Objective To study the curative effect of continuous renal replacement therapy (CRRT) to the patients with acute renal failure after liver transplantation. Methods From Mar. 2004 to Jan. 2005, the continuous renal replacement therapy was applied to 7 patients with acute renal failure after liver transplantation. The average time of CRRT was 36.1h. The volume of fluid displacer during CRRT was 2-4L/h and the volume of blood flow was 150～250ml/min. Normal heparin was used as anticoagulant. Results For the 7 patients, 4 improved, 2 died. The contents of blood urea nitrogen (BUN) and blood Cr of all the 7 patients have obviously declined(P0.05). The haemodynamic variables were stabilized during CRRT and no obvious side-effect related to CRRT was found. Conclusions CRRT improved the prognosis to the patients with acute renal failure after liver transplantation, showed a favorable tolerance, and may be applied as a emergency measure to the patients with acute renal failure.

Objective To research the toxicokinetics model of lead acetate in the domestic rabbits.Methods Injecting lead acetate into the vein of the domestic rabbit at the dose of 3 mg/kg,then the blood was collected at the 10th,20th,30th,60th,90th,120th,180th,240th and 360th min.The concentrations of the blood lead were measured by differential potentiometric stripping analysis,the data were analyzed by DAS2.0 software.Results The linear was at the range of 10 to 50 ?g/ml,the major toxicokinetics parameters were:t1/2? = 8.60 min,t1/2? = 67.69 min,t1/2? = 729.84 min,V1= 77 033.08 L/kg,CL = 709.27 L/(min?kg),AUC(0-t) = 3 106.59 ng/(L?min).According to the smallest principle of AIC,the lead concentration in vivo conformed to the three compartmental models in domestic rabbit after injecting lead acetate at 3 mg/kg.Conclusion The lead concentration conforms to the three compartmental models in the domestic rabbit after intravascular injection of lead acetate,and it is eliminated according to the first order processes.

ObjectiveTo investigate the effect of continuous renal replacement therapy (CRRT) on the elderly patients with acute renal function failure.Methods11 elderly patients with acute renal function failure were treated with continuous renal replacement therapy. The average time of CRRT was 24.8 h. The ultrafiltration rate during CRRT was 2～4 L/h and blood flow rate was 150～250 ml/min. Normal heparin was used as anticoagulant.ResultsAmong 11 patients, 7 were mend, 3 died. The blood urea nitrogen (BUN) and creatinine (Cr) levels of all patients obviously declined (P<0.01). The haemodynamic variables of all patients were stabilized during CRRT and no obvious side-effect related to CRRT was found.ConclusionThe treatment of CRRT can improve the sufferer prognosis to the elderly patients with acute renal function failure, not restricted by age, and is the effective means to the elderly patients with acute renal function failure.

OBJECTIVE To investigate the epidemiological conditions of bacterial colonization in respiratory tract,and antibiotic resistance under the antibiotic pretreatment in liver transplanted patients. METHODS From Oct 2002 to Jan 2005,121 liver transplanted patients were admitted to ICU.Among them,45 patients who were intubated more than 48 hours were included in this study.All of the patients received antibiotic pretreatment after operation.Sputum specimens were collected after 24 hours and 48 hours in ICU via the intubated tube with bronchoscopy. RESULTS Thirty nine pathogens were isolated from 36 patients during 48 hours.Pseudomonas aeruginosa was the predominant pathogen.Only 8 bacilli were susceptible to the antibiotics. CONCLUSIONS Although antibiotic pretreatment performed,bacterial colonization in respiratory tract emerges early in liver transplanted intubated patients.Antibiotic pretreatment may make the susceptible bacteria escape.

Objective To discuss the characteristics of multiple blood supplies and the significance of multiple intra-arterial embolization in massive hemoptysis. Methods Forty-four patients with massive hemoptysis underwent digital subtraction angiography (DSA) and intra-arterial embolization after ineffective medical treatment. The characteristics of blood supply of lesions,the methods of intra-arterial embolization and the clinic efficacy were retrospectively analyzed. Results All the patients, one artery was embolized in 9 patients,2 arteries were embolized in 18,3 in 14 and 4 in 3. The hemoptysis decreased or ceased immediately after intra-arterial embolization in 43 patients and recurrence within lweek in 2,which were controlled with additional emblization. 1 patient died in surgery. Conclusion The lesions of massive hemoptysis had complicated blood supplies,and multiple intra-arterial embolization was very important.

Objective To discuss the clinical value of interventional management before surgical therapy for massive gastrointestinal hemorrhage, and to compare the clinical efficacy and re-bleeding rate between hypophysin infusion group and embolization group. Methods During the period of June 1998-Apr.2009, 31 patients with massive gastrointestinal hemorrhage in our institution underwent preoperative interventional managements before they received surgical treatment. According to DSA manifestations, the patients underwent trunsarterial hypophysin infusion or transcatheter embolization as interventional management. The clinical efficacy of interventional procedures and its influence on the surgery were evaluated, and the hemostasis rate and re-bleeding rate were compared the two kind of intervention managements. The numeration data were analyzed with Fisher's exact test, and the SPSS 11.0 was used as statistical software. Results The interventional managements were successfully performed in all the 31patients, with a total hemostasis rate of 83.9% (26/31) and a total re-bleeding rate 30.7% (8/26). The hemostasis rate and re-bleeding rate of hypephysin infusion group and embolization group were 69.2% (9/13), 94.4% (17/18) and 44.4% (4/9), 23.7% (4/17), respectively. All the 31 patients received surgery after interventional therapy, of which selective operation was carried out in 20. Neither surgery-related or intervention-related serious complications nor death occurred. Conclusion Preoperative interventional managements can provide patients with massive gastrointestinal hemorrhage with valuable chance of a successful surgery, enable the physician to take a selective operation to replace an emergency one, as a result, the surgical risk will be greatly reduced. Therefore, it is worth popularizing the preoperative interventional managements in clinical practice.