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| 1 | 培育世界一流科技期刊的机遇、挑战与对策研究显示文摘中央深化改革委员会第五次会议审议通过《关于深化改革培育世界一流科技期刊的意见》一年多来,中国科学技术协会联合相关部门对标中央要求,合力协同推进,联手打出系列组合拳,受到国内外科技界、期刊界广泛关注.对科技期刊怎么看、怎么办,已成为科技界的大课题、大事件.何为世界一流科技期刊、为什么要培育世界一流期刊、如何有效推进期刊建设等问题,也在各界引起广泛讨论.笔者在此分享一些个人的思考. | 张昕 王素 刘兴平 | 2020 | 科学通报2020，65，9： | 82 |
| 2 | Focus on peripherally inserted central catheters in critically ill patients显示文摘Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings(emergency, intensive care, surgery) and for different purposes(fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device(CVAD)(mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters(PICCs) and centrally inserted central catheters(CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe-due to their placement into peripheral veins of the armand the advantage of a central location of catheter tip suitable for all osmolarity and p H solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as wellas the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs(i.e., low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD(CICCs or PICCs). Second, an inappropriate CVAD choice and, particularly, an inadequate insertion technique are relevant-and often not recognized-potential risk factors for complications in critically ill patients. We strongly believe that all healthcare professionals involved in the choice, insertion or management of CVADs in critically ill patients should know all potential risk factors of complications. This knowledge may minimize complications and guarantee longevity to the CVAD optimizing the risk/benefit ratio of CVAD insertion and use. Proper management of CVADs in critical care saves lines and lives. Much evidence from the medical literature and from the clinical practice supports our belief that, compared to CICCs, the so-called power-injectable peripherally inserted central catheters are a good alternative choice in critical care. | Paolo Cotogni Mauro Pittiruti | 2014 | World Journal of Critical Care Medicine2014，3，4： | 52 |
| 3 | Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients显示文摘Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C. | Gang Lv Guo-Qiang Wang Zhen-Xi Xia Hai-Xia Wang Nan Liu Wei Wei Yong-Hua Huang Wei-Wei Zhang | 2019 | Military Medical Research2019，6，3： | 60 |
| 4 | 基于SBAR沟通模式的ICU护士交接班索引卡的设计及应用显示文摘目的:设计 ICU 护士交接班索引卡,提高护士间沟通及交接班质量,保障患者安全。方法依据SBAR标准沟通模式设计ICU护士交接班索引卡并于2015年5月应用于护理交接班过程中,比较使用前(2014年5月—2015年4月)、后(2015年5月—2016年4月)护士对患者病情掌握程度、交接班质量以及因沟通不良引发的不良事件所占比例。结果共383例患者使用索引卡,护士对患者的病情掌握程度由(86.62±5.23)分提高到(91.68±4.71)分,交接班质量由(90.89±3.35)分提高到(94.44±2.66)分,使用前后比较差异有统计学意义(t值分别为5.57,5.58;P〈0.05)。因沟通不良引发的护理不良事件下降,院内压疮发生率从3.17%下降至1.04%,差异有统计学意义(χ^2=4.17,P〈0.05)。结论基于SBAR沟通模式的ICU护士交接班索引卡有助于促进ICU护士之间的有效沟,提高交接班质量,保障患者安全。 | 任国 俞萍 易利华 | 2016 | 中华现代护理杂志2016，22，34： | 35 |
| 5 | Prevention of stress-related ulcer bleeding at the intensive care unit: Risks and benefits of stress ulcer prophylaxis显示文摘Stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit(ICU). It poses a risk of clinically relevant upper gastrointestinal(GI) bleeding. Therefore, stress ulcer prophylaxis(SUP)is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. Proton pump inhibitors(PPI) and, less effectively, histamine 2 receptor antagonists(H2RA) prevent GI bleeding in critically ill patients in the ICU. However, the routine use of pharmacological SUP does not reduce overall mortality in ICU patients. Moreover, recent studies revealed that SUP in the ICU might be associated with potential harm such as an increased risk of infectious complications, especially nosocomial pneumonia and Clostridium difficile-associated diarrhea. Additionally, special populations such as patients with liver cirrhosis may even have an increased mortality rate if treated with PPI. Likewise, PPI can be toxic for both the liver and the bone marrow, and some PPI show clinically relevant interactions with important other drugs like clopidogrel. Therefore, the agent of choice, the specific balance of risks and benefits for individual patients as well as the possible dose of PPI has to be chosen carefully. Alternatives to PPI prophylaxis include H2 RA and/or sucralfate. Instead of routine SUP, further trials should investigate risk-adjusted algorithms, balancing benefits and threats of SUP medication in the ICU. | Lukas Buendgens Alexander Koch Frank Tacke | 2016 | World Journal of Critical Care Medicine2016，5，1： | 24 |
| 6 | 老年重症患者肠内营养期间腹泻发生的危险因素分析显示文摘目的 探讨入住ICU的老年患者肠内营养期间腹泻发生的危险因素.方法 选取2015年7月—2016年5月入住山东省千佛山医院ICU接受肠内营养治疗的老年患者100例,按是否发生腹泻分为腹泻组(n=36)和对照组(n=64),收集两组患者的BMI、APACHEⅡ评分、是否存在低蛋白血症、是否机械通气、是否使用抗生素、抗酸药、促动力药等信息,采用单因素与多因素Logistic回归筛选肠内营养期间老年患者腹泻发生的危险因素.结果 多因素Logistic回归分析结果证实老年患者肠内营养期间腹泻发生的最危险因素是肠内营养期间患者机械通气(OR=2.528,P<0.05)和存在低蛋白血症(OR=4.184,P<0.05).结论 老年患者需评估血清蛋白含量,低蛋白血症患者要纠正低蛋白血症后再进行肠内营养;老年患者机械通气状态下进行肠内营养时要减慢滴速、减少剂量、间断输注. | 史颜梅 周亚婷 白琳 张淑香 | 2017 | 中华现代护理杂志2017，23，5： | 23 |
| 7 | 家长微信视频探视模式在NICU无陪护患儿中的应用显示文摘目的:探索微信视频在新生儿重症监护室( NICU)无陪护患儿家长探视中的应用,寻求降低无陪护患儿家长焦虑情绪的方法。方法选取2015年12月—2016年4月入住江苏省某三级甲等NICU的患儿家长100例,按随机数字表法分为观察组(微信视频组)50例及对照组(限时探视组)50例。对照组采用限时探视,观察组在对照组的基础上采用微信视频探视,于患儿入院时、第一次探视及出院时采用焦虑自评量表( SAS)及自制的满意度调查表进行评估和调查,比较两组探视家长焦虑状况及患儿家长对护理工作满意度。结果两组患儿家长入院时,比较差异无统计学意义( t=1.72,P〉0.05);第一次探视后及出院时观察组患儿家长焦虑心理明显减轻,两组焦虑评分:第一次探视时及出院时观察组得分分别为(51.35±7.38)分和(23.55±3.43)分,对照组分别为(59.68±8.42)分和(26.36±3.97)分,两组比较差异均有统计学意义( t值分别为-2.86,2.22;〈0.05);观察组患儿家长满意率为100%,高于对照组患儿家长满意率的88%,两组比较差异有统计学意义(t=6.383,〈0.05)。结论微信视频探视能够有效缓解无陪护患儿家长的焦虑情绪,有利于患儿康复,可以化解许多潜在的矛盾与纠纷,提高患儿家长对工作满意度,家长被动探视转变为主动探视的模式,减少了探视管理成本,为无陪护患儿探视的管理提供了一种新的有效方法。 | 陈惠娟 范从海 曹军华 蔡盈 杨雪梅 许燕 魏雪 | 2016 | 中华现代护理杂志2016，22，31： | 19 |
| 8 | Risk factors for ventilator-associated pneumonia in trauma patients:A descriptive analysis显示文摘BACKGROUND:We sought to evaluate the risk factors for developing ventilator-associated pneumonia(VAP)and whether the location of intubation posed a risk in trauma patients.METHODS:Data were retrospectively reviewed for adult trauma patients requiring intubation for>48 hours,admitted between 2010 and 2013.Patients’demographics,clinical presentations and outcomes were compared according to intubation location(prehospital intubation[PHI]vs.trauma room[TRI])and presence vs.absence of VAP.Multivariate regression analysis was performed to identify predictors of VAP.RESULTS:Of 471 intubated patients,332 patients met the inclusion criteria(124 had PHI and208 had TRI)with a mean age of 30.7±14.8 years.PHI group had lower GCS(P=0.001),respiratory rate(P=0.001),and higher frequency of head(P=0.02)and chest injuries(P=0.04).The rate of VAP in PHI group was comparable to the TRI group(P=0.60).Patients who developed VAP were 6 years older,had significantly lower GCS and higher ISS,head AIS,and higher rates of polytrauma.The overall mortality was 7.5%,and was not associated with intubation location or pneumonia rates.In the early-VAP group,gram-positive pathogens were more common,while gram-negative microorganisms were more frequently encountered in the late VAP group.Logistic regression analysis and modeling showed that the impact of the location of intubation in predicting the risk of VAP appeared only when chest injury was included in the models.CONCLUSION:In trauma,the risk of developing VAP is multifactorial.However,the location of intubation and presence of chest injury could play an important role. | Suresh Kumar Arumugam Insolvisagan Mudali Gustav Strandvik Ayman El-Menyar Ammar Al-Hassani Hassan Al-Thani1 | 2018 | World Journal of Emergency Medicine2018，9，3： | 17 |
| 9 | Innovative use of controlled availability fertilizers with high performance for intensive agriculture and environmental conservation显示文摘A variety of slow release fertilizers, controlled release (availability) fertilizers (CAFs),and stability fertilizers have been developed in response to the serious drawbacks of the conventional fertilizers since the early 1960's. Of these fertilizers, CAFs which are coated with resin are consumed in the largest quantity in the world. Selecting CAFs with higher performance, the author will discuss about: 1) Innovation of agro-technologies for various field crops including new concepts of fertilizer application, 2) high yielding of field crops, 3) enhancing quality and safety of farm products, and 4) controlling the adverse effect of intensive agriculture on the environment. | Sadao SHOJI | 2005 | Science China(Life Sciences)2005，48，z2： | 14 |
| 10 | 环节管理在NICU医疗器械性压疮预防中的应用效果显示文摘目的:探讨NICU医疗器械性压疮环节管理,通过各环节管理,达到降低NICU医疗器械性压疮的发生率。方法选取2012年6月—2014年5月726例患者作为对照组,采用常用的预防措施、常规的压疮分期进行护理。另收集2014年6月—2016年5月869例患者作为观察组,观察组在对照组护理的基础上,进行各环节干预:通过成立科室压疮督导小组进行干预、制定常用仪器设备相关压疮的护理措施、建立预防和管理医疗器械相关压疮的管理总则、加强人员培训考核及制定各级职责,观察医疗器械性压疮的发生率。结果对照组发生医疗器械相关性压疮28例,发生率为3.9%,观察组发生医疗器械相关性压疮7例,发生率为0.8%;对照组压疮发生的严重程度高于观察组,创面的治愈率低于观察组,差异有统计学意义( U=-2.001,〈0.05);培训后护理人员对医疗器械相关压疮知识掌握情况总分为(26.2±1.7)分,高于培训前(17.6±0.8)分,差异有统计学意义(t=-6.04,〈0.01)。结论通过对医疗器械相关压疮的环节管理,降低了医疗器械性压疮的发生率,提高了护理质量,规范了医疗器械的使用,更新了护士对医疗器械压疮护理的新理念。 | 郑翠霞 王秀萍 纪进华 徐娟 牛双 | 2016 | 中华现代护理杂志2016，22，31： | 11 |
| 11 | Attributable cost of a nosocomial infection in the intensive care unit: A prospective cohort study显示文摘AIM To study the impact of hospital-acquired infections(HAIs) on cost and outcome from intensive care units(ICU) in India. METHODS Adult patients(> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included. The impact of HAI on treatment cost and mortality was assessed. RESULTS The mean(± SD) age of the cohort(n = 499) was42.3 ± 16.5 years. Acute physiology and chronic health evaluation-Ⅱ score was 13.9(95%CI: 13.3-14.5); 86% were ventilated. ICU and hospital length of stay were 7.8 ± 5.5 and 13.9 ± 10 d respectively. Hospital mortality was 27.9%. During ICU stay, 76(15.3%) patients developed an infection(ventilator-associated pneumonia 50; bloodstream infection 35; urinary tract infections 3), translating to 19.7 infections/1000 ICU days. When compared with those who did not develop an infection, an infection occurring during ICU stay was associated with significantly higher treatment cost [median(inter-quartile range, IQR) INR 92893(USD 1523)(IQR 57168-140286) vs INR 180469(USD 2958)(IQR 140030-237525); P < 0.001 and longer duration of ICU(6.7 ± 4.5 d vs 13.4 ± 7.0 d; P < 0.01) and hospital stay(12.4 ± 8.2 d vs 21.8 ± 13.9 d; P < 0.001)]. However ICU acquired infections did not impact hospital mortality(31.6% vs 27.2%; P = 0.49).CONCLUSION An infection acquired during ICU stay was associated with doubling of treatment cost and prolonged hospitalization but did not significantly increase mortality. | Binila Chacko Kurien Thomas Thambu David Hema Paul Lakshmanan Jeyaseelan John Victor Peter | 2017 | World Journal of Critical Care Medicine2017，6，1： | 11 |
| 12 | Severe sepsis and septic shock in the elderly:An overview显示文摘The incidence of severe sepsis and septic shock is increasing in the older population leading to increased admissions to the intensive care units(ICUs). The elderly are predisposed to sepsis due to co-existing comorbidities, repeated and prolonged hospitalizations, reduced immunity, functional limitations and above all due to the effects of aging itself. A lower threshold and a higher index of suspicion is required to diagnose sepsis in this patient population because the initial clinical picture may be ambiguous, and aging increases the risk of a sudden deterioration in sepsis to severe sepsis and septic shock. Management is largely based on standard international guidelines with a few modifications. Age itself is an independent risk factor for death in patients with severe sepsis, however, many patients respond well to timely and appropriate interventions. The treatment should not be limited or deferred in elderly patients with severe sepsis only on the grounds of physician prejudice, but patient and family preferences should also be taken into account as the outcomes are not dismal. Future investigations in the management of sepsis should not only target good functional recovery but also ensure social independence and quality of life after ICU discharge. | Prashant Nasa Deven Juneja Omender Singh | 2012 | World Journal of Critical Care Medicine2012，1，1： | 9 |
| 13 | Management of parenteral nutrition in critically ill patients显示文摘Artificial nutrition(AN) is necessary to meet the nutritional requirements of critically ill patients at nutrition risk because undernutrition determines a poorer prognosis in these patients. There is debate over which route of delivery of AN provides better outcomes and lesser complications. This review describes the management of parenteral nutrition(PN) in critically ill patients. The first aim is to discuss what should be done in order that the PN is safe. The second aim is to dispel 'myths' about PN-related complications and show how prevention and monitoring are able to reach the goal of 'near zero' PN complications. Finally, in this review is discussed the controversial issue of the route for delivering AN in critically ill patients. The fighting against PN complications should consider:(1) an appropriate blood glucose control;(2) the use of olive oil- and fish oil-based lipid emulsions alternative to soybean oil-based ones;(3) the adoption of insertion and care bundles for central venous access devices; and(4) the implementation of a policy of targeting 'near zero' catheter-related bloodstream infections. Adopting all these strategies, the goal of 'near zero' PN complications is achievable. If accurately managed, PN can be safely provided for most critically ill patients without expecting a relevant incidence of PN-related complications. Moreover, the use of protocols for the management of nutritional support and the presence of nutrition support teams may decrease PN-related complications. In conclusion, the key messages about the management of PN in critically ill patients are two. First, the dangers of PN-related complications have been exaggerated because complications are uncommon; moreover, infectious complications, as mechanical complications, are more properly catheter-related and not PN-related complications. Second, when enteral nutrition is not feasible or tolerated, PN is as effective and safe as enteral nutrition. | Paolo Cotogni | 2017 | World Journal of Critical Care Medicine2017，6，1： | 8 |
| 14 | Clinical deep remission and related factors in a large cohort of patients with rheumatoid arthritis显示文摘Background:Clinical remission is the treatment target in rheumatoid arthritis (RA).This study aimed to investigate clinical remission and related factors in a large cohort of patients with RA.Methods:This study composed of 342 patients with RA.Data were collected by face-to-face interview of 1049 patients with RA who visited the Department of Rheumatology of three teaching hospitals from September 2015 to May 2016.The patients with RA were clinically assessed by rheumatologists and a four-page questionnaire was completed on site.Subsequently,patients fulfilled remission criteria were further analyzed.The practicability of different definitions of remission of RA was rated by a panel of rheumatologists.Sustained intensive disease modifying anti-rheumatic drug (DMARD) treatment was defined as a combination treatment with two or more DMARDs for at least 6 months.Results:In this cohort of 342 patients with RA,the proportions of patients achieving remission were 38.0%,29.5%,24.9%,21.1%,19.0%,18.1%,and 17.0%,based on criteria of disease activity score in 28 joints (DAS28) using CRP (DAS28-CRP),DAS28 using ESR (DAS28-ESR),routine assessment of patient index data 3 (RAPID-3),Boolean,simplified disease activity index (SDAI),clinical disease activity index,and the newly described clinical deep remission (CliDR),respectively.Boolean and CliDR are the best in practicability scored by rheumatologists (7.5 and 8.0,respectively).Compared with the non-sustained intensive group,sustained intensive treatment with DMARDs yielded higher remission rates of 25.6%,23.8%,and 21.3% in patients with RA based on Boolean (χ^2=3.937,P=0.047),SDAI (χ^2=4.666,P=0.031),and CliDR criteria (χ^2=4.297,P=0.038).The most commonly prescribed conventional synthesized DMARDs (csDMARDs) in patients with RA was leflunomide,followed by methotrexate,and hydroxychloroquine.Compared with the non-remission group,patients achieving remission had a longer median duration of DMARDs (45.0 [22.8–72.3] months,Z=-2.295,P=0.022).Conclusions:The findings in this study indicated that clinical deep remission is achievable in patients with RA.Sustained intensive DMARD treatment is needed to achieve a better outcome in RA. | Jia-Jia Liu Ru Li Yu-Zhou Gan Rui-Jun Zhang Jing Li Yue-Ming Cai Jin-Xia Zhao Hua Liao Jing Xu Lian-Jie Shi Ji Li Sheng-Guang Li Xiao-Lin Sun Jing He Xu Liu Hua Ye Zhan-Guo Li | 2019 | Chinese Medical Journal2019，，9： | 7 |
| 15 | Infection management strategy based on prevention and control of nosocomial infections in intensive care units显示文摘Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection,which is clinical problem often faced by intensive care units (ICU) doctors.Without positive treatment,the incidence and mortality of sepsis are high.^[1]As hospital infection control plays an essential role in treating the nosocomial infections in the ICU,and according to the clinical presentation of critically ill patients,the biological characteristics of pathogenic microorganisms and the ICU environment,this article put forward a strategy for the nosocomial infections in the ICU. | Long-Xiang Su Xiao-Ting Wang Pan Pan Wen-Zhao Chai Da-Wei Liu | 2019 | Chinese Medical Journal2019，，1： | 7 |
| 16 | Discussion on the Index System of Intensive Land Use Evaluation in Development Area显示文摘The establishment of evaluation index system is the key to the evaluation of intensive land use.On the basis of expounding connotation,characteristics and the principle of establishing evaluation index system,and as for the problems existing in Evaluation Regulation(Trial)of Intensive Land Use in Development Area,regarding the evaluation index system of intensive land use in the development area,in the light of the connotation of intensive land use in development area,coupled with the practical situation of the land use in China's development area,after referring to the research achievements of domestic and abroad scholars,some suggestions are put forward in order to improve and perfect the evaluation index system of intensive land us in development area. | LIU Xiang-dong1,GAO Jie2 1.School of Land Science and Technology,China University of Geosciences,Beijing 100083,China 2.Weida Real Estate Evaluation Corporation of Henan Province,Luoyang 471000,China | 2011 | Asian Agricultural Research2011，3，2： | 7 |
| 17 | Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital,Indonesia显示文摘Objective:To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit(ICU) of a tertiary care of Falmawati Hospital Jakarta Indonesia.Methods:A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods,and(heir antibiotic susceptibility testing was performed using disk diffusion method.Results:Specimens were collected from 385 patients who were given antimicrobial treatment,of which 249(64.68%) were cultured positive and 136(35.32%) were negative.The most predominant isolate was Pseudomonas aeruginosa(P.aeruginosa)(26.5%) followed by Klebsiella pneumoniae(K.pneumoniae)(15.3%) and Staphylococcus epidermidis(14.9%).P.aeruginosa isolates showed high rate of resistance to cephalexin(95.3%),cefotaxime(64.1%),and ceftriaxone(60.9%).Amikacin was the most effective(84.4%) antibiotic against P.aeruginosa followed by imipenem(81.2%),and meropenem(75.0%).K.pneumoniae showed resistance to cephalexin(86.5%),ceftriaxone(75.7%),ceftazidime(73.0%),cefpirome(73.0%) and cefotaxime(67.9%),respectively.Conclusions:Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins,and quinolone antibiotics.Regular surveillance of antibiotic susceptibility pallerns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients. | Maksum Radji Siti Fauziah Nurgani Aribinuko | 2011 | Asian Pacific Journal of Tropical Biomedicine2011，1，1： | 7 |
| 18 | Characteristics of postintensive care syndrome in survivors of pediatric critical illness: A systematic review显示文摘AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, neurocognitive and psychological morbidities.METHODS A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, Psyc INFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit(PICU) patients. Two reviewers independently screened all titles and abstracts and performed data extraction. From the 3176 articles identified in the search, 252 abstracts were identified for full text review and nineteen were identified for inclusion in the review. All studies reporting characteristics of PICS in PICU patients were included in the final synthesis. RESULTS Nineteen studies meeting inclusion criteria published between 1995 and 2016 were identified and categorized into studies reporting morbidities in each of three categories-physical, neurocognitive and psychological. The majority of included articles reported prospective cohort studies, and there was significant variability in the outcome measures utilized. A synthesis of the studies indicate that morbidities encompassing PICS are well-described in children who have survived critical illness, often resolving over time. Risk factors for development of these morbidities include younger age, lower socioeconomic status, increased number of invasive procedures or interventions, type of illness, and increased benzodiazepine andnarcotic administration.CONCLUSION PICS-related morbidities impact a significant proportion of children discharged from PICUs. In order to further define PICS in children, more research is needed using standardized tools to better understand the scope and natural history of morbidities after hospital discharge. Improving our understanding of physical, neurocognitive, and psychological morbidities after critical illness in the pediatric population is imperative for designing interventions to improve long-term outcomes in PICU patients. | Elizabeth A Herrup Beth Wieczorek Sapna R Kudchadkar | 2017 | World Journal of Critical Care Medicine2017，6，2： | 7 |
| 19 | Glucose control in critical care显示文摘Glycemic control among critically-ill patients has been a topic of considerable attention for the past 15 years. An initial focus on the potentially deleterious effects of hyperglycemia led to a series of investigations regarding intensive insulin therapy strategies that targeted tight glycemic control. As knowledge accumulated, the pursuit of tight glycemic control among critically-ill patients came to be seen as counterproductive, and moderate glycemic control came to dominate as the standard practice in intensive care units. In recent years, there has been increased focus on the importance of hypoglycemic episodes, glycemic variability, and premorbid diabetic status as factors that contribute to outcomes among critically-ill patients. This review provides a survey of key studies on glucose control in critical care, and aims to deliver perspective regarding glycemic management among critically-ill patients. | Jeremy Clain Kannan Ramar Salim R Surani | 2015 | World Journal of Diabetes2015，6，9： | 7 |
| 20 | Epigenetic therapies in acute myeloid leukemia: the role of hypomethylating agents, histone deacetylase inhibitors and the combination of hypomethylating agents with histone deacetylase inhibitors显示文摘Epigenetic regulation includes changes of DNA methylation and modifications of histone proteins and is essential for normal physiologic functions,especially for controlling gene expression.Epigenetic dysregulation plays a key role in disease pathogenesis and progression of some malignancies,including acute myeloid leukemia(AML).Epigenetic therapies,including hypomethylating agents(HMAs)and histone deacetylase(HDAC)inhibitors,were developed to reprogram the epigenetic abnormalities in AML.However,the molecular mechanisms and therapeutic effects of the two agents alone or their combination remain unknown.An overview of these epigenetic therapies is given here.A literature search was conducted through PubMed database,looking for important biological or clinical studies related to the epigenetic regimens in the treatment of AML until October 15th,2019.Various types of articles,including original research and reviews,were assessed,identified,and eventually summarized as a collection of data pertaining the mechanisms and clinical effects of HMAs and HDAC inhibitors in AML patients.We provided here an overview of the current understanding of the mechanisms and clinical therapeutic effects involved in the treatment with HMAs and HDAC inhibitors alone,the combination of epigenetic therapies with intensive chemotherapy,and the combination of both types of epigenetic therapies.Relevant clinical trials were also discussed.Generally speaking,the large number of studies and their varied outcomes demonstrate that effects of epigenetic therapies are heterogeneous,and that HMAs combination regimens probably contribute to significant response rates.However,more research is needed to explore therapeutic effects of HDAC inhibitors and various combinations of HMAs and HDAC inhibitors. | Qing-Yu Xu Li Yu | 2020 | Chinese Medical Journal2020，，6： | 6 |
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