Objective To explore the effect of family doctor contracting service combined with drug therapy on the quality of life of patients with hypertension. Methods Selected in May 2016 to May 2017 in a city in a district of three community health service center clinics diagnosed with hypertension in patients with 840 cases, were given amlodipine besylate tablets treatment, and the implementation of conventional health management And community intervention. According to whether or not to accept the family doctor contract service is divided into observation group (a total of 435 cases) and the control group (a total of 405 cases). Health status questionnaire (SF-36) was used to assess the quality of life before and after the intervention, and the blood pressure control and quality of life improvement were compared between the two groups before and after treatment.Results There was no significant difference in the blood pressure level between the two groups before treatment. The systolic and diastolic blood pressure in the observation group were better than those in the control group (P<0.05). There were no significant differences in physiological function, physiological function, physical pain, general health, mental health, energy, social function, affective function and total score of SF-36 before treatment. The scores of the observation group were significantly higher than those of the control group before and after treatment. The difference was statistically significant (P<0.05). Conclusion Family doctor contract service combined with drug therapy can effectively control the patient's blood pressure levels, improve the quality of life.

Objective To investigate the changes of serum homocysteine (Hcy) level before and after treatment in patients with colorectal cancer,and provide the reference for clinical therapeutic efficacy and prognosis.Methods Enzymatic circling assay was used to measure the serum Hcy levels in 50 controls and 58 patients with colorectal cancer before and after treatment with a.follow-up of 12 months.The changes of Hcy aud the relationship between Hcy and therapeutic efficacy or prognosis were analyzed.Results Scrum Hcy level in patients with colorectal cancer was significantly higher than that in controls [(16.90±5.35) μmol/L vs (10.23±3.06) μmol/L] (P ＜ 0.01),and it was closely associated with TNM stage.Serum Hcy level in patients of stage Ⅲ-Ⅳ was significantly higher than that of stage Ⅰ-Ⅱ [(18.49±5.13) μmol/L vs (15.20±4.86) μmol/L] (P ＜ 0.05).The Hcy level in patients at the end of treatment was significantly lower than that before treatment [(13.39±4.98) μmol/L vs (16.90±5.35) μmol/L] (P ＜ 0.01),and the Hcy level after the treatment for 3 month was significantly lower than that at the end of treatment [(10.23±3.17) μmol/L] (P ＜ 0.05).The Hcy level in patients with recurrence during 12 months after operation was significantly higher than that without recurrence [(17.18±4.82) μmol/L vs (12.36±3.19) μmol/L] (P ＜ 0.01).Conclusion Serum level of Hcy might be a useful marker for predicting therapeutic efficacy and prognosis in patients with colorectal cancer.

Objective:To compare the clinical outcomes and correction effects of kyphosis between Zero-profile device (Zero-p) and plate/cage structures (PCC) in treating cervical spondylotic myelopathy (CSM) patients with cervical kyphosis.Methods:From August 2016 to July 2018, a total of 54 cases of cervical spondylotic myelopathy patients with cervical kyphosis were analyzed retrospectively, including 26 cases treated with Zero-p and 28 cases treated with PCC system. There was no significant difference between the two groups in gender, age, body mass index (BMI) and operative segment. The operation duration and the blood loss were recorded. The clinical outcomes of the patients were measured by visual analogue score (VAS) for neck pain and Japanese Orthopedic Association (JOA) score for neurological function. Moreover, JOA recovery rate was obtained to assess the surgical results. The cervical lordosis (C 2-C 7 Cobb angle), the Cobb angle of the operation segment, the C 2-C 7 vertical axis (C 2 SVA) and the cervical range of motion (ROM) were measured on the lateral and dynamic radiographs of the cervical spine, respectively. Results:In the Zero-p group, the operation duration was 83.0±14.9 (range 60-120) min, intraoperative blood loss was 70.5±27.3 (range 30-150) ml. In PCC group, the operation duration was 100.0±23.9 (range 65-145) min, intraoperative blood loss was 104.2±38.8 (range 30-250) ml. There were significant difference in above parameters between two groups ( t=3.40, 2.06; P=0.00, 0.04). The follow-up duration in Zero-p group was 30.4±5.8 (range 24-36) months and 31.2±4.9 (range 24-36) months in PCC group without significant difference ( t=1.061, P=0.291). The VAS/JOA score of the Zero-p group was improved from (5.9±1.0)/(9.2±1.7) preoperatively to (2.1±0.8)/(14.9±1.0) at 1 month postoperatively, and to (3.4±1.0)/(15.1±0.9) at the last follow-up. The difference between them was statistically significant ( F=130.96, 221.40, P=0.00). The VAS/JOA score of the PCC group was improved from (5.9±1.1)/(8.7±1.6) preoperatively to (2.3±0.9)/(14.9±1.0) at 1 month after surgery, and to (2.6±0.9)/(15.6±1.1) at the last follow-up. The difference between them was statistically significant ( F=303.35, 126.64, P=0.00). However, the VAS score of neck pain in the Zero-p group at the last follow-up was significantly deteriorated, which was significantly higher than that in PCC group ( P<0.05). The cervical lordosis/operative segment Cobb angle in the Zero-p group was improved from preoperative (-6.7°±2.7°)/(-6.5°±3.2°) preoperatively to (14.2°±4.9°)/(12.9°±4.9°) at 1 month postoperatively, and to (5.9°±4.7°)/(5.0°±4.0°) at the last follow-up with statistical significance ( F=196.98, 179.97, P=0.00). The cervical lordosis/operative segment Cobb angle in the PCC group was improved from (-5.7°±3.5°)/(-6.1°±4.0°) preoperatively to (13.9°±6.9°)/(13.0°±6.4°) 1 month after surgery, and to (11.0°±5.5°)/(10.4°±5.6°) at the last follow-up with statistical significance ( F=127.27, 119.98, P=0.00). However, the cervical lordosis and operative segment Cobb angle at the last follow-up in the Zero-p group were significantly lost compared with those at 1 month after surgery, which were significantly smaller than those in the PCC group ( P<0.05). The incidence of dysphagia after operation was 7.7% (2/26) in the Zero-p group and 28.6% (8/28) in the PCC group (χ 2=5.11, P=0.02). Conclusion:For CSM patients with cervical kyphosis, PCC could achieve much better mid-term kyphotic correction and clinical outcomes. However, Zero-p should be avoided as much as possible.