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 investigate the effects of sevoflurane preconditioning on the expression of pulmonary angiotensin converting enzyme (ACE) mRNA in lung tissues during lung ischemia-reperfusion (I/R) in rats.Methods Fifty-four male Sprague-Dawley rats,weighing 250-320 g,were randomly divided into 3 groups (n =18 each):sham operation group (group S),I/R group and sevoflurane preconditioning group (group SP).The animals were anesthetized,tracheostomized and mechanically ventilated.Lung I/R was induced by clamping the left pulmonary hilum for 45 min followed by 120 min reperfusion in groups I/R and SP.While the left pulmonary hilum was only isolated but not ligated in group S.2.1％ sevoflurane was inhaled for 30 min,and lung I/R was induced 10 min after the end of inhalation in group SP.Six rats in each group were chosen at 30,60 and 120 min of reperfusion and sacrificed,lungs were removed for determination of wet/dry lung weight (W/D) ratio,MPO activity (by colorimetric method) and the expression of ACE mRNA (by RT-PCR) and for microscopic examination in lung tissues.Results Compared with group S,the W/D ratio,MPO activity and expression of ACE mRNA were significantly increased in groups I/R and SP (P ＜ 0.05).Compared with group I/R,the W/D ratio,MPO activity and expression of ACE mRNA were significantly decreased in group SP (P ＜ 0.05).Microscopic examination showed that the pathologic changes were significantly attenuated in group SP compared with group I/R.Conclusion Sevoflurane preconditioning can reduce lung I/R injury through downing-regulating the expression of ACE mRNA in rats.

Objective To prevent phenomena of using Radix Ginseng (dry Radix Ginseng and white sugar Radix Ginseng) instead of Panax quinquefolium L. and to avoid the occurrence of side effects. Methods Panax quinquefolium L and Radix Ginseng were distinguished by their characters and fluorescence identification. Results Fluorescence color was observed by using ultraviolet lamp (254 nm) under the light-shading condition. The hadromestome of Panax quinquefolium L showed amethyst fluorescence, the dry Radix Ginseng showed blue fluorescence, and the white sugar Radix Ginseng showed bright blue fluorescence. Conclusion Fluorometric method can be used to identify Panax quinquefolinm L and Radix Ginseng, This method is simple and easy for spread.

ObjectiveTo investigate the effect of sevoflurane anesthesia in the neonatal period on cognitive function and acetylcholinesterase(AChE) activity in hippocampus in developmental stages in rats.Methods Eighty 7 day-old SD rats weighing 12-16 g were randomly divided into 5 groups( n ＝ 16 each):groups A and B inhaled 3 ％ sevoflurane in oxygen for 6 and 2 h respectively; groups C and D inhaled 1.5 ％ sevoflurane in oxygen for 6 and 2 h respectively; group E inhaled oxygen only.The cognitive function was assessed using Morris water maze test in weaning period(16-21 day-old) and sexual maturity period (55-60 day-old) respectively.The rats were sacrificed at 30 min after Morris water maze test was finished at 21 and 60 d after birth,and the hippecampus were removed for determination of AChE activity using colorimetry method.ResultsCompared with group E,escape latency was prolonged during 17-20 d after birth in group A,and at 18,19 d after birth in groups B and C,and at 18 d after birth in group C,and AChE activity increased at 21 d after birth in group A( P < 0.05 or 0.01 ).Compared with group A,escape latency was shortened at 19,20 d after birth,and AChE activity decreased at 21 d after birth in groups B and C( P < 0.05 or 0.01).Compared with groups B and C,escape latency was shortened at 19,20 d after birth in group D( P < 0.05).There were no significantly differences in probe time in original platform quadrant,frequency of crossing the original platform and AChE activity at 60 d after birth and escape latency during sexual maturity period among the 5 groups( P ＞ 0.05).ConclusionSevoflurane anesthesia in the neonatal period can reversible decrease the congnitive function in developmental stages in rats in concentration and time dependent manners,and the mechanism may be related to increasing the AChE activity in hippocampus.

Objective Tc explore the value of application of Sevoflurane anesthesia induction in anesthesia management of foreign matter removal from trachea in children.Methods Sixty five cases of children with tracheal foreign matter related in our hospital from January 2015 to December 2016 were selected as the study objects,and were divided into two groups according to random number table method.The control group of 32 cases was given 2.5 mg/kg propofol to induce anaesthesia,and the observation group of 33 cases was given 8％ Sevoflurane inhalation to induce ancsthesia.One shot success rate,deoxygenation time,operation time,recovery time and the relative parameters (systolic pressure,diastolic pressure,respiratory rate and pulse oxygen saturation) at entrance time,before and after setting the mirror were contrasted and analyzed,and the intraoperative and postoperative adverse reactions were recorded in the two groups.Results There were no significant differences in respiratory rate,blood oxygen saturation,systolic blood pressure and diastolic blood pressure between two groups at entrance time and before setting the mirror (P ＞ 0.05).The respiratory rate and blood oxygen saturation of the observation group were higher than those of control group after setting the mirror and at withdrawing mirror time,with statistically significant differences (P ＜ 0.05).No statistically significant differences in other indexes (P ＞ 0.05).Deoxygenation time,operation time and recovery time of the observation group were significantly lower than those in the control group (P ＜ 0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusions Sevoflurane anesthesia induction can obviously shorten operation time and recovery time in foreign matter removal from trachea in children,and reduce the incidence of intraoperative and postoperative adverse reactions.It has good clinical effect.

Objective To evaluate the influence of sevoflurane anesthesia on the expression of growth-associated protein 43 (GAP-43) and neural cell adhesion molecule (NCAM) in hippocampal neurons of neonatal rats.Methods Thirty-six pathogen-free Sprague-Dawley rats,aged 7 weeks,weighing 15-20 g,were randomly divided into 4 groups (n =9 each) using a random number table:control group (C group),1.5％ sevoflurane 6 h group (L group),3％ sevoflurane 2 h group (H1 group) and 3％ sevoflurane 6 h group (H2 group).Group L inhaled 1.5％ sevoflurane in oxygen for 6 h.H1 and H2 groups inhaled 3％ sevoflurane in oxygen for 2 and 6 h,respectively.Group C inhaled 30％ oxygcn only.When the neonatal rats were 14 days old,the rats underwent Morris water maze test for 7 consecutive days.Place navigation and spatial probe tests were carried out.After the end of Morris water maze test,the rats were sacrificed,and the hippocampus was obtained for determination of the expression of GAP-43 and NCAM in hippocampal neurons.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,and the expression of GAP-43 was down-regulated in L,H1 and H2 groups,and the frequency of crossing the original platform was decreased in L and H2 groups.There was no significant difference in NCAM expression among the four groups.Conclusion The mechanism by which sevoflurane anesthesia decreases the cognitive function may be related to down-regulated expression of GAP-43,but not related to NCAM expression in hippocampal neurons of neonatal rats.

Objective To evaluate the effects of sevoflurane preconditioning and postconditioning on the activity of NF-κB during lung ischemia-reperfusion (I/R) in rats.Methods Fifty-four adult male Sprague-Dawley rats,weighing 300-350 g,were randomly divided into 3 groups (n =18 each) using a random number table:sham operation group (S group),I/R group and sevoflurane preconditioning and postconditioning group (SPP group).Lung I/R was induced by clamping the left pulmonary hilum for 45 min followed by 120 min reperfusion in I/R and SP groups.The left pulmonary hilum was only isolated but not ligated in group S.In group SP,2.1％ sevoflurane was inhaled for 30 min followed by 10 min washout,the left pulmonary hilum was then ligated for 45 min,and 2.1％ sevoflurane was inhaled for 30 min again starting from onset of reperfusion.Six rats were chosen at 30,60 and 120 min of reperfusion and sacrificed in each group,lungs were removed for determination of wet/dry lung weight (W/D) ratio and content of tumor necrosis factor-α (TNF-α) (by ELISA) and expression of nuclear transcription factor κB (NF-κB) p65 of nuclear protein (by Western blot) and for microscopic examination of the pathologic changes of lungs (with light microscope).Results Compared with S group,W/D ratio,TNF-α content and nuclear protein NF-κB p65 expression in lung tissues were significantly increased at each time point of reperfusion in I/R and SPP groups.Compared with I/R group,W/D ratio,TNF-α content and nuclear protein NF-κB p65 expression in lung tissues were significantly increased at each time point of reperfusion,and the pathological changes of lungs were attenuated in SPP group.Conclusion Sevoflurane preconditioning combined with postconditioning can reduce the lung I/R injury in rats through inhibiting NF-κB activity in lung tissues.

OBJECTIVE:To provide references for the legislation of Licensed Pharmacist Legislation. METHODS:Several misunderstandings appearing during the complementation of licensed pharmacist regulation were analyzed, as well as the reasons for these misunderstandings. RESULTS&CONCLUSION: The misunderstandings in the respect of legislative subjects, licensed posts, licensed treatment, talent market demand and further education should be avoided in the process of Licensed Pharmacist Legislation.

Objective:To investigate the changes of plasma moderate molecule substance (MMS)level in pediatric patients with congenital heart disease during open heart surgery. Method: Siteen cases were studied. Blood samples were taken before anesthesia, after tracheal intubtion, after sternotomy. and rewarming during cardiopulmonary bypass, to measure the plasma MMS levels with ultraviolet absorption spectrophotometry. Result: As compared with that before anesthesia, the MMS levels after tracheal intubtion,sternotomy,and rewarming during cardiopulmonary bypass were significantly elevated(P

Objective To investigate the effects of remifentanil on sinoatrial (SA) node autorhythmicity in rabbits.Methods Twenty-four healthy rabbits of both sexes weighing 1.8-2.2 kg were sacrificed.Their hearts were removed and sinoatrial nodes were dissected and placed in Tyrode solution saturated with 95 ％ O2-5 ％ CO2 at 36 ℃.The action potentials of the sinus node pacemaker cells were recorded by intracellular glass microelectrode technique.The experiment was performed in 3 parts (n =8 each).Part Ⅰ:the sinoatrial node was exposed to remifentanil 2,4,8,16 and 32 ng/ml respectively.The action potentials were recorded after the sinoatrial nodes were exposed to each concentration of remifentanil for 15 min.Part Ⅱ and Ⅲ:the sinoatrial nodes were first exposed to Ca2+ channel agonist Bay K8644 0.5 μmol/L or K+ channel blocker TEA 20 nmol/L for 15 min.Then remifentanil was added until the concentration reached 16 ng/ml (final concentration) and 15 min later the action potentials were recorded.The action potential parameters included,amplitude of action potential (APA),rate of pacemaker firing (RPF),action potential duration at 90％ repolarization (APD90) and velocity of diastolic depolarization (VDD).Results Remifentanil significantly decreased,APA,RPF,VDD and prolonged APD90 in a concentration dependent manner as compared with the baseline values.Pretreatment with Bay K8644 could block the effects of remifentanil on SA node pacemaker cells,while TEA did not affect the electrophysiologic effects of remifentanil on SA node pacemaker cells.Conclusion Remifentanil exerts a negative chronotropic action on SA node pacemaker cells.These effects are likely produced by decrease in Ca2+ current,while opening of K + channels is not involved in these effects.