Objective To investigate pulmonary infect flora distribution characteristics of stroke patients with tracheotomy in Intensive care unit (ICU) and analyze the risk factors.Methods A total of 792 cases of ICU stroke patients was selected,including 426 cases of tracheotomy patients,and 366 cases of non-tracheotomy patients.The incidence of lung infections was compared.Bacteriological examination was used for tracheotomy bacteriological studies for lung infected stroke patients with tracheotomy.Bacteria infection's characteristics was observed.The risk factors were analyzed.Results (1) The tracheotomy patient 's lung infection rate was 23.00％,higher than 9.56％ of the non-tracheotomy patients,the difference was statistically significant (X2 =19.125,P ＜0.05);(2) For lung infection-occurred patients with tracheotomy of ICU,gram-negative bacteria infection rate was 63.97％,significantly higher than 19.85％ of gram-positive bacteria and 16.18％ of fungi,the difference was statistically significant (x2 =18.255,17.042,P ＜ 0.01);(3) Lung infection rate of ICU stroke tracheotomy patients with unconscious,dysphagia,hospitalization time ＞ 14 d,blood glucose levels ≥≥7.8 mmol/L,and based diseases was significantly higher than that of patients with conscious,non-dysphagia,hospitalization time ≤＜14 d,blood sugar level ＜7.8 mmol/L,and no based diseases (P ＜ 0.05);(4) Consciousness,dysphagia,hospitalization,blood sugar levels,and the underlying disease were the independent risk factors of lung infection in ICU stroke tracheotomy patients (OR1 =11.528,OR2 =8.046,OR3 =15.174,OR4 =7.795,ORs =10.784,P ＜0.05).Conclusions Gram-negative bacteria is the main reason for pulmonary infections in ICU stroke tracheotomypatients patients with stroke.State of consciousness,invasive treatment,hospitalization,blood sugar levels,and the underlying disease are the independent risk factors.

OBJECTIVE: To evaluate the relationship between 24 h urinary ion content and kidney stones, and to explore the diagnostic values of kidney stone in primary gout patients. METHODS: Patients diagnosed with primary gout had ultrasound scanning of both feet and kidneys in Peking University First Hospital from Jan. 2020 to May 2021. Their clinical characteristics were compared between the positive and negative kidney stone groups, and the relationship between kidney stone and urinary ion composition were analyzed. Risk factors of kidney stone were analyzed. The explored diagnostic values were evaluated for urinary oxalate and citrate according with uric acid kidney stones by dual-energy computed tomography (DECT). RESULTS: Among the 100 gouty patients, 80 patients had uric acid crystal deposition in lower joints of extremity by ultrasonography, 61 patients had kidney stone, and 34 had kidney uric acid stones by DECT. All the multiple kidney stones were proved as uric acid kidney stones by DECT. Compared with patients without kidney stone group proved by ultrasonography, patients with kidney stone had longer gouty duration [(48.7±26.6) months vs. (84.0±30.6) months, P=0.01], higher 24 h urinary oxalate [(20.1±9.6) mg vs. (28.6±20.7) mg, P=0.001] and lower 24 h urinary citrate [(506.3±315.4) mg vs. (355.7±219.6) mg, P=0.001]. Compared with the patients without kidney stone by DECT, the patients with uric acid kidney stone also had longer disease duration [(49.1±28.4) months vs. (108.3±72.2) months, P=0.001], higher 24 h urinary oxalate [(23.6±16.9) mg vs. (28.5±18.8) mg, P < 0.05], lower 24 h urinary citrate [(556.0±316.3) mg vs. (391.7±261.2) mg, P < 0.05], higher serum uric acid [(466.2±134.5) μmol/L vs. (517.2±18.1) μmol/L, P < 0.05] and higher 24 h urinary uric acid [(1 518.1±893.4) mg vs. (1 684.2±812.1) mg, P < 0.05]. Logistic regression analysis showed long gout disease duration (OR=1.229, 95%CI: 1.062-1.522, P < 0.05), high serum uric acid level (OR=1.137, 95%CI: 1.001-1.213, P=0.01), low 24 h urinary citrate (OR=0.821, 95%CI: 0.659-0.952, P=0.01) were all risk factors of kidney stones by ultrasonography. Also, long gout disease duration (OR=1.201, 95%CI: 1.101-1.437, P=0.005), high serum creatine uric level (OR=1.145, 95%CI: 1.001-1.182, P=0.04), low 24 h urinary citrate (OR=0.837, 95%CI: 0.739-0.931, P=0.02) were all risk factors of kidney uric acid stones by DECT. CONCLUSION Long disease duration and low 24 h urinary citrate were risk factors for kidney stones.
Humans ; Urinary Calculi ; Uric Acid/analysis* ; Citric Acid ; Kidney Calculi/diagnostic imaging* ; Gout/diagnostic imaging* ; Citrates ; Oxalates