BACKGROUND & AIMS: BACKGROUND:The combination of inhaled corticosteroids (ICS) and long-acting beta2-agonists (LABA) is recommended by treatment guidelines for the treatment of persistent asthma. Two such combination products, salmeterol/fluticasone propionate (SFC, Seretide GSK, UK) and formoterol/budesonide (FBC, Symbicort, AstraZeneca, UK) are commercially available. OBJECTIVES:The purpose of these studies was to evaluate and compare the duration of bronchodilation of both combination products up to 24 hours after a single dose. METHODS:Two randomised, double blind, placebo-controlled, crossover studies were performed. Study A was conducted in 33 asthmatic adults receiving 400-1200 mcg of budesonide or equivalent. Serial forced expiratory volume in one second (FEV1) was measured over 24 hours to determine the duration of effect of both SFC (50/100 mcg) and FBC (4.5/160 mcg). Study B was conducted in 75 asthmatic adults receiving 800-1200 mcg of budesonide or equivalent and comprised a 4 week run-in of 400 mcg bd Becotide followed by 4 weeks treatment with either SFC 50/100 mcg bd or FBC 4.5/160 mcg bd taken in a cross-over manner. Serial 24-hour FEV1 was measured after the first dose and the last dose after each 4-weeks treatment period to determine the offset of action of each treatment. RESULTS:In study A, a single inhalation of SFC and FBC produced a sustained bronchodilation at 16 hours with an adjusted mean increase in FEV1 from pre-dose of 0.22 L (95% CI 0.19, 0.35 L) for SFC and 0.25 L (95% CI 0.21, 0.37 L) for FBC, which was significantly greater than placebo for both treatments (-0.05 L; p < 0.001). In study B, the slope of decline in FEV1 from 2-24 hours post dose was -16.0 ml/hr for SFC and -14.2 ml/hr for FBC. The weighted mean AUC over 24 hours was 0.21 Lxmin and 0.22 Lxmin and mean change from pre-dose FEV1 at 12 hours was 0.21 L for SFC and 0.20 L for FBC respectively CONCLUSION:Both SFC and FBC produced a similar sustained bronchodilator effect which was prolonged beyond 12 hours post dose and was clearly measurable at 24 h.

背景与目标： 摘要背景：吸入性糖皮质激素（ICS）和长效β2-激动剂（LABA）的结合被治疗指南推荐用于持续性哮喘的治疗。两种这样的组合产品，沙美特罗/丙酸氟替卡松（SFC，英国Seretide GSK）和福莫特罗/布地奈德（FBC，Symbicort，阿斯利康，英国）可商购。
目的：这些研究的目的是评估和比较两种组合产品在单剂给药后直至24小时的支气管扩张持续时间。
方法：进行了两项随机，双盲，安慰剂对照，交叉研究。研究A在接受400-1200 mcg布地奈德或同等剂量的33位哮喘成人中进行。在24小时内测量一秒钟的连续呼气量（FEV1），以确定SFC（50/100 mcg）和FBC（4.5 / 160 mcg）的作用持续时间。研究B在75位接受800-1200 mcg布地奈德或同等水平的哮喘成年人中进行，包括4周400 mcg bd的Becotide磨合，然后用SFC 50/100 mcg bd或FBC 4.5 / 160 mcg bd进行4周治疗以交叉方式拍摄。在每4周治疗期后的第一剂和最后一剂之后，测量连续的24小时FEV1，以确定每种治疗的作用抵消。
结果：在研究A中，单次吸入SFC和FBC在16小时产生了持续的支气管扩张，FEC1的平均调整值从给药前的0.22 L（95％CI 0.19，0.35 L）和0.25 L（95 FBC的％CI 0.21，0.37 L），均显着高于两种治疗的安慰剂（-0.05 L; p <0.001）。在研究B中，从剂量后2-24小时开始，FEV1的下降斜率对于SFC为-16.0 ml / hr，对于FBC为-14.2 ml / hr。在24小时内，加权平均AUC为0.21 Lxmin和0.22 Lxmin，对于SFC，从剂量前FEV1在12小时的平均变化分别为0.21 Lx和FBC 0.20 L
结论：SFC和FBC均产生相似的持续支气管扩张药作用，给药后延长至12小时以上，并且在24 h时明显可测量。

BACKGROUND & AIMS: BACKGROUND:Neoadjuvant chemotherapy (NAC) is increasingly used in the framework of breast-conserving therapy (BCT). Localization of the initial tumor is essential to guide surgical resection after NAC. This study describes the results obtained with I-125 seed localization in BCT including NAC. PATIENTS AND METHODS:Between January 2009 and December 2010, 85 patients treated with NAC and BCT after I-125 seed localization were included. Radiological and pathological response and resection margins were retrospectively evaluated. RESULTS:BCT was carried out in 85 patients without secondary local excisions. Nineteen patients with unifocal tumors and seven patients with multifocal tumors showed a complete pathological response (P = 0.18). Tumor-free resection margins were obtained in 78 patients (50 patients with unifocal and 28 patients with multifocal tumors, P = 0.27). Focally involved margins were found in four patients (two patients with a unifocal and two patients with a multifocal tumor, P = 0.27). A subsequent mastectomy was carried out in three patients (two patients with multifocal tumors, P = 0.29). CONCLUSIONS:BCT after NAC can be carried out successfully after initial localization with I-125 seeds in both unifocal and multifocal breast tumors with complete resection rates of >90%.

背景与目标： 背景：新辅助化疗（NAC）越来越多地用于保乳治疗（BCT）的框架中。初始肿瘤的定位对于NAC术后的手术切除至关重要。这项研究描述了I-125种子在包括NAC在内的BCT中的定位结果。
患者与方法：2009年1月至2010年12月，纳入85例I-125种子定位后接受NAC和BCT治疗的患者。回顾性评估放射学和病理学反应以及切除范围。
结果：85例患者均进行了BCT检查，未进行次要局部切除。 19例单灶性肿瘤患者和7例多灶性肿瘤患者表现出完全的病理反应（P = 0.18）。 78例患者获得了无肿瘤切除切缘（50例单灶患者和28例多灶肿瘤患者，P = 0.27）。在四名患者中发现了局部受累边缘（两名患有单灶的患者和两名患有多灶性肿瘤的患者，P = 0.27）。随后在三名患者中进行了乳房切除术（两名患有多灶性肿瘤的患者，P = 0.29）。
结论：NAC后的BCT可以在单灶和多灶乳腺肿瘤中首次定位I-125种子后成功进行，完全切除率> 90％。

BACKGROUND & AIMS: :Despite adequate surgical treatment by radical cystectomy and pelvic lymphadenectomy, about half of patients suffering from muscle-invasive urothelial bladder cancer will die. Both overall and cancer-specific survival has been improved by neoadjuvant chemotherapy. However, it is still not possible to predict who is likely to benefit from neoadjuvant treatment and who will not. In contrast to neoadjuvant chemotherapy, the efficacy of adjuvant chemotherapy has not definitely been proven. In metastatic urothelial cancer chemotherapy is usually a palliative treatment option. However, in a significant proportion of patients, disease stabilisation and even long-term response can be achieved. Important advances to tailor first- and second-line chemotherapy have recently been reported for clinical prognostic parameters. This review discusses the current standards and developments in the chemotherapeutic treatment of urothelial bladder cancer. Furthermore, it should provide a framework for reasonable treatment choices in daily clinical practice.

背景与目标： ：尽管通过彻底的膀胱切除术和盆腔淋巴结清扫术进行了适当的手术治疗，但约有一半患有肌肉浸润性膀胱尿路上皮癌的患者会死亡。新辅助化疗改善了总生存期和癌症特异性生存期。但是，仍无法预测谁可能从新辅助治疗中受益，而谁则不会。与新辅助化疗相反，辅助化疗的功效尚未得到肯定的证实。在转移性尿路上皮癌中，化疗通常是姑息治疗的选择。但是，在相当大比例的患者中，可以实现疾病稳定甚至长期反应。最近已经报道了调整一线和二线化疗的重要进展，可用于临床预后指标。这篇综述讨论了尿路上皮膀胱癌的化学治疗的当前标准和发展。此外，它应该为日常临床实践中合理的治疗选择提供一个框架。

BACKGROUND & AIMS: :In a neoadjuvant setting, three parameters for Ki-67 could be obtained: pre-treatment Ki-67, post-treatment Ki-67 and Ki-67 change between pre- and post-treatments. It is uncertain which of the three parameters has the greatest prognostic significance, and whether this parameter has significance in each subtype of breast cancer. A total of 385 patients who received neoadjuvant anthracycline followed by taxane chemotherapy and subsequent surgery for breast cancer were analyzed retrospectively. By immunohistochemistry (IHC), patients were divided into four subtypes (Luminal A, Luminal B, Triple negative, and HER2). Ki-67 was examined by IHC in pre-treatment core needle samples and post-treatment surgical excision specimens. The relapse-free survival (RFS) rate was compared among each subtype. The median follow-up period was 56 months. The rate of pathological complete response was higher for HER2 (34.8 %) and Triple negative (24.3 %) subtypes than for Luminal B (8.3 %) and Luminal A (3.8 %) subtypes (p < 0.0001). A reduction in Ki-67 was observed in 58.5, 83.4, 70.2, and 74.2 % of patients in the Luminal A, Luminal B, Triple negative, and HER2 subtypes, respectively. Ki-67 change between pre- and post-treatments was an independent prognostic factor, but pre-treatment Ki-67 and post-treatment Ki-67 were not independent prognostic factors in a multivariate analysis. The RFS was significantly different between patients whose Ki-67 was reduced and those not reduced for Luminal B (81.4 vs. 50.0 %, p = 0.006), Triple negative (74.8 vs. 43.5 %, p = 0.006) and HER2 (82.7 vs. 59.0 %, p = 0.009). However, for Luminal A, the difference in RFS was not associated with changes of Ki-67 (78.8 vs. 75.3 %, p = 0.193). Ki-67 change between pre- and post-neoadjuvant chemotherapy is an independent prognostic factor in patients of Luminal B, Triple negative, and HER2 subtypes. Pre-treatment Ki-67 and post-treatment Ki-67 were not independent prognostic factors in a multivariate analysis.

背景与目标： ：在新辅助条件下，可以获得Ki-67的三个参数：治疗前Ki-67，治疗后Ki-67和Ki-67在治疗前和治疗后的变化。尚不确定这三个参数中的哪一个具有最大的预后意义，以及该参数在每种乳腺癌亚型中是否具有意义。回顾性分析了总共385例接受新辅助蒽环类药物，紫杉烷化学疗法以及随后的乳腺癌手术的患者。通过免疫组织化学（IHC），将患者分为四个亚型（A型，B型，三阴性和HER2型）。 IHC在预处理核心针样品和治疗后手术切除样品中对Ki-67进行了检查。比较了每个亚型的无复发生存率。中位随访期为56个月。 HER2（34.8％）和三阴性（24.3％）亚型的病理完全缓解率高于Luminal B（8.3％）和Luminal A（3.8％）亚型（p <0.0001）。在Luminal A，Luminal B，三阴性和HER2亚型的患者中，分别有58.5％，83.4％，70.2％和74.2％的患者观察到Ki-67降低。在多变量分析中，治疗前后Ki-67的变化是独立的预后因素，但治疗前Ki-67和治疗后Ki-67并非独立的预后因素。对于Luminal B患者，Ki-67降低和未降低的患者的RFS显着不同（81.4 vs. 50.0％，p = 0.006），三阴性（74.8 vs. 43.5％，p = 0.006）和HER2（82.7vs。 59.0％，p = 0.009）。但是，对于Luminal A，RFS的差异与Ki-67的变化无关（分别为78.8％和75.3％，p = 0.193）。新辅助化疗前后的Ki-67改变是Luminal B，三阴性和HER2亚型患者的独立预后因素。在多变量分析中，治疗前Ki-67和治疗后Ki-67并非独立的预后因素。

BACKGROUND & AIMS: A 19-year-old:female patient with malignant schwannoma in the right knee was treated by combination chemotherapy including lipophilic anticancer compounds (cyclophosphamide, doxorubicin, vincristine and dacarbazine). The tumor was radically removed after chemotherapy, but metastatic lesions were noted in the right inguinal nodes. The patient died due to the cachexic state six months after surgery. In human neoplasm, P-glycoprotein (P-Gp) encoded by human multidrug resistance gene MDR1 is known to be related with multidrug resistant phenotype. Northern blot analysis revealed apparent MDR1 expression in the metastatic lesion, while the primary lesion showed faint MDR1 expression detected by only reverse transcriptase-polymerase chain reaction. P-Gp positive tumor cells were immunohistochemically detected both in the metastatic lesion and the primary lesion. The P-Gp-positive tumor cells in the metastatic lesion showed anaplastic features with highly atypical nuclei. These results suggest that MDR1 overexpression is related to the multidrug resistance phenomenon in the malignant schwannoma with morphological differences.

背景与目标： 一名19岁的女性右膝恶性神经鞘瘤患者接受了包括亲脂性抗癌化合物（环磷酰胺，阿霉素，长春新碱和达卡巴嗪）的联合化疗。化疗后肿瘤被彻底清除，但右侧腹股沟淋巴结中发现转移灶。该患者在术后六个月因恶病质死亡。在人类肿瘤中，已知由人类多药耐药基因MDR1编码的P-糖蛋白（P-Gp）与多药耐药表型有关。 Northern印迹分析显示转移性病变中明显的MDR1表达，而原发性病变仅通过逆转录酶-聚合酶链反应检测到微弱的MDR1表达。在转移性病变和原发性病变中均免疫组织化学检测到了P-Gp阳性肿瘤细胞。转移性病变中的P-Gp阳性肿瘤细胞表现出高度非典型性的间变性特征。这些结果表明，MDR1过表达与恶性神经鞘瘤的多药耐药现象有关，但在形态学上存在差异。