简介：AIMToevaluatewhetherindividualswithgastriccancer（GC）arediagnosedearlieriftheyhavefirstdegreerelativeswithGC.METHODS：Atotalof4282patientsdiagnosedwithGCatNationalCancerCenterHospitalfrom2002to2012wereenrolledinthisretrospectivestudy.Weclassifiedthepatientsaccordingtopresenceorabsenceoffirst-degreefamilyhistoryofGCandcomparedageatdiagnosisandclinicopathologiccharacteristics.Inaddition,wefurtherclassifiedpatientsaccordingtospecificfamilymemberwithGC（father,mother,sibling,oroffspring）andcomparedageatGCdiagnosisamongthesepatientgroups.Baselinecharacteristicswereobtainedfromaprospectivelycollecteddatabase.Informationaboutthefamilymember＇sageatGCdiagnosiswasobtainedbyquestionnaire.RESULTS：Atotalof924patients（21.6%）hadafirstdegreefamilyhistoryofGC.ThemeanageatGCdiagnosisinpatientshavingpaternalhistoryofGCwas54.4±10.4yearsandwassignificantlyyoungerthaninthosewithoutafirst-degreefamilyhistory（58.1±12.0years,P〈0.001）.However,thisfindingwasnotobservedinpatientswhohadanaffectedmother（57.2±10.0years）orsibling（62.2±9.8years）.Amongpatientswithfamilymemberhavingearly-onsetGC（〈50yearsold）,meanageatdiagnosiswas47.7±10.3yearsforthosewithanaffectedfather,48.6±10.4yearsforthosewithanaffectedmother,and57.4±11.5yearsforthosewithanaffectedsibling.Thus,patientswithaparentdiagnosedbefore50yearsofagedevelopedGC10.4or9.5yearsearlierthanindividualswithoutafamilyhistoryofGC（bothP〈0.001）CONCLUSION：Early-onsetGCbeforeageof50wasassociatedwithparentalhistoryofearly-onsetofGC.Individualhavingsuchfamilyhistoryneedtostartscreeningearlier.

简介：AIM:Toinvestigatethediversecharacteristicsofdifferentpathologicalgradingsofgastricadenocarcinoma(GA)usingtumor-relatedgenes.METHODS:GAtissuesindifferentpathologicalgradingsandnormaltissuesweresubjectedtotissuearrays.Expressionsof15majortumor-relatedgenesweredetectedbyRNAinsituhybridizationalongwith3’terminaldigoxin-labeledanti-sensesinglestrandedoligonucleotideandlockednucleicacidmodifyingprobewithinthetissuearray.Thedataobtainedwereprocessedbysupportvectormachinesbyfourdifferentfeatureselectionmethodstodiscovertherespectivecriticalgene/genesubsetscontributingtotheGAactivitiesofdifferentpathologicalgradings.RESULTS:IncomparisonofpoorlydifferentiatedGAwithnormaltissues,tumor-relatedgeneTP53playsakeyrole,althoughothersixtumor-relatedgenescouldalsoachievetheAreaUnderCurve(AUC)ofthereceiveroperatingcharacteristicindependentlybymorethan80%.ComparingthewelldifferentiatedGAwithnormaltissues,wefoundthat11tumor-relatedgenescouldindependentlyobtaintheAUCbymorethan80%,butonlythegenesubsets,TP53,RBandPTEN,playakeyrole.Onlythegenesubsets,Bcl10,UVRAG,APC,Beclin1,NM23,PTENandRBcoulddistinguishbetweenthepoorlydifferentiatedandwelldifferentiatedGA.Noneofasinglegenecouldobtainavaliddistinction.CONCLUSION:Differentfromthetraditionalpointofview,thewelldifferentiatedcancertissueshavemorealterationsofimportanttumor-relatedgenesthanthepoorlydifferentiatedcancertissues.

简介：Objective:Gastriccancer(GC)isoneoftheleadingcausesofdeathinChinaandotherAsiancountries.Recently,gastricendoscopyhasbecomethemainapproachforGCscreening,buttheidentificationofhigh-riskindividualsremainsachallengeinGCscreeningprograms.Methods:Therewere7,302patientswithchronicgastritisinvolvedinthisstudy.Endoscopicexaminationswereperformed,andtheirdemographiccharacteristicsandlifestyledatawerecollected.EachpossibleassociatedfactorofGC/premalignantandprecursorlesionswasevaluatedbyunivariateandmultivariatelogisticregressions.Nomogramswereusedforvisualizationofthosemodels,andreceiveroperatingcharacteristic(ROC)curveanalysiswasusedtopresentthepredictiveaccuracy.Results:Wedetected8(0.11%)gastricadenocarcinomas,17(0.23%)dysplasiacases,14(0.19%)hyperplasiacases,52(0.71%)intestinalmetaplasiacases,217(2.97%)inflammatorylesions,141(1.93%)gastriculcers,10(0.14%)atrophicgastritiscases,1,365(18.69%)erosivegastritiscases,and5,957(81.58%)superficialgastritiscasesin7,302patients.Theage(P<0.001),gender(P=0.086),laborintensity(P=0.018)andleekfoodintake(P=0.143)wereidentifiedasindependentpredictivefactorsofGC/premalignantlesionspossibility.Thecorrespondingnomogramexhibitedanareaunderthecurve(AUC)[95%confidenceinterval(95%CI)]of0.82(0.74–0.89)forthemodelinggroupand0.80(0.75–0.85)forthevalidationgroup.Theage(P=0.002),gender(P=0.024),smoking(P=0.002)andleekfoodintake(P=0.039)wereindependentpredictivefactorsofprecursorlesionspossibility.ThecorrespondingnomogramexhibitedanAUC(95%CI)of0.62(0.60–0.65)forthemodelinggroupand0.61(0.59–0.63)forthevalidationgroup.Conclusions:WeidentifiedseveralpotentialassociatedfactorsandprovidedapreclinicalnomogramwiththepotentialtopredictthepossibilityofGC/premalignantandprecursorlesions.

简介：AIM:Toinvestigatewhethergenemethylationintheperitonealfluid(PF)predictsperitonealrecurrenceingastriccancerpatients.METHODS:ThegenemethylationofCHFR(checkpointwithforkheadandringfingerdomains),p16,RUNX3(runt-relatedtranscriptionfactor3),E-cadherin,hMLH1(mutLhomolog1),ABCG2(ATP-bindingcassette,sub-familyG,member2)andBNIP3(BCL2/adenovirusE1B19kDainteractingprotein3)wereanalyzedin80specimensofPFbyquantitativemethylation-specificpolymerasechainr...

简介：Objective:Oxidativestressislinkedtoincreasedriskofgastriccancerandmatrixmetalloproteinases(MMPs)areimportantintheinvasionandmetastasisofgastriccancer.WeaimedtoanalyzetheeffectoftheaccumulationofoxidativestressinthegastriccancerMKN-45and23132/87cellsfollowinghydrogenperoxide(H2O2)exposureontheexpressionpatternsofMMP-1,MMP-3,MMP-7,MMP-9,MMP-10,MMP-11,MMP-12,MMP-14,MMP-15,MMP-17,MMP-23,MMP-28,andβ-cateningenes.Methods:ThemRNAtranscriptsinthecellsweredeterminedbyRT-PCR.FollowingH2O2exposure,oxidativestressintheviablecellswasanalyzedby2’,7’-dichlorofluoresceindiacetate(DCFH-DA).Caffeicacidphenethylester(CAPE)wasusedtoeliminateoxidativestressandtheconsequenceofH2O2exposureanditsremovalontheexpressionsofthegeneswereevaluatedbyquantitativereal-timePCR.Results:TheexpressionsofMMP-1,MMP-7,MMP-14,MMP-15,MMP-17andβ-catenininMKN-45cellsandonlytheexpressionofMMP-15in23132/87cellswereincreased.RemovaloftheoxidativestressresultedindecreaseintheexpressionsofMMPgenesofwhichtheexpressionswereincreasedafterH2O2exposure.β-catenin,atranscriptionfactorformanygenesincludingMMPs,alsodisplayeddecreasedlevelsofexpressioninbothofthecelllinesfollowingCAPEtreatment.Conclusions:OurdatasuggestthatthereisaremarkablelinkbetweentheaccumulationofoxidativestressandtheincreasedexpressionsofMMPgenesinthegastriccancercellsandMMPsshouldbeconsideredaspotentialtargetsoftherapyingastriccancersduetoitscontinuousexposuretooxidativestress.

简介：Objective:Previousworkindicatedthataneuploidyofchromosome8incirculatingtumorcells(CTCs)correlatedwiththerapeuticefficacyforadvancedgastriccancer(AGC)patients.Inthisfollow-upstudyperformedonthesamepopulationofAGCpatients,weinvestigatedwhetherandhowaneuploidyofchromosome8inCTCscorrelateswithpatients'clinicalprognosis.Methods:Theprospectivestudywasperformedon31patientswithnewlydiagnosedAGC.Previouslyestablishedintegratedsubtractionenrichment(SE)andimmunostaining-fluorescenceinsituhybridization(iFISH)platformwasappliedtoidentify,enumerateandcharacterizeCTCs.QuantificationofCTCsandanalysisoftheiraneuploidyofchromosome8wereperformedonpatientsbeforeandaftertherapy.Results:CTCsweremeasuredin93.5%ofAGCpatients,andtwoCTCsubtypeswithdiversethresholdvalueswereidentified,multiploidCTCswiththethresholdof≥2per7.5mLandmultiploidplustriploidCTCswiththethresholdof≥4,whichwerefoundtosignificantlycorrelatewithpoorprogression-freesurvival(PFS)andoverallsurvival(OS).Inparticular,patientswith≥10%increasedmultiploidCTCsafteraninitial6weeksoftherapyhadpoorPFSandOS,whereasimprovedPFSandOSwereobservedonthosewhohad≥10%decreasedmultiploidCTCs.Afteradjustingforclinicallysignificantfactors,≥10%increasedpost-therapymultiploidCTCswastheonlyindependentpredictorofPFSandOS.Conclusions:AneuploidyofCTCscorrelateswithprognosisofAGCpatients.QuantitativecomparisonmonitoringmultiploidCTCsbeforeandaftertherapymayhelppredictimprovedorinferiorprognosisandchemoresistance.

简介：Inthepresentstudy,thechemosensitivityofMGc80-3humangastricadenocarcinomacellswasdeterminedbymeansofcolony-formingassayandtheinvitroactivitiesof10anticancerdrugswereexaminedonthebasisoftheclinicallyachievablepeakplasmadrugconcentration.TheresultsshowedthatMGc80-3cellsweremostsensitivetomitomyc’nC,adriamycinand5-fluorouracil,beingconsistentwiththeresponsenotedinclinicalgastriccancer.Thiscelllinemayretainitsoriginaldrugsensitivityandmaybeusefulinscreeningfornewcompoundswithactivityagainstthisdisease.

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简介：Toprovidegeneticinformationandmaterialsforbreedinghybridjaponicaricewithwideadaptabilityandstrongcompetitiveadvantageofyield,eliteallelesandtheircarriervarietiesofgrowthduration(GD)andproductivepaniclenumberperplant(PN)weredetected.Anaturalpopulationcomposedof94japonicavarietieswasphenotypedfortheGD,PNandplantheight(PH)intwoenvironments.TheconditionalphenotypicdataweretransferredbythelinearmodelmethodinsoftwareQGAStation1.0,andassociationmappingbasedontheunconditionalandconditionalphenotypevaluesofGDandPNwasanalyzedbyusinggenerallinearmodelinsoftwareTASSEL.Atotalof34simplesequencerepeat(SSR)markerlociassociatedwithGDandPNweredetectedinthetwoenvironments.Amongthem,15wereassociatedwithGD,and19wereassociatedwithPN.FoureliteallelesofRM8095-120bp,RM7102-176bp,RM72-170bpandRM72-178bpwereassociatedwithGD,andtheircarriervarietieswereHongmangshajing,Nipponbare,HongmangshajingandNannongjing62401,respectively.TheseeliteallelesfromthecarriervarietiescanshortenGDby2.039.93dwhentheywereintroducedintoimprovedmaterials.RM72-182bpassociatedwithPNwasaneliteallele,anditscarriervarietywasXiaoqingzhong.ItcanincreasePNbythreewhenintroducedintoimprovedmaterials.Moreover,theseeliteallelescanbeusedtoimprovetargettraitswithoutinfluencinganothertwotraits.

简介：目的：研究左旋精氨酸对大鼠胰腺腺泡细胞（AR42J）节律基因Per1表达的影响。方法：采用12-十四酸佛波酯-13-乙酸盐诱导AR42J细胞节律基因表达。在Per1RNA表达出现稳定近日节律后,设置实验组与对照组,实验组中加入含L-Arg培养液,对照组加入等量不含L-Arg培养液,采用RT-PCR法检测不同时间点AR42J细胞中Per1RNA的表达水平。结果：RT-PCR结果显示加入L-Arg实验组的Per1RNA表达量比对照组明显降低（P〈0.05）。结论：L-Arg可引起胰腺腺泡细胞中的Per1RNA表达降低,提示氨基酸可影响节律基因的表达。

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简介：Objective:ResponseEvaluationCriteriainSolidTumors(RECIST)guidelineversion1.0(RECIST1.0)wasproposedasanewguidelineforevaluatingtumorresponseandhasbeenwidelyacceptedasastandardizedmeasure.WithanumberofissuesbeingraisedonRECIST1.0,however,arevisedRECISTguidelineversion1.1(RECIST1.1)wasproposedbytheRECISTWorkingGroupin2009.ThisstudywasconductedtocompareCTtumorresponsebasedonRECIST1.1vs.RECIST1.0inpatientswithadvancedgastriccancer(AGC).Methods:Wereviewed61AGCpatientswithmeasurablediseasesbyRECIST1.0whowereenrolledinotherclinicaltrialsbetween2008and2010.Thesepatientswereretrospectivelyre-analyzedtodeterminetheconcordancebetweenthetworesponsecriteriausingtheκstatistic.Results:ThenumberandsumoftumordiametersofthetargetlesionsbyRECIST1.1weresignificantlylowerthanthosebyRECIST1.0(P<0.0001).However,therewasexcellentagreementintumorresponsebetweenRECIST1.1andRECIST1.0(κ=0.844).Theoverallresponserates(ORRs)accordingtoRECIST1.0andRECIST1.1were32.7%(20/61)and34.5%(20/58),respectively.Onepatientwithpartialresponse(PR)basedonRECIST1.0wasreclassifiedasstabledisease(SD)byRECIST1.1.OftwopatientswithSDbyRECIST1.0,onewasdowngradedtoprogressivediseaseandtheotherwasupgradedtoPRbyRECIST1.1.Conclusions:RECIST1.1providedalmostperfectagreementwithRECIST1.0intheCTassessmentoftumorresponseofAGC.

简介：Ithasbeenfoundthatexpressionof15-lipoxygenasc-1(15-LOX-1)anditsmainproduct,13-C-hydroxyoctadecadienoicacid(13-S-HODE),aredecreasedinhumancolorectalandesophagealcancersandthatnonsteroidalanti-inflammatorydrugs(NSAIDs)cantherspeuticallyinduce15-LOC-1expressiontotriggerapoptosisinthosecancercellsindependentlyCOX-2.WefoundthataspecificCOX-2inhibitorSC-236similarlyinduceapoptosisingastriccancercells,althoughthemechanismsoftheseeffectsremaintobedefined.Inthepresentstudy,wetestedwhetherSC-236inducedapoptosisthroughup-regulationof15-LOX-1ingastriccancercells.Wefoundthat,(a)SC-236inhibitedgrowthofgastriccancercellsmainlybyapoptosisinduced;(b)SC-236induced15-LOX-1expressionandincreasedendogenous13-S-HODEproduct,insteadof15-S-HETEduringapoptosisingastriccancercellswithout15-LOX-1expressionbeforetreatmentbySC-236;(c)sc-236didn'teffectexpressionofCOX-1,COX-2,5-LOXand12-LOX;and(d)15-LOX-1inhibitionsuppressedSC-236inducedapoptosis.ThesefindingsdemonstratedthatSC-236inducedapoptosisingastriccancercellsviaup-regulationof25-LOX-1.Theyalsosupporttheconceptthatthelossoftheproapopoticroleof15-LOX-1inepithelialcancersisnotlimitedtohumancolorectalandesophagealcancers.

简介：AbstractBackground:Endoscopic biopsy can underestimate gastric malignancies as low-grade intraepithelial neoplasia (LGIN). Definitively diagnosed LGIN would progress. This study aimed to evaluate predictive factors to identify malignancies misdiagnosed as LGIN by biopsy and LGIN at high risk of progression.Methods:The clinical records of patients diagnosed with gastric LGIN by endoscopic biopsy who underwent at least two endoscopies during the first year of follow-up between 2007 and 2017 were retrospectively collected. Three endoscopists reviewed photographs of the initial endoscopy, described lesion characteristics, and made endoscopic diagnoses. Logistic regression was used to analyze predictors to identify malignancies underestimated as LGIN. A receiver operating characteristic curve was used to evaluate the diagnostic accuracy of these predictors. Patient clinical outcomes of follow-up >1 year were collected. Kaplan-Meier estimates with log-rank tests and Cox proportional hazards regression were used to analyze predictors of progression.Results:Overall, 48 of 182 (26.4%) patients were proven to have malignancies. A single lesion, a large lesion size, and marked intestinal metaplasia (IM) were independent predictors of initially misdiagnosed malignancies. The area under the curve of these predictors was 0.871, with a sensitivity of 68.7% and specificity of 92.5%. Twelve of 98 patients (12.2%) progressed during the 33-month median follow-up period. A whitish appearance, irregular margins, marked IM, and histological diagnosis of LGIN more than twice within the first year were predictors for progression.Conclusions:Lesions diagnosed as LGIN by biopsy with marked IM and other predictors above should be prudently treated for high potential to be malignancies or progress. Endoscopic follow-up with repeated biopsies within the first year is recommended.

简介：AbstractBackground:Endoscopic resection bleeding (ERB) classification was proposed by the authors’ team to evaluate the severity of intraoperative bleeding (IB) during endoscopic submucosal dissection (ESD). This study aimed to evaluate the application of ERB classification and to analyze the risk factors of major IB (MIB) and postoperative bleeding (PB) associated with ESD for gastric neoplastic lesions.Methods:We retrospectively enrolled a total of 1334 patients who underwent ESD between November 2006 and September 2019 at The First Medical Center of Chinese People’s Liberation Army General Hospital. All patients were divided into the non-MIB group (including ERB-0, ERB-controlled 1 [ERB-c1], and ERB-c2) and the MIB group (including ERB-c3 and ERB-uncontrolled [ERB-unc]) according to the ERB classification. Risk factors of major MIB and risk factors of PB were analyzed using a logistic regression model.Results:Among the 1334 patients, 773 (57.95%) had ERB-0, 477 (35.76%) had ERB-c1, 77 (5.77%) had ERB-c2, 7 (0.52%) had ERB-c3, and no patients had ERB-unc. The rate of PB in patients with IB classifications of ERB-0, ERB-c1, ERB-c2, and ERB-c3 were 2.20% (17/773), 3.35% (16/477), 9.09% (7/77), and 2/7, respectively. In multivariate analysis, proximal location (odds ratio [OR]: 1.488; 95% confidence interval [CI]: 1.045-3.645; P = 0.047) was the only significant risk factor of MIB. Chronic kidney disease (CKD) (OR: 7.844; 95% CI: 1.637-37.583; P = 0.010) and MIB (ERB-c3) (OR: 13.932; 95% CI: 2.585-74.794; P = 0.002) were independent risk factors of PB.Conclusions:Proximal location of lesions was a significant risk factor of MIB. Additionally, CKD and MIB (ERB-c3) were independent risk factors of PB. More attention should be paid to these high-risk patients for MIB and PB.

简介：AIM:Toanalyzethemismatchrepair(MMR)statusandtheARID1Aexpressionaswellastheirclinicopathologicalsignificanceingastricadenocarcinomas.METHODS:WeexaminedtheexpressionsofMMRproteinsandARID1Abyimmunohistochemistryinconsecutive489primarygastricadenocarcinomas.Theresultswerefurthercorrelatedwithclinicopathologicalvariables.RESULTS:ThelossofanyMMRproteinexpression,indicativeofMMRdeficiency,wasobservedin38cases(7.8%)andwassignificantlyassociatedwithanolderage(68.6±9.2vs60.4±11.7,P<0.001),afemalesex(55.3%vs31.3%,P=0.004),anantrallocation(44.7%vs25.7%,P=0.021),andadifferentiatedhistology(57.9%vs39.7%,P=0.023).AbnormalARID1Aexpression,includingreducedorlossofARID1Aexpression,wasobservedin109cases(22.3%)andwassignificantlycorrelatedwithlymphaticinvasion(80.7%vs69.5%,P=0.022)andlymphnodemetastasis(83.5%vs73.7%,P=0.042).ThetumorswithabnormalARID1AexpressionmorefrequentlyindicatedMMRdeficiency(47.4%vs20.2%,P<0.001).AmultivariateanalysisidentifiedabnormalARID1Aexpressionasanindependentpoorprognosticfactor(HR=1.36,95%CI:1.01-1.84;P=0.040).CONCLUSION:OurobservationssuggestthattheAIRD1Ainactivationisassociatedwithlymphaticinvasion,lymphnodemetastasis,poorprognosis,andMMRdeficiencyingastricadenocarcinomas.

简介：目的：观察艾灸预处理对急性胃黏膜损伤大鼠胃黏膜细胞凋亡相关因子的影响，探讨艾灸诱导HSP70与上述因子的关系，从细胞凋亡线粒体信号转导途径探讨艾灸预处理保护胃黏膜损伤的机制。方法：将32Wister大鼠随机分为4组，即捆绑组、模型组、艾灸穴位组、艾灸非穴组。艾灸穴位组和艾灸非穴组大鼠艾灸预处理8d，捆绑组和模型组大鼠只捆绑，不艾灸。除捆绑组外，其余各组制备大鼠急性胃黏膜损伤模型。采用Western—blot方法检测大鼠胃黏膜细胞色素C（Cyt—c）的表达，免疫组织化学方法检测胃黏膜HSP70，胃黏膜细胞凋亡，Apaf-1，Caspase-9，Caspase-3，Bcl-2和BaX的表达。结果：与捆绑组相比，模型组大鼠胃黏膜HSP70表达，胃黏膜细胞凋亡指数，胞浆Cyt—C，Apaf-1，Caspase-9，Caspase-3，Bcl-2和Bax含量明显增加（P〈0．05或P〈0．01）。与模型组相比，艾灸穴位组大鼠胃黏膜HSP70表达和Bcl-2明显增加（P〈0．01），而细胞凋亡指数，胞浆Cyt—C，Apaf-1，Caspase-9，Caspase-3，Bax均显著降低（P〈0．01）。与艾灸穴位组相比，艾灸非穴组大鼠胃黏膜HSP70表达和Bcl-2显著降低（P〈0．01），而凋亡指数，Cyt—c，Apaf-1，Caspase-9，Caspase-3，Bax显著升高（P〈0．05或P〈0．01）。结论：艾灸通过上调大鼠胃黏膜细胞HSP70表达，并影响细胞凋亡线粒体信号转导途径相关因子Cyt—C，Apaf-1，Caspase-9，Caspase-3，Bcl-2和Bax，由此抑制胃黏膜细胞凋亡，达到保护胃黏膜损伤的作用。

简介：AbstractBackground:About 10% of patients get a surgical-site infection (SSI) after radical gastrectomy for gastric cancer, but SSI remains controversial among surgeons. The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI.Methods:The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer. SSI was defined in accordance with the National Nosocomial Infection Surveillance System. We evaluated patient-related and peri-operative variables that could be risk factors for SSIs. The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI.Results:Among the 590 patients, 386 were men and 204 were women. The mean age was 56.6 (28-82) years and 14.2% (84/590) of these patients had an SSI. Among them, incisional SSI was observed in 23 patients (3.9%) and organ/space SSI in 61 patients (10.3%). Multivariate logistic regression analysis identified sex (odds ratios [ORs] = 2.548, and 95% confidence interval [CI]: 1.268-5.122, P = 0.009), total gastrectomy (OR = 2.327, 95% CI: 1.352-4.004, P = 0.002), albumin level (day 3 after surgery) <30 g/L (OR= 1.868, 95% CI: 1.066-3.274, P = 0.029), and post-operative total parenteral nutrition (OR = 2.318, 95% CI: 1.026-5.237, P = 0.043) as independent risk factors for SSI.Conclusions:SSI was common among patients after radical gastrectomy for gastric cancer. The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.