Objective Todetecttheexpressionofvascularendothelialgrowthfactor(VEGF)andmigrationinhibitoryfactor (MIF) in colorectal cancer .Methods The immunohistochemical staining (SP method) was used to measure the expression of VEGF and MIF in 80 samples of colorectal cancer and 80 samples of normal colorectal tissues at 5 cm apart from the tumor edge . The relationship between VEGF and MIF with the clinical pathologic characteristics of colorectal cancer was anlyzed .Results The positive rates of VEGF and MIF in the colorectal cancer tissues were 77 .50% and 82 .50% respectively ,but which in the normal colorectal tissues were 22 .50% and 27 .50% respectively ,the positive rate of VEGF and MIF expression in the colorectal cancer tis‐sues were higher than that in the normal colorectal tissue with statistical difference (P<0 .05) .The expression of VEGF and MIF had correlation with the tumor infiltration depth ,lymph node metastasis ,and clinical stage ,but no correlation with gender ,age and histodifferentiation .Conclusion VEGF and MIF are highly expressed in the colorectal cancer tissues .

Objective To analyze and improve the current situation of the use of preoperative antimicrobials in surgery patients,so as to provide reference for improving the rate of timely use of antimicrobials before operation.Methods Because of the poor timely preoperative antimicrobials usage in Taizhou Hospital of Zhejiang Province,the lean A3 management tool was applied in May 2016 to analysis the reasons for untimely use of antimicrobial drugs and unreasonable time of administration,and continually improve the control of reasonable administration time of antimicrobial drugs. The rate of timely antimicrobials administration before operation were compared before and after the intervention within the whole hospital.Results The problems before improvement included complicated preparation before surgery in orthopaedic,gynaecology and gastrointestinal surgery department,prolonged surgery waiting time,advanced use of antimicrobial agents,and double medication combination in gynaecology surgery. After the intervention,the timely rate of antimicrobials usage improved from 56.7％ in April 2016 to 88.1％ in September 2016.Conclusions Tracking and evaluating the timely rate of antimicrobials use,adjusting the timing of operation and informing patients operation time according to characteristics of specialty,and improving the process of operation department could greatly improve the preoperative timely rate of antimicrobial drugs.

Objective: To investigate the clinical effects of primary revision after artificial hip replacement and causes of revision surgery. Methods: A total of 344 patients who underwent revision surgery after total hip arthroplasty (THA) and artificial femoral head replacement from January 2010 to December 2016 were retrospectively analyzed. There were 141 males and 203 fe-males, with a mean age 65.64±10.81 years (28-87 years). A total of 351 hip revisions were performed in 344 patients with 7 pa-tients in bilateral revisions. All patients were followed up for 60.38±22.75 months (24-105 months). All patients with periprosthet-ic infection underwent two-stage revision after prosthesis placement, and all others underwent one-stage revision. The clinical out-comes of revision surgery were assessed with the Harris hip score and the survival rate of the revision prosthesis. According to the duration from artificial hip replacement to revision surgery, all patients were divided into early revision (less than 5 years) and late revision (more than 5 years) groups. They were also divided into two groups according to the age of the patient in revision sur-gery: >55-year-old and ≤55-year-old groups. The causes of revision, hip reoperation and re-revision were recorded. Results: In the 351 hip revisions, a total of 238 (67.8%) had aseptic loosening, 41 (11.7%) periprosthetic fractures, 30 (8.5%) periprosthetic infection, 23 (6.6%) recurrent dislocation and 19 (5.4%) the eccentric liner wear. The infection rate was significantly higher in the early revision group (21.1%) than that in the late revision group (4.2%) (χ²=24.443, P<0.001). The aseptic loosening rate was sig-nificantly higher in the late revision group (72.4%) than that in the early revision group (54.4%) (χ²=9.899, P=0.002). Sixteen pa-tients underwent hip surgery after revision, including 6 recurrent dislocations, 4 aseptic loosening, 3 periprosthetic fractures, and 3 periprosthetic infections. Eight of them underwent revision surgery, including 4 cases of aseptic loosening, 2 cases of periprosthet-ic fractures, and 2 cases of recurrent dislocation. The duration from the primary revision to the second revision was 22.1±10.0 months (1-75 months). The 5-year and 8-year survival rates of the revision prostheses were 99.3%[95%CI(98.3%, 100.3%)] and 92.6% [95%CI(87.1%, 98.1%)], respectively. The proportions of prosthetic infection and eccentric liner wear in the ≤55-year-old group were significantly higher than those in the >55-year-old group (χ²=3.981, P=0.046; χ²=5.226, P=0.022), while the propor-tion of aseptic loosening in the >55-year-old group was significantly higher than that in the ≤55-year-old group (χ²=5.254, P=0.022). The 8-year survival rates of the revision prostheses of ≤55-year-old group and >55-year-old group were 76.8% [95%CI(50.5%, 103.1%)] and 95.4% [95%CI(91.1%, 99.7%)], respectively. Conclusion Young patients have a higher risk of re-revi-sion after revision THA.