In order to determine the risk factors and outcomes of ventilator-associated pneumonia (VAP) in the neonatal intensive care unit (NICU), a retrospective cohort study was conducted on 259 patients who were ventilated >48 h. Clinical characteristics and risk factors were compared and non-conditional logistic regression analysis was performed to determine independent predictors for VAP. There were 52 episodes of VAP (20.1%). The main pathogens were G- bacterium (82.1%, 23/28). Hospital stay in the VAP group was 19.9±5.9 vs. 16.7±7.2 days in controls (P<0.01). The mortality rate of the VAP group was 13.5% (7/52) vs. 12.1% in controls (P>0.05). By logistic regression analysis the following independently predicted VAP: re-intubation (OR 5.3, 95% CI 2.0, 14.0), duration of mechanical ventilation (OR 4.8, 95% CI 2.2, 10.4), treatment with opiates (OR 3.8, 95% CI 1.8, 8.5) and endotracheal suctioning (OR 3.5, 95% CI 1.6, 7.4). VAP occurred at significant rates among mechanically ventilated NICU patients and is associated with care procedures. The risk factors of neonatal VAP were re-intubation, duration of mechanical ventilation, treatment with opiates and endotracheal suctioning. Additional studies are necessary to develop interventions to prevent neonatal VAP.
A novel 2D coordination polymer, [Mn(pyphen)(L)] (1) (L=3-carboxy-1-(4'-(2''- carboxy)biphenylmethyl)-2-oxidopyridinium and pyphen=pyrazino[2,3- f ][1,10]phenanthroline), has been synthesized under hydrothermal conditions, and characterized by elemental analysis, IR, UV/Vis spectra and its optical band gap. Crystal data for 1: C34H21MnN5O5, monoclinic, space group P21/c, a=12.484(4), b=13.473(5), c=16.479(3) Å, b =99.618(6)° , V =2732.8(14) Å3, Z =4. In 1, each L ligand coordinates to three Mn(II) atoms through its two carboxylate groups and one phenolate unit. In this way, L2- ligands link neighboring Mn(II) atoms to generate a layer structure.
New kinds of bifunctional antioxidant enzyme mimics were prepared, and their superoxide anion radical (O2•–) and hydroxyl radical (•OH) scavenging activity was investigated. These conjugates were prepared by binding insoluble salphen [N,N-(phenylene)salicylidene] Schiff-base metal complexes (HO-salphen-M, M = Co, Mn, Cu) with bovine serum albumin (BSA). They were characterized by UV–vis spectra, circular dichroism (CD), and native polyacrylamide gel electrophoresis (PAGE). It showed that the binding mode was an axial coordination between HO-salphen-Co and amino acid residue of BSA. The structure of BSA was maintained when the binding amount of HO-salphen-Co was less than 10. After combining HO-salphen-Co into BSA, the low solubility of HO-salphen-Co was overcome, and the O2•– and •OH scavenging activity of BSA was improved two orders of magnitude. In similar inhibitory value, the scavenging rate of salphen-Co20@BSA was far higher than -others. The scavenging activity of different proportion salphen-Co@BSA was salphen-Co20@BSA > salphen-Co10@BSA > salphen-Co5@BSA > salphen-Co2@BSA. But salphen-Cu@BSA and salphen-Mn@BSA did not show •OH scavenging activity.
Objective To enhance the quality of medical service for Chinese patients through research of service quality from Chinese medical personnel.
Methods ServQual scale was used for infection medical staffs randomly by sampling questionnaire in Beijing, Shanghai, Chengdu, Chongqing, Guangzhou and Nanning. The data collected were entered and analyzed using SPSS 20.0. Statistical methods included frequency, factor analysis, reliability analysis, correlation analysis, independent samples t test, one-way analyses of variance, simultaneous regression analysis and structural equation model analysis.
Results The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.970. The Cronbach’s α for the reliability analysis was 0.975. The Pearson correlation coefficients were 0.624-0.874 and statistically significant. Undergraduates felt good, PhD students felt bad; the doctors felt bad; managers felt good. Standard 5 dimensions of the regression coefficients were positive, including empathy (β = 0.288), reliability (β = 0.241) impacting on perceived service quality mostly. The control ability and stability of the standard error of perceived service quality directly effected value were 0.646 and 0.382, respectively.
Conclusions Medical staffs of infectious disease department have poor perception of service quality. Hospitals should improve awareness and of clinicians and deepen the reform of the medical care system.
Background: Despite important advances in the diagnosis and treatment of acute pulmonary embolism (APE), diagnosis of pulmonary embolism (PE) is difficult in patients with chronic obstructive pulmonary disease (COPD) and exacerbation.
Objective: We evaluated PE in patients with chronic obstructive pulmonary disease and exacerbations of unknown origin.
Methods: Two-hundred and eight patients with COPD and severe exacerbations were studied. All patients had CT pulmonary angiography (CTPA) and lower limb ultrasonography. Arterial blood gas measurements, D-dimers and endothelin-1 (ET-1) levels were recorded.
Results: The frequency of PE was 33%. The following were more common in the PE group (χ2 = 4.32-6.79, mean p < 0.05): immobilization ≥ 7 days; a ≥ 1 cm difference in edema of the lower limbs; deep venous thrombosis; syncope; S1Q3T3 syndrome; and a decrease in PaCO2 ≥ 5 mm Hg. Plasma D-dimers and ET-1 levels were significantly higher in the PE group. Risk factors identified from logistic regression analysis were immobilization ≥ 7 days, ≥ 1 cm difference in lower limb edema, and deep venous thrombosis.
Conclusions: Overall, 33% of 208 patients had a PE, and the risk was greater in those who had been immobilized, those who had a ≥ 1 cm difference in edema of the lower limbs, and those who had a deep venous thrombosis.
Any axis of precision machines possesses six-degree-of-freedom (6-DOF) motion errors, also called the geometric errors, due to manufacturing tolerances and assembly errors, namely three linear and three angular errors. Conventional optical instruments allow measurement of only one or two errors at a time. In order to achieve fast measurement, many multi-degree-of-freedom measurement (MDFM) systems have been developed over the past 20 years, from three-degree-of-freedom (3-DOF) to 6-DOF. This article summarizes reports of optical measurement techniques of MDFM systems for precision linear, planar and XYZ stages. Comments are also given for the applicability to practical uses.
In order to investigate the neuropathological effects on the developing rat brain after intrauterine infection, identification of glail fibrillary acidic protein (GFAP), 2′, 3′-cyclic nucleotide phosphodiesterase (CNPase), and neurofilament (NF) was observed. Escherichia coli (E. coli) was inoculated into uterine horn of pregnant rats when gestation was 70% complete (15 days) and the control group was inoculated with normal saline. Immunohistochemistry was used for evaluation of GFAP, CNPase, and NF expression in pup brains at postnatal day 7 (P7) and reverse transcriptase-PCR (RT-PCR) to analyze macrophage inflammatory protein-1 α mRNA (MIP-1 α mRNA), macrophage inflammatory protein-1 β mRNA (MIP-1β mRNA), the regulated upon activation normal T expressed and secreted chemokine mRNA (RANTES mRNA) and Eotaxin mRNA expression in pup brains at P1, P3 and P7. The numbers of GFAP-positive cells of the E. coli-treated group pups were marked increased in periventricular white matter and hippocampus at P7 compared with the control group but no significant different levels of GFAP expression in corpus callosum were found between two groups. The integrate density (ID) of CNPase-positive staining of the Escherichia coli-treated group pups were marked decreased in periventricular white matter and corpus callosum at P7 compared with the control group. The ID of NF-positive staining of the Escherichia coli-treated group pups were marked decreased in periventricular white matter at P7 compared with the control group and no significant different levels of NF expression in corpus callosum were found between two groups. The expression of MIP-1 α mRNA and MIP-1 β mRNA in brain of the E. coli-treated pup rat were higher than the control at P1, but the expression of MIP-1 α mRNA and MIP-1 β mRNA in brain of the pup rat at P3 and P7 had no significant difference between two groups. The alteration of expression of GFAP, CNPase, and NF in the brain of neonatal rats after intrauterine infection suggested that intrauterine infection could cause neonatal white matter damage. Moreover, the transient increase in expression of chemokine such as MIP-1 α, MIP-1 β in neonatal brain after intrauterine infection indicated that MIP-1 α, MIP-1 β may be a mechanism mediating between the neonatal white matter damage and the intrauterine infection.