Urinary tract infection is the most common infectious complication after kidney transplantation.To further reduce the incidence of urinary tract infection after kidney transplantation,improve the diagnosis and treatment level of urinary tract infection after kidney transplantation in China,prevent the development of bacterial drug resistance and ensure the safety and effectiveness of drug use,Branch of Organ Transplantation of Chinese Medical Association organized experts in the fields of kidney transplantation and infectious diseases to consider clinical status of urinary tract infection after kidney transplantation in China,refer to"Diagnosis and Treatment of Urological and Andrological Diseases in China(2022 edition)"and"Urinary Tract Infection in Solid Organ Transplant Recipients in American Society of Transplantation Practical Guidelines for Infectious Diseases(2019 edition)",and formulate"Guidelines for Clinical Diagnosis and Treatment of Urinary Tract Infection in Kidney Transplant Recipients in China"from the perspectives of clinical classification and definition,epidemiology and etiology,diagnosis and treatment of urinary tract infection after kidney transplantation,respectively.

AIM To study the flavonoids from the leaves of Cinnamomum camphora(L.)Presl.and their antioxidant activities.METHODS The 95％ethanol extraction from the leaves of C.camphora was isolated and purified by liquid-liquid extraction,macroporous adsorption resin chromatography,HW-40C gel column chromatography,molecular exclusion chromatography and preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The antioxidant activity was determined by DPPH method.RESULT Ten flavonoids were isolated and identified as(2R,3S)-7-methoxy-5-O-β-D-glucopyranosyl-afzelechin(1),quercetin-3-O-sambubioside(2),quercetin-3-O-β-D-apiosyl-(1→2)-β-D-glucoside(3),quercetin-3-O-robibioside(4),kaempferol-3-O-β-D-rutinoside-7-O-β-D-glucoside(5),kaempferol-3-O-α-L-rhamnoside-7-O-β-D-glucoside(6),5,3'-di-O-methyl-epicatechin(7)、cinchonain Ⅱb(8)、quercetin-3,4'-di-O-β-D-glucoside(9)、(-)-epicatechin(10).The IC50 value of compound 8 scavenging DPPH free radical was 4.8 μg/mL.CONCLUSION Compound 1 is a new compound,and compound 2-6 are obtained from Cinnamomum genus for the first time,compound 7-9 are first isolated from this plant.Compound 8 shows good antioxidant activities..

Objective To analyze retrospectively the HRCT signs in the patients with invasive pulmonary aspergillosis and evaluate the value of HRCT in the diagnosis of invasive pulmonary aspergillosis.Methods The cilinical and HRCT images of 30 cases with invasive pulmonary aspergillosis diagnosed by fiber bronchoscopy, CT guided biopsy or sputum culture were collected.HRCT images were analyzed and the HRCT signs were summarized by two experienced chest imaging radiologists.Results 19 patients had a variety of CT signs, the sign of tree in bud was seen in 8 cases, bronchial stenosis 6 cases, bronchiectasis 8 cases, ground-glass opacity 8 cases, acinic nodules 10 cases, nodular lesions 12 cases, acinar nodules with halo sign 4 cases, nodules with halo sign 9 cases, cavity 10 cases.11 cases only had a single CT sign, the sign of tree in bud was seen in 2 cases, bronchiectasis 2 cases, ground-glass opacity 1 case, acinar nodules 2 cases, nodules with halo sign 2 cases, cavity 2 cases.The occurrence rates of various signs in 30 cases were as follows, the sign of tree in bud was 33.3%, bronchial stenosis 20%, bronchiectasis 33.3%, ground-glass opacity 30%, acinar nodule 40%, nodular lesion 46.6%, halo sign 53.3%,cavity 40%.Conclusion The main HRCT signs in the patients with invasive pulmonary aspergillosis includes tree in bud, bronchial stenosis, bronchiectasis, ground-glass opacity, acinar nodules, nodal lesions,pulmonary cavity and halo sign.The signs of bronchiectasis with tree in bud sign, acinar nodule and halo sign in the HRCT images are highly specific in the diagnosis of invasive pulmonary aspergillosis.

Objective To investigate the prediction value of procalcitonin and Cystatin C in the evaluation of patients with sepsis 28 day mortality.Method A total of 106 patients with sepsis in Ezhou central hospital.The expressions of PTC and CysC in the serums of the patients were measured on the first day of the hospitalization by microparticle enzyme immunoassay.Pearson correlation analysis was performed to test the correlation of PTC and Cys-C with PCIS.Logistic regression models were used to examine the risk factors of patients' death.The AUC curve was used to test the value of PTC and Cys-C in prognosis of patients with sepsis.Result After follow-up 28 days:①41.18 ％ patients (n=21) diedat the end of the follow up.②In the death group,the PCT concentration was 67.2 ± 20.6ng/ml,significantly higher than the survival group (44.5± 13 ng/ml,t=-5.57,P＜0.01);the Cys-C was 78.8±21.4 mg/ml,significantly higher than the survival group (64.2±16.9,t=-3.14,P＜0.01).③Pearson correlation analysis showed that the expression of PCT and Cys C in peripheral blood was negatively correlated with PCIS (r =-0.578,-0.761,all P＜ 0.05).④ Multivariate logistic regression showed PTC and Cys-C were the independent risk factors for prognosis of patients with sepsis (P＜0.05).⑤ROC analysis showedthe AUC value of PTC and Cys C were 0.866 (95 ％CI=0.749～0.93),0.87 (95％CI=0.77～0.94)respectly.The AUC value of (PTC & Cys-C) was 0.89 (95 ％CI,0.82～0.95),which wassignificantly increased compared with PTC or Cys-C (both P ＜0.05).Conclusion The combined detection of PCT and Cys-C has good predictive value in the evaluation of mortality in children with sepsis.

OBJECTIVE: To evaluate the efficacy and safety of sodium dimercaptopropane sulfonate( DMPS) in the treatment of patients with increased urinary mercury. METHODS: By random sampling method,68 patients with elevated urinary mercury were chosen as study subjects. Among them,61 cases were observation subjects working with mercury and 7 cases were chronic occupational mild mercury poisoning. DMPS was used to eliminate mercury by intramuscular injection. The changes of urinary mercury level were observed before and after treatment,and the curative effect was analyzed. RESULTS: The median( the 25 th and 75 th percentiles) of natural voiding urinary mercury was 36. 6( 28. 4,55. 6) μmol / mol creatinine and 24 hours total urine mercury amount was 1 074. 7( 608. 0,1 646. 3) μg / d in the first course of treatment.After 1 to 8 courses of mercury expulsion,the 24 hours total urine mercury amount in 68 patients were lower than the normal reference level( 45. 0 μg / d). The median( the 25 th and 75 th percentiles) of one-time morning urinary mercury level before hospital discharge was 2. 7( 1. 8,4. 0) μmol / mol creatinin,which was lower than the level of natural voiding urinary mercury( P < 0. 05). The first and second course of treatment resulted in the highest decline in urinary mercury,followed by a gradually decreased in urinary mercury in later courses. The number of treatment courses in observation subjects working with mercury was less than that in patients with chronic mild mercury poisoning [( 4. 0 ± 1. 3) vs( 5. 6 ±1. 1) times,P < 0. 05]. There was a positive correlation between the number of treatment courses and the level of natural voiding urinary mercury or 24 hours total urine mercury amount in the first course of treatment( P < 0. 01). The number of courses of mercury expulsion was not related to gender,length of service and age( P > 0. 05). One patient had dizziness and pale after intramuscular injection of DMPS,the symptom was disappeared with symptomatic treatment; 68 patients after treatment have no other adverse reactions. CONCLUSION: Using DMPS as mercury displacement treatment was effective and relatively safe. The change of urinary mercury after DMPS treatment can be used as a basis for establishing clinical standard for patients with increased urinary mercury.

Objective To observe the efficacy and safety of liver decanoic sulfonic sodium in the treatment of elderly patients with acute coronary syndrome (ACS).Methods84 ACS patients over 70 years were randomly divided into the treatment and control groups.Two groups were treated on the basis of general,treatment 40 cases of liver of dibutyl sebacate with sodium sulfonated added 2.5 mg subcutaneous injection parumbilical,day 1,course 8 d ; control group 44 cases combined with low molecular weight heparin calcium 0.4 ml,2 times/day 1 time every 12 hours,according to body weight adjusted dose,Parumbilical shot in course of 8 days,observing the clinical effect of two groups during the treatment,as well as 4 weeks and bleeding during the treatment the incidence of cardiovascular events.Results The clinical effects of treatment and control groups was no significant difference (95％ and 91％,P ＞0.05) ; None of the two sets of death,myocardial infarction and recurrent malignant ventricular arrhythmia; none of the two sets of bleeding occurs,treatment of minor bleeding rates were significantly lower than those of control groups (7.5％ and 25％,P ＜ 0.05).Conclusion The study of dibutyl sebacate with sodium heparin and low molecular weight heparin calcium in the treatment of ACS are valid,but the former which significantly reduce the incidence of minor bleeding.Liver decanoic sulfonic sodium for acute coronary syndrome ACS)anticoagulation can not only effectively reduce cardiovascular events,but also significantly reduce bleeding risk,regardless of the patient's age,gender,renal function and risk stratification,especially for bleeding in high risk elderly patients with safe and clinical promotion.

Objective To explore contrast-enhanced ultrasonography (CEUS) in diagnosis renal injuries complicated with active bleeding of different velocity,and analysis the related factors of renal traumatic degree.Methods Thirty-four Ⅰ - Ⅴ grade lesions of renal injury were made in 4 dogs and 6 New Zealand rabbits.Two and three dimensional CEUS were used to observe traumatic extension,and traumatic position,involving in vascular as well.Then the injury condition was classified and assessed synthetically.Results The range of lesions observed by using 2D and 3D ultrasound had consistency with those of the pathologic sample (length-diameter:F =0.4724,P =0.6252; transverse diameter:F =1.6174,P =0.20490),3D-CEUS can display the vascular that involved by renal injury.In the same traumatic extension condition,the time of animal becoming shocked and injury severity was related to not only traumatic extension but also different velocity of active bleeding and involving in vascular.Conclusions Contrastenhanced ultrasound can objectively reflect renal injury severity,and more information can be provided to clinical for management.

ObjectiveTo explore a method for reconstruction of the middle and lower facial tension system for surgical rejuvenation.MethodsFrom 2003 to 2011,257 female patients were treated with this procedure,in which superficial musclo-aponeurotic system (SMAS) of the cheeks were tightened and fixed to the deep temporal fascia and the temporal muscle fascia in muhidirectional and oblique toward the eye and ear rather than just toward the ear through purse string suture method to achieve the goals of facial rejuvenation.ResultsThe follow-up data were obtained in 50 cases,with time range of 3-60 months.Each case was evaluated by both the patient and the surgical team.Excellent or good results were achieved for 255 cases.In all we succeeded in correcting the nasolabial sulcal deformity,and the cheek ptosis,and the contour of the face were more smoothly than that of preoperative appearance.The outlines of lower face became narrow,and thinner than the preoperative.All the patients were without loss of facial identity.Complications occurred occasionally,including the tensional blister on the dermal suture point and local numbness.No incision scar,alopecia and facial nerve injury occurred.Effects of rejuvenation were obvious and natural in 3-6 months after surgery.Especially 12 months after operation the results were the best.ConclusionsThis technique addresses the multiple factors involved in the senescent changes of the midface.Proper patient selection,good aesthetic judgment,and surgical competence are required to restore the midface and lower face tension system reconstruction.This novel approach is safe and effective,and the result is stable and lasting.

Objective To investigate the relationship among the levels of B-type natriuretic peptide (BNP) and the extent,prognosis of acute aortic dissection (AAD).Methods The serum levels of BNP were measured in 42 AAD cases.According to the increasing level of BNP,the patients were divided into two groups:group A ( BNP≥ 500 ng/L,n =23 ) and group B ( BNP ＜ 500 ng/L,n =19 ).The extent of the disease and cardiovascular events were compared between the two groups.Results All the patients have elevated levels of BNP.The incidence of lasting aortic dissection (47.83％ vs.15.79％,P =0.048 ) and mortality ( 26.09％ vs.0,P =0.024) were higher in group A compared with those of group B.Conclusion The lasting and higher levels of BNP predict the increasing risk of bad prognosis in acute aortic dissection.

Objective To study the effect of low tidal volume ventilation in patients with respiratory failure due to neuromuscular disease. Methods Fifty-seven patients with neuromuscular disease and respiratory failure requiring mechanical ventilation were divided into low tidal volume ventilation group ( group A: 2 7 cases ) and routine tidal volume ventilation group (group B: 30 cases ). Indices of airway pressure and blood gas were recorded. The levels of TNF, IL-6, IL-8 in Bronchoalveolar Lavage Fluid (BALF) were measured after ventilation. The survival rates of 14 days and weaning success rates of 14 days were observed. Results The pH value in arterial blood gas at 0.5 and 24 hour after ventilation was 7.30 ± 0.08,7.40 ± 0.06 in group A,which were significantly lower than those of 7. 39 ± 0. 06,7.47 ± 0. 04 in group B at the same time point ( P ＜ 0. 05 ). The PaCO2 levels at0.5 and24 h were (60.4 ± 16.9)mm Hg and (38.2 ±7.3)mm Hg in group A,which were also significantly higher than those of (46. 6 ±8. 1 )mm Hg and (29.2 ±6.9)mm Hg at the same time point in group B (P ＜ 0.05 ). The airway peak pressure at 0.5 and 24 hour were (21.5 ± 4.5 ) mm Hg and ( 18.6 ± 3.8 ) cm H2O in group A,which were significantly lower than those of (29.4 ±5.1)cm H2O and (31.3 ±4.7)cm H2O at the same time point in group B (P ＜ 0. 05 ). The levels of TNF in BALF at 24 and 48 hour were ( 1385 ± 341 ) ng/L and (1345 ±411 )ng/L in group A,which were significantly lower than those of (1914 ± 501 )ng/L and (2214 ± 544)ng/L in group B at the same time point (P ＜0.01 ). The level of IL-6 in BALF at 24 and 48 hour were (249 ±64)ng/L and (209±49)ng/L in group A,which were significantly lower than those of (324 ±79) ng/L and (343 ±60)ng/L in group B at the same time point ( P ＜ 0. 01 ). The levels of IL-8 in BALF at 24 and 48 hour were (79. 4 ±23.6) ng/L and (92. 7 ± 32. 5)ng/L in group A,which were significantly lower than those of (143 ± 36)ng/L and (162 ±49)ng/L in group B at the same time point (P ＜0.01 ). No significant difference was found in the survival rates of these two groups (100% vs. 96. 7% ,P ＞0. 05). The higher weaning success rate was observed higher in group A (59. 3% ) than group B (33.3%, P ＜ 0. 05 ). Conclusions For patients with respiratory failure resulting from neuromuscular disease,low tidal volume ventilation can decrease ventilation-induced cytokine release, alleviate ventilator-induced lung injury, and increase the success rate of ventilator weaning.