Objective To explore the therapeutic effect of Cefoselis sulfate and Cefepime on the stroke-associated pneumonia in elderly patients.Methods 96 cases of stroke-associated pneumonia with positive pathogen were divided into two groups treated with Cefoselis versus Cefepime respectively.Body temperature,leukocyte count,arterial partial oxygen pressure,the serum level of C-reactive protein (CRP) and bacterial clearance rate were observed before and after the treatment.The cefoselis sulfate group (n =48) or the cefepime group (n =48) was treated with 2.0 g Cefoselis sulfate or 2.0 g Cefepime every 12 hours for 7 to 10 days.Results In post-treatment versus pretreatment,both two groups showed that clinical symptoms and inflammatory indicators were improved,and the patient's body temperature,white blood cell count and neutrophil cell count,hs-CRP and arterial partial oxygen pressure were significantly decreased (all P＜0.05).Arterial partial oxygen pressure was better in post-versus pre-treatment (P＜0.05).The total effective rate was 87.5％ in Cefoselis sulfate group and 83.3％ in cefepime group (P ＞ 0.05).The bacterial clearance rate was higher (89.6％) in Cefoselis sulfate groups than in cefepime groups (67.9％) (P＜0.05).In posttreatments of Cefoselis sulfate groups versus Cefepime groups,white blood cell count and neutrophil cell count,hs-CRP and arterial partial oxygen pressure showed no statistically significant differences (all P ＞ 0.05).Conclusions Compared with Cefepime,Cefoselis has the similar anti-infection efficacy in the treatment of stroke-associated pneumonia.While,the bacterial clearance rate and the total effective rate are better in cefoselis group than in Cefepime group.

Objective To investigate the efficacy and safety of intravenous thrombolysis with low-dose and standard-dose recombinant tissue plasminogen activator(rt-PA)in the elderly patients(aged over 80 years)with acute ischemic stroke(AIS).Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt-PA low-dose group(n=93,0.6 mg/kg)and rt-PA standard-dose group(n=108,0.9 mg/kg).The incidence of intra-cranial hemorrhage,symptomatic intracranial hemorrhage,fatal intracranial hemorrhage,neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety.The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness.A stratified analysis of 90-day outcomes was performed based on stroke severity and age.Results The incidence of intracranial hemorrhage,symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt-PA low-dose group was lower than that in rt-PA standard-dose group(P＜0.05).There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index.The 90-day good prognosis rate of moderate stroke sub-group and of≥90 years of age sub-group in rt-PA low-dose group were both higher than that of rt-PA standard-dose group(P＜0.05).Conclusions For AIS patients with moderate stroke and aged over 90 years,intravenous thrombolytic therapy with rt-PA 0.6 mg/kg is recommended.