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OBJECTIVE@#To investigate the incidence and infection regularity of ventilator-associated pneumonia (VAP) in patients undergoing tracheal intubation and to provide reference for the prevention and treatment of VAP infection in the future.@*METHODS@#A retrospective study was conducted to collect the microbial data of airway secretion cultures from 72 patients with endotracheal intubation admitted to the emergency ward of Shanghai Fifth People's Hospital from May 2020 to February 2021, and the species of microorganisms and intubation time were statistically analyzed.@*RESULTS@#Among 72 patients with endotracheal intubation, males were more than females (58.33% vs. 41.67%); Patients over 60 years old accounted for 90.28%; pneumonia was the main primary disease, accounting for 58.33%. Pathogenic tests showed that: (1) 72 patients were infected with Acinetobacter baumannii (AB), Klebsiella pneumoniae (KP), and Pseudomonas aeruginosa (PA) 48 hours after intubation, 51.39% (37/72), 27.78% (20/72), and 26.39% (19/72), respectively. The infection rate of AB was significantly higher than that of KP and PA. Within 48 hours of intubation, the infection rates of AB, KP, and PA were 20.83% (15/72), 13.89% (10/72), and 4.17% (3/72), respectively. Of the 42 patients with primary pneumonia, 61.90% (26/42) were infected with one or more of the three pathogenic bacteria AB, KP, and PA 48 hours after intubation, indicating a change in the etiology of the pathogenic bacteria, with the main pathogenic bacteria transitioning from other pathogenic bacteria to AB, KP, and PA. (2) AB, KP, and PA were prone to cause late onset VAP (i.e., intubation ≥ 5 days). Respectively, among VAP patients infected with AB, late onset VAP accounted for 59.46% (22/37). Among patients infected with KP, 75.00% (15/20) had late onset VAP. Among patients infected with PA, late onset VAP accounted for 94.74% (18/19), indicating a higher proportion of late onset VAP caused by PA and KP. (3) Infection was closely related to intubation time, and the pipeline can be replaced according to the peak period of infection. AB and KP infections peaked within 4 days after intubation, reaching 57.69% (30/52) and 50.00% (15/30), respectively. It is recommended to replace the tubes or undergo sensitive antimicrobial therapy around 3-4 days after starting the machine. The proportion of PA infection after 7 days of intubation was 72.73% (16/22), and it was considered to replace the pipeline after 7 days. (4) Most of the three pathogenic bacteria, AB, KP, and PA were carbapenem resistant pathogens with multiple drug resistance. Except for PA, the infection rate of carbapenem resistant bacteria (CRAB, CRKP) was significantly higher than that of non-carbapenem resistant bacteria (AB, KP), accounting for 86.54% (45/52) and 66.67% (20/30) of the corresponding infection cases, respectively, while CRPA only accounts for 18.18% (4/22).@*CONCLUSIONS@#The main differences in VAP infection caused by AB, KP, and PA pathogens are infection time, infection probability, and carbapenem resistance. Targeted prevention and treatment measures can be implemented for patients with intubation.
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Female , Male , Humans , Middle Aged , Pneumonia, Ventilator-Associated , Retrospective Studies , China , Intubation, Intratracheal , Acinetobacter baumannii , Klebsiella pneumoniaeABSTRACT
Objective:To analyze the predictive value of serum Nesfatin-1 combined with the Status Epilepticus Severity Scale (STESS) score on the short-term prognosis of children with status epilepticus (SE).Methods:A clinical data of 145 children with SE who were admitted to the Children′s Hospital Affiliated to Zhengzhou University, Henan Children′s Hospital, Zhengzhou Children′s Hospital, from January 2016 to January 2020 were analyzed retrospectively.After admission, the serum levels of Nesfatin-1 and the STESS score were measured.According to the Glasgow Outcome Scale (GOS) score at discharge, children with SE were divided into poor prognosis group (<5 scores) and good prognosis group (5 scores). Univariate and multivariate Logisitc regression analyses were performed to analyze influence of the serum Nesfatin-1 level and STESS score on the short-term prognosis of children with SE.Receiver operating characteristic (ROC) curve was depicted to evaluate the predictive value of serum Nesfatin-1 level combined with STESS score in the short-term prognosis of children with SE. Results:Twenty-five cases out of 145 (17.24%) children with SE were discharged with a GOS score of <5 (poor prognosis group), 120 cases were in the good prognosis group.In the poor prognosis group, the overall attack (88.00% vs.66.67%), attack time of SE > 1 h (76.00% vs.27.50%), admission to child intensive care unit(PICU) (76.00% vs.37.50%), implementation of endotracheal intubation (16.00% vs.5.00%), abnormal electroencephalogram(EEG) results (73.91% vs.41.03%), abnormal proportion of head imaging results (82.61% vs.29.49%), serum Nesfatin-1 level[(3.65±1.45) μg/L vs.(2.20±0.77) μg/L] and STESS score[(3.01±0.75) points vs.(1.80±0.60) points] were significantly higher than those in the good prognosis group (all P<0.05). Logistic regression analysis showed that the attack time of SE > 1 h, admission to PICU, abnormal EEG, abnormal proportion of head imaging results, serum Nesfatin-1 level and STESS score were independent risk factors for the poor short-term prognosis of children with SE ( OR=4.217, 3.456, 2.626, 4.109, 3.040 and 2.012, respectively, all P<0.001). The cut-off value of serum Nesfatin-1 level and STESS score was 3.01 μg/L and 2.38 points, respectively.The Youden index and AUC of the combination of serum Nesfatin-1 level and STESS scores were 0.736 and 0.921 (95% CI: 0.861-0.959), respectively, which were better than those of single detection of either serum Nesfatin-1 level [Youden index 0.447; AUC 0.795(95% CI: 0.720-0.858)] or STESS scores [Youden index 0.562; AUC 0.859(95% CI: 0.792-0.911)]. Conclusions:The abnormal increases in serum Nesfatin-1 level and STESS score are risk factors for poor prognosis of SE in children, and their combination has a high predictive value for the poor short-term prognosis.
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Objective@#To investigate and analyze the clinical features, epidemiologic information and pathogenic characteristics of a rabies patient.@*Methods@#Clinical data of the patient(boy) was collected and epidemiological survey was conducted, fluorescence quantitative reverse transcription-polymerase chain reaction (FQRT-PCR) and reverse transcription-polymerase chain reaction (RT-PCR) were used to detect the samples of saliva, cerebrospinal fluid (CSF), skin tissue with hair follicle at the back of the neck for rabies laboratory diagnosis.@*Results@#Early symptoms of the boy were vomiting, diarrhea, fever and irritability, followed by coma and death. The boy had nasal trauma one month ago and the domestic dog died of illness during the same period. He did not accept the rabies post-exposure prophylaxis (PEP). The result of the saliva sample was positive by FQRT-PCR. The predicted segments of the glycoprotein(G), nucleoprotein (N) genes of rabies virus were amplified from the positive saliva sample of the patient by RT-PCR. Compared with rabies virus strains in Henan province, the nucleotide homology and amino acid homology in G gene segment were 96.5%-98.8% and 96.5%-99.2% respectively.@*Conclusions@#The case was diagnosed in laboratory as rabies case. The pathogenic rabies virus strain was endemic in Henan province. The nasal trauma, the dead domestic dog were probably related to the infection of the boy.
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Objective To investigate the expression of Notch receptors and its relationship with clinicopathological features and prognosis in gastric cancer tissues. Methods Immunohistochemical SP method was used to detect the expression levels of Notch1, Notch2, Notch3 and Notch4 corresponding receptors in 45 patients with gastric cancer from January 2014 to May 2015 in the Third Affiliated Hospital of Hunan University of Traditional Chinese Medicine. The correlation between expression levels of Notch receptors and lymph node metastasis, TNM staging, disease-free survival (DFS) and overall survival (OS) were analyzed. Results Notch1, Notch2, Notch3 and Notch4 corresponding receptors were mainly distributed in the cytoplasm, and the positive expression rates in gastric cancer tissues were 93.3％ (42/45), 86.7％ (39/45), 80.0％ (36/45), and 77.8％ (35/45), which were higher than those in adjacent tissues [31.1％ (14/45), 24.4％(11/45), 40.0％ (18/45), and 46.7％ (21/45)], and the differences were statistically significant (all P< 0.05). There was no correlation between the expression of Notch1, Notch2, Notch3 and Notch4 corresponding receptors and lymph node metastasis, TNM staging, DFS and OS in gastric cancer tissues (all P> 0.05). Conclusion Notch receptors are highly expressed in gastric cancer tissues, and have no correlation with lymph node metastasis, TNM staging, DFS and OS of patients after surgery.
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In this article we present the types of wireless sensor network (WSN) and their application in the medical field,including patient monitoring,disability assistance,emergency rescue and biological monitoring.Then we propose the challenges that WSN has to face in medical field concerning the development issue of safety,energy consumption and reliability.Finally,foreground of the WSN technology is prospected.
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Objective To establish a small cell lung cancer (SCLC) multidrug resistance (MDR) cell line SH77/CDDP and analyze its biological properties. Methods The SCLC MDR cell line SH77/CDDP was established by increasing gradually the dose of cisplatin, the first line chemotherapeutic drug for lung cancer. The chemosensitivities of SH77/CDDP and its parental cell line to 7 chemotherapeutic drugs were tested. Changes in cellular morphology and ultrastructure were observed. The cell growth curve and cell cycle were also determined. Results SCLC MDR cell line SH77/CDDP having different drug resistance to the 7 chemotherapeutic drugs was established successfully. Compared with that of its parental cell, the size of MDR cell was a bit bigger. The ratio of nucleus to cell plasma decreased and mitochondria, Golgi bodies, rough endoplasmic reticulums and free ribosomes increased. The finger like apophysis was obvious. The rate of cell proliferation of SH77/CDDP was similar to that of SH77, but the number of cells in S phase increased( P
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Objective To study the drug sensitivity of chemotherapeutic drugs by MTT method. Methods Twenty five lung cancer specimens obtained by operation were used for primary culture and the sensitivity of the cancer cells to four drugs, adriamycin(ADM), cis dichlorodiamine platinum(DDP), vincristine(VCR) and etoposide(VP16), was tested by MTT assay. TOPOⅡ, p53, bcl 2 and GST ? proteins in 10 cases of lung cancer tissue were determined by immunohistochemistry. Results The successfully obtained results in 21 cases showed that the effective rate of ADM, DDP, VCR and VP16 was 19.0%, 38.1%, 23.8% and 23.8% respectively. Positive expressions of TOPOⅡ, p53, bcl 2 and GST ? proteins were found in lung cancer tissue in the 10 cases which had different multi drug resistance(MDR) to the four drugs. Conclusion It is possible to test the drug sensitivity of the primary cultured lung cancer cells obtained from operation by MTT method and the results are useful for the selection of anticancer drugs. The expressions of TOPOⅡ, p53, bcl 2 and GST ? are factors to determine MDR for lung cancer cells.
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Arbuscular mycorrhizal fungi(AMF) are ancient,asexual,and obligate symbiotic endophytes which have not been cultured in vitro.So there is some limitation in the study of mycorrhizology.While the molecular technology based on DNA analysis could increase the detection sensitivity and specificity of AMF.rDNA sequence homology and variability can reveal the relationship between species and their evolution.Thus rDNA sequence analysis are widely used in the classification,identification,genetic,ecology and bio-diversity of AMF.This article summarizes the rDNA sequence analysis techniques and their application in phylogeny,molecular detection and community structure of AMF in different plant vegetation.
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Objective To obtain the expression pattern of multidrug resistance-associated gene in human small cell lung cancer(SCLC)MDR cell line SH77/CDDP and provide basis for further studying the mechanism of human SCLC MDR induced by cisplatin.Methods Total RNA was isolated from SCLC MDR cell line SH77/CDDP and its parental cells,and synthesized into double-stranded cDNA,then synthesized into biotin-labeled cRNA probe by in vitro transcription.The cRNA probes were separately hybridized with Affymetrix GeneChip and human U133 set chips(U133A and U133B,containing 39 000 transcripts,including 33 000 known human genes and 6 000 unknown cDNA expression sequence tags,ESTs),and the signals were scanned by the GeneArray Scanner.The results were analyzed by bioinformatics.Results Compared with the gene expression profile of parental SH77 cells,2 389(6.13%)genes were up-regulated in SCLC MDR cell line SH77/CDDP cells,of which 461(1.19%),89(0.23%),26(0.07%)and 7(0.02%)genes were separately up-regulated one-fold,two-folds,three-folds and four-folds.36 genes,including ABCC3,HSP70,CYP26B1,CYP4A11,IGF1R,LOX2,CAP2,LRP2BP,AKNA,ELTD1 and otherwise,were up-regulated 2.5-5.1 folds.According to Gene Ontology and Tree View analysis,these 35 genes were involved in transport,cell adhesion,signal transduction,transcription and ion binding and so on.Conclusion Many multidrug resistance-associated genes induced by cisplatin have been screened by high-throughput gene chip method.Validating their cellular functions will help to identify the mechanism of human SCLC MDR induced by cisplatin.