ObjectiveTo study the protective effects of terlipressin on the renal function of recipients afterlivertransplantation.MethodsAmong 35casesreceivingorthotopicliver transplantation (OLT),16 cases were given terlipressin (group T):continuous infusion of terlipressin (1mg) into the vein immediately after the operation,twice every day for 3-4 days;19 cases were given dopamine and procaine (group D):continuous infusion of dopamine (40 mg) and procaine (0.5 g) into the vein immediately after the operation,twice every day for 3-5 days.In both two groups,the serum creatinine and urea nitrogen levels were normal before the operation. Serum creatinine,urea nitrogen,serum β2 microglobulin and urine amount were determined.ResultsSerum creatinine,urea nitrogen,serum β2 microglobulin and urine amount were increased significantly at 5th day after operation in both two groups (P＜0.05).As compared with group D,urea nitrogen and serum β2 microglobulin were decreased,while the urine amount increased significantly at 5th day after operation in group D (P＜0.05).Three cases (18.8％) in group T,and10 cases (52.6％ ) in group D developed RFALT at 5th day after operation (P＜0.05).ConclusionTerlipressin can protect the renal function of recipients after liver transplantation,and it can more effectively provide good recovery conditions for the recipients who develop RFALT after liver transplantation.

ObjectiveTo explore causes and prevention experience for neuropsychopathic symptoms after liver transplantation.MethodsThe clinical data of 62 patients who underwent transplantation in our hospital were retrospectively analyzed for the causes of neuropsychopathy symptoms and treatment experience was Summarized.ResultsSixteen patients(25.8％ ) had psychiatric symPtoms after liver transplantation in three weeks,four of them more severe.The common clinical manifestation was sleep disorders,mania,anxiety,depression,delirium and change of cognition.The pre-operation encephalopathy history,liver function,blood loss,time in the ICU after surgery,post-operation infection and the concentration of immunosuppressive agents were risk factors for psychiatric symptoms.All patients were cured.ConclusionsPsychiatric symptoms are commonly seen after liver transplantation and have a variety of etiology and clinical manifestations.Psychological counseling should be strengthened.The appropriate therapeutic measures for different etiology can improve patient outcomes.

Objective:To establish a risk prediction model for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) using regression analysis and verify the model.Methods:The risk factors and acute exacerbation of 1 326 patients with chronic obstructive pulmonary disease (COPD) who entered the stable phase and followed up for 6 months in the four completed multi-center large-sample randomized controlled trials were retrospectively analyzed. Using the conversion-random number generator, about 80% of the 1 326 cases were randomly selected as the model group ( n = 1 074), and about 20% were the verification group ( n = 252). The data from the model group were selected, and Logistic regression analysis was used to screen independent risk factors for AECOPD, and an AECOPD risk prediction model was established; the model group and validation group data were substituted into the model, respectively, and the receiver operating characteristic (ROC) curve was drawn to verify the effectiveness of the risk prediction model in predicting AECOPD. Results:There were no statistically significant differences in general information (gender, smoking status, comorbidities, education level, etc.), body mass index (BMI) classification, lung function [forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), etc.], disease status (the number and duration of acute exacerbation in the past year, duration of disease, etc.), quality of life scale [COPD assessment test (CAT), etc.] and clinical symptoms (cough, chest tightness, etc.) between the model group and the validation group. It showed that the two sets of data had good homogeneity, and the cases in the validation group could be used to verify the effectiveness of the risk prediction model established through the model group data to predict AECOPD. Logistic regression analysis showed that gender [odds ratio ( OR) = 1.679, 95% confidence interval (95% CI) was 1.221-2.308, P = 0.001], BMI classification ( OR = 0.576, 95% CI was 0.331-1.000, P = 0.050), FEV1 ( OR = 0.551, 95% CI was 0.352-0.863, P = 0.009), number of acute exacerbation ( OR = 1.344, 95% CI was 1.245-1.451, P = 0.000) and duration of acute exacerbation ( OR = 1.018, 95% CI was 1.002-1.034, P = 0.024) were independent risk factors for AECOPD. A risk prediction model for AECOPD was constructed based on the results of regression analysis: probability of acute exacerbation ( P) = 1/(1+ e- x), x = -3.274 + 0.518×gender-0.552×BMI classification + 0.296×number of acute exacerbation + 0.018×duration of acute exacerbation-0.596×FEV1. The ROC curve analysis verified that the area under ROC curve (AUC) of the model group was 0.740, the AUC of the verification group was 0.688; the maximum Youden index of the model was 0.371, the corresponding best cut-off value of prediction probability was 0.197, the sensitivity was 80.1%, and the specificity was 57.0%. Conclusion:The AECOPD risk prediction model based on the regression analysis method had a moderate predictive power for the acute exacerbation risk of COPD patients, and could assist clinical diagnosis and treatment decision in a certain degree.

ObjectiveSleep-related painful erections （SRPE） is a rare sleep disorder characterized by repeated awakening due to painful interruptions of penile erections during nighttime sleep， and its etiology is currently unclear. The purpose of this study is to explore the impact of potential risk factors on the incidence of SRPE. MethodsInformation was collected through questionnaires administered to patients who presented at the urology department and suffered from SRPE or did not suffer from SRPE. A total of 290 participants completed the study， including 145 controls and 145 cases. Logistic regression analysis was used to assess the impact of age， occupation， sleep initiation time per night， frequency of sexual intercourse per week， psychological status， erectile dysfunction， chronic prostatitis， prostate enlargement， lumbar spine disease， central nervous system disease， hypertension， diabetes and family history on the onset of SRPE. ResultsSingle-factor logistic regression analysis found that a history of chronic prostatitis， intellectual labor occupation， central nervous system disease， late sleep onset， frequency of sexual activity， and anxiety status might be related to the onset of SRPE. After incorporating these factors into a multivariate regression analysis model， it was found that having sexual activity ≥2 times/week （OR 95%CI = 0.326（0.179，0.592） and late sleep onset （after 24：00） （OR 95%CI = 0.494（0.265，0.918）might be protective factors for SRPE， while a history of chronic prostatitis（OR 95%CI = 3.779（2.082，6.859） might be a risk factor for SRPE. However， there was no significant statistical difference in the impact of central nervous system diseases and occupation on multivariate analysis. ConclusionChronic prostatitis and anxiety status may be independent risk factors for SRPE； having sexual activity ≥2 times/week and delaying sleep time appropriately may be independent protective factors.