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Objective: To clone the key enzyme gene involved in the biosynthesis of esculentoside A(EsA),acetoacetyl-CoA transferase(AACT) gene was cloned from Phytolacca americana for bioinformatics analysis and prokaryotic expression. Method: Total RNA was extracted from the root of P. americana, and then cDNA was synthesized through the reverse transcription. Based on analysis of the transcriptome data of P. americana, the specific primers of PaAACT gene were designed,and the cDNA sequence of PaAACT gene was amplified by polymerase chain reaction(PCR) method. Prokaryotic induction,expression and purification of the target protein were induced through the construction of the prokaryotic expression vector pET-32a-PaAACT. Result: The open reading frame (ORF) of PaAACT gene was 1 254 bp,and encoded 417 amino acid residues. Bioinformatic analysis showed that the molecular formula of PaAACT protein was C1 914H3 120N538O576S17,inferring that its molecular weight was 43.43 kDa,the theoretical isoelectric point was 8.90,and the instability index of PaAACT protein was 32.27,which was a stable protein. According to bioinformatics analysis,PaAACT protein was a member of the thiolase family and contained one conserved site and one active site of the thiolase family at the C-terminal. PaAACT protein may be located in the cytoplasm,without a signal peptide or transmembrane domain. The phylogenetic analysis indicated that PaAACT protein showed the highest homology with AACT protein from polygonaceae plants (such as Beta vulgaris). The recombinant PaAACT protein was successfully expressed in Escherichia coli BL21(DE3) strain through IPTG induction, and the purified target protein was obtained by Ni2+ affinity chromatography. Conclusion: In this study,the PaAACT gene was cloned from P. americana,which lays a foundation for further determination of enzyme activity assay of PaAACT and preparation of antibody,and provides the theoretical basis for studying its role in the biosynthesis pathway of EsA.
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Objective: To investigate the impact of discontinued dual antiplatelet therapy(DAPT) of aspirin combining clopidogrel within 5 days on peri-operative bleeding in patients with coronary artery bypass grafting (CABG). Methods: A total of 2012 patients with off-pump CABG were retrospectively enrolled in our study including 1506 male and the mean age was at 61.92 years. All patients received regular DAPT previously and discontinued the medication≤5 days due to emergency or prior limited CABG. Based on the days from discontinued DAPT to operation, the patients were divided into 6 groups: 0-day group, n=220, 1-day group, n=240, 2-day group, n=360, 3-day group, n=332, 4-day group, n=428 and 5-day group, n=432. Relationships between risk factors of bleeding and discontinued DAPT time were studied. Results: Bleeding was defined by BARC (bleeding academic research consortium) standard. The incidences of bleeding events in 0-day group, 1-day group, 2-day group, 3-day group, 4-day group and 5-day group showed a decreasing trend as 29.1%, 24.6%,19.4%, 13.0%, 14.5% and 13.0% respectively, P<0.01. Post-operative chest drainage volume≥2L within 24h (P=0.13) and intracranial bleeding (P=0.60) had no obvious tendency changes; occurrence rates of 48h peri-operative transfusion≥5 U whole blood or red blood cells (P<0.01) and re-operation(P<0.01) had a decreasing trend by prolonged time of discontinued medication. The minor endpoint events were similar. Compared to (3-5) days discontinued medication, the patients with (0-2) days discontinued DAPT were with the higher incidences of overall bleeding, re-operation and 5U transfusion, the differences had statistical meaning. Conclusion: The incidence of bleeding presented a decreasing trend by prolonged time of discontinued DAPT before CABG;transfusion and re-operation had the statistical meaning for bleeding. Discontinued medication less than 3 days may increase bleeding events and therefore, in high risk patients, prior CABG discontinued medication should be more than 3 days.
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<p><b>OBJECTIVE</b>To assess the role of neuronavigation in assisting endoscopic transsphenoidal surgery for pituitary adenomas.</p><p><b>METHODS</b>Ten endoscopic endonasal transsphenoidal reoperations for pituitary adenomas were selected. Clinical records were reviewed retrospectively. Five of 10 patients had gigantic adenoma, 3 microadenoma, 2 large adenoma.</p><p><b>RESULTS</b>The mean setup time was 5 minutes, and the operative time was 50 minutes in image-guided procedures. In all cases, the system worked well without malfunction. Continuous information regarding instrument location and trajectory was provided to the surgeon. Measurements of intraoperative accuracy in the axial, coronal, and.sagittal planes indicated a mean verified system error of 1.5 mm. for pituitary adenomas. After operation, the symptoms relieved in all patients.</p><p><b>CONCLUSIONS</b>Neuronavigation can be applied during endonasal transsphenoidal endoscopic surgery and requires a minimal amount of time. It makes reoperation easier, faster, and safer.</p>