2例主动脉DeBranch术后并发乳糜胸患者的护理

总结2例主动脉DeBranch术后并发乳糜胸的护理经验,包括严密观察引流量、颜色、性状的变化,以便早发现、早干预;按医嘱做好戒脂饮食管理及静脉营养支持;加强液体管理,预防右心功能不全。经保守治疗,2例患者均治愈出院,留置心包胸腔引流管分别为18 d、25 d。

Effects of Weak Light on Starch Accumulation and Starch Synthesis Enzyme Activities in Rice at the Grain Filling Stage

Dynamic changes of starch, amylose, sucrose contents and the activities of starch synthesis enzymes under shading treatments alter flowering were studied using two rice varieties IR72 （indica） and Nipponbare （japonica） as materials. Under shading treatments, the starch, amylose and sucrose contents decreased, while ADP-glucose pyrophosphorylase （ADPGPPase） activity only changed a little, soluble starch synthase activity and granule bound starch synthase activity decreased, soluble starch branching enzyme （SSBE, Q-enzyme） activity and granule bound starch branching enzyme （GBSBE, Q-enzyme） activity increased, and starch debranching enzyme （DBE, R-enzyme） activity varied with varieties. Correlation analyses showed that the changes of starch content were positively and significantly correlated with the changes of sucrose content in the weak light. Both ADPGPPase activity and SSBE activity were positively and significantly correlated with starch accumulation rate. It was implied that the decline of starch synthase activities was related to the decrease of starch content and the increase of the activity of starch branching enzyme played an important role in the decrease of the ratio of amylose to the total starch under the weak light.

Bentall+Debranch手术后机械通气肺感染患者护理1例

总结1例Bentall+Debranch手术后机械通气肺感染患者在治疗后病情好转的护理经验。护理要点:由于患者接受的手术较为复杂,对身体整体系统影响较大,因此对患者循环系统与呼吸系统两方面着重处理以及特殊病情观察,制定符合患者病情的准确有效的护理措施,如伤口护理、消毒隔离、等,并且结合患者病情及心理给予针对性的心理疏导以及健康宣教。经过精细的治疗与护理患者病情好转,脱机试验后,入院43 d成功拔出气管插管,目前生命体征平稳,治疗效果满意。

主动脉夹层患者行Debranch术的手术护理

总结了5例主动脉夹层患者行Debranch术中护士的手术配合,包括术前做好心理护理和手术器械、物品的充分的准备;术中密切监测体温、脑氧饱和度,同时关注重点护理环节。认为手术室护士扎实的理论及实践操作能力,能提高手术配合预见性、保证手术顺利完成。

1例Stanford B型夹层合并双瓣风湿性病变患者的围术期护理

主动脉夹层（aorticdessection，AD）是指血液冲破内膜，血流进入主动脉壁中层，将主动脉壁撕裂成为内、外两层的一种疾病。主动脉夹层的病情凶险，预后极差。主要治疗方法有药物治疗，血管腔内介入治疗和传统手术治疗。

1例主动脉弓部溃疡合并脑梗死病人行Debranch+主动脉腔内修复术的围术期护理

急性主动脉综合征(AAS)是一组临床特点相近且以主动脉源性胸背痛和高血压为主要特点的疾病,包括主动脉夹层、穿透性主动脉溃疡(penetrating aortic ulcer,PAU)和主动脉壁间血肿(aortic intramural hematoma,IMH)[1]。有证据表明,40%~50%的PAU 可并发主动脉夹层,或在发生时就可能发生破溃出血,有学者认为它们是主动脉夹层的早期征象[2]。目前对这两种急性主动脉病发病机制、临床特点、治疗及转归与主动脉夹层存在明显区别,处理不当极易导致主动脉夹层破裂。我科于2018年3月收治1例主动脉弓部溃疡合并脑梗死及高血压行外科Debranch术+内科主动脉腔内修复术的病人,经精心治疗、护理后康复出院。现将护理报告如下。

Origin and evolution of the main starch biosynthetic enzymes

Starch,a semi-crystalline energy storage form primarily found in plant plastids plays a crucial role in various food or no-food applications.Despite the starch biosynthetic pathway’s main enzymes have been characterized,their origin and evolution remained a subject of debate.In this study,we conducted the comprehensive phylogenetic and structural analysis of three types of starch biosynthetic enzymes:starch synthase(SS),starch branching enzyme(SBE)and isoamylase-type debranching enzyme(ISA)from 51,151 annotated genomes.Our findings provide valuable insights into the possible scenario for the origin and evolution of the starch biosynthetic pathway.Initially,the ancestor of SBE can be traced back to an unidentified bacterium that existed before the formation of the last eukaryotic common ancestor(LECA)via horizontal gene transfer(HGT).This transfer event likely provided the eukaryote ancestor with the ability to synthesize glycogen.Furthermore,during the emergence of Archaeplastida,one clade of SS was transferred from Deltaproteobacteria by HGT,while ISA and the other clade of SS originated from Chlamydiae through endosymbiosis gene transfer(EGT).Both these transfer events collectively contributed to the establishment of the original starch biosynthetic pathway.Subsequently,after the divergence of Viridiplantae from Rhodophyta,all three enzymes underwent multiple duplications and N-terminus extension domain modifications,resulting in the formation of functionally specialized isoforms and ultimately leading to the complete starch biosynthetic pathway.By shedding light on the evolutionary origins of key enzymes involved in the starch biosynthetic pathway,this study provides important insights into the evolutionary events of plants.

Effects of the activities of key enzymes involved in starch biosynthesis on the fine structure of amylopectin in developing rice (Oryza sativa L.) endosperms

The dynamic changes of the activities of enzymes involving in starch biosynthesis, including ADP-glucose pyrophosphorylase (AGPase), soluble starch synthases (SSS), starch branching enzyme (SBE) and starch debranching enzymes (DBE) were studied, and changes of fine structure of amy- lopectin were characterized by isoamylase treatment during rice grain development, using trans anti-waxy gene rice plants. The relationships between the activities of those key enzymes were also analyzed. The amylose synthesis was significantly inhibited in transgenic Wanjing 9522, but the total starch content and final grain weight were less affected as compared with those of non-transgenic Wanjing 9522 rice cultivar. Analyses on the changes of activities of enzymes involving in starch bio- synthesis showed that different enzyme activities were expressed differently during rice endosperm development. Soluble starch synthase is relatively highly expressed in earlier stage of endosperm de- velopment, whilst maximal expression of granule-bound starch synthase (GBSS) occurred in mid-stage of endosperm development. No obvious differences in changes of the activities of AGPase and SBE between two rice cultivars investigated, except the DBEs. Distribution patterns of branches of amy- lopectin changed continually during the development of rice grains and varied between two rice culti- vars. It was suggested that amylopectin synthesis be prior to the synthesis of amylose and different enzymes have different roles in controlling syntheses of branches of amylopectin.

Effects of extrusion and enzymatic debranching on the structural characteristics and digestibility of corn and potato starches

Amylose content has a profound impact on the contents of slowly digestible starch and resistant starch.Enzymatic debranching is a safe method to increase the amylose content,however,the lower substrate concentration and high viscosity of fully gelatinized starch limit the efficiency and yield of this method.This paper aims to explore the effects of extrusion and enzymatic debranching on increasing the amylose content thereby increasing slowly digestible starch and resistant starch contents.Different starch concentrations (10%,15%,and 20%) of extruded corn starch (ECS) and extruded potato starch (EPS) were used to debranch.Both debranched ECS and debranched EPS showed high amylose content of approximately 90%,indicating that all samples with different starch concentrations achieved high-efficiency enzymatic debranching.The high-performance liquid chromatograph results indicated that the samples were mainly short amylose.The samples exhibit a typical B-type crystalline structure and the relative crystallinity of them exceeds 37%.The short amylose exhibited rapid rearrangement ability,with the gelatinization temperature range of rescanning determined as 80–125℃,this will facilitate the formation of slowly digestible starch and resistant starch.The slowly digestible starch and resistant starch contents of the samples (debranched ECS and debranched EPS) were between 23% and 30% and between 31% and 37%,respectively.These results indicate that the extrusion and enzymatic debranching of a high substrate concentration can efficiently increase the amylose content,thereby significantly reducing the digestibility of starch,and has broad prospects of the actual production of slowly digestible starch and resistant starch.