BACKGROUND The central venous line is an essential component in monitoring and managing critically ill patients.However,it poses patients with increased risks of severe infections with a higher probability of morbidit...BACKGROUND The central venous line is an essential component in monitoring and managing critically ill patients.However,it poses patients with increased risks of severe infections with a higher probability of morbidity and mortality.AIM To define the trends of the rates of central line-associated bloodstream infections(CLABSI)over four years,its predicted risk factors,aetiology,and the antimicrobial susceptibility of the isolated pathogens.METHODS The study was a prospective case-control study,performed according to the guidelines of the Center for Disease Control surveillance methodology for CLABSI in patients admitted to the adult intensive care unit(ICU)and auditing the implementation of its prevention bundle.RESULTS Thirty-four CLABSI identified over the study period,giving an average CLABSI rate of 3.2/1000 central line days.The infection's time trend displayed significant reductions over time concomitantly with the CLABSI prevention bundle's reinforcement from 4.7/1000 central line days at the beginning of 2016 to 1.4/1000 central line days by 2018.The most frequently identified pathogens causing CLABSI in our ICU were gram-negative organisms(59%).The most common offending organisms were Acinetobacter,Enterococcus,and Staphylococcus epidermidis,each of them accounted for 5 cases(15%).Multidrug-resistant organisms contributed to 56%of CLABSI.Its rate was higher when using femoral access and longer hospitalisation duration,especially in the ICU.Insertion of the central line in the non-ICU setting was another identified risk factor.CONCLUSION Implementing the prevention bundles reduced CLABSI significantly in our ICU.Implementing the CLABSI prevention bundle is crucial to maintain a substantial reduction in the CLABSI rate in the ICU setting.展开更多
BACKGROUND:To analyze early changes in white blood cells(WBCs),C-reactive protein(CRP)and procalcitonin(PCT)in children with multiple trauma,before secondary inflammation develops.METHODS:This single-center retrospect...BACKGROUND:To analyze early changes in white blood cells(WBCs),C-reactive protein(CRP)and procalcitonin(PCT)in children with multiple trauma,before secondary inflammation develops.METHODS:This single-center retrospective study collected data from patients with blunt traumatic injury admitted to the pediatric intensive care unit(PICU).According to the prognostic outcome of 28 d after admission to the PICU,patients were divided into survival group(n=141)and non-survival group(n=36).Characteristics between the two groups were compared.Receiver operation characteristic(ROC)curve analysis was conducted to evaluate the capacity of different biomarkers as predictors of mortality.RESULTS:The percentages of children with elevated WBC,CRP,and PCT levels were 81.36%,31.07%,and 95.48%,respectively.Patients in the non-survival group presented a statistically significantly higher injury severity score(ISS)than those in the survival group:37.17±16.11 vs.22.23±11.24(t=6.47,P<0.01).WBCs were also higher in non-survival group than in the survival group([18.70±8.42]×109/L vs.[15.89±6.98]×109/L,t=2.065,P=0.040).There was no significant difference between the survival and non-survival groups in PCT or CRP.The areas under the ROC curves of PCT,WBC and ISS for predicting 28-day mortality were 0.548(P=0.376),0.607(P=0.047)and 0.799(P<0.01),respectively.CONCLUSIONS:Secondary to multiple trauma,PCT levels increased in more patients,even if their WBC and CRP levels remained unchanged.However,early rising WBC and ISS were superior to PCT at predicting the mortality of multiple trauma patients in the PICU.展开更多
To promote the development of Traditional Chinese Medicine (TCM), it is necessary to innovate the traditional prescription. It is feasible to use one or several components to substitute TCM, which can be regarded as a...To promote the development of Traditional Chinese Medicine (TCM), it is necessary to innovate the traditional prescription. It is feasible to use one or several components to substitute TCM, which can be regarded as a process of discarding the dregs and preserving the essential components. In this way, traditional prescription can be converted into various combinations of pharmacological ingredients deriving from several TCMs. Furthermore, some of pharmacological ingredients should be modified to increase their efficacy. It is practical to select the main structural unit with specific substituents having strong pharmacological activity. After the innovation mentioned above, the prescription will evolve into a variety of modified components having distinct pharmacological activity, and this is the novel integration of active ingredients.展开更多
47XYY syndrome is a rare sex chromosome variant with an extra Y chromosome. Most patients with a 47XYY karyotype have a normal phenotype. This disorder seems to be associated with a higher risk of developing behavior ...47XYY syndrome is a rare sex chromosome variant with an extra Y chromosome. Most patients with a 47XYY karyotype have a normal phenotype. This disorder seems to be associated with a higher risk of developing behavior and cognitive problems, tall stature and infertility in adulthood. We report here a rare case of 47, XYY syndrome associated with an 11-beta-hydroxylase deficiency revealed by a stature advance along with precocious puberty after obtaining informed consent from parents. To our knowledge, this is the first case reported in the literature.展开更多
Hepatitis C virus(HCV)is a globally widespread ribonucleic acid virus that transmits through blood and sexual contact.Its morbidity and mortality are particularly higher in economically underdeveloped areas.Therefore,...Hepatitis C virus(HCV)is a globally widespread ribonucleic acid virus that transmits through blood and sexual contact.Its morbidity and mortality are particularly higher in economically underdeveloped areas.Therefore,an economical and effective diagnostic method for detection of HCV is urgently needed.In this study,we evaluated the diagnostic accuracy of the SD BIOLINE rapid diagnostic test for HCV detection.We searched for studies related to SD BIOLINE and HCV in PubMed,Embase,Web of Science,and the Cochrane Library and then designed inclusion and exclusion criteria.After extracting valid data,the included literature was evaluated with the quality assessment tool Quality Assessment of Diagnostic Accuracy Studies.After our data analysis,the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic accuracy,summary receiver operating characteristic curve,funnel plot,box plot,and Fagan plot of the diagnosticmethod were determined.Nine articles with nine sets of data were finally included.The sensitivity and specificity were 0.94 and 0.98,respectively,the positive likelihood ratio was 79.53,the negative likelihood ratio was 0.05,the diagnostic odds ratio was 1590.32,and the summary receiver operating characteristic curve was 0.9958.The SD BIOLINE test has the advantages of high sensitivity,high specificity,low cost,and easy operation for diagnosing HCV.Therefore,we recommend using SD BIOLINE for rapid and effective screening of HCV,which is especially applicable for economically underdeveloped areas.展开更多
文摘BACKGROUND The central venous line is an essential component in monitoring and managing critically ill patients.However,it poses patients with increased risks of severe infections with a higher probability of morbidity and mortality.AIM To define the trends of the rates of central line-associated bloodstream infections(CLABSI)over four years,its predicted risk factors,aetiology,and the antimicrobial susceptibility of the isolated pathogens.METHODS The study was a prospective case-control study,performed according to the guidelines of the Center for Disease Control surveillance methodology for CLABSI in patients admitted to the adult intensive care unit(ICU)and auditing the implementation of its prevention bundle.RESULTS Thirty-four CLABSI identified over the study period,giving an average CLABSI rate of 3.2/1000 central line days.The infection's time trend displayed significant reductions over time concomitantly with the CLABSI prevention bundle's reinforcement from 4.7/1000 central line days at the beginning of 2016 to 1.4/1000 central line days by 2018.The most frequently identified pathogens causing CLABSI in our ICU were gram-negative organisms(59%).The most common offending organisms were Acinetobacter,Enterococcus,and Staphylococcus epidermidis,each of them accounted for 5 cases(15%).Multidrug-resistant organisms contributed to 56%of CLABSI.Its rate was higher when using femoral access and longer hospitalisation duration,especially in the ICU.Insertion of the central line in the non-ICU setting was another identified risk factor.CONCLUSION Implementing the prevention bundles reduced CLABSI significantly in our ICU.Implementing the CLABSI prevention bundle is crucial to maintain a substantial reduction in the CLABSI rate in the ICU setting.
基金This work is supported by National Natural Science Foundation of China(81270726)Natural Science Foundation of Liaoning Province(20170541023)National Natural Science Foundation of China(81771621).
文摘BACKGROUND:To analyze early changes in white blood cells(WBCs),C-reactive protein(CRP)and procalcitonin(PCT)in children with multiple trauma,before secondary inflammation develops.METHODS:This single-center retrospective study collected data from patients with blunt traumatic injury admitted to the pediatric intensive care unit(PICU).According to the prognostic outcome of 28 d after admission to the PICU,patients were divided into survival group(n=141)and non-survival group(n=36).Characteristics between the two groups were compared.Receiver operation characteristic(ROC)curve analysis was conducted to evaluate the capacity of different biomarkers as predictors of mortality.RESULTS:The percentages of children with elevated WBC,CRP,and PCT levels were 81.36%,31.07%,and 95.48%,respectively.Patients in the non-survival group presented a statistically significantly higher injury severity score(ISS)than those in the survival group:37.17±16.11 vs.22.23±11.24(t=6.47,P<0.01).WBCs were also higher in non-survival group than in the survival group([18.70±8.42]×109/L vs.[15.89±6.98]×109/L,t=2.065,P=0.040).There was no significant difference between the survival and non-survival groups in PCT or CRP.The areas under the ROC curves of PCT,WBC and ISS for predicting 28-day mortality were 0.548(P=0.376),0.607(P=0.047)and 0.799(P<0.01),respectively.CONCLUSIONS:Secondary to multiple trauma,PCT levels increased in more patients,even if their WBC and CRP levels remained unchanged.However,early rising WBC and ISS were superior to PCT at predicting the mortality of multiple trauma patients in the PICU.
基金Supported by Natural Science Foundation-funded Project:study of velvet antler polypeptides differentiating mesenchymal stem cells toward neurons in vitro(No.81470171)Natural Science Foundation-funded Project:Suxiaopingchuan prescription can therapy model mice of airway remodeling in asthma and reduce the inflammatory secretion of sensitized nci-h292 cells by inhibiting the TGFβ1-SMAD3-SMURF2 signaling pathway(81803915)
文摘To promote the development of Traditional Chinese Medicine (TCM), it is necessary to innovate the traditional prescription. It is feasible to use one or several components to substitute TCM, which can be regarded as a process of discarding the dregs and preserving the essential components. In this way, traditional prescription can be converted into various combinations of pharmacological ingredients deriving from several TCMs. Furthermore, some of pharmacological ingredients should be modified to increase their efficacy. It is practical to select the main structural unit with specific substituents having strong pharmacological activity. After the innovation mentioned above, the prescription will evolve into a variety of modified components having distinct pharmacological activity, and this is the novel integration of active ingredients.
文摘47XYY syndrome is a rare sex chromosome variant with an extra Y chromosome. Most patients with a 47XYY karyotype have a normal phenotype. This disorder seems to be associated with a higher risk of developing behavior and cognitive problems, tall stature and infertility in adulthood. We report here a rare case of 47, XYY syndrome associated with an 11-beta-hydroxylase deficiency revealed by a stature advance along with precocious puberty after obtaining informed consent from parents. To our knowledge, this is the first case reported in the literature.
文摘Hepatitis C virus(HCV)is a globally widespread ribonucleic acid virus that transmits through blood and sexual contact.Its morbidity and mortality are particularly higher in economically underdeveloped areas.Therefore,an economical and effective diagnostic method for detection of HCV is urgently needed.In this study,we evaluated the diagnostic accuracy of the SD BIOLINE rapid diagnostic test for HCV detection.We searched for studies related to SD BIOLINE and HCV in PubMed,Embase,Web of Science,and the Cochrane Library and then designed inclusion and exclusion criteria.After extracting valid data,the included literature was evaluated with the quality assessment tool Quality Assessment of Diagnostic Accuracy Studies.After our data analysis,the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic accuracy,summary receiver operating characteristic curve,funnel plot,box plot,and Fagan plot of the diagnosticmethod were determined.Nine articles with nine sets of data were finally included.The sensitivity and specificity were 0.94 and 0.98,respectively,the positive likelihood ratio was 79.53,the negative likelihood ratio was 0.05,the diagnostic odds ratio was 1590.32,and the summary receiver operating characteristic curve was 0.9958.The SD BIOLINE test has the advantages of high sensitivity,high specificity,low cost,and easy operation for diagnosing HCV.Therefore,we recommend using SD BIOLINE for rapid and effective screening of HCV,which is especially applicable for economically underdeveloped areas.
