OBJECTIVE: To evaluate the prognosis of septic right ventricular dysfunction (SRVD) based on bedside ultrasound and explore its risk factors. METHODS: A prospective observational study was conducted involving septic and septic shock patients admitted to the intensive care unit (ICU) of the General Hospital of Ningxia Medical University from February 2021 to January 2022. Tricuspid annular plane systolic excursion (TAPSE) was measured by M-mode ultrasound within 24 hours after ICU admission. According to the results of TAPSE, the subjects were divided into SRVD group (TAPSE < 16 mm) and non-SRVD group (TAPSE ≥ 16 mm). The gender, age, occurrence of septic shock, underlying diseases, source of patients, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, maximal body temperature within 24 hours after ICU admission, location and number of infections, duration of mechanical ventilation, and 28-day mortality were collected. Hemodynamic parameters, organ function indexes, oxygen therapy parameters and arterial blood gas analysis indexes were recorded within 24 hours after ICU admission. The differences of the above indexes between the two groups were compared. Binary multivariate Logistic regression analysis was used to screen out the independent risk factors for SRVD, and a nomogram of SRVD risk factors was drawn. RESULTS: 116 patients with sepsis and septic shock were enrolled, of which 24 (20.7%) had SRVD and 92 (79.3%) had no SRVD. Compared with the non-SRVD group, the patients in the SRVD group had higher emergency transfer and infection site ≥ 2 ratio, APACHE II score, SOFA score, higher cardiac troponin I (cTnI), myoglobin (Mb), MB isoenzyme of creatine kinase (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), serum creatinine (SCr), arterial blood lactic acid (Lac) and lower left ventricular ejection fraction (LVEF), platelet count (PLT) within 24 hours after ICU admission, and higher proportion of norepinephrine application and continuous renal replacement therapy (CRRT). Binary multivariate Logistic regression analysis showed that LVEF [odds ratio (OR) = 0.918, 95% confidence interval (95%CI) was 0.851-0.991, P = 0.028], PLT (OR = 0.990, 95%CI was 0.981-0.999, P = 0.035), SCr (OR = 1.008, 95%CI was 1.001-1.016, P = 0.025), and the usage of norepinephrine (OR = 15.198, 95%CI was 1.541-149.907, P = 0.020) were independent risk factors for SRVD in patients with sepsis and septic shock. Based on the above four independent risk factors, a nomogram of SRVD risk factors was drawn. The results showed that the score was 64 when LVEF was 0.50, 18 when SCr was 100 μmol/L, 85 when PLT was 100×10⁹/L, and 39 when norepinephrine was used. When the total score reached 253, the risk of SRVD was 88%. Compared with non-SRVD group, the duration of mechanical ventilation in SRVD group was slightly longer [hours: 80.0 (28.5, 170.0) vs. 47.0 (10.0, 135.0), P > 0.05], and the 28-day mortality was significantly higher [41.7% (10/24) vs. 21.7% (20/92), P < 0.05]. CONCLUSIONS Patients with sepsis may have right ventricular dysfunction, impaired renal function and increased mortality in the early stage. The decrease in LVEF and PLT, the increase in SCr and the application of norepinephrine are independent risk factors for SRVD in patients with sepsis.
Humans ; Prognosis ; Ventricular Dysfunction, Right/diagnostic imaging* ; Risk Factors ; Prospective Studies ; Intensive Care Units ; Shock, Septic ; Male ; Ultrasonography ; Female ; Sepsis/complications* ; Middle Aged ; Point-of-Care Systems ; Aged ; Logistic Models ; APACHE

BACKGROUND:The surface of dental impression is inevitable to carry various bacteria caused by direct contact with the patient saliva, mucosa and blood during preparation;therefore, disinfection of the dental impression is necessary. OBJECTIVE:To evaluate the disinfection efficiency of glutaraldehyde, chlorine dioxide and electrolyzed oxiding water on dental impressions and to investigate the dimensional stability of impressions after disinfection, thus providing basis for establishing a standard and reasonable disinfection method. METHODS:Alginate impression materials were contaminated in vitro, and then immersed in glutaraldehyde, chlorine dioxide and electrolyzed-oxiding water for 5, 10 and 15 minutes, respectively. The colonies were counted after germiculture to compare the disinfection efficiency of three disinfectants. The impressions were poured in die stone after immersion, the dental models were structured-light scanned and three-dimensional digital dental models were reconstructed. Al the data were global y registered, and linear dimensions were measured on the digital models to deduce the influence of disinfection on surface accuracy and dimensional stability of the impressions. RESULTS AND CONCLUSION:The disinfecting rate reached 100%through immersion in 2%alkaline glutaraldehyde for 5 minutes, and the disinfection of kil ing the hepatitis B virus was effective after 10-minute immersion. The disinfecting rate of 600 ppm chlorine dioxide for 15 minutes kil ing experimental bacteria reached 99%and effective for kil ing the hepatitis B virus. While the disinfecting rate of kil ing experimental bacteria was less than 99%through immersion in electrolyzed oxiding water for 15 minutes, and was not effective for hepatitis B virus. The three-dimensional digital dental models did not differ significantly. These results suggest that immersion in 2%alkaline glutaraldehyde for 10 minutes or 600 ppm chlorine dioxide for 15 minutes can effectively disinfect alginate impressions and make no significant effect on the dimensional stability.

Objective To design the ISO15189 management information middleware based on laboratory information management system (LIS) and evaluate its application.Methods The ISO15189 management information middleware was designed based on LIS and the middleware technology as underlaying platform,and the multifunction management of LIS was implemented by the data warehouse technology and the data cleaning and extraction technology.Results The designed middleware made LIS implement the functions such as data exchange and transmission,data sharing,and data intelligence processing ISO15189 management information across multiple systems.It constructed a data warehouse by extracting,transforming,and loading useful data from multiple profession systems in laboratories,and flexibly presented data to the users by operating multidimensional data set from various aspects.Conclusion The ISO15189 management information middleware based on LIS has high value in the management of ISO15189 accredit,which may make the management work more standard,efficiency,and intelligence.

Objective To observe the clinical effect of monosialotetrahexosyl ganglioside sodium injection (GM1) on spastic cerebral palsy. Methods 98 children with spastic cerebral palsy were randomly divided into control group (n=50) and treatment group (n=48). Both groups received Bobath approach, and the treatment group received GM1 in addition. They were assessed with Functional Independence Measure for Children (WeeFIM), Gross Motor Function Measure (GMFM) and Gesell Development Schedule (GDS) before and after 90 days of treatment. Results The scores of WeeFIM, all the dimensions of GMFM and the gross motor, fine motor, personal-social and adaption of the GDS improved in both groups after treatment (P<0.05), and improved more in the treatment group than in the control group (P< 0.05). Conclusion GM1 may further improve the recovery of function for children with spastic cerebral palsy.