Objective To investigate traditional Chinese medical emotional intervention on the cognition function of senile patients after abdominal surgery. Methods Seventy senile patients having elective abdominal operation were randomized into intervention group and control group, 35 cases in each group. The control group received routine peri-operative nursing, and the intervention group was given routine peri-operative nursing and emotional intervention based on the theory of traditional Chinese medicine. The cognition function was evaluated with mini-mental state examination (MMSE) on preoperative day 1, postoperative day 3 and 7, and serum S100βprotein level was detected before operation and on postoperative day 7. Results (1)Time for recovery from general anesthesia in the intervention group was much shortened as compared with that of the control group(P<0.05). (2)On postoperative day 3, the incidence of postoperative cognitive dysfunction(POCD) was much lower than that of the control group(P<0 . 0 5), and on postoperative day 7 , the difference of POCD incidence was insignificant between the two groups(P>0.05). (3) On postoperative day 7, serum S-100β protein level in the two groups was increased as compared with that before treatment(P<0.05), but the difference between the two groups was insignificant(P>0.05). Conclusion Traditional Chinese medical emotional intervention has an effect on shortening time for recovery from general anesthesia and decreasing POCD incidence, but has no effect on POCD incidence and serum S100βprotein level on postoperative day 7.

Objective To investigate the use of PLR induced VTI changes combined with P(cv-a)CO2 in sepsis shock early fluid resuscitation. Methods 54 patients with sepsis shock admitted in Chancheng district central hospital from March 2016 to May 2017 were randomly divided into the treatment group (n=26) and the control group (n=28). The treatment group were monitored by the PLR induced VTI changes combined with P(cv-a)CO2, while the control group were monitored by CVP. The changes of 6 h, 12 h, 24 h, CVP, BNP and LAC levels, the time of vasoactive drugs, the time of mechanical ventilation, ICU hospitalization time and mortality were compared between the two groups. Results There were no statistic difference in fluid infusion within 6h, CVP, BNP, and LAC levels in the two groups; Fluid infusion within 12 h and 24 h, CVP and BNP in the treatment group were lower than those in the control group (P<0.05); the two groups for the treatment of 12 h,24 h plasma, LAC levels were no significant difference; The application time of vasoactive drugs, the time of mechanical ventilation and the length of hospitalization in ICU in the treatment group were shorter than those in the control group (P<0.05); The 28 day mortality was not statistically different between the two groups. Conclusion PLR induced VTI changes combined with P (cv-a) CO2 in septic shock early fluid resuscitation monitoring is superior to CVP, which has the important research significance.

Objective To explore the role of endogenous and exogenous β-glucuronidase( β-G) in the development of primary common duct stones.Method Using modified Fishman method to test the activities of the endogenous and exogenous β -G in 35 patients with primary common duct stones(experimental group) and 11 patients with cystic polypus (control group) respectively.Results The activities of endogenous β -G in the bile of experimental group and control group were (7859.1 ± 738.5 ),(2174.9 ± 348.4 ) U/L(P ＜0.01).While the activities of exogenous β-G in experimental group and control group were (6786.1 ±544.3),(1504.7 ±655.7) U/L (P ＜0.01).In experimental group,there were significant statistical differences in the activities of the exogenous β -G in the sample obtained on the day of operation and 7 days after operation from 13 cases with the acute inflammation [(8935.7 ± 845.9),(2176.1 ± 956.7) U/L]and from 22 cases with the chronic inflammation [(5137.2 ±540.7),(1838.8 ±733.3) U/L],and there were significant higher in the activities of the exogenous β -G in the sample obtained on the day of operation from the acute inflammation compared to those from the chronic inflammation (P ＜ 0.05 ).Conclusions There is obvious correlation between either endogenous or exogenous β -G with primary common duct stones.And the endogenous β -G might be one of the fundamental cause in the development of primary common duct stones.

Objective To investigate the effect of acute non-isovolemic hemodilution in combination with tranexamic acid on cycle function blood gas and electrolytes with brain tumor surgery. Methods Forty-two patients undergoing brain tumor were randomly divided into two groups. Patients in group A received ANIH plus tranexamic acid , while patients in group B received ANIH alone. Collected blood was transfused before the end of surgery. HR、CVP、MAP,hemoglubin, blood gas and plasma electrolytes were respectively recorded before ANIH(T1), at 0 min (T1) and 1 h (T2) after ANIH, and at the end of operation (T4). Results There were no significant changes in HR, CVP, MAP. At T2, T3, T4, Hb, Hct in both two groups lower than those at T1(P <0.05); at T4, Hb, Hct in group A were higher than those in group B. There were no significant changes in pH , PaO2, PaCO2, BE between the both two groups. There were no significant changes in Na +, Cl-, Ca2+and K+between the both two groups. Conclusion ANIH has little effect on the cycle function and blood gas electrolyte. ANIH in combination with TA has a section blood effect. It can be used in the brain tumor operation with TA security.

Objective To study the effect of acute non-isovolemic hemodilution (ANIH) plus tranexamic acid on bleeding and coagulation factors. Methods Forty-two patients with brain tumor under general anesthesia were randomly divided into group N and group T with 21 patients in each group. Group N was given ANIH , while group T was given tranexamic acid and ANIH. Bleeding, transfusion, urine volume were recorded. Coagulation factors and D-dimer were detected one day before and after surgery. Hemoglobin was recorded before and after ANIH and after auto-blood was transfused. Results There was less bleeding in group T. Hemoglobin in group T was higher after transfusion. No significant difference was found in Group T and group N in terms of urine volume and transfusion rate. Both the two groups had no difference on variation of coagulation factors. Conclusion ANIH with tranexamic acid has no significant effect on coagulation but produces synergetic effect on decreasing bleeding. They can be applied in surgery of brain tumor safely.

Objective To investigate the effects of controlled hypotension (CH) combined with tranexamic acid (TA) on peri-operative blood loss and coagulation function in patients undergoing brain tumor surgery. Methods Forty patients undergoing brain tumor surgery were randomly allocated into group A and group B with 20 patients in each group. Patients in group A received CH alone, while patients in group B received CH combined with TA. Coagulation factors and d-dimer levels were measured 24 hours before and after surgery. Amount of blood loss, intravenous fluid transfused, urine output and postoperative drainage were recorded. Results D-dimer levels of 24 hours after surgery increased compared with that of 24 hours before surgery. In group B, the d-dimer level increased more than that of group A (P < 0.05). No significant difference was found in coagulation factor levels between group A and group B. Amount of blood loss, intravenous fluid transfused and postoperative drainage flows of patients in group B were lower than that in group A (P < 0.05). There were no significant changes in urine output and fluid infusion volume between two groups. Conclusion CH compared with TA can reduce perioperative blood loss in patients undergoing brain tumor surgery , with no obvious coagulant function abnormality. Collectively, it should be a safe and reliable method for clinical application.

Objective To compare the early fluid resuscitation effect of transpulmonary thermodilution (PICCO) monitoring combined with the passive leg raising (PLR) test and central venous pressure(CVP) mo-nitoring in severe sepsis .Methods Sixty patients with severe sepsis admitted in this hospital from January to December 2016 were selected and divided into the treatment group (n=28) and control group(n=32) accord-ing to the random number table method .The treatment group adopted PICCO monitoring combined with PLR ,while the control group adopted CVP monitoring .The changes of plasma natriuretic peptide (BNP) and blood lactic acid(LAC) levels at 6 ,24 ,48 ,72 h in two groups ,time of vasoactive drugs withdrawn ,mechanical ventilation time ,ICU stay length ,and occurrence situation of multiple organ dysfunction syndrome (MODS) and death were compared between the two groups .Results The plasma BNP levels at 24 ,48 ,72 h in the treat-ment group were lower than those in the control group at the same period ,the difference was statistically sig-nificant(P<0 .05);The plasma LAC levels at 24 ,48 ,72 h in the treatment group were lower than those in the control group at the same periods ,the difference was statistically significant (P<0 .05);The vasoactive drug withdrawal time in the treatment group was faster than that in the control group ,the mechanical ventilation time was shorter than that in the control group ,and the ICU stay time was shorter than that in the control group ,the difference was statistically significant (P<0 .05);The occurrence rates of MODS and death had no statistical difference between the two groups (P>0 .05) .Conclusion The PICCO monitoring combined with PLR in severe sepsis has better early fluid resuscitation curative effect than the CVP monitoring and has im-portant study significance .

Objective:To evaluate the clinical efficacy of multi-disciplinary single center's CCCG-HB-2016 regimen in the treatment of hepatoblastoma (HB) in children.Methods:Clinical data of 36 HB patients treated with CCCG-HB-2016 program from Aug 2016 to March 2020 were analyzed.Results:These 36 patients included 20 boys and 16 girls. The serum AFP was all higher than 2 792 ng/ml,there was a correlation between AFP and tumor risk stratification ( H=14.973, P<0.05). Twenty eight cases (77.78%) were epithelial type and 8 cases (22.22%) were mixed epithelial mesenchymal type.All children were treated by tumor resection combined with chemotherapy, and there was a correlation between tumor risk stratification and surgical resection of liver lobe ( H=8.847, P<0.05). The probability of bone marrow suppression in the low-risk group was 58.33% (35/60),that in the intermediate-risk group was 73.49% (61/83) and in the high-risk group was 80.23% (69/86).All 36 cases were followed up to March 31, 2020,with an average follow-up of 21.9 months and the median survival was 22.5 months.The overall survival rate (OS) and event-free survival rate (EFS) were 97.2% and 83.3% respectively. Conclusions:The multidisciplinary CCCG-HB-2016 regimen was with a high success rate and along with a high incidence of bone marrow suppression.

Objective: To explore the new gene mutation and clinical manifestations of Caroli syndrome in 2 blood brother cases. Methods: The clinical data of the 2 brothers with clinical diagnosis of Caroli syndrome were analyzed, and the related genes were detected by second-generation sequencing technology. Results: The PKHD1 gene of both brothers had the mutation of c. 5059A>T(exon32). c. 4358(exon 32)delC shift mutation, neither of which has been reported in OMIM database. Conclusion After analysis, c. 4358(exon32) delC and c. 5059A>T(exon32) may be the new pathogenic mutation of this disease, with the same mutant genotype but completely different phenotype.