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 explore the expression levels of serum glycerophospholipid metabolites lysophosphatidylcholine(LPC)18∶3 and lysophosphatidylethanolamine(LPE)16∶1 in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their correlation with clinical prognosis.Methods A total of 112 AECOPD patients diagnosed and treated in Tangshan People's Hospital from January 2019 to January 2022 were selected as the AECOPD group.According to the 3-month follow-up prognosis of the AECOPD group patients,they were divided into survival group(n=90)and death group(n=22).During the same period,60 stable COPD patients were selected as the stable period group,while 60 healthy individuals in the same period were selected as the control group.High performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS)was used to detect serum LPC18∶3 and LPE16∶1 levels in each group.Pearson method was used to analyze their correlation.Logistic regression analysis was used to analyze factors affecting the prognosis of AECOPD patients.Receiver operating characteristic curve was drawn to evaluate the prognostic value of LPC18∶3 and LPE16∶1 in AECOPD patients.The prognosis of AECOPD patients with different serum LPC18∶3 and LPE16∶1 expression groups was compared by K-M curve.Results Serum LPC18∶3(21.67±4.35 μ mol/L),LPE16∶1(16.20±5.17 μ mol/L),PEF％pred,FEV1％pred,and FEV1/FVC％in AECOPD group were lower than those of stable phase group(43.24±6.17 μ mol/L,32.19±5.98 μmol/L)and the control group(68.14±8.78 μ mol/L,44.82±7.44 μ mol/L),with significant differences(F=461.240～1 102.534,all P＜0.05).The serum LPC18:3 and LPE16:1 levels in the AECOPD group were positively correlated with lung function indicators such as PEF％pred,FEV1％pred,and FEV1/FVC％(r=0.603～0.756,allP＜0.05).The course of COPD and PCT of AECOPD patients in the death group were higher than those in the survival group(t=3.961,2.509),while the PEF％pred,FEV1％pred,FEV1/FVC％,serum LPC18∶3(17.20±4.11μ mol/L),and LPE16∶1(10.15±3.03 μ mol/L)in the death group were lower than those in the survival group(22.76±4.35 μ mol/L,17.68±5.22 μ mol/L),with significant differences(t=4.141～6.490,all P＜0.05).Serum LPC18∶3(OR=0.691,95％CI:0.519～0.920)and LPE16∶1(OR=0.586,95％CI:0.382～0.901)were independent protective factors,while the course of COPD(OR=1.510,95％CI:1.203～1.895)and procalcitonin(OR=1.759,95％CI:1.159～2.671)were risk factors affecting the prognosis of AECOPD patients.The area under the curve(95％CI)of combined serum LPC18∶3 and LPE16∶1 for prognosis evaluation of AECOPD patients was better than that of serum LPC18∶3 and LPE16∶1 predicted separately[0.866(0.822～0.907)vs 0.794(0.748～0.830),0.786(0.739～0.836)](Z=3.957,4.195,P=0.002,＜0.001).The mortality risk of AECOPD patients in the low expression group of LPC18∶3 and LPE16∶1 was higher than that in the high expression group of LPC18∶3 and LPE16∶1(log rankx2=4.475,5.763,P=0.034,0.016).Conclusion The serum levels of glycerophospholipid metabolites LPC18∶3 and LPE16∶1 in AECOPD patients were decreased,which were related to lung function status.The combination of the two may effectively evaluate the prognosis of AECOPD patients.

Objective To investigate the changes in the levels of serum visinin-like protein-1(VILIP-1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in patients with acute cerebral hem-orrhage(ACH)and their correlation with the degree of neurological deficits and prognosis.Methods Totally 115 cases of ACH patients admitted to this hospital from January 2021 to January 2023 were selected as the ACH group,and another 115 healthy volunteers with physical examination in the same period were selected as the control group.The ACH patients were divided into mild deficit group(39 cases),moderate deficit group(46 cases)and severe deficit group(30 cases)according to the degree of neurological deficit assessed by the national institutes of health stroke scale(NIHSS).Patients with ACH were divided into a poor prognosis group(27 cases)and a good prognosis group(88 cases)after 90 d of follow-up according to the prognosis as-sessed by the modified Rankin scale.Serum VILIP-1 and sTREM-1 levels were measured by enzyme-linked immunosorbent assay.Spearman correlation was used to analyze the correlation between NIHSS scores and se-rum VILIP-1 and sTREM-1 levels in ACH patients,a multifactorial Logistic regression model was set up to analyze the factors affecting the prognosis of ACH patients,and the predictive value of serum VILIP-1 and sTREM-1 levels in poor prognosis in ACH patients was analyzed by plotting the receiver operating character-istic(ROC)curve.Results Compared with the control group,serum VILIP-1 and sTREM-1 levels were ele-vated in the ACH group(P＜0.05).Serum VILIP-1 and sTREM-1 levels increased sequentially in the mild-deficiency,moderate-deficiency,and severe-deficiency groups(P＜0.05).Spearman correlation analysis showed a positive correlation between NIHSS scores and serum VILIP-1 and sTREM-1 levels in ACH patients(r=0.792 and 0.781,both P＜0.001).After 90 d of follow-up,the incidence of poor prognosis in 115 ACH patients was 23.48％(27/115).Multifactorial Logistic regression analysis showed that increased hematoma volume and elevated NIHSS score,VILIP-1,and sTREM-1 were independent risk factors affecting the progno-sis of patients with ACH(P＜0.05).ROC curve analysis showed that the area under the curve of serum VIL-IP-1 and sTREM-1 levels combined to predict poor prognosis in ACH patients was 0.872,which was greater than that of serum VILIP-1 and sTREM-1 levels alone,which were 0.784 and 0.772(P＜0.05).Conclusion Ele-vated serum VILIP-1 and sTREM-1 levels in ACH patients are closely associated with increased degree of neurological deficit and poor prognosis,and the combined detection of serum VILIP-1 and sTREM-1 has high predictive value for poor prognosis in ACH patients.