ABSTRACT
High-flow nasal cannula oxygenation (HFNC) characterized as a new non-invasive respiratory support technology, has been widely used in recent years. Compared with conventional oxygen therapy (COT), non-invasive ventilation (NIV), HFNC can offset patient discomforts, and effectively arrest the deterioration of acute respiratory failure (ARF) in immunosuppressed patients. Although there is no benefit of HFNC over COT on reducing mortality in immunocompromised patients with ARF, HFNC is associated with a lower intubation rate and the improved prognosis of transplant recipients and solid cancer patients. Although the association between the prognosis of HFNC treatment and the pathogenic differences of ARF patients remains unknown, HFNC has, as one of the alternative methods for treating ARF in immunosuppressed patients, outstanding clinical significance. The treatment of HFNC in immunosuppressed patients with ARF, such as transplantation, malignancy, pneumocystis pneumonia, and interstitial pneumonia are reviewed in this article, in order to guide the clinical application of HFNC in such patients.
ABSTRACT
OBJECTIVES:To evaluate the efficacy of rapamycin(RPM)oral liquid plus cyclosporine(CsA)on the preven?tion of early acute rejection after renal allograft.METHODS:20patients undergoing primary renal allografting were randomly divided into RPM trial group and Azathioprine(Aza)control group,10cases in each group,who were respectively assigned to receive CsA and adrenocortial hormones-based immunosuppression for6months,indexes including survival rates of recipients/kidneys,incidences of acute rejection and adverse reactions between2groups were compared.RESULTS:For the17patients who had finished6-month treatment,the survival rates(recipients/kidneys)were100%.Only2episodes of acute rejection occurred in one case in Aza group.Both groups had2cases of severe adverse episodes.CONCLUSIONS:The combined therapy pf RPM plus CsA is effective in the prevention of acute renal allograft rejection,and it can maintain renal function at a good level.Nevertheless,it may increase the hepatotoxicity of CsA.
ABSTRACT
Porokeratosis is an uncommon autosomally dominant inher ted disorder. Clinically, it is characterized by nonhealing plaques that develop most comnorly on the limbs. We report a case of disseminated superficial porokeratosis in immunosuppre sed kidney transplant recipient. An abrupt and extensive eruption of porokeratosis was observed in a 46-year-old man 7 months after renal transplantation, while being treated with cyclosporin A and prednisone. The histological features were essentially the same as the typical cornoid lamella. Immunosuppression may exacerbate or initiate the developm nt of porokeratosis in patients predisposed to alterations of cutaneous growth dynamics.