Objective To investigate the value of self-made minimally invasive cancellous bone harvester.Methods From February 2007 to October 2008,cancellous bones of 35 cases were obtained by the self-made minimally invasive cancellous bone harvester from the area between the point 1 cm posterior to the anterior superior iliac spine and the tubercle of iliac crest.ResultsThe average amount of harvested bone is 2.37 cm3(range 1-4 cm3).The operation time ranged 3-5 min,and the blood loss was 1-2 ml.The incidence rate of complications was 5.7%(2/35).Conclusions The minimally invasive bone harvester is safe and reliable.It can be used for some bone grafting surgeries.

Objective: To understand the characteristics and trends of colorectal cancer incidence and mortality in Lishui residents from 2014 to 2018,so as to provide basis for the development of prevention and treatment measures of colorectal cancer. Methods : The incidence and mortality data of colorectal cancer in Lishui from 2014 to 2018 were collected through the information management system of chronic disease surveillance in Zhejiang Province. The incidence,mortality and annual percentage change(APC)of colorectal cancer were calculated and analyzed in different genders,ages and regions were analyzed. Results: From 2014 to 2018,there were 4 403 new cases of colorectal cancer in Lishui,with the crude and standardized incidence rate of 34.89/100 000 and 20.99/100 000,respectively. There were 2 369 deaths,with a crude mortality rate of 18.77/100 000 and a standardized mortality rate of 10.17 /100 000. The crude incidence rate and crude mortality rate in males were higher than those in females(39.71/100 000 vs. 29.77/100 000,21.31/100 000 vs. 16.08/100 000,both p<0.05). There were no statistically significant differences between urban and rural residents in the crude incidence rate and crude mortality rate(37.24/100 000 vs. 34.44/100 000,19.75/100 000 vs. 18.45/100 000,both p<0.05). The crude incidence rate and crude mortality rate increased with age. The APC of the mortality rate of colorectal cancer among urban residents was 11.31%,showing an increasing trend from 2014 to 2018(p<0.05). Conclusion The incidence and mortality of colorectal cancer are high in Lishui,and the focus groups are men,people aged over 40 years and urban residents.

Objective: To learn the characteristics of gastric cancer incidence and mortality in Lishui from 2014 to 2018，and to provide basis for prevention and control strategies for gastric cancer. Methods: The data of gastric cancer in Lishui from 2014 to 2018 was collected from Zhejiang Chronic Disease Surveillance Information Management System. The incidence and mortality rates of gastric cancer were calculated，and the trend of them was evaluated by annual percentage change（APC）. Results: The crude incidence rate of gastric cancer in Lishui was 44.77/100 000（5 650 cases）and the standardized one was 26.93/100 000. From 2014 to 2018，the incidence rates of gastric cancer showed a decreasing trend（APC=-0.79%，P<0.05）. The crude mortality rate of gastric cancer in Lishui was 25.39/100 000（3 205 cases）and the standardized one was 14.21/100 000. From 2014 to 2018，the mortality rates of gastric cancer were stable（APC=-4.61%，P>0.05）. The standardized incidence and mortality rates of gastric cancer in males were 34.77/100 000 and 18.35/100 000，which were higher than 16.77/100 000 and 8.52/100 000 in females（P<0.05）. The standardized incidence and mortality rates of gastric cancer in rural residents were 46.07/100 000 and 26.11/100 000，which were higher than 38.49/100 000 and 22.02/100 000 in urban residents. The incidence and mortality rates increased with age after 15 years old，and reached the peak at the age group of 80-84 years old. Conclusion The incidence and mortality of gastric cancer in Lishui from 2014 to 2018 were at a high level，which were higher in males than in females and were higher in rural than in urban areas；while the incidence had a downward trend.

Objective: To investigate the sodium,potassium and blood pressure of adult residents in Liandu District of Lishui,and to provide evidence for salt reduction intervention. Methods: A stratified random sampling method was used to select residents aged 18 to 69 years in Liandu District from December 2016 to February 2017. A questionnaire survey and physical examination were conducted to collect basic information. The 24-hour urine samples were collected to detect sodium and potassium intake. Results: Among 300 participants,the average daily intake of sodium was（10.59±3.90）g,which was higher in men than in women [（11.11±4.33）g vs.（10.08±3.37）g,P<0.05]. There were 274 participants with average daily intake of sodium more than 6 g,accounting for 91.33%. The average daily intake of potassium was（1.67±0.71）g,which was higher in women than in men [（1.77±0.72）g vs.（1.57±0.68）g,P<0.05]. The average daily intakes of potassium were significantly different among different age groups,with participants aged 20 to 29 years the lowest（P<0.05）. There were 217 participants with average daily intake of potassium less than 2 g,accounting for 72.33%. The ratio of sodium to potassium was 4.7±2.2,which was higher in men than in women（5.3±2.7 vs. 4.1±1.4,P<0.05）and decreased with age（P<0.05）. There were 291 participants with the ratio more than 1.87,accounting for 97.00%. The prevalence of hypertension was 31.67%,which was 33.65% in men and 29.80% in women. Conclusion The residents in Liandu District have high intake of sodium and prevalence of hypertension,yet low intake of potassium.

Objective Next Generation Sequencing(NGS) platform was used to study the characteristics of hot gene mutations in non-small cell lung cancer (NSCLC). The distribution, type and frequency of mutation sites were systematically analyzed to evaluate the pathogenicity of mutation sites . Methods A total of 94 NSCLC tissue samples were included in this study including paraffin-embedded (FFPE) samples and fresh tissue samples, which were collected from July 2015 to April 2017 at the Qilu Hospital of Shandong University. The patient's age ranged from 35 to 82 years with a median age of 61 years. There were 63 males and 31 females. 22 hot genes in NSCLC were selected as the detection panel, including KRAS, EGFR, BRAF, PIK3CA, AKT1, ERBB2, PTEN, NRAS, STK11, MAP2K1, ALK, DDR2, CTNNB1, MET, TP53, SMAD4, FBXW7, NOTCH1, ERBB4, FGFR1 and FGFR2. Mutation detection was performed using the Ion AmpliSeq Colon and Lung Cancer Panel of the Thermo fisher's Ion Torrent sequencing platform. The sequencing data was analyzed using Ion Torrent suite v4.4.2 software. Results Among the 22 mutant genes commonly found in NSCLC, the mutation frequency of TP53 was the highest, accounting for 46.9％ of all mutations, followed by the EGFR mutation (28.1％); A total of 89 mutations were detected, including 63 hot spot mutations (reported mutations) and 26 new mutations (unreported mutations). The most frequently detected mutation was the frameshift deletion of exon 19 of EGFR, followed by the mutation of exon L858R;Analysis of the mutation in targeted drug sites of EGFR showed that the frameshift deletion of exon 19 of EGFR was the most frequently detected, followed by the mutation of exon L858R on chromosome 21. Bioinformatics software was used to analyze the pathogenicity of 26 new mutation sites. Results showed that in addition to ATK1:c. 47-12G>A and TP53: c. 214 C>G, the remaining 24 new mutation sites had at least one major impact on the gene function in three aspects, including gene conservation, amino acid sequence change and protein structure influence. Conclusion In this study, NGS was used to conduct combined detection of mutation sites of multiple hot genes, which might cover more comprehensively genetic variation and provide a basis for screening the most suitable targeted therapy groups. The pathogenicity prediction of new mutations and the changes in tumor-related signaling pathways involved provide a reference for further study of the pathogenesis of NSCLC.

Objective : To investigate the knowledge,attitude and practice of salt reduction for hypertension prevention among residents in Liandu District of Lishui,and to provide reference for intervention of salt reduction. Methods : Residents aged 18-69 years in two communities and three towns of Liandu District were selected by multistage stratified random sampling method. They were investigated the prevalence of hypertension and knowledge,attitude and practice of salt reduction for hypertension prevention. Logistic regression models were used to analyze the influencing factors for knowledge,attitude and practice of salt reduction for hypertension prevention. Results : Among 1 801 participants,1 509 completed the survey,with a response rate of 83.79%. The prevalence of hypertension was 31.88%. The proportions of the participants who had knowledge, attitude and practice of salt reduction for hypertension prevention were 33.40%,60.70% and 58.58%,respectively. The results of multivariate logistic regression analysis showed that women（OR=1.583,95%CI：1.248-2.008）,hypertension（OR= 1.734,95%CI：1.303-2.308）,30 to 39 years old（OR=0.368,95%CI：0.226-0.597）,junior high school and above education（OR=0.057-0.403,95%CI：0.036-0.577）were the influencing factors for the knowledge of salt reduction for hypertension prevention;women（OR=1.342,95%CI：1.072-1.679）,married（OR=1.582,95%CI：1.167-2.144）,junior or senior high school education（OR=0.235-0.525,95%CI：0.163-0.736）,having the knowledge（OR=2.640,95%CI：2.033-3.430）were the influencing factors for the attitude of salt reduction for hypertension prevention;women（OR=1.632,95%CI：1.304-2.044）,30 to 39 years old（OR=0.494,95%CI：0.346-0.705）,rural residents（OR= 1.617,95%CI：1.276-2.050）,family history of chronic diseases（OR=1.455,95%CI：1.148-1.845）,having the knowledge（OR= 1.396,95%CI：1.084-1.797）,having the attitude（OR=4.059,95%CI：3.203-5.145）were the influencing factor for the practice of salt reduction for hypertension prevention. Conclusion The residents in Liandu District had low levels of the knowledge,attitude and practice of salt reduction for hypertension prevention. The higher levels of the knowledge and attitude of salt reduction for hypertension prevention,the higher level of the practice.

Objective: To investigate the functional outcomes and postoperative complications of Cheng's GIRAFFE reconstruction after proximal gastrectomy. Methods: A descriptive case series study was conducted. Clinical data of 100 patients with adenocarcinoma of the esophagogastric junction who underwent Cheng's GIRAFFE reconstruction after proximal gastrectomy in Cancer Hospital of University of Chinese Academy of Sciences (64 cases), Zhejiang Provincial Hospital of Chinese Medicine (24 cases), Lishui Central Hospital (10 cases), Huzhou Central Hospital (1 case) and Ningbo Lihuili Hospital (1 case) from September 2017 to June 2021 were retrospectively analyzed. Of 100 patients, 64 were males and 36 were females; the mean age was (61.3 ± 11.1) years and the BMI was (22.7±11.1) kg/m(2). For TNM stage, 68 patients were stage IA, 24 were stage IIA and 8 were stage IIB. Postoperative functional results and postoperative complications of radical gastrectomy with Giraffe reconstruction were analyzed and summarized. Gastroesophageal reflux disease questionnaire (RDQ) score and postoperative endoscopy were used to evaluate the occurrence of reflux esophagitis and its grade (grade N, grade A, grade B, grade C, and grade D from mild to severe reflux). The continuous data conforming to normal distribution were expressed as (mean ± standard deviation), and those with skewed distribution were presented as median (Q1, Q3). Results: All the 100 patients successfully completed R0 resection, including 77 patients undergoing laparoscopic surgery and 23 patients undergoing laparotomy. The Giraffe anastomosis time was (38.6±14.0) min; the blood loss was (73.0±18.4) ml; the postoperative hospital stay was 9.5 (8.2, 13.0) d; the hospitalization cost was (6.0±0.3) ten thousand yuan. Fourteen cases developed perioperative complications (14.0%), including 7 cases of pleural effusion or pneumonia, 3 cases of anastomotic leakage, 2 cases of gastric emptying disorder, 1 case of gastrointestinal hemorrhage and 1 case of anastomotic stenosis, who were all improved and discharged after symptomatic management. Patients were followed up for (33.3±1.6) months. Eight patients were found to have reflux symptoms by RDQ scale six months after surgery, and 11 patients (11/100,11.0%) were found to have reflux esophagitis by gastroscopy, including 6 in grade A, 3 in grade B, and 2 in grade C. All the patients could control their reflux symptoms with behavioral guidance or oral PPIs. Conclusion: Cheng's GIRAFFE reconstruction has good anti-reflux efficacy and gastric emptying function; it can be one of the choices of reconstruction methods after proximal gastrectomy.
Adenocarcinoma/surgery* ; Aged ; Esophageal Neoplasms/surgery* ; Esophagitis, Peptic/etiology* ; Esophagogastric Junction/surgery* ; Female ; Gastrectomy/methods* ; Gastroesophageal Reflux/etiology* ; Humans ; Laparoscopy ; Male ; Middle Aged ; Reconstructive Surgical Procedures/methods* ; Recovery of Function ; Retrospective Studies ; Stomach Neoplasms/surgery*