EGFR/HER-2 is an attractive therapeutic target for solid tumors.Lapatinib is an orally administered dual inhibitor of EGFR/HER-2 tyosine kinases.Preclinical experiments in vitro and in vivo models indicate that lapatinib is active against various solid tumors.Phase Ⅰ trials have shown an acceptable adverse event.Phase Ⅱand Ⅲ trials demonstrate the promising results for the treatment of metastatic,refractory,inflammatory,or brain metastatic breast cancer.With the further developments of biology,the molecular targeted chemotherapy becomes a novel adjuvant therapy for advanced breast cancer patients.

0.05). Platelet decreased significantly in group A (P

China has high prevalence of gastric cancer, with the morbidity and mortality leading the list of malignancy. The conditions of diagnosis and treatment of gastric cancer in China fail to meet the need of a large number of patients because of restriction in re-gional development. Therefore, we are facing a very serious situation of fighting against gastric cancer. Multidiscipline, individualiza-tion, and standardization are the development tendency of diagnosis and treatment of gastric cancer. Numerous topics about gastric cancer are currently controversial and solutions to these problems depend on the development of evidence-based medicine. This re-view summarized the recent progress in the clinical methods used for stomach cancer, laparoscopic surgical techniques, diagnosis and treatment of early gastric cancer, conversion therapy of advanced gastric cancer, therapeutic strategy of esophageal-gastric junction cancer, enhanced recovery after surgery, and translational research and clinical trials of gastric cancer. Moreover, the foci and prob-lems of the diagnosis and treatment of gastric cancer were discussed to provide reference for further studies.

Systemic lupus erythematosus(SLE)is an autoimmune disease that affects primarily women,commonly in their reproductive years but does not influence fertility.More recent prospective studies indicate that pregnancy is safe for the majority of mothers if it is planned when SLE is quiescent.In pregnant women with lupus nephritis,the outcome of the fetal and maternal is strongly correlated with lupus activity,kidney function and the presence of aPL at the time of conception.To prevent renal complications,prednisone is given after conception,and reinforcement for a few days before the estimated delivery and for a week after delivery or miscarriage with rapid tapering to maintenance levels may be suggested.Treatment of flares includes corticosteroids,hydroxychloroquine,azothioprine and cyclosporin A.Blood pressure is controlled with methyldopa,labetalol nifedipine or hydralazine.

Objective To investigate the effects of minocycline on regional cerebral blood flow and the expression of endothe-lin-1(ET-1) in ischemic penumbra of rats after focal cerebral ischemia reperfusion injury .Methods Middle cerebral artery occlusion (MCAO) with nylon suture was used to be established as focal cerebral ischemia reperfusion mode (I/R) ,a total of 35 male Spra-geue-Dawley rats were randomly divided into 3 groups :sham-operated group(n= 10) ,model group(n= 15) and minocycline group (n= 15) .After 24 hours of I/R ,The neurobehavioral function of rats was evaluated by Longa′s test ,the regional cerebral blood flow in ischemic penumbra was assessed with laser-Doppler flowmetry .After 6 and 24 hours of I/R ,the expression of ET-1 in peri-in-farct region was measured by both immunohistochemistry and radioimmunoassay .Results Compared with sham-group ,the Longa′s test scales ,ET-1 protein expression increased and the rCBF decreased in ischemic penumbra in model group(P< 0 .05) .the Longa′s test scales ,ET-1 protein expression decreased and the rCBF decreased in ischemic penumbra in minocycline group when compared to the model group(P< 0 .05) .Conclusion Minocycline could promote neurological functional recovery of rats after MCAO ,which might be attributed to increase the cerebral blood flow and regulate the endothelin-1 expression in ischemic penumbra .

OBJECTIVE:To investigate the effects of lidocaine epidural block combined with general anesthesia on postopera-tive related indexes of lung cancer patients. METHODS:In retrospective analysis,108 patients with lung cancer were divided into observation group (56 cases) and control group (52 cases) according to anesthesia method. Both groups were given intravenous dripping of Propofol injection combined with Fentanyl injection,inhaled 1%sevoflurane for inhalation to assist anesthesia and inter-mittent intravenous drip of Vecuronium for injection to maintain muscle relaxation. On this basis,observation group was treated with epidural infusion of 2.0% Lidocaine hydrochloride injection 5 mL/h to maintain anesthesia;control group was given epidural infusion of 0.9% Sodium chloride injection 5 mL/h to maintain anesthesia. The anesthesia time,operation time,intraoperative bleeding volume,postoperative recovery time,the amount of fentanyl,propofol,vecuronium bromide and sevoflurane,the occur-rence of postoperative anesthesia complications (nausea,vomiting,dizziness,drowsiness,skin itching) and other complications (cardiac function insufficiency,cardiovascular events,atrial fibrillation,infection,transient cerebral ischemia,acute coronary com-prehensive syndrome,cerebral apoplexy)were observed in 2 groups as well as active and calm VAS score 4 h and 1,2,3,4,5 after surgery. RESULTS:The anesthesia time,operation time,intraoperative bleeding volume,postoperative recovery time,the amount of fentanyl,propofol,vecuronium bromide and sevoflurane,calm VAS score 4 h,1 d,2 d after surgery and active VAS score 4 h,1 d,2 d,3 d after surgery,the incidence of drowsiness in observation group were significantly shorter or lower than control group,while the incidence of dizziness was significantly higher than control group,with statistical significance(P<0.05). There was no statistical significance in the amount of vecuronium,calm and active VAS score in other time,the incidence of nau-sea,vomiting,skin itching,cardiac function insufficiency,cardiovascular events,atrial fibrillation,infection,transient cerebral ischemia,acute coronary syndrome and stroke between 2 groups(P>0.05). CONCLUSIONS:Lidocaine epidural block combined with general anesthesia can reduce the perioperation bleeding amount,postoperative pain,shorten postoperative recovery time and do not increase postoperative complications.

Objective To investigate the causes,diagnosis and treatment of small intestinal bleeding.Methods The clinical datas of 34 cases of small intestinal bleeding confirmed by surgery and pathology were analyzed retrospectively.Results Tumor was the first cause of small intestinal bleeding(13/34),there was no significant difference between the number of benign and malignant tumor,other causes were inflammatory small intestinal diseases(9/34),small intestinal diverticulum(7/34),angiodysplasia(4/34) and heterotopic pancreas(1/34).There were 11,3 and 2 cases who were diagnosed by double contrast barium meal,angiography and radionucleide scanning respectively,18 cases were diagnosed by exploratory laparotomy.Most patients were treated by intestinal segmentectomy.Conclusion Neoplasia is the most common cause of small intestinal bleeding,other causes are inflammatory small intestinal diseases,small intestinal diverticulum andangiodysplasia.Acombination of double contrast barium meal,angiography,radionucleide scanning,exploratory laparotomy and/or enteroscopy are helpful to diagnose small intestinal bleeding.Medical or endoscopic thyrapy is the first choice for treating small intestinal bleeding,surgical procedure,mainly intestinal segmentectomy,is the second choice.

Objective To study the relationship between gastrin and c-myc, c-fos expression in colorectal cancerous tissue and the mechanism of gastrin effect on colorectal cancer.Methods The gastrin and c-myc, c-fos expression in 48 cases of colorectal cancerous tissue and cancer-adjacent mucosa were detected with immunohistochemistry techniques. Results　The positive rate of gastrin in colorectal cancerous tissue was 39.58%. The rate of the well differentiated adenocarcinoma was higher than that of the poorly differentiated and mucinous adenocarcinoma(P＜0.05). The positive rates of c-myc and c-fos in colorectal cancerous tissue were higher than those in cancer-adjacent and normal mucosa. The positive rate of c-myc and c-fos in the group with gastrin positive expression were 78.94% and 73.68%, higher than those in the group with negative gastrin expression(37.93% and 31.04%). Conclusion Some of colorectal cancer cells formed and secreted gastrin through autocrine. The increase of c-myc, c-fos etc oncogene expression probably stimulate the cancer cells proliferation.