Epidemiology and Outcome of Severe Sepsis and Septic Shock in Intensive Care Units in Mainland China

Introduction

Information about sepsis in mainland China remains scarce and incomplete. The purpose of this study was to describe the epidemiology and outcome of severe sepsis and septic shock in mixed ICU in mainland China, as well as the independent predictors of mortality.

Methods

We performed a 2-month prospective, observational cohort study in 22 closed multi-disciplinary intensive care units (ICUs). All admissions into those ICUs during the study period were screened and patients with severe sepsis or septic shock were included.

Results

A total of 484 patients, 37.3 per 100 ICU admissions were diagnosed with severe sepsis (n = 365) or septic shock (n = 119) according to clinical criteria and included into this study. The most frequent sites of infection were the lung and abdomen. The overall ICU and hospital mortality rates were 28.7% (n = 139) and 33.5% (n = 162), respectively. In multivariate analyses, APACHE II score (odds ratio[OR], 1.068; 95% confidential interval[CI], 1.027–1.109), presence of ARDS (OR, 2.676; 95%CI, 1.691–4.235), bloodstream infection (OR, 2.520; 95%CI, 1.142–5.564) and comorbidity of cancer (OR, 2.246; 95%CI, 1.141–4.420) were significantly associated with mortality.

Conclusions

Our results indicated that severe sepsis and septic shock were common complications in ICU patients and with high mortality in China, and can be of help to know more about severe sepsis and septic shock in China and to improve characterization and risk stratification in these patients.     

道路交通事故致胫腓骨骨折的特点及救治

目的:总结交通事故伤中胫腓骨骨折的流行病学分类、特点及救治注意事项。方法:对136例交通事故伤中胫腓骨骨折患者的临床资料进行回顾性分析。结果:交通事故致胫腓骨骨折以多发伤及复合伤多见,经早期彻底清创、恰当的骨折固定、抗生素应用等,治愈77例,截肢2例,伤口浅表感染6例,骨髓炎1例。结论:交通事故伤中胫腓骨骨折大多伤情严重,感染率高,且开放性居多,早期及时选择合适的治疗方法是取得良好预后的关键。     

蒲公英的化学成份及其药理作用

蒲公英种类繁多、资源丰富、化学成分复杂,其活性成分主要有黄酮类、萜类、酚酸类、蒲公英色素、植物甾醇类、倍半萜内酯类和香豆素类等。蒲公英具有良好的广谱抗菌、抗自由基、抗病毒、抗感染、抗肿瘤作用,有养阴凉血、舒筋固齿、通乳益精、利胆保肝、增强免疫力等功效。蒲公英与其它中药配合用于治疗烧伤合并感染、胃痛、急性胆道感染、腮腺炎等多种疾病。     

赤眼蜂在田间环境下的存活时间及其影响因子研究

目前,淹没式释放是赤眼蜂田间应用的主要方式,在这种释放方式下成虫羽化后在田间的存活时间是影响其防治效果的一个重要因素。本研究以松毛虫赤眼蜂雌成虫为材料,将赤眼蜂引入固定在桃树上的透气的塑料管中,研究了田间不同地面植被（紫花苜蓿和自然生杂草）和不同试验日期（5月31日、6月5日、7月17日、7月24日、8月24日和8月30日）温度、湿度、食物和叶片等因子对成虫存活时间的影响。结果表明：不同地面植被和不同试验日期松毛虫赤眼蜂成虫的存活时间差异显著,成虫的存活时间紫花苜蓿区明显长于自然生杂草区;5月31日和6月5日试验日期的成虫存活时间最长,7月17日和7月24日试验日期成虫的存活时间最短。成虫的存活时间与温度和湿度都呈显著负相关,但温度对成虫存活时间的影响更为显著。松毛虫赤眼蜂羽化后补充营养可以显著延长成虫的存活时间;食物充足的条件下,桃叶的存在使成虫的存活时间明显延长。结论认为,在田间环境下温度和食物是影响赤眼蜂成虫存活时间的主要因子。     

植物大环寡肽研究进展

本文综述了植物大环寡肽(cycbtides)的研究进展,列举出迄今已报道的40多个植物大环寡肽,着重介绍了这类活性物质的生源、生物活性和结构特征。     

Effects of a nematode Meloidogyne incognita and its interaction with above‐ground herbivory on an invasive wetland plant,alligator weed (Alternanthera philoxeroides)

Invasive plants may be attacked both above ground and below ground. Few studies have, however, investigated the simultaneous effects of above‐ground and below‐ground herbivory. In the present study, we report the effects of beetle herbivory and nematode infection on alligator weed, Alternanthera philoxeroides, an invasive plant in China. We found that the root‐knot nematode Meloidogyne incognita widely occurred on the plant in south China. To examine its effect on the plant in conjunction with above‐ground herbivory, we conducted a field common garden experiment with a local insect defoliator, Cassida piperata. We also included the native congener Alternanthera sessilis in our experiments for a comparison of the response of invasive and native species. We found no significant effects on plant biomass of the nematode infection in conjunction with the above‐ground herbivory. Further chemical analysis, however, showed that the water‐soluble carbohydrate content in roots of A. philoxeroides was significantly increased in plants attacked by both the nematode and the herbivore compared with the water‐soluble carbohydrate content in plants attacked by only the nematode or herbivore alone. We found no such change in the native congener A. sessilis. Together these results may suggest that A. philoxeroides tolerates joint above‐ground and below‐ground damage by allocating more resources to below‐ground material.     

苦豆子提取物与埃玛菌素混用对小菜蛾生长发育和繁殖的影响

将苦豆子甲醇和水提取物分别与埃玛菌素混合,在室内测定了两混合物对小菜蛾生长发育和繁殖的影响.结果表明:苦豆子甲醇提取物 埃玛菌素和苦豆子水提取物 埃玛菌素对小菜蛾3龄幼虫口服毒力明显高于埃玛菌素,其LC50值分别为0.19、0.32和0.51 mg.L-1;用两混合物以及埃玛菌素亚致死剂量处理3龄幼虫,试虫化蛹率、羽化率和成虫的繁殖力均呈现明显不良影响.     

双钩巢粉虱产卵分泌物的化学成分

双钩巢粉虱Paraleyrodes pseudonaranjae Martin原产于南美洲,现已分布于美国的佛罗里达、夏威夷和中国的香港、广东、广西、海南等地.这种粉虱的产卵方式与螺旋粉虱Aleurodicus disperses Russell等相似,卵粒以白色的分泌物覆盖.本文采用气相色谱/质谱联用技术研究了双钩巢...     

荒漠绿洲边缘不同粒径砂砾凝结水量

根据临泽荒漠绿洲边缘的凝结水观测数据,分析了砂砾粒径与凝结水形成量的关系。结果表明：粒径＜0.02 mm的粉砂凝结量最大,7—10月日平均凝结量为(0.097±0.032) mm,其次是砂壤土,日平均凝结量(0.072±0.026) mm;而粒径为5.0～2.0 mm、2.0～0.2 mm和0.2～0.02 mm的砂砾凝结量较小,日平均凝结量分别为(0.052±0.021) mm、(0.057±0.018) mm和(0.059±0.016) mm。总之,凝结量随砂砾粒径的减小而增大,同时本文还分析了旱季农田砂土覆盖对土壤水分蒸发的抑制作用。     

多荚草中的新三萜皂甙

从石竹科植物多荚草（Ｐｏｌｙｃａｒｐｏｎ ｐｒｏｓｔｒａｔｕｍ（Ｆｏｒｓｓｋ．）Ａｓｃｈｅｒｓ．ｅｔ Ｓｃｈｗｅｉｎ．ｅｘ Ａｓｃｈｅｒｓ）中分离得到３个新的柴胡皂甙类化合物：ｐｒｏｓｔｒａｔｏｓｉｄｅ Ａ￣Ｃ（１￣３）。它们的结构通过波谱方法分别鉴定为：３－Ｏ－｛β－Ｄ－ｘｙｌｏｐｙｒａｎｏｓｙｌ－（１→２）－β－Ｄ－ｇｌｕｃｏｐｙｒａｎｏｓｙｌ－（１→４）－「β－Ｄ－ｇｌｕｃｏｐｙｒａｎｏｓｙ