Objective To assess the health-related quality of life in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods The patients were collected from the outpatient department,a tertiary hospital in ShaanXi Province.The demographic characteristics such as age,gender,weight and height were collected.Spirometry was performed for every patient after salbutamol 400 μg was inhaled.6-minute walk test was done according to the guidelines which developed by American Thoracic Society in 2002.Four questionnaires,including COPD Assessment Test (CAT),Clinical COPD Questionnaire-week Version (CCQ),St George's Respiratory Questionnaire for COPD Patients (SGRQ-C) and Chronic Respiratory Questionnaire-Self Administered Standardized Activities-First Administration Version (CRQ-SAS),were answered by every participant.Results Totally 90 participants were enrolled between September 2013 and September 2014.75 cases(83.3％) were male and 70 cases (77.8％) were smokers or ex-smokers,the mean age was (67.8±9.7)years,and the mean educational history was (8.9±3.0)years.The mean body mass index was (23.3 ± 3.6) kg/m2,and the mean post-brochodilator FEV1 was (51.2 ± 18.7) ％ predicted.The average 6-minute walk distance was (424.5 ± 99.1) meters.The average scores of CAT and CCQ were(20.4±6.9) and (2.4±0.8),respectively.The mean SGRQ-C score was (38.5 ± 16.2).The symptoms,activity and impacts average scores of SGRQ-C were (64.3± 18.8),(45.1 ±21.3) and (25.7 ± 16.1).For CRQ-SAS,the average scores of dyspnea,fatigue,emotional function and mastery were (2.9±1.3),(2.9±1.1),(3.0±1.1) and (2.9±1.1),respectively.There was a weak correlation between FEV1 and each questionnaire scores.There was a moderate correlation between 6-minute walk distance and SGRQ-C,CCQ and CRQ-SAS.However,there was a weak correlation between CAT and 6-minute walk distance.For 6-minute walk distance,activity score of SGRQ-C,impacts score of SGRQ-C and history of coronary artery disease were independent influencing factors.For BODE index,activity and impacts score of SGRQ-C were independent influencing factors.Conclusions CAT,CCQ,SGRQ-C and CRQ-SAS are suitable to assess health-related quality of life for elderly patients with stable COPD,among four questionnaires,SGRQ-C is the best one.

Objective: To investigate the current awareness of core knowledge about cancer prevention and its influencing factors among residents in Zhejiang Province, in order to provide a reference for formulating provincial health education strategies of cancer prevention. Methods : From November 2019 to October 2020, the permanent residents aged 18-74 years in Zhejiang Province were selected using multi-stage stratified sampling method. A questionnaire was designed according to Core Information and Knowledge on Cancer Prevention to collect general information, health status, and awareness of core knowledge about cancer prevention. The multivariate logistic regression model was used to analyze the influencing factors. Results: Among 6 974 valid respondents, 3 139 ( 45.01% ) were males and 3 835 ( 54.99% ) were females. The overall awareness rate of core knowledge about cancer prevention was 74.66%; the awareness rates of basic knowledge, risk factors and primary prevention, screening and early diagnosis as well as treatment and rehabilitation were 79.08%, 80.83%, 76.08% and 82.99%, respectively. The multivariate logistic regression analysis showed that the residents who were in rural areas ( OR=0.659, 95%CI: 0.585-0.743 ), ≥45 years old ( OR: 0.794-0.801, 95%CI: 0.655-0.981 ) and with obesity (OR=0.531, 95%CI: 0.436-0.647) had lower awareness rates, while the residents who were with an educational level of junior high school/technical school/senior high school or above ( OR: 1.390-4.361, 95%CI: 1.208-5.600 ), married (OR=1.414, 95%CI: 1.142-1.752), administrative/technical personnel ( OR=2.602, 95%CI: 2.005-3.377 ), service staff/private business owners ( OR=1.368, 95%CI: 1.111-1.684), retired ( OR=1.345, 95%CI: 1.105-1.639 ) and others ( OR=1.542, 95%CI: 1.295-1.838 ), and with experience of cancer screening or examination ( OR=1.267, 95%CI: 1.123-1.428 ) had higher awareness rates. Conclusions The awareness rate of core knowledge about cancer prevention in Zhejiang Province is 74.66%. Health education for the residents aged ≥45 years, living in rural areas, having low educational levels, and having obesity should be

Objective To investigate the epidemic characteristics and trends of incidence and mortality of prostate cancer in cancer registration areas in Zhejiang province from 2000 to 2009.Methods Clinical data incidence and mortality of prostate cancer were collected from 6 cancer registration areas in Zhejiang province,including Hangzhou,Jiaxing,Jiashan,Haining,Shangyu and Xianju.Crude rates,standardized rate and change trend,age-specific rates and annual percent change (APC,95％ CI) of prostate cancer were checked,sorted and analyzed in Zhejiang Cancer Center.Results The prostate cancer incidence rate from 2000 to 2009 was 9.79/100 000,age-standardized incidence rates by world standard population (ASIRW) was 6.39/100 000,and the incidence cumulative risk of males aged 0-74 was 0.72％ ; while the mortality rate was 2.73/100 000,age-standardized mortality rates by world standard population was 1.74/100 000,and the mortality cumulative risk of males aged 0-74 was 0.14％.Age-specific incidence of prostate cancer remained low before 50,years old and peaked at over 85-year-old group (130.30/100 000).Age-specific mortality of prostate cancer increased after 55,and also peaked at over 85-year-old group (81.19/100 000).The annual prostate cancer incidence rate generally grew from 1.39/100 000 (2000) to 13.89/100 000 (2009),and the APC was 14.18％ (95％ CI,9.68％-18.98％).Meanwhile,the prostate cancer mortality rate also increased from 1.52/100 000 (2000) to 3.58/100 000 (2009),and the APC was 11.83％ (95％ CI,5.69％-18.33％).Conclusion Prostate cancer incidence and mortality in Zhejiang cancer registration areas increased sharply,and the prevention and treatment of prostate cancer should be strengthened.

Objective To investigate the effects of dexmedetomidine continuous intravenous infusion on the hemodynamic response of ephedrine and the recovery process of patients undergoing neck surgery under general anesthesia.Methods Select elective fitting line surgery under general anesthesia of 100 patients with cervical disease from January 2015 to December 2015 in the First People's Hospital of Yongkang,randomly divided into low dose group and high dose group, 50 cases in each group, before induction of anesthesia, patients received continuous intravenous pumping of dexmedetomidine 0.4μg/kg in low dose group or 0.8μg/kg in high dose group,after ten mins 0.4μg/kg prior to anesthesia induction,until the end of operation withdrawal;5 min after laryngeal mask insertion, ephedrine 0.1 mg/kg were intravenous administered in two groups.Observe the following indicators:the after entering the operation room ( T0 ) , anesthesia before induction ( T1 ) , after induction ( T2 ) , administration of ephedrine ( T3 ) , the maximum value time(TBP,THR) of heart rate and blood pressure in 10 minutes.Increased of HR,SBP,DBP,recovery related indicators.Results HR, SBP and DBP levels compared no significant difference of T0 with two groups,T1, T2 and T3,HR,SBP, DBP were lower than T0 with two groups(P<0.05),high dose group were lower than low dose group of HR, SBP, DBP(P <0.05);TBP and THR no significant difference of two groups,high dose group were higher than low dose group of Increased of HR,SBP,DBP(P<0.05);high dose group were lower than low dose group of after extubation cough score and sedation agitation score(P<0.05).Spontaneous breathing recovery time and extubation time, called the open time, orientation recovery time,the difference between the two groups was not statistically significant.Conclusion 0.8μg/kg dexmedetomidine continuous intravenous injection of ephedrine in patients with neck pressor effect stronger than the 0.4μg/kg,0.8μg/kg compared with 0.4μg/kg can reduce the recovery period of cough and restlessness,different doses had no effect on recovery.

Objective:To investigate cancer mortality in Zhejiang cancer registration areas from 2010 to 2014. Methods:Cancer regis-tration data were collected from 14 cancer registries of Zhejiang province. The number of cases, crude rates, proportions, age stan-dardized rates, cumulative rates, cut rates, age-specific rates, top 10 mortality ranks, and annual percentage change (APC) of cancer mortality were calculated. Results:A total of 108,514 cancer deaths in Zhejiang cancer registration areas from 2010 to 2014, including 70,578 males and 37,936 females, were recorded. The crude mortality rate was 186.06/105. The standardized mortality rates in Chi-nese (ASMRC) and world populations were 103.02/105 and 101.73/105, respectively. The cumulative mortality rate (0-74 years old) was 11.46%. The ratio of ASMRC in male and female was 1.95, and that in urban and rural areas was 0.93. Age-specific cancer mortality in-creased significantly after 40 years old and peaked at the 85+age group. The crude cancer mortality increased from 2010 (182.85/105) to 2014 (191.00/105) by 4.46%. After age standardization, the mortality rate standardized by Chinese population was reduced from 107.85/105 to 100.60/105. The APC of ASMRC was-1.96%(P=0.017). The top three mortality cancers were lung cancer, liver cancer and gastric cancer. The top 10 cancers accounted for 89.51%of all cancer deaths. The mortality rates in different age groups were inconsis-tent. Leukemia was the main cancer type among 0~14-year-old population. Liver cancer was the most common cancer type in 15~44-year-old population. Lung cancer was the main cancer in population above 45 years old. The ASMRCs of liver cancer, gastric cancer and esophageal cancer decreased, whereas those of pancreatic cancer, prostate cancer and ovarian cancer increased. Conclusion:Can-cer mortality in Zhejiang cancer registration areas increased, which revealed that the number of cancer deaths will continue to in-crease. However, the ASMRC decreased, which indicated that cancer prevention in Zhejiang province had achieved certain effects. Fur-ther measurements, such as health education, cancer screening, and early detection and treatment, should be improved to reduce the danger of cancer.

Objective:To explore the clinical efficacy of Budesonide and Formoterol Fumarate Powder in the treatment of patients with bronchial asthma and its effect on the serum levels of inflammatory factors.Methods:123 cases treated and diagnosed as bronchial asthma in our hospital from February,2014 to February,2016 were randomly divided into the observation group (65 cases) and control group (58 cases).The serum levels of IL-17,IL-33,MMP-9,pulmonaryfunction,quality of life,total effective rate and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 92.3％,which was significantly higher than that of the control group (81.03％,P＜0.05).After therapy,the serum level ofIL-17,IL-33 in both groups were largely decreased compared with those before therapy (p＜0.05),and those of observation group were significantly lower than the control group (p ＜0.05);the serum level of MMP-9 in both groups showed no statistical difference compared with that of before therapy.Similarly,the level of FEV1,PEF and FEV1/FVC of observation group were obviously increased compared with those before therapy (p＜0.05) and were significantly higher than those of the control group (p＜0.05);the quality of life in the observation group was better than that of the control group based on the SGRQ score (p ＜0.05).Conclusion:Budesonide and Formoterol Fumarate Powder was effective on the patients with chronic bronchial asthma,which could control the inflammatory reactions,improve the pulmonary function as well as the quality of life.

Objective To evaluate the effect of preoperative sleep disturbance on efficacy of postoperative analgesia and comfort in patients undergoing colorectal cancer resection surgery.Methods 60 colorectal cancer patients with elective anesthesia laparoscopic radical resection were selected.According to the presence or absence of preoperative sleep disorders,they were divided into the sleep disorder group (group A) and non-sleep disorders group (group B),30 patients in each group.Two groups of patients used the same method to maintain anesthesia induction.Intraoperative intravenous nicardipine controlled hypotension in parallel to maintain MAP 60-75mmHg,HR 65-95times/min.The patients received PCIA pump at the end of surgery.Postoperative 24h VAS scores were maintained VAS score ≤3 points,when VAS score ＞ 3 points,given the pressing PCA analgesia remedy.The remedy situation within 24 hours after surgery and comfort analgesic score were recorded.Results Compared with group B,postoperative PCIA pressing number of group A significantly increased [A group:(11 ± 5),group B:(6 ± 5),t =2.44,P ＜ 0.05].At the end of surgery,postoperative 2h,4h,8h pain scores of group A were (2.8 ± 0.4),(2.5 ± 0.7),(3.2 ± 0.6),(3.5 ± 0.5),respectively,which were significantly higher than those of group B [(1.8 ± 0.5) points,(1.8 ± 0.4) points,(1.9 ± 0.3) points,(2.9 ± 0.3) points; at the end of surgery t =5.78,postoperative 2h t =4.56,postoperative 4h t =4.17,postoperative 8h t =2.09,all P ＜ 0.05],but postoperative 12h,24h had no significant change in pain scores (P ＞ 0.05).Compared with group B,the comfort scores of A group at the end of surgery,postoperative 2h,4h,8h,12h[group A:(2.8 ±0.3) points,(2.5 ±0.9)points,(2.6 ±0.9) points,(2.5 ±0.5) points,(2.9 ± 0.6) points ; group B:(3.8 ± 0.4) points,(3.3 ± 0.5) points,(3.6 ± 0.8) points,(3.3 ± 0.3) points,(3.3 ± 0.6) points] were significantly lower (at the end of surgery t =9.87 ; postoperative 2h t =4.94 ; postoperative 4h t =6.87 ; postoperative 8h t =7.61 ; postoperative 12h t--2.79,all P ＜ 0.05),after 24h comfort score had no significant change (P ＞ 0.05).Conclusion Preoperative sleep disorders can affect laparoscopic colorectal cancer after radical surgery analgesia and comfort of patients.

Objective To compare the detection rate of esophageal and cardiac mucosal lesions be?tween screening endoscopy and conventional routine endoscopy. Methods Using iodine staining,a total of 8 918 patients aged 40?69 were screened for esophageal and cardiac early cancer in Xianju and Tiantai county of Zhejiang Province from January 2010 to July 2013.Matched with age, data of 43 834(the conven?tional group) patients who underwent routine endoscopy during the same time period were also retrieved. The detection rates of esophageal and cardia mucosa lesions in both groups were compared and analyzed. Results The detection rate of esophageal mucosal lesions in screening group was significantly higher than that in the conventional group[7?? 48%(667/ 8 918)VS 2?? 17%(953/ 43 834),P<0?? 001].The total detection rate was the lowest in 2010 among 4 years, while that in 2011?2013 were higher and similiar. The detection rate of cardiac mucosal lesions in screening group was higher than that in the conventional group [ 0?? 78%(70/ 8 918)VS 0?? 70%(309/ 43 834)] without significant difference(P>0?? 05). The detection rates of low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and mucosa cancer and total detection rates between 2 groups were similar(P>0?? 05). Conclusion Through training, endoscopists can grasp the skills of finding esophageal mucosal lesions. Iodine staining should be used as addition to conventional endos?copy in areas with high incidence of esophageal cancer. Conventional white light endoscopy plays a limited role in detection of cardia mucosal lesion, depending on joint inspection of other related methods.

AIM: To investigate the effects of metformin on airway inflammation, remodeling and neovascularization in a mouse model of chronic asthma and its possible mechanisms.METHODS: BALB/c mice were randomly divided into saline group, ovalbumin (OVA) group and OVA+metformin group, with 8 in each.At the end of OVA exposure, blood and bronchoalveolar lavage fluid (BALF) were collected for the measurement of OVA specific IgE and leukocyte counts.Lung tissue sections were stained with hematoxylin-eosin, periodic acid-Schiff and Masson's trichrome to detect inflammatory cell infiltration, goblet cell hyperplasia, and collagen deposition around the airway, respectively.Immunohistochemistry was used to evaluate the number and percentage area of new blood vessels (CD31+), and the protein level of phosphorylated AMP-activated protein kinase (p-AMPK) in the airway.RESULTS: Compared with saline group, the eosinophil percentage and OVA specific IgE in serum in OVA group were all increased obviously (P<0.01).Metformin inhibited the above increases (P<0.05).Compared with control group, a marked increase in inflammation infiltration, PAS+ cells and collage deposition in the airway mucosa in OVA group were observed.Metformin partially relieved the above changes.CD31+ vessels in the wall of bronchi showed the abundance of blood vessels observed in OVA group compared with control group, which was suppressed by the treatment with metformin (P<0.05).The protein level of p-AMPK was reduced in the lung tissue challenged with OVA as compared with control group (P<0.05), while metformin increased the protein level of p-AMPK (P<0.01).CONCLUSION: The protein level of p-AMPK in the airway in OVA group is attenuated.Metformin effectively inhibits airway inflammation, remodeling and neovascularization possibly via activating AMPK signaling pathway.

Objective To investigate the effects of dexmedetomidine combined with sevoflurane on elderly patients with postoperative recovery quality.Methods Selected 60 cases of abdominal rectal cancer resection for elderly patients,which were ASA I or II,were randomly divided into two groups by a random number table method, while each groupincluded 30 cases:the control group( group N) and the dexmedetomidine group( group D) .Before the induction of anesthesia,group D vein was injected with micro pump ( more than 10 min) of dexmedetomidine 1μg/kg ( which was formulated with physiological saline as 4μg/mL) ,and then was given to maintain the dexmedetomidine 0.5μg/h and N group was injected with micro pump of the same volume of normal saline.The two groups of anesthesia were same,by which the static inhalation of composite general anesthesia.Observation were recorded before induction of anesthesia(T0),given dexmedetomidine(TI),after intubation 1 min(T1),5 min(T2),drawing tube immediately (T3),extubation after 5min(T4),30min(T5)the time of HR,BP,SpO2,BIS;propofol and remifentanil dosage,opera-tive time,operation time,a nesthesia time,recovery time,drawing tube time,extubation after Ramsay Sedation score, pain score,patient satisfaction and adverse reactions were recorded.Results In T3 period,the changes of HR (82 ± 14)times/min,SBP (130 ±8)mmHg,DBP (85 ±13)mmHg in group N were more obvious than (70 ±12)timse/min, SBP (121 ±7)mmHg,DBP (79 ±9)mmHg in group D,the difference between the two groups had statistical signifi-cance(t=6.28,4.63,2.08,all P<0.05).In T5 period,the levels of blood glucose (5.3 ±1.1)mmol/L and cortisol (402 ±78) nmol/L and ( 0.260 ±0.044 ) ng/L in group D were significantly lower than ( 5.9 ±1.2 ) mmol/L, (550 ±92)nmol/L,IL-6 (0.300 ±0.066)ng/L in group N(t=2.02,6.72,2.76,all P<0.05).However,the composite of dexmedetomidine group D patients with respiratory recovery time(7.5 ±2.3)min,calling the eyes open time(7.8 ±2.5) min,pull out the time of endotracheal tube (14.2 ±3.3) min compared with groups N of patients with respiratory recovery time (7.8 ±2.5)min,calling the eyes (14.8 ±3.2)min,pull out the time of endotracheal tube (13.9 ±3.1)min,showed no statistical significance (t=0.88,0.44,0.36,all P>0.05).In group N,postoper-ative restlessness in 8 cases,nausea and vomiting in 10 cases,chills in 9 cases,which were significantly higher than 2 cases,2 cases,2 cases in group D(χ2 =4.32,6.67,5.45,all P<0.05).At the same time,the satisfaction score of patient in group D (3.0 ±0.3)point,which was significant higher than (2.7 ±0.5)points in group N (t=1.88,P<0.05).Conclusion Dexmedetomidine detomidine composite sevoflurane anesthesia can improve the postoperative re-covery quality of elderly patients with rectal cancer radical surgery.