Application of the theory of PDCA cycle to guide to build the hospital's project continuous quality improvement management mode,By Analyzing reasons,optimizing processes,improving the bidding system,regulating the declaration format,increasing of directors' participation,playing the role of expert,and evaluating the effect to continue improving the quality of hospital's project.PDCA cycle method effectively aroused the enthusiasm of young scientific research personnel,and promoted the continuous development of scientific research work.

Science and technology innovation is an important quality of young talents in the new period requirements and training objectives,as well as hospital's driving force and source of the future sustainable development.Under the innovation-driven strategy,characterized by cultivating young talents of science and technology innovation,with the efforts to develop and improve young talents cultivation way,our hospital aim to accelerate the development of young talent as soon as possible.By setting up a hospital's fund,we gradually formed a stable funding system including the four directions of clinical,nursing,management,education.With the development purposes of young researchers as the main body,adhere to improve the quality of hospital funds is the key,we aim at forming a reasonable fund scale.Through the top level design,strict process management,implementation of opening argument and a series of strong measures to ensure project quality,we promote youth science and technology innovation talents effectively.

Objective To investigate the effects of propofol administered at different intervals on acute lung injury induced by endotoxin shock and the mechanism in rats.Methods Seventy-six healthy adult male Wistar rats, weighing 250-290 g were anesthetized with 30 % pentobarbital sodium 30 mg. kg-1 ip. Carotid artery and jugular vein were cannulated for BP monitoring and administration of drugs and fluid. The animals were randomly divided into 5 groups : group A received only normal saline (NS) ( n = 8) ; group B received LPS 8 mg' kg and NS iv ( n =17); group C-E received a bolus of propofol 5 mg .kg-1 iv, 1 h before (group C) or together with (group D) or 1 h after intravenous LPS (group E) followed by propofol infusion at 10 mg . kg-1 . h-1 ( n = 17 in each group). The animals were observed for 5 h after LPS. Blood samples were taken from femoral artery before (baseline) and 1, 3 , 5 h after LPS for determination of PaO2 ,pH, and serum TNF-a and NO levels. The survival rates of the animals in the 5 groups during the 5 h after LPS were compared. The animals were sacrificed and the lungs were removed at the end of 5 hour observation for determination of lung TNF-a and MDA content and myeloperoxidase (MPO) activity and microscopic examination. Results Propofol given 1h before (group C) and simultaneously with LPS (group D) significantly attenuated the decrease in MAP, pH and PaO2 and increase in serum contents of TNF-a and NO and lung TNF-a, MDA contents and MPO activity induced by LPS. The 5 hour survival rate was also significantly higher in group C and D than that in group B. Conclusion Early propofol administration is beneficial during endotoxin-induced shock.

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 investigate the effect of propofol on transforming growth factor (TGF)-β1/Smad2 signaling pathway in lung tissues in rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI).Methods Fifty-six male Wistar rats,aged 7-8 weeks,weighing 260-300 g,were randomly divided into 5 groups:control group (group A,n =8) ; LPS group (group B,n =12); 3 propofol groups (groups C,D,E,n =12).ALI was induced by intravenous LPS 8 mg/kg in groups B,C,D and E.In groups C,D,E,propofol 5 mg/kg was injectedintravenously before LPS administration and at 0 and 1 h after LPS administration,respectively,followed by infusion of propofol at 10 mg· kg-1 · h-1 until 5 h after LPS administration.Group A received the equal volume of normal saline.Arterial blood samples were collected immediately before LPS administration and 1,3 and 5 h after LPS administration for determination of pH value and PaO2.Then the animals were sacrificed and the lungs were immediately removed for calculation of the wet/dry lung weight ratio and for determination of the expression of TGF-β1-mRNA and Smad2 in lung tissues.Results Compared with group A,pH value and PaO2 were significantly decreased,wet/dry lung weight ratio was increased and the expression of TGF-β1 mRNA and Smad2 was up-regulated in groups B and E (P ＜ 0.05).Compared with group B,pH value and PaO2 were significantly increased,wet/dry lung weight ratio was decreased and the expression of TGF-β1 mRNA and Smad2 was down-regulated in groups Cand D,and PaO2 was significantly increased in group E (P ＜ 0.05).Conclusion The mechanism by which propofol alleviates ALI induced by LPS is related to inhibition of TGF-β1/Smad2 signaling pathway.

Objective To explore the application of direct observation of procedural skills (DOPS) in anesthesia-related effects skills teaching. Methods Anesthesia students in the Department of Anesthe-siology, Clinical Medical College, Yangzhou University between June 2013 and June 2015, received an anesthesia-related DOPS examination at the mid-internship and pre-delivery. Through the DOPS assessment results, the analysis of teachers' and students' satisfaction degree on the evaluation results, the teaching effect of DOPS was evaluated. At the same time, the students were surveyed to find out the satisfaction degree of DOPS. SPSS 18.0 was applied to processing the date. Measurement data were expressed as mean plus or minus standard deviation, and t test was used in the comparison between groups. Results Interim assessment indicators for each individual average of more than four points , the individual departmental rotation examination scores were higher than the overall average score interim assessment results. Compared with interim assessment, satisfaction of teachers has made great progress in the end of assessment [(8.46 ± 0.32) vs. (8.14 ±0.60)], satisfaction of students was [(8.57 ±0.59) vs. (8.20 ±0.45)], satisfaction of the students was higher than the teachers [(8.57±0.59) vs. (8.46±0.32)], and the differences were statistically significant. Conclusion DOPS as an effective anesthesia-related skill of teaching and assessment method, can improve the level of anesthesia anesthesia-related skills of college students.

Objective To evaluate the effect of mechanical stretch preconditioning on pathological stretch-induced activation of γ-aminobutyric acid (GABA) signaling pathway in human type Ⅱ alveolar epithelial cells (AEC Ⅱ).Methods AEC Ⅱ cell line (A549 cells) culturedin vitro were divided into control group (group C), pathological stretch group (group P1) and mechanical stretch preconditioning group (group P2). In group C, A549 cells were cultured routinely. In group P1, A549 cells were exposed to 20% cyclic stretch for 6 hours. In group P2, A549 cells were exposed to 5% cyclic stretch for 60 minutes, and then exposed to 20% cyclic stretch for 6 hours. The cells were harvested for determination of the cell viability by methyl thiazolyl tetrazolium assay, lactate dehydrogeuase (LDH) release was determined by colorimetric method, the levels of interleukin (IL-1β and IL-6) and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA), the mRNA expressions of IL-1β, IL-6 and TNF-α were determined by reverse transcription-polymerase chain reaction (RT-PCR), and the protein expressions of glutamic acid decarboxylase (GAD) and γ-aminobutyric acid A receptor (GABAAR) were determined by Western Blot.Results Compared with group C, the cell viability of group P1 was significantlydecreased (A value: 0.196± 0.071 vs. 0.886±0.107), the release rate of LDH was significantly increased [(12.3±2.4)% vs. (1.9±0.5)%]; the contents and mRNA expressions of IL-1β, IL-6 and TNF-α in cell culture medium were significantly increased [IL-1β (ng/L): 138.6±19.7 vs. 32.7±7.4, IL-6 (ng/L): 196.5±31.7 vs. 55.4±13.8, TNF-α (ng/L): 111.3±21.8 vs. 20.8±7.6; IL-1β mRNA (2-ΔΔCT): 2.79±0.44 vs. 0.83±0.12, IL-6 mRNA (2-ΔΔCT): 1.99±0.25 vs. 0.56±0.11, TNF-α mRNA (2-ΔΔCT): 2.54±0.37 vs. 0.72±0.09]; the protein expressions of GAD and GABAAR were significantly decreased [GAD (gray value): 0.38±0.12 vs. 1.75±0.45, GABAAR (gray value): 0.29±0.09 vs. 1.68±0.39; allP < 0.05]. Compared with group P1, the cell viability of group P2 was significantly increased (A value: 0.523±0.132 vs. 0.196±0.071),the release rate of LDH was significantly decreased [(6.9±1.7)% vs. (12.3±2.4)%]; the contents and mRNA expressions of IL-1β, IL-6 and TNF-α in cell culture medium were significantly decreased [IL-1β (ng/L): 79.2±11.6 vs. 138.6±19.7, IL-6 (ng/L): 89.6±15.6 vs. 196.5±31.7, TNF-α (ng/L): 55.9±11.4 vs. 111.3±21.8; IL-1β mRNA (2-ΔΔCT): 1.92±0.36 vs. 2.79±0.44, IL-6 mRNA (2-ΔΔCT): 1.09±0.18 vs. 1.99±0.25, TNF-α mRNA (2-ΔΔCT): 1.77±0.25 vs. 2.54±0.37]; the protein expressions of GAD and GABAAR were significantly increased [GAD (gray value): 1.26±0.33 vs. 0.38±0.12, GABAAR (gray value): 1.04±0.15 vs. 0.29±0.09; allP < 0.05]. Conclusion The mechanism by which mechanical stretch preconditioning attenuates pathological stretch-induced injury in human AECⅡ is related to the activation of GABA signaling pathway.

ObjectiveTo investigate the risk factors for early postoperative cognitive dysfunction (POCD) in elderly patients after colorectal cancer surgery.Methods One hunderd and twenty ASA Ⅱ or Ⅲ patients aged ≥ 65 yr undergoing colorectal cancer surgery were divided into POCD group and non-POCD group according to the results of the Mini-Mental State examination (MMSE) at 7th day after operation.Age,weight,sex,the educational level,anatomical location of the tumor,TNM stages,complications,preoperative TCM syndrome type,duration of anesthesia,emergence time,the blood loss during opertion and the number of intraoperative hypotension were recorded.The cognitive function was assessed at 1 d before operation and at 1,3,7 d after operation using MMSE.The risk factors for POCD were analyzed by multivariate logistic regression analysis.ResultsThe incidence of POCD was 29.2 ％.Logistic regression analysis results indicated that age,the educational level,anatomical location of the tumor and the number of intraoperative hypotension were the risk factors for POCD( P ＜ 0.05).Conclusion Age,the educational level,anatomical location of the tumor and the number of intraoperative hypotension are risk factors for POCD in elderly patients after colorectal cancer surgery.

Objective To evaluate the relationship between hippocampal monocyte chemotactic protein-1 (MCP-1) and its receptor C-C chemokine receptor 2 (CCR2) and postoperative cognitive dysfunction (POCD) in aged rats.Methods Forty-eight male Sprague-Dawley rats,aged 20-22 months,weighing 480-550 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group C) and POCD group.POCD group inhaled 2.0％ isoflurane and underwent splenectomy.Before surgery and at 1,3 and 7 days after surgery,Morris water maze test was performed to evaluate the spatial learning and memory ability.The escape latency and swimming distance were recorded.Eight rats were sacrificed after the end of Morris water maze test performed at 1,3 and 7 days after surgery.Then the brains were removed,and the hippocampi were isolated for detection of the expression of MCP-1 and CCR2 by Western blot.Results Compared with group C,the escape latency and swimming distance were significantly prolonged,and the expression of MCP-1 and CCR2 in hippocampi was up-regulated at 1,3 and 7 days after surgery in POCD group.Conclusion Up-regulation of hippocampal MCP-1 and CCR2 expression may be involved in the mechanism of POCD in aged rats.

According to the characteristics of minor students majored in clinical anesthesia, an objective structured clinical examination (OSCE) program was established. This OSCE was applied to clinical anesthesia minor students for departmental rotation examination. Meanwhile, a questionnaire was set to collect students' attitude towards the OSCE assessment program. Results showed that OSCE assessment program could objectively and comprehensively reflect the students' clinical skills. Students participated in OSCE were quite satisfied with its design, organization, quality and effectiveness.