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.

The mechanism of invasion and metastasis of colorectal carcinoma was associated with many aspects, including correlative genes such as k-ras,c-met,nm23,c-SRC,HES-6 and P107; immunoreaction; angiogenesis; correlative molecules interacting with extracellular matrix,nitric oxide. The paper summarized the current development in this field.

Glucuronosyltransferase ; genetics ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; genetics

OBJECTIVETo investigate the expression of chemokine stromal cell-derived factor-1 (SDF-1) receptor CXCR4 in human gingival mesenchymal stem cells (GMSCs) and the migration potential of GMSCs stimulated with SDF-1.

METHODSHuman GMSCs were isolated by single-cell cloning method. Their cell surface markers were characterized by flow cytometry, and the rate of colony formation was evaluated. Differentiation assay was used to detect the differentiation potential of GMSCs. The expression of chemokine SDF-l receptor CXCR4 in GMSCs was detected by immunocytochemical staining. The chemotactic effect of SDF-1 on GMSCs was detected using a 24-multiwell Transwell cell culture chamber. The number of net migrated cells was counted in different microscope fields.

RESULTSHuman GMSCs possessed high self-renewal potential and formed single-cell colonies cultured in vitro. GMSCs expressed mesenchymal stem cells-associated markers CD44, CD73, CD90, CD105, and CD166, and the expression of hemopoietic stem cell surface markers CD14, CD34, and CD45 was negative. GMSCs differentiated into osteoblasts and adipocytes under defined culture conditions. The colony forming unit-fibroblastic for GMSCs was 21.4%/±2.8%. Immunocytochemical staining demonstrated that GMSCs expressed chemokine SDF-1 receptor CXCR4. The number of GMSCs migrating at concentrations of 100 ng.mL-1 and 200 ng.mL-1 of SDF-l in the Transwell cell culture chamber was significantly higher than that of the negative control (189.3±4.4, 164.6±4.9 cells/field vs. 47.8±2.5 cells/field, P<0.01). Treatment with the CXCR4 neutralizing antibody, an antagonist for CXCR4, significantly reduced the migratory effect compared with the negative controls (29.0±2.4 cells/field vs. 47.8±2.5 cells/field, P<0.01).

CONCLUSIONHuman GMSCs express chemokine SDF-l receptor CXCR4. SDF-1 may participate in regulating chemotaxis of human GMSCs. Results suggest that the migration induced by SDF-1 is mediated by CXCR4.

Adipocytes ; Cell Culture Techniques ; Cell Differentiation ; Chemokine CXCL12 ; metabolism ; Chemotaxis ; Flow Cytometry ; Gingiva ; physiology ; Humans ; Mesenchymal Stromal Cells ; physiology ; Osteoblasts ; Receptors, CXCR4 ; Signal Transduction

Mr ZHENG Yugui, a distinguished acupuncturist in Qilu area, is one of the successors of Chengjiang acupuncture school in Shandong province. Through collecting the papers and works concerning Mr ZHENG, the academic thoughts are summarized, including careful and clear differentiation of syndrome, specific and precise selection of acupoints, reinforcing and reducing methods based on qi, and gentle and soft manipulation of needles. He has discovered new acupoints such as Fengyan point, etc. He also focuses on moxibustion and creates Taiyang moxibustion method. In addition, to develop acupuncture education, Mr ZHENG has played a deep and important role in spreading Chengjiang acupuncture school in Shandong province.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; China ; History, 20th Century ; Humans ; Schools

0 01) in the two groups were significantly different Conclusion After CPR in non hemorrhagic CA, quick infusion of polyglucose and sodium chloride solution is beneficial to the recovery of erythrocyte rheological parameters before CPR

It is very important to train junior doctors'clinical skills,especially surgical skills.Operation protocol presentations before each surgical procedure provide good opportunities for them to learn these skills,and at same time,this presentation ensures a better surgical outcome as well.Each presentation is prepared under the direction of a senior doctor.A protocol is composed of the patient medical history,physical examination,accessory check up reports,diagnosis and surgical procedure.It is not only a good method for the young doctors to learn but also for their teachers to teach each student individually.

Objective To evaluate the effect of sevoflurane on left ventricular function in patients undergoing elective coronary artery bypass grafting (CABG) .Methods Thirty-five ASA Ⅱ or Ⅲ patients of both sexes (30 males, 5 females) aged 53-75 yr weighing 46-100 kg undergoing CABG were enrolled in this study. Transesophageal echocardiography (TEE) probe was placed. The TEE variables including cardiac index (CI), left ventricular short axis shortening (FS), left ventricular ejection fraction (LVEF), low propagation velocity ( Vp), E wave velocity (E) , A wave velocity ( A) , systolic wave velocity ( S) , diastolic wave velocity ( D), AR wave velocity, E/A ratio and S/D ratio were recorded before inhalation of sevoflurane (T_1 ) , and 5 min (T_2) and 15 rain ( T_3) after inhalation of sevoflurane after splitting of sternum, and before inhalation of sevoflurane (T_4 ), 5 min (T_5) and 15 min (T_6) after inhalation of sevoflurane after the closure of sternum. The end-tidal concentration of sevoflurane corresponded to 1 MAC. Anesthesia was induced with midazolam 0.05 nig/kg, sufentanil 0.5μg/kg and rocuronium 0.9 mg/kg and maintained with infusion of propofol at 4-6 mg·kg~(-1) ·h~(-1), remifentanil at 0.2-0.4μgkg~(-1)·h~(-1) and atracurium at 0.5 mg·kg~(-1)·h~(-1). The patients were mechanically ventilated after tracheal intubation (V_T 8 ml/kg, RR 12 bpm, I:E 1:2, FiO_2 70%-80% ) .Results (1) MAP and CI were significantly decreased at 5 and 15 min after sevoflurane inhalation. LVEF and FS were also decreased. (2) There was no significant change in diastolic function indexes after sevoflurane inhalation including E and A wave velocity, systolic wave velocity, diastolic wave velocity, E/A ratio and S/D ratio. (3) Cardiac function improved after CABG. CI, LVEF and FS were significantly increased after CABG as compared with preoperative values. Conclusion In patients undergoing elective CABG, sevoflurane (the end-tidal concentration corresponding to 1 MAC) can depress left ventricular systolic function but does not affect left ventricular diastolic function.

Objective:To explore the prevention effect of forced-air warming to the upper body on hypothermia during thoracoscopic surgery in the lateral decubitus position.Methods:A total of 82 patients undergoing thoracoscopic surgery in the lateral position from December 2018 to July 2019 in Jiangsu People's Hospital, the First Affiliated Hospital of Nanjing Medical University were divided into upper body group and lower body group according to the random number table method. Each group was 41 cases. Patients received forced-air warming on the upper body or lower body in the upper body group and lower body group, respectively. The bladder temperature was measured as core temperature at operation room, intubation, start of the surgery, 30 min after surgery, 60 min after surgery, 90 min after surgery, 120 min after surgery, end of the surgery. The incidence of intraoperative hypothermia, perioperative adverse complications and vital index at leaving the room were compared between upper body group and lower body group.Results:The core temperature at start of the surgery, 30 min after surgery, 60 min after surgery, 90 min after surgery were (36.70±0.12), (36.65±0.16), (36.30±0.18), (36.32±0.19) ℃ in the upper body group, and (36.42±0.13), (36.32±0.17), (36.17±0.14), (36.21±0.15)℃ in the lower body group, the differences were statistically significant ( t values were 2.743-10.362, P<0.05). However, there was no statistically significant in the core temperature at other time points between the two groups ( P>0.05). The incidences of intraoperative hypothermia and perioperative shiver were 12.2%(5/41), 4.9%(2/41) in the upper body group, and 31.7%(13/41), 21.9%(9/41) in the lower body group, the differences were statistically significant ( χ2 values were 4.556, 5.145, P<0.05). There was no statistically significant in the other perioperative adverse complications and vital index at leaving the room between two groups ( P>0.05). Conclusions:Forced-air warming was more effective on the upper body in resistive body core temperature. Besides, the incidences of hypothermia and shiver on the upper body is lower.

Aged ; Antigens, CD ; metabolism ; Antigens, CD20 ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; CD3 Complex ; metabolism ; CD79 Antigens ; metabolism ; Diagnosis, Differential ; Histiocytes ; immunology ; pathology ; Hodgkin Disease ; immunology ; pathology ; Humans ; Leukocyte Common Antigens ; metabolism ; Lymphoma, B-Cell ; immunology ; pathology ; Lymphoma, Large B-Cell, Diffuse ; immunology ; pathology ; Male ; T-Lymphocytes ; immunology ; pathology