Patients with HER-2-positive advanced breast cancer were associated with poor prognosis. Meanwhile, HER-2-targeted ther-apy has dramatically improved survival and prognosis among breast cancer patients. Over the years, multiple HER-2-targeting drugs stepped into clinical practice, and the targeted agents are now considered as the standard of care in the first-line setting and beyond. This review basically summarizes the importance of HER-2-targeted therapy, the significance of the clinical trial results, and the clinical practice guidelines for the management of patients with HER-2-positive advanced breast cancer.

Objective: To study the stability of forsythiaside. Methods: The stability of forsythiaside was studied by using UV spectrum obsiving the changes of spectrums in different conditions. Results: Forsythiaside was very unstable under the condition of alkali (pH=9.40), relatively stable at the pH=6.86, 60?Cand stable at the pH= 4.03 . Conclusion: The stability of forsythiaside can be affected by the condition of the acid, alkali and temperatures obviously.

The optimal treatment of elderly women with breast cancer still faces many difficulties. Life expectancy, comorbidity, and functional status influence clinical decision and survival. Standard adjuvant medical treatments should not be withheld from healthy older patients with reasonable life expectancies. In this study, adjuvant medical treatment literatures for elderly breast cancer patients, including endocrine therapy, chemotherapy, and HER2-targeted therapy, were reviewed, focusing on efficacy and toxicity of drugs for elderly women.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Brain Neoplasms ; secondary ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; secondary ; Exanthema ; chemically induced ; Female ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Protein Kinase Inhibitors ; adverse effects ; therapeutic use ; Quinazolines ; adverse effects ; therapeutic use ; Remission Induction ; Survival Rate ; Vomiting ; chemically induced

OBJECTIVE Approach the cause of esophageal perforation and the analysis of diagnosis, therapy and its outcome in this disease. METHODS We retrospectively review 11 patients of esophageal perforation between1997 and 2004 in our department. There were 9 cases were taken out foreign bodies from their esophageal, another 2 cases haven't been found any foreignbodies and 1 of 2 was caused by iatrogenic reasons. Perforation occurred in the cervical esophagus was 4, and in the thoracic esophagus was 7. Their symptoms were dysphagia or pain, retrosternal-pain, dyspnea, subcutaneous emphysema, fever, hematemesis or melena. RESULTS 7/11 cases visited the clinic during 24 hours after foreign-body occured, 4/11 cases visited after 24 hours and the last visited clinic on 27th day late. Dysphagia was the most common presenting symptom specially with pain in eating, noted in 9 cases (81.8 %); retrosternal-pain and fever were noted in 8 cases (72.7 %), subcutaneous emphysema in 5 (45.5 %), dyspnea in 2 (18.2 %), hematemesis and melena.in 1 (9.1 %). 5 cases were died and the common mortality was 45.45 % (5/11). The mortality in primary repair with surgery treatment was 66.7 % (2/3); the mortality in conservative management was 37.5 % (3/8). The mortality of the perforation in cervical esophagus was 25 % (1/4), in thoracic esophagus was 57.14 % (4/7). The mortality of the visit time in 24 hours was 28.57 % (2/7),and out of 24 hour was 75% (3/4). CONCLUSION Sophageal perforation is usually caused by foreign body or iatrogenic in ENT-Head&Neck surgery. The esophageal perforation will been cured that decided in early visiting, taking away of foreign-boby, the right choice of antibiotic, nutritional support, primary healthy statement of esophagus. We regard that should perform non-operational conservative therapy in the patients who resulted in esophageal perforation except abscess or remain causing by foreign body. And the high risks in mortality of the repairing in surgery should been noticed.

Objective To investigate the feasibility and effects of minimally invasive video-assisted parathyroidectomy(MIVAP)for parathyroid adenoma or cyst.Methods A 2 cm skin transverse incision was made above the suprasternal notch.Without gas insufflation,a cavity was built with retractors.Under endoscopic assistance,parathyroidectomy was performed by using a harmonic scalpel(3 cases of nonfunctioning parathyroid cyst and 7 cases of parathyroid adenoma accompanying hyperparathyroidism).Results The operation was successfully accomplished in all the 10 cases,without conversions to open surgery.The operative time was 20～70 min(mean,40 min).No hoarseness,choking cough,or hemorrhage occurred.A transient hypocalcemia developed in 3 cases.All the patients were followed for 2～18 months(mean,9 months),with satisfactory curative and cosmetic results.Conclusions Minimally invasive video-assisted parathyroidectomy appears to be a safe and effective treatment with good cosmetic results and postoperative outcomes.

Inflammatory bowel disease(IBD),the precise etiology of which remains unknown,is comprised of two forms of chronic intestinal inflammation,ulcerative colitis and Crohn's disease.Recent researches suggest that angiopoiesis plays an important role in the development of IBD.Many cytokines can enhance angiopoiesis,such as fibroblast growth factor-2,interleukin-8,platelet-derived growth factor,transforming growth factor-? and particularly vascular endothelial growth factor.This review summarizes the angiopoietic factors correlated with IBD.

Objective To investigate the effects of Irbesartan on endothelial function and autonomic nervous system activity of patients with essential hypertension. Methods The endothelium dependent flow mediated dilatation (F-MD) and the endothelium independent nitroglycerin mediated dilatation (NTG-MD) were evaluated by the brachial ultrasound examination. Time-domain indices of heart rate variability (HRV) were measured by 24 h ambulatory electrocardiogram. The changes of blood lipoproteins, blood glucose, insulin levels, endothelial function and heart rate variability in 60 patients with mild-moderate essential hypertension and 20 healthy controls were compared, and the effects of different antihypertensive agents (AT1 receptor blocker and diuretic) for 8-week treatment were observed. Results Endothelial dysfunction and abnormal autonomic nervous activity were observed in patients with mild-moderate essential hypertension as follow: mildly decreased total HRV and mildly increased 24-hour average heart rate, significantly decreased parasympathetic tone-rMSSD and PNN50, obviously lowered endothelium dependent F-MD. The postprandial insulin level and insulin/glucose ratio of patients with hypertension was significantly higher than that of healthy controls. The decreased blood pressure level caused by AT1 receptor blocker (Irbesartan) and diuretic (Indapamide) was similar. Irbesartan for 8-week therapy resulted in a significant improvement of the endothelium dependent F-MD and insulin resistence, the increase of vagal nervous activity and the decrease of 24-hour average heart rate, but Indapamide presented no such effects. Conclusion This study suggested that patients with mild-moderate essential hypertension have significantly abnormal endothelial function and autonomic nervous activity, and the beneficial effect of Irbesartan is associated with an improvement of insulin resistence and heart rate variability, not with the decrease of blood pressure level.

Objective To investigate the effects of S-adenosylmethionine (SAM) on ethanol-induced liver injury in rats. Methods 48 female SD rats were randomly divided into 4 groups as control, model, small and large dose SAM groups. Except control group, all rats were fed high fat-containing diet plus ethanol and fish oil gavage for 8 weeks. SAM was administered by intraperitioneal injection after 4 weeks of exposure to ethanol. Plasma total homocysteine (tHcy), serum aminotransferase activity (ALT), liver malondialdehyde (MDA), glutathione (GSH) contents were assayed, and expression of TNF-? was detected by immunohistochemistry, and liver histology was also examined. Results Compared with control group, model group rats developed marked liver damage, accompanied by an increase of tHcy, ALT, and MDA levels, but a decrease of GSH levels (P0.05). Conclusion SAM prevents alcohol-induced liver injury in rats by reducing liver lipid peroxidation, together with down-regalation of expression of TNF-?. SAM does not affect the plasma total homocysteine levels.

Objective To explore the clinical and CT characteristics of extreme lateral lumbar disc herniations and improve the diagnosis. Methods A retrospective analysis of the clinical and CT manifestations in 15 patients with extreme lateral lumbar disc herniations proved by operation was done. Results Extreme lateral lumbar disc herniation at L4/5 level is more common. Intraforaminal lumbar disc herniations combined with extraforaminal herniation were seen in most cases. The clinical findings often presented lumbar bi-root compression syndromes. Conclusion The clinical presentation combined with CT image is the key to the correct diagnosis.