The early prognostic value of the 1-4-day BCM/PA trend after admission in neurocritical patients.

The purpose of this study was to investigate early stage dynamic changes in relevant indicators in neurocritical patients to identify biomarkers that can predict a poor prognosis at an early stage (1-4 days after admission). This study retrospectively collected clinical data, inflammatory indicators, and nutritional indicators from 77 patients at the neurology intensive care unit. The 3-month modified Rankin scale score was used as the outcome indicator. A linear mixed model was used to analyze changes in inflammatory indicators and nutritional indicators in neurocritical patients over time from 1-4 days after admission. Logistic regression was used to determine the independent risk factors for a poor prognosis in neurocritical patients and to construct a predictive model. The predictive efficacy of the model was verified using leave-one-out cross-validation and decision curve analysis methods. The analysis results showed that 1-4 days after admission, the inflammatory indicators of white blood cell and absolute monocyte counts and the nutritional indicators of body cell mass(BCM), fat-free mass, body cell mass/phase angle (BCM/PA), intracellular water, extracellular water, and skeletal muscle index increased overall, while the nutritional indicators of albumin and visceral fat area decreased overall. The logistic multivariate regression model showed that the Charlson comorbidity index (CCI) (odds ratio (OR) = 2.526, 95% CI [1.202, 5.308]), hemoglobin (Hb)(on admission)-Hb(min) (OR = 1.049, 95% CI [1.015, 1.083), BCM(on admission) (OR = 0.794, 95% CI [0.662, 0.952]), and the change in BCM/PA 1-4 days after admission (OR = 1.157, 95% CI [1.070, 1.252]) were independent risk factors for a poor prognosis in neurocritical patients. The predictive analysis showed that the predictive power of Model 1 with BCM/PA (area under the curve (AUC) = 0.95, 95% CI (0.90, 0.99)) was 93%, 65%, 141%, and 133% higher than that of Model 2 without BCM/PA, the CCI, the APACHE II score, and the NRS2002 score (all P < 0.05), respectively. The CCI, Hb(on admission)-Hb(min), BCM(on admission), and an increase in BCM/PA 1-4 days after admission were independently associated with a poor prognosis in neurocritical patients. Of these variables, BCM/PA may be a valid indicator for early stage prediction of a poor prognosis in neurocritical patients.

Risk factors of nosocomial infection in patients underwent artificial liver support system: a retrospective case-control study.

BACKGROUND: Although nosocomial infection is one of the most discussed problems in patients undergoing artificial liver support system (ALSS) treatment, only few solutions have been proposed so far. This study aimed to explore the risk factors of nosocomial infection in patients treated with ALSS in order to aid in the development of future preventive measures. METHODS: This retrospective case-control study included patients treated with ALSS at the Department of Infectious Diseases, First Affiliated Hospital of xxx Medical University between January 2016 and December 2021. RESULTS: One hundred seventy-four patients were included. There were 57 patients in the nosocomial infection group and 117 patients in the non-nosocomial infection group, of them 127 males (72.99%) and 47 females (27.01%) with an average age of 48.15 ±â€…14.19 years old. Multivariate logistic regression analysis revealed that total bilirubin [odds ratio (OR) = 1.004; 95% confidence interval (CI), 1.001-1.007; P  = 0.020], number of invasive procedures (OR = 2.161; 95% CI, 1.500-3.313; P  < 0.001), blood transfusion (OR = 2.526; 95% CI, 1.312-4.864; P  = 0.006) were independent risk factors and haemoglobin (Hb) (OR = 0.973; 95% CI, 0.953-0.994; P  = 0.011) was a protective factor for nosocomial infection in patients treated with ALSS. CONCLUSION: The total bilirubin, transfusion of blood products and higher number of invasive operations were independent risk factors for nosocomial infection in patients treated with ALSS, while higher Hb was a protective factor.

The correlation between feeding intolerance and poor prognosis of patients with severe neurological conditions: a case-control study.

BACKGROUND: This study aims to investigate the current status of feeding intolerance (FI) among patients with severe neurological conditions and to further determine the correlation between FI and their poor prognosis. METHODS: This study performed a retrospective analysis of the medical data of 58 patients from January 2017 and December 2017. Patients were divided into two groups according to modified Rankin Scale (mRS) scores. Logistic regression was used to analyze the relevant factors for the poor prognosis of these patients. RESULTS: General data analysis showed that age and diagnosis(stroke) were significantly different between the two groups (P < 005). Univariate analysis showed that APACHE II score, vomiting within 3 days of NICU admission, gastrointestinal bleeding within 3 days of NICU admission, and occurrence of FI within 3 days of NICU admission were all risk factors for a poor prognosis of these patients (P < 005). Multivariate logistic regression analysis showed that FI within 3 days of NICU admission (OR 8026, 95%CI (1550-26039)) and diagnosis (stroke) (OR 10654, 95%CI (1746-21291)) were independent factors for a poor prognosis of patients with severe neurological conditions. CONCLUSION: The incidence of early FI in stroke patients is correlated with a poor prognosis.

Risk Factors and Predictive Model of Diarrhea Among Patients with Severe Stroke.

OBJECTIVE: To investigate the risk factors and predictive model of diarrhea among patients with severe stroke. METHODS: The study analyzed the retrospective clinical data of patients with new-onset stroke who had been admitted to the intensive care unit at the Department of Neurology of X Hospital, between September 2017 and April 2018. All data were analyzed with a binary logistic regression, and a logistic regression equation was used to build a predictive model of diarrhea among patients with severe stroke. RESULTS: A total of 153 patients with severe stroke were included in this study, including 45 patients (29.41%) with diarrhea. The binary logistic multivariate analysis showed that the National Institutes of Health Stroke Scale score at admission (odds ratio [OR], 1.123; 95% confidence interval [CI], 1.016-1.242), the Glasgow Coma Scale score at admission (OR, 1.563; 95% CI, 1.048-2.330), antibiotic use (OR, 2.168; 95% CI, 1.041-4.514), gavage feeding time (OR, 1.260; 95% CI, 1.098-1.445), and hospital stay before the occurrence of diarrhea (OR, 0.652; 95% CI, 0.552-0.770). The receiver operating characteristic curve was 0.862 (95% CI, 0.799-0.925), the specificity was 0.778, and the sensitivity was 0.843. CONCLUSIONS: The National Institutes of Health Stroke Scale score at admission, the Glasgow Coma Scale score at admission, antibiotic use, gavage feeding time, and hospital stay before the occurrence of diarrhea independently predict diarrhea among patients with severe stroke. This model can be used to predict the risk of diarrhea among patients with severe stroke.

The correlation between feeding intolerance and poor prognosis of patients with severe neurological conditions: a case-control study.

Background: This study aims to investigate the current status of feeding intolerance (FI) among patients with severe neurological conditions and to further determine the correlation between FI and their poor prognosis.Methods: This study performed a retrospective analysis of the medical data of 58 patients from January 2017 to December 2017. Patients were divided into two groups according to modified Rankin Scale (mRS) scores. Logistic regression was used to analyze the relevant factors for the poor prognosis of these patients.Results: General data analysis showed that age and diagnosis(stroke) were significantly different between the two groups (P < 0.05). Univariate analysis showed that APACHE II score, vomiting within 3 days of NICU admission, gastrointestinal bleeding within 3 days of NICU admission and occurrence of FI within 3 days of NICU admission were all risk factors for a poor prognosis of these patients(P < 0.05). Multivariate logistic regression analysis showed that FI within 3 days of NICU admission(OR 8.026, 95%CI(1.550-26.039)) and diagnosis(stroke)(OR 10.654, 95%CI (1.746-21.291)) were independent factors for a poor prognosis of patients with severe neurological conditions.Conclusion: The incidence of early FI in stroke patients is correlated with a poor prognosis.

Study of the interaction between a new Schiff-base complex and bovine serum albumin by fluorescence spectroscopy.

A new Schiff-base compound, N'-(2-hydroxynaphthalenemethylene)-4-(2-hydroxyl naphthalenemethylenamine)benzoylhydrazine (1), was synthesized and the interaction between zinc complex (1-Zn) and bovine serum albumin (BSA) was investigated by fluorescence and absorption spectroscopies. A marked increase in the fluorescence intensity of 1-Zn was observed at 475 nm upon addition of BSA when excitation wavelength was set at 370 nm in pH 7.4 Tris-HCl buffer solution. Reversely, the intrinsic fluorescence of BSA could be quenched by 1-Zn complex. The quenching mechanism was suggested as static quenching according to the Stern-Volmer equation and the UV-vis absorption spectral change of 1-Zn upon addition of BSA. The binding constants K(b) and the number of binding sites n were calculated. The effect of 1-Zn on the conformation of BSA was studied using synchronous fluorescence spectroscopy and three-dimensional fluorescence spectroscopy. In addition, the binding average distance r between the donor (BSA) and acceptor (1-Zn) was estimated based on the Förster's non-radiation energy transfer theory.