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.

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.

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.

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 toxic effects of ozone on rat astrocytes in vitro. Methods Twelve 1-2 day old Wistar rats were anesthetized with ether. Their brains were removed. Astrecytes were enzymatically isolated with trypsin and cultured. After different-speed cultivation and serial passage, astrocytes were seeded into 24 well plates and divided into 4 groups (n = 7 each): group Ⅰ normal control (group C) and group Ⅱ , Ⅲ , Ⅳ (group O2-O340, 60, 80) were exposed to ozone 40, 60 and 80 μg/ml respectively. After 2 and 4 h incubation, the astroeytes were examined under microscope. Supernatant was collected and cells were broken for determination of SOD activity and MDA content in the cells and LDH leaking ratio. Results Cells in group O2-O3 60 and 80 exhibited hypertrophy, vacuoles and black denatured grains in the cytoplasm and increase in proceses. SOD activity and MDA content were significantly increased at the end of 2 h incubation in group O2-O340, 60 and 80 as compared with blank control group. LDH leaking ratio and MDA content were increased in a concentration dependent manner at the end of 2 h and 4 h incubation, while SOD activity was decreased concentration dependently at the end of 4 h incubation. SOD activity was signifieandy decreased, while LDH leaking ratio was increased at 4 h as compared with that at 2 h in group O2-O360 and 80. Conclusion Ozone has toxic effects on cultured rat astroeytns in a concentration and time dependent manner.

Objective To sum up the clinical experience of the diagnosis and treatment of membranous glomerulopathy associated with chronic graft-versus-host disease(cGVHD) following allogeneic stem tell transplantation(alloSCT).Methods One case of acute acute lymphoblastic leukemia(received) HLA complete matched alloSCT and subjected to methopterin and Tacrolimus(FK506)postoperatively for prevention of GVHD.Nineteen days after operation,the patient suffered from(acute) GVHD and recovered by using methylprednisolone.On the day of 182 and 235 after transplantation,FK506 and prednisone were withdrawn.Five days later,cGVHD occurred,showing liver(dysfunction) and nephrotic syndrome.Membranous glomerulopathy(stage II) was pathologically (diagnosed) and treated with FK506 and prednisone.Results In membranous glomerulopathy,the(patient) got albuminuria(++++),leukocytes 75/?L,epicytes(359.5)/?L,pathological casts(+),24-h urine protein(4.28) g.Renal biopsy revealed that glomeruli were slightly enlarged,partial(capillary) compressed to be closed,glomerular basement membrane(GBM) was slightly thickened and mesangium slightly proliferate.Masson stain indicated the deposition of pink material along the glomerular capillary walls.And IgG(+++),C3(+++) and IgA(++) were detected at the GBM in a granular pattern by immunofluorescent stain.Electron microscopy showed numerous subepithelial(deposits).After treatment with prednisone and FK506 for 2 months,proteinuria was gradually(decreased).Conclusions GVHD associated membranous glomerulopathy should be considered when the patient got nephrotic syndrome or proteinuria after alloSCT.Renal biopsy is beneficial to the diagnosis of GVHD.Glucocorticoid and FK506 is effective in the treatment of GVHD.

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.