Objective:To summarize the nursing experience of a patient with diarrhea associated with Clostridium difficile infection after liver transplantation.Methods:To make individualized nursing plan for patients with diarrhea associated with Clostridium difficult infection after liver transplantation. Nursing measures were carried out from the aspects of prevention and control of infection, adjustment of immunosuppression program, collection and delivery of samples, perianal skin care, predictive first aid nursing, enteral and parenteral nutrition support, rehabilitation activity guidance, psychological nursing and so on.Results:After 22 days of careful treatment and nursing, the patient's condition improved, the yellow soft stool was discharged once or twice a day, the results of laboratory fecal bacterial culture turned negative and the isolation was lifted.Conclusions:The main points of nursing for such patients include prevention and control of infection, reasonable adjustment of immunosuppressive program during severe recurrent diarrhea, vigilance of rejection, correct collection and delivery of samples to ensure correct culture results, close monitoring of defecation, implementation of structured skin care program, improvement of condition warning level, predictive first aid nursing, combined with enteral and parenteral nutrition support to enhance resistance. Formulate individual activity plans to promote rehabilitation; use the concept of shared decision-making to guide the whole process of psychological counseling.

Objective To explore the value of contrast-enhanced ultrasound in the diagnosis and classification of traumatic spleen rupture , as compared with enhanced CT. Methods The manifestations of contrast-enhanced ultrasound on surgically or clinically confirmed spleen rupture in 40 patients were retrospectively analyzed. The performance of contrast-enhanced ultrasound on diagnosis and classification was compared with that of enhanced CT. Results For 40 patients with traumatic spleen rupture , the of accuracy of enhanced CT and contrast-enhanced imaging in the diagnosis of traumatic spleen rupture was 97.5%, with no significant statistical differences (chi-square = 0, P = 1). On contrast-enhanced ultrasound examination, 14 patients were diagnosed as true splenic rupture , 9 as subcapsular spleen rupture , and 16 as central splenicrupture, with a accuracy rate of 92.5% (37/40); and accuracy rate for enhanced CT was 90.0% (36/40), there was no significant statistical difference (chi-square = 1.97, P > 0.05). Conclusions Contrast-enhanced and enhanced CT have good consistency in the diagnosis and classification of traumatic spleen rupture. Contrast-enhanced ultrasound can accurately determine the scope and degree of spleen damage , resulting in more accurate classification; and it has values in the diagnosis of traumatic spleen rupture and choice of therapies.

Objective To explore the influence of nursing intervention on the social support and compliance of parents of severe β-Mediterranean anemia children. Methods A total of 100 cases of Mediterranean anemia children’s parents were surveyed with the Social Support Rating Scale (SSRS) and self-made compliance questionnaires, the investigation was performed before the intervention,6 months, 1 year after the intervention. Results The scores of objective support, subjective support and supporting availability after the intervention were all higher than those before intervention (F=269.04, 125.12, 243.04, all P<0.01). In the pairwise comparison tests, the ranks of objective support score and subjective support score were:1 year after intervention>6 months after intervention>before intervention (P<0.01);the score of supporting availability was lower than the scores of 6 months and 1 year after intervention (P<0.01). The compliance of blood transfusion on time and taking deferoxamine on time before and after the interventions had statistical meanings (Hc=100.40,70.53, all P<0.01). In the pairwise comparison tests, the compliance score before intervention was lower than the score after intervention (P < 0.01). Conclusions Nursing intervention can improve the social support and compliance of the parents with severe Mediterranean anemia children.

Selecting high-quality patient report outcome measures for patients with liver transplantation may properly assess health condition from their perspective, assist nurses in identifying patients′ reports of health issues, and deliver targeted nursing care for them. This paper reviewed the current status of researches on measurement tools for patient reported outcomes in liver transplantation both domestically and internationally, including the content, characteristics, disadvantages and situation recommendations of the generic and specific measurement tools. The purpose is to provide a reference for choosing patient reported outcomes measurements, symptom management as well as the caring strategies in liver transplantation.

Objective:To explore the nursing points of pneumocystis carinii pneumonia after liver transplantation in infants.Methods:Strengthened artificial airway management for children to improve dyspnea. Adopted nasal high-flow humidifying oxygen therapy to correct hypoxemia. Implemented individual temperature management to effectively control high fever. Strengthened children′s medication management, predictive skin management, using the protective isolation and psychological nursing.Results:After timely treatment and careful nursing, the condition of the three children was improved, SpO 2 was maintained at 0.95-1.00, and the patients were discharged successfully. One patient with respiratory failure died of multiple organ failure due to the deterioration of the condition after receiving extracorporeal membrane oxygen and supportive treatment. Conclusions:The infants with pneumocystis carinii pneumonia after liver transplantation should strengthen airway management, correct hypoxia. At the same time to do a good job of symptomatic care, strengthen the observation of the condition, can promote the rehabilitation.

To summarize the perioperative nursing experience of a child with erythropoietic protoporphyria who underwent liver transplantation and splenectomy.The key points of preoperative care include implementing diversified interventions to reduce the accumulation of porphyrin in the body;actively controlling pain and improving the comfort of children;early debridement and treatment,and good care of solar allergic dermatitis.The key points of postoperative care include protecting the transplanted liver and preventing the deposition of protoporphyrin;strengthening respiratory management to control lung infection;psychological counseling throughout the process to reduce negative emotions;individualized follow-up management to prepare for bone marrow transplantation.After careful treatment and nursing,the child recovered smoothly and was discharged from the hospital.A follow-up visit after 1 month discharge showed a good recovery.

To summarize the perioperative nursing care in 32 cases of pancreatic cancer undergoing radical surgery combined with intestinal autotransplantation.Key points:to set up a multidisciplinary surgical team and create surgical emergency plans;to well prepare equipment,supplies,and environment;to utilize node control concepts to control operation safety;to carry out the clustered surgical infection management and phased implementation of isolation technology;to prevent and control the inadvertent perioperative hypothermia;organ irrigation,repair and preservation;to prevent the complication.After above precise surgical cooperation and meticulous care,all operations were implemented successfully,and patients were transferred to the intensive care unit for further treatment safely.

Objective:To summarize the nursing experience of liver transplantation in a patient with acute liver failure, renal injury, shock, hepatic encephalopathy and hyperlactic acidemia caused by K-amine poisoning.Methods:A case of severe K-amine poisoning admitted to the First Affiliated Hospital of Zhejiang University Medical College on June 29, 2022 was treated by multidisciplinary team cooperation. The treatment scheme of blood purification combined with liver transplantation was adopted, individualized nursing measures were implemented, including fluid resuscitation, blood purification, prevention and treatment of complications such as brain edema and infection of hepatic encephalopathy, immunosuppressive treatment after liver transplantation, occupational protection, health education and follow-up management.Results:After careful treatment and nursing, the liver and kidney function of the patient recovered smoothly and was discharged on the 33rd day after liver transplantation.Conclusions:In view of the rapid progress of acute liver failure caused by K-amine poisoning and the involvement of multiple organs, blood purification combined with liver transplantation successfully saved the lives of patients under the cooperation of multidisciplinary teams. Do a good job in disease monitoring and individualized nursing to improve the long-term survival rate of patients.

To summanze the nursing points of enterostomy among 6 children with small intestinal transplantation,which could provide references for clinical nursing.Key points:to set up a multidisciplinary team and develop an observation plan about enterostomy;to monitor the blood circulation of enterostomy closely,so as to identify the vascular complications as soon as possible;to closely observe the excrement of enterostomy and being vigilant for rejection reaction;to select reasonable nursing supplies based on the situation of enterostomy;to treat the abdominal incision fluid leakage timely,and pay attention to protect the skin around the enterostomy and take measures to control infection;furthermore,to attach great importance to continuous nursing care and improve the quality of home care.After above careful treatment,all the 6 children survived;they were discharged from hospital 3～4 months later after the operation of enterostomy restoration.Followed up 2～4 months,6 children recovered well.

Objective To investigate the current status of frailty in liver transplant candidates and to analyze the influencing factors.Methods The convenience sampling method was used to select 150 liver transplant candidates who were hospitalized in the Department of Liver Transplantation of a tertiary hospital in Hangzhou from July 2022 to July 2023.They were investigated by the general patient data,Fried Frailty Phenotype,Barthel Index,Nutrition Risk Screening 2002,General Health Status Scale.Statistical methods including single factor and multifactor analysis were conducted for influencing factors of frailty in liver transplant candidates.Results The pre-frailty and frailty rates in 145 liver transplant candidates were 42.07％and 45.52％,respectively,and only 12.41％were non-frailty.The results of ordered multiple Logistic regression showed that age,total bilirubin,hemoglobin,and general health status were influential factors in the frailty of liver transplant candidates(P＜0.05).Conclusion Liver transplant candidates have a high incidence of frailty.Age,total bilirubin,hemoglobin,and general health status are influential factors in frailty.Nurses should pay attention to the assessment of frailty in liver transplant candidates,and take timely and targeted nursing interventions to prevent or delay the occurrence and development of frailty.