Precordial exercise mapping: improved diagnosis of coronary artery disease.

Surface mapping of the exercise electrocardiogram (ECG) provides a measure of the precordial area, severity, and time course of ST-segment changes occurring after exercise. Sixteen-lead isopotential surface maps were recorded before and after exercise in 109 patients with probable angina who subsequently underwent coronary arteriography. In addition, exercise ECGs with three orthogonal leads were obtained in 53 of these patients, and with a single unipolar chest lead in all 109. Of the 109 patients, 85 had significant (greater than or equal to 70%) narrowing of at least one major coronary artery. The sensitivities of the precordial surface mapping, orthogonal leads, and single chest lead (V5) when compared with the findings at coronary arteriography were 95%, 68%, and 64% respectively, while the specificities of the three lead systems did not differ significantly. The technique of precordial surface mapping after exercise may easily be applied in clinical practice and requires only conventional equipment available in most hospitals. It effectively aids diagnosis of coronary artery disease.     

Potential accuracy of genetic evaluation for calving difficulty with incomplete data on calving difficulty and/or birth weight using a bivariate threshold-linear animal model

The purpose of this study was to evaluate the potential loss of accuracy in direct and maternal predicted breeding values (PBV) for calving difficulty (CD) with different levels of missing records of CD and/or birth weight (BW), using a bivariate threshold-linear animal model. Data obtained from the American Gelbvieh Association included 84,420 first-parity records with both CD and BW available. The final pedigree file included 178,858 animals. The model included fixed calf-sex-dam-age, random herd-year-season, and animal direct and maternal effects. Different levels of missing observations for CD and BW were obtained by randomly deleting 0, 25, 50, 75, and 100% of records for both traits in various combinations. Correlation estimates between PBV for CD obtained with complete and incomplete data were used to measure the changes in PBV for different levels of missing records. Reported correlations are means of three replicates. The results suggest that the information on direct and maternal PBV provided by CD records is more reliable than the information provided by BW records. The difference was especially large when a high proportion of CD records were missing. Correlations above 0.96 and 0.95 for direct and maternal PBV, respectively, when missing 25% or 0% of the CD or BW records suggest that small changes would be predicted with a low proportion incomplete data. For genetic prediction of popular sires (with > 100 pogeny), a higher proportion of missing records could be tolerated. The results suggest that the bivariate threshold-linear animal model is useful for routine genetic evaluation of CD with incomplete field data.     

Effects of Vitamins C and E Combination on Element Levels in Blood of Smoker and Nonsmoker Radiology X-Ray Technicians

X-ray radiation is detrimental to human cells and may lead to development of life-threatening diseases. Cigarette paper and cigarette smoke contain toxic elements, whereas vitamins C and E (VCE) may have regulator effects on the elements. We investigated effects of VCE administration on X-ray-induced element changes in blood of smoker and nonsmoker X-ray technicians. Twenty technicians and 30 healthy age-matched control subjects were used in the study. Ten of the X-ray technicians and 15 of the control were smokers. Blood serum samples were taken from the control. Oral vitamins C (500 mg) and E (150 mg) were supplemented daily to the smoker and nonsmoker X-ray technicians for 5 weeks. Serum samples were taken from the X-ray technicians before and after 5 weeks. Copper, zinc, selenium, aluminum, iron, magnesium, and calcium levels were investigated in control and X-ray technicians, both smokers and nonsmokers. Copper, zinc, and selenium levels were lower in the total X-ray group and smoker X-ray group than in control and nonsmoker X-ray group, although iron, magnesium, and calcium levels were higher in X-ray group than in control. The copper, zinc, selenium, and aluminum levels were higher in the VCE treatment group than those in X-ray group, although magnesium and calcium levels were decreased by the treatment. The serum zinc, copper, selenium, and magnesium levels were lower in smoker control group when compared to nonsmoker control group. The serum zinc levels were lower in smoker X-ray group than nonsmoker X-ray group, although iron level was higher in smoker X-ray group than in nonsmoker X-ray group. VCE prevents the smoke and X-ray-induced selenium, zinc, magnesium, and copper decrease to strengthen the antioxidant trace element levels in the serum of the technicians.     

Coagglutination as a test for Neisseria gonorrhoeae

After growth on Thayer-Martin medium, 196 strains of freshly isolated Neisseria gonorrhoeae were subjected to a coagglutination reaction. The sensitivity of the test was 94% and did not vary much in the hands of four consecutive technicians. In a group of 99 strains tested by one of the technicians non-interpretable results were obtained with 17% of the strains when the test was performed with cells taken from the first or primary plate, against 9% when cells from the secondary (subcultured) plate were used. The lowest number of non-interpretable results was found with a modified Thayer-Martin medium, which also showed the lowest number of false negatives (2%).No non-interpretable results were obtained when the bacterial suspension was first heated to 100°C for 3 min. In a group of 14 recently isolated strains of non-gonococcal species there was only one, preventable, false-positive strain and there were none in a group of 12 meningococci (all of them laboratory strains).In comparison with the fermentation test with Lingelsheim's sugars, the coagglutination test with cells taken from the primary plate with Thayer-Martin medium yielded a conclusive result more often. The test is simple and rapid and does not require special technical equipment. It seems to deserve a place as a confirmative test in the search for gonococci in samples from the urogenital-anal area.     

Drift studies--comparison of field and wind tunnel experiments

Drift at pesticide application leads to a pollution of non-target crops, non-target species and surface water. Spray drift is influenced by many factors like environmental conditions, vegetation, technical conditions, and physical properties of the tank mixes and influenced by Chemicals. Field experiments to characterise spray drift effects with the risk of permanent changing weather conditions can be supported by wind tunnel experiments. Wind tunnel experiments do not lead to the same soil deposition curves like field experiments, but the ratio of drift reduction potential is comparable.     

Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy.

T-wave alternans is a marker of cardiac electrical instability with the potential for arrhythmia risk stratification. The modified moving average method was developed to measure alternans in settings with artifacts, noise, and nonstationary data. Algorithms were developed and performance characteristics were validated with simulated electrocardiograms (ECGs). Experimental laboratory ECGs with dynamically changing alternans values were analyzed. Alternans values estimated by modified moving average analysis correlated strongly with input alternans values (r(2) = 0.9999). Rapidly changing alternans levels and phase reversals did not perturb the measurement. When heart rate was increased from 60 to 180 beats/min, with T-wave alternans apex moving from 237 to 103 ms after the R wave, the measured alternans peak varied <5% from input value. Simulated 50- to 1,000-microV motion artifact spikes typical of treadmill ECGs produced inaccuracies <2%. Alternans values in experimental laboratory study using standard electrodes tracked vulnerability to myocardial ischemia-induced ventricular fibrillation with 100% sensitivity and specificity at a cut point of 0.75 mV. Modified moving average analysis is a robust method that precisely measures T-wave alternans in settings with artifacts, noise, and nonstationary data typical of clinical ECGs and yields an accurate estimate of risk for ventricular fibrillation.     

Structural studies on the sialic acid polysaccharide antigen of Escherichia coli strain Bos-12.

A polysaccharide, antigenically related to group C meningococcus, has been isolated from Escherichia coli strain Bos-12 (016; K92; NM). Like groups B and C meningococcal polysaccharide, the Bos-12 antigen is a pure polymer of sialic acid. 13C NMR studies on the meningococcal group B and C polysaccharides have indicated that the former consists of sialic acid units linked 2 leads to 8- alpha, whereas the latter contains the sialic acid residues linked 2 leads to 9-alpha (Bhattacharjee, A.K., Jennings, H.J., Kenny, C.P., Martin, A., and Smith, I.C.P. (1975), J. Biol. Chem. 250, 1926). Comparison of natural abundance 13C NMR spectra of the Bos-12 polysaccharide with group B and C meningococcal polysaccharides established that Bos-12 was either (a) an equimolar mixture of 2 leads to 8-alpha linked sialic acid homopolymers or (b) a 2 leads to 8-alpha/2 leads to 9-alpha heteropolymer. These possibilities were distinguished in the following manner. The fact that Bos-12 polysaccharide precipitated with anti-group C serum but not with anti-group B serum would seem to exclude a. Further, chemical studies (periodate oxidation followed by tritiated NaBH4 reduction) gave saccharides with a radioactive-labeling pattern expected for alternating 2 leads to 8-alpha/2 leads to 9-alpha sialic acid linkages. Bos-12 is thus an 2 leads to 8/2 lead to 9-alpha heteropolymer.     

Vitamin C and E combination modulates oxidative stress induced by X‐ray in blood of smoker and nonsmoker radiology technicians

X‐ray radiation is detrimental to human cells and may lead to development of life‐threatening diseases. Cigarette smoke contains about 500 chemicals that include organic and oxidant compounds whereas vitamin C and E (VCE) have scavenger effects on the compounds. We investigated effects of VCE administration on X‐ray‐induced oxidative toxicity in blood of smoker and nonsmoker X‐ray technicians. Twenty technicians and 30 healthy age‐matched subjects control were used in the study. Ten of the X‐ray technicians and 15 of the control were smokers. Blood samples were taken from the control. Oral vitamin C (500 mg) and vitamin E (150 mg) were daily supplemented to the smoker and nonsmoker X‐ray technicians for 5 weeks. Blood samples were taken from the X‐ray technicians after and before 5 weeks. Plasma and erythrocytes lipid peroxidation (LP), reduced glutathione (GSH) levels, erythrocytes glutathione peroxidase (GSH‐Px), and plasma antioxidant vitamin concentrations were investigated in control and X‐ray technicians with smoker and nonsmoker. Plasma and erythrocytes LP levels were higher in the total X‐ray group and smoker X‐ray group than in control and nonsmoker X‐ray group, respectively although the LP level was decreased by the VCE treatment. The plasma vitamin C, vitamin A, vitamin E, and β‐carotene concentrations were lower in the X‐ray group than in control although their concentrations were increased by the treatment. The erythrocytes GSH level and GSH‐Px activity were found to be higher in the treatment group than in the X‐ray group. Plasma GSH level was not found to be different in all group. Reactive oxygen species may play role in the mechanism that has been proposed to explain the biological side effect of X‐ray radiation and smoke. VCE prevents the smoke and X‐ray‐induced oxidative stress to strengthen antioxidant vitamin concentrations in the blood of the technicians. Copyright © 2009 John Wiley & Sons, Ltd.     

Influence of intrinsic myocardial conduction on paced QRS morphology during cardiac resynchronization therapy follow up

We report two cases of patients of cardiac resynchronization therapy (CRT) whose ECGs, during follow up, showed different paced QRS morphology as compared to those of immediate post-device implantation. Parameters of leads, including sensitivity and capture thresholds, were unchanged. There was no lead dislodgement confirmed on fluoroscopy. The ECGs obtained in device off mode showed different intrinsic QRS morphology as compared to those of pre-implant morphology. These changes were attributable to electrolyte imbalance in one patient and progressive intraventricular conduction defect in the other. These cases demonstrate that intrinsic myocardial conduction pattern influences paced QRS morphology. Irreversible change in paced QRS morphology may indicate poor prognosis.     

Statistical Inference for Hardy-Weinberg Proportions in the Presence of Missing Genotype Information

In genetic association studies, tests for Hardy-Weinberg proportions are often employed as a quality control checking procedure. Missing genotypes are typically discarded prior to testing. In this paper we show that inference for Hardy-Weinberg proportions can be biased when missing values are discarded. We propose to use multiple imputation of missing values in order to improve inference for Hardy-Weinberg proportions. For imputation we employ a multinomial logit model that uses information from allele intensities and/or neighbouring markers. Analysis of an empirical data set of single nucleotide polymorphisms possibly related to colon cancer reveals that missing genotypes are not missing completely at random. Deviation from Hardy-Weinberg proportions is mostly due to a lack of heterozygotes. Inbreeding coefficients estimated by multiple imputation of the missings are typically lowered with respect to inbreeding coefficients estimated by discarding the missings. Accounting for missings by multiple imputation qualitatively changed the results of 10 to 17% of the statistical tests performed. Estimates of inbreeding coefficients obtained by multiple imputation showed high correlation with estimates obtained by single imputation using an external reference panel. Our conclusion is that imputation of missing data leads to improved statistical inference for Hardy-Weinberg proportions.     

上海市二、三级医院肿瘤化疗病案质量现状与分析

目的 了解上海市二、三级医院肿瘤化学药物治疗（以下简称“化疗”）质量情况,完善肿瘤化疗质量控制体系。方法 依据上海市肿瘤化疗质控中心督查方案,对全市103家从事肿瘤化疗的二、三级医院开展了2015年肿瘤化疗质量现场核查,采用SPSS 13.0进行数据汇总和分析。结果 上海市二、三级医院之间,肿瘤专业科室和非专业科室之间,肿瘤化疗病案的质量存在显著的不平衡,主要问题包括知情同意书内容不完整（33.04%）,病理诊断不齐全或缺失（15.50%）,肿瘤分期不规范或未分期（56.27%）,化疗目的（42.44%）、化疗适应证（37.47%）和禁忌证（12.21%）不齐全或缺失,化疗疗效评价记录不全或未评价（24.10%）,中期评估记录不全或未评价（27.72%）,入院病史（16.28%）及化疗当日记录（32.04%）不完整或缺失等。结论 上海市医院肿瘤化疗病案的质量与医院的级别和是否为专科显著相关。各医院应该针对自身存在的问题,加强对化疗质量控制标准的学习。     

Analysis of changes in the beat-to-beat P-wave morphology using clustering techniques

Several pathologies related to the atrial electrical activity can be detected in the electrocardiogram P-wave. A protocol for analyzing P-wave morphology changes has been developed in this article. By using this protocol a study on the beat-to-beat P-wave morphology changes of 89 ECG signals is performed. An algorithm based on the embedding space techniques has been used to extract the P-wave information of the ECG. The P-waves obtained in several of these ECGs exhibit significant alternate morphology changes. The morphologies have been classified by using the K-means clustering algorithm. The mechanism behind the P-wave morphology change process and its possible pathophysiological importance remains to be clarified.     

Figaro: a novel statistical method for vector sequence removal

MOTIVATION: Sequences produced by automated Sanger sequencing machines frequently contain fragments of the cloning vector on their ends. Software tools currently available for identifying and removing the vector sequence require knowledge of the vector sequence, specific splice sites and any adapter sequences used in the experiment-information often omitted from public databases. Furthermore, the clipping coordinates themselves are missing or incorrectly reported. As an example, within the approximately 1.24 billion shotgun sequences deposited in the NCBI Trace Archive, as many as approximately 735 million (approximately 60%) lack vector clipping information. Correct clipping information is essential to scientists attempting to validate, improve and even finish the increasingly large number of genomes released at a 'draft' quality level. RESULTS: We present here Figaro, a novel software tool for identifying and removing the vector from raw sequence data without prior knowledge of the vector sequence. The vector sequence is automatically inferred by analyzing the frequency of occurrence of short oligo-nucleotides using Poisson statistics. We show that Figaro achieves 99.98% sensitivity when tested on approximately 1.5 million shotgun reads from Drosophila pseudoobscura. We further explore the impact of accurate vector trimming on the quality of whole-genome assemblies by re-assembling two bacterial genomes from shotgun sequences deposited in the Trace Archive. Designed as a module in large computational pipelines, Figaro is fast, lightweight and flexible. AVAILABILITY: Figaro is released under an open-source license through the AMOS package (http://amos.sourceforge.net/Figaro).     

Spatial heterogeneity of action potential alternans during global ischemia in the rabbit heart

Cardiac ischemia causes beat-to-beat fluctuation in action potential duration (APD) alternans, which leads to T wave alternans and arrhythmias. Occurrence of APD alternans that is out of phase at two sites is especially important, but most APD alternans studies have involved rapid pacing of normal myocardium rather than ischemia. To determine the spatial features of APD alternans during ischemia, blood-perfused rabbit hearts were stained with 4-[beta-[2(di-n-butylamino)-6-napthyl]vinyl]pyridinium (di-4-ANEPPS) and imaged with a high-resolution camera. Hearts were perfused with oxygenated Tyrode solution at 37 degrees C for staining and then switched to a 50:50% blood/Tyrode mixture. Hearts were paced from the right ventricle at 3/s, and made ischemic by stopping flow for 6 min. Images of 10,000 pixels were obtained at 300 frames/s. Motion artifact was controlled by immobilization and by manual selection of undistorted single-pixel records. Upstroke propagation and conduction isochrones were displayed by computerized image processing. APD alternans was demonstrated in six of seven hearts, and was out of phase in different regions of the image in three hearts. The largest spatial variation in the onset of depolarization to 50% repolarization (APD50) was 155%. This caused beat-to-beat reversal of repolarization. An alternans map could be constructed for well-immobilized portions of the image. There were discrete regions of APD alternans separated by a boundary, as occurs with intracellular Ca2+ concentration alternans. Pixels as close together as 1.1 mm showed an APD alternans that was out of phase. The out-of-phase APD alternans was not due to conduction alternans, as shown by upstroke intervals and conduction isochrones. This contrasts with rapid pacing, where a causal relationship appears to exist. These new observations suggest distinct mechanisms for the genesis of arrhythmias during ischemia.     

The joint Task Group on clinical utility of labelled antibodies of the Society of Nuclear Medicine Europa (SNME) and the European Nuclear Medicine Society (ENMS)

In September 1985 a task group on the clinical utility of labelled antibodies was founded by the Society of Nuclear Medicine - Europe. This document was elaborated to report the aims and the programs of the group. In September 1986 the European Nuclear Medicine Society decided to participate in this initiative and a joint task group was created. INITIAL DOCUMENT: A. The aims to the Task Group are to monitor, co-ordinate and promote research and clinical application of techniques using radiolabelled antibodies in nuclear medicine. A.1. The Group should develop into a major point of reference, giving scientific and technical support to each member of the Society involved in this field. B. To pursue these purposes it will be necessary to develop the following: B.1. Criteria to evaluate the suitability of antigen-antibody systems for tumour detection and/or therapy. B.2. Criteria for quality control of radioimmunoreagents. B.3. Criteria for the prevention of adverse reactions or damage due to the reagent. B.4. Selection of suitable dosimetric methods for diagnostic or therapeutic applications. B.5. Elaboration of protocols for clinical experiments, including appropriate techniques to be applied in single cases. B.6. Organization of cooperative studies. C. The Task Group should promote: C.1. Informal meetings between the members of the Group. C.2. Workshops open to the members of the Society and other researchers. C.3. Publication of reports in appropriate journals.     

Properties of fetal heartbeat intervals during labour

This study was designed to investigate the range of beat-to-beat changes in fetal inter-beat (RR) intervals during routine clinical monitoring in labour. Fetal RR intervals were automatically measured and collected from 10 fetuses. Intervals which were incorrectly measured were excluded, and the remaining 23510 intervals were used to compile the distribution of beat-to-beat changes. The inter-quartile range of this distribution was 23 ms and the 99th centile fell at approximately 50 ms. No relationship could be established between beat-to-beat changes and the absolute RR interval. These findings differ from the results published by other workers on the basis of data obtained antenatally or during early labour. In addition, the results suggest possibilities for improving algorithms designed to enhance data quality in fetal heart rate monitoring.     

Variations in the Quality of Care at Large Public Hospitals in Beijing,China: A Condition-Based Outcome Approach

Background

Public hospitals deliver over ninety percent of all outpatient and inpatient services in China. Their quality is graded into three levels (A, B, and C) largely based on structural resources, but empirical evidence on the quality of process and outcome of care is extremely scarce. As expectations for quality care rise with higher living standards and cost of care, such evidence is urgently needed and vital to improve care and to inform future health reforms.

Methods

We compiled and analyzed a multicenter database of over 4 million inpatient discharge summary records to provide a comprehensive assessment of the level and variations in clinical outcomes of hospitalization at 39 tertiary hospitals in Beijing. We assessed six outcome measures of clinical quality: in-hospital mortality rates (RSMR) for AMI, stroke, pneumonia and CABG, post-procedural complication rate (RS-CR), and failure-to-rescue rate (RS-FTR). The measures were adjusted for pre-admission patient case-mix using indirect standardization method with hierarchical linear mixed models.

Results

We found good overall quality with large variations by hospital and condition (mean/range, in %): RSMR-AMI: 6.23 (2.37–14.48), RSMR-stroke: 4.18 (3.58–4.44), RSMR-pneumonia: 7.78 (7.20–8.59), RSMR-CABG: 1.93 (1.55–2.23), RS-CR: 11.38 (9.9–12.88), and RS-FTR: 6.41 (5.17–7.58). Hospital grade was not significantly associated with any risk-adjusted outcome measures.

Conclusions

Going to a higher grade public hospital does not always lead to better patient outcome because hospital grade only contains information about hospital structural resources. A hospital report card with some outcome measures of quality would provide valuable information to patients in choosing providers, and for regulators to identify gaps in health care quality. Reducing the variations in clinical practice and patient outcome should be a focus for policy makers in the next round of health sector reforms in China.     

模拟采食干扰下克隆整合对两种箭竹分株种群更新的影响

动物对植物的采食会刺激植物进行补偿性更新生长, 克隆整合效应能够通过分株之间的物质传输增强克隆植物的这种补偿生长。现今对克隆整合效应在箭竹(Fargesia)补偿更新中的作用仍未得到全面认识。2011年10月到2012年11月, 设立了糙花箭竹(Fargesia scabrida)和缺苞箭竹(F. denudata)各40个样方, 分别进行不剪除样方内分株和剪除样方内分株数量的25%、50%、75%四种模拟采食干扰处理, 并将样方四周的根状茎切断或保持连接。从2012年6月起观测并统计了箭竹分株种群的累积出笋率、总出笋率、补充率, 以及新生分株的株高、基径和单株生物量。结果表明: (1)在不剪除分株的样方, 切断根状茎连接显著增加了糙花箭竹的出笋率和补充率, 但降低了新生分株的株高和单株生物量, 也显著降低了缺苞箭竹的出笋率和补充率; (2)保持根状茎连接时, 25%的剪除强度仅仅降低了糙花箭竹新生分株的单株生物量; 同样在保持根状茎连接的条件下, 25%、50%的剪除强度使缺苞箭竹种群的补充率有所降低, 而切断根状茎后缺苞箭竹在25%的剪除强度下的分株补充率反而升高; (3) 75%的剪除强度并未影响两种箭竹新生分株数量更新, 但造成新生分株质量显著下降; 切断根状茎连接显著降低了糙花箭竹的新生分株的株高和基径, 对缺苞箭竹影响不显著。实验证明克隆整合影响了两种箭竹新生分株的萌发、存活和生长, 但不是两种箭竹进行补偿更新的主要机制, 仅在糙花箭竹分株种群受到重度采食干扰后的更新中才起到明显的促进作用; 两种箭竹均能在50%的剪除强度下通过补偿生长恢复种群的稳定, 75%的剪除强度则会造成箭竹新生分株质量的下降。     

经颈静脉途径制备Beagle犬心脏记忆模型

目的经颈静脉途径应用心室起搏的方法制备心脏记忆犬模型。方法 8只普通级成年健康Beagle犬经腹腔麻醉后,Seldinger’s法穿刺颈外静脉成功后送入心内膜起搏电极,将电极头端固定于右室心尖部,近端连接于脉冲发生器。起搏频率设置较犬窦性心律时的基础心率快15%,保证起搏器连续起搏。结果连续起搏1周后所有动物均成功制备为心脏记忆模型。建模后犬的心率、呼吸、体重与建模前比较,无明显改变;所有模型组犬起搏前心电图均为窦性心律,起搏1周后出现心脏T波记忆,在下壁导联以及胸前导联均出现T波倒置,停止起搏后,心脏T波记忆逐渐消失;模型组犬与正常组犬心肌病理相比,无明显改变。结论经颈静脉途径应用心室起搏法建立心脏记忆犬模型的方法,具有手术简单,创伤小,诱发方式与临床相似等优点,为深入展开心脏记忆的机制研究奠定基础。     

Effective Strategy of the Combination of High-Intensity Focused Ultrasound and Transarterial Chemoembolization for Improving Outcome of Unresectable and Metastatic Hepatoblastoma: a Retrospective Cohort Study

The combination of high-intensity focused ultrasound (HIFU) and transarterial chemoembolization (TACE) has been experimentally performed in a variety of malignant tumors, and its validity has not yet been evaluated for hepatoblastoma (HB). We evaluated the disease-response rate, resection rate, and toxicity in children with unresectable or metastatic HB (stage III and stage IV HB) after sequential treatment with TACE plus HIFU in a controlled clinical trial. The 35 patients with unresectable or metastatic HB were nonrandomly assigned to HIFU ablation (n = 12) or C5V chemotherapy (n = 23). The rates of complete resection, tumor response, and treatment toxicity were evaluated for both regimens. Nine patients who received C5V and 10 patients who received TACE plus HIFU became operable (P = .02). The 3-year event-free survival and overall survival rates were 43.03% and 56.68% in the C5V group and 38.57% and 57.86% in the TACE plus HIFU group, respectively. Acute grade 3 or 4 adverse events, including neutropenia, thrombocytopenia, and anemia, were more frequent in patients treated with C5V therapy than in patients receiving TACE plus HIFU. HIFU ablation achieved a higher rate of complete resection and a lower rate of severe complications compared with C5V treatment in children with advanced HB (Chinese Clinical Trials Registry No. ChiCTR-PRCH-08000182).