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Objective To explore the clinical value of methylation at promoter sites of urine protein kinase Y-linked(PRKY)gene in the early diagnosis of prostate cancer(PCa).Methods Urine samples were collected from 50 suspected PCa patients.After extracting DNA,the methylation levels of the PRKY gene promoter sites cg05163709,cg08045599,and cg05618150 were detected using quantitative methylation-specific PCR(qMSP).Simultaneously,the patients were divided into the benign prostatic hyperplasia(BPH)group and the PCa group.The differences in clinical indicators between the two groups were analyzed,as well as the methylation status of the PRKY gene promoter sites in the urine of the two groups of patients.The receiver operating charac-teristic(ROC)curve of PRKY promoter sites methylation was established,and the area under the curve(AUC)was calculated to analyze the diagnostic value of PRKY promoter sites methylation in PCa,and to perform com-bined diagnosis with clinical indicators.Results The methylation rates of cg05163709 and cg05618150 in urine specimens of PCa patients were significantly higher than those of BPH patients.The AUC for cg05163709 methyla-tion in diagnosing PCa was 0.762,with a sensitivity of 86.70%.It showed better performance in early screening for PCa compared to total prostate specific antigen(tPSA),percentage free prostate specific antigen(f/tPSA)and prostate specific antigen density(PSAD)index.We found that the AUC for cg05618150 methylation in conjunc-tion with PSAD in diagnosing PCa was 0.787,with a sensitivity of 86.70%.The AUC of cg05163709 methylation and PSAD in the joint diagnosis of PCa was 0.855,and the specificity could reach 95.00%.Conclusion The methylation of urine PRKY gene promoter sites cg05163709 and cg05618150 shows high sensitivity and specificity in diagnosing PCa,making them promising biomarkers for early detection of PCa.
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AIM: To investigate the risk factors associated with neovascular glaucoma(NVG)after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).METHODS: The PDR patients who received 23G PPV treatment at Shenyang He Eye Specialist Hospital from October 2015 to September 2020 and were followed up for at least 12mo with complete data were retrospectively collected. The patients were divided into two groups according to the occurrence of NVG during follow-up. The preoperative and intraoperative variables between two groups were compared. The cumulative hazard ratio for NVG was evaluated. RESULTS: A total of 151 PDR patients(169 eyes)with a mean follow-up of 18.07±12.55(1~79)mo were included, of which 30(17.8%)eyes developed NVG, the mean time of occurrence was 6.27±4.01(1~17)mo, and 50%(15 eyes)of NVG occurred within 5mo after vitrectomy. The cumulative hazard ratios of NVG at postoperative 3, 6 and 12mo were 4.8%, 12.6% and 18.1%, respectively. Multivariate logistic regression analysis showed that preoperative best corrected visual acuity(OR=3.077, 95%CI: 1.203~7.869, P=0.019), preoperative iris rubeosis(OR=7.897, 95%CI: 1.313~47.498, P=0.024), and contralateral NVG(OR=22.108, 95%CI: 1.562~312.861, P=0.022)were risk factors with the occurrence of NVG, while the number of intraoperative retinal laser photocoagulation(OR=0.772, 95%CI: 0.666~0.893, P=0.001)was the protective factor with the occurrence of NVG.CONCLUSIONS: The incidence of NVG in PDR eyes after PPV was 17.8%, of which 50% occurred within 5mo after surgery. PDR eyes with poor baseline visual acuity, iris rubeosis, and contralateral NVG are prone to postoperative NVG, and sufficient intraoperative retinal laser photocoagulation has a certain protective effect. PDR eyes after PPV should be closely followed up for 1a.
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Objective Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist with sedative and analgesic properties but without respiratory depression effect and has been widely used in perioperative anesthesia. Here we performed a systematic review and meta-analysis to evaluate the effect of dexmedetomidine on maintaining perioperative hemodynamic stability in elderly patients.Methods PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched for randomized-controlled trials (RCTs) on the application of dexmedetomidine in maintaining perioperative hemodynamic stability in elderly patients from their inception to September, 2021. The standardized mean differences (SMD) with 95% confidence interval (CI) were employed to analyze the data. The random-effect model was used for the potential clinical inconsistency.Results A total of 12 RCTs with 833 elderly patients (dexmedetomidine group, 546 patients; control group, 287 patients) were included. There was no significant increase in perioperative heart rate (HR), mean arterial pressure (MAP), and diastolic blood pressure (DBP) in the dexmedetomidine group before and during the operation. In addition, the variations of hemodynamic indexes including HR, MAP, SBP (systolic blood pressure), and DBP were significantly lower in the dexmedetomidine group compared with the control group (HR: SMD = -0.87, 95% CI: -1.13 to -0.62; MAP: SMD = -1.12, 95% CI: -1.60 to -0.63; SBP: SMD = -1.27, 95% CI: -2.26 to -0.27; DBP: SMD = -0.96, 95% CI: -1.33 to -0.59). Subgroup analysis found that with the prolongation of 1.0 μg/kg dexmedetomidine infusion, the patient's heart rate declined in a time-dependent way.Conclusion Dexmedetomidine provides more stable hemodynamics during perioperative period in elderly patients. However, further well-conducted trials are required to assess the effective and safer doses of dexmedetomidine in elderly patients.
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Humans , Aged , Dexmedetomidine/adverse effects , Hemodynamics , Hypnotics and Sedatives/pharmacology , Blood Pressure , Heart RateABSTRACT
Objective Under noninvasive positive pressure ventilation, in view of inconvenient operations in human airway, and avoiding the interference of spontaneous breathing and the necessary leakage flow, the method for dynamic online monitoring of the respiratory resistance (R) and compliance (C) was studied.Methods At the end of expiration, when the exhaled flow was 0, relative to the expiration positive airway pressure (EPAP), a step-dropped pressure was produced with the amplitude Δp and hold time Δt. Under this dropped pressure, a short-time discharged flow was generated from the lung, and the discharged flow was applied to calculate the R and C. In addition, a respiratory model was developed in MATLAB to simulate the breaths of normal adult, acute respiratory distress syndrome (ARDS) patient and chronic obstructive pulmonary disease (COPD) patient. A serial of simulation experiments were carried out for obtaining data and verification.Results The calculated R and C from simulation for normal adult, ARDS patient, COPD patient, deviated from the actual value by 1.60% and -1.60%, 1.21% and -1.19%, -12.53% and 14.32%, respectively.Conclusions The proposed algorithm is practicable and feasible for calculating the R and C. The simulation results are beneficial for studying and realizing the intelligent ventilation and proportional assist ventilation in respirator.
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Objective:To investigate the status of satisfaction of postgraduates majoring in public health with the teaching material of The prevention and control of chronic non- communicable disease, so as to provide the basis for promoting the teaching and optimizing the reprint of the teaching material. Methods:An online survey was conducted among 180 public health postgraduates of Batch 2018 to Batch 2020 from China CDC who took the selective course of "prevention and control of chronic non-communicable diseases". The survey content included the overall satisfaction of the respondents with the teaching material and such four levels of satisfaction as primary indicators at the content level, thinking level, motivation level and arrangement level and 20 secondary indicators. The statistical analysis was made by SPSS 25.0.Results:The effective response rate was 90.56% (163/180), and the overall satisfaction of postgraduates with the teaching material was 88.96%. The satisfaction of "scientificity", "comprehensiveness", "internal coordination" and "hierarchy" at the content level, "systematic thinking" and "quality education" at the thinking level, "deepening the understanding and application of relevant knowledge in the field of chronic disease prevention and control" and "the content is convenient for self-study and helps guide the construction of new knowledge" at the motivation level, and "accurate words, fluent language and easy to read and understand" and "firm binding, good paper quality and clear printing" at the arrangement level of the teaching material was more than 90.00%. Only the satisfaction of "the critical thinking" at the thinking level and "stimulating learning enthusiasm" at the motivation level was less than 85.00%.Conclusion:The teaching material of The prevention and control of chronic non- communicable disease meets the learning needs of postgraduates majoring in public health, and students have high overall satisfaction evaluation on the teaching material. It is necessary to further optimize the two aspects of "the critical thinking" and "stimulating learning enthusiasm" in the revision of the teaching material.
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The high frequency oscillatory ventilation (HFOV) is characterized with low tidal volume and low mean airway pressure, and can well support the breathing of the patients with respiratory diseases. Since the HFOV was proposed, it has been widely concerned by medical and scientific researchers. About the HFOV, this paper discussed its current research status and prospected its future development in technologies. The research status of ventilation model, mechanisms and ventilation mode were introduced in detail. In the next years, the technologies in developing HFOV will be focused on: to develop the branched high-order nonlinear or volume-depended resistance-inertance-compliance (RIC) ventilation model, to fully understand the mechanisms of HFOV and to achieve the noninvasive HFOV. The development in technologies of HFOV will be beneficial to the patients with respiratory diseases who failed with conventional mechanical ventilation as one of considerable ventilation methods.
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Humans , High-Frequency Ventilation , Lung , Respiration, Artificial , Respiratory Distress Syndrome, Newborn , Tidal VolumeABSTRACT
A questionnaire was used to investigate the emergency training needs of novel coronavirus pneumonia of disease prevention and control institutions in provinces, deputy provincial level regions and cities specifically designated in the state plan, and the effect evaluation of emergency training activities conducted by Chinese Center for Disease Control and Prevention (China CDC). The results showed that 67.4% of 47 disease prevention and control institutions (31/46) believed that the emergency training at the initial stage of the epidemic should be conducted as soon as possible, and the form of network training should be given priority. The training should focus on the urgently needed technologies such as epidemiological investigation, formulation and response of prevention and control strategies, laboratory testing, etc. The teaching materials should highlight pertinence and practicability and be presented in the form of electronic video. The average satisfaction score of the video training conducted by China CDC was (8.81±1.125) and the score of audio-video courseware was (8.97±0.893). The needs analysis and evaluation of novel coronavirus pneumonia prevention and control in disease prevention and control institutions could provide reference for the follow-up training and improve the emergency training management.
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Humans , COVID-19 , China/epidemiology , Pneumonia/prevention & control , SARS-CoV-2 , Surveys and QuestionnairesABSTRACT
Public health physician is one of the four statutory types of physicians in China, but there is no consensus on their connotation. The main problems are that public health physician is confused with those who perform public health tasks, the relationship between public health physician and clinician and the connotation of prescription right is not clear, and there is limitation in public health education and relevant laws and regulations. Public health physician is positioned as professionals who monitor, investigate, evaluate, and intervene in population health-related issues. It is suggested to retain the practicing qualification of public health physicians and highlight the attribute of public health physicians′ prescribing the prescriptions for community health. Encourage public health physicians to obtain qualification for clinicians to individual prescription, Encourage clinicians to access to public health physician qualification. Improve public health school education, take the pilot of public health physician standardization training, cultivate "prevention and treatment combined" physician.
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Objective@#To understand the internship of students majoring in preventive medicine in 6 colleges and universities in China, and provide reference suggestions for the improvement of internship arrangement.@*Methods@#By using the method of combined clustering and convenient sampling, the fifth grades students majoring in preventive medicine in six universities in the eastern, central and western China were surveyed by using questionnaires to collect the information of their attitudes (to) and suggestions for clinical and public health internships.@*Results@#A total of 596 students were surveyed. In terms of the benefits of clinical internship and public health internship, students who thought that the internship was fruitful accounted for >88%, and more students thought that reform is needed in clinical internship compared with public health internship. In clinical internship, the students through that the time arrangement was not appropriate enough (95, 39.58%), the content should be more detailed and in-depth (73, 30.42%) and the content did not conform to the professional direction (54, 22.50%). In public health internship, the students thought that the time arrangement was not appropriate (77, 45.56%), the content should be more detailed and standardized (65, 38.46%) and the types of internship bases should be more diversified (20, 11.83%).@*Conclusions@#The undergraduates majoring in preventive medicine felt to be benefited from clinical practice and public health internships and thought they are of necessity. At the same time, there are still many problems which needs to be improved in the two types of internships. It is necessary to make joint efforts from students, teachers, colleges and practice bases to promote the continuous improvement of undergraduate internship.
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Traditionally, adequate tidal volume is considered to be a necessary condition to support respiratory patient breathing. But the high frequency ventilation (HFV) with a small tidal volume can still support the respiratory patient breathing well. In order to further explore the mechanisms of HFV, the pendelluft ventilation between left and right lungs was proposed in this paper. And a test platform by using two fresh sheep lungs was developed for investigating the pendelluft ventilation between the left and right lungs. Furthermore, considering the viscous resistance ( ), inertance ( ) and lung compliance ( ) in the lung, a second-order lung ventilation model was designed to inspect and evaluate the pendelluft ventilation between left lung and right lungs. On referring to both results of experiments in practice and simulation in MATLAB Simulink, between the left and right lungs, the phase difference in their airflow happens during HFV at some frequencies. And the pendelluft ventilation between the left and right lungs is resulted by the phase difference, even if the total airflow entering a whole lung is 0. Under HFV, the pendelluft ventilation between left and right lungs will benefit the lungs being more adequately ventilated, and will be improve the utilization rate of oxygen in the lungs.
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Animals , Humans , High-Frequency Ventilation , Lung , Physiology , Pulmonary Gas Exchange , Respiration, Artificial , Sheep , Tidal VolumeABSTRACT
ObjectiveTo investigate the difference in the outcomes in patients with acute anterior circulation stroke having achieved the Thrombolysis in Cerebral Infarction (TICI) 2b and TICI 3 recanalization after mechanical thrombectomy.MethodsThe patients with acute anterior circulation stroke having achieved successful recanalization after mechanical thrombectomy were enrolled retrospectively.They were divided into TICI 2b (almost complete recanalization) group and TICI 3 (complete recanalization) group.The good outcome was defined as the modified Rankin Scale score 0-2 at 3 months after onset.ResultsA total of 83 patients were enrolled in the study, including 38 patients (45.8%) with TICI 2b and 45 (54.2%) with TICI 3;49 (59.0%) had good outcome, and 34 (40.9%) had poor outcome.The good outcome rate in the TICI 3 group was significantly higher than that in the TICI 2b group (68.9% vs.47.4%;χ2=3.946, P=0.047).After adjusting for age, hypertension, diabetes, baseline systolic blood pressure, triglyceride, intravenous thrombolysis, and ASITN/SIR collateral grades, TICI 3 was an independent predictor for good outcome at 3 months after onset (odds ratio [OR] 3.759, 95% confidence interval [CI] 1.098-12.871;P=0.035), while the higher baseline National Institutes of Health Stroke Scale score (OR 0.820, 95% CI 0.715-0.941;P=0.005) and higher fasting glucose (OR 0.610, 95% CI 0.410-0.906;P=0.014) were the independent predictors for poor outcome at 3 months after onset.ConclusionsThere are difference in the outcomes in patients with successful recanalization in anterior circulation stroke treated with mechanical thrombectomy.The outcome is substantially better in TICI 3 than TICI 2b patients.
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Objective To evaluate the safety and efficacy of low-dose platelet glycoprotein Ⅱb/Ⅲa antagonist tirofiban on preventing reocclusion during mechanical thrombectomy (MT) for in situ thrombosis(IST).Methods It is a retrospective cohort study, and 112 patients treated with MT, from the Nanjing Prospective Stroke Registration, were enrolled from February 2014 to October 2014. During MT, if angiography after a successful recanalization(defined as Thrombolysis In Cerebral Infarction(TICI) 2b/3) showed residual stenosis at the site of occlusion, additional angiographies were made every 10 min for 30 min.Then, if angiography displayed reocclusion in the corresponding vessels, a repeat recanalization was operated, followed by a low dose intra-arterial tirofiban infusion. MRA or CT angiography (CTA) was implemented to identify intracranial atherosclerosis (ICAS) 5-7 days after the procedure. The patients with confirmed ICAS were enrolled in the IST group. The rest were enrolled in the non-in situ thrombosis (NIST) group.Results A total of 80 patients with acute cerebral infarction were enrolled in the study. IST rate was 32.5%(26/80).All IST patients were confirmed ICAS by follow-up vascular imaging. Instant reocclusion after successful recanalization was significantly more common in the IST group(57.7%(15/26) vs 3.7%(2/54);χ2=30.568, P=0.000) than in the NIST group.In the case of the efficacy and safety of low-dose intra-arterial tirofiban infusion, 82.6%(19/23) of the reocclusion patients eventually accomplished TICI 2b/3, the rest 17.4%(4/23) of the cases were intractable to the procedure and needed rescue stent implantation.The modified Rankin Scale scores in patients infusing tirofiban were superior to the unused patients in 90 days. There was no patient with symptomatic intracranial hemorrhage after the procedure. Conclusions Patients with IST have higher cerebrovascular reocclusion rate during MT. After MT, low-dose intra-arterial tirofiban infusion may prevent reocclusion, and the prognosis is better.
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Objective At present, the risk factors for cognitive impairment in epilepsy patients are not quite clear.This study was to explore the impacts of the clinical features, emotional health and quality of life (QOL) on the cognitive function of the adult patients with mild cognitive impairment (MCI).Methods Using the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) scales, we evaluated the cognitive functions of the 109 adult epileptics of the outpatient clinic of neurology in Jinling Hospital.We assessed their emotional health with Hamilton Depression Scale-24 (HAMD-24), estimated their QOL with Quality Of Life in Epilepsy-31 (QOLIE-31), and collected their baseline clinical data by questionnaire survey.Results There were 67 cases of MCI (61.5%) among the 109 patients.The residential area was the strongest predictor of MCI in the adult epileptics (OR=0.226, 95% CI: 0.082-0.627).Among other risk factors of post-epileptic MCI were the total scores of HAMD-24 (OR=0.770, 95% CI: 0.644-0.921) and QOLIE-31 (OR=0.712, 95% CI: 0.575-0.880), QOL (OR=1.070, 95% CI: 1.015-1.128), cognitive function (OR=1.120, 95% CI: 1.043-1.203), and social function (OR=1.103, 95% CI: 1.035-1.175).Conclusion The incidence of MCI is high in adult patients with epilepsy.The development and progression of post-epileptic MCI can be delayed by more emphasis on the evaluation of cognitive function, emotional health, and quality of life.
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Objective In order to understand the current management status on education/ training and needs for training among new employees working at the provincial CDC in China during 2012-2014,so as to provide basis for setting up related programs at the CDC levels.Methods Based on data gathered through questionnaire surveys run by CDCs from 32 provincial and 5 specifically-designated cities,microsoft excel was used to analyze the current status on management of education and training,for new employees.Results There were 156 management staff members working on education and training programs in 36 CDCs,with 70% of them having received intermediate or higher levels of education.Large differences were seen on equipment of training hardware in different regions.There were 1 214 teaching staff with 66 percent in the fields or related professional areas on public health,in 2014.5084 new employees conducted pre/post training programs,from 2012 to 2014 with funding as 750 thousand RMB Yuan.99.5% of the new employees expressed the needs for further training while.74% of the new staff members expecting a 2-5 day training program to be implemented.79% of the new staff members claimed that practice as the most appropriate method for training.Conclusions Institutional programs set for education and training at the CDCs need to be clarified,with management team organized.It is important to provide more financial support on both hardware,software and human resources related to training programs which are set for new stuff members at all levels of CDCs.
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Objective In order to understand the current management status on education/ training and needs for training among new employees working at the provincial CDC in China during 2012-2014,so as to provide basis for setting up related programs at the CDC levels.Methods Based on data gathered through questionnaire surveys run by CDCs from 32 provincial and 5 specifically-designated cities,microsoft excel was used to analyze the current status on management of education and training,for new employees.Results There were 156 management staff members working on education and training programs in 36 CDCs,with 70% of them having received intermediate or higher levels of education.Large differences were seen on equipment of training hardware in different regions.There were 1 214 teaching staff with 66 percent in the fields or related professional areas on public health,in 2014.5084 new employees conducted pre/post training programs,from 2012 to 2014 with funding as 750 thousand RMB Yuan.99.5% of the new employees expressed the needs for further training while.74% of the new staff members expecting a 2-5 day training program to be implemented.79% of the new staff members claimed that practice as the most appropriate method for training.Conclusions Institutional programs set for education and training at the CDCs need to be clarified,with management team organized.It is important to provide more financial support on both hardware,software and human resources related to training programs which are set for new stuff members at all levels of CDCs.
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Objective To obtain the environmental gamma radiation dose and the radioactivity level of environment medium in the Ninghai areas adjacent to Sanmen Nuclear Power Station before the Station running, and to establish the baseline data for environmental background radiation. Methods The environmental gamma radiation rate and cumulative dose was measured by sodium iodide scintillation detection and cumulative dose of thermoluminescence method.The total αand total βof water source in the monitoring areas was detected by low background αor βdetector, and the radionuclide in the food samples was detected byγ-ray spectrometer. Results Annual effective dose per residents in surveillance areas was 0.928 mSv.γ-ray of field external radiation dose rate was (98.32 ±21.08) nGy/h, and the annual cumulative environmental radiation dose was ( 1.040 ±0.044 ) mSv.There were seasonal differences in theγ-ray of field external radiation dose rate and cumulative environmental radiation dose.γ-ray of external radiation dose rate and the annual environmental cumulative dose in the range of 20 km was higher than in the range of 10 km and 30 km, but there were no statistical significance.Radioactive detection value of food samples were much less than the national standards, and the total radioactivity index of water source samples can be up to the national standard of drinking water. Conclusion Radioactive background in Ninghai areas adjacent to the Sanmen Nuclear Power Station was in the normal range, and there was seasonal variations.The study established baseline data for environmental background radiation before the Sanmen Nuclear Power Station running.In the future, the food sample monitoring should be focused on the artificial radionuclide 90 Sr, 137 Cs, 131 I , etc.
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Human epidermal growth factor receptor 2 (HER2) belongs to the transmembrane glycoprotein receptor family. Overexpression of HER2 could directly lead to tumorigenesis and metastasis. This phenomenon could be observed in the breast cancer, ovarian cancer, gastric cancer, lung cancer and prostate cancer. Compared with the conventional chemotherapy, the targeted treatment of antibody is more specific and has lower side effects. This review describes the current status of monotherapy and combination therapies of anti-HER2 antibodies, trastuzumab and pertuzumab, with chemotherapeutic drugs. The development trends of new formats of anti-HER2 antibody drugs such as bispecific antibody, immunotoxin are also discussed.
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Humans , Antibodies, Monoclonal, Humanized , Therapeutic Uses , Antineoplastic Agents , Therapeutic Uses , Drug Delivery Systems , Immunoconjugates , Therapeutic Uses , Immunotoxins , Therapeutic Uses , Neoplasms , Metabolism , Therapeutics , Receptor, ErbB-2 , Metabolism , TrastuzumabABSTRACT
Monoclonal antibody-targeted therapy has been a hot spot in current clinical cancer treatment. As current antibody drugs have large molecule sizes leading to poor tissue penetration, and high dosage in clinical application leading to high cost, to overcome the problems, the development of new antibody drugs with miniaturization and high potency has become a new trend. In recent years, the conjugates of monoclonal antibodies and cytotoxins, called antibody-drug conjugates (ADCs), have entered the arsenal of anti-cancer drugs, becoming a new format of antibody drugs and attracting extensive attentions. The ADC molecule usually consists of antibody, linker and effector molecule. According to different effector molecules, ADCs can be divided into three categories as chemo-conjugates, immunotoxins and radio-conjugates. When ADC molecules are internalized into cancer cells, cytotoxins will be released by chemical, enzyme degradation or by action of lysosomal proteases, then kill targeted cells by inhibiting protein synthesis, depolymerizing microtubules or breaking double-strand DNA. Recently, two ADC drugs have been approved by the US FDA and more ADC drug candidates are in clinical phase II or III trials which show significantly clinical effects and attracting much attention and competition of pharmaceutical enterprises. In this review, antibody conjugates in the past and present will be summarized and the future development trends and challenges of this type of antibody drugs will be discussed.
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Humans , Antigens, CD , Metabolism , Hematologic Neoplasms , Metabolism , Therapeutics , Immunoconjugates , Chemistry , Therapeutic Uses , Immunotherapy , Methods , Immunotoxins , Chemistry , Therapeutic Uses , Radioimmunotherapy , MethodsABSTRACT
Monoclonal antibody-targeted therapy has been a hot spot in current clinical cancer treatment. As current antibody drugs have large molecule sizes leading to poor tissue penetration, and high dosage in clinical application leading to high cost, to overcome the problems, the development of new antibody drugs with miniaturization and high potency has become a new trend. In recent years, the conjugates of monoclonal antibodies and cytotoxins, called antibody-drug conjugates (ADCs), have entered the arsenal of anti-cancer drugs, becoming a new format of antibody drugs and attracting extensive attentions. The ADC molecule usually consists of antibody, linker and effector molecule. According to different effector molecules, ADCs can be divided into three categories as chemo-conjugates, immunotoxins and radio-conjugates. When ADC molecules are internalized into cancer cells, cytotoxins will be released by chemical, enzyme degradation or by action of lysosomal proteases, then kill targeted cells by inhibiting protein synthesis, depolymerizing microtubules or breaking double-strand DNA. Recently, two ADC drugs have been approved by the US FDA and more ADC drug candidates are in clinical phase II or III trials which show significantly clinical effects and attracting much attention and competition of pharmaceutical enterprises. In this review, antibody conjugates in the past and present will be summarized and the future development trends and challenges of this type of antibody drugs will be discussed.
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Human epidermal growth factor receptor 2 (HER2) belongs to the transmembrane glycoprotein receptor family. Overexpression of HER2 could directly lead to tumorigenesis and metastasis. This phenomenon could be observed in the breast cancer, ovarian cancer, gastric cancer, lung cancer and prostate cancer. Compared with the conventional chemotherapy, the targeted treatment of antibody is more specific and has lower side effects. This review describes the current status of monotherapy and combination therapies of anti-HER2 antibodies, trastuzumab and pertuzumab, with chemotherapeutic drugs. The development trends of new formats of anti-HER2 antibody drugs such as bispecific antibody, immunotoxin are also discussed.