Purpose:The search for effective and low-risk treatment methods for colorectal cancer (CRC) is a pressing concern, given the inherent risks and adverse reactions associated with traditional therapies. Photothermal therapy (PTT) has emerged as a promising approach for cancer treatment, offering advantages such as non-radiation, non-invasiveness, and targeted treatment. Consequently, the development of nanoparticles with high stability, biocompatibility, and photothermal effects has become a significant research focus within the field of PTT.Methods:In this study, TiO2-Ti3C2 nanocomposites were synthesized and characterized, and their photothermal conversion efficiency in the near-infrared region II (NIR-II) was determined. Then studied the in vivo and in vitro photothermal activity and anti-tumor effect of TiO2-Ti3C2 in human colorectal cancer cell lines and nude mice subcutaneous tumor model.Results:The results showed that TiO2-Ti3C2 nanocomposites have strong absorption ability in the NIR-II, and have high photothermal conversion efficiency under 1064 nm (0.5 W/cm2, 6 min) laser stimulation. In addition, in vitro experiments showed that TiO2-Ti3C2 nanocomposites significantly inhibited the invasion, migration, and proliferation of colorectal cancer cells, and induced cell apoptosis; in vivo, experiments showed that TiO2-Ti3C2 nanocomposites-mediated PTT had good biocompatibility and efficient targeted inhibition of tumor growth.Conclusion:In conclusion, TiO2-Ti3C2 nanocomposites can be used as NIR-II absorption materials in PTT to suppress the invasion, migration, and proliferation of colorectal cancer cells, induce colorectal cancer cell apoptosis, and thus inhibit the development of CRC. Therefore, TiO2-Ti3C2 nanocomposites can be used as potential anti-tumor drugs for photothermal ablation of colorectal cancer cells.

目的 探讨根治性全胃切除术中采用弯型梅氏解剖剪联合血管控制技术的效果及安全性.方法 186例行根治性全胃切除术患者,其中术中采用弯型梅氏解剖剪联合血管控制技术患者89例为观察组,采用传统手术操作方法者97例为对照组,比较2组肿瘤位置、分化程度、临床分期、新辅助化疗情况;比较2组淋巴结清扫个数、阳性淋巴结个数、术中出血量、手术时间、术后住院时间及术后并发症发生情况.结果 观察组肿瘤位置、分化程度、临床分期、新辅助化疗情况与对照组比较差异均无统计学意义(P＞0.05).观察组术中出血量[(198.2±62.8)mL]少于对照组[(247.9±113.8)mL](t=3.729,P＜0.001),手术时间[(120.2±31.1)min]短于对照组[(147.8±28.7)min](t=6.283,P＜0.001),淋巴结清扫个数[(19.8±5.4)个]、阳性淋巴结个数[(3.8±2.2)个]、术后住院时间[(11.8±3.5)d1]及术后并发症发生率(6.7％)与对照组[(19.0±5.6)个、(3.2±2.3)个、(12.9±4.7)d、8.2％]比较差异均无统计学意义(P＞0.05).结论 根治性全胃切除术中采用弯型梅式解剖剪联合血管控制技术可充分清扫淋巴结,减少术中出血量,缩短手术时间.

BACKGROUND:Studies have validated the potential of methylated cell-free DNA as a biomarker in various tumors, and methylated DNA in plasma may be a potential biomarker for cancer.AIM:To evaluate the diagnostic value of RASSF1A methylation in plasma for colorectal cancer (CRC) and hepatocellular carcinoma (HCC).METHODS:A total of 92 CRC patients, 67 colorectal polyp (CRP) patients, 63 HCC patients, and 66 liver cirrhosis (LC) patients were enrolled. The plasma DNA was subjected to DNA extraction, double-strand DNA concentration determination, bisulfite conversion, purification, single-strand DNA concentration determination, and digital polymerase chain reaction (PCR) detection. The methylation rate was calculated. The diagnostic value was evaluated by the area under the curve (AUC).RESULTS:The age and sex in the CRC and CRP groups and the HCC and LC groups were also matched. The DNA methylation rate of RASSF1A in plasma in the CRC group was 2.87 ± 1.80, and that in the CRP group was 1.50 ± 0.64. DNA methylation of RASSF1A in plasma showed a significant difference between the CRC and CRP groups. The AUC of RASSF1A methylation for discriminating the CRC and CRP groups was 0.82 (0.76-0.88). The AUCs of T1, T2, T3 and T4 CRC and CRP were 0.83 (0.72-0.95), 0.87 (0.78-0.95), 0.86 (0.77-0.95), and 0.75 (0.64-0.85), respectively. The DNA methylation rate of RASSF1A in plasma in the HCC group was 4.45 ± 2.93, and that in the LC group was 2.46 ± 2.07. DNA methylation of RASSF1A in plasma for the HCC and LC groups showed a significant difference. The AUC of RASSF1A methylation for discriminating the HCC and LC groups was 0.70 (0.60-0.79). The AUCs of T1, T2, T3 and T4 HCC and LC were 0.80 (0.61, 1.00), 0.74 (0.59-0.88), 0.60 (0.42-0.79), and 0.68 (0.53-0.82), respectively.CONCLUSION:RASSF1A methylation in plasma detected by digital PCR may be a potential biomarker for CRC and HCC.

OBJECTIVE:To investigate the epidemiological characteristics and identify the risk factors of Giardia lamblia infections among patients with colorectal cancer in Henan Province.METHODS:A cross-sectional study was performed for questionnaire surveys among colorectal cancer patients in Henan Cancer Hospital during the period from March to July, 2021. Patients' stool samples were collected, and the triosephosphate isomerase (tpi) gene of G. lamblia was amplified in stool samples using nested PCR assay to characterize the parasite genotype. Univariate analysis and multivariate logistic regression analyses were employed to identify the risk factors of G. lamblia infections among colorectal cancer patients.RESULTS:A total of 307 colorectal cancer patients were investigated, including 176 males (57.3%) and 131 females (42.7%). PCR assay detected 8.1% [95% confidential interval (CI): (0.056, 0.117)] prevalence of G. lamblia infections among the study subjects, and there was no significant difference in the prevalence between men [9.1%, 95% CI: (0.057, 0.143)] and women [6.9%, 95% CI: (0.037, 0.125)] (χ2 = 0.495, P = 0.482). In addition, there was no age-specific prevalence of G. lamblia infections among the participants (χ2 = 1.534, P = 0.675). Multivariate logistic regression analysis identified use of septic tanks [odds ratio (OR) = 3.336, 95% CI: (1.201, 9.267)], daily use of well water [OR = 3.042, 95% CI: (1.093, 8.465)] and raising livestock [OR = 3.740, 95% CI: (1.154, 12.121)] as risk factors of G. lamblia infections among colorectal cancer patients, and the prevalence of abdominal pain was significantly greater in colorectal cancer patients with G. lamblia infections than in those without infections (P = 0.017). Among the 25 patients with G. lamblia infections, assemblage A was characterized in 24 (96.0%) cases and assemblage B in one case (4.0%).CONCLUSIONS:The prevalence of G. lamblia is high among colorectal cancer patients in Henan Province, and assemblage A is the dominant genotype of G. lamblia. Use of septic tanks, daily use of well water and raising livestock are risk factors of G. lamblia infections among patients with colorectal cancer.

目的 探讨并寻找血浆中长链非编码核糖核苷酸(lnc RNA)在胃癌患者中的临床价值.方法 选择我院收治的胃癌患者140例作为试验组,根据胃癌患者的性别和年龄等组成选取本院同期体检健康的受试者140名为对照组.在试验组和对照组中使用全基因组lnc RNA基因芯片技术去寻找胃癌患者中的潜在lnc RNA生物标志物.建立受试者特征曲线(ROC)去评价诊断的准确性.结果 在胃癌患者的血浆中有3 870个lnc RNA被不同程度的表达,其中有5个lnc RNA在第一阶段的胃癌患者中高度表达,在第二验证阶段胃癌患者的和正常健康的对比中,血浆中有2个lnc RNA(HCG 22和CTC-338M12.3)在胃癌患者中高度表达(P＜0.05),而且HCG 22和CTC-338M12.3的ROC的曲线面积(AUC)分别是0.769(95％ CI0.656～0.881)和0.732(95％ CI0.617 ～ 0.846),它们联合检测的AUC是0.919(95％ CI0.856 ～0.983).结论 血浆中lnc RNA HCG 22和CTC-338M12.3可能作为胃癌诊断的一个潜在的生物标志物.

结肠癌完整结肠系膜切除(CME)强调沿肿瘤引流血管根部解剖,以最大限度清扫淋巴结及保证脏层筋膜光滑和完整无缺损.笔者单位将组织剪的不同操作联合左手控制技术应用于右半结肠癌手术,清扫肠系膜上血管根部、胃结肠静脉干、结肠中血管根部淋巴结.

Objective To evaluate surgical repair of vesicorectovaginal fistula using transvaginal pedicled omentum pull-through combined transanal colon pull-through.Methods A total of 11 patients with postoperative vesicorectovaginal fistulas complicating female reproductive system malignant tumors undergoing repairement from Aug 2013 to Aug 2018 were retrospectively analyzed.In order to isolate,protect the bladder and eliminate residual vaginal cavity using transvaginal pedicled omentum pull-through,combined transanal colon pull-through to repair vesicorectovaginal fistula.Results All the 11 patients in this group completed the operation successfully,and no air or stool passing from the vaginal after the operation.The fistula disappeared in five patients confirmed by cystography and enterograph.The average operation time was 115 min,the average blood loss was 260 ml.Incision fat liquefaction was found in two.Incision infection occurred in one.Urinary dysfunction in two.Anal stenosis was found in four patients which were healed by anal dilation.Conclusions Transvaginal pedicled omentum pull-through combined transanal colon pull-through can eliminate vesicorectovaginal fistula,improve life quality and avoid colostomy.

AIM To investigate the value of multiparameter joint analysis in the early diagnosis of gastric cancer (GC) in clinical practice. METHODS Concentrations of CEA, CA724 and three kinds of cytokines (TNF-α, IL-6 and IL-8) in 176 GC patients, 117 atypical hyperplasia patients, and 204 healthy control individuals were used for building the diagnostic model, then 58 GC patients, 41 atypical hyperplasia patients, and 66 healthy control individuals were enrolled independently. The joints of the indicators were analyzed by binary logistic regression analysis method. RESULTS For discriminating the healthy control group and the GC group, IL-6 had the best diagnostic value, and the area under curve (AUC) of joint analysis was 0.95 (0.93-0.97). For the early stage and advanced stage GC, the AUC were 0.95 (0.92-0.98) and 0.95 (0.92-0.97). For discriminating the atypical hyperplasia group and GC group, CA724 had the best diagnostic value, and the AUC of joint analysis was 0.97 (0.95-0.99). For the early stage and advanced stage GC groups, the AUC were 0.98 (0.96-0.99) and 0.96 (0.94-0.98). After evaluation, for discriminating the GC, early stage GC and advanced cancer group from the healthy control group, the diagnostic sensitivity was 89.66%, 84.21% and 92.31%, respectively, and the specificity was 92.42%, 90.91% and 90.91%. For discriminating the GC, early stage GC and advanced cancer groups from the atypical hyperplasia group, the diagnostic sensitivity was 87.93%, 78.95% and 92.31%, respectively, and the specificity was 87.80%, 85.37% and 90.24%. CONCLUSION We have built a diagnostic model including CEA, CA724, IL-6, IL-8, and TNF-α. It may provide potential assistance as a screening method for the early detection of GC.

Objective To detect the frequency of programmed death-1 (PD-1) + T cell immunoglobulin domain and mucin domain-3 (Tim-3) + on CD4 + T lymphocytes in colorectal cancer (CRC) patients and to analyze their potential relationship with the progression of CRC.Methods Fifty-eight patients with CRC in department of surgery,the Affiliated Cancer Hospital of Zhengzhou University from January 2012 to January 2013 were enrolled.All the peripheral blood samples and 7 cases of tumor and para neoplastic tissues from surgically treated CRC patients were obtained.The frequency of PD-1 + Tim-3 + on CD4 + T lymphocytes was analyzed by flow cytometry.Results The frequencies of PD-1 + Tim-3 + cells among CD4 + cells were significantly higher in CRC patients than those in the 20 normal volunteers (2.1％ vs.1.2％,P =0.012).Significant difference was observed in the Tim-3 + PD-1 + CD4 + percentage in stage Ⅲ/Ⅳ patients compared to the patients with stage Ⅰ / Ⅱ (3.5％ vs.1.9％,P =0.024) and normal volunteers (3.5％ vs.1.2％,P =0.002).As compared with the matched paraneoplastic tissue (21.58％ vs.5.66％,P =0.002) and their counterparts in blood (21.58％ vs.2.44％,P =0.001),the frequency of Tim-3 + PD-1 + cells in tumor-infiltrating CD4 + T cells was significantly in creased in the tumor tissues.The PD-1 + Tim-3 + population in CD4 + T cells produced much lower IFN-γthan that from fractions PD-1 + Tim-3-,PD-1-Tim-3-and PD-1-Tim-3 +.Conclusion The frequencies of PD-1 + Tim-3 + cells among CD4 + cells were significantly increased in CRC patients,indicating that CD4 + T cells are the more exhausted ones within TILs.It may be one of the mechanisms related to immune escape of tumor cells,and acceleration of the development of CRC.

Although miR-542-3p has been found to be aberrantly downregulated in variety of human tumors, little is known about its role in colorectal cancer (CRC). This study was designed to assess the prognostic value of miR-542-3p in CRC by examining the expression profile of miR-542-3p in patients with CRC and investigate the possible molecular mechanism underlying the function of miR-542-3p. Our results showed that low levels of miR-542-3p were significantly associated with advanced tumor stage and lymph node metastasis and miR-542-3p can serve as an independent prognostic marker for CRC. Furthermore, ectopic induced expression of miR-542-3p significantly suppressed cell proliferation, induced apoptosis, inhibited migration and invasion in vitro and in vivo. Mechanistically, we identified OTUB1 as a direct and functional target for miR-542-3p, at least partly responsible for the anti-tumor effect of miR-542-3p in CRC. Our study demonstrates the importance of miR-524-3p/OTUB1 signaling in CRC development and suggests that targeting this signaling may highlight a new therapeutic approach for treatment of CRC.

Objective To investigate the underlying molecular mechanisms of microRNA-520e (miR-520e) in the migration and invasion of lung cancer cell line A549.Methods The reverse transcription-polymerase chain reaction (RT-PCR) was adopted to detect the expression differences of miR-520e in lung cancer cell line A549 and normal lung epithelial cell line BEAS-2B.Transfected miR-520e mimics to obtain miR-520e overexpressing cell lines.Using migration assay and Transwell assay to detect the effect of miR-520e on the migration and invasion of A549 cells.Bioinformatics was employed to predict the miR-520e-targeted Zinc finger protein 367 (ZNF367) gene.Dual luciferase assay was adopted to analyze the mechanism of miR-520e regulating ZNF367.Western blotting was used to detect the changes of ZNF367 in lung cancer cells.The effect of ZNF367 on the migration and invasion of A549 cells was studied by small interfering RNA (siRNA).Results The expression of miR-520e was 0.342 ± 0.214 in A549 cells compared with that of BEAS-2B cells (1.000 ± 0.135,P =0.000).After transfection with miR-520e mimic,compared with untransfected group [normal control (NC) group:1.000 ± 0.273] the expression of miR-520e in mimic group was 2.617 ±0.124 (P =0.000).After 24 hours of incubation,compared with NC group [(100.000 ± 12.347) ％],the cell migration rate in mimic group was [(43.727 ± 16.746) ％] and in scramble group was [(91.722 ± 7.631) ％],overexpression of miR-520e inhibits lung cancer cell migration (P =0.000).Invasion experiments show that,the number of invasive cells in the mimic group [(36.458 ± 21.301) ％] was lower compared with the miR-520e scramble group [(93.783 ± 9.125) ％] and the NC group [(100.000 ± 15.114) ％,P =0.000].Luciferase reporter gene results showed that transfection of miR-520e mimics inhibited luciferase activity by 0.374 ± 0.241 (P =0.000).The expression of ZNF367 was down-regulated by miR-520e mimics (0.426 ± 0.153,P =0.000;0.368 ± 0.127,P =0.000) by RT-PCR and Western blotting.Further experiments showed that miR-520e targets ZNF367 gene to regulate the migration and invasion of lung cancer cells.Conclusion miR-520e inhibits the migration and invasion of lung cancer A549 cells by regulating ZNF367

BACKGROUND:T lymphocytes play an indispensably important role in clearing virus and tumor antigen. There is little knowledge about impacts of inhibitory molecules with cytokine on tumor-infiltrating CD4+ T-cells in the presence of gastric cancer (GC). This study investigated the distribution of tumor-infiltrating T-cells subset and the differentiation as well as inhibitory phenotype of T-cells from blood and tissues of GC patients.MATERIALS AND METHODS:Patients with GC diagnosed on the basis of pre-operative staging and laparotomy findings were approached for enrollment between 2014 and 2015 at the Affiliated Cancer Hospital of Zhengzhou University, China. Phenotypic analysis based on isolation of tumor-infiltrating lymphocytes and intracellular IFN-γ staining assay is conducted. Statistical analysis is performed to show significance.RESULTS:The results showed that the percentage of CD4+ T-cells among CD3+ cells in tumors was significantly higher than that in the matched paraneoplastic tissue. CD4+ CD25high CD127low regulatory T-cells (Tregs), PD-1+, Tim-3+, and PD-1+ Tim-3+ cells were up-regulated on tumor infiltrating T-cells from patients with GC compared to their expressions on corresponding peripheral blood and peritumoral T-cells. Blockades of PD-1+ and Tim-3+ were effective in restoring tumor infiltrating T-cells' production of interferon-gamma (IFN-γ). Combined PD-1+ and Tim-3+ inhibition had a synergistic effect on IFN-γ secretion by CD4+ T-cells.CONCLUSION:The results suggested that the composition, inhibitors, and location of the immune infiltrate should be considered when evaluating antitumor immunotherapy. A new insight into the mechanisms underlying T cell dysfunction is provided.

目前腹横肌平面阻滞技术越来越受到重视［1－2］。加之罗哌卡因作为局麻药物进行切口局部浸润麻醉可有效减轻术后切口疼痛［3－6］。因此，本科室自2014年7月开始，对胃癌患者创新性采用腹横肌平面阻滞并联合罗哌卡因切口局部浸润麻醉，取得了较好的疗效，现报告如下。

Objective:To retrospectively analyze related factors of subtype transformation and to identify prognostic factors for pa-tients with retroperitoneal liposarcoma (RPLS). Methods:This study retrospectively analyzed the clinical data of 92 patients with RPLS, which were confirmed by postoperative pathology from July 1997 to October 2014 in Henan Provincial Tumor Hospital. Related studies were reviewed, and the prognoses were followed up. The factors may affect subtype transformation or prognoses were applied to the statistical analysis. Results:A total of 74 patients with RPLS were included according to the recruiting standard. The 5-year survival rate was 48.65%. Lobulated tumors (P=0.013) were the correlative factors that influenced subtype transformation. The Log-rank test showed that the age at diagnosis (P=0.045), multi-visceral resection (P=0.042), tumor necrosis (P<0.001), subtype transformation (P<0.001), and malignant level of pathological subtypes of the first operation (P<0.001) influenced overall survival. Multivariate Cox re-gression analysis showed that tumor necrosis and the malignant level of the initial histological grade were independent factors of over-all survival. Conclusion:Lobulated tumors are likely to transform the subtype. The prognosis of patients with RPLS is correlated with multi-visceral resection, tumors necrosis, subtype transformation, and the malignant level of pathological subtypes of the first opera-tion. Multi-visceral resection could not improve the 5-year survival rate of RPLS, and adjuvant therapy could not improve the prognosis.

OBJECTIVE:To investigate the advantages of thoracoabdominal radical gastrectomy for advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction. METHODS:Clinical data of 86 patients with Siewert type Ⅱ adennocarcinoma of the esophagogastric junction who received surgical treatment at the Henan Provincial Tumor Hospital from January 2015 to January 2016 were retrospectively analyzed. Among them, 44 patients underwent abdominal operation (abdominal group), and 42 patients underwent thoracoabdominal radical gastrectomy (thoraco-abdominal group). The operation time, lymph node number, distance between the tumor and cutting edge, amount of intraoperational blood loss, postoperative pulmonary complications, and postoperative hospital stay in the two groups were compared. RESULTS:Comparing the thoracoabdominal group with the abdominal group, the number of removed lymph nodes was 41.57±9.22 vs. 35.09±10.61 (P<0.01), the number of removed mediastinal lymph nodes was 6.38±1.50 vs. 3.52±1.42 (P<0.01), the distance between the tumor and cut edge was (5.62±0.73) cm vs. (3.30±0.85) cm (P<0.01), whereas the operation time, intraoperative blood loss, postoperative pulmonary complications, occurrence of anastomotic leakage and hospital stay were statistically not significantly different (P>0.05 for all). CONCLUSIONS:For patients with advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction, radical gastrectomy through thoracoabdominal approach can resect a longer segment of the esophagus, dissect more mediastinal lymph nodes, and does not increase post-operative complications and extend hospital stay, thus, exhibits obvious advantages in the surgical treatment of Siewert Ⅱ adenocarcinoma of the esophagogastric junction.

目的：探讨Ⅲ期直肠癌前切除术中预防性肠造瘘的最佳还纳时机。方法回顾性分析11例接受预防性肠造瘘的Ⅲ期直肠癌患者的临床资料，分析患者术后盆腔局部复发高危时间和造瘘口还纳的最佳时机。结果11例患者中有3例患者分别在术后第7、11、13个月发生局部复发和(或)远处转移，其中1例患者在术后第11个月拟行造瘘口还纳时发现盆腔局部复发。结论Ⅲ期直肠癌患者术后局部复发率较高，术后1年后其复发风险显著降低，因此，建议接受预防性肠造瘘的Ⅲ期直肠癌患者在术后1年后再考虑还纳造瘘口。

目的 探讨胃癌根治术中解剖剪锐性清扫No.12a组淋巴结的可行性.方法 行全胃癌D2根治手术患者243例,术中均应用解剖剪进行No.12a组淋巴结清扫.结果 本组患者术中清扫No.12a组淋巴结(2.2±0.6)个,淋巴结清扫时间(3.5±1.5)min;其中淋巴结转移率14.4％(35/243),无胆囊坏死、胆漏、术后黄疸、术后出血等并发症发生.结论 胃癌根治术中解剖剪锐性清扫No.12a组淋巴结安全、可行.

Objective To analyze the reasons and treatment of parastomal hernia after Miles operation.Methods The clinical data of 1 58 patients who underwent abdominal perineal resection of low rectal cancer in Affiliated Tumor Hospital of Zhengzhou University,from January 2007 to May 201 3,were retrospectively reviewed.Of these,46 patients had lateral rectus abdominis positioned stoma,83 had trans-rectus stoma,and 29 were extraperitoneal stoma.A total of 1 6 patients had developed the parastomal hernia after operation,including 1 1 cases in lateral rectus patients,and 5 cases in trans-rectus patients.The possible reasons of parastomal hernia were summarized.Results 1 0 cases of parastomal hernia had cured by tension-free hernia repair,and 6 had cured by conservative treatment.Wound infection occurred in only 1 patient,who cured by dressing,drainage and antibiotic treatment.Chronic pain was observed in 1 patient and had been treated by symptomatic treatment.None of serious mesh-related complications was found. Conclusion The reasons of parastomal hernia in this series was associated with the way of colostomy, surgical operation,and increased abdominal pressure.Either conservative or operative treatment can be taken according to the state of illness.

目的 分析导致胃癌术后患者发热的主要原因以及影响发热的相关因素,以期及早发现、处理术后并发症,对高危人群采取防范措施.方法 观察2013-06-2014-05间165例行根治性全胃切除术的胃癌患者术后发热情况,分析发热原因.依据患者年龄(＜60岁中青年、≥60岁老年)、术前BMI是否正常、总蛋白是否正常、男性患者是否有吸烟史、老年患者中是否具有基础疾病分组,比较各组发热率的差异是否具有统计学意义.结果 165例患者中53例出现术后发热,导致发热的原因中胸腔积液居首位,其次为腹腔积液.中青年组发热率(42.6％)明显高于老年组(32.9％),差异有统计学意义(P =0.015 ＜0.05);男性患者有吸烟史组发热率(96.4％)明显高于无吸烟史组(8.3％),差异有统计学意义(P =0.001 ＜0.05);术前BMI正常组与术前BMI异常组,术前总蛋白正常组与术前总蛋白异常组,老年患者中有慢性疾病组与无慢性疾病组发热率差异均无统计学意义.结论 胸腔积液及腹腔积液是导致胃癌术后发热的主要原因.中青年患者相比老年患者更容易出现术后发热,有吸烟史者比无吸烟史者更容易出现术后发热.