Muirnymann7355
To analyze the risk factors of neurological function recovery and occurrence of cerebral hemorrhage transformation (HT) after recombinant tissue-type plasiminogen activator (re-PA) in patients with acute ischemic stroke (AIS).
The 173 patients with AIS who received rt-PA thrombolysis in Changshu Hospital of Xuzhou Medical University from March, 2018 to January, 2020 were selected as research objects, and they were divided into HT group (46 cases) and non HT group (127 cases) according to whether HT occurred. The data such as gender, age, body mass index (BMI), past histories including smoking, drinking, hypertension, diabetes mellitus, stroke, atrial fibrillation, coronary heart disease, National Institutes of Health Stroke Scale (NIHSS) score before thrombolysis, systolic blood pressure before thrombolysis, diastolic blood pressure before thrombolysis, hemoglobin, blood glucose, triglyceride, total cholesterol, thrombolytic time, responsible infarction, CT low density foci, estimated glomerular filtratioafter intravenous thrombolysis with rt-PA, eGFR is protective factor of poor prognosis, but it has no correlation with HT, Fib before thrombolysis has no correlation with HT and poor prognosis.
To investigate the correlations between the changes of N-acetylaspartate/creatine (NAA/Cr) detected by magnetic resonance spectroscopy (MRS), and of the relative apparent diffusion coefficient (rADC) detected by diffusion weighted imaging (DWI) and the occurrence and outcome of secondary brain injury (SBI) in patients with spontaneous intra-cerebral hemorrhage (SICH).
One hundred and eight SICH patients diagnosed by CT from January 2014 to December 2019 in the First People's Hospital of Huzhou were selected as the research objects. see more MRS and DWI examinations were performed on day 2 after admission. The body temperature, blood pressure, blood glucose, blood sodium, arterial oxygen partial pressure (PaO
) and other indexes were continuously monitored. The patients were divided into two groups SBI group (46 cases) and control group (62 cases) according to whether there were secondary brain injury factors (SBIF). The differences in NAA/Cr and rADC of the edema area and Glasgow outcome score (GOS) after 6 month. SBI should be actively prevented and intervention, carried out.
To analyze the relationship between D-lactate, intestinal fatty acid binding protein (I-FABP) and the severity as well as the prognosis of patients in intensive care unit (ICU).
Using a retrospective approach, the data derived from a prospective, randomized, single-blind, multicenter clinical study published earlier by our group were further analyzed to evaluate the effect of fat-modified enteral nutrition (EN) suspension on the intestinal barrier in ICU patients. In this study, a total of 141 patients were recruited from 7 ICUs in South China, and 15 healthy volunteers were included as healthy control group. Clinical data of patients were collected, including gender, age, disease severity related indicators such as acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), C-reactive protein (CRP) and initial ICU diagnosis, as well as prognostic indicators such as length of stay in ICU, length of stay in hospital and prognosis of patients at 28 days. To com with prognosis on day 28 (R
= -0.203, P = 0.022; R
= -0.208, P = 0.023; R
= -0.211, P = 0.021). The area under curve (AUC) analysis showed that D-lactate on day 5 and I-FABP on day 0 and day 5 had independent predictive value for 28-day prognosis, with AUC of 0.634, 0.638 and 0.652, P values of 0.023, 0.024 and 0.017, 95% confidence intervals (95%CI) of 0.533-0.734, 0.523-0.754 and 0.525-0.778, respectively. When the cut-off values were 7.71 mg/L, 593.55 ng/L and 468.10 ng/L, the sensitivity were 51.5%, 68.5% and 75.3%, and the specificity were 91.0%, 60.0% and 60.0%, respectively.
Serum D-lactate and I-FABP were increased significantly and decreased with the improvement of the condition, and these two molecular biomarkers have certain value in predicting the prognosis of ICU patients.
Serum D-lactate and I-FABP were increased significantly and decreased with the improvement of the condition, and these two molecular biomarkers have certain value in predicting the prognosis of ICU patients.
To analyze the clinical characteristics and related influencing factors of carbapenem resistant Klebsiella pneumoniae (CRKP) in patients with artificial airway and mechanical ventilation in intensive care unit (ICU), and provide theoretical basis for clinical prevention of Klebsiella pneumoniae infection.
The clinical data of patients with pulmonary infection of Klebsiella pneumoniae in ICU of Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2016 to December 2019 were collected. Compared CRKP pneumonia patients (study group) with carbapenem antibiotic sensitive Klebsiella pneumoniae (CSKP) pneumonia patients (control group), the clinical characteristics [gender, age, acute physiology and chronic health evaluation II (APACHE II), duration of mechanical ventilation, proportion of patients with mechanical ventilation > 10 days, use of antibiotics before detection of Klebsiella pneumoniae, white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), albumin, bCRKP. The detection rate of TEM was the highest (74.00%), and qnrA was the lowest (6.67%).
The occurrence of CRKP in ICU patients with artificial airway and mechanical ventilation is related to many factors. It is necessary to shorten the mechanical ventilation time, avoid the nonstandard use of carbapenem antibiotics, and improve the serum albumin level, so as to reduce the incidence of CRKP pneumonia and improve the prognosis of patients.
The occurrence of CRKP in ICU patients with artificial airway and mechanical ventilation is related to many factors. It is necessary to shorten the mechanical ventilation time, avoid the nonstandard use of carbapenem antibiotics, and improve the serum albumin level, so as to reduce the incidence of CRKP pneumonia and improve the prognosis of patients.
