关键词： Medicinal plant extracts   Hypericum perforatum L   St. John's wort   Gram-positive bacteria   antibacterial activity   LC-Q-TOF-MS  

摘要： This study aimed to determine the secondary metabolite profiles and antibacterial activity of H. perforatum L extracts against Gram-positive clinical isolates. The plant materials (Sample A and Sample B) were macerated with n-hexane, ethyl acetate and methanol (MeOH). The antibacterial activitiy of plant extracts and routinely used antibiotics were tested against Gram-positive bacteria. The secondary metabolite profiles of Sample A were determined by LC-Q-TOF-MS. The MIC values for n-hexane and ethyl acetate extracts of Sample A were lower than the susceptibility breakpoints of most broad-spectrum antibiotics (e.g. vancomycin, teicoplanin and linezolid) in a certain proportion of Gram-positive bacteria. The n-hexane extract of Sample A showed good antibacterial activity with MICs lower than the susceptibility breakpoint of teicoplanin in 58% of coagulase-negative staphylococci. The n-hexane and ethyl acetate extracts of Sample A had rich phloroglucinol constituents. The n-hexane and ethyl acetate extracts of Sample A could be alternative antibacterial agents against Gram-positive bacteria.

关键词： percutaneous coronary intervention   risk   STEMI  

摘要： Background There may be variability in willingness to perform percutaneous coronary intervention (PCI) in higher-risk patients who present with ST-segment-elevation myocardial infarction (STEMI). We sought to describe current treatment selection patterns and hospital-level variability. Methods and Results We identified patients presenting with STEMI with a culprit lesion on coronary angiography between January 1, 2019, and March 31, 2023, using the NCDR (National Cardiovascular Data Registry) CPMI (Chest Pain-Myocardial Infarction) registry. We compared patient-level characteristics of patients who did and did not undergo PCI at each hospital. There were 178 984 patients from 582 US hospitals presenting with STEMI who were included. Among patients with STEMI and a culprit lesion, 6180 did not undergo PCI (3.5%). Patients with a presentation of STEMI and a culprit lesion who did not undergo PCI were older (67 [interquartile range, 58-76]) years versus 62 ([interquartile range, 54-71] years, P<0.001), more likely to present with heart failure (15.0% versus 7.4%, P<0.001), and more likely to have cardiac arrest before arrival (9.7% versus 5.1%, P<0.001) than patients who underwent PCI. Patients who did not undergo PCI had higher predicted mortality rates (12.5%+/- 17.9% versus 6.5%+/- 11.5%, P<0.001) and observed mortality rates (21.7% versus 6.4%, P<0.001) compared with patients who underwent PCI. Conclusions There is variability in the percentage of patients with culprit lesions on invasive coronary angiography undergoing PCI for STEMI, with 3.5% of patients with STEMI not receiving PCI overall, and >5% of patients not undergoing PCI in a quarter of US hospitals. Differences in observed versus predicted mortality rates for patients who did or did not undergo PCI may highlight the effects of risk-avoidant behavior.

关键词： Enterococcus faecalis   Enterococcus faecium   antimicrobial resistance   VRE   vanA   optrA   ST  

摘要： Background/Objectives: Enterococcus is one of the major nosocomial pathogens. The present status of antimicrobial resistance determinants and virulence factors was analyzed for current Enterococcus causing infectious diseases in Bangladesh. Methods: Clinical isolates of Enterococcus recovered from various specimens in a tertiary care hospital were analyzed. Antimicrobial susceptibility was measured by a broth microdilution test, and resistance genes/virulence factors were detected by uniplex/multiplex PCR, along with sequencing analysis as required. The sequence type (ST) of E. faecalis and E. faecium was identified based on a multilocus sequence typing (MLST) scheme. Results: For a one-year period, a total of 143 isolates (135 E. faecalis, 7 E. faecium, and 1 E. hirae) were collected. Although all E. faecalis isolates were susceptible to penicillin, high resistance rates were noted against erythromycin (87%) and levofloxacin (62%). High-level resistance to gentamicin was detected in 30% of E. faecalis and 86% of E. faecium. Vancomycin resistance due to vanA was identified in one isolate each of E. faecalis (ST1912, CC116) and E. faecium (ST80, CC17). Three E. faecalis isolates (2.2%) with ST32 or ST1902 were resistant to linezolid, harboring optrA-fexA. Conclusions: The present study identifies the vancomycin-resistant Enterococcus harboring vanA from humans in Bangladesh and shows the potential spread of optrA in multiple lineages of E. faecalis.

摘要： 在当今竞争激烈的时代,企业的发展面临着诸多挑战与机遇.对于国有企业而言,如何实现党建工作与科研生产经营的深度融合、相互促进,是关系到企业持续健康发展的关键所在.航空工业昌河飞机工业(集团)有限责任公司(以下简称"昌飞公司")经过不断探索和实践,走出了一条企业党建与科研生产经营双融双促的成功之路,为企业的发展注入了强大动力.

关键词： Editorials   disparities   primary percutaneous coronary intervention   public reporting   ST-segment-elevation myocardial infarction  

关键词： Diet   weaning practices   Romans   stable isotope analysis   Molecular Bioarcheology   Roman Suburbium  

摘要： This paper aims to provide the isotopic characterization of the diet consumed by people buried in a graveyard of the Imperial Rome Suburbium (1st-3rd centuries CE), where numerous children were buried. A sample of 50 human remains from Quarto Cappello del Prete was selected for carbon and nitrogen stable isotope analysis. Published data related to coeval faunal remains set the baseline of the diet. The results for humans were integrated with previously analyzed data from Quarto Cappello del Prete. The resulting sample of 71 people has been dissected for stratification according to demographics, focusing on the ability to ascertain the weaning process in children. Isotopic data are steady with an overall diet mainly based on terrestrial resources, where C3 plants played a pivotal role in the diet, though the delta 13C range suggests that the foodstuff should have been heterogeneous. The remarkable amount of children allows us to evaluate the weaning process. Infants seem to be adequately weaned after 3 years, when they were considered as adults to what concerns the dietary habits. These data represent a valuable enhancement for understanding the weaning practices in ancient Rome, contributing to supporting the hypothesis about lifestyle and health in the Roman Imperial period.

关键词： acute myocardial infarction   cardiogenic shock   emergency research   exception from informed consent   randomized trials  

摘要： Cardiogenic shock (CS) is critical end-organ hypoperfusion attributable to reduced cardiac output. Acute ST-segment-elevation myocardial infarction with CS (AMI-CS) has high mortality. Clinical research is challenging in such patients as they often cannot provide consent, lack available legal representatives, and require initiation of therapy. Multiple trials have enrolled patients with AMI-CS outside the United States under deferred consent. Trials in the United States have enrolled patients with out-of-hospital cardiac arrest under exception from informed consent (EFIC). However, AMI-CS has a longer therapeutic window to initiate treatment than out-of-hospital cardiac arrest, and more patients or their representatives can engage in treatment decisions. We provide a rationale for how a trial enrolling patients with AMI-CS could qualify for conduct using EFIC by meeting each criterion specified in US human subject regulations. AMI-CS is a life-threatening situation, available treatments are unsatisfactory, and collection of valid evidence is necessary. Obtaining informed consent is often not feasible, and trial participation could benefit subjects. Only enrolling consented patients is impracticable and could reduce the study's generalizability. We propose a therapeutic window of 30 minutes within the study intervention must be initiated, with consent sought within 15 minutes, respecting any refusal or objection to enrollment, and otherwise enrollment under EFIC. A trial could enroll patients with AMI-CS under EFIC and can involve both patients and their representatives. Successful use of EFIC in trials of other interventions in patients with CS or enrolling patients with other acute cardiovascular conditions could increase the available evidence base to improve care.

关键词： NSTE-ACS   NSTEMI   frailty   geriatric syndromes   percutaneous coronary intervention   fractional flow reserve   optical coherence tomography   intravascular ultrasound  

摘要： IntroductionInvasive management of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) should be considered regardless of age, but a key challenge is deciding which patients are most likely to benefit from an invasive approach in the older population. In addition to assessment of the clinical signs and symptoms, a holistic assessment of geriatric syndromes such as frailty, multimorbidity and cognitive impairment is of increasing importance. Recent trials have validated the roles of physiological assessment and intracoronary imaging to guide *** coveredThis review focuses on the comparison between invasive and conservative management in the older population with NSTE-ACS, the clinical characteristics of the older population with NSTE-ACS, and the role of physiological assessment and intracoronary imaging to guide revascularisation in this *** opinionInvasive management in the older population with NSTE-ACS may not improve mortality but reduces the risk of non-fatal myocardial infarction and repeat revascularisation. Decisions surrounding invasive versus conservative management should be individualized to each patient, depending on patient preference, clinical features, comorbidities and frailty. In patients where invasive management is indicated, a combination of physiological assessment and intracoronary imaging is likely to improve revascularisation outcomes, especially in the context of complex anatomical characteristics like multivessel disease.