Objective To evaluate the incidence of surgical site infection (SSI)in patients with colorectal cancer and identify the risk factors of SSI.Methods A total of 392 patients who underwent colorectal cancer resection at the First Affiliated Hospital of Chongqing Medical University between September 2012 and September 2013 were included and analyzed in terms of the presence of SSI.SSI risk factors were identified by both univariate and multivariate analysis.Results The overall incidence of SSI was 23.0%.Univariate analysis showed that duration of operation above 75 th percentile,colostomy,surgical procedure, type of surgical incision,and American Society of Anesthesiologists (ASA)score were significantly associated with higher risk of SSI (P <0.05).Binary logistic regression suggested that duration of operation above 75 th percentile (P = 0.000,OR =3.017),colostomy (P =0.008,OR=2.642),Contaminated incision (P =0.016,OR=3.311)and laparoscopic surgery (P =0.016,OR=0.523)were significantly different in terms of presence or absence of SSI.Conclusions Duration of operation above 75th percentile,colostomy and contaminated incision are independent risk factors,while laparoscopic surgery is a protective factor for SSI in patients with colorectal cancer.

Objective To investigate the value of protective transverse colostomy in decreasing postoperative anastomotic leakage and stricture after laparoscopic resection for rectal cancer.Methods The clinical data of 128 patients with rectal cancer who were admitted to the Jinhua Hospital of Zhejiang University from March 2008 to February 2012 were retrospectively analyzed.All the patients received laparoscopic anterior resection of rectal cancer after neoadjuvant chemoradiotherapy.Sixty-one patients received protective transverse colostomy (colostomy group) and 67 patients did not receive protective transverse colostomy (non-colostomy group).The incidences of postoperative anastomotic leakage and stricture,condition of the patients and the prognosis of the patients in the 2 groups were compared.Patients were followed up via out-patient examination,in-patient chemotherapy or phone call till May 2013.All data were analyzed using the t test,chi-square test or Fisher exact probability.Results The overall incidence of postoperative anastomotic leakage was 7.03％ (9/128).The incidences of postoperative anastomotic leakage in the colostomy group and non-colostomy group were 6.56％ (4/61) and 7.46％ (5/67),with no significant difference between the 2 groups (x2 =0.000,P ＞ 0.05).The systemic condition of 4 patients who were complicated with anastomotic leakage in the colostomy group was comparatively better,and all of them were cured by conservative treatment.The condition of 5 patients who were complicated with anastomotic leakage in the non-colostomy group was severe,and 4 of them received reoperation,with the reoperation rate of 4/5 ; the other patient received conservative treatment.There was significant difference in the reoperation rate between the 2 groups (P ＜0.05).The overall incidence of postoperative anastomotic stricture was 13.28％ (17/128).The incidences of postoperative anastomotic stricture in the colostomy group and the non-colostomy group were 19.67％ (12/61) and 7.46％ (5/67),with significant difference between the 2 groups (x2=4.133,P ＜ 0.05).The incidences of severe anastomotic stricture of the colostomy group and the non-colostomy group were 8.20 (5/61) and 0,respectively.Conclusion Protective transverse colostomy could not reduce the incidence of postoperative anastomotic leakage,but could mitigate the symptoms followed anastomotic leakage and reduce the reoperation rate.Protective transverse colostomy may improve the incidence of anastomotic stricture,therefore it should be applied cautiously.

Based on the introduction of multi-agent and individual artificial hip joints, this paper reports a multi-agent design system for individual artificial hip joints. Three agents are defined, the first is to optimize the diameter of hip joint, the second for FEM, the third for simulation between the prosthesis and acetabulum cup. The paper lays emphasis on the second agent.
Acetabulum ; Hip Joint ; Hip Prosthesis ; Humans ; Prosthesis Design

Objective To investigate the development and application of blood purification in PICU. Methods The demographic data,diagnosis,length of stay,prognosis,patterns and frequency of blood purifi-cation and complications of PICU patients treated with blood purification in our hospital from 2010 to 2017 were retrospectively analyzed. Results The patients with blood purification accounted for 3. 1％ of hospital-ized children in the same period. From 2010 to 2017,the patients and times with blood purification increased by 370. 6％ and 398. 3％ respectively. The times of continuous veno-venous hemodiafiltration(CVVHDF), plasma exchange and hemoperfusion increased by 135. 2％,6300％ and 1600％ respectively. The frequency of CVVHDF,plasma exchange and hemoperfusion accounted for 42. 8％(492/1151),33. 5％(386/1151), and 23. 7％ (273/1151) respectively. Drug and toxic poision accounted for the highest proportion of 28. 6％(81/284),neurological diseases accounted for 20. 8％(59/284),sepsis with multiple organ dysfunction syn-drome accounted for 18. 0％( 51/284 ) , digestive system diseases, autoimmune diseases, renal diseases and metabolic diseases accounted for 14. 4％( 41/284 ) ,4. 9％( 14/284 ) ,4. 9％ ( 14/284 ) and 4. 2％( 12/284 ) respectively. The cure rate was 63. 8％. Complication included thrombus. Conclusion Blood purification has become the preferred modality for the management of critically ill children. Pediatric blood purification tech-niques have developed rapidly in our PICU and domestic pediatric. Further specification is required,so that it may represent the adequate choice for critical ill children.

Objective To investigate the nutritional status of children with mechanical ventilation, explore the influencing factors of nutritional status,and provide a basis for clinical nutrition support for chil-dren with mechanical ventilation. Methods The children with mechanical ventilation who had ventilated for more than 5 days during the period from February 1,2017 to October 31,2017 were selected as subjects. Ac-cording to the mechanical ventilation time,they were divided into group A (5-16 d) and group B (17-29 d). We assessed malnutrition,screened nutritional risk,and measured albumin both on the admission and with-drawal of the ventilator, respectively. We also calculated the average caloric intake value (EI) and fluid vol-ume during mechanical ventilation. Measured resting energy expenditure (MREE)was calculated by using the Schofield-HTWT formula. Feeding status during mechanical ventilation was assessed by average EI/MREE. Results The incidence of malnutrition at admission was 36. 1%(13/36),and the incidence of malnutrition was 55. 6%(20/36) when evacuated from the ventilator. There was a significant difference(P<0. 05). The incidence of malnutrition was similar in group A and group B on admission,but the incidence of malnutrition in group B(62. 5%) was significantly higher than that in group A (53. 6%) when weaning. The average cal-orie in group B[(32. 25 ± 7. 36)kcal/(kg·d)]was significantly lower than that in group A[(40. 11 ± 6. 00) kcal/(kg·d)]. The mechanical ventilation time of group B[(540. 63 ± 89. 66) h] was significantly longer than that of group A[(224. 46 ± 64. 06)h](P<0. 05). Conclusion Children with mechanical ventilation in the PICU have a higher incidence of malnutrition and the nutritional status deteriorates further during hospital-ization,which may be related to calorie supply,duration of mechanical ventilation,fluid volume,and primary disease.

Alzheimer's disease (AD) is an aging-related neurodegenerative disease and is associated with the accumulation of amyloid-β (Aβ) peptides in patient brains. AD can be classified into the familial type and sporadic type. () is the major risk gene for familial AD (fAD) because its mutations comprised over 80%of the total mutations causing fAD. PS1 is the catalytic subunit of the enzyme γ-secretase, which is responsible for the proteolytic cleavage of amyloid precursor protein (APP) to produce Aβ. Although novel fAD-causing mutations in PS1 are being reported increasingly, the molecular mechanisms underlying how these mutations induce fAD remain elusive. Since over 90%of the fAD-causing mutations in PS1 leads to a reduction of γ-secretase activity, the loss-of-function mutation hypothesis has been emerged, which suggests that the loss of PS1 functions may be the root cause of AD. Recently, increasing number of evidence supports this hypothesis. First, loss-of-function mutations increase the production of long-length Aβ by disturbing the cleavage sites of γ-secretase APP, thereby increasing the ratio of Aβ/Aβ; Second, loss-of-function mutations dysregulate endoplasmic reticulum calcium homeostasis in neurons; Third, loss-of-function mutations inhibit the autophagy activity of neurons, resulting in the abnormal accumulation of cleaved products from APP; Fourth, loss-of-function mutations alter the endocytosis and transcytosis processes in neurons, leading to neuratrophy; Fifth, loss-of-function mutations activate brain immune cells (astrocytes and microglia), which mount a strong neuroinflammation response; Last, loss-of-function mutations reduce the rates of glycolysis and the production of lactic acid, disrupting the balance of neuronal energy supply. In this article we summary the research progress on the loss-of-function hypothesis and pose several topics which would guide studies of this field in future.