Objective : To compare the clinical characteristics of ordinary and severe coronavirus disease 2019 ( COVID-19 ) cases, so as to provide basis for the diagnosis, treatment and prognosis. Methods : We recruited 77 COVID-19 cases in Wenzhou Central Hospital from January 15 to February 29, 2020, collected their general information, clinical symptoms, laboratory test and CT scan results, and compared the clinical features of ordinary and severe cases. Results: There were 50 ordinary cases and 27 severe cases. The age, prevalence of hypertension and other baseline diseases of severe cases were higher than those of ordinary cases ( P<0.05 ) . The maximum body temperature during 1-3 days of hospitalization, proportion of body temperature rising, prevalence of cough, yellow phlegm, hemoptysis, chest tightness and shortness of breath of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The proportion of pulmonary consolidation, glazing and patch shadow, the number of solid changes and the cumulative number of lesions of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The values of LYM during 1-10 days of hospitalization, total T-lymphocyte percentage, CD4 count and percentage, CD8 count, Hb and oxygenation index of severe cases were lower than those of ordinary cases; while the values of LDH and NLR during 1-10 days of hospitalization, N8R, AST, ferritin, CRP during 1-7 days of hospitalization and D-dimer of severe cases were higher than those of ordinary cases ( all P<0.05 ). Conclusions Severe COVID-19 cases have older age, higher prevalence of baseline diseases, fever, shortness of breath symptoms, more lung consolidation and lesions, significantly decreased lymphocyte level ( especially CD4 ) , and increased LDH, NLR, ferritin and CRP.

Objective:To evaluate the imaging features of CT scan in patients with COVID-19.Methods:Clinical data of 56 patients with COVID-19 from January 17 to 19, 2020 admitted to Wenzhou Central Hospital and the Second Affiliated Hospital of Wenzhou Medical University were retrospectively reviewed. The clinical manifestations, lung imaging characteristics and treatment outcomes of patients with different severity were analyzed with SAS software.Results:Fever (92.8%, 52/56), dry cough (75.0%, 42/56) and asthenia (58.9%, 33/56) were the first symptoms in most of the patients; some patients also had shortness of breath (25.0%, 14/56) and pharyngeal pain (10.7%, 6/56). Chest high-resolution CT scan showed that in 42 moderate patients, ground glass-like high-density shadows in the lung were observed in 30 cases (71.4%) ; localized plaque consolidation shadows and bronchial inflation signs were observed in 10 cases (23.8%). In 12 severe patients, 11 had high-density patches involving multiple lung lobes (≥3). In 2 critically ill patients the patches and stripes involving the entire lung were observed; and cord-like high-density shadow, local consolidation and fibrosis were also shown.Conclusion:The multiple ground-glass changes outside the lungs are early imaging manifestations of COVID-19 patients. The increase in pulmonary lobe consolidation and fibrosis may indicate the disease progression, and the degree of lung consolidation and fibrosis is closely related to the disease severity.

Objective To summarize the perioperative nursing care of a patient with ischemia-free liver transplantation. Methods The nursing measures were developed according to the characteristics of the disease and the individual conditions of the patients: including preoperative psychological care;preoperative preparation; prevention of postoperative infection; meticulous observation of the patient′s conditions, transplanted liver function and postoperative complications; the early guidance of rehabilitation activity, nutritional support treatment and the care of water and electrolyte balance. Results The patient recovered well with careful nursing care and no nursing-related complications occurred, and he was discharged successfully on the 18th day after surgery. Conclusion According to the patient's condition and individual situation, the development of nursing measures can effectively prevent the potential infection, timely discover the changes of the patient′s condition, understand the recovery of the transplanted liver function and observe the related postoperative complications, and help to promote the early recovery of patients.

Objective To investigate the nursing of the adult recipients who accept children organ donations after cardiac death(DCD)complicated with portal venous thrombosis after liver transplantation. Methods We retrospectively analyzed 1 case completed in 2015 related to the adult recipients who accept children organ donations after cardiac death with portal venous thrombosis after liver transplantation in clinical situation,in view of the portal vein thrombosis of portal vein catheter thrombolysis,portal vein carotid stenting, close observation and nursing are used for patients′condition change. Results After positive clinical therapy and careful nursing,portal venous thrombolysis effect is good, and portal venous blood flowing after carotid stenting,clinical symptoms were alleviated. The liver function recovered well after surgery, and the patient discharged successfully,followed by regular visits from the hospital. Conclusions Children organ donations after cardiac death for liver can be successfully applied in the adult recipients,but the understanding of related complications after surgery need to be strengthened.The symptom observation,early detection,active nursing intervention,are conducive to the prognosis of patients.

Objective To investigate the value of intravoxel incoherent motion MR imaging (IVIM-MRI)on monitoring impairment of renal function in hydronephrosis.Methods Left hydronephrosis model of Healthy New-Zealand rabbits made by ureteral incomplete obstruction were scanned by IVIM-MRI at 4, 8, 12, and 16 weeks.The change of IVIM-MRI quantitative parameters (ADC values, D values, D* values, and f values) in left hydronephrosis kidney were observed.The correlation between these parameters and glomerular filtration rate (GFR) were evaluated.Results ADC values, D values, D* values and f values at cortex and medulla in left hydronephrosis model of rabbits decreased gradually in the progression of renal damage after 4, 8, 12, and 16 weeks.For D value, f value and ADC values, there was statistical significant difference among the group of 12 weeks, the group of 16 weeks, the control group, and the group of 4 weeks;statistical significant difference was also observed between the group of 8 weeks and the group of 16 weeks by LSD contrast.ADC values, D values, D* values, and f values were positively correlated to GFR at 4, 8, 12, and 16 weeks for left hydronephrosis model of rabbits.Conclusion IVIM-MRI could monitor impairment of renal function in hydronephrosis dynamically.

Objective To investigate the nursing points of pancreatic leakage after upper abdominal multiple organ transplantation. Methods A retrospective study was conducted on the nursing experience of two patients with end-stage liver disease and type 2 diabetes mellitus who were complicated with pancreatic leakage after upper abdominal multiple organ transplantation from March 2009 to July 2015. Results The blood glucose of these patients returned to normal level within 1 week after operation and insulin was discontinued. Pancreatic leakage was occurred in the two patients at 14 and 21 days after operation, respectively. They were both successfully discharged after active treatments and nursing cares including completely drainage, the application of drugs that inhibited the secretion of pancreatic enzymes and digestive tract glands, strengthening infection control, nutritional support and other conservative treatments. Conclusions It is the key to improve the recovery of pancreatic leakage after upper abdominal multiple organ transplantation with careful observation of abdominal signs and abdominal drainage tube, accurate use of somatostatin, nutritional support, maintenance of water and electrolyte balance, and psychological intervention.

Purinergic 2X7 receptor (P2X7R) and Nod like receptor pyrin domain containing 3 (NLRP3) inflammasome contribute to the inflammatory activation.Great attention has been paid to P2X7R and NLRP3 inflammasome in recent years,especially in the fields of central nervous system.To further elucidate the role of the P2X7R and NLRP3 inflammasome in the central nervous system,we review the latest research progress of composition and physiological functions of P2X7R and NLRP3 inflammasome and how they play their roles in diseases of the central nervous system.

Objective To explore the effects of different time spans for off-bed activities on postoperative rehabiliatioin of patients with liver transplantation. Methods The clinical data of 42 patients having undergone allogeneic liver transplantation during Jan. 2014 to Oct. 2015 were assigned as the observation group. Another 44 patitents during the same period , matched to those in the observation group in terms of general data , were assigned as the control group . The clinical data of two groupos were reviewed to make comparisons in terms of the time for anus exhaust , the time spans for gastric tube and urinary catheter indwelling , abdominal cavity effusion and hemorrhage and pulmonary infection 3 days after operation. Result The time for anus exhaust and the time spans for gastric tube and urinary catheter indwelling in the observation group were all significantly shorter than the control gorup (P<0.05), but there were insignifiant differences between the groups in abdominal cavity effusion and hemorrhage and pulmonary infection. Conclusion Off-bed activities 3 days after operation is safe and feasible for the patients having undergone allogeneic liver transplantation. It can promote their process of rehabilitation.

BACKGROUND:Large numbers of experimental data have confirmed that bone marrow mesenchymal stem cel s have a positive therapeutic effect on cerebral ischemia-reperfusion injury, but there are few reports about intravenous administration of bone marrow mesenchymal stem cel conditioned medium in the treatment of stroke.
OBJECTIVE:To investigate the effects of the conditioned medium of rat bone marrow mesenchymal stem cel s on the recovery of neurological function in rats after cerebral ischemia-reperfusion injury.
METHODS:The bone marrow mesenchymal stem cel s were isolated from rat bone marrow. When cel s at passage 2 or 3 reached 90%confluence, the original culture medium was removed. Then the cel s were cultured in serum-free DMEM for 18 hours. After that, the culture solution was col ected as the conditioned medium of rat bone marrow mesenchymal stem cel s. Adult rats were subjected to 2 hours of right middle cerebral artery occlusion. Ischemia-reperfusion injury rats were randomly assigned to three groups:control group, simple culture medium group and conditioned medium group, and respectively given injection of normal saline, DMEM, conditioned medium (10 mL/kg) via the tail vein at 2, 24, 48 hours after operation.
RESULTS AND CONCLUSION:There was no difference in the behavioral tests among the three groups at postoperative 2 hours (P>0.05). Compared with the control and simple culture medium group, neurological impairment was significantly improved in the conditioned medium group at postoperative 1, 3, 5 days (P<0.05), but there was no significant difference between the control and simple culture medium groups. At postoperative 5 days, brain edema was significantly eased in the conditioned medium group in comparison to the control and simple culture medium groups (P<0.05), and there was also no difference between the latter two groups (P>0.05). These results suggest that rat bone marrow mesenchymal stem cel s-conditioned medium via intravenous administration can significantly ease brain edema and improve the neurologic function after cerebral ischemia-reperfusion injury.

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