Background: The prognostic impact of poor nutritional status in severe encephalitis is not clearly understood. We aim to investigate the relationship between the Prognostic Nutritional Index (PNI) and poor outcomes of severe encephalitis.

Background: The sulfonylurea receptor 1–transient receptor potential melastatin 4 (SUR1–TRPM4) channel is a target key mediator of brain edema. Sulfonylureas (SFUs) are blockers of the SUR1–TRPM4 channel. We made two assessments for the pretreatment of SFUs: (1) whether it associates with lower perihematomal edema (PHE) and (2) whether it associates with improved clinical outcomes in diabetic patients who have acute basal ganglia hemorrhage.Methods: This retrospective case-control study was conducted in diabetic adults receiving regular SFUs before the onset of intracerebral hemorrhage (ICH). All of the patients received the clinical diagnosis of spontaneous basal ganglia hemorrhage. The diagnosis was confirmed by a CT scan within 7 days after hemorrhage. For each case, we selected two matched controls with basal ganglia hemorrhage based on admission time (≤5 years) and age differences (≤5 years), with the same gender and similar hematoma volume. The primary outcome was PHE volume, and the secondary outcomes were relative PHE (rPHE), functional independence according to modified Rankin Scale score and Barthel Index at discharge, and death rate in the hospital.Results: A total of 27 patients (nine cases and 18 matched controls), admitted between January 1, 2009 and October 31, 2018, were included in our study. There was no significant association between SFU patients and non-SFU patients on PHE volumes [15.4 (7.4–50.2 ml) vs. 8.0 (3.1–22.1) ml, p = 0.100]. Compared to non-SFU patients, the SFU patients had significantly lower rPHE [0.8 (0.7–1.3) vs. 1.5 (1.2–1.9), p = 0.006]. After we adjusted the confounding factors, we found that sulfonylureas can significantly reduce both PHE volume (regression coefficient: −13.607, 95% CI: −26.185 to −1.029, p = 0.035) and rPHE (regression coefficient: −0.566, 95% CI: −0.971 to −0.161, p = 0.009). However, we found no significant improvement in clinical outcomes at discharge, in the event of pretreatment of SFUs before the onset of ICH, even after we adjusted the confounding factors.Conclusion: For diabetic patients with acute basal ganglia hemorrhage, pretreatment of sulfonylureas may associate with lower PHE and relative PHE on admission. No significant effect was found on the clinical outcomes when the patients were discharged. Future studies are needed to assess the potential clinical benefits using sulfonylureas for ICH patients.

目的 观察疏解郁颗粒治疗中轻度抑郁症的临床疗效.方法 选取2013年9月—2017年10月西安市中医医院收治的100例中轻度抑郁症病人,随机分为治疗组(40例)、逍遥丸对照组(30例)、氟西汀对照组(30例).治疗组给予院内制剂解郁颗粒治疗,逍遥丸对照组、氟西汀对照组分别给予逍遥丸和盐酸氟西汀胶囊治疗.观察3组治疗前后汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、中医症状评分变化.根据HAMD及中医症状评分量表评分结果 评价疗效.结果治疗组总有效率为87.50％,逍遥丸对照组总有效率为80.00％,氟西汀对照组总有效率为86.67％,治疗组与氟西汀对照组比较差异无统计学意义(P>0.05),治疗组与逍遥丸对照组比较差异有统计学意义(P<0.05).治疗4周后,3组HAMD、SAS、SDS评分均低于治疗前,差异均有统计学意义(P<0.05).治疗4周后,治疗组HAMD、SDS评分与氟西汀对照组比较差异无统计学意义(P>0.05),治疗组、氟西汀对照组HAMD、SDS评分低于逍遥丸对照组(P<0.05),3组间SAS评分比较差异有统计学意义(P<0.05).治疗4周后,3组少寐多梦、眠浅易醒、心烦易怒、情绪低落、郁郁不欢、倦怠乏力均较治疗前有改善(P<0.05或P<0.01).治疗组少寐多梦、眠浅易醒、心烦易怒、情绪低落、郁郁不欢较治疗前改善明显(P<0.01);逍遥丸组与氟西汀组情绪低落、郁郁不欢较治疗前改善明显(P<0.01).结论 解郁颗粒治疗抑郁症的临床疗效及改善抑郁症状方面与氟西汀相当,但优于逍遥丸.

Objective To explore the relationship between gastric juice pH and hospital-acquired pneumonia ( HAP) , the gastric bacterial colonization and etiology of HAP in neurologic intensive care unit patients by monitoring gastric juice pH value.Methods From October 2014 to May 2015, consecutive seventy-two tube feeding patients admitted in the Department of Neurology Intensive Care Unit in Xijing Hospital were enrolled in this research.The type and concentration of pathogens from gastric contents were collected, while samples from upper respiratory tract and pharynx were detected dynamically at the same time.Results (1)The group with new onset HAP was higher in gastric juice pH (6.4(5.4,6.4) vs 5.4 (2.5, 6.4), Z=-2.37, P=0.01); (2) The isolation rate of colonized bacteria in gastric cavity was associated with the pH of gastric juice , achieving 60.8% ( 42/69 ) in HAP group; ( 3 ) When the gastric juice pH was >4, the isolation rate of Gram-negative bacilli in gastric cavity obviously increased (63.6%(28/44) vs 35.7%(10/28),χ2 =5.323, P=0.021); (4)The same pathogens were found in stomach-pharynx-upper respiratory tract in 7 cases ( 17.5%) of the total 40 HAP patients.Conclusion Increased gastric juice pH was associated with gastric colonization , especially Gram-negative bacilli , and may lead to a higher incidence of new onset HAP in patients on enteral feeding.