Objective To investigate the effect of ultrasound-guided serratus plane block onefficacy of postoperative analgesia in patients undergoing radical mastectomy. Methods From January 2013 to December 2016, sixty-eight ASA physical statusⅠorⅡ patients scheduled for radical mastectomy under general anesthesia were randomly divided into two groups (n = 34 each): SP block group (observation group) and control group. After induction of anesthesia, ultrasound-guided homolateral SP block was performed, and 0.375% ropivacaine 20 ml was injected in observation group, while the equal volume of normal saline was used instead in control group. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation in two groups. The scores of prince henry pain scale (PHPS) were evaluated at the 2nd, 4th, 8th, 12th and 24th hour (T1, T2, T3, T4, T5) after operation. The consumption of sufentanil, propofol and remifentanil was recorded.Meantime, the times of successfully delivered doses (D1) and attempts (D2) within 24 h after operation were added up, and D1/D2 was calculated. The adverse effects were also recorded. Results The scores of PHPS at T1 [(1.4 ± 0.5) scores vs. (3.1 ± 0.6) scores], T2 [(1.5 ± 0.6) scores vs. (2.9 ± 0.8) scores], T3 [(1.7 ± 0.5) scores vs. (2.8 ± 0.7) scores], and the consumption of sufentanil [(53.4 ± 16.7)μg vs. (87.8 ± 24.5)μg], remifentanil[(288.7 ± 42.1)μg vs. (376.5 ± 61.6)μg] were significantly lower in observation group than those in control group, while D1/D2 (0.89 ± 0.12 vs. 0.57 ± 0.18) was higher (P<0.05). The incidence of adverse reactions was significantly lower in observation group: 0 vs. 20.6% (7/34), P<0.05. Conclusions Ultrasound-guided SP block reduces the perioperative opioids consumption and enhances the efficacy of postoperative analgesia in patients undergoing radical mastectomy.

Objective:To explore the application status and development trend of massive open online course (MOOC) in the field of higher medical education in China, so as to provide the reference for future research in this field.Methods:The related literatures collected from China National Knowledge Infrastructure (CNKI), Wanfang Data service platform, VIP database and China Biology Medicine disc were searched from their inception to March 1st, 2020, and the statistical analysis was carried out on the annual volume, journal distribution, fund support, author distribution, cited frequency, literature type and high-frequency keywords by using the bibliometrics method. The extracted data was set up in Excel 2010, and descriptive statistics was made by frequency analysis.Results:The study collected 754 articles, which were included in 262 journals, mainly medical education journals. The funding rate reached 50%. Huang Ping, Zhang Xin, Li Xinhui and seven others were core authors. Basic medical curriculum application research represented by human anatomy was the most. MOOC application research focused on theoretical curriculum. The curriculum evaluation included such five aspects as terminal evaluation, formative evaluation, platform assessment, comprehensive ability and autonomous learning ability. The research focus was the mixed teaching mode based on MOOC and its application in nursing education, traditional Chinese medicine education and continuing medical education.Conclusion:In the past five years, MOOC has developed rapidly in China's higher medical education, and the core authors have formed, but there is a lack of in-depth cooperation. In the future, we should increase the applied research of experimental (training) courses, and further improve the design of experimental research and curriculum evaluation system.