目的 观察并比较注射用重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白（益塞普）剂量递减方案与标准剂量维持方案治疗强直性脊柱炎（AS）的疗效及安全性。方法 选择2015年1月—2016年6月共18个月在我院治疗的80例AS患者为研究对象,随机分为两组,A组40例,给予益塞普递减方案治疗,B组40例,给予益塞普标准剂量维持方案治疗,比较两组的用药疗效及安全性。结果 治疗后,两组的BASDAI、BASFI评分,腰背痛VAS评分,血清CRP、ESR水平均低于治疗前（P<0.05）,但两组组间比较未见统计学意义（P>0.05）;在治疗期间,A组与B组的不良反应发生率（32.50%、55.00%）及复发率（27.50%、22.50%）比较均无统计学意义（P>0.05）;经统计,A组的年平均药物费用为（47 391±4 830）元,少于B组（82 038±5 127）元（P<0.05）。结论 采用益塞普剂量递减方案治疗AS安全有效,能在短时间内控制疾病活动及改善临床症状,且花费更低,患者接受度更高。

Objective To observe and compare the clinical effect and safety of dose reduction scheme for recombinant human tumor necrosis factor receptor antibody fusion protein （hTNFR：Fc,etanercept） for injection and standard dose maintenance scheme in treatment of ankylosing spondylitis （AS）. Methods 80 cases of patients with AS and who were treated in our hospital from January 2015 to June 2016 for 18 months were selected as the research objects,and were randomly divided into two groups.The group A of 40 cases were treated with etanercept of degressive scheme therapy,while the group B of 40 cases were treated with etanercept of standard dose maintenance therapy. Then,the clinical effect and safety of drug use of two groups were compared. Results The BASDAI,BASFI score,VAS score of low back pain,serum CRP and ESR levels of two groups after treatment were lower than those before the treatment （P < 0.05）,but there was no statistical significance between the two groups （P > 0.05）. During the treatment,there was no significant difference in the incidence of adverse reactions （32.50%,55%） and recurrence rate （27.50%,22.50%） between group A and group B （P > 0.05）. By statistics,the average annual drug cost in group A was RMB （47 391±4 830） yuan,which was less than that in group B of RMB （82 038±5 127） yuan （P < 0.05）. Conclusion The etanercept of degressive scheme therapy in treatment of AS are safe and effective,which may control disease activity and improve clinical symptoms in a short time,and low costs. The patient will receive higher degree of acceptance.

目的 观察小剂量阿帕替尼联合经肝动脉化疗栓塞术(TACE)对晚期肝癌的疗效。方法 选择2016年1月1日—2017年12月31日在我院住院治疗的晚期肝癌患者38例,将其随机分为对照组和观察组,每组19例,对照组给予TACE治疗,观察组在TACE治疗的基础上联合口服阿帕替尼(250 mg/d)。随访两组患者的存活状态,Kaplan-Meier 法计算中位生存期,并绘制生存曲线,采用log-rank法比较两组患者生存曲线的差异。结果 对照组和观察组中位生存期分别为4.3月、5.8月,两组生存曲线比较有差异(χ²=4.691,P=0.043)。结论 相比于单纯TACE治疗,小剂量阿帕替尼联合TACE方案可以延长晚期肝癌患者的生存期。

目的 观察两种不同剂量的阿托品对右美托咪定心脏窦房结及房室结抑制作用的逆转效果。方法 健康志愿者20名,男12名,女8名,18～30岁。受试者先后给予右美托咪啶(1.5±0.5)μg/kg负荷量,持续泵注量(0.75±0.25)μg/(kg·h)进行试验观察。试验过程中如受试者心率＜(50±5)次/分,房室结前传2∶1小于150次/分的受试者随机进入0.5 mg阿托品剂量拮抗组(A₁),1 mg阿托品剂量拮抗组(A₁),每组10例。与泵注前(T₀),静脉泵注右美托咪定后(50±5)min(T₁),阿托品静脉推注后(10±5)min(T₂)经食道左心房调搏测定窦房结恢复时间(SNRT),校正窦房结恢复时间(CSNRT),房室结前传2∶1点阻滞点和房室结有效不应期(AVNERP)测量。结果 组内比较:泵注右美托咪定后T₁时点与基础值T₀时点比较两组窦房结及房室结功能受到抑制,SNRT 均延长(P<0.05),CSNRT比较无差异(P>0.05),房室结前传2∶1阻滞点降低(P<0.05), AVNERP延长(P<0.05)。阿托品使用后T₂时点的A₁组的各指标及A₂组的AVNERP恢复到基础水平(P>0.05),A₂组的SNRT、CSNRT均较T₀时点缩短(P<0.05),A₂组房室结前传2∶1阻滞点均较T₀时点增高(P<0.05)。组间比较:2组T₀时窦房结及房室结功能各指标比较均无差异(P>0.05),T₂时点A₂组SNRT、AVNERP较A₁缩短(P<0.01),T₂时点A₂组2∶1阻滞点均较A₁组增高(P<0.05)。结论 0.5 mg阿托品能逆转右美托咪定心脏窦房结及房室结抑制作用,1 mg阿托品增进右美托咪定影响下的窦房结及房室结传导功能。

Objective To investigate two different doses atropine make reverse effects on the function of sinus node and the atrioventricular node inhibiting action dexmedetomidine (Dex). Methods 20 healthy volunteers were included in the clinical trials aged 18~30 years (12 male, 8 female). The volunteers were administered with Dex at loading dose 1.5±0.5 μg/kg and then at 0.75±0.25 μg/(kg·h). During the trail, the volunteers who happened the minimal heart rate less than 50±5 bpm, atrioventricular node forward 2∶1 block point less than 150 bpm needed to randomly accept 0.5 mg(group A₁)or 1 mg(group A₂)atropine to antagonize(n=10). SNRT, CSNRT, AVN 2∶1 block point and AVNERP were recorded through TELAP. Results Intra-group comparison indicated functional parameters of SN and AVN were inhibited by Dexsat T₁. SNRT were prolonged (P<0.05), AVN 2∶1 block point were decreased (P<0.05),AVNERP were prolonged at T₁ compared with T₀(P<0.05). All indexes in group A₁ and AVNERP in group A₂ were back to basal level after using atropine at T₂(P<0.05). SNRT, CSNRT were shorted at T₂ compared with T₀ in group A₂(P<0.05). AVN 2∶1 block point had more increased at T₂ compared with T₀ in group A2(P<0.05). Inter-group comparison indicated no significant differences in functional parameters of SN、AVN at T₀(P>0.05). SNRT, AVNERP were shorted at T₂ in group A₂ compared with group A₁. AVN 2∶1 block point were increased at T2 in group A₂ compared with group A₁. Conclusion 0.5 mg atropine may reverse the function of SN and AVN that are inhibited by Dex. 1 mg atropine may increase functions of SN and AVN that are inhibited by Dex.

目的 探讨口服小剂量罗红霉素联合桉柠蒎肠溶软胶囊治疗慢性鼻窦炎的疗效。方法 将96例慢性鼻窦炎患者随机分为治疗组和对照组,每组48人,对照组给予口服小剂量罗红霉素片 150 mg,2次/天,治疗组在口服相同剂量罗红霉素的基础上加用桉柠蒎肠溶软胶囊胶囊300 mg,2次/天。治疗1个月与3个月后两组疗效进行比较。结果 1个月和3个月后治疗组疗效优于对照组,两组之间差异有统计学意义(P＜0.05 )。结论 小剂量罗红霉素联合桉柠蒎肠溶软胶囊治疗慢性鼻窦炎临床效果显著,且用药方便,值得向基层医院推广。

Objective To observe the effect of eucalyptol limonene and pineneELP enteric soft capsule combined with roxithromycin on chronic sinusitis in clinical treatment. Methods 96 patients with chronic sinusitis were randomly divided into two groups: 48 cases were treated with roxithromycin(150 mg twice a day),and 48 cases were treated with roxithromycin combined with ELP enteric soft capsule (300 mg twice a day). The symptoms of patients were evaluated after 1 and 3 months treatment. Results The difference was significant between the group treated with ELP enteric soft capsule combined with roxithromycin and the group treated with roxithromycin alone after 1 month and 3 months (P＜0.05). Conclusion ELP enteric soft capsule combined with roxithromycin treating chronic sinusitis not only has evident clinical effect,but also is easy,which is worth recommending to the primary hospital.

目的 观察地西他滨与小剂量CAG方案治疗白血病的短期疗效。方法 选取66例AML患者进行前瞻性研究,按随机数表法分为观察组与对照组,各33例。观察组采取地西他滨与小剂量CAG方案进行治疗,对照组采取标准CAG方案,两组接受相同的支持治疗,均治疗1个疗程。比较两组化疗结束后4周的完全缓解率(CRR)、总缓解率(ORR)、红细胞输注量、血小板输注量、抗生素应用情况、不良反应发生率。结果 观察组CRR与CRR分别为69.70%与81.82%,高于对照组39.40%与57.58%（P<0.05）。两组红细胞输注量、血小板输注量、抗生素应用次数的差异均无统计学意义（P>0.05）。两者均未见肾功能损伤与治疗相关死亡患者。两组肝功能异常与恶心呕吐总发生率的差异及血小板减少与粒细胞缺乏的严重程度均无统计学意义（P>0.05）。结论 地西他滨联合小剂量CAG方案治疗白血病可提高疗效,且不增加不良反应,是治疗AML的有效方案之一。

目的 本研究旨在采用连续气道监测法对患者呼吸力学指标进行动态观察,同时监测脑电双频指数（Bispectral index,BIS）和清醒镇静评分（The Observer's Assessment of Alertness/Sedation Scale,OAA/S）,全面系统地评估右旋美托咪定（dexmedetomidine ,Dex）对患者自主呼吸功能和镇静深度的影响,为Dex临床安全应用提供参考依据。方法 80例患者随机分为四组,Dex 0.5 μg/kg组（D₁组）,1.0 μg/kg组（D₂组）,1.5 μg/kg组（D₃组）和对照组（D₀组）,每组病人20例。麻醉诱导前35min分别静脉泵注Dex或0.9%生理盐水10 mL。记录预先给药前（T0 ）、预处理后5min（T1）、10min（T2）、15min（T3）、20min（T4）、25min（T5）和30min（T6）患者的潮气量（V_T）、分钟通气量（MV）、呼气末二氧化碳分压（P_ETCO₂）、呼吸频率（RR）、第一秒呼出率（FEV₁%）、顺应性环（PV环）、阻力环（FV环）、脉搏氧饱和度（SpO₂）、心率（HR）、平均动脉压（MAP）等呼吸力学参数和循环参数及脑电双频谱指数（BIS）及警觉/镇静评分（OAA/S）,并于T0、T1、T3和T6抽取动脉血行血气分析记录PaO₂、PaCO₂和pH值。结果 与对照组相比,D₁组的V_T、RR、MV、P_ETCO₂、FEV₁%、PaCO₂和SpO₂均无变化（P>0.05）,PV环和FV环形态基本正常;D₂组和D₃组MV分别降低16.9%和27.0%;PaCO₂分别升高11.0%和19.9%;FEV₁%分别下降11.0%和14.9%。四组患者均无发生呼吸暂停,而且所有患者SpO₂均在98%或以上。D₃组自主呼吸的PV环和FV环图形面积明显缩小（P<0.05）。D₁组BIS值均在85以上,OAA/S 4分为65%,镇静满意率低,OAA/S 3分仅20%;D₂组镇静满意率最高,OAA/S 3分达70%,且无出现过度镇静;D₃组有60%患者OAA/S评分小于或等于2。结论 静脉泵注Dex所产生的的镇静效应及其对呼吸力学的影响,随着泵注Dex剂量增大,患者镇静程度加深,虽然SpO₂仍在正常范围,但呼吸会受到一定抑制（PV环和FV环图形面积缩小,PaCO₂ 均上升）,临床推荐静脉泵注Dex剂量为0.5 μg/kg~1 μg/kg以策安全。

Objective The purpose of this study was to observe the dynamic indexes of respiratory mechanics in patients with continuous airway monitoring,and to monitor the Bispectral index （BIS） and the Observer's Assessment of Alertness/Sedation Scale （OAA/S）. We evaluated the effect of dexmedetomidine （Dex） on the autonomic respiratory function and the sedative depth of the patients in a comprehensive and systematic way,so as to provide reference for the clinical safety of Dex. Methods In the study,we randomly divided 80 patients into four groups,Dex 0.5,group g/kg （group D₁）,1 group g/kg （group D₂）,1.5 g/kg group （D₃ group） and control group （D₀ group）. There were 20 cases in each group. At about 35min before anesthesia induction,Dex or 0.9% saline 10 mL was injected intravenously. The following time points were selected： pre- administration （T0）,pre-treated 5min （T1）,pre-treated 10min （T2）,pre-processed 15min （T3）,pre-processed 20min （T4）,pre -treated 25min （T5） and pre-treated 30min. The following experimental parameters were recorded at the above time point： tidal volume （VT）,minute ventilation （MV）,end expiratory carbon dioxide partial pressure （P_ETCO₂）,respiratory frequency （RR）,first second exhalation rate （FEV1%）,compliance ring （PV ring）,resistance ring （FV ring）,pulse oxygen saturation （SpO₂）,heart rate （HR）,and respiratory mechanics parameters and circulatory parameters such as mean arterial pressure （MAP）,bispectral index （BIS） and vigilance / sedation score （OAA/S）. At the same time at T0,T1,T3 and T6,arterial blood gas was extracted,and PaO₂,PaCO₂ and pH values were recorded. Results Compared with the control group,the value of VT,RR,MV,PETCO₂,FEV1%,PaCO₂ and SpO₂ in group D₁ did not change significantly （P>0.05）,and the morphology of PV ring and FV ring were basically normal. In group D₂ and group D₃,MV decreased by 16.9% and 27% respectively;PaCO₂ increased by 11% and 19.9% respectively;FEV1% decreased by 11% and 14.9% respectively. No apnea occurred in the four groups,and all patients had SpO₂ at 98% or above. The area of PV rings and FV rings of spontaneous breathing in group D₃ was reduced （P<0.05）. The BIS values in group D₁ were above 85,OAA/S 4 was 65%,sedative satisfaction rate was low,20% patients had a score of 3 in OAA/S;group D₂ had the highest sedative satisfaction rate,70% of patients had a score of 3 in OAA/S,and no excessive sedation;60% of patients in group D₃ with an OAA/S score that was less than or equal to 2. Conclusion The sedation effect that was caused by intravenous infusion of Dex and its effect on respiratory mechanics are as follows： with the increase of Dex's dose,the degree of sedation is deepened. Although SpO₂ is still in the normal range,the respiration will be restrained （the area of PV ring and FV ring is narrowed,the value of PaCO₂ is increased）,and the clinical recommendation of intravenous infusion Dex is at a dose of 0.5µg /kg~1µg /kg for safety reasons. .

目的 探讨不同剂量右美托咪定(Dex)对腰硬联合麻醉下经皮肾镜碎石术患者的镇静效应和安全性。方法 腰硬联合麻醉下行俯卧位经皮肾镜碎石术患者80例,随机分成4组。D1组、D2组、D3组俯卧位后静脉泵注负荷剂量DEX 0.5 μg/kg,输注的时间为10min,随后分别静脉泵注DEX 0.3 μg/(kg·h)、0.5 μg/(kg·h)、 0.7 μg/(kg·h)至术毕;C组俯卧位后静脉泵注生理盐水10 mL/h至术毕。记录T0～T6共7个时点的HR、MAP、p(O₂)和BIS值;在T0、T3～T6等时点对患者静息Ramesay镇静评分;观察患者不良反应发生情况;询问综合满意度。结果 D2组和D3组的HR、MAP、BIS、Ramesay镇静评分在T3~T6等时点明显慢于C组(P＜0.05);D3组心动过缓和头晕等不良反应的发生率明显高于D1组、D2组和C组(P＜0.05),D2组和D3组术中躁动的发生率明显低于D1组和C组(P＜0.05),D1组、D2组和D3组高血压、寒战和恶心呕吐的发生率明显低于C组(P＜0.05),且综合满意度明显高于C组。结论 DEX本药物用于该类手术的镇静疗效及安全性均优于对比的药物。建议临床使用剂量为DEX负荷剂量0.5 μg/kg,随后以0.5 μg/(kg·h)维持。

目的 研究不同剂量重组人干扰素α1b雾化吸入治疗毛细支气管炎的疗效及安全性。方法 选取2016年1月—2016年9月期间我院儿科收治的年龄≤2 a的毛细支气管炎患儿86例,均符合毛细支气管炎诊断标准,随机分为观察一组(29例)、观察二组(29例)和对照组(28例)。所有患儿均给予综合常规治疗,观察一组患儿雾化吸入生理盐水+质量浓度为0.2 g/L的沙丁胺醇+1 μg/(kg·次)重组人干扰素α1b,观察二组患儿雾化吸入生理盐水+质量浓度为0.2 g/L的沙丁胺醇+2 μg/(kg·次)重组人干扰素α1b。比较三组患儿治疗有效率、临床症状改善和不良反应发生情况。结果 观察一组与观察二组在治愈率和总有效率两个方面均显著高于对照组(P<0.05),但观察一组与观察二组治愈率和总有效率比较差异不显著(P>0.05);观察一组和观察二组患儿临床症状和体征持续时间明显少于对照组(P<0.05),但观察一组和观察二组患儿临床症状和体征持续时间无显著差异(P>0.05);三组患儿不良反应发生率差异不显著(P>0.05)。结论 低剂量与高剂量雾化吸入重组干扰素α1b对于小儿毛细支气管炎临床疗效接近,且均无严重不良反应,综合经济效益和社会效益考虑,在临床上推广低剂量雾化吸入重组干扰素α1b治疗小儿毛细支气管炎更具价值。

Objective To study the effects of different doses of recombinant human interferon α1b inhalation efficacy and safety in the treatment of bronchiolitis. Methods 86 cases of children, who were less than 2 years old were selected in department of pediatrics from January 2016 to September 2016. They were randomly divided into for observation group Ⅰ (29 cases), observation group Ⅱ(29 cases) and control group (28 cases). All the patients were treated with conventional therapy. Group Ⅰ with atomization inhalation of salbutamol and 0.02% with saline+1 μg /kg times of recombinant human interferon α1b were observed and the same as in the two groups Ⅱ with atomization inhalation of salbutamol and 0.02% with saline+2 μg /kg recombinant human interferon α1b. The treatment efficiency, the improvement of clinical symptoms and adverse reactions were compared. Results The cure rate and total effective rate of observation group Ⅰand Ⅱ were significantly higher than those in the control group (P<0.05), there were no significant differences in the cure rate and total effective rate between observation group Ⅰand Ⅱ(P>0.05). The clinical symptoms and signs of the patients of observation group Ⅰand Ⅱ were significantly higher than those in the control group (P<0.05), there were no significant differences in the clinical symptoms and signs of the patients between observation group Ⅰand Ⅱ(P>0.05). There was no significant difference in the incidence of adverse reactions between the three groups (P>0.05). Conclusion There were no serious adverse reactions in low dose and high dose of atomization inhalation of recombinant interferon α1b for close to the clinical curative effect of children with bronchiolitis. Considering comprehensively economic benefits and social benefits, it is worth of promotion low dose of atomization inhalation of recombinant interferon 1b in the treatment of children with bronchiolitis.

目的 观察分析急性左心衰竭患者应用不同剂量硝酸甘油对血浆中氨基末端B型脑钠肽(NT-proBNP)的影响。方法 选取我院120例急性左心衰竭患者作为研究对象,采用随机数字表法进行分组,其中对照组给予小剂量硝酸甘油,观察组患者采取大剂量硝酸甘油,观察并比较两组患者用药后NT-proBNP的变化情况及临床疗效。结果 经不同剂量药物治疗后,观察组总有效率(96.67%)明显高于对照组(68.33%),差异有统计学意义( χ²=16.681,P＜0.05);用药前,两组患者NT-proBNP水平相近,差异无统计学意义(t=0.384,P＞0.05);用药后6 h、12 h及24 h,观察组患者NT-proBNP指标水平有明显降低,较对照组改善明显,差异有统计学意义(t=17.470、13.988、13.900,P＜0.05)。结论 在常规治疗基础上,应用硝酸甘油微泵注入,采用大剂量硝酸甘油给药治疗急性左心衰竭,可在短时间内降低患者NT-proBNP指标水平,缓解患者症状,临床效果显著。

Objective To observe and analyze the influence and significance of different doses of nitroglycerin on plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute left ventricular failure. Methods One hundred and twenty patients with acute left heart failure were randomly assigned into control group and observation group. Patients in the control group were treated with low dose of nitroglycerin, while patients in the observation group were given high dose of nitroglycerin. NT-proBNP and clinical efficacy in the two groups were observed and compared after treatment. Results After different doses of drug treatment, the overall response rate in the observation group (96.67%) was significantly higher than that in the control group (68.33%), with statistically significant difference (χ²=16.68, P<0.05). Before treatment, NT-proBNP levels were similar, without statistically significant difference (t=0.384, P>0.05). At 6, 12 and 24 hours after treatment, NT-proBNP level was obviously decreased, which was improved than the control group, there were statistically significant differences (t=17.470, 13.988, 13.900, P<0.05). Conclusion Conventional treatment combined high-dose nitroglycerin micro-injection may reduce NT-proBNP indicator levels, relieve symptoms, and have significant clinical effect in patients with acute left heart failure.

目的 观察手术前静滴不同剂量复方麝香注射液对老年患者全麻术后早期轻度认知障碍(MCI)发生的影响。方法 选择下肢与下腹部手术全麻患者120例(ASA Ⅰ-Ⅱ级),将其随机分为4组,组Ⅰ(n=30,对照),采用质量浓度为9 g/L的生理盐水100 mL静脉滴注;组II(n=30):应用低剂量复方麝香注射液(0.1 mL/kg,加入质量浓度为9 g/L的生理盐水100 mL)手术开始前0.5 h静脉滴注,其速率为200 mL/h;组Ⅲ(n=30): 应用中剂量复方麝香注射液(0.2 mL/kg), 药物配伍、治疗时间和注射速度与组Ⅱ相同;组Ⅳ(n=30):高剂量复方麝香注射液(0.3 mL/kg),用药方法同组Ⅱ。各组术前用药、麻醉诱导、术中麻醉深度、麻醉苏醒等用药与方法相同;观察各组患者术前、术后第1天、3天、7天的CCSE、FAQ、MMSE评分等。结果 4组患者手术时间、麻醉时间、术中出血量、苏醒时间基本相同(P>0.05),4组手术后第1天、3天及7天CCSE、FAQ、MMSE认知功能评分均减少, 组Ⅱ、组Ⅲ、组Ⅳ下降的变化幅度较小,得分高于组Ⅰ(P<0.05),组Ⅱ、组Ⅲ、组Ⅳ组间比较差异无统计学意义(P﹥0.05);术后第1天、3天、7天MCI发生率,组Ⅰ分别为66.7%、33.3%和16.7%;组Ⅱ为50.0%、16.7%和6.7%;组Ⅲ为50.0%、16.7%和6.7%。组Ⅳ为46.7%、20.0%和10.0%,用药组比组Ⅰ降低(P<0.05),但组Ⅱ、组Ⅲ、组Ⅳ之间无明显差异(P﹥0.05);4组术后不良反应组间比较差异无统计学意义。结论 术前静脉滴注复方麝香注射液0.1 mL/kg可有效降低老年患者全麻术后MCI的发生,增加麝香注射液剂量(0.2 mL/kg、0.3 mL/kg)对于老年手术患者MCI未见增效作用,临床选用静滴的剂量0.1 mL/kg即可。

Objective To observe the effect of different doses of compound musk injection before operation on early mild cognitive impairment (MCI) in elderly patients after general anesthesia. Methods We selected 120 cases of lower limb and lower abdominal surgery general anesthesia (ASA level Ⅰ-Ⅱ),and divided them randomly into 4 groups: Group Ⅰ (n=30,control): 0.9% saline 100mL intravenous infusion; Group Ⅱ (n=30): low dose compound musk injection (0.1 mL/kg,add 0.9% saline 100 mL), 0.5h before the start of surgery, intravenous drip, the rate was 200 mL/h; Group Ⅲ (n=30): medium dose compound musk injection (0.2 mL/kg), the same as group Ⅱ in drug compatibility,treatment time and injection rate; Group Ⅳ (n=30): high dose compound musk injection (0.3 mL/kg), the same as group Ⅱ in drug compatibility, treatment time and injection rate. Each premedication, induction of anesthesia, anesthesia depth,intraoperative awake and anesthesia medication were the same. And we observed each group about preoperative and postoperative CCSE,FAQ and MMSE(mini-mental state examination) score of the 1st days,3rd days and 7th days. Results In the 4 groups of patients,the operation time,anesthesia time,intraoperative blood loss,recovery time were basically the same (P>0.05); CCSE,FAQ,MMSE cognitive function scores of 4 groups were reduced after operation on the first day,the third day and the seventh day; group Ⅱ,group Ⅲ,group Ⅳ decreased slightly.The scores were higher than group Ⅰ (P<0.05),and there were no significant differences between group Ⅱ,group Ⅲ and group Ⅳ (P>0.05); The incidence of MCI in first days, third day and seventh day after operation respectively was: group Ⅰ 66.7%,33.3% and 16.7%; group Ⅱ 50%,16.7% and 6.7%; group Ⅲ 50%,16.7% and 6.7%; group Ⅳ 46.7%,20% and 10%.Those of the drug groups were lower than group Ⅰ (P<0.05), but there was no significant difference between group Ⅱ, group Ⅲ and group Ⅳ (P>0.05).There were no significant differences in the 4 groups in postoperative adverse reactions. Conclusion Preoperative intravenous infusion of compound musk injection 0.1 ml/kg, may effectively reduce the incidence of MCI in elderly patients after general anesthesia. Increasing musk injection dose (0.2 ml/kg,0.3 ml/kg and 0.4 mg/kg) was no synergistic effect on MCI in elderly patients,0.1ml/kg is enough.