Objective To investigate the effect of fatty liver graft on early poor prognosis in postoperative liver transplant adult patients.Methods The clinical data of 125 adult patients undergoing liver transplantation (LT) from fatty liver graft from January 2008 to October 2012 were retrospectively analyzed.Patients were divided into poor-prognosis group and non-poor-prognosis group.18 clinical factors were compared between these two groups by single factor and multiple factor Logistic regression analysis.Results Degree of steatosis (x2 =10.088,P =0.004),recipients' age (t =-3.917,P =0.002),pre-LTserum creatinine values (Z =-2.623,P =0.009),liver warm ischemia time (Z =-2.305,P =0.021),cold ischemia time (Z =-3.394,P =0.001) were identified to be statistically significant by the single factor analysis (P ＜ 0.05);By multivariate stepwise Logistic regression analysis on the above parameters,cold ischemia time (x2 =10.141,P =0.001,OR =1.003) and degree of steatosis (x2 =8.360,P =0.004,OR =4.619) were found as the independent risk factors,into the regression equation:Y =0.003 × cold ischemia time + 1.530 × degree of steatosis-4.243.Conclusions Donor liver cold ischemia time,degree of steatosis are independent risk factors for poor prognosis in early stage after liver transplantation.

Objective To study the expressions and the clinicopathologic significance of Ezrin and PTEN protein in intrahepatic cholangiocarcinoma.Methods The ICC tissues (the ICC group) and the corresponding para-carcinoma tissues (the control group) were collected from 50 patients with intrahepatic cholangiocarcinoma (IHC) to detect the expressions of Ezrin and PTEN protein by using SP immunohistochemistry (IHC).The clinicopathologic parameters were analyzed.Results The positive expression rates of Ezrin were 78.0％ (39/50) and 46.0％ (23/50) in the ICC group and the control group,respectively.The difference in expression between the two groups was statistically significance (P＜0.05).The expression of Ezrin in the ICC group was highly related to tumor size,differentiation grade,TNM stage,and lymphatic metastasis (P＜0.05),but it was not related to age,gender,serum CA19-9 level,hepatitis B virus infection,intrahepatic duct calculus (P＞0.05).The positive expression rates of PTEN was 46.0％ (23/50) and 88.0％ (44/50) in the ICC group and the control group,respectively.The difference in expression between the two groups was statistically significance (P＜0.05).The expression of PTEN in the ICC group was highly related to differentiation grade,TNM stage,and lymphatic metastasis (P＜0.05),but it was not related to age,gender,serum CA19-9 level,hepatitis B virus infection,tumor size,intrahepatic duct calculus (P＞0.05).There was a negative correlation between the expression of Ezrin and PTEN protein in ICC (r=-0.382,P＜0.01).Conclusion The abnormal and negative correlation between the expression of Ezrin and PTEN protein in ICC may play an important role in invasion and metastasis of ICC.

Objective: To explore the clinical features and complications of foreign bodies in the upper gastrointestinal tract in children and to investigate the effectiveness of endoscopic management. Methods: Data of patients with foreign bodies in upper gastrointestinal tract were collected retrospectively at Endoscopy Center, the Children's Hospital, Zhejiang University School of Medicine, from January 2011 to December 2016. Clinical characteristics, the types of foreign bodies, the location and duration of foreign body impaction were summarized. The risk factors of complications and endoscopic removal failure were analyzed by using Logistic regression analysis. Results: A total of 1 334 patients (825 males and 509 females) were enrolled. The median age was 2.5 years, with a range from 0.25 to 15 years and peak age 1-3 years. Twenty patients had esophageal diseases. The most common foreign body ingested was coin (n=964, 72.3%). Foreign bodies were most commonly located in the esophagus (n=1 002, 75.1%), especially in the upper esophagus (n=857, 85.5%). The duration of foreign body impaction ranged from 3 hours to 5 years. Among 1 334 patients, 252 patients (18.9%) developed complications, including ulcers (n=101, 40.0%) and perforations(n=13, 5.2%). The success rate of endoscopic removal was 96.6% (n=1 288). By Logistic regression analysis, sharp foreign body ingestion (OR=6.893, 95%CI: 4.421-10.746) , esophageal impaction (OR=5.253, 95%CI:3.352-8.233) and foreign body impaction longer than 24 hours (OR=4.336, 95%CI:3.091-6.082) were risk factors of complications. Sharp foreign body ingestion was the risk factor of endoscopic failure (OR=5.372, 95%CI:2.773-10.406) . Conclusions Coin is the most common foreign body in upper gastrointestinal tract. Sharp foreign bodies impacted in the esophagus over 24 hours increase the risk of complications. Endoscopic removal of foreign bodies from the upper gastrointestinal tract in children has a high success rate. Sharp foreign body ingestion increases the risk of failure in endoscopic removing.

Rotavirus (RV) is one of the leading causes of acute gastroenteritis in infants and young animals worldwide. Rotavirus infection has obvious species specificity and mainly causes diarrhea in infants and young animals. The host innate responses suppress the infection and replication of rotavirus through activating multiple signaling pathways. Meanwhile, rotavirus also antagonizes the innate immune responses in various ways. This article reviewed the mechanisms of host innate immune responses to rotavirus infection and the antagonistic mechanism of rotavirus against host innate immunity with a view to providing reference for the development of therapeutic drugs and the prevention of rotavirus infection.

The performance appraisal of tertiary public hospitals is key to their high-quality development. Since 2019, Children′s Hospital of Zhejiang University School of Medicine has taken the following measures to leverage performance appraisal. Namely promoting medical technology innovation to enhance the diagnosis and treatment capabilities of difficult and critical diseases; Reasonably setting a target system, improving the performance appraisal mechanism of the hospital; Improving operational efficiency, enhancing the sense of gain by children patients; Building a high-quality talent pool, promoting sustainable development, and effectively promoting high-quality development of hospitals. These measures can provide reference for promoting the high-quality development of hospitals.

Intra-abdominal infections (IAI) is common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The principles of IAI management included early diagnosis, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using critical care resources, combined with an optimal surgical approach. In order to facilitate clinical management, establish a global standard and provide guidance for clinicians, the World Society of Emergency Surgery (WSES), the Global Alliance for Infection in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) worked together to complete an international multi-society document, which provided the evidence-based clinical pathways. Herein, we made a comprehensive interpretation for the clinical pathways combined with the latest domestic and international research developments, aiming to provide evidence for domestic doctors on the diagnosis and treatment of IAI, and ultimately benefit patients.