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Objective:To analyze the treatment process of a renal transplant patient infected with coronavirus disease 2019 (COVID-19), and discuss the management strategy for the immunocompromised hosts.Methods:The diagnosis and treatment of a case of transplant patients with COVID-19 admitted to Horgos designated hospital of Xinjiang Uygur Autonomous Region in October 2021 were reviewed. The medical history and laboratory and imaging examination treatment and outcome of this case were analyzed.Results:The recipient was a middle-aged male with a time from renal transplantation of 3 years. The onset was moderate to low fever, accompanied by cough and fatigue. Chest CT showed multiple ground glass shadows under the pleura of both lungs, mainly in both lower lungs, gradually worsening until "white lung" appeared, with early renal and cardiac insufficiency. In the course of treatment, immunosuppressants were reduced and the dosage of glucocorticoid was increased. In the early stage, due to renal insufficiency and hyperkalemia, dialysis was conducted for 3 times. Oral abidol and Lianhua Qingwen capsule were given as antiviral and anti-infection treatment. Special immunoglobulin and convalescent plasma of COVID-19 were used to boost the immunity of patients. The patient was eventually clinically cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 for the kidney transplantation recipient are not significantly different from other populations, but immunocompromised hosts are more likely to suffer from organ dysfunction. The adjustment of immunosuppressants and glucocorticoids, respiratory support, selection of antibiotics, organ protection, nutritional support and traditional Chinese medicine intervention in the treatment of renal transplant recipients with severe COVID-19 need further discussion.
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Objective To observe the clinical effect of HuaYu TongFu KaiQiaoFang on serum homocysteine (Hcy)in patients with acute cerebral infarction. Methods Sixty cases of acute cerebral infarction admitted into the comprehensive ward and intensive care unit(ICU)of the First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine from December 2010 to January 2012 were randomly divided into two groups,each group including 30 cases. The control group was given conventional treatment,and based on the conventional therapy,the treatment group was additionally given HuaYu TongFu KaiQiaoFang(a traditional Chinese medicine decoction including the following ingredients:Safflower 10 g,Chishao 10 g,Chuanxiong 10 g,Notoginseng 10 g,Angelica Sinensis 10 g, Shichangpu 10 g,Polygalae 10 g,Glauber's salt 5 g,Rhubarb 6 g),one dose a day by oral or nasal administration for consecutive 14 days. Before and after treatment in the two groups,the serum Hcy level was detected by enzyme-linked immunosorbent assay(ELISA),and the clinical efficacy was assessed by Pearson or Spearman correlation analysis to observe the correlation between neurological deficit score(NDS)and Hcy levels. Results Before treatment, the difference of serum Hcy(μmol/L)and NDS levels between the two groups was not statistically significant(both P>0.05),while after treatment,the levels in the two groups were significantly decreased in comparison with those before treatment(P<0.05 or P<0.01),and the degree of descent in treatment group was more obvious compared with that in control group(Hcy:7.78±2.51 vs. 10.18±2.41,NDS:10.60±2.25 vs. 14.60±3.70,both P<0.05). After treatment,the total effective rate in the treatment group was significantly higher than that in the control group (90.0%vs. 76.7%,P<0.05). Before treatment,the NDS was positively correlated with Hcy(r=0.675,P<0.05). Conclusion HuaYu TongFu KaiQiaoFang can significantly reduce the level of serum Hcy and improve the nerve function,thus its clinical effect for treatment of acute cerebral infarction is remarkable.
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Objective To clarify the actions of tranilast,an anti allergic drug,on chronic constriction mononeuropathy through an experiment using an animal model according to the method of Bennett et al. Methods 36 rats were divided into 2 groups: one was treated with tranilast(200mg/kg?d-1,p.o every experimental day),the other was controlled with solvent only. Chronological changes of heat evoked withdrawal latencies on a hot plate,nerve coducting velocitics, and histopathological changes were compared between the two groups from one to four weeks after loose ligation in the sciatic nerve. Results The changes of the withdrawal latency and nerve conducting velocities in the tranilast treatment group were significantly longer than those in the control. The rats without tranilast treatment showed inflammation in and around the constricted nerve bundles,axonal degeneration,phagocytes invasion and interstitial edematous changes at 7 days,numerous axonal sprouts and remyelination at 14 days,and regeneration in the nerve bundles at 28 days. In contrast,the rats treated with tranilast showed less inflammation or nerve fiber degeneration,and better regeneration than those of the control. Conclusion The actions of tranilast appear to have beneficial effects on prophylaxis of a chronic constriction mononeuropathy and on preservation of the nerve functions in rats.