Fast track surgery(FTS)is an idea and theory which has widely used in the surgical operations,through the whole treatment of patient' s surgery. A series of positive measures has been adopted, FTS has ameliorated the velocity of the rehabilitation and prognosis after operation, and improved the quality of life and the therapeutic effect. We reviewed the new concept and the application prospect of FTS in the gastrointestinal surgery in this article.

Objective To summarize the advancement of hereditary thrombophilia.Methods Relevant literatures about hereditary thrombophilia published recently domestic and abroad were reviewed and analyzed.Results The hereditary risk factors of venous thromboembolism were different among different races.In western population,the main risk factors were activated protein C resistance (APC-R) and mutation of factor V Leiden,methylene tetrahydrofolate reductase polymorphism (C677T) and prothrombin G20210A.While in Chinese population,the disorder of protein C system and hyperhomocysteinemia were the major genetic risk factor.The existence of multiple genetic risk factors increased the incidence of primary and recurrent venous thromboembolism.Conclusion Further study on the relations between the hereditary risk factors and thrombophilia will be very important for prediction and prevention of the venous thromboembolism.

With development of molecular biology,breast cancer has entered an era of molecular classifi-cation,thus making biomarker based personalized medicine is the trend of breast cancer treatment.HER2-posi-tive breast cancer of high invasiveness and bad prognosis accounts for 20%~30%.Targeting HER2,trastuzumab is the first humanized monoclonal antibody which can improve the prognosis of HER2-positive patients and it is recommended by guidelines and expert consensus at home and abroad for anti-HER2 therapy in any stage.How-ever,the cardiotoxicity,de novo resistance and acquired resistance of trastuzumab make the clinician to explore the second line anti-HER2 therapy.Lapatinib is the first FDA approved and HER1,HER2 double-targeting tyrosine kinase inhibitor which can be a better choice after failure with trastuzumab.This article reviews the appli-cation,some clinical and mechanism of drug resistance researches of Lapatinib.

Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; drug therapy ; metabolism ; pathology ; Female ; Humans ; Receptor, ErbB-2 ; metabolism ; Trastuzumab

OBJECTIVETo summarize laws of acupoint selection of prescriptions for treatment of cervicogenic headache by acupuncture in modern literature.

METHODSRandomized controlled trials (RCTs) involving acupuncture and moxibustion for treatment of cervicogenic headache were recruited from CBM (1978-2012), VIP (1989-2012), Wanfang Database (1998-2012), CNKI (1979-2012), PubMed (1966-2012), EMbase (1980-2012), and Cochrane Library (Volume 4, 2012). Hand recruitment was also auxiliarily used. The frequency and percentage of common acupoints, the distribution of acupoints along 14 meridians and across each part of the body, the application of specific acupoints, and features of using prescriptions for specific acupoints were statistically described.

RESULTSTotally 37 recruited papers included 42 acupoints and 159 times. Common acupoints covered Fengchi (GB20, 28 times), Jingjiaji (EX-B2, 21 times), Baihui (DU 20, 12 times), Tianzhu (BL9, 1 times), and Ashi point (11 times). Meridians along which acupoints were used mainly covered Foot-shaoyang Gallbladder Meridian, Foot-taiyang Bladder Meridian,and DU meridian. Acupoints were mainly needled from head, neck, and upper limbs. Eight confluence points and luo-connecting point were commonest used as specific acupoints. Acupuncture prescriptions were mostly composed of multiple acupoints. Filliform needle was mainly used in acupuncture methods, followed by electro-acupuncture needle.

CONCLUSIONSModern acupuncture treatment of cervicogenic headache focuses on local specific points and acupoints along meridians. Acupoints were mostly selected from head, neck, and upper limbs by syndrome typing of Chinese medicine.

In recent years,the abnormal expression of microRNA-21 (miR-21) in head and neck carcinoma have been found in many studies,which may be closely related to the genesis and development of thyroid carcinoma,nasopharyngeal carcinoma,laryngocarcinoma and oral carcinoma,etc.MiR-21 may also be valuable for the clinical diagnosis,treatment and prognosis of head and neck carcinoma.

In recent years,the abnormal expressions of BRAF,Runx2,Runx3 and S100A4 genes in thyroid papillary carcinoma have been found in many studies.The abnomal expressions of those genes are closely related to the tumor invasion,lymph node metastasis,mulifocality of thyroid papillary carcinoma,which may be valuable in clinical diagnosis and treatment.

Objective To investigate the effect of fat-1 gene encoding n-3 fatty acid desaturase on the proliferation and apoptosis of colon cancer cell HT-29. Methods fat-1 gene was transfected into HT-29 cells by liposomal reagent. The expression of fat-1 gene was detected by fluorescent micrographs and RT-PCR. Gas chromatography, MTT and flow cytometry were used to examine the change in n-6/n-3 PUFAs ratio, proliferation, cell cycle and apoptosis, respectively. Results After transfection of fat-1 gene, n-6/n-3 PUFAs ratio decreased significantly. Apoptosis of HT-29 cells was induced and cell cycle was changed. Apoptosis mainly appeared in the synthesis phase. Conclusion fat-1 gene encoding n-3 fatty acid desaturase can significantly decrease n-6/n-3 ratio. Consequently, apoptosis was triggered and cell cycle was changed. Tranfection of fat-1 gene into HT-29 cells may be a new potential treatment for colon cancer.

Objective To summarize the onset and the management of serious responsiveness during the tilt table test (TTT), and the prevention measures. Methods Thirty six elderly patients (26 males and 10 females, aged between 60 70) were tested with a tilt angle of 70 degrees for a maximum of 45 minutes and then processed with isoproterenol provocative tilt testing. ECG and blood pressure were monitored during the test and the peripheral intravenous cannula were maintained for all patients with normal saline. Results Twenty one of the 36 patients were defined as positive including 10 showing serious responsiveness. Of the 10 patients, 3 had a history of atherosclerosis involving internal carotid arteries; among the 3 with bradycardia, 2 were associated with II? A V block, and another one was with chronic atrial fibrillation. The serious reponsiveness included asystole for more than 5 seconds(3 cases) , serious bradycardia for more than 1 minute(3 cases) , and serious hypotension for more than 1 minute (4 case), respectively. Those with serious responsiveness were managed with returning to supine position, or intraveneous atropine, or CPR (2 cases), or oxygen given(4 cases). Only 2 hypotensive patients recovered gradually in 10 minute emergent management while others recovered rapidly and with no complication. Conclusions TTT may result in serious responsiveness especially in elderly patients though it is non invasive method. Therefore, proper patient selection according to the indications, control of isoproterenal infusion and close observation of vital signs are important for a safe consequence.

Objective To explore an efficient treatment for bladder outlet obstruction caused by small benign prostatic hyperplasia(BPH). Methods From January 1996 to January 2005,69 patients with BPH were surgically treated.Of these patients,27 cases underwent open surgery,22 transurethral resection of prostate(TURP) and 20 TURP plus transurethral incision of bladder neck(TUIBN).There were no significant differences between the 3 groups in age,disease course,preoperative prostate weight and the excised prostate weight.The efficacy of open surgery,TRUP and TURP plus TUIBN were comparatively evaluated by international prostate symptom score(IPSS),peak urinary flow rate(Qmax),post void residual drine volume(PVR) and postoperative complications.Results After operation,the mean score of IPSS of patients which treated with open surgery decreased from(24.6+3.8) to(15.1?3.8),and the Qmax increased from(8.2?3.1)ml/s to(10.5?4.2)ml/s,and the PVR decreased from(96.0?36.0)ml to(54.0?27.0)ml.The IPSS of TURP group decreased from(22.3?5.6) to(11.7?2.7),and the Qmax increased from(8.5?3.6)ml/s to(11.4?4.2)ml/s,and the PVR decreased from(105.0?39.0)ml/s to(32.0?14.0)ml/s.The IPSS of the TURP plus TUIBN group decreased from(23.6?5.7) to(6.4?2.3),and the Qmax increased from(9.1?3.8)ml/s to(19.5?6.2) ml/s,and the PVR decreased from(98.0?37.0)ml to(8.0?5.0)ml.There were significant differences between the TURP plus TUIBN group and the other two groups in the IPSS,Qmax and PVR(P