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Objective To investigate the relationship between serum level of pyruvate kinase M2 (PKM2), galectin-3(Gal-3) and citrolinated histone H3 (CitH3) and pulmonary infection in patients with mechanical ventilation (MV). Methods A total of 120 patients with MV admitted to Jinhua Central Hospital from October 2022 to March 2024 were included in the study. They were divided into pulmonary infection group (n=50) and non-pulmonary infection group (n=70). Serum level of PKM2, Gal-3 and CitH3 was detected by ELISA. The patients were divided into good prognosis group (n=79) and bad prognosis group (n=41). Multivariate Logistic regression analysis was performed to analyze the factors affecting the adverse prognosis of MV patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum PKM2, Gal-3 and CitH3 for poor prognosis in patients undergoing MV. Results Compared with non-pulmonary infection group, serum level of PKM2, Gal-3 and CitH3 in pulmonary infection group was increased (P＜0.05). The level of serum PKM2, Gal-3 and CitH3 in the poor prognosis group was increased (P＜0.05). The Clinical Pulmonary Infection score (CPIS) of the poor prognosis group was higher than that of the good prognosis group (P＜0.05). PKM2, Gal-3 and CitH3 were all risk factors for poor prognosis in MV patients (P＜0.05). The area under the curve (AUC) of PKM2, Gal-3, CitH3 and combined prediction of poor prognosis were 0.712, 0.839, 0.779 and 0.925, respectively. AUC of combined diagnosis of PKM2, GAL-3, CITH3 and combined diagnosis was better than that of single detection (Z=4.261, 2.521, 3.676, P＜0.001, 0.05, 0.001). Conclusions The serum level of PKM2, Gal-3, and CitH3 in MV patients with concurrent pulmonary infections is found to be higher than those in those without pulmonary infections, so these three factors have potential predictive value for poor prognosis of MV patients. [ABSTRACT FROM AUTHOR]

Objective To investigate serum β2-MG, sCHE, and PSGL-1 expression in patients with esophageal cancer and their relationship to lung infection after mediastinoscopy. Methods A total of 118 patients with esophageal cancer were selected and divided into infected and uninfected groups according to whether they developed lung infection after surgery. An automatic microbiological identification system was used to detect the pathogenic bacteria of lung infection. ELISA was used to detect the levels of β2-MG, sCHE, and PSGL-1. Multivariate logistic regression was used to analyze the influencing factors of postoperative lung infection in patients with esophageal cancer. ROC curves were plotted to analyze the assessment value of serum β2-MG, sCHE, and PSGL-1 on postoperative lung infection. Results Fifty-two strains of bacteria were isolated from the sputum of 38 patients with postoperative lung infections, and these included 35 (67.31%) Gram-negative, 14 (26.92%) Gram-positive, and 3 (5.77%) fungal strains. The difference in long-term smoking history between the infected and uninfected groups was statistically significant (P<0.05). Serum β2-MG and PSGL-1 levels were significantly higher and sCHE levels were significantly lower in the infected group than in the uninfected group (P<0.05). Serum β2-MG and PSGL-1 levels were sequentially higher (P<0.05) and sCHE levels were sequentially lower (P<0.05) in the mild, moderate, and severe lung infection groups. Long-term smoking history, β2-MG, and PSGL-1 were risk factors affecting postoperative lung infection in patients with esophageal cancer (P<0.05), and sCHE was a protective factor (P<0.05). The AUCs of serum β2-MG, sCHE, and PSGL-1 for assessing postoperative lung infections were 0.807, 0.845, and 0.800, respectively, and the AUC of the three combined factors for assessing postoperative lung infections was 0.954, which was superior to that assessed individually (Zcombination vs. β2-MG=2.576, Zcombination vs. sCHE=2.623, Zcombination vs. PSGL-1=2.574, all P<0.05). Conclusion The serum levels of β2-MG and PSGL-1 increase and the sCHE level decreases in patients with esophageal cancer and postoperative pulmonary infection, which are also related with lung infection. Combined testing can improve the evaluation value of postoperative pulmonary infection in patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Establishing a nomogram prediction model for postoperative pulmonary infection in hip fractures and taking early intervention measures is crucial for improving patients’ quality of life and reducing medical costs. OBJECTIVE: To construct a nomogram risk prediction model of postoperative pulmonary infection in elderly patients with hip fracture, and provide theoretical basis for feasible prevention and early intervention. METHODS: Case data of 305 elderly patients with hip fractures who underwent surgical treatment at Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine between January and October 2020 (training set) were retrospectively analyzed. Using univariate and multivariate logistic regression analysis and Hosmer-Lemeshow goodness of fit test, receiver operating characteristic curve was utilized to analyze the diagnostic predictive efficacy of independent risk factors and joint models for postoperative pulmonary infections. Tools glmnet, pROC, and rms in R Studio software were applied to construct a nomogram model for predicting the risk of postoperative pulmonary infection in elderly patients with hip fractures, and calibration curves were further drawn to verify the predictive ability of the nomogram model. Receiver operating characteristic curves, calibration curves, and decision curves were analyzed for 133 elderly patients with hip fractures (validation set) receiving surgery at the same hospital from November 2022 to March 2023 to further predict the predictive ability of the nomogram model. RESULTS AND CONCLUSION: (1) The postoperative pulmonary infection rate in elderly patients with hip fractures in this group was 9.18% (28/305). (2) Single factor and multivariate analysis, as well as forest plots, showed that preoperative hospitalization days, leukocyte count, hypersensitive C-reactive protein, and serum sodium levels were independent risk factors (P < 0.05). The Hosmer-Leme show goodness of fit test showed good fit (χ² =4.57, P=0.803). Receiver operating characteristic curve analysis was conducted on the independent risk factors and their joint models mentioned above, and the differentiation of each independent risk factor and joint model was good, with statistical significance (P < 0.05). (3) The graphical calibration method, C-index, and decision curve were used to validate the nomogram prediction model. The predicted calibration curve was located between the standard curve and the acceptable line, and the predicted risk of the nomogram model was consistent with the actual risk. (4) The validation set used receiver operating characteristic curve, graphic calibration method, and decision curve to validate the prediction model. The results showed good consistency with clinical practice, indicating that the model had a good fit. The nomogram risk prediction model constructed for postoperative pulmonary infection in elderly patients with hip fractures has good predictive performance. The use of the nomogram risk prediction model can screen high-risk populations and provide a theoretical basis for early intervention. [ABSTRACT FROM AUTHOR]

Objective To analyze the risk factors of pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction heart failure, and establish a risk predicting model of pulmonary infection in those patients by decision tree CART algorithm. Methods 320 elderly patients with heart failure with reduced left ventricular ejection fraction admitted from January 2020 to December 2022 were retrospectively selected as study objects, and were divided into an infection group and a non-infection group according to whether the patients were complicated with pulmonary infection. Logistic regression model and decision tree CART model were used to construct a prediction model of heart failure with reduced left ventricular ejection fraction complicated with pulmonary infection, and 5-fold cross-validation method was used for internal verification. The prediction efficiency of the models was compared. Results In the 320 patients, the incidence of pulmonary infection was 30.94%. The data on age, smoking history, diabetes mellitus, cardiac function grades, COPD, invasive procedures, length of hospital stay were compared between the infection and non-infection groups (P < 0.05). logistic regression analysis showed that age of ≥ 75 years smoking history, complications with diabetes or/and COPD, cardiac function grade Ⅲ/Ⅳ, invasive procedures, and hospital stay of ≥14 days were independent risk factors for pulmonary infection in the patients (P < 0.05). Probability forecasting model P = 1[/ 1 + e (-3.368+0.763*X1+0.814*X2+0.652*X3+1.085*X4+0.865*X5+1.027*X6+0.652*X7)], with an overall accurate rate of prediction of 80.9%. The Omnibus test showed P < 0.001. The accuracy of prediction was 73.6% after the cross-validation of 5 fold. The decision tree model showed that invasive procedures were the most important influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction, with an information gain of 0.280. The ROC showed that the AUC value of logistic regression model was slightly higher than that of the decision tree (Z = 2.850, P = 0.004), and the prediction efficiency of both models was medium. Conclusions Age, smoking history, complications with diabetes mellitus or/and COPD, cardiac function grades, invasive procedures, and length of hospital stay are all influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction. The decision tree model constructed in this study has a better efficiency for risk prediction, and it can provide reference for early clinical screening and intervention of heart failure with reduced left ventricular ejection fraction. [ABSTRACT FROM AUTHOR]

Objective To construct a risk prediction model for pulmonary infection in stroke patients and verify its clinical predictive performance. Methods Using convenience sampling, 750 stroke patients hospitalized in a tertiary hospital in Guizhou Province from January 2021 to January 2023 were selected as study subjects. They were divided into a pulmonary infection group (n=267) and a non-pulmonary infection group (n=483) based on whether pulmonary infection occurred. Comparative analysis of relevant data between the two groups was conducted. Logistic regression analysis was applied to establish a risk prediction model. The goodness-of-fit of the model was tested using the Hosmer-Lemeshow (H-L) test, and the predictive performance of the model was evaluated by the area under the receiver operating characteristic curve (ROC curve). Another 145 eligible patients from February to August 2023 were selected to validate the predictive performance of the model. Results Univariate and multivariate analyses revealed that dysphagia [odds ratio (OR) =10.462], coexisting pulmonary diseases (OR=6.046), hypokalemia (OR=2.266), hyponatremia (OR=3.807), low hemoglobin (OR=4.036), National Institutes of Health Stroke Scale (NIHSS) score at admission (OR=38.135), Activities of Daily Living (ADL) score at admission (OR=12. 942), and length of hospital stay (OR=8.992) were independent risk factors for pulmonary infection in stroke patients (P＜0.05). The risk prediction model formula was: Logit (P) =-4.761+2. 348× (dysphagia score) +1.799× (coexisting pulmonary diseases score) +0.818× (hypokalemia score) +1. 337× (hyponatremia score) +1.395× (low hemoglobin score) +3. 641× (NIHSS score) +2.560× (ADL score) +2.196× (length of hospital stay score). The area under the ROC curve of the modeling group was 0.953 [95% confidence interval (95%CI) 0.940-0. 967, P＜0.001], with a Youden index of 0.762, a sensitivity of 0.880, a specificity of 0. 882, and a P value of 0. 553 in the H-L test. The validation results showed that the area under the ROC curve of the validation group was 0. 946 (95%CI: 0. 927-0. 987, P＜0.001), with a sensitivity of 0. 898, a specificity of 0. 875, an accuracy of 88. 3%, and a P value of 0. 510 in the H-L test. Conclusion The established risk prediction model for pulmonary infection in stroke patients has good predictive performance, providing a reference for clinical healthcare professionals to early identify high-risk groups for stroke induced pulmonary infection and facilitating the timely adoption of preventive management measures. [ABSTRACT FROM AUTHOR]

Objective To analyze the influencing factors of pulmonary infection in patients with primary liver cancer (PHC) before intervention, and establish a nomogram risk prediction model to verify it. Methods A total of 1 635 patients with PHC diagnosed and hospitalized for the first time were selected and divided into the infected group (197 cases) and the non-infected group (1 438 cases) according to whether they had pulmonary infection. General data such as body mass index (BMI), chronic hepatitis B (CHB), chronic hepatitis C (CHC), Barcelona stage (BCLC), white blood cells (WBC), neutrophils (NEU), hemoglobin (Hb) and other blood routine indicators were collected. Total protein (TP), prealbumin (PA), aspartate aminotransferase (AST), gamma glutamylaminotransferase (GGT), alkaline phospholipase (ALP), abnormal prothrombin (PIVKA- Ⅱ), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), cholinesterase (ChE), total cholesterol (TC) and other blood biochemical indicators, CD3 cell count (CD3+ ), CD4 cell count (CD4+ ), CD4/CD8 ratio (CD4+ /CD8+ ), CD19 cell count (CD19+ ), interleukin (IL)-2, interferon (IFN)-α, tumor necrosis factor (TNF) - α and other cytokines were also collected. Univariate analysis and Lasso regression were used to screen variables, and binary Logistic regression analysis was used to determine risk factors for pulmonary infection in PHC patients before intervention. The risk prediction model was established and evaluated. Results Compared with the noninfected group, age, smoking rate, CHC, pleural effusion, gastrointestinal hemorrhage, Child-Pugh grade C, BCLC Phase A /C /D ratio, WBC, NEU, AST, GGT, ALP, PIVKA-Ⅱ, AFP, CEA, PCT, hs-CRP, IL-2, IL-5, IL-6, IL-8, IL-10, IL-12, IFN-γ and TNF-α levels were higher in the infected group, and levels of BMI, CHB ratio, Hb, TP, PA, ChE, TC, CD3+, CD4+, CD4+ /CD8+, CD19+ and IFN-α were lower (P < 0.05). Lasso regression and binary Logistic regression analysis showed that pleural effusion, gastrointestinal hemorrhage, higher level of age, WBC, Hb and lower level of TP were independent risk factors for pulmonary infection in patients with PHC before intervention. The area under receiver operating curve (ROC) of the established nomogram model was 0.700（95%CI: 0.659-0.740), and Hosmer-Lemeshow test results showed good goodness-fit of the model. Self-sampling was repeated 1 000 times for internal verification. The consistency of the model was good. Conclusion Pleural effusion, gastrointestinal hemorrhage, higher level of age, WBC, Hb and lower level of TP are independent risk factors for pulmonary infection in PHC patients before intervention. The established nomogram prediction model can effectively evaluate the risk of pulmonary infection in PHC patients before intervention. [ABSTRACT FROM AUTHOR]

目的: 分析BLUE超声在基层医院肺部感染诊断中的应用效果。方法: 选取2024年02月-2024年11月本 院65例疑似肺部感染患者开展研究, 均进行多层螺旋CT (MSCT) 检查, 以此为金标准, 实施BLUE超声检查, 分析 BLUE超声诊断效果。结果: MSCT检出62例阳性, 3例阴性, BLUE超声分别为60例和5例, BLUE超声的诊断准确率 为92.31%, 特异度为66.67%, 敏感度为95.16%; 主要超声图像: 肺滑动征消失2例, 占比3.08%, 胸腔积液1例, 占比 1.54%, 肺不张1例, 占比1.54%, 支气管充气征4例, 占比6.15%, 肺泡间质综合征6例, 占比9.23%, B线25例, 占比 38.46%, 异常胸膜线18例, 占比27.69%。结论: 基层医院检查肺部感染时, 采用BLUE超声, 有较高诊断效能, 超声 图像清晰、明显, 值得推广。 [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical value of peripheral blood neutrophil extracellular traps (NETs) markers in patients with pulmonary infections after radical gastrectomy for gastric cancer. Methods A total of 403 gastric cancer patients who underwent radical gastrectomy at the 922nd Hospital of the Joint Service Support Force of the PLA from May 2015 to August 2022 were selected for the study. Patients were divided into three groups based on postoperative pulmonary infection status; non infection group (n=332), non pulmonary infection group (n=43), and pulmonary infection group (n=28). Preoperative and postoperative serum inflammatory markers, including white blood cells (WBC), neutrophil-to-lymphocyte ratio (NLR), high sensitivity C-reactive protein (hs-CRP), vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNF-α), interleukin (IL)1B, IL-6, IL-8, and NETs related markers cell - free DNA (cfDNA), myeloperoxidase DNA (MPODNA) complexes, and citrullinated histone H3 (CitH3), were compared among the three groups. The correlation between peripheral blood NETs markers and serum in flammatory markers was analyzed using Pearson correlation analysis. Receiver operating characteristic (ROC) curve analy- sis was employed to assess the diagnostic value of peripheral blood NETs markers for postoperative pulmonary infection in gastric cancer patients. Results Postoperatively, compared with the non infection group, the non pulmonary infection and pulmonary infection groups showed significant increases in serum inflammatory markers, including WBC, NLR, hs-CRP, VEGF, TNF-α, IL-13, IL-6, and IL-8 (all P < 0.05 ) The non pulmonary infection group exhibited significantly elevated peripheral blood cf - DNA levels, while the pulmonary infection group had significantly higher levels of cf-DNA, MPO-DNA complexes, and CitH3 (all P < 0.05 ) . Compared with the non pulmonary infection group, the pulmonary infection group showed significant increases in NLR, hs-CRP, TNF-α, IL-6, and IL-8 levels, and Ci-tH3 expression (all P < 0.05 ) . Pearson correlation analysis revealed a positive correlation between peripheral blood NETS markers (cf-DNA, MPO-DNA complexes, and CitH3) and serum TNF-α r = 0.275 0. 204, 0.238, P < 0 ). ROC curve analysis demonstrated that the areas under the curve (AUCs) for ef-DNA, MPO-DNA, and CitH3 in diag- nosing postoperative pulmonary infection in gastric cancer patients were 0. 809, 0.700, and 0. 751, respectively. Conclusion Peripheral blood NETs markers cf-DNA, MPO-DNA complexes, and CitH3 are positively correlated with postoperative pulmonary infections in gastric cancer and have significant diagnostic value for postoperative pulmonary infections. [ABSTRACT FROM AUTHOR]

目的　分析老年慢性心力衰竭合并肺部感染患者短期肺部感染再发的危险因素，并探讨相关影响因素及 联合预测因子对短期肺部感染再发的预测价值。方法　选择老年CHF合并肺部感染患者122例，患者康复出院后 每个月随访1次，记录随访6个月内患者肺部感染再发情况。收集患者临床资料，包括年龄、性别、吸烟史、饮酒史、 心功能分级、基础疾病等一般资料，出院时血清降钙素原（PCT）、白蛋白（ALB）、超敏C反应蛋白（CRP）、N末端B型 钠尿肽前体（NT-proBNP）等实验室指标及出院时老年营养风险指数（GNRI）评分。比较出现与未出现肺部感染再发 的老年CHF合并肺部感染患者临床资料，取P<0. 01的临床资料进一步纳入多因素Logistic回归分析。采用多因素 Logistic逐步回归分析老年CHF合并肺部感染患者短期肺部感染再发的影响因素，绘制受试者工作特征（ROC）曲线 分析相关影响因素及联合预测因子对短期肺部感染再发的预测效能。结果 122例老年 CHF 合并肺部感染患者 中，出现肺部感染再发38例，未出现肺部感染再发84例。出现与未出现肺部感染再发患者年龄、出院时CRP/ALB、 出院时血清 NT-proBNP、出院时 GNRI 比较 P 均<0. 01；多因素 Logistic 逐步回归分析结果显示，年龄大、出院时高 CRP/ALB、出院时高血清NT-proBNP、出院时低GNRI评分是老年CHF合并肺部感染患者短期肺部感染再发的独立 危险因素（P 均<0. 05）。ROC 曲线显示，年龄、出院时 CRP/ALB、出院时血清 NT-proBNP、出院时 GNRI单独预测老 年 CHF合并肺部感染患者短期肺部感染再发的曲线下面积（AUC）分别为 0. 680、0. 815、0. 652、0. 724；各指标联合 预测老年 CHF合并肺部感染患者短期肺部感染再发的 AUC为 0. 884。结论　年龄大、出院时高 CRP/ALB、出院时 高血清NT-proBNP、出院时低GNRI评分是老年CHF合并肺部感染患者短期肺部感染再发的独立危险因素，基于上 述危险因素的联合预测因子对老年CHF合并肺部感染患者短期肺部感染再发具有良好的预测效能。 [ABSTRACT FROM AUTHOR]

Objective To investigate the factors influencing the development of severe pneumonia in patients with human immunodeficiency virus (HIV )/acquired immunodeficiency syndrome (AIDS). Methods This study retrospectively analyzed the clinical data of 139 patients with HIV/AIDS combined with pulmonary infections admitted to the Department of Infectious Diseases of General Hospital of Ningxia Medical University from January 2017 to August 2023, among which 48 cases were in the severe pneumonia group and 91 cases were in the non-severe pneumonia group. The influencing factors on the occurrence of severe pneumonia in patients with HIV/AIDS were analyzed by using logistic regression, and the predictive value of the indicators for severe pneumonia was analyzed by plotting the work characteristics of the subjects (ROC) curves. Results The incidence of severe pneumonia was 34. 5% (48/139) in 139 patients with HIV/AIDS coinfection of the lungs. Univariate analysis showed that cough, shortness of breath, percentage of neutrophils, percentage of lymphocytes, absolute value of lymphocytes, prothrombin activity (PTA), CD4+T and CD8+T lymphocyte counts, neutrophil/lymphocyte ratio (NLR), albumin, number of pathogens greater than or equal to two, and continuous strong antiretroviral therapy (ART) treatment (>three months) were significantly associated with severe pneumonia in HIV/AIDS patients (P <0. 05). Logistic stepwise regression analysis showed that previous pneumocystis pneumonia (PCP), number of pathogens greater than or equal to two, elevated NLR, elevated PTA, and shortness of breath were independent risk factors for severe pneumonia in HIV/AIDS patients, continuous ART treatment (>three months) and CD8+ T cell count were independent protective factors (P <0. 05). The area under the curve of multi-factor combined prediction is the largest (AUC=0. 917, 95%CI 0. 873-0. 961, P <0. 01). Conclusion The occurrence of severe pneumonia in HIV/ AIDS patients is closely related to previous PCP, number of pathogens greater than or equal to two, high NLR, high PTA, shortness of breath, continuous ART treatment (>three months), CD8+T cell count. Multifactor combined prediction have good predictive value [ABSTRACT FROM AUTHOR]

Objective: To explore the correlation between the dynamic changes of early immune cells in acute respiratory distress syndrome( ARDS) caused by multiple injuries and lung infection. Methods: Multiple injury patients with ARDS( 235 cases) admitted to the First Affiliated Hospital of Hunan University of Chinese Medicine from October 2017 to February 2023 were selected as the research subjects and included them in the training set; according to simple clinical pulmonary infection scores (sCPIS), they were divided into a pulmonary infection group (94 cases, >6 points) and an uninfected group (141 cases, ≤6 points). Another multiple injury patients with ARDS (78 cases) were selected to be included in the validation set to verify the effectiveness of the prediction model. Dynamic detection of lymphocytes were used flow cytometry. Compared and analyzed the clinical data of two groups of patients. Constructed a joint model and used Cox regression to analyze the relationship. Multi factor Logistic regression analysis of risk factors, construction of a simple risk scoring model and evaluation. Results: As the patient progresses, CD4+ and CD8+ first decrease and then increased, and the lowest stage was 3~15 d after onset; CD19+ was gradually increasing; CD16+ gradually decreased and fluctuated within a certain range. The joint model showed that for every 1 piece/μl longitudinal decrease in CD4+, CD8+, CD19+, and CD16+, the risk of pulmonary infection increased by 5.6%, 4.1%, 3.4% and 1.3%, respectively( P<0.05). Injury severity score( ISS), chest injury as the main factor, emergency surgery, acutephysiology and chronic health evaluation Ⅱ (APACHE Ⅱ), broncho-alveolar lavage fluid( BALF) sTREM-1 level, and CD4+, CD8+, and CD19+ level on the 15th day after onset all were independent influencing factors for the occurrence of pulmonary infection( P<0.05). The score of the simple risk scoring model is 0~36.7 points, which could be divided into three risk levels: low (<16 points), medium (16~22 points), and high risk (>22 points); there was no significant difference in the incidence of pulmonary infection between the two episodes of patients (P>0.05). The evaluation results showed that the predictive model has good discrimination. Conclusion: The fluctuation of immune cells will increase the risk of pulmonary infection in patients with multiple injuries ARDS; Baseline CD4+, CD8+, and CD19+ levels are independent influencing factors for the occurrence of pulmonary infection; controlling high-level immune cells and maintaining stability is crucial for improving prognosis. [ABSTRACT FROM AUTHOR]

To investigate the effect of Suhuang Zhike capsule combined with thymosin in the treatment of elderly patients with COPD complicated with pulmonary infection and its influence on immune function and blood gas indexes. 80 elderly patients treated in hospital were studied. All patients were diagnosed with COPD disease and were complicated with pulmonary infection. The admission time of the patients was distributed from September 2020 to September 2023, and the patients were divided into groups according to different treatment methods, among which 40 patients were divided into matched group and thymosin treatment was added on the basis of conventional symptomatic treatment, and the other 40 patients were divided into observation group and Suhuang Zhike capsule was added on the basis of matched group. Compared the total therapeutic effective rate, inflammatory factors [C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α)] of the two groups, immune function [CD3+, CD4+ /CD8+ , Natural killer cell, NK)], blood gas index [partial pressure of carbon dioxide (PaCO2), arterial partial pressure of oxygen oxygen, PaO2), pH], occurrence of adverse reactions [nausea, vomiting, dizziness, rash, diarrhea]. The total response rate in the observation group was higher than that in the matched group (P<0.05). Post-treatment, the CRP and TNF- α levels in the observation group were significantly lower than those in the matched group (P<0.05). Post-treatment, the levels of CD3+, CD4+ /CD8+, and NK were higher in the observation group than in the matched group (P<0.05). After receiving treatment, the PaCO2 index level in the observation group was lower than that in the matched group (P<0.05), and the level of PaO2 and pH index in the observation group was higher than that in the matched group (P<0.05). The total incidence of adverse reactions such as nausea, vomiting, dizziness, rash and diarrhea in the two groups was 2.50% in the observation group and 7.50% in the matched group. There was no difference in the total incidence of adverse reactions between the two groups (P>0.05). In elderly patients with COPD complicated with pulmonary infection, the addition of Suhuang Zhike capsule on the basis of conventional symptomatic treatment and thymosin treatment can significantly improve the total effective rate of clinical treatment, improve the level of inflammatory factors and blood gas indexes, and enhance immune function, without increasing the risk of adverse reactions [ABSTRACT FROM AUTHOR]

Pulmonary infection by pathogenic microorganisms is a common disease of the respiratory system with high mortality and poor prognosis, but its pathogenesis remains unclear. In recent years, single-cell RNA sequencing （scRNA-seq） has been widely used in the study of lung infection to provide an atlas of immune cells of patients, identify new immune cell subsets, analyze differential expression genes, reveal pathways related to inflammatory immune pathways in pathogenic microbial infection, monitor the levels of cytokines, and identify novel biomarkers of lung infection. Therefore, this paper presents a review of the application of scRNA-seq in pulmonary infection by pathogenic microorganisms. [ABSTRACT FROM AUTHOR]

Objective To investigate the influencing factors of pulmonary infection during hospitalization after minimally invasive intracranial hematoma removal in patients with intracerebral hemorrhage (ICH) and construct a prediction model, in order to provide guidance for medical staff to evaluate the risk of postoperative pulmonary infection in ICH patients and develop prevention strategies. Methods ICH patients who underwent minimally invasive intracranial hematoma removal at the Department of Neurosurgery, Suzhou Ninth Hospital Affiliated to Soochow University from January 2018 to July 2023 were continuously included. The ICH patients were divided into pulmonary infection group and non-pulmonary infection group according to whether they had pulmonary infection during hospitalization. The clinical data of the two groups were compared. Multivariate logistic regression analysis was used to explore the influencing factors of pulmonary infection after minimally invasive intracranial hematoma removal in ICH patients, and the logistic regression model was constructed. At the same time, the gradient boosting machine (GBM) algorithm of R was used to construct a GBM prediction model for pulmonary infection after minimally invasive intracranial hematoma removal in ICH patients. The prediction efficiency of the two models was analyzed by ROC curve and compared by Delong test. Results A total of 297 ICH patients who underwent minimally invasive intracranial hematoma removal were included in the study. Among them, 52 cases (17.5%) occurred pulmonary infection during postoperative hospitalization. Multivariate analysis showed that malnutrition (OR 2.737, 95%CI 1.249-5.998, P=0.012), tracheotomy (OR 2.716, 95%CI 1.296-5.690, P =0.008), and indwelling gastric tube (OR 3.521, 95%CI 1.724-7.193, P <0.001) were independent risk factors for pulmonary infection in ICH patients after minimally invasive intracranial hematoma removal. High preoperative GCS score (OR 0.622, 95%CI 0.515-0.752, P<0.001) and oral care (OR 0.105, 95%CI 0.028-0.390, P<0.001) were protective factors. According to ROC curve analysis, the AUC of the logistic regression model was 0.837, and the AUC of the GBM prediction model was 0.861. Delong test showed that the efficiency of GBM prediction model was better than that of logistic regression model (Z=2.318, P=0.021). Conclusions Malnutrition, tracheotomy and indwelling gastric tube were the risk factors of pulmonary infection in ICH patients after minimally invasive intracranial hematoma removal, while high preoperative GCS score and oral care were protective factors. The efficiency of GBM model based on the above indicators was better than logistic model. [ABSTRACT FROM AUTHOR]

With the optimization of surgical technologies and postoperative management regimens, the number of lung transplantation has been significantly increased, which has become an important treatment for patients with end-stage lung disease. However, due to the impact of comprehensive factors, such as bronchial ischemia and immunosuppression, the incidence of airway stenosis after lung transplantation is relatively high, which severely affects postoperative survival and quality of life of lung transplant recipients. In recent years, with the improvement of perioperative management, organ preservation and surgical technologies, the incidence of airway stenosis after lung transplantation has been declined, but it remains at a high level. Early diagnosis and timely intervention play a significant role in enhancing clinical prognosis of patients with airway stenosis. In this article, the general conditions, diagnosis, treatment and prevention of airway stenosis after lung transplantation were reviewed, aiming to provide reference for comprehensive management of airway stenosis after lung transplantation and improving clinical prognosis of lung transplant recipients. [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the diagnostic value of metagenomic next-generation sequencing(mNGS) for detecting pulmonary infection. Methods PubMed, Embase, Web of Science, the Cochrane Library, CNKI, WanFang, VIP databases were searched for studies according to the criteria of inclusion and exclusion, enrolling literature recorded from database establishment to May 30,2022. Statistical analysis was performed by Meta-Discl. 4, RevMan5. 3 and STATA15.0 software. Results A total of 12 relevant studies were enrolled, including 1 154 patients. The results of meta-analysis showed that the pooled sensitivity was 0.82(95% CI 0.79-0.84, 189.1%), and the pooled specificity was 0.73 (95% CI 0.68 0.78, I² = 85.4%). The heterogeneity in sensitivity and specificity between studies was significant. The area under the curve (AUC) of the total subject operating characteristic curve (SROC) was 0.850, and the Q index was 0. 782. Conclusion The diagnostic performance of mNGS in the clinical application of lung infections is acceptable. [ABSTRACT FROM AUTHOR]

Organ transplantation has become an effective treatment for multiple end-stage diseases. However, the recipients of organ transplantation need to take immunosuppressive drugs for a long time after operation, which leads to low immune function and relatively high incidence of bacterial, viral and fungal infections. Traditional microbial detection methods, such as pathogen culture, immunological detection and polymerase chain reaction, have been widely applied in infection detection, whereas these methods may cause problems, such as long detection time and presumed pathogens. Metagenomic next-generation sequencing has been widely adopted in infection prevention and control in organ transplantation in recent years due to high detection rate and comprehensive detection of pathogen spectrum. In this article, the application of metagenomic next-generation sequencing in the prevention and control of infection in solid organ transplantation was reviewed, aiming to provide reference for the diagnosis and treatment of transplantation-related infection. [ABSTRACT FROM AUTHOR]

Objective To analyze the clinical features of children with tracheobronchomalacia (TBM) complicated with pulmonary infection，and to explore the significance of fiberoptic bronchoscopy in the diagnosis and treatment of this disease. Methods Clinical data of 236 children admitted to our hospital due to recurrent pulmonary infection were collected. Among them, 37 children were diagnosed with TBM by fiberoptic bronchoscopy. Clinical features of TBM and fiberoptic bronchoscopy results were analyzed. The differences between TBM and non-TBM children were statistically compared. Results The proportion of TBM children aged<1 year was high (30/37) . The average age of TBM children was significantly younger than that of non-TBM counterparts, and the average length of hospital stay of TBM children was significantly longer than that of non-TBM counterparts, and the differences were statistically significant (both P < 0.05). The main manifestations of TBM and non-TBM children were cough, wheezing and recurrent respiratory tract infection, and there were no statistical differences in the male-to-female ratio (all P > 0.05). Fiberoptic bronchoscopy found mild and moderate TBM at a single site in TBM children, and favorable outcomes were obtained. Conclusion TBM is one of the important factors of recurrent pulmonary infection and wheezing in young children. It is challenging to identify the symptoms of TBM. Bronchoscopy is beneficial to timely diagnosis and treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the efficacy, safety and economical efficiency of Reduning injection combined with meropenem and polymyxin B in the treatment of pulmonary infection of multi-drug resistant gramnegative bacteria (MDR-GNB). METHODS: A total of 130 patients with pulmonary infection of MDR-GNB admitted into the hospital from Oct. 2020 to Jan. 2023 were selected to be divided into the control group and observation group via random number table method, with 65 cases in each group. The control group was given polymyxin B combined with meropenem, while the observation group was given Reduning injection based on the control group, the course of treatment was 7-14 days. The clinical efficacy, bacterial clearance rate, improvement time of clinical signs of infection, changes of inflammatory factors before and after treatment, and incidences of adverse drug reactions of two groups were observed; conomic evaluation was conducted by using cost-effectiveness analysis. RESULTS: The clinical total effective rate and bacterial clearance rate of the observation group were respectively 87. 69% ( 57 / 65) and 92. 31% (60 / 65), significant higher than those of the control group [72. 31%(47 / 65) and 75. 38%(49 / 65)], with statistically significant differences ( P < 0. 05 ). The remission time of fever, disappearance time of cough and expectoration, disappearance time of lung rales, improvement time of imageological examination and duration of treatment of the observation group were significantly shorter than those of the control group, with statistically significant differences (P < 0. 05). After treatment, the white blood cell count, C-reactive protein, procalcitonin and serum amyloid protein A levels of the observation group were significantly lower than those of the control group, with statistically significant differences (P<0. 05). The incidences of adverse drug reactions of the observation group and the control group were respectively 10. 77% ( 7 / 65 ) and 7. 69% ( 5 / 65 ), the difference was not statistically significant (P>0. 05). The cost-effectiveness (C / E) of clinical effective rates of the observation group and the control group were respectively 352. 56 and 577. 88, the C / E of bacterial clearance rates were respectively 334. 91 and 554. 34; relative to the observation group, the incremental cost-effectiveness ratio of clinical effective rate and bacterial clearance rate in the control group were respectively -706. 80 and -642. 09. CONCLUSIONS: Reduning injection can effectively improve the clinical efficacy of polymyxin B combined with meropenem in the treatment of pulmonary infection of MDR-GNB, without increasing adverse drug reactions, with significant economical efficiency advantages. [ABSTRACT FROM AUTHOR]

Objective To systematically review effects of different anesthesia methods on pulmonary in- fection after hip replacement. Methods The databases such as PubMed, CochrianeLibriariy, Web of Science, EMbase, CNKI, VIP and Wanfang were retrieved, and the randomized controlled trials on the effects of in- traspinal anesthesia and general anesthesia on pulmonary infection after hip replacement were collected. Ac- cording to the anesthesia method, intraspinal anesthesia was included in the observation group, general anes- thesia was included in the control group, and the observation group was further divided into the lumbar/epi- dural anesthesia subgroup, the lumbar hard combined anesthesia subgroup, the 50-65 years old subgroup.and the >65 years old subgroup. Meta analysis was performed by using RevMan 5. 3 software. Results A total of 14 articles were included, involving 1 478 patients. Meta analysis showed that the incidence of postoperative pulmonary infection in the observation group was lower than that in the control group, with statistically sig- nificant difference (P<0.001). The incidence of postoperative pulmonary infection in the lumbar/epidural an- esthesia subgroup and the lumbar hard combined anesthesia subgroup were lower than that in the control group, and the difference were statistically significant (P<0.05). There was no statistically significant differ- ence in the incidence of postoperative pulmonary infection between the lumbar/epidural anesthesia subgroup and the lumbar hard combined anesthesia subgroup (P>0.05). The incidence of postoperative pulmonary infection in the 50-65 years old subgroup and the >65 years old subgroup was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Intraspinal anesthesia is superior to general anesthesia, which can reduce the incidence of pulmonary infection after hip replacement. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To observe the rehabilitation effect of active cycle of breathing technique (ACBT) combined with a series of expectoration training in elderly stroke patients with pulmonary infection after tracheotomy. Methods: 63 elderly stroke patients with pulmonary infection after tracheotomy who were hospitalized in Department of Geriatric Medicine of Changsha Third Hospital from May 2020 to February 2022 were selected. The enrolled patients were divided into control group and study group by random number table method, with 31 cases and 32 cases respectively. The control group was given conventional treatment combined with a series of expectoration training, and the study group was combined with ACBT on the basis of the control group. The clinical symptoms, pulmonary function indexes [forced vital capacity (FVC), maximum ventilation volume per minute (MVV) and peak expiratory flow (PEF)], blood gas analysis indexes [partial oxygen pressure (PO2), oxygen saturation (SaO2), partial carbon dioxide pressure (PaCO2)], inflammatory factors [procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] in the two groups were compared. Results: The daily sputum aspiration times in the study group was less than that in the control group, the infection window control time and extubation time were shorter than those in the control group, and the clinical pulmonary infection score (CPIS) score was lower than that in the control group (P<0.05). 4 weeks after treatment, the FVC, MVV and PEF in the study group were higher than those in the control group (P<0.05). 4 weeks after treatment, PO2 and SaO2 in the study group were higher than those in the control group, while PaCO2 was lower than that in the control group (P<0.05). 4 weeks after treatment, PCT, CRP and IL-6 in the study group were lower than those in the control group (P<0.05). Conclusion: The application of ACBT combined with a series of expectoration training in elderly stroke patients with pulmonary infection after tracheotomy can improve the clinical symptoms, pulmonary function, blood gas analysis index, and the level of inflammatory factors. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical characteristics, diagnosis and treatment of Goodpasture syndrome complicated with lung infection. Methods Clinical data of one case of Goodpasture syndrome complicated with pulmonary infection were retrospectively analyzed. Literature review was performed from PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Data Knowledge Service platform using“ Goodpasture syndrome” and“ infection” as search terms from the database inception date to September 2022. Clinical manifestations and prognosis of Goodpasture syndrome complicated with pulmonary infection were summarized. Results The 51-year-old male patient, was admitted to our hospital due to elevated serum creatinine level for more than one month and blood in sputum for over 10 d. The patient had a cough of yellow-green purulent sputum. Moist rales were heard in bilateral lungs. Renal biopsy showed crescentic glomerulonephritis, and anti-glomerular basement membrane IgG antibody was weakly positive. Chest CT scan revealed multiple inflammations in both lungs. The culture of bronchoalveolar lavage fluid showed the phenomenon of phagocytosis. Sputum fungal smear and fluorescent staining, alveolar lavage fluid culture, next-generation sequencing (NGS) of alveolar lavage fluid indicated a variety of microbial infections. The diagnosis of Goodpasture syndrome complicated with lung infection was considered. He was discharged after receiving renal replacement, immunosuppression, and anti-infection therapies. Three months later, the patient was transferred to ICU due to “severe pneumonia, septic shock, and respiratory failure” and eventually died. A total of 27 cases of Goodpasture syndrome complicated with pulmonary infection were researched. The common pathogens of pulmonary infection were invasive pulmonary Aspergillus, Pneumocystis carinii, Mycobacterium tuberculosis and cytomegalovirus, etc. Thirteen patients died, and 4 of them died of respiratory failure and/or respiratory infection. Conclusion Extensive attention should be diverted to the risk of infection in patients with Goodpasture syndrome, especially severe lung infection. [ABSTRACT FROM AUTHOR]

Objective To analyze the effects of bifidum on intestinal flora and related immune function markers in patients with sepsis caused by lung infection, and to provide data for supporting clinical application. Methods One hundred and forty-three cases of sepsis caused by lung infection were randomly divided into two groups, including 71 cases of control group （received conventional treatment） and 72 cases of study group （received bifidum in addition to conventional treatment）. Critical illness scores ［Acute Physiological and Chronic health （APACHEⅡ） score and Sequential Organ failure （SOFA） score］ were evaluated before treatment and at 7 days after treatment, respectively. Fecal samples were collected to analyze the colonies of Lactobacillus, bifidum, Enterobacter, enterococcus, Escherichia coli and Clostridium. Peripheral blood was collected and the level of T lymphocyte subpopulation in blood was determined by flow cytometry. The plasma D-lactic acid and bacterial endotoxin levels were detected by intestinal barrier function biochemical index analysis system. The plasma levels of procalcitonin （PCT）, hypersensitive C-reactive protein （hs-CRP） and interleukin-6 （IL-6） were also determined by ELISA. Results Before treatment, there were no significant differences in critical disease score, intestinal flora number, intestinal function, T lymphocyte subsets and inflammatory factors between the two groups （P > 0.05）. After treatment, APACHEⅡ and SOFA scores in both groups were significantly reduced, and APACHEⅡ scores in the study group were significantly lower than those in the control group （P < 0.05）. After treatment, the number of Lactobacillus, bifidum and CD3+T% levels in both groups increased, while the number of enterococcus, Escherichia coli, intestinal function score, D-lactic acid, endotoxin, TNF-ɑ, IL-6 and IL-1β levels decreased. The levels of Lactobacillus, bifidum and CD3+T% in the study group were higher than those in the control group, while the levels of Escherichia coli, D-lactic acid, endotoxin, hs-CRP and IL-6 in the study group were lower than those in the control group （P < 0.05）. Conclusion Adding bifidum in the clinical treatment of sepsis caused by lung infection can improve the distribution of intestinal flora to a certain extent and alleviate the damage of intestinal barrier function caused by inflammation, which may be helpful to promote the repair of patients. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical characteristics and outcomes of localized pulmonary infection by Scedosporium apiospermum (S. apiospermum) in order to provide evidence for diagnosis and treatment. Methods We reviewed 8 patients diagnosed with S. apiospermum pulmonary infection from Jan 2018 to Dec 2021 at the department of infectious disease of Zhongshan Hospital, Fudan University. The clinical data, radiological findings, treatment and prognosis of the patients were analyzed retrospectively. Results Among the 8 patients, there were 3 males and 5 females, with an average age of 58（27-76) years. Identified by MALDI-TOF MS，6 cases were S. apiospermum and 2 cases were S. boydii. There was 1 case had systemic sclerosis with pulmonary interstitial disease and diabetes, treated with Prednisone 10 mg/qd and Mycophenolate Mofetil 0.5 g/qd，6 cases were accompanied by underlying pulmonary diseases, and 1 case had no underlying disease. The most common clinical symptoms were cough, followed by sputum production, haemoptysis, fever, dyspnea and weight loss. The mean BMI was 19.5（15.6-23.2) kg/m², and the BMI was less than 18.5 kg/m² in 4 cases. The white blood cell counts, neutrophil counts and procalcitonin (PCT) were normal in all patients. The average value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hs-CRP) were 32 mm/h (increased in 4 cases) and 24.8 mg/L (increased in 5 cases). G test and GM test were negative. The average CD4 lymphocyte count of patients was 512.8（226.0-943.0) /μL, and the counts of 5 cases were <500/μL. The chest CT findings were diverse： bronchiectasis (5 cases), nodules (3 cases), consolidation (3 cases), cavities (2 cases), pleural thickening (2 cases), and tree bud sign (2 cases), and various imaging findings often existed in combination. All the patients were treated with voriconazole, and 4 patients developed liver insufficient and visual hallucination after taking the medicine were stopped or adjusted to posaconazole. Follow up for 6 months after the start of treatment, the clinical symptoms of all patients were significantly improved. In imaging，5 cases were absorbed，2 cases were similar, and 1 case was deteriorated, which was considered to be caused by mycobacterium infection. Conclusion The clinical and imaging manifestations of localized pulmonary infection by S. apiospermum are non-specific, inflammation markers ESR and hs-CRP are only slightly elevated, and the positive rates of G test and GM test are low, which make early diagnosis difficult. All the patients were treated with voriconazole and the overall prognosis is good. [ABSTRACT FROM AUTHOR]

肺部感染作为常见的感染性疾病，全球发病率高、死亡率高，致病菌类型多种多样，目 前常用的病原体检测主要有形态学鉴定、细菌培养和抗原抗体检测，部分罕见的病原体不易被检测 出，给临床诊断带来困难。宏基因二代测序（mNGS） 技术作为一项新的检测技术，处于高速发展阶 段，并已逐步应用于临床，具有高通量、高灵敏度和检测周期短等特点。mNGS 对提高肺部感染性疾 病的病原学诊断效率和检测效能具有巨大的潜力，特别是常规检测方法存在局限性的领域，如罕见疾 病、新发传染病及检测条件苛刻的微生物等。现针对mNGS技术在肺部感染病原体诊断的优势和局限性 等方面进行综述，探讨其临床应用价值，为通过mNGS 技术实现肺部感染性疾病的精准诊断和治疗提 供依据。 [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical characteristics of hypophosphatemia in diabetic ketoacidosis (DKA) complicated with pulmonary infection. Methods A patient with DKA complicated with Aspergillus fumigatus pneumonia who developed severe hypophosphatemia was reported. Revelant studies were searched from PubMed，CNKI, Wanfang Data and Chongqing VIP using“diabetic ketoacidosis”and“hypophosphatemia”as the keywords.Clinical data of retrieved cases of DKA complicated with hypophosphatemia were collected and analyzed. Results The 35-year-old male patient were diagnosed with diabetes mellitus complicated with DKA, Aspergillus fumigatus pneumonia and severe hypophosphatemia. After fluid rehydration, hypoglycemic and antifungal treatment, serum phosphorus level was restored to normal range spontaneously along with DKA correction and pulmonary infection control. The patient was discharged after improvement. According to literature review, 16 cases of DKA complicated with hypophosphatemia with complete clinical data were searched. Clinical manifestations mainly include respiratory failure, rhabdomyolysis, seizures, cardiac arrest, fatigue, and no symptoms, etc. Some patients can spontaneously recover, whereas other patients require supplemental phosphorus therapy. Conclusions DKA patients complicated with pulmonary infection are prone to hypophosphatemia with non-specific clinical manifestations, which can be life-threatening in severe cases. Early recognition is helpful to improve clinical prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of hyperbaric oxygen (HBO) combined with bronchoalveolar lavage on the clinical efficacy and serum levels of soluble triggering receptor expressed on myeloid cell-1(sTREM-1), high mobil ity group protein B1 (HMGB1) and C-reactive protein/albumin (CRP/Alb) in patients with severe craniocerebral injury and pulmonary infection (PI). Methods: 72 patients with severe craniocerebral injury and PI admitted to Lu'an Hospital Affiliated to Anhui University of Traditional Chinese Medicine from September 2019 to September 2022 were selected as the study subjects. They were divided into observation group and control group according to random number table method, with 36 patients in each group. The control group was treated with bronchoalveolar lavage, while the observation group was treated with HBO combined with bronchoalveolar lavage. Collect the clinical data of the two groups, and compared the clinical efficacy, clinical signs[body temperature, arterial partial pressure of oxygen (PaO2), white blood cell count (WBC)], clinical pulmonary infection score (CPIS), adjusted score of systemic inflammatory response syndrome (ASS) score, glasgow coma score (GCS), serum indicators (sTREM-1, HMGB1, CRP/Alb) before and after treatment. Results: The total effective rate in the observation group was 94.44% higher than 77.78% in the control group (P<0.05); After treatment, the body temperature, WBC, CPIS score and ASS score of the observation group were lower than those of the control group, while PaO2 and GCS scores were higher than those of the control group(P<0.05); After treatment, the serum levels of sTREM-1, HMGB1, CRP/Alb in the observation group were lower than those in the control group(P<0.05). Conclusion: HBO combined with bronchoalveolar lavage in the treatment of severe craniocerebral injury and PI can reduce inflammatory reaction, reduce the degree of PI, reduce clinical signs and improve clinical efficacy. [ABSTRACT FROM AUTHOR]

Objective To search the best evidence about the prevention and nursing of pulmonary infection in patients with ischemic stroke at home and abroad, and evaluate and summarize the evidence, so as to provide scientific reference for clinical nurses to evaluate the prevention and nursing plan. Methods According to the principle of 6S [SEIRI (sorting out), SEITON (rectifying), SEISO (cleaning), SEIKETSU (sweeping), SHITSUKE (literacy) and SAFETY (safety)], the domestic and foreign literatures were systematically searched. The types of literatures searched were the best evidence, guidelines, expert consensus, clinical practice and systematic evaluation, and the retrieval time was from the establishment of the database to May 2022. Literature screening, quality evaluation and evidence extraction were conducted by two professional researchers. Results A total of 12 articles were included, including 2 guidelines, 5 systematic reviews, 1 expert consensus, 3 evidence summaries and 1 clinical decision. The summarized evidence includes 30 recommendations from eight aspects: risk factor assessment, early identification and prevention, medication care, diet care, strengthening respiratory care, posture adjustment, strengthening functional exercise and oral care. Conclusion The prevention and nursing of ischemic stroke complicated with pulmonary infection has certain practical reference significance, which is helpful to improve the quality of clinical nursing. [ABSTRACT FROM AUTHOR]

Objective: To explore the value of serum procalcitonin (PCT), leukocyte differentiation antigen 14 subtype (presepsin) and growth arrest specific gene product 6 (Gas6) in evaluating the condition and prognosis of senile patients with chronic heart failure (CHF) complicated with pulmonary infection. Methods: 412 senile patients with CHF who were divided into pulmonary infection group (n=176) and non-pulmonary infection group (n=236) according to whether they were complicated with pulmonary infection. Another 40 healthy patients during the same period were selected as healthy control group. The serum PCT, presepsin and Gas6 levels of the three groups were compared. The prognosis of senile patients with CHF complicated with pulmonary infection within 28d of hospitalization was counted, and they were divided into death group (n=37) and survival group (n=139) according to different prognosis. Multivariate Logistic regression models were used to analyze the risk factors of death in senile patients with CHF complicated with pulmonary infection. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum PCT, presepsin combined with Gas6 for mortality in senile patients with CHF complicated with pulmonary infection. Results; The serum PCT, presepsin and Gas6 levels in the pulmonary infection group and the non-pulmonary infection group were higher than those in the healthy control group, and the pulmonary infection group was higher than the non-pulmonary infection group (P<0.05). Multivariate Logistic regression analysis showed that higher age, cardiac function grade Ⅳ, elevated PCT, elevated presepsin and elevated Gas6 were independent risk factors for death of senile patients with CHF complicated with pulmonary infection (P<0.05). The ROC results showed that the AUC of serum PCT, presepsin, and Gas6 alone and in combination to predict the risk of death in senile patients with CHF complicated with pulmonary infection were 0.663, 0.731, 0.751 and 0.855, respectively. The predictive efficacy of the combined detection of three indicators was better than that of individual detection of each indicator. Conclusion: Serum PCT, presepsin and Gas6 levels increased in senile patients with CHF complicated with pulmonary infection, and are independent risk factors for poor short-term prognosis. Detecting the levels of PCT, presepsin, and Gas6 has certain evaluation value for the condition and prognosis of senile patients with CHF complicated with pulmonary infection. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of general anesthesia (GA) combined with thoracic paravertebral nerve block (TPVB) on postoperative analgesia and pulmonary infection in patients undergoing lung cancer surgery. Methods A total of 170 lung cancer patients who underwent thoracoscopic lung lobectomy were divided into the GA group (80 cases) and the GA combined with TPVB group (90 cases) according to the anesthetic regimen. Intraoperative dosage of anesthetics, postoperative pressing times of analgesic pump, diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR) before anesthesia induction, after anesthesia induction and after operation, and pain (VAS) score within 48 h after operation were compared between the two groups. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) were measured by enzyme-related immunosorbent assay before and after surgery in the two groups. The postoperative recovery time and the incidence rates of pulmonary infection and adverse anesthesia reactions were compared between the groups. Results The dosages of remifentanil, propofol and the total pressing times were lower in the GA combined with TPVB group than those in the GA group (P＜0.05). DBP, SBP and HR after anesthesia induction and after operation were higher in the GA combined with TPVB group than those of the GA group (P＜0.05). The VAS scores at 4, 8, 12, 24 and 48 h after operation were lower in the GA combined with TPVB group than those of the GA group (P＜0.05). After operation, levels of IL-6, TNF-α and IL-8 were lower in the GA combined with TPVB group than those in the GA group (P＜0.05). The recovery time of spontaneous breathing, extubation time, length of stay in recovery room, postoperative first ambulation time and hospital stay were shorter in the GA combined with TPVB group than those of the GA group (P＜0.05). The incidence rates of postoperative pulmonary infection and adverse anesthesia reactions were lower in the GA combined with TPVB group than those in the GA group (P＜0.05). Conclusion GA combined with TPVB can achieve good analgesic effect on patients undergoing lung cancer surgery and reduce the incidence of postoperative pulmonary infection. [ABSTRACT FROM AUTHOR]

慢性阻塞性肺疾病 (COPD) 是一种常见的呼吸系统疾病, 其患者往往容易发生肺部感染。本研究旨在 探讨慢阻肺患者肺部感染发生的相关因素, 以期为临床预防和治疗提供指导。通过回顾性分析方法, 对慢阻肺患者的 临床资料进行收集和分析, 发现年龄、吸烟、职业性粉尘暴露、糖皮质激素的不合理应用、并发症的出现以及广谱抗 生素的广泛应用等因素与慢阻肺患者肺部感染的发生密切相关。基于这些发现, 本文提出了相应的预防和治疗策略, 以期降低慢阻肺患者肺部感染的发生率, 改善其生活质量。 [ABSTRACT FROM AUTHOR]

To analyze the risk factors for pulmonary infection after thoracoscopy surgery for lung cancer and to investigate the predictive value of preoperative C-reactive protein/albumin ratio (CRP/Alb), procalcitonin (PCT) and serum amyloid A (SAA) on the risk of infection. 360 patients with lung cancer who were treated by thoracoscopy surgery in the Affiliated Hospital of Xuzhou Medical University from March 2019 to October 2021 were selected, and they were divided into the pulmonary infection group with 57 cases and the non-pulmonary infection group with 303 cases according to whether pulmonary infection occurred 72 h after thoracoscopy surgery. Clinical data were collected from patients, and serum CRP/Alb, PCT and SAA levels of patients were detected 1 day before operation. Univariate and multivariate Logistic regression were used to analyze the risk factors of pulmonary infection after thoracoscopic surgery for lung cancer. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of preoperative serum CRP/Alb, PCT and SAA levels for pulmonary infection after thoracoscopic surgery for lung cancer. Univariate analysis showed that the proportion of age逸60 years, smoking history, diabetes mellitus, operation time≥ 3h, intraoperative blood loss逸200 mL, mechanical ventilation time逸12 h, thoracic drainage time逸5 d, and serum CRP/Alb, PCT and SAA levels in the pulmonary infection group were higher than those in the non-pulmonary infection group (P<0.05). Multivariate Logistic regression analysis showed that age逸 60 years, smoking history, diabetes mellitus, operation time逸3 h, mechanical ventilation time逸12 h, thoracic drainage time逸5 d and elevated serum CRP/Alb, PCT and SAA were independent risk factors for pulmonary infection after thoracoscopy surgery for lung cancer (P<0.05). ROC curve analysis showed that the area under curve of preoperative serum CRP/Alb, PCT and SAA combined in predicting pulmonary infection after thoracoscopy surgery for lung cancer was greater than that of each index alone. Age, smoking history, diabetes mellitus, operation time, mechanical ventilation time, thoracic drainage time and elevated CRP/Alb, PCT and SAA are risk factors for pulmonary infection after thoracoscopy surgery for lung cancer. The combined preoperative serum CRP/Alb, PCT and SAA have a high value in predicting pulmonary infection after thoracoscopy surgery for lung cancer. [ABSTRACT FROM AUTHOR]

To investigate the relationship between procalcitonin (PCT), high mobility group protein 1 (HMGB1), CD4+ /CD8+ ratio and secondary pulmonary infection in patients with type 2 diabetes complicated with pulmonary tuberculosis. 97 patients with type 2 diabetes complicated with pulmonary tuberculosis who were admitted to the Respiratory and Critical Care Department of West China Hospital of Sichuan University from January 2019 to June 2022 were selected, and they were divided into pulmonary infection group (53 cases) and non-pulmonary infection group (44 cases) according to whether they had secondary pulmonary infection during treatment after admission. Serum PCT, HMGB1 levels and peripheral blood CD4+ /CD8+ ratio in the two were detected. Univariate and multivariate Logistic regression analysis was used to analyze the factors of secondary pulmonary infection in type 2 diabetes patients complicated with pulmonary tuberculosis. The value of PCT, HMGB1 and CD4+ /CD8+ ratio in predicting secondary pulmonary infection in type 2 diabetes patients complicated with pulmonary tuberculosis was analyzed by receiver operating characteristic (ROC) curve. The levels of serum PCT and HMGB1 in pulmonary infection group were higher than those in non-pulmonary infection group(P<0.05), and the peripheral blood CD4+ /CD8+ ratio was lower than that in non-pulmonary infection group (P<0.05). The elevated levels of glycosylated hemoglobin, serum PCT and HMGB1 were the risk factors of secondary pulmonary infection in type 2 diabetes patients complicated with pulmonary tuberculosis (P<0.05), and the high CD4+ /CD8+ ratio was the protective factor (P<0.05). PCT, HMGB1, CD4+ /CD8+ ratio predicted the area under the curve of secondary pulmonary infection in type 2 diabetes patients complicated with pulmonary tuberculosis was 0.719, 0.761, 0.738, and the area under curve predicted by PCT, HMGB1, and CD4+ /CD8+ ratio was 0.878, which were higher than that predicted by each indicator alone. The increase of serum PCT and HMGB1 levels and the decrease of peripheral blood CD4+ /CD8+ ratio in type 2 diabetes patients complicated with pulmonary tuberculosis are all related to secondary pulmonary infection. The combination of PCT and HMGB1 with CD4+ /CD8+ ratio can help predict the risk of secondary pulmonary infection in type 2 diabetes patients complicated with pulmonary tuberculosis. [ABSTRACT FROM AUTHOR]

目的　系统评价心脏大血管术后预防性应用无创辅助通气的效果及安全性。方法　计算机检索 Pubmed、Embase、Web of science、Cochrane Library、中国知网、万方数据库、维普数据库，搜索1992年8月—2022年8 月发表的关于比较心脏大血管术后预防性应用无创辅助通气与传统术后管理效果及安全性差异的临床随机对照试 验，根据制定的纳入和排除标准筛选文献。根据干预措施不同将资料分为干预组（预防性无创辅助通气治疗）和对 照组（普通氧疗、雾化吸入、肺部理疗等常规治疗），提取早期病死率、肺部感染发生率、严重氧合障碍发生率、再次气 管插管率、治疗后呼吸频率、ICU 住院时间、住院时间、心脏不良事件发生率、肾脏并发症发生率等资料，采用 Rev‑ Man 5. 4统计软件进行Meta分析，Cochrane进行文献质量评价，漏斗图进行发表偏倚评估。结果　共纳入10篇符合 要求的文献，涉及 1 306例心脏大血管术后患者。Meta分析结果显示，干预组术后肺部感染发生率（RR=0. 29，95% CI：0. 12～0. 74，P=0. 01）、严重氧合障碍发生率（RR=0. 42，95% CI：0. 25～0. 70，P<0. 01）、再次气管插管率（RR= 0. 39，95% CI：0. 17～0. 93，P=0. 03）及住院时间（MD=-1. 63，95% CI：-2. 91～-0. 35，P=0. 01）低于对照组，两组早 期病死率、术后呼吸频率、ICU 住院时间、术后心脏不良事件及肾脏并发症发生率差异均无统计学意义（P 均> 0. 05）。结论　术后预防性应用无创辅助通气能够降低患者术后发生肺部感染、严重氧合障碍及再次气管插管的风 险，并可缩短住院时间，且安全性较高。 [ABSTRACT FROM AUTHOR]

Objective To analyze clinical characteristics and risk factors of pulmonary infection caused by extensively drug-resistant Acinetobacter baumannii (XDRAB), evaluate antimicrobial therapy and prognosis of XDRAB patients, aiming to provide references for effective prevention and control of nosocomial infection and clinical diagnosis and treatment. Methods Patients with XDRAB isolated from the lower respiratory tract specimens were collected. The number of repeated cases and colonization strains were excluded. The case data were analyzed and summarized by the method of retrospective case analysis. Results A total of 210 XDRAB strains were detected. The distribution of clinical departments was mainly concentrated in the ICU, with 108 cases (51.4%). Respiratory diseases (OR = 2.294, 95% CI: 1.018-5.170, P < 0.05), carbapenems (OR = 12.723, 95% CI: 4.585-35.306, P < 0.05), quinolones (OR= 10.100, 95% CI: 1.950-52.317, P < 0.05), β-lactam inhibitors (OR = 4.012, 95% CI: 1.659-9.702, P < 0.05) were the independent risk factors for XDRAB infection. The non-improvement rate in the XDRAB group was higher than that in the non-XDRAB group (χ² = 94.500, P < 0.05). Conclusions The proportion of XDRAB isolated from the ICU is the highest. Respiratory diseases and antibacterial drugs (carbapenems, β-lactam inhibitors, quinolones) are the independent risk factors for XDRAB infection. The prognosis of XDRAB infected patients is poor. [ABSTRACT FROM AUTHOR]

Objective　 To establish the death prediction model within 28-day admission for patients with sepsis induced by pulmonary infection, and to predict their nosocomial prognosis. Methods　 The clinical data of patients with sepsis induced by pulmonary infection admitted to the ICU from January 2017 to December 2021( modeling group) and the clinical data of patients with sepsis induced by pulmonary infection admitted to the ICU from January 2015 to December 2016( verification group) were retrospectively collected, including the baseline characteristics( age, height, body weight, type of underlying diseases), vital signs (mean arterial pressure, heart rate, respiratory rate, SpO2, body temperature), laboratory tests (blood gas analysis within 24 hours of ICU admission, electrolytes, liver and kidney function, coagulation function, blood routine), organ function status score(APACHEII score, SOFA score), treatment measures( whether sedation, respiratory support, vasoactive drugs), and outcome. Univariate and multivariate Logistic regression analyses were performed on data in the modeling group. The influencing factors of death in patients with sepsis induced by pulmonary infection were screened out. Then Logistic regression equation was established and visualized as a nomogram using the R4. 0. 3 software "rms" package. The model was verified in the validation group. The patient outcome was predicted by 28- day death prediction regression equation and compared with the real outcome. The discrimination and calibration degree of the model were evaluated by the area under receiver operating characteristic curve (AUROC) and the calibration curve. It was compared with the diagnostic performance of ICU prognostic scores commonly used in clinical practice, such as SOFA score and APACHEII score. Results　 In this study, a total of 970 patients with sepsis induced by pulmonary infection were included. There were 739 cases in the modeling group, 117 cases died, and 622 cases survived. There were 231 cases in the verification group, 24 cases died, and 207 cases survived. Variables that were statistically different between the death group and the survival group included age, weight, SOFA score, obesity, anemia, use of vasoactive drugs, mechanical ventilation, heart rate, respiratory rate, mean arterial pressure, body temperature, SpO2, red blood cell count, aspartate aminotransferase, albumin, blood glucose, creatinine, lactic acid, international normalized ratio, blood potassium, and arterial oxygen partial pressure (all P<0. 05), and there were no statistical differences in the other indicators. Multi⁃ variate Logistic regression analysis showed that the independent influencing factors were age, body weight, SOFA score, creatinine, lactate and respiratory rate. We assigned them as X1-X6, respectively, and then, based on the above indepen⁃ dent influencing factors, the Logistic regression equation was established： Logit(P) = -7. 673+0. 047X1-0. 022X2+ 0. 202X3+0. 013X4+0. 130X5+0. 137X6. P was the predicted probability of 28-day death in patients with sepsis induced by pulmonary infection. Then the Logistic regression equation was visualized as a nomogram. In this study, the AUR of the mortality prediction model was 0. 826( 95% CI 0. 779-0. 873) and 0. 850(95% CI 0. 763-0. 937) in the modeling and validation groups, respectively. The AUR of SOFA score for death prediction in the modeling group and validation group were 0. 721(95% CI 0. 661-0. 780) and 0. 698( 95% CI 0. 589-0. 808), respectively, and the AUR of APACHE II score for death prediction in the modeling group and validation group were 0. 623 (95% CI 0. 553-0. 693) and 0. 554 (95% CI 0. 435-0. 673), respectively. The calibration curve had a high degree of coincidence with a straight line of 45°in the plane Cartesian coordinate system, indicating that the model performed well. Conclusion　 The death prediction model within 28-day admission for patients with sepsis induced by pulmonary infection is successfully established, that is Logit(P) = -7. 673+0. 047X1-0. 022X2+0. 202X3+0. 013X4+0. 130X5+0. 137X6, which provides an optimal prediction of the shortterm mortality risk scientifically and effectively. [ABSTRACT FROM AUTHOR]

Objective To analyze the risk factors of lung cancer patients complicated with pulmonary infection after thoracoscopic surgery and establish a predictive nomogram model. Methods A total of 315 patients with primary lung cancer who had undergone thoracoscopic surgery from January 2018 to October 2021 in our hospital were divided into two groups according to the incidence of pulmonary infection. Two groups of clinical data were collected for single-factor and regression analyses, and independent predictors were obtained. On this basis, a risk model was constructed and its predictive effectiveness was evaluated. Results The independent risk factors of lung cancer patients complicated with pulmonary infection after thoracoscopic radical operation were as follows: age≥62.5 years, smoking index≥100, PEF≤72.1 ml/s, TNM stage Ⅲ/Ⅳ, and operation time≥188.5 min (P<0.05). Based on the above factors, the risk model of the column chart was established. Model-verification results showed that the C-index of the model was 0.909, and the correction curve showed that the column chart model had good differentiation and consistency. Conclusion Lung cancer patients’ age, smoking index, TNM stage, PEF, and operation time are closely related to pulmonary infection after thoracoscopic radical operation. The nomogram model is useful for identifying high-risk patients and reducing postoperative complications. [ABSTRACT FROM AUTHOR]

上消化道肿瘤是以食管癌、胃癌为主,目前以手术为首选治疗的癌症。肺部感染是肿瘤根治术 后常见的并发症,在延长住院时间、增加经济负担的同时,甚至有发展成呼吸衰竭致死的可能。国内外研究报 道,肺部感染的危险因素包括高龄、吸烟、合并肺部疾病、合并糖尿病、营养状况差、麻醉方式、手术方式、手术时 长、引流管放置、术后疼痛等,并提出多种干预措施,以减少其发生。该文对上消化道肿瘤术后并发肺部感染的 危险因素及干预措施予以综述。 [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum procalcitonin (PCT), angiotensin II (Ang II) and human monocyte chemotactic protein-1 (MCP-1) and cardiac function and poor prognosis in patients with chronic heart failure (CHF) complicated with pulmonary infection. Methods: 94 patients with CHF complicated with pulmonary infection who were treated in our hospital from March 2018 to March 2020 were selected as the combined infection group, in the same period, 54 patients with CHF without complicated with pulmonary infection who were treated as the control group. The level of serum PCT was detected by chemiluminescence immunoassay, the levels of serum Ang II and MCP-1 were detected by enzyme-linked immunosorbent assay. The levels of serum PCT,Ang II, MCP-1 and cardiac function indexes left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), heart rate (HR) were compared between the two groups. The correlation between the levels of serum PCT, Ang II, MCP-1 and LVEF, LVESD, LVEDD, HR was analyzed in the combined infection group. After active treatment,patients in the combined infection group were divided into good prognosis group and poor prognosis group according to whether adverse cardiac events occurred during hospitalization and follow-up for 6 months. Univariate and multivariate Logistic regression models were used to analyze the prognostic factors of patients with CHF complicated with pulmonary infection. Results: The levels of PCT, Ang II,MCP-1, LVESD, LVEDD and HR in the combined infection group were higher than those in the control group (P<0.05), and the level of LVEF was lower than that in the control group (P<0.05) . The levels of serum PCT, Ang II and MCP-1 were negatively correlated with LVEF (P<0.05), and positively correlated with LVESD, LVEDD and HR (P<0.05). Univariate analysis showed that the prognosis of patients with CHF complicated with pulmonary infection was related to the course of heart failure, New York Heart Association (NYHA) cardiac function grade, N-terminal B-type natriuretic peptide (NT-proBNP), PCT, Ang II, MCP-1 levels (P<0.05) . Multivariate Logistic regression analysis showed that the course of heart failure > 6 years, NYHA cardiac function grade III and IV, NT-proBNP > 570 ng/L,PCT>3.27 μg/L, Ang II>68.47 ng/L and MCP-1>267.65 ng/L were the risk factors for the prognosis of patients with CHF complicated with pulmonary infection (P<0.05). Conclusion: The abnormal increase of the levels of serum PCT, Ang II and MCP-1 in patients with CHF complicated with pulmonary infection is related to the cardiac function and prognosis of patients, and which can be used as an auxiliary index for the evaluation of cardiac function and prognosis of patients. [ABSTRACT FROM AUTHOR]

Objective To evaluate the predictive value of neutrophil to lymphocyte ratio(NLR) and B-type natriuretic peptide (BNP) in elderly patients with heart failure complicated with pulmonary infection. Methods 178 heart failure patients in our hospital from June 2018 to May 2020 were selected as the research objects, and they were divided into pulmonary infection group (n=92) and non-pulmonary infection group (n=86) according to whether they were complicated with pulmonary infection. The differences of NLR and BNP levels and other clinical indicators between the two groups were compared. Univariate and multivariate Cox regression were used to analyze the influence of NLR and BNP levels on heart failure complicated with pulmonary infection. The predictive value of NLR combined with BNP on heart failure complicated with pulmonary infection was analyzed by receiver operating characteristic (ROC) curve. Results Multivariate logistic regression analysis showed that NLR (OR=7.606, 95% CI: 3.123-18.526) and BNP (OR=4.264, 95% CI: 1.682-10.811) were independent risk factors of elderly heart failure complicated with pulmonary infection after adjusting for other related variables. Pearson correlation analysis showed that BNP level was positively correlated with NLR level (r=0.400, P<0.001). The area under ROC curve of NLR, BNP and NLR+BNP in predicting pulmonary infection in elderly patients with heart failure was 0.810, 0.756 and 0.838, respectively. Conclusion BNP and NLR are independent risk factors of elderly patients of heart failure with pulmonary infection .The combined detection of BNP and NLR has predictive value for those patients. [ABSTRACT FROM AUTHOR]

目的 探讨银黄清肺胶囊辅助治疗尘肺病合并肺部感染痰热壅肺证的临床效果。方法 选取 2020年9月至2021年7月湖南省中医药研究院附属医院肺病科收治的60例尘肺病合并肺部感染痰热壅肺证 患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,各30例。对照组采用左氧氟沙星抗感染、氨 茶碱解痉平喘、溴己新化痰及吸氧等常规处理,治疗组在对照组的基础上加用银黄清肺胶囊,疗程为10d。比 较两组患者的疗效、治疗前后中医症候积分、炎症因子水平和动脉血氧饱和度(SaO2)的变化情况。结果 治疗 组患者的总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的中医症候积分均较治疗前明 显降低,且治疗组治疗后的中医症候积分均低于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后的 C-反应蛋白(CRP)及降钙素原(PCT)水平均明显低于治疗前,且治疗组治疗后 CRP及 PCT 水平均明显低于对 照组,差异均有统计学意义(P<0.05)。治疗后,两组患者 SaO2 水平较治疗前均升高,且治疗组高于对照组, 差异均有统计学意义(P<0.05)。结论 尘肺病合并肺部感染痰热壅肺证患者在常规西医治疗基础上加用银 黄清肺胶囊治疗,可有效改善患者症状,降低感染指标,提高SaO2,疗效满意,值得临床应用. [ABSTRACT FROM AUTHOR]

To observe the pathogenic bacteria distribution characteristics in postoperative pulmonary infection in patients with lung cancer, and to analyze the influencing factors of infection. From March 2018 to December 2020, the clinical datas of patients with lung cancer (n=358) who were treated in our hospital were analyzed. The number of postoperative pulmonary infection in patients with lung cancer was counted, and they were divided into infected group and uninfected group according to this. The pathogenic bacteria distribution characteristics were observed, and the risk factors of infection were discussed. Among 358 patients with lung cancer, 32 patients developed postoperative pulmonary infection, with an infection rate of 8.94%. 49 s of pathogenic bacteria were isolated from 32 cases of postoperative pulmonary infection in patients with lung cancer, including 31 strains of Gram-negative bacteria, accounting for 63.27%. 15 strains of gram-positive bacteria accounted for 30.61%. 3 strains of fungi, accounting for 6.12%. The top five were Klebsiella pneumoniae with 24.49%, Enterobacter clovis with 14.29%, Staphylococcus aureus with 12.24%, Pseudomonas aeruginosa with 10.20% and A cinetobacter baumannii with 10.20%. Univariate and multivariate logistic regression analysis showed that postoperative pulmonary infection was associated with long-term smoking history, operation method, incision pain score, chronic obstructive pulmonary disease history, age, operation time and diabetes mellitus history ( P<0.05). The risk factors of postoperative pulmonary infection in patients with lung cancer included chronic obstructive pulmonary disease history, incision pain score 4~6 scores, long-term smoking history, diabetes mellitus history, age ≥ 60 years, the operation method was routine operation, operation time ≥ 3 h (P<0.05). Incision pain score, long-term smoking history, chronic obstructive pulmonary disease history, age, operation time, diabetes mellitus history, and operation method are all risk factors for postoperative pulmonary infection in patients with lung cancer, and active measures can be taken to deal with these factors, gram-negative bacteria are the main pathogens of postoperative pulmonary infection in patients with lung cancer, and reasonable preventive antibiotics should be given for clinical treatment. [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the risk factors of postoperative pulmonary infection in patients with esophageal cancer. Methods The databases of SinoMed, PubMed, EMBASE, Web of Science, the Cochrane Library, CINAHL, CBM, CNKI, Wanfang and VIP were searched by computer. The literature on postoperative pulmonary infection in patients with esophageal cancer published from the establishment of the database to June 2021was collected. The meta-analysis was performed by using RevMan5. 3and Stata16. 0software. Results A total of 19literatures involving 6 529patients were included. Age greater than or equal to60years old, smoking history, diabetes, chronic obstructive pulmonary disease, coronary heart disease, hypoproteinemia, tumor located in the upper middle part, operation time greater than or equal to 4h, open chest surgery, one lung ventilation, intraoperative blood loss greater than 800mL, postoperative no use of auto-controlled epidural analgesia, use time of acid inhibitor, and recurrent laryngeal nerve injury were risk factors for postoperative pulmonary infection in patients with esophageal cancer (P<0. 05) . Conclusion There are many risk factors of postoperative pulmonary infection in patients with esophageal cancer. Medical staff should pay attention to relevant risk factors, early prevention and early intervention, so as to reduce the incidence of pulmonary infection and improve the quality of life and prognosis of patients. [ABSTRACT FROM AUTHOR]

Objective To establish and evaluate the predictive value of the risk prediction model for lung infection within postoperative 1 year in kidney transplant recipients. Methods Clinical data of 197 kidney transplant recipients were retrospectively analyzed. All recipients were divided into the infection group (n=42) and non-infection group (n=155) according to the incidence of lung infection within postoperative 1 year. The incidence and risk factors of lung infection after kidney transplantation were analyzed. Risk prediction model was established by multiple logistic regression analysis. Forty-five kidney transplant recipients who met the inclusion criteria, including 8 cases in the infection group and 37 cases in the non-infection group, were selected to verify the predictive effect of the established model. Results The incidence of lung infection within 1 year after kidney transplantation was 21.3% (n=42), including 38 cases (90%) of pneumonia severity index (PSI) class I, 1 case (2%) of PSI class III and 3 cases (8%) of PSI class Ⅴ . Lung infection occurred within 1 month after operation in 13 cases, within postoperative 2-6 months in 22 cases and after postoperative 6 months in 7 cases. Nineteen recipients were diagnosed with bacterial infection, 7 cases of fungal infection, 10 cases of viral infection and 6 cases of mixed infection. Smoking history, diabetes mellitus history, pulmonary disease history and albumin level of <35 g/L were the independent risk factors for lung infection after kidney transplantation (all P<0.05). The equation of risk prediction model for postoperative lung infection in kidney transplant recipients was logit (lung infection within postoperative 1 year in kidney transplant recipients)=-1.891+1.063×smoking history (yes=1, no=0)+1.398×diabetes mellitus history (yes=1, no=0)+1.732×pulmonary disease history (yes=1, no=0)+1.269×albumin level (<35 g/L=1, ≥35 g/L=0). The area under the curve (AUC) of receiver operating characteristic (ROC) was 0.788, the sensitivity was 0.786, the specificity was 0.645, and the Youden index was 0.431, respectively. Hosmer-Lemeshow goodness-of-fit test demonstrated that the predicted value of this model yielded relatively high consistency with the observed value. The AUC in the verification group was 0.834. Hosmer-Lemeshow goodness-of-fit test validated high degree of calibration of this model. Conclusions The risk prediction model, consisting of smoking history, diabetes mellitus history, pulmonary disease history and albumin level as predictors, may effectively predict the incidence of lung infection within postoperative 1 year in kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the pathogenic bacteria composition, drug resistance characteristics and death influencing factors of patients with acute respiratory distress syndrome (ARDS) complicated with pulmonary infection. Methods: From January 2017 to January 2020, 98 patients with ARDS complicated with pulmonary infection who were treated in our hospital were included in this study. Sputum isolation and culture were carried out for all patients, and drug sensitivity test was carried out for pathogenic bacteria obtained from the separation. In addition, the number of patients who died within 28 days after admission was counted, univariate and multivariate Logistic regression analysis of influencing factors of death in patients with ARDS complicated with pulmonary infection. Results: A total of 163 strains of pathogenic bacteria were detected in 98 patients with ARDS complicated with pulmonary infection, from high to low, 123 strains of Gram-negative bacteria accounted for 75.46%, 33 strains of Gram-positive bacteria accounted for 20.25%, and 7 strains of fungus accounted for 4.29%. Among them, Gram-negative bacteria were mainly Pseudomonas aeruginosa (50 strains, accounting for 30.67%), A cinetobacter baumannii (32 strains, accounting for 19.63%) and Klebsiella pneumoniae (21 strains, accounting for 12.88% ). Pseudomonas aeruginosa, A cinetobacter baumannii, Staphylococcus aureus and hemolytic Staphylococcus had different degrees of resistance to common antibiotics, while Klebsiella pneumoniae had 0.00% resistance to Cefoperazone/sulbactam, cefepime, piperacillin/tazobactam and levofloxacin. Multivariate Logistic regression analysis showed that age ≥ 60 years, elevated C-reactive protein (CRP) and procalcitonin (PCT) levels, Acute physiological Function and Chronic health status scoring system Ⅱ (APACHE Ⅱ) score ≥ 25 scores, oxygenation index < 80 mmHg, length of Medical Intensive Care Unit (MICU) stay ≥ 10 d and mechanical ventilation time ≥ 6 d were all risk factors for death in patients with ARDS complicated with pulmonary infection (all OR>1, P<0.05). Conclusions: The pathogenic bacteria of patients with ARDS complicated with pulmonary infection are mainly Gram-negative bacteria, among which, Klebsiella pneumoniae has good sensitivity to Cefoperazone /sulbactam, cefepime, piperacillin/tazobactam and levofloxacin. Age, CRP, PCT level, APACHE Ⅱ score, oxygenation index, length of MICU stay and mechanical ventilation time are the influencing factors for the death of these patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationships between serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), interleukin-12 (IL-12) and pulmonary infection after mechanical ventilation in the elderly of intensive care unit (ICU). Methods A total of 195 elderly patients undergoing mechanical ventilation were selected and divided into the pulmonary infection group (n=82) and non-pulmonary infection group (n=113) according to whether they had pulmonary infection. The basic data of patients were collected, and enzyme-linked immunosorbent assay was used to detect serum sTREM-1 and IL-12 within 6 h after mechanical ventilation in the two groups. Multivariate Logistic regression analysis was used to analyze the influencing factors of pulmonary infection after mechanical ventilation in the elderly; the receiver operating characteristic curve was drawn, and the area under the curve was used to evaluate the diagnostic value of each index. Results Compared with the non-pulmonary infection group, the levels of serum sTREM-1 and IL-12 in pulmonary infection group were higher (both P<0. 05). Serum sTREM-1 and IL-12 were the influencing factors of pulmonary infection after mechanical ventilation in the elderly (both P<0. 05). The area under the curve of sTREM-1 + IL-12 was significantly larger than that of each index alone in the diagnosis of pulmonary infection after mechanical ventilation in the elderly (P<0. 05). Conclusion The elevated levels of serum sTREM-1 and IL-12 are the risk factors of pulmonary infection in elderly patients after mechanical ventilation, and the combined detection of them has a certain diagnostic value for patients with pulmonary infection. [ABSTRACT FROM AUTHOR]

恶性血液病、实体器官移植、先天性免疫缺陷、艾滋病等免疫功能低下患者肺部感染常见, 其中大部分患 者会发展成重症感染而导致急性呼吸衰竭、脓毒血症等, 预后较差。免疫功能低下患者的病原菌谱及病原体种类与 免疫功能正常患者在很大程度上有所不同, 多数为机会性病原体与混合性感染为主。因此, 早期精准诊断病原体对 于治疗和改善临床预后具有决定性作用。宏基因组二代测序 (mNGS) 是一种可同时独立无偏移检测数千至上亿基 因片段的检测技术, 以快速及准确的优势在病原体检测诊断中广泛应用。mNGS在免疫功能低下合并肺部感染患 者的诊断中具有巨大的潜力, 在未来可能成为补充常规诊断方法的宝贵工具。 [ABSTRACT FROM AUTHOR]

Objective To explore the risk factors of multidrug resistant (MDR) bacteria infection in patients with pulmonary infection in department of neurosurgery, and to provide basis for nosocomial infection prevention and clinical treatment of MDR bacteria in department of neurosurgery. Methods The clinical data of 263 patients with pulmonary infection in department of neurosurgery in Xi′an Daxing hospital from May 2020 to June 2021 were analyzed retrospectively. According to whether MDR bacteria were detected from lower respiratory tract samples, the patients were divided into MDR bacteria group（141 cases) and non-MDR bacteria group (122 cases). The pathogenic characteristics and drug resistance of Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa were compared between the two groups. The risk factors of MDR bacteria infection in neurosurgery patients with pulmonary infection were determined by univariate analysis and binomial Logistic regression analysis. Results The resistance rates of Acinetobacter baumannii and Klebsiella pneumoniae isolated in the MDR group to most common clinical antibiotics were higher than those in the non-MDR group (P＜0.05). According to the binomial Logistic regression analysis, age ≥ 65 years old, length of time of hospitalization ≥ 30 d, bedridden, malnutrition, anemia, tracheotomy, time of non-restricted antibiotics ≥ 7 d, time of restricted antibiotics ≥ 7 d were independent risk factors of MDR bacterial infection in neurosurgery patients with pulmonary infection (P＜0.05). Conclusion Advanced age, time of hospitalization ≥ 30 d, bedridden, malnutrition, anemia, tracheotomy, time of non restricted antibiotics ≥ 7 d, time of restricted antibiotics ≥ 7 d were independent risk factors of MDR bacterial infection in neurosurgery patients with pulmonary infection. Patients with high risk factors should be regularly screened for MDR bacteria. Various measures should be taken to strengthen the management of such patients and prevent the occurrence of MDR bacteria infections and hospital transmission. [ABSTRACT FROM AUTHOR]

To explore the clinical value of fiberoptic bronchoscope sputum suction combined with alveolar lavage in patients with lung infection after lung cancer surgery. 82 patients with lung infection after lung cancer surgery who were treated in Jiangsu Provincial People's Hospital from January 2017 to December 2020 were selected, they were randomly divided into control group (fiberoptic bronchoscope sputum suction and routine treatment) and study group (fiberoptic bronchoscope sputum suction, routine treatment and pulmonary bubble lavage), with 41 cases in each group. The control group was treated with routine anti infection and fiberoptic bronchoscope sputum suction, the study group was treated with alveolar lavage on the basis of the control group. The curative effects of the two groups were observed, and the changes of respiratory function, quality of life and peripheral blood helper T cell 17 (Th17 cell) / regulatory T cell (Treg) were compared between the two groups. The total clinical effective rate of the study group was better than that of the control group(P<0.05). 1 week after treatment, airway resistance(Raw), peak airway pressure (PIP) and respiratory work(WOB) decreased in the two groups, and the study group was lower than that in the control group (P<0.05). 1 week after treatment, the percentage of Th17 cells in mononuclear cells, interleukin-6 (IL-6) and interleukin-17 (IL-17) in the two groups decreased, and the study group was lower than that in the control group (P<0.05). 1 week after treatment, the percentage of Treg cells in mononuclear cells and interleukin-10 (IL-10) in the two groups increased, and the study group was higher than that in the control group (P<0.05). 1 week after treatment, the scores of social / family status, physiological status, relationship with doctors, functional status, additional attention and emotional status in the two groups increased, and the scores in the study group were higher than those in the control group (P<0. 05). Fiberoptic bronchoscope sputum suction combined with alveolar lavage can promote the improvement of respiratory function of patients with lung infection after lung cancer surgery, regulate the imbalance of peripheral blood Th17 cells / Treg cells, and improve the quality of life. [ABSTRACT FROM AUTHOR]

目的 研究综合护理在神经外科重症监护室 (NICU) 患者预防肺部感染中的应用效果。 方法 采用回顾性分析方法。选取2020年1—12月该院神经外科收治入住 NICU 的患者 156 例作为对照组, 另将 2021 年1—10月该院神经外科收治入住NICU 的患者131例作为观察组。对照组采用常规护理进行干 预, 观察组采用综合护理进行干预, 统计2组患者肺部感染发生率、平均抗菌药物应用时间、住院时间、住院费 用等。结果 观察组患者肺部感染率为 6.10% (8/131), 明显低于对照组的13.46% (21/156), 差异有统计学 意义(P <0.05)。观察组患者平均抗菌药物应用时间明显短于对照组, 差异有统计学意义(P <0.05)。 结论 综合护理措施能够提高神经外科重症患者的护理质量, 减少抗菌药物的应用时间, 有效预防肺部感染及 并发症的发生, 促进患者康复。 [ABSTRACT FROM AUTHOR]