Amiodarone,one of Class Ⅲ antiarrhythmic drugs,may lead to hepatic injury,the incidence of which is about 14% to 82% . Clinical manifestations differ widely from asymptomatic elevated liver enzymes to fulminant hepatic failure and even death. Histopathological findings are similar to those of alcoholic liver disease and characterized by lysosomes phospholipidosis and granular cells. Pathogenesis includes toxicity of amiodarone and its major metabolite,immunological mechanisms,and genetic factors. Intravenous AIHI is mainly related to the effect of cosolvent,polysorbate 80. Men,heart failure and plasma concentration >2.5 mg/ L may be risk factors. Indications to use amiodarone should be strictly controlled and patients' physical conditions should be considered for choosing methods of administration. Monitoring closely is needed for liver function and/ or blood concentration during treatment. When liver function is abnormal, weigh the benefits and risks of treatment carefully,and decide whether dosage reduction or withdrawal of the drug is necessary.

Amiodarone,one of Class Ⅲ antiarrhythmic drugs,may lead to hepatic injury,the incidence of which is about 14% to 82% . Clinical manifestations differ widely from asymptomatic elevated liver enzymes to fulminant hepatic failure and even death. Histopathological findings are similar to those of alcoholic liver disease and characterized by lysosomes phospholipidosis and granular cells. Pathogenesis includes toxicity of amiodarone and its major metabolite,immunological mechanisms,and genetic factors. Intravenous AIHI is mainly related to the effect of cosolvent,polysorbate 80. Men,heart failure and plasma concentration >2.5 mg/ L may be risk factors. Indications to use amiodarone should be strictly controlled and patients' physical conditions should be considered for choosing methods of administration. Monitoring closely is needed for liver function and/ or blood concentration during treatment. When liver function is abnormal, weigh the benefits and risks of treatment carefully,and decide whether dosage reduction or withdrawal of the drug is necessary.

ObjectiveTo investigate the applicability and superiority of modified Seldinger technique (MST).MethodsTotally 108 patients receiving peripherally inserted central catheter (PICC) through vascular ultrasound combined with MST technology were enrolled as MST group and another 108 patients receiving PICC using traditional direct vision method as control group.The first puncture success rate,PICC succesa rate,catheterization time required,and early complication rate were compared between these two groups.ResultsThe first puncture success rate was 88.89％ in MST group and 72.22％ in control group (P=0.002) ; the catheterization success rate was 82.41％ in MST group and 57.41％ in control group ( P =0.000).In the MST group,there were two cases where the catheter within neck was ectopic ( P =0.003 ),two cases experienced bleeding at the puncture sites (P =0.017),three cases had phlebitis (P =0.001 ),and one case suffered from catheter blockage (P=0.010).In the eontrol group,the corresponding numbers were 13,10,18,and 9.However,the time required for PICC showed no significant difference between these two groups (P=0.685).In the MST group,15 cases were catheterized in less than 15 minutes,72 cases between 15 and 25 minutes,and 21 cases for more than 25 minutes.In the control group,12 cases were catheterized in less than 15 minutes,70 cases between 15 and 25 minutes,and 26 cases for more than 25 minutes.ConclusionPICC through MST can be more effective in positioning the targeting blood vessels,increasing the success rate of catheter insertion,reducing various tissue damages,and lowering potential complications.