Objective The clinical effects of single lung transplantation （SLT）and bilateral lung transplantation（BLT）in the treatmentof end-stagepulmonaryfibrosiswere compared to provide a reference for the choice of clinical treatment. Methods Retrospectiveanalysisofpatients withpulmonaryfibrosis who underwent lung transplantation at Wuxi People's Hospital affiliated to Nanjing Medical University between February 2020 and December 2020 was performed，a total of 72 patients were included，and were divided into two groups based on the type of surgery, including single-lung transplantation group（24 cases）and bilateral-lung transplant transplantation group（48 cases）. Preoperative characteristics，intraoperative conditions，functional improvement andpostoperative complications between the two groups were analyzed retrospectively. Results TheageinSLT groupwas significantly older than the BLT group〔65（57，69.75）years vs 55（48，61.75）years，P ＜ 0.05〕，which was in consistent with the fact that single lung transplantation was mostly performed in the elderly patients in this center. The two groups were comparable in other preoperative clinical data（P ＞ 0.05）. The predicted value of FVC% and FEV1% in the BLT group were better than those in the SLT group（P ＜ 0.05）. However the cold ischemia timeand total operation time were shorter in the SLT group than in the BLT group，and the intraoperative blood loss was less in SLT group than that in the BLT group（P ＜ 0.05）. There were no significant differences between the twogroups in the incidence of bronchial stenosis，bronchial stenosis，bronchial stenosis and primary graft dysfunction （P＞0.05）. Conclusion BLT has advantages in treating patients with end-stage pulmonary fibrosis and can effectively improve postoperative lung function，but SLT should still be considered in some selected patients. 

Objective To initially explore of left ventricular assisted method（left ventricular assistdevice， LVAD）on cardiopulmonary exercise test （cardiopulmonary exercise test， CPET）. Methods Ananalysis of 11 patients with end-stage heart failure who underwent LVAD implantation in our hospital from October 2021to October 2022 was conducted，these patients underwent cardiopulmonary exercise test early after surgery and relevantparameters were collected for analysis. Results Among the 11 LVAD patients from October 2021 to October 2022，9 cases were males (81.8%)，and the mean age was 42 years ；A total number of 7 cases were dilated cardiomyopathyand 2 cases were myocardial insufficiency，accounting for 36.4%. Preoperative echocardiography suggested that thesepatients had poor left heart function〔left ventricular ejection fraction（21.4±4.2）%，left ventricular diastolic diameter（80.6±10.4）mm〕，but the right heart function was in the normal range〔right ventricular anterior and posterior diameter（24.8±4.9）mm，（18.2±4.7）mm systolic displacement of the tricuspid annulus〕. The SWAN-GANZ catheter indicateda high pulmonary artery pressure〔pulmonary artery systolic pressure（41.5±8.7）mmHg〕. Clinical outcome: onepatient had perioperative death，and 10 patients survived well. Postoperative activity tolerance: The activity tolerancewas poor at 30 days after surgery，but activity tolerance improved significantly at 3 months，with peak oxygen uptake〔（12.9 ± 2.8）ml/（kg·min）vs（15.8 ± 1.3）ml/（kg·min），P ＝ 0.05〕and the slope of carbon 2 ventilation effectiveness〔（42.6 ± 6.3）ml/（kg·min）vs（31.7 ± 6.6）ml/（kg·min），P ＝ 0.001〕. Conclusion LVAD is an effective means totreat end-stage heart failure and can significantly improve the activity tolerance in patients with heart failure.

Objective To explore the use of A/C mode of weaning in patients with mechanical ventilationdependent pneumonectomy after lung transplantation. Methods The clinical data of 4 patients with postoperativepneumonectomy weaning difficulties from August 2021 to December 2021 was analyzed the relevant literatures werereviewed. Results Four patients with difficult postoperative pneumonectomy weaned after lung transplantation weresuccessfully weaned using the A/C mode for an average of 12.5 days. Conclusion Patients with difficult evacuation afterlung transplantation can be weaned by using A/C mode.

Objective To evaluate the significance of detecting cytomegalovirus antigenemia in thediagnosis of cytomegalovirus infection in renal transplant patients. Methods From September 2021 to December2021，a total number of 110 blood samples from 90 renal transplant patients in The First Hospital of Kunming were collected.The CMV pp65 antigenemia test was compared with the results of IgG antibody and CMV DNA. The correlation betweenthe CMV pp65 antigenemia results and creatinine，tacrolimus（tacrolimus，Tac/FK506）concentration，lymphocyte subsetswas evaluated. Results The consistency between CMV pp65 antigenemia results and CMV DNA results was 65.5%，the difference was statistically significant（P ＜ 0.05）. The consistency between the CMV pp65 antigenemia test resultsand the CMV IgG antibody test results was 57.3%，the difference was not statistically significant（P ＞ 0.05）. There wasno significant difference between CMV pp65 antigenemia results and creatinine as well as FK506 drug concentrations（P ＞ 0.05）. In the comparison between CMV pp65 antigenemia results and lymphocyte subsets，there was only astatistically significant difference between CMV pp65 and NK cell absolute value（P ＜ 0.05）. Conclusion Theconsistency between CMV pp65 antigen and CMV IgG antibody was 57.3%. The consistency between CMV pp65 antigenand CMV DNA was 65.5%. The combined detection of CMV pp65 antigen and CMV DNA has certain significance inimproving the accuracy of clinical diagnosis of CMV infection. There was no statistically significant difference in the serumcreatinine level and the whole blood FK506 drug concentration between the CMV pp65 antigen negative group and thepositive group. The absolute value difference of NK cells was statistically significant. The probability of CMV infection inrenal transplant patients with high absolute value of NK cells was low.

Objective To improve the management of individualized drug therapy and drug safety inpregnancy patients after kidney transplantation，and to reduce maternal and fetal adverse events. Methods Toformulate individualized medication regimen and provide medication education from the aspects of adjustment ofimmunosuppressants，optimization of antihypertensive drugs，supplementation of folic acid，selection and monitoring ofanticoagulant drugs，monitoring of high uric acid and lactation were conducted. Results First trimester : The blood HCGinspection was positive indicating pregnancy .The patient's medication regimens were adjusted to the immunosuppressanttacrolimus capsule（5 mg Bid），hypotensor nifedipine controlled release tablets（30 mg QD），folic acid tablets（5 mg QD），dydrogesterone table（10 mg Q12 h）. Second trimester ：anticoagulant therapy of dapheparin sodium injection（5000 U/d）was given. At the same time，oral tacrolimus（5 mg Bid）was continued to maintain immunotherapy，and nifedipinecontrolled release tablet（30 mg QD）was used to reduce blood pressure. Perinatal period ：dexamethasone intramuscular（6 mg Q12 h）injection was given to promote fetal lung maturation and reduce lung complications of premature newborns.To prevent infection，Ceftazidime injection（2 g Bid）and metronidazole sodium chloride injection（100 ml Qd）weregiven for 5 d . Leonurus intramuscular injection was 1 ml to promote uterine contraction，in the meantime, the patients continueto take tacrolimus to maintain immunotherapy and nifedipine to reduce blood pressure. Conclusion The cooperation amongphysicians，pharmacists and nurses could provide whole-process management for kidney transplantation patients and improvetreatment effect. Meanwhile，pharmacists can effectively improve clinical dialectical thinking and evidence-based thinking throughparticipating in the whole process of treatment practice，laying a foundation for improving the level of pharmaceutical care.

Objective To analyze the factors affecting the delayed extubating of endotracheal intubationafter liver transplantation. Methods The medical records of liver transplantation patients under general anesthesiain Eastern Theater General Hospital from September 1，2020 to March 31，2023 were collected retrospectively. Accordingto the extubating time，they were divided into the early extubating group within 1 h after extubating and the delayedextubating group within 3 h after extubating. ，Extubating difficult group extubating 24 h without extubating. The clinicaldata of the three groups of liver transplant recipients were compared，and the risk factors of prolonged extubating time afterliver transplantation were analyzed by univariate analysis and multivariate Cox regression analysis. Results A total of237 patients were included，including 82 cases（34.60%）in the early extubating group，119 cases（50.21%）in the delayedextubating group，and 36 cases（15.19%）in the difficult extubating group. The results of univariate analysis showedstatistical differences in age，body mass index（BMI），Child-Pugh score，MELD score，duration of liver-free period，type of inotropes，mean intraoperative body temperature，and minimum body temperature after reperfusion between thethree groups（P ＜ 0.05）. Multifactorial Cox regression analysis showed that increased age（HR ＝ 0.980，95% CI ＝0.966 ～ 0.994，P ＝ 0.005），high MELD score（HR ＝ 0.966，95% CI ＝ 0.941 ～ 0.991，P ＝ 0.009），and intraoperativepumping of rocuronium were independent risk factors for delayed postoperative extubating，and cis-atracurium comparedwith rocuronium（HR ＝ 1.834，95% CI ＝ 1.244 ～ 2.703，P ＝ 0.002），and meclizine compared with rocuronium（HR ＝1.660，95% CI ＝ 1.073 ～ 2.567，P ＝ 0.023）. Higher mean body temperature（HR ＝ 2.447，95% CI ＝ 1.449 ～ 4.132，P ＝ 0.001）and higher minimum body temperature after reperfusion（HR ＝ 1.288，95% CI ＝ 1.023 ～ 1.622，P ＝ 0.031）were in favor of shorter extubating time. Conclusion Increasing age，high MELD score，and intraoperative pumping ofrocuronium were independent risk factors for delayed postoperative extubating，and intraoperative use of cis-atracurium，vecuronium，and aggressive temperature protection favored rapid postoperative extubating.