ABSTRACT
Objective To explore risk factors for healthcare-associated infection (HAI)in patients undergoing craniocerebral operation,and provide guidance for the prevention of HAI in patients in department of neurosurgery. Methods 200 patients who underwent craniocerebral operation in a department of neurosurgery from November 2013 to November 2014 were surveyed,risk factors for HAI were analyzed.Results Among 200 patients undergo-ing craniocerebral operation,81 patients developed 99 cases of HAI,HAI rate was 40.50%,HAI case rate was 49.50%;the top five HAI sites were lower respiratory tract,urinary tract,intracranial site,bloodstream,and in-testinal tract.Univariate analysis showed that patients’age ≥60,Glasgow Coma Scale (GCS)<15,intraoperative blood loss ≥800 mL,staying in intensive care unit(ICU),indwelling gastric tube,ventricular drainage,using ventilator,tracheotomy,and using H2 receptor antagonists were important risk factors for HAI in patients undergo-ing craniocerebral operation (all P <0.05).Multivariate logistic regression analysis showed that patients’age ≥60, GCS<15,staying in ICU,and using H2 receptor antagonists were independent risk factors for HAI in patients un-dergoing craniocerebral operation.Conclusion Strengthening the surveillance of HAI patients undergoing cranioce-rebral operation and realizing risk factors for HAI are helpful for taking comprehensive prevention measures and re-ducing the incidence of HAI.
ABSTRACT
Background and purpose:To date, it mainly depended on imaging examination for detection of residual lesions, recurrence and distant metastasis, evaluation the sensitivity of radiotherapy and chemotherapy, and prognosis in nasopharyngeal carcinoma (NPC). Thus, searching for new tumor markers for NPC early diagnosis and individualized treatment is still merited. This study was aimed to investigate the expressions of serum macrophage inflammatory protein (MIP)-3α and cystatin A in patients with NPC before and after treatment, and to explore two markers’ value in NPC diagnosis, clinicopathological characteristics and clinical outcome assessment. Methods:The serum levels of MIP-3αand cystatin A in 140 primary NPC patients without distant metastasis before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA) and compared with those in 100 healthy controls. Results:The sensitivity of MIP-3αand cystatin A were 92.1%and 42.1%, respectively;and the specificity of MIP-3αand cystatin A were 86.0%and 85.0%, respectively. All 140 NPC patients had complete remission (CR) or partial remission (PR). Serum levels of MIP-3αand cystatin A in pre-treatment patients with NPC were higher than those in post-treatment patients and controls. Serum MIP-3αand cystatin A levels were associated with overall stage of NPC, and MIP-3αwas also associated with T classification of NPC. The serum MIP-3αlevel in NPC with CR after treatment reduced to the level in control group, and that was still significantly higher in NPC with PR than in control group. No significant difference was found in the serum cystatin A level between NPC with CR or PR after treatment and control group. During 1-year follow-up, the post-treatment serum levels of MIP-3αand cystatin A were significantly higher in patients with distant metastasis than in patients without distant metastasis and controls. There was found statistically significant correlation between MIP-3α and cystatin A.Conclusion:MIP-3α may be a potential marker of NPC serological diagnosis. The detection of serum MIP-3αand cystatin A may contribute to the NPC staging and prediction of short-term clinical outcomes.