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Gut microbiota plays an important role in digestive system diseases and has been paid more and more attention.Chronic pancreatitis is a common clinical disease of digestive system, its pathogenesis is not completely clear.Gastrointestinal microflora dysbiosis is associated with many pancreatic diseases.Similarly, the occurrence of chronic pancreatitis is related to the gut microbiota dysbiosis, and the intestinal microecological balance is broken, resulting in varying degrees of gastrointestinal microflora dysbiosis and bacterial translocation, which affects the occurrence and development of chronic pancreatitis.This review analyzes the changes of gut microbiota in chronic pancreatitis and the possible pathogenesis, so as to provide a reference for discussing the clinical value of gut microbiota in the diagnosis and treatment of chronic pancreatitis.
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Objective:To investigate the effect of dietary avoidance therapy on gut microbiota in infants who were diagnosed as cow′s milk protein allergy by comparing the gut microbiota changes before and after the treatment.Methods:The infants with artificial feeding and clinical diagnosis of cow′s milk protein allergy were collected from the outpatient of Gastroenterology departement in our hospital.They were fed with amino acid formula instead of ordinary formula for 4 weeks.Among them, 23 cases of successful intervention were selected.The fecal samples before and after treatment were collected, and the fecal genomes were extracted respectively.The PCR products of specific segments of 16S rDNA were sequenced by high-throughput sequencing.The results were analyzed by bioinformatics, and the differences of flora composition before and after the intervention were compared to find the different species between groups.Results:No obvious difference was found between before and after treatment of gut microbiota diversity( P>0.05). The compose of gut microbiota of the cow′s milk protein allergy was changed after feeding with amino acid milk.At the level of phylum, proteobacteria decreased significantly after treatment.At the level of class, alphaproteobacteria and gammaproteobacteria decreased significantly.Enterobacteriaceae, enterobacteriaceae and streptococcus granulosus decreased significantly.At the family level, the number of peptostridium, peptostridium and clostridium decreased significantly compared with that before treatment.Lactobacillus eubacteriaceae and eubacterium, ruminococcaceae, limosum, pasteurella, pasteurellaceae, haemophilus parainfluenzae T3T1, infantis ATCC15697/JCM1222/DSM2008 and Pseudocatenulatum-DSM20438/JCM1200/LMG10505 were higher than that before treatment with statistically different( P<0.05). Conclusion:For children with cow′s milk protein allergy, the harmful bacteria in intestinal flora decreased and the beneficial bacteria increased after dietary avoidance treatment.
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In recent years, endoscopic retrograde cholangiopancreatography(ERCP)has gradually become the main diagnosis and treatment for congenital biliopancreatic diseases as well as acute recurrent pancreatitis(ARP)in children.Post-ERCP pancreatitis(PEP)is the most common complication, and a few can develop severe acute pancreatitis endangering the children′s life, so it is of great clinical significance to identify the risk factors for PEP in children.Various factors associated with PEP were identified in pediatric patients, such as endoscopic sphincterotomy(EST), rapid multiple injections of pancreatic duct contrastagents, prophylactic pancreatic duct stents, and lack of operator experience.This article reviews the progress on risk factors of PEP.
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Chronic pancreatitis is a focal or diffuse chronic inflammation and fibrosis of pancreatic tissue, which is progressive, persistent and irreversible.Chronic pancreatitis in children has its own characteristics of early onset and frequent occurrence, which greatly affects the nutritional status and quality of life of children.Recently, diagnosis and treatment of this severe inflammation gradually improved with a burgeoning technique: endoscopic retrograde cholangiopancreatography (ERCP), especially in the treatment of pediatric chronic pancreatitis.The detection rate of the disease has been increasing year by year.As an effective and safe procedure for the treatment of chronic pancreatitis in children, ERCP has replaced traditional surgery and become the first-line treatment method for pediatric chronic pancreatitis.
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Objective To understand the comparability of the detection results of four items (ALT ,AST , GGT ,ALP) of liver enzymology in 11 clinical laboratories in Xinjiang Production and Construction Corps (XPCC) and offer reference for improving mutual recognition of the results .Methods Eleven clinical labora-tories of XPCC organized the result comparability tests of 4 items of liver enzymology twice in 2017 ,and the samples with 5 batches were completed in each comparability test .One set of detection system in each labora-tory was used as comparability system according to comparability scheme .The detection results were analyzed through Robust Z Score and the evaluation criterion was :|Z|≤2 "satisfied";2< |Z|<3"warning";|Z|≥3 "not satisfied".Results The detection results of all 10 batch samples in 4 clinical laboratories showed |Z|≤2 in 2 comparability tests .In the first comparability test ,the detection results of 5 batch samples for 4 items were |Z|≤2 in 5 laboratories .In the second comparability test ,the detection results of 5 batch samples for 4 i-tems were |Z|≤2 in 8 laboratories ,but the ALT results of 5 batch samples in 1 laboratory showed positive deviation(Z≥3)and the GGT results of 5 batch samples in the other laboratory showed negative deviation (Z≤ -3) .Conclusion The 11 clinical laboratories in XPCC should continuously improve quality management system and make sure that the mutual recognition of the detection results of 4 items of liver enzymology is effective .
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Objective To investigate the effects of Helicobacter pylori( HP) on gut microbiota in children by comparing the difference of gastric microbiota between HP-positive and HP-negative individuals. Methods Genome was extracted from excrements of 8 HP-positive cases and 8 HP-negative cases. After genomic extraction,the hypervariable region of 16S rRNA gene were amplified and a small fragment library was constructed,and high-throughput sequencing was carried out, then the data of the lower machine was effectively sequenced by biological information processing. We could seek for the species that have changed significantly due to HP infection by comparing the differences in the composition of intestinal flora between the two groups. Results Compared with HP-negative group,HP-positive group showed less OTUs. The dif-fenece of biodiversity between them was conspicuous. The Caproiciproducens,Enterobacteriaceae,Enterobac-teriales,Blautia-obeum,Esherichia-albertli,human-gut-metagenome and Dorea in HP-positive group were sig-nificantly higher than HP-negative group,while the Bacteroides-uniformis, Bacteroidaceae and Bacteroides in HP-negative group were significantly higher than HP-positive group. Conclusion HP could significantly affect the structure and composition of gut microbiota in children.
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Objective To investigate the clinical value of the polymerase chain reaction (PCR) technique in detection of pediatric helicobacter pylori(HP) infection.Methods A total of 130 children with different digestive tract symptoms received esophagogastroduodenoscopy,and 120 children between 3 and 17 years old were enrolled.The gastric antrum mucosa was taken under the gastroscope for 2 blocks,and the gastric juice was absorbed as the specimen.One block of gastric antrum mucosa was examined histopathologi-cally,and the other block of gastric antrum mucosa and gastric juice were examined by PCR.We used the primers UreC,HP-16s,CSTP to detect HP,and then used the primers Cag750 and Cag595 to detect CagA. Results A total of 28 cases(23.33%) of upper gastrointestinal ulcer were detected by gastroscopy,and HP was detected by histopathological method in 26 cases(21.67%),and 41 cases(34.17%) were detected by PCR method.The detection rate of HP by PCR was significantly higher than that of HP in pathological method (χ2= 4.659,P = 0.031). By pathological examination of HP,14 cases (50%) and 12 cases (13.04%) with peptic ulcers and no peptic ulcers were detectd,and the difference in detection rate was statistically significant(χ2=17.275,P<0.001).Samples of children with peptic ulcers and no peptic ulcers were detected in 16 cases(57.14%) and 25 cases (27.17%) by PCR,and the difference in detection rate was statistically significant (χ2=8.572,P=0.003).The CagA were detected in 7 cases of peptic ulcers and 7 cases of non peptic ulcers by PCR,and the difference in detection rate was statistically significant(25.00%vs 7.61%,χ2=6.300,P=0.012).Conclusion The PCR method could quickly and sensitively detect the HP and its CagA gene,and the detection of gastric mucosa and gastric juice by PCR could improve the detection rate of HP.A combination of PCR and pathological method is suggested as the detection method for children′s HP infection.
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Objective To investigate the effects of the frozen embryo transplantation for patients with poor outcome of endometrial growth by using growth hormone (GH) intrauterine perfusion combined with replacement cycle in the treatment of thin endometrium.Methods This was a prospective study and study participants were consecutively recruited between Jun 2014 and September 2015.A total of 88 frozen thawed embryo transfer cycles was divided into two groups from the Reproductive Center of Hunan Provincial Maternal and Child Health Hospital.Group A were 63 hormone replacement therapy (HRT) cycles and Group B were 25 GH intrauterine perfusion combined HRT cycles.Results The endometrial thickness of 22 thin endometrium patients from Group B were increased above 7 mm on progesterone day.The endometrial thickness on transplant day of Group A was (9.28 ± 1.64) mm,which was significantly higher than Group B (7.9 ± 0.86) mm (P ＜ 0.05).The clinical pregnancy rate (50.79％ vs 52.0％),implantation rate 31.1％ vs 47.17％),miscarriage rate (9.38％ vs 15.38％) had no significant difference between Groups A and B.The endometrial thickness from 7 mm to 7.9 mm on transplant day,the clinical pregnancy rate (30.76％ vs 54.54％) had no significant difference in two groups (P ＞0.05),but the implantation rate of group A was significantly lower than that of group B (20％ vs 52.17％) (P ＜0.05).When the endometrial thickness was above 8 mm on transplant day,the clinical pregnancy rate (58.33％ vs 63.63％),implantation rate (36.36％ vs 50％) had no significant difference between groups A and B (P ＞ 0.05).Conclusions GH uterine cavity perfusion was a useful method for treatment of thin endometrium,and was helpful for improvement of endometrial thickness and receptivity,improved embryo implantation environment by assistance for HRT under the high estrogen levels.
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Objective To explore the clinical characteristics and diagnosis of hepatolenticular degeneration (WD) in children. Method The clinical data of 38 children with WD were analyzed retrospectively. Results In the 38 cases (15 males and 23 females), the median age at diagnosis was 6 years, and the average interval between onset and confirmed diagnosis was 5.7 months. The median course of disease was 2 months and the longest was 3 years. Hepatic dysfunction was the most common initial symptom (71.1%), and 27 cases had glutamic acid aminotransferase > 2 ULT (71.1%); Serum ceruloplasmin decreased obviously in 3 cases (94.7%), copper oxidase was significantly reduced in 37 cases (97.4%); 24 h urine copper increased in 33 cases, in which 32 cases(84.2%)had>150 μg/24 h.The K-F rings were presented in 10 cases(26.3%).ATP7B gene sequencing was performed in 19 cases, and the positive rate was 83.3%. Conclusions Onset with liver lesions was common in children with WD, The combination of the results of serum ceruloplasmin, copper oxidase, and 24 h urine copper may made a clinical diagnosis.For a highly suspected case with inadequate evidence,the ATP7B gene detected is helpful.
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Objective To explore the clinical characteristics and diagnosis of hepatolenticular degeneration (WD) in children. Method The clinical data of 38 children with WD were analyzed retrospectively. Results In the 38 cases (15 males and 23 females), the median age at diagnosis was 6 years, and the average interval between onset and confirmed diagnosis was 5.7 months. The median course of disease was 2 months and the longest was 3 years. Hepatic dysfunction was the most common initial symptom (71.1%), and 27 cases had glutamic acid aminotransferase > 2 ULT (71.1%); Serum ceruloplasmin decreased obviously in 3 cases (94.7%), copper oxidase was significantly reduced in 37 cases (97.4%); 24 h urine copper increased in 33 cases, in which 32 cases(84.2%)had>150 μg/24 h.The K-F rings were presented in 10 cases(26.3%).ATP7B gene sequencing was performed in 19 cases, and the positive rate was 83.3%. Conclusions Onset with liver lesions was common in children with WD, The combination of the results of serum ceruloplasmin, copper oxidase, and 24 h urine copper may made a clinical diagnosis.For a highly suspected case with inadequate evidence,the ATP7B gene detected is helpful.
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Objective To understand the prevalence rate and related factors of chronic kidney disease (CKD) among elderly people aged more than 65 years old in the 66th regiment of the fourth division of A Crops in Xinjiang .Methods A total of 2 030 elderly people aged more than 65 years old in the 66th regiment of the fourth division of XPCC were distributed in 6 communities . Totally 334 permanent residents aged more than 65 years old were chosen from 2 communities by the stratified random sampling method .The renal injury indicators and related factors were detected .Results Among 329 residents with intact data ,after the age correction ,the prevalence rate of albuminuria ,hematuria and renal function decrease were 22 .2% ,14 .2% ,4 .9% ,respectively .The prevalence rate of CKD in this group was 32 .8% ,CKD stage 1―3 were dominated .The awareness rate was 15 .1% .The multiva‐riate Logistic regression analysis showed that gender and hypertension were independently associated with CKD .Conclusion The prevalence rate of CKD among elderly people aged over 65 years old in the 66th regiment of the fourth division of this Crops is high‐er .The related factors are gender and hypertension .
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Objective To improve the standard of the quality control of compound chlorhexidine acetate ointment . Methods TLC was used to control the quality of menthol crystal and camphor .A method to determine chlorhexidine acetate and cocaine hydrochloride simultaneously by HPLC was established .Results The spots of menthol crystal and camphor in TLC were clear .Chlorhexidine acetate and cocaine hydrochloride showed excellent linearity ,which were at the range of 10.01-160.14 μg/ml and 10 .01-160 .14 μg/ml ,respectively .The average recoveries were 101 .5% (RSD=1 .8% ) and 100 .5% (RSD=2 .8% ) .Conclusion The methods were simple ,sensitive and with good reproducibility and could be used to control the quality of compound chlorhexidine acetate ointment .
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Objective To improve the quality control standard of lidocaine hydrochloride injection .Methods A method for determination of related substances in lidocaine hydrochloride injection was established .Lidocaine hydrochloride was as‐sayed by HPLC .The chromatographic conditions :C18 chromatographic column was used .The mobile phase was phosphate buffer and acetonitrile (50∶50 ,adjusted to pH 8 with phosphoric acid) .The detection wavelength was 254 nm .Results Ac‐cording to the result of method verification ,related substances could be examined by HPLC .Lidocaine hydrochloride was as‐sayed by HPLC ,which showed excellent linearity at the range of 373 .62‐3 736 .19 μg/ml .The average recoveries were 102 .1% (RSD=0 .9% ) .Conclusion The improved standard could be used to control the quality of lidocaine hydrochloride injection .
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Objective To verify the clinical applicability of the published standard intervals (WS/T402-2012) for WBC , RBC ,PLT and Hb based on the health examination results of Han and Uygur populations in Urumqi .Methods This was a retro-spective study .The results of WBC ,RBC ,PLT and Hb from health examination individuals of Han and Uygur populations from August 2013 to January 2015 were collected ,9 307 health subjects age range from 20 to 79 years of the two nationalities were cho-sen using health examination information system .The percents of health subjects failed falling in the published standard interval were calculated to verify the judgment criterion ,fail falling rate < 10 .00% was regard as qualified .Results The test of normality revealed that the Han and Uygur′s results of all verified items were skewed distributions .The 2 .5% and 97 .5% percentiles of the results of two nationalities :WBC Han(3 .6 ~ 9 .6) × 109 /L ,Uygur(3 .8 ~ 9 .9) × 109 /L ;RBC Han Male (4 .3 ~ 5 .9) × 1012 /L and Female (3 .9 ~ 5 .2) × 1012 /L ,Uygur Male (4 .4 ~ 5 .8) × 1012 /L and Female (3 .9 ~ 5 .2) × 1012 /L ;PLT Han(130 ~ 351) × 109 /L , Uygur(145 ~ 370) × 109 /L) ,and Hb Han :Male (133 ~ 178)g/L and Female (111 ~ 153)g/L ,Uygur :Male (133 ~ 174) g/L and Fe-male (110 ~ 152)g/L .The significant differences of each testing item were found in the different sex from the same nationality(P<0 .01) .The percents of health subjects failed falling in the published standard interval were < 10 .00% in both Han and Uygur na-tionality .Conclusion The published standard reference intervals for WBC ,RBC ,PLT and Hb are applicable to our laboratory for the detection of Han and Uygur populations .
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Objective To verify the clinical applicability of the published standard intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) based on the health examination results of Han and Uygur populations in Urumqi .Methods This was a retrospective study .The results of serum TP ,ALB ,ALT ,AST ,ALP ,GGT from healthy examination individuals of Han and Uygur populations (from 2013 August to 2015 January) were collected and the healthy cases (age range:20 -79 years old) were chosen to calculate the 2 .5% and 97 .5% percentiles ,excluding the significant abnormal results according to the Medical Deciding Level 2 recommended by Staland .The percents of health cases not falling in the published standard interval were calculated to meet the judgment criterion of verification (<10% ) .Results The test of normality revealed that the Han and Uygur's results of all veri‐fied items were skewed distributions .The 2 .5% and 97 .5% percentiles of the results of two populations were as follows ,TP(Han 65 -81 g/L ;Uygur 64-81 g/L) ,ALB(Han 41-53 g/L ;Uygur 40-52 g/L) ,ALT(Han:male 9-51 U/L and female 7-42 U/L ;Uygur:male 9-53 U/L and female 6-43 U/L) ,AST(Han:male 14-42 U/L and female 12-37 U/L ,Uygur:male 12-42 U/L and female 12-38 U/L) ,ALP(Han:male 45-119 U/L ;Uygur:male 47-122 U/L) ,ALP(female 20-49 years old:Han 35-95 U/L and Uygur 40-104 U/L) ,ALP(female 50-79 years old:Han 43-131 U/L and Uygur 51-132 U/L) ,GGT(Han:male 11-71 U/L and female 8-54 U/L ;Uygur :male 11 -73 U/L and female 7 -55 U/L ) .The percents of AST results for Han's male , Uygur's male and Uygur's female not falling in the published standard reference interval were slightly over 10% ,but AST results o‐ver 10% were mainly under the lower limit of the published standard reference interval .The health case percents for the other veri‐fied items of Han and Uygur populations not falling in the published standard reference interval were under 10% .Conclusion The published standard reference intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) are applicable in our la‐boratory for the detection of Han and Uygur population .
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Objective:To improve the determination method for compound sodium acetate injection. Methods:Atomic absorption spectrophotometry ( AAS) was used to determine sodium chloride, calcium chloride and potassium chloride in compound sodium acetate injection. Results:The linear range of calcium ion, potassium ion and sodium ion was 9.124 ×10 -7-1.369 ×10 -5 g·ml-1(r =0.999 5),1.501 ×10 -7 ~4.504 ×10 -6 g·ml-1(r=0.999 2) and 7.500 ×10 -8-2.251 ×10 -6 g·ml-1(r=0.999 5), and the av-erage recovery was 100. 4%(RSD=1. 4%,n=9),102. 4%(RSD=1. 6%,n=9) and 100. 3% (RSD=1. 1%,n=9), respectively. Conclusion:The method is simple, accurate and reproducible, and can be used to control the quality of compound sodium acetate in-jection.
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Objective To provide the objective evidence for reducing stat test turnaround time (TAT) reasonably through the comparative analysis of different intervals of stat test TAT between emergency department (ED) and intensive care unit (ICU ) . Methods Laboratory information system was used to collect data about blood cell analysis and biochemical profiles of department of emergency and ICU from 1st January to 31th March ,2014 ,then comparatively analyzing different intervals of stat test TAT be‐tween two departments .Results TAT outlier rates of stat CBC tests ordered by ED and ICU were 2 .4% and 15 .1% ,and that of stat biochemical profiles ordered by ED and ICU were 12 .3% and 24 .5% ,respectively .there were no significant differences in mean times between order‐to‐receipt of stat CBC tests and biochemical profiles ordered by ED and collection‐to‐receipt of stat CBC tests and biochemical profiles ordered by ICU [(11 .2 ± 4 .0) min vs .(11 .2 ± 4 .5) min ,P>0 .05 ;(13 .2 ± 14 .1)min vs .(13 .8 ± 9 .8) min ,P>0 .05] .ED had significantly shorter mean time of receipt‐to‐report than ICU for stat CBC tests and biochemical profile [(5 .8 ± 4 .4) min vs .(19 .3 ± 12 .5) min ,P0 .01] .The TAT mean times of stat CBC tests and biochemical profiles ordered by ED were shorter than those ordered by ICU [(17 .0 ± 6 .2) min vs .(30 .5 ± 14 .9) min ,P<0 .01 ;(46 .9 ± 17 .2) min vs .(49 .3 ± 16 .5) min ,P<0 .01] .Conclusion The ED TATs for CBC tests and biochemical pro‐files are reasonably set ,and each interval of the ED TATs is well controlled .The ICU TATs for CBCs and biochemical profiles should be reset ,and the process of stat test for ICU should be optimized .
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<p><b>OBJECTIVE</b>To evaluate the growth of children in weight and height before and after liver transplantation and the relation between malnutrition and postoperative time.</p><p><b>METHOD</b>Growth was assessed for children who received liver transplantation from July 2007 to December 2012 after operation during follow-up. Weight and height were measured for 51 children in May 30, 2013. Weight and height percentiles of each child were calculated in accordance with data surveying on physical development of children in nine provinces/municipalities. Underweight was defined as weight less than the third percentile of same age and sex groups. Growth retardation was defined as height less than the third percentile of same age and sex groups. Children were set into 2 groups (before liver transplantation group, after liver transplantation group). The incidence of underweight and growth retardation were analyzed by chi-square test. Children were divided into 4 groups according to the length of time from operation time to May 30, 2013: 1 year after liver transplantation (1-365 days); 2 years after liver transplantation (366-730 days); 3 years after liver transplantation (731-1 095 days) ; 4 years or more after liver transplantation (1 096-2 133 days) . The underweight and growth retardation were analyzed by hierarchical log linear model.</p><p><b>RESULT</b>The mean age of 51 children was 44.78 months (range 13 months to 13 years old), 26 of them were male and 25 female. The number of children with underweight and growth retardation were 20 (39%) and 35 (69%) respectively before transplantation and were 5 (10%) and 14 (27%) respectively after transplantation. There was a significant difference between underweight incidence before and after operation (χ(2) = 10.385, P = 0.001). There was significant difference between growth retardation incidence before and after operation (χ(2) = 15.710, P = 0.000). The subjects included 10 patients at 1 year after operation (underweight n = 3, growth retardation n = 3), 19 patients at 2 years (underweight n = 1, growth retardation n = 9), 10 patients at 3 years (underweight n = 1, growth retardation n = 2), 12 patients at 4 years and above (underweight n = 0, growth retardation n = 0). Parameter analysis of hierarchical log linear estimates: underweight at 1 year = 0.661, underweight at 2 years = -0.214, underweight at 3 years = 0.119, underweight at 4 years and above = -0.566. Growth retardation at 1 year = 0.282, at 2 years = 0.613, at 3 years = 0.051, at 4 years and above = -0.946.</p><p><b>CONCLUSION</b>Compared with after liver transplantation, obvious malnutrition existed in patients before transplantation. Patients have the ability to catch-up growth after liver transplantation. Reduced effect of underweight occurred in second year after liver transplantation. Reduced effect of growth retardation occurred in third year after liver transplantation.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Biliary Atresia , Therapeutics , Body Height , Body Weight , Child Development , Growth Disorders , Epidemiology , Liver Cirrhosis , Therapeutics , Liver Transplantation , Malnutrition , Epidemiology , Postoperative Period , Retrospective Studies , Thinness , Epidemiology , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>To summarize the clinical characteristics, early diagnosis, comprehensive treatment and prognosis of 6 cases of children with post-transplantation lymphoproliferative disorder (PTLD) after liver transplantation.</p><p><b>METHOD</b>Data of 6 cases with PTLD seen between January 2011 and December 2013 were retrospectively analyzed. The anti-rejection drug dose adjustments, the effect of rituximab, antiviral therapy and comprehensive treatment program after surgery were explored.</p><p><b>RESULT</b>(1) The diagnosis of PTLD was confirmed by histologic findings. Six cases of PTLD including 3 males and 3 females were diagnosed as congenital biliary atresia and underwent split liver transplantation. The occurrence rate of PTLD was 2.9%. (2) The median time to the development of PTLD was less than 6 months. The initial symptom of PTLD in all patients was fever and clinical manifestations of PTLD were non-specific, depending on the involving organs. Five cases of PTLD developed gastrointestinal symptoms, including diarrhea, abdominal pain, and abdominal distension. One case developed respiratory symptoms, including cough and tachypnea. Three cases had lymph node involvement. In 2 cases pathophysiology involved polymorphic lymphocyte proliferation and in 4 cases B lymphocyte proliferation. (3) Two cases died, in whom EBV DNA was not detected and were diagnosed as PTLD by surgical pathology before death. Four survived cases had high EBV-DNA load and then were diagnosed as PTLD by biopsy pathology. (4) Of the 6 cases of PTLD, 2 cases died and 4 cases survived. The overall mortality was 33%. The dead cases were only treated with laparotomy because of intestinal obstruction or perforation and the survived cases were treated with tacrolimus at reduced doses or discontinuation and rituximab. In 2 cases antiviral therapy (acyclovir) was continued, including 1 cases of intestinal obstruction treated with surgical repair. All the survived patients were followed up for 4 months to 1 year and no evidence has been found.</p><p><b>CONCLUSION</b>EBV infection is the high risk factor for PTLD after liver transplantation. Close clinical surveillance of EBV DNA for pediatric liver transplantation was important for the early diagnosis of PTLD. Reducing doses of immunosuppressive agents and rituximab is the initial therapy for PTLD. A reduction in the dose of tacrolimus is suggested. Operation therapy can also play a role in the management of local complications.</p>
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Female , Humans , Infant , Male , Antiviral Agents , Biliary Atresia , Therapeutics , DNA, Viral , Drug Therapy, Combination , Early Diagnosis , Epstein-Barr Virus Infections , Diagnosis , Therapeutics , Immunosuppressive Agents , Liver Transplantation , Lymphoproliferative Disorders , Diagnosis , Mortality , Therapeutics , Pediatrics , Postoperative Complications , Retrospective Studies , Survival Rate , TacrolimusABSTRACT
Objective:To study the optimal extraction process of Yinxiejing. Methods: An orthogonal experimental method was used with reflux time, reflux times, ethanol concentration and volume as the influencing factors, and emodin and osthole content as the indices. Results:The optimal extraction conditions for Yinxiejing were as follows:refluxing twice with 2 h every time using 8-fold 80%ethanol. Conclusion:The optimum process is stable and feasible.