The Role of Jasmonates as Antibulbing Substances in the Bulb Formation of Onion

Onion plants form spherical bulbs under long-day conditions.Substances regulating bulb formation remain unknown.In the course of chemical studies on the bulb formation,α-linolenic acid was isolated from onion extracts as an antibulbing substance,the amount of which was synchronized with the bulb formation.Since allene oxide synthase inhibitor canceled the antibulbing activity ofα-linolenic acid,it was disclosed that jasmonic acid concerns this regulation.Structure-activity-relationship study revealed that its(3R,7S)stereochemistry is necessary for showing its antibulbing activity.It is concluded that(3R,7S)-jasmonate derived fromα-linolenic acid actually participates in the regulation of bulb formation.

Improving advantages and reducing risks in increasing cyclone height via an apex cone to grasp vortex end

For a cyclone, it is possible to improve separation efficiency and reduce pressure drop by increasing the cyclone height. However, an exceeded height increase could result in a dramatical drop in separation efficiency. In this study, experimental and computational fluid dynamics simulation results exhibit that the introduction of an apex cone at the dust outlet could avoid the risk of separation efficiency drop but lead to a continuous reducing of the pressure drop. Generally, the optimal cyclone height should be closely related to the natural vortex length. While, when the vortex end contracts into the separation space in the cyclone with an exceeded height, severe back-mixing of particles always occurs, which will result in the decrease of separation efficiency. Herein, it is found that when an apex cone is installed at the dust outlet, the vortex end can be grasped by the cone so as to weaken the back-mixing of particles.Meanwhile, the introduction of this apex cone can enhance the secondary separation to capture the back-mixed particles again so as to protect the efficiency. In addition, it is found that the enhanced secondary separation could come from either the stagnant current of axial velocity in the center or the improved tangential velocity of inner vortex whereas the forcibly extending the length of vortex to exceed its natural length will not significantly increase efficiency.

Skeletal muscle mass and quality before preoperative chemotherapy influence postoperative long-term outcomes in esophageal squamous cell carcinoma patients

BACKGROUND Previous reports have focused on muscle mass as a prognostic factor in esophageal cancer.AIM To investigate how preoperative body type influences the prognosis of patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemotherapy(NAC)and surgery.METHODS The subjects were 131 patients with clinical stage Ⅱ/Ⅲ esophageal squamous cell carcinoma who underwent subtotal esophagectomy after NAC.Skeletal muscle mass and quality were calculated based on computed tomography images prior to NAC,and their statistical association with long-term outcomes was examined retrospectively in this case-control study.RESULTS The disease-free survival rates in the low psoas muscle mass index(PMI)group vs the high PMI group were 41.3%vs 58.8%(P=0.036),respectively.In the high intramuscular adipose tissue content(IMAC)group vs the low IMAC group,the disease-free survival rates were 28.5%vs 57.6%(P=0.021),respectively.The overall survival(OS)rates for the low PMI group vs the high PMI group were 41.3%vs 64.5%(P=0.008),respectively,and for the high IMAC group vs the low IMAC group,they were 29.9%vs 61.9%(P=0.024),respectively.Analysis of the OS rate revealed significant differences in patients aged 60 years or older(P=0.018),those with pT3 or above disease(P=0.021),or those with lymph node metastasis(P=0.006),aside from PMI and IMAC.Multivariate analysis demonstrated that pT3 or above hazard ratio(HR):1.966,95%confidence interval(CI):1.089-3.550,(P=0.025),lymph node metastasis(HR:2.154,95%CI:1.118-4.148,P=0.022),low PMI(HR:2.266,95%CI:1.282-4.006,P=0.005),and high IMAC(HR:2.089,95%CI:1.036-4.214,P=0.022)were significant prognostic factors for esophageal squamous cell carcinoma.CONCLUSIONSkeletal muscle mass and quality before NAC in patients with esophageal squamous cellcarcinoma are significant prognostic factors for postoperative OS.

Purification and Characterization of Hyaluronate Lyases Produced by Two Types of Bacteria

Hyaluronate lyases were obtained from two types of naturally isolated bacterial strains Paenibacillus yunnanensis and Paennarthrobacter nicotinovorans.PyHL(form P.yunnanensis)in the culture supernatant of the bacteria was purified by two steps of column chromatography.The enzyme showed the molecular mass of 74 kDa by SDS-PAGE and the maximal activity at pH 5.0,35℃.PyHL maximally degraded hyaluronate by an endo-type manner,and showed low degradation activity toward chondroitin sulfates.Dermatan sulfate was not the substrate.PnHL(from P.nicotinovorans)in the culture supernatant of the bacteria was purified by two steps of column chromatography.The enzyme showed the molecular mass of 70 kDa by SDS-PAGE and the maximal activity at pH 6.0,30℃.Genomic analysis of P.nicotinovorans on the bases of the internal amino acid sequences of PnHL.

Plantar Spitz Nevus Resembling Malignant Melanoma: Description of Immunohistochemical Findings

Spitz nevus (SN) is predominantly distributed throughout the lower extremities, while an acral location is rare. Since SN occasionally resembles the clinicopathological presentation of malignant melanoma (MM), it presents a diagnostic challenge, especially on glabrous skin. Past reports suggest that several genetic aberrations are associated with specific clinicopathological subtypes of melanocytic tumors. Immunohistochemistry can provide a clue to the presence or absence of a molecular aberration typical of Spitz tumors. We describe a case of a plantar SN with genetic analysis, including anaplastic lymphoma kinase (ALK), ROS proto-oncogene 1 (ROS1), BRAF (V600E) protein, and BRCA1-associated protein-1 (BAP1). However, we were not able to detect a characteristic gene aberration. To the best of our knowledge, no genetic aberrations in plantar SN cases have been reported. A comprehensive understanding of tumor genomics is expected to play an essential role in the classification of melanocytic tumors. Further genetic research on plantar SN is required to establish new criteria for distinguishing between SN and MM.

中国锦紫苏类病毒的检测及其分子生物学特征研究

从无明显症状表现的11株锦紫苏叶片中抽提低分子量的RNA，经Return-PAGE、RT-PCR和Dot-blot hybridization检测，结果表明11株锦紫苏全部带有锦紫苏类病毒（Coleus blumei viroid，CBVd）。将部分PCR产物克隆到pGEM-3Zf（＋）载体上并进行DNA序列测定。序列分析结果，所克隆的序列（GenBank登录号分别为DQ178395、DQ178396、DQ178397、DQ178398和DQ178399）与GenBank中报道的锦紫苏类病毒1号（CBVd—1）序列同源性为85．23％～99．20％。从市场上购买的锦紫苏种子经Return—PAGE和RT-PCR检测不携带锦紫苏类病毒。这是中国发生的锦紫苏类病毒的首次报道。

BaO修饰的Ni0.5Cu0.5Ox-YSZ阳极的制备及性能

阳极积碳会导致直接氧化甲烷型固体氧化物燃料电池(SOFCs)的性能衰减,为增加甲烷燃料中电池的稳定性,采用硬模板法与分次浸渍法制备BaO/Ni0.5Cu0.5Ox包覆柱状YSZ复合阳极材料,制作单电池BaO/Ni0.5Cu0.5Ox-YSZ/YSZ/LSM,并进行电性能与长期稳定性测试。用SEM(扫描电子显微镜)与EDS(能谱议)对实验后的阳极结构与表面成分进行观察与分析。结果表明:在800℃的甲烷环境下,单电池的最大功率密度为323 mW/cm2;运行100 h后,电压降只有2.12%。实验后的阳极SEM像表明,阳极呈立体多孔结构,有利于燃料气体与反应废气的扩散;催化金属颗粒均匀包覆着柱状YSZ,扩大了电化学反应区域。EDS能谱分析表明,有少量积碳形成,阳极孔道未被堵塞,证明了阳极结构的稳定。单电池稳定性的增强归功于立体多孔阳极的制备与碱性氧化物BaO的加入。

基于双波段植被指数(TBVI)的柑橘冠层含氮量预测及可视化研究

氮素(nitrogen,N)是果树生长发育的必需重要元素,及时准确地无损检测果树的氮素水平对果实增产、合理施肥以及减少环境污染等具有重要意义。研究了基于高光谱成像技术进行柑橘冠层含氮量预测及可视化的可行性。实验采用高光谱成像光谱仪ImSpector V10E(Spectral imaging Ltd.,Oulu,Finland)分别采集柑橘叶片实验室样本和野外整个植株冠层的高光谱图像。利用ENVI软件提取每个叶片样本感兴趣区域(ROD的平均光谱数据作为整个样本的光谱数据进行分析,同时采用杜马斯燃烧法快速定氮仪(Elementar Analytical,Germany)测定叶片样本的含氮量。通过简单相关分析和双波段植被指数(TBVI)的获取,建立基于光谱数据的含氮量预测模型。计算表明,基于811和856nm的双波段植被指数(TBVI)能够建立最佳的柑橘叶片含氮量预测模型(R^2=0.607 1)。在此基础上,计算上述TBVI的冠层图像,把基于该TBVI的含氮量预测模型导入到TBVI图像中计算生成冠层含氮量的预测分布图。图中直观地显示柑橘嫩叶、中叶、老叶的含氮水平从高到低分布,实现了冠层含氮量的可视化。结果表明,利用高光谱成像技术可以实现柑橘冠层氮素水平的检测和诊断,这为实施基于每颗果树信息的变量施肥技术提供了参考信息。

A case of invasive hemolymphangioma of the pancreas

Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy revealed bleeding at the duodenum. Computed tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding.

Clean coal technologies in Japan： A review

Coal is the primary fossil fuel most used in the world for the electricity generation, iron making, and cement/concrete and chemical production. However, utilization of coal also results in emissions of CO_2, SO_x, NO_x and other noxious compounds. The development of clean coal technology(CCT) is a main issue to maintain a clean environment. CCT in Japan is considered the highest level in the world. In this review, the developing CCTs in Japan including high efficiency combustion technologies, advanced gasification technologies, CO_2 recovery and utilization technologies, and flue gas cleaning technologies are introduced and discussed. It is expected to provide some new view-of-points for CCT development.

Stool antigen tests for the management of Helicobacter pylori infection

Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.

Does flexible small-diameter colonoscope reduce insertion pain during colonoscopy?

AIM It is well known that colonoscopy can bedifficult due to abdominal pain induced duringcolonoscope insertion,if sedative agents are notgiven.Recently,an extra-flexible,small-diameter colonoscope(CF-SV,Olympus Inc.,Japan)was developed in order to improve safetyand comfort.The aim of this study was toaccess the usefulness of the CF-SV.METHODS One hundred patients undergoingsigmoidoscopy were recruited and colonoscopywas performed by one experiencedcolonoscopist.First,a routine-type colonoscope(CF-2301)was inserted into the colon withoutsedation.When the patient complained ofabdominal pain(even if mild),the scope wasnot advanced further and was withdrawn afterthe anatomic location of its tip was determinedfluoroscopically.Then,the CF-SV was inserteduntil it reached the cecun or the site whereabdominal pain occurred.Previous abdominalsurgery and abdominal disease were consideredas unfavorable factors(UF)and the relationshipbetween abdominal pain and UF,age and genderwere investigated.Furthermore,the colonicinsertion pressures in 36 patients with abdominalpain were measured with a force gauge.RESULTS Thirty-four cases(34%)felt no painwith the CF-2301 and successful pancolon-0scopies to the cecum were performed.Sixty-six cases(66%)complained of abdominal pain.The procedure was painless for 47% of men and24% of women,respectively.The CF-2301 scopefailed to reach the sigmoid-descending colon junctions in 59(89.4%)of the 66 patientscomplaining of abdominal pain.However,CF-SVreached proximal area in 94.9% of those whofailed with CF-2301.The median pressure forpain-inducing was 700 g/cm^2.CONCLUSION Unsedated patients with UFwere prone to complain of pain when thestandard-type CF-2301 scope was used.Thenewly developed extra-flexible CF-SV is usefulfor the aged and for those with UF or being proneto suffer from abdominal pain.Sedative agentsmay be unnecessary if this new type ofcolonoscope is used.

An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture

AIM: To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.METHODS: Among 63 consecutive patients with soft pancreas undergoing a pancreaticoduodenectomy from 2003 to 2006, 35 patients were treated with a new reconstructive method. Briefly, after the pancreatic transaction, a stent tube was inserted into the lumen of the pancreatic duct and ligated with it by a fast-absorbable suture. Another tip of the stent tube was introduced into the intestinal lumen at the jejunal limb, where a purse-string suture was made by another fast-absorbable suture to roughly fix the tube. The pancreaticojejunostomy was completed by ligating two fast-absorbable sutures to approximate the ductal end and the jejunal mucosa, and by adding a rough anastomosis between the pancreatic parenchyma and the seromuscular layer of the jejunum. The initial surgical results with this method were retrospectively compared with those of the 28 patients treated with conventional duct-to-mucosa anastomosis.RESULTS: The incidences of postoperative morbidity including pancreatic fistula were comparable between the two groups (new; 3%-17% vs conventional; 7%-14% according to the definitions). There was no mortality and re-admission. Late complications were also rarely seen.CONCLUSION: A pancreaticojejunostomy using an irradiated polyglactin 910 suture material and a temporary stent is easy to perform and is feasible even in cases with a narrow pancreatic duct and a normal soft pancreas.

Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

Hemosuccus pancreaticus is a rare cause of intermittent upper gastrointestinal bleeding. We report two cases of hemosuccus pancreaticus with multiple episodes of upper gastrointestinal bleeding. The causes of hemorrhage were rupture of pseudoaneurysm of the splenic artery and bleeding from the wall of pancreatic pseudocyst. Interventional radiology is the first modality for early diagnosis and possible treatment of hemosuccus pancreaticus. When angiography shows no abnormal findings or interventional radiological therapy can not be successful, surgery should be considered without delay. Our patients herein underwent surgery without recurrence or sequelae. Intraoperative ultrasonography and pancreatoscopy were helpful modalities for confirming the source of hemorrhage and determining the cutting line of the pancreas. When we encounter intermittent upper gastrointestinal bleeding with an obscure source, hemosuccus pancreaticus should be included in differential diagnoses especially in patients with chronic pancreatitis, which would lead to a prompt and proper treatment.

Removal of biomass tar by steam reforming over calcined scallop shell supported Cu catalysts

In this study, the main purpose is to develop low-cost catalysts with high activity and stability for high quality syngas production via steam reforming of biomass tar in biomass gasification process. The calcined waste scallop shell（CS） supported copper（Cu） catalysts are prepared for steam reforming of biomass tar. The prepared Cu supported on CS catalysts exhibit higher catalytic activity than those on commercial CaO and Al;O;. Characterization results indicate that Cu/CS has a strong interaction between Cu and CaO in CS support, resulting in the formation of calcium copper oxide phase which could stabilize Cu species and provide new active sites for the tar reforming. In addition, the strong basicity of CS support and other inorganic elements contained in CS support could enhance the activity of Cu/CS. The addition of a small amount of Co is found to be able to stabilize the catalytic activity of Cu/CS catalysts,making them reusable after regeneration without any loss of their activities.

Intraoperative ultrasound as an educational guide for laparoscopic biliary surgery

AIM: To analyze the efficacy of routine intraoperative ultrasound (IOUS) as a guide for understanding biliary tract anatomy, to avoid bile duct injury (BDI) after laparoscopic cholecystectomy (LC), as well as any burden during the learning period. METHODS: A retrospective analysis was performed using 644 consecutive patients who underwent LC from 1991 to 2006. An educational program with the use of IOUS as an operative guide has been used in 276 cases since 1998. RESULTS: IOUS was highly feasible even in patients with high-grade cholecystitis. No BDI was observed after the introduction of the educational program, despite 72% of operations being performed by inexperienced surgeons. Incidences of other morbidity, mortality, and late complications were comparable before and after the introduction of routine IOUS. However, the operation time was significantly extended after the educational program began (P < 0.001), and the grade of laparoscopic cholecystitis (P = 0.002), use of IOUS (P = 0.01), and the experience of the surgeons (P = 0.05) were significant factors for extending the length of operation. CONCLUSION: IOUS during LC was found to be a highly feasible modality, which provided accurate, real- time information about the biliary structures. Theeducational program using IOUS is expected to minimize the incidence of BDI following LC, especially when performed by less-skilled surgeons.

Des-gamma-carboxy prothrombin as an important prognostic indicator in patients with small hepatocellular carcinoma

AIM:To clarify the effect of a high des-gamma-carboxy prothrombin (DCP) level on the invasiveness and prognosis of small hepatocellular carcinoma. METHODS: Among 142 consecutive patients with known DCP levels, who underwent hepatectomy because of hepatocellular carcinoma, 85 patients met the criteria for small hepatocellular carcinoma, i.e. one ≤ 5 cm sized single tumor or no more than three ≤ 3 cm sized tumors. RESULTS: The overall survival rate of the 142 patients was 92.1% for 1 year, 69.6% for 3 years, and 56.9% for 5 years. Multivariate analysis showed that microscopic vascular invasion (P = 0.03) and serum DCP ≥ 400 mAU/mL (P = 0.02) were independent prognostic factors. In the group of patients who met the criteria for small hepatocellular carcinoma, DCP ≥ 400 mAU/mL was found to be an independent prognostic factor for recurrence-free (P = 0.02) and overall survival (P = 0.0005). In patients who did not meet the criteria, the presence of vascular invasion was an independent factor for recurrence-free (P = 0.02) and overall survivals (P = 0.01). In 75% of patients with small hepatocellular carcinoma and high DCP levels, recurrence occurred extrahepatically. CONCLUSION: For small hepatocellular carcinoma, a high preoperative DCP level appears indicative fortumor recurrence. Because many patients with a high preoperative DCP level develop extrahepatic recurrence, it is necessary to screen the whole body.

Influence of proton pump inhibitor treatment on Helicobacter pylori stool antigen test

AIM: To investigate the effects of proton pump inhibitor (PPI) treatment on stool antigen test using the TestMate pylori enzyme immunoassay. METHODS: This study assessed 28 patients [16 men and 12 women; mean age (63.1 ± 5.9) years; range, 25-84 years] who underwent stool antigen test and urea breath test (UBT) before and after PPI administration. RESULTS: Using the UBT as the standard, the sensitivity, specif icity and agreement of the stool antigen test in all 28 patients were 95.2%, 71.4%, and 89.3%, respectively, before PPI administration, and 88.9%, 90.9%, and 89.3%, respectively, after PPI treatment. Mean UBT values were 23.98% ± 5.33% before and 16.19% ± 4.75% after PPI treatment and, in 15 patients treated for ≥ 4 wk, were signif icantly lower after than before 4 wk of PPI treatment (12.58% ± 4.49% vs 24.53% ± 8.53%, P = 0.048). The mean optical density (A450/630) ratios on the stool antigen test were 1.16 ± 0.20 before and 1.17 ± 0.24 after PPI treatment (P = 0.989), and were 1.02 ± 0.26 and 0.69 ± 0.28, respectively, in the group treated for > 4 wk (P = 0.099).

Lactogenic hormones alter cellular and extracellular microRNA expression in bovine mammary epithelial cell culture

Background： Bovine milk contains not only a variety of nutritional ingredients but also microRNAs （miRNAs） that are thought to be secreted by the bovine mammary epithelial cells （BMECs）. The objective of this study was to elucidate the production of milk-related miRNAs in BMECs under the influence of lactogenic hormones. Results： According to a microarray result of milk exosomal miRNAs prior to cellular analyses, a total of 257 miRNAs were detected in a Holstein cow milk. Of these, 18 major miRNAs of interest in the milk were selected for an expression analysis in BMEC culture that was treated with or without dexamethasone, insulin, and prolactin （DIP） to induce a lactogenic differentiation. Quantitative polymerase chain reaction （qPCR） results showed that the expressions of miR-21-Sp （P = 0.005）, miR-26a （P = 0.016）, and miR-320a （P = 0.011） were lower in the DIP-treated cells than in the untreated cells. In contrast, the expression of miR-339a （P-- 0.017） in the cell culture medium were lower in the DiP-treated culture than in the untreated culture. Intriguingly, the miR-148a expression in cell culture medium was elevated by DIP treatment of BMEC culture （P = 0.018）. The medium-to-cell expression ratios of miR- 103 （P = 0.025）, miR-148a （P 〈 0.001）, and miR-223 （P = 0.013） were elevated in the DIP-treated BMECs, suggesting that the lactogenic differentiation-induced secretion of these three miRNAs in BMECs. A bioinformatic analysis showed that the miRNAs down-regulated in the BMECs were associated with the suppression of genes related to transcriptional regulation, protein phosphorylation, and tube development. Conclusion： The results suggest that the miRNAs changed by lactogenic hormones are associated with milk protein synthesis, and mammary gland development and maturation. The elevated miR-148a level in DIP-treated BMECs may be associated with its increase in milk during the lactation period of cows.

Treatment of young patients with lupus nephritis using calcineurin inhibitors

Recent advances in the management of lupus nephritis,together with earlier renal biopsy and selective use of aggressive immunosuppressive therapy,have contributed to a favorable outcome in children and adolescents with systemic lupus erythematosus(SLE).Nevertheless,we believe that a more effective and less toxic treatment is needed to attain an optimal control of the activity of lupus nephritis.Recent published papers and our experiences regarding treatment of young patients with lupus nephritis using calcineurin inhibitors are reviewed.Although it has been reported that intermittent monthly pulses of intravenous cyclophosphamide(IVCY)are effective for preserving renal function in adult patients,CPA is a potent immunosuppressive agent that induces severe toxicity,including myelo-and gonadal toxicity,and increases the risk of secondary malignancy.Thus,treatment for controlling lupus nephritis activity,especially in children and adolescents,remains challenging.Cyclosporine A(Cs A)and tacrolimus(Tac)are T-cell-specific calcineurin inhibitors that prevent the activation of helper T cells,thereby inhibiting thetranscription of the early activation genes of interleukin(IL)-2 and suppressing T cell-induced activation of tumor necrosis factor-α,IL-1βand IL-6.Therefore,both drugs,which we believe may be less cytotoxic,are attractive therapeutic options for young patients with lupus nephritis.Recently,a multidrug regimen of prednisolone(PDN),Tac,and mycophenolate mofetile(MMF)has been found effective and relatively safe in adult lupus nephritis.Since the mechanisms of action of MMF and Tac are probably complementary,multidrug therapy for lupus nephritis may be useful.We propose as an alternative to IVCY,a multidrug therapy with mizoribine,which acts very similarly to MMF,and Tac,which has a different mode of action,combined with PDN for pediatric-onset lupus nephritis.We also believe that a multidrug therapy including Cs A and Tac may be an attractive option for young patients with SLE and lupus