The problem of thrombus and hemolysis in blood pump has always been an important topic to study in the development of the blood pump. Numbers of research results show that it is the complicated flow and the high shear stress of the mechanical movement that result in the thrombus and hemolysis. In this study, with the cooperation of Shanghai Children's Medical Center, we have used computational fluid dynamics (CFD) commercial software FLUENT to compute and analyze the flow characteristics in a non-blade centrifugal blood pump. The results figure out that this pump has a reasonable flow distribution and the shear stress distribution is under the critical broken state of red blood cell; meanwhile, there is less thrombus and hemolysis in this pump. So it is in the foreground for clinical use.
Computer Simulation ; Heart Defects, Congenital ; therapy ; Heart-Assist Devices ; adverse effects ; Hemodynamics ; Hemolysis ; Hemorheology ; Humans ; Models, Theoretical ; Stress, Mechanical ; Thrombosis ; prevention & control

OBJECTIVE： To provide reference for the evaluation of the correlation between drugs and adverse drug reaction （ADR） and the implementation of medication therapy management （MTM）. METHODS： Clinical information of a elderly patient with chronic disease （hypertension and coronary heart disease） whose suffered from leukocyte and platelet counts reduction and abnormal liver biochemical examination after taking candesartan were analyzed retrospectively in outpatient department of Tianjin Third Central Hospital. MTM pharmacists analyzed the correlation of candesartan with ADR using Naranjo evaluation scale method. The reasons for abnormal liver biochemical examination were analyzed by Naranjo evaluation scale method combined with Roussel Uclaf causality analysis method （called RUCAM method for short）. The medication reconciliation was conducted according to the results， and pharmacists cooperated with doctors to set individualized medication regimen and follow-up. RESULTS： By Naranjo evaluation scale method， analysis results showed that candesartan was “probably related” to ADR. By RUCAM method， analysis results showed that candesartan was “probably related” to liver biochemical abnormalities. MTM pharmacists suggested that candesartan should be stopped in time and the patient’s medication should be adjusted. The physician and the patient adopted the pharmacist’s advice. After 38 days of drug withdrawal， the patient’s ADR symptoms disappeared， and leukocyte count， platelet count and liver biochemical examination were normal. After adjustment of medication， the patient was followed up for 6 months with normal blood pressure. CONCLUSIONS： Naranjo evaluation scale method and RUCAM are simple and feasible in evaluating the correlation of drugs with ADR and hepatotoxicity. The two methods are consistent in evaluating the correlation between drugs and hepatotoxicity. Naranjo scale method and RUCAM method can be combined to analyze the correlation between drugs and ADR with abnormal liver biochemical examination.