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 clinical and imaging characteristics of isolated pontine infarction as well as the influencing factors for early progressive motor deficits (PMD) and short-term prognosis.Methods A total of 86 patients with isolated pontine infarction who admitted in hospital within 24 hours of symptom onset were analyzed retrospectively.The patients were divided into paramedian pontine infarction (PPI) and lacunar pontine infarction (LPI) according to the maximal diameter of the lesions and the locations of infarction.They were divided into either a PMD group or a non-PMD group according to the early status of PMD.They were also divided into a poor outcome group (mRS score ＞ 2) and a good outcome group (mRS score ≤ 2) according to the modified Rankin Scale (mRS) scores at discharge.The clinical and imaging features of the different patient groups were compared.Results The patients' constituent ratios of hyperlipidemia (57.14％ vs.33.33％;x2 =4.80,P=0.028),hemiplegia (97.14％ vs.72.55％;x2 =8.718,P=0.003),basilar artery stenosis (45.71％ vs.17.65％;x2=7.930,P=0.005) and poor outcome at discharge (54.29％ vs.31.37％ ; x2 =4.515,P =0.034),and the baseline National Institutes of Health Stroke Scale (NIHSS) scores (6.00 ± 2.39 vs.4.61 ± 3.41; t =2.087,P =0.040) in the PPI group (n =35) were significantly higher than those in the LPI group (n =51).The constituent ratios of the baseline diastolic blood pressure levels (97.82 ± 15.61 mm Hg vs.89.55 ± 12.23 mm Hg,1 mm Hg=0.133 kPa; t =2.258,P =0.031),PPI (63.64％ vs.32.81％ ;x2 =6.445,P =0.011) and basilar artery stenosis (59.10％ vs.18.75％ ;x2 =12.922,P =0.000) in the PMD group (n =22) were significantly higher than those in the non-PMD group (n =64).The baseline NIHSS scores (6.80 ± 2.63 vs.3.73 ± 2.55; t =5.426,P =0.000),fasting blood glucose levels (9.40 ±5.15 mmol/L vs.6.56 ±2.69 mmol/L; t =2.985,P=0.004) and the constituent ratios of PPI patients (54.29％ vs.31.37％ ;x2 =4.515,P =0.034) in the poor outcome group (n =35) were significantly higher than those in the good outcome group (n =51).Multivariate logistic regression analysis showed that basilar artery stenosis was an independent risk factor for the onset of PPI (odds ratio [OR] 3.801,95％ confidence interval [CI] 1.357-10.646; P =0.011) and the early PMD of isolated pontine infarction (OR 4.571,95％ CI 1.214-17.214; P=0.025).The baseline NIHSS score ≥ 5 was its independent predictor for poor outcome (OR 4.277,95％ OR 1.505-12.151; P =0.006).Conelusions PPI is mainly associated with the lesions in the branches of basilar artery.The baseline NIHSS score ≥ 5 may be an independent predictor for short-term poor outcome of isolated pontine infarction.Its early PMD and short-term poor outcome may be associated with the basilar artery lesions.

The main shortcomings of using electrocortical stimulation (ECS) in identifying the motor functional area around the focus in neurosurgery are certainly time-consuming, possibly cerebral cortex injuring and perhaps triggering epilepsy. To solve these problems, we in our research presented an intraoperative motor cortex functional mapping based on electrocorticography (ECoG). At first, using power spectrum estimation, we analyzed the characteristic of ECoG which was related to move task, and selected Mu rhythm as the move-related feature. Then we extracted the feature from original ECoG by multi-resolution wavelet analysis. By calculating the sum value of feature in every channel and observing the distribution of these sum values, we obtained the correlation between the cortex area under the electrode and motor cortex functional area. The results showed that the distribution of the relationship between the cortex under the electrode and motor cortex functional area was almost consistent with those identified by ECS which was called as the gold-standard. It indicated that this method was basically feasible, and it just needed five minutes totally. In conclusion, ECoG-based and passive identification of motor cortical function may serve as a useful adjunct to ECS in the intraoperative mapping.
Brain Mapping ; Electric Stimulation ; Electrocorticography ; Electrodes, Implanted ; Electroencephalography ; Epilepsy ; Humans ; Motor Cortex ; physiology ; Wavelet Analysis

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.