The training of airway management plays a vital role in standardized residency training plan during the rotation in the department of anesthesiology.Problem based-learning and airway simulation practice should be applied step by step based on the different requirements of standardized residency training plan.The training should be started from mask ventilation to endotracheal intubation,meanwhile clinical thinking ability and teamwork ability should be cultivated for the residents so that they can master the technique of airway management skillfully whenever and wherever.

Objective To investigate the correlation between serum soluble epithelial cadherin (sE-cad) and postoperative recurrence and prognosis in patients with advanced gastric cancer.Methods The level of serum sE-cad in 85 patients with advanced gastric cancer (advanced gastric cancer group) was detected by ELISA technique preoperative and postoperative 1 month,and compared with 30 healthy controls(control group).The patients in advanced gastric cancer group were followed up for 3 years,the level of serum sE-cad in recurrent patients and non-recurrent patients was compared.Results The level of serum sE-cad in advanced gastric cancer group preoperative was significantly higher than that in control group [(24.3 ± 14.8) μ g/L vs.(9.4 ± 3.8) μ g/L,P ＜ 0.01].The level of serum sE-cad in advanced gastric cancer group was significantly decreased postoperative 1 month [(12.5 ± 6.4) μ g/L vs.(24.3 ± 14.8) μ g/L,P ＜0.01].The level of serum sE-cad in recurrent patients was significantly higher than that in non-recurrent patients and postoperative 1 month [(20.7 ±9.8)μg/L vs.(12.5 ±6.4),(14.8 ±6.2) μg/L,P＜0.01].Univariate analysis revealed that preoperative high serum sE-cad level was related with tumor size,differentiated degree,lymph node metastasis ratio,depth of tumor invasion (P ＜0.05),but had no relationship with histological type(P＞ 0.05).Elevated preoperative serum sE-cad level negatively affected the postoperative survival rate and recurrence rate.Multivariate Logistic regression anaiysis revealed that preoperative serum sE-cad level was an independent risk factor for postoperative 3 years survival rate in advanced gastric cancer (HR =2.068,P =0.013).Conclusions Preoperative elevated serum sE-cad level is related with pathologic features in patients with advanced gastric cancer,and may be an important prognostic factor.Postoperative monitoring the level of serum sE-cad is useful for evaluating the prognosis and recurrence.

Objective To develop the software of Management Information System of Medical Materials.Methods Based on the platform of NET,three layers of C/S was applied in equipment & apparatus department for good operation platform,frequent data access and rapid response.Besides,the current HIS was utilized to protect the system to be extensible,easily-updated and easily-maintained.Results The application of Management Information System of Medical Materials could meet the requirement in scientific and standard supply,application and management of medical materials.The software was used in scores of hospitals with good effect.Conclusion Being able to organically integrate with other functional module,the software provides a powerful tool for the scientific management of hospital equipment.

ObjectiveTo study the correlation between preoperative serum angiopoietin-2 (Ang2) levels and lymph node metastasis in early gastric cancer(EGC).MethodsPreoperative serum Ang-2 and CEA levels in 62 patients with EGG and 30 normal controls were measured by ELISA technique respectively.The metastasis of lymph node in these cases were determined by HE staining.The relation between preoperative serum Ang-2 levels and lymph node metastasis in EGC and pathologic characterization was investigated.ResultsCompared with normal controls,preoperative serum Ang-2 levels in EGC group were significantly elevated [( 282.5 ± 110.6 ) μg/L vs ( 187.4 ± 32.7 ) μg/L,P ＜ 0.01].Preoperative serum Ang-2 levels in node-positive gastric cancer group was significantly higher than that in the node-negative gastric cancer group [(34 7.2 ± 79.5 ) μg/L vs (265.6 ± 90.2) μg/L,P ＜ 0.01],while CEA levels changed a little.Preoperative serum Ang-2 levels in the EGC group presented marked correlation with the differentiated degree of the tumor tissue,tumor size,depth of tumor invasion but it had no correlation with the histological type.Preoperative serum Ang-2 levels were an independent high-risk factor of lymph node metastasis in EGC according to multivariate logistic regression analysis.ConclusionsPreoperative serum Ang-2 levels may be a good clinical predictor for lymph node metastasis of EGC,which is useful for the treatment direction.

Objective To compare the blood high mobility group box-1 (HMGB-l) versus N-terminal prohormone of brain natriuretic peptide (NT-proBNP) for assessment of cardiac dysfunction in the patients with severe sepsis.Methods Ninety-eight patients of both sexes,aged 18-75 yr,were divided into 3 groups according to left ventricular ejection fraction (LVEF):non-cardiac dysfunction group (LVEF ≥ 50 ％,n =43),mild cardiac dysfunction group (30％ ≤ LVEF ＜ 50％,n =41),and severe cardiac dysfunction group (LVEF ＜ 30％,n =14).Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was performed.Venous blood samples were obtained for determination of the concentrations of HMGB-1 and NT-proBNP.Days of hospitalization and the survival rates within 28 days after admission to hospital were recorded.Pearson correlation between blood HMGB-l,NT-proBNP concentrations and LVEF was analyzed.Results Compared with non-cardiac dysfunction group,LVEF was significantly decreased,APACHE Ⅱ score and blood HMGB-1 and NT-proBNP concentrations were increased,days of hospitalization were prolonged,and the survival rates were decreased in mild and severe cardiac dysfunction groups,and the changes in the parameters mentioned above were more obvious in severe cardiac dysfunction group.The correlation coefficient between blood HMGB-1 concentration and LVEF was -0.639 and between blood NT-proBNP concentration and LVEF was-0.521,showing significant difference.Conclusion Blood HMGB-1 concentration provides higher reliability than blood NT-proBNP concentration in assessing the degree of cardiac dysfunction in the patients with severe sepsis.

[ ABSTRACT] AIM:To observe the treatment effect and its immune regulation of human amnion epithelial cells ( hAECs) on Alzheimer’ s disease ( AD)-like pathology rat model.METHODS: The hAECs were isolated from amnion with trypsin digestion, and the phenotype of hAECs was analyzed by flow cytometry.SD rats ( n=48) were randomly divid-ed into sham control group, model group, medium group and hAECs group.AD-like pathology rat model was induced by bilateral intraventricular injection of lipopolysaccharide (LPS).hAECs (5 ×105) were injected into the hippocampus of the AD-like pathology rats.At 2 weeks after transplantation, the animals were tested by Morris water maze to observe the function of learning and memory.The pathological change of the brain was observed by HE staining.The expression of am-yloid β-protein 42 (Aβ42) and Tau protein and the level of acetylcholine (ACh) in the injury brain were determined by immunohistochemistry.The survival and differentiation of hAECs in the hippocampus were measured by immunofluorescent technique.The percentages of lymphocyte subsets in the peripheral blood mononuclear cells were analyzed by flow cytome-try.The contents of serum cytokines were detected by cytometric bead array.RESULTS:Compared with model group and medium group, hAECs group showed shortened escape latency ( P<0.01) , increased frequency of going through the plat-form (P<0.05), reduced loss of hippocampal neurons, decreased expression of Tau protein and Aβ42 in the hippocampus (P<0.05), increased ACh level in the hippocampus (P<0.05), decreased percentages of Th1 and Th17 subsets, in-creased percentages of Th2 and Treg cells ( P<0.05) , decreased concentrations of IFN-γand IL-2 in the serum, and in-creased concentration of IL-4 ( P<0.05 ) .CONCLUSION: hAECs improve the cognitive learning and memory function and alleviate pathologic damage of hippocampus through immune regulation in AD-like pathology rats.

Objective To investigate the emotional memory characteristic in patients with leuloaraiosis(LA) and explore the neurobiological mechanisms through observing the changes of emotional memory.Methods Different valence images (including positive,neutral and negative pictures) were used to test twenty-four patients with Leuloaraiosis(LA group)and twenty-four healthy colltrols(HC group) at the same time.The emotional memory was evaluated by the recognition of emotional pictures.Results In appraisal of the emotional pictures,there was no significant difference between patients with LA (positive (10.42±2.30) and neulral (12.87±2.29),respectively) and healthy controls (positive (11.38 ± 3.25) and neutral (12.75 ± 2.86),respectively) in positive and negative appraisal (all P＞0.05).But the negative appraisal decreased between LA group (11.63 ± 1.81) and HC group (12.75 ± 2.02) (P＞ 0.05).Compared with healthy controls (38.08+±5.45),patients with LA(33.67±7.10) showed sharply decline in the emotional images memorizing task(P＜0.05).And the accuracy in recognizing positive and netural valence pictures in patients with LA ((Positive(11.04±2.40) and neulral (10.42±2.93)) was significantly lower than that in healthy controls ((positive(12.79±2.17) and neutral(12.08±2.59))(P＜0.05).But in negative stimulus,there was no significant difference between LA group(13.20± 1.86)and HC group(12.20±2.65) (P＞0.05).In addition the total correct recognition,positive and neutral valence in pictures recognition were negativly correlated with the se verity of white matter lesions in the LA patients group(r=-0.308,P=0.033;r=-0.462,P=0.003;r=-0.352,P=0.014).Conclusion The emotional memory is impaired in patients with LA,and the degree of damage is accompornied with the severity degree of LA.The emotional memory for positive and neutral vanlence pictures is impaired but the emotional memory for neutral is relatively reserved in patients with LA in pictures recognition phase.It suggests that impaired emotional memory with different valences may be related to different neuromechanisms.

Objective A large number of injured earthquake patients were accepted by the hospital whilethe professional surgeons were relatively lack. This article introduced the hospital emergency management in 2008Sichuan Wenchuan Earthquake, China. Method Within 3 days, Central Hospital of Mianyang accepted andtreated over 1000 patients after Wenchuan Earthquake jolted on 12 May 2008,and within 2 weeks, the number ofpatients reached 1500. The hospital carded out emergency management plan: (1) emergency comprehensive treat-ment district was established, which was divided into traumatic surgery district, general surgery district, and gen-eral medical district. Traumatic surgery district is responsible for treating traumatic patients, and most doctors andnurses were in this district. The district also had preview, contamination, operation, isolation, monitoring sec-tions, and the tents were numbered and labeled. General surgery district and general medical district were responsi-ble for patients not from earthquake, and only few doctors and nurses were in the two districts. According to the in-jury degree, all the wounded were classified into acute and severe, moderate and minor injuries, and wore red,yellow and blue label on the wrists, respectively. The name, gender, age and diagnosis of each patient and thename of doctor were written on the label. The infectious patients and non-infectious patients were separated.Results Near 200 operations and near 300 operations were performed at one night and at one day, respectively.Within one week, only 1 patient had the lung infection, and one patient with gangrenous emphysema was effective-ly treated. In-hospital cross infection and epidemic of infection disease didn't happen. Conclusions Emergencymanagement model and mechanism, which referred to the model of the battlefield ambulance, played an importantrole in treating a large number of injured patients.

Objective To study the difference and clinical significance of serum Angiopoietin-2 (Ang-2) level in gastric cancer, precancerous disease and the changes in post operation follow-up patients.MethodsSerum Ang-2 and CEA levels were detected with ELISA method in 158 gastric cancer patients, 31 chronic astrophic gastritis patients, 38 gastric adenomatous polyp patients, 28 chronic gastritis patients with benign gastric ulcer and 30 healthy controls.The changes of serum Ang2 levels in 131 patients with radical gastrectomy were measured in 2-year post-operational followed-up and the prognosis was also evaluated.The correlation between serum Ang-2 level and the pathologic character of gastric cancer was analyzed.ResultsThe serum Ang-2 and CEA levels of gastric cancer group were (331.8± 64.3) μg/L and (42.6 ± 37.3) μg/L, respectively, which were significantly higher than those of healthy control group [(187.4±32.7) μg/L and (4.2±3.1) μg/L]and benign gastric ulcer group [(197.3±35.4) μg/L and (4.5±3.2) μg/L](all P ＜0.01).The serum Ang-2 level in chronic astrophic gastritis group was also markedly increased (P＜0.05), however there was no significant change in CEA level.There was no obvious change of Ang-2 and CEA level in gastric adenomatous polyp group (P＞0.05).Pre-operation serum Ang-2 levels of the relapse group and the metastasis group were significantly higher than that of no relapse group (P＜0.05).Post-operation serum Ang-2 level of no relapse group decreased to normal range in 1 month and without obvious increase in 2 years follow-up.The serum Ang-2 level of the relapse group also decreased to normal range in 1 month post-operation, while which was significantly higher than that of no relapse group and normal control group from 6 months to 2 years after operation (P＜0.01).Serum Ang-2 level of the metastasis group was markedly higher than that of no relapse group and normal control group during 2 years after operation (P＜0.01).The 2-year survival rate of no relapse group was significant higher than that of relapse group and metastasis group.The change of serum Ang-2 level was correlated with in the gastric cancer differentiation degree, TNM pathologic classification, lymphatic metastasis, distant metastasis, the depth of invasion and the tumor size (P＜0.01), however not correlated with histopathology type and the location of tumor.ConclusionSerum Ang-2 level may be a new and valuable gastric cancer marker, which will help to monitor tumor relapse, migration and prognosis assessment.

AIM: To explore the effects of sodium ferulate (SF) on function of macrophages in colonic tissue of the colitis rats in vivo. METHODS: The immunological colitis model of rats was produced. SF was used intracolonically for 21 days. The contents of malondialdehyde (MDA), nitric oxide (NO), prostaglandin E_2 (PGE_2) and the activity of superoxide dismutase (SOD), interleukin-1 (IL-1), TNF-?, myelopexoxidase (MPO), and the expression level of NF-?B p65 in colonic tissue of the rats were detected. RESULTS: SF (200,400,800 mg/kg) decreased the elevated contents of MDA, NO, PGE_2, the activity of IL-1, TNF-?, MPO, and the expression level of NF-?B p65, while increased the reduced activity of SOD in colonic tissue of the colitis rats in a dose-depended manner. CONCLUSION: SF restrained the activity of activated colonic macrophages and relieved the colonic inflammation reaction in vivo in colitis rats, which may be related to the suppression of NF-?B activation. [