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 observe the effect of healthy education on BMD and the risk of bone fracture in pa- tients with primary osteoporosis.Methods 628 patients with primary osteoporosis were randomly divided into two groups under the same conditions,and healthy education were conducted in treated group but were not conducted in control group.Two years later,BMD and the rates of bone fractures were collected and analysed.Results Compared with control groups,the bone loss was significantly lower at the feroral neck,Ward's triangle and the great trochanter,and the risk of bone fractures was remarkably reduced in treated group(P

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.

OBJECTIVE To investigate the distribution and the resistance of pathogens from the children with VAP in PICU,and to analyze the reasons of antibiotics resistance of the pathogens.METHODS The sputum obtained from the children with final diagnosis of VAP in PICU was cultured and identified from Jan 2005 to Dec 2006.The resistance of the bacteria identified to antibiotics used frequently was determined by Kirby-Bauer method.RESULTS A total of 187 strains were isolated from sputum specimens,of which Gram-negative bacilli and Gram-positive cocci accounted for 76.5% and 23.5%,respectively.Acinetobacter baumannii(17.7%),Escherichia coli(16.0%),Pseudomonas aeruginosa(15.0%) and Klebsiella pneumoniae(13.9%) were the most frequently isolates of Gram-negative bacilli.Their resistant rates to ?-lactam antibiotics were high,especially the ESBLs-producing strains in E.coli and K.pneumoniae.The Staphylococcus epidermidis(5.9%),Staphylococcus aureus(4.8%) and Enterococcus faecalis(4.3%) were the most common strains of Gram-positive cocci.No vancomycin-resistanct strains were found,but resistance rates to ?-lactam antibiotics and other antibiotics were high in S.epidermidis and S.aureus.CONCLUSIONS The main strains cultured from the sputum specimens of children with VAP in PICU are Gram-negative bacilli with high resistance rates to antibiotics,especially the ESBLs producing bacilli to ?-lactam antibiotics.Staphylococcus are the main Gram-positive cocci.

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 explore continuous renal replacement therapy(CRRT) machine for plasma exchange in critical disease in children.Methods Retrospective study of 8 patients(8 month to 14 years,mean 5.7 years) and 32 plasma exchange treatments,after(adowble) lumen catheter inserted into the subclayian venous,using the Baxter BM25 machine with commercially available plasma filters.Results Five patients(3 ABO-incompatibility in bone marrow transplantation,1 thrombotic thrombocytopaenic purpura TTP,1 sepsis) gained full recovery.One systemic lupus erythematosus(SLE) and 1 sepsis experienced moderate improvement while 1 case of acute disseminated encephalomyelitis failed PE treatment.The average total exchange volume was 80-100 mL/kg,achieved at a blood flow rate of 5-10 mL/(kg?min) and a turnover rate of 60-120 mL/(kg?h) over a 3-hours duration.Thirty-one PE treatments were finished smoothly,one of which experienced the serious complication involving plasma filter.Conclusion Plasma exchange therapy is a safe and effective procedure for severe autoimmune abnormalities and pathogen removal in children.

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.