Objective:To explore the influencing factors of chronic renal allograft dysfunction (CRAD) after renal transplantation.Methods:The clinical data of 1 457 renal transplant recipients who underwent renal transplantation between January 2008 and December 2018 in the First Hospital of Jilin University were retrospective analyzed. The recipients were divided into CRAD group and control group according to whether or not the recipient with CRAD after renal transplantation. The clinical data including sex, age, body mass index (BMI) before transplantation, protopathy, dialysis before transplantation, type of kidney donor, immunity induction and immunosuppressant regiments. Group t test was used to compare the age and BMI of recipients before transplantation between CRAD group and control group. Chi-square test or Fisher exact probability method were used to compare the sex, protopathy, preoperative dialysis form, type of kidney donor, immunity induction and immunosuppressant protocols between the two groups. The variables with statistical difference in univariate analysis were included in Logistic regression for multivariate analysis. A P<0.05 was considered statistically significant.Results:The occurrence rate of CRAD was 4.19%(61/1 457). Among 61 recipients with CRAD 59 recipients received dialysis again after transplantation, and 2 recipients died of interstitial lung disease at 8 and 10 months postoperatively, respectively. The rest recipients (n=1396) were all survived with transplant kidneys. The age, preoperative BMI, preoperative dialysis form, immune induction protocol between of recipients between the two groups had significant difference (t=-2.835 and -2.722, χ2=29.400, 18.310 and 27.250, all P<0.05). Logistic regression multivariate analysis showed that age, BMI, preoperative dialysis form and immune induction protocol of recipients were independent risk factors for CRAD (all P<0.05).Conclusions:Stricter control of age and BMI of renal transplant recipients, early renal transplantation and immunity induction are beneficial to reduce the occurrence of CRAD and prolong the survival time of transplant kidnay.

移植肾输尿管梗阻是肾移植术后常见的泌尿系统并发症,可发生于术后任何时间,其发病率随肾移植术后时间的增加而增加[1],若不能早期诊断及治疗,易导致移植肾丧失功能。现将吉林大学第一医院2010年1月至2020年1月收治的23例移植肾输尿管梗阻患者的诊治情况报道如下。1资料与方法1.1临床资料23例移植肾输尿管梗阻患者,其中男性15例,女性8例,年龄22-70岁。

正>亲属肾移植手术中,因左肾静脉较长,术中易与髂外静脉行端侧吻合,同时左侧肾蒂容易暴露,便于夹闭左侧肾动脉近心端,因此左肾常常成为供肾的首选。本文回顾性分析我院2012年1月至2019年9月63例右侧供肾的原因,为亲属肾移植右侧供肾的选取提供临床依据。1资料与方法1.1一般资料63例亲属供肾者,男性25例,女性38例,年龄21-64岁,平均年龄50.7岁,平均体

近年来,因供肾短缺,我国亲属活体肾移植数量呈明显上升趋势.由于解剖学优势,亲属活体供肾通常首选左侧肾脏,但当存在肾脏血管变异、肾盂结石、肾囊肿及女性供者未生育等特殊情况时,需要选择右侧供肾.本研究回顾性分析吉林大学第一医院亲属活体肾移植供者临床资料,观察左、右侧供肾对供者的影响.

Objective: To investigate the effect of modified fecal drainage device on avoiding the occupational exposure infection of the medical staffs in the treatment of corona virus disease 2019 (COVID-19), and to provide the reference for the clinical treatment of COVID-19 and avoiding the occupational exposure infection of the medical staffs. Methods: The clinical data of a critical COVID-19 patient with diarrhea as the main symptom were collected. The modified fecal drainage device of F18 silicone gastric tube connected with disposable negative pressure drainage device was uesd to treat the fecal excrement of the patient. The general data of the medical staffs, containing 16 doctors and 48 nurses∗ were collected. The COVID-19 serological antibodies and pharyngeal swabs of the medical staffs were tested every 2 weeks. Results: The 78-year-old woman patient was admitted to hospital due to diarrhea∗ cough and expectoration for 15 d, chest distress and shortness of breath for 10 d» and fever for 1 d. The test result of COVID-19 pharyngeal swabs of the patient was positive. After the feces were collected with the modified fecal drainage device, the average operation time of medical staffs was reduced from 20 min to 10 min, the patient's perianal skin flushing subsided, and no incontinence-associated dermatitis ( IAD ) occurred. The patient was cured but remained in hospital for the other underlying diseases. The test results of COVID-19 serological antibodies and pharyngeal swabs of 64 medical staffs were all negative, all the medical staffs had no infection. Conclusion: The modified fecal drainage device has better stability, which can effectively prevent IAD and the spread of COVID-19 and reduce the risk of occupational exposure infection of medical staffs, and it is suitable for clinical promotion application.

<正>呃逆症是膈肌和肋间肌等辅助呼吸肌的阵挛性不随意挛缩,伴吸气期声门突然闭锁,空气迅速流入气管内,发出特异性声音。呃逆频繁或持续48 h以上,称为顽固性呃逆。移植术后患者频繁呃逆症状,严重消耗患者的体力、影响患者睡眠,对经手术创伤抵抗力低下的机体造成二次伤害;还可能造成切口裂开、引流增多等情况影响疾病及手术伤口的康复;甚至引起急性呼吸窘迫综合征,严重时甚至会造成患者休克危及生命[1]。我科于2013年2月收治1例尿毒症患者,行同种异体肾移植术,术后并发顽固性呃逆,经过积极的原因分析,实施及时有效的护理对策,干预效果满意,现报告如下。

Objective To study the relationship between sleeping disorder and anxiety of nursing undergraduate students.Methods Pittsburgh sleep quality index (PSQI) and Hamilton Anxiety Scale (HAMA) were adopted to investigate 120 nursing undergraduate students randomly chosen from Nursing School of Jilin University to discuss the relationship between sleeping disorder and anxiety.Results An analysis of correlation and regression indicated that : PSQI and the total average scores of scores of HAMA were in a notably positive correlation, also anxiety could lead to sleeping disorder.Conclusions The nursing undergraduate students should pay more attention to their own sleep quality, reduce or eliminate the anxiety syndrome, thereby becoming a nurse with a sound mental and physical health.