الملخص
Objective:To summarize and analyze the clinical treatment of aspergillus infection in the central nervous system.Methods:Data was obtained from a recipient who were diagnosed with invasive aspergillosis in the central nervous system after liver transplantation.We retrospectively analyzed the clinical character of the recipient." Liver transplantation" , " Aspergillus" , " brain" and " aspergillus" were searched for literature published in English or Chinese in Wanfang data, CNKI and PubMed database for nearly 5 years until January 2022.Results:A 33 years old recipient was admitted to the hospital with fatigue, chest distress and shortness of breath after liver transplantation on postoperative day(POD)48.On the computed tomography(CT)scan of the chest, multiple exudative lesions was observed in both lungs.Multiple sputum cultures were grown as Candida albicans.The symptoms of chest tightness and shortness of breath were significantly improved by treating with caspofungin compared before.On POD 79, the recipient developed stubborn nausea and vomiting.Cranial enhanced magnetic resonance imaging(MRI)showed central nervous system(CNS)infection.Numerous traditional pathogenic microorganisms tests of cerebrospinal fluid(CSF)were all negative.With the help of metagenomics next generation sequencing(mNGS), aspergillus fumigatus was detected in CSF.The recipient received therapy with voriconazole and rehabilitation.Therapy with voriconazole was continuous for 8 months.Unfortunately, the recipient developed cholestasis due to repeated biliary infection and eventually died of liver failure 13 months later.Conclusions:Although the mortality rate of aspergillus infection in the central nervous system is very high after liver transplantation, timely and effective treatment is still expected to improve its prognosis.
الملخص
Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.
الملخص
Objective To analyze extent of damage and influence factors of healthy function of patients with cerebral infarction. Methods A total of 188 cases of patients with acute period of cerebral apoplexy were surveyed, and the gen-eral information of patients were surveyed by self-made scale. The damage of healthy function was surveyed by disease severity extent scale, and the related factors of healthy function damage patients were analyzed. Results The highest dimensionality score was entertaining (68.8±13.7) scores, the second was housekeeping (53.1±15.4) scores, the third was body movement (45.2±11.5) scores, in which highest score was body flexibility (59.0±12.4) scores; The lowest was diet and social psychology function (23.2±6.3) and (25.6±6.8). The total healthy function damage score was (35.7±10.1). Healthy Function of pa tients aged more than 70 years, illiterate and with primary school education, non-marital, smoking , introverted , diseased region located at lobe of brain and animal force was level 4 or below decreased more (P<0.05 or P<0.01). Multiple factors analysis showed smoking was a risk factor, and family support, muscle strength, lacunar cerebral infarction to protect factors. Conclusion The extent of damage healthy function of patients with cere-bral infarction is high, in which the scores of entertaining and housekeeping dimensionality are the highest, and the body flexibility score of body movement function dimensionality is the highest. Smoking is the dangerous factor, and family support, animal force and lacunar infarction are protection factors. The relevant nursing shall be given and the life quality of patients shall be improve in the clinical nursing.