Objective:To evaluate the relationship between intraoperative concentration of C-X-C motif chemokine 13 (CXCL13) in peripheral blood and postoperative delirium (POD) in elderly patients under general anesthesia.Methods:Ninety-three patients of both sexes, aged 65-85 yr, of American Society of Anesthesiologists physical statusⅠor Ⅱ, scheduled for elective hip replacement under general anesthesia, were selected.Peripheral venous blood samples were collected to determine the concentrations of CXCL13 and interleukin-6 (IL-6) before anesthesia and during surgery (30 min after skin incision). The Confusion Assessment Method Scale in Chinese was used to detect the development of POD every day within 7 days after surgery in 2 groups.The patients were divided into POD group and non-POD group.Logistic regression analysis was used to identify the risk factors for POD.Results:Seventeen patients developed POD (19%). There was significant difference in ages, preoperative mini-mental state examination (MMSE) scores before surgery, hospital stay time and intraoperative concentrations of CXCL13 and IL-6 in peripheral blood between group non-POD and group POD ( P<0.05). The results of logistic regression analysis showed that preoperative MMSE scores, intraoperative concentrations of CXCL13 and IL-6 in peripheral blood and advanced ages were independent risk factors for the development of POD ( P<0.05). Conclusion:Preoperative MMES scores, intraoperative concentrations of CXCL13 and IL-6 in peripheral blood and advanced ages are independent risk factors for the development of POD.

Coding system is the basis of delicacy and informatization management of medical supplies, and is the link between enterprise production and clinical use. Rational construction of coding system can realize dynamic analysis of big data, guide clinical use, improve the use efficiency, and form a traceability system. Coordinating with medical security standardization work guidance, the authors analyzed the characteristics of current classification, and constructed a new medical supplies coding system by combining the clinical characteristics, price supervision, level of risk, properties of medical charge and insurance, production date and traceability, etc. This new medical supply coding system could contribute to analyzing the usage structure and strengthening price supervision, medical supplies classification and traceability management, which could be appropriate for the monitoring of the whole supply chain, from production, logistics, procurement, supplies usage, charge, medical insurance to traceability management.