Background Postoperative pneumonia (PP) is one of the most common complications after cardiac surgery. This study was designed to access the diagnostic value of interleukin-6 (IL-6) for pneumonia within the first 5 days after cardiac surgery in adults. Method This prospective observational study enrolled 694 patients who admitted to our center from 10 October 2020 to 30 June 2021. Blood samples were collected after admission and on five consecutive days after surgery to measure IL-6, procalcitonin (PCT), C-reactive protein (CRP) and white blood cells (WBC) respectively. Combined with clinical data, we assessed the diagnostic performance of different biomarkers using univariate and multifactorial analyses as well as receiver operating characteristic curves (ROC) and the area under the curve (AUC). Result Finally, 68 patients were diagnosed with PP (PP Group). In addition, 626 cases were assigned to the control group (Non-PP Group). From postoperative day 1 (POD1) to day 5, IL-6 and PCT levels showed higher diagnostic value (P < 0.001, P < 0.05, respectively); meanwhile, there was no difference in white blood cell counts between the two groups; CRP showed some value from POD2 onwards (P < 0.001). Among these biomarkers, IL-6 on POD1 [AUC: 0.78, 95% confidence interval (CI): 0.71–0.83], IL-6 on POD2 (AUC: 0.77, 95% CI: 0.71–0.82) and CRP levels on POD3 (AUC: 0.77, 95% CI: 0.70–0.84) had the highest diagnostic value. Multivariate analysis found that smoking status [odds ratio(OR): 7.79, 95% CI: 3.05, 19.88, p < 0.001], drinking status (OR: 22.68, 95% CI: 9.29, 55.37, p < 0.001) and hypertension (OR: 2.85, 95% CI: 1.28, 6.35, p = 0.011), IL-6 on POD2 (OR: 1.01, 95% CI: 1.00, 1.01, p = 0.018), mechanical ventilation time (OR: 1.03, 95% CI: 1.00, 1.05, p = 0.040) and intensive care unit stay time (OR: 1.01, 95% CI: 1.00, 1.02, p < 0.001) were independent risk factors for postoperative pneumonia. Conclusion Smoking, drinking, hypertension, prolonged duration of mechanical ventilation and intensive care unit stay, and IL-6 on POD2 were independent risk factors for pneumonia after cardiovascular surgery. IL-6 level on POD2 may serve as a promising indicator, better than WBC, PCT and CRP.
Four samples of banana stems and leaves were prepared, which were processed through adding no additives, adding molasses, adding lactic acid bacteria (LAB), and adding both LAB and molasses respectively. In order to find out the regular pattern of microbial flora, microbial flora of each sample was analyzed during ensiling. It was found out that growth of LAB reached its peak of 6.4×107~7.8×109 CFU/g FM in the 6th day of ensiling, growth of aerobic bacteria reached its peak of 2.8×104~5.6×104 CFU/g FM in the 3rd day of ensiling, and growth of yeast reached its peak of 8.6×104~5.8×106 CFU/g FM in the 3rd day of ensiling. All of the samples with different way of processing showed the same trend that growth of microbial flora number were increased gradually and then decreased. It were also found out that decrease of pH value had relation with LAB number, and decrease of pH value were lagged behind the peak number of LAB, and number of aerobic bacteria and yeast were decreased with reproducing of LAB and decline of pH value. Nutrition constituent of forage made of banana stems and leaves was as follows: Dry matter 32.27%~33.59%,Crude protein 7.42%~8.16%, Acid detergent fiber 38.21%~41.43%. Quality of silage added with molasses, LAB and both molasses and LAB were better than that with no additives.
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