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Objective To explore the correlation between main indicators of donor liver and early prognosis after liver transplantation.Methods The clinical data of 166 donors and recipients of post-mortem organ donation (DD) from June 2017 to June 2018 were retrospectively analyzed.The effects of donor age,sex,body mass index,serum sodium level,total bilirubin,prothrombin time and international standardized ratio on early allograft dysfunction (EAD) in liver transplant recipients were investigated.According to the culture results of donor liver preservation solution,the results were divided into positive group and negative group.Combined with the culture results of blood,sputum and drainage fluid after liver transplantation,the early infection rate of recipients in the two groups was observed.Results Univariate analysis showed that preoperative donor bilirubin total ＞17.1 mmol/L and donor cold ischemia time ＞8 h were risk factors for postoperative EAD in transplant recipients.Multivariate analysis showed that donor cold ischemia time ＞8 h was an independent risk factor for postoperative EAD in liver transplant recipients;the incidence of EAD in the group with cold ischemia time ＞8 h was significantly higher than that in the group with cold ischemia time ≤8 h (26.3％ vs.7.0％;P =0.003).The positive rate of postoperative sputum culture and drainage fluid culture in the donors with positive donor culture was 43.9％ and 48.8％,respectively,which was significantly higher than that in the negative group (10.7％ and 13.1％).The difference was statistically significant (P =0.000,P =0.000).The positive rate of postoperative blood culture in the positive group and the negative group was 12.2％ and 6.0％ with the difference being not statistically significant (P =0.161).Conclusion Cold ischemia time of the donor ＞8 h is an independent risk factor for EAD in recipients after liver transplantation.Shortening the cold ischemia time of donor liver can reduce the incidence of postoperative EAD in recipients.The culture results of preservation solution have a certain guiding effect on the postoperative anti-infective treatment of the recipients.
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Objective To assess the level and trend of community acquired respiratory distress syndrome (CARDS) toxin after the infection of Mycoplasma pneumonia(MP),and evaluate the clinical characteristics,the level of immunoglobulin E (IgE) and interleukin-4 (IL-4) so as to find the association among these factors.Methods According to whether the child had wheezing symptoms,all the 63 children were divided into wheezing group (26 ca-ses) and non-wheezing group (3 cases).The levels of CARDS toxin were respectively detected in the acute stage of MP infection,3 and 6 months later after MP infection in different groups,moreover,IgE and IL-4 levels were monitored at the same time.Results (1) The mean level of IgE were (384.96 ± 316.62) × 103 IU/L and (87.32 ± 66.32) × 103 IU/L in wheezing group and non-wheezing group,respectively,and there was statistically significant difference (P ＜ 0.05).(2) The load of CARDS toxin in wheezing group and non-wheezing group were (1.87 ± 0.62) Delta Rn and (1.15 ± 0.48) Delta Rn in the stage of acute infection,respectively,and there was statistically significant difference (P ＜ 0.05).Nevertheless,differences between 2 groups after 3 months and 6 months were not significant.(3) In the acute stage,the level of CARDS toxin in the severe cases were higher than the mild cases [(2.37 ± 0.37) Delta Rn vs (1.21 ± 0.45) Delta Rn],and there was statistically significant difference (P ＜ 0.05).(4) IL-4 showed significant difference in the acute stage and 3 months later after acute infection between 2 groups,however,there were no difference between 2 groups after 6 months later.(5)The load of CARDS toxin showed no significant difference between 2 groups at 3 months [(0.96 ± 0.35) vs.(0.99 ± 0.40) Delta Rn,P =0.757] and 6 months [(0.67 ± 0.20) vs.(0.69 ±0.32) Delta Rn,P =0.641] later after MP infection.(6)The children in wheezing group coughed for (24.89 ±7.04) days after acute infection and the last time for non-wheezing group was (16.46 ± 4.79) days,and there was statistically significant difference(P =0.000).Conclusions The load of CARDS toxin decreased after acute MP infection and it was still detectable six months after onset in the blood.The level of CARDS toxin was associated with the cough and wheezing symptom and the severity of disease.
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Objective To summmrize the clinical characteristics complications,antimicrobial resistance and prognosis in 15 children with streptococcus pneumoniae meningitis so as to improve the diagnosis and treatment of this disease.Methods A systematic retrospective analysis was carried out in the Qilu Children's Hospital of Shandong University from Jan.2010 to Jan.2013,and clinical data from 15 children with streptococcus pneumococcal meningitis were retrospectively analyzed and followed up for 6 months in order to observe the prognosis.Results Eleven cases of streptococcus pneumoniae meningitis occuned in the winter and spring.And it often occuned in children less than 2 years of age who lived in rural areas (13 cases).The clinical manifestations showed diverse characteristics,severe symptoms,obvious changes in symptoms and cerebrospinal fluid were observed.Severe or death cases had low temperature,low leukopenia or low blood platelet.Common complications of streptococcus pneumoniae meningitis included anemia (10 cases),hypoalbuminemia (9 cases),sepsis (8 cases).Multi-drug resistance and complications in streptococcus pneumoniae meningitis led to the therapeutic difficulties.In this study,3 cases were cured,9 cases had varying degrees of sequences,such as left languages,sports,hydrocephalus and cognitive dysfunction,and 3 cases died,and the main cause of death was multiple organ dysfunction syndrome.Conclusions Streptococcus pneumoniae meningitis mainly occurred in the winter and spring.And the children under 2 years of age who lives in rural areas were often attacked.Clinical characteristics and cerebrospinal fluid changes obviously; severe cases are common with low temperature,low leukopenia or blood platelet.And there aye often diverse complications and multi-sequelae; the problem of multi-drug resistant and complications can lead to great difficulties in the clinical treatment.