Fluid therapy plays an important role in maintaining the stability of vital signs and the good perfusion of tissues.Therefore,it is the basis for treatment of diseases.The purpose of fluid therapy is to keep the patient's effective circulating volume,increase cardiac output,and ensure adequate tissue perfusion,which may facilitate the transport of oxygen and nutrients.Perioperative fluid therapy has gone through the progress from choosing the type of liquid to reforming the mode of fluid treatment.Since the concepts of fast track surgery and precision medicine appeared,the anesthesiologists and surgeons have pay more attention to the goal-directed fluid therapy(GDFT).GDFT aims to maintain organ perfusion and oxygen transport of tissues by regulating the amount of fluid on basis of a physiological index.As a new fluid therapy,GDFT contributes to maintaining oxygen delivery and reducing both morbidity and mortality.This article reviews the progress and challenges for GDFT.

Objective Perioperative fluid therapy has always been the most basic and important measure to maintain the stability of patients'cyclic system.Colloid and crystalloid,as common perioperative fluid,play different roles in clinical application due to the different molecular sizes.In the recent years,besides their contribution to maintain the stability of cyclic system,scientists have begun to pay attention to the effect on coagulation,especially their comparison.This paper mainly discusses the study status of the influence on coagulation produced by different liquids.

For pharmaceutical industries, clinical data is one of the most valuable deliverables. It is also the basis of analysis, submission, approval, labeling and marketing of a drug product. To ensure the integrity and reliability of clinical data, a scientific standardized quality control (QC) has to be established at each step of a clinical trial. Data validation is conducted to ensure the reasonability and compliance of clinical data by checking data quality before the data is statistically analyzed. This paper focuses on purpose of data validation, creation of data validation plan, rationale of data validation, types of data validation and performance of user acceptance testing on clinical database.

For pharmaceutical industries, clinical data is one of the most valuable deliverables. It is also the basis of analysis, submission, approval, labeling and marketing of a drug product. To ensure the integrity and reliability of clinical data, a scientific standardized quality control (QC) has to be established at each step of a clinical trial. Data validation is conducted to ensure the reasonability and compliance of clinical data by checking data quality before the data is statistically analyzed. This paper focuses on purpose of data validation, creation of data validation plan, rationale of data validation, types of data validation and performance of user acceptance testing on clinical database.
Clinical Trials as Topic ; standards ; Data Accuracy ; Data Collection ; standards ; Databases, Factual ; Quality Control ; Reproducibility of Results

Objective To explore the expression and significance of phosphatidylinositol-3 kinase (PI3K)in ovarian cancer,and the effect of combined PI3K inhibitor(LY294002)therapy with cisplatin on epithelial ovarian carcinoma,and to explore if there is a synergistic effect between the two therapies. Methods The expression levels of PI3K p85 subunit proteins and mRNA were evaluated by western blot and RT-PCR in normal ovarian tissue(G1),ovarian benign tumor tissue(G2),ovarian borderline tumor tissue(G3)and ovarian cancer tissue(G4),and the relevant clinical pathological parameters were analyzed.SKOV3 ceils were isolated and cultured by enzymolysis method.SKOV3 cells were treated with culture medium only,LY294002(1,10,30,50,100 ?mol/L),cisplatin(0.33,1.25,2.5,5, 10 ?mol/L),LY294002(50 ?mol/L)+cisplatin(10 ?mol/L)for 2 days,respectively.The effect of LY294002 and cisplatin on the growth of SKOV3 cells was measured by methyl thiazolyl tetrazolium assay. Results There was no positive expression of PI3K p85 subunit proteins in G1 and G2,while the expression was 2/6 in G3,and 85%(33/39)in G4.PI3K p85 subunit mRNA expression levels were 0.178?0.102 in G1,0.643?0.112 in G2,0.847?0.058 in G3,1.689?0.423 in G4;there was a significant difference between G1,G2,G3 and G4(P0.05).Significant differences were noted between protein expression levels in G4(Ⅲ,Ⅳ)and G4(Ⅰ,Ⅱ;P

Diabetes,characterized by chronic increase of blood glucose,is a group of metabolic diseases.It is usually treated by oral administration with antidiabetic drug and insulin with western medicine.Diabetes is called consumptive thirst in TCM.Professor NAN Zheng thought the pathogenesis of consumptive was yin defi ciency and dryness-heat at the early stage,and at the protracted stage it was usually characterized by qi defi ciency,blood stasis,pathogen intruding into collateral and poison damaging zang and fu.He established a series of treatment plan,involving diet,movement,and the Chinese materia medica.Professor NAN opposed to abusing insulin and the insulin multi-purpose theory,and proposed the treatment should start from change of bad life style and combine with application of Chinese medicine to regulate yin-yang and qi-blood of fi ve viscera,treat triple diabetes at the same time.So long as syndrome differentiation was accurate,the Chinese materia medica may replace the insulin and prolong the life.In conclusion,this article enumerates 3 typical cases diabetes withdrawal of insulin with TCM by Professor NAN Zheng.

180 min and arterial blood pressure instability are independent determinats for cerebral complication. Conclusion No single risk factor explained the onset of cerebral complication. Rather, a combination of factors, especially longer CPB time, postoperative arterial blood pressure instability produced the highest odds of deficit.

Objective To analyze the clinical efficacy of preoperative concurrent radiotherapy and chemo-therapy and radical operation in the treatment of cervical cancer patients with locally advanced cervical cancer (IB -IIB).Methods 80 patients who were diagnosed locally advanced (stage IB -IIB)cervical cancer,were divided into observation group (preoperative radiotherapy and chemotherapy group)and control group (radical radio-therapy group).The short -term efficacy,complications and follow -up data were compared between the two groups. Results The short -term efficacy of the observation group was 87.2%,which of the control group was 95.1%,and there was no significant difference (χ2 =1.579,P =0.209).As to the early complications of the two groups,there were no significant differences in gastrointestinal tract reaction(χ2 =0.000,P =0.987),rectal reaction(χ2 =2.709, P =0.100),bladder reaction (χ2 =1.343,P =0.247)and bone marrow suppression(χ2 =1.898,P =0.168).Late complications:in the observation group,the radiation proctitis[4 cases(10.3%)vs.14 cases(34.1%)]and the radiation cystitis[3 cases(7.7%)vs.13 cases(31.7%)]were less than those of the control group,the differences were statistically significant(χ2 =6.542,P =0.011&χ2 =7.205,P =0.007).The average follow -up time was 38.6 months in the observation group,which was 44.8 months in the control group.There was no significant difference in survival rate between the two groups(χ2 =0.075,P =0.784 & χ2 =0.032,P =0.858).Conclusion Locally advanced cervical cancer (IB -IIB)patients received preoperative concurrent radiotherapy and chemotherapy has important clinical value.The treatment makes the local giant block tumor shrink significantly,which is conducive to the implementation of surgery,and reduce the incidence of late complications compared with radical radiotherapy.

Objective Hepatitis-associated aplastic anemia( HAAA) is a rare and severe disease that can be fatal,if left untreated. In the childhood,it is a syndrome in which marrow failure follows the develop-ment of hepatitis. The aim of this study was to summary clinical characteristic of children with HAAA. Methods We retrospectively reviewed the hospital records of 7 children with HAAA from 2001 to 2010,and summarized and classified the clinical features of HAAA,the laboratory characteristics in 7 patients with com-bined aplastic anemia and severe hepatits,the immune status of those patients,the pathogen of those patients and the results of treatment. Results The average age of patients was 11. 1 years old(8~14 years old). The clinical features were similar in all cases. The early stage of disease,all the children had markedly elevated liver enzyme levels and peripheral blood count was normal. After symptomatic treatment,the hepatic function began to recover but appeared pancytopenia. Bone marrow biopy showed hypoplasia. The median time from onset of hepatic symptoms until diagnosis of aplasic anemia was 43. 3 days. All the children had immune dis-order. Only one boy showed parovirus B19-IgM positive and another girl was diagnosed as acute HAV hepati-tis,the pathogen results of other children were negative. All the patients were treated by immunosuppressive therapy,one patient gave up due to some reasons and others had completed remission. Conclusion HAAA is a life-threatening hematologic disorder in which an episode of hepatitis precedes AA by a period of weeks or months. Characteristically,the HAAA syndrome is more prevalent among young men. It is reported that it is in a higher frequency of patients with non-A,non-B hepatitis. Clincal features and experimental results strong-ly suggest a central role for an immune-mediated pathogenesis. The main treatment is immunosuppressive therapy,which include hormone,antithymocyte glubulin and cyclosporine.

ObjectiveTo study the effects of angiogenesis on the development of endometrial carcinoma. Methods Hysterectomy specimens were stained immunohistochemically by the marker of factor Ⅷ-related antigen for endothelium vessels in normal controls, patients with endometrial hyperplasia and with endometrial carcinoma. Results The microvascular density(MVD) in tumour increased gradually from normal endometrium to endometrial hyperplasia and to endometrial carcinoma(P<0.01). MVD correlated with the mvometrial invasion, histologic grades and the stages.ConclusionMYD in endometrial hyperplasia increases. MVD can be used as a prognostic factor.