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.

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.

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 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 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 effect of insulin on apoptosis in hippocampal neurons of sevoflurane-anesthetized mice.Methods Forty-five pathogen-free healthy male BALB/c mice,aged 5-6 weeks,weighing 18-22 g,were divided into 3 groups (n=15 each) using a random number table:control group (group C),sevoflurane group (group Sev) and insulin plus sevoflurane group (group IS).Insulin 2 U/20 μ1 was instilled via the nasal cavity for 7 consecutive days in group IS,and 0.9％ normal saline 20 μl was given instead in group C.After the end of insulin treatment,2.5％ sevoflurane was inhaled for 1 h in Sev and IS groups,and Morris water maze test was performed to assess the cognitive function 1 day later.The mice were then sacrificed and hippocampal tissues were obtained for determination of neuronal apoptosis (by TUNEL) and expression of Bcl-2 and Bax (by Western blot).Apoptosis index (AI)was calculated.Results Compared with group C,the escape latency was significantly prolonged at day 4 after operation,the percentage of time spent on the target quadrant was decreased at day 5 after operation,AI was increased,the expression of Bax was up-regulated,and the expression of Bcl-2 was down-regulated in group Sev (P＜0.05).Compared with group Sev,the escape latency was significantly shortened at day 4 after operation,the percentage of time spent on the target quadrant was increased at day 5 after operation,AI was decreased,the expression of Bax was down-regulated,and the expression of Bcl-2 was up-regulated in group IS (P＜ 0.05).Cornclusion Insulin improves the cognitive function of sevoflurane-anesthetized mice through inhibiting apoptosis in hippocampal neurons.

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.