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Background: Although compliance with the guideline recommendations for heart failure (HF) is associated with improved survival, the effects of medication on clinical practice often fail to meet expectations due to physician and/or patient-related reasons that are unclear. This study analyzed physicians’ compliance with guideline-directed medical therapy (GDMT) based on real-world clinical data and identified risk factors of low compliance. Methods: This study included patients with HF, who were treated at the Affiliated Hospital of North Sichuan Medical College from July 2017 to June 2021. All patients were divided into high compliance, moderate compliance, and low compliance with GDMT groups. The proportion of patients receiving treatment in compliance with GDMT was analyzed, the relationship between compliance with GDMT and clinical outcomes was evaluated, and the risk factors of low compliance were identified. Results: Of all patients with HF included in the study, 498 (23.8%) had low compliance with GDMT, 1413 (67.4%) had moderate compliance with GDMT, and 185 (8.8%) had high compliance with GDMT. The readmission rate of patients in the moderate compliance with GDMT group was significantly higher than that in the high and low compliance groups (p = 0.028). There were no significant differences in the rates of severe cardiovascular disease among the three groups. The mortality rate of patients in the high compliance with GDMT group was significantly higher than that of the other groups (p < 0.001). We found that a history of hypertension; New York Heart Association (NYHA) classification (III and IV vs. I); and abnormal heart rate, high-sensitive troponin T (hsTnT), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), uric acid, and left ventricular diastolic dysfunction (LVDD) were all significantly associated with low compliance with GDMT. Conclusions: The proportion of physicians’ compliance with GDMT in treating patients with HF is low. Risk factors of low compliance include hypertension; NYHA classification (III and IV vs. I); and abnormal heart rate, hsTnT, NT proBNP, uric acid, and LVDD.

Abstract Background Dermatophytosis is a fungal infectious disease caused by dermatophytes, which produce protease and keratinase to digest keratin, leading to the colonization, invasion, and infection of the stratum corneum of the skin, hair shafts, and nails. Trichophyton interdigitale belongs to Trichophyton mentagrophytes complex, which is the common pathogen causing dermatophytosis. Fungal keratitis, also called keratomycosis, is an infectious disease of cornea. Case presentation Here, we report a case of simultaneous dermatophytosis and keratomycosis caused by Trichophyton interdigitale. A 67-year-old man presented with extensive erythema all over the body since 4 years ago, fungal infection of left eye for 2 years, and loss of vision in the eye. These symptoms had become aggravated in the last month. Dermatological examinations showed extensive erythematous plaques with clear borders and scales, scattered red papules with ulceration, and scabs throughout the body. Onychomycosis was observed on the nails of left hand, conjunctival infection with secretion and loss of vision were noted in left eye. Hyaline septate hyphae were observed under direct microscopic examination, fungal culture and internal transcribed spacer sequencing revealed T. interdigitale. Histopathological examination suggested infectious granuloma. A diagnosis of dermatophytosis and keratomycosis caused by T. interdigitale with loss of vision in left eye was made. The patient was treated with luliconazole cream (two applications per day) and itraconazole (100 mg, BID, PO). Complete clinical remission was achieved after 1 month. Subsequently, the patient underwent left eye enucleation in the ophthalmology department. Conclusions In the present study, we reported a case of simultaneous dermatophytosis and keratomycosis caused by T. interdigitale, and reviewed the literature on corneal infection caused by Trichophyton. A total of 10 articles with 45 patients were published between 1973 and 2018. The pathogen of 27 patient were identified to species level. There were T. schoenleinii (17), T. mentagrophytes (4), T. verrucosum (3), T. rubrum (1), T. erinacei (1), and T. interdigitale (1). Five patients had corneal trauma, one had contact lens use history. Direct microscopic examination, fungal culture, and analysis of physiological characteristics were the main methods of identification. Early diagnosis and prompt treatment may help improve the management and outcomes.

α-toxin, an essential virulence factor secreted by Staphylococcus aureus (S. aureus), is a critical exotoxin in multiple infections. In this study, we found that aloe-emodin (AE), a natural compound lacking anti-S. aureus activity, could inhibit the hemolytic activity of α-toxin. Oligomerization assays, molecular dynamics simulations, and fluorescence-quenching analyses were used to determine the mechanism of this inhibition. The oligomerization of α-toxin was restricted by the engagement of AE with K110, T112, and M113 of the toxin, which eventually resulted in inhibition of the hemolytic activity. Lactate dehydrogenase and live/dead assays demonstrated that AE decreased the injury of human lung epithelial cells (A549) and mouse lung macrophages (MH-S) mediated by S. aureus. Furthermore, treatment with AE showed robust protective effects in mice infected by S. aureus. These findings suggest that AE effectively inhibited the pore-forming activity of α-toxin and showed a protective effect against S. aureus virulence in vitro and in vivo, which may provide a new strategy and new antibacterial agent for clinical treatment of S. aureus infections.

Rosmarinic acid (RA), a polyphenolic phytochemical, is a natural prolyl oligopeptidase inhibitor. In the present study, we found that RA exerted potent anti-inflammatory effects in in vivo models of acute lung injury (ALI) induced by lipopolysaccharide (LPS). Mice were pretreated with RA one hour before challenge with a dose of 0.5 mg/kg LPS. Twenty-four hours after LPS was given, bronchoalveolar lavage fluid (BALF) was obtained to measure pro-inflammatory mediator and total cell counts. RA significantly decreased the production of LPS-induced TNF-a, IL-6, and IL-1β compare with the LPS group. When pretreated with RA (5, 10, or 20 mg/kg) the lung wet-to-dry weight (W/D) ratio of the lung tissue and the number of total cells, neutrophils and macrophages in the BALF were decreased significantly. Furthermore, RA may enhance oxidase dimutase (SOD) activity during the inflammatory response to LPS-induced ALI. And we further demonstrated that RA exerts anti-inflammation effect in vivo models of ALI through suppresses ERK/MAPK signaling in a dose dependent manner. These studies have important implications for RA administration as a potential treatment for ALI.

Rosmarinic acid (RA), a polyphenolic phytochemical, is a natural prolyl oligopeptidase inhibitor. In the present study, we found that RA exerted potent anti-inflammatory effects in in vivo models of acute lung injury (ALI) induced by lipopolysaccharide (LPS). Mice were pretreated with RA one hour before challenge with a dose of 0.5 mg/kg LPS. Twenty-four hours after LPS was given, bronchoalveolar lavage fluid (BALF) was obtained to measure pro-inflammatory mediator and total cell counts. RA significantly decreased the production of LPS-induced TNF-α, IL-6, and IL-1β compare with the LPS group. When pretreated with RA (5, 10, or 20 mg/kg) the lung wet-to-dry weight (W/D) ratio of the lung tissue and the number of total cells, neutrophils and macrophages in the BALF were decreased significantly. Furthermore, RA may enhance oxidase dimutase (SOD) activity during the inflammatory response to LPS-induced ALI. And we further demonstrated that RA exerts anti-inflammation effect in vivo models of ALI through suppresses ERK/MAPK signaling in a dose dependent manner. These studies have important implications for RA administration as a potential treatment for ALI. [ABSTRACT FROM AUTHOR]

An efficient encoding method is proposed for a class of quasi-cyclic low-density parity-check (QC-LDPC) codes with a multiple-diagonal parity-check structure. Its easy implementation with Chinese digital terrestrial/television multimedia broadcasting standard as an example is discussed. It is shown that the proposed encoder runs significantly faster and requires much fewer resources than the conventional shift-register- adder-accumulator encoder. [ABSTRACT FROM AUTHOR]

For efficient hardware implementation of QC-LDPC encoders, four types of rotate-left-accumulator (RLA) circuits are proposed. Although the performance of a type I RLA circuit is exactly identical to the most widely used shift-register-adder-accumulator (SRAA) circuit, its reasonable structure can derive the other three counterparts. Both type II and III RLA circuits are highly area efficient, and have the same speed as the SRAA circuit. Compared with these serial-in circuits, the parallel-in type IV RLA circuit is faster at the cost of more memory, and suitable for applications where generator matrices have fewer block rows or special parity-check matrices are used to encode. [ABSTRACT FROM AUTHOR]

Geniposide, a main iridoid glucoside component of gardenia fruit, has been shown to possess anti-inflammatory activity. However, its potential use for acute lung injury (ALI) has not yet been studied. The aim of this study was to evaluate the anti-inflammatory properties of geniposide using a mouse ALI model. ALI was induced by intranasal injection of lipopolysaccharide (LPS). Pretreatment of mice with geniposide (20, 40, or 80 mg/kg) resulted in a marked reduction in inflammatory cells and total protein concentration in the bronchoalveolar lavage fluid (BALF) of mice. Levels of inflammatory mediators, including tumour necrosis factor- α (TNF- α), interleukin-6 (IL-6), and interleukin-10 (IL-10), were significantly altered after treatment with geniposide. Histological studies using hematoxylin and eosin (H&E) staining demonstrate that geniposide substantially inhibited LPS-induced alveolar wall changes, alveolar haemorrhage, and neutrophil infiltration in lung tissue, with evidence of reduced myeloperoxidase (MPO) activity. In addition, we investigated potential signal transduction mechanisms that could be implicated in geniposide activity. Our results suggest that geniposide may provide protective effects against LPS-induced ALI by mitigating inflammatory responses and that the compound's mechanism of action may involve blocking nuclear factor-kappaB (NF- κB) and mitogen-activated protein kinases (MAPK) signalling pathway activation., (© Georg Thieme Verlag KG Stuttgart · New York.)