RESUMEN
Objective:To establish an environmental management strategy for the prevention of ventilator-associated pneumonia from the perspective of etiological characteristics and to verify its application effect.Methods:Based on a sampling survey, this study constructed preventive management strategies for ventilator-associated pneumonia by blocking pathogen characteristics from the perspective of both colonization and infection management in patients. From July 2021 to June 2023, a non-synchronous randomized controlled study was conducted, including a control group of 59 cases and an experimental group of 57 cases from ICU of Tianjin Teda Hospital, all of them were mechanically ventilated patients. The effectiveness of the strategy was confirmed.Results:In the control group, there were 35 males and 24 females, with an average age of (46.97 ± 18.84) years. In the experimental group, there were 39 males and 18 females, with an average age of (47.49 ± 13.85) years. During the study period, there were 9 cases of ventilator-associated pneumonia (VAP) in the control group and 2 cases in the experimental group, the difference between the two groups was statistically significant (exact odds ratio=0.031). The duration of mechanical ventilation in the experimental group (122.41 ± 18.36) h, which was shorter than that in the control group (187.62 ± 18.05) h, and the difference was statistically significant ( t=19.28, P<0.05). The length of ICU stay in the experimental group was (8.38 ± 0.79) d, in the control group was (10.99 ± 1.10) d, the difference between them was statistically significant ( t=14.66, P<0.05). On the 7th day, there were 7 cases of positive pathogenic bacteria in sputum culture in the experimental group, which was significantly different from the 29 cases in the control group ( χ2=16.73, P<0.05). Conclusions:The vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics can reduce the incidence of VAP, shorten the duration of mechanical ventilation and ICU stay, and reduce the pathogen load in the sputum of mechanically ventilated patients on the 7th day.
RESUMEN
Objective:To study the molecular mechanism of NO participting the plasticity of normal visual development and the effect of visual deprivation on expression of NO.Methods:The VC of rats were sliced coronally at the ages from postnatal 14 days(p14)to P45,and the sections were processed for nicotinamide adenine dinucleotide phsphate diaphorase(NADPH-d)histochemical staining.Changes in number,cell body area and total length of dendrites of NOS positive neurons in VC from normal groups and monocular deprivation groups were observed with microscope and analysed by Computer Image Analysis System.Results:The number of NOS-positive neurons in VC of normal rats reached a peak at P14,and gradually reduced.The area of neurons are largest,the dendrites of neuones are more compex and longer in P21.Conclusion:NOS exhibits a transient expression on the high level.Monocular deprivation has not influenced the expression of NOS in VC.