Objective To explore clinical application of 3D printed osteotomy guide in mild to moderate hallux valgus correction. Methods Patients with mild to moderate hallux valgus surgery were randomly divided into two groups.30 feet in the experimental group were treated with osteotomy guide assisted orthopedic surgery，and 30 feet in the control group were treated with routine orthopedic surgery.The wound healing and postoperative weight-bearing position IMA were compared between the two groups，and the postoperative foot and ankle function was evaluated by American foot and ankle surgery first metatarsophalangeal joint scoring system（AOFAS）. Results All the wounds healed i after operation.there was no difference in the scores of IMA and AOFAS in the weight-bearing position between the two groups.The postoperative IMA of the experimental group was（5.18±0.82）° and the IMA of the control group was（6.34±0.75）°.There was significant difference between the two groups（P<0.05）.The AOFAS score of the experimental group was（89.05±5.16）and the control group was（82.84±5.02），there was significant difference between the two groups（P<0.05）. Conclusion 3D printed osteotomy guide plate in the treatment of mild to moderate hallux valgus operation can better correct the IMA，improve the function of foot after operation than the traditional operation method.

Objective To investigate the clinical effect of magnetic navigation retrograde interlocking intramedullary nail distal locking technique in the treatment of middle and lower femoral fractures. Methods A retrospective analysis of the patients with mid-lower femoral fractures who were admitted to our hospital from January 2017 to February 2019 and were followed up were divided into two groups：navigation lock group（group A）and mechanical aiming lock group（Group B），16 patients in Group A using electromagnetic navigation distal locking technology，22 patients in Group B using mechanical targeting distal locking technology.The following indicators were compared in the two groups：the success rate of the intraoperative distal one-time locking in the two groups，operation time，intraoperative blood loss，complication rate，fracture healing rate，fracture healing time，postoperative knee KOOS score. Results The success rate of distal locking once in group A was higher than that of group B，the operation time was shorter than that of group B，the intraoperative blood loss was less than that of group B，the incidence of complications was lower than that of group B，and Knee function postoperative score was better than that of group B，the difference was statistically significant（P<0.05）.The fracture healing rate in group A was higher than that in group B，and the fracture healing time was shorter than that in group B，but the difference was not statistically significant（P>0.05）. Conclusion Magnetic navigation retrograde interlocking intramedullary nail distal locking technique for the treatment of mid-lower femoral fracture has the advantages of short locking time，high efficiency and short radiation exposure time.

Objective To explore the therapeutic effect of patients with chronic lateral lateral ankle instability after modified Brostrom surgery and arthroscopic ligament enhancement. Methods Fifty-six patients with chronic lateral lateral ankle instability and surgical treatment were enrolled in our hospital from January 2016 to August 2018.They were divided into modified Brostrom group and arthroscopy group according to random number table，28 cases in each group.Patients in the modified Brostrom group were treated with modified Brostrom，and the arthroscopy group underwent arthroscopic fixation of the ligament with anchors and sutures.After treatment，the two groups of patients were followed up for 1 year.The operation time，intraoperative blood loss，postoperative activity time，wound healing and ankle instability were compared between the two groups.The FOAS scoring system，FAAM scoring system，talar inclination angle，and talar advance distance were evaluated at 6 months and one year after surgery to evaluate the ankle joint function status and the recurrence of 〖JP2〗lateral ankle instability. Result The arthroscopic operation time（50.91±8.07）min and postoperative ground movement time（4.67±1.36）d were shorter than the modified Brostrom operation group（56.76±7.93）min and postoperative ground movement time（6.35±2.04）d.The bleeding volume in the arthroscopy group（37.05±8.17）ml was less than that in the modified Brostrom operation group（42.43±6.98）ml，P<0.05.The pain score（54.23±5.28/44.63±4.45）and symptoms（52.53±6.34/47.81±5.22）of the arthroscopic group at 6 months and 1 year after surgery were significantly lower than the pain score（66.12±5.29/62.19）and symptoms（62.25±6.23/52.88±4.67）of the modified Brostrom group（P<0.05）.The differences in living ability，sports ability，quality of life，daily activities，activity ability and total scores were statistically significant 6 months and 1 year after surgery（P<0.05）.The talar tilt angle（4.43±1.03）° 〖JP3〗and talar advance distance [（4.65±1.41）mm] in the arthroscopic group after 1 year were lower than those of the modified Brostrom operation group [（5.73±1.45）°/（5.68±1.69）mm，P<0.05] .There was no significant difference in wound healing between the two groups during follow-up，but the incidence of ankle instability（14.28%）in the modified Brostrom group was higher than that in the arthroscopy group（P<0.05）. Conlusion For the treatment of patients with chronic lateral ankle instability，arthroscopic ligament augmentation and fixation can not only reduce surgical trauma，but also improve ankle motion capacity and obtain better ankle stability compared with modified Brostrom，and help patients to go to the ground as early as possible.

Objective To review and analyze the clinical application of “tibiofibular line” in the injury of tibiofibular syndesmosis. Methods From June 2017 to July 2019，we used the concept of “tibiofibular line” to judge 45 patients with ankle injury，and successfully screened 32 patients with injury of tibiofibular syndesmosis. Results 32 patients were followed up for 10～22 months，with an average of 16 months，fracture healing time was 6～10 months with an average of 7 months. Conclusion “Tibiofibular suture”plays an important role in the diagnosis of lower tibiofibular syndesmosis injury，which can significantly reduce the misdiagnosis rate and missed diagnosis rate of lower tibiofibular syndesmosis injury，It can provide another accurate diagnosis method for the injury of tibiofibular syndesmosis.

Objective To investigate the relationship between internal fixation of anatomical plate，DIDPIF and ULPIF and the recovery of patients with complex tibial plateau fractures，the infection rate of incision and the degree of motion of knee joint. Methods A total of 150 patients with complex tibial plateau fractures were selected to be treated in our hospital from January 2016 to January 2019.According to the random number table method，the patients were divided into anatomic plate fixation group，DIDPIF treatment group and ULPIF treatment group，with 50 patients in each group.The clinical curative effect，postoperative complications，knee joint function and the three groups of patients were observed. Results There was no significant difference in operative time [（95.43±15.16）vs（96.01±16.09）vs（95.99±15.19）] min，intraoperative blood loss [（281.55±52.07）vs（283.59±53.11）vs（282.66±53.04）] ml and incision length [（11.38±0.73）vs（10.97±0.44）vs（10.64±0.69）] cm among anatomic plate fixation group，DIDPIF treatment group and ULPIF treatment group（P>0.05）.There were significant differences in weight-bearing time，healing time and knee joint exercise time among the three groups（P<0.05）；Among them，the load time and healing time of ULPIF treatment group were significantly lower than that of DIDPIF treatment group （P<0.05），the time of knee joint exercise in the DIDPIF treatment group was significantly less than that in the ULPIF treatment group.After operation，3 months，12 months after operation of TPA and PA were significant different among the three groups（P<0.05），〖JP3〗while there was no significant difference between the DIDPIF treatment group and the ULPIF treatment group（P<0.05）.There was no significant difference in HSS score and excellent and good rate between DIDPIF treatment group and ULPIF treatment group（P>0.05），but both of them were significantly higher than those of the anatomic internal fixation group（P<0.05）.In terms of postoperative complications，there was no statistically significant difference between the DIDPIF treatment group and ULPIF treatment group，while both of them were significantly lower than anatomical plate internal fixation group（P<0.05）. Conclusion The curative effect of unilateral locking plate internal fixation and double incision double plate internal fixation in the treatment of tibial plateau fracture is similar，both can obtain satisfactory fixation stability，better than anatomical plate internal fixation.In addition，the patient has a good lower limb strength line and a high recovery rate of knee joint function after recovery，but each has its advantages and disadvantages，so the operation method should be selected clinically according to the actual situation of the patient.

Objective To investigate the clinical efficacy of minimally invasive incision on acute closed rupture of Achilles tendon guided by epidural needle. Methods A retrospective case series study was conducted to analyze the operative outcome of 29 patients with Achilles tendon rupture.They were randomly divided into observation group（minimally invasive incision group）and control group（conventional incision group）with 16 and 13 respectively.The interval between injury and operation ranged from 0.5h to 5days.All patients were treated with personalized plaster fixation after surgery，and performed functional exercise for 1～2 months.After one year follow-up at least，the operative time、postoperative complications（wound infection，sural nerve injury，Achilles tendon re-rupture）、AOFAS score and ATRS score in two groups were compared. Results Compared with the conventional group[（48.91±12.56）min]，the mean operative time of the minimally invasive group[（41.78±9.56）min] was slightly longer，but there was no significant difference（P>0.05）.During the follow-up，no postoperative sural nerve injury or Achilles tendon re-rupture occurred in both group，and 3 cases of skin infection and necrosis/delayed healing occurred in the conventional group.By the end of the follow-up，the AOFAS scores of the two groups were significantly improved（P<0.05），but there was no difference in the AOFAS and ATRS scores between the two groups（P>0.05）. Conclusion The duration of minimally invasive incision in the treatment of Achilles tendon rupture under the guidance of epidural needle is slightly longer，but compared with the conventional surgery，it can effectively avoid post-operative complications.

Objective To the relationship between the degeneration of paraspinal muscles and postoperative clinical efficacy of short decompression and fusion in patients with degenerative lumbar scoliosis. Methods From December 2013 to December 2017，53 patients were treated for DLS with short decompression and intervertebral fusion.According to the preoperative MRI measurement of the paraspinal muscles cross section area（CSA）and the fatty rate，All patients was divided into the observation group（28 cases）and the control group（25 cases）.Preoperative measurement of Cob Angle，CSA and fatty rate of paraspinal muscles，visual analog scale（VSA），Oswestry dysfunction index（ODI）. Results There was no significant difference in Cob's angle，VAS and ODI between the two groups（P>0.05）.There was a significant difference in Cobb's angle between the two groups at 6 months after operation and before operation.12 months after operation，the Cobb's angle in the observation group was higher than that in the control group（P<0.05），while the VAS and ODI scores in the control group were better than those in the observation group（P<0.05）.There was significantly difference between the two groups in the CSA of the multifidus and the erector spinalis（P<0.05）.In the observation group，there was significantly difference in CSA between the concave side and the convex side（P<0.05）.There was significant correlation between the fatty rate and the postoperative ODI score，r=0.462. Conclusion Before operation，we should pay attention to the evaluation of the degree of degenerative paravertebral muscles，especially the fatty rate of the polysplit muscles，lengthen the fixed segment or strengthen the exercise of the lumbodorsal muscles，which is helpful to relieve the postoperative lumbodorsal pain.

Objective To explore the effect of T-type full-mechanical lateral anastomosis（TSA）in the treatment of esophageal cancer. Methods 108 patients who underwent radical laparoscopic radical esophagectomy in our hospital from January 2016 to April 2018，were enrolled according to the order of admission.The patients were divided into the experimental group（with TSA anastomosis during surgery）and the control group（rounded during surgery）.The end-to-side anastomosis of the tubular anastomosis was performed in 54 cases.The surgical anastomosis time，postoperative hospital stay，surgical complications，anastomotic stenosis，and anastomotic area were compared between the two groups. Results The anastomosis time（17.4±2.1）min in the test group was significantly lower than that in the control group（25.8±3.0）min（P<0.05）.There was no significant difference in the postoperative hospital stay（13.8±2.0）days in the test group and（14.3±2.3）days in the control group（P>0.05）.The surgical complication rate of patients in the test group was 12.96% lower than that in the control group（37.04%）（P<0.05）；At 6 months after surgery，the incidence of anastomotic stenosis in the experimental group was 1.85% lower than that in the control group 14.81%，and the difference was statistically significant（P<0.05）；At 6 months after operation，the anastomosis area（2.17±0.30）cm2 in the test group was higher than that in the control group（1.90±0.28）cm2，and the difference was statistically significant（P<0.05）. Conclusion The use of left-neck T-type full-mechanical lateral anastomosis in esophageal cancer surgery can effectively shorten the time of anastomosis，reduce postoperative complications，and especially reduce the occurrence of anastomotic stenosis.

Objective To evaluate the perioperative nutritional status of patients with rectal cancer in different stages，and to provide evidence-based medical basis for timely nutritional intervention by clinicians. Methods A prospective study was conducted in 240 patients undergoing resection of rectal cancer from September 2016 to November 2018.BMI，grip strength and subjective global assessment of nutrition（SGA）and serum albumin（ALB）were used to evaluate the nutritional status of 240 patients undergoing resection of rectal cancer during perioperative period.It was estimated that the same nutritional measurements were used at admission and discharge，and patients were reevaluated one month after discharge. Results 〖JP2〗A total of 240 rectal cancer patients were enrolled in the study，171（71.3%）with locally early rectal cancer and 69（28.8%）with locally advanced rectal cancer.SGA assessed that 74（30.1%）and 122（50.8%）of the 240 patients were malnourished at admission and discharge respectively，and the nutritional status at discharge was significantly worse than that at admission（P<0.05）.Body weight and ALB deteriorated significantly during hospitalization，and the follow-up showed that they continued to deteriorate in the short term after discharge，the weight and ALB were（68.2±15.3）kg，（37.8±0.4）g/L at admission and（63.8±16.9）kg，（35.9±0.56）g/L at discharge，（62.4±17.5）kg，（32.5±3.7）g/L at follow-up（P<0.05）.In addition，the body weight，SGA score（≥4）and ALB level of patients with locally advanced rectal cancer at admission，discharge and one month after discharge were lower than those in locally advanced rectal cancer（P< 0.05）. Conclusion Most patients with rectal cancer have good nutritional status at admission，but the nutritional status will deteriorate during hospitalization and early discharge，especially in patients with locally advanced rectal cancer.

Objective To explore the clinical application of anterograde mesenteric artery（SMA）technique first in pancreaticoduodenectomy（PD）. Methods The clinical data of 146 cases of PD patients in our hospital in January 2012～2017 December were analyzed retrospectively.According to the inclusion criteria，the clinical data of 60 patients were further analyzed，and 2 groups were divided：the study group（n=30）：anterograde anatomy of SMA first；the control group（n=30）：no anterograde anatomy of SMA first was used. Results The study patients' operation time（382.1±63.9）min，time of hospitalization（14.6±1.2）d，ICU time（2.3±0.8）d，intraoperative bleeding（190.2±192.0）ml，blood transfusion rate 8（26.7%） were significantly lower than those of the control group，which were （443.6±49.2）min，（18.4±2.0）d，（4.9±0.8）d，（373.0±362.6）ml，66.7%（20/30），respectively（P＜0.05）. Conclusion Anatomic SMA first technique can significantly shorten the operation time，time of hospitalization and ICU time for tumor invasion of the superior mesenteric vein，and reduce the amount of bleeding，blood transfusion rate.

Objective To investigate the clinical value of laparoscopy technology in the diagnosis and treatment of suspected acute appendicitis. Methods A total of 86 patients admitted to the department of general surgery of our hospital from January 2013 to October 2018 with a diagnosis of suspected acute appendicitis were selected.54 patients undergoing laparoscopic exploration and laparoscopic appendectomy were divided into the observation group，while 32 patients undergoing traditional exploratory laparotomy and open appendectomy were divided into the control group.Comparing and analyzing the difference of clinical indexes between the two groups after different surgical methods. Results Compared with the control group，the observation group had shorter operation time and less surgical bleeding volume.After operation，the observation group not only felt less pain，but also recovered the intestinal function and performed off-bed activities earlier than the control group.Furthermore，the observation group had shorter hospitalization time and lower incidence of postoperative complications including incision infection，abdominal residual abscess and ileus.Their differences were statistically significant（P＜0.05）.However there was no significant difference in hospitalization cost between two groups（P>0.05）. Conclusion With the advantages of higher diagnostic accuracy and therapeutic efficiency，smaller surgical trauma，slighter pain，less postoperative complications，and quicker recovery，the laparoscopy technology is efficient in the diagnosis and treatment of suspected acute appendicitis.

Objective To compare the content，clinical efficacy and safety of inflammatory factors in patients with acute cholecystitis treated by laparoscopic minimally invasive surgery. Methods 100 patients with acute cholecystitis admitted to our hospital from January 2015 to January 2019 were randomly selected as the study subjects.The control group was treated with traditional open cholecystectomy，while the observation group was treated with laparoscopic minimally invasive surgery.After treatment，the clinical indicators of the patients were recorded and the therapeutic effect of the patients was counted. Results The hospitalization time，intraoperative bleeding volume，operation time，recovery of gastrointestinal function and time of getting out of bed in the observation group were significantly lower than those in the control group（P<0.05）.One day after operation and seven days after operation，there were significant differences in TNF-alpha，interleukin and C-reactive protein between the observation group and the control group（P<0.05）.There were significant differences in the effective rate and the incidence of complications between the observation group and the control group（P<0.05）. Conclusion Cholecystectomy in abdominal cavity has the advantages of less trauma，less intraoperative bleeding and fast recovery of intestinal function，which can effectively reduce inflammatory response and improve the treatment effect.The operation scheme is worthy of clinical application.

Objective To explore the method and feasibility of individualized and multi-mode management for iatrogenic bile duct injury（IBDI）. Methods From January 2010 to December 2018，22 cases of iatrogenic bile duct injury in general surgery of Panzhihua Group General Hospital of Panzhihua City were retrospectively reviewed.According to the clinical manifestation and injury type of biliary tract injury，the patients were treated with unobstructed external drainage or combined endoscopic biliary duct drainage，biliary plastic repair，choledochojejunostomy，and injury control surgery. Results There were 22 cases of iatrogenic bile duct injury，5 cases were treated with location puncture drainage or external drainage or combined endoscopic drainage，and 9 cases underwent repair of bile duct injury or combined T-tube support drainage.Roux-en-Y choledochojejunostomy was performed in 8 cases，including injury control surgery in 1 case.Overall effective rate 100%. Conclusion Iatrogenic bile duct injury has many types，clinical manifestations are different，or even accompanied by various serious complications.Individualized and multi-mode treatment measures should be taken according to different clinical manifestations and different injury types.

Objective To investigate the efficacy of endoscopic sphincterotomy（sEST）combined with balloon dilatation（EPBD）in the treatment of common bile duct stones combined with duodenal papillary diverticulum（JPDD）and serum bilirubin levels. Methods The clinical data of 87 patients with common bile duct stones and JPDD who underwent endoscopic retrograde cholangiopancreatography（ERCP）in our hospital from January 2015 to June 2017 were retrospectively analyzed.Among them，42 patients were treated with sEST combined with EPBD（experimental group）.45 patients were treated with sEST（control group）.The stone removal status and postoperative general indexes，the serum bilirubin levels [serum total bilirubin（TBil），direct bilirubin（DBil）] before surgery and 1 day after surgery of the two groups were compared. Results The success rate of one-time stone removal in the experimental group was 92.86%，which was significantly higher than 77.78% in the control group（P<0.05）.The rate of lithotripsy in the experimental group and the recurrence rate of one year after surgery were 4.76% and 2.38%，respectively，which were significantly lower than the control group's 20.00% and 15.56%（P<0.05）.TThe hospital stay in the experimental group was（7.85±2.17）d，which was shorter than that of the control group（9.72±2.85）d（P<0.05）.1 day after surgery，the serum levels of TBil and DBil in the experimental group were（156.06±51.27）μmol/L and（92.85±29.74）μmol/L，respectively，the serum TBil and DBil levels in the control group were（171.72±56.48）μmol/L and（105.42±34.81）μmol/L，respectively，which were significantly lower than those before surgery（P<0.05）.But there were no significant differences between the two groups（P>0.05）. Conclusion sEST combined with EPBD in the treatment of common bile duct stones combined with JPDD can significantly improve the success rate of one-time stone removal，reduce the use of lithotripsy and stone recurrence rate，patients recover faster，and can effectively improve their serum bilirubin levels.

Objective To compare the clinical effects of two surgical methods in abdominal incisional hernia，and to explore the safety and feasibility of laparoscopic repair in abdominal incisional hernia. Methods The clinical data of 52 patients with incisional hernia of abdominal wall admitted to hepatobiliary surgery of our hospital from August 2012 to December 2018 were retrospectively analyzed.Among them，28 cases were treated with Onlay repair（pre-sheath repair）and 24 cases were treated with laparoscopic repair.The operation time，intraoperative blood loss，post-operative pain，post-operative complications and operation were compared and analyzed between the two groups.Posterior recovery and inflammatory markers. Results （1）The operation time of laparoscopic repair group was longer than that of Onlay repair group，and intraoperative blood loss was less than that of Onlay repair group（P<0.05），2 cases of intestinal injury in laparoscopic group and 4 cases of intestinal injury in Onlay group had statistical significance（P<0.05）.（2）12，24，48 hours after operation，abdominal cavity.（3）2 cases of incision infection，1 case of incomplete intestinal obstruction and 3 cases of complications（12.50%）in laparoscopic repair group.In Onlay group，there were 1 case of seroma，4 cases of incision infection，3 cases of incomplete intestinal obstruction and 8 cases of complications（28.57%）.There was no intestinal fistula after operation in both groups.The incidence of complications in laparoscopic repair group was lower than that in Onlay repair group（P<0.05）.（4）The hospital stay and ambulation time in laparoscopic group were shorter than those in Onlay group（P＜0.05）.The cost of hospitalization was higher than that of Onlay repair group（P＜0.05）.（5）12，24，48 hours after operation，the serum inflammatory factors（CRP，IL-6，PCT）in laparoscopic group were lower than that in Onlay control group（P＜0.05）.（6）After 6-48 months follow-up，there was no significant difference in recurrence rate between the two groups（P>0.05），but the recurrence rate in laparoscopic group（4.17%）was slightly lower than that in Onlay group（7.14%）.（7）After 6 months follow-up，the quality of life scores of the observation group were higher than those of the control group（P<0.05）. Conclusion Both methods are safe and effective in the treatment of incisional hernia of abdominal wall.Laparoscopic repair for abdominal incisional hernia has the advantages of early postoperative activity，short hospital stay and less complications.

Objective To observe the differences of display effects of excretory MR cholangiography（MRCG）to the biliary tract after injection of multihance，and to evaluate the morphology and excretory function of the biliary tract. Methods We selected 24 cases who were examined by MR，and we compared and analyzed the display effects of enhanced T1 biliary tract reconstructing and excretory MRCG images including 1hour，2hours and 3hours after injection of multihance for the intrahepatic and extrahepatic bile duct，gallbladder and bile duct wall. Results （1）The intrahepatic biliary duct display effects of excretory MRCG-2 hours was better than those of excretory MRCG-3 hours（P<0.05），and there were no significant differences between excretory MRCG-1 hour and MRCG-2 hours（P>0.05）；（2）the extrahepatic bile duct display effects of excretory MRCG-2 hours and MRCG-3 hours was better than those of excretory MRCG-1 hour（P<0.05）；（3）the gallbladder display effect of excretory MRCG-3 hours was better than those of excretory MRCG-2 hour and MRCG-1 hour（P<0.05），and those of MRCG-2 hours was better than those of MRCG-1 hour（P<0.05）；（4）the biliary tract anatomic structure display effects of excretory MRCG-1 hour，MRCG-2 hours and MRCG-3 hours was all better than those of enhanced T1 biliary tract reconstructing images（P<0.05）；（5）the biliary tract wall display effect of enhanced T1 biliary tract reconstructing images was much better than 〖JP2〗those of excretory MRCG-1 hour，MRCG-2 hours and MRCG-3 hours（P<0.05），and the enhanced T1 biliary tract reconstructing images can display the biliary tract thickness、smoothness or not，enhancing characteristics，condition in the bile duct and the surrounding soft tissue. Conclusion The excretory MRCG by enhanced scan with multihance has an important research and clinical application value.The ideal biliary tract delay time of bile excretion period is about 2hours after injection of multihance.

Objective To evaluate the effect of goal-directed fluid therapy on postoperative cognitive dysfunction in elderly patients undergoing colorectal carcinoma radical surgery. Methods 98 patients undergoing colorectal carcinoma radical surgery，were randomly divided into goal-directed fluid therapy group（GDFT group）and control group（Con group）by random sequences generated by SPSS 17.0，49 cases in each group.The radial artery puncture catheter was connected to the Vigileo-FloTrac system for monitoring stroke volume variation（SVV）.Fluid infusion was guided by goal-directed fluid therapy based on SVV in GDFT group.Conventional therapy was used in Con group.The MMSE score was assessed at 1 day before surgery，1 day，3 days，1 week，1 month，3 months and 6 months after surgery，and the postoperative cognitive dysfunction was diagnosed with 1SD principle.Peripheral venous blood was extracted at 1 day before surgery，1 day，3 days and 1 week after surgery for the detection of S100 immunoglobulin and neuron-specific enolase（NSE）. Results The incidence of POCD in the GDFT group at 1 day after surgery（30.6%/57.1%），3 days after surgery（28.6%/55.1%），1 week after surgery（22.4%/51.0%），1 month after surgery（16.7%/42.6%），3 months after surgery（17.4%/39.1%）〖JP3〗and 6 months after surgery（15.6%/36.4%） was significantly lower than that in the Con group，with statistically significant differences（P<0.05）.There was no statistically significant difference in S100 serum protein [（121.4±13.4）pg/ml and（122.3±11.6）pg/ml] and NSE [（6.8±1.1）ng/ml and（7.0±1.2）ng/ml] concentrations between the two groups at 1 day before surgery（P>0.05）.The concentration of S100 [（206.6±18.7）pg/ml and（231.5±17.3）pg/ml]，[（191.8±14.6）pg/ml and（217.9±15.8）pg/ml]，[（171.5±13.3）pg/ml and（195.7±16.2）pg/ml] and NSE [（19.4±1.6）ng/ml and（24.7±2.1）ng/ml]，[（17.3±1.8）ng/ml and（22.0±2.3）ng/ml]，[（15.9±1.8）ng/ml and（20.6±2.0）ng/ml] in the GDFT group at 1 day after surgery，3 days after surgery and 1 week after surgery was significantly lower than that in the Con group（P<0.05）. Conclusion Goal-directed fluid therapy can reduce the incidence of POCD in elderly patients undergoing colorectal carcinoma radical surgery within 6 months after surgery.

Objective To study the effect of laparoscopic radical prostatectomy on prostate cancer patients and to analyze the effects of TGF- β1，TGF- β3，and PSA levels. Methods From October 2017 to October 2018，104 cases of prostate cancer patients admitted to our hospital were retrospectively analyzed and divided into laparoscopic group and open group according to different treatment methods.Open radical prostatectomy was performed in the open group and laparoscopic radical prostatectomy was performed in the laparoscopic group.Follow-up for 1 year，the survival rate，TGF-β1，TGF-β3 and PSA levels and postoperative complications of the two groups were compared 30 days after surgery，1 day before treatment and 30 days after treatment，respectively. Results The 12-month survival rate of the laparoscopic group was 96.15%（50/52），higher than that of the open group of 84.62%（44/52）（P<0.05）.The serum levels of TGF-β1 and TGF- β3 in the two groups after operation were lower than the before operation（all P<0.05），but the difference between the two groups was not significant（P>0.05）.The serum t-psa and f-psa levels in the two groups after operation were lower than the before operation（all P<0.05），but the difference between the two groups was not significant（P>0.05）.The incidence of postoperative complications in the laparoscopic group was lower than the open group（P<0.05）. Conclusion Laparoscopic radical resection of prostate cancer has a significant effect on patients with prostate cancer，and can effectively improve the levels of TGF- 1，TGF- 3 and PSA，and reduce the risk of postoperative complications.It is worthy of clinical application.

With the aging of the society，the elderly hip surgery is increasing.The decline or obstacle of the elderly patient’s function has put forward higher requirements on the management of anesthesia.This paper compares and evaluates the challenges faced by the elderly patients with hip fracture，the selection and comparison of anesthesia methods，the characteristics of ultrasound-guided peripheral nerve block technique and its effect on the perioperative period of hip surgery in the elderly，and confirms the application of ultrasound-guided peripheral nerve block technique.