Adult ; Apolipoproteins E ; genetics ; Asian Continental Ancestry Group ; Exons ; genetics ; Female ; Humans ; Kidney Diseases ; genetics ; Mutation ; genetics ; Young Adult

Objective To investigate the heart rate control and related influencing factors of patients with coronary heart disease and arrhythmia in Qinghai in 2019. Methods Clinical data of 263 patients with coronary heart disease and arrhythmia in our hospital in 2019 were retrospectively analyzed. According to their resting heart rate control status at 6 months after discharge, the patients were divided into a well-controlled heart rate group (n=151) and a poorly controlled heart rate group (n=112). The clinical characteristics of patients with different heart rate control status were compared, and influencing factors of heart rate control were analyzed. Results Among patients with coronary heart disease and arrhythmia in Qinghai in 2019, atrial arrhythmia had a higher incidence rate (55.51%), and the main types of arrhythmia were atrial premature beat. The rate of good heart rate control of patients at 6 months after discharge was 57.41%. The heart rate control status was related to the resting heart rate at discharge, age, smoking status, treatment methods, type of coronary heart disease, CCS grade, NYHA classification, hypertension, diabetes mellitus, cardiac enlargement, use of beta blocker and awareness of heart rate control target at discharge (t=32.370, P<0.001; χ²=26.300, P<0.001; χ²=45.690, P<0.001; χ²=15.161, P<0.001; χ²=67.500, P<0.001; χ²=18.788, P<0.001; χ²=10.228, P=0.006; χ²=78.769, P<0.001; χ²=66.374, P<0.001; χ²=51.165, P<0.001; χ²=43.360, P<0.001; χ²=40.315, P<0.001), and the difference was statistically significant. Smoking, coronary artery bypass grafting, myocardial infarction, diabetes mellitus, non-use of beta blockers, and poor awareness of heart rate control were independent risk factors for poor heart rate control in patients with coronary heart disease and arrhythmia (P<0.05). Conclusion In 2019, the rate of good heart rate control in patients with coronary heart disease and arrhythmia in Qinghai is above the average level, and the health education on heart rate control relate knowledge for high-risk groups should be strengthened.

Fusidic acid is the only fusidane-type antibiotic that has been clinically used. However, biosynthesis of this important molecule in fungi is poorly understood. We have recently elucidated the biosynthesis of fusidane-type antibiotic helvolic acid, which provides us with clues to identify a possible gene cluster for fusidic acid ( cluster). This gene cluster consists of eight genes, among which six are conserved in the helvolic acid gene cluster except and . Introduction of the two genes into the NSAR1 expressing the conserved six genes led to the production of fusidic acid. A stepwise introduction of and revealed that the two genes worked independently without a strict reaction order. Notably, we identified two short-chain dehydrogenase/reductase genes and in the cluster, which showed converse stereoselectivity in 3-ketoreduction. This is the first report on the biosynthesis and heterologous expression of fusidic acid.