Objective To investigate the impact of nutritional risk of preoperative patients with different parts of colorectal cancer. Methods 385 cases of surgical patients diagnosed with colorectal cancer were selected in the retrospective study in April 2008 to March 2009, Gastrointestinal Surgery Center of West China Hospital in Sichuan University. Patients were divided into the right colon cancer group, the left colon cancer group, the rectal cancer group, using internationally recognized NRS- 2002 Scale and serum nutrition indicators to assess their preoperative nutrition. Results NRS-2002 score in the right colon cancer group showed higher than the left colon and rectal cancer group, but no statistical difference between the latter two rates; serum concentrations of HGB, TP, ALB, A/G were lower in the right colon cancer group than the other two groups, but the concentrations of ALT, AST, Ca2+, PO43-showed no statistical difference among three groups. Conclusions The proximal colon (right colon cancer) were more susceptible to the risk of preoperative malnutrition, the patients with different parts of colorectal cancer should be given to the corresponding preoperative nutritional assessment and nutritional support.

Aim To study the influences of miR-203 on ursolic acid (UA ) sensitivity in leukemic K562 cell.Methods In the experimental system,eukaryot-ic expression vector of hsa-miR-203 (PmiR-203 )was transfected into K562 cells using LipofectamineTM 2000.K562 cells were incubated with different con-centration of UA alone or in combination with PmiR-203 .The cell proliferation was analyzed by MTT as-say.The cell apoptosis was measured by double stai-ning with Annexin V and Propidium Iodide.The ex-pression of Bcr/abl protein was detected by Western Blot.Results The miR-203 promoted the sensitivity of UA by up to 1 .55-fold and the IC50 was reduced from 44.3μmol · L-1 to 30.7 μmol · L-1 .The a-mount of apoptotic cells was increased in UA combined with PmiR-203 group (P<0.05).PmiR-203 downreg-ulated the expression of Bcr/abl protein in K562 cells. Conclusion Our results support a substantial role of miR-203 that enhances UA sensitivity in K562 cell and the mechanism appears to be related to the dounregula-tion of Bcr/abl by miR-203 .

Objective To study the influence of preoperative nutritional status for postoperative recovery effect of patients with colorectal cancer. Methods Selected 395 patients with colorectal cancer from Feb 2008 to Jan 2009, evaluated their preoperative nutritional status by NRS-2002, and then divided them into three groups according to the NRS-2002 values. Compared the indexes which indicated postoperative recovery effect among the three groups. Results The nutritional risk level were related with the time of postoperative pulled out the catheter and plasma drainage, the time of consumption, exhaust and defecation and the length of hospital stay. There was no significant correlation between the nutrition risk score and the time of pulled out the stomach robe and getting out of bed. Conclusions There were some influence of preoperative nutritional status on postoperative recovery effect of patients with colorectal cancer, nurses should emphases the preoperative nutrition evaluation and then carry out related nutritional support and associated nursing cares.

Objective To explore the potential role of high levels of adiponectin (AD) in the inflammatory joint of rheumatoid arthritis (RA). Methods ELISA was used to measure the levels of AD, IL-Iβ,IL-6, IL-8, TNF-α, MCP-1 and MMP-9 in the synovial fluids of RA and osteroarthritis (OA), the levels of these cytokines were tested after the synovial fibroblasts (SFLs) were stimulated with AD. Doublelabeling immunohistochemistry was used to analyze the expression of AD in RA synovium. Cytokines were measured by ELISA after SFLs were stimulated with AD. The expression of RANKL was detected by real-time PCR after MH7A were treated with AD and IL-6 ANOVA, Student's t-test, Mann-Whitney U-tese, Spearman's-test were used for statistical analysis. Results High levels of AD in RA synovial fluids were correlated with IL-6 levels. Double labeling immunohistochemistry showed that AD was localized in fibroblasts. MCP-1 and IL-6 were dramatically increased in human synovial fibroblasts following incubation with recombinant AD for 24 h. RANKL mRNA was significantly increased in MH7A after treated with AD and IL-6. Conclusion High levels of AD in the inflammatory joints of RA are likely to contribute to the high expression of IL-6, MCP-1 and RANKL, which may play an important role in the chronic inflammation, osteoclasts activation and bone erosion in RA.

Objective:To investigate the risk factors of multi-drug resistant organism（MDRO）infection in orthopedic trauma patients.Methods:A retrospective case series study was made on clinical data of 95 orthopedic patients with in-hospital wound infection admitted to West China Hospital of Sichuan University from January 2020 to December 2020，including 71 males and 24 females at age of 14-70 years［（42.6 ± 13.8）years］. MDRO infection occurred in 38 patients（DRO group），while not in 57 patients（non-MDRO group）. Etiological characteristics of wound infections were observed. Univariate analysis was used to compare variables between the two groups，including baseline data（gender，age，length of hospital stay，chronic comorbidity）and injury as well as hospitalization information（transfer from another hospital，emergency admission，time from injury to first treatment，open injury，combination with fracture，wound contamination，depth of wound，ICU stay，number of operations，cumulative operation time，type of incision，length of hospital stay before diagnosis of infection，type of antibiotics used，usage of hormones/immunosuppressive agents，level of hemoglobin/serum albumin/blood glucose on admission）. Binary Logistic regression was used to analyze independent risk factors for MDRO infection.Results:A total of 119 pathogenic bacteria were detected on the wound，including 21 gram-positive cocci（18%），91 gram-negative bacilli（76%）and 7 others（6%）. Top five strains were Acinetobacter baumannii，Enterobacter cloacae，Escherichia coli，Staphylococcus aureus and Pseudomonas aeruginosa. Univariate analysis showed the two groups had significant differences in terms of length of hospital stay，wound contamination，ICU stay，length of hospital stay before diagnosis of infection，type of antibiotics used and levels of hemoglobin and serum albumin on admission（ P < 0.05），but not in gender，age，hypertension，diabetes，transfer from another hospital and emergency admission（ P > 0.05）. Multivariate Logistic regression analysis showed MDRD infection was obviously correlated with the long hospital stay（ OR = 1.033， 95%CI 1.005-1.061， P < 0.05），time from injury to first treatment over 6 hours（ OR = 4.282， 95%CI 1.174-15.616， P < 0.05），types of antibiotics used ≥ 3（ OR = 7.486， 95%CI 2.451-22.863， P < 0.05）and low level of hemoglobin on admission（ OR = 0.973， 95%CI 0.962-0.985， P < 0.05）. Conclusions:For orthopedic trauma patients，MDRO infection is independently associated with long hospital stay，time from injury to first treatment，type of antibiotics use and level of hemoglobin on admission，suggesting that decreased length of hospitalization，shortened time of first wound treatment，individualized and rational usage of antibiotics and timely correction of anemia are important measures to prevent MDRO infection.

Objective:To investigate the risk factors of muscle necrosis in patients with acute compartment syndrome（ACS）.Methods:A retrospective case-control study was conducted for clinical data of 111 ACS patients admitted to West China Hospital, Sichuan University from January 2010 to December 2020, including 84 males and 27 females; age 18-76 years [45（36, 55）years]. Muscle necrosis was presented in 35 patients（necrotic muscle group）, but was not seen in 76 patients（non-necrotic muscle group）. The univariate analysis was performed for the two groups in the demographic data（sex, age, ethnicity, body mass index, smoking history, chronic comorbidities）, injury patterns [ mechianism of injury（low energy injury, high energy injury, crush injury, other injury）, time from injury to treatment, first visit or not, combination with bone fracture or not, open injury or not, presence of tension blisters or not], medical treatment（number of debridements, fasciotomy or not）and laboratory indicators [hemoglobin（Hb）, platelet count（PLT）, white blood cell count（WBC）, prothrombin time（PT）, international normalized ratio（INR）, partially activated prothrombin time（APTT）, fibrinogen（FIB）, D-Dimer（D-D）, alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, albumin（ALB）, intravenous blood glucose（GLU）, creatine kinase（CK）, peak value of CK during hospitalization（natural logarithmic conversion, lnCK）, serum sodium（NA）, serum potassium（K）, serum calcium（CA）]. Further multivariate logistic regression was performed to analyze the independent risk factors of muscle necrosis in ACS patients.Results:The univariate analysis showed that there were statistically significant differences between the two groups in the mechanism of injury, first visit or not, combination with bone fracture or not, number of debridements, Hb, PT, INR, D-D, AST, ALB, GLU, CK and lnCK（ P<0.05）, while not in the basic data, time from injury to treatment, open injury or not, presence of tension blisters or not, fasciotomy or not, PLT, WBC, APTT, FIB, ALT, NA, K and CA（ P>0.05）. The multivariate logistic regression analysis showed that high energy injury（ OR=5.143, 95% CI 1.216-21.758, P<0.05）, crush injury（ OR=22.313, 95% CI 2.625-189.635, P<0.05）, other mechanism of injury（ OR=9.019, 95% CI 1.036-78.554, P<0.05）, first visit or not（ OR=0.071, 95% CI 0.006-0.819, P<0.05）, Hb（ OR=0.979, 95% CI 0.961-0.998, P<0.05）, GLU（ OR=1.218, 95% CI 1.020-1.455, P<0.05）and lnCK（ OR=1.805, 95% CI 1.235-2.639, P<0.05）were significantly related with muscle necrosis. Conclusion:The mechanism of injury, first visit or not, Hb, GLU and lnCK are the independent risk factors of muscle necrosis in patients with ACS.

Currently, the management of domestic laboratory developed test (LDT) is still in the exploration stage, and new plans and ideas need to be investigated that are suitable for our national development. By analyzing encountered issues, combining the actual needs of the government, healthcare reform, and patients, this article proposes that "promoting healthy development of LDT projects and focusing on the organic combination of patients′ interest protection and innovation support" is an important direction for LDT management, around which the new idea for LDT project management is proposed, that is, LDT management model targeting product registration. The core of this management model is to target product registration and to ensure low service fees for patients and continuous real-time data monitoring. Benefit and risk analysis demonstrate that this management model can to a larger extent balance the realistic demands of patients, medical institutions, in vitro diagnostics companies, and government management departments, which benefits promoting the perfection and development of LDT projects in our country.

The unique characteristics of the tumor microenvironment (TME) could be exploited to develop antitumor nanomedicine strategies. However, in many cases, the actual therapeutic effect is far from reaching our expectations due to the notable tumor heterogeneity. Given the amplified characteristics of TME regulated by vascular disrupting agents (VDAs), nanomedicines may achieve unexpected improved efficacy. Herein, we fabricate platelet membrane-fusogenic liposomes (PML/DP&PPa), namely "platesomes", which actively load the hypoxia-activated pro-prodrug DMG-PR104A (DP) and physically encapsulate the photosensitizer pyropheophorbide a (PPa). Considering the different stages of tumor vascular collapse and shutdown induced by a VDA combretastatin-A4 phosphate (CA4P), PML/DP&PPa is injected 3 h after intraperitoneal administration of CA4P. First, CA4P-mediated tumor hemorrhage amplifies the enhanced permeation and retention (EPR) effect, and the platesome-biological targeting further promotes the tumor accumulation of PML/DP&PPa. Besides, CA4P-induced vascular occlusion inhibits oxygen supply, followed by photodynamic therapy-caused acute tumor hypoxia. This prolonged extreme hypoxia contributes to the complete activation of DP and then high inhibitory effect on tumor growth and metastasis. Thus, such a combining strategy of artificially-regulated TME and bio-inspired platesomes pronouncedly improves tumor drug delivery and boosts tumor hypoxia-selective activation, and provides a preferable solution to high-efficiency cancer therapy.