RESUMEN
Objective@#To investigate the application of clohexidine wipes in patients after liver transplantation and the effect of infection prevention.@*Methods@#A total of 279 patients who received orthotopic liver transplantation in the first affiliated hospital of sun yat-sen university from January 2017 to December 2018 and were transferred to the intensive care department of our hospital after the surgery were selected as subjects. Among them, 145 patients who received liver transplantation between January and December 2017 were selected as the control group. From January to December, 2018, 134 patients after liver transplantation were enrolled as the intervention group, and were treated with clohexidine 2% gluconate wet wipes, and the hospital infection rate, infection rate, multiple drug-resistant bacteria infection rate, bath time consumption, and adverse reaction rate were compared between the two groups.@*Results@#The hospital infection rate of the control group was 20.00% (29/145), the infection rate of patients was 37.93%(55/145), the infection rate of multiple drug-resistant bacteria was 25.52%(37/145), and the infection rate of the intervention group was 11.19% (15/134), 24.63% (33/134), 14.93% (20/134). The differences were statistically significant (χ2=4.065, 5.709, 4.806, P<0.05). The bath time of the control group was (16.70±1.42) minutes, and the intervention group was (14.07±1.53) minutes. Compared with the control group, the bath time of the intervention group was saved, and the difference was statistically significant (t=9.637, P<0.01).No discomfort symptoms such as disinfectant allergy were found in both groups.@*Conclusion@#The application of clohexidine 2% gluconate wet wipes in the wiping bath of patients after liver transplantation had a good effect, significantly reducing the hospital infection rate, saving the time of wiping bath.
RESUMEN
Objective To explore the relationship between sudomotor function and peripheral artery disease (PAD),and to evaluate the effectiveness of sudomotor function testing to screen diabetic patients at high risk of PAD comparing to ankle-brachial index (ABI) and toe-brachial index (TBI).Methods A total of 263 diabetes mellitus (DM) outpatients in the 306th Hospital of PLA from August 2014 to April 2015 were enrolled in the study.ABI and TBI were measured by the Doppler method.Sudomotor function was evaluated by measuring the electrochemical skin conductance (ESC) of the hands and feet using the Sudoscan instrument.Cardiovascular autonomic neuropathy (CAN) was assessed and recorded as cardiac autonomic neuropathy risk-score (CAN-RS) by Sudoscan.Results ESC values of the feet and hands were positively correlated with ABI and TBI.The diabetes patients with abnornal ABI and TBI had significantly lower hand ESC [(45.63±12.87) μS vs.(68.10±17.40) μS,(59.17±19.58) μS vs.(68.57±17.11) μS;P＜ 0.05] and feet ESC [(44.54±25.48) μS vs.(70.92±19.46) μS,(59.21±24.52) μS vs.(71.71±19.02) μS;P＜ 0.05],and higher CAN-RS[(49.17± 15.41)％ vs.(36.33±16.25)％,(44.90±16.09)％ vs.(35.39±16.05)％;P＜ 0.05],than diabetes patients with normal ABI and TBI.Using ABI as the gold standard,the areas under the receiver operating characteristics (ROC) curve of the diagnostic performance of hands ESC,feet ESC and CAN-RS to identify PAD were 0.87,0.84 and 0.74,respectively (P＜0.001).Conclusion Sudomotor function testing can be helpful and beneficial to identify PAD in patients with diabetes.
RESUMEN
Objective To investigate the alteration on the expression levels of protein and messenger RNA(mRNA)of aquaporin-8(AQP8)in the hepatocytes of pregnant rats with intrahepatic cholestasis induced by ethinylestradiol.Methods A total number of 20 15-day pregnant rats were randomly divided into two groups:control group，intrahepatic cholestasis of pregnancy(ICP)group.In ICP group，rats were subcutaneously injected with ethinylestradiol(2.5 mg·kg-1·d-1)for 5 days to make the model of ICP.In control group，rats received subcutaneous injection of appropriate volume of propylene glycol for 5 days.The protein expression and subcellular localization of AQP8 in the hepatocytes of pregnant rats were detected using immunohistochemical methods.The mRNA expression of AQP8 in the hepatocytes was assayed by RT-PCR method.Results The model of ICP of pregnant ats was made successfully.Expressions of AQP8 protein and mRNA were detected in two groups.AQP8 protein level in ICP group was 10.8±2.4，significantly decreased than in control group 17.1±2.2(P＜0.05).AQP8 mRNA level in ICP group was 1.07±0.11，significantly higher than in control group 0.80±0.11(P＜0.05).Conclusion Down-regulated AQP8 protein expression and up-regulated AQP8 mRNA expression in the hepatocytes of pregnant rats with intrahepatic cholestasis may contribute to the pathogenesis of ICP.
RESUMEN
OBJECTIVE:To study curative effect of the combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate as acute graft-versus-host disease(aGVHD) prophylaxis on HLA-matched unrelated donor or HLA-mismatched related donor allogenic peripheral blood stem cell transplantation(Allo-PBSCT).METHODS:Thirteen patients with haematological malignancies who underwent HLA-matched unrelated donor or HLA-mismatched related donor Allo-PBSCT with the combination of cyclosporine A as aGVHD prophylaxis at Haikou Municipal People's Hospital from September to November 2008 were selected,including 7 of unrelated donor,3 of haplotype transplantation,and 3 of 1-locus mismatched.The conditioning regimen was performed at 7 days prior to transplantation,with cyclosporine A 5-10 mg/(kg?d),12 hours per time with twice per day.From day 7 prior to transplantation,mycophenolic acid was intravenous drip once per day,then 2.5 mg/(kg?d) antithymocyte globulin at days 5-2 prior to transplantation,1.5 mg/d interleukin 11 was subcutaneous injected at day 2 prior to and 10 days after transplantation,followed by intravenous drip 15 mg/m2 amethopterin at day 1 and 10 mg/m2 at days 3,6,11 after transplantation.The drug doge was reduced and stopped gradually after 3-6 months,which could be prolonged for haplotype grafter.Recombinant human granulocyte colony-stimulating factor was injected subcutaneously at day 3 prior to transplantation,and PBSCT was collected at days 4 and 5 after medication,which was infused to patients with subclavian vein at the same day.In total(7.82-9.11)?108/kg mononuclearcell and(2.9-7.7)?106/kg CD34+ cells were infused.RESULTS:Hematopoiesis was rebuilt in all patients with 46.15%(6/13) aGVHD incidence rate,including 8 %(1/13) of Ⅲ-Ⅳ aGVHD.Up to April of 2009,all patients live and work as normal except one patient who can not visit public places.CONCLUSION:The combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate is effective in the prevention of aGVHD.
RESUMEN
Allotransplantation of peripheral blood-derived hemopoietic stem cells is the best therapy for acute leukemia. With increases of only-child families, sibling donors are decreasing. Moreover, the probability is low and time consuming is long to search a matched hemopoietic stem cell donor from the Chinese Marrow Donor Program. Haploidentical stem cell transplantation would bring a hope for donor resource. However, difficult transplantation and high incidence of graft versus host disease are two risks. Based on modified regimen and cyclosporine A+short-term amethopterin, mycophenolic acid, interleukin-11, anti-lymphocyte immunoglobulin and hemopoietic stem cells mobilized by recombinant human granulocyte colony-stimulating factor can prevent graft versus host disease. This therapy succeeded in two cases with no severe graft versus host disease.
RESUMEN
Objective To analyse the effect of mobilization and collection's time of peripheral blood stem cells(PBSC) from 8 cases of healthy donors. Methods The 10 donors were studied by self-control design.The number of aphereses was two times every donors. Healthy donors received rhG-CSF according to two different PBSC collection starting time: group 1:PBSC collection was starts 2 hours(2 h) after the fourth day or the fifth day of rhG-CSF. group 2:PBSC collection was starts 4 hours(4 h) after the fourth day or the fifth day of rhG-CSF.(The first dose of rhG-CSF was given on day 1, considering day 0 as the day before starting mobilization). In this study we have compared with two groups of apheresis product. Results The MNC count was significantly higher for donors 4 h collection (groups 2) then 2 h. ( groups 1)(P