Objective To summarize the experience of establishing a split liver transplantation pig model using extracorporeal normothermic machine perfusion (NMP).Methods Twenty miniature pigs were purchased with ten as donors and another ten as receptors.The graft was spliced along Taira line and the right half was reserved for transplantation.Hemodynamics and bile production volume were monitored,and blood biochemical and blood gas analysis indicators were detected during machine perfusion.Pathological change was observed by HE stain.Hemodynamics during liver transplantation,5-day survival rate and the cause of death were recorded.Results Hemodynamic,biochemical and blood gas analysis indicators remained stable during NMP.All receptor pigs were successfully extubated and awake after surgery.Two receptors died on the second day after the operation.The 5-day survival rate was 80％.Conclusion The split liver transplantation pig model using extracorporeal normothermic machine perfusion is feasible and appropriate,and it lays the foundation for further investigation.

Ischemia reperfusion injury (IRI) is a multistep pathophysiological process involving a complex of multi-factors.To alleviate the IRI is of great importance in clinical liver transplantation,especially for marginal donor livers.This article overviewed the protective strategies and the latest progress for alleviation of IRI in three stages of liver transplantation,which includes liver procurement,preservation and reperfusion.

OBJECTIVE:To investigate the characteristics and the prevention of traditional Chinese medicine-induced death. METHODS: The traditional Chinese medicine-induced death cases from 1994 to 2006 collected by retrieving full-text data base of CHKD were analyzed statistically. RESULTS: Of the total traditional Chinese medicine-induced death cases, drugs were chiefly administered by intravenous drip and oral administration, and allergic shock was the chief death causes. CONCLUSION: Clinicians and pharmacists should attach great importance on the ADRs induced by traditional Chinese medicines to ensure safe and effective drug use.

OBJECTIVE:To comprehend the causes for adverse drug reactions (ADR)associated with the traditional Chinese medicine injections in order to improve therapeutic safety.METHODS:Through tracking visits and retrospective study of patient cases,100 control cases and 93 ADR cases are analyzed in terms of medicine,patient,prescribing and nursing,both by single-factor and multi-factor approach.RESULTS:The main causes of ADR associated with traditional Chinese medicine injections are:overdosing,combined administration of drugs,longer-than-required time gap between dispensing and transfusion,failure to do pre-dosing liver or kidney function checkup,irrelevance of indication,lack of detailed instruction about way of administration and dosing,and lack of remarks on pharmacological action.CONCLUSION:It’s vitally important to improve prescribing and nursing behaviors for the sake of enhanced safety of clinical use of drugs.

Objective To evaluate the safety and clinical effect of ABO-incompatible (ILT) pediatric living donor liver transplantation.Method We analyzed 169 pediatric living donor liver transplantation recipients from Sept.20,2006 to Dec.31,2014.There were 16 ABO-incompatible liver transplantation cases.The median age was 6 months.The blood agglutitin titer was monitored.The titer was controlled lower or equal to 1 ∶ 16.The method to decrease blood agglutitin titer included IVIG and plasma exchange.The patients were treated with Tacrolimus combined with methylprednisolone.Basiliximab for injection was used.The patients were followed-up for 9-26months.The survival rate,acute rejection,vascular and biliary tract complications,and infection were monitored.Result All the patients survived.There was once case of acute rejection,1 case of bile duct dilatation,2 cases of portal vein stenosis,8 cases of EBV viremia,5 cases of CMV viremia,and 6 cases of lung infection.The liver functions of all the 16 recipients were recovered within 3 weeks.Conclusion ABO-incompatible liver grafts can be used safely in pediatric patients.

OBJECTIVE: To analyze the chief factors influencing the adverse drug reactions (ADR) in outpatient use of antibiotics so as to formulate corresponding policies for intervention. METHODS: The patients who had been treated i.v with antibiotics from Mar. 2006 to Mar. 2007 were enrolled: 105 in trial group showed ADR, another 105 in control group showed no ADR. The ADR influencing factors were compared between the two groups from aspects of patients, nursing, and medication to find out the significant differences. RESULTS: The chief factors influencing the adverse drug reactions (ADR) in outpatient use of antibiotics included the indications of drugs, dosage, dosing interval, drug combination, and availability of medication guidance. CONCLUSION: The outpatient intravenous use of antibiotics is far from rational, which needes further intervention.

OBJECTIVE:To investigate the incidence of adverse drug reactions(ADRs),the ratio of irrational drug use and the average daily drug costs after the initiation of clinical pharmacists' intervention on the combined use of antibiotic injections in the outpatient department.METHODS:By a controlled prospective study,500 patients in the intravenous center in outpatient department whose records were in line with inclusion criteria were included before intervention as controls,and after the initiation of clinical pharmacists' intervention on the combined use of antibiotic injection in the outpatient department,500 patients meeting the inclusion criteria were enrolled as trial group.A database was established and the results were analyzed statistically.RESULTS:The irrational drug use was noted in 52 cases in the control group versus 21 cases in the trial group and the ADRs or adverse drug events were noted in 18 cases for the control group versus 9 cases for the trial group.The daily mean drug cost reduced by 29.84 yuan after intervention.CONCLUSION:The intervention measures contributed to the reduction in incidences of irrational drug use and ADRs and drug costs.

OBJECTIVE:To improve the safety of antibiotic injections in outpatient department. METHODS:In a prospective randomized control study,outpatients treated with antibiotic injections in 2007 were chosen to be the subjects. The subjects were randomized into control group and intervention group. Education,administration intervention and inspection were adopted in clinical intervention considering the factor of drug combination. The rationality of drug combination and the incidence of ADR before and after intervention were observed. RESULTS:As compared with control group,the rationality of drug combination in intervention group was improved obviously(P

Objective To summarize the experience of treating the end stage of liver disease complicated with renal failure using combined liver-kidney transplantation.Methods The clinical data of 28 cases receiving combined liver-kidney transplantation were retrospectively analyzed, including the inclusion criteria of surgical indications, modus operandi, protocol of immunosuppression and the prognosis post-operation.Results Among these 28 cases in our study, 22 cases suffered from liver and renal failure, accounting for 78.6%; 4 cases were diagnosed as having hepatorenal syndrome, accounting for 14.3%; and 1 case had hyperoxaluria and polycystic liver with polycystic kidney. As for the modus operandi we used, piggy-back procedure was adopted for 4 patients and classic procedure without bypass was used for the rest. Donor kidneys were all put in the right iliac fossa. During the follow-up period of 5 months to 7 years, one-and 3-year survival rate of the recipients was 92.9% and 78.3% respectively. Among these 28 recipients, 4 cases had the graft renal dysfunction early post-operation: One died and 3 recovered through consecutive therapy. One case received re-transplantation of the liver 3 months after the first due to the relevant complications and then recovered. During this period, no impact on the renal function occurred. Eleven cases had pulmonary infection post-operation, and 1 died. No acute rejection occurred.Conclusion Combined liver-kidney transplantation is the effective treatment to the patients with end stage liver disease complicated with renal dysfunction. Suitable case selection and perfect operation timing were the key points to the success of combined liver-kidney transplantation.