Eighty-six patients with community-acquired pneumonia who suffered from cerebrovascular sequelae were admitted to hospital from 2005 to 2007.Patients were randomized into ticarcillin sodium/clavulanate potassium group and cefuroxime Sodium group.Sputum culture was performed for each case before and after treatment.Gram-negative bacilli accounted for 74%of infection,and the most common pathogens were klebsiella pneumoniae(26%)and Escherichia coli(14%).The response rates in two groups were 93%and 72%,respectively(χ2=6.54,P＜0.05).Bacteria eradication rates in two groups were 90%and 62%,respectively(χ2=6.00,P＜0.05).Ticarcillin sodium and clavulanate potassium is an effective antibiotic for community-acquired pneumonia in elderly patients with cerebrovascular sequelae.

Objective To study the correlation between lactate/albumin ratio level and incidence of multiple organ dysfunction syndrome (MODS) as well as mortality in patients with severe sepsis or septic shock.Methods In January 2012-September 2013, 54 patients who were admitted to the intensive care unit(ICU) of a hospital developed severe sepsis and septic shock on the first day of admission, clinical data of patients were analyzed.Results On the first and second days of admission, 30(55.56%)and 26(53.06%)patients developed MODS;lactate/albumin ratio between MODS group and non-MODS group on the first and second days of admission were both significantly different (both P<0.05).Multivariate logistic regression analysis showed that lactate/albumin ratio, oxygenation index (PaO2/FiO2), as well as acute physiology and chronic health evaluation (APACHE Ⅱ) were independent risk factors for predicting MODS in patients with severe sepsis.Lactate/albumin ratios between MODS group and non-MODS group, death group and non-death group were both significantly different (both P<0.05);lactate/albumin ratio was correlated with APACHE Ⅱand PaO2/FiO2, the higher the APACHE Ⅱ score and the lower the PaO2/FiO2, the higher of lactate/albumin ratio.The area under the receiver operating curve (ROC curve) analysis showed that incidence and mortality of MODS on the first day of admission predicted by lactate /albumin ratio were 0.85 and 0.84 respectively;sensitivity, specificity, positive predictive value, and negative predictive value of occurrence of MODS predicted by lactate /albumin ratio>1.735 were 80.00%, 79.17%, 82.67%, and 75.92% respectively, sensitivity, specificity, positive predictive value, and negative predictive value of mortality were 100.00%, 51.02%, 17.23%, and 100.00% respectively.Conclusion Lactate/albumin ratio level is closely correlated with incidence and mortality of MODS in patients with severe sepsis or septic shock.