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Objective:To explore the clinical features and managements of novel coronavirus (2019-nCoV) infection after kidney transplantation.Methods:The authors reviewed medical history, laboratory values, imaging studies, treatment options and clinical outcomes of two confirmed hospitalized cases of COVID-19 after kidney transplant in February 2020. Both cases were middle-aged males and confirmed as COVID-19 at 11 or 12 months after transplantation. They both presented initially with moderate-to-low fever, cough and fatigue. Chest computed tomography (CT) hinted at multiple peripheral patchy ground glass opacities or patchy exudation and in bilateral multiple lobular and subsegmental with obscure boundary. Both had varying degrees of renal function and cardiac insufficiency.Results:In case 1, the dose of immunosuppressants was tapered while a higher dose of glucocorticoids was prescribed during treatment. In case 2, the dose of immunosuppressants was not tapered and continuous renal replacement therapy (CRRT) performed thrice in the early disease course due to renal insufficiency and hyperkalemia. Both cases received oxygen inhalation, lopinavir/ritonavir, oral abidor and interferonα-2b antiviral therapy, antibiotics treatment. Both cases were cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 patients after kidney transplantation are not significantly different from those of other people. However, early renal function and heart function abnormalities occur. How to adjust the immunosuppressant in the treatment course of severe COVID-19 after renal transplantation should be further explored.
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Objective To observe the effect of antibacterial dressing tamponade combined with seal negative pressure drainage in the treatment of necrotizing fasciitis .Methods 52 patients with necrotizing fasciitis were selected . After full scavenging of fasciitis and necrotic tissue,then filled the whole wound with a kind of dressings with antibacterial properties-Nano silver antiseptic dressing,and a negative pressure drainage tube was placed at the bottom of the wound.Then the wound was closed with a transparent paste ,and the air was cut off,in order to make the antibacterial dressing could not only anti bacteria ,but also play a role in the growth of the wound ,and at the same time,the tissue leachate in the wound was drained through the negative pressure tube in time ,so as to accelerate the wound healing and reduce the use of antibiotics .Results Among the 52 cases,the rest were cured except for 1 case of individual cause of abandonment of treatment died of toxic shock .,the average hospitalization time was (29.0 ±15.3)days,days of using antimicrobial was (3.8 ±1.6)days,90% cases stopped using antibiotics within 1 week.Conclusion Antibacterial dressing tamponade combined with seal negative pressure drainage in the treatment of necrotizing fasciitis can reduce the switching frequency,reduced antibiotic using intensity,shorten the healing time,it is a kind of very good method.
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Objective To observe the clinical efficacy of desloratadine citrate disodium tablets combined with narrow band ultraviolet B in the treatment of pityriasis rosea.Methods According to the digital table,88 pityriasis rosea patients were randomly divided into the two groups.45 cases of the study group were treated by desloratadine citrate disodium tablets combined with narrow ultraviolet B,43 cases of the control group were treated by desloratadine citrate disodium tablets alone.The both two groups applied Binghuangfule cream.The therapeutic effect and safety of the two groups were compared.Results The cure rate in study group was 71.11％,which of the control group was 51.16％,the difference was not statistically significant (x2 =3.69,P ＞ 0.05).The effective rate of the treatment group was 91.11％,which of the control group was 69.77％,the difference between the two groups was statistically significant (x2 =6.43,P ＜ 0.05).Conclusion The result reveals that desloratadine citrate disodium tablets combined with narrow band ultraviolet B is more effective and worthy to be used in clinical practice.
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BACKGROUND:Cel transplantation offers a new promise of rebuilding the damaged myocardium. But the results of them are not consistent. It is not clear if the transplanted cel s can permanently improve heart function and the mechanism underlying this therapeutic effect. OBJECTIVE:To study the effect of intracoronary autologous bone marrow mononuclear cel transplantation on cardiac function, and angiogenesis and cytokine production in canines with acute myocardial infarction. METHODS:Left anterior descending coronary artery ligation was used to produce acute myocardial infarction models in hybrid canines. Bone marrow mononuclear cel s were harvested by using puncture of anterior crest and posterior superior iliac spine to prepare cel suspension. Sixteen hybrid canines were randomly divided into transplantation group (n=10) and control group (n=6). Bone marrow mononuclear cel s (transplantation group, n=10) or normal saline (control group, n=6) were intracoronarily infused into infarction-related arteries 2 hours after acute myocardial infarction. To evaluate the heart function, we used echocardiography at 2 hours and 6 weeks after acute myocardial infarction. Capil ary density was assessed 6 weeks after transplantation by using von Wil ebrand factor test. The mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, basic fibroblast growth factor and matrix metal oproteinase-9 in the infarct area were determined by reverse transcription-PCR at 6 weeks after transplantation. RESULTS AND CONCLUSION:In contrast to the control group, ejection fraction and stroke volume at 6 weeks after transplantation increased significantly in the transplantation group. The transplantation group had a greater amount of new vessels in the peri-infarct area than the control group. Compared with the control group, the mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, and basic fibroblast growth factor significantly increased in the transplantation group, but the mRNA level of matrix metal oproteinase-9 significantly decreased in the transplantation group. These findings suggest that intracoronary transplantation of autologous bone marrow mononuclear cel s may improve the cardiac function, and increase capil ary density, especial y in the border zone of infarcted myocardium. Otherwise, bone marrow mononuclear cel transplantation can increase the mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, and basic fibroblast growth factor, but decrease the mRNA level of matrix metal oproteinase-9.
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BACKGROUND: Stem cell regeneration can repair injured myocardium. However, bone marrow mononuclear cells (BM-MNCs) transplantation for non-ischemic heart failure remains poorly understood.OBJECTIVE: To investigate effect of transplantation of autologous BM-MNCs on cardiac function in canine model of heart failure by rapid ventricular pacing. METHODS: Implantation and model control groups were subjected to model establishment of heart failure by rapid pacing of apex of right ventricle, and respectively injected with CM-DiI-labeled BM-MNCs and normal saline into myocardium. After 4 weeks, all dogs were sacrificed, and specimens of myocardium were collected from the apex, anterior wall and interventricular septum. All specimens were labeled by FITC. Myocardial fibrosis conditions of implanted cells were observed, collagen volume fraction was determined, and hemodynamic indexes were measured. RESULTS AND CONCLUSION: BM-MNCs labeled by CM-DiI and FITC were observed in the transplantation group showing yellow fluorescence, while in the control group FITC-labeled green fluorescence was seen. HE and Masson staining showed that inflammatory cell infiltration in interstitial matrix, displaying interstitial fibrosis and myocardial fibrosis in model control group, but no obvious inflammatory cell infiltration or myocardial fibrosis was observed in the transplantation group, indicating a success model establishment of heart failure by rapid ventricular pacing. Compared with model control group, the collagen volume fraction decreased significantly (P < 0.05), ejection fracture remarkably increased (P < 0.05), but left ventricular end-diastolic and end-systolic diameter remained unchanged in the transplantation group (P > 0.05). Autologous BM-MNCs in canine model of heart failure show myocardium-like cells differentiation, and improve heart function, which possibly associate with the ability of inhibiting the myocardial fibrosis.