[Effect of CIK on long-term survival in the treatment of HCC after RFA combined TACE].

OBJECTIVE: To evaluate the clinical effects of autologous cytokine-induced killer cell(CIK) on the cumulative survival and reactivation rate of hepatitics B virus(HBV) after radiofrequency ablation(RFA) combined with transcatheter arterial chemoembolization(TACE). METHODS: A total of 156 patients with hepatocellular carcinoma treated from June 2006 to September 2012 in Shengli Oilfield Central Hosptial were divided into control group(RFA, TACE) and research group(RFA, TACE, CIK). According to the tumors number, diameter and vascular invasion condition, the patients were divided into another 4 groups: the high and low risk group with tumor ≤5 cm, the high and low risk group with tumor>5 cm.The prognosis of these groups was analyzed. The effects on HBV reactivation rate between antiviral and unantiviral patients were respectively analyzed . RESULTS: The ratios of the research and control group over 1-, 3-, 5-year were 75.3%(70/93), 58.9%(53/90), 21.5%(20/93)vs 71.4%(45/63), 55.6%(35/63), 22.2%(14/63)(P>0.05), the ratios of the research and control group in the high risk group with tumor≤5 cm were 75.0%(18/24), 58.3%(14/24), 37.5%(9/24)vs 58.8%(10/17), 41.2%(7/17), 23.5%(4/17)(P<0.05). The incidences of HBV reactivation for the research and control group were 6.0% and 24.3%(P<0.05). CONCLUSION: Postoperative adjuvant CIK therapy with tumor≤5 cm after RFA combined with TACE is beneficial to the high risk group and decreases the risk of HBV reactivation.

[Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China].

Objective: Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence. Methods: Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS. Results: A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ(2)=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ(2)=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ(2)=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ(2)=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ(2)=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ(2)=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ(2)=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions: For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.

Chemical and microbiological parameters in New Orleans floodwater following Hurricane Katrina.

Hurricane Katrina, rated as a Category 4 hurricane on the Saffir-Simpson scale, made landfall on the U.S. Gulf Coast near New Orleans, Louisiana on Monday, August 29, 2005. The storm brought heavy winds and rain to the city, and several levees intended to protect New Orleans from the water of Lake Pontchartrain were breached. Consequently, up to 80% of the city was flooded with water reaching depths in excess of three meters in some locations. Research described in this paper was conducted to provide an initial assessment of contaminants present in floodwaters shortly after the storm and to characterize water pumped out of the city into Lake Pontchartrain once dewatering operations began several days after the storm. Data are presented which demonstrate that during the weeks following the storm, floodwater was brackish and well-buffered with very low concentrations of volatile and semivolatile organic pollutants. Dissolved oxygen was depleted in surface floodwater, averaging 1.6 mg/L in the Lakeview district and 4.8 mg/L in the Mid-City district. Dissolved oxygen was absent (< 0.02 mg/L) at the bottom of the floodwater column in the Mid-City district 9 days afterthe storm. Chemical oxygen demand (Mid-City average = 79.9 mg/L) and fecal coliform bacteria (Mid-City average = 1.4 x 10(5) MPN/100 mL) were elevated in surface floodwater but typical of stormwater runoff in the region. Lead, arsenic, and in some cases, chromium, exceeded drinking water standards but with the exception of some elevated Pb concentrations generally were typical of stormwater. Data suggest that what distinguishes Hurricane Katrina floodwater is the large volume and the human exposure to these pollutants that accompanied the flood, rather than very elevated concentrations of toxic pollutants.