A total of 1273 elders above 65 years old received health check-up in our community.Among them,63.3％ ( 806/1273 ) had a history of hypertension and 64.9％ ( 523/806 ) showed abnormal blood pressure.And 43.2％ (202/467) of those without a history of hypertension were firstly found to have abnormal blood pressure.Among 674 blood testers,19.6％ had an elevated level of fasting blood glucose.And 11.4％ of those without a history of diabetes had an elevated level of fasting blood glucose.Hyperuricemia (21.8％,n =147),hypercholesteremia ( 11.1％,n =75),hypertriglyceridemia (35.5％,n =239) and increased low density lipoprotein-cholesterol (LDL-C) (46.3％,n =312) were noted.The levels of total cholesterol and LDL-C were higher in females than those in males ( both P ＞ 0.05 ).The results suggested that general practitioners should pay more attention to the management of chronic diseases and the health education and screening of high-risk populations.

Objective To analyze the repair methods of bone defects caused by the harmful removal of lower extremity long bone segmental bone fibrous structure,and to provide reference for clinical treatment.Methods Six cases of patient with adverse fibrous structure,3 cases with the jnjury of backbone of the tibia and 3 cases of femoralshaft damage were conducted as the research objects.Bone defect length after tumor resection was (17.3 ±4.2)cm,inorder to coinside with the peroneal vessels in the other side,fibulas with peroneal vessels from both sides should be cutdown.Dual fibula medial periosteal was stripped from the central longitudinal incision to the bone crest,folding fibulatwo -stage to make the front sides face to face,and then fixed the ends.The peroneal vascular was looped on one sideof graft to form a U shape.The vessels out of damage region was dissected,and was inserted fibula between the ends offracture,as the case wire or screws may be used.The peroneal vessels had to coinside with those in damage region,andimaging assessment should be taken to evaluate the healing of bone joints after surgery,at the same time,assessingpostoperative function by functional scores of Bone Cancer Society of the United States was also neccessary,finallyvascular anastomosis through the bleeding condition of the grafts were detected.Results All patients were followedup for 5 -8 years,the bone healed 1 year later,and the transplanted bone marrow cavity got recanalization 5 years later,at the same time,there was no tumorigenesis in the double fibula,and x -ray showed the good healing.All bonesturned to be normal ones without nonunion,infection and other complications.Final follow -up score of lower limbswas 91.2%.Conclusion It is effective and feasible to use a combination of double fibula to repair lower extremitylong bone defects caused by large bone fibrous dysplasia in the periosteum.

Hypoxic preconditioning improves organism in stress response such as operation.This dissertation expound the effects of hypoxic preconditioning on hepatic carcinoma after hepatic resection.Hypoxic preconditioning protect remainder hepatocyte from ischemia reperfusion injury in the remaining liver by regulating HIF-1,nuclear factor-kappa B and being kind to our mitochondria; remote-ectopic hypoxic preconditioning and cross-pluripotential hypoxic preconditioning preserve residual liver.Hypoxic preconditioning can relieve liver from ischemia reperfusion injury after hepatocellular carcinoma hepatectomy,but no clear evidence demonstrate it improve residual liver regeneration.This need further experimental study.

Objective Explore the value of video-assisted thoracoscopic extended thymectomy in the treatment of myasthenia gravis.Methods This is a prospective randomized control study.Fifty-four patients who were confirmed to be MG preoperatively from 2005 to 2008 were divided into VATS group(27 cases)and thoracotomy group(27cases).Thymectomy and dissection of all faity tissue anterior to pericardium were performed in both groups.Results When compared with thoacotomy group,VATS group had less blood loss,shorter postoperative hospital stay and time of postoperative chest drainge tube left.One patient was converted to open surgery because of the injury to the brachiocephalic vein.During a period of followed-up 624 months,symptom was improved in 81% of the patients in VATS group and 85% in thoractomy group(P>0.05).Conclusion Extened thymectomy with VATS is safe and feasible with the advantage of less invasion,less surgical trauma and pain,lower rate of complication and good curative effect.

[Objective]To evaluate the effect of bone cement oscillator on increasing bone cement-bone interface binding intensity.[Method]Sixty fresh femoral bones of adult pig were randomly divided into experiment group and control group under the 30%,50%,70% ultimate shear strengh of the cement/bone.There were 10 samples in each subgroup.Mechanics test was performed by MTS-810 material testing machine,and the binding intensity of bone cement-bone interface in oscillating cement-bone interface binding intensity in experiment group was compared with control group.[Result]Mechanics test showed bone cement group were significantly stronger than control group under the 30%,50% ultimate shear strengh of the cement-bone(P 0.05).[Conclusion]Bone cement oscillator can increase binding intensity of bone-cement interface,and effectively reduce long-term aseptic loosening of artificial prostheses.

Objective To study the application of VATS and gasless laparoscopy to the treatment of portal hepertension Methods 12 operations of the splenectomy combined with ligation of pericardial vein and lower part of lung covered by omentum majus were performed throngh the thoracoscopy and laparascopy Results All of the 12 operations were successful. The procedures lasted (2.5～5.2) hours with mean time being 3.3 hours. Gastrointestinal function recovered in (48-72) hours after operation. The duration of hospitalization was (9～11)days. No postoperative thoracic and abdominal cavity complications were found. The average duration of hospitalization after operation was 10.3 days.12 cases were followed up for 2 month to 4 years and no rebleeding was found. Conclusions The procedures including ligation of pericardial vein under VATS combined with gasless laparoscopy assisted splenectomy and lower part of lung covered by omentum majus for the treatment of portal hypertension is passable.

Objective To explore the efficacy of breast-conserving therapy of ductal carcinoma in situ (DCIS),and to evaluate its safety.Methods 54 patients with DCIS receiving breast-conserving therapy(the experimental group) and 49 patients with DCIS treated with mastectomy(the control group) in the First Affiliated Hospital of Wenzhou Medical College from Mar.2010 to Mar.2013 were retrospectively analyzed.The follow-up results of the 2 groups were analyzed in terms of the local recurrence,distant metastasis and the 3-year diseasefree survival(DFS).The efficacy and safety of breast-conserving treatment were evaluated.Results All patients were followed up for 5 months to 39 months,with the average of(22.3 ± 8.5) months.No local recurrence happened in the experimental group.There was 1 case of chest wall recurrence in the control group.One case in the experimental group and 2 cases in the control group had distant metastasis.DFS rate in the 2 groups was 100％ and 95.9％ relatively.No statistically significant difference was found between the 2 group in terms of the above items (P ＞ 0.05).Conclusion For DCIS patients,the difference between breast-conserving therapy and mastectomy surgery in the rate of local recurrence and distant metastasis was not significant.Breast-conserving therapy is safe for DCIS patients and should be further promoted.

Objective To investigate the dosimetric comparison of target volumes and organs at risk (OAR) between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for esophageal cancer by a meta-analysis.Methods A literature search was performed to collect the clinical studies on dosimetric comparison between VMAT and IMRT.The primary endpoints of interest were dosimetric parameters of target volumes and OAR, number of monitor units (MUs), and treatment time (TT).Results A total of 17 studies involving 323 patients were included in this meta-analysis.When the total dose was>50.4 Gy, VMAT showed significantly lower mean dose (Dmean) of gross tumor volume (GTV) and maximum dose (Dmax) of planning target volume (PTV) than IMRT (P=0.009;P=0.039).There were no significant differences in Dmean, V30, and V40 of the heart, Dmax of the spinal cord, and V5, V10, and Dmean of the lung between VMAT and IMRT (P>0.05).VMAT showed significantly lower V15, V20, and V30 of the lung than IMRT (P=0.001;P=0.000;P=0.023).When the single dose was 1.8 Gy and 2.0 Gy, VMAT showed significantly lower TT (reduced by 323.5 s and 193.7 s) and number of MUs (reduced by 275.4 MU and 134.2 MU) than IMRT (P=0.000 and 0.009;P=0.000 and 0.022).Conclusions VMAT can significantly reduce TT, MUs, irradiation dose to the lung, and the risk of radiation pneumonitis, and improve the utilization rate of equipment.Compared with IMRT, VMAT has no significant advantages in protection of the spinal cord and the heart and dosimetric parameters of target volumes except Dmean of PTV and Dmean and Dmax of GTV when the total dose was ≤50.4 Gy.

Objective To synthesis,nine N-[3-(2-furanyl)-acryloyl]-N'-substituted benzyl piperazine derivatives were synthesized and evaluated for their primary biological activities.Methods First, the furylacrylic acid was synthesized, Then the target compounds could be obtained by direct furylacrylic acid with the different substituted benzyl piperazine derivatives.In the biological active experiments, taking the different concentrations, comparing with the blank test, the inhibitory effect of the target compounds on VSMC proliferation was investigated by MTT.Results The successful synthesis of nine new compounds.The method was mild and get high yields.The structures of these compounds were confirmed by IR 1 H-NMR, MS, and elemental analysis.The results of preliminary activity test showed that the synthesized products exhibited inhibitory activity at different concentrations , and the highest inhibitory rate was 15μg/mL.Pharmacological results showed that the compounds 3e, 3f and 3 g showed the moderate inhibitory activities against vascular smooth muscle cells proliferation were higher than other compounds , and were worth further studying.Conclusion The synthesized compounds have inhibitory activities and could very well lead to the development of novel types of treat atherosclerosis drug .

Objective To investigate the effect of Heat shock protein 70 induced by hypoxic precondition on apoptosis of the remnant livers after the hepatectomy of transplanted hepatic cancer models in SD rants and it's possible mechanisms.Methods Sixty SD rats of transplanted hepatic cancer models were divided into group A (sham operation group),group B (IR + hepatectomy group),and group C (hypoxia precondition + IR + hepatectomy group),with 20 rats in each group.C group was given 10％ oxygen atmosphere for 90 minutes before operation,In 15 minutes of hepatic vascular occlusion with pringle method,Left lateral of liver which tumor was located was resected.At 1,8,12,24 hours after operation,Five rats of each group were killed respectively,then the remnant liver tissues were sampled to measured the hepatocytes apoptosis rate with flow cytometry,expression of heat shock protein 70 (HSP70) and Bax were detected by Western blotting.The serum AST and ALT activities were measured by an automatic analyzer.The histological changes of the hepatocytes were also observed by optical microscopy.All the data were statistically analyzed.Results (1) Compared with A and B group,the HSP70 expression increased obviously in C group at each time point (all P ＜ 0.05).The protein showed a weak expression in group A and B group,while the index had no significant differences between two groups (P ＞ 0.05).(2) In B group compared with A group,the expression of Bax and the hepatocytes apoptosis rate were significantly increased (all P ＜ 0.01 or P ＜0.05).However,amplitudes of the above changes in C group were significantly lower than those of B group (all P ＜ 0.05).(3)The liver function was improved in group HP.The pathological examination showed that the liver tissues in A group were general normal and in C group were showed mild changes,but in B group presented evident pathological changes.Conclusions HP can protect against ischemia-reperfusion injury after the hepatectomy of transplanted hepatic cancer models in SD rants,one of possible mechanisms is that HP can induce HSP70 expression at great intensity,which may decrease expression of Bax protein and the apoptosis of hepatocytes.