Objective To investigate the association between body mass index and postoperative complications in patients with colorectal cancer.Methods 120 patients with colorectal cancer were prospectively studied.According to the body mass index,all patients were assigned to study group (BMI ＜ 18.5kg/m2) or control group (BMI ≥ 18.5kg/m2),60 cases in each group.All patients received elective colorectal cancer resection.The operation situation,postoperative complications,postoperative recovery and postoperative stress reaction of the two groups were observed.Results There were no significant differences in the operation time,the number of lymph node dissection and the amount of bleeding between the two groups during the operation (all P ＞ 0.05).Compared with the control group,the total infection rate of the study group was significantly higher(11.67％ vs.1.67％,x2 =4.324,P =0.038);the incidence of postoperative complications was significantly increased (25.00％ vs.5.00％,x2 =7.908,P =0.005).There were no significant differences in other complications such as wound infection,anastomotic leakage,anastomotic obstruction,adverse cardiovascular events and stress ulcer (all P ＞ 0.05).Compared with the control group,the postoperative anal exhaust time of the study group was significantly prolonged [(51.48 ± 9.47) h vs.(43.73 ± 8.63) h,t =5.382,P =0.000];and the length of hospital duration was significantly prolonged [(20.35 ± 3.21) d vs.(16.28 ± 3.48) d,t =6.462,P =0.000].There were no significant differences in recurrence rate,mortality rate and progression free survival between the two groups after 1 year (all P ＞ 0.05).There were no significant differences in preoperative IL-6 and CRP levels between the two groups (all P ＞ 0.05).Compared with the control group,the IL-6 level of the study group at 7-day after operation was significantly higher[(165.56 ±45.39) ng/L vs.(122.58 ± 29.58) ng/L,t =6.459,P =0.000];CRP level was significantly higher [(23.49 ± 8.48) mg/L vs.(15.37 ±6.53)mg/L,t =4.285,P=0.002].Conclusion Body mass index less than 18.5 kg/m2 is a risk factor for postoperative infection and complications in patients with colorectal cancer,and is associated with increased stress response and prolonged hospital stay.

Objective To investigate the clinical value of elderly gastric cancer patients undergoing preoperative use of hydroxyethyl amylase. Methods From June 2012 to February 2016 underwent gastrointestinal surgery in our hospital 54 cases of radical resection of gastric cancer patients with clinical research, according to the patients divided into experimental group, control group 27 cases, preoperative intravenous hydroxyethyl starch or Ringer lactate solution, monitoring the hemodynamic changes, inflammatory factors and coagulation indexes in patients in two groups.Results T0 moment, MAP, CVP and HR of experimental group and control group were no significant difference; in T1, T2, T3, MAP and HR of experimental group were higher than that of control group (P<0.05), the CVP value was lower than the control group (P<0.05);T1 T2, T3, PT and APTT in two groups compared with T0 times were significantly increased (P<0.05); pre-treament, there was no significant difference in serum TNF-α, IL-10, IL-6 and CRP between the observation group and the control group; post-treament, The levels of TNF-α, IL-10, IL-6 and CRP in the observation group were lower than those in the control group ( P <0.05 ) .Conclusion The elderly gastric cancer patients undergoing preoperative use of hydroxyethyl amylase is important for inflammation and maintain stable hemodynamics in patients with postoperative .

Objective To analyze the treatment-delay situation of tuberculosis(TB) patients and its influencing factors in ethnic minority areas to provide reference basis for formulating the effective prevention and control measures.Methods The medical records data in 1166 cases of pulmonary TB in Jinping county during 2010-2014 were collected from national TB information management system,their treatment-delay related situation was analyzed and its influencing factors were also analyzed by adopting the Logistic regression model.Results Among 1 166 cases of pulmonary TB reported by Jinping County during 2010-2014,568 cases were treatment-delay,the treatment-delay rate was 48.71％ (568/1 066),the treatment-delay time ≥30 d accounted for 67.25 (382/568),which ≥183 d(half a year) accounted for 6.51％ (37/568),which ≥365 d accounted for 2.64％ (15/568),and the maximal treatment-delay time reached 7 years(2 549 d);the multivariate Logistic regression analysis results showed that compared with non-peasants,sputum smear negative,non-critical patients,peasants(OR=1.867,95％ CI:1.300-2.700),sputum positive(OR=1.631,95 ％ CI:1.200-2.100),critical patients(OR =0.684,95 ％ CI:0.500-0.900) were the risk factors for the treatment-delay in the pulmonary TB patients in ethnic minority areas.Conclusion The treatment-delay of pulmonary TB patients in ethnic minority areas has no relation with the nationality difference,patient's peasant occupation,sputum smear positive and whether severe case are the influencing factors of treatment-delay in pulmonary TB patients.

Objective To investigate the expression and significance of β-catenin and peroxisome prolifera-tot-activated receptor-γ,(PPARγ) in bepatocellular carcinoma. Methods Tissue microarrays were established to detect β-catenin and PPARγ expression in 49 cases of hepatocellular carcinoma,49 cases of adjacent nontumoral liv-er tissue and 6 cases of normal liver tissue. The relationships between PPARγ and β-catenin as well as between PPARγ and clinicopathological parameters were observed. Results The aberrant expression rate of β-catenin was 69.39%,48.98 % and 0 respectively (P=0.001). The positive expression rate of PPARγ was 51.02%,30.61% and 0 respectively (P=0.016). Clinicopathological analysis revealed that the increase of PPARγ expression was not associated with age,tumor size,serum alpha fetoprotein (AFP) levels,tumor embolus of portal vein or inferior vena cava,and HBsAg infection(χ2=0.214,3.201,0.046,3.201,P>0.05 for each),but correlated with differentiation grades(χ2=4.693,P<0.05). Aberrant expression of β-catenin was associated with PPARγ expression(χ2= 5.130,P<0.05). Conclusion Aberrant expression of β-catenin may involve in the liver carcinogenesis. The high expression of PPARγ in hepatocellular carcinoma is significantly correlated with the clinicopathological characteris-tics. Detection of PPARγ is valuable for diagnosing hepatocellular carcinoma,and evaluating malignancy extent and prognosis.

Objective To investigate the therapeutic effect of early stage minimally invasive laparoscopic retroperitoneal approach of catheter drainage on early inflammatory response of severe acute pancreatitis ( SAP ) . Methods 37 SAP patients with peritoneal effusion were divided into the observation group (19 cases with early laparoscopic retroperitoneal approach of catheter drainage )and normal treatment group(18 cases with conventional drainage)using a random number table.All patients were given conventional therapy , such as fasting, gastroin-testinal decompression , anti-infection, fluid resuitation and using gastric acid and trypsin inhibitors .In addition to conventional therapy , the observation group received the early laparoscopic retroperitoneal approach of catheter drainage.The inflammatory indexes responding to acute inflammation such as TNF-α,IL-6,IL-8, IL-10 and C-re-active protein(CRP)were detected before and after treatment .Meanwhile, the date of resume diet, APACHEⅡscores and duration of systemic inflammatory response ( SIRS) , incidence of multiple organ dysfunction syndrome ( MODS) and the mortality were observed .Results The acute inflammatory response occurred in both groups . The plasma levels of TNF-a,IL-6,IL-8,IL-10 and CRP in the two groups decreased obviously after 3-day treat-ment.However, the plasma levels of inflammatory mediators in the normal treatment group increased while those early laparoscopic retroperitoneal approach of catheter drainage group kept decreasing after 7-day treatment .There was a significant difference between the two groups (P<0.01).Time for resuming to diets and duration of SIRS in the observation group were less than those in the normal treatment group ( P<0.01 ) , APACHEⅡscore were significantly less than those in normal treatment group also (P<0.01).The rates of MODS, overall postoperative complication rate and mortality were significantly lower in the observation group (P<0.05).Conclusions Early laparoscopic retroperitoneal approach of catheter drainage can effectively improve the prognosis in patients with SAP and decrease the production of inflammatory mediators .Early laparoscopic retroperitoneal approach of cathe-ter drainage is simple , feasible and micro-invasive with encouraging outcomes , therefore it is an effective and safe treatment option for patients with SAP .

Objective To evaluate the potential of interventional regional arterial infusion for severe acute pancreatitis (SAP). Methods Regional arterial infusion with somatostatin and antibiotic was performed in 20 cases of SAP within 4 hours after diagnosis confirmed,and pressurized infusion lasted for 5 days. Another 28 cases of SAP as control group received drug treatment all over the body. The SAP clinical data such as symptom,mortality,complication rate and stay time in hospital were analysed in two groups. Results There were significant differences in remission,serum amylase,urine amylase and lipase between the regional and total infusion groups. The stay time in hospital,mortality,complication and operation rate were lower in regional infusion group than those of control group(P

Objectives:To investigate the influence of PN via portal vein on insulin and glucagon in liver regeneration. Methods:The rabbits were randomly devided into control group( n =5),PN via portal vein group(group Ⅰ, n =10) and PN via central vein group(group Ⅱ, n =10).The PN was performed for 6 days after partial hepatectomy.The concentration of serum insulin and glucagon in portal and perpheral vein were analysed with radioimmunoassay. Results:The concentration of serum insulin was increased in group Ⅰ and group Ⅱ,and it was increased significantly( P 0.05),but it was increased significantly in portal vein blood in group Ⅰ( P

Objective To summary the experience of AngioJet mechanical thrombectomy for the treatment of acute deep venous thrombosis (DVT) of lower extremity.Methods Clinical data of 28 patients suffering from acute DVT of lower extremities treated by AngioJet mechanical thrombectomy were analyzed retrospectively from October 2013 to February 2015.Venous recanalization was graded by a thrombus score based on pre-and post-treatment venography.Follow-up was performed by Doppler ultrasound and clinical evaluation.Results Twelve patients were planted temporary vena cava filters.The average length of hospitalization was (3.9 ± 1.1) days.The average operation time was (1.2 ± 0.4) hours.The dosage of urokinase was (320 ± 120) × 104 U and heparin was (46 ± 10)mg during surgery.The average reduction of hemoglobin was (7.5 ± 2.6) g/L.Two patients (Grade Ⅰ thrombolysis) were converted to catheter-directed thrombolysis (CDT).There were 10 (35.7％) cases achieving grade Ⅱ and 16 (57.1％) cases achieving grade Ⅲ,respectively.Technique success rate were 92.9％.Minor bleeding events occurred in 2 patients.Nine (32.1％) patients had stents implanted.One year follow-up found patent deep venous in 26 (92.9％) patients and stent patency rate was 88.9％ (1/9).Two (7.1％) cases developed mild postthrombotic syndrome (PTS).Conclusion AngioJet is a safe and effective tool to treat acute DVT accelerating thrombolytic therapy,and reducing bleeding complications.

Objective To investigate the feasibility and clinical value of the road drainage after early mini-mally invasive treatment of severe acute pancreatitis (severe acute pancreatitis,SAP).Methods A retrospective analysis were used to investigate the clinical data of 37 patients with SAP in March 2011 to March 2011 after conven-tional treatment and early minimally invasive approach drainage treatment.Drainage of early after minimally invasive approach group were treated by laparoscopic retroperitoneal approach surgery in the early onset,and were removed of necrotic tissue and catheter drainage of the retroperitoneal clearance.Then postoperative double pipe for irrigation and the negative pressure drainage were applied.Two groups of postoperative complications,mortality,medical expenses, length of hospital stay,etc.were compared.Results Early minimally invasive drainage of into the road after acute physiology and chronic health evaluation (APACHE Ⅱ)was superior to the conventional treatment group (P =0.00).The overall incidence of complications and mortality of multiple organ dysfunction syndrome (multiple out-raged dysfunction syndrome,MODS),was superior to the conventional treatment group,and the differences were statis-tically significant (P =0.023,P =0.033,P =0.046).Early into the road drainage of hospitalization expenses after minimally invasive were reduced ((19.74 ±2.22)than (36.15 ±1.92)ten thousand yuan,t =23.989,P =0.000),hospitalization time were shorter (4.76 ±0.64)weeks than (6.03 ±0.73)weeks,t =5.635,P =0.000). Conclusion Early minimally invasive retroperitoneal approach of drainage treatment of SAP can reduce the incidence of complications and mortality,reduce hospitalization expenses,shorten hospitalization time,and has the clinical feasi-bility and application value.

Objective To determine the effects of individual antibiotic and immunosuppressive regime on postoperative infection in liver transplant recipients. Method There were 31 cases of liver transplantation from March 2001 to May 2005. The recipients received individual antibiotic and immunosuppressive regime based on the drug susceptibility testing and monitoring of blood drug concentration. The incidence and pattern of infection and the mortality in these recipients were analyzed retrospectively. Results There were 15 episodes of infection during recipients' staying in hospital. The common etiologies were Enterobacter cloacae, pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, and Staph. epidermidis. According to the drug sensitive test, targocid/tienam and tazocin were mostly used in antibiotic regime for treatment of postoperative infection. With monitoring of blood concentration, appropriate application of immunosuppressive agents decreased the incidence of infection from 86.7% before 2003 to 48.4% after 2003 (P0.05). Conclusion Individual application of antibiotic and immunosuppressive regime leads to the suppression of infections and other complications in liver transplant recipients.