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Objective To investigate the effect of hepatitis B vaccine immune response after liver transplantation in children under 5 years old and assess the necessity of multiple vaccination.Methods A retrospective collection of children who had liver transplantation from February 2014 to December 2018 in the same liver transplantation group in the Department of General Surgery,Beijing Friendship Hospital,Capital Medical University were analyzed.In accordance with the requirements of the doctor,170 children under 5 years old injected with over 4 doses were enrolled,including 75 males and 95 females,aged from 4 months to 5 years old.After every dose of vaccination,the blood were collected to detect hepatitis B following regular review in liver transplantation clinic,observe the effect of HBsAb (hepatitis B surface antibody) after postoperative hepatitis B vaccination.Count data were represented by cases and percentage (％),and comparison between groups were analyzed by chi-square test.Results After the first course of treatment,in total children under 5 years old who completed the first course of treatment,121 cases got successful immune responses (HBsAb ≥ 100 IU/L) and 49 cases got the responses failure (HBsAb ＜ 100 IU/L).After the second course of treatment,29 cases got successful immune responses,and only 20 cases finally failed to response (HBsAb ＜ 10 IU/L) to 8 injections namely two courses.The factors affecting the immune effect of hepatitis B vaccination were not related to gender,primary disease,liver feeding mode,and postoperative vaccination time,and were related to age,place of residence,and preoperative level of HBsAb titer (100 IU/L).The immune responses rate of children averagly aged over 2 years old was significantly higher than that of children under 1 year old after the first course of postoperative vaccination.Children with preoperative hepatitis B vaccination and ＞ 100 IU/L anti-HBs titer had a higher immune response rate after the first course of postoperative vaccination (84.72％),and the immune response rate of children with anti-HBs titers ＜ 100 IU/L after the first course of hepatitis B vaccine was slightly lower(60.71％).Conclusions Most post-liver transplantation children can obtain protective antibodies to prevent re-infection of hepatitis B virus by inoculation with hepatitis B vaccine.Multiple inoculation can effectively induce hepatitis B antibody production and improve immune response level economically.The hepatitis B vaccination proved to be indispensable and is one of the current methods promoted and applied to post-liver transplantation.
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Objective@#To investigate the effect of hepatitis B vaccine immune response after liver transplantation in children under 5 years old and assess the necessity of multiple vaccination.@*Methods@#A retrospective collection of children who had liver transplantation from February 2014 to December 2018 in the same liver transplantation group in the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University were analyzed. In accordance with the requirements of the doctor, 170 children under 5 years old injected with over 4 doses were enrolled, including 75 males and 95 females, aged from 4 months to 5 years old. After every dose of vaccination, the blood were collected to detect hepatitis B following regular review in liver transplantation clinic, observe the effect of HBsAb (hepatitis B surface antibody) after postoperative hepatitis B vaccination.Count data were represented by cases and percentage (%), and comparison between groups were analyzed by chi-square test.@*Results@#After the first course of treatment, in total children under 5 years old who completed the first course of treatment, 121 cases got successful immune responses(HBsAb≥100 IU/L) and 49 cases got the responses failure (HBsAb<100 IU/L). After the second course of treatment, 29 cases got successful immune responses, and only 20 cases finally failed to response (HBsAb<10 IU/L)to 8 injections namely two courses. The factors affecting the immune effect of hepatitis B vaccination were not related to gender, primary disease, liver feeding mode, and postoperative vaccination time, and were related to age, place of residence, and preoperative level of HBsAb titer (100 IU/L). The immune responses rate of children averagly aged over 2 years old was significantly higher than that of children under 1 year old after the first course of postoperative vaccination. Children with preoperative hepatitis B vaccination and >100 IU/L anti-HBs titer had a higher immune response rate after the first course of postoperative vaccination (84.72%), and the immune response rate of children with anti-HBs titers <100 IU/L after the first course of hepatitis B vaccine was slightly lower(60.71%).@*Conclusions@#Most post-liver transplantation children can obtain protective antibodies to prevent re-infection of hepatitis B virus by inoculation with hepatitis B vaccine. Multiple inoculation can effectively induce hepatitis B antibody production and improve immune response level economically. The hepatitis B vaccination proved to be indispensable and is one of the current methods promoted and applied to post-liver transplantation.
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Objective To investigate the effect of preoperative anxiety on propofol EC50 for nomovement during Painless gastroscopy.Methods Thirty-one patients (without anxiety) and twenty-seven patients (with anxiety) undergoing gastroscopy under general anesthesia were enrolled on the study.Anesthesia was conducted with a target-controlled infusion (TCI) of propofol.The initial target effect-site propo fol concentration (Ceprop) was 5.0 μg/ml and was adjusted stepwise by 0.5 μg/ml by an up-down sequential method to reach no-movement.Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety (5.32 μg/ml,95％ CI:4.75-5.88 μg/ml vs 4.75 μg/ml,95％ CI:4.48-5.01 μg/ml,P ＜ 0.05).Conclusions During painless gastroscopy,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety when intravenous injected of fentanyl 0.1 μg/kg.
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Objective To investigate whether the median(50%)effective effect-concentration(EC50)of propofol inducing loss of consciousness (LOC) varies. Methods 56 patients undergoing gastroscopy under general anaesthesia were enrolled on the study. Anaesthesia was conducted with a target-controlled infusion(TCI) of propofol. The initial target effect-site propofol concentration (Ceprop) was 5.00 μg/mL and was adjusted stepwise by 0.50μg/mL by an up-down sequential method to reach no-movement. Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety(6.46μg/mL vs. 5.75μg/mL,P<0.05). Conclusions During general anaesthesia ,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety. Differences in preoperative anxiety levels may reduce anaesthetic effects.
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Objective To investigate whether the median(50%)effective effect-concentration(EC50)of propofol inducing loss of consciousness (LOC) varies. Methods 56 patients undergoing gastroscopy under general anaesthesia were enrolled on the study. Anaesthesia was conducted with a target-controlled infusion(TCI) of propofol. The initial target effect-site propofol concentration (Ceprop) was 5.00 μg/mL and was adjusted stepwise by 0.50μg/mL by an up-down sequential method to reach no-movement. Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety(6.46μg/mL vs. 5.75μg/mL,P<0.05). Conclusions During general anaesthesia ,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety. Differences in preoperative anxiety levels may reduce anaesthetic effects.
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Objective To compare the pharmacodynamics of rocuronium intermittently administered according to body surface area and real body weight and individual differences. Method Forty-two patients undergoing elective surgery under general anesthesia were enrolled into the body surface area group (BSA group) and the real body weight group (RBW group), with 21 patients in each group. The patients in the two groups were induced with 2ED95 of rocuronium according to body surface area and real body weight (16.64 mg/m2 in BSA group; 0.6 mg/kg in RBW group). Whenever T1 recovered to 10%, a dosage of 0.5ED95 was administred repeatedly for 30 min before the end of the operation. The time of neuromuscular blockade and recovery of muscle relaxation were recorded, and the dosage of rocuronium was also recorded. Results No significant difference in each index of neuromuscular block time-effect was found between the two groups (P > 0.05). The single dosage and maintainance amount of muscle relaxation were less in the BSA group than that in RBW group (P < 0.05). Compared with the RBW group, the single dosage, dosing intervals, pharmacological duration and the time TOFr recovered to 0.7 between the different individuals were less in the BSA group (P < 0.05). Conclusion The intermittent administration of rocuronium can maintain the same clinical efficacy according to body surface area as that according to real body weight , with significantly less dosageand reducing the differences of individuals in blockade time-effect of muscle relaxation.
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Objective Focusing on the diagnosis, treatment and prevention of central venous catheter (CVC)-related bloodstream infections(CRBSI) in clinical practice, to provide clinical evidences for reducing the incidence of central venous catheter-related bloodstream infections Methods The related articles within the latest 5 years were reviewed, and the related monitoring data of the hospital were analyzed. Results ( 1 )The pathogens of CRBSI invaded bloodstream through the puncture point/hub, and the pathogens of the secondary CRBSI came from the infections in other sites, invading bloodstream and adhering the catheter tip. (2)Highlights on the diagnosis of CRBSI: For the patients with CVC, the possibility of the CRBSI should be considered when severe fever not due to non-infectious causes occurred. Infection occurring time and pathogen are different between the general catheters and the anti-infective catheters. The effect of antiinfection of the anti-infective catheters are limited. To pull out the catheters is the most effective treatment measures. Routine puncture point culture should be rejected. ( 3 ) Prevention of CRBSI: The indications of CVC intubation should be undisputed. Silicone catheter should be used. The catheter should not be indwelled more than 5 days. Conclusions Invasive operation, the lasting time of catheterization and using a lot of antibiotics are the susceptible factors for CRBSI. Hospital should establish suite intervention methods and operation procedures,strengthen education of the medical staff and proceed with targeted monitor for decreasing the rate of infectious.