Factual reflections and recommendations on extracorporeal photopheresis in pediatrics

One of the biggest challenges in evaluating available literature on extracorporeal photopheresis (ECP) practices in pediatric patients is the marked heterogeneity of approaches to the patient evaluation, procedural aspects and apheresis product analysis. These issues are most relevant in ECP management in children with graft versus host disease (GVHD) after hematopoietic stem cell transplantation. Extracorporeal photopheresis in pediatric patients is considered relatively safe with few adverse effects reported from retrospective or observational studies. Careful patient eligibility assessment for ECP procedures and close monitoring while on ECP therapy is still required by transfusion medicine and pediatric specialists. Particular attention is necessary considering the rapidly changing clinical status of children with graft versus host disease after hematopoietic stem cell transplantation, focusing on hemodynamic compromise, hematologic and metabolic disturbances. This is a review of the approaches to some of the safety issues in long-term ECP therapy in low-weight pediatric patients.     

体外循环技术在肿瘤外科治疗中的应用

目的:探讨体外循环在肿瘤外科治疗应用中的可行性和适应症,总结经验教训。方法:本院2010年~2015年体外循环下肿瘤手术12例,年龄26~72 岁 男性8例,女性4例。肾癌6例,其中单纯伴下腔静脉瘤栓2例,同时合并右心房瘤栓4例,1例合并冠心病同时行CABG术（术中死亡）;肝癌合并下腔静脉、右心房瘤栓1例;气管肿瘤2例;卵巢肉瘤合并下腔静脉、右心房瘤栓1例;肺癌侵犯左心房1例,侵犯右心房1例。浅低温心脏不停跳体外循环下（9例）或心脏停跳体外循环（3例）; 腔静脉,主动脉插管10例,阻断瘤栓远端下腔静脉,据瘤栓部位切开下腔静脉、右心房,剥离切除瘤栓;股动,静脉转流2例,建立气管通路后停止转流;原发肿瘤依据具体情况同期处理（旷置1例,余行切除）。结果:体外循环转流时间(56.17+63.72)min;原发肿瘤根治切除率91.67%。术中死亡一例,其余均存活出院。随访4例肾癌2个月、1例肺癌病人1个月,均存活无肿瘤复发及转移。结论:体外循环如严格控制适应症,有利于提高手术切除率,改善晚期肿瘤病人生活质量及延长生存时间;并可有效预防肺栓塞等严重并发症。     

论管理控制的有效性和可行性研究

本文从管理控制的有效性和管理控制的可行性两个部分进行研究,以理论与实践相结合和深入浅出的写作手法展开讨论,以帮助读者在各自工作岗位上准确把握管理控制对企业可持续发展的重要性和有效性。