Objective To investigate the incidence of hepatocellular carcinoma (HCC) among patients with esophageal varices bleeding previously treated with endoscopic sclerotherapy, and to evaluate the factors influencing prognosis of HCC patients.Methods The clinical data of patients (from April 1987 to May 2003) who had received sclerotherapy for esophageal varices bleeding, and also that of HCC patients who had had sclerotherapy for esophageal varices bleeding were retrospectively reviewed. The survival rates of HCC patients were evaluated with Wilcoxon-Gehan method. Sixteen risk factors for HCC were assessed by multivariate analysis (Cox model). Results A total of 934 cases were treated with sclerotherapy, among which 109 patients suffered from HCC while 825 patients did not. In 22 HCC patients with esophageal varices bleeding sclerotherapy was not given. 31 out of 825 patients (3.76%) developed HCC during the follow-up period. 17 out of 31 patients received regular follow-up while 14 cases did not. The median surviving time of 31 patients was 13 months. The survival rate of patients with HCC under regular follow-up was significantly higher than that of patients under irregular follow-up(P=0.0002); risk factors, i.e. Child-Pugh classification, age and regular or irregular follow-up, were significantly related to the prognosis of patients with HCC(P=0.039、0.029 and 0.021, respectively). Conclusion Surveillance of patients with decompensated liver cirrhosis may increase the diagnostic rate of small HCC and prolong life expectancy; sclerotherapy can lower the incidence of HCC and it may play an active role in decreasing the incidence of HCC.

Adults-onset nesidioblastosis,as a differential diagnosis of organic hyperinsulinemic hypoglycemia,is very rare and has been recognised as "noninsulinoma pancreatogenous hypoglycaemia syndrome(NIPHS)".Here we described an extremely rare case of NIPHS in an eldly type 2 diabetes mellitus with insulin therapy.A 84-year old male was diagnosed as type 2 diabetes six years ago and switched from an oral hypoglycemic drug to pro-mixed insulin treatment 3 years ago.According to medical records,he had good-glucose control over few hypoglycemia.He was admitted to hospital due to frequent fasting hypoglycaemic episodes and comas despite withdrawal of any anti-diabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin/C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinemic hypoglycemia with high C-peptide level was consistent with the possible diagnosis of insulinoma,but localizing studies including computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% distal pancreatectomy was performed.Histological examination of the resected pancrease revealed an increased number and size of islets consistent with nesidioblastosis.After transient decline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglycemia was mild and controlled by regular night eating postpancreaectomy.Abstract:SUMM ARY Adults-onset nesid ioblastosis,as a d ifferential d iagnosis of organic hyperinsulinem ic hypo-glycem ia,is very rare and has been recognised as"noninsulinoma pancreatogenous hypoglycaem ia syn-drome(NIPHS)".Here we described an extremely rare case ofNIPHS in an eldly type 2 d iabetesmelli-tus with insulin therapy.A 84-year old male was d iagnosed as type 2 d iabetes six years ago and switched from an oral hypoglycem ic drug to pro-m ixed insulin treatment 3 years ago.Accord ing tomed ical records,he had good-glucose control over few hypoglycem ia.He was adm itted to hospital due to frequent fasting hypoglycaem ic episodes and comas despite withdrawal of any anti-d iabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin /C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinem ic hypoglycem ia with high C-peptide level was consistentwith the possible d iagnosis of insulinoma,but localizing stud ies includ ing computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% d istal pancreatectomy was performed.H istological exam ination of the resected pancre-ase revealed an increased number and size of islets consistent with nesid ioblastosis.After transient de-cline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglyce-m ia was m ild and controlled by regular night eating postpancreaectomy.

In this study, 5'-CMP was sulfonated, and then the modified 5'-CMP was connected to a protein carrier as an immunogen to immunize BALB/c mice. After cell hybridization, screening and recloning , a McAb (B10) with high sensitivity and specificity was selected. In a dot Hot using the McAb B10, less than 0.05 pg of sulfonated DNA could be detected while 10 ng of DNA was not coloured The result showed that the sensitivity of McAb B10 was higher than that of the McAb from "Chemiprobe" kit