Objective To evaluate feasibility and reliability of using Simplified Acute Physiology Score Ⅱ (SAPS Ⅱ)in predicting mortality in critically ill patients with neurological diseases.Methods All 653 patients hospitalized in neurological intensive care unit (N-ICU) from Jan 2005 to Dec 2007 were retrospectively studied.SAPSⅡ scores were scaled upon admission at 24,48 and 72 h,and possibility of hospital mortality (PHM) was calculated based on SAPS Ⅱ score.Neurological diseases diagnosis made initially at time of hospitalization was classified into five categories:intracranial hemorrhage,cerebral infarction,neurologic infection,neuromuscular diseases and other neurologic diseases.At each of four time points,the SAPSⅡscores were compared between the survival group and death group,and the relationship of SAPS Ⅱ score and prognosis were analyzed.The calibration of the SAPS Ⅱ were accessed with the Hosmer-Lemeshow goodness-of-fit chi-squared statistic and the discrimination with area under the receiver operating characteristic curve (AUROC).Multivariate logistic regression was used to analyze the relationship between disease category and prognosis.Results SAPS Ⅱ scores in the death group (46.53±12.22,47.28±13.84,48.58±14.18 and 49.06±14.61)at each time point were significantly higher than those in the survival group (34.70±11.78,30.28±12.24,29.79±12.36 and 29.69±12.96;t=11.12,14.02,14.43 and 13.49 at 0,24,48 and 72 h,respectively,P＜0.01).Furthermore,univariate logistic regression analyses demonstrated that SAPS Ⅱ score was correlated with prognosis (OR=1.080,1.100,1.109,1.100 at 0,24,48 and 72 h,respectively,P＜0.01).The scores at 48 and 72 h were more accurate in predicting mortality.SAPS Ⅱ had good calibration at each time points (x2=5.305,7.557,6.369 and 8.540,P＞0.05),however,the consistency of expected mortality with observed mortality was satisfactory only at 48 and 72 h(82.6%,83.4%),so was the discrimination ( AUROC=0.825,0.847 respectively).There was no correlation between disease categories and outcome.Conclusion SAPS Ⅱ scoring,best evaluated at 48 and 72 h after hospitalization,can be used as a reliable predictor of probability of mortality in patients hospitalized in N-ICU and prediction can be applied in these patients with all different neurology diseases.

Objective: A method for determination of glycyrrhizine and paeoniflorin in Fubao Danggui Jiao by RP HPLC was established.Methods: Shim pack CLC ODS column was used with TBAH solution (10→300) methanol (36∶64) (pH=6.0) as a mobile phase for glycyrrhizine and acetonitrile water (containing 0.1% phosphoric acid) (15∶85) as a mobile phase for paeoniflorin. The detection wavelength was at 254nm and 230nm, respectively. The flow rate was 1mL?min -1 .Results: A good linearity was found at the concentration range of 100 1000ng for glycyrrhizine and paeoniflorin. The average recovery was 98.37%,97.44% and the relative standard deviation was 0.32%,0.48%, respectively.Conclusion: This method was simple,accurate,rapid,sensitive and reproducible. The RP HPLC could be used for quality control of Fubao Danggui Jiao preparations.

Objective:To explore the distribution of pathogenic bacteria and risk factors of hospital-acquired late-onset sepsis(LOS) in premature infants.Methods:The clinical data of 82 premature infants with hospital-acquired LOS(observation group) admitted to the Dali Maternal and Child Health Hospital from April 2017 to April 2020 were retrospectively analyzed, and 118 premature infants without sepsis during the same period were selected as the control group.The distribution of pathogenic bacteria in premature infants with hospital-acquired LOS was analyzed, and the risk factors of hospital-acquired LOS in premature infants were analyzed by Logistic regression.Results:A total of 89 strains of pathogenic bacteria were detected among 82 children in the observation group, including 42 strains of gram-positive bacteria(47.19%), 39 strains of gram-negative bacteria(43.82%), and 8 strains of fungi(8.99%). Multivariate Logistic regression analysis showed that gestational age less than 32 weeks, birth weight less than 1 500 g, small for gestation age infants, tracheal intubation, central venous catheterization, parenteral nutrition time more than 7 days, use of broad-spectrum antibiotics and antibiotic use time more than 7 days were independent risk factors for hospital-acquired LOS in premature infants( P<0.05). Conclusion:Coagulase-negative staphylococcus is the most common pathogen of hospital-acquired LOS in premature infants, followed by Klebsiella pneumoniae.Low gestational age and low birth weight, mechanical ventilation, central venous catheterization, parenteral nutrition time and prolonged use of antibiotics can increase the risks of hospital-acquired LOS for premature infants.