Clinical application of metagenomic next-generation sequencing in non-immunocompromised patients with severe pneumonia supported by veno-venous extracorporeal membrane oxygenation.

Objectives: This study aims to explore the pathogen-detected effect of mNGS technology and its clinical application in non-immunocompromised patients with severe pneumonia supported by vv-ECMO. Methods: A retrospective analysis was conducted on a cohort of 50 non-immunocompromised patients who received vv-ECMO support for severe pneumonia between January 2016 and December 2022. These patients were divided into two groups based on their discharge outcomes: the deterioration group (Group D), which included 31 cases, and the improvement group (Group I), consisting of 19 cases. Baseline characteristics and clinical data were collected and analyzed. Results: Among the 50 patients enrolled, Group D exhibited a higher prevalence of male patients (80.6% vs. 52.6%, p < 0.05), more smokers (54.8% vs. 21.1%, p < 0.05), and were older than those in Group I (55.16 ± 16.34 years vs. 42.32 ± 19.65 years, p < 0.05). Out of the 64 samples subjected to mNGS detection, 55 (85.9%) yielded positive results, with a positivity rate of 83.7% (36/43) in Group D and 90.5% (19/21) in Group I. By contrast, the positive rate through traditional culture stood at 64.9% (74/114). Among the 54 samples that underwent both culture and mNGS testing, 23 (42.6%) displayed consistent pathogen identification, 13 (24.1%) exhibited partial consistency, and 18 (33.3%) showed complete inconsistency. Among the last cases with complete inconsistency, 14 (77.8%) were culture-negative, while two (11.1%) were mNGS-negative, and the remaining two (11.1%) presented mismatches. Remarkably, mNGS surpassed traditional culture in pathogen identification (65 strains vs. 23 strains). Within these 65 strains, 56 were found in Group D, 26 in Group I, and 17 were overlapping strains. Interestingly, a diverse array of G+ bacteria, fungi, viruses, and special pathogens were exclusive to Group D. Furthermore, Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae were more prevalent in Group D compared to Group I. Importantly, mNGS prompted antibiotic treatment adjustments in 26 patients (52.0%). Conclusions: Compared with the conventional culture, mNGS demonstrated a higher positive rate, and emerges as a promising method for identifying mixed pathogens in non-immunodeficient patients with severe pneumonia supported by vv-ECMO. However, it is crucial to combine the interpretation of mNGS data with clinical information and traditional culture results for a comprehensive assessment.

Fluorescent Probes with Variable Intramolecular Charge Transfer: Constructing Closed-Circle Plots for Distinguishing D2O from H2O.

It is difficult to distinguish between H2O and D2O due to their very similar properties. Triphenylimidazole derivatives with carboxyl groups (TPI-COOH-2R) show intramolecular charge transfer that responds to polarities and pH of solvents. Here, a series of TPI-COOH-2R with very high photoluminescence quantum yields (73-98%) were synthesized to distinguish D2O from H2O by the method of wavelength-changeable fluorescence. In a mixed THF/water solution, the increase of H2O and D2O contents will separately induce different pendulum-type fluorescence variations and form plots of closed circles with the same starting and ending points from which a THF/water ratio that displays the most different emission wavelengths (up to 53 nm with an LOD of 0.064 vol %) can be determined to further distinguish D2O from H2O. This is proved to be originated from the various Lewis acidities between H2O and D2O. The results of theoretical calculations and experiments suggest that, for different substituent groups in TPI-COOH-2R, an appropriate electron-donating effect is beneficial to distinguish between H2O and D2O, while the electron-pulling effect is adverse. Moreover, because the potential hydrogen/deuterium exchange does not affect the as-responsive fluorescence, this method is reliable. And this work provides a new strategy for the design of fluorescent probes for D2O.

Development of prediction model of low anterior resection syndrome for colorectal cancer patients after surgery based on machine-learning technique.

BACKGROUND: Low anterior resection syndrome (LARS) is a common postoperative complication in patients with colorectal cancer, which seriously affects their postoperative quality of life. At present, the aetiology of LARS is still unclear, but some risk factors have been studied. Accurate prediction and early management of medical intervention are keys to improving the quality of life of such high-risk patients. OBJECTIVES: Based on machine-learning methods, this study used the follow-up results of postoperative patients with colorectal cancer to develop prediction models for LARS and conducted a comparative analysis between the different models. METHODS: A total of 382 patients diagnosed with colorectal cancer and undergoing surgery at West China Hospital from April 2017 to December 2020 were retrospectively selected as the development cohort. Logistic regression, support vector machine, decision tree, random forest and artificial neural network algorithms were used to construct the prediction models of the obtained dataset. The models were internally validated using cross-validation. The area under the curve and Brier score measures were used to evaluate and compare the differentiation and calibration degrees of the models. The sensitivity, specificity, positive predictive value and negative predictive value of the different models were described for clinical use. RESULTS: A total of 342 patients were included, the incidence of LARS being 47.4% (162/342) during the six-month follow-up. After feature selection, the factors influencing the occurrence of LARS were found to be location, distance, diverting stoma, exsufflation and surgical type. The prediction models based on five machine-learning methods all showed acceptable performance. CONCLUSIONS: The five models developed based on the machine-learning methods showed good prediction performance. However, considering the simplicity of clinical use of the model results, the logistic regression model is most recommended. The clinical applicability of these models will also need to be evaluated with external cohort data.

Role and Clinical Application of Metagenomic Next-Generation Sequencing in Immunocompromised Patients With Acute Respiratory Failure During Veno-Venous Extracorporeal Membrane Oxygenation.

Objectives: There are few studies of metagenomic next-generation sequencing (mNGS) in immunocompromised patients assisted by veno-venous extracorporeal membrane oxygenation (vv-ECMO). The present study is aimed to investigate the pathogen-detected effect and clinical therapy value of mNGS technologies in immunocompromised patients assisted by vv-ECMO. Methods: Our study retrospectively enrolled 46 immunocompromised patients supported by vv-ECMO from Jan 2017 to June 2021 at the First Affiliated Hospital of Zhengzhou University, respectively. Patients were divided into the deterioration group (Group D) (n = 31) and improvement group (Group I) (n = 15) according to their outcomes. Baseline characteristics and etiological data of patients during hospitalization of 2 groups were compared. The pathogens detected by mNGS and antibiotic regimens guided by mNGS in immunocompromised patients assisted by vv-ECMO were analyzed. Results: Compared with Group I, the deterioration patients showed a higher percentage of chronic obstructive pulmonary disease (COPD) (32.3% vs. 6.7%, p < 0.01) and were significantly older (47.77 ± 16.72 years vs. 32 ± 15.05 years, p < 0.01). Within 48 h of being ECMO assisted, the consistency of the samples detected by traditional culture and mNGS at the same time was good (traditional culture vs. mNGS detection, the positive rate of bronchoalveolar lavage fluid (BALF) culture: 26.1% vs. 30.4%; the positive rate of blood sample culture: 12.2% vs. 12.2%, p > 0.05). However, mNGS detected far more pathogen species and strains than conventional culture (30 strains vs. 78 strains, p < 0.01); the most popular pathogen was Klebsiella pneumoniae. Parts of patients had their antibiotic treatment adjustments, and the improvement patients showed less usage of broad-spectrum antibiotics. Conclusions: mNGS may play a relatively important role in detecting mixed pathogens and personalized antibiotic treatment in immunocompromised patients assisted by vv-ECMO.

Outcomes of Transferred Adult Venovenous and Venoarterial Extracorporeal Membrane Oxygenation Patients: A Single Center Experience.

Objectives: Extracorporeal membrane oxygenation (ECMO) patients with or without transport both have high hospital mortality rate and there are few data on adult VA-ECMO transport patients. Hence, this study was designed to analyze factors that affect the outcomes of patients with ECMO transport. Methods: This study retrospectively enrolled 126 ECMO patients transferred from regional hospital to the First Affiliated Hospital of Zhengzhou University by our ECMO team during June 2012 to Sept 2020. Data were calculated and analyzed. Results: The median distance of transportation was 141 (76-228) km, the median transport time consuming was 3 (1.3-4) h, the percentage of complications during transport was 40.5% (except for bleeding on cannula site, and no one death during transport), and the survival rate in hospital was 38.9%. Compared with survivors, the non-survivors were older and showed higher SOFA score, longer time with ECMO assisted, longer time in ICU and in hospital. However, after divided into VA-ECMO and VV-ECMO groups, the older age showed no significant difference between survivors and non-survivors groups of VA-ECMO patients. Moreover, the Cox regression survival analysis showed that higher SOFA score and lactate level indicated higher ICU mortality of VA-ECMO patients while higher SOFA score, higher lactate level, older age and lower MAP after transportation (<70mmHg) indicated higher ICU mortality of VV-ECMO patients. However, there was no significant difference of comorbidities and complications in survivors and non-survivors groups of ECMO patients. Conclusions: The transportation for ECMO patients can be feasible performed although life-threatening complications might occur. The SOFA score and the lactate level could be used to evaluate the risk of ICU mortality of transportation ECMO patients. Besides, lower MAP after transportation (<70mmHg) had potential predictive value for short-term outcome of VV-ECMO patients.

Heparin-free after 3000 IU heparin loaded in veno-venous ECMO supported acute respiratory failure patients with hemorrhage risk: a novel anti-coagulation strategy.

BACKGROUND: The anti-coagulation protocol of patients with hemorrhage risk primary disease who need extracorporeal membrane oxygenation (ECMO) supported is controversial. This study evaluated the feasibility of a new anti-coagulation strategy, that is heparin-free after 3000 IU heparin loaded in veno-venous ECMO (VV ECMO) supported acute respiratory failure patients with hemorrhage risk. METHODS: A retrospective study was performed in a series of hemorrhage risk patients supported with VV ECMO at the First Affiliated Hospital of Zhengzhou University, between June 2012 to Sept 2020. A total of 70 patients received a low heparin bolus of 3000 units for cannulation but without subsequent, ongoing heparin administration. Patients were divided into survival (n = 25) and non-survival group (n = 45). Data of coagulation, hemolysis and membrane lung function were calculated and analyzed. The complications of patients were recorded. Finally, the binary Logistic regression was conducted. RESULTS: The longest heparin-free time was 216 h, and the mean heparin-free time was 102 h. Compared with survivors, the non-survivors were showed higher baseline SOFA score and lower platelet counts in 0.5 h, 24 h, 48 h and 96 h after ECMO applied. However, there was no significant differences between survivors and non-survivors in ACT, APTT, INR, D-dimer, fibrinogen, LDH, blood flow rate, Δp and Ppost-MLO2 (all p < 0.05) of all different time point. Moreover, only the baseline SOFA score was significantly associated with mortality (p < 0.001, OR(95%CI): 2.754 (1.486-5.103)) while the baseline levels of ACT, APTT, INR, platelet, D-dimer, fibrinogen and LDH have no association with mortality. The percentage of thrombosis complications was 54.3% (38/70) including 3 oxygenator changed but there was no significant difference of complications in survival and non-survival groups (p > 0.05). CONCLUSIONS: The anticoagulation protocol that no heparin after a 3000 units heparin bolus in VV ECMO supported acute respiratory failure patients with hemorrhage risk is feasible.

Screening and verification of CYP3A4 inhibitors from Bushen-Yizhi formula to enhance the bioavailability of osthole in rat plasma.

ETHNOPHARMACOLOGICAL RELEVANCE: With the features of multiple-components and targets as well as multifunction, traditional Chinese medicine (TCM) has been widely used in the prevention and treatment of various diseases for a long time. During the application of TCM, the researches about bioavailability enhancement of the bioactive constituents in formula are flourishing. Bushen-Yizhi formula (BSYZ), a TCM prescription with osthole (OST) as one of the main bioactive ingredients, have been widely used to treat kidney deficiency, mental retardation and Alzheimer's disease. However, the underlying biological mechanism and compound-enzyme interaction mediated bioavailability enhancement of OST are still not clearly illuminated. AIM OF THE STUDY: The aim of this study is to explore the material basis and molecular mechanism from BSYZ in the bioavailability enhancement of OST. Screening the potential CYP3A4 inhibitors using theoretical prediction and then verifying them in vitro, and pharmacokinetics study of OST in rat plasma under co-administrated of screened CYP3A4 inhibitors and BSYZ were also scarcely reported. MATERIALS AND METHODS: Screening of CYP3A4 inhibitors from BSYZ was performed with molecular docking simulation from systems pharmacology database. The screened compounds were verified by using P450-Glo Screening Systems. A multiple reaction monitoring (MRM) mass spectrometry method was established for OST quantification. Male Sprague-Dawley rats divided into four groups and six rats in each group were employed in the pharmacokinetics study of OST. The administrated conditions were group I, OST (20 mg/kg); group II, BSYZ (containing OST 1 mg/mL, at the dose of 20 mg/kg OST in BSYZ); group III, co-administration of ketoconazole (Ket, 75 mg/kg) and OST (20 mg/kg); group IV, co-administration of CYP3A4 inhibitor (10 mg/kg) and OST (20 mg/kg). They were determined by using HPLC-MS/MS (MRM) and statistical analysis was performed using student's t-test with p < 0.05 as the level of significance. RESULTS: 21 potential CYP3A4 inhibitors were screened from BSYZ compounds library. From the results of verification in vitro, we found 4 compounds with better CYP3A4 inhibition efficiency including Oleic acid, 1,2,3,4,6-O-Pentagalloylglucose, Rutin, and Schisantherin B. Under further verification, Schisantherin B exhibited the best inhibitory effect on CYP3A4 (IC50 = 0.339 µM), and even better than the clinically used drug (Ket) at the concentration of 5 µM. In the study of pharmacokinetics, the area under the curve (AUC, ng/L*h) of OST after oral administration of BSYZ, Ket and Schisantherin B (2196.23 ± 581.33, 462.90 ± 92.30 and 1053.03 ± 263.62, respectively) were significantly higher than that of pure OST treatment (227.89 ± 107.90, p < 0.01). CONCLUSIONS: Schisantherin B, a profoundly effective CYP3A4 inhibitor screened from BSYZ antagonized the metabolism of CYP3A4 on OST via activity inhibition, therefore significantly enhanced the bioavailability of OST in rat plasma. The results of this study will be helpful to explain the rationality of the compatibility in TCM formula, and also to develop new TCM formula with more reasonable drug compatibility.

Short-course neoadjuvant chemoradiotherapy and surgery are beneficial in Chinese patients: A retrospective study.

Preoperative neoadjuvant chemoradiotherapy (NACR) is used to reduce tumor size for easier resection or improved resectability rates. Considering the difficulties regarding health insurance and health resources in China, an evidence-based short-course neoadjuvant chemoradiotherapy with surgery to cure patients was performed. This study compared the postoperative effects between short-course neoadjuvant chemoradiotherapy and surgery and surgery without neoadjuvant chemoradiotherapy.The current retrospective study was based on a rectal cancer database, including 274 patients diagnosed with rectal cancer between January 2014 and October 2016. Data were analyzed with respect to curative rate, postoperative recovery indicators (times to nasogastric tube, urinary catheter, and drainage tube removal and times to first oral feeding and passing of flatus postsurgery), chemoradiotherapy-related indicators [white blood cell count (WBC) and carcinoembryonic antigen (CEA) levels], and adverse effects indicators, evaluated according to Common Terminology Criteria for Adverse Events Version 4.0.There was no significant difference between the combined therapy and surgery groups (P > .05) in terms of radical resection rates and the times to urinary catheter removal and passing flatus (P > .05). Statistically significant differences (P < .05) in terms of earlier time for removal of the nasogastric and drainage tubes and time to first oral feeding were observed in the combined therapy group. The decreases in WBC and CEA levels in the combined therapy group were significantly greater than those in the surgery group 1 week after surgery (P < .05); after 1 month, the CEA decrease in the combined therapy group was significantly greater than that in the surgery group (P < .05). More patients in the combined therapy group experienced vomiting, indigestion, dehydration, oral mucositis, sensory neuritis, and alopecia compared with those in the surgery group 1 week after surgery (P < .05); after 1 month, only the incidence of alopecia was higher in the combined therapy group (P < .05).The combined therapy group demonstrated earlier postoperative recovery compared with the surgery group. Short-course neoadjuvant chemoradiotherapy with surgery may lead to postoperative treatment-related adverse effects of varying degrees; however, these adverse effects eventually improve with time.

Fast-track improves post-operative nutrition and outcomes of colorectal surgery: a single-center prospective trial in China.

Fast-track (FT) has been shown to enhance post-operative recovery. The aim of this study was to compare the effects of FT and traditional nutrition on post-operative rehabilitation, as well as evaluate the feasibility of applying FT in nutrition management of colorectal surgery. A prospective and randomized controlled trial was performed. This study included 464 patients who underwent colorectal surgery. The patients were randomly assigned into an FT group and a traditional group. The nutritional risk screening (NRS 2002) score, post-operative recovery index and surgical complications were compared between the FT and traditional groups. The NRS 2002 score in the FT group was better than the traditional group (p<0.05). Serum indicators for nutrition (HGB, ALB, A/G) and immune function (lymphocyte rate [LYMPH%], IgA, and CD4+) in the FT group were superior to those in the traditional group (p<0.05) on post-operative day 5. The first time to aerofluxus, defecation, oral intake and ambulation in the FT group was shorter when compared to the traditional group (p<0.05). The complication incidence was significantly lower in the FT group than in the traditional group (p<0.05). In particular, the occurrence rate of anastomotic leakage was higher in the traditional group than in the FT group (0.5% vs 2.8%, p<0.05). Taken together, these data suggest that FT management can improve the nutritional condition and outcomes of colorectal surgical patients.

Quality of life of elderly Chinese rectal cancer patients after preventative anal surgery: a cohort study.

BACKGROUND/AIM: To assess the QOL in rectal cancer patients after preventative anal operation and to discuss the influence of age on perceived quality of life. METHODOLOGY: A prospective study of 342 patients with rectal cancer from May 2011 to January 2012 in the gastrointestinal surgery department was randomly selected and divided into the elderly group and the young group, and the differences in their QOL assessed by the questionnaire QLQ-C30, after preventative anal surgery (7 days) were compared. RESULTS: A total of 207 patients met the study criteria and were divided into the elderly group (≥60 years, 107 cases) and the young group (<60 years, 100 cases). The incidences of complication with pneumonia (p=0.030), wound infection (p=0.024) and ileus (p=0.036) were higher in the elderly group. In the QLQ-C30 assessment, the physical function in the elderly group was worse (p=0.004). Additionally, the fatigue of symptom, sleep disturbance and poor appetite (p<0.001), and global quality of life (p=0.002) were worse in the elderly group too. However, the role and emotional function were better in the elderly group (p<0.001). CONCLUSIONS: The QOL in elderly patients is generally worse than young patients, and a targeted approach should be used.

[Analysis of cardiopulmonary bypass diluted autologous blood transfusion: a report of 5000 cases].

OBJECTIVE: To explore the clinical application and experience of cardiopulmonary bypass (CPB) diluted autologous transfusion so as to provide clinical rationales for blood conservation. METHODS: At Department of Cardiothoracic Surgery, First Affiliated Hospital, Zhengzhou University, the clinical data were reviewed for 5000 CPB surgical patients without banked blood from September 1996 to March 2012 to analyze the clinical application of autologous blood transfusion and summarize the experience of depth hemodilution. No significant changes occurred in blood pressure, central venous pressure or heart rate after blood collection. The values of blood gases stayed within the normal perioperative range. The collected blood and all the remaining blood in CPB machine were reinfused to bring the postoperative level of Hb to over 90 g/L. Only 129 cases on a second thoracotomy for hemostasis required banked blood transfusion because of hemogloblin (Hb) under 70 g/L. RESULTS: Hb, hematocrit (Hct), pH, base excess (BE), lactate (Lac), cerebral oxygen saturation (rSO2) and arterial oxygen saturation (SaO2) indicated a statistically significant during CPB compared with pre-anesthetic (P < 0.05). The remaining indicators stayed within the normal perioperative range except for Hb and Hct. There were 146 cases of deaths. And the causes were postoperative low cardiac output (n = 34), cerebrovascular accident (n = 48), malignant arrhythmias (n = 28) and lung infection and multiple organ dysfunction (n = 36). The case fatality rate was merely 2.92%. All survivors recovered well and no heart, brain, kidney or other complications occurred. CONCLUSION: Hct 15%-19% depth of hemodilution with proper cooling and anesthetic management during cardiopulmonary bypass is both safe and feasible. And neutralization heparinemia in stored blood before CPB by protamine is one of the effective methods of blood conservation.

Minilaparotomy to rectal cancer has higher overall survival rate and earlier short-term recovery.

AIM: To report our experience using mini-laparotomy for the resection of rectal cancer using the total mesorectal excision (TME) technique. METHODS: Consecutive patients with rectal cancer who underwent anal-colorectal surgery at the authors' hospital between March 2001 and June 2009 were included. In total, 1415 patients were included in the study. The cases were divided into two surgical procedure groups (traditional open laparotomy or mini-laparotomy). The mini-laparotomy group was defined as having an incision length ≤ 12 cm. Every patient underwent the TME technique with a standard operation performed by the same clinical team. The multimodal preoperative evaluation system and postoperative fast track were used. To assess the short-term outcomes, data on the postoperative complications and recovery functions of these cases were collected and analysed. The study included a plan for patient follow-up, to obtain the long-term outcomes related to 5-year survival and local recurrence. RESULTS: The mini-laparotomy group had 410 patients, and 1015 cases underwent traditional laparotomy. There were no differences in baseline characteristics between the two surgical procedure groups. The overall 5-year survival rate was not different between the mini-laparotomy and traditional laparotomy groups (80.6% vs. 79.4%, P = 0.333), nor was the 5-year local recurrence (1.4% vs. 1.5%, P = 0.544). However, 1-year mortality was decreased in the mini-laparotomy group compared with the traditional laparotomy group (0% vs. 4.2%, P < 0.0001). Overall 1-year survival rates were 100% for stage I, 98.4% for stage II, 97.1% for stage III, and 86.6% for stage IV. Local recurrence did not differ between the surgical groups at 1 or 5 years. Local recurrence at 1 year was 0.5% (2 cases) for mini-laparotomy and 0.5% (5 cases) for traditional laparotomy (P = 0.670). Local recurrence at 5 years was 1.5% (6 cases) for mini-laparotomy and 1.4% (14 cases) for traditional laparotomy (P = 0.544). Days to first ambulation (3.2 ± 0.8 d vs 3.9 ± 2.3 d, P = 0.000) and passing of gas (3.5 ± 1.1 d vs. 4.3 ± 1.8 d, P = 0.000), length of hospital stay (6.4 ± 1.5 d vs 9.7 ± 2.2 d, P = 0.000), anastomotic leakage (0.5% vs. 4.8%, P = 0.000), and intestinal obstruction (2.2% vs 7.3%, P = 0.000) were decreased in the mini-laparotomy group compared with the traditional laparotomy group. The results for other postoperative recovery function indicators, such as days to oral feeding and defecation, were similar, as were the results for immediate postoperative complications, including the physiologic and operative severity score for the enumeration of mortality and morbidity score. CONCLUSION: Mini-laparotomy, as conducted in a single-centre series with experienced TME surgeons, is a safe and effective new approach for minimally invasive rectal cancer surgery. Further evaluation is required to evaluate the use of this approach in a larger patient sample and by other surgical teams.

[A prospective study on quality of life in post-operative colorectal cancer patients with fast-track].

OBJECTIVE: To explore the impact of postoperative recovery and short term quality of life in the patients with colorectal cancer in fast track model. METHODS: There were 122 patients enrolled into this prospective study in Gastrointestinal Surgery Center, West China Hospital of Sichuan University, from October 2008 to January 2009, and 121 patients completed the whole study. The patients were divided into the fast track group (62 cases) and the tradition track group (59 cases), postoperative recovery and the QLQ-C30 scores were evaluated at one week after the surgery. RESULTS: The fast track group showed earlier recovery than the tradition group in first aerofluxus [(3.96 +/- 1.40) d vs. (5.66 +/- 3.11) d, P < 0.05], first intake [(3.12 +/- 1.93) d vs. (5.96 +/- 3.23) d, P < 0.05], first ambulation [(2.05 +/- 1.16) d vs. (5.13 +/- 1.36) d, P < 0.05] and in-hospital time post-operation [(7.85 +/- 5.31) d vs. (10.11 +/- 3.37) d, P < 0.05]. The incidence of wound infection (1.61% vs. 6.78%, P < 0.05) and intestinal obstruction (1.61% vs. 8.47%, P < 0.05) in fast track were significantly lower than those in the traditional track group. The general health of fast track in C30 is better too (80.46 +/- 15.54 vs. 76.58 +/- 15.28, P < 0.05). In the functional assessment of C30, the physical function (87.35 +/- 5.12 vs. 85.02 +/- 8.70, P < 0.05) and emotional function (90.00 +/- 0.00 vs. 85.35 +/- 12.39, P < 0.05) both were better in the fast track group. In the symptom assessment of C30, fast track group is less fatigue (71.70 +/- 2.86 vs. 87.12 +/- 10.80, P < 0.05) and pain (71.78 +/- 3.76 vs. 77.63 +/- 8.33, P < 0.05). Better sleep (75.78 +/- 11.68 vs. 82.70 +/- 19.40, P < 0.05) and less loss of appetite(73.24 +/- 8.60 vs. 78.02 +/- 16.42, P < 0.05) were found in fast track group. CONCLUSION: The fast track group manifested faster in postoperative recovery and can improve the quality of life in postoperative patients with colorectal cancer.