ABSTRACT
Periviable extremely preterm infant (PEPI) refers to preterm infants born on the border of viability, mainly those with gestational age less than 24 weeks or birth weight less than 500 g. PEPI has increased in the past decades, and about half of the survivors live without severe neurodevelopmental impairment. The management of PEPI remains one of the most complex fields in perinatal-neonatal medicine. Active interventions can reduce the risk of morbidity and mortality in PEPI during early life and short-term follow-up after discharge without increasing the risk of neurodevelopmental impairment. Clinical decision-making about PEPI should not be restricted to population-based prenatal data but should mainly be based on postnatal individual characteristics and conditions. Parents should make an informed choice after detailed consultation with their physician. When the prognosis is uncertain, resuscitation and intensive care could be given and reassessed subsequently. Current interventions or treatments of PEPI refer to strategies for infants born at 24-27 gestational weeks, which need to be refined in practice.
ABSTRACT
Objective To investigate the expression of cytokine induced apoptosis inhibitor 1 (CIAPIN1) protein in colon cancer tissues and its relationship with the pathological features of tumor.Methods A total of 80 cases of colon cancer tissues and 40 cases of paracancer tissues were collected from our hospital after surgery from January 2014 to January 2017.Immunohistochemical staining and Western blotting were used to detect the expressions of CIAPIN1 protein in the two types of specimens.The relationships between CIAPIN1 protein and the occurrence and development of colon cancer were analyzed.Results The positive rate of CIAPIN1 protein expression in colon cancer tissues was significantly lower than that in paracancer tissues (30.0％ vs.85.0％,x2 =32.303,P ＜0.001).The relative expression level of CIAPIN1 protein in colon cancer tissues was significantly lower than that in paracancer tissues (0.507 ±0.183 vs.1.874 ±0.361,t =22.513,P ＜0.001).The positive expression rate of CIAPIN1 in colon cancer tissues was not correlated with the age (x2 =0.086,P =0.769),sex (x2 =0.779,P =0.377),tumor invasion depth (x2 =0.879,P =0.348),tumor location (x2 =0.725,P =0.395),tumor size (x2 =2.241,P =0.134),tumor differentiation status(x2 =1.372,P =0.241),and the pathological type (P =0.715),but was significantly correlated with lymph node metastasis (x2 =10.813,P =0.001) and clinical stage (x2 =5.610,P =0.018).Conclusion The expression of CIAPIN1 protein in colon cancer tissues reduces significantly,and is correlated with clinical stage and lymph node metastasis.
ABSTRACT
Objective To observe the association between clinical pharmacokinetic of paclitaxel and adverse reactions in patients with gynecological malignant tumor.Methods 78 patients with female malignant tumor selected from Jan.2009 to Dec.2013 in Kailuan General Hospital were treated with paclitaxel (intravenous drip 175 mg/m2 3 h).The blood drug level of paclitaxel was measured at different time after treating.The DAS software was used to calculate the parameter of pharmacokinetic of paclitaxel,and the SPSS software was used to analyze the association between clinical pharmacokinetic of paclitaxel and adverse reaction in patients with female malignant tumor.Results The peak plasma concentrations (Cmax)was (3.99 ± 1.07)mg/L,the areas under the plasma concentration-time curve (AUC)was (9.74 ±2.45)mg/(h·L),the plasma elimination half-life (t1/2z)was (13.7 ±3.2)h,the apparent volumes of distribution (Vd)was (162.9 ±49.5)L/m2,the plasma clearance rates (CL)was (8.2 ±1.0)L/(h·kg).The kinetics of paclitaxel was fitted to two-compartment model.The time of drug concentration >0.1 μmol/L (t>0.1 )in responder patients (16.8 ± 4.8)h was higher than that in nonresponder patients (13.5 ±2.9)h,and the difference was significant (P<0.05).The Cmax in patients with severity adverse reactions (4.61 ±0.86)mg/L were higher than those in patients without severity adverse reaction (3.65 ±1.13)mg/L,and the difference was significant (P<0.01).Conclusion The Cmax of paclitaxel is associated with efficacy after treatment and severity adverse reactions.
ABSTRACT
Roles of reference method in clinical biochemistry were introduced.Reference method is an important component of the reference system.Reference methods are primarily used for the establishment and assurance of the traceability of measurement results through calibrating and evaluating routine methods and assigning values to reference materials.Calibration biases and non-specificities of routine methods and the commutability of reference materials are the major issues in the standardization of clinical biochemistry.Standardization also requires availability of commutable reference materials.Reference methods are irreplaceable tools to identify the issues and to characterize reference materials.
ABSTRACT
The‘prevention and early treatment of diseases’conception as‘Huangdi Neijing’suggested,is the highest academic realm among the Chinese medical theory,it flows through the entire process of Chinese medical theory and diseases prevention.Four aspects of the prevention conception manifested in the process of Chinese medical prevention of diseases are: Taking preventive measures before confirmed diagnosis(health cultivation),impeding diffusion after confirmed diagnosis, deterring diffusion from deterioration,and restraining deterioration from being malignant.The malignant causal chain conversion of the coexistence of asthenia and sthenia is considered as the inducing links of critical illness’occurrence,evolution and transformation.Therefore,to intercept the malignant causal chain conversion comes to the key technique of Chinese medical remedy for critical illness.The‘prevention and early treatment of diseases’conception must impenetrate the versal process of treating critical illness.The overall clue and method of Chinese medical remedy for critical illness is to identify and grasp the vital contradiction and each respect of the malignant causal chain conversion which concurs with the evolution of the critical illness,simultaneously utilize the method which combined the prevention in etiology and pathogenesis with the remedy in etiology and pathogenesis,then actuate the pathologically changed organism to extricate from critical conditions at the first opportunity, finalizing with convalescence and recuperation thereafter.
ABSTRACT
The institutional review board is crucial to ensure the scientific and ethical quality of human participant research. This paper analyzes a survey on the current constitution and operation of institutional review boards (IRBs) in Korea, conducted by the Korean Association of Institutional Review Boards in April 2002. Out of 74 IRBs, 63 responded to the survey (85.1% response rate). IRB membership has a male-to-female ratio of approximately 80:20, a predominance of male clinicians (60%) and an underrepresentation of community people unaffiliated to the institutions (less than 10%). Most IRBs (around 80%) confine the scope of their reviews to the clinical evaluation of drugs or devices, leaving the remaining areas of research involving human participants untouched. As their role is limited, the majority of IRBs do not operate actively: 72% of responding IRBs reviewed less than one protocol per month in 2001. Sixty two percent of institutions have never discussed the need for insuring research participants' risks or making indemnity arrangements. This survey reveals many shortcomings and points for improvement by the institutional support bodies, including the need to establish regular education programs for IRB members and investigators.