[A multicenter epidemiological study of acute bacterial meningitis in children].

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum ß-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ2=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.

[Clinical characteristics of Mycoplasma pneumoniae infection and factors associated with co-infections in children].

Objective: To describe the clinical characteristics of Mycoplasma pneumoniae infection and analyze the factors associated with co-infections with other pathogens in children, and provide evidence for improvement of community acquired pneumonia (CAP) prevention and control in children. Methods: Based on the surveillance of hospitalized acute respiratory infections cases conducted in Soochow University Affiliated Children's Hospital (SCH), the CAP cases aged <16 years hospitalized in SCH between 2018 and 2021 were screened. The pathogenic test results of the cases were obtained through the laboratory information system, and their basic information, underlying conditions, and clinical characteristics were collected using a standardized questionnaire. The differences in clinical characteristics between M. pneumoniae infection and bacterial or viral infection and the effect of the co-infection of M. pneumoniae with other pathogens on clinical severity in the cases were analyzed; logistic regression was used to analyze the factors associated with the co-infections with other pathogens. Results: A total of 8 274 hospitalized CAP cases met the inclusion criteria. Among them, 2 184 were positive for M. pneumoniae (26.4%). The M. pneumoniae positivity rate increased with age (P<0.001), and it was higher in girls (P<0.001) and in summer and autumn (P<0.001). There were statistically significant differences in the incidence of wheezing, shortness of breath, wheezing sounds and visible lamellar faint shadow on chest radiographs, as well as fever and hospitalization days among M. pneumoniae, bacterial, and viral infection cases (all P<0.05). In the cases aged <60 months years, co-infection cases had higher rates of wheezing, gurgling with sputum and stridor; and in the cases aged ≥60 months, co-infection cases had a higher rate of shortness of breath (all P<0.05). Multifactorial logistic regression analysis showed that being boys (aOR=1.38,95%CI:1.15-1.67), being aged <6 months (aOR=3.30,95%CI:2.25-4.89), 6-23 months (aOR=3.44,95%CI:2.63-4.51), 24-47 months (aOR=2.50,95%CI:1.90-3.30) and 48-71 months (aOR=1.77,95%CI:1.32-2.37), and history of respiratory infection within 3 months (aOR=1.28,95%CI:1.06-1.55) were factors associated with co-infections of M. pneumoniae with other pathogens. Conclusions: M. pneumoniae was the leading pathogen in children hospitalized due to CAP. M. pneumoniae infections could cause fever for longer days compared with bacterial or viral infections; M. pneumoniae was often co-detected with virus or bacteria. Being boys, being aged <72 months and history of respiratory infection within 3 months were associated factors for co-infections.

[Study on clinical symptoms and influencing factors of influenza-associated severe acute respiratory illness in children younger than 5 years old in Suzhou of China, 2011-2017].

Objective: To study the influencing factors of influenza-associated severe acute respiratory illness (SARI) in children younger than 5 years of old in Suzhou, and to provide evidence to support the improvement of prevention and control strategies for influenza in children. Methods: We conducted a prospective influenza surveillance for hospitalized SARI and outpatient influenza-like illness (ILI) at Children's Hospital of Soochow University from April 2011 to March 2017. We compared the clinical and other characteristics of influenza-positive patients with SARI to those with ILI to find the differences and to identify influencing factors of influenza-associated SARI, using χ2 test and unconditional logistic regression. Results: We found 786 cases of influenza-associated ILI and 413 cases of influenza-associated SARI during the study period. Cough, runny nose, shortness of breath, asthma or wheezing were more common in influenza-associated SARI than in influenza-associated ILI (P<0.01). Univariate and multivariate logistic regression showed that the influencing factors which significantly associated with increased risk of influenza-associated SARI were as follows: younger age (<6 months OR=3.6, 6-23 months aOR=2.5), respiratory infection history within 3 months (aOR=4.5), chronic lung disease history (OR=3.4), fever above 39.0 ℃ (39.0-39.9 ℃ aOR=2.4, ≥40.0 ℃ aOR=6.0), and the presence of A/H1N1 (aOR=2.3), A/H3N2 (aOR=1.9). Conclusion: Children younger than 2 years old, with a history of chronic lung disease, a history of respiratory infection within 3 months, or with a fever peak above 39.0 ℃ should seek medical advice as soon as possible or receive annual influenza vaccination to reduce the incidence of influenza-associated serious outcomes.

[Estimation of hospitalization rate of Haemophilus influenzae associated community-acquired pneumonia in children under 5 years in Suzhou, 2010-2014].

Objective: To estimate the hospitalization rate of Haemophilus (H.) influenzae associated community-acquired pneumonia in children under 5 years in Suzhou. Methods: From 2010 to 2014, medical records and bacteriology results of children under 5 years hospitalized with community-acquired pneumonia in Children's Hospital of Soochow University were collected, retrospectively. Detection rate of H. influenzae was describe. The hospitalization rate of H. influenzae associated community-acquired pneumonia was estimated using the number of local children in urban area of Suzhou, which was obtained from the immunization platform of Suzhou Center for Disease Prevention and Control. Results: A total of 28 043 hospitalized pneumonia cases were included from 2010 to 2014, in which 19 526 (69.63%) had bacteriological examination. The overall detection rate of H. influenzae was 11.06% (2 160/19 526), and children aged 12-23 months had the highest positive rate (14.29%, 550/3 850), and the rate was higher during winter-spring than during summer-autumn (χ2=455.11,P<0.01). The average hospitalization rate of H. influenzae associated pneumonia in children under 5 years was 760.36/100 000 (95%CI: 733.70/100 000-787.01/100 000), which was higher in winter and spring (898.79/100 000 and 1 249.52/100 000) than in summer and autumn (514.35/100 000 and 359.04/100 000), and the hospitalization rate was higher in boys (942.12/100 000) than in girls (563.76/100 000), the differences were all significant (P<0.01). The highest hospitalization rate was observed in children aged 1-5 months (2 478.31/100 000) and the hospitalization rate decreased with age (χ2=2 129.80, P<0.01). Conclusion: There was a considerable burden of H. influenzae associated community-acquired pneumonia in children under 5 years in Suzhou, especially in children under 6 months.

[Hospitalization rates for influenza-associated severe acute respiratory illness in children younger than five years old in Suzhou of China, 2016-2018].

We analyzed the influenza surveillance data of Children's Hospital of Suzhou University from 2016 to 2018 and estimated the hospitalization burden of children under 5 years old due to influenza infection in Suzhou. The results showed that the influenza virus positive rate of 1 451 severe acute respiratory infection (SARI) cases in Children's Hospital of Suzhou University was 13.6% (95%CI: 11.8%-15.3%; 197 cases), among which the influenza pandemic intensity in 2017-2018 was relatively high, and A/H1N1 was the main pandemic virus. It was estimated that the hospitalization rate of influenza-related SARI in children under 5 years old in Suzhou was 6.9‰ (95%CI: 6.6‰-7.2‰), among which the hospitalization rate of children aged<6 months was higher, up to 11.4‰ (95%CI: 9.9‰-12.8‰).

[Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017].

Objective: To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou, China, 2011-2017. Methods: From March 2011 to February 2017, we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital. Through standard questionnaires and follow-up survey via telephone, we collected information regarding the demographic characteristics, medical history, clinical symptoms and both direct and indirect costs associated with influenza, of the patients. We then compared clinical characteristics and economic burden of influenza A/H1N1, A/H3N2, and B infections among children with ILI. Results: We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs. 791 (12.9%) of the swabs showed positive for influenza virus, including 88 (11.1%) subtype influenza A/H1N1, 288 (36.4%) subtype influenza A/H3N2, and 415(52.5%) type influenza B. The proportions of cough, rhinorrhea, wheezing, vomiting and convulsion in influenza-positive children were higher than those influenza-negative children. Except for the prevalence rates of cough (χ(2)=9.227, P=0.010), wheezing (χ(2)=7.273, P=0.026) and vomiting (χ(2)=8.163, P=0.017), other clinical symptoms appeared similar between the three viral subtypes. Among all the ILI children, the average total cost per episode of influenza was 688.4 Yuan (95%CI: 630.1-746.7) for influenza-negative children; 768.0 Yuan (95%CI: 686.8-849.3) for influenza-positive children and 738.3 Yuan (95%CI: 655.5-821.1) for influenza B. Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (χ(2)=7.237, P=0.028). Conclusion: Children infected influenza showed higher prevalence rates of cough, rhinorrhea, wheezing, vomiting and convulsion than those without influenza. Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.

Estrogen and progesterone promote breast cancer cell proliferation by inducing cyclin G1 expression.

Breast cancer is the most common cause of cancer among women in most countries (WHO). Ovarian hormone disorder is thought to be associated with breast tumorigenesis. The present study investigated the effects of estrogen and progesterone administration on cell proliferation and underlying mechanisms in breast cancer MCF-7 cells. It was found that a single administration of estradiol (E2) or progesterone increased MCF-7 cell viability in a dose-dependent manner and promoted cell cycle progression by increasing the percentage of cells in the G2/M phase. A combination of E2 and progesterone led to a stronger effect than single treatment. Moreover, cyclin G1 was up-regulated by E2 and/or progesterone in MCF-7 cells. After knockdown of cyclin G1 in MCF-7 cells using a specific shRNA, estradiol- and progesterone-mediated cell viability and clonogenic ability were significantly limited. Additionally, estradiol- and progesterone-promoted cell accumulation in the G2/M phase was reversed after knockdown of cyclin G1. These data indicated that estrogen and progesterone promoted breast cancer cell proliferation by inducing the expression of cyclin G1. Our data indicated that novel therapeutics against cyclin G1 are promising for the treatment of estrogen- and progesterone-mediated breast cancer progression.

[A case report of childhood Farber's disease and literature review].

Objective: To explore the clinical features, diagnosis, treatment and the prognosis of Farber disease by case report and literature review. Method: The clinical information of a case with farber's disease diagnosed in October 2015 at Peking University First Hospital was collected and analyzed, including clinical manifestation, electrophysiology, magnetic resonance imaging, pathology, treatments and prognosis.ASAH1 gene mutational analysis was conducted in the patient and her parents.By using "Farber's disease, ASAH1" as keywords, literature was searched from Pubmed, CHKD and HGMD database from January 1951 to January 2016. Result: The girl, 2 years 2 months old, was sent to our hospital in October 2015, with complains of "joint swelling for 17 months, development regress of intelligence and movement for 11 months, intermittent seizures for 2 months" .The clinical manifestation of the patient was characterized by painful and deformed joints, subcutaneous nodules, progressive hoarseness, and the progressive neurological system deterioration.Joints swelling and deformity behave as the first symptoms.A series of electroencephalogram showed slow background and spike wave.Visual evoked potential was significantly abnormal.Brain magnetic resonance imaging (MRI) showed hypomyelination and progressive diffuse brain atrophy.Histology of subcutaneous nodule showed proliferation of the connective tissue with hyalinization, cholesterol crystal like changes, and a large number of foamy cell infiltration.Compound heterozygous mutations of ASAH1 gene, c. 304_305 ins A (p.T102Nfs14) and c. 314T>C (p.L105p), were found in the patient, and the former is inherited from her mother, the latter from her father.Antiepileptic treatment and other symptomatic treatments were delivered to the patient, but the effectiveness was poor.One reference from China hownet and 35 references from Pubmed have reported a total of 26 cases.Twenty out of 26 patients (77%) had the onset under 1 year of age.By region, there were 12 patients (12/26, 46%) from India, and the others around world.Among these 12 indian patients, 10 lack of complete clinical data.Among the rest 16 patients, 4 patients' parents were consanguineous; 8 patients with the main clinical manifestation of painful and deformed joints, subcutaneous nodules, and hoarse cry; 4 patients with hepatic failure and impaired spleen; 5 patients with rapid neurological deterioration; 1 patient with bone destruction; 7 patients under liver and skin biopsies, pathologically showing a large number of foam cells and "Farber bodies" . There are 33 genetic mutations, and 45% (15/33) mutations are concentrated in ASAH1 exon 6-10. Conclusion: Farber disease is a rare autosomal recessive disease caused by deficiency of lysosomal acid ceramidase.Histopathology of granulomatous tissue plays an important role in the early diagnosis.

Medical and endoscopic management of high-grade dysplasia in Barrett's esophagus.

The management of high-grade dysplasia in Barrett's esophagus has clearly changed over recent years. The risk of cancer development is still substantial, with about one in three patients developing cancer, but a number of patients do not develop cancer. The nature of high-grade dysplasia has also been genetically elucidated with more evidence of chromosomal instability being present at this stage than previously thought. Therapy of the condition has evolved more toward endoscopic therapy, given the good results of radio-frequency ablation and photodynamic therapy in eliminating dysplasia and decreasing cancer development in randomized controlled trial. The best candidates for treatment include compliant patients that have relatively short segments of Barrett's esophagus, an anatomically straight segment, lack of nodularity, and an intact p16. However, even with excellent long-term results similar to surgical resection, the risk of recurrence is present in over 14% of patients, which indicates that there will be a need to continue surveillance endoscopy in these patients.

Portal vein aneurysms with multiple associated findings.

BACKGROUND: This study was done to investigate imaging features of portal vein aneurysms (PVA) associated with multiple associated findings and discuss the value of three-dimensional multiphase contrast-enhanced MR angiography (3D DCE-MRA) in detecting PVA. PATIENTS AND METHODS: 3D DCE-MRA with comprehensive use of various post processing methods was performed in 10 PVA patients. Imaging features of these PVA were analyzed. RESULTS: Of the 10 patients, PVA were located in the splenic vein in three cases, in the intrahepatic portal vein in three cases, at the confluence of the superior mesenteric vein and splenic vein in two cases, and in the main portal vein in two cases. The maximal diameter of the PVA varied from 2.0 cm to 8.39 cm (mean±SD, 3.72±1.84 cm). There were several cases associated with multiple associated findings, such as cavernous transformation of the portal vein, arterio-portal fistulas, arteriovenous malformation and multiple aneurysms of the splenic artery. CONCLUSIONS: 3D DCE-MRA proved to be effective in detecting PVA, improving the diagnosis of associated findings, and in supplying more information for clinical treatment of PVA.

Magnetic resonance imaging in determination of myocardial ischemia and viability: comparison with positron emission tomography and single-photon emission computed tomography in a porcine model.

BACKGROUND: In patients with chronic left ventricular dysfunction, the size of the viable cardiac muscle is correlated with the prognosis and the outcome of myocardial revascularization. PURPOSE: To evaluate the diagnostic value of various imaging techniques in determination of myocardial ischemia and viability. MATERIAL AND METHODS: A chronic myocardial ischemia animal model was established, in which 10 pigs underwent magnetic resonance imaging (MRI), positron emission tomography (PET), and single-photon emission computed tomography (201Tl SPECT) before and 1-2 months after modeling. The size of myocardial ischemia and necrosis was judged, and the imaging manifestations were compared with pathologic findings. RESULTS: Seven of the 10 animals completed all examinations uneventfully. On dobutamine-stressed cine MRI, 10 (8.93%) segments were found to be akinetic. Perfusion was abnormal in 34 (30.35%) segments. Delayed hyperenhancement was observed in 12 (10.71%) segments. PET detected myocardial necrosis in 17 (15.18%) segments, and SPECT detected myocardial necrosis in nine (8.04%) segments. Histological examination with triphenyltetrazolium chloride (TTC) showed pale necrosis in 14 (12.50%) segments. The number of necrotic segments detected by PET was significantly greater than that by contrast-enhanced MRI (chi2 = 5, P = 0.0253, kappa = 0.8028) and cine MRI (chi2 = 7, P = 0.0082, kappa = 0.7079). It was also greater than that by TTC (chi2 = 3, P = 0.0833, kappa = 0.8879), although the difference was statistically insignificant. The number of necrotic segments detected by SPECT was significantly smaller than that by TTC (chi2 = 5, P = 0.0253, kappa = 0.7590), as was the number of necrotic segments detected by cine MRI (chi2 = 4, P = 0.0455, kappa = 0.8100). There was no statistically significant difference in the detection of necrotic segments between contrast-enhanced MRI and TTC (chi2 = 2, P = 0.1573, kappa = 0.9130). CONCLUSION: Cardiac MRI can determine viable myocardium and clearly delineate the location and degree of myocardial necrosis. PET slightly overestimates the extent of the necrotic myocardium and is unable to distinguish transmural necrosis from subendocardial necrosis.

Surface modification of titanium through amino group implantation.

We modified Ti surfaces by implantation of amino (NH(2+)) groups at 10(16) and 10(17) cm(-2). The implanted surfaces were characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning Auger electron spectroscopy (AES), and second ion mass spectroscopy (SIMS). The experimental results showed that the implanted Ti specimens were covered by a dominant hydrocarbon overlayer due to contamination and the surface oxide layer of implanted specimens became thicker. XPS, AES, and SIMS depth profiles showed that implanted elements had a typical ion implantation distribution and that titanium nitride (TiN) was formed.

[Effect of Rg2 on hemodynamics of hemorrhagic shock and its antioxidation in dogs].

OBJECTIVE: To investigate the protective effect of Rg2 on hemodynamics of hemorrhagic shock and its antioxidant properties. METHOD: Twenty mongrel dogs were randomly divided into Rg2 group, Shen Mai group and control group. The hemorrhagic shock model was built in all dogs by artery bleeding and mean arterial blood pressure was kept < 5.33 kPa for 4.5 hours. Rg2 0.5-1.0 mg.kg-1 and Shen Mai 100 mg.kg-1 were intravenously administered after hemorrhagic shock appeared. RESULT: Rg2 significantly enhanced blood pressure, LVSP and +/- dp/dtmax on hemorrhagic shock dogs who had lost compensation ability. Rg2 0.5-1.0 mg.kg-1 could reduce serum MDA, increase superoxide dismutase activity and prolong survival rate of dogs after shock. All these data have statistically significant when compared to control group (P < 0.05, P < 0.01, P < 0.001). CONCLUSION: These results suggest that Rg2 is more potent and effective than Shen Mai in improving hemodynamic state and activiting SOD on hemorrhagic shock dogs.

Preparation of graded porous titanium coatings on titanium implant materials by plasma spraying.

Graded porous titanium coatings have been deposited on titanium substrates for dental implants by plasma spraying in an argon atmosphere. X-ray diffraction (XRD), scanning electron microscopy (SEM), surface roughness measurement, and tensile strength tests were performed on graded porous coatings. The results showed that Ti(3)O(5) was formed in the outermost surface of the porous coatings due to oxidation. The graded porous coatings consisted of three layers. The outer layer was full of macropores with a surface roughness of approximately 100 microm. The diameter of many macropores reached and even surpassed 150 microm, which could be beneficial for tissue to grow into the coating. The middle layer consisted of a mixture of micropores and macropores. The inner layer was a very dense and tight interface layer that included mechanical, physical, and metallurgical bonding. In tensile strength tests, testing bars peeled off the coatings, because the adhesive agent fractured, but the coatings remained intact.

A novel tetanus neurotoxin-insensitive vesicle-associated membrane protein in SNARE complexes of the apical plasma membrane of epithelial cells.

The importance of soluble N-ethyl maleimide (NEM)-sensitive fusion protein (NSF) attachment protein (SNAP) receptors (SNAREs) in synaptic vesicle exocytosis is well established because it has been demonstrated that clostridial neurotoxins (NTs) proteolyze the vesicle SNAREs (v-SNAREs) vesicle-associated membrane protein (VAMP)/brevins and their partners, the target SNAREs (t-SNAREs) syntaxin 1 and SNAP25. Yet, several exocytotic events, including apical exocytosis in epithelial cells, are insensitive to numerous clostridial NTs, suggesting the presence of SNARE-independent mechanisms of exocytosis. In this study we found that syntaxin 3, SNAP23, and a newly identified VAMP/brevin, tetanus neurotoxin (TeNT)-insensitive VAMP (TI-VAMP), are insensitive to clostridial NTs. In epithelial cells, TI-VAMP-containing vesicles were concentrated in the apical domain, and the protein was detected at the apical plasma membrane by immunogold labeling on ultrathin cryosections. Syntaxin 3 and SNAP23 were codistributed at the apical plasma membrane where they formed NEM-dependent SNARE complexes with TI-VAMP and cellubrevin. We suggest that TI-VAMP, SNAP23, and syntaxin 3 can participate in exocytotic processes at the apical plasma membrane of epithelial cells and, more generally, domain-specific exocytosis in clostridial NT-resistant pathways.

Comparative study of different interventional therapies for primary liver cancer.

AIM: To compare the therapeutic effect of three types of inter-ventional management for primary liver cancer. METHODS: A total of 468 patients with primary liver cancer were randomly allocated to the following three groups: 138 cases treated with chemotherapy alone using mitomycin C, adriamycin and 5-FU (group A); 158 cases treated with chemoembolization using lipiodol (group B); and 172 cases with chemoembolization using lipiodol and gelfoam (group C). All patients were angiographically and sonographically followed-up. RESULTS: In group C, 67.5% patients had AFP value decreased by > 50%, which was much higher than the 43.3% in group B and 32.2% in group A. Tumor size reduction by ≥ 50% occurred in 20.3% of patients in group A, 41.2% of patients in group B and 44.8% of patients in group C. The intergroup differences between group A and group B or C were significant (P < 0.01). The 1-year and 3-year survival rates were 20.5% ± 3.6% and 1.9% ± 2.4% for group A, 51.3% ± 4.4% and 10.1% ± 4.9% for group B, and 63.0% ± 2.4% and 13.9% ± 5.0% for group C, respectively. The differences between all three groups were significant (P < 0.05). The mean survival time for patients in groups A, B and C were 9.6 mo, 16.1 mo and 17.9 mo, respectively. CONCLUSION: Chemoembolization with lipiodol and gelfoam was the most effective therapy for primary liver cancer in this study. The position of the embolization should be far and middle sections of the hepatic artery, and the proximal section should be reserved as the route of the next intra-arterial chemoembolization.

[Effect of Leontopodium leontopodioides (Willd.) Beauv. on inflammation induced by animal reversed passive arthus (RPA)].

The extract from Leontopodium leontopodioides 50-100mg/kg ip has been proved able to suppress the swelling of normal or adrenalectomised rat hind paws induced by RPA, and strongly inhibit the cutaneous hemorrhage of animals induced by RPA, lysosome or lysosome of broken membrane. It has also been shown that the extract 100 mg/kg ip can markedly inhibit the migration of leukocytes. These suggest that the anti-inflammatory properties of the extract are not dependent on the pituitary-adrenal system or membrane of lysosome.

Tissue-specific expression of the gene encoding hepatocyte nuclear factor 1 may involve hepatocyte nuclear factor 4.

Hepatocyte nuclear factor 1 (HNF-1) is a transcriptional regulatory protein possibly involved in the activation of many liver-specifically expressed genes. HNF-1 mRNA is restricted to a small number of tissues, suggesting that the HNF-1 gene itself is regulated at the transcriptional level. We have isolated and characterized the promoter region of this gene and have determined its transcriptional potential in several cell types by cell-free transcription and transient transfection experiments. In in vitro transcription assays, an HNF-1 promoter is active in nuclear extracts from liver and kidney, two tissues that contain HNF-1, but silent in nuclear extracts from spleen and lung, which are devoid of this transcription factor. Likewise, in transfection experiments, HNF-1 promoter-chloramphenicol acetyltransferase (CAT) fusion genes are expressed in Hep G2 cells, which express HNF-1, but not in mouse L cells or Hela cells, which do not express HNF-1. In both cell-free transcription and transient transfection assays, a relatively short promoter segment located between positions -82 and -40 is necessary and sufficient to direct cell type-specific HNF-1 transcription. This region contains a single site for a DNA-binding protein that has been tentatively identified as hepatocyte nuclear factor 4, a member of the steroid hormone receptor family.