Objective:Analyze the risk factors of sepsis in patients with acute pancreatitis, and establish a risk prediction model of sepsis in patients with acute pancreatitis.Methods:Clinical data of patients with acute pancreatitis was extracted from the Medical Information Mart for Intensive Care-Ⅲ (MIMIC-Ⅲ) database. Lasso regression analysis was used to screen potential risk factors for concurrent sepsis in acute pancreatitis. Based on this, logistic regression analysis was used to construct a risk prediction model for concurrent sepsis in acute pancreatitis and a calibration curve was plotted. The predictive ability and clinical applicability of the model were evaluated by calculating the C-index, plotting the calibration curve of the model, and analyzing the clinical decision curve and impact curve.Results:A risk prediction model for concurrent sepsis in acute pancreatitis was established, which included 10 potential risk factors including clinical signs and laboratory test results. The model had a C-index of 0.800, with a validation C-index of 0.774 after resampling. The calibration curve showed good consistency with the ideal curve. In addition, the clinical decision curve and impact curve analysis showed that this model has good clinical applicability. Acute pancreatitis patients can benefit from using this calibration curve model to obtain clinical net benefits.Conclusions:The risk prediction model of acute pancreatitis complicated with sepsis based on MIMIC-Ⅲ has good clinical practicability.

纹带棒状杆菌为棒状杆菌属细菌,该菌广泛存在于人类皮肤和鼻咽部黏膜等,是机会致病菌[1].目前,由于人口老龄化加剧及免疫力低下者增多,近年来有关纹带棒状杆菌感染的报道有所增加,其可引起包括颅内感染在内的多种感染,但于尿液中分离出此菌却少有报道[2-4].本研究回顾性分析1例由纹带棒状杆菌引起泌尿系统感染患者的诊治过程.

目的 筛选影响卵巢癌发生发展的关键基因,并分析其作用机制.方法 利用高通量基因表达(GEO)数据库、癌症基因图谱(TCGA)数据库及KMplot数据库筛选卵巢癌关键基因,分析其与患者临床病理学特征的关系,同时使用GESA进行信号通路聚类分析,并使用TIMER数据库确定与之密切相关的基因,通过STRING数据库绘制互作网络图,预测其作用机制.结果 通过筛选共得到13个差异基因,其中ARX和FAM150B与患者预后有关,且其表达量越低,患者总生存期越短(P<0.01).进一步分析发现ARX和FAM150B的表达量还与IL-6、PIK3R2、PIK3CD、VAV1、PIK3CA、RAC2、PIK3R1及MAPK1的表达量相关(P<0.05).使用STRING数据库分析发现ARX和FAM150B通过TUBA1A、EGFR、PLXNA2对以上基因进行调控.结论 ARX和FAM150B在卵巢癌组织中呈低表达状态,它们的表达量和患者的预后密切相关.ARX和FAM150B可对一系列基因进行调控,从而减弱机体的抗肿瘤免疫反应,促进卵巢癌的发生发展.

目的 探讨某三级医院无乳链球菌感染中各病区的阳性率及近三年来抗生素耐药变化情况,为临床治疗无乳链球菌感染的合理用药提供依据.方法 以广州医科大学附属第五医院2016年1月至2018年12月门诊及住院患者细菌培养分离的无乳链球菌菌株353例为研究对象,其中2016年度无乳链球菌标本118份,2017年度无乳链球菌标本153份,2018年度无乳链球菌标本82份,均经VITEK-2 Compact全自动微生物鉴定药敏分析仪鉴定,经肉汤稀释法测得无乳链球菌对常见抗生素的药敏情况,采用WHONET 5.6软件对常用抗生素敏感性试验结果进行数据分析.结果 353份无乳链球菌标本主要来源于阴道分泌物和宫颈分泌物,妇科为无乳链球菌标本分布最多的临床科室,分别为2016年度34.75％(41/118)、2017年度41.18％(63/153)、2018年度47.56％(39/82);其次是产科和泌尿外科.无乳链球菌药物敏感性试验结果显示,耐药率最高的为四环素,最高耐药率91.5％,对红霉素、克林霉素、环丙沙星、左旋氧氟沙星耐药率较高,分别是72.0％～77.1％、61.9％～66.7％、23.7％～28.0％、22.9％～25.6％,未发现对万古霉素、青霉素、利奈唑胺、替加环素耐药的菌株.结论 无乳链球菌临床分布以妇科、产科和泌尿外科为主,其对四环素类和大环内酯类抗生素的耐药率较高,应重视对围产期妇女无乳链球菌预防性筛查工作.