[Prognosis of the central nervous system involvement in patients with hemophagocytic lymphohistiocytosis].

Objective: To investigate the characteristics and prognostic factor of central nervous system (CNS) involvement in patients with hemophagocytic lymphohistiocytosis (HLH) . Methods: From January 2006 to October 2015, 152 patients with HLH, 88 patients had CNS involvement, their clinical data were collected, and survival was analyzed using the Kaplan-Meier life table method, univariate and multivariate Cox regression model analyses were applied to identify the risk factors of prognosis. Results: ①57.9% patients complicated with neurological symptoms, cerebrospinal fluid abnormalities were observed in 37.0% patients, 57.5% patients had abnormal neuroradiology. ②36 patients survived well, 3 patients lost to follow-up, 49 dead, 1 survival patient had epilepsy. ③The 3-year overall survival rate of 88 patients was 44%. ④abnormal CSF and unreceived IT bore a significant, independent adverse prognostic value (P<0.05) . Conclusion: CNS involvement in HLH has a high frequency and poor prognosis, few patients remained neurologic sequelae; abnormal CSF related to poor prognosis, positive intrathecal injections could improve the prognosis.

Identification of differentially expressed genes in a pistillody common wheat mutant using an annealing control primer system.

HTS-1 is a new kind of pistillody wheat. All or parts of its stamen are transformed into pistils or pistil-like structures, and it has more seed sets per floret than normal wheat under normal cultivation conditions. To investigate the expression divergence in this mutant, an annealing control primer system was used to identify differentially expressed genes (DEGs) in the young spikelets. As a result, three DEGs, including HDB2, HGF2, and HCG4, were detected, with variable expression in HTS-1 and the control. After further confirmation using real-time reverse transcription polymerase chain reaction analysis, these genes were overexpressed in HTS-1 wheat. NGF2 was identified in the double ridge to floret differentiation stages; HDB2 and HCG4 were identified in the stage of pistil and stamen-differentiating. Therefore, we inferred that the homeotic transformation of stamens into pistil-like structures occurred during the early stage of stamen development. Sequence alignment analysis revealed that HDB2 encodes a putative protein of 189 amino acids, with high homology to the DEAD-box ATP-dependent RNA helicase, and HCG4 was identical to the Chinese spring wheat cDNA clone predicted protein according to GenBank. However, NGF2 was not found to have significant similarity to any reported proteins, suggesting it is a new functional gene in wheat. The results suggest that HDB2, HCG4, and HGF2 are minor genes contributing to pistillody trait formation in HTS-1.

A new reduced height gene found in the tetraploid semi-dwarf wheat landrace Aiganfanmai.

Aiganfanmai is a dwarf tetraploid wheat landrace (Triticum turgidum var. turgidum) that stably produces the semi-dwarf trait. Plant height varies from 80-105 cm under cultivation. Compared with tall durum wheat (T. turgidum var. durum) variety Langdon, we found it to have short spikes and seeds, besides a semi-dwarf character. We crossed Aiganfanmai with Langdon to analyze the genetic basis of the semi-dwarf trait. The F(2) population segregated at a 1:3 ratio for the short trait to the normal, which demonstrates that Aiganfanmai carries a recessive reduced height (Rht) gene. This gene was found to be located between the molecular markers Xgwm471 and Xgwm350 on chromosome arm 7AS by microsatellite analysis. No Rht gene had been reported from this chromosome; we designated it as Rht22. Rht 22, unlike other previously reported Rht genes, does not reduce internodal cell length. Reduced cell numbers might explain the short stem trait.

Normal human telomeres are not late replicating.

Telomeres in yeast are late replicating. Genes placed next to telomeres in yeast can be repressed (telomere positional effects), leading to the hypothesis that telomeres may be heterochromatic and may control the expression of subtelomeric genes. In addition, yeast telomeres are processed to have a transient long overhang at the end of S phase. The applicability of the yeast data to human biology was examined by determining the timing of telomere replication and processing in normal human diploid fibroblasts. Telomeres were purified from synchronized cells that had been labeled with 5-bromodeoxyuridine (BrdU) at hourly intervals, and the fraction of labeled telomeres was analyzed by retrieval with anti-BrdU antibodies. We determined that normal human telomeres replicate throughout S phase rather than being very late replicating. Furthermore, the overall timing of replication was unaffected by telomere length in young versus old cells or cells whose telomeres had been elongated following transfection with the catalytic subunit of telomerase. Finally, the asymmetry in the length of the G-rich overhang in daughter telomeres produced by leading versus lagging strand synthesis was shown to be established within 1 h of telomere replication, indicating there is no significant delay between synthesis and the processing events that contribute to the establishment of asymmetric overhangs. Therefore, the timings of replication and processing of human telomeres are very different from those of yeast.

Sulfated galactans from Australian specimens of the red alga Phacelocarpus peperocarpos (Gigartinales, Rhodophyta).

Polysaccharides from the red alga Phacelocarpus peperocarpos were extracted with hot water, clarified, and precipitated with 2-propanol. The native preparation was highly sulfated (36.2% w/w). Alkali modification decreased the sulfate content by 2.0% w/w. The alkali-modified polysaccharide is composed mostly of galactose (Gal. 51 mol%) and 3,6-anhydrogalactose (AnGal, 41 mol%), with minor amounts of a mono-O-methylgalactose (MeGal, 1 mol%), xylose (Xyl, 6 mol%), and glucose (Glc, 1 mol%). The FTIR spectrum of the alkali-modified polysaccharide resembled kappa-carrageenan with absorption at 930 cm-1 (indicative of AnGal) and 850 cm-1 (Gal 4-sulfate). However, an additional, major band of absorption occurred sulfate ester substitution at O-6 of at 820 cm-1, indicating the presence of equatorial sulfate ester substitution at O-6 of Gal residues. A combination of linkage and 13C NMR spectroscopic analyses showed that the polysaccharide was composed predominantly of a novel repeating-unit, O-beta-D-galactopyranosyl 4,6-disulfate)-(1-->4)-3,6-anhydro-alpha-D-galactopyranose. Minor structural variations also occurred, including alternative patterns of sulfation and the presence of terminal Xylp. The location of the terminal Xylp residues was not certain but evidence supported their attachment at O-3 of some 4-linked Galp residues. The cell-wall galactans remain unchanged during the life cycle of the alga.

A study of the association between squamous cell carcinoma and adenocarcinoma in the lung, and history of menstruation in Shanghai women, China.

The menstrual history of 162 cases of female lung adenocarcinoma and 19 cases of squamous cell carcinoma was compared with 187 age-matched female controls, and analyzed for statistical significant differences that may exist between the two groups using the Epi-infor program, the Chi-square test, and the Bartlett test for homogeneity of variance. Parameters related to menstrual history included: age of menarche, menstrual cycle, number of days of menstrual period, amount of menstrual flow, menstrual pain, breast bloating/tenderness, and total number of menstrual cycles prior to menopause or diagnosis of lung cancer. The results show that cases of squamous cell carcinoma have a higher total number of menstrual cycles than controls, raising the possibility that estrogen may play a role in the induction of squamous cell carcinoma. Cases with adenocarcinoma were found to have shorter menstrual periods than controls, suggesting that activity of the corpus luteum may be related to the occurrence of adenocarcinoma. Progesterone (PR) and estrogen (ER) receptor levels were also measured in 21 adenocarcinoma surgical specimens. A positive ER and PR receptor expression was correlated with later menarche and earlier menopause.

Current status of lung cancer diagnosis and treatment in Shanghai.

The status of diagnosis and treatment of lung cancers discovered during 1 year in the Shanghai population are presented. A total of 940 lung cancers was detected from inhabitants of 35-64 years of age, with a male/female ratio of 1.8:1. Pathology showed 35.7% adenocarcinoma and 35.1% squamous cell carcinoma. There was a predominance of adenocarcinoma (47.6%) in females and of squamous cell carcinoma (44.6%) in males. Most (68.6%) of the lesions detected were already advanced in contrast to 14.7% of Stage I disease. The need for vigilance on the part of doctors was demonstrated by the fact that 23.3% of patients were seen by the doctor within 1 month after presenting with symptoms and 44.5% of them had their diagnosis suspected within 1 month after their first hospital visit. The treatment consisted of surgery for 33.3%, chemotherapy for 35%, traditional Chinese medicine for 20% and symptomatic management for 9.6% of patients. As only 55.8% Stage I patients were treated by surgery, the treatment protocol seemed to be improperly biased. The adequate training of health workers was shown by the fact that 79.7% of these patients were confirmed by pathology and/or cytology and most of the Stage I lesions were diagnosed outside the hospital.

[In vitro drug sensitivity testing and chemotherapy of lung cancer].

100 lung cancer operated fresh specimens were collected for in vitro drug sensitivity testing, most of them were NSCLC. Those drugs were MMC(M), ADM(A), PDD(P) and VCR(O). 42% of them were sensitive to 2-4 drugs, but 39% were not sensitive to any of the 4 drugs, the sensitive rate of ADM was higher, 41%, MMC, VCR, and PDD were 37% and 32% respectively, but with no statistical meaning. There were 9 sensitive chemotherapy combination, MAPO combination was the highest, 73.8% of the specimens was sensitive to ADM and PDD, 73.8% of the combination included MMC. The in vitro sensitive drugs and sensitive rate were corresponded to the response rate on NSCLC clinically. As above-mentioned, it convinces us that in vitro drugs sensitivity may be meaningful for the design of combination chemotherapy regimen and developing new drugs for lung cancer.

[Prognostic factors in lung cancer based on Shanghai population].

Life table, Cox model and Cox multivariate model were used to measure the prognostic factors in 1417 new prevalent lung cancer cases in Shanghai population of urban area. There were 3 main prognostic factors in lung cancer as follows: a. histologic type was correlated to prognosis, among which, squamous type was the best, SCLC the worst, the factor influenced to prognosis of various types was stage and therapy. b. the earlier stage the better prognosis, and related to a optimal therapy. c. Combined therapy was good for prognosis, it was optimal for either surgical or nonsurgical therapy. Early detection, extension of combined therapy and make public of knowledge on lung cancer were encouraged.

[Diagnosis and treatment of lung cancer in Shanghai--an analysis of present status].

The status of diagnosis and treatment of lung cancers as discovered in one year's interval in the Shanghai population is presented. A total of 940 lung cancers was detected from inhabitants 35-64 years of age, with a male-female ratio of 1.8:1. Pathology showed 35.7% adenocarcinoma and 35.1% squamous cell carcinoma. There was a predominance of adenocarcinoma (47.6%) in the female and squamous cell carcinoma (44.6%) in the male. Most (68.6%) of the lesions detected were already advanced in contrast to 14.7% of Stage I disease. The necessity of the doctor's vigilance was demonstrated by the fact that 23.3% of patients was seen by the doctor within one month after the presenting symptom and 44.5% of them had their diagnosis made within one month after their first hospital visit. The treatment consisted of surgery for 33.3%, chemotherapy for 35%, traditional Chinese medicine for 20% and symptomatic management for 9.7% of patients. As only 55.8% Stage I patients was treated by surgery, the protocol of treatment seemed to be improperly biased. Adequate training of the health workers was shown by the fact that 79.7% of these patients was confirmed by pathology and/or cytology and most of the Stage I lesions were diagnosed outside the hospital.

[The influence of post-operative chemotherapy courses on the prognosis of small cell lung cancer treated with chemotherapy and surgery].

A group of 110 cases of SCLC treated with chemotherapy (CT) and surgery, their 5-yr survival rate was 28.9%. Different 5-yr survival rates were seen in the patients with one to more than 4 courses of post-operative CT, there were 17.7%, 27.3%, 31.3% and 53.7% respectively. The 5-yr survival rate of the patients with 3 or 4 CT courses was better than those patients with only one or two CT courses, P less than 0.05, especially meaningful in the patients treated with CT-surgery-CT, their 5-yr survival rates were 8.3%, 40%, 66.7% and 62.6% respectively, among which group, 11 cases refused to receive post-operative CT died within one year and one month. It was suggested that post-operative CT was very important to the long survival rate of SCLC treated with CT and surgery, 3 and more than four courses of post-operative CT were optimal.

[High risk factors of lung cancer and its early detection].

High risk factors and early detection of lung cancer were studied in a population of greater than 45 years old of 10 122 in Lu Wen District. It was shown as follows: 1. The high risk factors of lung cancer were male greater than 50 years old, and with a smoking history of greater than 400 pack year. 2. Questionnaire 70-110 mm X-ray chest film and sputum cytological examination for the suspicious lung cancer were the screen test for the high risk group. Their prevalence rate of lung cancer was 4.74/1000, 50% of them was in p-staging I, it was 6.3 times higher, than in the specialized hospital, their 5-yr survival rate was 31.5%. It was higher than that in the general population.

The importance of surgery as the first step in multimodality treatment of small cell bronchial carcinoma. The ISC Lung Cancer Study Group.

For patients with small cell lung cancer (SCLC) in their early stages (TNM I, II), surgery for cure was used to eliminate the primary tumour and its regional lymph-nodes followed by intermittent chemotherapy and radiotherapy within the first six postoperative months. After the pathohistological examination of the operation-specimen a two-arm-randomization was performed: standard chemotherapy (1000 mg/m2 cyclophosphamide, 50 mg/m2 doxorubicin, 1.4 mg/m2 vincristine) compared with sequential chemotherapy using three different drug-combinations (A: 1500 mg/m2 cyclophosphamide, 100 mg/m2 lomustine, 15 mg/m2 methotrexate; B: 1000 mg/m2 cyclophosphamide, 40 mg/m2 doxorubicin, 1 mg/m2 vincristine; C: 5 x 1.6 g/m2 ifosfamide plus mesna, 5 x 120 mg/m2 etopside). Thereafter disease-free patients only received prophylactic cranial irradiation (PCI: administering 3600 TD Gy/18 fractions) according to the protocols of the International Society of Chemotherapy Studies I and II. Preliminary evaluations in March 1990 of 170 patients from 24 cooperating departments for thoracic surgery showed that the projected life-table four-year-survival rate of 63 patients with SCLC at pTNM-stage I was 61%, of 54 patients at pTNM-stage II was 35%, of 13 patients at stage pT3, 4 NO, 1 MO was 59% and of 40 patients at stage pT N2 MO was 35%. The indication for surgery is emphasized for pTNM-stages I + II. For N2-lesions surgery would not be recommended in general, but the survival rate seems to indicate that this treatment was not detrimental, being rather more favourable compared with chemotherapy or radiotherapy alone. The continuation and enlargement of these studies seem not only justified, but emphatically indicated.(ABSTRACT TRUNCATED AT 250 WORDS)

Liquid chromatographic determination of L-ascorbate 2-polyphosphate in fish feeds by enzymatic release of L-ascorbate.

An accurate method was devised to assay L-ascorbic 2-polyphosphate esters (AsPP) in fish feed by phosphatase digestion followed by determination of the released L-ascorbic acid (AsA). Compressed yeast and dithiothreitol are added to the phosphatase reaction mixture to give 95-100% recovery of AsA, which is quantitated by reverse-phase liquid chromatography (LC) with electrochemical detection. Chromatograms of all feed digests showed baseline resolution of AsA. In 3 feeds, to which 75-125 ppm AsA equivalents in the form of AsPP were added, the assay procedure gave 98-100% recovery of AsA.

[Survival rate of 2636 patients with bronchogenic carcinoma].

2636 patients with bronchogenic carcinoma treated by resection are analyzed. The 5- and 10-year survival rates were 40.6% and 29.8%, respectively. The main factors influencing the survival rates are: 1. Pathology stage: The 5-year survival rates of stages I, II, and III were 58.3%, 33.6% and 26.4% and 10-year survival rates were 44.6%, 23.8% and 17.8%, respectively while in stage III, the 5-year survival rate of T3N0M0 was much better than that of N2 group, 43.2% and 16.7%; 2. Histology type: Squamous type had the best 5-year survival rate (47.9%) and adenocarcinoma worse (35.7%). Though the 5-year survival rate of small cell lung cancer was the lowest (21.2%), it was twice as high as the group treated by surgery only which was reported in 1979. We consider that it is due to the beneficial effect of chemotherapy instituted with surgery since 1976 3. The prognosis of specimens with negative stump was better than those with positive ones. There are no obvious differences in the prognosis affected by other factors such as age, sex, smoking history, time of diagnosis, central or peripheral type, preoperative radiotherapy or the extent of surgery.

Surgery for cure followed by combined modality treatment for small cell bronchial carcinoma. ISC Lung Cancer Study Group.

For patients with small cell lung cancer (SCLC) at early stages (TNM I, II) surgery for cure is used to eliminate the primary tumour and its regional lymph-nodes followed by intermittent chemotherapy and radiotherapy within the first six postoperative months. After the pathohistological examination of the operation-specimen a two-arm-randomization is performed: standard chemotherapy compared with sequential chemotherapy using three different drug-combinations. Thereafter tumour-free patients only receive prophylactic cranial irradiation. In preliminary evaluations of March 1988, of 121 patients from 20 cooperating departments it was found that the projected life-table survival rate, three years postoperatively, of 47 patients with SCLC at stages pT1-3 N0 M0 was 65%, of 46 patients at stages pT1-3 N1 M0, 56% and of 28 patients at stages pT1-3 N2 M0, 34%. The indication for surgery were emphasized for pTNM-stages I+II. For N2-lesions surgery would not be recommended in general, but the survival rate seemed to indicate that this treatment was not detrimental, but rather more favourable compared with chemotherapy or radiotherapy only. The continuation and enlargement of these studies seem not only justified but emphatically indicated. Multicentre cooperation has to be organized to collect within a reasonable period of time a sufficient number of patients to enable subdivisions to be made according to various prognostic factors.

Lung cancer and prior tuberculosis infection in Shanghai.

In a population-based case-control study of lung cancer in Shanghai involving interviews during 1984-86 with 1,405 cancer patients and 1,495 controls, a significant 50% elevation in the risk of lung cancer, adjusted for cigarette smoking, was observed among persons who had a history of tuberculosis. Among those diagnosed with tuberculosis within the past 20 years, the risk exceeded 2.5-fold. In males the lung cancers tended to occur on the same side as the previous tuberculosis infection. For both sexes, the effect of recent tuberculosis was most apparent for adenocarcinoma and peripheral tumours. No relationship was found between lung cancer risk and the type of tuberculosis therapy, including use of isoniazid. The findings suggest that tuberculosis may predispose to lung cancer, with the association most apparent among recent survivors of the infection.

[CMC chemotherapy regimen combined with surgery of small cell lung cancer (SCLC)].

From Dec. 1982 to Oct. 1984, 35 patients with SCLC proved by pathology or cytology, were treated by cyclophosphamide + methotrexate + CCNU (CMC) regimen combined with surgery in our hospital. All the patients received chemotherapy for more than 2 courses and the overall response rate was 85.7%, complete remission (CR) rate was 14.3%. Toxic reactions were tolerable to the patients. Treatment result was better in SCLC with localized than extensive disease. Operation was done for 9 out of 21 patients with localized lesions which had responded to chemotherapy. Of them, 1 died of postoperative complication, 2 were lost in follow-up and the rest 6 were disease-free for 8-32 months with a median survival time of 19 months. The 1 year survival rate was 75%. The results indicate that in limited disease of SCLC, successful chemotherapy combined with surgery can prolong the survival time. For patients with an limited disease which has given a CR, surgical resection should be strived for.