Analysis of medicine consumption in peacekeeping level II hospitals

Background: The peacekeeping military units of contributing countries are unfamiliar with the conditions prevailing in foreign mission areas and therefore have difficulties with medical supplies storage.Aim: The aim of this study is to provide reasonable and practical guidance on the maintenance of medical supplies in the peacekeeping military units of contributing countries.Materials and methods: A total of 1,972 prescriptions were received by the pharmacy in the peacekeeping level II hospital in the Republic of Sudan from February to July of 2009 including a total of 186 drug categories and 17,713 minimum packing units. Pairwise comparison was performed using the c2 test. When thetotal number of samples was smaller than 40, the Fisher’s exact test was adopted for pairwise comparison.Results: The majority of the consumed medicines mainly belonged to 6 categories, including specialty drugs, anti-microbial drugs, Chinese patent medicines, gastrointestinal drugs, central nervous system drugs, and drugs regulating fluids, electrolytes, and acid-base balance. Altogether, the drugs in the 6 categories accounted for 74% of all consumed medicines that were divided into a total of 20 categories.Conclusions: Medicine consumption in peacekeeping level II hospitals is unique, therefore the drugs used in military medical facilities should be prepared according to their actual needs in the area of peacekeeping operations

Role of CCR8 and Other Chemokine Pathways in the Migration of Monocyte-derived Dendritic Cells to Lymph Nodes

Studying the influence of chemokine receptors (CCRs) on monocyte fate may reveal information about which subpopulations of monocytes convert to dendritic cells (DCs) and the migration pathways that they use. First, we examined whether prominent CCRs on different monocyte subsets, CCR2 or CX3CR1, mediated migration events upstream of the accumulation of monocyte-derived DCs in lymph nodes (LNs). Monocytes were labeled and traced by uptake of latex microspheres in skin. Unexpectedly, neither CCR2 nor CX3CR1 were required. However, absence of CCR2 led to an increased labeling of the minor Gr-1int monocyte population, and the number of latex+ DCs that emigrated to LNs was correspondingly increased. Characterization of Gr-1int monocytes revealed that they selectively expressed CCR7 and CCR8 mRNA in blood. CCR7 and CCR8 pathways were used by monocyte-derived DCs during mobilization from skin to LNs. The role of CCR8 in emigration from tissues also applied to human monocyte-derived cells in a model of transendothelial trafficking. Collectively, the data suggest that Gr-1int monocytes may be most disposed to become a lymphatic-migrating DCs. When these monocyte-derived DCs exit skin to emigrate to LNs, they use not only CCR7 but also CCR8, which was not previously recognized to participate in migration to LNs

A liquid biopsy assay for identifying early-stage hepatocellular carcinoma in asymptomatic HBsAg-seropositive individuals

Biannual screening of hepatocellular carcinoma (HCC) by ultrasonography and serum α-fetoprotein has been proposed to the HBsAg-seropositive individuals. The widespread application to all of them was restricted due to limited acceptability of resource and anxiety-producing procedures. We recently developed a novel liquid biopsy assay to identify HCC cases in asymptomatic HBsAg-positive individuals

Conventional type 1 dendritic cells in protective antitumor immunity and its potential in hepatocellular carcinoma

Immunotherapy is revolutionizing the clinical management of cancer patients by modulating T cells and natural killer cells. Dendritic cells (DCs) have the capacity to orchestrate the expansion and function of these effector cells both in lymphoid and non-lymphoid tissues of cancer patients. Distinct subtypes of DCs have various capacities to prime and activate different T cell responses. Here, we review conventional type 1 dendritic cells (cDC1s) and their crucial role in protective anti-tumor immunity. Targeting cDC1s as a cancer vaccine against the development of hepatocellular carcinoma will be discussed

Reducing liver cancer risk beginning at birth: experiences of preventing chronic hepatitis B virus infection in China

In China, the death numbers due to primary liver cancer every year account for more than half of this disease burden worldwide. Hepatocellular carcinoma (HCC) represents the major histological type of primary liver cancer. In the Chinese population, at least 85% HCC cases are due to chronic infection with hepatitis B virus (HBV), most of which were acquired in the perinatal period or in early life. As of January 1992, HBV immunization of newborns was introduced to the national Expended Program of Immunization of China. Prior to this program, the Qidong County in China conducted an hepatitis B intervention study, which was a population-based, cluster randomized, controlled trial of HBV vaccination in neonates. The study demonstrated that among young adults < 30 years old, neonatal HBV immunization decreased around 84% risk of HBV-related liver cancer, and 70% risk of mortality due to severe end-stage chronic liver diseases. More than 72% efficacy of neonatal vaccination against chronic HBV infection in adulthood was achieved; however, when catch-up HBV vaccination was given to children at age 10-14 years, the protection efficacy was only 21%. No difference in mortality of HBV-related liver diseases was observed among the young adults < 30 years who received and those who did not receive the catch-up HBV vaccination. These results highlight the crucial importance of HBV vaccination of neonates in reducing the liver cancer risk beginning at birth in highly HBV endemic regions. Due to large numbers of HBV-infected pregnant women with high viremia in China, clinical studies in which antiviral therapy with the nucleot(s)ide analogues was given to HBV-infected pregnant women have provided important evidence that such therapy can reduce the risk of mother-to-child HBV transmission. These clinical data based on cohort studies, randomized clinical trials, and clinical practices in the Chinese population provide important information on prevention of liver cancer, particularly HCC, by preventing chronic HBV infection starting from birth for other populations