Objective To investigate the influence of sodium bicarbonate Ringer's solution and compound Ringer's solution on patients'acid-base balance and liver and kidney function during controlled low central venous pressure(CLCVP)hepatectomy.Methods A total of 60 patients with primary liver cancer who underwent CLCVP hepatectomy in the Affiliated Cancer Hospital of Zhengzhou University from June 2020 to June 2022 were selected and randomly divided into the sodium bicarbonate Ringer's solution group and compound Ringer's solution group,with 30 patients in each group.Patients in the sodium bicarbonate Ringer's solution group were infused with sodium bicarbonate Ringer's solution,while patients in the compound Ringer's solution group were infused with compound Ringer's solution after anesthesia induction and before liver parenchymal disconnection.The pH value,base excess(BE)and blood lactic acid(Lac)levels were detected using the blood gas analyzer in the two groups before anesthesia induction(T,),at the beginning of surgery(T2),2 h during surgery(T3),4 h during surgery(T4),and at the end of surgery(T5),respectively.The levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),and serum creatinine(Scr)were detected using the automatic biochemical analyzer 24 h before and 24 h after surgery,respectively.The body mass,surgical time,intraoperative infusion volume,urine volume,changes in body acid-base balance during surgery,and changes in liver and kidney function before and after surgery between the two groups were compared.Results There was no statistically significant difference in body mass,surgical time,intraoperative infusion volume,and urine volume between the two groups of patients(P＞0.05).At T,,there was no statistically significant difference in pH value,BE and Lac levels between the two groups of patients(P＞0.05).Compared to T,,the pH value in the compound Ringer's solution group increased at T2 and decreased at T3,T4 and T5,while BE and Lac levels from T2 to T5 showed an increasing trend(P＜0.05);compared to T,,the pH value in the sodium bicarbonate Ringer's solution group increased at T2 and decreased at T3,BE and Lac levels increased at T2 and T3(P＜0.05),and there was no statistically significant difference in pH value,BE and Lac levels at T4 and T5 compared to T1(P＞0.05).At T5,the pH value in the sodium bicarbonate Ringer's solution group was significantly higher than that in the compound Ringer's solution group,while the BE and Lac levels were significantly lower than those in the compound Ringer's solution group(P＜0.05).There was no statisti-cally significant difference in the levels of ALT,AST,BUN and Scr 24 hours before surgery between the two groups of patients(P＞0.05);compared to 24 hours before surgery,there was no significant change in the levels of ALT,AST,BUN and Scr 24 hours after surgery(P＞0.05);there was no statistically significant difference in the levels of ALT,AST,BUN and Scr 24 hours after surgery between the two groups(P＞0.05).Conclusion Compared to compound Ringer's solution,sodium bicarbonate Ringer's solution has a smaller impact on the internal environment of the body during the CLCVP hepatectomy and can effectively maintain the stability of the body's acid-base balance.Both the two solutions have no significant impact on the patient's liver and kidney function.

Objective To investigate the clinical feasibility,safety and advantages of transum-bilical laparoscopic single-site surgery in large hysterectomy.Methods A total of 82 patients with laparoscopic large hysterectomy were selected as the study objects.Among them,41 patients under-went transumbilical single-hole laparoscopic surgery(single-hole group)and 41 patients underwent traditional multi-hole laparoscopic surgery(multi-hole group).Operation time,intraoperative blood loss,24 h postoperative Visual Analogue Score(VAS),postoperative exhaust time,postoperative morbidity,postoperative hospital stay,cosmetic incision score,postoperative inflammatory index,neutrophil lymphocyte ratio(NLR),incidence of complications and the difference of hemoglobin be-fore and after surgery were compared between the two groups.Results The operation was successful-ly completed in both groups without conversion to laparotomy,and no serious surgical complications occurred.No auxiliary holes were added in the single-hole group.The postoperative exhaust time in the single-hole group was significantly shorter than that in the multi-hole group,the VAS score at 24 h after surgery and NLR at the first day after surgery were significantly lower than those in the multi-hole group,and the aesthetic score of the postoperative incision was significantly higher than that in the multi-hole group(P＜0.05).Conclusion Under the condition of strict control of surgi-cal indications,transumbilical laparoscopic single-site surgery in large hysterectomy has good safety and high feasibility,and has the advantages of fast postoperative exhaust,relieved postoperative pain,light immunosuppression and a incision.

Objective To investigate the clinical feasibility,safety and advantages of transum-bilical laparoscopic single-site surgery in large hysterectomy.Methods A total of 82 patients with laparoscopic large hysterectomy were selected as the study objects.Among them,41 patients under-went transumbilical single-hole laparoscopic surgery(single-hole group)and 41 patients underwent traditional multi-hole laparoscopic surgery(multi-hole group).Operation time,intraoperative blood loss,24 h postoperative Visual Analogue Score(VAS),postoperative exhaust time,postoperative morbidity,postoperative hospital stay,cosmetic incision score,postoperative inflammatory index,neutrophil lymphocyte ratio(NLR),incidence of complications and the difference of hemoglobin be-fore and after surgery were compared between the two groups.Results The operation was successful-ly completed in both groups without conversion to laparotomy,and no serious surgical complications occurred.No auxiliary holes were added in the single-hole group.The postoperative exhaust time in the single-hole group was significantly shorter than that in the multi-hole group,the VAS score at 24 h after surgery and NLR at the first day after surgery were significantly lower than those in the multi-hole group,and the aesthetic score of the postoperative incision was significantly higher than that in the multi-hole group(P＜0.05).Conclusion Under the condition of strict control of surgi-cal indications,transumbilical laparoscopic single-site surgery in large hysterectomy has good safety and high feasibility,and has the advantages of fast postoperative exhaust,relieved postoperative pain,light immunosuppression and a incision.

Objective: To explore prevalence of childhood neglect and autonomic nervous function, and its association in sixth graders students in Harbin, and to provide clues to improve physical and mental health of children and adolescents. Methods: Cluster sampling method was used to select 1 259 students from grade 6 in 5 schools in two districts of Harbin, and Childhood Trauma Questionnaire-Short Form (CTQ-SF) and TOHO University Medical Index (TMI) were filled in. Results: The total rate of childhood neglect was 45.7%, of which the rate of emotional neglect and physical neglect were 18.8%, 40.8%. The rate of autonomic nerves disorder was 47.2%. The rate of autonomic nerves disorder in students suffered from neglect, emotional neglect, physical neglect are higher than those without any of neglect(χ2=50.52, 32.02, 43.61, P<0.01), and with the increase of the degree of neglect, the rate of autonomic nervous disorder were gradually increasing(χ2=47.99, 47.07, 49.24, P<0.01). After controlled for gender, neglect, emotional neglect, physical neglect were positively associated with autonomic nerves disorder(OR=1.53-2.34, P<0.05), and the odd ratio for autonomic nerves disorder among those with mild-to-moderate,moderate-to-severe and extremely servere neglect was 1.37, 1.83, 5.10 compared to those with none or mild neglect. Conclusion Childhood neglect is closely related to adolescent the autonomic nerves disorder in sixth graders students in Harbin. Moreover, the more serious the childhood neglect is, the higher the detection rate of autonomic nerves disorder is. In order to improve the physical and mental health of children and adolescents, it is necessary to pay attention to childhood neglect and early assessment of their autonomic function.

To explore the mediating role of psychological resilience to childhood abuse and binge eating. This study assessed the childhood abuse, binge eating and psychological resilience of 3 453 middle school students in Harbin city, Heilongjiang Province. SPSS PROCESS macro program, combined with Bootstrap method, was employed to explore the mediating effect of psychological resilience. The incidence of middle school students experiencing at least one type of abuse in their childhood was 81.3% (2 807/3 453). Childhood abuse, psychological resilience and binge eating were all significantly different in terms of gender, household registration and whether they were only child (all P values<0.05). There was a significant positive correlation between childhood abuse and binge eating. Psychological resilience was negatively associated with childhood abuse and binge eating. Childhood abuse could not only directly predict the binge eating behavior of adolescents, but also could indirectly affect it via psychological resilience.

Objective: To observe the short-term changes of Body Mass Index (BMI) and Waist Circumference (WC) in junior high school students in Harbin, and to explore its association with the changes of high-sensitivity C-reactive protein (hs-CRP) in the same period. Furthermore, to analyze the value of hs-CRP to predict the BMI and WC changes in children and adolescents. Methods: Convenient sampling method was used,and the students in grades 6 and 7 in junior high school in Harbin were selected by stratified clicstering. Physical examination and serum hs-CRP were performed for two consecutive years. According to the results of the two surveys, the subjects were divided into control group (normal → normal), case group (abnormal → abnormal), improved group (abnormal → normal) and progression group (normal → abnormal). The multinomial logistic regression was used to analyze the predictive value of hs-CRP changes for BMI and WC changes. Results: The rate of overweight and obesity among samples from junior high school was 30.6%. The increment of BMI in female was more obvious than that in male(U=17 358.0，P<0.05). Both increments in BMI and WC were positively correlated with increments in hs-CRP(P<0.05). The risk of occurrence of "BMI always abnormal" and "WC always abnormal" increased sequentially in hs-CRP "normal → abnormal", "abnormal → normal" and "abnormal → abnormal", were 3.45 times, 5.98 times and 38.84 times of "BMI is always normal", respectively; and were 3.45 times, 4.26 times and 28.50 times of "WC is always normal", respectively. The risk of "BMI improvement" was 7.70 times more than that of BMI "always normal" when hs-CRP "abnormal → normal". Conclusion The prevalence of overweight and obesity in junior high school students in Harbin is high. The BMI increases faster in female from junior high school. The trends of change of BMI and WC are consistent with the trend of change of hs-CRP. The “hs-CRP change” has a good predictive value for BMI and WC development.

Objective: To understand current situation and relations of childhood abuse and psychological capital, providing scientific basis for adolescent mental health promotion. Methods: Stratified cluster sampling method was used to select 1 894 students from junior high schools and senior high schools in Harbin. Questionnaire survey was conducted by using Childhood Trauma QuestionnaireShort Form (CTQ-SF) and Positive Psychological Capital (PPQ). Results: The total rate of childhood abuse among adolescents in the region was 98.3%. In addition to emotional abuse, scores of other dimensions of childhood abuse were higher for boys than for girls(P<0.01). Childhood abuse in rural area was higher than those in urban area except physical abuse(P<0.05). High psychological capital was observed among participants with boys higher in selfefficacy and resilience than that of girls(P<0.05). Psychological capital in urban students was higher than rural students(P<0.05). Except for the negative correlation between sexual abuse and resilience, all other dimensions of childhood abuse were negatively correlated with four dimensions of psychological capital. Stepwise regression analysis showed that emotional abuse, emotional neglect and physical neglect was negatively correlated with all dimensions of psychological capital(P<0.01); Sexual abuse showed negative association with selfefficacy and optimism(P<0.01). Conclusion Childhood abuse is closely related to psychological capital among adolescents in Harbin, suggesting exposure to childhood abuse might confer detrimental effects on psychological capital development.

To explore the mediating role of psychological resilience to childhood abuse and binge eating. This study assessed the childhood abuse, binge eating and psychological resilience of 3 453 middle school students in Harbin city, Heilongjiang Province. SPSS PROCESS macro program, combined with Bootstrap method, was employed to explore the mediating effect of psychological resilience. The incidence of middle school students experiencing at least one type of abuse in their childhood was 81.3% (2 807/3 453). Childhood abuse, psychological resilience and binge eating were all significantly different in terms of gender, household registration and whether they were only child (all P values<0.05). There was a significant positive correlation between childhood abuse and binge eating. Psychological resilience was negatively associated with childhood abuse and binge eating. Childhood abuse could not only directly predict the binge eating behavior of adolescents, but also could indirectly affect it via psychological resilience.

To explore the mediating role of psychological resilience to childhood abuse and binge eating. This study assessed the childhood abuse, binge eating and psychological resilience of 3 453 middle school students in Harbin city, Heilongjiang Province. SPSS PROCESS macro program, combined with Bootstrap method, was employed to explore the mediating effect of psychological resilience. The incidence of middle school students experiencing at least one type of abuse in their childhood was 81.3% (2 807/3 453). Childhood abuse, psychological resilience and binge eating were all significantly different in terms of gender, household registration and whether they were only child (all P values<0.05). There was a significant positive correlation between childhood abuse and binge eating. Psychological resilience was negatively associated with childhood abuse and binge eating. Childhood abuse could not only directly predict the binge eating behavior of adolescents, but also could indirectly affect it via psychological resilience.

Objective: To investigate the clinical characteristics, cell morphology, genetics, gene mutations of the patients with chronic neutrophilic leukemia (CNL). Methods: Five CNL patients from the Second Hospital of Shanxi Medical University between May 2011 and May 2017 who conformed to 2016 World Health Organization (WHO) diagnostic criteria were retrospectively analyzed from clinical characteristics, laboratory features and treatment methods. Results: The peripheral blood white blood cell count (WBC) of 5 CNL patients was significantly increased, and the average WBC was 81.26×10⁹/L [(29-217)×10⁹/L]. Morphological analysis of peripheral blood cell showed a sustained increasing number of matured neutrophilia (0.80-0.85). Neutrophil alkaline phosphatase (NAP) activity was increased (144-266). Bone marrow cell morphology typically showed granulocyte proliferation without obvious dysplasia. Gene detection showed 3 patients with CSF3R T618I mutation and 2 patients with JAK2 V617F mutation in 5 WHO-defined CNL patients. Bone marrow biopsy with reticular staining showed that marrow fibrosis (MF) degree in patients with JAK2 V617F mutation (MF≥2) was higher than that in patients with CSF3R T618I mutation(MF<2). Conclusions CNL is a rare type of chronic leukemia, and CSF3R T618I mutation is a specific diagnostic index for CNL. JAK2 V617F mutations alone may be related to myelofibrosis, which remains to be further studied.