Clinical characteristics and short-term prognosis of 22 cases with SARS-CoV-2 infection associated acute encephalopathy / 中华儿科杂志

Objective: To investigate the clinical features and short-term prognosis of patients with SARS-CoV-2 infection associated acute encephalopathy (AE). Methods: Retrospective cohort study. The clinical data, radiological features and short-term follow-up of 22 cases diagnosed with SARS-CoV-2 infection associated AE in the Department of Neurology, Beijing Children's Hospital from December 2022 to January 2023 were retrospectively analyzed. The patients were divided into cytokine storm group, excitotoxic brain damage group and unclassified encephalopathy group according to the the clinicopathological features and the imaging features. The clinical characteristics of each group were analyzed descriptively. Patients were divided into good prognosis group (≤2 scores) and poor prognosis group (>2 scores) based on the modified Rankin scale (mRS) score of the last follow-up. Fisher exact test or Mann-Whitney U test was used to compare the two groups. Results: A total of 22 cases (12 females, 10 males) were included. The age of onset was 3.3 (1.7, 8.6) years. There were 11 cases (50%) with abnormal medical history, and 4 cases with abnormal family history. All the enrolled patients had fever as the initial clinical symptom, and 21 cases (95%) developed neurological symptoms within 24 hours after fever. The onset of neurological symptoms included convulsions (17 cases) and disturbance of consciousness (5 cases). There were 22 cases of encephalopathy, 20 cases of convulsions, 14 cases of speech disorders, 8 cases of involuntary movements and 3 cases of ataxia during the course of the disease. Clinical classification included 3 cases in the cytokine storm group, all with acute necrotizing encephalopathy (ANE); 9 cases in the excitotoxicity group, 8 cases with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and 1 case with hemiconvulsion-hemiplegia syndrome; and 10 cases of unclassified encephalopathy. Laboratory studies revealed elevated glutathione transaminase in 9 cases, elevated glutamic alanine transaminase in 4 cases, elevated blood glucose in 3 cases, and elevated D-dimer in 3 cases. Serum ferritin was elevated in 3 of 5 cases, serum and cerebrospinal fluid (CSF) neurofilament light chain protein was elevated in 5 of 9 cases, serum cytokines were elevated in 7 of 18 cases, and CSF cytokines were elevated in 7 of 8 cases. Cranial imaging abnormalities were noted in 18 cases, including bilateral symmetric lesions in 3 ANE cases and "bright tree appearance" in 8 AESD cases. All 22 cases received symptomatic treatment and immunotherapy (intravenous immunoglobulin or glucocorticosteroids), and 1 ANE patient received tocilizumab. The follow-up time was 50 (43, 53) d, and 10 patients had a good prognosis and 12 patients had a poor prognosis. No statistically significant differences were found between the two groups in terms of epidemiology, clinical manifestations, biochemical indices, and duration of illness to initiate immunotherapy (all P>0.05). Conclusions: SARS-CoV-2 infection is also a major cause of AE. AESD and ANE are the common AE syndromes. Therefore, it is crucial to identify AE patients with fever, convulsions, and impaired consciousness, and apply aggressive therapy as early as possible.

Analysis of rehabilitation effects of cochlear implantation in elderly patients with prelingual deafness / 临床耳鼻咽喉头颈外科杂志

Objective:The auditory and speech rehabilitation effects were assessed by the Categories of Auditory Performance（CAP） and the speech intelligibility rating scale（SIR） after cochlear implantation（CI） in prelingually elderly patients by telephone follow-up or face-to-face conversation. Methods:The clinical data of the prelingually deaf patients who underwent unilateral CI in the Department of Otorhinolaryngology and Head and Neck Surgery, Shanxi People's Hospital, from December 2016 to December 2021 were collected. Thirty-eight patients were divided into Group A（SIR 1, 17 cases）, Group B（SIR 2, 10 cases） and Group C（SIR 3, 11 cases） according to the preoperative SIR Score. Nineteen patients with post-lingual hearing impairment were selected as the control group（Group D, 19 cases）. The effects of hearing and speech rehabilitation were evaluated using CAP and SIR Scores before surgery, 6 months after startup, and 1 year after startup. Results:There were no significant differences in CAP scores among the three groups of patients with prelingually deaf patients at 6 months and 1 year after startup（P>0.05）, but there were significant differences between group A and group D at 6 months and 1 year after startup（P<0.05）; the SIR Score of group A had statistical difference before surgery and 6 months after startup（P<0.05）, group B had statistical difference before surgery and 1 year after startup（P<0.05）, and group C and D had no statistical difference before surgery and 6 months and 1 year after startup, respectively（P>0.05）. Conclusion:For the prelingually deaf elderly patients, hearing will develop rapidly 6 months after startup, and the effect of postoperative auditory rehabilitation was positively correlated with the preoperative speech ability. In the aspect of speech, the prelingually dear elderly patients who have poor preoperative speech ability could benefit more from CI early after surgery. CI is not contraindicated in prelingually deaf elderly patients, even those with poor preoperative speech function.

Sentinel surveillance on HIV status and related factors among men who have sex with men above 50 years in Taizhou Prefecture from 2010 to 2017 / 上海预防医学

[Objective] To investigate the HIV infection status and behavioral characteristics of men who have sex with men (MSM) over the age of 50 in Taizhou during 2010-2017 HIV sentinel surveillance, analyze the related factors of HIV infection, and provide basis for developing targeted intervention strategies. [Methods] HIV sentinel surveillance data from 2010 to 2017 in Taizhou was used to analyze the demographic characteristics, HIV awareness, and sexual behaviors of MSM over the age of 50. Also, HIV infection status and related factors were analyzed by multivariate regression analysis. [Results]A total of 334 MSM aged over 50 were surveyed by HIV sentinel surveillance in 2010-2017, and the HIV positive rate was 14.1％. The average age of the 334 MSM was (59.6 ± 7.2) years, and those with junior high school education and below accounted for 76.0％, with awareness of AIDS knowledge being 85.6％. And78.7％ of them had anal sex with men in the past 6 months. Among them, 30.4％ used condoms each time. And 4.8％ of them had commercial sex with men and 37.1％ had sex with women in the past 6months. Multivariate analysis showed that syphilis-positiveness was a risk factor for HIV infection and awareness of HIV-related knowledge proved to be a protective factor for HIV infection. [Conclusion] The MSM over 50 years old in Taizhou has a high rate of HIV-positiveness and high-risk behaviors exist. It is imperative to strengthen dynamic HIV surveillance for this population and behavioral intervention to reduce HIV related risky behavior.

Expression and significance of c-fos in resistant cell line TU177/VCR of larynx squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the effect of c-fos on multidrug resistance of laryngeal cancer TU177 cells.@*Method@#Increasing drug concentration gradient is adopted to establish the stability of the laryngeal cancer drug resistance in cell line; RT-PCR and Western blot were used to detect difference of the c-fos between TU177 and TU177/VCR cells; plasmids with human c-fos knockdown or over expression were transfected into TU177/VCR and TU177 cells respectively, and the effects of different treatment on cell proliferation were investigated with MTT.@*Results@#The drug resistance of TU177/VCR cells was 26.25-fold in vincristine (VCR), 7.33-fold in Paclitaxel (TAX), 2.41 in cisplatin (DDP), and 5.50 in 5-fluorouracil (5-FU), comparing with TU177( P<0.05). The TU177/VCR cells had significantly higher c-fos expression compared to TU177 cells( P<0.05). The results showed that the IC50 values of 5-FU for the NC group and c-fos shRNA group were (306.2±6.3)μmol/L and (81.3±3.9)μmol/L, respectively, which was decreased by 73% in the c-fos shRNA group compared to that in the NC group (P<0.05). Similarly, the results showed that the IC50 values for 5-FU were (55.3±9.4) μmol/L in NC group and (288.1±7.3)μmol/L in c-fos WT group, which was increased 5.21-fold in c-fos WT cells.@*Conclusion@#C-fos plays important role in multidrug resistance of larynx cancer cell TU177/VCR, and might become a new molecular target for laryngeal cancer treatment.

Susceptibility-weighted Imaging in Thrombolytic Therapy of Acute Ischemic Stroke / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To provide a comprehensive and latest overview of susceptibility-weighted imaging (SWI) in the application of thrombolysis in acute ischemic stroke, and to update the decision-making effect and clinical value of SWI on identifying stroke patients suitable for thrombolytic therapy and possible benefits and risks followed.</p><p><b>DATA SOURCES</b>Literatures referred to this review were collected from PubMed, Medline, and EMBASE published till May 2017, using the search terms including susceptibility-weighted imaging, gradient-echo, T2*, thrombolysis, recombinant tissue plasminogen activator (rt-PA), thrombolytic therapy, and stroke.</p><p><b>STUDY SELECTION</b>Papers in English or with available English abstracts were considered, with no limitation of study design. References were also identified from the bibliographies of identified articles and the authors' files.</p><p><b>RESULTS</b>SWI is of guiding significance for thrombolytic therapy in stroke patients, it can predict the location and length of thrombus and ischemic penumbra. It is worthy of noting that susceptibility vessel sign (SVS) on SWI can be used to predict recanalization after thrombolytic therapy and whether it is better to implement endovascular thrombolectomy in combination or alone. SWI is sensitive in detecting cerebral microbleed (CMB), and CMB might not be a contraindication for thrombolytic therapy, yet CMBs in multiple foci could possibly be related to intracranial hemorrhage (ICH) after thrombolysis. SVS and CMB on SWI sequence are of instructive value in performing antiplatelet therapy after thrombolytic therapy. Cerebral venous change on SWI is related to lower recanalization rate and poor outcome after thrombolysis.</p><p><b>CONCLUSIONS</b>It seems that SWI can be applied to guide individualized thrombolytic therapies and assist clinicians in making better decisions by weighing benefits and risks. However, there still exist controversies about the relationship between signs on SWI and thrombolytic therapy.</p>

Relationship between Apolipoprotein Superfamily and Parkinson's Disease / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>Parkinson's disease (PD) is featured with motor disorder and nonmotor manifestations including psychological symptoms, autonomic nervous system dysfunction, and paresthesia, which results in great inconvenience to the patients' life. The apolipoprotein (Apo) superfamily, as a group of potentially modifiable biomarkers in clinical practice, is of increasing significance in the diagnosis, evaluation, and prognosis of PD. The present review summarized the current understanding and emerging findings of the relationship between Apo superfamily and PD.</p><p><b>DATA SOURCES</b>All literatures were identified by systematically searching PubMed, Embase, and Cochrane electronic databases with terms "Parkinson disease," "apolipoprotein," and their synonyms until May 2017.</p><p><b>STUDY SELECTION</b>We have thoroughly examined titles and abstracts of all the literatures that met our search strategy and the full text if the research is identified or not so definite. Reference lists of retrieved articles were also scrutinized for additional relevant studies.</p><p><b>RESULTS</b>The levels of plasma ApoA1 are inversely correlated with the risk of PD and the lower levels of ApoA1 trend toward association with poorer motor performance. Higher ApoD expression in neurons represents more puissant protection against PD, which is critical in delaying the neurodegeneration process of PD. It is suggested that APOE alleles are related to development and progression of cognitive decline and age of PD onset, but conclusions are not completely identical, which may be attributed to different ApoE isoforms. APOJ gene expressions are upregulated in PD patients and it is possible that high ApoJ level is an indicator of PD dementia and correlates with specific phenotypic variations in PD.</p><p><b>CONCLUSIONS</b>The Apo superfamily has been proved to be closely involved in the initiation, progression, and prognosis of PD. Apos and their genes are of great value in predicting the susceptibility of PD and hopeful to become the target of medical intervention to prevent the onset of PD or slow down the progress. Therefore, further large-scale studies are warranted to elucidate the precise mechanisms of Apos in PD.</p>

Application of EABR and ESRT in children with inner ear malformation after cochlear implantation / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the characteristics and laws of changes in electrically evoked auditory brainstem responses(EABR),electrically evoked stapedius reflex(ESRT) after cochlear implantation in children with inner ear malformation.METHODS 88 cases of Australian 24 multi-channel cochlear implants were divided into normal group and inner ear malformation group,The EABR and ESRT thresholds were measured at different periods within one year after operation.Behavior auditory responses,T-level and C-level were measured 1 year postoperatively to analyze their characteristics and changes.RESULTS The EABR and ESRT thresholds in the patients with inner ear malformation were significantly higher than those in the normal cochlear group(P＜0.05).The changing trend of EABR and ESRT were the same in the 2 groups,the overall trend is that low frequency value is low,high frequency value is higher.EABR,ESRT threshold increased gradually after 1 year,EABR was significantly correlated with T-level,and ESRT was significantly correlated with C-level.CONCLUSION The changes of EABR and ESRT thresholds in the cochlear implantation of the inner ear malformation group were similar to those of the normal cochlear group,the thresholds can be used to guide mapping for the inner ear malformation of the cochlear implant.

Packing effects of different hemostatic materials during functional endoscopic sinus surgery: histocompatibility comparison / 中国组织工程研究

BACKGROUND:At present, the most common materials for clinical hemostasis are absorbable tampons and Vaseline gauze. OBJECTIVE:To compare the packing effects of absorbable tampons and Vaseline gauze in functional endoscopic sinus surgery. METHODS:Totaly 100 sinusitis patients, 57 males and 43 females, aged 16-61 years, with a history of 5 months to 23 years, were randomized into two groups: patients in the observation group were treated with absorbable tampons and patients in the control group treated with Vaseline gauze during functional endoscopic sinus surgery. Patient's discomfort, bleeding when the filer was extracted at 48 hours, and nasal bleeding within postoperative 24 hours were compared between the two groups. RESULTS AND CONCLUSION: No adverse reaction related to absorbable tampons occurred in the observation group, indicating that the absorbable tampon has better histocompatibility. Patient's discomfort, bleeding when the filer was extracted at 48 hours after operation, and nasal bleeding within postoperative 24 hours were significantly improved in the observation group compared with the control group (P < 0.05). These findings suggest that the absorbable tampons has a better hemostatic function, which can effectively reduce postoperative nasal bleeding and relieve postoperative discomfort in patients with sinusitis.

Surgical treatment for displaced clavicle fracture combined with coracoid process: 9 cases report / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of internal fixation in treating displaced clavicle fracture combined with coracoid process.</p><p><b>METHODS</b>From January 2005 to July 2012, 9 patients with displaced clavicle fracture combined with coracoid process were treated by internal fixation. Among them, there were 6 males and 3 females with an average age of 40.1 (ranged from 20 to 57) years old. According to Eyres classification: 3 cases were type II B, 1 case was type II A, 3 cases were type III B, and 2 cases were type V A. All patients had history of injury, and diagnosed as coracoid fracture X-ray and CT before operation. Herscovici criteria was used to evaluate function of shoulders joint after operation.</p><p><b>RESULTS</b>Seven of 9 patients were followed up from 6 to 18 (averaged 11) months. The incisions were healed at stage I, coracoid process obtained bony healing, and reduction of acromioclavicular joint well. According to Herscovici criteria, 6 patients got excellent results and 1 in good.</p><p><b>CONCLUSION</b>Internal fixation for the treatment of displaced clavicle fracture combined with coracoid process could restore physiological anatomical position of coracoid process, and benefit for recovery of limb function.</p>

Paraneoplastic neurological syndrome in 12 children / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the basic clinical characteristics of paraneoplastic neurological syndrome (PNS) in children.</p><p><b>METHOD</b>To retrospectively analyze the clinical data of 12 PNS children who were hospitalized in neurology department in Beijing Children's Hospital from 2010 to 2011. Some patients were followed up after surgery.</p><p><b>RESULT</b>In 12 patients with PNS, 11 were male and 1 was female. The mean onset age were (30.5 ± 15.3) months. The mean duration from neurological symptom onset to finding out of tumor was (112.7 ± 154.4) days. The onset of the disease in 2 patients was acute, in 3 was subacute and in the other 7 was chronic (2 of 7 had 2 to 3 relapses). Of 12 patients, 11 had symptoms of ataxia (3 patients also had opsoclonus and myoclonus, OMS), 1 had weakness of limbs at onset and then had ataxia. Nine of 12 patients had surgery, and pathologic diagnosis was neuroblastoma and ganglioneuroma. Six patients were followed-up for 8 to 21 months. One patient had a little improvement and 5 almost recovered.</p><p><b>CONCLUSION</b>The PNS children can have neurological symptoms only at the onset and there were no particular evidence of tumor. It is prone to misdiagnosis. The prognosis of PNS in children was poor.</p>

Anti-N-methyl-D-aspartate receptor encephalitis in seven children / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the clinical and laboratory features and diagnosis of the patient with anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis in children.</p><p><b>METHOD</b>The data of clinical feature, laboratory findings, and radiological manifestation were reviewed and analyzed.</p><p><b>RESULT</b>Of the 7 patients, 4 were female and 3 were male. The age of onset was from 6.6 to 15.5 years (average 9.5 years). The onset of 4 cases started with convulsion. Six cases had seizures which was difficult to control by antiepileptic drugs. All patients had psychiatric symptoms and speech disorder. Six cases had different levels of decreased consciousness and dyskinesias. 6 cases had autonomic nerve instability, and 7 cases developed sleep disorders. The results of MRI examination were normal in all patients. The EEG of most patients showed focal or diffuse slow waves. Six cases had oligoclonal bands. All cases were confirmed to have the disease by detection of anti-NMDA receptor antibodies. No tumor was detected in any of the patients. All patients received immunotherapy.</p><p><b>CONCLUSION</b>Anti-NMDAR encephalitis is a severe but treatable disorder that frequently affects children and adolescents. Pediatric patients had clinical manifestations similar to those of adult patients. But children have a lower incidence of tumors and hypoventilation also occurs less frequently in children. Most of children had a good prognosis.</p>

Research of modified skin flap of external canal in auditory canal shaping to enlarge / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the new method of modified skin flap of external canal in auditory canal shaping to enlarge at radical mastoidectomy in endaural incision.@*METHOD@#From 1999 to 2009, 412 patients with 428 ears in operation were randomly divided into two groups. Patients underwent open mastoidectomy and some patients were performed concurrent tympanoplasty. A group (control group)were operated in traditional skin flap of external canal, B group is modified group. Bleed and effusion from the wound surface, the time of dry ear and the change of diameter of extermal acoustic meatus after one year were observed after the surgeries and deal the results with SPSS.@*RESULT@#The difference had statistical significance in bleed and effusion from the wound surface, the time of dry ear and the shrink of external acoustic meatus in 12 months among two groups.@*CONCLUSION@#Modified skin flap of external canal in auditory canal shaping to enlarge can help to make a no-wound dehiscence by wiping out the raw surface of external acoustic meatus. It is better than traditional skin flap of external canal.

Endoscopy nasal microsurgery and multiple techniques in treatment of nasopharyngeal angiofibromas / 肿瘤研究与临床

Objective To explore the methods for endoscopy nasal microsurgery and multiple techniques in treatment of nasopharyngeal angiofibromas. Methods CT, MRI and digial substraction angiography (DSA) and endoscopic examination had been used. ALL 12 patients accepted preoperative feeding artery embolum, hypotention anesthesia and injected adrenaline-lidocaine. Microelectrotomy-electrocoagulation had been used to remove tumor. Results All patients were treated by endoscopic nasal surgery. No complications had occurred. No recurrence were found in follow-up period. Conclusion The important factors to reduce amount of introperative bleeding are to select proper operative patients and use multiple techniques. Endoscopy nasal surgery has dominance in reducing complications, wound, tumor recurrence, operative time and nasal function.

The application of cerebral angiography in the forensic postmortem examination / 法医学杂志

As a "Gold Standard" in clinical diagnosis of cerebrovascular disease, cerebral angiography also plays an important role in forensic postmortem examination. The key roles of identifying the site of cerebrovascular disease and the cause of death as well as providing guidance for autopsy and postmortem sampling and the broad future application of cerebral angiography in forensic practice are reviewed.

The prospect of application of toxicogenetics/pharmcogenetics theory and methods in forensic practice / 法医学杂志

Individual response to drugs, toxicants, environmental chemicals and allergens varies with genotype. Some respond well to these substances without significant consequences, while others may respond strongly with severe consequences and even death. Toxicogenetics and toxicogenomics as well as pharmacogenetics explain the genetic basis for the variations of individual response to toxicants by sequencing the human genome and large-scale identification of genome polymorphism. The new disciplines will provide a new route for forensic specialists to determine the cause of death.

Retinal examination with ophthalmic endoscopy in forensic autopsy / 法医学杂志

Autopsy by forensic pathologist is a main mean currently to determine the cause of sudden unexpected death. Retinal examination is important but seldom performed during a forensic autopsy for various reasons. The value of retina examination has not been recognized. With invention of ophthalmic endoscopy and its subsequent application in postmortem retina examination, it has proved to be useful adjunct to determine the cause of death and to estimate the postmortem interval.

Complications of 195 Children with Cerebral Palsy / 中国康复理论与实践

@#ObjectiveTo analyze the complications of cerebral palsy (CP) children.Methods195 CP children (113 boys and 82 girls, 7 months to 11 years old) were examined by electroencephalogram, eye consultation, auditory brainstem response and Gesell developmental schedule except routine examinations to detect the complications.Results27(13.8%) CP children had motor delay as the only sign. 168 CP children had one or more complications, 168(86.2%) cases with mental retardation, 92(47.2%) cases with visual disability, 40(20.5%) cases with growth delay, 25( 12.8 %) cases with epilepsy, 12(6.2%) cases with hearing disability, 11(5.6%) cases with microcephaly, 3(1.5%) cases with abnormal behavior. 15(7.7%) cases of CP children had at least two kinds of complications, 123(63.1%) cases had three kinds of complications, 30(15.4%) cases had four kinds of complications.ConclusionMost of the CP children have one or more complications.

Ultrasound guided percutaneous puncture and sclerotherapy with alcohol for peripelvic cysts / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of ultrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts and investigate the clinical effect.</p><p><b>METHODS</b>A total of 169 cases of peripelvic cyst patients were evaluated, of whom 36 cases (21.3%) had hydronephrosis secondary to peripelvic cysts, 8 cases (4.7%) had renal calculus. All patients underwent ultrasound and intravenous phelography (IVP) examination, 59 patients also had CT scan. Hydatid fluid was analyzed by amine test. Percutaneous aspiration was guided by ultrasound, 95% alcohol was used to sclerosis the peripelvic cysts when amine test was negative or positive but did not have communication with pelvis through opacification. Ultrasound were done at 1, 3, 6 months and every 1 year thereafter, follow-up period were 6 months to 5 years.</p><p><b>RESULTS</b>One hundred and sixty-five peripelvic cysts (97.6%) were cured by once sclerotherapy, the diameter of another 4 cases (2.4%) diminished to less than 1.5 cm by once sclerotherapy. Thirty-six cases of hydronephrosis were all resolved after sclerotherapy. Eight cases had renal calculus, of whom 4 cases underwent extracorporeal shockwave lithotripsy, 2 cases underwent percutaneous nephrolithotomy, and 2 cases did not treat the stone. Five patients had gross hematuria after aspiration, but all diminished in 3-5 d.</p><p><b>CONCLUSION</b>Ultrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts had the superiority of safety, effectiveness micro-invasion and low complication.</p>

Multivariate analysis of recurrence in T1 bladder transitional cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the prognostic value of some clinicopathologic indexes and biologic tumor markers in predicting recurrence in T1 transitional cell carcinoma (TCC) of the bladder.</p><p><b>METHODS</b>The expressions of p53, E-cadherin and VEGF of 75 patients with T1 primary bladder TCC were detected by streptabitin peroxidase (SP) immunohistochemical methods. The effects of clinicopathologic indexes and biologic tumor markers on recurrence were assessed by Kaplan-Meier and Cox proportional hazards model.</p><p><b>RESULTS</b>The 1-, 3-, and 5-year recurrence- free survival rates were 68.0%, 45.3% and 20.9%. In Kaplan-Meier analysis, tumor mutifocality and the expression of p53, E-cadherin and VEGF were associated with recurrence. In multivariate analysis, the independent recurrence variables were tumor mutifocality, the expression of p53 and E-cadherin.</p><p><b>CONCLUSION</b>Tumor mutifocality and the abnormal expression of p53 and E-cadherin are the variables that independently predict recurrence in T1 transitional cell carcinoma of the bladder.</p>