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A new kind of pregnane-type alkaloid, 20α-dimethylamino-3β-senecioylamino-16β-hydroxy-pregn-5-ene (K-6), was isolated from Pachysandra terminalis Sieb. et Zucc., and its antibacterial activity against MRSA and MRSE was evaluated. We found that K-6 showed antibacterial effects against MRSA and MRSE with minimum inhibitory concentration values (25 mg/L), but did not induce antibiotic resistance in bacteria easily. The administration of K-6 dose-dependently improved the animal survival rate of mice infected with MRSA, with survival rates of 36.34% and 66.67% in the low-dose and high-dose groups, respectively. The protective effects were associated with the reduction of the bacterial titers in the blood and with the morphological amelioration of infected tissues. Scanning and transmission electron microscopy analyses indicated that the cytoplasm shrink of bacterial cells led to noticeable gaps between the cell membrane and cell cytoplasm, and the severely damaged cell membrane resulted in leakage of intracellular content, which ultimately caused the lethal effect of K-6 on bacteria. These findings demonstrated that K-6 is a potential agent against MRSA and MRSE., (Copyright © 2014 John Wiley & Sons, Ltd.)

Aims: We report the results of long-term follow-up of the Pacing to Avoid Cardiac Enlargement (PACE) trial, a prospective, double-blinded, randomized, multicentre study that confirmed the superiority of biventricular (BiV) pacing compared with right ventricular apical (RVA) pacing in prevention of LV adverse remodelling and deterioration of systolic function at 1 and 2 years., Methods and Results: Patients with bradycardia and preserved LVEF were randomized to receive RVA (n = 88) or BiV pacing (n = 89). Co-primary endpoints were LV end-systolic volume (LVESV) and LVEF measured by echocardiography. There were 149 patients who had extended follow-up, with a mean duration of 4.8 ± 1.5 years (2.5-7.8 years). The primary endpoint analyses were performed in 146 patients (74 in the RVA group and 72 in the BiV group). In the RVA pacing group, the LVEF decreased while the LVESV increased progressively at follow-up, but remained unchanged in the BiV pacing group. The differences in LVEF between the RVA and BiV groups were -6.3, -9.2, and -10.7% at 1-year, 2-year, and long-term follow-up, respectively (all P < 0.001). The corresponding differences in LVESV were +7.4, +9.9, and +13.1 mL, respectively (all P < 0.001). The deleterious effects of RVA pacing consistently occurred in all the pre-defined subgroups. Furthermore, patients with RVA pacing had a significantly higher prevalence of heart failure hospitalization than the BiV group (23.9% vs. 14.6%, log-rank χ²  = 7.55, P  = 0.006)., Conclusion: Left ventricular adverse remodelling and deterioration of systolic function continued at long-term follow-up in patients with RVA pacing; this deterioration was prevented by the use of BiV pacing. Also, heart failure hospitalization was more prevalent in the RVA pacing group., (© 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.)

Aims: We assessed the left ventricular (LV) and peripheral performance at rest and during exercise in healthy and heart failure subjects with normal ejection fraction (HFNEF) or with reduced ejection fraction (HFREF)., Methods: All subjects received echocardiography at rest and with bicycle Ergometer exercise. The exercise images for two-dimensional speckle tracking were acquired with submaximal heart rate of 90-100 beats/min, while images for M-mode and tissue Doppler imaging were stored with attainment of >85% of predicted heart rate., Results: A total of 80 HFNEF, 50 HFREF and 50 controls were studied. There was progressive decrease of two-dimensional global circumferential, radial and longitudinal strains (GCS, GRS and GLS), M-mode and tissue Doppler imaging long-axis parameters from controls, HFNEF to HFREF patients (all P < 0.05) at rest and on exercise. The degree of exercise-induced, long-axis augmentation (GLS and M-mode long axis excursion) decreased progressively from controls, HFNEF to HFREF subjects (all P < 0.05), while the increase in GCS and GRS was similar in all groups. The ventricular-arterial coupling ratio did not change in HFREF but reduced in HFNEF and controls during exercise (P < 0.01). All subjects had a similar resting heart rate, but patients exhibited chronotropic non-competence during exercise (P < 0.001)., Conclusions: Ventricular and peripheral dysfunction was evident in HFNEF at rest and deteriorated during exercise. The HFNEF patients had significantly impaired long-axis augmentation at stress that was intermediate between HFREF patients and controls. These findings have relevance to generation of symptoms on exercise in both HFNEF and HFREF., (© 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.)

In the fierce market environment, the enterprise which wants to meet customer needs and boost its market profit and share must focus on the new product development. To overcome the limitations of previous research, Chan et al. proposed a dynamic decision support system to predict the customer lifetime value (CLV) for new product development. However, to better meet the customer needs, there are still some deficiencies in their model, so this study proposes a CBR-based and MAHP-based customer value prediction model for a new product (C&M-CVPM). CBR (case based reasoning) can reduce experts' workload and evaluation time, while MAHP (multiplicative analytic hierarchy process) can use actual but average influencing factor's effectiveness in stimulation, and at same time C&M-CVPM uses dynamic customers' transition probability which is more close to reality. This study not only introduces the realization of CBR and MAHP, but also elaborates C&M-CVPM's three main modules. The application of the proposed model is illustrated and confirmed to be sensible and convincing through a stimulation experiment.