ABSTRACT
Objective To explore the diagnostic value of gram-stained sputum smears in elderly patients with ventilator-associated lower respiratory infection (VALRI).Methods 368 elderly patients undergoing mechanical ventilation over 48 hours in ICU were retrospectiely analyzed from Jun 2009 to Jun 2011.42 patients fulfilled the inclusion criteria (with good-quality sputa and presence of the same microorganism in sputum and blood cultures).58 gram-stained smears and sputum cultures were obtained and analyzed.Results The diagnostic sensitivity and specificity of Gram-positive bacteria and Gram-negative bacteria by gram-stained smears were 82.35％ and 78.05％,80.49％ and 82.35％,respectively.The positive and negative predictive value of Gram-positive bacteria and Gramnegative bacteria were 63.64％ and 91.43％,91.67％ and 60.87％,respectively.The coincidence rates in diagnosing Gram-positive bacteria and Gram-negative bacteria were 81.03％ and 79.31％,respectively.Conclusions Gram-stained sputum smear is reliable in diagnosing ventilator-associated lower respiratory infection in elderly patients,and has a certain clinical significance in guiding to the selection of antibiotics.
ABSTRACT
Objective:To observe the effects of vitamin A deficiency during pregnancy on the lung vitamin A status,its receptor and pulmonary surfactant of fetal rats.Methods:Prenatal vitamin A normal(VAN)and marginal vitamin A deficiency(MVAD)of Sprague-Dawley rat models were employed.There were 6 in each group.Then they were randomly divided into dexamethasone(Dex)group and control group respectively.I.e VAN-Dex group,VAN-NS group,MVAD-Dex group and MVAD-NS group.From the gestational days 16 to 18,all the rats were given Dex or Saline by intramuscular injection respectively.On the gestational day 19,fetal rats were harvested by cesarean section.The vitamin A concentrations of lung were detected by high-performance liquid chromatography(HPLC),and the levels of pulmonary surfactant(PS)and retinoic acid receptor(RAR)mRNAs were detected by semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR);then the values of PS and RAR mRNAs were compared to glyceraldehyde-3-phosphate dehydrogenase(GAPDH)mRNA.Results:(1)The vitamin A concentrations of lungs in VAN-NS group were higher than those of MVAD-NS group,higher in VAN-Dex group than in MVAD-Dex group,higher in MVAD-Dex group than in MVAD-NS group,and higher in VAN-Dex group than in VAN-NS group.There were significant differences among the four groups(P0.05).(3)With regard to the levels of RAR mRNA,the levels of RAR-? and RAR-? mRNAs in VAN-Dex group were higher than those in VAN-NS group,higher in MVAD-Dex group than in MVAD-NS group,lower in VAN-Dex group than in MVAD-Dex group,lower in VAN-NS group than in MVAD-NS group.The levels of RAR-? mRNA in the four groups were similar to those of the RAR-? and RAR-? mRNAs.And There were significant differences(P