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OBJECTIVE：To provide reference for the early diagnosis and selection of treatment regimens of pregnancy- associated breast cancer （PABC）. METHODS ：The disease characteristics ，treatment process and prognosis of 2 cases of PABC were analyzed in our hospital. The relevant literature published from Jan. 1986 to Apr. 2019 in PubMed database was retrieved. The case reports that the title ，keywords or abstracts involved “Breast cancer and pregnancy ”“Pregnancy-associated breast cancer ” “Breast cancer during pregnancy ”“Breast carcinoma during pregnancy ”“Case reports ”were included. Cases which didn ’t meet the definition of PABC were excluded. The general information ，tumor clinical characteristics ，drug treatment plan ，maternal/fetal prognosis and other information of patients were extracted for summary and descriptive statistical analysis. RESULTS & CONCLUSIONS：Two patients were both diagnosed during lactation. The prognosis was good after neoadjuvant chemotherapy and surgical resection. A total of 36 case reports were obtained through literature search and screening ，as well asclinical data of 45 patients（39 diagnosed during pregnancy and 6 diagnosed during lactation ）.Neoadjuvant chemotherapy AC regimen （doxorubicin+ cyclophosphamide）was used in 35.0％（14/40）of cases after excluding the cases without relevant information ；elective caesarean section was performed in 59.5％（22/37）of cases ，37.8％（14/37）of cases were delivered ，and 1 case chose to terminate pregnancy；survival rate of patients was 80.8％（21/26），and the average weight of newborns was 2 407 g（1 015-3 830 g）. Six patients each received taxanes during pregnancy and 9 patients during postpartum. The determination of chemotherapy for PABC should comprehensively consider a variety of factors. It is necessary to comprehensively weigh the benefit risks of the mother and child，try to avoid chemotherapy in early pregnancy ，and especially consider the impact of chemotherapy on the fetus. The chemotherapy regimen is still dominated by anthracyclines. Based on this ，an individualized regimen is formulated and close monitoring should be performed when using paclitaxel.
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OBJECTIVE： To provide reference for the revision of China National Formulary for Children and make a sample for Chinese medical institutions to formulate their own formulary. METHODS： The suggestions on formulary revision and the formulation of formulary in medical institutions were put forward through comparing the selection principle， catalogues， chapters， drug items， formulary quantity and coincident drugs of World Health Organization （WHO） Model Formulary for Children （2010 edition） （WMFc）， British National Formulary （Children edition） （2016-2017 edition） （BNFc）， Chinese National Formulary （Children edition） （2013 edition） （CNFc）. RESULTS & CONCLUSIONS： The selection principle of WMFc was safe， effective and economical； that of BNFc was accurate and up-to-date， that of CNFc was safe， effective， economical and appropriate. The catalogues of three formularies included introduction， outline and separated section， but the contents or descriptions were different. For example， in separated section， WMFc was divided into 27 chapters， BNFc was divided into 16 chapters and CNFc was divided into 20 chapters. The chapters and catalogues of WMFc were classified according to ATC； those of BNFc were classified according to organ system and disease arrangement； those of CNFc were classified according to disease treatment system. 15 chapters of three formularies were the same， such as drug for nervous system diseases， drug for endocrine system and drug for respiratory system. The unique chapter of CNFc was “drugs for stomatological diseases”. The drug items of three formularies included drug name， indications， usage and dosage， contraindication， ADR， matters need attention， preparation and specifications， etc. Compared with CNFc， unique chapters of WMFc included ATC numbering， drug interaction， liver injury， etc.； those of BNFc included pharmacological action， interaction， allergy， etc. WMFc contained 271 drugs， CNFc 847 drugs and BNFc 955 drugs. Among them， there were 166 overlaps between WMFc and CNFc， 359 between BNFc and CNFc， 174 between WMFc and BNFc. There were 141 same drugs in the three formularies. When revising or formulating formulary， our country should not copy them mechanically， but should revise formulary according to our national conditions. It is necessary to refer to selection principles of WMFc and BNFc， update our children’s formulary in certain or real time， standardize drug access criteria of formulary， rationally increase the variety of drug and call on the relevant departments of the state to improve the standards for the formulation of drug instructions for children.
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Aromatic antiepileptic drugs such as carbamazepine are the first-line treatment for epilepsy. The adverse reactions have greatly limited their clinical application. The occurrence rate of severe skin adverse reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is low,but they are often fatal.Human leukocyte antigen (HLA) gene polymorphisms are reported to be related with skin adverse reactions caused by aromatic antiepileptic drugs,but the exact mechanism is unclear.This article will perform a review about the correlation between skin adverse reactions caused by aromatic antiepileptic drugs and HLA gene polymorphisms published in recent years,in order to provide theoretical basis for further study of HLA susceptibility genes in Chinese Han population,and provide a reference for achieving individualized treatment of epilepsy.
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Objective To evaluate the uncertainty of the pseudo-ginsenoside GQ (PGQ) concentration in human plasma by HPLC-MS/MS.Methods The whole process of PGQ determination by HPLC-MS/MS in human plasma was evaluated and the uncertainty caused by repeatability,weighing,standard solution preparation,biological sample preparation,extraction recovery process,recovery,instrument precision and calibration curve fitting were evaluated,respectively.The combined and expanded uncertainty values were both calculated.Results The expanded uncertainty values for low (15.16 ng·mL-1),medium (2 516.67 ng·mL-1) and high (3 902.00 ng·mL-1) levels of PGQ were 1.39,177.74 and 262.69 ng·mL-1,respectively (P =95 ％,k =2).Conclusion The uncertainty of the PGQ determination in human plasma by HPLC-MS/MS is mainly caused by recovery,repeatabihty and sample preparation at low concentration,by sample preparation and recovery at medium and high concentration.