Objective To investigate the predictive value of serum CC chemokine ligand 21(CCL21)and tumor specific growth factor(TSGF)for liver metastasis of colorectal cancer(CRC).Methods From January 2018 to January 2023,120 CRC patients in Xi'an Third Hospital were selected as the research subjects and di-vided into the non-metastasis group(n=68)and the metastasis group(n=52)according to whether liver me-tastasis occurred.Additionally,135 healthy subjects who underwent physical examinations in the hospital dur-ing the same period were selected as the control group.The level of CCL21 was detected by enzyme-linked im-munosorbent assay(ELISA),and the level of TSGF was detected by colorimetry.Univariate and multivariate Logistic regression analyses were used to analyze the influencing factors of liver metastasis in CRC.The re-ceiver operating characteristic(ROC)curve was used to analyze the predictive value of CCL21 and TSGF lev-els for liver metastasis of CRC,and the Z-test was used to compare the differences in the area under the curve(AUC).The Kaplan-Meier method was used to conduct survival analysis on CRC patients with liver metasta-sis,and the Log-rank test was used to analyze the differences in survival curves between groups.Results Compared with the control group,the levels of CCL21 and TSGF in the patients increased after the occurrence of CRC,and further increased after liver metastasis,and the differences were statistically significant(P＜0.05).Liver metastasis in CRC patients was correlated with the degree of differentiation,depth of invasion and lymph node metastasis of the patients(P＜0.05).Invasion depth(T3-T4),lymph node metastasis,and elevated levels of CCL21 and TSGF were independent risk factors for liver metastasis in CRC patients(P＜0.05).The AUC of the combined diagnosis of liver metastasis in CRC patients by CCL21 and TSGF was 0.909,which was superi-or to the separate diagnosis of the two(0.780,0.790),and the differences were statistically significant(P＜0.05).The survival rate of the high-expression group of CCL21(48.00％)was lower than that of the low-ex-pression group,and the survival rate of the high-expression group of TSGF(50.00％)was lower than that of the low-expression group(83.33％),and the differences were statistically significant(Log-rank x2=6.429,6.344;P=0.011,0.012).Conclusion The levels of serum CCL21 and TSGF in CRC patients are relatively high.The combined detection of the two has certain predictive value for the occurrence of liver metastasis.

Objective To understand the distribution and drug resistance of pathogens isolated from blood culture samples Chang’an Hospital from 2012 to 2014 to provide basis for rational use of antibacterial drugs.Methods The clinical date of distribution,changes and drug resistance of main pathogens in blood culture samples during 2012 and 2014 in chang anhospi-tal were retrospectively analyzed.Results 512 pathogenic bacterial strains were isolated from 4 792 blood culture samples in 2012~2014.Among them,gram-negative bacteria accounted for 62.50% (320/512),Escherichia coli ,Klebsiella pneumoni-ae and Pseudomonas aeruginosa accounted for 25.20% (129/512),14.26% (73/512)and 8.20% (42/512)respectively;Gram-positive bacteria accounted for 29.30% (150/512),Staphylococcus aureus and Coagulase-negative Staphylococcus ac-counted for 11.52% (59/512)and 10.16% (52/512)respectively.The rate of fungi was 7.62% (39/512).Susceptibility re-sults showed that Escherichia coli and Klebsiella pneumoniae had highly sensitive to carbapenems,but had a varying degrees of resistance to other antibacterial drugs.The rate of drug resistant of Gram-positive cocci to Penicillin,Erythromycin and Clindamycin had been a high level,but no strains being resistant to van comycin and linezolid had been detected.Conclusion The pathogens causing bloodstream infection widely distribute,and have highly drug-resistant.It is necessary to under-stand the distribution of pathogens isolated from blood culture as well as the changes of drug resistance in a timely manner so as to guide the reasonable clinical medication.