Objective To investigate the effect of ulinastatin treatment on the inflammatory factor expression and prognosis in patients with ventilator-associated pneumonia (VAP). Methods One hundred patients with VAP were enrolled, and the patients were given the standardized treatment of VAP. The patents were divided into high dose group (33 cases, using the ulinastatin 20 000 U/d), normal dose group (34 cases, using the ulinastatin 10 000 U/d) and control group (33 cases, no using the ulinastatin) by random digits table method. The serum C-reactive protein (CRP), procalcitonin, interleukin (IL)-6 and tumor necrosis factor (TNF)-αlevels at the first, third, fifth and seventh day of diagnosis were detected. All the patients were followed up for 1 month, and the antibiotics treatment time, mechanical ventilation time, ICU stay time and mortality were recorded. Results The CRP, procalcitonin, TNF-αand IL-6 from the first day of diagnosis to the seventh day of diagnosis in 3 groups showed the downward trend, and there were statistical differences (P<0.05). There were no statistical differences in CRP and procalcitonin at the third, fifth and seventh day of diagnosis among 3 groups (P>0.05). At the third, fifth and seventh day of diagnosis, the TNF-α levels in high dose group were (46.02 ± 4.65), (23.88 ± 7.76) and (11.05 ± 2.56) ng/L, the IL-6 levels were (15.53 ± 4.54), (11.33 ± 3.45) and (6.62 ± 2.45) ng/L;the TNF-αlevels in normal dose group were (56.02 ± 6.42), (38.88 ± 9.34) and (27.05 ± 3.42) ng/L, the IL-6 levels were (18.23 ± 2.45), (15.33 ± 4.34) and (11.23 ± 3.34) ng/L; the TNF-α levels in control group were (68.13 ± 4.77), (52.88 ± 7.46) and (42.12 ± 3.76) ng/L, the IL-6 levels were (20.02 ± 3.23), (17.23 ± 2.34) and (15.33 ± 2.33) ng/L. The TNF-αand IL-6 levels at the third, fifth and seventh day of diagnosis in high dose group were significantly lower than those in normal dose group and control group, and those in the normal dose group were significantly lower than those in control group, and there were statistical differences (P<0.05). The mechanical ventilation time, antibiotics treatment time and ICU stay time in high dose group were significantly shorter than those in normal group and control group:(15.34 ± 5.67) d vs. (18.44 ± 6.32) and (22.34 ± 5.21) d, (7.45 ± 2.54) d vs. (10.45 ± 4.56) and (14.43 ± 6.24) d, (18.42 ± 7.45) d vs. (20.43 ± 4.98) and (26.35 ± 5.97) d, and those in normal group were significantly shorter than those in control group, and there were statistical differences (P<0.05). There was no statistical differences in the mortality among 3 groups (P>0.05). Conclusions Ulinastatin can inhibit the expression of IL-6 and TNF-α in patents with VAP, shorten the antibiotics treatment time, mechanical ventilation time, ICU stay time and mortality, and improve prognosis.

ObjectiveTo investigate the risk factors and pathogenic characteristics of catheterrelated infection (CRI) in intensive care unit (ICU),so as to find a better way for its treatment.Methods Retrospective analysis was performed on 247 deep-venous catheter (DVC) from January 2007 to December 2010.ResultsAmong 247 patients,positive results of 41 patients diagnosed CRI,negative results of 206 patients undiagnosed CRI.Compared with undiagnosed CRI patients,found the correlation of the underlying infectious diseases,indwelling time of catheter and puncture sites associated with CRI occurred(P ＜ 0.05 ).CRI major pathogen was gram-positive bacteria (58.5％,24/41 ),in which Staphylococcus epidermis was the major pathogenic bacteria(22.0％,9/41).The drug resistance occurred in most pathogen.Conclusions The occurrence of CRI is related with multiple clinical factors.The gram-positive bacteria is the major pathogen.The etiological monitor should be enforced in patients with DVC.

Objective To investigate the potential role of soluble triggering receptor expressed on ayeloid cells-1(sTREM-1) expression in serum,endotracheal aspiration (ETA),bronchoalveolar lavage fluid (BALF) and exhaled breath condensate (EBC) as early biomarkers for the diagnosis of ventilator-associated pneumonia (VAP) in patients with acute ischemic stroke.Methods One hundred and thirty-two patients with clinically suspected VAP were prospectively included in this multicenter study.The levels of sTREM-1 in serum,ETA,BALF and EBC were analyzed for diagnostic evaluation at the time of VAP clinically suspected.The bacterial count over 104/CFU as a gold standard for VAP,and the receiver operating characteristic curves were used to identify the ideal cutoff values.Results VAP was confirmed in 76 patients (57.58％).In VAP patients (VAP group) and non-VAP patients (non-VAP group),the level of sTREM-1 in BALF was 32.35 (30.08-41.72) and 18.92(11.89-31.72) ng/L,and the level of sTREM-1 in EBC was 1.57 (1.02-2.61) and 0.41(0.19-1.61)ng/L respectively.The level of sTREM-1 in BALF and in EBC in VAP group was significantly higher than that in non-VAP group (P ＜0.05).The optimum cutoff value for sTREM-1 in BALF according to the maximum Youden index was 23.61 ng/L.This cutoff value had 85.5％ sensitivity and 73.1％ specificity,with 0.813 area under the curve.sTREM-1 in BALF had excellent correlation with that in EBC (R2 =0.78,P ＜ 0.05).Conclusions The results of this prospective study suggest that sTREM-1 levels in BALF and EBC have better roles in facilitating the diagnosis of VAP and thus may be practically recommended to guide the administration of antibiotics when VAP is suspected.

Pentraxin 3 (PTX3) is a soluble pattern recognition receptor (PRR), which is produced by severalkinds of cells, such as neutrophils, dendritic cells, macrophages, and epithelial cells.PTX3 is known to play an important protective effect against Aspergillus. Genetic linkage ingene-targeted mice and human PTX3 plays a non-redundant role in the immune protectionagainst specific pathogens, especially Aspergillus. Recent studies have shown that the polymorphismof PTX3 is associated with increased susceptibility to invasive aspergillosis (IA). Inthis review, we provide an overview of these studies that underline the potential of PTX3 indiagnosis and therapy of IA.

Pentraxin 3 (PTX3) is a soluble pattern recognition receptor (PRR), which is produced by severalkinds of cells, such as neutrophils, dendritic cells, macrophages, and epithelial cells.PTX3 is known to play an important protective effect against Aspergillus. Genetic linkage ingene-targeted mice and human PTX3 plays a non-redundant role in the immune protectionagainst specific pathogens, especially Aspergillus. Recent studies have shown that the polymorphismof PTX3 is associated with increased susceptibility to invasive aspergillosis (IA). Inthis review, we provide an overview of these studies that underline the potential of PTX3 indiagnosis and therapy of IA.

Antimicrobial resistance has emerged as a critical global public health concern since the 21 st century. On May 27, 2023, the 76th World Health Assembly endorsed the first global infection prevention and control strategy, proposing the direction of the Global Action Plan for Antimicrobial Resistance (AMR). This article provides an overview of the current global landscape of microbial resistance and the key research topics outlined by WHO in the fight against antimicrobial resistance. Combining with the current trends of bacterial resistance in China and the challenges of drug resistance prevention and control, this paper explores the response measures of medical institutions in clinical and laboratory settings, and advocates for interdisciplinary collaboration to promote the rational application of antimicrobial drugs as the most effective way to combat drug resistance.

Background::Life’s Simple 7, the former construct of cardiovascular health (CVH) has been used to evaluate adverse non-communicable chronic diseases (NCDs). However, some flaws have been recognized in recent years and Life’s Essential 8 has been established. In this study, we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions (PAFs) of low-moderate CVH scores in the 44 NCDs.Methods::In the UK Biobank, 170,726 participants free of 44 common NCDs at baseline were included. The Life’s Essential 8 composite measure consists of four health behaviours (diet, physical activity, nicotine exposure, and sleep) and four health factors (body mass index, non-high density lipoprotein cholesterol, blood glucose, and blood pressure), and the maximum CVH score was 100 points. CVH score was categorized into low, moderate, and high groups. Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition (ICD-10) code using linkage to national health records until 2022. Cox proportional hazard models were used in this study. The hazard ratios (HRs) and PAFs of 44 NCDs associated with CVH score were examined.Results::During the median follow-up of 10.85 years, 58, 889 incident NCD cases were documented. Significant linear dose-response associations were found between higher CVH score and lower risk of 25 (56.8%) of 44 NCDs. Low-moderate CVH (<80 points) score accounted for the largest proportion of incident cases in diabetes (PAF: 80.3%), followed by gout (59.6%), sleep disorder (55.6%), chronic liver disease (45.9%), chronic kidney disease (40.9%), ischemic heart disease (40.8%), chronic obstructive pulmonary disease (40.0%), endometrium cancer (35.8%), lung cancer (34.0%), and heart failure (34.0%) as the top 10. Among the eight modifiable factors, overweight/obesity explained the largest number of cases of incident NCDs in endocrine, nutritional, and metabolic diseases (35.4%), digestive system disorders (21.4%), mental and behavioral disorders (12.6%), and cancer (10.3%); however, the PAF of ideal sleep duration ranked first in nervous system (27.5%) and neuropsychiatric disorders (9.9%).Conclusions::Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs. Among CVH metrics, avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases, NCDs in digestive system, mental and behavioral disorders, and cancer.