[Single-center study of different treatment for advanced or unresectable angiosarcoma patients].

Objective: To evaluate the efficacy and safety of different medical treatment in advanced or unresectable angiosarcoma. Methods: This study was a single-center retrospective clinical study. Fifty-five advanced or unresectable angiosarcoma patients treated in Sun-Yat Sen University Cancer Center from January 2005 to August 2020 were enrolled. There were 34 patients who received first-line doxorubicin-based chemotherapy (doxorubicin group), 12 patients received first-line doxorubicin or liposome doxorubicin plus paclitaxel or albumin bound paclitaxel chemotherapy (combination therapy group), and 4 patients received first-line paclitaxel-based treatment (paclitaxel group). There were 6 patients who received anti-angiogenesis targeted therapy, another 2 patients received anti-PD-1 antibody plus anti-angiogenesis targeted therapy. Targeted therapy and immunotherapy plus targeted therapy included 5 cases of first-line therapy and 3 cases of second-line therapy. The therapeutic effect was evaluated by RECIST 1.1 standard. The adverse reactions were evaluated by CTCAE4.0 standard. Kaplan-Meier survival analysis was evaluated with Log rank test. Cox proportional hazard model was used to analyze the influencing factors. Results: There were 18 patients achieved partial response (PR) in 34 patients in the doxorubicin group, median progression-free survival (mPFS) was 4.5 months, and median overall survival (mOS) was 15 months. Four patients achieved PR in 12 patients in the combination therapy group, mPFS and mOS were 4 months and 19 months. Two patients achieved PR in 4 patients in the paclitaxel group, mPFS and mOS were 3 months and 9 months. However, only 1 in 6 patients achieved PR for anti-angiogenesis targeted therapy, mPFS and mOS were 3 months and 16 months. Two patients who received anti-PD-1 immunotherapy combined with anti-angiogenesis targeted therapy acquired PR for 17 months and more than 16 months. Median PFS (7.5 months) were longer in those with primary liver, lung and spleen angiosarcoma than in those with other primary site (3.0 months, P=0.028). The mOS (20 months) was longer in females than that in males (12 months, P=0.045). Primary tumor site, sex, age and treatment were not independent prognostic factors for angiosarcoma patients (P>0.05). Grade 3-4 cardiac toxicity was found in 2 patients in the combination therapy group. Conclusions: Doxorubicin-based and paclitaxel-based chemotherapy are the most important treatment for advanced angiosarcoma. Potential efficacy for targeted therapy combined with anti-PD-1 immunotherapy are showed in some patients with long duration of response and moderate adverse event.

Studies on an outbreak of neonatal diarrhea caused by EPEC 0127:H6 with plasmid analysis restriction analysis and outer membrane protein determination.

An outbreak of enteropathogenic Escherichia coli (EPEC) 0127:H6 diarrhea occurred at two nurseries for the newborn in Chongqing in May 1987. Sixty-nine neonates had diarrhea; two deaths resulted. The epidemic strains, carrying 1.5 and 60 Md plasmid DNA, had an identical restriction digest profile and the same outer membrane protein pattern and could produce localized adherence to HeLa, HEp-2 and FL cells. The rates of contamination with EPEC 0127:H6 on medical staff's hands in these two nurseries were 11.8% and 8.7%, respectively, whereas 85 samples from milk, air and other sources were all negative for EPEC. The source of infection was the index case's mother who had had watery stools. Transmission of EPEC 0127:H6 from infant to infant took place by way of the fecal-oral route, most likely via the hands of medical staff attending their care. We present the first case, confirmed by plasmid and restriction analyses and outer membrane protein determination, of a neonate who acquired EPEC during delivery through ingestion of organisms residing in the maternal birth canal.

Studies on adherence and outer membrane protein of enteropathogenic Escherichia coli 0127: H6 and their related plasmids.

The following characteristics were found in 20 epidemic strains of enteropathogenic Escherichia coli (EPEC) 0127: H6 isolated from an outbreak of neonatal diarrhea: 1) Absent Vero toxin production; 2) No potential for invasiveness; 3) Possession of 1.5 and 60 Md plasmid identical restriction digest and outer membrane protein (OMP) patterns; 4) Ability of localized adherence to HEp-2, HeLa and FL cells; 5) Capability to cause diarrhea in rabbits with destruction of the ileal microvilli at the areas of bacterial adherence. After elimination of the 60 Md plasmid from EPEC 0127: H6 the 45 and 82 Kd OMPs of the parent strain were lost. These plasmid-cured strains became non-adherent to HEp-2, HeLa and FL cells, and unable to cause diarrhea in rabbits. These results suggest that the pathogenic mechanism of EPEC 0127: H6 induced diarrhea may be related to the genes on a 60 Md plasmid expressed as 45 and 82 Kd OMPs which cause localized adherence to epithelial cells and destruction of ileal microvilli. This damage leads to a marked reduction in absorptive surface area, resulting in diarrhea.