Objective:To analyze the risk factors leading to the failure of enhanced recovery after surgery (ERAS) in inflammatory bowel disease (IBD) patients with colorectal resection.Methods:A retrospective case-control study was conducted. Clinical data of consecutive IBD patients who received colorectal resection under ERAS protocol in Jingling Hospital from January 2019 to February 2021 were analyzed. ERAS failure was defined as prolonged postoperative length of hospital stay, or unplanned reoperation, accidental readmission or death within 30 days after operation. The patients were divided into failed ERAS group and successful ERAS group according to whether the ERAS failed. Univariate and Logistic multivariate analyses were performed to identify the risk factors of ERAS failure in IBD patients with colorectal resection.Results:A total of 216 patients were enrolled. There were 65 patients in failed ERAS group and 151 in successful ERAS group. Univariate analysis showed that compared with successful ERAS group, the ratio of body mass index (BMI) <18.5 kg/m 2 (61.5% vs.46.4%, P = 0.041) , the ratio of preoperative nutritional risk screening tools 2002 (NRS-2002) score ≥3 points (69.2% vs. 48.3%, P = 0.005) , the ratio of preoperative modified Glasgow prognostic score (mGPS) = 2 points (30.8% vs. 10.6%, P<0.001) , the ratio of preoperative steroids use within 4 weeks before operation (44.6% vs. 23.8%, P<0.001) , the ratio of neostomy (63.1% vs. 46.4%, P = 0.024) , the ratio of intraoperative infusion volume>3 L (44.6% vs. 21.9%, P = 0.038) were higher in failed ERAS group, while the the ratio of preoperative enteral nutrition was lower (53.8% vs. 68.2%, P = 0.044) . Multivariate analysis showed that preoperative NRS-2002 score ≥3 points ( OR = 2.212, 95% CI: 1.133-4.321, P = 0.020) , mGPS = 2 points ( OR = 3.510, 95% CI: 1.555-7.926, P = 0.003) and preoperative steroids use within 4 weeks before operation ( OR = 2.600, 95% CI: 1.313-5.146, P = 0.006) were the independent risk factors of ERAS failure in IBD patients with colorectal resection. Conclusions:ERAS failure is more likely to occur in IBD patients after colorectal resection with charactertics including preoperative NRS-2002 score ≥3 points, mGPS=2 points, and preoperative steroids use within 4 weeks before operation. Preoperative nutritional preconditioning, perioperative hormone discontinuation, and control of preoperative inflammatory response may promote the successful implementation of ERAS in IBD patients with surgery.

Objective:To analyze the risk factors leading to the failure of enhanced recovery after surgery (ERAS) in inflammatory bowel disease (IBD) patients with colorectal resection.Methods:A retrospective case-control study was conducted. Clinical data of consecutive IBD patients who received colorectal resection under ERAS protocol in Jingling Hospital from January 2019 to February 2021 were analyzed. ERAS failure was defined as prolonged postoperative length of hospital stay, or unplanned reoperation, accidental readmission or death within 30 days after operation. The patients were divided into failed ERAS group and successful ERAS group according to whether the ERAS failed. Univariate and Logistic multivariate analyses were performed to identify the risk factors of ERAS failure in IBD patients with colorectal resection.Results:A total of 216 patients were enrolled. There were 65 patients in failed ERAS group and 151 in successful ERAS group. Univariate analysis showed that compared with successful ERAS group, the ratio of body mass index (BMI) <18.5 kg/m 2 (61.5% vs.46.4%, P = 0.041) , the ratio of preoperative nutritional risk screening tools 2002 (NRS-2002) score ≥3 points (69.2% vs. 48.3%, P = 0.005) , the ratio of preoperative modified Glasgow prognostic score (mGPS) = 2 points (30.8% vs. 10.6%, P<0.001) , the ratio of preoperative steroids use within 4 weeks before operation (44.6% vs. 23.8%, P<0.001) , the ratio of neostomy (63.1% vs. 46.4%, P = 0.024) , the ratio of intraoperative infusion volume>3 L (44.6% vs. 21.9%, P = 0.038) were higher in failed ERAS group, while the the ratio of preoperative enteral nutrition was lower (53.8% vs. 68.2%, P = 0.044) . Multivariate analysis showed that preoperative NRS-2002 score ≥3 points ( OR = 2.212, 95% CI: 1.133-4.321, P = 0.020) , mGPS = 2 points ( OR = 3.510, 95% CI: 1.555-7.926, P = 0.003) and preoperative steroids use within 4 weeks before operation ( OR = 2.600, 95% CI: 1.313-5.146, P = 0.006) were the independent risk factors of ERAS failure in IBD patients with colorectal resection. Conclusions:ERAS failure is more likely to occur in IBD patients after colorectal resection with charactertics including preoperative NRS-2002 score ≥3 points, mGPS=2 points, and preoperative steroids use within 4 weeks before operation. Preoperative nutritional preconditioning, perioperative hormone discontinuation, and control of preoperative inflammatory response may promote the successful implementation of ERAS in IBD patients with surgery.

Objective:To investigate pouch function, quality of life, and their influencing factors after ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC) .Methods:Clinical data of 111 patients undergoing IPAA in the UC database at Department of General Surgery, Jinling Hospital from 2014 to 2020 were retrospectively analyzed. Through the questionnaire, pouch functional score (PFS) and Cleveland global quality of life (CGQL) were obtained. These patients were diveided into two groups according to the PFS score. Univariate and multivariate analysis were used to compare the clinical features and reveal the risk factors of PFS.Results:A total of 111 patients were enrolled in this study, including 65 males and 38 females. 63 patients were in the good pouch function group, and 48 in the poor pouch function group. The median score of PFS was 7 (3.0-10.0) . Univariate analysis showed that compared with the good pouch function group, the poor pouch function group had a longer duration of disease before operation[44.5 (21.0-86.0) months vs. 14.0 (5.0-70.0) months, P = 0.005], a shorter follow-up time[16.0 (7.0-28.8) months vs. 26.0 (15.0-39.0) months, P = 0.020], and a higher proportion of pouchitis (29.1% vs. 12.9%, P = 0. 031) . The multivariate logistic regression analysis showed duration of disease before operation ( OR = 0.974, 95% CI: 0.951-0.997, P = 0.030) and pouchitis ( OR = 3.251, 95% CI: 1.168-9.045, P = 0.024) were the independent risk factor of PFS in UC patients.The median CGQL was 0.77 (0.67-0.87) . The median surgical satisfaction score was 9.0 (8.0-10.0) . There was a correlation between CGQL and PFS ( rs = -0.376, P<0.001) . Conclusions:Most patients recover well after IPAA, and are highly satisfied with the operation. A good pouch function has a positive influence on the quality of life.

Objective:To investigate pouch function, quality of life, and their influencing factors after ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC) .Methods:Clinical data of 111 patients undergoing IPAA in the UC database at Department of General Surgery, Jinling Hospital from 2014 to 2020 were retrospectively analyzed. Through the questionnaire, pouch functional score (PFS) and Cleveland global quality of life (CGQL) were obtained. These patients were diveided into two groups according to the PFS score. Univariate and multivariate analysis were used to compare the clinical features and reveal the risk factors of PFS.Results:A total of 111 patients were enrolled in this study, including 65 males and 38 females. 63 patients were in the good pouch function group, and 48 in the poor pouch function group. The median score of PFS was 7 (3.0-10.0) . Univariate analysis showed that compared with the good pouch function group, the poor pouch function group had a longer duration of disease before operation[44.5 (21.0-86.0) months vs. 14.0 (5.0-70.0) months, P = 0.005], a shorter follow-up time[16.0 (7.0-28.8) months vs. 26.0 (15.0-39.0) months, P = 0.020], and a higher proportion of pouchitis (29.1% vs. 12.9%, P = 0. 031) . The multivariate logistic regression analysis showed duration of disease before operation ( OR = 0.974, 95% CI: 0.951-0.997, P = 0.030) and pouchitis ( OR = 3.251, 95% CI: 1.168-9.045, P = 0.024) were the independent risk factor of PFS in UC patients.The median CGQL was 0.77 (0.67-0.87) . The median surgical satisfaction score was 9.0 (8.0-10.0) . There was a correlation between CGQL and PFS ( rs = -0.376, P<0.001) . Conclusions:Most patients recover well after IPAA, and are highly satisfied with the operation. A good pouch function has a positive influence on the quality of life.

Objective To investigate the clinical characteristics and risk factors of the incidence of herpes zoster after renal transplantation. Methods Clinical data of 830 recipients undergoing renal transplantation for the first time in the Organ Transplantation Research Institute of the 309th Hospital of Chinese People's Liberation Army from March 2009 to March 2012 were retrospectively analyzed. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors of the incidence of herpes zoster after renal transplantation. Results Among 830 patients, 42 (5.1%) suffered from herpes zoster postoperatively. Clinical manifestations of herpes zoster mainly included varicella-zoster rash in the head, face, trunk and limbs. No patient died from herpes zoster. Post-herpetic neuralgia (PHN) was the most common complication of herpes zoster. Univariate Logistic regression analysis revealed that advanced age and adrenal cortical hormone (hormone) shock therapy could increase the risk of herpes zoster viral infection after renal transplantation (OR=2.414, P=0.016; OR=2.936, P=0.003). Multivariate Logistic regression analysis demonstrated that advanced age and hormone shock therapy were the independent risk factor of the incidence of herpes zoster following renal transplantation (OR=2.238, P=0.030; OR=2.755, P=0.005). Conclusions Herpes zoster after renal transplantation is clinically manifested with varicellazoster rash. Advanced age and hormone shock therapy are the independent risk factor of the incidence of herpes zoster after renal transplantation.

In this study, a neutral desorption-extractive electrospray ionization mass spectrometry ( ND-EESI-MS) method was developed for the direct and rapid detection of dichlorvos ( DDVP) in honey samples without any sample pretreatment procedure. Under the positive ionization mode, the main characteristic parent ion of DDVP was m/z 223 (MW:222) and daughter ions were m/z 109 and m/z127. Under the optimized working conditions, with the signal intensity of m/z 127 as quantitative index, the quantitative information of DDVP residues in honey was acquired effectively. The results showed that the linear range of DDVP for spiked honey was 5-1000 ng/mL (R2=0. 998) with the limit of detection (LOD) of 1. 0 ng/mL (n=3) and the recoveries for the DDVP spiked honey samples at the concentration levels of 10 , 30 and 400 ng/mL were 93 . 0%-103. 0%, with the relative standard deviations (RSDs, n=6) of less than 4. 4%. Meanwhile, for detection of spiked honey with gas chromatography-flame photometric detector ( GC-FPD ) , the linear range was 5-1000 ng/mL (R2=0. 999) with the LOD of 1. 6 ng/mL(n=3), and the recoveries of DDVP at the spiked honey concentration levels of 10 , 30 and 400 ng/mL were 94 . 9%-110 . 3%, with the RSDs of less than 7. 6%.