Objective To evaluate the predictive effect of preoperative CTP score,MELD score and MELD-Na score on short-term prognosis (≤ 3 months) after liver transplantation,to analyze factors which correlated with survival,and to seek indicators that accurately predicted short-term outcomes.Methods The clinical data of 73 consecutive patients with end-stage liver diseases who underwent liver transplantation in a single center were retrospectively analyzed.The area under the ROC curve (AUC) was used to determine the predictive power.Correlated factors were analyzed by multivariate logistic regression.The statistical processing package used was SAS 9.1.3 software.Results 11 (15.1％) of 73 patients died within 3 months after liver transplantation.The areas under the ROC curve of the preoperative CTP score,MELD score and MELD-Na score for predicting short-term survival were 0.817,0.839 and 0.860 respectively.There was no significant difference among these 3 scoring systems.On univariate analysis,indicators significantly correlated with early mortality were preoperative serum sodium,serum urea,PT-INR,CTP score,MELD score and MELD-Na score.On logistic multiple regression,only MELD-Na score remained as a significant indicator (P =0.001,β =-2.496,OR =0.085,95％ CI:0.019 ～ 0.370).Conclusions The MELD-Na scoring system showed superior predictability of early mortality in patients who underwent liver transplantation.The preoperative MELD-Na score was an independent risk factor of short-term survival.The higher the MELD-Na score,the higher was the early mortality.

Objective To investigate the application of the Healthcare Failure Mode and Effects Analysis ( HFMEA) system to reduce occupational exposure of HIV for surgical staff.Methods Based on the method of HFMEA system utilization, the occupational exposure prevention team for surgical medical staff had been set up to analyze the failure mode and the causes of potential risks,and to calculate the Risk Priority Number ( RPN) .In this study some improvement measures had been carried out, aiming at the failure mode and priority problems.We counted and implemented circumstances of exposure before and after the HFMEA implementation, and evaluated the appraisement of surgical staffs for the implementation of HFMEA.Results Before administration of HFMEA,twenty two HIV-infected patients were admitted in our institution,of which six patients caused occupational exposure, five cases of blood-borne exposure, and one cases of mucous membrane exposure.After administration of HFMEA,thirty HIV-infected patients were admitted, of which only one patient caused occupational exposure, for blood-borne exposed type.The exposure rate before and after HFMEA administration had statistical significance (χ2 =4.36, P <0.05 ).Surgical staffs rendered a positive appraisement for HFMEA administration and 32 (100) staffs recommended it to enhance the recognition of HIV patients contact safety protection and minimize HIV occupational exposure.Conclusions Could reduce occupational exposure rate for surgical medical staff by usage of HFMEA to evaluate and reduce occupational exposure of HIV patients, safe injection, personal protective equipment and medical waste management.