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Objective:To investigate the clinical manifestations and related risk factors of patients with Pseudomonas aeruginosa (PAE) bloodstream infection, and to provide references for clinical diagnosis and treatment of PAE bloodstream infection after combining with bacterial resistance condition. Methods:The clinical data and biological data of all patients with PAE bloodstream infection who received treatment in the Third Affiliated Hospital of Wenzhou Medical University from January 2019 to December 2020 were analyzed retrospectively. The independent influential factors of PAE bloodstream infection were analyzed using binary logistic regression. Results:Eighty-three patients had PAE bloodstream infection. Among them, 71 patients were included in the final analysis. Among the 71 patients, 36 patients (50.70%) had carbapenem-resistant Pseudomonas aeruginosa ( CRPA). Univariate analysis showed that the history of hospitalization within 90 days ( χ2 = 3.90, P = 0.048), indwelling catheterization ( χ2 = 5.08, P = 0.024), septic shock ( χ2 = 4.00, P = 0.046), mechanical ventilation ( χ2= 12.35, P < 0.001), deep venous catheter ( χ2 = 4.08, P = 0.043), acute physiology and chronic health evaluation score II ≥ 10 points ( χ2 = 4.06, P = 0.044), and multi-drug resistance ( χ2 = 11.75, P = 0.001) were the suspicious influential factors of CRPA bloodstream infection. Multivariate logistic regression analysis showed that mechanical ventilation was an independent risk factor for CRPA bloodstream infection ( OR = 7.43, 95% CI 1.182-46.674, P = 0.032). Multi-drug resistance was an independent risk factor for CRPA bloodstream infection ( OR = 5.842, 95% CI 1.520-22.450, P = 0.010). Conclusion:Mechanical ventilation and multi-drug resistance are the independent influential factors of CRPA bloodstream infection. Invasive operations such as mechanical ventilation should be avoided in the clinic.
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[ ABSTRACT] AIM:To study the role of Radix Pseudostellariae polysaccharide ( RPP) in hepatic insulin resist-ance.METHODS:Six-week-old C57BL/6J mice were randomly divided into low-fat diet (LFD) control group and high-fat diet ( HFD) model group.After 16 weeks, intraperitoneal pyruvate tolerance test ( IPPTT) was performed to determine the establishment of the HFD-induced hepatic insulin resistance model.HFD containing RPP (500 mg/kg) was given for 4 consecutive weeks.IPPTT, liver malondialdehyde ( MDA) level and liver mitochondrial MDA level were measured.The protein levels of p-AKT (Ser473/Thr308), p-AMPK, nuclear factor E2-related factor 2 (Nrf2), NQO1 and IκBαin the liver tissues were measured by Western blot.RESULTS:After administration of RPP, a significant reduction in the levels of blood glucose and hepatic mitochondrial MDA was observed.The levels of p-AKT ( Ser473/Thr308) and p-AMPK were significantly elevated in the liver tissues.The hepatic IκBαlevels were up-regulated.RPP also enhanced the expression of Nrf2 system-regulated proteins NQO1 and HO-1 in the liver tissues.CONCLUSION:Radix Pseudostellariae polysaccha-rides effectively reduce HFD-induced hepatic insulin resistance in C57BL/6J mice and improves liver glucose metabolism by ameliorating HFD-impaired hepatic transduction of insulin signaling, activating Nrf2-associated signaling and inhibiting the expression of inflammatory signaling proteins.