Preparation and Methicillin-Resistant Staphylococcus aureus Biofilm Elimination Effect of Baicalein-Loaded Hyaluronic acid/β-Cyclodextrin grafted Chitosan Nanoparticles

Methicillin-resistant Staphylococcus aureus(MRSA)is a common pathogen causing acquired infections.Antibiotics are routinely employed for bacterial infection treatment.Excessive antibiotic use for bacterial infections heightens resistance,and MRSA resistance is being prevalent[1].MRSA exhibits substantial resistance to conventional antibiotics,which is associated with its biofilm-forming capability.The bacterial biofilm serves as a barrier,restricting nutrient access and slowing internal metabolism,increasing antibiotic resistance.The bacterial biofilm forms a defensive layer,resisting antibiotic penetration while preventing nutrient entry,inducing a slow bacterial metabolism,and increasing bacterial resistance[2].Consequently,biofilm formation and the emergence of resistance to conventional antibiotics have become substantial challenges in the field of infectious diseases.The development of agents to remove biofilm barriers is urgently required because biofilms are extremely hazardous.

Consensus on glycemic management for patients with coronary heart disease and type 2 diabetes

The prevalence of patients with coronary heart disease(CHD)and diabetes mellitus is notably high,posing sig-nificant residual cardiovascular risks even after routine interventions such as antihypertensive,lipid-lowering,and antithrombot-ic treatments.Recent studies have demonstrated that certain glucose-lowering medications confer cardiovascular benefits for pa-tients with type 2 diabetes.However,a survey indicates that cardiologists may not be fully acquainted with the optimal screen-ing timing,indicators,and diagnostic criteria for type 2 diabetes,and there is insufficient awareness and a low rate of prescrip-tion of novel glucose-lowering medications with proven cardiovascular efficacy,such as glucagon-like peptide-1 receptor agon-ists(GLP-1 RAs)and sodium-glucose co-transporter-2 inhibitors(SGLT-2i).In this context,based on domestic and international guidelines or consensus and the latest evidence-based evidence,this consensus aims to standardize the glycemic management for patients with acute coronary syndrome,chronic coronary syndrome,and perioperative management for percutaneous coronary intervention.It highlights the key points of screening and diagnosis of type 2 diabetes,and the comprehensive management of cardiovascular risk in patients with CHD.The consensus elaborates on the principles and algorithms of glycemic management for CHD patients,without involving acute complications of diabetes,clarifies the clinical practice of glucose-lowering medications with cardiovascular benefits,and promotes the standardized use of these medications in cardiovascular and other related spe-cialty fields.Additionally,it addresses the glucose-lowering treatment to comprehensively reduce cardiovascular risks.

Sleep quality and characteristics of older adults with acute cardiovascular disease

Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the care team,including vital sign checks,medication delivery,and blood draws for laboratory investigations,are routinely done in many hospitals.Frequent interruptions by staff and noise by other patients have been cited as barriers to restorative sleep in the hospital.

Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction

Objective To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction(NSTEMI)from the MOSCA-FRAIL clinical trial.Methods The MOSCA-FRAIL trial randomized 167 frail patients,defined by a Clinical Frailty Scale(CFS)≥4,with NSTEMI to an invasive or conservative strategy.The primary endpoint was the number of days alive and out of hospital(DAOH)one year after discharge.For this subanalysis,we compared the impact of an invasive strategy on the outcomes between vulnerable(CFS=4,n=43)and frail(CFS>4,n=124)patients.Results Compared to vulnerable patients,frail patients presented lower values of DAOH(289.8 vs.320.6,P=0.146),more read-missions(1.03 vs.0.58,P=0.046)and higher number of days spent at the hospital during the first year(10.8 vs.3.8,P=0.014).The cau-ses of readmission were mostly non-cardiac(56%).Among vulnerable patients,DAOH were similar regardless of strategy(invasive vs.conservative:325.7 vs.314.7,P=0.684).Among frailest patients,the invasive group tended to have less DAOH(267.7 vs.311.1,P=0.117).Indeed,patients with CFS>4,invasively managed lived 29 days less than their conservative counterparts.In contrast,the-re were no differences in the subgroup with CFS=4.Conclusions Adult patients with frailty and NSTEMI showed different prognosis according to the degree of frailty.A routine in-vasive strategy does not improve outcomes and might be harmful to the frailest patients.

Association between the frontoparietal network,clinical symptoms and treatment response in individuals with untreated anorexia nervosa

Background Anorexia nervosa(AN)has been characterised as a psychiatric disorder associated with increased control.Currently,it remains difficult to predict treatment response in patients with AN.Their cognitive abilities are known to be resistant to treatment.It has been established that the frontoparietal control network(FPCN)is the direct counterpart of the executive control network.Therefore,the resting-state brain activity of the FPCN may serve as a biomarker to predict treatment response in AN.Aims The study aimed to investigate the association between resting-state functional connectivity(RSFC)of the FPCN,clinical symptoms and treatment response in patients with AN.Methods In this case-control study,79 female patients with AN and no prior treatment from the Shanghai Mental Health Center and 40 matched healthy controls(HCs)were recruited from January 2015 to March 2022.All participants completed the Questionnaire Versionof the Eating Disorder Examination(version 6.0)to assess the severity of their eating disorder symptoms.Additionally,RSFC data were obtained from all participants at baseline by functional magnetic resonance imaging.Patients with AN underwent routine outpatient treatment at the 4th and 12th week,during which time their clinical symptoms were evaluated using the same measures as at baseline.Results Among the 79 patients,40 completed the 4-week follow-up and 35 completed the 12-week follow-up.The RSFC from the right posterior parietal cortex(PPC)and dorsolateral prefrontal cortex(diPFC)increased in 79 patients with AN vs 40 HCs after controlling for depression and anxiety symptoms.By multiple linear regression,the RSFC of the PPC to the inferior frontal gyrus was found to be a significant factor for self-reported eating disorder symptoms at baseline and the treatment response to cognitive preoccupations about eating and body image,after controlling for age,age of onset and body mass index.The RSFC in the dIPFC to the middle temporal gyrus and the superior frontal gyrus may be significant factors in the treatment response to binge eating and loss of control/overeating in patients with AN.Conclusions Alterations in RSFC in the FPCN appear to affect self-reported eating disorder symptoms and treatment response in patients with AN.Our findings offer new insight into the pathogenesis of AN and could promote early prevention and treatment.

Cluster sampling methodology to evaluate immunization coverage

BACKGROUND Immunization is a key component of primary health care and an indisputable human right.Vaccines are critical to the prevention and control of infectious disease outbreaks.The coronavirus disease 2019(COVID-19)pandemic and associated disruptions over the past two years have strained the health systems,with many children missing out on essential childhood vaccines.AIM To evaluate the immunization coverage among 12-23-month-old children in the rural areas of Community Health Centre(CHC)Dighal and to determine the factors influencing the existing immunization coverage.METHODS A coverage evaluation survey was conducted according to the 30-cluster sampling technique,which is the standard methodology for such surveys devised by World Health Organization.A total of 300 children aged 12-23 months were included,whose immunization details were noted from their immunization cards.RESULTS Full immunization rate was noted in 86.7%of the children,with partial and non-immunized children accounting for 9%and 4.3%respectively.The full immunization dropout rate was 4.2%.The common reasons for partial or non-immunization were family problem including illness of mother,vaccine not being available and child being ill.Place of birth(P=0.014)and availability of immunization card(P<0.001)were significant predictors of the immunization status.Since the study was conducted in 2020/2021,health services were disrupted due to the COVID-19 lockdown.CONCLUSION Due to the coverage being higher than the national average,it was concluded that the immunization coverage was optimal and not affected by the COVID-19 pandemic.

The Promoting Role of TCM Nursing in the Rehabilitation of Stroke Hemiplegia Patients

Objective: To explore the promoting function of TCM nursing in the rehabilitation of hemiplegia patients with stroke. Methods: 78 stroke hemiplegic patients admitted from April 2022 to April 2024 were randomly divided into a control group of 38 cases who received routine care, and an experimental group of 40 cases who received routine nursing basis plus traditional Chinese medicine nursing;the nursing effects of the two groups of patients were compared. Results: After 12 days of nursing care, the experimental group showed better psychological status [SAS score (21.71 ± 3.21), SDS score (22.18 ± 2.31)], limb motor function, daily living ability, and neurological function [NIHSS score (12.23 ± 2.21)] than the control group, with significant differences in data (P Conclusion: Traditional Chinese medicine nursing for stroke hemiplegia patients is more conducive to promoting rehabilitation than routine nursing.

The Diagnostic Value of Oligoclonal Band Detection in Viral Encephalitis

Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.

Nurses’experiences in providing antenatal care during COVID-19 lockdown in Ghana

Background:The coronavirus disease 2019(COVID-19)pandemic posed a major global health threat,leading to the disruption and strain of numerous health systems globally.The situation deprived essential routine healthcare services,including antenatal care,of the needed attention,significantly affecting facility workers.This study therefore aimed to explore the lived experiences and challenges faced by nurses providing antenatal care during the COVID-19 pandemic.Methods:Data were collected through in-depth interviews with seven antenatal care nurses.The interviews were transcribed and analyzed using thematic analysis to identify recurring themes.Four main themes emerged:(1)Knowledge capital,which refers to the essential knowledge and skills required;(2)Interventions,highlighting the measures taken to adapt care;(3)Antenatal care challenges,detailing the specific obstacles faced;and(4)Coping strategies,outlining the methods used by nurses to manage stress and maintain care quality.Results:The results highlight the emotional and economic toll of the pandemic on antenatal care nurses and the importance of effective collaboration and coping strategies.The findings also underscore the crucial role of teamwork,dedication,quick adjustment,and the role of information communication technology in maneuvering through pandemics to provide continuous essential care.Conclusion:These insights are crucial for health agencies and organizations to develop supportive strategies that ensure the continuity of healthcare delivery and safeguard the well-being of healthcare workers during crises.

Analysis of Blood Lipids, Blood Glucose, Blood Uric Acid, and Blood Routine Test Results in Retired Employees of a Unit in the Civil Aviation System

Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.

Study on Improving the Internal Quality of Tobacco Stems by Using Pectinase

[Objective] This study aimed to reduce the content of cell wall materials in tobacco stems and improve their internal quality. [Method] Pectinase was used to decompose cell wall materials in tobacco stems, followed by determination of the contents of four cell wall materials, six routine chemical components, as well as aroma constituents. [Result] Pectinase could effectively reduce the contents of cell wall materials in tobacco stems, with the largest decrease of 6.84%; after pectinase treatment,the content of reducing sugar in tobacco stems increased obviously, and the contents of total sugar, potassium ion, chloride ion and total nitrogen increased to varying degrees, of which the contents of potassium ion and reducing sugar displayed upward trends with the increase of pectinase concentration. Pectinase treatment significantly increased the contents of Maillard reaction products, with the most increase of 67.2%;the contents of carotenoid degradation products, phenylalanine degradation products and neophytadiene all increased to varying extents, and the contents of both Maillard reaction products and phenylalanine degradation products revealed ascending trends with the increase of pectinase concentration. [Conclusion] Pectinase treatment can effectively decompose cell wall materials in tobacco stems, improve routine chemical constituents, and increase the contents of aroma constituents.

Effect of Carbohydrate Content in Feed on the Daily Metabolic Rate of S. meridionalis

The routine metabolic rate in southern catfish juvenile(24.3-250.8 g)fed with saccharine feed(CHO)was measured in this study.Fish were fed with iso-nitrogenous(40 % crude protein)and iso-lipidic(10% crude lipid)experimental feed containing 0(control feed),15%,30% of carbohydrate level.The routine metabolic rates of 15 % and 30% dietary carbohydrate group were significantly higher than that of 0% dietary carbohydrate group.The relationship between body mass(Wt)and routine metabolic rate(Rr)of southern catfishfed with different test feed could be described as:(1)0% CHO:ln(Rr)=0.986 ln(Wt)+1.419 r2=0.922,n=25,P<0.001;(2)15% CHO:ln(Rr)=0.912 ln(Wt)+1.741 r2=0.966,n=21,P<0.001;(3)30% CHO:ln(Rr)=0.762 ln(Wt)+2.378 r2=0.958,n=21,P<0.001.The intercept was increased and mass coefficient was decreased with the increase of carbohydrate level in feed.It could be concluded that southern Silurus meridionalis had poor metabolic capacity which led the increase of routine metabolic rate of fish with small size.But with the increase of body size southern Silurus meridionalis might had a better adaptation to high carbohydrate concentration.

从企业进化论的视角看企业自主创新

企业进化论是现代企业理论和战略管理理论的一个重要学派。企业进化论把企业当作生命体,认为企业具有类似于生物体遗传基因的routine。Routine企业之间差异的根源,是企业的核心竞争力所在。为了适应不断变化的环境,通过探索活动(自主创新)实现企业routine的进化。根据企业进化论对企业自主创新的剖析可以得出如下结论:第一,只有自主创新才能形成持久的竞争力;第二,自主创新应从企业自身条件和需要出发;第三,自主创新要适度;第四,自主创新要注意节奏;第五,自主创新要有长远眼光。

“胎盘血管阻力的新型评分方法”点评

1原文摘要Background Umbilical artery Doppler velocimetry is a routine method for fetal surveillance in high-risk pregnancy.Uterine artery Doppler seems to give comparable information,but it can be difficult to interpret as there are two arteries,which might show notching and/or increased pulsatility index(PI)as signs of increased vascular impedance.Combining the information on vascular re-

Co-selection may explain the unexpectedly high prevalence of plasmid-mediated colistin resistance gene mcr-1 in a Chinese broiler farm

DEAR EDITOR,The rise of the plasmid-encoded colistin resistance gene mcr-1 is a major concern globally.Here,during a routine surveillance,an unexpectedly high prevalence of Escherichia coli with reduced susceptibility to colistin (69.9%) was observed in a Chinese broiler farm.Fifty-three (63.9%) E.coli isolates were positive for mcr-1.All identified mcr-1-positive E.

Active source monitoring at the Wenchuan fault zone:coseismic velocity change associated with aftershock event and its implication

With the improvement of seismic observation system, more and more observations indicate that earthquakes may cause seismic velocity change. However, the amplitude and spatial distribution of the velocity variation remains a controversial issue. Recent active source monitoring carried out adjacent to Wenchuan Fault Scientific Drilling （WFSD） revealed unambiguous coseismic velocity change associated with a local M8 5.5 earthquake. Here, we carry out forward modeling using two-dimensional spectral element method to further investigate the amplitude and spatial distribution of observed velocity change. The model is well constrained by results from seismic reflection and WFSD coring. Our model strongly suggests that the observed coseismic velocity change is localized within the fault zone with width of ~ 120 m rather than dynamic strong ground shaking. And a velocity decrease of -2.0 % within the fault zone is required to fit the observed travel time delay distribution, which coincides with rock mechanical experiment and theoretical modeling.

Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression

Background Patients with anxious major depressive disorder(MDD)are more likely to have poorer outcomes than those with non-anxious MDD.However,the effect of esketamine on adolescents with anxious versus non-anxious MDD has remained unknown.Aims We compared the efficacy of esketamine in adolescents with MDD and suicidal ideation,both anxious and non-anxious.Methods Fifty-four adolescents with anxious(n=33)and non-anxious(n=21)MDD received three infusions of esketamine 0.25mg/kg or active-placebo(midazolam 0.045 mg/kg)over 5 days,with routine inpatient care and treatment.Suicidal ideation and depressive symptoms were assessed using the Columbia Suicide Severity Rating Scale and the Montgomery-Asberg Depression Rating Scale.Multiple-sample proportional tests were used to compare the differences between groups on treatment outcomes 24 hours after the final infusion(day 6,primacy efficacy endpoint)and throughout the 4-week post-treatment(days 12,19 and 33).Results In subjects who received esketamine,a greater number of patients in the non-anxious group than the anxious group achieved antisuicidal remission on day 6(72.7%vs 18.8%,p=0.015)and day 12(90.9%vs 43.8%,p=0.013),and the non-anxious group had a higher antidepressant remission rate compared with the anxious group on day 33(72.7%vs 26.7%,p=0.045).No significant differences in treatment outcomes were observed between the anxious and non-anxious groups at other time points.Conclusions Three infusions of esketamine as an adjunct to routine inpatient care and treatment had a greater immediate post-treatment antisuicidal effect in adolescents with non-anxious MDD than in those with anxious MDD;however,this benefit was temporary and was not maintained over time.

Investigations for the assessment of adult patients presenting to the emergency department with supraventricular tachycardia

Dear editor,Patients with supraventricular tachycardia(SVT)commonly present to the emergency department(ED).Current guidelines[1,2]do not recommend routine pathology testing and a report on the topic has questioned their role.A systematic review concluded that troponin testing is commonly performed with a high proportion of positive fi ndings,but these results were not associated with major adverse cardiac events.[3]The conclusions of this review were limited by paucity of data and heterogeneity among studies.

Multiple haploids, triploids, and tetraploids found in modern-day “living fossil” Ginkgo biloba

Ginkgo biloba,the last extant representative of a lineage of Mesozoic gymnosperms,is one of the few seed plants with an exceptionally long(~300 Myr)evolutionary history free of genome-wide duplications(polyploidy).Despite this genome conservatism,we have recently found a viable spontaneous tetraploid Ginkgo sapling during routine screening of several plants,demonstrating that natural polyploidy is possible in Ginkgo.Here we provide a much wider flow cytometry survey of ploidy in some European Ginkgo collections,and own seedlings(>2200 individuals and~200 cultivars).We found a surprisingly high level of ploidy variation in modern-day Ginkgo and documented altogether 13 haploid,3 triploid,and 10 tetraploid Ginkgo plants or cultivars,most of them being morphologically distinct from common diploids.Haploids frequently produced polyploid(dihaploid)buds or branches.Tetraploids showed some genome size variation.The surveyed plants provide a unique resource for future Ginkgo research and breeding,and they might be used to accelerate the modern diversification of this nearly extinct plant lineage.