Objective To evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1 ) in endotracheal aspirate and plasma of patients with ventilator-associated pneumonia ( VAP) . Methods The consentration of sTREM-1 in plasma and endotracheal aspirate, and serum high-sensitivity C-reactive protein ( hs-CRP) were measured by enzyme-linked immunosorbent assay ( ELISA) in 68 patients with VAP ( VAP group) , 50 patients underwent ventilation without VAP ( non-VAP group) , and 50 healthy individuals ( control group) . The sensitivity and specificity of each parameter were calculated. Results In the patients with VAP, sTREM-1 in plasma and endotracheal aspirate before treatment were significantly higher than that in the non-VAP group [ ( 143.62 ±46.82) pg/mL vs. ( 68.56 ±16.24) pg/mL, ( 352.86 ±92.57) pg/mL vs. ( 126.21 ±42.28) pg/mL, Plt;0.05] ; sTREM-1 in plasma and endotracheal aspirate on the 3rd and the 7th day during treatment were significantly decreased ( Plt;0. 05) . By ROC analysis, the cut-off value of sTREM-1 in endotracheal aspirate were 193.64 pg/mL, with sensitivity and specificity of 93.84% and 89.51% respectively. The areas under ROC curve of sTREM-1 in endotracheal aspirate were 0.912. Clinical diagnostic value of sTREM-1 in endotracheal aspirate was better than plasma sTREM-1 and serum hs-CRP ( areas under ROC curve were 0. 768 and 0. 704 respectively) . Conclusions sTREM-1 may be helpful for evaluating the therapeutic effect in patients with VAP. The diagnostic value of sTREM-1 in endotracheal aspirate may be superior to plasma sTREM-1 and serum hs-CRP.
目的探讨单操作孔胸腔镜在纵隔肿瘤治疗中的临床应用价值。 方法回顾性分析我科2012年至3月至2014年3月我院胸外科采用单操作孔胸腔镜切除纵隔肿瘤18例的临床资料，男11例、女7例，年龄45.5（30～55）岁。胸腺瘤12例，胸腺瘤合并重症肌无力3例，胸腺囊肿4例，畸胎瘤2例。 结果所有患者均在胸腔镜下或胸腔镜辅助下完成，其中16例采用单操作孔胸腔镜下操作，其中有1例因术中出血，延长操作孔切口，完成止血，另有1例因肿瘤直径约8 cm，合并胸膜腔部分粘连，增加一副操作孔完成。术中操作时间80（40～120）min，术中出血量100（50～300）ml，术后胸腔引流管留置时间3（2～5）d，住院时间6（4～8）d，均未出现严重并发症。术后随访18例患者1个月至2年，均未见肿瘤复发，其中合并重症肌无力的3例患者，术后肌无力均消失。 结论单操作孔胸腔镜治疗前纵隔肿瘤是安全有效且可行的。
The issue of bacterial drug resistance has remained unresolved, and in recent years, biomimetic nanostructured surfaces inspired by nature have garnered significant attention due to their bactericidal properties demonstrated through mechanical mechanisms. This article reviewed the main research progress in the field of nanostructured mechanical bactericidal surfaces, including various preparation methods for nanostructured surfaces with mechanical bactericidal properties, as well as the basic mechanisms and related physical models of the interaction between bacteria and nanostructured surfaces. In addition, the application of nanostructured surfaces in biomedicine was introduced. Finally, the article proposed the major challenges faced by mechanical bactericidal research and the future development direction.