Objective To investigate the clincal characteristics of central hyponatremia.Methods The clinical data of 34 patients with central hyponatremia were analysed retrospectively.Results 34 patients with different cerebral diseases appeared dysphoria,sleepiness,aggravating disturbances of consciousness,vomiting,limb seizures and dehydration basis on primary diseases during the hospitalization.The laboratory examinations showed that the level of blood natrium was 260 mmol/d in all the cases,and the central venous pressures in 5 cases were lower than 6 cm H2O among 8 cases.The 19 cases were diagnosed as central hyponatremia——syndrome of inappropriate ADH secretion(SIADH);7 cases were diagnosed as central hyponatremia——cerebral salt wasting syndrome(CSWS).The other 8 cases were diagnosed as SIADH firstly,but final diagnosis were corrected as CSWS according to the symptoms increasing after dehydration therapy.The 19 case of SIADH received the therapy of limiting water and diuresis,and 15 cases of CSWS received the therapy of hydration and supplementing sodium.The several days after the treatment,the levels of the blood natrium and the urinary natrium were backed to the normal values in all the patients and the condition was improved exapet 3 cases remained coma.Conclusions Hyponatremia,hypernatruria and changes of consciousness are the clinical charateritics of central hyponatremia.The treatment principle in SIADH is limiting water,and in CSWS is hydration and supplementing sodium.

Objective:To investigate the effects of acupoint massage on cognitive function and sleep quality in elderly patients with hypertension. Methods:A total of 68 elderly patients with hypertension were enrolled, and their ages were all over 60 years old. They were divided into a control group and a treatment group by simple random method, with 34 cases in each group. Patients in the control group were treated by routine psychological health guidance and sleep knowledge education, while patients in the treatment group were treated by acupoint massage on the base of the interventions given to the control group. Both of their treatment courses were 3 months. Pittsburgh sleep quality index (PSQI) scores and mini-mental state examination (MMSE) scores before and after treatment were recorded and compared. Results:Two groups’ PSQI scores before treatment had no significant difference (P>0.05). After 3 months of treatment, their PSQI scores were statistically different (P<0.05). There was also no between-group statistical difference in MMSE score before treatment (P>0.05), but there was a significant difference after treatment (P<0.05). Conclusion:Acupoint massage for elderly patients with primary hypertension can improve their sleep quality and enhance their cognitive function, thus it is worthy of being applied in clinical nursing work.

ObjectiveTo explore feasibility study of the Montreal cognitive assessment (MoCA) in detecting subcortcial vascular cognitive impairment-no dementia(VaCIND-S).MethodsSeventy-five Chinese Han were assessed by the MoCA and MMSE.40 met criteria for VaCIND -S and 35 were considered cognitively normal.ROC curve analyses were performed to determine optimal sensitivity and specificity.ResultsNo differences were found between groups on age,gender,education degrees.According to their MoCA scores,cognitive impairments including memory,visuospatial,executive function,attention,language,and orientation sub-scores in VaCIND-S ( (0.43 ± 1.01),(2.21 ± 1.19),(2.11 ± 1.13),(4.66 ± 1.48),(4.42 ±1.31),(4.86 ± 1.12)) significantly decreased compared with those in controls( (2.93 ± 1.36),(3.29 ± 1.06),(3.53 ±0.93),(5.94 ±0.24),(5.44 ± 0.71 ),(5.80 ± 0.48 ) ) (P ＜ 0.05 ).The MMSE scale was insensitive to cognitive impairment as compared with MoCA scale.Using cut-off score of 23.5,the MoCA exhibited excellent sensitivity (0.971 ) and specificity (0.789).ConclusionMoCA is a more sensitive instrument than the MMSE for the detection of VaCIND-S and warrants further investigation regarding its applicability in large and varying ethnic population.

Objective To study the effects of Huazhi Rougan granule in treatment of nonalcoholic fatty liver disease and its effect on level of adiponectin, interleukin-6 and tumor necrosis factor-α.Methods 88 patients with nonalcoholic fatty liver disease from October 2014 to September 2015 in our hospital were selected,and divided into observation group and control group according to the order of admission.The control group were taken silibinin meglumine tablets for treatment on the basis of aerobic exercise , dietary guidance.The observation group on the basis of aerobic exercise , dietary guidance were given Huazhi Rougan granule for treatment.The observation group were taken aerobic exercise and metformin for treatment.Two groups of patients with clinical efficacy were evaluated, blood parameters, adiponectin, interleukin-6 and tumor necrosis factor-αwere measured before and 30 days after treatment between the two groups of patients.Results After treatment, the total clinical efficacy of the observation group was significantly higher than the control group ( P<0.05 ) .The levels of adiponectin in the observation group were significantly higher than those in the control group (P<0.05).The level of IL-6, TNF-αin the observation group were significantly lower than those in the control group (P<0.05).Low density lipoprotein cholesterol and triglyceride in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Huazhi Rougan granule can effectively reduce the levels of TNF-αand IL-6 and increase the level of adiponectin in nonalcoholic fatty liver patients, and the clinical curative effect is good.

Objective To investigate the clinical significance of the carbon nanoparticles (CN) in prophylactic central compartment lymph node dissection (PCCND) in treatment of clinically node-negative (cN0) papillary thyroid carcinoma.Methods A total of 102 cN0 patients in our department from Dec.2016 to Jun.2017 were enrolled in our study and randomly allocated to the control group (n=51) and the CN group (n=51).All the patients have received (near) total unilateral lobectomy or bilateral thyroidectomy plus the affected side PCCND.The baseline characteristics,lymph node-related indices (including number of total dissected lymph nodes and metastatic lymph nodes at central area) and postoperative complication indices were collected and compared between the 2 groups.Results The differences of baseline characteristics between CN group and the control group were not significant (all P＞0.05).The total number of dissected lymph nodes was 573 in CN group and 334 in the control group.The average lymph nodes in each patient was 11.2±5.46 in CN group,which was higher than 6.5±4.3 of the control group (P＜0.001).The average count of positive lymph nodes was higher in CN group than in the control group (2.0±3.3 vs 0.8±1.5) (P＜0.05).Transient hypocalcaemia happened to 2 patients in CN group and 9 patients in the control group (P=0.025).Conclusions CN can increase the number of lymph nodes in central neck dissection and the rate of metastatic lymph nodes resection.It can decrease the risk of transient parathyroid injury.CN is clinically valuable in treatment of cN0 papillary thyroid cancer undergoing PCCND.

Objective:To evaluate the feasibility of the gasless transoral endoscopic thyroidectomy using an innovative space maintaining method.Methods:From Dec. 2018 to Apr. 2019, patients from Anhui Tumor Hospital treated with gasless transoral endoscopic thyroidectomy were retrospectively analyzed. Index such as intraoperative blood loss, operative time, postoperative hospital stay, and complications were recorded.Results:A total of 24 patients were included into this analysis. All operations were successfully completed. The mean blood loss was (41.3±26.4) ml, operation time was (191.8±40.8) min, postoperative hospital stay was (6.3±1.0) d. Nobody had drinking cough, recurrent laryngeal nerve palsy, massive bleeding, hypoparathyroidism or infection with use of preventive antibacteria. Transient lower jaw numbness was found in 8 patients and almost recovered within one month.Conclusions:Gasless transoral endoscopic thyroidectomy with the suspension device seems to be feasible and safe. Further study is needed to verify its validity.