Objective To evaluate the factors affecting the treatment of old persons diagnosed hypertension. Method A sample of 55566 persons from the community of Yanji area of Shanghai was recruited. Results Among the 19295 persons over sixty there are 5842 patients with hypertension, the morbidity was 30.3%. Among the 36271 persons aged fifteen to fifty-nine there are 3536 patients with hypertension, the morbidity is 9.7%. The ratio of non-treatment in the old age group is 3.1% and in younger group is 8.8%. However,the compliance to the treatment was better in the younger than in old group(73.7% vs 56.2%). The age,hypertension grade and sex were all accounted for the differences in the regularity of the hypertension treatment. Conclusion Further effort on the education of non-old hypertensive patients is essential to decrease the damage from hypertension.

Objective To study the different biomechanics surgical effects of posterolateral fusion , the transverse fusion and the interbody fusion. Method Scan CT was followed with preprocess of images. The Mimics , HyperMesh and Geomagic Studio Reverse engineering softwares were used to establish the modles of lumbar fusion , then the finite element computation was conducted by using the Abaqus finite element software. Result The EF of each lumbar modle was established , the EF of the interbody fusionwas rised evidently. After the fusion , the stress of the adjacent lumbar were also rised, among them the stress of the upper adjacent segment in tnterbody fusion was the most in extension and rotation , with statistical significance ( P < 0 . 05 ) . In the antexion the stress of the transverse fusion was the most, and the new type of posterolateral fusion least, three of them all hadstatistical significance (P<0.05). In the lateral flexion, they had no statistical significance (P>0.05). About the under adjacent sengment, in the extension and antexion, the stress of the interbody fusion was the most, and the new type of posterolateral fusion was the least, the three of them all haved statistical significance (P<0.05, respectively). In the rotation and lateral flexion, with no statistical significance (P>0.05). Conclusion After the fusion, the EF of the lumbar and the stress of the lumbar disc are all established, the interbody fusion is most, while the others are lower.

Objective To investigate the value of combined therapy for hand post-burn scars.Methods We retrospectively analyzed 78 hands post-burn scars in 46 cases from 2007 to 2011.A mong them,scar contracture releasing,scar excision,free skin grafting and fixation with Kirschner's pins were performed in 38 hands,scar excision and regional flat transfer were performed in 18 hands,scar excision and skin grafting were performed in 18 hands,abdominal expanded flap transplantation and scar excision were performed in 4 hands.All patients received elastic sleeve pressure therapy,sili cone gel for external application and function training.Within six months after the operation,52 hands received drug delivery by wax therapy,16 hands incision with scar proliferation received drug injection into scar.We followed up all patients from half a year to three years after the treatment to observe the recovery of the appearance and function of the hands.Results We mainly chose surgery,elastic sleeve pressure therapy,silicone gel for external application,drug injection into scar,wax therapy,function training and so on treating the hand post-burn scars and found that the joins deformities caused by scar contracture were largely or totally corrected.The function and appearance were satisfying.Conclusions It is a good method to treat hand scars by surgery and post-surgery combined physical rehabilitation therapy,which deserves to popularization.

For the problems that 3 first-class ternary hospitals which are not directly affiliated to medical universities are facing in cultivating high-educated staff's scientific abilities,analyze the importance to carry out scientific work in clinic and discuss how to improve their scientific abilities from hospitals,departments and high-educated staff themselves.

Objective To explore the related factors of hepatitis B virus(HBV) drug resistance and their clinical significance . Methods The retrospective analysis was performed on the dinical data in 153 cases of CHB in our hospital during 2011-2013 .The 8 viral drug resistance loci of 4 known nucleosides analogues lamivudine ,adefovir ester ,entecavir and telbivudine were performed the direct sequencing by using the double DNA end termination method(Sanger method);the related clinical factors of drug‐resist‐ant virus genotypes were statistically analyzed and the correlation between prognosis and drug resistance was analyzed .Results A‐mong 153 patients with CHB ,47 cases(29 .8% ) appeared virus genotype drug‐resistant ,the common sites were 204M‐I(18 cases) , 204M‐V(8 cases) ,followed by 181A‐T(10 cases) ,181A‐V(5 cases) ,then 180L‐M (14 cases) .The proportion of viral drug resist‐ance in the patients with family history ,HBeAg positive ,using the nucleotide analogues in the past and the baseline ALT≥5 times was significantly increased ,the incidence rates were 38 .8% ,34 .8% ,34 .6% and 50 .0% respectively .The multivariable COX re‐gression found that HBV‐DNA genetic drug resistance increased the risk of progression to cirrhosis of the liver ,the OR value was 4 .704(95% CI:1 .199 -18 .454) .Conclusion the Sanger method for direct sequencing is reliable and accurate method of HBV‐DNA genotype drug resistance .The proportion of viral drug resistance in the patients with a family history of hepatitis B ,HBeAg positive ,using nucleotide analogues and baseline ALT≥5 times is significantly increased;HBV‐DNA genotype drug resistance also increases the risk of progression to cirrhosis of the liver .

Objective To evaluate the efficacy of the combined saphenous nerve-great saphenous vein flap and cutaneous branches of posterior tibial artery flap in repairing refractory wounds. Methods Eighteen cases of pedal chronic ulcers were treated with the combinedsaphenous nervegreat Saphenous vein flap and cutaneous branches of posterior tibial artery flap, in which the wounds were treated with vacuum suction techniques before the operation in 6 cases. Wounds were from 8 cm× 13 cm to 1 cm× 17 cm in zine after debricement, and the designed size of the flaps was from 8 cm× 14 cm to 11 cm× 18 cm. Results After the treatment, 18 cases were evaluated as excellent in 10 cases, and good in 8 cases, in which the primary sealing of the wounds was achieved in 17 cases, but one case presented with focal necrosis of smaal size owing to vein drainage disturbance in a distallypedicled flap, and was healed after flap transplantation. Follow-up for 6 months to 2 years showed that all the patients were satisfied with the results. Conclusions The combined flap has reliable blood supply, skin pedicle of the flap is longer, superior texture and satisfied appearance, and incisive area of the flap is larger. It is particularly useful in repairing refractory wound in foot.

Objective To search for new therapeutic apparatus and method of acupuncture. Methods 650-660 nm semiconductor laser and 10.6 um CO2 infrared laser were coupled to generate integrated laser acupuncture. Controllable infrared electric heating device with negative ion smokeless moxa was mounted on this integrated laser acupuncture machine to compose the smokeless and pain-free acupuncture therapeutic apparatus. Results The integrated laser acupuncture has both the conventional acupuncture effect and heated effect generated by laser; Negative ion moxa under the control of infrared electric heating device can be electrically distillatod without open fire at the temperature lowering than the burning point and generate both warming effects and chemical effects. The negative ion moxa composed Tourmaline can send off massive negative ion when burning, which can decrease harmful gas and purify environment. Conclusion The new type of acupuncture therapeutic apparatus conquered insufficiencies of conventional acupuncture as pain, breakdown of needle,bleeding, infection, smoking, bad smell, burning, and blistering, and retain and enforce the acupuncture functions of treatment,health-care, and cosmetology.

Objective · To investigate effect of fucoidan on autophagy, migration and invasion in human multiple myeloma U266 cells. Methods · The U266 cells treated with fucoidan were cultured in vitro. The formation of autophagosomes was observed by transmission electron microscopy (TEM). Transwell assay was used to evaluate the effect of fucoidan on migratory and invasive abilities of U266 cells. The protein levels of LC3-Ⅱ/LC3-Ⅰ, Beclin-1, P62, MMP9, CXCR4, p-AKT/T-AKT, p-mTOR/T-mTOR were detected by Western blotting. MMP9 concentration in the culture medium was examined by ELISA. Results · ① Autophagosomes increased in fucoidan-treated cells compared with control group under TEM. ② Migratory and invasive abilities were inhibited by fucoidan in a dose-dependent manner, which were suppressed by chloroquine. ③ Western blotting demonstrated that expression of LC3-Ⅱ/LC3-Ⅰ, Beclin-1 and MMP9 increased in fucoidan-treated cells, while P62, CXCR4, p-AKT/T-AKT and p-mTOR/T-mTOR decreased compared with control group. ④ The result of ELISA showed that MMP9 concentration in the culture medium of fucoidan-treated cells significantly decreased. Conclusion · Fucoidan induces autophagy and inhibits migration and invasion in U266 cells.

ObjectiveTo investigate the clinical effect and safety of percutaneous radiofrequency ablation (RFA) combined with systemic chemotherapy in the treatment of unresectable or postoperative recurrent intrahepatic cholangiocellular carcinoma. MethodsThe patients with unresectable or postoperative recurrent cholangiocellular carcinoma who were treated from January 2011 to December 2016 were enrolled. All patients underwent CT-guided RFA, followed by systemic chemotherapy since one week after surgery, with the regimen of gemcitabine given concurrently with cisplatin (gemcitabine 1000 mg/m2 combined with cisplatin 25 mg/m2 on days 1 and 8, for 6 cycles in total). Treatment outcome and safety were observed. ResultsThere were 45 lesions in total, and RFA and chemotherapy were performed for all lesions. The overall objective response rate was 79.2%. The complete ablation rate of the lesions at one month after surgery was 86.7% (39/45). The patients were followed up for 11-67 months after surgery, and at the end of follow-up, the rate of local progression was 200% (9/45). The median time to progression was 13.0 months, the median survival time was 28.6 months, and the 1-, 2-, and 3-yaer survival rates were 87.3%, 69.3%, and 32.6%, respectively. Major side effects included hematological toxicity and elevated aminotransferases, and there were no serious adverse events associated with RFA. ConclusionRFA combined with systemic chemotherapy is a safe and feasible regimen for unresectable or postoperative recurrent intrahepatic cholangiocellular carcinoma.

There are still high incidence and mortality rates of hepatocellular carcinoma at present, and systemic treatment plays an important role in the treatment of advanced hepatocellular carcinoma. This article describes the application of molecular-targeted drugs and immune checkpoint inhibitors in hepatocellular carcinoma and points out that dual-targeted therapy, dual immunotherapy, and targeted therapy combined with immunotherapy are the current research hotspots in the treatment of hepatocellular carcinoma.