OBJECTIVE: To investigate the safety and effectiveness of balloon occlusion and intra-sac thrombin injection in the endovascular repair of ruptured abdominal aortic aneurysm. METHODS: From October 2019 to October 2022, the clinical data of 16 patients with rAAA treated with balloon occlusion technique and intra-sac thrombin injection combined with EVAR were retrospectively analyzed, including 13 males and 3 females, aged 42-85 years, with a median age of 70.5 years. The time of preoperative first aid (from hospital arrival to operation start), average operation time, stay in intensive care unit (ICU), average hospitalization time, success rate of surgical treatment, perioperative (30 d) mortality rate, incidence of complications, the maximum diameter and volume change of the aneurysm were observed and recorded. RESULTS: Among the 16 patients with ruptured abdominal aortic aneurysm, the technical success rate was 100.0% (16/16). One patient died of multiple organ dysfunction 6 hours after operation. The success rate of surgical treatment was 93.8% (15/16). The preoperative first aid time was (53.3±6.2) min, the average operation time was (89.9±17.1) min, the stay in the intensive care unit (ICU) was (1.7±0.8) d, and the average hospitalization time was (7.8±1.3) d. The intraoperative balloon occlusion time was (32.4±4.1) min. The postoperative renal function of all the patients had no significant deterioration compared with that preoperative. Abdominal compartment syndrome (ACS) occurred in 1 patient after operation, which improved after CT puncture and drainage. The median follow-up time was 36 months. During the follow-up period, 1 patient died of acute myocardial infarction 2 years after operation, and the remaining 14 patients survived. Among the 14 follow-up patients, 1 type Ⅱ endoleak occurred, and no other types of endoleak occurred. By the end of the follow-up, the maximum diameter of the aneurysm sac in 14 patients was significantly lower than that before operation [(44.6±8.0) mm vs.(66.0±15.5) mm, P < 0.001], and in 12 patients with CTA, the volume of the aneurysm sac was significantly shrunk than that before operation [(311.7±170.3) mm³ vs. (168.6±68.1) mm³, P < 0.05]. CONCLUSION Balloon occlusion during endovascular repair is safe and effective in the treatment of ruptured abdominal aortic aneurysm; intraoperative thrombin injection of the aneurysm sac can significantly reduce the incidence of intraoperative and postoperative abdominal compartment syndrome and endoleak and, to a certain extent, improve the success rate of treatment.
Humans ; Male ; Female ; Aged ; Balloon Occlusion/methods* ; Aortic Aneurysm, Abdominal/surgery* ; Thrombin/administration & dosage* ; Retrospective Studies ; Aged, 80 and over ; Middle Aged ; Aortic Rupture ; Endovascular Procedures/methods* ; Adult ; Treatment Outcome ; Operative Time

Production of chiral amines and unnatural amino-acid using ω-transaminase can be achieved by kinetic resolution and asymmetric synthesis, thus ω-transaminase is of great importance in the synthesis of pharmaceutical intermediates. By genomic data mining, a putative ω-transaminase gene hbp was found in Burkholderia phytofirmans PsJN. The gene was cloned and over-expressed in Escherichia coli BL21 (DE3). The recombinant enzyme (HBP) was purified by Ni-NTA column and its catalytic properties and substrate profile were studied. HBP showed high relative activity (33.80 U/mg) and enantioselectivity toward β-phenylalanine (β-Phe). The optimal reaction temperature and pH were 40 ℃ and 8.0-8.5, respectively. We also established a simpler and more effective method to detect the deamination reaction of β-Phe by UV absorption method using microplate reader, and demonstrated the thermodynamic property of this reaction. The substrate profiling showed that HBP was specific to β-Phe and its derivatives as the amino donor. HBP catalyzed the resolution of rac-β-Phe and its derivatives, the products (R)-amino acids were obtained with about 50% conversions and 99% ee.
Bacterial Proteins ; biosynthesis ; genetics ; Burkholderia ; enzymology ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Transaminases ; biosynthesis ; genetics

Objective To study the clinical efficacy of intensive insulin therapy (IIT) on patients with severe heart failure,pulmonary infection and hyperglycemia.Methods A retrospective analysis was studied on 104 patients with severe heart failure,pulmonary infection and hyperglycemia from January 2009 to August 2012,and 48 cases were treated by insulin conventional treatment (control group),while 56 cases were treated by IIT treatment (observation group).The blood glucose changes at each time and time of antibiotic using,pulmonary infection control situation and mortality rate between the two groups were observed and compared.Results The blood glucose before treatment in observation group and control group were (15.8 ± 4.3) and (15.3 ± 5.1) mmol/L,and there was no statistical difference (P ＞ 0.05).The blood glucose levels at 24,48,72 h and 1 week after treatment in observation group were (8.3 ± 2.1),(8.0 ± 1.2),(7.9 ± 1.3) and (7.9 ± 1.1) mmol/L,in control group were (12.5 ± 3.2),(11.7 ± 2.1),(11.3 ± 1.5) and (11.2 ± 1.7) mmol/L.The blood glucose levels after treatment in the two groups were significantly lower than those before treatment,but in observation group were significantly lower than those in control group,and there were statistical differences (P ＜0.01).The time of antibiotic using in observation group was significantly shorter than that in control group [(14.3 ± 2.5) d vs.(20.1 ± 3.2) d],and there was statistical difference(t =10.368,P ＜ 0.01).The total effective rate of pulmonary infection in observation group was significantly higher than that in control group [87.5％(49/56) vs.68.8％(33/48)],and there was statistical difference (x2 =5.448,P ＜ 0.05).The mortality rate in observation group was significantly lower than that in control group [8.9％ (5/56) vs.22.9％ (11/48)],and there was statistical difference (x2 =6.423,P ＜ 0.05).Conclusion The IIT used in the treatment of patients with severe heart failure,pulmonary infection and hyperglycemia can significantly improve the prognosis of patients and reduce mortality rate,which is worthy of clinical application.