Chemokine is a kind of cytokine that induces cell transport to inflammation sites. It plays an important role in controlling the differentiation, development and directed migration of immunocytes. CCL20 is one of the important members of chemokine family, and it belongs to CC subfamily. Its receptor is CCR6. CCL20 can be expressed in activated monocytes, T lymphocytes, dendritic cells and endothelial cells, and CCR6 can be expressed in liver, lung, and lymphoid tissues. The expression of CCL20 can be induced by tumor necrosis factor α (TNFα), interleukin 1β (IL-1β), IL-17, CD40 ligand and interferon γ (IFN-gamma;). In summary, CCL20 plays an important role in tumor growth, invasion and metastasis (mainly refers to intrahepatic metastasis). Copyright© 2011 by TUMOR.

Objective To explore the risk factors and to develop the management methods of massive perihepatic blood accumulation after liver transplantation. MethocSs Clinical data of 117 patients, who received performed ortho topic liver transplantation in the Department of Biliary Tract Surgery (I) of Eastern Hepatobiliary Surgery Hospital of Second Military Medical University from Mar. 2004 to Apr. 2007, were retrospectively studied to analyze the mdependent risk factors associated with the occurrence of massive perihepatic blood accumulation by univariate analysis andmultivariate analysis, and to summarize the corresponding treatment methods. Results Twelve of 117 cases died ln the perioperative period, and 105 caseswere lncluded in this study. Among 105 cases, 9 (8. 57%) had postoperative massive perihepatic blood accumulation accompanied by aggravated yellowing of the skin and sclera, elevated whole blood leukocyte count and neutrophil proportion in a short period of time, and impaired liver function. Univariate analysis showed the massive perihepatic blood accumulation was associated with a history of upper abdominal surgery (P=0. 001), pre-operative hemoglobin (P= 0. 031), pre-operative leukocyte count (P= 0. 001), pre-operative platelet count (P<0. 001) and post-operative bile leakage (P=0.001); Multivariate analysis showed a history of upper abdominal surgery (P=0. 008, 0R=15. 000) and post-operative bile leakage (P=0. 034, OR=20. 770) were independent risk factors for massive perihepatic blood accumulation. Conclusion The main methods to prevent massive perihepatic blood accumulation include knowing the history of upper abdominal surgery m patients, strictly protecting the blood supply of bile duct, accurate anastomosis and preventing bile leakage. Puncture or removal of hematocele timely is effective for massive perihepatic blood accumulation.

Acrylic Resins ; adverse effects ; Adult ; Breast Implantation ; adverse effects ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Middle Aged

OBJECTIVETo report the procedure of segmentectomy for hepatoma located in segment IX.

METHODS11 cases of hepatoma originated from segment IX were treated by segmentectomy without interruption of blood flow of the liver. Among total 11 cases, 10 cases were primary liver cancer, the other one was secondary liver cancer.

RESULTSTumor diameters from 6 to 14 cm (median 9.2 cm), no perioperative death occurred in this group. Intraoperative blood losses were 200-600 ml (median 350 ml) without severe postoperative complications. Postoperative hospitalization time were 9-14 days (median 11 days). Transhepatic artery chemoembolization (TACE) was given at 4-6 weeks after operation and repeated at intervals of 2 to 4 months for 1 year. During the follow up time of 5-29 months (media 17 months), 10 patients were tumor-free and 1 patient developed an intrahepatic metastasis.

CONCLUSIONSSegmentectomy without interruption of blood flow of the liver is safe and practical for hepatoma located in segment IX.

Adult ; Carcinoma, Hepatocellular ; pathology ; surgery ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; pathology ; surgery ; therapy ; Male ; Middle Aged

Objective To investigate the status of genotype of the KPC(Klebsiella pneumoniae carbapenemase)-encoding genes in Pan-resistant K. Pneumoniae, isolated from the 98th Hospital of People' s Liberation Army, Huzhou district, Zhejiang province, China. Methods 19 strains of Pan-resistant K. Pneumoniae were isolated from the inpatients between November, 2008 and July,2009. Phenotypic confirmatory test for suspected carbapenemases production were carried out by Modified Hodge test. Carbapenemase gene of blaKPC was analyzed by PCR and verified by DNA sequencing. Results In 19 strains of K. Pneumoniae, the positive rates of Modified Hodge test and gene of blaKPC were both 100.0%. These genes all belonged to blaKPC-2 subtype confirmed by nucleotide sequence analysis. Among them, the blaKPC-2 gene sequence of the HZ001 strain (its original serial number was HZ9871 ) had been registered in GenBank (GenBank Accession Number: GU086225).Conclusion All of the Pan-resistant K. Pneumoniae isolated from the inpatients harbored blaKPC-2 type carbapenemases gene and causing an outbreak in a hospital. Carbapenemases that producing type KPC-2 might be the major reason which causing the resistance to Carbapenems antibiotics.

Objective: To explore the prevalence and risk factors of orthostatic hypotension (OH) in elderly hypertension patients. Methods: A total of 532 retired hypertension patients elder than 65 years in Guangzhou military region were enrolled. The patients were divided into 2 groups: Hypertension group, n=414 and Hypertension combining OH (H+OH) group, n=118. The patient's age (65-79、≥ 80), hypertension grade (Grade 1-3) and complication status were studied. The risk factors for H+OH prevalence were analyzed by multivariate Logistic regression analysis. Results: The incidence rate of H+OH was 22.2％ (118/532). In H+OH group, the ratios of elderly and very elderly patients were 6.7％ and 23.1％, P<0.05 and the ratios of OH occurrence for hypertension grade 1, 2 and 3 were 12.6％, 23.3％ and 25.2％ respectively, P<0.05. Multivariate Logistic regression analysis presented that systolic blood pressure (BP) in supine position, BP at immediate standing, heart rate in supine position, heart rate after 2 minutes standing and chronic cardiac insufficiency were the impact factors for H+OH occurrence, P<0.05. Conclusion: In elderly hypertension patients, incidence of OH was increasing with age elevating; H+OH has been related to age, severity of hypertension and chronic cardiac insufficiency.

Objective To explore the influence of prepositioned service on medical equipment procurement demand presentation.Methods An observation group was established with the projects involving the material purchasing department in medical equipment procurement demand presentation in 2022,and a control group was formed with the projects not involving the material purchasing department in 2021.The two groups were compared in terms of presentation modification rate,rate of parameter challenge,success rate of parameter challenge and annual department satisfaction.Results The rate of parameter challenge and success rate of parameter challenge in the observation group were 8.37％,3.04％and 1.14％respec-tively,which were significantly lower than those(15.45％,6.67％and 3.94％respectively)in the control group(all P＜0.05);the mean value of the annual departmental satisfaction of the observation group was(82.25±8.01)points,which was significantly higher than that of the control group(73.51±8.91)points(P＜0.05).Conclusion The involvement of the material purchasing department in clinical department demand presentation effectively enhances medical equipment procurement demand presentation and satisfaction of clinical departments for the material purchasing department.[Chinese Medical Equipment Journal,2023,44(9):88-91]

OBJECTIVETo evaluate the surgical outcomes after transumbilical single-port access laparoscopic surgery for colorectal cancer.

METHODSPatients undergoing transumbilical single-port access laparoscopic radical resection for colorectal cancer at the Zhongshan Hospital of Xiamen University were included.

RESULTSThree patients underwent transumbilical single-port access laparoscopic radical resection for sigmoid colon cancer and 1 for rectal cancer between August 2010 and September 2010. There were no intraoperative or postoperative complications. No conversion was required. The mean operative time was 206 min and the mean estimated blood loss was 75 ml. The mean number of harvested lymph nodes was 21. Patients were ambulatory in the same day of surgery or postoperative day 1. Length of hospital stay ranged from 7 to 10 days.

CONCLUSIONSTransumbilical single-port access laparoscopic surgery is safe for colorectal cancer. Long-term outcomes warrant further investigation.

Adult ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Umbilicus ; surgery

Objective To analyze the impact of attack frequency as well as therapy strategies on outcome of patients with vasovagal syncope (VVS).Methods A total of 159 patients (aged from 15-59 years old) with VVS were included in this study.Patients were divided into low frequency (＜ 3) group (n =95) and high (≥3) frequency group (n =64) according to the attack frequency in the past 5 years at the primary survey.Patients received one of the three therapies:no treatment,physical therapy,and comprehensive treatment.All cases were followed up with telephone or outpatient visit for 24 months.Results Incidence of syncope was significantly higher in the high frequency group and in the low frequency group [40.6％ (26/64) vs.11.6％ (11/95),P ＜0.01].The overall improvement rate was significantly higher in the low frequency group than that of high frequency group (P ＜ 0.01).Improvement rate was significantly higher in the physical therapy subgroup and the comprehensive treatment subgroup than no treatment subgroup for patients with low attack frequency [81.8％ (27/33) vs.47.1％ (8/17),P ＜ 0.05 ; 82.2％ (37/45) vs.47.1％ (8/17),P ＜ 0.05],and in comprehensive treatment subgroup than in physical therapy subgroups observed between and [62.2％ (28/45) vs.31.6％ (6/19),P ＜ 0.05] for patients with high attack frequency.Conclusion Outcome is related to previous attack frequency for patients with VVS,physical therapy is effective for reducing the recurrence rate of syncope in VVS patients with low attack frequency while physical therapy combined with pharmacotherapy should be applied for VVS patients with high attack frequency to improve outcome.

OBJECTIVETo study the expression of ecotropic viral integration site (EVI1) gene in childhood acute myeloid leukemia (AML) and the clinical features of EVI1-positive children with AML.

METHODSThe clinical data of EVI1-positive children with AML were collected and analyzed. RT-PCR and real-time quantitative PCR were used for qualitative and quantitative analysis of expression of EVI1. Flow cytometry (FCM) was used for determining the immunophenotypes of bone marrow cells. Multiparameter FCM was used for monitoring minimal residual disease. The karyotypes were determined.

RESULTSOf 241 children with AML, 33 (13.7%) were positive for EVI1 expression. There were no significant differences in age at first visit as well as the white blood cell count, hemoglobin level, and platelet count in peripheral blood between EVI1-positive and EVI1-negative children with AML (P>0.05), but EVI1-positive children had a significantly increased proportion of females compared with EVI1-negative children (P<0.05). The change in EVI1 expression was not synchronous with clinical remission and the change of MRD: some children had clinical remission or negative conversion of MRD before negative conversion of EVI1, while some had negative conversion of EVI1 before clinical remission or while MRD showed positive. EVI1 gene was usually co-expressed with other fusion genes. CD33 (100%), CD38 (88%), and HLADR (76%) were highly expressed in EVI1-positive children with AML. Abnormal chromosome structure or number was found in 15 patients. Compared with EVI1-negative children, EVI1-positive children had significantly lower complete remission rates after the first course of treatment (P<0.05).

CONCLUSIONSEVI1-positive children with AML have a poor short-term prognosis. In the development of AML, the activation of EVI1 gene is not isolated, but the result of interactions with other genes or chromosome abnormalities, and the mechanism of activation and its function need further study.

Adolescent ; Child ; Child, Preschool ; Chromosome Aberrations ; DNA-Binding Proteins ; genetics ; Female ; Flow Cytometry ; Gene Expression Regulation, Neoplastic ; Humans ; Immunophenotyping ; Infant ; Leukemia, Myeloid, Acute ; genetics ; immunology ; MDS1 and EVI1 Complex Locus Protein ; Male ; Neoplasm, Residual ; Prognosis ; Proto-Oncogenes ; genetics ; Transcription Factors ; genetics