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 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 investigate the effects of sevoflurane anesthesia on learning and memory functions and S100β protein in anaplasis in the 7-day-old rat.Methods 48 SD rats of both sexes aged 7-day-old weighing 1 2-1 6 g were randomly divided into 3 groups (1 6 rats in each group):group A and group B inhaled 3 ％ sevoflurane in oxygen(1L/min) for 6h and 2h respectively; group C inhaled oxygen(1L/min) only.After inhalation,the effects of sevoflurane anesthesia on learning and memory function were assessed by Morris water-maze test and Y-maze test from 16d to 24d.The rats were killed in the day of 8d and 25d respectively,and the blood were collected for the expression of serum concentration S100β protein by enzyme-linked immunosorbent assay.Results (1) Results of Morris water-maze test:Compared with group C,escape latency prolonged in group A and group B in 17-20d(P ＜ 0.05 or 0.01) ;escape latency prolonged in group A compared with group B in 19-20d(P ＜ 0.01) ;but there were no significant differences in the probe time in original platform quadrant and the frequency of crossing original platform among three groups(P ＞0.05).(2) Result of Y-maze test:In 22d,the total reaction time of group A and B were longer than group C (P ＜0.05 or 0.01),and the error number was increased in group A and B compared with group C(P ＜ 0.01) ; while in 23-24d,there were no significant differences between every index of each groups (P ＞ 0.05).(3) Results of the blood serum index:In 8d,serum concentration of S100β protein was significantly increased in group A and B compared with group C (P ＜0.01),and serum concentration of S100β protein was significantly increased in group A compared with group B (P ＜ 0.05) ; But there were no significant differences in serum concentration of S100β protein of each groups in 25d(P ＞ 0.05).Conclusion Sevoflurane anesthesia in the 7-day-old rat can temporarily decrease the ability of learning and memory functions in the length of inhalation time dependent manner,and the mechanism may be related to the increased expression of serum concentration of S100β protein transiently.

Objective To evaluate the clinical efficacy and safety of piperacillin and sulbactam sodium combinations in the treatment of common infections. Methods This was a multi-centre, prospective and open study. All subjects from 57 wards caught common infection like respiratory ( RTI) or urinary diseases ( UTI). The dosages of piperacillin and sulbactam sodium combinations 2. 5 g injection were determined according to indications:for adult, 2. 5 g or 5 g per time, 2 time/day; for severe or obstinate infection, 2.5 g or 5 g per time, 3 time/day. General information, clinical response pre- and posttreatment, infected locus, drug recipe and protocol, prognosis and adverse reaction were recorded. Results Data of 579 cases were collected with 388 males and 191 females. The average age was (66. 8 ± 17. 0) years. There were 500 patients who were suffering with RTI, with 362 cases of pneumonia, 102 of acute exacerbation of chronic bronchitis, and 36 of other infections. There were 50 cases with UTI, with 31 of simple urinary tract infection, and 19 of complex urinary tract infection. In addition, there were 9 cases of combined RTI and UTI, and 20 of other infections including peritonitis. The average duration of antimicrobial for RTI and UTI was (8. 65 ± 3. 78 ) days and (7. 45 ± 3. 46) days respectively with the total efficacy rate was 92. 6% and 98. 0% respectively for RTI and UTI. The incidence of adverse events was only 0.86% (5 cases), including nausea, rash, itching, ALT elevation and suspected drug induced fever in each one. Conclusion Piperacillin and sulbactam sodium compound had high clinical efficacy and safety in the treatment of common infections including RTI and UTI.

Objective To analyze the bone metabolism in hospitalized patients with Graves disease and the changes after 131I therapy.Methods The differences of bone metabolism were analyzed between 315 patients with Graves disease and 300 normal controls in a case-control study.The changes in bone turnover markers and BMD levels before and one year after 131I therapy were observed in 60 patients.Results Compared to normal control,bone turnover markers were markly higher and BMD levels were lower in patients with Graves disease.The level of thyroid hormones were positively related to bone turnover markers,while negatively related to total hip BMD (Z-score).But there was no linear relationship with lumbarand femoral neck BMD (Z-score).After one year of 131I therapy,bone turnover markers were markly lower than that before treatment,while BMD levels were partly higher than that before treatment.Conclusions In Graves disease patients,bone turnover markers were generally increased,while BMD levels decreased compared with normal people.After 131I therapy,along with the improvement of thyrotoxicosis,the high bone turnover rate can be suppressed,and BMD can partly recover.

Objective To study the changes of the putamen metabolites with magnetic resonance spectrum(MRS),and to explore possible underlying unrecongnised aetiological factor and pathophysiology mechanism in the central nervous system of the patients with Tourette' s syndrome.Methods Twenty-two cases of Tourette' s syndrome,and twenty-two gender and age-matched subjects ( the control subjects ) were performed on a clinical 3.0 T MRI system.Proton prob-voxel spectroscopy imaging (1H-MRS) was obtained from two sides of the putamen.The metabolites included N-acetylaspartate (NAA),creatine and phosphocreatine ( Cr),choline-containing compounds (Cho),and myoinositol ( MI ).The value of the NAA,Cr,Cho,and MI were calculated by integration of their peaks.The ratios of NAA/Cr,Cho/Cr,ML/Cr were calculated respectively.Repeated measures analysis of variance ( ANOVA ) was used to test both the value of NAA/Cr,Cho/Cr,MI/Cr of the putamen for group difference,with group as between-subjects factor and side as within-subjects factor.Results The NAA/Cr ratio in patients ( left:1.29 ± 0.13 ; right:1.34 + 0.15 ) was significantly lower than that in the control subjects ( left:1.50 ± 0.08,T =1.962,P ＜0.05 ; right:1.52 ± 0.11,T =1.865,P ＜ 0.05 ).There was no significant difference in the Cho/Cr and MI/Cr ratio between both groups.Conclusion The abnormalities of the structure and(or) function in the putamens of patients may be the one of the underlying anaetiological factors and pathophysiology mechanisms of the Tourette' s syndrome.

ObjectiveTo investigate the central nervous system mechanisms of active of movement switch in the patients with Tourette' s syndrome( TS),and to explore the possible underlying distinct neural networks for tic trigger and generation. Methods Participants were 14 patients with TS and 14 age- and gender-matched healthy volunteers with no history of physical,psychiatric or neurological disease: All patients were assessed with functional magnetic resonances imaging (fMRI)of the brain during the intermittent performance of finger-tapping switch tasks,Blood-oxygen-level dependent-fMRI was performed using a 3.0 Tesla MR.The area over which the activation was distributed was calculated,and the activation volumes were also compared between the patients with TS and the control subjects.ResultsThe regions activated in the patients with TS and in the volunteers were similar in several brain regions,including contralateral precentral and postcentral gyrus,contralateral mesia pre-front gyrus,contralateral cingulate gyrus,contralateral insula and ipsilataral cerebellum. There were also many different activation areas between the patients and the control subjects. The patients with TS demonstrated more significant and extended activation in the contralateral pre- and postcentral gyrus than the healthy volunteers.The volume of the left pre- and postcentral gyrus of the TS patients was (8.024 ±0.071 ) cm3,while the volume of the left pre-and postcentral gyrus of the control subjects was ( 6.480 ± 0.026) cm3 ( t =3.026,P ＜ 0.01 ) ; The volume of the right pre- and postcentral gyrus was (6.192 ± 0.019) cm3 in the TS cases,while there was (5.608 ±0.037) cm3 in the control subjects (t =2.752,P ＜0.05).There were significant differences in the volumes of bilateral pre- and postcetral gyrus between the TS and control subjects. The activations of conralateral thalamus without contralateral insula were found in the patients with TS. Conversely, the contralateral insula activation without thalamus activation could be found in the healthy volunteers.ConclusionThe thalamus might play an important role in the aetiological and physiopathologic mechanisms of the TS. The thalamus along with the parietal cortex,cingulate cortex and insular cortex appear to constitute a distinct neural network for tic trigger and generation.

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on NAFLD in MSG-IR mice and to provide mechanism insights into its therapeutic effect. The MSG-IR mice with insulin resistance were treated with high dose (0.1 micromol.kg-1d-1) and low dose (0.025 micromol.kg-1d-1) of FGF21 once a day for 5 weeks. Body weight was measured weekly. At the end of the experiment, serum lipids, insulin and aminotransferases were measured. Hepatic steatosis was observed. The expression of key genes regulating energy metabolism were detected by real-time PCR. The results showed that after 5 weeks treatment, both doses of FGF21 reduced body weight (P<0.01), corrected dyslipidemia (P<0.01), reversed steatosis and restored the liver morphology in the MSG model mice and significantly ameliorated insulin resistance. Additionally, real-time PCR showed that FGF21 significantly reduced transcription levels of fat synthetic genes, decreased fat synthesis and promoted lipolysis and energy metabolism by up-regulating key genes of lipolysis, thereby liver fat accumulation was reduced and liver function was restored to normal levels. In conclusion, FGF21 significantly reduces body weight of the MSG-IR mice, ameliorates insulin resistance, reverses hepatic steatosis. These findings provide a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of NAFLD.

BACKGROUND AND OBJECTIVELung adenocarcinoma (AC) is the most common type of lung cancer, however, its mechanism of oncongenesis is still unknown. The aim of this study is to screen candidate genes of lung adenocarcinoma using bioinformatics strategy and elucidate the mechanism of lung adenocarcinoma.

METHODSTwo published microarray data (GSE7670 and GSE10072) was obtained from Gene Expression Omnibus (GEO). Significance analysis of microarrays was performed with the software dchip, and differential expression genes from dchip analysis were defined as "test gene set". Genes correlated with lung adenocarcinoma, obtained by data mining tools genecard and Fable were regarded as "train gene set". Finally, candidate genes of lung adenocarcinoma were screened by the tool "Toppgene".

RESULTSThree hundred and forty-four differential genes were defined as "test gene set", and 277 genes correlated with lung adenocarcinoma were regarded as "train gene set". Thirty-six candidate genes were screened out by Toppgene, among them, 21 genes had nearly no report in cancer. In the following QRT-PCR experiment, CD36, PMAIP1 and FABP4 were down-regulated expression in A549, which coincided with the gene chip.

CONCLUSIONIt is demonstrated that Toppgene is useful in identification of the candidate genes of lung adenocacinoma, which provides the proof for the discovery of the specific disease genes.

Bovine spongiform encephalopathy (BSE) is an infectious disease which can threaten animal husbandry and human health seriously. The disease mainly violates the central neural system. This article selectively reviewed current researches on the analytical detection of BSE and transmissible spongiform encephalopathy (TSE).
Animals ; Cattle ; Encephalopathy, Bovine Spongiform ; diagnosis ; transmission ; virology ; Humans ; Prions ; isolation & purification