Objective To explore the predictive value of fibrin degradation product to albumin ratio(FDP/ALB),neutrophil to lymphocyte and platelet ratio(NLPR)for the severity of elderly community-acquired pneumonia(CAP).Methods 147 elderly CAP patients hospitalized in the Department of Respiratory and Critical Care,Affiliated Hospital of Chengde Medical University from March 2021 to March 2023 were selected and divided into non severe CAP group(n=94)and severe CAP group(n=53)according to the severity of the disease.The general and clinical data of two groups of patients were recorded,and calculated neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),C-reactive protein(CRP)to albumin ratio(CAR),FDP/ALB,NLPR,and oxygenation index,the differences between two groups of the above indicators were compared and correlation analysis were conducted;The predictive value of FDP/ALB,NLPR,and other traditional inflammatory indicators on the severity of elderly CAP were compared.Results CRP,procalcitonin(PCT),white blood cells(WBC),neutrophil(NEU),fibrin degradation product(FDP),NLR,CAR,CURB-65 scores,FDP/ALB,and NLPR in severe CAP group were significantly higher than those in non severe CAP group,while lymphocyte(LYM),platelet(PLT)and albumin(ALB)were significantly lower than those in non severe CAP group(P＜0.05);There were no statistically significant differences in age,gender,smoking history,underlying diseases,and PLR between two groups(P＞0.05).Spearman correlation analysis showed a positive correlation between FDP/ALB,NLPR and CRP,PCT,WBC,NLR,CAR CURB-65 scores,while a negative correlation with oxygenation index(P＜0.05).Multivariate Logistic regression analysis showed that FDP/ALB and NLPR were independent risk factors for severe CAP in the elderly(P＜0.05).The analysis of receiver operating characteristic curve showed that the ability of FDP/ALB,NLPR,NLR,CAR,PCT,NEU,CURB-65 score,CRP,and WBC to predict the severity of elderly CAP gradually decreased(P＜0.05).Conclusion The predictive value of FDP/ALB and NLPR for the severity of elderly CAP is significantly better than traditional inflammatory indicators(CRP,PCT,WBC,NEU,NLR,CAR,CURB-65 scores),which should be taken seriously by clinical workers.

Objective To explore the predictive value of fibrin degradation product to albumin ratio(FDP/ALB),neutrophil to lymphocyte and platelet ratio(NLPR)for the severity of elderly community-acquired pneumonia(CAP).Methods 147 elderly CAP patients hospitalized in the Department of Respiratory and Critical Care,Affiliated Hospital of Chengde Medical University from March 2021 to March 2023 were selected and divided into non severe CAP group(n=94)and severe CAP group(n=53)according to the severity of the disease.The general and clinical data of two groups of patients were recorded,and calculated neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),C-reactive protein(CRP)to albumin ratio(CAR),FDP/ALB,NLPR,and oxygenation index,the differences between two groups of the above indicators were compared and correlation analysis were conducted;The predictive value of FDP/ALB,NLPR,and other traditional inflammatory indicators on the severity of elderly CAP were compared.Results CRP,procalcitonin(PCT),white blood cells(WBC),neutrophil(NEU),fibrin degradation product(FDP),NLR,CAR,CURB-65 scores,FDP/ALB,and NLPR in severe CAP group were significantly higher than those in non severe CAP group,while lymphocyte(LYM),platelet(PLT)and albumin(ALB)were significantly lower than those in non severe CAP group(P＜0.05);There were no statistically significant differences in age,gender,smoking history,underlying diseases,and PLR between two groups(P＞0.05).Spearman correlation analysis showed a positive correlation between FDP/ALB,NLPR and CRP,PCT,WBC,NLR,CAR CURB-65 scores,while a negative correlation with oxygenation index(P＜0.05).Multivariate Logistic regression analysis showed that FDP/ALB and NLPR were independent risk factors for severe CAP in the elderly(P＜0.05).The analysis of receiver operating characteristic curve showed that the ability of FDP/ALB,NLPR,NLR,CAR,PCT,NEU,CURB-65 score,CRP,and WBC to predict the severity of elderly CAP gradually decreased(P＜0.05).Conclusion The predictive value of FDP/ALB and NLPR for the severity of elderly CAP is significantly better than traditional inflammatory indicators(CRP,PCT,WBC,NEU,NLR,CAR,CURB-65 scores),which should be taken seriously by clinical workers.

Objective To explore the effects of the 4C continuing care model on the living ability and neurological function in patients with cerebral apoplexy during the rehabilitation period.Methods Totally 112 patients with cerebral apoplexy admitted in No.3 Ward of Qiongyuan People's Hospital from July 2014 to July 2016 and divided into the observation group (n=56) and the control group (n=56). Patients in the control group received conventional nursing care, while patients in the observation group received 4C continuing care. The patients' living ability, limb movement function and neurological function 1, 6 and 12 month before and after intervention were recorded and compared between the two groups.Results There was no statistical difference in the scores of living ability and neurological function between the two groups before intervention (P>0.05), However, there was statistical difference in the scores of living ability and neurological function between the two groups 1, 6 and 12 month after intervention (P<0.05). There was no statistical difference in the scores of limb movement function between the two groups before intervention (P>0.05). However, there was statistical difference in the scores of limb movement function between the two groups 6 month and 12 month after intervention (P<0.05).Conclusions The 4C continuing care model can effectively enhance the living ability and neurological function recovery in patients with cerebral apoplexy during the rehabilitation period.

Objective To investigate the effect of ulinastatin in adjuvant treatment of ventilator-associated pneumonia(VAP)and preliminary clinical efficacy of the therapy mechanism.Methods 76 patients with ventilator-associated pneumonia from January 2015 to February 2016 in Qingyuan People's Hospital of Zhejiang Province were selected and randomly divided into control group and observation group,38 cases in each group.Two groups were given mechanical ventilation,phlegm,anti infection,rehydration,nutritional support and other conventional treatment,the observation group on the basis of routine treatment for ulinastatin adjuvant therapy,comparison of two groups of treatment,the simultaneous determination of serum interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)and tumor necrosis factor alpha(TNF-alpha)levels were measured before and after treatment.Results The total efficiency of the observation group was 94.74％,significantly higher than the control group 78.95％,the difference was statistically significant(P<0.05),the two groups after treatment of serum CRP and PCT levels were decreased significantly compared with before treatment,the observation group after treatment,serum CRP and PCT levels were(45.19+5.79)mg/L and(1.08+0.36)μg/L was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05),the two groups after treatment of serum IL-6 and TNF-α levels were decreased significantly compared with before treatment,the observation group after treatment,serum IL-6 and TNF-α levels were(165.29+19.23)pm/mL and(1.16+0.25)pm/mL,was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05).Conclusion The inflammatory reaction in patients with ventilator-associated pneumonia ulinastatin can effectively reduce auxiliary patients,reduce inflammatory factors on lung injury,can alleviate the disease progression and to improve its prognosis.