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Objective To investigate the risk factors and prognostic factors of bloodstream infection in intensive care unit(ICU). Methods The data of patients with bloodstream infection in ICU of Harrison International Peace Hospital from October 2014 to October 2017 were retrospectively analyzed and 210 patients with negative blood culture were selected. The physiological and laboratory parameters were compared between patients with positive blood culture and those with negative blood culture. Multivariate logistic regression analysis was used to screen the risk factors of bloodstream infection. Overall, 189 patients with bloodstream infection were classified into survival group(n=121)and death group(n=68)according to the survival status within 30 days after blood culture. The risk factors related to 30-day patient outcome following bloodstream infection were analyzed. Results A total of 189 cases of bloodstream infection were identified in the ICU during the 3-year period, including 118 cases due to gram-negative bacilli, 65 cases caused by gram-positive cocci, and 6 cases due to fungi. Univariate analysis showed that prior use of carbapenem or third generation cephalosporins, central venous catheterization, length of hospital stay≥2 weeks, and mechanical ventilation were the risk factors of bloodstream infection(P<0.05). Multivariate logistic regression analysis showed that prior use of carbapenems or third-generation cephalosporins(OR=20.15), central venous catheterization(OR=25.34), and mechanical ventilation(OR=18.26)were independent risk factors for bloodstream infection in ICU patients. Univariate analysis showed that prior use of carbapenem or third generation cephalosporins, mixed infection or septic shock, multi-drug resistant bacterial infection, and high APACHE Ⅱ(acute physiological and chronic health evaluation system Ⅱ)score were significant risk factors for 30-day mortality following bloodstream infection(P<0.05). Multivariate logistic regression analysis showed mixed infection or septic shock(OR=15.30), multi-drug resistant bacterial infection(OR=10.75)and high APACHE Ⅱ score(OR=13.70)were independent risk factors for 30-day mortality following bloodstream infection. Conclusions Prior use of carbapenem or third generation cephalosporins, central venous catheterization and mechanical ventilation are independent risk factors for bloodstream infection in ICU patients. Mixed infection or septic shock, multi-drug resistant bacterial infection, and high APACHE Ⅱ score are independent risk factors for 30-day mortality following bloodstream infection.
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Objective To observe the mechanisms of autophagic eukaryotic cells in Acinetobacter microvilli removal and protein histological study on apoptosis induced by macrophages .Methods A model of Acinetobacter baumannii infection was established in 24 female OCR mice .The mice were randomly divided into control group (n= 12) and observation group (n= 12) .The control group was injected with normal saline ,and the observation group was injected with autophagy eukaryotic cells ,the histopathological changes of Acinetobacter and the induction of macrophage apoptosis were observed .Results There was no significant difference in the bacterial counts between the two groups of mice immediately after implantation (P>0 .05) ,the bacterial counts in the 24 and 48 h in the observation group was significantly lower than that in the control group (P<0 .05) .The lung tissue of mice in the ob-servation group injected after autophagy was normal ,the alveolar cavity was open ,no abnormal substances were found ,the alveolar wall was not obviously thickened ,and no inflammatory cell infiltration was found in the wall .The mice in the control group were in-jected with normal saline and lacked the ability to remove Acinetobacter ,resulting in a large number of inflammatory cell infiltra-tion ,vasodilatation ,and congestion in some mice .Conclusion Autophagic eukaryotic cells injected with Acinetobacter baumannii can increase the clearance rate ,induce apoptosis of macrophages and improve the quality of Acinetobacter baumannii .
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Objective To observe the mechanisms of autophagic eukaryotic cells in Acinetobacter microvilli removal and protein histological study on apoptosis induced by macrophages .Methods A model of Acinetobacter baumannii infection was established in 24 female OCR mice .The mice were randomly divided into control group (n= 12) and observation group (n= 12) .The control group was injected with normal saline ,and the observation group was injected with autophagy eukaryotic cells ,the histopathological changes of Acinetobacter and the induction of macrophage apoptosis were observed .Results There was no significant difference in the bacterial counts between the two groups of mice immediately after implantation (P>0 .05) ,the bacterial counts in the 24 and 48 h in the observation group was significantly lower than that in the control group (P<0 .05) .The lung tissue of mice in the ob-servation group injected after autophagy was normal ,the alveolar cavity was open ,no abnormal substances were found ,the alveolar wall was not obviously thickened ,and no inflammatory cell infiltration was found in the wall .The mice in the control group were in-jected with normal saline and lacked the ability to remove Acinetobacter ,resulting in a large number of inflammatory cell infiltra-tion ,vasodilatation ,and congestion in some mice .Conclusion Autophagic eukaryotic cells injected with Acinetobacter baumannii can increase the clearance rate ,induce apoptosis of macrophages and improve the quality of Acinetobacter baumannii .
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Objective To investigate the diagnostic value of nuron specific enolase( NSE),S100βprotein,glial fibrillary acidic protein( GFAP)and myelin basic protein( MBP)in patients with early brain contusion and laceration. Methods One hundred and twelve cases with brain contusion and laceration diagnosed by CT or MRI were selected as our subjects who hospitalized Harrison international peace hospital from Apr. 2012 to Jul. 2013. Of them,68 cases with mild head injury were served as mild group and 44 cases of severe traumatic brain injury were served as severe group. And 83 healthy people without lung disease and nervous system diseases were served as control group. Electro chemiluminescence assay and ELISA methods were used to measure the level of NSE,S100β,GFAP,MBP. Results the level of serum NSE,S100β protein,GFAP and MBP in mild group were(18. 14 ± 6. 83),(0. 92 ± 0. 45),(0. 78 ± 0. 37))(4. 37 ± 1. 84)μg/ L,respectively, and(32. 11 ± 12. 48),(1. 58 ± 0. 94),(4. 26 ± 1. 96),(14. 72 ± 6. 77)μg/ L,respectively in severe group, and(8. 94 ± 3. 49),(0. 12 ± 0. 08),(0. 13 ± 0. 09),(1. 98 ± 0. 89)μg/ L,respectively in control group. There were significant differences among three groups( F = 137. 520,120. 083,283. 727,205. 569 respectively;P< 0. 01). All indexes were different between control and mild groups( q = 10. 599,13. 296,5. 881,6. 018;P< 0. 01),as well as between the mild and severe groups(q = 13. 600,9. 249,26. 639,22. 029;P < 0. 01),and between control and severe group(q = 23. 408,21. 258,32. 797,28. 134;P < 0. 01). Conclusion The level of serum NSE,S100β,GFAP,MBP can be used as early indicators of brain injury secondary diagnosis and secondary index for evaluating damage degree.
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Objective To investigate the diagnostic value of the combined detection of serum glial fibrillary acidic protein (GFAP)and myelin basic protein (MBP)in the patients with early brain contusion and laceration.Methods ELISA was adopted to detect serum GFAP and MBP.The one-way ANOVA analysis was adopted to conduct the comparison among groups and the q test was adopted to conduct the pairwise comparison for analyzing the differences between the brain contusion and laceration patients with the healthy population.Results The serum GFAP and MBP levels had statistically significant differences among the mild craniocerebral injury group,severe craniocerebral injury group and the healthy control (P <0.05);which had statistically signifi-cant differences between the control group and the mild craniocerebral injury group(P <0.05);which had statistically significant differences between the mild craniocerebral injury group and the severe craniocerebral group (P <0.05 );which had statistically significant differences between the control group and the severe craniocerebral injury group (P <0.05).The serum GFAP and MBP levels in the early stage of brain contusion and laceration were significantly higher than those in the control group,moreover,the more severe the injury,the more obvious the increase of serum GFAP and MBP.Conclusion The combined detection of serum GFAP and MBP can be regarded as the auxiliary indexes for the early diagnosis of early brain contusion and laceration and the eval-uation of the injury degree.