Objective To study the best method of radiation protection shielding calculation for the gamma photon produced in positron annihilation.Methods With 18F as the typical of nuclide,different methods or literature about constant and the calculation of the TVL or recommended values were adopted to calculate and analyze the shielding thickness by lead as block material.Results The shielding thickness by the dose constant was calculated by point source model (0.142 μSv· m2· MBq-1 · h-1) and TVL of lead recommended by NCRP was the biggest:at the control area the unit thickness for lead shield was 7.562 × 10-4 mm· MBq-1 for one patient.While by the dose constant recommended by AAPM TG108 (0.092 μSv·m2 ·MBq-1 ·h-1) and lead TVL recommended by IAEA was the minimum.The unit thickness for lead shield at the control area was 4.982 × 10-4 mm · MBq-1 · patient-1,with difference of 36.2％.Conclusions The dose constant and the TVL value of lead from AAPM.TG 108 are recommended for the calculation.In shielding design attention should be paid to the distance protection,the separate toilet with shielding for patients,and the separate corridors beteen doctors and patients.

Objective To investigate the efficacy of tertiary liver transplantation.Methods The clinical data of 4 patients with hepatobiliary disease who were admitted to the General Hospital of Chinese People's Armed Police Forces from April 2002 to December 2012 were retrospectively analyzed.All the patients received orthotopic liver transplantation,and received tacrolimus + mycophenolate mofetil (MMF) + hormone after operation.All the patients were followed up till May 2014,and their prognosis was learned.The measurement data were analyzed using the t test.Results Three patients with benign hepatic disease received tertiary liver transplantation due to biliary complications and chronic rejection,and 1 patient with hepatic cancer received tertiary liver transplantation because of hepatic cancer recurrence.The average interval between the primary and secondary liver transplantation was 16.0 months,which was shorter than 22.5 months of the interval between the secondary and tertiary liver transplantation.The mean operation time in the secondary liver transplantation was (11.4 ± 1.0)hours,which was significantly shorter than (14.1 ± 2.2) hours in the tertiary liver transplantation (t =3.644,P ＜ 0.05).The median volumes of blood loss in the secondary and tertiary liver transplantation were 1 300 mL and 1 800 mL,and the median volumes of blood transfusion were 1 400 mL and 3 100 mL.The hepatic function of the 4 patients recovered smoothly at the early time after liver transplantation.Two patients (3 cases) were complicated with infection postoperatively (1 patient was infected by pseudomonas aeruginosa within 30 days after liver transplantation,and was cured by active antimicrobial treatment),and they were cured after anti-infectional treatment.One patient died of hepatic failure at the 80th month after the primary liver transplantation,1 died of hepatic cancer recurrence complicated by pulmonary,bone and retroperitoneal lymph node metastasis at the 107th month after the primary liver transplantation,and the other 2 patients survived for 104 months and 26 months after the primary liver transplantation,respectively.Conclusion Tertiary liver transplantation is effective for the treatment of biliary complications and chronic rejection after liver transplantation,and it can extend the life span of patients with hepatic cancer recurrence if there are insufficient donor resources.

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 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 probe into the value of micro-perfusion examination at the early stage after right lobe living donor liver transplantation by contrast-enhanced ultrasound(CEUS). Methods Twenty-six recipients of right lobe living donor liver transplantation received CEUS examination at 1,7,15 and 30 days respectively after operation using contrast medium SonoVue. Perfusion patterns were observed and analyzed considering operation method. Results Of 26 recipients, 15 cases showed normal perfusion patterns with normal hemodynamics; 11 cases showed abnormal perfusion patterns with abnormal hemodynamics:8 had conduit venous obstruction,4 high portal vein blood flow. The abnormal patterns was in the early arterial phase of enhancement process at the first day examination, showing hyper- and hypo- enhancement area compared with normal liver parenchyma. And the difference gradually disappeared in the subsequent examination. Conclusions Abnormal micro-perfusion patterns are highly related to abnormal inflow and outflow in the early post operation stage. The main reasons are conduit venous obstruction and excessive perfusion of portal vein. CEUS can be used as an effective method in evaluating the graft micro-perfusion.

Objective To study the efficacy of peg-interferon plus ribavirin treatment for hepatitis C recurrence after liver transplantation.Methods The clinical data of 16 patients with hepatitis C recurrence after liver transplantation were collected from June 2002 to March 2012 in our hospital.Results There were 1620 patients receiving liver transplantation.66 of these patients received the treatment because of hepatitis C related diseases.16 of the 66 patients received peg-interferon plus ribavirin treatment after liver transplantation.The hepatitis C virus (HCV) RNA concentrations of all the 16 patients were detected.Twelve of the 16 patients were negative for HCV RNA,and the HCV RNA concentration was reduced by more than 2 log after treatment for 12 weeks in 2 cases.The early viral response (EVR) was 87.5％.The HCV RNA of all the 16 patients became negative after treatment for 24 weeks.Conclusion The EVR was high (87.5％) among patients who received peg-interferon plus ribavirin treatment after liver transplantation,and the combination therapy with interferon plus ribavirin was safe and effective for hepatitis C recurrence after liver transplantation.

Objective To explore the diagnostic value of parametric imaging of contrast-enhanced ultrasound(CEUS) on recurrent hepatocellular carcinoma after liver transplantation.Methods CEUS images of 41 recurrent hepatocellular carcinoma after liver transplantation was analyzed by Sonoliver CAP software.The color code image,curve image and quantitative parameter of DVP of each recurrence lesion was recorded,then typed and analyzed statistically.Results The DVP patterns were classified into 3 types,they were washed out types,non-washed out types and negative types.The washed out types,non-washed out types and negative types on color code image and curve image of DVP were 70.73％ (29/41),24.39％ (10/41),4.88％ (2/41) and 63.41％(26/41),34.15％ (14/41) and 2.44％ (1/41) respectively.The maximum intensity,rise time,time to peak of the recurrence lesion and the surrounding liver parenchyma were (149.98± 65.29) ％,(12.32 ± 5.83)s,(13.01 ±6.07)s and (100±0.00)％,(26.10± 10.81)s,(29.69± 11.60)s respectively,and showed statistical differences (P ＜0.05).Conclusions The difference of blood perfusion between the recurrence lesion and the surrounding liver parenchyma can be displayed by DVP's dynamic,direct and quantitative imaging,which can be used to provide valuable information about the detection of intrahepatic lesion of recurrence after liver transplantation.

ObjectiveTo analyze the etiologies and diagnosis of jaundice after liver transplantation during mid later stage and summarize the experience of clinical practice.Methods822 liver transplantation patients were collected from the Department of Internal Medicine, Organ Transplantation Institute in General Hospital of Chinese People's Armed Police Forces between June 2005 and Dec.2008.The clinical data of these cases were analyzed retrospectively.ResultsAmongst 822 patients,129 experienced jaundice after liver transplantation and the occurrence of jaundice ranged from 43 days to 39 months postoperation.Total bilirubin levels were from 27.4 to 503 μmol/L.The etiologies of jaundice and its percentage were as follow:59 cases of biliary complications (45.7％),36 of rejection (27.8％ ),11 cases of virus infection (8.5％),5 cases of drug-induced hepatic injury (3.9％),4 cases of tumor recurrence (3.1％),4 cases of Gilbert syndrome (3.1％),3.cases of dysfunction of papillary muscle (2.3％),2 cases of vascellum complication (1.6％),2 cases of radiation hepatitis (1.6％),1 case of hepatapostema (0.8％),2 cases of unknown reasons (1.6％),respectively.The jaundice of most patients (93％) got released while small part of patients (7％)failed to treatment,of whom 5 cases received liver re-transplantation and 4 cases died of disease progression.ConclusionThe etiologies of jaundice after liver transplantation during mid-later stage are diversiform and complex.And the etiological diagnosis is the premise to treat effectively.

Objective To compare the adjuvanticity of type-A,B and C CpG-ODN in mice.Methods Three types of CpG-ODN were identified through in vitro stimulation of murine splenocytes with various CpG-ODN.BALB/c mice were immunized with HBsAg,together with different types of CpG-ODN,and antigen-specific IgG.IgG1 and IgG2a titers were measured 4 weeks later by indirect ELISA.Resuits Compared with the control group.all 3 types of CpG-ODN enhanced humoral immune response to HBsAg.However,type-B and C CpG-ODN induced much higher levels of antigen-specific IgG and IgG2a than type A CpG-ODN.Type-C CpG-ODN induced a similar TH 1-biased immune response as type-B CpG-ODN,revealed by decreased IsG1 to IgG2a ratio.In contrast,although type-A CpG-ODN increased IgG titers,it did not switch the balance between TH1 and TH2 immune responses.Conclusion All 3 types of CpG-ODN can enhance the humoral immune response to vaccines,but their aaiuvanticity could be mediated through different mechanisms.

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.