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 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 evaluate the role of orexin in the sleep disorder after isoflurane anesthesia in rats.Methods Sixty-four male Sprague-Dawley rats,aged 10-12 weeks,weighing 280-320 g,were randomly divided into 2 groups (n =32 each) using a random number table:control group (C) and isoflurane group (Ⅰ).Group Ⅰ inhaled 1.2％ isoflurane from 8:00 to 13:30 to induce anesthesia,followed by 0.5 h of recovery.Group C received no anesthesia and the other procedures were similar to those previously described in group Ⅰ.The induction time and awakening time were recorded.Eight rats were randomly chosen to record the movement condition (locomotor time and activity) from 14:00 to 8:00 the next morning.Before beginning of anesthesia,at 4 h after beginning of anesthesia,and at 4 and 10 h after the end of anesthesia,6 rats were randomly chosen in each group to count the orexin/c-fos double-labeled neurons in hypothalamus.The ratio of activated orexin neurons (orexin/c-fos double-labeled neurons to orexin positive neurons) was calculated and plasma orexin-A concentration was detected.Results The induction time was (2.14 ± 0.17) min,awakening time was (8.7 ± 0.5) min,and EEG showed that there was no typical burst and suppression patterns in group Ⅰ.There was no significant difference in the number of orexin positive neurons between the two groups (P ＞ 0.05).Compared with group C,the time for locomotor activity was significantly prolonged,and the activity was increased during the night (P ＜ 0.01),the number of activated neurons,ratio of activated orexin neurons and plasma orexin-A concentration were decreased at 4 h after beginning of anesthesia in group Ⅰ (P ＜ 0.01).The plasma orexin-A concentration was lower at 4 h after beginning of anesthesia,while higher at 10 h after the end of anesthesia than before beginning of anesthesia in group Ⅰ (P ＜ 0.05).The number of activated neurons was significantly larger and ratio of activated orexin neurons was higher before beginning of anesthesia and at 10 h after the end of anesthesia and the plasma orexin-A concentration was higher at 4 and 10 h after the end of anesthesia than at 4 h after beginning of anesthesia in group Ⅰ (P ＜ 0.05 or 0.01).Conclusion The development of sleep disorder after isoflurane anesthesia during the day time in rats is related to the regulatory role of orexin in it.

Objective To evaluate the effects of sevoflurane anesthesia on the sleep architecture of rats.Methods Sixteen pathogen-free healthy male Sprague-Dawley rats,aged 10-12 weeks,weighing 300-350 g,were divided into 2 groups (n=8 each) using a random number table:control group (group C) and sevoflurane group (group S).Each rat was implanted with a transmitter for recording electromyogram and electroencephalogram via telemetry.The rats were exposed to 2.4％ sevoflurane and pure oxygen 1.5 L/min for 5.5 h followed by 0.5 h washout with pure oxygen in group S,and the rats were exposed to pure oxygen 1.5 L/min for 6 h in group C.Then the rats were taken into the sleep monitoring box,and the 24 h after anesthesia was divided into 4 time periods according to the circadian rhythm:L1 (14:00-20:00),D1 (20:00-02:00),D2 (02:00-08:00) and L2 (08:00-14:00).The total time spent on wakefulness,on non-rapid eye movement (NREM) sleep and on REM sleep,the number of wakefulness,NREM sleep and REM sleep,and the time spent on wakefulness,on NREM sleep and on REM sleep during each time period were recorded using Version 3.0 Neurosore software.Results Compared with group C,the total time spent on wakefulness was significantly shortened,the total time spent on REM sleep was prolonged,the number of NREM sleep was increased,the time spent on REM sleep in L1 and D1 time periods was prolonged,the time spent on wakefulness in D2 time period was shortened,the time spent on NREM sleep was prolonged (P＜0.05),and no significant change was found in the total time spent on NREM sleep or the number of REM sleep and wakefulness in group S (P＞0.05).Conclusion Sevoflurane anesthesia can change the stability of sleep architecture,increase REM sleep and reduce wakefulness in rats.

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 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.