Tumor surface antigen human epidermal growth factor receptor 2 (Her2) is a type I receptor tyrosine kinase, which belongs to human epidermal growth factor receptor family. Her2-overexpression is associated with tumorigenesis and metastasis. Due to significant clinical effects, Her2-targeted cancer therapy especially therapeutic antibody has become the hot spot in the field of cancer treatment. Anti-Her2 antibody drugs include monoclonal antibodies, antibody-drug conjugates, bispecific antibodies and emerging "two in one" antibody. Based on structure and function of Her2, this review focuses on recent advances in active mechanisms and clinical researches of these antibodies.
Antibodies, Bispecific ; therapeutic use ; Antibodies, Monoclonal ; therapeutic use ; Humans ; Immunoconjugates ; therapeutic use ; Neoplasms ; drug therapy ; Receptor, ErbB-2 ; immunology

Myeloid differentiation protein-2(MD-2)can separately and simultaneously bind lipopolysaccharide(LPS)and toll-like receptor 4(TLR4)has been shown to play critical roles in mediated recognition responses to LPS by TLR4 and signal transduction induced by LPS.MD-2 can be bound by LPS,not TLR4.The cells have no responsiveness or weak responsiveness to LPS without MD-2.MD-2 can be secreted into blood plasma,formed soluble MD-2 and remotely regulated cells that contained TLR4 without MD-2.MD-2 has been shown to play important roles in endotoxin signal transduction.MD-2 is a small molecular,short nucleic acid fragment,easily regulated should become a new potential anti-inflammatory target.

Objective To investigate the risk factors for early postoperative cognitive function in the patients with peritoneal surface malignancies after cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy(CRS-HIPEC).Methods Fifty-one patients(21 men and 30 women), ranged from 25 to 65 years,42-80 kg,ASA Ⅰ-Ⅲ,undergoing CRS-HIPEC under combined intrave-nous-inhalational anesthesia,were studied.Patients were assigned into postoperative cognitive dys-function (POCD)group or non-POCD group according to their performances of visual verbal learning test,concept shifting task,letter-digit coding test and stroop color-word test 1 day before operation and 7 days after operation.Years of education,medical history,duration of operation,intraoperative blood loss,frequency of cardiovascular events,amount of fluid infused per hour and VAS scores were recorded.Venous blood samples were taken at five time points:before surgery(T0 ),30 minutes after the beginning of the procedure(T1 ),30 minutes after the beginning of HIPEC(T2 ),at the end of the surgery(T3 )and 24 hours after the surgery(T4 ),to determine the concentration of serum amyloid A (SAA).pH,PaCO 2, Hb,blood glucose were recorded at T0-T2.Then the data was statistically analyzed.Results According to the diagnostic criteria,twenty patients developed POCD 20 (39.2%). There were significant differences between POCD and non-POCD groups on age,gender, pre-operative complications and the origin of tumor(P <0.05).The concentration of SAA increased from T2 and reached the peak at T4 ,and SAA concentration for patients in POCD group was higher than that for patients in non-POCD group(P <0.05).Compared with non-POCD group,the levels of blood glucose were significantly increased in POCD group at T2 (P <0.05).Conclusion CRS-HIPEC resul-ted in exaggerated and prolonged inflammatory response.Advanced age,female,diabetes,hyperten-sion,peritoneal carcinomatosis from ovarian cancer and endometrial cancer are associated with early POCD in the patients undergoing CRS-HIPEC.

Objective To find out whether the benefits entitled to peasants have increased since NRCM is in place in Beijing, and to analyze the extent of such benefit increase if any. Methods The first is to calculate changes to the reimbursement ratio of hospitalization charges for the peasants covered by NRCM; the second is to calculate the role played by NRCM for alleviating the catastrophic health expenditure of peasants. Results The reimbursement ratio of hospitalization charges for peasants covered by NRCM rose from 32.4% in 2004 to 45.4% in 2007. Survey data from districts and counties in the sampling test indicate that NRCM has gained an ever growing power in alleviating the catastrophic expenditure of peasants. Conclusion Recent years have witnessed a marked growth in medical charges, peasants' income, and peasants' demand for medical services. Against such a background, NRCM can still sharply downsize their catastrophic health expenditure, and its role keeps intensifying. This proves that the fund raising speed of NRCM has greatly outpaced the growth of medical charges and peasants' demand for medical services, and NRCM is playing a more effective role in alleviating the peasants from poverty caused by diseases.

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Objective To construct Fisher discrminant functions with index of ultrasonography. Methods A total of 48 non-neoplastic ovarian cysts, 137 benign and 120 malignant ovarian tumors were enrolled in this study. Taking ultrasonographic parameters and Doppler blood flow signals as differential diagnosis variable, a diagnosis model was developed using stepwise discriminant analysis. Then a projection and territorial map were drew and the diagnostic ability of the model was verified with substitution method and jackknife. Results ①Univariate analysis indicated that ovarian cysts volume, end-diastolic blood flow velocity (V_(ED)), mean blood flow velocity (V_m), resistance index (RI), pulse index (PI), physical property, echo, shape, boundary, ascites and blood flow signal have statistical difference among the three kinds of ovarian cysts. ②Stepwise discriminant analysis showed that volume, resistance index, physical property, shape and boundary are the independent prognostic variables. The two Fisher discriminant functions were as following: Function 1=0.002volume-4.793 RI+0.468physical property+0.862shape+0.901boundary-4.076, Function 2=0.005volume-1.480 RI+0.851physical property-0.291shape+0.443boundary+0.524. ③The projective positions of three kinds of ovarian cysts at 2D coordinates were clear. ④The sensibility and specificity of mode for diagnosis non-neoplastic ovarian cysts, benign and malignant ovarian tumors was 91.67%, 88.32% and 93.33% with substitution method, and was 91.67%, 86.13% and 93.33% with jackknife method. Conclusion Cysts volume, RI, physical property, shape and boundary are the significant differential prognostic variables. Fisher discriminant analysis can provide a reliable prognostic model for ovarian cysts.

Objective To investigate the change in the proportion of NK or NKT cells in the peripheral blood of patients with HBV associated acute-on-chronic liver failure(HBV-ACLF) .Methods the frequency of NK or NKT cells in the blood of 25 healthy controls(HC) ,40 patients with chronic hepatitis B(CHB) and 26 HBV-ACLF patients was detected by flow cytometry .The differ-ences in the proportion of NK and NKT cells among the three groups were analyzed by SPSS software and the correlation was ana-lyzed between the frequence of NK or NKT cells and HBV markers and the level of liver function .Results the proportion of NK cells in HC ,CHB ,or HBV-ACLF group was (15 .0 ± 6 .0)% ,(11 .4 ± 6 .8)% ,(8 .9 ± 6 .7)% respectively ,and the difference be-tween the HBV-ACLF group and HC or CHB group was statistically significant (P<0 .05) .And for the NKT cells ,its frequence in the HC ,CHB ,or HBV-ACLF group was (1 .9 ± 1 .3)% ,(4 .3 ± 3 .7)% ,(5 .4 ± 8 .6)% respectively ,and there was significant difference between the HBV-ACLF group and HC group(P<0 .05) .Conclusion The proportion of NK cells in HBV-ACLF has a significant decline ,while NKT cells has a significant increases .it indicate that NK or NKT cells might be play a certain role in the HBV-ACLF development process .

Background and purpose:Neuroendocrine neoplasm is one kind of infrequent neoplasms from neuroendocrine cell and peptidergic neurons. This study aimed to investigate the epidemiology and clinicopathological characteristics of neuroendocrine neoplasms (NEN) in Dalian. Methods: We retrospectively analyzed all neuroendocrine neoplasms patients in First Afifliated Hospital of Dalian Medical University from 2000 to 2013. The epidemiology characteristics, pathogenic sites and pathological types were reviewed, and the differences between gender and age were also analyzed. The statistics analysis such as independent-samples t test and one-way ANOVA and chi-square test were performed. Results:There were 279 NEN cases, including 166 male and 113 female patients (male:female=1.14:1), detection rate was 0.258%. The mean age of all cases was 59.4±17.1 (20-83), for male 58.9±19.4 (20-81) and female 61.7±15.0 (29-83). There was no statistical signiifcance of detection rate and mean age between male and female patients. Digestive system was the most common occurred site of NEN (71.68%), then was the respiratory system (20.79%). There was no statistical significance of pathogenic sites between male and female.In all case, 132 with neuroendocrine tumor (47.31%), 140 with neuroendocrine cancer (50.18%), 7 with mixed adenoneuroendocrine carcinoma (2.51%). There was no statistical signiifcance of pathological types between male and female (P>0.05).Conclusion:Recently, the detection rate of neuroendocrine neoplasms was raised in Dalian, but there was no signiifcance differences in detection rate,pathogenic sites and pathological types between male and female.