Mastering peripheral nerve block technique is a basic requirement for residents stan-dardization training. Ultrasound-guided nerve block has broken through the limitation of traditional blind operation, promoted the quality and safety of anesthesia, and improved the quality of the peripheral nerve block teaching. However, the safety of ultrasound-guided nerve block technique must be based on the speci-fication training. In the teaching experience, we have used theoretical study, simulation training and clinical practice to explore a new method for upgrading the quality of resident doctor training.

Objective To evaluate the clinical effect of controllable blood pressure depression in combination with acute hypervolmic hemodilutien (AHH) during operation. Methods 40 patients with esophageal or cardiac carcinomas were randomly divided into controllable blood pressure depression in combination with AHH group(group I)and control group (group Ⅱ), each group containing 20 patients. MAP, CVP and HR were monitored during operation. And Hb,Hct and Plt were aslo monitored before operation, 1h after AHH and 24h after operation. The volume of solution infusion,blood loss and blood transfusion were recorded during operation. Results MAP after operation in group I was significantly lower than that before operation in groups I and Ⅱ(P

Objective:To clarify the treatment effects of T4K on Class II division 1 malocclusion.Methods:Twenty patients (10 girls and 10 boys) aged 8~10 years old with Class II division 1 malocclusion were treated with T4K appliance(Myofunctional Research Co., Queensland, Australia).A control group of 20 patients aged 9~11 years old with untreated Class II division 1 malocclusions was used to eliminate the possible growth effects. Lateral cephalograms were taken before and after treatment. Final cephalograms were taken (12.1?1.8) months after T4K application.The subjects in control group were observed for (11.2?2.1) months.The mean and standard deviations for cephalometric measurements were analyzed by paired-samples and independent-sample t-tests. Results:In the treated subjects significant changes including anterior rotation and sagittal growth of the mandible, increased SNB and facial height, reduced ANB, increased lower incisor proclination, upper incisor overjet reduction were observed.Conclusion:T4K appliance is effective in the treatment of class II division 1 malocclusion.

6 OSAS patients wore the appliance. Polysomnographic monitoring and cephalometric analysis were performed before and after treatment to analyze the effect of the appliance. With the appliance on after one month, the patients felt better. The values of AHI decreased significantly(P<0.01), and the lowest SaO_2 increased significantly(P<0.01).Cephalometric analysis showed a widened airway(P<0.05)after treatment. The results showed that TMJ appliance is an easy and effective treatment of OSAS.

Objective To investigate the expression and prognostic role of ADP-ribosylation factor 6 (ARF6) in human endometrial carcinoma.Methods 51 endometrial carcinoma tissues and matched tumor-adjacent tissues were collected from Jan.2010 to Dec.2011 in People's Hospital of Linzi District of Zibo City and Penglai People's Hospital.mRNA expression of ARF6 was detected by qRT-PCR,and the protein expression of ARF6 was detected by immunohistochemistry.The correlation between ARF6 and clinicopathological features was analyzed by chi-square test,and the Kaplan-Meier survival curves were drawn to describe the prognostic effects of ARF6 expression.Results Both mRNA and protein expression of ARF6 were down-regulated in endometrial carcinoma tissues than those in matched tumor-adjacent tissues (P＜0.05).Positive expression of ARF6 was associated with lynphatic metastasis (P＜0.05) and advanced TNM stage (Ⅲ+Ⅴ,P＜0.05).Both the 3-year overall survival rate and disease-free survival rate were lower in ARF6 positive expression group than in ARF6 negative expression group(P＜0.05).Conclusion Positive expression of ARF6 in human endometrial carcinoma is related to the malignant clinicopathological features and poor prognosis.

Objective:To explore the effects of lanthanum nitrate low-dose on 2 type diabetic rat pancreas INSR ,IRS1 and apoptosis of cells.Methods:The 50 male Wistar rats were randomly divided into normal control group (10) and model group(40),and were given normal diet and high-fat high-sugar diet.After 8 weeks,making the module intraperitoneal injection of streptozotocin (STZ,30 mg/kg) rats to induce type 2 diabetes model ,after a successful modeling experimental animals were divided into three groups namely the control group,diabetic model group and La(NO3)3 treatment group,three groups of rats were given daily saline,saline,lanthanum (0.2 mg/kg) nitrate administered a month ,then were sacrificed blood and pancreas.By radioimmunoassay to detect glucose ,insulin levels(in rat serum);by ELISA to detect the protein content of INSR and IRS 1(in rat serum);by immunohistochemistry to detect the protein expression levels of INSR and IRS1(in rat pancreas tissue);TUNEL apoptosis detection kit was used to detect pancreatic tissue percentage of apoptosis;HE staining was used to detect pathological changes of the pancreas.Results: Compared with the normal control group,diabetic model rats blood glucose and pancreatic tissue apoptosis rate were significantly increased ,blood insulin,INSR and IRS1 protein content and pancreatic tissue the protein expression levels of INSR and IRS 1 were significantly reduced ,difference was statistically significant ( P<0.01 );La( NO3 ) 3 treatment group blood glucose and pancreatic tissue apoptosis rate were slightly elevated ,blood insulin , INSR and IRS1 protein content and pancreatic tissue the protein expression levels of INSR and IRS 1 were slightly reduced significantly(P<0.05);Light microscopy showed pancreatic tissue in the control group closely arranged ,plump,large volume islet pancreatic tissue of diabetic rats in groups evacuate more smaller islet volume ,pancreatic tissue lanthanum nitrate basic set tight,plump,slightly islet volume small.Conclusion:Oral lanthanum nitrate can be lowered blood sugar levels and inhibiting apoptosis of pancreatic tissue ,increased insulin levels and the protein expression levels of INSR and IRS 1 in pancreatic tissue ,have a protective effect on diabetic rat pancreas .

Objective:Guanxinshutong on cerebral ischemia reperfusion ( I/R) in rats learning and memory ability and brain Bcl-2,Bax protein expression to explore the protection mechanisms of Guanxinshutong on cerebral I /R injury in brain tissue.Methods:Healthy Wistar rats for the study were randomly divided into sham operation group ,I/R model group,high dose Guanxinshutong (1 g/kg) and low dose Guanxinshutong (0.5 g/kg) group,n=15.cerebral I/R model was estabhished by using the left commom cartid artery ligation method,modeling each group were fed daily before saline ,saline,Guanxinshutong (1 g/kg) and Guanxinshutong (0.5 g/kg), continuous 7 days;3 d after water maze training while continuing administration ,continuous 7 d,the eight day ,Morris water maze test;after the test,the rats were sacrificed blood and brain tissue ,serum by ELISA of Bcl-2 and Bax protein levels change;using HE staining of rat brain pathology;using immunohistochemistry assay in rat brain organization of Bcl-2 and Bax protein levels changes.Results:Compared with the sham group ,Guanxinshutong high-dose group test latency slightly longer timers after platform and platform quadrant dwell decreased slightly ,serum and brain tissue slightly elevated levels of Bax protein ,Bcl-2 protein levels decreased slightly but not significantly different ( P>0.05 ) ,low-dose group Guanxinshutong through latency test in rats ,after the number of platforms and platform quadrant dwell time decreased , serum and brain tissue elevated levels of Bax protein , Bcl-2 protein content decreased significantly different(P<0.01),cerebral I/R model group was significantly prolonged latency test ,after the number of platforms and platform quadrant dwell time significantly reduced serum and brain tissue was significantly increased Bax protein ,Bcl-2 protein content decreased with significant differences ( P<0.01 ).Conclusion: Guanxinshutong can significantly improve spatial memory , and by reducing Bax protein content and increased Bcl-2 protein,inhibition of cerebral I/R injury of apoptosis,and thus the brain tissue I/R has a protective effect.

Objective To compare the response of haemodynamics and intraocular pressure (IOP) to laryngeal mask airway (LMA) and tracheal intubation (TT) in children with glaucoma.Methods A prospective,randomized study was conducted in 50 glaucomatous children,scheduled to undergo trabeculectomy and divided into LMA group (25 cases) and TT group (25 cases) by random digits table method.Endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam was noted in each patient.Heart rate (HR),mean arterial pressure (MAP),tip perfusion index (TPI),IOP were measured after anesthesia induction (T1),endotracheal intubation or placement laryngeal mask immediately (T2),endotracheal intubation or placement after laryngeal mask 1 min (T3),2 min (T4),3 min(T5),5 min(T6).Results There was no significant difference in endotracheal intubation or placement of the laryngeal mask operation time and the dosage of midazolam between two groups (P ＞ 0.05).Compared with T1,HR,IOP were increased at T2-T4,MAP was increased at T2-T3,TPI was decreased at T2-T5 in TT group,there was significant difference(P ＜ 0.05).There was no significant difference in HR,MAP,TPI,IOP among different points in LMA group (P ＞ 0.05).HR,MAP,IOP in LMA group at T2-T4 were lower than those in TT group [HR:(119.3 ±8.9),(117.6 ±8.5),(115.2 ±6.9) beats/min vs.(131.3 ±7.1),(128.1 ±6.8),(123.2 ± 8.6)beats/min,MAP:(36.9 ± 5.1),(37.1 ±4.8),(34.7 ±4.6) mmHg (1 mmHg =0.133 kPa) vs.(44.1 ± 4.9),(42.8 ± 5.5),(41.9 ± 7.1) mmHg,IOP:(27.6 ± 2.5),(27.0 ± 2.0),(25.9 ± 2.3) mmHg vs.(34.2 ± 2.2),(32.9 ± 1.6),(31.1 ± 2.2) mmHg],TPI at T2-T5 was higher than that in TT group (3.25 ± 0.28,2.99 ± 0.26,3.15 ± 0.31,3.40 ± 0.30 vs.2.69 ± 0.29,2.22 ± 0.27,2.41 ± 0.30,2.66 ± 0.33),and there was significant difference (P ＜0.05).Conclusion Insertion of LMA in glaucomatous children is not associated with significant changes in haemodynamics and IOP response and offers advantages over tracheal intubation.

Objective To evaluate the role of delta and kappa opioid receptors in sufentanil preconditioning (SPC)-induced attenuation of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Forty adult male Sprague-Dawley rats,aged 2-3 months,weighing 250-330 g,were randomly divided into 5 groups (n =8 each) using a random number table:sham operation group (group S),group I/R,group SPC,δ receptor antagonist naltrindole + SPC group (NTD + SPC group),and κ receptor antagonist nor-binaltorphimine (nor-BNI) + SPC group (BNI + SPC group).Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion.In group SPC,5 min infusion of sufentanil 3μg/kg was repeated 3 times at 5 min interval before myocardial ischemia.In NTD + SPC group,naltrindole 5 mg/kg was intravenously injected,at 10 before SPC.In BNI + SPC group,nor-BNI 5 mg/kg was injected intravenously at 15 min before SPC.Arterial blood samples were collected at 120 min of reperfusion for measurement of the serum cardiac troponin I (cTnI) and creatine kinase isoenzyme-MB (CK-MB) concentrations.The rats were then sacrificed and hearts removed for determination of myocardial infarct size (IS) and area at risk (AAR).IS/AAR ratio was calculated.Results Compared with S group,the serum cTnI and CK-MB concentrations were significantly increased in I/R,NTD + SPC and BNI + SPC groups,and the serum CK-MB concentrations were increased in SPC group,and IS/AAR ratio was increased in I/R group (P ＜ 0.05 or 0.01).The serum cTnI and CK-MB concentrations were significantly lower in SPC,NTD + SPC and BNI + SPC groups and IS/AAR ratio was lower in SPC and BNI + SPC groups than in I/R group,and higher in NTD + SPC and BNI + SPC groups than in SPC group (P ＜ 0.05 or 0.01).Conclusion Both κ and δ opioid receptors mediate SPC-induced attenuation of myocardial I/R injury in rats.

Objective To investigate the application of admission test as a medical management in the labor room.Methods Eight hundred and fifty singleton pregnant women underwent admission test in labor room at Women's Hospital,School of Medicine,Zhejiang University from Dec.2009 to Dec.2011 were enrolled into this study.They were divided into two groups:normal group (admission test was normal,n =658) and abnormal group (admission test was abnormal or undetermined,n =192).Deliveries and perinatal outcomes of them were observed.The difference between the two groups were compared with two independent sample t test and Chi-square test.Results There were no significant differences in the mean age at delivery of the women and mean birth weight of neonates between the two groups (all P＞0.05).The cesarean section rate of normal group (34.2％,225/658) was lower than that (59.4％,114/192) of abnormal group (x2=3.93,P＜0.05).The rates of prematurc rupture of membranes (72.4％,139/ 192),fetaldistress (42.2％,81/192),neonatal asphyxia (16.5％,27/192) and neonatal complications (31.8％,61/192) in abnormal group were significantly higher than those [31.0％ (204/658),24.2％ (159/ 658),0.2％(1/658) and 2.6％ (17/658)] in normal group (x2 =105.78,40.84,52.54 and 151.92,P＜0.01respectively).Conclusions Admission test is a good method to forecast placental function during labor and perinatal outcomes,which might play an important role in medical management in labor room.