As the burden of anesthesiology teaching is heavy in undergraduate course, teachers can communicate with the students by nonverbal behaviors, such as eye contact, silent language, facial expression, paralanguage, which can make class atmosphere active, develop harmonious teacher-student relationship, and improve the quality of class teaching. Teachers of anesthesiology should take some measures, such as rehearsing lessons, summing up the experience of the lessons in time, accu-mulating the experience of nonverbal behaviors, and doing some exercise for the nonverbal behavior as much as possible, so as to set up an excellent atmosphere for teaching ,and meanwhile improve the quality of anesthesiology teaching.

Anesthesia related skills training is an important component of standardized residency training plan.Attention should be paid to the clinical thinking ability,preoperative assessment capacity,sterile concepts and technologies,cardiopulmonary brain recovery skills and teamwork ability cultivation during the rotation of resident physieians and resident surgeons,and comprehensive and scientific examination system should be established

Objective: To observe the balance of modified coagulation and fibrinolysis in patients undergoing open heart surgery with cardiopulmonary bypass (CBP). Method: The balance of modified coagulation-fibrinolysis in 20 cases were measured by coagulation-fibrinolysis dynamicography instrument (FD-Ⅲ) at the pre-CPB, post-CPB, 24, 48 and 168 hours postoperatively. Result: At the post-CPB, coagulation starting time(CST), maximum coagulation time (MCT), whole time of fibrinolysis reaction (WFT) and balance time (BLT) were significantly more than at pre-CPB (P

Objective To evaluate the impact of subclinical hypothyroidism (SCH) on the outcome of pregnancy and the therapeutic effect of L-T4.Methods A total of 1 786 pregnant women during the first, second, and third trimesters were enrolled for thyroid screening by determining serum free thyroxine (FT4), total thyroxine (TT4), thyrotropin (TSH), and thyroid peroxidase antibody;123 pregnant women with SCH were successfully divided into treated group (n =42) and untreated group (n =81).The treated group was treated by L-T4 based on American Thyroid Association (ATA) 2011 guideline.Collected items include obstetric outcomes and complications.Results (1) Compared to control group, the rate of spontaneous abortion in pregnant women during first trimesters was increased in SCH group (20.99％ vs 8.45％, x2 =12.96, P =0.00), with higher incidence of diabetes during second trimester (24.69％ vs 10.45％, x2 =14.11, P =0.00).The incidences of hypertension during pregnancy, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight showed no difference between two groups (all P ＞ 0.05).(2) Compared with the untreated group, the incidences of spontaneous abortion and diabetes were decreased in the treated group (7.14％ vs 20.99％, x2 =3.89, P =0.05;9.52％ vs 24.69％, x2 =4.05, P =0.04), while the incidences of hypertension, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight infant accident rate were not different between two groups (all P ＞ 0.05).Conclusions SCH during the frist trimester is a risk factor of spontaneous abortion;SCH during the middle stage of pregnancy is a risk factor of gestational diabetes mellitus.Treatment of SCH with L-T4 may be beneficial.

Objective To investigate the effects of preconditioning with different concentrations of nerve growth factor (NGF)-β on ischemia-reperfusion (I/R) injury in isolated rat hearts.Methods Thirty-two male Sprague-Dawley rats weighing 200-300 g,aged 8-10 weeks,were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg and heparin 500 IU/kg.Their hearts were excised and perfused in a Langendorff apparatus with K-H solution oxygenated with 95％ O2-5％ CO2 at 37 ℃.After 10 min of stabilization,the isolated hearts were randomly divided into 4 groups (n=8 each): I/R group and different concentrations of NGF-β groups (groups N1-N3).In group I/R,the hearts were continuously perfused with K-H solution for 30 min,perfusion was suspended for 30 min followed by 120 min reperfusion.In groups N1-N3,the hearts were continuously perfused with K-H solution containing NGF-β0.1,0.2 and 0.4 ng/ml,respectively,for 20 min,followed by 10 min washout,and perfusion was suspended for 30 min followed by 120 min reperfusion.HR,Left ventricular end-diastolic pressure (LV-EDP),left ventricular developed pressure (LVDP) and + dp/dtmax were measured at the end of 10 min stabilization (baseline,T1),immediately before suspension of perfusion (T2),and at 5,30,60 and 120 min of reperfusion (T3-6).The activities of creatine kinase MB (CK-MB) and lactate dehydrogenase (LDH) in the coronary effluent were measured at T1 and T3-T6.Myocardial tissues were obtained at T6 for detection of apoptosis (by TUNEL) and for microscopic examination.Apoptotic index (AI) was calculated.Results Compared with the baseline value at T1,LVDP and + dp/dtmax were significantly decreased,and LVEDP and activities of LDH and CK-MB were significantly increased at T3-T6 in each group,HR was significantly decreased in groups I/R,N2 and N3,while HR was significantly increased in group N1 (P ＜ 0.05).Compared with group I/R,LVDP,+ dp/dtmax and HR were significantly increased,LVEDP,activities of LDH and CK-MB and AI were significantly decreased in group N1,LVDP,+ dp/dtmax and HR were significantly decreased,and activities of LDH and CK-MB were significantly increased in group N2,and LVDP,+ dp/dtmax and HR were significantly decreased,and LVEDP,activities of LDH and CK-MB and Al were significantly increased in group N3 (P ＜ 0.05).LVDP,+ dp/dtmax and HR were significantly lower,and LVEDP,activities of LDH and CK-MB and AI were significantly higher in groups N2 and N3 than in group N1,and in group N3 than in group N2 (P ＜ 0.05).The pathologic changes were reduced in group N1 compared with I/R,N2 and N3 groups.Conclusion Preconditioning with the optimum concentration of NGF-β can at-tenuate I/R injury in isolated rat hearts,however,the injury can be aggravated when the concentration is too large,and inhibition of apoptosis in myocardial cells is involved in the mechanism of myocardial protection.

Objective To evaluate the effect of pretreatment with nerve growth factor-beta (NGF-β) on ischemia-reperfusion (I/R) injury in isolated rat hearts by comparing it with NGF-β preconditioning.Methods Pathogen-free male Sprague-Dawley rats,weighing 200-300 g,aged 8-10 weeks,were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Their hearts were excised and perfused in a Langendorff apparatus with KH solution aerated with 95％ O2 and 5％ CO2 at 37℃.Twenty-four isolated rat hearts were randomly divided into 3 groups (n =8 each) using a random number table:I/R group,NGF-β pretreatment group (group NGFPt) and NGF-β preconditioning group (group NGFPc).The hearts were perfused with K-H solution for 10 min (equilibration) in each group.In group I/R,the hearts were continuously perfused with K-H solution for 30 min.The hearts were continuously perfused with K-H solution containing NGF 0.1 μg/ml for 20 min before ischemia in group NGF-Pt.The hearts were continuously perfused with K-H solution containing NGF 0.1 μg/ml for 20 min followed by 10 min washout before ischemia in group NGFPc.The perfusion was suspended for 30 min followed by 120 min of reperfusion with K-H solution in each group.HR,left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP) and + dp/dtmax were measured at the end of 10 min equilibration (baseline,T1),immediately before suspension of perfusion (T2),and at 5,30,60 and 120 min of reperfusion (T3-6).The activities of creatine kinase isoenzyme-MB (CK-MB) and lactate dehydrogenase (LDH) in coronary effluent were measured at T1 and T3-6.Myocardial specimens were obtained at T6 for detection of myocardial apoptosis (by TUNEL) and for microscopic examination.Apoptotic index (AI) was calculated.Results Compared with the baseline value at T1,+ dp/dtmax was significantly decreased,and LVEDP and activities of CK-MB and LDH were increased at T3-6 in each group,LVDP and HR were decreased at T3-6 in group I/R,LVDP was decreased at T3,4 in group NGFPt and at T3-6 in group NGFPc,and HR was increased at T2-6 in NGFPt and NGF Pc groups (P ＜ 0.05).Compared with group I/R,LVDP,+ dp/dtmax and HR were significantly increased and LVEDP and activities of CK-MB and LDH and AI were decreased in NGFPt and NGFPc groups (P ＜ 0.05).Compared with group NGFPc,LVDP,+ dp/dtmax and HR were significantly increased,while the LDH activity and AI were decreased (P ＜ 0.05) and no significant changes were found in LVEDP and CK-MB activity in group NGFPt (P ＞ 0.05).The pathologic changes of myocardium were significantly reduced in NGFPt and NGFPc groups as compared with I/R group.Conclusion Pretreatment with 0.1 μg/ml NGF-β attenuates I/R injury in isloated rat hearts,and the efficacy is superior to that of NGF-β preconditioning.

ObjectiveTo investigate the effect of cardiopulmonary bypass (CPB) on the secretory function of islet cells in rabbits.MethodsTwenty adult New Zealand white rabbits of both sexes,weighing 2.5-3.0kg,were randomly divided into 2 groups ( n =10 each):sham operation group (group S) and CPB group.The rabbits were anesthetized with 3％ pentobarbital sodium 30 mg/kg.Blood samples were collected from the left femoral artery at 5 min after anesthesia (T1),immediately before CPB (T2 ),immediately after aortic clamping (T3 ),and at 5,35 and 75 min after aortic unclamping (T4-6) in the two groups for determination of levels of blood glucose,insulin and glucagons.Insulin resistance index was calculated.ResultsCompared with group S,the blood glucose concentration and levels of insulin and glucagons and insulin resistance index at T3-6 were significantly increased in group CPB ( P ＜ 0.05).ConclusionAlthough increase in blood glucose enhances the secretion of insulin in islet β cells,hyperglycemia cannot be compensated completely by the increased insulin during CPB in rabbits.The increase in blood glucose may be related to islet α cell resistance.

Objective: The bacterial superantigen staphylococcal enterotoxin A (SEA) has the potent ability of inducing T cell activation as well as directing activated T cells to kill tumour cells. However, its application in the tumour treatment is limited due to its systemic immune activation.In order to minimize its side effects SEA liposomes is prepared and their toxcicity in vivo is investigated . Methods: SEA liposomes were prepared by the method of reverse-phase evaporation . SEA liposomes were administered intravenously . In vivo the toxcicity of SEA liposomes was investigated by the measurement of blood pressure, colonic temperature and breath rate of New Zealand rabbits. Mice plasma TNF-? and IFN-? level were determined by ELISA . Results:After iv administration of SEA liposomes, significant reduction of mice plasma TNF-? and IFN-? level was observerd. As compared to free SEA, liposomal SEA had less effect on blood pressure, colonic temperature and breath rate of the rabbits. Conclusion:SEA Liposomes had relatively low toxicity. These advantage was probably due to its lower systemic immune activation effect and inducing consequent lower systemic TNF-? and IFN-? level.

Objective To explore advantages of simulation-based medical education for overseas students on training of anesthcsia emergency skills.Methods twenty eight oversea students accepting anesthesia practice course were divided into two groups,each group fourteen.The students of simulation group (group S) were lectured with simulation-based medical education method,while the students of control group (group C) were lectured with tradition education method.Results the practice examination record and satisfaction degree for teaching in group S were both higher than that in group C (P＜0.05).Conclusion The simulation-based medical education was better than tradition education method on training of anesthesia emergency skills for oversea students.The simulation-based medical education may raise the learning interest of oversea students obviously,and it is beneficial to students' mastery of practice skills.

A peptide microarray-based fluorescence and resonance light scattering ( RLS ) two readout assay was developed for screening thrombin inhibitors in blood samples. In this assay, the biotinylated peptide microarray was used as the platform. The peptide C-terminal fragments carried biotin sites departed from the slide when the biotinylated peptides were digested by thrombin hydrolysis reaction. The hydrolysis progress was labeled by fluorescence and 30 nm peptide-stabilized gold nanoparticles through the biotin-avidin reaction. In the presence of thrombin inhibitors, the hydrolysis reactions were blocked, and the inhibition capability of inhibitors could be detected by the fluorescent and RLS signal changes. The order of the half maximal inhibitory concentration ( IC50 ) of thrombin inhibitors in pure thrombin solution and spiked human serum were argatrobanHAT-Ⅲ>trypsin inhibitor>E-64>AEBSF. The reversible or irreversible characters of argatroban and HAT-Ⅲ had been estimated in human plasma. Compared with the experimental data of fluorescent and RLS assay in blood sample, the RLS assay labeled by 30 nm gold nanoparticles are more suitable for the inhibitor detection in complicated blood sample.