Objective To investigate the clinical value of continuously detecting serum and pelvic drainage fluid C-reactive protein (CRP) and drainage fluid matrix metalloproteinase-9 (MMP-9) in the early diagnosis of anastomotic leakage after anterior resection of low rectal cancer.Methods The levels of CRP and MMP-9 in serum and pelvic drainage fluid were measured on postoperative 1,3,5,7 d in 158 patients with low rectal cancer anterior resection.The patients were divided into the anastomotic group (n=9) and non-anastomotic leakage group (n=149).The differences in the detection values between the two groups were compared and analyzed statistically.Results Among 158 cases,anastomotic leakage occurred in 9 cases.The correlation analysis of serum and drainage fluid CRP detection value and postoperative days (POD) in the two groups showed the POD 3,POD 5 and POD 7 difference was statistically significant (P＜0.05).The ROC curve analysis showed that the accuracy of the serum and drainage fluid CRP continuous detection for diagnosing the anastomotic leakage on postoperative 3 d was middle,which on postoperative 5,7 d was higher.The patients with CRP detection value ＞ 128.23 mg/L and drainage fluid CRP ＞89.93 mg/L on postoperative 5 d and those with CRP detection value＞113.71 mg/L and drainage fluid CRP＞81.75 mg/L on postoperative 7 d developed the anastomotic leakage.The drainage fluid MMP-9 detection value had no statistical difference between the anastomotic leakage group and the non-anastomotic leakage group (P＞0.05).Conclusion Continuous detection of serum and drainage fluid CRP level can be used for early diagnosing postoperative anastomotic leakage in low rectal cancer anterior resection.The drainage fluid MMP-9 continuous detection has no relation with early diagnosis of anastomotic leakage after low rectal cancer anterior resection.

Objective: To investigate the association between body mass index ( BMI ) and mortality risk among older Chinese based on the China Health and Retirement Longitudinal Study ( CHARLS ). Methods: The demographic features, BMI, prevalence of chronic diseases and mortality among the elderly at ages of 60 years and greater were captured from the CHARLS database from 2011 to 2018. A multivariable Cox proportional hazards regression model was used to examine the association between BMI and the risk of death. Results: Totally 6 023 subjects were enrolled, including 3 006 men ( 50.09% ) and 3 017 women ( 49.91% ), and 68.69% of the participants ( 4 137 subjects ) were at ages of 60 to 69 years. There were 637 subjects ( 10.58% ) with underweight, 1 544 ( 25.63% ) with overweight, and 557 ( 9.25% ) with obesity. During the follow-up period ( 35 091 person-years ), 1 035 subjects died. Multivariable Cox proportional hazards regression analysis revealed an increased risk of mortality among the underweight elderly ( HR=1.496, 95%CI: 1.261-1.775 ) and a reduced risk of mortality among the obese elderly ( HR=0.671, 95%CI: 0.511-0.881 ) relative to the elderly with normal weight, after adjustment for age, gender, smoking, household registration, administration of anti-diabetic drugs, administration of anti-dyslipidemia drugs, and administration of anti-hypertensive drugs. Conclusion It is found that the risk of mortality among the Chinese elderly correlatives with BMI through the analysis of CHARLS data.

Objective To explore the related risk factors of anastomotic leakage after low rectal cancer anterior resection op-eration .Methods The clinical data of 158 patients with low rectal cancer anterior resection operation in this hospital from January 2011 to June 2016 were retrospectively analyzed .The clinical features and treatment factors were performed the univariate and mult-ivariate correlation analysis .Results The total incidence rate of anastomotic leakage was 5 .7% (9/158) .The univariate analysis showed that the age ,sex ,body mass index(BMI) ,preoperative concurrent disease ,tumor stage ,location ,pathological type ,preopera-tive intestinal obstruction and surgical mode (laparoscopy and laparotomy) had no significant correlation with postoperative anasto-motic leakage (P>0 .05) .Preventive ileostomy did not affect the incidence rate of anastomotic leakage (P=0 .694) .Postoperative placement of anorectal decompression tube could reduce the incidence rate of anastomotic leakage (P=0 .047) .The univariate and multivariate analysis showed that postoperative diarrhea was an independent risk factor for anastomotic leakage occurrence (OR=10 .522 ,P=0 .001) .Conclusion Postoperative early diarrhea is an independent risk factor for anastomotic leakage occurrence after rectal cancer anterior resection operation .Postoperative placement of anorectal decompression tube can reduce the incidence rate of anastomotic leakage .

To explore the mechanism for changes in brain microstructure in long-term abstinent from methamphetamine-dependence by using the diffusion tensor imaging (DTI).
 Methods: A total of 26 patients with long-term abstinent methamphetamine-dependence, whose abstinence time more than 14 months, and 26 normal controls all underwent cognitive executive function tests and DTI scans. We used voxel-based analysis to compare the fractional anisotropy (FA) and mean diffusivity (MD) to obtain the abnormal brain regions of DTI parameters between the two groups. Spearman correlation analysis was used to explore the correlation between FA, MD of the brain regions with abnormal parameters and cognitive executive function tests.
 Results: There were no statistical differences in the cognitive executive function tests between the two groups (P>0.05). Compared with the normal control group, the long-term abstinent from methamphetamine-dependence group showed the decreased FA in the right precuneus, right superior frontal gyrus, right calcarine, left inferior temporal gyrus and the increased MD in the right triangular part of inferior frontal gyrus, right precuneus, right posterior cingulate, right middle temporal gyrus, bilateral middle occipital gyrus, left superior parietal lobule, and lobule VIII of cerebellar hemisphere. The MD values of the right middle temporal gyrus in the long-term abstinent group were negatively correlated with the number of completions within 60 seconds (r=-0.504) and within 120 seconds (r=-0.464) .
 Conclusion: The DTI parameters in multiple brain regions from the methamphetamine-dependence patients are still abnormal after a long-term abstinence. DTI can provide imaging evidence for brain microstructural abnormalities in long-term abstinent from methamphetamine-dependence.
Amphetamine-Related Disorders ; Anisotropy ; Brain ; Diffusion Tensor Imaging ; Humans ; Methamphetamine