We analyzed the special characteristics of postgraduate education for anesthesiology majors based on the current situation of medical postgraduate education.Next,we introduced the ‘ sandwich' teaching method and discussed how it can promote students' subjective initiative by transforming various learning patterns.Finally,the effectiveness of study was elevated by ‘sandwich' teaching method.

The Hodgkin and Reed/Sternberg (HRS) tumor cells of classical Hodgkin's lymphoma (HL) and the lymphocyte-predominant (LP) tumor cells of nodular lymphocyte-predominant HL are both derived from germinal center B cells.Several studies show that HL pathogenesis includes the deregulated activity of numerous members and regulators of the NF-κB and JAK/STAT signaling pathways,genetic lesions of epigenetic regulators,and the interactions between tumor cells and other infiltrating cells in the microenvironment,et al.

Objective To investigate the effects of Buyang-Huanwu decoction combined with western medicine on early diabetic renal injury.Methods 200 cases of early diabetic renal injury were randomly recruited into study group and control group,with 100 cases in each group.The control group was treated with insulin injection and oral benazepril hydrochloride,and the blood pressure,blood lipid changes were closely monitored; while the study group was additionally treated with Buyang-Huanwu decoction on the basis of the control group.Results The total therapeutic effects in the study group was significantly higher than the control group (x2=15.62,P＜0.01).The values of FBG,2 h PG,DBP,SBP,HbAlc in both groups were significantly reduced after the treatment (P＜0.05,t=4.23,4.47,3.59,3.87,3.99 in the study group,t=4.34,4.76,4.05,3.78,3.69 in the control group) ; but the difference between the two groups had no significance (P＞0.05).Before treatment rnALB,Urea,Cr,TG and TC were not significantly different (P＞0.05) ; the values of mALB,Ureaand Cr were significantly reduced in the study group after the treatment (P＜0.05,t=4.56,3.73,3.28);especially mALB in the study group was obviously lower than the control group (P＜0.05,t=5.01).Conclusion Buyang-Huanwu decoction combined with western medicine was effective to treat early renal damage of type 2 diabetes,with the functions of reducing urinary protein,improving microcirculation and protecting renal function.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pterygopalatine Fossa ; innervation ; Rhinitis ; physiopathology ; therapy ; Smell ; Treatment Outcome ; Young Adult

Objective To evaluate the clinical effect of bandage contact lens on patients after the pterygium excision surgery.Methods 200 patients with pterygium excision were used retrospectively analysis and were divided into control group and observation group by random digital table method.Patients in observation group wore bandage contact lens while those in control group did not (traditional method).The degree of pain in both groups was evaluated at 8 hours,24 hours and 48 hours after surgery.In addition,patients were surveyed for the satisfaction of our treatment when discharge.Results The ocular foreign body sensation,eye burning,tears and eye open difficult were obviously decreased in observation group (t=5.643,10.315,P ＜ 0.01).The overall comfort level of the patients in observation group was obviously improved.pain feeling of the eye after surgery in 8h,24h and 48h markedly decreased in observation group (t=6.196-12.495,P ＜ 0.01).The degree of satisfaction scores of preoperative guidancein,postoperative pain control,emotion,mental nursing,self-care ability,comfort in observation group were (1.59-0.62) points,(1.83±0.70) points,(1.42±0.68) points,(1.42±0.68) points,(1.48±0.67) points,(1.29±0.77) points,(1.43-0.64)points which were obviously increased than (0.76±0.55) points,(0.83±0.64points,(0.82±0.56) points,(0.80±0.47) points,(0.79±0.61) points,(0.66±0.54) points (t=4.311-9.354,all P＜ 0.01).Conclusions Compared with traditional treatment,bandage contact lens can significantly reduce the discomforts after the pterygium excision surgery,and increase the postoperative comforts of patients.It proves that bandage contact lens have extensive clinical value.

Objective To investigate the effect of Shenfu injectio on insulin resistance in rabbits undergoing cardiopulmonary bypass (CPB) . Methods Thirty New Zealand white rabbits of both sexes weighing 2.2-2.5 kg were randomly divided into 3 groups (n = 10 each): group I sham operation (group S); group Ⅰ CPB and group Ⅰ CPB + Shenfu injectio (group SFI). In group IE (group SFI) Shenfii injectio 10 ml/kg was injected intraperitoneally (IP) once a day for 2 days and at 30 min before anesthesia. In group Ⅱ and Ⅲ the duration between aortic cross-clamping and unclamping was 60 min. MAP was maintained at 50-60 mm Hg during CPB. The plasma glucose and insulin concentrations were measured immediately after induction of anesthesia (T_1), immediately after aortic cross-clamping (T_2) , and at 5, 35 and 75 min after aortic unclamping (T_3, T_4 , T_5) and insulin resistance index (HOMA-IR) was calculated. The expression of insulin receptor substrate-1 (IRS-1), phosphatidyl-inositol 3 kinase (PI3Kp85) and glucose transporters (CLUT4) in skeletal muscle was detected at 150 min of CPB by immuno-histochemistry. Results Compared with the baseline values at T_1 , plasma glucose and insulin concentrations and HOMA-IR were significantly increased at T_(2-5) in all 3 groups ( P < 0.05) . CPB significantly increased the plasma glucose and insulin concentrations and HOMA-IR at T_(2-5) in group Ⅱ and Ⅲ as compared with group S ( P < 0.05). The expression of PI3Kp85 and GLUT4 in muscle was significantly decreased in group Ⅱ and Ⅲ as compared with group S ( P < 0.05). Shenfu injectio significantly decreased plasma glucose concentration and HOMA-IR and increased plasma insulin concentration in group fD as compared with group Ⅱ . Shenfu injectio significantly attenuated the CPB-induced changes in IRS-1, PI3Kp85 and GLUT4 expression in muscle. Conclusion Shenfu injectio can ameliorate CPB-induced insulin resistance and the mechanism may be related to the up-regulation of the expression of insulin signal transduction molecules in skeletal muscle.

Objective To investigate the significance of an accessory hepatic vein (AHV) in the interventional treatment of Budd-Chiari syndrome (BCS).Methods From Mar.2011 to Jun.2013,35 patients with BCS who also had an AHV were included into this study.The patients were divided into two groups according to whether the AHV was obstructive:21 patients had obstruction to the inferior vena cava (IVC) and to the 3 hepatic veins (HV),but the AHV was open; 14 patients had obstruction to the AHV and the 3 HVs.In 13 of these patients the IVC was open,but 1 patient had obstruction to the IVC.During treatment,the patients in the AHV open group underwent balloon dilation or stent insertion of IVC ; patients in the AHV obstruction group underwent balloon dilation or stent insertion of AHV.The patient with obstruction to the IVC underwent balloon dilation of IVC first.Results All patients were successfully treated without any procedure-related complications.In the AHV open group,the average pressure of the AHV decreased from (28.81 ± 6.23) cmH2 O (1 cmH2O =0.098 kPa) before treatment to (18.62 ± 5.06) cmH2O after treatment (P ＜ 0.01) ; the average serum TBIL decreased from (23.24 ± 6.41) μmol/L before treatment to (19.52 ± 4.31) μmol/L after treatment (P ＜ 0.01) ; the average serum albumin changed from (33.76 ± 3.74) g/L before treatment to (34.05 ± 3.62) g/L after treatment (P =0.485).In the AHV obstruction group,the average pressure of the AHV decreased from (36.29 ± 11.65) cmH2O before treatment to (22.07 ± 7.67) cmH2O after treatment (P ＜ 0.01) ; the average serum TBIL decreased from (31.24 ± 9.54) μmol/L before treatment to (20.93 ±7.26) μmol/L after treatment (P ＜0.01) ; the average serum albumin changed from (32.14 ± 4.55) g/L before treatment to (32.11 ± 4.47) g/L after treatment (P =0.861).During follow-up,no patients experienced recurrence of symptoms in the AHV open group; one patient experienced recurrence of symptoms 5 months after treatment in the AHV obstruction group.This patient received a second balloon dilation of the AHV.Conclusions For patients with BCS with IVC and the 3 HVs obstruction,if the AHV was open,we could only treat the IVC.For patients with BCS with AHV and the 3 HVs obstruction,AHV dilation followed by recanalization of AHV was also effective.

BACKGROUND:Treatment methods for high anal fistula include fistula removal, incision and thread drawing, selective mucosal flap displacement, fibrin glue closure, fistula liagtion between sphincter, most of which show many advantages, including long-term healing, a low success rate, high recurrence rate, and high postoperative complication rate.
OBJECTIVE:To observe the clinical effect of acelular extracelular matrix in the treatment of high anal fistula, and to explore a minimaly invasive treatment for high anal fistula.
METHODS: Totaly 100 cases of high anal fistula were randomly divided into treatment group and control group, 50 cases in each group. Treatment group were treated with alogenic acelular extracelular matrix, and control group were treated with traditional low incision with high thread-drawing. Then, we observed and compared the operation time, bleeding volume, postoperative pain score (visual analog scale score), postoperative pain
duration, anal incontinence severity score (Wexner score), wound healing time, one-stage success rate, cure rate, recurrence rate.
RESULTS AND CONCLUSION: Compared with the control group, the treatment group showed lower scores in the operation time, bleeding volume, wound healing time, visual analog scale score, postoperative pain duration, and anal incontinence severity score (P < 0.05), but higher scores in one-stage success rate and cure rate (P < 0.05). There was no difference in the recurrence rate between the two groups. These findings indicate that the alogenic acelular extracelular matrix for treatment of high anal fistula exhibits smal trauma, quick recovery,
short course of treatment, high cure rate and has no damage to the anal function and appearance.

Objective: To observe the anti-tumor effect of Phellinus Linteus and Coriolus Versicolor Capsules (PLCVC) in S180 sarcoma and H22 hepatoma animal models in mice. Methods: The sarcoma S1180 and hepatoma H22 models were established in mice. After 12 days of treatment, the animals were killed, and the subcutaneous sarcoma were separated and weighted. The levels of vascular endothelial growth factor(VEGF), CD4 and CD8 of S180 tumor tissue were investigated by immunohistochemical method. KM mice were intraperitoneal injected with H22 hepatoma cells, and treated with different experimental drugs. The survival time was observed and recorded, and life-prolongation rate was calculated. Result: PLCVC could inhibit the growth of S180 and H22 tumor, and inhibit the expression of VEGF, improve the expression of CD4 and CD8. The survival time of the mice treated by PLCVC were significantly longer than the untreated group. Conclusion: PLCVC can inhibit the growth of tumour, the mechanism is partially related to inhibiting angiogenesis and improving the immunological function.

Objective To quantitatively study the posterior fossa effective space and its relationship with hemifacial spasm (HFS).Methods We conducted a case-control study of patients diagnosed with HFS and sex-and age-matched healthy controls.All subjects underwent high-resolution three-dimensional MRI.The software of 3D-Slicer was used to measure the posterior fossa space and hindbrain tissue volume between the two groups.Results Sixty patients and 60 controls were enrolled in this study.Compared to controls,patients with HFS had a higher posterior fossa crowdedness index (PFCI;83.7％ ± 0.6％ vs 79.2％ ± 0.4％;t =2.58, P =0.01).The multivariate linear regression analysis revealed that a higher PFCI was associated with younger age (r =-0.61, P =0.02), female gender (r =0.76, P =0.003) and HFS (r =-0.43, P =0.01).Conclusions Patients with HFS have a more crowded posterior fossa space than healthy controls, potentially leading to cranial nerve and vascular structure crowding, thus increasing HFS risk.Women have a higher PFCI, which may explain the strong female preponderance in epidemiologic studies.