目的分析高血压脑出血术后颅内感染的病原菌特征及其相关危险因素,为临床颅内感染防治提供依据。方法选择2017年1月—2019年12月在滁州市第一人民医院神经外科行手术治疗的102例高血压脑出血患者为研究对象,回顾性分析其临床资料,观察...目的分析高血压脑出血术后颅内感染的病原菌特征及其相关危险因素,为临床颅内感染防治提供依据。方法选择2017年1月—2019年12月在滁州市第一人民医院神经外科行手术治疗的102例高血压脑出血患者为研究对象,回顾性分析其临床资料,观察颅内感染患者的病原菌分布特点,分析颅内感染相关的危险因素。结果 102例高血压脑出血患者术后发生颅内感染23例,革兰阳性病原菌主要为表皮葡萄球菌,占25.00%,革兰阴性病原菌主要为鲍曼不动杆菌,占32.14%。其中表皮葡萄球菌对青霉素、环丙沙星、红霉素、克林霉素、利奈唑胺、万古霉素和替加环素的耐药率分别为100.00%、85.71%、100.00%、85.71%、0.00%、0.00%、0.00%,鲍曼不动杆菌对哌拉西林、头孢他啶、头孢曲松、亚胺培南、左氧氟沙星、复方新诺明和替加环素的耐药率分别为100.00%、88.89%、100.00%、44.44%、55.56%、66.67%、0.00%。感染组与非感染组患者在性别、年龄、BMI、手术时间、ASA评分和是否合并糖尿病之间差异无统计学意义(均P>0.05),而术前格拉斯哥昏迷指数(Glasgow coma scale,GCS)评分、引流管时间和是否留置脑室引流管差异具有统计学意义(均P<0.05),多因素分析显示GCS评分和是否留置脑室引流管为颅内感染的独立危险因素(均P<0.05)。结论高血压脑出血术后颅内感染病原菌主要为表皮葡萄球菌和鲍曼不动杆菌,且具有多重耐药的特点,术前GCS评分和是否留置脑室引流管为颅内感染的独立危险因素,临床上需引起重视。展开更多
Ionic liquids （ILs） have attracted many attentions in the dissolution of cellulose due to their unique physicochemical properties as green solvents. However, the mechanism of dissolution is still under debate. In th...Ionic liquids （ILs） have attracted many attentions in the dissolution of cellulose due to their unique physicochemical properties as green solvents. However, the mechanism of dissolution is still under debate. In this work, computational investigation for the mechanisms of dissolution of cellulose in [Bmim]Cl, [Emim]C1 and [Emim]OAc ILs was performed, and it was focused on the process of breakage of cellulose chain and ring opening using cellobiose as a model molecule. The detailed mechanism and reaction energy barriers were computed for various possible pathways by density functional theoretical method. The key finding was that 1Ls catalyze the dissolution process by synergistic effect of anion and cation, which led to the cleavage of cellulose chain and formation of derivatives of cellulose. The investigation on ring opening process ofcellobiose suggested that carbene formed in ILs played an important role in the side reaction of cellulose, and it facilitated the formation of a covalent bond between cellulose and imidazolium core. These computation results may provide new perspective to understand and apply ILs for pretreatment of cellulose.展开更多
文摘目的分析高血压脑出血术后颅内感染的病原菌特征及其相关危险因素,为临床颅内感染防治提供依据。方法选择2017年1月—2019年12月在滁州市第一人民医院神经外科行手术治疗的102例高血压脑出血患者为研究对象,回顾性分析其临床资料,观察颅内感染患者的病原菌分布特点,分析颅内感染相关的危险因素。结果 102例高血压脑出血患者术后发生颅内感染23例,革兰阳性病原菌主要为表皮葡萄球菌,占25.00%,革兰阴性病原菌主要为鲍曼不动杆菌,占32.14%。其中表皮葡萄球菌对青霉素、环丙沙星、红霉素、克林霉素、利奈唑胺、万古霉素和替加环素的耐药率分别为100.00%、85.71%、100.00%、85.71%、0.00%、0.00%、0.00%,鲍曼不动杆菌对哌拉西林、头孢他啶、头孢曲松、亚胺培南、左氧氟沙星、复方新诺明和替加环素的耐药率分别为100.00%、88.89%、100.00%、44.44%、55.56%、66.67%、0.00%。感染组与非感染组患者在性别、年龄、BMI、手术时间、ASA评分和是否合并糖尿病之间差异无统计学意义(均P>0.05),而术前格拉斯哥昏迷指数(Glasgow coma scale,GCS)评分、引流管时间和是否留置脑室引流管差异具有统计学意义(均P<0.05),多因素分析显示GCS评分和是否留置脑室引流管为颅内感染的独立危险因素(均P<0.05)。结论高血压脑出血术后颅内感染病原菌主要为表皮葡萄球菌和鲍曼不动杆菌,且具有多重耐药的特点,术前GCS评分和是否留置脑室引流管为颅内感染的独立危险因素,临床上需引起重视。
基金Supported by the National Natural Science Foundation of China(21210006,21276255,21406230,91434111)the Natural Science Foundation of Beijing of China(2131005,2142029)
文摘Ionic liquids （ILs） have attracted many attentions in the dissolution of cellulose due to their unique physicochemical properties as green solvents. However, the mechanism of dissolution is still under debate. In this work, computational investigation for the mechanisms of dissolution of cellulose in [Bmim]Cl, [Emim]C1 and [Emim]OAc ILs was performed, and it was focused on the process of breakage of cellulose chain and ring opening using cellobiose as a model molecule. The detailed mechanism and reaction energy barriers were computed for various possible pathways by density functional theoretical method. The key finding was that 1Ls catalyze the dissolution process by synergistic effect of anion and cation, which led to the cleavage of cellulose chain and formation of derivatives of cellulose. The investigation on ring opening process ofcellobiose suggested that carbene formed in ILs played an important role in the side reaction of cellulose, and it facilitated the formation of a covalent bond between cellulose and imidazolium core. These computation results may provide new perspective to understand and apply ILs for pretreatment of cellulose.
