Construction of performance management system for pharmacy department of tertiary public hospitals under new situation / 中国药房

OBJECTIVE To provide reference for improving the work efficiency of staff and promoting the discipline construction of pharmacy department. METHODS By analyzing the current situation of performance management in the pharmacy department of our hospital， the key successful factors were sorted out， strategic decoding was carried out and key performance indicators were extracted. The quarterly and annual performance appraisal forms were formulated for the departments of pharmacy warehouse， outpatient pharmacy， ward pharmacy， clinical pharmacy department， prescription examination center， laboratory and other departments； the performance management information platform was built. The work efficiency and output of each department were compared half a year before and after the implementation of the performance management plan. RESULTS After the implementation of the program， the average queuing time for drug collection in the outpatient department was shortened from 5 minutes to 3 minutes， the average number of dispensing infusion bags per hour in the pharmacy intravenous admixture services increased from 50 bags to 60 bags， and antibacterial use density of the hospital decreased from 42.7 DDD（defined daily doses） to 40.2 DDD. The number of academic papers published had increased from 8 to 10， and the satisfaction of clinical departments with ward pharmacies increased from 85% to 95%. CONCLUSIONS The performance management system has been successfully established in pharmacy department of our hospital， which can improve the enthusiasm of pharmacists， reflect the value of pharmaceutical care， and promote the discipline construction of pharmacy.

Research progress of accelerated liver regeneration induced by associating liver partition and portal vein ligation for staged hepatectomy / 中华肝胆外科杂志

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can induce accelerated regeneration of future liver remnant (FLR) and provide the opportunity of radical resection for previously inoperable patients with liver cancer, which has been considered to be one of the most important breakthroughs in liver surgery during the 21st century. It is of great significance to fully understand the mechanism of accelerated liver regeneration induced by ALPPS. This article comprehensively reviews the research progress in this field during the past 10 years.

Association among job burnout, tolerance to uncertainty and working with sickness in clinical nurses / 中国职业医学

OBJECTIVE: To explore the association among job burnout, tolerance to uncertainty and working with sickness in clinical nurses. METHODS: A total of 1 159 clinical nurses from 10 cities in Henan Province and Fujian Province were recruited by stratified cluster sampling method and tested by questionnaires including the Chinese Perceived Stress Scale-14, the Intolerance of Uncertainty Scale-12, the Sickness Presenteeism Questionnaire, and the Maslach Burnout Inventory-general Survey. Bootstrap was used to analyze the association among perceived stress, tolerance to uncertainty, working with sickness and job burnout. RESULTS: Perceived stress score was(31.4±4.8), and 802(69.2%) of nurses had high perceived stress level. The score of tolerance to uncertainty was(29.8±8.5), and the score of working with sickness score was(5.5±2.0). The job burnout score was(47.9±11.8), and 570(49.2%) nurses had job burnout. Bootstrap test results showed that the perceived stress score positively affected job burnout score [standardized partial regression coefficient(β)=0.30, P<0.01]. Working with sickness score played a regulatory role between perceived stress and job burnout scores(β=0.16, P<0.01), and tolerance to uncertainty score played an intermediary role between perceived stress and job burnout scores(β=0.08, P<0.01). The regulating effect of working with sickness score played a role through the mediation of tolerance to uncertainty score. CONCLUSION: Job burnout was very serious in clinical nurses. Perceived stress can directly or through tolerance to uncertainty affect the job burnout of clinical nurses and is synergistically affected by sickness presenteeism.

Application of Mental Rotation Test in Motor Imagery Ability Assessment for Stroke Patients / 中国康复理论与实践

Objective:To study the judgment strategies of stroke patients facing different visual stimulus and the main factors affecting the mental rotation test results. Methods:From May to October, 2018, 15 stroke patients and 15 age-sex-education-matched healthy controls accepted standard software-based mental rotation tests with four kinds of visual stimulus: hand back, hand palm, Chinese characters and alphabets. Reaction time and response accuracy were recorded. All the subjects were assessed with Montreal Cognitive Assessment (MoCA), and the patients were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) additionally. Results:When hand back, hand palm and alphabets worked as visual stimulus, the response accuracy was less in the patients than in the controls (F > 7.027, P < 0.05). For all the tests, the reaction time was more in the patients than in the controls (F > 14.827, P < 0.001). The main effect of rotation angle was significant to reaction time when picture of hands as visual stimulus (F > 7.747, P < 0.001), while it was the least at 0°. The MoCA scores negatively correlated with reaction time in both groups (r < -0.375, P < 0.05), as well as the FMA-UE scores in the patients (r < -0.581, P < 0.05). Conclusion:Different types of visual stimulus may affect the judgment strategies and results of mental rotation test. Motor imagery ability is impaired for stroke patients, however, the basic reaction model maintains somehow.

Construction of prognostic risk model for patients with colon adenocarcinoma based on immunogenomics analysis / 解放军医学杂志

Objective To analyze the immune genome environment of colon adenocarcinoma (COAD), find the immune genes related to the prognosis of COAD patients, and construct a prognostic risk score model to provide a basis for prognosis evaluation and individual diagnosis and treatment of COAD patients. Methods The RNA-seq data and clinical data of COAD patients were downloaded from TCGA (The Cancer Genome Atlas) database. Samples were divided into Tumor group and Normal group according to the type of tissues, and the differentially expressed immune genes were screened by R language. The immune genes related to the prognosis of COAD patients were screened by Cox regression analysis, and the prognostic risk score model was constructed. The COAD patients were divided into high-risk group and low-risk group according to their median risk score. The predictive efficiency of the immune gene prognosis model was evaluated by Kaplan-Meier analysis and Receiver Operating Characteristic (ROC) curve, and the correlation between immune gene prognostic risk model and the immune cell infiltration was analyzed. Results A total of 220 differentially expressed immune genes existed in Tumor group and Normal group. By Cox univariate and multivariate regression analysis, seven prognosis-related immune genes were screened, i.e. CXCL5 (C-X-C motif Chemokine Ligand 5), IGHV5-51 (Immunoglobulin Heavy Variable 5-51), IGKV1-33 (Immunoglobulin Kappa Variable 1-33), CHGA (Chromogranin A), UCN (Urocortin), VIP (Vasoactive Intestinal Peptide) and NR3C2 (Nuclear Receptor subfamily 3 group C member 2). The overall survival rate of COAD patients was higher in low-risk group than in high-risk group (P<0.001). The overall 5-year survival rate in high-risk group and low-risk group were 49.4% and 75.8%, respectively. ROC curve showed that AUC was 0.741, suggesting that the immune gene prognosis model had a good predictive efficiency, and was associated with immune cell infiltration of B cells, CD4+ T cells, CD8+ T cells, dendritic cells, macrophages and natural killer cells. Conclusions An immune gene risk score model has been constructed, The importance of such a prognostic model is systematically evaluated and verified in individualized treatment of patients with colon adenocarcinoma, so as to provide a direction for finding new immunotherapy targets.

Simultaneous super-selective hepatic arterial and portal vein embolization for staged hepatectomy in patients with hepatocellular carcinoma and cirrhosis / 中华肝胆外科杂志

Objective To study the feasibility and safety of simultaneous super-selective hepatic arterial and portal vein embolization for staged hepatectomy (ASAPS) in the treatment of patients with hepatocellular carcinoma (HCC) and cirrhosis.Methods The clinical data of 8 patients with HCC who underwent ASAPS at the First Affiliated Hospital of the Army Medical University from December 2016 to January 2018 were retrospectively analyzed.All the patients,including 7 males and 1 female with an average age of 44.3± 9.2,were diagnosed to have cirrhosis with insufficient volume of future liver remnant (FLR).Portal vein embolization (PVE) and super-selective hepatic arterial embolization (SHAE) were performed simultaneously.The patients were then closely monitored for the volumes of FLR.Once the FLR achieved the target volume,a second staged resectional surgery would be performed.The postoperative major complications,laboratory tests and patient long-term survival were studied.Results The ratio of FLR to the average standard liver volume (SLV) increased from (28.5±5) ％ to (49.6±7.3) ％ following the first-stage procedure.All the patients underwent liver resection successfully.The average second-stage operation time was 342.6±92.8 min,and the intraoperative blood loss was 743.8±432.1 ml.Both the postoperative serum alanine amin otransferase (ALT) and aspartate aminotransferase (AST) levels were elevated remarkably and then droppedto the near normal levels.All the patients were discharged home without any severe complications.Among them,3 patients relapsed early in the postoperative period,5 survived without recurrence,and 3 survived for over 1 year.Conclusions The first-stage surgery of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) using ASAPS was minimally invasive.The volume growth rate of the FLR after ASAPS was comparable to that of the conventional first stage of ALPPS.In conclusion,ASAPS is a promising alternative to the traditional ALPPS as the first-line treatment of patients with insufficient FLR.

Effects of Huaiqihuang granules on immune function in children with severe Mycoplasma pneumoniae pneumonia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To observe the effects of Huaiqihuang granules on the immune function in children with severe Mycoplasma pneumoniae pneumonia.</p><p><b>METHODS</b>Pediatric inpatients with severe Mycoplasma pneumoniae pneumonia were randomly divided into Huaiqihuang granule treatment group (n=51) and conventional treatment group (n=47). The Huaiqihuang granule treatment group was orally administered Huaiqihuang granules in addition to the conventional treatment, while the conventional treatment group received conventional treatment only. Levels of serum IgA, IgG, and IgM, percentages of CD4and CD8 T lymphocyte subsets, and CD4/CD8ratio were examined in the two groups. The incidence rate of respiratory tract re-infection within three months following treatment was compared between the two groups.</p><p><b>RESULTS</b>The levels of serum IgA, IgG, and IgM, the percentage of CD4 T lymphocytes, and the CD4/CD8ratio were significantly higher in the Huaiqihuang granule treatment group than in the conventional treatment group three months after treatment (P<0.05). In contrast, the percentage of CD8T lymphocytes was significantly lower in the Huaiqihuang granule treatment group than in the conventional treatment group (P<0.05). In addition, the incidence rate of respiratory tract re-infection within three months following treatment was significantly lower in the Huaiqihuang granule treatment group than in the conventional treatment group (P<0.05).</p><p><b>CONCLUSIONS</b>Huaiqihuang granules can regulate immune functions and reduce the incidence of short-term respiratory tract re-infection in children with severe Mycoplasma pneumoniae pneumonia.</p>

Application of case based learning assisted bilingual teaching in hepatobiliary surgery clinical practice / 中华医学教育探索杂志

We introduced Case based learning into traditional bilingual teaching, dividing the hepatobiliary surgery teaching into four phases: preview, introduction, group discussion and estimation after class . Through the classroom organization analysis of common cases of liver and gallbladder surgery, we took students as the main body, teacher as the guide, to complete the bilingual teaching. Auxiliary case based learning used in bilingual teaching of liver and gallbladder surgery practice is beneficial to improving the quality of bilingual teaching, and helps to cultivate the students' clinical thinking. However, there are still some deficiencies of the case aided bilingual teaching, which needs continuous improvement.

Clinical significance of dissection of superior mesenteric vein 14v group lymph node in gastric cancer metastasis / 重庆医学

Objective Through investigate dissection of 14v group lymph node of patients with gastric cancer and its metastasis , to explore the influence factors and prognosis of dissection of 14v group lymph node .Methods 120 cases of gastric cancer patients who underwent radical gastrectomy and dissected 14v group lymph node since Mar .2004 to Mar .2012 were analyzed ,through his-topathological and immunohistochemical examination to detect the 14v group lymph node metastasis and calculation .Results Gas-tric antrum carcinoma were detected 176 nodes ,29 nodes were metastasis ,but there were none in other places .About TNM classifi-cation ,14v group lymph node metastasis among patients in stage Ⅳ(5 cases) was 50 .0% ,in stage ⅢC(7 cases)was 33 .3% ;About Borrmann classification ,14v group lymph node metastasis among patients in borrmann type Ⅳ (4cases) was 80 .0% ,in stage Ⅲ(11cases) was 30 .6% ,which were higher than that of other types(P<0 .05) .Among the 18 cases which had 14v group lymph node metastasis ,15 cases(83 .3% )invaded serosa ,invading the surrounding organs .The 5 year rate of 14v group metastasis patients was 7 .7% .Conclusion Gastric carcinoma tumor size ,tumor stage ,Borrmann classification ,invading the surrounding organs and tissues and metastasis in 14v group lymph node have a certain relationship .14v lymph node dissection for lately TNM stage gastric tumor has no certain significance .

The application of scissors knife in difficult endoscopic submucosal dissection / 中华消化内镜杂志

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) with scissors knife in difficult cases.Methods A total of 36 sessions of ESD in 34 patients were performed from May 2010 to May 2012 with application of new scissors knife.The complications and followup outcomes were recorded.Results All lesions were removed successfully with an en bloc resection rate at 91.7％.Delayed bleeding occurred in 2 patients (5.6％),and both of them were cured sucessfully with endoscopy.No perforation happened and the average hospitalization time was 5 days.Follow-up endoscopy performed 6 or 12 months after ESD in 6 patients revealed no recurrence or residual lesions.Other patients are under follow-up now.Conclusion The scissors knife is easy to manipulate,which can ensure the safety and efficiency of ESD.

Pancreaticoduodenectomy combined with portal vein and superior mesenteric vein resection and reconstruction / 中华消化外科杂志

The majority of the pancreatic cancer was diagnosed at advanced stage.The tumor may invade portal vein and/or superior mesenteric vein.Moore et al.firstly reported pancreaticoduodenectomy combined with portal vein and superior mesenteric vein resection and reconstruction in 1951.This procedure has improved the resection rate of pancreatic cancer.A 72-year-old man suffered from pancreatic cancer was admitted to the Southwest Hospital in September 2011.Because the tumor invaded the confluence of portal vein and superior mesenteric vein,thus the patient underwent a pancreaticoduodenectomy combined with portal vein and superior mesenteric vein resection and reconstruction.The patient recovered smoothly without any complication,and he had a normal liver function and CA19-9 value,and no local and remote metastasis was detected during the follow-up.

Radical resection of pancreatic cancer combined with vascular resection and reconstruction / 中华消化外科杂志

Most of the pancreatic cancer was diagnosed at advanced stages and the resection rate was only 10％-20％.Vascular invasion was a common event in the pathogenesis of pancreatic cancer.However,in the traditional view,vascular invasion is a contraindication of pancreatic resection.With the development of surgical techniques and perioperative management,radical resection of pancreatic cancer with vascular resection and reconstruction was performed in some large centers.Preliminary results suggested that this procedure could increase the resection rate and 5-year survival to 26％-46％ and 20％ respectively,without increasing morbidity and mortality.Radical resection of pancreatic cancer with vascular resection and reconstruction was a safe and effective method for the surgical treatment of advanced pancreatic cancer,which should be performed by experienced pancreatic surgeons.

Exploring the new strategy of training and education for hepatobiliary robotic surgeons / 中华医学教育探索杂志

Robotic surgery is a major trend of mini-invasive surgery,which is still in its infancy in China.The training and education of robotic surgeons is a problem to be solved imperatively.In our clinical practice,we explored the new strategy of training and education for hepatobiliary robotic surgeons by assimilating the essence of traditional surgery education and by drawing lessons from the successful training of robotic surgery in foreign countries.Satisfactory teaching effect was obtaincd.

Efficacy of pancreaticoduodenectomy combined with vascular resection and reconstruction / 中华消化外科杂志

Objective To investigate the efficacy of pancreaticoduodenectomy (PD) combined with vascular resection and reconstruction.Methods The clinical data of 56 patients who received PD combined with vascular resection and reconstruction at the Southwest Hospital of Third Military Medical University from January 2007 to May 2011 were retrospectively analyzed.The incidence of perioperative complications,mortality and postoperative conditions were also analyzed.Results The mean operation time and intraoperative blood transfusion were 473 minutes (range,234-853 minutes) and 781 ml (range,0-900 ml),respectively.Seven patients did not receive blood transfusion.The median period of hospital stay was 25.9 days (range,17-100 days).A total of 43 patients underwent PD combined with vascular reconstruction.The incidence of perioperative complications and mortality rate were 34％ (19/56) and 7％ (4/56),respectively.There were 42 patients with pancreatic ductal adenocarcinoma,5 with ampullary carcinoma,3 with distal bile duct carcinoma,4 with papillary carcinoma of duodenum,1 with pancreatic neuroendocrine carcinoma and 1 with pancreatic serous cystadenoma.All patients were followed up till August 2011,and the 1-year survival rate was 57％ (32/56).The mean survival time was 13.5 months.The weight of 32 surviving patients increased and no abdominal pain occurred.Within 3 months after the operation,5 patients had slight diarrhea and were administered antidiarrheal; thrombosis in the artificial blood vessels and peritoneal effusion were found in 1 patient,while 6 months later,collateral circulation was formed and the peritoneal effusion was diminished.Conclusion PD combined with vascular resection and reconstruction can improve the quality of life for patients with pancreatic cancer and with blood vessels involvement.

Comparative study of the teaching modes based on problem-based learning and lecture-based learning in clinical practice of hepatobiliary surgery / 中华医学教育探索杂志

Objective To investigate the effect of the teaching modes based on problem-based learning (PBL) and lecture-based learning (LBL) in clinical practice of hepatobiliary surgery.Methods 166 5-year program students were divided into 2 groups:PBL group (n=83)and LBL group (n=83).The performance in interrogation,physical examination,medical records and theoretical tests were analyzed.Results PBL group had better performance in all the above aspects compared to LBL group (P<0.05).Conclusions The teaching mode based on PBL is a good method,which Can inspire the students and improve their ability to solve problems in clinical practice of hepatobiliary surgery.

Test-retest reliability of Mandarin monosyllable lists: a multi-center study in Chinese dialectal regions / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To develop 22 Chinese Mandarin monosyllable lists with good psychometrical equivalence. This study was to evaluate the test-retest reliability of these lists when it was used in speech recognition test in normal hearing dialectal speakers.</p><p><b>METHODS</b>Seven cities including Dalian, Shanghai, Hangzhou, Wuhan, Guangzhou, Fuzhou and Xiamen were selected as testing centers which contain 6 typical Chinese dialectal regions including north of China, East of China, north of Fujian, south of Fujian, Guangdong and mid-south of China. At each center, 22 local normal hearing people were selected to join this study. Every participant was tested by each recognition test of all 22 lists twice in two sessions and same test order respectively. The second run of testing was carried out within 10 days-1 month since first run of testing.</p><p><b>RESULTS</b>There was a significant correlations between scores obtained at the two sessions (r = 0.682, P < 0.01). Paired student-t test had shown that a gross score of all dialectal participants was significantly higher than that of initial test to retest (P < 0.01). The mean increment of score was (2.7 +/- 10.1)%. A significant difference of test-retest score in 7 sites was 19.8% and it was equal to 5 test items. A one way ANOVA analysis had indicated that there were statistically significant difference between the score improvement of 7 test sites (P < 0.01). Another analysis had shown that there was no significant correlation between test-retest score improvement and intra-session intervals (P = 0.947).</p><p><b>CONCLUSIONS</b>Mandarin monosyllabic recognition test seems to be more stable, and the present study has indicated a systematic differences in Chinese Mandarin monosyllable recognition scores between test and retest. Monosyllable recognition test is not susceptible to memory effect. Pearson's correction analysis is not suitable to evaluation for test-retest reliability.</p>

Diagnosis and surgical management of functional pancreatic endocrine tumors: a report of 45 cases / 中华消化外科杂志

Objective To investigate the diagnosis and treatment of functional pancreatic endocrine tumors (PETs). Methods The clinical data of 45 patients with functional PETs who were admitted to the Southwest Hospital from January 1998 to December 2008 were retrospectively analyzed. Etiologic and localization diagnosis were made preoperatively according to the manifestation and the results of color doppler ultrasound and computed tomography, respectively. Eight patients received resection of the body and tail of the pancreas and spleen, 32 received tumor enucleation, one received resection of the pancreaticobiliary junction and four received pancreaticoduodenectomy. All patients received chemotherapy after the operation. Results Thirty-four cases of the PETs were benign and the rest eleven cases were malignant. Eight cases of the PETs were in the head of the pancreas,26 in the tail of the pancreas, seven in the body of the pancreas and four cases were with multiple PETs. The diameters of the PETs were 0. 3-5.0 cm, and the diameters of the PETs in 19 cases were above 2.0 cm. Eight patients were complicated with pancreatic leakage, two with incision infection and one with abdominal infection. Of the 33 patients with insulinoma, the blood glucose of five patients with multiple PETs was still abnormal after the operation, three patients underwent reoperation and the other two were treated by diazoxide to control the blood glucose in the normal range. The clinical symptoms of the seven patients with gastrinoma disappeared after the operation, and the gastric ulcer was healed, the 12-hour gastric juice volume and the level of the gastric acid were in the normal range after a continuous treatment with proton pump inhibition agents for 6 months. Necrotizing or migratory rash and diabetes of the four patients with glucagonoma were cured three weeks later, and the level of the amino acid was back to normal. Diarrhea and electronic disturbance of one patient with vasoactive intestinal peptide tumor were alleviated after the operation. Thirty-nine patients were followed up for 20-120 months. Of the 32 patients with benign PETs, two patients had tumor recurrence, and three patients died of other diseases. Of the seven patients with malignant PETs, two patients survived, and three patients died of hepatic metastasis or tumor recurrence, two patients died of other diseases. Conclusions Surgical treatment is effective for the treatment of functional PETs. Palliative resection of the tumor also can obviously improve the life quality of patients with fuctional PETs.

The establishment of an arterialized liver transplantation model in mice / 中华普通外科杂志

Objective To establish a stable orthotopic liver transplantation(OLT)model with hepatic artery reconstruction in mice.Methods Of the 66 OLT mice,33 recipient mice underwent conventional 'two cuff' technique without hepatic artery reconstruction(control group),33 with hepatic artery reconstruction using 'stent' technology(experimental group).Results The 2 week posttransplant survival rate was 84.85%(28/33)and 81.82%(27/33)in the arterialized and nonarterialized groups respectively.Serum γ-GT and ALP level of arterialized recipient were much lower than those of nonarterialized animals.The pathology of the donor liver showed that rearterialization helps to relieve bile duct injury of liver allograft.Conclusions The hepatic artery supply plays a central role in preventing bile duct injury after transplantation.This mouse OLT model may meet the need for the study of problems associated with liver transplantation.

Experimental study of relationship of bile composition imbalance with bile duct injury / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the change of bile composition and its role in bile duct injury after orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>Rats were randomly divided into 3 groups: group A (sham surgery), group B (OLT with 1 h cold preservation), group C (OLT with 12 h cold preservation). The arterialized rat liver transplantation model with biliary extra-drainage was used in group B and C. Animals were sacrificed at posttransplant 1, 3, 5, 7, 10 and 14 day. Routine bile chemistry and pathological assays were performed.</p><p><b>RESULTS</b>Cold preservation/reperfusion injury (CPRI) could repress the secretion of bile salts and phospholipid. However, in contrast with a rapid increase of bile salt secretion, the biliary secretion of phospholipid recovered more slowly, leading to an abnormal high bile salts/phospholipid ratio early after transplantation. Further analysis suggested that the secretion of bile salts correlated strongly with biochemical and histopathological signs of bile duct injury.</p><p><b>CONCLUSIONS</b>CPRI can lead to great changes of graft bile composition, which plays a role in the pathogenesis of bile duct injury following liver transplantation.</p>

Effect of cold preservation and reperfusion injury on early-stage bile salt secretion after liver transplantation in rat model / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the effect of cold preservation and reperfusion injury (CPRI) on the bile salt spectrum in rat orthotopic liver transplantation (OLT) model.</p><p><b>METHODS</b>A special analysis method was established to investigate the bile salts in rat by reverse phase high performance liquid chromatography (RP-HPLC). Rats were randomly divided into 3 groups: group A (control group, n = 6), group B (group with 1 h graft preservation pre-OLT, n = 6) and group C (group with 12 h graft preservation pre-OLT, n = 6). The bile samples of 0 - 14 post-transplantation days were analyzed by RP-HPLC.</p><p><b>RESULTS</b>Eleven kinds of bile salts were detected in rat bile. It showed that CPRI could influence the concentration of bile salts significantly in rat model after OLT, the concentration of hydrophobic bile salts (TCA and TCDCA) increased significantly in group B and C. However, the concentration of hydrophilic bile salts (TUDCA and THDCA) just increased in a short-time. The hydrophobicity index (HI) wasn't significantly changed during the first 4 post-transplant days. Thus the HI of bile salts elevated gradually from the 5th day and reached the peak at the 10th day after OLT.</p><p><b>CONCLUSION</b>The increase of the proportion of hydrophobic bile salts may be one of the major factors leading to the increase of bile toxicity after OLT.</p>