| 1 | Hepatology International|HBV相关慢加急性肝衰竭合并细菌感染患者预后模型的建立和验证显示文摘细菌感染是HBV相关慢加急性肝衰竭(HBV-ACLF)最常见的并发症之一,可导致高病死率。然而,目前关于HBV-ACLF合并细菌感染患者的预后模型建立的研究未见报道。该研究旨在建立和验证一个能预测HBV-ACLF合并细菌感染患者30 d死亡风险的临床模型。研究者筛选2018年6月—2020年12月在华中科技大学同济医学院附属同济医院被诊断为HBV-ACLF的住院患者,共513例患者纳入前瞻性队列,其中224例合并细菌感染患者纳入建模队列。通过logistic回归分析筛选出独立预测因素并建立预测HBV-ACLF合并细菌感染患者30 d死亡风险列线图。同时回顾性筛选2016年1月—2018年5月在该院被诊断为HBV-ACLF的住院患者,共192例患者纳入验证队列,用于评估列线图的区分度、校准度和临床实用性。 | 张忠威 陈韬 宁琴 YANG ZY CHENG QY | 2022 | 临床肝胆病杂志2022，38，4： | 9 |
| 2 | Pulmonary infection control window in treatment of severe respiratory failure of chronic obstructive pulmonary diseases: a prospective, randomized controlled, multi-centred study显示文摘Background Early withdraw from invasive mechanical ventilation (MV) followed by noninvasive MV is a new strategy for changing modes of treatment. This study was conducted to estimate the feasibility and the efficacy of early extubation and sequential noninvasive MV commenced at beginning of pulmonary infection control window in patients with exacerbated hypercapnic respiratory failure caused by chronic obstructive pulmonary diseases (COPD). Methods A prospective, randomized controlled study was conducted in eleven teaching hospitals' respiratory or medical intensive care units in China. Ninety intubated COPD patients with severe hypercapnic respiratory failure triggered by pulmonary infection (pneumonia or purulent bronchitis) were involved in the study. When the pulmonary infection had been controlled by antibiotics and comprehensive therapy, the 'pulmonary infection control window (PIC window)' has been reached. Each case was randomly assigned to study group (extubation and noninvasive MV via facial mask immediately) or control group (invasive MV was received continuously after PIC window by using conventional weaning technique).Results Study group (n=47) and control group (n=43) had similar clinical characteristics initially and at the time of PIC window. Compared with control group, study group had shorter duration of invasive MV [(6.4±4.4) days vs (11.3±6.2) days, P=0.000], lower rate of ventilator associated pneumonia (VAP) (3/47 vs 12/43, P=0.014), fewer days in ICU [(12±8) days vs (16±11) days, P=0.047] and lower hospital mortality (1/47 vs 7/43, P=0.025).Conclusions In COPD patients requiring intubation and invasive MV for hypercapnic respiratory failure, which is exacerbated by pulmonary infection, early extubation followed by noninvasive MV initiated at the start of PIC window may decrease significantly the duration of invasive MV, the risk of VAP and hospital mortality. | Wang, C Zhan, QY Cao, ZX Wei, LQ Cheng, ZZ Liu, S Zhang, JL Chen, RC Luo, Q Niu, SF Zhu, L Wu, DW Fang, BM Wu, TH Wang, CZ Liu, YN | 2005 | Chinese Medical Journal2005，，19： | 6 |
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