Patient: abdominal distension with ascites and jaundice. It has been more than two months since the symptoms were discovered. Presentation Magnetic resonance imaging was performed on February 9: the liver was significantly irregular in shape with wavy changes. The foci of diffuse nodular, isometric T1 and isometric T2 abnormal signals were seen in the parenchyma, STIR showed high signal, the size of the foci varied, and the boundary was unclear. The gallbladder was enlarged, and the wall of the gallbladder was obviously swollen, with a thickening of about 21 mm at the thickest point, showing long T1 and long T2 signal changes. No enlarged lymph nodes were seen in the retroperitoneum. Summary: 1, multiple diffuse lesions in the liver, considering the possibility of liver cancer combined with intrahepatic metastasis; 2, cirrhosis, ascites, splenomegaly; 3, unsatisfactory portal vein, considering tumor thrombosis; 4, acute inflammatory changes in the gallbladder; 5, varices in the lower esophagus and fundus. Table of blood test results on February 14, 2009 Item Laboratory results Reference data Total bilirubin 191.2 0-20 Direct bilirubin 156.5 0-7 Indirect bilirubin 34.7 0-17 Glutathione 289 0-40 Glutathione 746 0-40 Alkaline phosphatase 1247 05-136 Glutamyltransferase 750 0-50 Total protein 50.8 55-85 Albumin 26.3 35-55 Globulin 24.5 20-35 Albumin-to-globulin ratio 1.07 1.2-2.3 Total bile acids 152.0 0.5-10 Creatinine 69 42-120 Cystatin c 0.97 0.35-0.75 Uric acid 349 200-400 B-microglobulin 2.01 1-2.8 Gastroscopy on February 7 showed pleural effusion, abdominal effusion, pancreatic polyps Presenting ulcer, duodenal ulcer. Please ask the following questions: 1. What kind of treatment is used to prolong life to the maximum by presenting the above symptoms? 2.If I can’t go to a big hospital for financial reasons, what measures should I take to prolong my life nearby? I hope the experts will suggest the best treatment plan. Doctor: It’s a bit of a pity that the patient should have been seen earlier, because looking at her labs, her clinical symptoms should have appeared very early, and should have included at least one or two months of weakness, loss of appetite, jaundice, edema, etc. The disease was not diagnosed until now, which makes treatment very difficult. I think just treat it in a regular hospital in Jiaozuo, including liver preservation therapy, albumin or plasma supplementation to reduce edema, immunotherapy and some nutritional therapy. After the patient’s physical condition has improved, other tumor-specific treatments will be considered. Patient: Dr. Zheng: Hello! The results of the last blood test provided are one week after treatment. Before treatment, the total bilirubin was 100.2, but after one week of treatment, it was almost twice as high instead of coming down. Glutathione and glutathione aminotransferase decreased by 20-30 after one week of treatment, but the effect was not obvious. The doctor said there is no better way to restore liver function as soon as possible so that the next step of treatment can be taken. I hope Dr. Cheng can provide a good treatment to save my mom. Thank you on your knees! Doctor: I understand your feelings, but at this point in the disease, there should not be many methods that can be used. The first thing you need to do is to follow the treatment ideas that I have provided and treat it for a while and then see. You have to wait for a while to get better. Patient: I will listen to you, and I will contact you if there are any changes. Thank you! Patient: Dr. Cheng: Hello! What is the best way to relieve my mother’s pain of bloating? It is very difficult to pass urine and stool. I’m looking forward to hearing from you! Doctor: You can take some medications to promote gastrointestinal motility, such as morbutine. Let the patient get out of bed and move around if possible, or move passively in bed. Eat more fruits and vegetables and other easy-to-digest foods.