ABSTRACT
Objective To explore the value of ultrasound elastography in the non-invasive monitoring of liver elasticity of stable recipients at different stages after liver transplantation. Methods Clinical data of 73 stable recipients after liver transplantation were collected. According to the time after liver transplantation, all patients were divided into the early group (n=25) and medium-to-long group (n=48). In addition, 38 healthy subjects were assigned into the control group. The ultrasound indexes and liver function indexes were statistically compared among each group. The ultrasound elastography indexes of liver and spleen were analyzed, and their correlation with liver function indexes was analyzed. Results Compared with the control group, the ultrasound indexes, alanine aminotransferase (ALT), γ-glutamyl transferase (GGT) and alkaline phosphatase (ALP) levels were significantly increased in the early group (all P < 0.05), and the ultrasound indexes in the medium-to-long group were significantly increased, whereas the GGT level was significantly decreased (all P < 0.05). Compared with the early group, the right oblique diameter of liver, ALT, GGT and ALP levels were significantly decreased in the medium-to-long group (all P < 0.05). Compared with the control group, the sound touch elastography (STE) and sound touch quantify (STQ) values of liver and STE value of spleen in the early group and medium-to-long group were significantly increased (all P < 0.05). Compared with the early group, the ultrasound elastography indexes of liver and spleen in the medium-to-long group were remarkably decreased (all P < 0.05). The ultrasound elastography indexes of liver were weakly correlated with the ALT, aspartate aminotransferase (AST) and GGT levels, significantly correlated with ALP level. The STE value of spleen was weakly correlated with the ALP level. The STE value of liver was significantly correlated with the STQ value of liver. The STE and STQ values of liver were weakly correlated with the STE value of spleen. Conclusions The characteristics of liver elasticity in stable recipients after liver transplantation are various among different stages. Persistent monitoring of liver elasticity may provide a novelnon-invasive monitoring method during follow-up after liver transplantation.
ABSTRACT
Objective:To investigate the clinical characteristics of children with invasive pneumococcal di-sease (IPD) and the sensitivity of Streptococcus pneumoniae (SP) isolates to antibacterial drugs, so as to provide the reference for diagnosis and treatment of IPD. Methods:The clinical data of IPD patients in the Children′s Hospital of Chongqing Medical University from January 2014 to December 2018 as well as the drug sensitivity results of SP isolates were retrospectively analyzed.Results:The male to female ratio of 139 patients enrolled was 1.5∶1.0.One hundred and sixteen (83.5%) patients were under 5 years old.Of the 31 patients (22.3%) with underlying diseases, 7 patients (5.1%) had hematological malignancy, 6 patients (4.3%) had congenital heart diseases, and 18 patients (12.9%) were immunosuppressed.The common sources of infection were the respiratory system (59.0%, 82/139 cases) and the central nervous system (28.8%, 40/139 cases). The in-hospital mortality rate among them was 15.8% (22/139 cases). More than 90.0% of the SP isolates were insusceptible to Erythromycin, Tetracycline and Clindamycin, and 74.8% (104/139 cases) of the isolates were insusceptible to Meropenem.The susceptibility rate of SP isolates to Amoxicillin was 69.1% (96/139 cases). The SP isolates were completely susceptible to Vancomycin, Linezolid, Moxifloxacin and Ofloxacin.Meningitis isolates had lower susceptibility rates to Penicillin (10.0% vs. 54.5%, P<0.001) and Cefotaxime (32.5% vs. 74.7%, P<0.001) than those in nonmeningitis isolates. Conclusions:Children under 5 years old with underlying diseases are susceptible to IPD and have a high mortality rate.The SP isolates in children with IPD are highly insusceptible to Erythromycin, Tetracycline, Clindamycin and Meropenem, and completely susceptible to Vancomycin, Linezolid, Moxifloxacin and Ofloxacin.Meningitis isolates are less susceptible to Penicillin and Cefotaxime than non-meningitis isolates.