ABSTRACT
Objective To analyze the risk factors affecting postoperative incisional infection in Crohn's disease (CD) patients after bowel resection.Methods The retrospective case-control study was conducted.The clinicopathologieal data of 239 CD patients who underwent bowel resection in the Sixth Affiliated Hospital of Sun Yat-sen University between January 2007 and December 2016 were collected.All patients underwent bowel resection.Observation indicators:(1) surgical situations;(2) follow-up;(3) risk factors analysis affecting postoperative incisional infection;(4) clinical factors affecting preoperative anemia.The follow-up using outpatient examination or ward diagnosis was performed to detect incisional infection within 30 days postoperatively up to January 2017.The normality test was done by Shapiro-Wilk.Measurement data with normal distribution were represented as x-±s,and comparison between groups was evaluated with the t test.Measurement data with skewed distribution were described as M (range),and comparison between groups was analyzed using the Wilcoxon ranksum test.The univariate analysis and multivariate analysis were done using the Logistic regression model.The P＜ 0.05 in univariate analysis was incorporated into multivariate analysis for analysis in the forward wald.Results (1) Surgical situations:of 239 patients,11 underwent emergency surgery and 228 underwent elective surgery;65 and 174 underwent respectively laparoscopic surgery and open surgery;179 received digestive tract reconstruction and anastomosis and 81 received enterostomy (21 combined with anastomosis and enterostomy).Among 239 patients,137,113,101,58,54 and 11 were complicated respectively with fiber stenosis,intestinal fistula,obstruction of small intestine,abscess,cellulitis and enterobrosis (some patients combined with multiple signs).(2) Follow-up:239 patients were followed up at 30 days postoperatively.During the follow-up,48 with incisional infection were improved by symptomatic treatment.(3) Risk factors analysis affecting postoperative incisional infection:① Results of univariate analysis showed that illness behavior,sedimentation rate of RBC ＞ 20 mm/h,preoperative anemia,preoperative chronic intestinal fistula,open surgery,intraoperative fiber stenosis and intraoperative intestinal fistula were risk factors affecting occurrence of postoperative incisional infection [odds ratio (0R)=2.530,2.579,4.233,2.988,2.554,0.503,3.052,95％ confidence interval (CI):1.218-2.259,1.141-5.833,1.598-11.210,1.522-5.864,1.082-6.029,0.265-0.954,1.555-5.993,P＜0.05].② Results of multivariate analysis showed that preoperative anemia and intraoperative intestinal fistula were independent risk factors affecting occurrence of postoperative incisional infection (OR =3.881,2.837,95％ CI:1.449-10.396,1.429-5.634,P＜0.05).(4) Clinical factors affecting preoperative anemia:cases (male) with preoperative anemia,body mass index (BMI),cases with sedimentation rate of RBC ＞ 20 mm/h,platelet (PLT) ＞ 300x109/L,elevated C-reactive protein,albumin (Alb) ＜35 g/L were respectively 120,(17.4±2.9)kg/m2,130,75,139,65 in patients with preoperative anemia and 65,(18.3±2.9)kg/m2,36,12,39,10 in patients without preoperative anemia,with statistically significant differences (x2 =17.966,t =2.210,x2 =12.219,14.440,14.661,12.272,P＜0.05).Conclusion The preoperative anemia and intraoperative intestinal fistula are independent risk factors affecting occurrence of postoperative incisional infection,and preoperative anemia is associated with perioperative inflammatory conditions.
ABSTRACT
Objective:To test the effects and differences of gratitude,indebtedness and happiness on people's helping behaviors. Methods:Totally 190 college students from 3 classes in Henan Province were selected. Three sit-uational experiments of gratitude,indebtedness and happiness were used to inspire participants'mood according-ly. Each class randomized to receive a situational experiment,the altruism subscales of Philosophies of Human Na-ture(PHN),the assessment tool of helping others and helping others voluntarily were used to measure the college students'altruistic idea,helping others and helping behavior voluntarily,and the methods of descriptive statistics,co-variance analysis and regression analysis was adopted. Results:In helping others and helping others voluntarily,ac-cording to the results of covariance analysis,the effect of covariate altruistic ideas was significant [F(1,186)=9. 24,10. 52;Ps<0. 01],and the main effect of emotional state was also significant[F(2,186)=3. 50,3. 45;Ps<0. 05 ]. The scores of helping others and helping others voluntarily were higher in the gratitude group than in the happiness group[(4. 21 ±0. 10)vs. (3. 86 ±0. 09),(4. 22 ±0. 09)vs. (3. 90 ±0. 08)]. Regression analysis showed that gratitude could positively predict helping others and helping others voluntarily(β=0. 33,0. 20),and happiness could positively predict helping others voluntarily(β=0. 16). Conclusion:Excluding the effect of altruism idea to helping others and helping others voluntarily,the effects of emotional state to helping others and helping others vol-untarily are all significant. It suggests that participants under the state of gratitude could show more helping others and helping others voluntarily than participants under happiness,that is to say,comparing with happiness,gratitude may be more conducive to the cultivation of helping behavior.