Sun Simiao expounded much profound healthy ethics thought in his《Qian Jin Fang》.He inherited and developed the harmonious viewpoint of health,and emphasized health based on the morality and advocated launching health education to the masses.Now these ideas also have important actual significance.

Objective To assess the accuracy of MRI measurement of hippocampal formation in predicting postoperative cognitive dysfunction (POCD) in elderly patients.Methods Forty-one ASA Ⅱor Ⅲ patients aged≥65 yr undergoing gastrointestinal tract surgery were enrolled in this study.MRI was performed to measure the volume of hippocampal formation before surgery and the results were standardized according to the individual intracranial volume.All patients underwent a battery of neuropsychological tests including sensitive tests on the Wechsler adult memory scale and Wechsler adult intelligence scale,trail making test and the grooved pegboard test.We used the Z score to identify POCD as recommended by Moiler.All patients were then divided into POCD group and non-POCD group according to the results of the neuropsychological tests.The results of the tests were correlated with the volume of hippocampal formation measured by MRI.The value of MPI measurement of hippocampal volume in predicting POCD was analyzed.Results Thirty-six patients completed the whole battery of neuropsychological tests after surgery.Thirteen of the 36 patients were found to have COPD (36%) on the 4th postoperative day.The hippocampal volume was significandy smaller in POCD group (4.75±0.23) than in non-POCD group(5.06±0.31).Hippocampal volume was found to be effective in predicting POCD.The overall accuracy of prediction was 77.8%(28/36 patients) with 92.3% sensitivity (12/13 patients),70.0% specificity (16/23 patients) and 0.623 Youden index.Conclusion The MRI measurement of hippocampal volume is valuable as a predictor of POCD in the elderly.

Persistent primitive trigeminal artery (PPTA) is the most common permanent abnormal vascular anastomosis between carotid artery and basilar artery. PPTA is a rare cerebrovascular variation and is often associated with cerebrovascular disease (CVD). Clinically, PPTA manifests itself in symptoms such as trigeminal neuralgia, oculomotor paralysis, abducens nerve paralysis, subarachnoid hemorrhage, etc. This paper aims to review 116 PPTA cases with CVD and other cerebrosis, which have ever been reported since 1983 in English or Chinese medical literature.

Comparing with free perforator flap, pedicled flap is a relatively simpler and safer technique, with lesser donor site morbidity. In recent years, the application of pedicled perforator flaps has emerged as a new option for breast reconstruction. Those pedicled perforator flaps include thoracodorsal artery perforator flap, intercostal artery perforator flap (lateral intercostal artery perforator flap, anterior intercostal perforator flap) etc. Serratus anterior artery perforator flap, superior epigastric artery perforator flap, and lateral thoracic artery perforator flap can also be raised technically. To enhance surgical accuracy, it is necessary to evaluate the location and quality of perforator vessels preoperatively. Proper flap design is of more importance for pedicled flap when compared with it's free flap counterpart. Although free flap approach remains the golden standard in breast reconstruction when considering autologous tissue transplantation, pedicled perforator flap has the apparent merits of minimized surgical trauma, less time-consuming and less stress for reconstructive surgeons.

Objective To evaluate the efficacy of narrow-band ultraviolet B (NB-UVB) for the treatment of early-stage mycosis fungoides (MF).Methods A retrospective study was performed on 98 patients with early-stage MF treated with NB-UVB from January 2003 to December 2013.The rate of and time to recurrence of MF were assessed,and long-term side effects were evaluated in these patients.Results Among 52 patients achieving complete remission,the median number of sessions of NB-UVB radiation was 30 (range,18-87),the median cumulative radiation dose was 24.16 J/cm2 (range,9.11-108.86 J/cm2),and the median follow-up duration was 41 months (range,11-90 months).Relapse occurred in 14 (26.9％) patients with the median time to recurrence being 8.2 months (range,3-60 months).The patients suffering from relapse achieved complete remission after treatment with NB-UVB again.Adverse reactions mainly included skin erythema and itching at the early stage of radiation,as well as temporary pigmentation after radiation.Cutaneous carcinoma occurred in none of these patients during 11-90 months of follow-up.Conclusions NB-UVB phototherapy appeared to be effective for the treatment of early-stage MF,and no cutaneous carcinoma occurred in these patients during the follow-up.Although MF may relapse in some cases,repeated NB-UVB phototherapy is still effective.

Objective To analyze the clinical symptoms,pathological features and K-ras mutation alterations of intraductal tubulopapillary neoplasm (ITPN),and to better understand ITPN.Methods We collected the clinical data of 3 cases of ITPNs of Changhai Hospital and 16 cases in literature,and analyzed the morphology,K-ras mutation,immunophenotype of tumor cells by routine H&E staining,immonohistochemistry,and fluorescence PCR.Then it was compared with 81 cases of intraductal papillary mucinous tumor (IPMT).Results All the 3 patients of ITPN were male,with a median age of 43 years.Two lesions were located in pancreatic head and 1 case in pancreatic body and tail.ITPNs presented as intraductal solid masses,and consisted of cells with uniformly median-to-high grade nuclear atypia,and tumor cells were arranged as glandular and cribriform.One case was accompanied with invasive ductal adenocarcinoma and peripancreatic lymph node metastasis.All tumor cells of epithelial marker cytokeratin was positively expressed,and p53 was positively expressed in some tumor cells.However,CHR,NSE,MUC2 and MUC5AC were negatively expressed,and K-ras mutation was not detected.The tumor cells of IPMT were presented as papillary pattern and cribriform structure was observed.The majority of cells were mucous epithelium,or goblet cells (intestinal type),a few were eosinophilic epithelium (eosinophilic cells type) and cuboidal epithelium (pancreatic,biliary duct type),MUC2 and MUC5AC was positively expressed,and K-ras mutation rate was 50％.Conclusions As a new tumor entity of pancreas,ITPNs show distinctive features with IPMTs.

Objective To analyze the etiology and the clinical characteristis of fever in older patients in Wenzhou.Methods Totolly 87 cases admitted to the First Affiliated Hospital of Wenzhou Medical College from January 2001 to April 2004 were retrospectively analyzed;all cases displayed fever as the major clinical manifestation and met the criteria of fever well.Results The etiology of fever which was infectious disease was in 44 of the 87 cases,accounting for 50.6%,collagen-vascular diseases 4.6%,neoplasms 10.3% and miscellaneous diseases 5.7%.In 28.7% of the cases the etiology could not be found.And in the infectious disease the tuberculosis accounted for 13.6%(6/44). Ultrasonography ,X-rays,CT scan,MRI,the marrow puncture and biopsy contributed to the final diagnosis in 21.1%,16.9%,63%,0,16.7% and 57.1% of the cases,respectively.Conclusion Because the symptoms of the older patients'febrile diseases are atypical,the diagnosis is more difficult.Infectious disease still remains a major cause of the fever in the elderly.A thorough history of disease,full physical examination of the patient and routine laboratory studies,especially erythrocyte sedimentation rate,are very important in determining the etiology of febrile disease.Early and reasonable use of non-invasive imaging techniques and the essential invasive methods are helpful to diagnosis.

To evaluate the efficacy of intravenous administration of aminocaproic acid in pre-venting secondary hemorrhage after traumatic hyphemas. Methods: 60 patients with traumatic hyphemaswere random separated into two groups: (1 ) Routine treated group: 31 patients received intramuscular ad-ministration of adrenosin or dicynone and oral administration of steroids t (2) Arninocaproic acid treatedgroup: 29 patients received aminocaproic acid in an intravenous drip. Results: The incidence of secondaryhemorrhage in the amin0caproic acid treated group was much lower than that in the routine treated group(P

Objective To investigate the possible association between HLA-B51 alleles and Behcet's disease (BD). Methods Totally, 61 Chinese patients of Han nationality, who were diagnosed with BD according to the International Study Group (ISG) criteria, were recruited. The control cohort consisted of 100 healthy individuals. Blood samples were obtained from all the subjects. PCR-sequenee specific primers (SSPs) were used to for the genotyping of HLA-B51 alleles (HLA-B5101-HLA-B5109). Results Com- pared with the control group (11 positive, 11% ), the frequency of HLA-B51 (18 positive, 29.5% ) was sig- nificantly increased in BD patients (χ2=8.79, P<0.01, RR=3.39). The HLA-B51-positive patients and controls consistently carried HLA-B5101 allele with no other alleles observed. There were 15 males and 3 females in HLA-B51 positive patients, 22 males and 21 females in HLA-B51-negative patients, and signifi- cant differences in gender distribution was observed between HLA-B51-positive and negative patients (P<0.05 ). Moreover, the average age of onset in HLA-B51-positive patients significantly differed from that in HLA-B51-negative patients (28.4±10 years vs 37.3±12 years, P<0.05). However, no significant differ- ences were noticed in the clinical types, course, skin lesions, prevalence of genital ulcer, eye damage, joint involvement, or pathergy reaction between HLA-B51-positive and -negative patients (P0.05). Conclu- sions This study supports that HLA-B5101 allele is associated not only with the development of BD, but also with the gender and onset age of patients with BD of Chinese Han nationality.

Transcriptomics studies the variety, structure, function and regulation of all transcripts in a given cell and in a given time. It provides a novel procedure for revealing the molecular mechanism and regulatory network of different development stages of nasopharyngeal carcinoma. The progress of isolation, identification and function study of tumor susceptibility/suppressor gene, gene transcription profiling and transcription regulatory networks have been introduced.