Effect of post pyloric feeding on hospital-acquired pneumonia and mortality in patients with critical respiratory disease / 肠外与肠内营养

Objective:To investigate the effect of post pyloric feeding on hospital-acquired pneumonia and mortality in patients with critical respiratory disease.Methods:A retrospective survey of 41 cases of post pylorus feeding (post pylorus feeding group,n =41) in respiratory intensive care unit (RICU) was carried out,and 41 patients who received nasogastric feeding (nasogastric feeding group,n =41) were investigated in the same RICU.The incidence of ventilator-associated pneumonia (VAP),the incidence of hospital-acquired pneumonia (HAP,excluding VAP) and the in-hospital mortality of RICU were observed and compared between the two groups.Vomiting,aspiration,gastric retention,diarrhea,and the times of stopping enteral feeding were observed and compared as well.Results:The incidence of HAP in the post pylorus feeding group was 2.4％,which was significantly lower than that in the nasogastric feeding group (22％,P ＜ 0.05).The incidences of VAP in the post pylorus feeding group and nasogastric tube feeding group were 16.7％ and 8.7％ individually,which was no significant difference between the two groups (P ＞ 0.05).The mortality in RICU in the post pyloric feeding group was 36.6％,which was similar to that in the nasogastric feeding group (41.5％) (P ＞ 0.05).There was no difference in terms of vomiting,aspiration,gastric retention,diarrhea,and the times of stopping enteral nutrition.Conclusion:Compared with nasogastric feeding,post pyloric feeding reduces the incidence of HAP in critical respiratory patients.Nevertheless,post pyloric feeding fails to affect the incidence of VAP and in-hospital mortality in RICU.

Distribution and change in antimicrobial resistance of bacteria from sputum of patients in respiratory intensive care unit / 中国感染控制杂志

Objective To investigate the distribution and antimicrobial resistance of bacteria isolated from sputum of patients in respiratory intensive care unit (RICU).Methods Non-repetitive bacteria isolated from sputum specimens of 557 hospitalized patients in RICU of a tertiary first-class hospital between January 2013 and December 2015 were collected,antimicrobial resistance of bacteria was analyzed.Results A total of 1 131 bacterial strains were isolated,212 (18.8 ％) were gram-positive bacteria and 919 (81.2 ％) were gram-negative bacteria.The top five species were Acinetobacter baumannii (30.2 ％),Pseudomonas aeruginosa (21.1 ％),Staphylococcus aureus (18.2％),Klebsiella pneumoniae (9.8％),and Serratia marcescens (8.3％).In 2013-2015,isolation rate of Staphylococcus aureus and non-fermentative bacteria showed no obvious changing tendency,but isolation rate of Enterobacteriaceae strains had increasing tendency.Antimicrobial susceptibility testing results showed that Acinetobacter baumannii and Pseudomonas aeruginosa exhibited high resistance rates to imipenem,levofloxacin,and gentamicin (all ＞ 60％),resistance rate of Pseudomonas aeruginosa to ceftazidime showed a downward trend (from 59.4％ to 37.5％);isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 96.1％,susceptibility to tigecycline,vancomycin,linezolid,compound sulfamethoxazole,quinupristin/dalfopristin were almost 100％;resistance rates of Enterobacteriaceae strains to sulfonamide decreased from 55.6％ to 14.3 ％,but resistance rates to ceftazidime,cefotaxime,imipenem,levofloxacin,and gentamicin were all ＞60％.Conclusion The major bacteria isolated from sputum of patients in RICU are Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,antimicrobial resistance of isolated bacteria is serious.

E-cadherin mediates adhesion and endocytosis of Aspergillus fumigatus blastospores in human epithelial cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Aspergillus fumigatus (A. fumigatus) is a ubiquitous saprophytic fungus responsible for the majority of invasive mold infections in patients undergoing chemotherapy, organ transplantation or with persistent neutropenia. This study aimed to determine the role of E-cadherin for adhesion and endocytosis of A. fumigatus blastospores in the human epithelial cell line A549.</p><p><b>METHODS</b>A. fumigatus blastospores were incubated with the total protein of A549 to investigate the binding of E-cadherin and blastospores followed by an affinity purification procedure. After establishing the adhesion model, the adhesion and endocytosis of A. fumigatus blastospores by A549 cells were evaluated by down-regulating E-cadherin of A549 cells using blocking antibody or small interfering RNA (siRNA).</p><p><b>RESULTS</b>E-cadherin was adhered to the surface of A. fumigatus blastospore. Adhesion and endocytosis of the blastospores were reduced by blocking or down-regulating E-cadherin in A549 cells.</p><p><b>CONCLUSIONS</b>E-cadherin is a receptor for adhesion and endocytosis of A. fumigatus blastospores in epithelial cells. This may open a new approach to treat this fungal infection.</p>

The effects of rhG-CSF and rhSCF on peripheral blood leukocytes and CFU-GM in rhesus monkeys / 中国实验血液学杂志

To evaluate the effects of rhG-CSF and rhSCF on mobilization of the peripheral blood stem cells, 15 monkeys were divided into control, rhG-CSF 10 micro g/(kg x day) and rhG-CSF 10 micro g/(kg x day) + rhSCF 50 micro g/(kg x day) treated groups. Monkeys were administered with vehicle, rhG-CSF and rhG-CSF + rhSCF subcutaneously once daily for 14 days, respectively. The results showed that the highest counts of leukocyte of rhG-CSF treated group were 411% of baseline value on day 7 after administration, compared with that of rhG-CSF + rhSCF treated group which were 538% on day 9. The highest counts of leukocytes lasted for 3 days in combined treated group. CFU-GM from peripheral blood in the two groups were 8.37 and 11.75 times higher at 5 and 9 days respectively after the mobilization. It is concluded that rhG-CSF significantly increases the number of peripheral blood leukocytes and CFU-GM, and a better effect can be obtained by rhSCF + rhG-CSF combined administration.