OBJECTIVE: To compare the efficacy and safety of intravenous colistin sulfate combined with nebulized inhalation versus intravenous monotherapy for pulmonary infections caused by carbapenem-resistant organism (CRO). METHODS: A multicenter retrospective cohort study was conducted. Clinical data were collected from patients admitted to the intensive care unit (ICU) of 10 tertiary class-A hospitals in Henan Province between July 2021 and May 2023, who received colistin sulfate for CRO pulmonary infections. Data included baseline characteristics, inflammatory markers [white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), C-reactive protein (CRP)], renal function indicators [serum creatinine (SCr), blood urea nitrogen (BUN)], life support measures, anti-infection regimens, clinical efficacy, microbiological clearance rate, and prognostic outcomes. Patients were divided into two groups: intravenous group (colistin sulfate monotherapy via intravenous infusion) and combination group ((intravenous infusion combined with nebulized inhalation of colistin sulfate). Changes in parameters before and after treatment were analyzed. RESULTS: A total of 137 patients with CRO pulmonary infections were enrolled, including 89 in the intravenous group and 48 in the combination group. Baseline characteristics, life support measures, daily colistin dose, and combination regimens (most commonly colistin sulfate plus carbapenems in both groups) showed no significant differences between two groups. The combination group exhibited higher clinical efficacy [77.1% (37/48) vs. 59.6% (52/89)] and microbiological clearance rate [60.4% (29/48) vs. 39.3% (35/89)], both P < 0.05. Pre-treatment inflammatory and renal parameters showed no significant differences between two groups. Post-treatment, the combination group showed significantly lower WBC and CRP [WBC (×10⁹/L): 8.2±0.5 vs. 10.9±0.6, CRP (mg/L): 14.0 (5.7, 26.6) vs. 52.1 (24.4, 109.6), both P < 0.05], whereas NEU, PCT, SCr, and BUN levels showed no significant between two groups. ICU length of stay was shorter in the combination group [days: 16 (10, 25) vs. 21 (14, 29), P < 0.05], although mechanical ventilation duration and total hospitalization showed no significant differences between two groups. CONCLUSIONS Intravenous colistin sulfate combined with nebulized inhalation improved clinical efficacy and microbiological clearance in CRO pulmonary infections with an acceptable safety profile.
Humans ; Colistin/therapeutic use* ; Retrospective Studies ; Administration, Inhalation ; Anti-Bacterial Agents/therapeutic use* ; Carbapenems/pharmacology* ; Male ; Female ; Middle Aged ; Gram-Negative Bacteria/drug effects* ; Aged ; Treatment Outcome ; Respiratory Tract Infections/drug therapy*

Objective·To analyze the development trend and current situation of high-level clinical research at Shanghai Jiao Tong University School of Medicine(SJTUSM)from 2015 to 2023,and to summarize the strategies for improving clinical research capability of SJTUSM,aiming to provide reference and inspiration for medical universities to promote high-level clinical research.Methods·Papers published by first authors from SJTUSM or its affiliated hospitals during this period were retrieved in the Web of Science core collection database.General descriptive methods were used to quantify the number of clinical research papers,registered clinical trials,clinical research talent teams,and the current status of clinical research cooperation.Bibliometric methods were used to visualize the international collaboration and topic distribution of retrieved clinical research papers.The differences in the number of clinical research publications,Q1 publications,publications in top clinical medical journals,and full-time researchers between the periods of 2015?2018 and 2019?2023 were compared and analyzed.Results·From 2015 to 2023,a total of 9 468 clinical research papers were published by SJTUSM or its affiliated hospitals as the first author's institution,showing an increasing trend year by year.During this period,the number of Q1 publications of SJTUSM's clinical research,publications in top clinical medical journals,clinical studies registered on the United States Clinical Trial Registry website,clinical studies registered on the Chinese Clinical Trial Registry website,clinical guidelines and expert consensus publications,full-time research team members,and newly added national-level talents all showed an overall upward trend.Tumors,cardiovascular and cerebrovascular diseases,major chronic diseases,and mental illnesses were the main research hotspots.A total of 1 308 papers(13.82%)were international collaborative papers.Developed countries/regions such as the United States(733 papers),Australia(137 papers),and the United Kingdom(99 papers)were closely cooperating with SJTUSM.From 2019 to 2023,there was a significant increase in the number of clinical research papers,Q1 publications,publications in top clinical medical journals,and newly added full-time research team members in affiliated hospitals compared to the period from 2015 to 2018(all P<0.05).Conclusion·SJTUSM has strengthened top-level design,conducted in-depth major diseases,and constructed a systematic,integrated and closed-loop model for enhancing clinical research level along the"platform-talent-methodology"pathway,resulting in a number of high-quality clinical research outcomes.

Nowadays,the one hospital with multiple districts has become a common model for the development of large public hospitals at present.Through the analysis of the common problems in the development of one hospital with multiple districts,the homogeneous management of one hospital with multiple districts has practical problems,it reflected in difficulties in space management,difficulties,difficulties in staff management,difficulties in system management,difficulties in collaborative development of medical service,difficulties in assessment,difficulties in cost management,difficulties in culture integrations.The case of the scientific management of one hospital with multiple districts in a tertiary public hospitals of provincial state-owned is analyzed,the experience are summarized in terms of organizational structure level,development orientation level,personnel level,performance pay level,cost control level,basic facilities level,culture level,to expected to provide references for promoting the construction of one hospital with multiple districts in public hospitals.

Nowadays,the one hospital with multiple districts has become a common model for the development of large public hospitals at present.Through the analysis of the common problems in the development of one hospital with multiple districts,the homogeneous management of one hospital with multiple districts has practical problems,it reflected in difficulties in space management,difficulties,difficulties in staff management,difficulties in system management,difficulties in collaborative development of medical service,difficulties in assessment,difficulties in cost management,difficulties in culture integrations.The case of the scientific management of one hospital with multiple districts in a tertiary public hospitals of provincial state-owned is analyzed,the experience are summarized in terms of organizational structure level,development orientation level,personnel level,performance pay level,cost control level,basic facilities level,culture level,to expected to provide references for promoting the construction of one hospital with multiple districts in public hospitals.

Nowadays,the one hospital with multiple districts has become a common model for the development of large public hospitals at present.Through the analysis of the common problems in the development of one hospital with multiple districts,the homogeneous management of one hospital with multiple districts has practical problems,it reflected in difficulties in space management,difficulties,difficulties in staff management,difficulties in system management,difficulties in collaborative development of medical service,difficulties in assessment,difficulties in cost management,difficulties in culture integrations.The case of the scientific management of one hospital with multiple districts in a tertiary public hospitals of provincial state-owned is analyzed,the experience are summarized in terms of organizational structure level,development orientation level,personnel level,performance pay level,cost control level,basic facilities level,culture level,to expected to provide references for promoting the construction of one hospital with multiple districts in public hospitals.

Nowadays,the one hospital with multiple districts has become a common model for the development of large public hospitals at present.Through the analysis of the common problems in the development of one hospital with multiple districts,the homogeneous management of one hospital with multiple districts has practical problems,it reflected in difficulties in space management,difficulties,difficulties in staff management,difficulties in system management,difficulties in collaborative development of medical service,difficulties in assessment,difficulties in cost management,difficulties in culture integrations.The case of the scientific management of one hospital with multiple districts in a tertiary public hospitals of provincial state-owned is analyzed,the experience are summarized in terms of organizational structure level,development orientation level,personnel level,performance pay level,cost control level,basic facilities level,culture level,to expected to provide references for promoting the construction of one hospital with multiple districts in public hospitals.

Nowadays,the one hospital with multiple districts has become a common model for the development of large public hospitals at present.Through the analysis of the common problems in the development of one hospital with multiple districts,the homogeneous management of one hospital with multiple districts has practical problems,it reflected in difficulties in space management,difficulties,difficulties in staff management,difficulties in system management,difficulties in collaborative development of medical service,difficulties in assessment,difficulties in cost management,difficulties in culture integrations.The case of the scientific management of one hospital with multiple districts in a tertiary public hospitals of provincial state-owned is analyzed,the experience are summarized in terms of organizational structure level,development orientation level,personnel level,performance pay level,cost control level,basic facilities level,culture level,to expected to provide references for promoting the construction of one hospital with multiple districts in public hospitals.

Nowadays,the one hospital with multiple districts has become a common model for the development of large public hospitals at present.Through the analysis of the common problems in the development of one hospital with multiple districts,the homogeneous management of one hospital with multiple districts has practical problems,it reflected in difficulties in space management,difficulties,difficulties in staff management,difficulties in system management,difficulties in collaborative development of medical service,difficulties in assessment,difficulties in cost management,difficulties in culture integrations.The case of the scientific management of one hospital with multiple districts in a tertiary public hospitals of provincial state-owned is analyzed,the experience are summarized in terms of organizational structure level,development orientation level,personnel level,performance pay level,cost control level,basic facilities level,culture level,to expected to provide references for promoting the construction of one hospital with multiple districts in public hospitals.

Nowadays,the one hospital with multiple districts has become a common model for the development of large public hospitals at present.Through the analysis of the common problems in the development of one hospital with multiple districts,the homogeneous management of one hospital with multiple districts has practical problems,it reflected in difficulties in space management,difficulties,difficulties in staff management,difficulties in system management,difficulties in collaborative development of medical service,difficulties in assessment,difficulties in cost management,difficulties in culture integrations.The case of the scientific management of one hospital with multiple districts in a tertiary public hospitals of provincial state-owned is analyzed,the experience are summarized in terms of organizational structure level,development orientation level,personnel level,performance pay level,cost control level,basic facilities level,culture level,to expected to provide references for promoting the construction of one hospital with multiple districts in public hospitals.