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Objective:To identify the distribution of research hotspots and frontiers of multidrug-resistant bacteria in intensive care units in China through the method of visualization, and to predict future research directions, analyze the research development process, so as to provide reference basis for further research in this field.Methods:Studies related to multidrug-resistant bacteria in intensive care units published in China from 2000 to 2019 by CNKI were reviewed. According to the keywords by CiteSpace 5.6.R2, the co-occurring network was generated to analyze the distribution of research hotspots in this field. Meanwhile, the mutation map of keywords was used to forecast the future research directions to a certain extent.Results:A total of 1 324 articles were finally included in the quantitative analysis. From 2000 to 2019, the number of publications in the field of multi-drug resistant bacteria in intensive care units showed a gradual increase, of which the number of publications increased rapidly from 2008 to 2014 (the number of publications increased from 34 to 124 articles). In the initial stage of research, conceptual keywords appeared, such as intensive care unit, infection, pathogenic bacteria and drug resistance among others. A dense keywords group appeared from 2008 to 2014, which covered several aspects, such as nosocomial infection, Acinetobacter baumannii, pathogenic bacteria, drug resistance, pulsed field gel electrophoresis and nursing etc., suggesting that research in this field has entered a period of vigorous development. High-frequency keywords, such as risk factors, pathogens, antibiotics, nosocomial infections, drug resistance genes and homology appeared from 2015 to 2019, thus representing the hotspots in recent years. Conclusions:The overall research on multidrug-resistant bacteria in intensive care units in China has gradually improved. The current studies focus on homology analysis and multidrug-resistant bacteria infections, among other topics. Further explorations at the genetic level will be conducted to fill the research vacancy in this field and to provide molecular biological basis for reducing the occurrence of multidrug-resistant bacteria in the future.
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ObjectiveTo investigate the efficacy of bundle treatment on patients with moderate or severe acute respiratory distress syndrome (ARDS).Methods A multicenter prospective observational study comparing the result of historical treatment strategy and bundle treatment was conducted. According to the new Berlin standard of definition, 73 patients with moderate or severe ARDS due to pulmonary factors, age from 18 to 65 years, admitted to Department of Critical Care Medicine of Taian Central Hospital and Handan Central Hospital were enrolled. Thirty-three patients admitted during September 2012 to May 2014 (prospective observation period) were enrolled as the bundle treatment group. Forty patients with matched disease history admitted from January 2010 to August 2012 were enrolled as the control group. The patients in bundle treatment group received bundle treatment based on the treatment strategy of primary diseases. Bundle treatment included restrictive fluid management, respiratory support, high-dose ambroxol combined with Xuebijing injection, prevention of ventilation associated pneumonia (VAP), individualized sedation plan, installation of continuous blood purification treatment for critical patients. A special team was organized to ensure the successful implementation of all bundle measures. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, oxygenation index, duration of mechanical ventilation, the length of intensive care unit (ICU) stay, incidence of VAP, and 28-day mortality 5 days after treatment were compared between two groups.Results There were no significant differences in basic characteristics of patients between the two groups, including gender, age, etiology, severity, etc. (allP> 0.05) with comparability. Compared with the control group, there was no significant difference in APACHEⅡ score 5 days after treatment in bundle treatment group (15.1±2.8 vs. 16.2±3.0,t = 1.618,P = 0.110). Compared with control group, oxygenation index in bundle treatment group was significantly improved [mmHg (1 mmHg = 0.133 kPa): 135.4±34.5 vs. 117.1±34.2,t = -2.273,P = 0.026), the duration of mechanical ventilation was obviously reduced (days: 8.70±2.50 vs. 10.10±2.67,t = 2.308,P = 0.024), incidence of VAP was significantly lower [18.2% (6/33) vs. 32.5% (13/40),χ2 = 5.027,P = 0.025], and 28-day mortality rate was obviously lowered [24.2% (8/33) vs. 37.5% (15/40),χ2 = 4.372,P = 0.037], the length of ICU stay shown no statistical difference (days:10.40±1.94 vs. 11.30±2.34,t = 1.620,P = 0.110).Conclusion Implementation of bundle treatment can significantly shorten the duration of mechanical ventilation, reduce the incidence of VAP, and improve the prognosis of patients.
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Objective To study the effect of erythropoietin (EPO) on neural function and brain cell apoptosis in rats after cardiopulmonary resuscitation.Methods Adult male SD rats were randomly divided into control group and EPO group with 24 in each group.A rat model of asphyxial cardiac arrest and cardiopulmonary resuscitation was established.The neurological functions were assessed using neurological deficit score (NDS) 12 h and 24 h after cardiopulmonary resuscitation.The expressions of the apoptosis-inducing factor (AIF) and caspase-3 mRNA in cerebral cortex tissue were detected using reverse transcription-polymerase chain reaction (RT-PCR) at 0 h,12 h,and 24 h,respectively.Results Compared with the DNS scores in the control group (12 h:(60.00± 3.38) ;24 h:(54.50±2.56),respectively),12 h and 24 h NDS scores were (70.50±4.04) and (65.88±2.64) in EPO group after cardiopulmonary resuscitation,and the difference was statistically different (P＜0.01).The AIF mRNA expression levels of 12 h (1.31±0.26) and 24 h (1.87±0.17) after cardiopulmonary resuscitation in EPO group were obviously lower than those in the control group (12 h:(1.88 ± 0.18),24h:(2.71 ± 0.24),respectively),and the differences were statistically different (P＜0.01).The Caspas-3 mRNA expression levels of 12 h (1.49± 0.15) and 24 h (1.56±0.10) after cardiopuhmonary resuscitation in EPO group were obviously lower than those in the control group (12 h:(1.68± 0.10),24h:(1.84 ± 0.16),respectively),and the differences were statistically significant (P＜0.01).Conclusion EPO can reduce AIF and caspase-3 mRNA transcription,reduce apoptosis in cortical neurons caused by the cerebral ischemia and reperfusion injury after cardiopulmonary resuscitation,and therefore improve brain function.