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Objective To observe the effects of probiotics on gut microecology,immune function,and inflammatory index in patients with critical cerebral infarction.Methods A total of 70 patients with critical cerebral infarction treated in our hospital from January 2015 to January 2019 were retrospectively studied.They were randomly divided into a control group (n =35) receiving routine treatment and an observation group (n =35) receiving routine treatment added to capules containing live Bifidobacterium,Lactobacillus,and Enterococcus for 4 weeks.The changes of gut microflora,immune function and inflammatory index were compared between the two groups.Results The number of Bifidobacterium,Lactobacillus,and Enterococcus colonies were significantly increased and the colony count of yeast was decreased in the observation group after treatment versus pre-treatment (P＜0.05).There were no significant differences between pre-versus post-treatment in the colony count in the control group(P＞0.05).The level of CD4+ and CD4+/CD8+ ratio were significantly higher in observation group than in the control group(P ＜0.05),and the level of CD8+ was lower in observation than in the control group(P ＜0.05)after treatment.The levels of hemoglobin(Hb),total protein(TP),albumin(Alb),interleukin(IL)-6and tumor necrosis factor (TNF) were decreased in the two groups,but the decrement of the levelsof IL-6 and TNF was more marked in the observation group than in the control group(P ＜0.05),However,the levels of Hb,TP,A1b in the observation group were lower tan those in te control group(all P ＜0.05).Conclusions Probiotics can significantly improve the intestinal flora and immune function,release the deterioration of nutritional status,and inhibit the inflammatory response in patients with critical cerebral infarction,which is worthy of clinical promotion.
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Objective@#To observe the effects of probiotics on gut microecology, immune function, and inflammatory index in patients with critical cerebral infarction.@*Methods@#A total of 70 patients with critical cerebral infarction treated in our hospital from January 2015 to January 2019 were retrospectively studied.They were randomly divided into a control group(n=35)receiving routine treatment and an observation group(n=35)receiving routine treatment added to capules containing live Bifidobacterium, Lactobacillus, and Enterococcus for 4 weeks.The changes of gut microflora, immune function and inflammatory index were compared between the two groups.@*Results@#The number of Bifidobacterium, Lactobacillus, and Enterococcus colonies were significantly increased and the colony count of yeast was decreased in the observation group after treatment versus pre-treatment(P<0.05). There were no significant differences between pre-versus post-treatment in the colony count in the control group(P>0.05). The level of CD4+ and CD4+/CD8+ ratio were significantly higher in observation group than in the control group(P<0.05), and the level of CD8+ was lower in observation than in the control group(P<0.05)after treatment.The levels of hemoglobin(Hb), total protein(TP), albumin(Alb), interleukin(IL)-6 and tumor necrosis factor(TNF)were decreased in the two groups, but the decrement of the levelsof IL-6 and TNF was more marked in the observation group than in the control group(P<0.05), However, the levels of Hb, TP, A1b in the observation group were lower tan those in te control group(all P<0.05).@*Conclusions@#Probiotics can significantly improve the intestinal flora and immune function, release the deterioration of nutritional status, and inhibit the inflammatory response in patients with critical cerebral infarction, which is worthy of clinical promotion.
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<p><b>BACKGROUND</b>The brain death confirmation tests occupy a different position in each country's diagnostic criteria (or guideline); the choices of tests are also different. China brain death criteria include clinical judgment and confirmation tests. This study aimed to confirm the preferred confirmatory test and complementary confirmatory tests.</p><p><b>METHODS</b>We did a clinical brain death determination on deep coma patients, and then divided them into brain death group and non-brain death group. According to the Chinese standards for determining brain death, both the groups accepted confirmatory tests including electroencephalograph (EEG), somatosensory evoked potentials (SEP), and transcranial Doppler (TCD). The sensitivity, specificity, false positive rate, and false negative rate were calculated to evaluate the accuracy of the confirmatory tests.</p><p><b>RESULTS</b>Among the 131 cases of patients, 103 patients met the clinical criteria of brain death. Respiratory arrest provocation test was performed on 44 cases and 32 cases (73%) successfully completed and confirmed that they have no spontaneous breathing. Of the three confirmation tests, EEG had the highest completion rate (98%) and good sensitivity (83%) and specificity (97%); TCD had followed completion rate (54%) and not good sensitivity (73%) and specificity (75%); SEP had the lowest completion rate (49%), good sensitivity (100%), and not good specificity (78%). After the combination of SEP or TCD with EEG, the specificity can increase to 100%.</p><p><b>CONCLUSIONS</b>The completion rate of respiratory arrest provocation test remains a problem in the clinical diagnosis of brain death. If the test cannot be completed, whether to increase a confirmatory test is debatable. SEP had an ideal sensitivity, and the specificity will reach 100% after combining with TCD or EEG. When a confirmed test was uncertain, we suggest increasing another confirmatory test.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Brain Death , Diagnosis , Evoked Potentials, Somatosensory , Physiology , Ultrasonography, Doppler, TranscranialABSTRACT
Objective To implement and evaluate evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia.Methods This study is a prospective before and after comparison study.Collected 200 acute stroke patients with dysphagia and divided them into test group (trained medical staffs) and control group(untrained medical staffs) equally according to the time order.Two groups of 100 patients were surveyed using a checklist before and after implementation of 10 guidelines about nutrition support.Before the implementation of guidelines,the staffs were enforced training,and summarized regularly.Compliances with guidelines by doctors and nurses were compared,and outcomes of patients were assessed.Results Compared with the control group,the correct implementation of the project significantly improved in the experimental group on nutritional risk screening (92.0％,64.0％; x2 =22.840),nutritional supplements selection (80.0％,48.0％; x2 =22.220),nutrition infusion methods (90％,18％ ; x2 =1.040) and nutrition infusion adjustment (abdominal distension/adjusted:21/10,6/4;x2 =9.634,constipation/adjusted:41/40,57/53 ; x2 =5.122,all P ＜ 0.05).The mortality rate,poor prognosis and length of stay in department of neurology intensive care unit and in hospital were not significant different between the experimental group and the control group.The incidence of hospital-acquired pneumonia was significantly lower in the experimental group (44.3％) than that in the control group (67.5％,x2 =7.281,P =0.007),but other patient outcomes were unaffected significantly.Conclusion Implementation of evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia is associated with improvements in clinical quality and selected patient outcomes.