ABSTRACT
Objective@#To investigate the epidemiological data of ventilator-associated pneumonia(VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients.@*Methods@#Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed.@*Results@#Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively; Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48%. Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors.@*Conclusions@#The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care
ABSTRACT
Objective To investigate the epidemiological data of ventilator-associated pneumonia (VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients. Methods Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed. Results Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively;Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48% . Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors. Conclusions The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care
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Objective To investigate the expression of Pim‐1 in non small cell lung cancer and adjacent normal tissues ,and study the relationship between c‐Myc and Pim‐1 in the corresponding tissue gene expression .Methods Totally 30 cases of non small cell lung cancer tissue and adjacent normal lung tissues were collected by surgical operation in department of thoracic surgery . Clinical data were statisticed and tracking late pathologic results ,using RT‐PCR ,qRT‐PCR and immunohistochemical method to de‐tect Pim‐1 mRNA ,c‐Myc and Pim‐1 protein expression in lung cancer and adjacent normal tissue ,and to analyze the relationship be‐tween the expression of Pim‐1 and c‐Myc .Results The positive rate of Pim‐1 mRNA and protein expression in non small cell lung cancer was obviously higher than that in adjacent normal tissue ,the mRNA expression levels were 0 .798 ± 0 .083 and 0 .394 ± 0 .107 (P0 .05) ,bue had related to ymph node metastasis and TNM stages of tumor (P<0 .05) ,with lymph node metastasis and TNM sta‐ges increases ,its expression quantity also rise .There was a positive correlation between Pim‐1 and c‐Myc protein expression ,corre‐lation coefficient (r) was 0 .433 (P=0 .017) .Conclusion High expression of Pim‐1 in non small cell lung cancer gene and is also increased with lymph node metastasis and TNM stages ,Pim‐1 and c‐Myc expression has positive correlation ,this could provide clues to the early diagnosis and prognosis evaluation of non small cell lung cancer ,and also provides a new train of thought and to find a new target for gene therapy of lung cancer .