ABSTRACT
Objective:To investigate the prognostic factors of severe patients with bloodstream infection (BSI) caused by Enterobacteriaceae bacteria. Methods:Patients suffered from BSI caused by Enterobacteriaceae bacteria admitted to department of critical care medicine of Binzhou Medical University Hospital from October 2016 to October 2019 were enrolled. The information of gender, age, combined shock, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), sensitivity of initial antibiotics, as well as the baseline of procalcitonin (PCT), white blood cell count (WBC), platelet (PLT), albumin (ALB) were collected. The 72-hour PCT clearance rate (72 h PCTc) was calculated after 72 hours' treatment. According to the clinical outcome after 28 days, the patients were divided into recovery group and death group. The differences of clinical indicators between the two groups were compared, and then the statistical significant variables were further performed by Logistic regression to analyze the factors affecting the prognosis of patients. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive efficacy of the factors in severe BSI. Results:A total of 86 patients were enrolled, among whom 54 cases recovered while 32 cases died, and the 28-day mortality was 37.2%. There was no significant difference in gender, age, sensitivity of initial antibiotics, baseline levels of PCT and WBC between two groups. In the death group, the shock incidence, APACHEⅡscore, SOFA score were significantly higher than those in recovery group [shock incidence: 84.4% (27/32) vs. 46.3% (25/54), APACHEⅡ: 24.94±7.65 vs. 17.02±6.57, SOFA: 11.00±3.27 vs. 6.30±2.65, all P < 0.01]; the PLT and ALB baseline levels, 72 h PCTc were significantly lower than those in recovery group [PLT (×10 9/L): 73.38±49.15 vs. 138.69±101.80, ALB (g/L): 25.47±5.91 vs. 28.59±4.53, 72 h PCTc: -44 (-170, 27)% vs. 63 (40, 77)%, all P < 0.01]. The above 6 variables were included in Logistic regression. The results showed that SOFA score was a risk factor for death in these patients [odds ratio ( OR) = 1.930, P = 0.037], while 72 h PCTc and ALB were protective factors ( OR values were 0.043, 0.783, P values were 0.008, 0.047). The SOFA, 72 h PCTc and ALB can be used to predict the prognosis of severe BSI, and the diagnostic value of the combination of three factors was the largest [area under the ROC curve (AUC) = 0.953, 95% confidence interval (95% CI) was 0.909-0.997], the sensitivity was 100%, and the specificity was 79.6%. Conclusions:Severe patients with BSI caused by Enterobacteriaceae bacteria had a high mortality. Higher SOFA score, and lower ALB and 72 h PCTc predicted the adverse outcome. The combination of the three factors has the greatest prognostic efficacy.
ABSTRACT
Objective To investigate the strengths and weaknesses of SPAIR and WE in iShim-IVIM of breast gland MRI scanning. Methods Twenty patients with breast tumor underwent iShim-IVIM and DCE-MRI scanning by SPAIR and WE technology. SNR ,CNR and ADC of the SPAIR-iShim and WE-iShim imaging were cal-culated and imaging quality were evaluated. Statistical analysis was done afterwards. Results The SNR and CNR of WE technology is higher than those of SPAIR statistically (P<0.05). There is no significant statistical differ-ence in score of the images between SPAIR and WE(P>0.05). The ADC of the center of the tumor has no signifi-cant statistical difference between SPAIR and WE(P>0.05). Conclusion The quality of the images using WE is significantly improved than SPAIR ,but both of them can meet the diagnostic requirements ,and the ADC has no statistical difference as well.
ABSTRACT
Objective To investigate the strengths and weaknesses of SPAIR and WE in iShim-IVIM of breast gland MRI scanning. Methods Twenty patients with breast tumor underwent iShim-IVIM and DCE-MRI scanning by SPAIR and WE technology. SNR ,CNR and ADC of the SPAIR-iShim and WE-iShim imaging were cal-culated and imaging quality were evaluated. Statistical analysis was done afterwards. Results The SNR and CNR of WE technology is higher than those of SPAIR statistically (P<0.05). There is no significant statistical differ-ence in score of the images between SPAIR and WE(P>0.05). The ADC of the center of the tumor has no signifi-cant statistical difference between SPAIR and WE(P>0.05). Conclusion The quality of the images using WE is significantly improved than SPAIR ,but both of them can meet the diagnostic requirements ,and the ADC has no statistical difference as well.