关键词： Herb   hypericaceae   phytomedicine   bioactive phytochemicals   tocols  

摘要： St. John's wort, scientifically known as Hypericum perforatum L., is a medicinal plant with a wide range of secondary metabolites with bioactive properties;however, it has poorly studied lipophilic phytochemicals. Two primary tocochromanols - alpha-tocopherol (alpha-T) and delta-tocotrienol (delta-T3) were identified in the aerial parts of wild St. John's wort in Latvia. In the stems and leaves, alpha-T dominated (62-81%), while delta-T3 - in the flower buds, flowers, dead petals, and immature seed pods (36-70%). The flower buds had the highest content of tocotrienols (42.17-69.65 mg/100 g dw), of which delta-T3 accounted for 36% and alpha-T3 - for 18% of the total identified tocochromanols. The unripe seed pods exhibited the highest concentration of delta-T3 among all samples tested (38.2-52.7 mg/100 dw). St. John's wort can be considered a natural source of delta-T3 in regions with temperate climates based on the findings of this study.

关键词： myocardial infarction   reperfusion injury   vagus nerve stimulation   ST-elevation myocardial infarction   hospital mortality   cardiogenic shock   atrial fibrillation   stroke   transient ischemic attack   transcutaneous vagus nerve stimulation  

摘要： Background: Despite the vast evidence of the beneficial effect of vagus nerve stimulation on the course of myocardial infarction confirmed in studies using animal models, the introduction of this method into actual clinical practice remains uncommon. Objective: The objective of our study was to evaluate the effect of transcutaneous vagus nerve stimulation (tVNS) on in-hospital and long-term outcomes for patients with ST-elevation myocardial infarction. Materials and Methods: A blind, randomized, placebo-controlled clinical trial was conducted. The participants were randomly split into two groups. The Active tVNS group was subjected to stimulation of the tragus containing the auricular branch of the vagus nerve. The Sham tVNS group underwent stimulation of the lobule. Stimulation was performed immediately on admission before the start of the percutaneous coronary intervention (PCI). Then, tVNS continued throughout the entire PCI procedure and 30 min after its completion. The primary endpoints were hospital mortality and 12-month mortality. The secondary endpoints were in-hospital and remote non-lethal cardiovascular events. The combined endpoint consisted of major adverse cardiovascular events (MACEs)-recurrent myocardial infarction, stroke/TIA, and overall mortality. Results: A total of 110 patients were randomized into the Active tVNS group (n = 55) and the Sham tVNS group (n = 55). The incidences of hospital mortality, cardiogenic shock, and AV block 3 were statistically less common in the Active tVNS group than in the Sham tVNS group (p = 0.024*, p = 0.044*, and p = 0.013*, respectively). In the long-term period, no statistical differences were found in the studied outcomes obtained following the construction of Kaplan-Meyer survival curves. When comparing groups by total mortality, taking into account hospital mortality, we observed a tendency for the survival curves to diverge (Logrank test, p = 0.066). Statistical significance was revealed by the composite end