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.

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.

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.
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.

Objective To establish and stabilize a new HLA-B locus typing strategy, reference strand mediated conformation analysis(RSCA)system and to conform its advantages.Methods Of 27 hematopoitic stem cell transplant patients and 63 potential donors DNA samples were extracted from peripheral blood cells and HLA-B loci were both typed by RSCA and PCR-SSP methods. The (ambi)-(guous) results were identified by using DNA sequencing. Results Among 90 samples, 87/90 ((96.7) %) cases could be designated definitely, but one of them was disagreement with the SSP result which was confirmed by sequencing, and 67/90 ((74.4) %) cases could be typed to allelic level. 1/90 ((1.1) %) case could not be identified by RSCA for its bad PCR results. Only one allele of each 2 samples could be designated and the other could not be identified by RSCA, which were further confirmed by sequencing method, and the results confessed which were known as alleles, but there were no corresponding data in RSCA database. Twenty samples were randomly selected to identify the replication rate of RSCA, and the results demonstrated that the replication rate was 100 %. Among PCR-SSP typing results, about 10 % samples might be typed for 1-3 times to confirm their types. Conclusion RSCA had some advantages such as high resolution, high sensitivity, high accuracy, high replication, finding new alleles, large scale and low cost, and was especially suitable for unrelated donor-recipient (screening).

Purpose To assess the initial and follow-up CT findings of proven pulmonary invasive fungal disease (IFD) in patients after hematopoietic stem cell transplantation (HSCT), and to look for the signs for the prognosis. Materials and Methods A retrospective investigation of the CT features and the evolution process was carried out in 13 patients with proven pulmonary IFD diagnosed by histological examination. Results The first abnormal CT finding showed single nodule or mass in 5 cases, two nodules or masses in 2 cases, multiple nodules or masses in 2 cases, patchy consolidation in 1 case, patchy ground glass opacity (GGO) in 1 case, multiple stripes and GGOs in 1 case, and multiple consolidations in peribronchial distribution in 1 case; the presence of reversed halo sign (RHS) was found in 7 cases, not including 4 cases with aspergillosis. The median initial diameter was 32.0 mm, and the median maximum diameter was 51.5 mm. 9 of them reached partial remission after drug treatment, and 9 accepted operation resection. In the end, there were 5 cases cured, 1 keeping stable, 2 suspected recurrent on imaging, and 5 dead. In summary, it showed less than 2 nodules or masses in 7 patients (group 1) and other imaging patterns in 6 patients (group 2), the former group had smaller max diameter (t=4.397, P<0.01), the effective rate within 12 weeks, operation resection rate and final cure rate of group 1 were 85.7%, 100.0% and 71.4%, and those of group 2 were 16.7%, 33.3% and 0, respectively, with group 1 all higher than group 2 (P<0.05). Conclusion Nodule or mass is the most common CT finding of pulmonary IFD in HSCT recipients, with high incidence of reversed halo sign, less than 2 nodules or masses on the first CT imaging may be associated with better prognosis.

Objective To investigate the feasibility and safety of endoscopic ultrasonography (EUS) guided interstitial chemotherapy for the pancreas in canine model. Methods A therapeutic 19gauge needle was inserted into the pancreas with EUS guidance,and seeds with sustained release of 5-iluorouracil were implanted into the tissue. After 14 days of clinical observation,the animals were sacrificed and the tissue response to local chemotherapy was examined. Results All the seeds were implanted successfuUy and no migration was observed. Chemotherapy induced tissue fibrous necrosis was localized in the pancreas without significant complications. The apoptotic index of tissue within 1 cm of the seeds increased.Biochemical parameters were normal in all the dogs. Conclusion EUS-guided implantation of seeds is a safe,simple and minimally invasive technique for interstitial chemotherapy in the pancreas.

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.