Objective To study the clinical application of laparoscopic operation and the morbidity and their prevention. Methods 21069 cases of laparoscopic surgery were reviewed retrospectively. Results Laparoscopic operation was used in 19 conditions including cholecystectomy (21002),hepatic operation (21), common bile duct calculi (3), spleen trauma (1),kidney cyst (3),gynoplasty (16),chest surgery (2), intestinal adhesion (14),assistant Miles (3),appendectomy (2),mesentery teratoma (1).Major complications (60) (0.29%) included injury of choleduct (18), bile leakage (18),hemorrhage (17),the injury of gastrointestinal tract (7). Conclusions Laparoscopic operation may be in a more extensive seope. The major complications can be reduced by strict procedures of laparoscopic operation.

Objective To survey the situation and related factors of maintenance medication treatment in schizophrenic patients re-hospitalized for relapse. Methods 362 patients re-admitted with schizophrenia and their relatives were interviewed with questionnaire which included 16 factors that might affect maintenance medication treatment. Results 63.8% patients stopped medication and 21.1% patients were on low-dose maintenance medication treatment by themselves, while 7.7% patients were on reasonable dose anti-psychotics in 2 years. The time of maintenance medication treatment related with insight (OR=2.2144, P=0.001), family care (OR=4.8842, P=0.025), outcomes of treatment (OR=2.2056, P=0.007) and negative life events (OR=0.4529, P=0.003). Conclusion Schizophrenic patients re-admitted with relapse often withdraw or reduce their medication by themselves, which risked with poor insight, poor therapeutic effect, poor care from their family, and more negative life events

Objective:To investigate the effects of dexmedetomidine combined with propofol on hemorheology and hemodynamics in patients with hypertensive intracerebral hemorrhage.Methods:126 patients with hypertensive intracerebral hemorrhage undergoing emergency surgery in Tengzhou Central People's Hospital from June 2017 to June 2019 were prospectively selected and randomly divided into control group (63 cases) and observation group (63 cases). The control group was given propofol induction anesthesia, and the observation group was given dexmedetomidine combined with propofol induction anesthesia. Hemodynamics, hemorheology before and after operation, clinical efficacy and postoperative complications were compared between the two groups.Results:24 hours after operation, the whole blood viscosity and plasma viscosity levels of the two groups were higher than those of the same group before operation, and the levels of erythrocyte aggregation index was lower than those of the same group before operation ( P>0.05); 24 hours after operation, the whole blood viscosity, plasma viscosity levels and the erythrocyte deformation index of the observation group were lower than those of the control group, and the erythrocyte aggregation index was higher than those of the control group, with statistically significant difference ( P<0.01). The levels of heart rate (HR) and systolic pressure (SP) in the observation group at T 1, T 2 and T 3 were normal and lower than those in the control group at the same time ( P<0.01). There was no significant difference in operation time and extubation time between the two groups ( P>0.05); the awakening time of the observation group was faster than that of the control group ( P<0.01). The incidence of restlessness, pharyngalgia, nausea, vomiting and rebleeding in the control group was 25.4%, higher than that in the observation group (9.5%), with statistically significant difference ( P<0.05). Conclusions:Dexmedetomidine combined with propofol induced anesthesia can stabilize intraoperative hemodynamics, improve postoperative hemorheology, promote postoperative awakening and reduce postoperative complications in patients with hypertensive intracerebral hemorrhage.

Objective:To explore the mediating role of aging attitude and anxiety in the relationship between self-worth and depression among the elderly.Methods:From July to August 2022, a total of 536 elderly people in Shijiazhuang University for the Elderly were surveyed by the elderly self-worth scale, generalized anxiety disorder-7(GAD-7), attitudes to aging questionnaire(AAQ) and patient health questionnaire(PHQ-9). SPSS 26.0 software was used for descriptive statistics and correlation analysis.AMOS 24.0 was used to construct an intermediation model, and Bootstrap method was used for mediating effect testing.Results:(1)The score of self-worth was 101.00 (92.00, 112.00), the score of aging attitude was 92.00 (83.00, 101.75), the score of anxiety was 2.00(0, 6.00), and the score of depression was 2.00 (0, 5.00). (2)Self-worth was positively correlated with aging attitude ( r=0.67, P<0.01), while negatively correlated with anxiety ( r=-0.45, P<0.01) and depression ( r=-0.48, P<0.01). The aging attitude was negatively correlated with anxiety ( r=-0.41, P<0.01) and depression ( r=-0.41, P<0.01). Anxiety was positively correlated with depression ( r=0.71, P<0.01). (3)The indirect effect of aging attitude between self-worth and depression in the elderly was -0.016, accounting for 19.75% (-0.016/-0.081)of the total indirect effect.The indirect effect of anxiety between self-worth and depression in the elderly was -0.045, accounting for 55.56%(-0.045/-0.081) of the total indirect effect.The chain mediating effect of aging attitude and anxiety between self-worth and depression in the elderly was -0.020, accounting for 24.69%(-0.020/-0.081) of the total indirect effect. Conclusion:Aging attitude and anxiety play a chain mediating role between self-worth and depression in the elderly.