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 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.

Purpose To investigate the expression of Dkk3 and Cyclin D1 protein in human hepatocellular carcinoma (HCC) and clinical significance.Methods Immunohistochemistry was used to detect Dkk-3 and Cyclin D1 protein expression level in 80 cases of hepatocellular carcinoma and corresponding para-cancer tissue.Results The expression of Dkk-3 in hepatocellular carcinoma was significantly lower than those in corresponding para-cancer tissue (P ＜ 0.05) and the expression of Cyclin D1 in hepatocellular carcinoma was significantly higher than those in CoTesponding para-cancer tissue (P ＜ 0.05).The up-regulation of Cyclin D1 and the down-regulation of Dkk-3 proteins were correlated with pathologic differentiation degree (P ＜0.05).There was a significant inverse correlation between Dkk3 and Cyclin D1 expression (P =0.044,rs =-0.226).Conclusion The abnormal expression of Dkk-3 and Cyclin D1 gene in human hepatocellular carcinoma suggest that Dkk-3 and Cyclin D1 gene may play an important role in the development and progression of the cancer.The combination deteetion of the two biomarkers may provide valuable data for diagnosis and prognosis estimation of HCC.

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 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.