1.Erratum: Author correction to "The FAPα-activated prodrug Z-GP-DAVLBH inhibits the growth and pulmonary metastasis of osteosarcoma cells by suppressing the AXL pathway" Acta Pharm Sin B 12 (2022) 1288-1304.
Geni YE ; Maohua HUANG ; Yong LI ; Jie OUYANG ; Minfeng CHEN ; Qing WENG ; Xiaobo LI ; Huhu ZENG ; Pei LONG ; Zepei FAN ; Junqiang YIN ; Wencai YE ; Dongmei ZHANG
Acta Pharmaceutica Sinica B 2023;13(3):1337-1339
[This corrects the article DOI: 10.1016/j.apsb.2021.08.015.].
2.Identification of SARS-CoV-2 through combined 2nd and 3rd generation sequencing technology
Qi LIN ; Zhi-Miao HUANG ; Zhi-Wei ZENG ; Wei CHEN ; Ming-Jian CHEN ; Yu-Wei WENG
Chinese Journal of Zoonoses 2023;39(11):1053-1059
To rapidly and accurately identify novel SARS-CoV-2 variants,we used combined 2nd and 3rd generation sequen-cing technology to sequence and analyze the viral genomes of two specimens from SARS-CoV-2 infection cases imported into Fujian Province.Nanopore and Illumina techniques were used to perform whole genome sequencing of SARS-CoV-2.A pangolin system was used to determine the virus type.Evolutionary analysis software was used to construct the phylogenetic tree.Next-clade was used to analyze the whole genome variation,and estimate ACE2 receptor affinity and immune escape ability.Two complete genome sequences of SARS-CoV-2 were obtained from respiratory specimens from the two cases,with lengths of 29 665 bp and 29 682 bp.The average genome coverage were>99.0%,and the virus typing results all indicated Omicron BQ.1 lineage.Phylogenetic analysis demonstrated that the two viruses were located in the same cluster of the Omicron BQ.1 line-age.On the basis of these findings and epidemiological data,we speculated that the two cases might have originated from the same infection.Variation analysis indicated that the two viruses shared all 77 mutation sites;except for S:A27S and S:24-26del,all were characteristic mutation sites of the BQ.1 lineage.The predicted ACE2 receptor affinity and immune escape abili-ty scores of the two viruses were both>0.6,thus suggesting significant changes in their biological characteristics and requiring continuous monitoring and warning.The combined 2nd and 3rd generation sequencing technology was successfully applied to i-dentify the first BQ.1 lineage of the SARS-CoV-2 imported into Fujian Province,considering the timeliness and accuracy of whole genome sequencing,thus providing a technical reference for SARS-CoV-2 variant monitoring.
3.Molecular tracking of long-distance transmission events of COVID-19 by lorry drivers in Fujian province
Qi LIN ; Zehui CHEN ; Zhimiao HUANG ; Xiaohong ZENG ; Quwen LI ; Yuwei WENG
Chinese Journal of Experimental and Clinical Virology 2023;37(1):55-60
Objective:To confirm the cross-provincial long-distance transmission events of Coronavirus Disease 2019 (COVID-19) by lorry drivers, the origin of infections of the cases and the transmission routes were tracked.Methods:Nasopharyngeal swab specimens from five lorry driver cases of COVID-19, found in Zhangzhou city in March, 2022 when the local outbreaks occurred in adjacent Quanzhou city, Fujian province, were collected to perform 2019 novel coronavirus (2019-nCoV) targeted genome amplification and followed by next-generation sequencing. The sequences were submitted to online 2019-nCoV analysis platforms to classify the type of variant and mutation sites. Phylogenetic tree for the viruses were constructed by phylogenetic analysis software. Combined with the epidemiological investigation, the origin of infections of the cases and the transmission routes were deduced.Results:Five complete genome sequences, with 29 770-29 839 bp in length and 99.53% average genomic coverage, of 2019-nCoV were successfully obtained. The viruses were all Omicron variants and further divided into three different subclades of BA.2. Of the five strains of 2019-nCoV, three were highly similar to the viruses of two distinct lineages co-circulated in Quanzhou city during the period of local outbreak of COVID-19, respectively. Phylogenetic analysis also revealed that the viruses from three infected lorry drivers were highly homologous to that from local outbreaks in Quanzhou city. The viruses from the rest two cases had seven to fourteen nucleotide mutations (corresponding to 5-7 amino acid substitutions) when compared with the viruses in local outbreaks in Quanzhou city, which excluded the involvement of the two cases into the transmission chains of local outbreaks. Combined with the field epidemiological investigations, the result revealed that the origin of infection of 2019-nCoV of the two sporadic lorry driver cases was outside of Fujian province.Conclusions:With the aid of high-throughput sequencing and bioinformatics technology combined with field epidemiological investigations, we speculated in this study that at least three origins of infection of 2019-nCoV in five lorry driver cases and cross-provincial long-distance transmission via two sporadic cases infected outside Fujian province when they returned.
4.Whole genome sequencing and analysis of 2019 novel coronavirus imported from a freighter in Fujian province, China
Qi LIN ; Zhimiao HUANG ; Zehui CHEN ; Xiaohong ZENG ; Wei CHEN ; Yingxiang ZHENG ; Yuwei WENG
Chinese Journal of Experimental and Clinical Virology 2022;36(2):121-127
Objective:To investigate the whole genome characteristics and mutation of imported 2019-nCoV and trace potential source at the genomics level, the viral genomes from the specimens of a cluster of COVID-19 cases which were imported from a freighter were directly sequenced and determined by high-throughput sequencing technology and bioinformatics analysis.Methods:Throat swab specimens from the 8 confirmed cases of COVID-19 from the same freighter were collected to perform the whole genome sequencing for 2019-nCoV using the targeted genome amplification, combined with Ion S5 next-generation sequencing (NGS) technology. Varieties of online virus analysis platforms was used to classify the viruses and analyze mutation sites in the whole genome. Phylogenetic analysis software was used to construct a phylogenetic tree for the viruses, combined with the epidemiological data of the case, to speculate about the source of the viruses.Results:Eight complete genome sequences of 2019-nCoV was successfully obtained. The complete genomes of the viruses were 29, 822-29, 865 bp in length, with the average sequencing depth of 11 928×-33 588× and the coverage of 99.73%-99.87%; the result of Pangolin classification showed that all the eight 2019-nCoV genomes belong to VOC/Delta (B.1.617.2) lineage. The result of whole genome mutation analysis showed that compared with the Wuhan reference strain, the median number of nucleotide mutations in the eight 2019-nCoV genome sequences was 35 (31 to 38), and the median number of amino acid mutations was 26 (24-28); the mutation sites were distributed in 8 gene coding regions (ORF1a, ORF1b, S, ORF3a, M, ORF7a, ORF8, N). Further analysis revealed that eight 2019-nCoV genomes contained 23 characteristic mutation sites belonging to the Delta (B.1.617.2·AY.2) variants of 2019-nCoV. Since the mutation sites among the eight 2019-nCoV genomes were not completely overlapped, and the epidemiological survey report showed that the freighter stopped at multiple ports and had personnel alternation, it was speculated that the clustered COVID-19 cases might have different origins. Phylogenetic analysis showed that all the eight 2019-nCoV genomes were on the AY.2 sub-lineage of the B. 1.617.2 lineage. This result was consistent with the result of Pangolin classification and mutation analysis.Conclusions:In this study, 8 whole genome sequences of Delta variants were obtained through NGS technology from the clustered COVID-19 cases which were imported from a freighter. The sequencing method and analysis result in this study could provide reference for the 2019-nCoV mutation analysis and tracing the source of the COVID-19 cases for the prevention and control of the COVID-19 epidemic.
5.Glycyrrhizic acid: a potential drug against COVID-19
Fu-jing GE ; Chen-ming ZENG ; Fang-jie YAN ; Mei-jia QIAN ; Wei-hua WANG ; Pei-hua LUO ; Qin-jie WENG ; Rang-xiao ZHUANG ; Jian-jun XI ; Jin-song HUANG ; Bo YANG ; Hong ZHU ; Qiao-jun HE
Acta Pharmaceutica Sinica 2021;56(5):1211-1216
Pneumonia caused by SARS-CoV-2 has seriously threatened human life and health worldwide and caused a large number of deaths. Viral infection and acute inflammation are important causes of death, so it is particularly important to combine antiviral therapy with anti-inflammatory therapy. Glycyrrhizic acid, the main component of the glycyrrhizic root extract, has a wide range of pharmacological effects as well as high efficiency and low toxicity, its preparation has been widely used in the treatment of chronic hepatitis and other diseases. Glycyrrhizic acid can regulate the expression and release of a variety of cytokines and play a significant anti-inflammatory effect. At the same time, glycyrrhizic acid also showed significant inhibition towards a variety types of viruses. Therefore, the potential application of glycyrrhizic acid as COVID-19 treatment should be explored.
6.The Establishment and Identification of Acute Myeloid Leukemia NOD-SCID-IL2rg
Wei-Ya ZHANG ; Gao-Chun ZENG ; Xiao-Mei CHEN ; Su-Xia GENG ; Yu-Lian WANG ; Qiong LUO ; Liu-Ping LUO ; Pei-Long LAI ; Jian-Yu WENG ; Xin DU
Journal of Experimental Hematology 2021;29(5):1429-1435
OBJECTIVE:
To establish the in vivo traceable acute myeloid leukemia mice model with Luciferase-Expressing KG1a Cells.
METHODS:
KG1a cells with stable luciferase gene expression (called as KG1a-Luc cells) were constructed by lentivirus transfection, then sifted out by puromycin. Eighteen male NOD-SCID-IL2rg
RESULTS:
KG1a cells expressing luciferase stably were successfully obtained. The tumor luminescence wildly spread at day 17 captured by in vivo imaging. The KG1a-Luc tumor cells could be detected in the peripheral blood of the mice, with the average percentage of (16.27±6.66)%. The morphology and pathology result showed that KG1a-Luc cells infiltrate was detected in bone marrow, spleens and livers. The survival time of the KG1a-Luc mice was notably shorter as compared with those in the control group, the median survival time was 30.5 days (95%CI: 0.008-0.260).
CONCLUSION
The acute myeloid leukemia NOD-SCID-IL2rg
Animals
;
Disease Models, Animal
;
Interleukin Receptor Common gamma Subunit
;
Leukemia, Myeloid, Acute
;
Luciferases/genetics*
;
Male
;
Mice
;
Mice, Inbred NOD
;
Mice, SCID
7.Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study
Danwen ZHENG ; Heng WENG ; Yuntao LIU ; Xin YIN ; Jun ZHANG ; Jian ZHANG ; Luming CHEN ; Yuanshen ZHOU ; Jing ZENG ; Yan CAI ; Wanxin WEN ; Qinghua ZHANG ; Lanting TAO ; Liangsheng SUN ; Tianjin CAI ; Weiliang WANG ; Shubin CAI ; Xindong QIN ; Xiaofeng LIN ; Xiaohua XU ; Haimei ZOU ; Qiaoli HUA ; Peipei LU ; Jingnan LIN ; Kaiyuan ZHANG ; Aihua OU ; Jiqiang LI ; Fang YAN ; Xu ZOU ; Lin LIN ; Banghan DING ; Jianwen GUO ; Tiehe QIN ; Yimin LI ; Xiangdong GUAN ; Xiaoneng MO ; Zhongde ZHANG
Chinese Journal of Emergency Medicine 2021;30(10):1220-1228
Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.
8.Efficacy and Safety of Breviscapine Injection Combined with Routine Treatment of AECOPD :A Meta-analysis
Sha CHENG ; Haiyan HE ; Chuang XIAO ; Zhiying WENG ; Chen CHEN ; Deyou ZENG ; Weimin YANG
China Pharmacy 2020;31(8):997-1002
OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of Breviscapine injection combined with routine treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to provide evidence-based reference for clinical drug use. METHODS :Retrieved from Cochrane Library ,PubMed,Embase,CBMdisc,CNKI,VIP and Wanfang database ,randomized controlled trials (RCTs)about Breviscapine injection combined with routine treatment (trial group ) versus routine treatment (control group )in the treatment of AECOPD were collected. After literature screening and data extraction , the qualities of literatures were evaluated with modified Jadad scale ;Meta-analysis was performed by using Rev Man 5.2 statistical software. RESULTS :A total of 19 RCTs were included ,involving 1 930 patients. Results of Meta-analysis showed that total response rate [OR =2.80,95% CI (1.96,4.01),P<0.000 01],FEV1[MD=0.65,95% CI(0.57,0.72),P<0.000 01], FEV1%[MD=5.33,95%CI(0.31,10.35),P=0.04],FVC[MD=0.69,95%CI(0.23,1.16),P=0.004], FEV1/FVC [MD = 4.83,95%CI(0.98,8.67),P=0.01],PEF [M D=0.95,95%CI (0.57,1.33),P<0.001],PaO2 [MD=4.70,95%CI(2.02, No.81402991) + 7.37),P<0.001],CD3 level [MD =5.11,95% CI(3.04, 7.18),P<0.001] and CD 4+ level [MD =2.62,95%CI(1.78, qq.com 3.47),P<0.001] of trial group were significantly higher than those of control group ;PaCO2 [MD=-3.33,95%CI(-5.02, -1.65),P<0.001],CD8+ level [MD =-2.55,95%CI(-4.28,-0.82),P<0.004],cough relief time [MD =-1.93,95%CI (-2.24,-1.63),P<0.001],sputum remission time [MD =-2.19,95%CI(-2.48,-1.89),P<0.001],wheezing remission time [MD =-1.59,95%CI(-1.86,-1.32),P<0.001] and hospital stay [MD =-1.73,95%CI(-2.06,-1.39),P<0.001] of trial groups were significantly lower or shorter than those of control group ;there was no statistical significance in CD 4+/CD8+ between 2 groups [MD =-0.11,95%CI(-0.23,0.01),P=0.06]. In terms of safety ,3 studies reported the occurrence of ADR , and no serious ADR occurred. CONCLUSIONS :Breviscapine injection can improve clinical efficacy and lung function ,enhance immunity in patients with AECOPD with good safety.
9.Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China
Ze LI ; Junru GAO ; Li SONG ; Peige WANG ; Jian'an REN ; Xiuwen WU ; Suming LUO ; Qingjun ZENG ; Yanhong WENG ; Xinjian XU ; Qingzhong YUAN ; Jie ZHAO ; Nansheng LIAO ; Wei MAI ; Feng WANG ; Hui CAO ; Shichen WANG ; Gang HAN ; Daorong WANG ; Hao WANG ; Jun ZHANG ; Hao ZHANG ; Dongming ZHANG ; Weishun LIAO ; Wanwen ZHAO ; Wei LI ; Peng CUI ; Xin CHEN ; Haiyang ZHANG ; Tao YANG ; Lie WANG ; Yongshun GAO ; Jiang LI ; Jianjun WU ; Wei ZHOU ; Zejian LYU ; Jian FANG
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1043-1050
Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.
10.Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China
Ze LI ; Junru GAO ; Li SONG ; Peige WANG ; Jian'an REN ; Xiuwen WU ; Suming LUO ; Qingjun ZENG ; Yanhong WENG ; Xinjian XU ; Qingzhong YUAN ; Jie ZHAO ; Nansheng LIAO ; Wei MAI ; Feng WANG ; Hui CAO ; Shichen WANG ; Gang HAN ; Daorong WANG ; Hao WANG ; Jun ZHANG ; Hao ZHANG ; Dongming ZHANG ; Weishun LIAO ; Wanwen ZHAO ; Wei LI ; Peng CUI ; Xin CHEN ; Haiyang ZHANG ; Tao YANG ; Lie WANG ; Yongshun GAO ; Jiang LI ; Jianjun WU ; Wei ZHOU ; Zejian LYU ; Jian FANG
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1043-1050
Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.

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