Prognostic Value of Serum Apolipoprotein B to Apolipoprotein A-I Ratio in Hepatocellular Carcinoma Patients Treated with Transcatheter Arterial Chemoembolization: A Propensity Score-Matched Analysis.

INTRODUCTION: The prognosis of advanced hepatocellular carcinoma (HCC) varies in patients receiving transcatheter arterial chemoembolization (TACE). In this study, we aimed to assess the prognostic value of serum apolipoprotein B (ApoB)/apolipoprotein A-I (ApoA-I) in this group of patients. METHODS: The serum lipid levels of HCC patients undergoing TACE were obtained from routine preoperative blood lipid examination. A propensity score-matched (PSM) analysis was used to eliminate the imbalance of baseline characteristics of the high and low ApoB/ApoA-I groups. Then, univariate and multivariate analysis were conducted to evaluate the prognostic value of ApoB/ApoA-I. RESULTS: In 455 HCC patients treated with TACE, ApoB/ApoA-I was positively correlated with AFP, T stage, distant metastasis, and TNM stage (p < 0.05). Patients with high ApoB/ApoA-I had a significantly shorter overall survival (OS) than those with low ApoB/ApoA-I (median OS, 21.7 vs. 39.6 months, p < 0.001). Multivariate analysis indicated that ApoB/ApoA-I was an independent prognostic index for OS (hazard ratio [HR] = 1.42, p = 0.008). After baseline characteristics were balanced, 288 patients were included in the PSM cohort. In this cohort, high ApoB/ApoA-I still predicted inferior OS in both univariate analysis (median OS, 27.6 vs. 39.3 months, p = 0.002) and multivariate analysis (HR = 1.58, p = 0.006). CONCLUSION: Serum ApoB/ApoA-I is a useful biomarker in predicting aggressive clinicopathological characteristics and poor prognosis in HCC patients treated with TACE.

The Prognostic Value of aspartate aminotransferase to lymphocyte ratio and systemic immune-inflammation index for Overall Survival of Hepatocellular Carcinoma Patients Treated with palliative Treatments.

Background: Lymphocytes were reported to play a significant part in host anticancer immune responses and influence tumour prognosis. Few studies have focused on the prognostic values of aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), aspartate aminotransferase to platelet count ratio index (APRI) and systemic immune-inflammation index (SII) in hepatocellular carcinoma (HCC) treated with palliative treatments. Methods: Five hundred and ninety-eight HCC patients treated with palliative therapies were retrospectively analysed. We randomly assigned patients into the training cohort (429 patients) and the validation cohort I (169 patients). Receiver operating characteristic (ROC) curves were used to identify the best cut-off values for the ALRI, APRI and SII in the training cohort and the values were further validated in the validation cohort I. Correlations between ALRI and other clinicopathological factors were also analysed. A prognostic nomogram including ALRI was established. We validated the prognostic value of the ALRI, SII and APRI with two independent cohorts, the validation cohort II of 82 HCC patients treated with TACE and the validation cohort III of 150 HCC patients treated with curative resection. In the training cohort and all the validation cohorts, univariate analyses by the method of Kaplan-Meier and multivariate analysis by Cox proportional hazards regression model were carried out to identify the independent prognostic factors. Results: The threshold values of ALRI, APRI and SII were 86.3, 1.37 and 376.4 respectively identified by ROC curve analysis in the training cohort. Correlation analysis showed that ALRI>86.3 was greatly associated with higher rates of Child-Pugh B&C, portal vein tumor thrombosis (PVTT) and ascites (P < 0.05). Correspondingly, ALRI level of HCC patients with Child-Pugh B&C, PVTT and ascites was evidently higher than that of HCC patients with Child-Pugh A, without PVTT and without ascites (P < 0.001). In the training cohort and the validation cohort I, II, III, the OS of patients with ALRI >86.3 was obviously shorter than patients with ALRI ≤86.3 (P <0.001). We identified ALRI as an independent prognostic factor by univariate and multivariate analyses both in training Cohort (HR=1.481, P=0.004), validation cohort I (HR=1.511, P=0.032), validation cohort II (HR=3.166, P=0.005) and validation cohort III (HR=3.921, P=0.010). The SII was identified as an independent prognostic factor in training cohort (HR=1.356, P=0.020) and the validation cohort II (HR=2.678, P=0.002). The prognostic nomogram including ALRI was the best in predicting 3-month, 6-month, 1-year, 2-year survival And OS among TNM, ALRI, ALRI-TNM and nomogram. Conclusions: The ALRI was a novel independent prognostic index for the HCC patients treated with palliative treatments.

The Predictive Value of Albumin-to-Alkaline Phosphatase Ratio for Overall Survival of Hepatocellular Carcinoma Patients Treated with Trans-Catheter Arterial Chemoembolization Therapy.

Background: We have previously reported the prognostic value of the albumin-to-alkaline phosphatase ratio (AAPR) for advanced hepatocellular carcinoma (HCC) patients who are not receiving any standard anticancer therapy. However, the prognostic value of the AAPR for HCC patients treated with trans-catheter arterial chemoembolization therapy (TACE) was not investigated. Methods: We retrospectively analysed 372 HCC patients treated with TACE (the training cohort) and applied receiver operating characteristic curves (ROC curves) to identify the best cut-off value for the AAPR in this cohort. Then, univariate analyses by the Kaplan-Meier method and multivariate analysis by a Cox proportional hazards regression model were conducted. Both comparisons of the ROC curves and the likelihood ratio test (LRT) were employed to evaluate the abilities of different factors in predicting the survival of patients in this cohort. Finally, the prognostic value of the AAPR was validated in two cohorts: one included 202 HCC patients treated with supportive care (validation cohort I), and the other included 82 HCC patients treated with TACE (validation cohort II). Results: We identified 0.439 as the best cut-off value of the AAPR by ROC curve analysis. An AAPR > 0.439 was significantly correlated with a lower frequency of Child-Pugh grade B, portal vein tumour thrombus (PVTT), T3-4 and lymph node metastasis (P < 0.05). The median overall survival (OS) of the patients with an AAPR > 0.439 was significantly longer than that of those with an AAPR ≤ 0.439 (58.4 m vs 17.8 m, respectively, P < 0.001). The AAPR was identified as an independent prognostic factor after univariate and multivariate analyses (HR = 0.636, P = 0.003). The independent prognostic value of the AAPR was also confirmed in validation cohorts I and II. Additionally, we substituted the AAPR for the Child-Pugh grade in the CLIP system and integrated the AAPR into the TNM system. We found that the area under the curve (AUC) of the AAPR-CLIP system was significantly larger than that of the CLIP and the TNM when predicting 3-month, 6-month, 1-year and 2-year survival (P < 0.05). There was no significant difference between the AUCs for the AAPR-CLIP and the AAPR-TNM. The LRT suggested that both AAPR-CLIP and AAPR-TNM had significantly larger χ2 values and smaller AIC values than that of their corresponding primary system (P < 0.05). Conclusions: The AAPR was an independent prognostic index for the HCC patients treated with TACE. Both AAPR-CLIP and AAPR-TNM outperformed their corresponding primary system in predicting OS in the current study.

Modified CLIP score with the albumin-bilirubin grade retains prognostic value in HBV-related hepatocellular carcinoma patients treated with trans-catheter arterial chemoembolization therapy.

Background: The Cancer of the Liver Italian Program (CLIP) score is commonly used for prognosis prediction of hepatocellular carcinoma (HCC). The CLIP includes the Child-Pugh grade, which is relatively subjective, for hepatic encephalopathy assessment. A newly developed scoring system called albumin-bilirubin grade (ALBI grade), consists of albumin and bilirubin to assess liver function reserve objectively. Here, we substituted the ALBI grade for the Child-Pugh grade to establish the ALBI-CLIP scoring system and validated its prognostic value in hepatitis B virus (HBV)-related HCC patients treated with trans-catheter arterial chemoembolization (TACE) therapy. Methods: We retrospectively analyzed HBV-related HCC patients who received TACE therapy. Baseline characteristics were collected and evaluated to classify patients according to ALBI-CLIP, CLIP and TNM systems. Univariate analyses using the Kaplan-Meier method and the log-rank test, as well as multivariate analysis using the Cox proportional hazards regression model, were conducted to detect independent prognostic factors for overall survival. Receiver operating characteristic (ROC) curves and a likelihood ratio test (LRT) were both utilized to compare the values of ALBI-CLIP, CLIP and TNM staging systems in predicting survival. Results: With a total of 389 patients included in the current study, 301 (77.4%) and 88 (22.6%) were classified as Child-Pugh grade A and B, respectively. However, 152 (39.1%), 227 (58.4%) and 10 (2.5%) patients were correspondingly classified into ALBI grade 1, 2 and 3. The areas under the curves of ALBI-CLIP, CLIP and TNM systems were 0.804, 0.778 and 0.734, respectively, for predicting 3-month survival; 0.796, 0.778 and 0.733, respectively, for 6-month survival; 0.697, 0.687 and 0.644, respectively, for 1-year survival; and 0.618, 0.612 and 0.569, respectively, for 2-year survival. The LRT indicated that the ALBI-CLIP and the CLIP had similar values of χ2 and Akaike information criterion (AIC) while the TNM system had the smallest χ2 value (χ2 = 12.1, 11.9, 10.5; AIC = 2620.2, 2620.5, 2621.1 for ALBI-CLIP, CLIP and TNM, respectively). Conclusions: In conclusion, our present study suggested that the ALBI-CLIP scoring system retained the prognostic value of the CLIP in HBV-related HCC treated with TACE therapy.

A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial.

BACKGROUND & AIMS: Nutritional interventions for malnutrition in cancer patients can be helpful. However, concise intervention recommendations remain controversial. Thus, the aim of this study was to report on a nutrition intervention conducted by a multidisciplinary team of specialist nurses and to explore the effect of nutritional intervention on cancer patients. METHODS: This prospective clinical trial study enrolled 110 colorectal cancer patients undergoing chemotherapy. The patients were evaluated upon admission using the 2002 Nutritional Risk Screening system (NRS-2002). The patients were randomly divided into intervention and control groups including 55 patients each. Patients in the control group were administered a normal diet, while those in the intervention group received individual recipes developed by a team of professional nurses, clinical doctors, dietitian, family caregivers, and the patients themselves. Patient weight and serum albumin and prealbumin levels were compared between the 2 groups at different time points. RESULTS: There was a significant difference in patient weight and serum albumin and prealbumin levels before and after nutrition intervention in the intervention group (P < .05). In the control group, weight did not change during ordinary diet guidance. Serum albumin level was slightly improved after 12 cycles of chemotherapy, similar to the prealbumin results. There were statistically significant differences in serum albumin and prealbumin levels between the intervention and control groups after nutrition intervention (P < .05). However, there was no statistically significant difference in weight between the groups after nutrition intervention (P > .05). CONCLUSION: A multidisciplinary team approach for nutrition intervention conducted by specialist nurses improved prealbumin levels in colorectal cancer patients undergoing chemotherapy, with no weight change.

Advance directives: cancer patients' preferences and family-based decision making.

BACKGROUND: Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients' personal will. OBJECTIVES: This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. RESULTS: While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. MATERIALS AND METHODS: Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients' awareness of their disease, and participation in an advance directive. CONCLUSIONS: Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.

Autologous transplantation of cytokine-induced killer cells as an adjuvant therapy for hepatocellular carcinoma in Asia: an update meta-analysis and systematic review.

BACKGROUND: High recurrence rate after curative treatment is the major problem for hepatocellular carcinoma (HCC). Cytokine-induced killer cells (CIKs) therapy was extensively studied among HCC patients. However, the value of CIKs therapy was controversial. A meta-analysis was performed to investigate the efficacy of adjuvant CIKs after invasive treatments among HCC patients. METHODS: We searched online for literatures studying sequential CIKs therapy for HCC patients. Recurrence-free survival (RFS), progress-free survival (PFS) and overall survival (OS) were set as the main endpoints. Both overall and subgroup analysis were accomplished. RESULTS: A total of 12 clinical trials with 1,387 patients were included. The pooled analysis showed a significant improvement of RFS, PFS and OS in CIK group (HR 0.56, 95% CI 0.47-0.67, p<0.00001 for RFS; HR 0.53, 95% CI 0.40-0.69, p<0.00001 for PFS; HR 0.59, 95% CI 0.46-0.77, p<0.0001 for OS). The proportion of CD4+ T cells increased significantly, while CD8+ T cells decreased significantly after CIKs therapy (WMD 4.07, 95% CI 2.58-5.56, p<0.00001; WMD -2.84, 95% CI -4.67 to -1.01, p=0.002, respectively). No significant differences of adverse events between CIK and non-CIK group existed. CONCLUSIONS: Conventionally invasive therapies combined with CIKs therapy could improve the prognosis of HCC patients, especially for RFS and PFS, with mild side effects. Optimizing patient selection shall be the direction in future studies.

Toxicity assessment and selective leaching characteristics of Cu-Al-Ni shape memory alloys in biomaterials applications.

BACKGROUND: Cu-Al-Ni shape memory alloys (SMAs) possess two-way shape memory effects, superelasticity, and damping capacity. Nonetheless, Cu-Al-Ni SMAs remain promising candidates for use in biomedical applications, as they are more economical and machinable than other SMAs. Ensuring the biocompatibility of Cu-Al-Ni SMAs is crucial to their development for biomedical applications. Therefore, this study aimed to assess the toxicity of Cu-Al-Ni SMAs using a Probit dose-response model and augmented simplex design. METHODS: In this study, the effects of Cu2+, Al3+ and Ni2+ metal ions on bacteria (Escherichia coli DH5α) using Probit dose-response analysis and augmented simplex design to assess the actual toxicity of the Cu-Al-Ni SMAs. RESULTS: Extraction and repetition of Escherichia coli DH5α solutions with high Cu2+ ion concentrations and 30-hour incubation demonstrated that Escherichia coli DH5α was able to alter its growth mechanisms in response to toxins. Metal ions leached from Cu-Al-Ni SMAs appeared in a multitude of compositions with varying degrees of toxicity, and those appearing close to a saddle region identified in the contour plot of the augmented simplex model were identified as candidates for elevated toxicity levels. When the Cu-13.5Al-4Ni SMA plate was immersed in Ringer's solution, the selective leaching rate of Ni2+ ions far exceeded that of Cu2+ and Al3+. The number of Cu2+, Al3+ and Ni2+ ions leached from Cu-Al-Ni SMAs increased with immersion time; however, at higher ratios, toxicity interactions among the metal ions had the effect of gradually reducing overall toxicity levels with regard to Escherichia coli DH5α. CONCLUSIONS: The quantities of Cu2+, Al3+ and Ni2+ ions leached from the Cu-13.5Al-4Ni SMA plate increased with immersion time, the toxicity interactions associated with these compositions reduced the actual toxicity to Escherichia coli DH5α.

[Data Integration and Information Sharing of Parasite Resources in Fujian Province].

Objective: To establish parasite library and database in Fujian Province by integrating information on human-animal coinfecting parasites, vectors and　intermediates, in the aim of resource sharing. Methods: According to the Standards and Technical Regulation for Preservation of Parasitic Germplasm Resources set by the Resource Sharing Platform for Parasitic and Tropical Diseases(referred to as Germplasm Resource Sharing Platform), the preserved and newly discovered parasitic germplasm resources in Fujian Center for Disease Control and Prevention were categorized, information described, preserved and displayed, and the information sharing was made through the Germplasm Resource Sharing Platform. Results: The library and database on parasites, medical vectors, and hosts were established. The library was comprised of 1 020 parasite specimens, vectors and hosts, including 100 （9.8%） adult worm specimens, 120（11.7%） eggs and larvae, and 800（78.4%） vectors and hosts. Information digitalization was achieved for 61 resources, including 9 species of nematodes, 16 species of trematodes, 7 species of tapeworms, 16 different medical mollusks, and 13 different medical arthropods, resulting in 3 150 pieces of information and 6 300 images. The database was integrated into the Germplasm Resource Sharing Platform for resource sharing. Conclusion: The library and database on parasite gemplasm resources in Fujian Province has been established. Information sharing is made available through the Germplasm Resource Sharing Platform.

A comparison of dioctahedral smectite and iodine glycerin cream with topical mouth rinse in treatment of chemotherapy induced oral mucositis: a pilot study.

PURPOSE OF THE RESEARCH: To compare the efficacy of dioctahedral smectite and iodine glycerin (DSIG) cream with topical mouth rinse (composed of saline, gentamicin and Vitamin B12) in treatment of chemotherapy induced oral mucositis (OM). METHODS AND SAMPLE: A total of 130 intensive chemotherapy or stem cells transplantation induced OM patients were recruited. Among these patients, 67 patients received topical mouth rinse and 63 patients received DSIG cream treatment. The OM would be treated on the OM appearance and sustained for 5 days. OM severity was measured daily using The American Oncology Nursing Society recommended Oral Assessment Guideline (OAG) score system. KEY RESULTS: Compared with topical mouth rinse treatment, a significant lower OAG score was observed in DSIG cream treated patients. Specifically, the OAG scores were respectively 12.1 ± 1.1, 12.0 ± 1.2, 11.3 ± 1.3 and 10.4 ± 1.3 from day 2 to day 5 in topical mouth rinse treatment subgroup. Correspondingly, the OAG scores were respectively 10.2 ± 1.0, 9.3 ± 0.9, 8.5 ± 0.6 and 8.0 ± 0.2 for DSIG cream treatment subset (all P < 0.05). Importantly, compared with topical mouth rinse treatment, the DSIG cream significantly shortened OM repair time (4.68 ± 0.98 vs. 8.76 ± 1.80 days, P < 0.001). After 5 days treatment, 54 patients (85.7%) obtained complete regression with an OAG score ≤8, and 7 patients (11.1%) had partial regression with an OAG score of 9-10 in DSIG cream treatment subgroup. However, only 2 patients (3.0%) obtained completed regression and 32 patients (47.8%) had partial regression in topical mouth rinse treatment cohort. Moreover, no serious side-effect was observed in both cohorts. CONCLUSIONS: Compared with topical mouth rinse, DSIG cream significantly lowered the OAG score and shortened OM duration.

[Studies on the growth-development and infectivity of Angiostrongylus cantonensis in dormant Pomacea canaliculata].

OBJECTIVE: To study the impact of dormancy of Pomacea canaliculata on the growth-development and infectivity of Angiostrongylus cantonensis. METHODS: The intermediate host snails (P. canaliculata) were infected with the first stage larvae of A. cantonensis from the laboratory. One day after infection the snails were kept dormant under 25.0-25.5 degrees C, and a sample of the snails was selected and dissected to examine the larval growth-development at various interval. Twenty days after infection, they were placed in room with natural winter conditions. Every 10 days a sample of the snails was dissected for larval activity. The third-stage larval infectivity from each group was identified by infecting SD rats. Meanwhile the survival and weight change of snails in the two groups were recorded, and were compared with those snails cultured in water under the corresponding temperature conditions mentioned above. RESULTS: The time for first-stage larvae of A. cantonensis in dormant snails to develop to third stage was shorter than that in the snails in aquarium. All the third stage larvae at various degree of activity recovered from snails in winter room conditions, including dormant snails and active snails in water, infected rats successfully. The dormant snails in winter room conditions stopped growing with decreased weight, but the survival rate was significantly lower than that of the snails in aquarium with the same condition along with an extending time of dormancy. CONCLUSION: The development of A. cantonensis larvae has not been affected when snails are kept dormant under 25.0-25.5 degrees C. The third stage larvae from snails at natural winter room temperature or in aquarium were all infective. As of the overwintering ways, it is better to keep the infected snails dormant than in the aquarium.

[Development of PCR assay for detection of Angiostrongylus cantonensis in Pomacea canaliculata].

OBJECTIVE: To establish a PCR assay for detecting the third-stage larvae of Angiostrongylus cantonensis in Pomacea canaliculata. METHODS: Polymerase chain reaction primers were designed by the software Lasergene, based on the specific cDNA of the third-stage larvae of A.cantonensis in Genbank. The total RNA was prepared from the third-stage larvae of A.cantonensis and of the snails by TRIzol one-step protocol. Amplification by RT-PCR was carried out following the kit protocol. RESULTS: RT-PCR assay revealed a clear differentiation between infected and negative snails. When a mixture of the total RNA from the negative snails and the third-stage larvae of A.cantonensis was tested by the PCR assay, the detectable level was 128 pg RNA, a concentration close to one third-stage larva of A.cantonensis, minimum concentration that could be found by naked eyes. The minimum detected total RNA concentration of the third-stage larvae of A.cantonensis was 105 pg by PCR assay. CONCLUSION: A PCR assay has been developed for detecting A.cantonensis larva in Pomacea canaliculata.

[Studies on susceptibility of Pomacea canaliculata of different developmental stages to infection with Angiostrongylus cantonensis].

UNLABELLED: OBJECTIVE To study the susceptibility of Pomacea canaliculata of different developmental stages to Angiostrongylus cantonensis infection. METHODS: P. canaliculata snails breeding at laboratory were divided into four rank (I-IV) according to the weight, and infected with the first stage larvae of A. cantonensis from Fujian Province. Their mortality, infection rate, worm burden, and the size, development and distribution of larvae in snails were examined. RESULTS: Snails at different developmental stages were readily infected with A. cantonensis. The infection rate was between 76% and 100%, with no significant difference among the groups (P>0.05). Snails at earlier developmental stage showed higher mortality. The heaviest worm burden and the largest number of snails harboring more than 100 larvae were found in snails of rank III. In general the larvae in snails showed a synchronous development in the groups. Sizes of the third stage larvae in snails of various ranks were homogeneous. The period before the third stage larva emergence and the time for a peak percentage of the larvae exhibited no significant difference among the four ranks. The larvae widely distributed in various parts of snails, with more in the lung and foot, and larvae from snails of different ranks could all infect rats successfully. CONCLUSION: P. canaliculata of the four ranks can all be infected by the first stage larvae of A. cantonensis. Rank III snails may be better for studying the relationship between P. canaliculata and A. cantonensis. The potential role of young snails in angiostrongyliasis transmission should be recognized.

[Survey on the current status of important human parasitic infections in Fujian province].

OBJECTIVE: To understand the prevalence of important human parasitic diseases in Fujian province. METHODS: According to the national guidelines, clustered random sampling was made for the survey. Modified Kato-Katz thick smear was applied to examine helminth eggs for soil-transmitted nematodes and Clonorchis sinensis. Cellophane and swab technique was applied for detecting Enterobius vermicularis eggs in children under 12. Questionnairing, skin test, serological test and eosinophil examination were carried out for Paragonimus infection. Questionnairing and serological test were used for Taenia infection and cysticercosis. Retrospective investigation was conducted with the data on outpatient and hospitalized cases with parasitic diseases. RESULTS: 45,736 people at 73 spots of 24 counties were investigated and 14 species of parasites were found. The overall infection rate of intestinal helminth infections was 36.15%. The prevalence of Ascaris lumbricoides, hookworms and Trichuris trichiura was 9.55%, 19.73% and 11.48% respectively. The infection rate of Enterobius vermicularis and Clonorchis sinensis was 22.06% and 0.60% respectively. The positive rate of skin test and serological test among skin test positives for Paragonimus infection was 7.07% and 9.23% respectively. The serology positive rate for cysticercosis was 2.28%, only 3 cases of taenia infection were found from 16371 persons investigated. Human infections with Angiostrongylus cantonensis, Diphyllobothrium latus, Taenia saginata, and Gnathostoma spinigerum were found for the first time in the Province. Metorchis orientalis and Echinostoma aegyptiaca infections in human were first recorded. CONCLUSION: The overall prevalence of soil-transmitted nematodes has decreased significantly in the province, although still highly prevalent in social-economically less developed areas. Meanwhile, attention should be paid to the food-borne parasitic infections in human population.

[Epidemiological study on group infection of Angiostrongylus cantonensis in Changle City].

OBJECTIVE: To make etiological and epidemiological investigation on the infection of Angiostrongylus cantonensis in 8 pupils in Changle City. METHODS: 1. CSF of patients was examined with the conventional method to detect pathogens and eosinophiles. 2. The fecal samples of wild rodents were collected from the spot and examined microscopically to discover the first stage larvae of A. cantonensis. 3. Snails (Pila gigas) were collected in the spot. The smashed head tissue was examined for the third stage larvae of A. cantonensis. 4. The patient's clinical symptoms and physical signs were recorded with an emphasis on central nervous system. RESULTS: 1. Two larvae of the third stage of A. cantonensis were found in CSF of one patient. Eosinophiles occupied 68% of the cell number in average (ranged from 47% to 83%) in CSF of the 8 patients. 2. The infection rate of the first stage larvae of A. cantonensis was 39.3% (44/112) in feces of the rodents. 3. The infection rate of the third stage larvae of A. cantonensis was 40.0% (82/205) in the snails. 4. Major clinical manifestations in the 8 patients included: severe headache(8/8), dizziness(8/8), nausea(8/8), vomiting(8/8), lethargy(7/8), lower limb hypodynamia(7/8). CONCLUSION: The confirmation of severe infection of A. cantonensis in 8 child patients demonstrated that a natural nidus of angiostrongyliasis is present in Chengle City.