OBJECTIVES: To investigate the risk factors of overall postoperative complications in elderly patients undergoing gastrointestinal surgeries. METHODS: This study was conducted among a total of 1388 elderly patients, who underwent elective gastrointestinal surgeries at 17 centers across China between April, 2020 and April, 2022. The primary outcome was the incidence of postoperative complications within 30 days, including procedure-related, neuropsychiatric, respiratory, cardiovascular, and gastrointestinal complications as well as acute kidney injury. Baseline characteristics, preoperative psychological and functional status, intraoperative anesthesia and surgical factors, intraoperative medication, use of nerve block, and postoperative analgesia methods were compared between the patients experiencing one or more postoperative complications and those without complications. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for postoperative complications. The relationship between postoperative acute pain and each type of complication were explored. RESULTS: The incidence of overall postoperative complications was 50.8% (705/1388) in these patients. Multivariate analysis showed that age (OR: 1.026; 95% CI: 1.006-1.046), prognostic nutritional index (OR: 0.998; 95% CI: 0.997-1.000), preoperative EuroQol-5 dimensions score (OR: 0.094; 95% CI: 0.018-0.500), blood loss (OR: 1.002; 95% CI: 1.001-1.003), and acute postoperative pain (OR: 1.308; 95% CI: 1.033-1.657) were significantly associated with the occurrence of postoperative complications. Specifically, patients experiencing severe postoperative pain had a significantly higher incidence of neuropsychiatric (27.2% vs 19.8%), procedure-related (17.3% vs 10.2%), and cardiovascular complications (3.6% vs 1.7%). CONCLUSIONS An advanced age, a low preoperative nutritional index, a poor quality of life score, a greater volume of intraoperative blood loss, and acute postoperative pain are independent risk factors for postoperative complications in elderly patients undergoing gastrointestinal surgeries. There is a significant association between acute postoperative pain and multi-system complications.
Humans ; Postoperative Complications/etiology* ; Aged ; Risk Factors ; Digestive System Surgical Procedures/adverse effects* ; Male ; Female ; China/epidemiology* ; Pain, Postoperative/epidemiology* ; Incidence ; Aged, 80 and over

Objective To investigate the influencing factors on thrombin time (TT) assay to ensure the accuracy of the detection results.Methods Totally 3 out-and in-patients from January to July 2015 with normal results of prothrombin time (PT),activated partial clotting enzyme live time (APTT) and fibrinogen (FIB) were selected,whose detection results were not satisfactory.The specimen underwent re-centrifugation,and then Beckman ACL TOP700 automatic coagulation analyzer was used to detect four coagulation indexes.The detection results were compared with those before re-centrifugation,and the differences between the results were analyzed statically.Results The values of PT,APTT and FIB of the three patients before and after re-centrifugation were (10.8,11.5,9.7 s),(29.5,32.7,25.2 s),(2.49,3.12,2.85 g/L) and (10.9,11.3,10.0 s),(30.4,31.5,25.9 s),(2.31,3.28,2.67 g/L) respectively,and the differences between the results were not significant (with t ranging from 0.627 to 1.719 and P＞0.05).The values of TT of the three patients before and after re-centrifugation were (66.51,127.3,89.62 s) and (12.2,15.7,13.8 s) respectively,and there were obvious differences between the values (with t ranging from 51.743 to 79.167 and P＜0.001).Conclusion Insufficient centrifugation has high influences on the detection result of TT except other coagulation indexes,and re-centrifugation is necessary for the accuracy of TT value to eliminate misdiagnosis.

Objective To understand the Shenzhen Dapeng new district and Longhua district 0～7 years old children in copper (Cu),zinc (Zn),calcium (Ca),magnesium (Mg),iron (Fc) and lead (Pb) 6 kinds of trace elements,in order to establish the reasonable dietary structure and provide a scientific basis for scientific and rational supplement of trace elements.Methods Collected 2 190 cases of 0～7 years old children for health physical examination in Dapeng New District Maternal and Child Health Care Hospital of Shenzhen form March to November 2015.According to the age,they were divided into the baby group (0～1 years old) of 637 cases,children group (2～4 years old) of 723 cases and preschool group (4～7 years old) of 830 cases of three groups.Used QL8000 automatic whole blood trace elements analyzer to test Fe,Zn,Ca,Cu,Mg and Pb 6 kinds of trace elements in whole blood,and the detection results were statistically analyzed and compared.Results Test results of 5 kinds of whole blood trace element(Fe,Zn,Ca,Cu,Mg) had different degrees lack in 2 190 cases of children aged 0 ～7,and lack of different level,lack of rate were 36.26％,32.83％,14.20％,0.64％ and 0.50％,respectively.Fe and Ca deficiency in young children group was most serious,lack of Zn in infant group was most serious,other microelement lack rate had no statistically significant difference between different groups (P＞ 0.05).Pb poisoning rate was 15.71％,the Pb poisoning rate decreases along with the age growth,and boys than girls,the difference was statistically significant (x2=3.15,P ＜0.05),different gender children other microelement lack rate differences had no statistical significance between the results.Conclusion The whole blood trace element of 0～7 years old children had different lack,mainly by Fe,Zn and Ca deficiency in Shenzhen Dapeng New District and Longhua District.But Children's Pb poisoning problem could not be ignored.Therefore,to streng then the 0～ 7 years old children's whole blood trace elements level survey,microelement lack of prevention and treatment of children is of great significance.

Objective:To detect anaemia parameter methodology performance for validation of Roche Cobas E601 automatic electrochemical luminescence immunity analyzer.Methods:Recommended by the American association of clinical laboratory standardization (CLSI) method was developed for the determination of folic acid, iron, protein, and this precision, accuracy, linear range, sensitivity, biological reference range and carry pollution index, and validated.Results: Cohas E601 determination of folic acid, iron, protein and precision, the daytime in this batch variation coefficient were 3.03%~4.27% and 3.51%~4.68%. Relative bias must lean on(%) between -3.54%~4.46%. The scope of determination of linear range and the manufacturer to provide similar. Folic acid, iron, protein and numerical value with the determination of this instrument manufacturers provide reference interval coincidence rate were 90.0%, 85.0% and 90.0% respectivel. Instrument to detect carry pollution rate is 0.04%~0.16%. CohasE601 detection sensitivity were 0.23 ng/ml, 0.21 ng/ml and 0.19 pg/ml.Conclusion: Cobas E601 detect folic acid, iron, protein and good performance of this methodology, but manufacturers provide biological reference range is not suitable for the local crowd, should establish the corresponding normal reference range.

Objective To understand Shenzhen Longgang,guangming and longhua new district four district hospital ICU pa-tients with secondary pulmonary tuberculosis merger lower respiratory infection of pathogenic bacteria distribution and drug resistance status of provide a reference for clinical diagnosis and rational use of antibiotics therapy.Methods Random selec-tion from February 2013 to October 2015 in the three district hospital ICU diagnosis of secondary pulmonary tuberculosis patients with lower respiratory infection in 593 cases of sputum specimen pathogenic bacteria culture and drug susceptibility results were retrospectively analyzed.Results 593 cases of ICU secondary pulmonary tuberculosis patients with respiratory tract infection of the communist party of China isolated 617 strains of pathogenic bacteria,fungi accounted for 49.6% (306/617),gram negative bacilli accounted for 40.4% (249/617),gram positive cocci accounted for 10.0% (62/617).Fungal in-fection main pathogens for white smooth candida yeast and candida yeast,respectively accounted for 44.2% (273/617)and
4.5% (28/617),gram negative bacillus mainlyKlebsiellaPneumoniae,Pseudomonasaeruginosa,and H.influenzae,respec-tively accounted for 16.7% (103/617),12.0% (74/617)and 7.3% (45/617),gram-positive cocci mainly for Saphylococcus aureus and Epidermisstaphylococcus and Hemolyticstaphylococci,respectively accounted for 4.5% (28/617),3.2% (20/617)and 0.9% (5/617).Pathogenicbacteria isolated from the multiple drug resistant bacteria,present different levels of resistance to commonly used antimicrobial agents.Conclusion ICU patients with secondary pulmonary tuberculosis merger of lower respiratory tract infection pathogens to fungi and gram-negative bacilli,the most commonWhite candida,Klebsiella pneumoniae,and Pseudomonasaeruginosa,and different levels of resistance to commonly used antimicrobial agents.

Objective To understand the different types of chronic hepatitis group in shenzhen area E viral hepatitis (hepatitis E infection status and provide scientific basis for the prevention and treatment of hepatitis E.Methods Randomly collected from July 2013 to June 2015 in shenahen Longhua New District People’s Hospital without hepatitis normal physical exami-nation and treatment group 1746 cases as control group,chronic hepatitis B viral hepatitis (hepatitis B)the crowd of 1 320 cases of hepatitis B,chronic viral hepatitis C (HCV)population group,615 cases of hepatitis C,respectively,the application method of enzyme-linked immunosorbent assay (ELISA)to detect serum hepatitis E antibody (anti HEV IgG)-IgG,ana-lyzed of different types of hepatitis a crowd hepatitise infection status,and compared the hepatitise infection rate if there was a difference between the different groups.Results 1 746 cases of control group in serum anti HEV-IgG positive rate was 3.49% (61/1 746),4.22% of men and women in 2.68%.1 320 cases of hepatitis B group was 10.9%,12.29% of men and women in 8.23%.615 cases of C group was 10.2%,12.35% of men and women in 7.64%.Hepatitis B and C group of HEV-IgG positive rate compared with control group difference was statistically significant (χ2 =9.163~9.405,P <0.05), and hepatitis B and hepatitis C group there was no statistically significant difference between positive HEV-resistant IgG (χ2=0.614,P >0.614),and hepatitis E infection rate than women,men was statistically significant difference (χ2 =2.873~4.025,P <0.05).Conclusion Chronic hepatitis B and C viral hepatitis crowd anti HEV-IgG positive rate was higher than normal people,no hepatitis hepatitis E infection rate among men than women.Therefore,strengthens to the chronic hepatitis B and C viral hepatitis a crowd of early discovery,early diagnosis and early treatment,to reduce hepatitis E infection rate has an important significance.

Objective To understand the present situation of the rate of carry genetic defect in Unmarried young men with thalassaemia in Shenzhen,which will provide a scientific basis for correct mating.Methods Randomly selected 6 182 cases of unmarried young people from March 2014 to October 2015 to hospital physical examination,Used Sysmex XN-9000 auto-matic blood cell sextant and erythrocyte osmotic fragility test to sccreen preliminarily for globin generation barrier anemia. The average red blood cell volume (MCV)≤82 fl and the average content of red blood cell (MCH)≤27 pg or osmotic fra-gility of red blood cells rate<60% of the population was made hemoglobin electrophoresis analysis.To early screening posi-tive by PCR,it was done reverse dot hybridization method for gene diagnosis,and the results were analyzed.Results 6 182 cases of unmarried young men at the beginning of globin generation barrier anemia screen positive rate was 17.3% (1 069/6 182),including suspectedα-was 12.2% (752/6 182)and suspiciousβ-was 5.1% (317/6 182).Gene diagnosis of globin generation barrier anemia positive rate was 11.6% (717/6 182),theα-was 6.7% (413/6 182),β-was 3.4% (209/6 182) and compoundαβ-was 1.5% (95/6 182).α-genetic defect types were mainly--SEA/αα,-α3.7/ααand-α4.2/ααand defect rate were 60.8%,23.5% and 10.4%,respectively.β-gene defect types are mainly CD41/42,CD17 and-28,defect rate were 41.1%,28.2% and 12.9%,respectively.Conclusion Unmarried young men in shenzhen area globin generation barrier ane-mia has certain carrying rate,local family planning department attaches great importance to it.Strengthen the unmarried young men globin generation barrier anemia screening,to guide the healthy birth mating and prevention of severe pauper’s birth,improve the rate of eugenic and superior nurture,has the vital significance.

Objective:To have the performance verification of Johnson Vitros 5600 fully automatic biochemical analyzer (hereinafter referred to as Vitros 5600 analyzer) emergency immunological parameter is to provide more accurate and more efficient service for the patients in emergency inspection items.Methods: According to the clinical laboratory standards institute (CLSI) evaluation criterion and Johnson validation plan, we verified the precision, accuracy, linear range, reference range, and carry pollution rate detection indexes of Myoglobin, Troponin I (TropI), N-terminal brain natriuretic titanium (NTproBNP) and total beta human chorionic gonadotropin (TβHCG) about the Vitros 5600 analyzer emergency projects evaluated the performance of the analyzer.Results: The batch precision CV of Myoglobin, TropI, NTproBNP and TβHCG tested by Vitros 5600 analyzer is 0.58~2.02%, < 2.5%, and the inter assay CV is 1.43~3.15%, < 5.0%. Accuracy relative bias is -3.52~4.21%. Linearity relationship is good within the scope of testing,r2 is 0.9836~0.9998, and the slope (a) is 0.9865~1.0207. Carry pollution rate is 0.096~0.180%. Reference range verification coincidence rate is R≥95%.Conclusion: The detection index performance of Vitros 5600 analyzer detecting immune emergency projects is good. It can meet the demand of emergency immune inspection work.

Objective:To explore the early diagnostic value of joint detection heart type fatty acid binding protein (h-FABP), troponin (cTnI), myoglobin (Mb) and creatine kinase isoenzyme Mb (CK-Mb) in children's hand, foot and mouth disease (HFMD) combined myocardial injury.Methods: Choice 276 cases of HFMD as observation group, and 40 healthy children as control group. Were determined h-FABP, cTnI, Mb and CK-Mb content in serum at different time, analysis of various index level differences and dynamic change between groups in different period.Results: Among 276 patients with HFMD, 57 cases of diagnosed myocarditis, concurrent rate was 20.65%. Within 0~3 hrs, abnormal rate of h-FABP, cTnI, Mb and CK-Mb in serum were 20.29%,1.81%,14.86% and 2.90%, in 276 cases of children with HFMD. The abnormal rate of h-FABP and Mb was obviously higher than that of cTnI and CK-Mb, the results between the difference was statistically significant (x2=35.132,x2=37.063,P<0.01),h-FABP abnormal rate is higher than CK-Mb, the difference was statistically significant(x2=3.175,P<0.05). the,serum h-FABP cTnI, Mb and CK-Mb concentrations in children of HFDM combined with suspicious viral myocarditis were significantly higher than that of control group, the difference had statistical significance (t=37.625,t=23.172,t=17.261,t=18.724,P<0.01). H-FABP and Mb concentration on HFMD combined myocarditis began to rise after the occurrence of 0~3 h, 4~9 h to peak, CTnI and CK-MB 4~9 h to rise, 10~12 h to peak, has been in a higher level in the 12~72 h.Conclusion: HFMD combined myocarditis had a higher incidence, h-FABP is the most sensitive indicator of early diagnosis, followed by Mb. CTnI and CK-MB are parameters of diagnosis sensitivity for HFMD combined with myocarditis in middle-late period.

Objective To explore the clinical application of jiont detection of critical patients procalcitomin (PCT)and (1,3)-beta D-glucan with deep fungus infection in ICU.Methods From November 2012 to August 2014 diagnosed with deep fun-gal infection of ICU critical patients,106 cases of patients with serum PCT and (1,3)-beta-D glucan content detection,and ICU of deep fungal infection in critically ill patients,519 cases were analyzed,with differencesbetween the paired t test to compare the results.Results 106 patients with deep fungal infection of ICU critical patients serum PCT for 0.701 ±0.22 pg/ml and (1,3)-beta-D glucan for 37.82±18.43 pg/ml,significantly higher than the 519 cases of ICU of deep fungal infec-tion in critically ill patients in the serum PCT for 0.238±0.12 pg/ml and (1,3)-beta-D glucan for 14.96 ±4.37 pg/ml, comparing differences between both results was statistically significant (t=7.426,8.179,P <0.05).106 patients with deep fungal infection of ICU critical patients serum PCT positive detection rate was 57.5% (61/106),significantly lower than the (1,3)-beta-D glucan positive detection rate 89.6% (95/106),difference was statistically significant (χ2 = 13.645,P <0.05).Conclusion Deep fungal infection in critical care patients in the ICU in the serum PCT and (1,3)-beta-D glucan con-tent of deep fungus infection in critically ill patients was significantly higher than the ICU,PCT and (1,3)-beta-D glucan joint detection of deep fungal infection in patients with ICU critical patients diagnosis has important clinical significance.