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 explore the effects of up-and down-regulation of Cox-2 expression on the growth and radiation sensitivity of human esophageal cancer EC9706 xenograft in nude mice.Methods Cox-2 specific siRNA and Cox-2 gene eukaryotic expression vector were constructed and transfected to esophageal cancer cells EC9706, and the stable transfected cell lines were obtained by the method of G418 screening.The expressions of Cox-2 mRNA and its protein were detected by RT-PCR and Western blot, respectively.The inhibitory effects of Cox-2 regulation combined with X-ray irradiation on cancer cell growth were detected by the nude mouse xenograft assay.Results Cox-2 gene expression was significantly decreased in the Cox-2 down-regulated group and increased in the Cox-2 up-regulated group.Compared with the control group without gene transfer, the average volumes of EC9706 xenograft tumor in the Cox-2 up-and down-regulated group significantly decreased (F =34.26, P ＜ 0.05) and increased (F =26.38, P ＜ 0.05) , respectively.After 20 Gy X-ray irradiation, the average volume of xenograft was significantly reduced in the Cox-2 down-regulated group (F =16.35, P ＜ 0.05) , but it had no significantly changes in the Cox-2 up-regulated group.Conclusions Down-regulation of Cox-2 expression inhibits the growth of human esophageal cancer EC9706 xenograft in a nude mice and increases cell radiation sensitivity, but upregulation of Cox-2 expression makes tumor cells to become radioresistant.

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 observe the major adverse reaction of irinotecan in combination with fluorouracil for advanced colorectal cancer,and sum up the nursing experience of acetylcholine syndrome and acute delayed diarrhea.Methods Pathologically confirmed 45 cases of patients with advanced colorectal cancer were treated with modified FOLFIRI regimen for total of 190 cycles.Results Acetylcholine syndrome rate was 28.9%,the incidence of acute delayed diarrhea was 40.0% ,more than 3 grade diarrhea was 6.7%.Conclusion The incidence of acute delayed diarrhea in Chinese patients is lower than in caucasians,and reasonable care measures can reduce the occurrence of adverse reactions,irinotecan in combination with fluorouracil is a safe and effective regimen for Chinese patients.