Objective To investigate the influence of therapy combined with clopidogrel hydrogen sulphate,aspirin and alprostadil on coagulation function of patients after liver transplantation.Methods Summarize the clinical data and therapeutic measures of twice postoperatively bleeding in abdominal cavity for one case underwent liver transplantation in our hospital and administered with clopidogrel hydrogen sulphate and aspirin for 14 years in preoperative period,and alprostadil was added in peri-operative period.Results The operation was successful,and the lost blood was 200 ml.The abdominal drainage were bright red,the volume ＞ 100 ml/h,on postoperative 2 days.The exploratory celiotomy were performed at 36 hours after operation,1500 ml of blood clot were removed,and active bleeding point was not observed.The abdominal drain tube were removed,the normal diet and normal liver function were recovered,on postoperative 4,7 and 14 days,respectively.The clinical manifestation of acute hemorrhagic shock were recurred on postoperative 17 days,and the emergency diagnostic doppler ultrasound test were performed and revealed excessive effusion in abdominal cavity,and then the second opening were performed,and confirmed that a branch of gastro-duodenal artery were bleeding point,3 000 ml of blood clot removed,and one month after liver transplantation the patient recovered and discharged.Conclusions Combining clopidogrel hydrogen sulphate and aspirin for long-term anticoagulation can influence the coagulation function.Close observation after transplantation and knowing clearly patient' s condition on time can provide evidence for diagnosis.Effective treatment should be carried out for saving.Enhancing protective segregation and individual mental nursing can promote patients' recovery.

Objective Discuss the preventions of complications and nursing characters after split liver transplantation in children. Methods Retrospectively analyze the clinical materials of the two cases of child split liver transplantations operated by our center. Results Acute rejection and simple appendicitis happened in one patient. Both patients had some complications including pleural effusion, neuro-system and psycho-system complications, electrolyte disturbances and etc. No bile leakage and bleeding occurred. They took a favorable turn with treatments. Conclusions There were some differences between children and adults in categories of primary liver diseases, pathophysiologic characters, operation methods and complications of operations. In children, the operations were difficult and the complications were more. The postoperative managements were complicated. Emphasizing observation after operation, finding complication as soon as possible and early treatment could help living through perioperative period.

OBJECTIVETo investigate the epidemiological characteristics of norovirus infection in Beijing.

METHODSBoth outbreaks and sporadic cases of acute gastroenteritis were studied through questionnaires while the stools of patients were collected. Noroviruses were detected by ELISA or RT-PCR, and PCR products were cloned and sequenced.

RESULTSEight outbreaks were reported between November 2006 and March 2007, which were confirmed as nosocomial infections. A total of 158 positive cases were detected among 409 sporadic cases of acute virus gastroenteritis with a positive rate of 38.63%. The highest positive rate (55.00%) was found in group aged from 40 to 44, while the lowest positive rate (21.74%) fell into groups aged from 55 to 59. The positive cases aged from 6 months to 91 years with the mean age of 40 years old including 84 males and 74 females. Data from sequence analysis showed that norovirus epidemic strains helonged to the GII/4 variants in Beijing, which were almost identical to the variants causing epidemics both in the Netherlands and in Japan.

CONCLUSIONNorovirus was important, causing virus-borne diarrhea between 2006 and 2007 in Beijing, and the epidemic strains were consistent with those isolated from both the Netherlands and Japan in 2006.

Adolescent ; Adult ; Caliciviridae Infections ; epidemiology ; virology ; Child ; Child, Preschool ; China ; epidemiology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Norovirus ; pathogenicity ; Reverse Transcriptase Polymerase Chain Reaction ; Young Adult

Objective To analyze the clinical values of super early enteral nutrition combined with microecopharmaceutics and delayed enteral nutrition on patients with severe acute pancreatitis. Methods Clinical data of thirty patients diagnosed as severe acute pancreatitis in our emergency department during January 2013 and December 2017 were reviewed retrospectively. Patients were divided into the treatment group (n=15, patients given enteral nutrition combined with microecopharmaceutics within 24 h after admission) and the control group (n=15, patients given delayed enteral nutrition after 48 h of admission). Two weeks after the treatment, the serum variables of C-reactive protein, total protein, albumin, recovery time of urine and blood amylase, length of hospital stay and APACHE Ⅱ score were compared between the two groups by using paired samples t test. Results The C-reactive protein [(46.7±13.1) mg/L vs. (190.72±19.3) mg/L, t=10.4, P<0.01] and APACHE Ⅱ score [(7.2±1.9) vs.(9.3±2.4),t=2.7,P<0.05] of the treatment group were significantly lower than those in the control group. The total protein [(58.1±6.3)g/L vs.(52.6±5.4)g/L, t=2.5, P<0.05] and albumin [(29.9±3.2)g/L vs.(22.0±2.8)g/L, t=7.12, P<0.01] of the treatment group were significantly higher than those in the control group. The recovery time of urine amylase [(13.2±2.1)d vs.(18.7±3.9)d, t=4.9, P<0.01] and blood amylase [(7.5±3.0)d vs.(11.1±3.4)d, t=3.1, P<0.01], and length of hospital stay[(14.9±4.5)d vs.(27.1±5.3)d, t=6.9, P<0.01] were significantly shorter in the treatment group compared with those in the control group. Conclusions Ultra-early enteral nutrition combined with microecopharmaceutics can shorten the length of hospital stay of patients with severe acute pancreatitis, and is safe and effective.

Objective To summarize the nursing care of acute appendicitis after orthotopic liver transplantation. Methods Clinical data and nursing experience of 3 liver transplantation recipients who complicated acute appendicitis and 4 cases who misdiagnosed acute appendicitis in the early postoperative period in our hospital were retrospectively analyzed. Results Three of which initially presented the symptoms of acute appendicitis in 8 d, 9 d and 13 d respectively after liver transplantation, including right lower quadrant paroxysmal pain, fever, and was emergently performed appendectomy and then got recover well. Of another 4 cases, duodenal diverticulum complicated perforation in 1 case in 9d and jejunum perforation in 1 case in 6d and bile leakage in another two cases respectively in 5d and 11d after liver transplantation. Conclusions Morbidity rate of acute appendicitis was low after liver transplantation, but it always had a severe situation, and immediately needed to be operated once diagnosed, which benefits for patients' recovery. Careful nursing management is very important for the immediate diagnosis of receipts complicated acute appendicitis and also enhanced the recipients' success rate after liver transplantation.