Objective To study the effects of cognitive behavioral therapy(CBT)on nutritional status and postoperative recovery in patients after gastric cancer surgery.Methods Sixty patients diagnosed with gastric cancer between January 1,2023,and December 30,2023,at the hospital in the department of gastroin-testinal and gland surgery were included in this study.Patients were randomly divided by drawing lots into ei-ther the observation group(received routine care plus CBT—based nursing program)or the control group(received routine care),with 30 patients in each group.Nutritional indicators and postoperative recovery out-comes were compared between the two groups.Results After the intervention,patients in the observation group showed significantly higher levels of albumin and hemoglobin compared to the control group(P＜0.05).However,there was no statistically significant difference in prealbumin levels between the two groups(P＞0.05).Furthermore,patients in the observation group scored higher on the Quality of Recovery-40 scale in terms of emotional state,physical comfort,psychological support,and overall score compared to the control group(P＜0.05).After the intervention,the observation group showed significantly lower HADS scores com-pared to the control group,with a statistically significant difference(P＜0.05).Conclusion CBT demon-strates significant positive effects in improving nutritional status and postoperative recovery quality in gastric cancer patients.CBT improves patients'emotional state,thereby affecting appetite and nutritional status,and promotes postoperative physical function recovery.

Objective: To explore the mechanism of Wuzang Wenyang Huayu decoction in improving the cognitive competence and the pharmacological mechanism for neurofibrillary tangles related to cyclin-dependent kinase-5(CDK-5).Method: The 10 SAMR1 mice were used as normal group,40 SAMP8 mice were randomly divided into model group,donepezil group (0.4 mg·kg^-1·d^-1),high and low dose Wuzang Wenyang Huayu decoction groups (5,1.25 g·kg^-1·d^-1).Drugs were administered by gastric lavage for 4 continuous weeks.Directional navigation and space exploration ability were evaluated with Morris amaze.Real-time PCR was used to measure the mRNA expression of CDK-5 in brain nerve tissues.Western blot was used to detect the protein expression of CDK-5 and phosphorylation of Tau protein.Meanwhile,neurofibrillary tangles in brain tissue were detected with silver staining method.Result: As compared with normal group,both CDK-5 expression and Tau protein phosphorylation in brain nerve tissues were remarkably increased in model group (P<0.01),with significantly increased neurofibrillary tangles and significantly decreased directional navigation ability and space exploration ability (P<0.01).As compared with model group,CDK-5 expression and Tau protein phosphorylation were lower in Wuzang Wenyang Huayu decoction treated groups (P<0.05,P<0.01),accompanied by decreased number of neurofibrillary tangles as well as improved directional navigation and space exploration ability (P<0.05,P<0.01).Conclusion: Wuzang Wenyang Huayu decoction can markedly improve the cognitive competence of SAMP8 mice,and the mechanism may be related to its inhibition on CDK-5 over-expression,and down-regulation of Tau protein phosphorylation and neurofibrillary tangles in brain tissue.

Objective To investigate the strategy of cardiopulmonary resuscitation (CPR) after lung protective mechanical ventilation in critical children and follow-up study of the survivals 90 d after discharge.Methods Four hundred and eighty-nine cases of respiratory cardiac arrest which occurred for various reasons from January 2011 to June 2016 were analyzed in Pediatric Intensive Care Unit (PICU) in Guiyang Children's Hospital,in which mechanical ventilation was performed after CPR in 251 cases,death,or giving up treatment within 24 h in 83 cases,children surviving ＞ 24 h in 168 cases,118 cases were assigned into small tidal volume ventilation group,and 50 cases into conventional tidal volume ventilation group,and according to the tidal volume to adjust positive end expiratory pressure ventilation (PEEP),and the oxygen partial pressure [pa (O2)] and the oxygen index (OI),the change of the indexes of blood gas analysis,lactic acid clearance,and oxygenation were also observed.To observe the complications of mechanical ventilation,the situation of withdrawing machine as well as the outcome of the children.Follow-up was conducted for 90 d,including continuous respiratory symptoms,lung imaging examination after discharge and lung function,nervous system examination.Results (1) After mechanical ventilation treatment of 48 hours,compared with the levels of fractional inspired oxygen (FiO2) (0.42 ± 0.15 vs.0.43 ± 0.22),pa (O2) (8.25 ± 0.22 vs.8.27 ± 0.68),OI (5.33 ± 2.01 vs.6.59 ± 1.99) and lactic acid clearance(61.05 ± 1.87 vs.60.93 ± 2.71) between the routine tidal volume ventilation group and the lower tidal volume ventilation group,showing that the difference had no statistical significance (t =1.645,1.165,2.302,2.037,all P ＞ 0.05).(2) In small tidal volume group,the incidence of ventilator associated lung injury was significantly lower than that in the conventional tidal volume group,and the difference was statistically significant (x2 =5.873,P ＜ 0.05).(3) Comparing 2 groups of different tidal volume ventilation,the mortality of critical ill children had no statistically significant difference (x2 =1.063,P ＞ 0.05).(4) One hundred and twenty-seven cases of children survived and were discharged,and compared with their discharge,the follow-up of 62 cases after discharge for 30 d,90 d showed that all the children's lung function improved,tidal volume,inspiratory and expiratory time ratio(I/E),volume ratio of peak(VP/VE),time ratio of peak(TP/TE) and breathing rate(RR) were also improved,and there was significant difference (F =43.225,6.108,68.821,78.237,20.361,all P ＜ 0.05).(5) Neurological examination and children's brain function classification rating scale showed that some children had nerve dysfunction.Conclusions Small tidal volume ventilation in reducing the occurrence of ventilator associated lung injury is superior to the conventional tidal volume ventilation.To improve case fatality rate of the children with cardiac arrest resuscitation and oxygenation is not better than the conventional tidal volume group.Dynamic monitoring is helpful to adjust breathing mechanics indexes and parameters and ventilator.Through the follow-up most of the discharged children recovered well,but a few had recurrent respiratory infection and neurological sequelae.

Objective To assess the efficacy of triple therapy including proton pump inhibitor (PPI), levofloxacin and amoxicillin for the first-line treatment of H. pylori infection, and the relation between H. pylori eradication and CYP2C19 genetic polymorphism. Methods Two hundred and five H. pylori-positive patients were divided into group E_(20) (esomeprazole 20 mg twice daily), group E_(40)(esomeprazote 40 mg twice daily),group R (rabeprazole 10 mg twice daily) and group L (lansoprazole 30 mg twice daily). Besides PPI, all patients were received levofloxacin 500 mg daily and amoxicillin 1000 mg twice daily for 1 week. The CYP2C19 genotypes were detected in 161 patients. The eradication of H. pylori were analyzed by intention-to-treat (ITT) and per protocol (PP) methods.ResultsThe H. pylori eradication was 86.70% in group E_(20), 88.5% in group E_(40),73.5% in group R and 78.1% in group L. Whereas the H. pylori eradication was 90% in patients with PM genotype,81.5% in patients with HetEM genotype and 82.1% in patients with HomEM genotype. The H.pylori eradication was 83.4% and 79.00% by per protocol (PP) and intention-to-treat (ITT) analyses,respectively. There was no significant difference in H. pylori eradication among four groups (P>0.05), and no relation was found between H. pylori eradication and genotypes (P>0.05). Conclusions PPI based triple therapy was effective in eradication of H. pylori, which is not influenced by CYP2C19 genotypes.

Objective To explore the optimal treatment plan for treatment- resistant depression (TRD). Methods Patients who meet the inclusion and exclusion criteria were treated with different antidepressants randomly. Before the treatment, at the 1 st, 2nd, 4th, 6th week after treatment, the efficacy was evaluated with the 17-item Hamilton Rating Scale for Depression (HAMD). Results A total of 1128 subjects were enrolled, including 987 patients of non-TRD and 141 patients of TRD. At 2nd, 4th, 6th week, the HAMD scores were higher in TRD group. At 6th week after treatment, the total rates of response were 73.86% in non-TRD and 58.87% in TRD group respectively. The rates of response were 54.3%, 57.9%, 57.1%, 62.5%, 63.6% respectively in TRD patients with augmentation treatment of lithium, thyroxine, electro-convulsive treatment, atypical antipsychotics and cognitive behavioral therapy. Conclusion The treatment of antidepressant combined with lithium, thyroxine, electro-convulsive treatment, atypical antipsychotics or cognitive behavioral therapy can improve the efficacy in TRD patients.

Objective To explore the optimal treatment plan for treatment- resistant depression (TRD). Methods Patients who meet the inclusion and exclusion criteria were treated with different antidepressants randomly. Before the treatment, at the 1 st, 2nd, 4th, 6th week after treatment, the efficacy was evaluated with the 17-item Hamilton Rating Scale for Depression (HAMD). Results A total of 1128 subjects were enrolled, including 987 patients of non-TRD and 141 patients of TRD. At 2nd, 4th, 6th week, the HAMD scores were higher in TRD group. At 6th week after treatment, the total rates of response were 73.86% in non-TRD and 58.87% in TRD group respectively. The rates of response were 54.3%, 57.9%, 57.1%, 62.5%, 63.6% respectively in TRD patients with augmentation treatment of lithium, thyroxine, electro-convulsive treatment, atypical antipsychotics and cognitive behavioral therapy. Conclusion The treatment of antidepressant combined with lithium, thyroxine, electro-convulsive treatment, atypical antipsychotics or cognitive behavioral therapy can improve the efficacy in TRD patients.