To improve the anesthesia skills of younger anesthesiologists ,department of anes-thesiology of the Affiliated Hospital of Yangzhou University formed the tutorial system based on tutori-al team. Through enhancing the selection of tutors,establishing of tutorial team and conducting clini-cal skill guidance and scientific research ability training,department of anesthesiology aimed to devel-op personal quality,clinical and scientific research ability of younger anesthesiologists in the process of clinical completion and application of scientific research subject.

Objective To explore the acute toxic reactions of memantine in neonatal rats. Methods Based on Completely Lethal dose(LD_(100)) and median lethal dose (LD_(50))of memantine in SD neonatal rats acquired in a preliminary test of death dose, 60 neonatal rats were randomly divided into normal group which were given water injection intraperitoneally and 5 study groups which were given different doses of memantine intraperitoneally.LD_(50) was calculated with Bliss method and the toxic reactions of memantine were observed in all neonatal rats of 6 groups after administration of memantine. Results LD_(50) of memantine in SD neonatal rats was((74.386?2.811)) mg/kg with 95% confidence at the range of 59.334-93.257 mg/kg.Side effects occurred at 1-4 minutes after administration. Excitatory jitteriness,ataxia,decreased respiratory rate and passivity were usually observed in groups with a lower dosage (52.0 mg/kg,61.2 mg/kg,72.0 mg/kg);some of them also manifested side lying, cyanosis and respiratory failure.While neonatal rats with a higher dosage (85 mg/kg,100 mg/kg)mainly manifested visible symptoms of inhibition, respiratory failure,side (lying) and cyanosis.However,no jitteriness and ataxia were observed in them.The neonatal rats usually died around 1 hour after memantine administration;survival rats usually returned to normal 4-5 hours after administration.Conclusion There is a positive correlation between toxic reactions and the mortality with memantine dosage in neonatal rats.

Objective To investigate the pathomorphology effects of memantine on organs in neonatal rats.Methods Sixty-eight neonatal rats were randomly divided into 7 groups:5 groups by different doses memantine intraperitoneally and the controls by water intraperitoneally.The pathomorphology changes of organs were observed in all dead neonatal rats promptly after administration of memantine and in all survived rats after 7 days recover.Results 1.The ratio of organ weight and body weight in dead neonatal rats were higher than those of controls.2.The result of pathomorphology indicated that neurodegeneration and necrosis in the brain,the liver congestion and cell degeneration.The other organs had not distinct changes.3.The pathologic changes and mortality rate of neonatal rats were positively correlated with the dosage of memantine.Conclusion Memantine will affect liver and brain of neonatal rats.

Objective To study CT-guided localization of additional pulmonary nodules with microcoils prior to video-assisted thoracoscopic surgery (VATS) resection in patients with suspected lung cancer.Methods Eleven patients suspected lung cancer underwent preoperative microcoils localization towards additional small pulmonary nodules.The head of microcoil was pinpointed adjacent to the target nodule while its end tail remained above the visceral pleura.VATS were performed within 24 hours, and comprehensive assessments were conducted according to surgical and pathological outcomes of primary and additional lesions, and suitable surgical processes were followed.Results All 11 localizing pulmonary nodules (4-15 mm in diameter) were successfully removed after VATS, 9 microcoils'' end tails of which were placed above visceral pleural surface.There were no serious complications related with localizing procedure.Other 16 lesions including 11 primary ones were resected.The surgical and pathological outcomes for lung lesions were utterly assessed.Conclusion Microcoil preoperative localization provides helpful orientation for complete resection and assessment of multiple pulmonary lesions in patients with suspected lung cancer.

Objective To compare the short-time effect of 3 different regimens of neoadjuvant chemotherapy (NACT) in patients with FIGO stage Ⅰb2-Ⅱb cervical squamous carcinoma.Methods A total of 50 patients with FIGO stage Ⅰb2-Ⅱb cervical squamous carcinoma were divided into 3 groups:systemic chemotherapy group (n=13) ,trans-arterial chemotherapy group (TAC,n=19) ,trans-arterial chemoembolization group (TACE,n=18) .After 1-3 periods of NACT,all patients received surgical operation.Tumor response and reduction ratio after NACT,side effects,hemorrhage volume in surgery and bad prognostic factors (including intraluminal tumor thrombi,pelvic lymph node metastasis,parametrial involvernent,positive surgical margin,ovary metastasis) of operation sample were statistically analyzed.Results Tumor response,reduction ratio and hemorrhage volume in surgery were significantly better in TAC group and TACE group than those in systemic chemotherapy group (P＜0.05) ,but no significant difference was found between TAC group and TACE group (P＞0.05) .The incidence rate of intraluminal tumor thrombi and lymph node metastasis was lower in TACE group than in systemic chemotherapy group and TAC group,but there was no statistical difference.No difference of parametrial involvement,positive surgical margin,ovary metastasis and side effects was found among 3 groups.Conclusion For stage Ⅰb2-Ⅱb cervical squamous carcinoma,preoperative TAC and TACE have more advantages than systemic chemotherapy.In comparison with TAC,TACE is expected to reduce the incidence rate of bad prognostic factors such as intraluminal tumor thrombi and pelvic lymph node metastasis.

Gymnastics ; physiology ; Humans ; Workload

Objective:To study the functional connectivity (FC) and metabolic effective connectivity (MEC) patterns of the default mode network (DMN) in healthy male adults based on a novel hybrid PET/MR system.Methods:Fifteen healthy male adults with median age of 29 years were recruited locally in Xi′an from January to May 2019. All subjects went through PET/MR scan to get the whole brain 18F-fluorodeoxyglucose (FDG) PET, resting-state functional MRI (fMRI) and magnetization prepared rapid gradient echo (MPRAGE) T 1 weighted imaging data. CONN18b and statistical parametric mapping (SPM) 12 softwares were used to analyze data. The voxel-wise FC and FDG metabolic data were extracted within 4 sub-networks of DMN, which included medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC) and bilateral lateral parietal (LP). The FC and MEC between 4 sub-networks were calculated based on merged resting-state fMRI and metabolic data, and analyzed by one-sample t test separately, with Bonferroni correction. Results:FC pathways were all significant within 4 sub-networks of DMN ( t values: 6.00-7.71, all P<0.008, Bonferroni corrected). Meanwhile, there were significant bi-directional MEC between MPFC and PCC(MPFC to PCC: t=10.03; PCC to MPFC: t=3.73, both P<0.004, Bonferroni corrected), as well as between bilateral LP (LP_L to LP_R: t=5.28; LP_R to LP_L: t=4.76, both P<0.004, Bonferroni corrected). There were significant uni-directional MEC from both MPFC and PCC to bilateral LP ( t values: 3.44-6.93, all P<0.004, Bonferroni corrected). Conclusions:Special FC and MEC patterns exist within DMN. The closely interrelated MPFC and PCC play more important roles in DMN, and they may mediate LP jointly. The novel integrated PET/MR system will bring new perspective on the organization of brain networks, which may deepen the comprehensive understanding of DMN.

ObjectiveTo observe the effect of Huanglian Wendan decoction and Danshen decoction combined with Wester medicineon stable coronary heart disease.Methods60 patients with angina or myocardial infarction were randomly divided into the control group and treatment group with 30 cases in each group. The patients of the control group were treated with routine medicine and those of the treatment group were added with traditional Chinese medicine (TCM) Huanglian Wendan decoction combined with Danshen decoction. The changes of angina, symptoms and signs of TCM, electrocardiogram (ECG), low density lipoprotein cholesterol (LDL-C) and high sensitive C-reactive protein (HS-CRP) of all patients were observed before and after treatment.ResultsAfter treatment, the frequency and duration of angina, dose of notroglycerine of patients in two groups were significantly different from those before treatment (P<0.01 ), but there was no significant difference between two groups (P>0.05). The symptoms such as chest discomfort and palpitation of patients of two groups improved after treatment (P<0.05～0.01), but the treatment group improved more obviously than the control group (P<0.05). The total effective rate showed by ECG were 53.3% in the control group and 73.3 % in the treatment group, there was no significant difference between two groups. HS-CRP and LDL-C of all patients decreased after treatment (P<0.01), but the treatment group was lower than the control group (P<0.05).Conclusion Huanglian Wendan decoction combined with Danshen decoction can relief clinical symptoms of stable coronary heart disease, which may be related with lipid decrease and inflammation reduction.

Acute Disease ; Fatal Outcome ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Respiratory Distress Syndrome, Newborn ; diagnosis ; therapy

Objective To report the microsurgical outeome of the meningiomas located in the eranio- cervical junction.Methods Seven eases of meningiomas arising from the craniocervical junction operated with microsurgical technique by use of the posterior approaehes including the suboccipital approach,the lower lateral suhoecipital approach and for lateral approach.Reviewed the related ariieales and were analysed relative to their approach selection and outcomes were analysed.Results The tumors ranged in size from 0.8 to 4.8 cm and the tumors location with 2 cases posterior,3 cases anterior and 2 cases lateral to the brain stem.3 in 7 cases were operated by use of the suboccipital approach,2 in 7 cases with the lower lateral suboccipital ap- proach and 2 in 7 cases with farlateral approach.Total excisions were got in 6 of 7 cases,4 in 6 cases with Simpson gradeⅠand 2 in 6 cases withⅡ.The subtotal excision was got in 1 of 7 cass.Follow-up with 6 ca- ses between 6 to 36 months,the occupied symptoms in 6 cases improved good.No remnant tumor and recur- rent were found in the MRI follow-up.Conclusion By using of the proper posterior approaches,the micro- surgical outonmes of the meningiomas arising from craniocervical junction are good.