Objective:To assess the value of the APACHE Ⅱ and CPIS in the prediction of mortality during VAP episodes in pulmonary patients.Methods:APACHE Ⅱ and CPIS scores were recorded on the day of the diagnosis of VAP for 58 patients.The primary outcome endpoint was the ICU mortality.Hosmer-Lemeshow goodness of fit tests and ROC curves were used to estimate the predictive calibration and resolution of the scoring systems.Results:Mortality rate was 43.1%.The mean APACHE Ⅱ(t = 3.797,P = 0.000 1)and CPIS scores(t = 3.462,P = 0.001)determined at the time ofVAP diagnosis were significantly higher in nonsurvivors than in survivors.In 33 survival patients,the mechanical ventilation time,the ICU stay time and the hospitalization time was positively correlated with APACHE Ⅱ,so as to CPIS score.Calibration was excellent for APACHE Ⅱ(?2 = 1.546,P = 0.845)and CPIS(?2 =1.341,P = 0.911);Resolution was good for APACHE Ⅱ and acceptable for CPIS,but APACHE Ⅱ was even more better.Conclusion:These results suggest that APACHE Ⅱ and CPIS scoring system also have a good calibration for predicting mortality in patients with ventilator-associated pneumonia,but APACHE Ⅱ has a better resolution.

Objective To evaluate the effects of exposure to MALs on immunity against Mycobacterium tuberculosis in human alveolar macrophages .Methods Plate counting were used to evaluate the effect of resisting Mycobacterium tuberculosis in human alveolar macrophages .Culture supernatants were harvested and human TNF‐α was measured by ELISA kit .Total nitrite levels in the media were measured using the Griess reagent .Results MALs stimulation attenuated the control of intracellular mycobacterial growth in human alveolar macrophages .The production of proinflammatory cytokines TNF‐α and Nitric oxide in human alveolar macrophages induced by Mycobacterium tuberculosis purified protein derivatives tuberculin (Mt‐PPD) and human interferonγwere attenuated by pretreatment in vitro with MALs .Conclusion MALs attenuated the responses of human alveolar macrophages a‐gainst Mycobacterium tuberculosis ,which may provide the new evidence to explain the phenomena in which some component of Mycobacteria in environment impacts the immunity against Mycobacterium tuberculosis infection .