DAPT score: predictive model of dual-antiplatelet therapy for acute cerebral infarction.

OBJECTIVE: This article analyzes factors which affect the prognosis of acute cerebral infarction (ACI) patients receiving a course of antiplatelet therapy with aspirin and (or) clopidogrel for 14 days and proposes a simple grading scale to predict the clinical effectiveness of these drugs. METHODS: We evaluated the association between ACI and risk factor (univariate analysis) on at day 14 post admission. Factors which potentially affected the 14-day prognosis of the patients were identified by logistic regression. A clinical grading scale, the DAPT score, was developed by weighing the independent predictors based on these factors. RESULTS: It is revealed that the factors which affected 14 days prognosis univariate analysis included age ≥ 50 years (P = 0.007), diabetes (P = 0.017), hypertension (P ≤ 0.001), hyperhomocysteinemia (P = 0.001), and ipsilateral carotid artery stenosis ≥ 50% (P = 0.019). Logistic regression also revealed that the factors which affected 14 days prognosis included age ≥ 50 years (P = 0.007), hypertension (P ≤ 0.001), hyperhomocysteinemia (P = 0.001), and ipsilateral carotid artery stenosis ≥ 50% (P = 0.014).The assigned values of age ≥ 50 years, Grade 1 hypertension, Grade 2 hypertension, Grade 3 hypertension, hyperhomocysteinemia, and ipsilateral carotid artery stenosis ≥ 50% were 1, 1, 2, 3, 1, and 1, respectively. We named this score (DAPT score) and it ranged between 0 and 6. Using 3 as a cutoff, the sensitivity was 90.6% and the specificity was 63.3%. CONCLUSIONS: The DAPT Score might be useful to for identifying with ACI who are suitable to receive aspirin combined with clopidogrel. Future large-scale, multi-center prospective studies are necessary.

Cascade synthesis of rare ketoses by whole cells based on L-rhamnulose-1-phosphate aldolase.

Dihydroxyacetone phosphate (DHAP)-dependent aldolases demonstrate important values in the production of rare ketoses due to their unique stereoselectivities. As a specific example, we developed an efficient Escherichia coli whole-cell biocatalytic cascade system in which rare ketoses were produced from abundant glycerol and catalyzed by four enzymes based on L-rhamnulose-1-phosphate aldolase (RhaD). For the semicontinuous bioconversion in which D-glyceraldehyde was continuously added, once D-glyceraldehyde was consumed, the final yields of D-sorbose and D-psicose were 15.30 g/L and 6.35 g/L, respectively. Moreover, the maximum conversion rate and productivity of D-sorbose and D-psicose were 99% and 1.11 g/L/h at 8 h, respectively. When L-glyceraldehyde was used instead of the D-isomer, the final yield of L-fructose was 16.80 g/L. Furthermore, the maximum conversion rate and productivity of L-fructose were 95% and 1.08 g/L/h at 8 h, respectively. This synthetic platform was also compatible with other various aldehydes, which allowed the production of many other high-value chemicals from glycerol.

Recent advances in the synthesis of rare sugars using DHAP-dependent aldolases.

The occurrence rates of non-communicable diseases like obesity, diabetes and hyperlipidemia have increased remarkably due to excessive consumption of a high-energy diet. Rare sugars therefore have become increasingly attractive owing to their unique nutritional properties. In the past two decades, various rare sugars have been successfully prepared guided by the "Izumoring strategy". As a valuable complement to the Izumoring approach, the controllable dihydroxyacetone phosphate (DHAP)-dependent aldolases have generally predictable regio- and stereoselectivity, which makes them powerful tools in C-C bond construction and rare sugar production. However, the main disadvantage for this group of aldolases is their strict substrate specificity toward the donor molecule DHAP, a very expensive and relatively unstable compound. Among the current methods involving DHAP, the one that couples DHAP production from inexpensive starting materials (for instance, glycerol, DL-glycerol 3-phosphate, dihydroxyacetone, and glucose) with aldol condensation appears to be the most promising. This review thus focuses on recent advances in the application of L-rhamnulose-1-phosphate aldolase (RhaD), L-fuculose-1-phosphate aldolase (FucA), and D-fructose-1,6-bisphosphate aldolase (FruA) for rare sugar synthesis in vitro and in vivo, while illustrating strategies for supplying DHAP in efficient and economical ways.