This paper analyzed the cultivation of postgraduates of anesthesiology and the academic achievements in anesthesiology department from 2003 to 2010 in our hospital and explored the experiences in postgraduate cultivation.Cultivation of postgraduates of anesthesiology should focus on multidisciplinary integration,cross-discipline communication,extension of scientific thinking,enhancement of clinical skills so as to create the opportunity for clinical and research work.

Objective To investigate the dose response effects of Shenfu injection, an intravenous drug made from traditional Chinese herbs, on the ischemic spinal cord injury in rabbits Methods New Zealand white rabbits were anesthetized with halothane and spinal cord ischemia was induced with 20 min infrarenal aortic occlusion Animals were randomly allocated to 4 groups, in group A(n=6) without pharmacologic intervention, in group B (n=6) ,group C (n=6) and group D (n=6) Shenfu injection 5,10 and 20ml?kg -1 were infused intravenously at a constant rate within 30min before the aortic cross clamping, respectively Neurologic status was scored by the Tarlov system 1,4,8,12,24 and 48h following reperfusion The animals were sacrificed 48h following reperfusion to sample the spinal cord (L5 7) immediately for histopathologic study Results All animals survived during the experiment Compared with that in group A, the neurologic deficit score (NDS) increased significantly at each observing time in group B, group C and group D (P0 05), but there was no significant difference between group B, C and D NDS in group A,B,C and D 48h after reperfusion were 0 5?0 8,3 2?0 9(P

Objective To investigate if isoflurane preconditioning induces ischemic tolerance against neuronal damage produced by middle cerebral artery occlusion (MCAO) in rats Methods Thirty male SD rats weighing 350 400g were randomly divided into three groups: control group (no pretreatment,n=10),isoflurane preconditioning group (ISO group) (inhalation of 2% isoflurane and 98% O 2 1h per day lasting 5d,n=10), oxygen preconditioning group (O 2 group) (inhalation of 98% O 2 1h per day lasting 5d ,n=10) Right MCAO was induced by a 3 0 nylon thread with round tip inserted cranially into right internal carotid artery under isoflurane anesthesia and maintained for 120 min The neurologic deficit score (NDS) was evaluated 1, 3, 6, 12, 16 and 24h after reperfusion and the infarct volume was calculated at 24th following reperfusion Results The NDS of ISO group was lower than that of other two groups at each time interval (P0 05) Conclusions Isoflurane pretreatment can induce ischemic tolerance against neuronal damage produced by transient MCAO in rats

Objective To study the clinical significance of the proinflammatory cytokines and anti-inflammatory cytokines in acute pancreatitis with systemic inflammatory response syndrome. MethodsIn this study, 13 cases of mild acute pancreatitis (MAP), and 19 cases of severe acute pancreatitis(SAP) were recruited to evaluate acute physiology and chronic health evaluation (APACHEⅡ) on post admission day 1,3,5,7 and Balthazar CT criteria on post admission day 1,7. Values of serum IL-6?IL-8?IL-10?IL-12 were measured. ResultsThe scores of APACHEⅡ and Balthazar CT criteria were lower in the MAP patients than those in the SAP patients(5.6?2.1 and 1.5?0.6 vs. 13.6?4.3 and 6.3?1.5, all P

Unclear cultivating aim and training plan as well as tutors' lacking of experience are the main problems of the postgraduate education for clinical medicine professional degree,which will cause the quality of clinical postgraduate training to fall greatly.Through the analysis,the author proposes increasing management authority of rotating disciplines for graduates,establishing tutor groups in rotating disciplines,making clear training plan,increasing the clinical simulation skill training courses,training and optimizing the professional master's tutors,which is to fit the needs of the postgraduate education for clinical medicine professional degree and to provide related references.

Objective To assess the results of colonoscopy surveillance in 5 years after polypectomy of non-advanced colorectal adenoma and to identify its risk factors. Methods Patients undergoing colonosco-py and followed up with colonoscopy within 5 years between January 2003 and December 2013 were retro-spectively analyzed.No substance or only small quantity of clear water left in the intestinal tract and colono-scopes accessing ileocecus were regarded as complete examination. The initial colonoscopy was regarded as the baseline colonoscopy. Patients with non-advanced adenomas were assigned to the case group and those without were to the control group. Data of clinical characteristics and colorectal findings were estimated and risk factors were identified. Results A total of 828 patients were included,374 patients in the case group and 454 in the control group on baseline colonoscopy.The case group had a low incidence of advanced adeno-mas at a 1 to 5 years interval when compared with the control group,both with adequate baseline examination [1. 5%(5/ 326)VS 2. 2%(9/ 408),P = 0. 51]. The detection rates of advanced adenomas on follow-up colonoscopy at 1 to 3 years and 3 to 5 years in case group were 1. 7%(3/ 178)and 1. 4%(2/ 148),respec-tively(P>0. 05).Regression analysis showed age≥50 years old and being male were the independent risk factors for advanced adenomas recurrence within 5 years follow-up. No colon cancer was found in 828 patients during the follow-up. Conclusion Surveillance colonoscopy intervals within 5 years is of little benefit to pa-tients who had adequate polypectomy. Too early reexaminations due to concerns about advanced adenomas recurrence can be avoided.

Objective To investigate how to avoid and deal with injuries to the aberrant right posterior hepatic duct during laparoscopic cholecystectomy (LC).Method We studied 1 710 patients who underwent LC in our unit from January 2011 to November 2013.There were 5 patients with right posterior hepatic duct abnormally,and this paper analysed the cases.Results In the 5 patients,one patient had the right posterior hepatic duct draining into the gallbladder body (Ⅰ A type),two patients had the right posterior hepatic duct draining into the cystic duct (ⅢA type),and two patients had the cystic duct draining into the right posterior hepatic duct (ⅢB type).There was no damage to the right posterior hepatic duct during operation.One patient was converted from LC to open operation.The major aberrance was class Ⅲ.Conclusions Variant bile duct is an important cause of bile duct injuries during LC.The right posterior hepatic duct variation is the most common form.To raise our vigilance and fully understand the types of aberrant right posterior hepatic duct,reasonable use of preoperative MRCP and intraoperative cholangiography in selected patients are fundamental.Aberrant right posterior hepatic duct injuries can effectively be avoided.

Objective To provide new evidences for understanding the mechanisms of promo-tive role of orexins in anesthetic emergence and the effect of microinjection of orexin-A/orexin-B into cerebral ventricle on the release of histamine.Methods Male SD rats were randomly divided into sa-line (control ), orexin-A and orexin-B groups. The microdialysis probe was inserted into hypothalamus under stereotaxic apparatus.The perfused fluid from the area of hypothalamic tube-romammillary nucleus was collected using in vivo microdialysis at 1 h,2 h and 3 h after 1 nmol or 5 nmol orexin-A or orexin-B microinjection into the cerebral ventricle (n =5 each).The concentrations of histamine at each time point in dialysates of perfused fluid were detected by high performance liquid chromatography (HPLC)to analyze its dynamic changes.After one week,each group was microin-jected with 10 nmol,15 nmol and 20 nmol orexin-A and orexin-B (n =5)into the cerebral ventricle respectively,dialysates was collect and histamine was detected at 1 h to analyze its dosage response. After one week,each group was microinjected 0.3 μl saline orexin-A and orexin-B (n =6)into the tu-beromammillary nucleus.Results Compared with the control group,microinjection of 1 nmol orexin-A significantly increased histamine release at 1 h,but the same dose of orexin-B had no such effect,5 nmol of orexin-A or orexin-B injections significantly facilitated histamine release at 2 h and 3 h (P <0.01).Microinjection of 10 nmol,15 nmol and 20 nmol orexin-A and orexin-B into ventricle caused an significant increase of histamine release at 1 h while the effect was the strongest in 20 nmol (P <0.05).Compared with the control group,microinjection of orexin-A significantly decreased time of the righting reflex (P <0.01),but the same dose of orexin-B had no such effect.Conclusion Micro-injection of both orexin-A or orexin-B into cerebral ventricle could promote the release of histamine, while the effect of orexin-A was stronger.Microinjection orexin-A into tuberomammillary nucleus sig-nificant facilitated recovery from isoflurane.

Objective To analyze the clinical and pathological features of upper gastrointestinal serrated lesions.Methods A total of 21 patients with upper gastrointestinal serrated lesions in Tianjin Medical University General Hospital between January 2011 and December 2015 were retrospective analyzed.Data of the patients including demographics, clinical and pathological features were collected.Among the 21 patients, 18 patients, who underwent colonoscopy simultaneously or within six months, were selected as the study group, each patient was compared to 4 randomly selected controls without serrated lesions, who also underwent colonoscopy within the same time period.Differences of colorectal neoplasia detection were analyzed between the cases and controls.Results The mean age of 21 patients was 55.3±17.2 years, and 11 cases were male.Involving the locations of serrated lesions, 17 cases were found in the stomach (including 3 in the cardia, 9 in the corpus, and 5 in the antrum), and followed by 3 in the duodenum and 1 in lower esophagus.The mucosa pathological morphology showed that 6 cases were serrated hyperplasia, 8 cases were hyperplastic polyps, 6 cases were serrated adenomas with low grade dysplasia and 1 case was in the duodenum intramucosal carcinoma.Seven (38.9%) colorectal adenomas were found in the study group, including 3 (16.7%) non-advanced colorectal adenomas and 4 (22.2%) advanced colorectal adenomas.Eight (11.1%) colorectal adenomas were found in the control group, including 5 (6.9%) non-advanced colorectal adenomas and 3 (4.2%) advanced colorectal adenomas.The rate of colorectal adenoma detection in the study group was significantly higher than that in the control group (38.9% VS 11.1%, P=0.010, OR=5.091, 95%CI:1.534-16.890).Conclusion Upper gastrointestinal serrated lesions can be found in various mucosal lesions with different pathological morphologies.Moreover colonoscopy is likely to be recommended to detect concurrent colorectal adenoma for these patients.

Objective: To investigate the effect of Atractyloside on sevoflurane postconditioning in focal cerebral ischemia.Methods: Fifty male SD rats were randomly assigned to five groups(n=10 each): control group(con),1.0 MAC group(sevo),1.0 MAC+ Atractyloside group(sevo+Atr),1.0 MAC+ vehicle group(sevo+vehicle)and Atractyloside group(Atr).All animals were subjected to the right middle cerebral artery occlusion(MCAO) for 120 min followed by reperfusion for 72 h.The animals in sevo groups were given 1.0 MAC sevoflurane inhalation from 20 min before to 10 min after reperfusion.The animals in Atr groups were given Atractyloside by ICV injection before sevoflurane postcondioning.The neurological deficit scores(NDS) were recorded at 24 h,48 h,and 72 h after reperfusion.Infarct volume percentage was determined after the last NDS assessment.Results: The infarct volume percentage ratio of sevo group(0.32?0.05) was significantly lower than that of con group(0.55?0.07)(P0.05).The infarct volume percentage ratio of sevo+Atr group and Atr group were significantly higher than that of Sevo group(P0.05).NDS of 24 h,48 h and 72 h after reperfusion in sevo group and sevo+vehicle were significantly higher than that in Con group.NDS of 24 h,48 h and 72 h after reperfusion in sevo+Atr group and Atr were significantly lower than that in Sevo group.Conclusion: Atractyloside abolished the protective effects of sevoflurane postconditioning on focal cerebral ischemia-reperfusion injury.