[Long-term results of multimodality treatment in patients with primary liver cancer]

This paper report the long-term results of multimodality treatment in 2388 patients with pathologically proven primary liver cancer (PLC) over the last three decades. The 5-and 10-year survival after resection of PLC was 39.3% and 29.2% respectively for the whole series (n = 1650), and 61.9% and 45.4% respectively for patients with small PLC (< or = 5 cm, n = 569). The 5-year survival after cryosurgery was 37.9% for the whole series (n = 191), and 53.1% for patients with small PLC (n = 56). The 5-year survival of 71 patients receiving sequential resection after cytoreduction therapy was 66.0%. The 5-year survival after re-resection for recurrence tumor (n = 147) was 34.5%. 214 patients survived more than 5 years; of these 113 patients (52.8%) were small PLC, and 57 patients survived more than 10 rears. It is concluded that early detection and resection of small PLC is the leading approach to get long-term survivors, cytoreduction and sequential resection might be an important approach to improving the prognosis of patients with unresectable PLC, re-resection for subclinical recurrance and metastasis after an initial curative resection was also important to prolong survival further.

[Analysis of cell origin of human hepatocellular carcinoma according to p53 gene mutation]

Paraffin-embedded hepatocellular carcinoma (HCC) samples were used to study point mutation of p53 gene at 249 codon in the exon 7 by polymerase chain reaction and gel electrophoresis under Hae III enzyme digestion. Fourteen primary tumor foci and 15 recurrent tumor foci from 11 patients were investigated. p53 gene point mutation was detected in 10 of 14 primary foci (71.4%), in 10 of 15 recurrent foci (66.7%) and in 10 of 12 multiple foci. The p53 genotype of the primary and recurrent tumor foci was the same in 5 patients but different in 6. The p53 genotype of the primary and recurrent tumor foci was identical in 5 patients with multiple tumor nodules. The results suggest that recurrent HCC was multi-centric in origin in 7 of the 11 patients but was mono-centric in the other 4 patients studied.

[The effect of antisense H-ras on growth and metastasis of a high metastatic tumor model of human hepatoma in nude mice LCI-D20]

OBJECTIVE

To investigate if treatment with antisense H-ras oligodeoxynucleotides (ODNs) modulates tumor growth, apoptosis and metastasis of a high metastatic tumor model of human hepatocellular carcinoma (HCC) in nude mice LCI-D20, in which over-expression of H-ras has been identified.

METHODS

LCI-D20 cells in primary culture were treated with 10 mumol/L antisense ODNs in vitro. 1.5 x 10(6) LCI-D20 cells with or without pretreatment were inoculated into each elevated subcutaneous (s.c) flap in fourteen nude mice, 6 animals for antisense H-ras ODN treated cells, 4 for H-ras non-specific antisense ODN treated cells, the rest 4 for cells without pretreatment.

RESULTS

In in vitro cell culture study, 5-day continuous suppression of H-ras expression by antisense H-ras ODNs resulted in significant inhibition of the proliferation of LCI-D20 cells (t = 31.529, P < 0.01). Cell cycle analysis showed a significant decrease in S phase (36.0 +/- 1.4) and a remarkable increase in G1/G0 fraction (56.7 +/- 1.1) after exposure to antisense H-ras ODNs in comparison with the cells without any treatment (58.5 +/- 0.9, t = 13.519, P < 0.01, 37.4 +/- 0.7, t = 14.802, P < 0.01). In situ end-labeling (ISEL) detection showed that apoptotic cell death was significantly increased in cells with 5-day treatment of antisense H-ras ODNs (34.0% +/- 4.5%) in comparing with cells without treatment (2.5% +/- 1.2%, t = 13. 434, P < 0.01) or treated with non-specific antisense ODNs (4.8% +/- 1.4%, t = 12.453, P < 0.01) at the corresponding time. In in vivo experiment, after six-week observation, tumor growth in antisense H-ras treated animals was significantly retarded in comparison with that of the untreated (t = 3.509, P < 0.01) or nonspecific antisense ODN treated animals (t = 3.452, P < 0.01).

CONCLUSIONS

Specific inhibition of H-ras expression by antisense H-ras ODNs could not only induce apoptotic cell death, inhibit the growth rate of LCI-D20 cells in vitro and in vivo, but also alter in vivo tumorigenesity and metastatic potential of LCI-D20 cells.

[Prognostic factors of primary liver cancer]

To investigate the prognostic factors of primary liver cancer (PLC) and improve the long-term results, 1,248 cases of PLC were analysed. Univariate analysis demonstrated that discovery approach, staging of PLC, original gamma-GPT, resection, radical resection, original AFP, tumor size, tumor number, and tumor capsule have very significant effects on prognosis of PLC (all P < 0.001); cirrhosis, HBsAg, local resection, and tumor embolus in portal vein were also significant difference (all P < 0.05); age, sex, original AFP, hepatitis, and differentiation of PLC cells were no significant difference (all P > 0.05). Multivariate analysis demonstrated that original gamma-GPT, radical resection, tumor size, and tumor number were the most significant prognostic factors (all P < 0.001). Some aspects improving long-term survival were discussed.

Kinamycin acetyltransferase I from Streptomyces murayamaensis, an apparently large, membrane-associated enzyme

Identification and initial characterization of an apparently large, membrane-associated multifunctional enzyme, kinamycin acetyltransferase I (KAT I), is described. KAT I activity was enriched 29-fold over the level in cell-free extracts of Streptomyces murayamaensis. Two acetyltransferase activities catalyzing acetyl coenzyme A dependent conversion of kinamycin F and E to kinamycin E and D, respectively, were inseparable in the course of the partial purification. Partial purification involved separation of KAT I from cytosolic proteins by differential ultracentrifugation, solubilization with 0.5% CHAPS zwitterionic detergent followed by ultracentrifugation, and Sephacryl S400 gel filtration chromatography of the resulting supernatant.

Expression of caveolin-3 in skeletal, cardiac, and smooth muscle cells. Caveolin-3 is a component of the sarcolemma and co-fractionates with dystrophin and dystrophin-associated glycoproteins

Caveolae are microdomains of the plasma membrane that have been implicated in signal transduction. Caveolin, a 21-24-kDa integral membrane protein, is a principal component of the caveolae membrane. Recently, we and others have identified a family of caveolin-related proteins; caveolin has been retermed caveolin-1. Caveolin-3 is most closely related to caveolin-1, but caveolin-3 mRNA is expressed only in muscle tissue types. Here, we examine (i) the expression of caveolin-3 protein in muscle tissue types and (ii) its localization within skeletal muscle fibers by immunofluorescence microscopy and subcellular fractionation. For this purpose, we generated a novel monoclonal antibody (mAb) probe that recognizes the unique N-terminal region of caveolin-3, but not other members of the caveolin gene family. A survey of tissues and muscle cell types by Western blot analysis reveals that the caveolin-3 protein is selectively expressed only in heart and skeletal muscle tissues, cardiac myocytes, and smooth muscle cells. Immunolocalization of caveolin-3 in skeletal muscle fibers demonstrates that caveolin-3 is localized to the sarcolemma (muscle cell plasma membrane) and coincides with the distribution of another muscle-specific plasma membrane marker protein, dystrophin. In addition, caveolin-3 protein expression is dramatically induced during the differentiation of C2C12 skeletal myoblasts in culture. Using differentiated C2C12 skeletal myoblasts as a model system, we observe that caveolin-3 co-fractionates with cytoplasmic signaling molecules (G-proteins and Src-like kinases) and members of the dystrophin complex (dystrophin, alpha-sarcoglycan, and beta-dystroglycan), but is clearly separated from the bulk of cellular proteins. Caveolin-3 co-immunoprecipitates with antibodies directed against dystrophin, suggesting that they are physically associated as a discrete complex. These results are consistent with previous immunoelectron microscopic studies demonstrating that dystrophin is localized to plasma membrane caveolae in smooth muscle cells.

[Quality standard of tanre kesou granules]

A TLC method was used in the identification of the following chemical consitituents of medicinal herbs in Tanre Kesou Granules: Radix Scutellariae, Bulbus Fritillariae Thunbergii, Pericarpium Citri Reticulatae and Fructus Aurantii Immaturus. The sample was purified through acidification with hydrochloric acid and extraction with ethyl acetatethe. The contents of baicalin in the preparation and Radix Scutellariae were determined by means of HPLC and TLC-densitometry. These methods fit for quality control of the preparation containing baicalin.

[Changing prognosis of primary liver cancer: some aspects to improve long-term survival]

The authors reported the changing prognosis of primary liver cancer (PLC) during the last three decades and the factors improving long-term results. Two thousand three hundred and eighty eight pathologically proven PLC cases were analyzed. Of them, 569 cases (23.8%) were small-sized PLC (< or = 5 cm in diameter). Hepatic resection was performed in 1,650 cases (69.1%) and local resection was done in 1,202 of the 1,650 (72.8%). Follow-up study was carried out every 2-3 months during the first 2 years after resection and every 6 months thereafter. For some unresectable huge PLC, cytoreduction and subsequent resection were performed. Five-year survival rate was 4.8% in 1958-1970 (n = 187), 11.2% in 1971-1982 (n = 582), and 45.7% in 1983-1994 (n = 1,628), respectively. Re-resection of subclinical recurrence was performed in 147 cases. Cytoreduction and subsequent resection were carried out in 71 cases. It is concluded that markedly changing prognosis of PLC was observed; factors improving long-term survival included (1) early detection and radical resection, (2) local resection instead of lobectomy, (3) re-resection for subclinical recurrence, and (4) cytoreduction and subsequent resection for otherwise unresectable PLC.

[Application of radiolabeled anti-HBx monoclonal antibody for HCC targeting therapy]

OBJECTIVE

To explore the possibility of anti-HBx McAb as a carrier of HCC targeting therapy after we prepared successfully the anti-HBx monoclonal antibody by immunizing BALB/C mice with 17KD hepatitis B virus X protein.

METHODS

The antibody was prepared, purified, identified, radiolabled and used in nude mice bearing human HCC and two HCC patients respectively for experimental and clinical trials. In the experimental study, 0.5mCi 131I-anti-HBx was injected peritoneally. In the clinical trial, the patients were treated with 131I-anti-HBx by injecting into the hepatic artery. After the treatment for one course, a total dose of 37.5 mCi was administered.

RESULTS

The survival periods of the mice were prolonged and the tumors were suppressed significantly. The symptoms of the patients were improved significantly with decreased titre of AFP. The B-ultrasonic and CT scanning showed that the tumors became smaller. For these reasons, one of the two patients was reoperated. The tumor was removed and necrosis of the whole tumor was noted except few living tumor cells on the edge of tumor specimen.

CONCLUSIONS

It is possible to use the anti-HBx monoclonal antibody as a carrier for human HCC targeting therapy.

[Detection and significance of HCV RNA in saliva, seminal fluid and vaginal discharge in patients with hepatitis C]

To investigate the transmission of HCV infection through family contact, we detected HCV RNS in body fluids (saliva, seminal and vaginal discharge) of 16 serum HCV RNA positive patients (including 7 men and 9 women) and in sera of their family members. The positive rates of HCV RNA in the body fluids were 31.25% (5/16) in saliva, 57.14% (4/17) in seminal fluid and 22.22% (2/9) in vaginal discharge, respectively. Among the family members in our series, all were negative for both anti-HCV and HCV RNA, despite two spouses positive for HCV RNA. This result strongly suggested the potential possibility of the transmission of HCV infection through the family contact.

[Highly metastatic model of human hepatocellular carcinoma established in nude mice using orthotopic organ selection of metastatic variant from patient specimens]

We succeeded in establishing a highly metastatic model of human hepatocellular carcinoma (HCC) in athymic nude mice (LCI-D20). The metastatic variant was obtained by using orthotopic implantation of histologically intact tumor tissue selected from 30 fresh surgical specimens. It exhibited various features seen in clinical liver cancer patients: local growth, regional invasion, spontaneous intrahepatic, lymphnode and pulmonary metastases, and peritoneal seeding with bloody ascites. All mice with the implant-tumor died within 6 weeks due to serious metastasis. The 100% rate of transplantability and metastasis maintained for over 16 passages. The morphological characteristics of implant tumor cells were similar to those of the original specimen by histological and electronmicroscopic observation, and kept on secreting alpha-fetoprotein (AFP) in recipient animals. Those data from DNA content analysis by flow cytometry (D. I. value, 1.61) and chromosome karyotype revealed the existence of hypotriploid and hypertriploid cells. The results demonstrated that orthotopic implantation model of human HCC displayed features of human clinical HCC in animals. It should allow development of new treatment modalities and study of metastatic mechanism of human HCC.

Dietary fiber and the chemopreventive modelation of colon carcinogenesis

Comparative international epidemiological data indicate that the difference between the highest and lowest colon cancer incidence is approximately 10-fold. This suggests that the dominant causes of colon cancer are environmental rather than genetic in origin, with the dominant environmental cause being the typical diet of Western industrialized countries. Many epidemiological and experimental studies have suggested an important role for dietary fiber in the prevention of colon cancer. Using the Fischer-344 rat as the experimental model, data clearly demonstrate a strong protective effect of a diet that is low in fat, high in fiber and high in calcium (low-risk diet). Such a diet prevents the development of both preneoplastic aberrant crypt foci (ACF) and colon tumors. Recent experiments have also demonstrated a direct relationship between a ras point mutation in ACF at different stages of rat colon carcinogenesis, and a ras point mutation that is subsequently present in colon tumors. Using wheat bran as the model dietary fiber source, its effects were compared to the effects of psyllium, phytic acid, vitamin E, beta-carotene, folic acid, alone or in combination, for their ability to prevent colon cancer in rats on high-risk Western-style diets. Our studies clearly demonstrated the ability of wheat bran to reduce ACF and colon tumors in rats that consumed high-fat, Western-style diets. Although phytic acid, which is a constituent of wheat bran, alone demonstrated strong cancer-preventive potential, our experiments provided evidence for the cancer-preventive effect of the crude fiber fraction that is independent of the effect of phytic acid. The synergistic combination of wheat bran with the soluble fiber psyllium led to enhanced protection; while the combination of wheat bran with beta-carotene showed only an additive effect. Beta-carotene appeared to show higher protection than wheat bran at an intake level that is nutritionally relevant to humans, suggesting the possibility of using beta-carotene to enhance the effects of dietary fiber in high-risk Western populations. Using ACF as an intermediate endpoint, it was also shown that vitamin E and beta-carotene appear to inhibit progression of ACF to colon cancer, while wheat bran and folic acid appeared to have weak cancer-preventive potential at this late stage of carcinogenesis. In conclusion, wheat bran alone, or in combination with psyllium, appears to have greater potential to inhibit earlier phases of carcinogenesis, while beta-carotene and vitamin E may also inhibit later stages of carcinogenesis. Despite considerable epidemiological and experimental evidence that increasing the fiber and lowering the fat content of the Western diet could substantially reduce the risk of cancer and heart disease, the real challenge is to find effective ways to educate and motivate people to overcome their intrinsic cultural resistance to such changes in their eating habits.

Molecular cloning of caveolin-3, a novel member of the caveolin gene family expressed predominantly in muscle

Caveolin, a 21-24-kDa integral membrane protein, is a principal component of caveolar membranes in vivo. Caveolin interacts directly with heterotrimeric G-proteins and can functionally regulate their activity. Recently, a second caveolin gene has been identified and termed caveolin-2. Here, we report the molecular cloning and expression of a third member of the caveolin gene gamily, caveolin-3. Caveolin-3 is most closely related to caveolin-1 based on protein sequence homology; caveolin-1 and caveolin-3 are approximately 65% identical and approximately 85% similar. A single stretch of eight amino acids (FED-VIAEP) is identical in caveolin-1, -2, and -3. This conserved region may represent a "caveolin signature sequence" that is characteristic of members of the caveolin gene family. Caveolin-3 mRNA is expressed predominantly in muscle tissue-types (skeletal muscle, diaphragm, and heart) and is selectively induced during the differentiation of skeletal C2C12 myoblasts in culture. In many respects, caveolin-3 is similar to caveolin-1: (i) caveolin-3 migrates in velocity gradients as a high molecular mass complex; (ii) caveolin-3 colocalizes with caveolin-1 by immunofluorescence microscopy and cell fractionation studies; and (iii) a caveolin-3-derived polypeptide functionally suppresses the basal GTPase activity of purified heterotrimeric G-proteins. Identification of a muscle-specific member of the caveolin gene family may have implications for understanding the role of caveolin in different muscle cell types (smooth, cardiac, and skeletal) as previous morphological studies have demonstrated that caveolae are abundant in these cells. Our results also suggest that other as yet unknown caveolin family members are likely to exist and may be expressed in a regulated or tissue-specific fashion.

Developmental pattern of expression and genomic organization of the calponin-h1 gene. A contractile smooth muscle cell marker

Calponin-h1 is a 34-kDa myofibrillar thin filament, actin-binding protein that is expressed exclusively in smooth muscle cells (SMCs) in adult animals. To examine the molecular mechanisms that regulate SMC-specific gene expression, we have examined the temporal, spatial, and cell cycle-regulated patterns of expression of calponin-h1 gene expression and isolated and structurally characterized the murine calponin-h1 gene. Calponin-h1 mRNA is expressed exclusively in SMC-containing tissues in adult animals. During murine embryonic development, calponin-h1 gene expression is (i) detectable in E9.5 embryos in the dorsal aorta, cardiac outflow tract, and tubular heart, (ii) sequentially up-regulated in SMC-containing tissues, and (iii) down-regulated to non-detectable levels in the heart during late fetal development. In addition, the gene is expressed in resting rat aortic SMCs, but its expression is rapidly down-regulated when growth-arrested cells reenter phase G1 of the cell cycle and proliferate. Calponin-h1 is encoded by a 10.7-kilobase single copy gene composed of seven exons, which is part of a multigene family. Transient transfection analyses demonstrated that 1.5 kilobases of calponin-h1 5'-flanking sequence is sufficient to program high level transcription of a luciferase reporter gene in cultured primary rat aortic SMCs and the smooth muscle cell line, A7r5. Taken together, these data suggest that the calponin-h1 gene will serve as an excellent model system with which to examine the molecular mechanisms that regulate SMC lineage specification, differentiation, and phenotypic modulation.

[The first exploration of the properties and laws of mutation plastids transmitting with cell division]

Suppose there are m plastids in an initial cell, in which i plastids are mutated. In the this paper we discuss the probability that m mutated plastids are distributed in a cell simultaneously during in the process of mutant plastids dividing and randomly distributing with cell division. Let x(t) = 1 denote the stochastic event that a cell contains only mutant plastids in t-th division and x(t) = 0 denote the opposite event. We may find some properties of the stochastic process ¿x(t), t epsilon T¿ demonstrating that the process is a Markov chain. Finally we can obtain the matrixes of transition probability between homogeneous heterogeneous plastids, this reveals some laws of mutant plastids transmitting with cell division.

Effects of the PGI2 analog beraprost sodium on glomerular prostanoid synthesis in rats with streptozotocin-induced diabetes

A study of albuminuria, creatinine clearance (CCr) and blood pressure of streptozotocin (STZ)-induced diabetic rats with or without treatment by a prostacyclin (PGI2) analog, beraprost sodium (BPS), is described. Glomerular prostanoid synthesis was measured by gas chromatography (GC) mass spectrometry. Renal specimens stained with hematoxylin and eosin and periodic acid-Schiff were examined by light microscopy. Mean values of albuminuria in BPS-treated diabetic rats were significantly decreased compared with those in nontreated diabetic rats. The ratio of kidney to body weight in the BPS-treated diabetic rats was significantly lower than that in the nontreated diabetic rats. Levels of CCr and blood pressure were decreased in diabetic rats after the treatment with BPS. GC mass spectrometry showed that BPS did not influence the glomerular synthesis of PGI2 and TXB2. No histologic injury in the renal tissues was observed in the diabetic rats with or without BPS treatment. We concluded that BPS (PGI2 analog) might decrease the levels of urinary albumin excretion and CCr due to its vasodilating effects in the early phase of STZ-induced diabetes in rats.

[Growth pattern and metastatic behaviour of orthotopically metastatic model of human hepatocellular carcinoma in nude mice]

Growth pattern, metastatic behaviour and serial alph-a-fetoprotein (AFP) level of highly metastatic model of human hepatocellular carcinoma in nude mice (LCI-D20), which constructed by using orthotopic implantation of histologically intact patient specimens, were studied by implanting into the liver, subcutis and peritoneum of nude mice. Pathologic (by light and electronmicroscopic examination) and biologic (chromosome karyotype and DNA contents by flow cytometry) characteristics of LCI-D20 were also observed. The results showed that transplantability of LCI-D20 was 100% in 12 generations (passage time: 20 days) and all of these mice implanted tumors died within 40 days after transplantation due to serious metastasis. After LCI-D20 implanted into the liver of nude mice, growing implant-tumors in progress were negatively related to their double time during animal survival. LCI-D20 maintained 100% (70/70) metastatic rate in nude mice that showed early intrahepatic metastasis and late lymphatic and pulmonary metastasis. The high metastatic potentials of LCI-D20 tumor cells were kept in subcutis and peritoneum (70%, 100% respectively). The increase of the serial AFP secreting from the tumor cells was correlated with the implantation tumor growth rate (797.5 micrograms/L/5th week). The data from histological and electronmicroscopic findings, chromosome karyotype and DNA content analysis of the tumor cells revealed characteristics of human hepatocellular carcinoma. The results indicated that LCI-D20 exhibited the variety of clinical behaviours seen in hepatoma patients and it could be a useful model for investigating the metastasis mechanism of human hepatoma and anti-metastasis therapy.

[The relation between p53 mutations and tumor invasiveness of human hepatocellular carcinoma]

We have combined the polymerase chain reaction (PCR) with the HaeIII enzyme restriction analysis to study the mutations at codon 249 of p53 gene in L02 human liver cell line, Bel-7402, SMMC-7721 human hepatocellular carcinoma cell lines and 19 surgical specimens of hepatocellular carcinoma (HCC) and their surrounding non-cancer liver tissues. None of the three cell lines and the non-cancer liver tissues was found to have p53 mutation; but 10 of 19 HCC samples (52.6%) had p53 point mutations, and the p53 gene mutated more frequently in HCC with incomplete capsule, intrahepatic metastasis, or multiple nodules than in those with well encapsulated (70% vs 33.3%, P < 0.05), no intrahepatic metastasis (71.4% vs 41.6%, P < 0.05) and single nodule (83.3% vs 38.5%, P < 0.05). These suggested that the codon 249 was a mutational hotspot of the p53 gene in human HCC seen in China, and p53 mutations may be related to invasiveness of human HCC.

Oligomeric structure of caveolin: implications for caveolae membrane organization

A 22-kDa protein, caveolin, is localized to the cytoplasmic surface of plasma membrane specializations called caveolae. We have proposed that caveolin may function as a scaffolding protein to organize and concentrate signaling molecules within caveolae. Here, we show that caveolin interacts with itself to form homooligomers. Electron microscopic visualization of these purified caveolin homooligomers demonstrates that they appear as individual spherical particles. By using recombinant expression of caveolin as a glutathione S-transferase fusion protein, we have defined a region of caveolin's cytoplasmic N-terminal domain that mediates these caveolin-caveolin interactions. We suggest that caveolin homooligomers may function to concentrate caveolin-interacting molecules within caveolae. In this regard, it may be useful to think of caveolin homooligomers as "fishing lures" with multiple "hooks" or attachment sites for caveolin-interacting molecules.

Absence of p53 gene mutations in rat colon carcinomas induced by azoxymethane

The K-ras and p53 genes are two of the most frequently mutated genes found in the human colonic tumors. Since azoxymethane (AOM) induced rat colonic neoplasms are similar to human colonic tumors in their histological features and proliferation characteristics, the rat has been used as an experimental model to study the pathogenesis of colon cancer in humans. Although the presence of K-ras point mutations has been reported in AOM induced rat colonic tumors, there are no reports describing the frequency for mutation of the p53 gene in these tumors. In this study, colon adenocarcinomas induced in rats by AOM were examined for the presence of point mutations in exons 5-8 of the p53 gene, using a combination of single strand conformation (SSCP) analysis, immunohistochemistry and direct DNA sequencing. SSCP analysis showed no differences in banding patterns between the normal mucosa and any of the 20 adenocarcinomas analyzed. Nuclear p53 immunoreactivity was absent in all tumors examined. Since p53 point mutations predominate in malignant colonic tumors, five adenocarcinomas with the greatest local invasiveness were analyzed by direct DNA sequencing of exons 5-8 of the p53 gene. Direct DNA sequencing did not reveal mutations in any of the adenocarcinomas analyzed, within the coding region of p53 gene that were sequenced. The results from the present study indicate that point mutations in the p53 gene, at least in the coding region (exons 5-8) are not involved in the development of colon cancer induced by AOM in the rat.

[Clinical significance of fungi-bearing status of hospitalized patients]

The samples for fungi culture were collected from 11 body parts of 1109 patients who had been admitted to hospitals in Wuhan for more than 3 days. The body parts included the cavities and foramina (inner canthus, nasal vestibule, external auditory canal), skin (finger raphe, cubital fossa, axillary fossa, nipple), and mucosa (pharynx, vagina, coronary sulcus and anal canal). 201 healthy subjects were also examined and served as controls. It was found that the total fungus-bearing rate in hospitalized patients was 88.73% (984/1109), while the rate in healthy subject was 76.62% (154/201) (X2 = 21.61). Among the hospitalized patients, the fungus-bearing rate in patients with leukemia, tumors, connective tissue diseases or severe infectious diseases was significantly higher than other patients (X2 = 4.30-9.87). In the hospitalized patients, the body parts with highest fungus-bearing rates were cavities and foramina, 80.70% (895/1109) for patients and 71.64% (144/201) for healthy subjects respectively. The skin had lowest fungus-bearing rate. 20.02% (222/1109) and 13.43% (26/201), and the mucosa had a rate of 50.77% (563/1109) for patients and 32.34% (65/201) respectively. The fungi in the hospitalized patients included 1884 strains (mean = 1.92 strains per case) in which the Candida accounted for 29.78% (561/1884) and Aspergilla 24.31% (458/1884) and those identified in healthy subjects covered 234 strains (mean = 1.52 strains per person) in which Penicillia accounted for 45.30% (106/234) and Saccharomycetes 26.07% (61/234). The patients who had been hospitalized for 3-10 days and over 20 days had higher fungus-bearing rate as compared with those who had been hospitalized for 10 to 20 days (X2 = 5.633-97.09). The patients before the administration of antibiotics and adrenocortical steroid and those who had been given these medicines for over 20 days had a higher fungus-bearing rate than those who had been on these medicines for 1-20 days.