Objective To investigate the predictive value of serum N-terminal pro brain natriuretic peptide NT-proBNP in left ventricular diastolic dysfunction(LVDD) in septic shock patients.Methods According to retrospective analysis of clinical data 96 patients with septic shock were divided into LVDD group and non-LVDD group.General clinical data,APACHE scores,NT-proBNP,Troponin I(TNI),creatinine,procalcitonin,D-dimer and lactic acid within the first 24 hours after admission were recorded,and multi-factors logistic regression analysis was conducted to find independent risk factors for left ventricular diastolic dysfunction in septic shock patients Receiver operating characteristic curve ROC was constructed to indicate the predictive value.Results There were no significant differences in general clinical data,procalcitonin,D-dimer and lactic acid between two groups.Compared with non-LVDD group the levels of NT-proBNP [lgNT-proBNP (3.66±0.38) vs.(3.03±0.59),P =0.000],TNI [lgTNI(-1.45±0.86)vs.(-2.36±0.82),P ＜ 0.01] and creatinine [(186.12±124.24)vs.(101.16±57.01),P ＜ 0.01] in LVDD group were significantly higher.It was shown by multi-factors logistic regression analysis that NT-proBNP (OR=8.731,95％CI;1.541-49.466,P=0.014) was an independent risk factor for left ventricular diastolic dysfunction in septic shock patients.The area under the curve AUC of NT-proBNP was 0.813 with the cut-off value of 1 725 pg/μL,sensibility =88.6％,specificity =62.1％.Conclusion NT-proBNP was avaluable indicator in predicting left ventricular diastolic dysfunction in septic shock patients.

Objective To analyze clinical characteristics and risk factors of pulmonary hypertension (PH) in patients with sepsis.Methods According to retrospective analysis of clinical data 136 cases with sepsis were divided into PH group and non-PH group.The clinical data,laboratory findings and ultrasonic cardiographic findings were recorded and compared between two groups.Multi-factors Logistic regression analysis was performed to find the independent risk factors of PH in patients with sepsis,and receiver operating characteristic curve ROC was constructed to indicate the predictable value.Results Of 136 patients with sepsis,32 (23.5％) developed PH.The PH group had higher NT-proBNP [lgNT-proBNP (3.67±0.41) vs.(3.33±0.59),P=0.003],higher E peak [(86.12±30.43) vs.(67.73±21.49),P=0.008],higher E/A peak [(1.09±0.46) vs.(0.83±0.29),P=0.014],higher left atrium diameter (LAD) [(36.49±5.97) vs.(31.32±4.69),P=0.001] and lower oxygenation index [(291.90±51.62) vs.(326.40±88.16),P=0.017] than the non-PH group (P ＜ 0.05).It was shown by multi-factors Logistic regression analysis that LAD (OR=1.198,P=0.010) was an independent risk factor of PH in patients with sepsis.The area under the curve AUC of LAD was 0.723,with the cut-off value of 31 mm (sensibility 82.6％,specificity 49.0％).Conclusions LAD was an independent risk factor of sepsis-associated pulmonary hypertension in sepsis patients.

Objective To compare the production of farnesol between Candida albicans (C.albicans) biofilms formed by resistant and standard strains in different media,and to investigate the changing trend of farnesol production in different phases of biofilm formation and the features of farnesol production by resistant C.albicans.Methods Fluconazole-resistant C.albicans strains were induced in vitro.Standard strains and fluconazole-resistant strains of C.albicans were separately inoculated onto different media,including RPMI 1640 medium,yeast extract peptone dextrose (YPD) medium,yeast nitrogen base (YNB) + 0.5％ glucose medium,RPMI 1640 + 10％ fetal calf serum (FCS),so as to form C.albicans biofilms.Morphological changes of C.albicans biofilms at 24 hours were observed under an inverted microscope,and gas chromatography-mass spectrometry (GC/MS)was performed to detect the level of farnesol at 1.5,3,6,12,24,36 and 48 hours.Results There were no obvious differences in the morphology of C.albicans biofilms between the resistant and standard strains when they were cultured in the same medium,while the morphology of C.albicans biofilms markedly differed between the 2 kinds of strains in the different media.Three-factor analysis of variance showed that the production of farnesol in the C.albicans biofilms changed over time (F =70.628,P ＜ 0.001).Concretely speaking,during the formation of resistant and standard C.albicans biofilms,the production of farnesol gradually increased in the RPMI 1640,YPD and YNB + 0.5％ glucose media until the biofilms matured,then showed a decreasing trend.However,the time to peak levels of farnesol was different between the 2 kinds of strains in these media.Moreover,the levels of farnesol in the 2 kinds of strains both slowly increased in the RPMI 1640 + 10％ FCS medium within 12-48 hours.Culture media also significantly affected the production of farnesol (F =176.665,P ＜ 0.001),and the levels of farnesol in the resistant and standard C.albicans biofilms were both higher in the YNB + 0.5％ glucose medium.When resistant and standard strains were separately cultured in the RPMI 1640 media and the YPD media,the level of farnesol was significantly higher in the resistant strains than in the standard stains (RPMI 1640 media at 36 hours:1.157 ± 0.064 vs.0.250 ± 0.075,P ＜ 0.05;YPD media at 6 hours:0.262 ± 0.036 vs.0.055 ± 0.062,P ＜ 0.05;YPD media at 12 hours:0.730 ± 0.030 vs.0.482 ± 0.024,P ＜ 0.05).However,when they were separately cultured in the YNB + 0.5％ glucose media,the farnesol level was significantly higher in the standard stains than in the resistant strains (36 hours:2.950 ± 0.677 vs.0.523 ± 0.266,P =0.020).Conclusion The media markedly affect the production of farnesol in the C.albicans biofilms,and there is a certain difference in the production of farnesol between resistant and standard C.albicans strains.