Peripheral nerve block technique is one of the basic skills necessary to residents and it is also one of the difficult points in the resident standardized training in the department of anesthesiology. In order to maximize the learning effect of the anesthesia professional residents in the case of limited number of cases, we need to constantly enrich the teaching technologies and teaching methods. Human 3D anatomy is used for theory teaching to maintain comprehension of nerve anatomy; Ultrasound-guided nerve block technique and ultrasound simulation training are used for nerve block practice to improve nerve block skills;Problem-based learning teaching method is introduced in nerve block cases to increase the residents' ability of clinical cases management.

Objective To introduce the nursing care of severe asthma patients treated by sedatives and muscle relaxants combined with mechanical ventilation. Methods Nurses with more than 3 years of working experiences in respiratory intensive care unit participated in the nursing care,such as ventilation monitoring,sedative effect assessment and artificial airway management. Results All the 18 patients were treated successfully,and the duration of mechanical ventilation ranged from 6 to 192 hours. The indicators of circulation and arterial gas after weaning were improved significantly (P<0.01). Conclusion Proper nursing care and correct sedative effect assessment is an important point to ensure treatment efficacy and reduce complications for severe asthma patients treated by sedatives and muscle relaxants combined with mechanical ventilation.

Objective To analyze the diagnostic process of a rare case of acute myeloid leukemia with minimal differentiation undergoing a lineage switch to mixed phenotype acute leukemia, NOS-rare types,and to investigate its difference from other acute myeloid leukemia and mixed phenotype acute leukemia. Methods Following tests were performed on the patient with switched mixed phenotype acute leukemia and three control leukemia patients ( including two acute myeloid leukemia with minimal differentiation and one mixed phenotype acute leukemia ). Cell morphology was analyzed by bone marrow smear and related cell chemical staining. Immunophenotyping of bone marrow was performed by flow cytometry ( FCM ). G-banding technique was used for karyotype analysis and RT-PCR was used for fusion gene detection. All the laboratory data of the switched patient were compared to that of three control patients in order to reveal the characteristics of such a rare phenotype switch in acute leukemia. Results Before switching, the morphology of acute myeloid leukemia with minimal differentiation demonstrated 0.82 blasts occurring in bone marrow, distinct nucleoli and absence of Auer rods. Blast cells expressed hematopoieticassociated antigens ( CD38, HLA-DR ), myeloid antigens ( CD13, CD56, CD11b ) and CD7. And these blasts were negative for MPO, CD33, CD15, CD79, CD19, CD22, cytoplasmic CD3, CD4 and CD8. After switching, 0. 42 blasts were found in bone marrow, showed eosinophilia and presence of basophile. Blast cells expressed hematopoietic-associated antigens ( CD38, HLA-DR ), myeloid antigens ( MPO, CD13 ),lymphoid antigens ( CD19, CD79a ,cytoplasmic CD3, and CD7 ). The control group showed typical morphology and immunophenotyping. No abnormal karyotype and fusion gene were detected. Conclusions It is a rare and complicated case that acute myeloid leukemia with minimal differentiation switched to mixed phenotype acute leukemia, NOS-rare types. The laboratory features, especially the change of immunophenotyping play an important role in the diagnosis.

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Objective Knowledge about the infiltration of macrophages in diabetic wounds can help to figure out the pathogene -sis of poor healing of diabetic wounds .The aim of this study was to observe the macrophage infiltration and the expression of relative in-flammatory factors during the wound healing of diabetic rats and explore the relationship between macrophages and diabetic wound heal -ing. Methods Male Sprague Dawley rats were randomly divided into STZ induced diabetic group and normal control group .Each group had 15 rats.A 1 cm2 full-thickness skin defect was created on the rat dorsum .Wound samples and was excised .On post injury day (PID) 3, 7, and 14, rats of each group were sacrificed after wound samples and tissues around the wound edge were obtained .The differences of the wound closure rate , macrophage infiltration and the relative mRNA expression of the inflammatory factors from macro-phages were observed . Results The wound closure rate was lower in diabetic group on PID 3, 7, and 14 ([29.5 ±5.4]%vs [45.9 ± 12.8]%, [71.6 ±3.1]%vs [80.1 ±6.9]%, [93.9 ±2.8]%vs [99.4 ±1.4]%, P<0.05).HE staining showed inflammatory cells infil-diabetic wound tissue on PID 3 (P<0.05) and a higher expression on PID 14 (P<0.05).The CCR7 fluorescence staining showed more positive staining cells stayed in diabetic wound on PID 14. Conclusion Macrophage infiltration decreases in the early phase of diabetic wound healing and sustains in wound tissue in advanced stage accompanied by the expression change of related inflammatory factors, which could contribute to the difficult wound healing of diabetic rats .

Objective To study the antitumor effect and the mechanism of the polysaccharide from Gloipeltis furcata on H_(22),tumor bearing mice.Methods The polysaccharides from Gloipeltis furcata were administered by oral route in mice bearing H_(22) tumor.The treatments lasted for 7 days.The inhibition rate against H_(22) tumor and the indices of thymus, spleen and liver were measured.In addition,the levels of antibodies against H_(22) tumor and GPT in serum,and GPT,GOT,MDA and SOD in liver were measured using commercially available kits.Results The administration of the polysaccharides from Gloipeltis furcata(200 mg?kg~(-1)?d~(-1) and 400 mg?kg~(-1)?d~(-1) ) for 7 days,the inhibition rates of H_(22) tumor were 35.64%(P

We carried out a questionnaire survey on the career planning situation of pharmacy postgraduate students at Peking university, so as to collect information for career planning education of pharmacy postgraduate students, which is expected to promote their employment on completion of degree. by. The results revealed the status quo of career planning and the demand for guidance in this aspect. Recommendations for career planning education of pharmacy postgraduate students were made thereby.

Objective To observe the change of brain iron content in deep gray nucleus using susceptibility weighted imaging (SWI) in patients with Parkinson's diseases (PD). Methods The SWI examination was performed in 40 PD patients (10 patients with Hoehn-Yahr stage Ⅰ , 9 patients with Hoehn-Yahr stage Ⅱ , 9 patients with Hoehn Yahr stage Ⅲ , 6 patients with Hoehn-Yahr stage Ⅳ, 6 ptients with Hoehn Yahr stage Ⅴ ) and 33 gender- and age- matched controls, after conventional brain magnetic resonance imaging examination on a 3.0T magnetic resonance imaging.The signal values of substantia nigra zona compacta (SNc), substantia nigra zona reticulate (SNr),red nucleus (RN), putamen (Pu), globus pallidus (GP) and caudate nucleus (CN) were assessed.Results Compared with the controls, the PD patients had statistically significance of signal value differences of SNc (P=0.002), SNr (P=0.043). RN (P= 0.003), Pu (P=0.023). GP (P=0.001) andCN (P=0.033). The more significant differences of SNc(P=0.001), SNr (P=0.010),RN (P＜0. 001 ), Pu (P=0. 008), GP (P＜0. 001) and CN (P=0. 011) were observed between more severe PD lesion and control. The signal values of SNc and GP showed obviously negative correlations with Hoehn-Yahr grading (SNcr=-0.943. P＜0.001; GPr=-0.923, P＜0.001). But there was weakly correlation of the signal values of SNr, RN, Pu, CN with Hoehn Yahr grading (SNr r=0. 496. P=0.001; RN r=-0. 480. P=0.002; Pu r=-0. 494, P=0.001; CN r=-0.471, P=0.002) Conclusions Measurement of the brain iron content of SNc and GP using SWI on MRI is a reliable means of diagnosing PD, and it has significant correlation with Hoehn-Yahr grading, It could evaluate the severity of PD.

Objective To explore the effect of antinuclear antibody ( ANA+dsDNA),extractable nuclear antigen (ENA) and antineutrophil cytoplasmic antibody (ANCA) on the clinical manifestation and cerebrospinal fluid characteristics of neuromyelitis optica (NMO).Methods All 41 patients with NMO in PUMC hospital from 1985 to 2009 were retrospectively reviewed.All patients underwent examination of serum ANA+dsDNA,ENA and ANCA.Fourteen positive-autoantibody patients were compared with 27negative-autoantibody patients in gender,onset age,duration,relapse ratio,first demyelination event,the extent of optic neuritis and myelitis,EDSS,CSF protein,WBC,Oligoclonal band, 24 hours IgG index and myelin basic protein.Results The 14 NMO patients (34.1%) had positive non-organ-specific antibodies.NMO patients who had negative autoantibodies were compared with NMO patients with positive autoantibodies with significantly higher EDSS (the EDSS score were 4.5 and 2.5 respectively,U=92.5,P=0.008),more complete damage of spinal cord (3/14 vs 0/27, x2=6.736, P=0.0095) and tended to have higher visual Function Scale in remitting phase.There was no significant difference on the gender,onset age,duration,relapse ratio,first demyelination event.The positive-autoantibody patients had higher CSF WBC (2.0 vs 0,U=68.0,P=0.007) and tended to have lower 24 hours IgG index (-8.663 vs 0.163,U=30.0,P=0.053).There was no significant difference in CSF protein,MBP and OB.Conclusion NMO patients with positive autoantibodies have more severe intrathecal autoimmune inflammatory and disability,so they might need more intensive treatment.

Objective The indication of hysterectomy in obstetrics emergency was studied in order to defend and decrease the incidence of hysterectomy.Method 27 cases with hysterectomy in obstetric emergency were retrospectively analyzed.Results The all indication of 27 cases of hysterectomy was endometrorrhagia in obstetric emergency.The first cause of endometrorrhagia was placental complication,the second cause was puerperal disseminated intravascular coagulation,the third cause was puerperal uterine anonym.Conclusion In order to decrease the incidence of hysterectomy in obstetric emergency,the family planning and health work of perinatal period should be done goodly,the antenatal examination should be strengthened and disseminated intravascular coagulation should be made a diagnosis and treatment timely.