Abstract To explore the critical care treatment and clinical outcome of patients with severe aneurysmal subarachnoid hemorrhage (SaSAH), and to provide clinical evidence for the treatment of patients with SaSAH. 160 patients with SaSAH of Hunt and Hess (H&H) grade III or above in the neurosurgical critical care unit at ourospital between June 2016 and June 2018 were enrolled in this study. Patients were treated with brain protective bundle based on step-wised protocol under multimodal monitoring and followed up for 3 months. The incidence of various clinical complications and the clinical prognosis after discharge were statistically analyzed. Furthermore, it carried on the correlation analysis to the risk factors and the prognosis. In 160 patients with SaSAH, 127 patients had responsible aneurysms located in the anterior circulation, and the other 33 patients were located in the posterior circulation. 70 patients (43.8%) underwent transcranial clipping, 81 patients (50.6%) underwent endovascular embolization and 9 patients (5.6%) did not intervene. Patients with IV and V grades of Glasgow Outcome Scale (GOS) were considered good recovery, and those with grade I, II and III were poor prognosis. The 30-day good prognosis rate was 41.3% (66/160) and the poor prognosis rate was 58.7% (94/160). Multivariate logistic regression analysis showed that the Hunt & Hess classification correlated well with prognosis (OR: 4.367,95% CI, 2.254-8.460, P < 0.001). The clinical prognosis of patients with SaSAH is still poor. In particular, under the critical care of neurosurgery, the application of brain protective bundle based on step-wised protocol under multimodal monitoring might improve the clinical prognosis of patients with SaSAH.

Ferulic acid esterases are capable of releasing phenolic compounds of the plant cell wall, increasing access to polysaccharides. In vitro determinations were performed in order to estimate the potential for ferulic acid esterase (Fae1A) isolated from rumen fungus Mucronatus Anaeromyces. This esterase was obtained from a previous study conducted in the Lethbridge Research Center, Alberta Canada, through cloning processes and hetero-expression of Fae1A gene in a strain of E. coli BL21. Three levels (0, 9 and 18 mg) of protein contained in the enzyme were combined with rumen fluid and incubated in 2 different fiber sources (alfalfa hay and wheat straw) using 15 replicates per treatment. The inclusion of the enzyme increased (P <0.05) the disappearance of dry matter in alfalfa hay, releasing more quantity (P <0.01) of reducing sugars (AR) at 4 and 12 h. Fae1A released more phenolic compounds vs. alfalfa hay wheat straw. Total and individual phenolic compounds released from alfalfa were increased according to the level of enzyme added. In the wheat straw, ferulic acid was double compared to the p-coumaric acid. In conclusion, the addition of Fae1A improved the amount of reduced sugars and phenolic compounds were released into the alfalfa hay and wheat straw, indicating its potential for use as a fibrinolytic enzyme and improve the digestibility of the fiber in the ruminant.

Las esterasas de ácido ferúlico son capaces de liberar compuestos fenólicos de la pared celular vegetal, aumentando el acceso a los polisacáridos. Se realizaron determinaciones In vitro con la finalidad de determinar el potencial de una esterasa de ácido ferúlico (Fae1A) aislada del hongo del rumen Anaeromyces mucronatus. Esta estearasa se obtuvo de un trabajo previo realizado en el Centro de Investigación de Lethbridge, Alberta Canadá, a través de procesos de clonación y hetero-expresión del gen Fae1aA en una cepa de E. coli BL21. Tres niveles (0, 9 y 18 mg) de proteína contenida en la enzima se combinaron con liquido ruminal e incubaron en 2 diferentes fuentes de fibra (heno de alfalfa y paja de trigo) utilizando 15 repeticiones por tratamiento. La inclusión de la enzima incrementó (P <0.05) la desaparición de la materia seca en el heno de alfalfa, liberándose más cantidad (P <0.01) de azúcares reducidos (AR) a las 4 y 12 h. Fae1A liberó más compuestos fenólicos del heno de alfalfa vs. la paja de trigo. Los compuestos fenólicos totales e individuales liberados de la alfalfa se incrementaron con el nivel de enzima añadida. En la paja de trigo, el ácido ferúlico se duplicó en comparación con el ácido p-cumárico. En conclusión, la adición de la Fae1A mejoró la cantidad de azucares reducidos y se liberaron compuestos fenólicos en el heno de alfalfa y la paja de trigo, lo que indica su potencial para ser usada como enzima fibrolítica y mejorar la digestibilidad de la fibra en los rumiantes.