PTSD)checklist-civilian version(PCL-C),Rosenberg self-esteem scale(RSES),and perceived social support scale(PSSS)within 7 d of burns(early stage of disease),at wound closure(early rehabilitation stage),and 3 months after wound closure(late rehabilitation stage).The data were collected and invalid data were excluded for statistical analysis.Results A total of 36 patients effectively completed all the scales.There were anxiety,depression and PTSD in patients with deep bums at special sites at different stages of the disease course,and the number of burn patients with anxiety,depression and PTSD showed a downward trend with the course of disease.The RSES score at the early rehabilitation stage was positively correlated with SAS score(rs=0.412,P=0.013),SDS score(rs=0.347,P=0.038)and PCL-C score(rs=0.447,P=0.006)at the early stage of disease,but not with SAS,SDS,or PCL-C scores at the early and late rehabilitation stages(all P＞0.05).There were no correlations between PSSS score at the early rehabilitation stage and SAS,SDS,or PCL-C scores at the early stage of disease or SAS or PCL-C scores at the early stage of rehabilitation(all P＞0.05),but there were negative correlations between PSSS score at the early rehabilitation stage and SDS score at the early stage of rehabilitation(r=-0.430,P=0.009)and SAS score(r=-0.467,P=0.004),SDS score(r=-0.483,P=0.003),and PCL-C score(rs=-0.351,P=0.036)at the late stage of rehabilitation.Conclusion Anxiety,depression,and PTSD are observed in patients with deep burns in special areas at different stages of the disease.A high level of self-esteem is associated with an increased risk of mental problems at early stage of burns.Conversely,a high level of social support is associated with a reduced likelihood of mental problems at late stage of rehabilitation.

Objective To explore the clinical efficacy and prognostic factors of YL-1 type hard channel trepanation and drainage combined with stereotactic treatment for hypertensive intracerebral hemorrhage.Methods A retrospective study was conducted on 110 patients with hypertensive intracerebral hemorrhage at the Cerebrovascular Disease Center of the First People's Hospital of Suzhou from August 2019 to October 2022.The observation group(55 cases)received YL-1 type hard channel drilling and drainage combined with stereotactic treatment,while the control group(55 cases)received simple YL-1 type hard channel drilling and drainage.The perioperative indicators,neurological damage,and prognosis of the two groups of patients were compared;Using multiple Logistic regression analysis to identify the prognostic factors affecting patients.Results The perioperative indicators,neurological damage,and prognosis of the observation group were better than those of the control group(P＜0.05);The admission NIHSS score(OR=2.504,P＜0.05),simple minimally invasive drilling and drainage(OR=1.881,P＜0.05),disease duration＞24 hours(OR=2.782,P＜0.001),and ventricular rupture(OR=2.252,P＜0.05)are risk factors for poor prognosis in patients.Conclusion The prolongation of the patient's disease course,ventricular rupture,and severe neurological damage are associated with poor prognosis.Combining stereotactic minimally invasive surgery has a positive significance for improving the prognosis of patients with cerebral hemorrhage.

Objective:To evaluate the short-term efficacy of single-anastomosis duodenoileal bypass as revision surgery following sleeve gastrectomy.Methods:The clinical data of 51 patients who underwent single-anastomosis duodenoileal bypass as revision surgery after sleeve gastrectomy in our center from Jan 2020 to Jan 2023 were retrospectively analyzed.Results:A total of 51 patients underwent single-anastomosis duodenoileal bypass at 47 (34, 60) months after sleeve gastrectomy. All patients completed single-anastomosis duodenoileal bypass surgery by laparoscopic approach without conversion to laparotomy. The operative time was (122.8±37.4) min, the intraoperative bleeding volumes was (24.2±13.5) ml, and the length of hospital stay was 6 (5, 6) d. One year after surgery, the patient's weight decreased from (98.5±16.2) kg to (69.8±8.2) kg, BMI decreased from (34.8±3.9) kg/m 2 to (24.7±2.1) kg/m 2, excess weight loss increased from 44.0%± 11.7% to 97.1%±18.1%, systolic blood pressure decreased from (147.6±17.2) mmHg to (121.7±7.5) mmHg, diastolic blood pressure decreased from (84.2±11.5) mmHg to (76.0±12.1) mmHg, fasting blood glucose decreased from (7.1±1.8) mmol/L to (4.6±0.4) mmol/L, triglycerides decreased from (1.7±1.1) mmol/L to (0.7±0.2) mmol/L, cholesterol decreased from (5.9±0.4 ) mmol/L to (3.9±0.4) mmol/L, LDL decreased from (3.7±0.5) mmol/L to (2.3±0.2) mmol/L, HDL increased from (1.1±0.3) mmol/L to (1.5±0.7) mmol/L, and uric acid decreased from (347.2±90.1) μmol/L to (270.9±59.6) μmol/L, the difference were statistically significant ( F=55.9, 114.1, 158.7, 54.3, 3.1, 59.3, 24.2, 91.5, 180.3, 8.2, 9.8, all P<0.05). Conclusion:As revision surgery of sleeve gastrectomy, single-anastomosis duodenoileal bypass is feasible and effective, significantly reducing weight and obesity complications.