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.

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.

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.

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

Objective To compare large dose or conventional dose of budesonide/formoterol fumarate powder in treatment of stable chronic obstructive pulmonary disease(COPD).Methods 120 patients with stable COPD from March 2015 to March 2016 in Jiaxing Second hospital were selected,were treated with budesonide/formoterol,and were divided into the conventional dose group and high dose groupaccording to different doses,60 cases in each group.Pulmonary function tests,CAT Chinese version scale assessment and 6 min walking distance(6MWD)test were performed before and after treatment,and adverse reactions and acute attack were observed.Results FEV1/FVC and FEV1％were significantly improved after treatment in the two groups,and those in the high dose group were significantly better than those in the conventional dose group,the difference was statistically significant(P<0.05),CAT score and 6MWD were significantly improved after treatment in the two groups,and those in the high dose group were significantly higher than those in the conventional dose group,the difference was statistically significant(P<0.05),adverse reactions such as palpitations,tachycardiain the high dose group were significantly higher than those in the conventional dose group,while the acute attack rate was significantly lower than that of the conventional dose group,the difference was statistically significant(P<0.05).Conclusion High dose of budesonide/formoterol inhalation in the treatment of patients with stable COPD powder can improve the pulmonary function and health status,but adverse reactions increase.

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.

Objective To evaluate the effects of percutanenous intrapulmonary injecti0n 0f IL-2 plus radiotherapy for lung cancer. Methods Twenty-two patients with inoperable non small cell lung cancer received percutanenous intrapulmonary injection of 100U ? 6 in 6 weeks; and radiation dose was 60 Gy/6wks. Results The total effective response rate (CR+PR) was 95. 4 % with the complete response rate (CR) of 40. 9 %. Couclusion Percutanenous intrapulmomary injection of IL-2 plus radiotherapy could improve the control rate of the patients with lung 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

Objective To study the protective effect of mon oclonal antibodies(McAb)against Can-dida albicans in systemic candidiasis.Methods Monoclonal antibody was produced wi th hybridoma technique.The effect of McAb on experimental mo use systemic candidiasis was observ ed,expecially on the following as-pects:the survival time of mice,colony forming unit(CFU)of Candida albicans and the histopathologic changes.Results Three types of McAb against the cell w all antigen of Candida albicans were generated,which were designated as 1B5,3E8and 4C7.P rolonged survival time,decreased C FU of Candida albicans in kid-neys,liver and brain,and alleviate d histopathologic changes could be s een in experimental mice treated wit h McAb 1B5and 3E8.McAb 1B5could recog nize a cell wall component of Candida albicans(MW:32000),and inhibit the adherence of Candida albicans to human buccal epithelial cells and umbilical vein endothelial cells.Conclusion McAbs 1B5and 3E8,are the protective monoclonal antibodies against Candida albicans,which inhibit the adherence of Candida albicans to epithelial cells and endothelial cells,thus reducing the invasiveness of the pathogen.