Lymph Node Ratio Enhances Predictive Value for Treatment Outcomes in Patients with Non-Small Cell Lung Cancer Undergoing Surgery: A Retrospective Cohort Study.

Purpose: To compare the prognostic value of lymph node ratio (LNR) and pN in patients with non-small cell lung cancer (NSCLC) undergoing surgery. Materials and methods: NSCLC patients were investigated between 2004 and 2015 from the Surveillance, Epidemiology, and End Results databases. The X-tile software was used to determine LNR cut-off values. Kaplan-Meier analysis was employed to assess cancer-specific survival (CSS) and overall survival (OS). Results: The identified cut-off values of LNR were 0.19 and 0.73. Median CSS for LNR1 (LNR < 0.19), LNR2 (0.19 ≤ LNR ≤ 0.73), and LNR3 (LNR > 0.73) were 71, 41, and 17 months. Both LNR2 (HR = 1.46, 95% CI: 1.36-1.57; P < 0.001) and LNR3 (HR = 2.85, 95% CI: 2.58-3.15; P < 0.001) demonstrated poorer median CSS compared to LNR1. Similarly, median OS for LNR1, LNR2, and LNR3 were 50, 35, and 16 months. LNR2 (HR = 1.36, 95% CI: 1.27-1.45; P < 0.001) and LNR3 (HR = 2.60, 95% CI: 2.37-2.85; P < 0.001) exhibited worse median OS compared to LNR1. A revised pN (r-pN) classification incorporating LNR and pN demonstrated superior penalized goodness-of-fit and discriminative ability in predicting CSS and OS compared to both LNR and pN. Conclusion: LNR outperformed pN in predicting CSS and OS in NSCLC patients undergoing surgery, potentially leading to more precise adjuvant treatment decisions.

Preoperative pelvic axial rotation: a possible predictor for postoperative coronal decompensation in thoracolumbar/lumbar adolescent idiopathic scoliosis.

BACKGROUND: The pelvis as the biomechanical foundation of spine, plays an important role in the balance of the stance and gait through the multi-link spinal-pelvic system. If the pelvic axial rotation (PAR) exists in adolescent idiopathic scoliosis (AIS) patients, it should theoretically have some effects on the body balance. PURPOSE: To explore the probable effects of preoperative PAR on the spinal balance in coronal plane in AIS patients with main thoracolumbar/lumbar (TL/L) curve after posterior spinal instrumentation. METHODS: Thirty-eight AIS patients (age: 15 ± 1.5 years) with main TL/L curve (51° ± 6.2°) were recruited retrospectively into this study. The mean follow-up period was 27 months (24-36 months). Standing full spine posteroanterior radiographs were taken preoperatively, 3 month and 1 year postoperatively, and at last follow-up. The convex/concave ratio (CV/CC ratio) of the anterior superior iliac spine laterally and the inferior ilium at the sacroiliac joint medially was measured on posteroanterior radiographs. According to the preoperative CV/CC ratios, the patients were divided into two groups: normal group (N-group: 0.95 ≤ CV/CC ≤ 1.05); and the asymmetrical group (A-group: CV/CC < 0.95, or >1.05). RESULTS: In all the patients, the 3-month-postoperative CV/CC ratio (1.026 ± 0.087) was significantly different from the preoperative CV/CC ratio (0.969 ± 0.095, P < 0.001), indicating that the pelvis had rotated in the opposite direction of the corrective derotation load applied to the TL/L spine after surgery. No significant change was found in the CV/CC ratio from 3-month-postoperative to the last follow-up (1.013 ± 0.103, P > 0.05). There was no significant difference in the demographic, phenotypic, and treatment variables between the N- (n = 16) and A-groups (n = 22) (P > 0.05). However, more coronal decompensation occurred in the A-group after surgery (36.4 vs. 0.0 %, P = 0.013): two patients having trunk translation, three having lower instrumented vertebra (LIV) translation, and one having LIV tilt; meanwhile, one patient having both LIV translation and LIV tilt, and one having both trunk translation and LIV tilt. CONCLUSIONS: The present study confirmed the existence of PAR in AIS patients, and indicated that the pelvis would experience an active rebalancing in the transverse plane within 3 months after spinal correction, and since then, its position would remain stable. Moreover, TL/L-AIS patients with preoperative asymmetrical PAR probably had greater risk of coronal decompensation postoperatively.

On the syntactic monoids associated with a class of synchronized codes.

A complete code C over an alphabet A is called synchronized if there exist x, y ∈ C* such that xA*∩A*y⊆C*. In this paper we describe the syntactic monoid Syn(C (+)) of C (+) for a complete synchronized code C over A such that C (+), the semigroup generated by C, is a single class of its syntactic congruence P C (+) . In particular, we prove that, for such a code C, either C = A or Syn(C (+)) is isomorphic to a special submonoid of 𝒯 (l) (I) × ð’¯ (r) (Λ), where 𝒯 (l) (I) and 𝒯 (r) (Λ) are the full transformation semigroups on the nonempty sets I and Λ, respectively.

Efficacy of First-Line Immunotherapy Combined With Chemotherapy in Extensive-Stage Small Cell Lung Cancer Patients With Different Brain Metastases Status: A Systematic Review and Meta-Analysis.

Background: This study aims to evaluate the efficacy of first-line immunotherapy combined with chemotherapy in extensive-stage small cell lung cancer (ES-SCLC) patients with differing brain metastasis statuses. Methods: We conducted a comprehensive search in public databases, such as PubMed, EMBASE, and the Cochrane Library, to identify randomized controlled trials involving ES-SCLC patients, with or without brain metastases, who underwent first-line immunotherapy combined with chemotherapy. The primary outcome measure was progression-free survival (PFS), and the secondary outcome measure was overall survival (OS). Results: Our analysis incorporated seven high-quality randomized controlled trials, encompassing 398 patients with brain metastases and 3,533 without. Among patients without brain metastases, the combination of immunotherapy and chemotherapy led to significantly improved PFS (hazard ratio (HR) = 0.72, 95% confidence interval (CI): 0.62 - 0.84, P < 0.001) and OS (HR = 0.77, 95% CI: 0.67 - 0.88, P < 0.001) in comparison to chemotherapy alone. Conversely, for patients with brain metastases, the addition of immunotherapy to chemotherapy did not result in a significant improvement in PFS (HR = 1.03, 95% CI: 0.66 - 1.61, P = 0.887) or OS (HR = 1.03, 95% CI: 0.82 - 1.31, P = 0.776) when compared to chemotherapy alone. Conclusions: In ES-SCLC patients without brain metastases, first-line immunotherapy combined with chemotherapy demonstrated improved PFS and OS in contrast to chemotherapy alone. However, patients with brain metastases did not experience similar benefits.

Increased expression of insulin-like growth factor-1 receptor is correlated with tumor metastasis and prognosis in patients with osteosarcoma.

BACKGROUND: The aim of this study was to investigate the association of insulin-like growth factor-1 receptor (IGF-1R) with metastasis and prognosis of osteosarcoma patients. METHODS: RT-PCR and Western blot assays were performed to detect IGF-1R mRNA and protein expression in 26 osteosarcoma and noncancerous bone tissues. Immunohistochemistry was performed to analyze the correlation of IGF-1R expression in 84 osteosarcoma tissues with clinicopathological factors or survival of patients. Lentivirus-mediated RNA interference system was employed to downregulate IGF-1R expression and analyze the effects of IGF-1R downregulation on invasion and metastasis of osteosarcoma cells. RESULTS: The relative levels of IGF-1R mRNA and protein expression were significantly higher in osteosarcoma tissues than in corresponding noncancerous bone tissues. The expression of IGF-1R protein was closely associated with surgical stage and distant metastasis of osteosarcoma patients. Osteosarcoma patients with high IGF-1R expression had poorer survival, and multivariate Cox analyses showed that high IGF-1R expression was an independent prognostic maker. Lentivirus-mediated targeting IGF-1R could significantly inhibit adhesion, migration, invasion, and metastasis of osteosarcoma cells, which might be correlated with of inactivation of Akt signaling pathway. CONCLUSIONS: IGF-1R is an independent prognostic marker for osteosarcoma patients and increased expression of this molecular is correlated with metastasis of osteosarcoma.

Postoperative radiotherapy in pIIIA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy: A meta-analysis.

BACKGROUND: This study aimed to evaluate the effect of postoperative radiotherapy (PORT) in patients with pIIIA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy. METHODS: Electronic databases (PubMed, Web of Science databases, Embase, and the Cochrane Central Register of Controlled Trials) were systematically searched to extract randomized control trials comparing PORT with observation in pIIIA-N2 non-small cell lung cancer patients until October 2021. Main outcomes were disease-free survival (DFS), overall survival (OS), and local recurrence. RESULTS: Three-phase 3 randomized control trials involving 902 patients were included: 455 patients in the PORT group and 447 patients in the observation group. The methodological quality of the 3 randomized control trials were high quality. The pooled analysis revealed that PORT decreased local recurrence rate (odds ratio = 0.56, 95% confidence interval [CI]: 0.40-0.76). However, PORT did not improve median DFS (hazard ratio = 0.84, 95% CI: 0.71-1.00) and OS (hazard ratio = 1.02, 95% CI: 0.68-1.52). CONCLUSIONS: PORT decreased the incidence of local recurrence. However, PORT did not improve DFS and OS.

Management of proximal humeral fractures in elderly patients with uni- or polyaxial locking osteosynthesis system.

INTRODUCTION: To evaluate the clinical efficacy of uni- and polyaxial locking osteosynthesis systems in the management of proximal humeral fractures in elderly patients, totally 76 cases were reviewed including 18 cases of two-part (Neer classification), 36 cases of three-part, and 22 cases of four-part fractures. METHODS: All the patients received open reduction and internal fixation with proximal humerus internal locking osteosynthesis system (PHILOS) or Numelock systems designed for proximal humerus. RESULTS: Results showed no significant difference between groups considering the Constant-Murley scores assessed at 6 and 12 months, postoperatively. Satisfactory outcomes were achieved in 73.7 and 75.0% of the patients from the PHILOS and Numelock groups, respectively. Complications included four cases of varus malunion, one case of screw cut-out, and another case of avascular necrosis. CONCLUSION: Both of the PHILOS and Numelock systems showed equally good results considering fixation stability and functional outcomes of proximal humeral fractures in elderly patients.

[The characteristics of type I, III collagen and LN in pulmonary fibrosis induced by uranium ore dust in rats].

OBJECTIVE: To explore the characteristics of LN and type I, III collagen in pulmonary fibrosis induced by uranium ore dust in rats. METHODS: 60 adult Wistar rats were divided randomly into two groups, control group (30 rats) and uranium ore dust group (30 rats). Non-exposed intratracheal instillation method was used. Uranium ore dust group was exposed 20 mg/ml uranium ore dust suspension 1ml per rat, meanwhile control group was exposed normal saline 1ml per rat. Post-exposed the 7, 14, 21, 30 and 60 d, 6 rats in each group were killed randomly, lung tissue were collected. The pathological changes in lung tissue were observed by microscope using HE staining, the collagen I and III in lungs were observed by polarizing microscope using Biebrich scarlet staining. The expression of LN protein in lung tissue was observed by immunohistochemistry-SP. RESULTS: During lung fibrosis, a large amount of the proliferated I and III collagen in lungs were observed. Post-exposure to uranium ore dust, the characteristics in proliferated collagen in lungs were type I collagen deposited in lung interstitium mainly in the early stage. The area percentage of collagen I and III was increased significantly at 7, 14, 21, 30 and 60d in the experimental group as compared with that in the control group (P < 0.05 or P < 0.01). The over expression of LN in the lung tissue were observed. The expression of LN was distributed in the lung tissue as thickening of the linear or cluster. The integral optical density of LN was increased significantly at 21, 30 and 60 d in the experimental group as compared with that in the control group (P < 0.05 or P < 0.01). CONCLUSIONS: After exposure to uranium ore dust, the characteristics in proliferated collagen in lungs are the type of I collagen deposited in lung interstitium mainly in the early stage, while the type of III collagen increase significantly at the later period. The overexpression of LN exists in the process of pulmonary fibrosis. It suggests that LN has a role effect in the process of pulmonary fibrosis.

Lentivirus-mediated shRNA targeting insulin-like growth factor-1 receptor (IGF-1R) enhances chemosensitivity of osteosarcoma cells in vitro and in vivo.

The overexpression of the type 1 insulin-like growth factor receptor (IGF-1R) has been reported to be associated with malignant transformation, tumor development and chemo- or radioresistance of tumor cells. Previously, we have reported that inhibition of IGF-1R could reverse the radioresistance of human osteosarcoma cells. However, whether inhibition of IGF-1R could enhance chemosensitivity of ostesosarcoma cells is unclear. In this study, lentivirus-mediated shRNA was employed to downregulate endogenous IGF-1R expression to study the function of IGF-1R in chemoresistance of osteosarcoma cells. Results showed that lentivirus-mediated shRNA targeting IGF-1R combined with chemotherapy (CDDP or DTX) could lead to growth suppression of osteosarcoma cells not only in vitro but also in vivo. Moreover, inhibition of IGF-1R gene combined with chemotherapy also synergistically enhanced Caspase-3-mediated apoptosis of osteosarcoma cells. The synergistical enhancement of apoptosis might be associated with downregulation of Bcl-2 and upregulation of Bax in osteosarcoma cells induced by IGF-1R inhibition. Therefore, the overexpression of IGF-1R gene might play important roles in chemoresistance of osteosarcoma cells, and lentivirus-mediated RNAi targeting IGF-1R would be an attractive anti-cancer strategy to chemosensitization of osteosarcoma cell.

Efficacy of intrathecal baclofen bolus on neuropathic pain in patients with spinal cord injury: A protocol for systematic review and meta-analysis.

BACKGROUND: This study will explore the efficacy and safety of intrathecal baclofen bolus (IBB) on neuropathic pain (NPP) in patients with spinal cord injury (SCI). METHODS: All potential literatures of IBB on NPP in patients with SCI will be searched from the following electronic databases from inauguration to the January 31, 2020: PUBMED, EMBASE, Cochrane Library, Web of Science, Chinese Scientific Journal Database Information, WANGFANG, and China National Knowledge Infrastructure. In addition, we will search other sources, such as dissertations and reference lists of included trials. There are no restrictions of language and publication status in searching all literature sources. The quality of each eligible trial will be assessed using Cochrane risk of bias tool, and publication bias will be checked using a funnel plot and Egger test. Statistical analysis will be conducted using RevMan 5.3 software. RESULTS: This study will scrutinize the efficacy and safety of IBB on NPP in patients with SCI through pain intensity of NPP, spasticity, walking ability, health-related quality of life, duration of stay at hospital (days), incidence of adverse event, and mortality rate. CONCLUSIONS: The findings of this study will present helpful evidence to judge whether IBB is effective on NPP in patients with SCI or not. STUDY REGISTRATION NUMBER: INPLASY202040192.

Neuromuscular electrical stimulation for cancer pain in children with osteosarcoma: A protocol of systematic review.

BACKGROUND: This systematic review will assess the effectiveness and safety neuromuscular electrical stimulation (NMES) for cancer pain (CP) in children with osteosarcoma. METHODS: This systematic review protocol will retrieve the following electronic databases from inception to June 1 in Cochrane Library, MEDLINE, EMBASE, Web of Science, Scopus, CNKI, and VIP database. Manual head-searching of reference lists and conference proceedings will be performed to further examine the articles of interest. No restrictions will be applied to language and publication status. We will utilize a 3-stage approach to scan titles, abstracts, and full-text studies against all eligibility criteria, and collect data from included trials. Study quality will be evaluated by the Cochrane Risk of Bias Tool. If possible, we will narratively summarize study results and carry out meta-analysis. RESULTS: This study will recapitulate the present high quality trials to appraise the effectiveness and safety of NMES for CP in children with osteosarcoma. CONCLUSION: The findings of this study will present evidence to determine whether NMES is effective and safe for CP in children with osteosarcoma.

Effectiveness of suprascapular nerve block for the treatment of frozen shoulder: A protocol of systematic review.

BACKGROUND: This study will appraise the effectiveness and safety of suprascapular nerve block (SNB) for the treatment of frozen shoulder (FS). METHODS: This study will incorporate studies relevant to SNB on FS. Articles will be searched in the electronic databases (MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO, Cochrane Library, WANGFANG, and CNKI) from inception to the present. In addition, this study will also retrieve conference proceedings and reference lists of included studies. All literature source searches will not be restricted by date and language. The Cochrane Risk of Bias Tool will be utilized to evaluate the quality of retrieved trials. Data will be collected independently by 2 authors. All collected data will be analyzed by RevMan 5.3 software. RESULTS: This study will synthesize the most recent published high quality trials on assessing the effectiveness and safety of SNB in treating FS. CONCLUSION: The findings of this study will provide a genuine understanding and helpful evidence to determine whether SNB is effective or not in treating FS. STUDY REGISTRATION NUMBER: INPLASY202050084.

Effectiveness of extracorporeal shock wave for post-stroke shoulder-hand syndrome: A protocol for systematic review and meta analysis.

BACKGROUND: Post-stroke shoulder-hand syndrome (PSSHS) is one of the most common sequelae in patients with stroke. Previous studies have reported that extracorporeal shock wave (EPSW) has been used to treat this condition effectively. However, its conclusions are still inconsistent. Therefore, this study will provide evidence to systematically assess the effectiveness and safety of EPSW for the treatment of PSSHS. METHODS: We will comprehensively search relevant randomized controlled trials (RCTs) assessing the effectiveness and safety of EPSW for the treatment of PSSHS in the following databases from their start to February 1, 2020 without language and publication date limitations: Cochrane Library, MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. For trials that meet all inclusion criteria, 2 researchers will independently extract the data from them and appraise study quality by Cochrane risk of bias. Any differences will be solved by discussion with the help of another researcher. All data will be performed and analyzed using RevMan 5.3 software. RESULTS: We will summarize up-to-date high quality RCTs to evaluate the effectiveness and safety of EPSW for the treatment of PSSHS. CONCLUSIONS: This study will provide a comprehensive evidence summary to determine whether EPSW is effective and safety for the treatment of PSSHS or not. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42020175630.

A new phenanthropyran and a new biphenanthrene from the rhizomes of Dioscorea septemloba and their antioxidant activities.

A new phenanthropyran, dioscorone B (1), and a new phenanthrene (2), together with seven known compounds (3-9), were isolated from the 75% ethanol extract of Dioscorea septemloba rhizomes. The chemical structures of these compounds were elucidated by comprehensive spectroscopic methods including NMR, HRESIMS, IR, and UV spectra. Compounds 1-5 were first isolated from genus Dioscorea. The proton and carbon chemical shifts of compounds 1-9 were unambiguously assigned based on the 1D-NMR and 2D-NMR data. Compounds 1-5 and 8-9 were first tested for their antioxidant activities. Compounds 1 and 2 showed excellent activities with IC50 values of 0.07 ± 0.10 µM and 0.13 ± 0.09 µM, respectively.

Characterization of alpha-nitromethyl ketone as a new zinc-binding group based on structural analysis of its complex with carboxypeptidase A.

Zinc-binding groups (ZBGs) are exhaustively applied in the development of the new inhibitors against a wide variety of physiologically and pathologically important zinc proteases. Here the alpha-nitro ketone was presented as a new ZBG, which is a transition-state analog featured by the unique bifurcated hydrogen bonds at the active site of carboxypeptidase A based on the structural analysis. Introduction of a nitro group at the alpha-position of the ketone could provide more non-covalent interactions without loss of the abilities to form a tetrahedral transition-state analog.

Efficacy of artificial femoral head replacement for femoral head avascular necrosis.

BACKGROUND: Femoral head avascular necrosis (FHAN) is one of the most common progressive orthopedic disorders. Previous studies have reported that artificial femoral head replacement (AFHR) can effectively treat patients with FHAN. However, no systematic review has investigated the efficacy of AFHR for FHAN. This study will assess the efficacy of AFHR for patients with FHAN. METHODS: We will search MEDLINE, EMBASE, Web of Science, Cochrane Library, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure up to March 1, 2019 without any restrictions. Any randomized controlled trials for assessing the efficacy of AFHR for patients with FHAN. The methodological quality for each eligible study will be assessed by using Cochrane risk of bias tool. Statistical analysis will be conducted by using RevMan 5.3. RESULTS: This study will provide current evidence of AFHR for patients with FHAN from several aspects, including pain intensity, function, and limitation of femoral head, health-related quality of life, and safety. CONCLUSION: This study will provide latest evidence on assessing the efficacy and safety of AFHR for FHAN.PROSPERO registration number: PROSPERO CRD42019126249.

Effectiveness of neuromuscular electrical stimulation and ibuprofen for pain caused by necrosis of the femoral head: A retrospective study.

This retrospective study analyzed the effectiveness of neuromuscular electrical stimulation (NMES) for pain relief caused by necrosis of femoral head (NFH).Totally, 80 cases of patients with NFH were analyzed and then were assigned to a treatment group or a control group in this study. Of these, 40 cases in the treatment group received ibuprofen and NMES therapy. The other 40 cases in the control group received ibuprofen alone. Cases in both groups were treated for a total of 6 weeks. The primary outcome of pain intensity was measured by a visual analog scale (VAS). The secondary outcome was assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, adverse events (AEs) were also recorded in each case. All outcomes were evaluated before and after the treatment.After treatment, patients in the treatment group showed more effectiveness in pain relief, as measured by VAS (P < .01) and WOMAC sub-pain scale (P < .01), except stiffness, as evaluated by WOMAC sub-stiffness scale (P = .07), and function, as assessed by WOMAC sub-function scale (P = .09), than patients in the control group. Additionally, no significant differences in AEs were detected between 2 groups.This study found that NMES may be helpful for pain relief in patients with NFH.

A linear nonribosomal octapeptide from Fusarium graminearum facilitates cell-to-cell invasion of wheat.

Fusarium graminearum is a destructive wheat pathogen. No fully resistant cultivars are available. Knowledge concerning the molecular weapons of F. graminearum to achieve infection remains limited. Here, we report that deletion of the putative secondary metabolite biosynthesis gene cluster fg3_54 compromises the pathogen's ability to infect wheat through cell-to-cell penetration. Ectopic expression of fgm4, a pathway-specific bANK-like regulatory gene, activates the transcription of the fg3_54 cluster in vitro. We identify a linear, C- terminally reduced and D-amino acid residue-rich octapeptide, fusaoctaxin A, as the product of the two nonribosomal peptide synthetases encoded by fg3_54. Chemically-synthesized fusaoctaxin A restores cell-to-cell invasiveness in fg3_54-deleted F. graminearum, and enables colonization of wheat coleoptiles by two Fusarium strains that lack the fg3_54 homolog and are nonpathogenic to wheat. In conclusion, our results identify fusaoctaxin A as a virulence factor required for cell-to-cell invasion of wheat by F. graminearum.

Nitro as a novel zinc-binding group in the inhibition of carboxypeptidase A.

2-Substituted 3-nitropropanoic acids were designed and synthesized as inhibitors against carboxypeptidase A (CPA). (R)-2-Benzyl- 3-nitropropanoic acid showed a potent inhibition against CPA (K(i)=0.15 microM). X-ray crystallography discloses that the nitro group well mimics the transition state occurred in the hydrolysis catalyzed by CPA, that is, an O,O'-bidentate coordination to the zinc ion and the two respective hydrogen bonds with Glu-270 and Arg-127. Because the nitro group is a planar species, we proposed (R)-2-benzyl-3-nitropropanoic acid as a pseudo-transition-state analog inhibitor against CPA.

Infantile hemangioma is originated from placental trophoblast, fact or fiction?

Infantile hemangiomas are common, benign tumors, distinctive for their perinatal presentation, rapid growth and subsequent involution. Hemangiomas can pose serious concerns to the cosmetic and psychosocial development of the afflicted child, but none of the current therapeutic modalities is ideal to date, partly because the origin of the pathogenic ECs in infantile hemangioma is unknown. Many clues and evidences suggest a link between infantile hemangiomas and the maternal placental trophoblasts. Shared expression of distinct endothelial markers in hemangioma and placental tissues raises a possibility that infantile hemangioma is originated from placental trophoblast. Moreover, the findings of a very high similarity between the transcriptomes of placenta and hemangioma provide strong support for this theory. Furthermore, epidemiologic and clinical evidences accumulated in recent years also suggest the placental trophoblast as the cell of origin for infantile hemangioma. These findings imply a unique relationship between hemangioma and the placental trophoblast and suggest a hypothesis that infantile hemangioma is originated from placental trophoblast. The hypothesis could provide new understanding of these vascular tumors of childhood and may become the most promising research fields for the etiology of infantile hemangiomas. Further study of the precise mechanisms for the placental trophoblast originated hemangiomas will produce new preventive strategies and therapeutic avenues, possibly immunologic treatment, to the very difficult problem.