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Background: It is still unclear whether viral genetic variability influences response to interferon (IFN)-alpha treatment. Recent reports suggest that IFN-alpha effects may be associated with hepatitis B virus (HBV) post-transcriptional regulation. This study was designed to explore the heterogeneity of HBV post-transcriptional regulatory elements (HPRE) and the relationship between the diversity of HPRE and the response to IFN-alpha treatment., Methods: The HPRE sequences from 31 Chinese patients infected with HBV were determined by directly sequencing of polymerase chain reaction (PCR) product, and comparing them to those from Caucasian patients. Subsequently, eukaryotic expression vectors containing HPRE at various points were constructed and transfected into HepG2 cells, which were then exposed to recombinant human cytokines., Results: The T to C point mutation at nt 1504 and the C to T (G) at nt 1508 in HPRE were found in 21 and 19 patients with chronic hepatitis B, respectively; the C to T point mutation at nt 1509 was found in 17 patients. These point mutations did not exist in the HPRE of the Caucasian patients. The activity of the CAT gene obviously increased in the case of T to C point mutation at nt 1504, but did not change in the case of the C to T (G) mutations at nt 1508 and 1509. The activity of the CAT gene at these point mutations of HPRE could be inhibited by IFN-alpha/gamma and tumor necrosis factor (TNF)-alpha except for the point mutations at nt 1508 of HPRE which may escape the suppression role of IFN-alpha on HPRE., Conclusions: There are point mutations between the HPRE of Chinese and Caucasian HBV patients, which might be correlated with response to IFN-alpha. The variation of HPRE might affect the function of HPRE and influence the regulative function of IFN-alpha other than that of IFN-gamma or TNF-alpha on HPRE.

Objective: To study the relation between the expression of p16 protein and Rb (retinoblastoma) protein and the transcription activity of nuclear factor-kappaB (NF-kappaB) and their roles in hepatocarcinogenesis., Methods: p16 protein and Rb protein in 35 hepatocellular carcinoma (HCC) tissues and the peritumoral areas (more than 3 cm away from the tumor) were examined by Western blot analysis. The transcription activity of NF-kappaB in these tissues was detected by electrophoretic mobility shift assays (EMSA) and super-shift assays., Results: The expression rates of p16 protein in the HCC tissues and peritumoral areas were 37% (13/35) and 48% (17/35) respectively (P < 0.01). The expression rates of Rb protein in the HCC tissues and peritumoral areas were 34% (12/35) and 74% (26/35) respectively (P < 0.01). The emergence rates of NF-kappaB with transcription activity in the HCC tissues and peritumoral areas were 77% (27/35) and 85% (30/35) respectively (P > 0.05). Four out of the 10 (40%) HCC tissues expressing p16 protein and Rb protein simultaneously turned up NF-kappaB with transcription activity, while 18 out of the 20 (90%) HCC tissues not expressing both p16 and Rb proteins turned up NF-kappaB with transcription activity (P < 0.05). 13 out of the 17 (76%) peritumoral areas expressing two kinds of proteins simultaneously turned up NF-kappaB with transcription activity and the emergence rate of NF-kappaB with transcription activity in the peritumoral areas not expressing the two kinds of proteins was 89% (8/9) (P > 0.05)., Conclusion: Dysfunction of p16 is the early event of hepatocarcinogenesis and dysfunction of Rb is the later event in this course. There is a positive correlation between p16 protein and Rb protein in HCC tissues. The loss of expression of p16 and Rb proteins plays important roles in the carcinogenesis and progression of HCC by affecting NF-kappaB transcription activity which may prevent hepocyctes from apoptosis, besides disturbing cell cycle.

Objective: To introduce the procedure of carotid stenting, and to summary experiences of 55 cases. To study the theory and clinical significance of carotid stenting for carotid artery stenosis., Methods: Fifty-five patients with severe carotid atheromatous stenoses were treated by stent implantation. Fifty-eight stents were implanted. Forty-one of these stents were Wallstent, 14 were Smart stents and 3 were OptiMed stents. Cerebral protection device was furnished for 18 patients., Results: During operation, there were 2 cases of small stroke and 2 cases of major stroke. One patient suffered from left eye area deficit, who had a little signs after 3 months. Another patient had consciousness loss and right-side paralysis and had a recovery in consciousness after salvage. The incidence of nervous system complications was 6.9%. Serious stroke rate was 3.5%. The incidence of circulatory system complications was 10.3%. Those patients who received cerebral protection device did not have nervous complication., Conclusion: Carotid stenting is effective for the treatment of carotid artery stenosis. The experienced surgeon can make this procedure safe. The procedure's safety is enhanced by using cerebral protection device.

Objective: To evaluate the clinical efficacy of fasciocutaneous flap in the repair of the III degree burn wound in the facio-cervical region., Methods: From January 1997 to October 2001, 11 cases of III degree burn wounds in the facio-cervical region were repaired with the cervical-thoracic fasciocutaneous flap ranging from 18 cm x 8 cm to 13 cm x 5 cm. Donor sites were covered with "Z" plasty or skin grafting., Results: Except for partial necrosis of distal end of the flap in 1 case, the flaps in the other 10 cases all survived and presented satisfactory appearance and function during the following up., Conclusion: The fasciocutaneous flap in the cervical-thoracic region may provide a large area of flap, and can be easily transferred. It's an ideal flap for the repair of skin defect in the facio-cervical region, especially for the repair of the wounds with infection or exposure of vessel, nerve and tendon.

Objective: To screen the differential points related with response to interferon-alpha in HBV post-transcriptional regulatory element (HPRE)., Methods: HPRE sequence of 31 Chinese patients with HBV infection were detected by direct sequencing of PCR products. Differential points in HPRE between Chinese patients and White patients were compared., Results: The T to C differential point at nt 1 504 and C to T(G) at nt 1 508 were found respectively in HPRE of 21 and 19 patients with chronic hepatitis B, the C to T differential point at nt 1 509 were found in 17 cases. These differential points were not found in HPRE of the White patients. The relationship between the HPRE differential points and the levels of HBV DNA was not observed., Conclusion: There were differential points in the HPRE between Chinese and White HBV patients, which might be correlated with response to interferon-alpha.