Prognostic significance of lymphocyte subpopulations for ICU-acquired infections in patients with sepsis: a retrospective study.

AIM: To determine the prognostic value of lymphocyte subpopulations in predicting intensive care unit (ICU)-acquired infections among patients admitted to the ICU with sepsis. METHODS: Data on peripheral blood lymphocyte subpopulations [CD3+ T cells, CD4+ T cells, CD8+ T cells, CD16+CD56+ natural killer (NK) cells and CD19+ B cells] were collected continuously from 188 patients admitted to the study ICUs with sepsis between January 2021 and October 2022. Clinical data collected from these patients, including medical history, number of organ failures, severity of illness scores, and characteristics of ICU-acquired infections, were reviewed. RESULTS: Lymphocyte subpopulation counts were significantly lower in patients who acquired an infection in the ICU compared with those who did not. Univariate analyses showed that the number of organ failures [odds ratio (OR) 3.37, 95% confidence interval (CI) 2.25-5.05], severity of illness scores [Sequential Organ Failure Assessment score - OR 1.69, 95% CI 1.41-2.02; Acute Physiology and Chronic Health Evaluation II score - OR 1.26, 95% CI 0.17-1.36], history of immunosuppressant use (OR 2.41, 95% CI 1.01-5.73) and lymphocyte subpopulations (CD3+ T cells - OR 0.60, 95% CI 0.51-0.71; CD4+ T cells - OR 0.51, 95% CI 0.41-0.63; CD8+ T cells - OR 0.32, 95% CI 0.22-0.47; CD16/CD56+ NK cells - OR 0.41, 95% CI 0.28-0.59; CD19+B cells - OR 0.52, 95% CI 0.37-0.75) were associated with ICU-acquired infections. Multi-factor logistic regression analysis demonstrated that APACHE II score (OR 1.25, 95% CI 1.13-1.38), CD3+ T cells (OR 0.66, 95% CI 0.54-0.81) and CD4+ T cells (OR 0.64, 95% CI 0.50-0.82) were independent significant risk factors for ICU-acquired infections. CONCLUSION: Assessing CD3+ T cells and CD4+ T cells within 24 h of ICU admission may help in identification of patients at risk for developing ICU-acquired infections.

A meta-analysis of clinical therapeutic effect of insulin glargine and insulin detemir for patients with type 2 diabetes mellitus.

BACKGROUND: Insulin have been recommended to decrease glycosylated hemoglobin (HbA1c) level in type 2 diabetes mellitus (T2DM) patients whose blood glucose control are unsatisfactory by using oral hypoglycemic drugs. AIM: To systematically estimate the therapeutic effect and security of insulin glargine and insulin detemir for treatment of type 2 diabetes mellitus. MATERIALS AND METHODS: We searched the Cochrane library, PubMed, EMBASE, etc databases. Quality evaluation of all randomized control tests (RCT) enrolled was conducted according to Cochrane manual, and meta-analysis was performed by using RevMan5.0 software. RESULTS: Both insulin glargine and insulin detemir can effectively control T2DM patient's blood glucose. CONCLUSIONS: Insulin detemir has evident superiority on reducing body weight than insulin glargine. As the doses are concerned, daily insulin dose of insulin detemir is higher than insulin glargine.