Can rifaximin for hepatic encephalopathy be discontinued during broad-spectrum antibiotic treatment?

Hepatic encephalopathy(HE)is a formidable complication in patients with decompensated cirrhosis,often necessitating the administration of rifaximin(RFX)for effective management.RFX,is a gut-restricted,poorly-absorbable oral rifamycin derived antibiotic that can be used in addition to lactulose for the secondary prophylaxis of HE.It has shown notable reductions in infection,hospital readmission,duration of hospital stay,and mortality.However,limited data exist about the concurrent use of RFX with broad-spectrum antibiotics,because the patients are typically excluded from studies assessing RFX efficacy in HE.A pharmacist-driven quasi-experimental pilot study was done to address this gap.They argue against the necessity of RFX in HE during broad-spectrum antibiotic treatment,particularly in critically ill patients in intensive care unit(ICU).The potential for safe RFX discontinuation without adverse effects is clearly illuminated and valuable insight into the optimization of therapeutic strategies is offered.The findings also indicate that RFX discontinuation during broadspectrum antibiotic therapy was not associated with higher rates of delirium or coma,and this result remained robust after adjustment in multivariate analysis.Furthermore,rates of other secondary clinical and safety outcomes,including ICU mortality and 48-hour changes in vasopressor requirements,were comparable.However,since the activity of RFX is mainly confined to the modulation of gut microbiota,its potential utility in patients undergoing extensive systemic antibiotic therapy is debatable,given the overlapping antibiotic activity.Further,this suggests that the action of RFX on HE is class-specific(related to its activity on gut microbiota),rather than drug-specific.A recent double-blind randomized controlled(ARiE)trial provided further evidence-based support for RFX withdrawal in critically ill cirrhotic ICU patients receiving broad-spectrum antibiotics.Both studies prompt further discussion about optimal therapeutic strategy for patients facing the dual challenge of HE and systemic infections.Despite these compelling results,both studies have limitations.A prospective,multi-center evaluation of a larger sample,with placebo control,and comprehensive neurologic evaluation of HE is warranted.It should include an exploration of longer-term outcome and the impact of this protocol in non-critically ill liver disease patients.

“三个务必”的哲学基础及其内在逻辑

“三个务必”遵循马克思主义的立场、观点和方法,具有系统完备而又逻辑严密的哲学基础。就唯物论基础而言,“三个务必”立足于社会主义初级阶段的基本国情,着眼于民族复兴的中心任务,致力于永葆党的先进性与纯洁性;就认识论基础而言,“三个务必”的目标宗旨是务必不忘初心、牢记使命,原则保障是务必谦虚谨慎、艰苦奋斗,实践方法是务必敢于斗争、善于斗争;就方法论基础而言,辩证方法论与思维方法论阐明了“三个务必”内在要素之间存在的异同特质与交融关系,实现了过去与未来、主观与客观、整体与部分、底线保障与高线追求的有机统一;就价值论基础而言,“三个务必”以人民为价值主体,以人民利益为价值取向,以人民幸福为价值目标。

Visible-to-near-infrared photodetectors based on SnS/SnSe_(2)and SnSe/SnSe_(2)p−n heterostructures with a fast response speed and high normalized detectivity

The emergent two-dimensional(2D)material,tin diselenide(SnSe_(2)),has garnered significant consideration for its potential in image capturing systems,optical communication,and optoelectronic memory.Nevertheless,SnSe_(2)-based photodetection faces obstacles,including slow response speed and low normalized detectivity.In this work,photodetectors based on SnS/SnSe_(2)and SnSe/SnSe_(2)p−n heterostructures have been implemented through a polydimethylsiloxane(PDMS)−assisted transfer method.These photodetectors demonstrate broad-spectrum photoresponse within the 405 to 850 nm wavelength range.The photodetector based on the SnS/SnSe_(2)heterostructure exhibits a significant responsivity of 4.99×10^(3)A∙W^(−1),normalized detectivity of 5.80×10^(12)cm∙Hz^(1/2)∙W^(−1),and fast response time of 3.13 ms,respectively,owing to the built-in electric field.Meanwhile,the highest values of responsivity,normalized detectivity,and response time for the photodetector based on the SnSe/SnSe_(2)heterostructure are 5.91×10^(3)A∙W^(−1),7.03×10^(12)cm∙Hz^(1/2)∙W−1,and 4.74 ms,respectively.And their photodetection performances transcend those of photodetectors based on individual SnSe_(2),SnS,SnSe,and other commonly used 2D materials.Our work has demonstrated an effective strategy to improve the performance of SnSe_(2)-based photodetectors and paves the way for their future commercialization.

OsWRKY65 enhances immunity against fungal and bacterial pathogens in rice

Diverse bacterial and fungal pathogens attack plants,causing biotic stress and severe yield losses globally.These losses are expected to become more serious as climate change improves conditions for many pathogens.Therefore,identifying genes conferring broad-spectrum disease resistance and elucidating their underlying mechanisms provides important resources for plant breeding.WRKY transcription factors affect plant growth and stress responses.However,the functions of many WRKY proteins remain to be elucidated.Here,we demonstrated the role of rice(Oryza sativa)WRKY groupⅢtranscription factor OsWRKY65 in immunity.OsWRKY65 localized to the nucleus and acted as transcriptional repressor.Genetic and molecular functional analyses showed that OsWRKY65 increases resistance to the fungal pathogen Fusarium fujikuroi through downregulation of GA signaling and upregulation of JA signaling.Moreover,OsWRKY65 modulated the expression of the key genes that confer susceptibility or resistance to Xanthomonas oryzae pv.oryzae to enhance immunity against the pathogen.In particular,OsWRKY65directly bound to the promoter region of OsSWEET13 and repressed its expression.Taken together,our findings demonstrate that the OsWRKY65 enhances resistance to fungal and bacterial pathogens in rice.

Natural Products and Antiviral Resistance

Viral diseases are minacious with the potential for causing pandemics and treatment is complicated because of their inherent ability to mutate and become resistant to drugs. Antiviral drug resistance is a persistent problem that needs continuous attention by scientists, medical professionals, and government agencies. To solve the problem, an in-depth understanding of the intricate interplay between causes of antiviral drug resistance and potential new drugs specifically natural products is imperative in the interest and safety of public health. This review delves into natural product as reservoir for antiviral agents with the peculiar potentials for addressing the complexities associated with multi-drug resistant and emerging viral strains. An evaluation of the mechanisms underlying antiviral drug activity, antiviral drug resistance is addressed, with emphasis on production of broad-spectrum antiviral agents from natural sources. There is a need for continued natural product-based research, identification of new species and novel compounds.

Cloning of Broad-spectrum Anti-disease NPR1 Gene with RT-PCR and Construction of Its Protein Expression Vector

[Objective] It is to clone broad-spectrum anti-disease gene NPR1 and to construct its protein expression vector.[Method] First to extract total RNA of Arabidopsis thaliana and design relevant primers,and then the method of reverse transcription PCR was adopted to clone.With the method of enzyme digestion and ligation,this gene will be directed into protein expression vector.[Result] After relevant testing,NPR1 was inserted into vector pMXB10 to obtain pMXB10-NPR1 protein expression vector.[Conclusion] Protein expression vector including NPR1 was successfully constructed.

Portraying Diabetic Foot Ulcers: Comparative Evaluation of Diabetic Foot Infections versus Diabetic Foot Ulcers

Background: Confusion often arises in caring for diabetic foot infections and ulcers, especially with antimicrobials;we aim to shed light on this entity and alert healthcare workers to its stewardship. Methods: Records were reviewed between February 2016 and September 2023. Data for patients diagnosed with diabetes and foot ulcers, infected or not, were examined following ICD 9 search terms. Records for patients were included if they were prediabetic/diabetic adults with foot ulcers, more than 18 years old, and on antidiabetic treatment. Patients were excluded if they insulin resistant, with normal HgbA1c levels, wheel-chair dependent, bed-bound, non-diabetic patients, diabetic patients who had vascular lower limb surgery earlier to ulcers, diabetic patients who had aortocoronary bypass, deep venous thrombosis within six months, malignancy, and severe clinical depression. A modified IWGDF/IDSA guidelines definitions for DFI and DFU was considered. Statistical analysis was done using R programming. Statistical methods were employed as appropriate, and a significant P-value was considered for P Results: Most characteristics were well balanced between DFI and DFU, on imaging osteomyelitis and tissue swelling were significantly more in DFI. Endovascular radiological procedures showed angiograms to be considerably more in DFI, while angioplasty was more in DFU, in addition to smoking. Bacteremia was uncommon, and swab cultures were mostly polymicrobial in both ulcers;no clear association with blood bacteria was detected with the polymicrobial growth, though few were concordant. Antimicrobials prescribed for both ulcers were not statistically different except for carbapenems, which were more in DFI (P Conclusion: Attention should be paid to best practices while caring for diabetic ulcers. These include swab culture interpretations, the use of antimicrobials, and plan management according to DFI or DFU to utilize either local care or combination with antimicrobials.

中国式现代化视角下爱国主义精神的认知之向、价值之能、实践之径

弘扬爱国主义精神是实现物质文明与精神文明相协调的基本要求,也是实现中国式现代化发展道路的应有之义。立足中国式现代化的新征程,中国青年弘扬爱国主义精神蕴含认知之向、价值之能与实践之径,坚持以系统思维实现内容、信仰、行动诸要素协同发力,形成内容共识、信仰共振、实践共行,帮助中国青年筑牢爱国主义立场,坚定爱国主义信仰、自觉践行爱国主义行为,为中国式现代化挺膺担当。

价值论视野中的政治哲学研究——发展中国政治哲学的几点思考

因应改革开放实践发展的内在要求,我国政治哲学研究勃然兴起,取得了很可骄人的成绩和重要的社会影响,成为哲学理论发展的一个理论生长点和亮丽风景线。在政治哲学研究中,存在着对政治哲学的定位、政治哲学的理论基础、政治哲学与唯物史观的关系等问题的争论。从价值论的角度来看,政治实践中存在多种政治力量的博弈,政治决策涉及多种重要价值的比较和权衡,伦理价值或道德价值仅仅是其中的一种特殊价值,如以伦理学为政治哲学的规范基础,或以某种理想的“好政治”“好生活”来推论出政府行为“应如何”,这种研究范式势必难以解释和揭示政治生活的复杂性,也难以起到指导性作用。构建和发展中国特色政治哲学,需要自觉坚持马克思主义科学与价值、批判性与规范性相统一的方法论原则,结合政治学、公共管理学等学科的研究成果,聚焦国家治理现代化和全球治理实践中的重大问题,从思维方式和价值观念两方面进行批判性的反思和提出建设性的意见,实现理论与实践的良性互动共同发展。

百年党史实践中的哲学问题

如果把中国历史视作一个自我生成、自我呈现的精神谱系,那么百年党史就是这个精神谱系的现当代形态。然而,如果我们把这个充满内在动力、充满生命力的、流动的精神谱系仅仅视作一个解释的对象、任意建构和重构的对象,便必然遮蔽它的内在张力和奔向未来的动力。相反,如果我们直面这个现当代精神谱系的原始发生和逻辑演进过程,那么它就是一部哲学问题的发生史。哲学问题或问题哲学是我们把握百年党史实践的一种致思方式,而不是一种意见、情绪和情感。百年党史实践中的哲学问题,有社会本体论、社会认识论和社会价值论三个层面,以及基于三个层面之上的基础性、根本性和全局性三种性质。如果能把三个层面和三种性质的问题还原到百年党史的实践中,并给出一个既有正确性前提又有正当性基础的分析和论证,那么这种真诚的态度和追求真理的精神就是值得肯定的。

Traditional Chinese medicine:an important broad-spectrum anti-coronavirus treatment strategy on COVID-19 background?

Coronaviruses exist widely in nature,can cause cross-species transmission,and pose serious threats to human and animal health.Over the past 20 years,coronaviruses have led to three major epidemics that have caused global panic,including severe acute respiratory syndrome,Middle East respiratory syndrome,and coronavirus disease-19.At present,coronavirus disease 19 not only spreads rapidly,but also mutates easily to escape host immune response,becoming more pathogenic.At present,there are no effective specific therapeutic drugs or vaccines.Drugs targeting severe acute respiratory syndrome coronavirus 2 and the host cell defense system that have been developed based on the structure and replication cycle of coronaviruses have a certain broad-spectrum antiviral effect;however,their efficacy still needs to be demonstrated in further clinical trials.Traditional Chinese medicine has an indispensable role in the ongoing response to coronavirus disease-19.Anti-virus treatment with traditional Chinese medicine has advantages such as broad-spectrum application,low toxicity and side effects,low susceptibility to drug resistance,and overall comprehensive regulation.Therefore,researches on effective components and mechanisms of action of the anti-viral effects of traditional Chinese medicine have increasingly gained attention.The present paper examines coronaviruses,specifically summarizing the genomes,replication mechanisms,and mutant strains.Afterward,the therapeutic effects and mechanisms of action of modern broad-spectrum anti-coronavirus drugs and traditional Chinese medicine are summarized.By considering the virus and the targets in the host comprehensively,in addition to the beneficial multi-target and multi-path antiviral effects of traditional Chinese medicines,this paper could guide the development of treatment strategies for broad-spectrum anti-coronavirus traditional Chinese medicines,and could facilitate the modernization and globalization of traditional Chinese medicine.

Screening of Broad-spectrum Resistance Resources against Rice Bacterial Leaf Streak

[ Objectives] Rice materials with broad-spectrum resistance against several pathogenic strains of Xanthomans oryzae pv. Oryzicola （Xooc） at multiple growth stages were screened, in order to provide reliable resistance sources for variety breeding against rice bacterial leaf streak. [ Methods] A total of 1 100 rice lines with rich genetic background were offered as selective objects, and highly susceptible cultivar Jingang 30 was used as the control. Inoculation was carried out with five strong pathogenic strains of Xooc through acupuncture method at various growth stages for resistance identification. [ Results] Fourteen disease-resistant materials were obtained through preliminary screening, accounting for 1.27% of the total materials. Nine materials moderately resistant to bacterial leaf streak were obtained via secondary screening, accounting for 0.82% of the total materials. Besides, three of them （ RL6, RL9 and RLL4） were resistant to a number of pathogenic strains of Xooc at three growth stages. In particular, RL16 presented broad-spectrum resistance to multi-strains with high resistance levels. Six of them （ RI2, RIA, RIS, RL8, RL11 and RL12） were resistant to single strain at single growth stage. [ Conclusions] The obtained three materials have broad-spectrum resistance to bacterial leaf streak at multiple growth stages, which can be served as an important source to cultivate disease-resistant rice varieties. RL6 maintains high broad-spectrum resistance at all growth stages, which can be used as a prior resistance source for rice variety breeding. Six materials obtained with resistance against bacterial leaf streak at particular growth stages can be used as candidate resistance sources.

Research Progress in Molecular Mechanism of Broad-spectrum Disease Resistance in Rice

Yield loss caused by crop diseases seriously restricts global food security.Breeding disease-resistant varieties with resistance(R)genes is acknowledged as the most economical and effective way to control diseases.Therefore,exploring broad-spectrum resistance(BSR)genes to pathogens and clarifying the underlying mechanism are the basis for effective utilization of BSR resources and finding new approaches for disease control.In the past 20 years,significant progress has also been made in plant immune mechanism and remarkable achievements have been made in researches on broad-spectrum disease resistance of major grain crops,and the potential molecular mechanisms of some BSR have been revealed.Here,the advances of broad-spectrum disease resistance in rice(including the representative cloned BSR genes and their molecular mechanisms)were reviewed.In addition,the problems,opportunities and challenges encountered by BSR were analyzed,and the development of BSR research and its application in rice production were prospected.

The Category of Recens and Pure-Mindedness in J6zefBafika＇s Axiological Reflection

I systematize thoughts within the scope of J6zef Ba6ka＇s philosophical system known as recentivism. I analyze the axiology of recentivism in two categories： recens （i.e., ＂now＂） and pure-mindedness. Also, I differentiate among pure-mindedness, which is a quality of homo euthyphronicus （i.e., pure-minded man）, simplicity, which is a quality of homo simplex （i.e., simple man）, and complexity, which is a quality of homo technicus （i.e., technical man）. Moreover, I present different meanings of pure-mindedness which form the basis for reflection in the axiology of recentivism, i.e., the ethics of pure-mindedness, euthyphronics, and esthetics. Then, I use these meanings of pure-mindedness to define the attitude of homo euthyphronicus. Homo euthyphronicus is a man who seeks balance between simplicity and complexity in the modem world, which is highly complex and full of civilization-related threats, while stressing the importance of axioiogical values.

Effectiveness of a Broad-Spectrum Sunscreen in the Prevention of Melasma in Asian Pregnant Women

Chloasma, or melasma, is a commonly acquired pigmentary disorder among Asian women. It may be considered as a physiological change during pregnancy. The incidence in Asian women is higher than that in other ethnic groups but further epidemiologic data are needed. There are very few studies related to the benefits of sunscreens to prevent this dermatosis. The aim of this study was to assess the effectiveness of a broad-spectrum sunscreen in the prevention of melasma in Korean pregnant women. We tested the effectiveness and tolerance of a sunscreen product (SPF 50+, UVA-PF 30) during a 12-month clinical trial including 220 Korean parturients with skin type III and IV. 217 women completed the study. Only 3 (1%) of the study population developed melasma, which was mild (MASI grade between 1.2 and 2.7). In addition, the clinical effectiveness of the evaluated sunscreen was judged “good to excellent” by the majority of study participants and by the research dermatologists. The “excellent” tolerance of the sunscreen under evaluation was confirmed “good” to “excellent” in 95% and 97% of cases. This study clearly demonstrates that this broad-spectrum sunscreen is well tolerated and effective in the prevention of melasma in Korean pregnant women. Although treatment remains elusive, prevention is possible.

Increasing Incidence of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL) and the Relation to Consumption of Broad-Spectrum Antimicrobial Agents 2003-2011 in a Large Area of Copenhagen, Denmark

Purpose: To investigate 1) the development in the incidence of ESBL-producing bacteria in hospitals and primary health care, 2) the contribution of primary health care to the incidence of ESBL-producing bacteria, and 3) the development in resistance patterns for all Escherichia coli and Klebsiella pneumoniae isolates in relation to antimicrobial consumption in hospitals and primary health care. Methods: ESBL-data were retrospectively collected from bacterial isolates from all specimens received at the Department of Clinical Microbiology from 2003 to 2011 together with the corresponding patient data. ESBL-production was detected in isolates from 1067 of 59,373 patients (1.8%) with an E. coli infection and in 263 of 8660 patients (3.0%) with a K. pneumoniae infection. Results: From 2003 to 2009, an increase in patients with an ESBL-producing isolate occurred in both hospitals and primary health care at the same time as an increased consumption of broad-spectrum antimicrobial agents was seen. Interventions to reduce prescription of cephalosporins and ciprofloxacin at the hospitals from 2010 resulted in a remarkable decrease in patients with ESBL-producing K. pneumoniae whereas a continuing increase was seen in patients with ESBL-producing E. coli both at hospitals and in primary health care. The proportion of patients with community-acquired ESBL-producing E. coli was stable with an increase of only 1.4% from 2007 to 2011. Conclusions: Reduction in prescription of broad-spectrum antimicrobial agents at the hospital level had an important impact on the incidence of ESBL-producing K. pneumoniae, but not on ESBL-producing E. coli.

新阶段消极网络亚文化治理的复杂性论析

复杂性是深化消极网络亚文化治理的重要视域,其超越还原论的方法论特征能为消极网络亚文化治理提供新思路。新阶段消极网络亚文化治理极具复杂性,主要表现在主体复杂性、客体复杂性、介体复杂性与环境复杂性等方面,因此亟须从复杂性视域对消极网络亚文化治理加以理论审视。应以价值论筑牢消极网络亚文化治理的善治理念,以信息论推进技术赋能消极网络亚文化治理,以控制论化解消极网络亚文化衍生的风险要素,以系统论完善消极网络亚文化治理的制度机制,从而提升消极网络亚文化综合治理效能,推进新时代网络文明建设。

工艺学、自由时间:人工智能时代马克思文艺思想体系的重构

局限于生产关系投射的意识形态观念论范畴,文艺学已不足以全面应对ChatGPT等生成式人工智能大模型正在锻造的文艺自动机器大生产方式的挑战。蒸汽机等实现了机器能量自动化,当今人工智能正在实现机器(计算机)智能自动化,引发人类生产工艺方式和生产力二次现代化革命,使物质生产必要劳动时间不断减少、剩余劳动时间和剩余产品不断增加,从而使从物质生产中游离出的自由时间越来越多,促进文艺精神生产越来越快发展;而代表生产现代化社会方式的资本,则力图把越来越多的自由时间束缚在自我增殖的封闭循环中,打破资本封闭循环而把自由时间解放出来,文艺将获得自由发展。在当今人工智能时代,打破学科壁垒,不局限于意识形态观念论范畴,结合工艺学方法论范畴和自由时间价值论范畴,全面重构马克思文艺思想体系,具有广泛而深远的重大意义。

Analysis of Enterobacteriaceae Producing Broad-Spectrum Beta-Lactamases in the Intensive Care Unit Setting

Strains of the Enterobacteriaceae family producing ESBL and AmpC broad-spectrum beta-lactamases that may survive in the hospital setting potentially cause infection in hospitalized patients due to contaminated objects or health care workers’ hands. Over a period of two months (November-December 2010), a single epidemiological study of microbial contamination of air, surfaces and health care workers (swabs from both nostrils and the right hand without a glove) was carried out at two intensive care units of the University Hospital Olomouc, Czech Republic. The bacteria were identified using standard microbiological methods. Phenotypic detection of ESBL and AmpC enzymes and basic genetic analysis of ESBL- and AmpC-positive isolates was performed. The same approach was used to identify and analyze bacteria isolated from clinical samples of patients hospitalized at the above departments over the study period. From a total of 140 environmental samples collected over the study period, 21 isolates of the Enterobacteriaceae family were identified, with ESBL and AmpC production being detected in 4 and 7 isolates, respectively. Among patients’ clinical samples, 10 ESBL- and 6 AmpC-positive isolates were detected. No similarity was found between environmental isolates and strains isolated from patients.

黄河文化的蠡测维度:黄河文化本体论及相关问题

黄河文化是内涵丰富的文化体系。对黄河文化的认识和把摸需要秉持多方向、多维度原则,这是触及黄河文化“本体论”的重要事项,是准确形成黄河文化概念、全面揭示黄河文化内涵的要求,也直接影响、制约乃至决定着保护传承弘扬黄河文化的意义与形式即“价值论”与“方法论”。要厘清黄河文化是什么,需要与国内外其他文化参酌、对照,借助“他者”以观察、发明黄河文化“为何”。作为中华文化“种质资源库”的黄河文化应当且能够在“两化”中踔厉前行。