OBJECTIVE: To study the effect of continuous renal replacement therapy on acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. METHODS: A patient was complicated with acute renal failure, severe acute pancreatitis, lung infection, bleeding in anastomosisbetween duodenum and jejunum, and peritonitis following simultaneous pancreas-kidney transplantation. He was treated with immunosuppressor, antibiotics, amylopsin inhibitor, haemostatic and alimentation; at the same time, he was treated with continuous renal replacement therapy for 22 days. The Baxter system was used for continuous venovenous hemofiltration. RESULTS: The vital signs and hemodynamic indicators were stable during continuous renal replacement therapy. Pulmonary edema was well controlled, and acid-base equilibrium of water electrolyte was maintained. The function of vital organs was stableand graft function was normal following continuous renal replacement therapy for 22 days. He was completely cured and out of hospital on day 40. CONCLUSION: Continuous renal replacement therapy plays an important role in treating acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. Thus, it is a well kidney support for ultaneous pancreas-kidney transplantation.

Objective: To investigate the effect of high dose gamma globulin combined with naloxone in the treatment of severe viral encephalitis in children, and its influence on nerve function and immune function. Methods: From March 2012 to May 2017, 103 children with viral encephalitis in the First People's Hospital of Wenling were randomly divided into observation group (53 cases) and control group (50 cases) according to the digital table.The control group was given routine treatment.The observation group was given naloxone combined with high dose gamma globulin on the basis of routine treatment.The therapeutic effect, clinical symptoms, serum neurological function and humoral immune function were compared between the two groups. Results: The total effective rate of the observation group was significantly higher than that of the control group (92.45% vs.78.00%)(χ²=4.319, P<0.05). The clinical symptoms, signs disappearance time and hospitalization time of the observation group were significantly shorter than those of the control group [(2.17±0.56)d vs.(3.12±0.79)d; (2.25±0.31)d vs.(3.87±0.93)d; (3.84±0.46)d vs.(5.31±0.69)d; (2.01±0.83)d vs.(3.86±1.21)d; (1.85±0.58)d vs.(2.79±0.77)d; (11.36±2.14)d vs.(13.05±1.85)d; (10.21±3.05)d vs.(13.85±3.72)d](t=7.072, 11.998, 12.789, 9.093, 7.024, 4.276, 5.444, all P<0.05). After treatment, the serum NSE, S-100β and NGF levels of the two groups were significantly decreased[(12.64±1.22)ng/L vs.(18.95±2.15)ng/L, (0.85±0.24)ng/L vs.(1.69±0.35)ng/L, (0.17±0.05)ng/mL vs.(0.98±0.12)ng/mL, (16.38±1.38)ng/L vs.(19.04±2.78)ng/L, (1.22±0.30)ng/L vs.(1.70±0.41)ng/L, (0.33±0.10)ng/mL vs.(0.96±0.14)ng/mL] (t=18.583, 14.010, 45.361, 6.239, 6.878, 25.58, all P<0.05), and the serum neurological function indicators of the observation group were significantly lower than those of the control group (t=14.592, 6.931, 10.358, all P<0.05). After treatment, the level of IgG in the two groups were significantly higher than those before treatment[(15.62±2.31)g/L vs.(9.12±1.74)g/L; (11.52±2.05)g/L vs.(8.97±1.56)g/L](t=16.363, 6.999, all P<0.05), and the IgG level in the observation group was significantly higher than that in the control group(P<0.05). There were no significant changes in the levels of IgM in the two groups before and after treatment (all P>0.05). Conclusion High-dose gamma globulin combined with naloxone can effectively improve the clinical efficacy of severe viral encephalitis in children, help to improve the clinical symptoms and signs of children, at the same time help to restore the nervous function of children and improve the humoral immune function, which is worthy of clinical application.