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.

Objective:To study the movement regularity of Ca~(2+) in tooth hard tissue.Methods:14 extracted intact caries-free teeth were cleaned and then immersed into artificial saliva in a divice with 3 chambers for enamel part,dentin part and cement part respectively.The concentration of Ca~(2+) in the chambers was measured with an ion meter,TECHNICON(AXON,USA),24 h after immersion of each tooth.Results:The Ca~(2+) concentration in tooth immersed fluid of enamel part was higher than that of dentin part(P

Objective To study the efficacy and safety of treating Parkinson disease(PD) by repetitive transcranial magnetic stimulation (rTMS). Methods 45 patients with PD were randomly divided into two groups. 30 patients received rTMS therapy and 15 patients were given sham stimulation. Stimuli were delivered at an intensity of 110% of resting threshold (RT) and a frequency of 1Hz once a day for 10 days. All the patients were followed-up at 1 month and 3 months after treatment. The efficacy was assessed by UPDRS score, grooved pegboard test, timed motor test and 10m turned back test. All the patients stopped using dopaminergic drugs for at least 12h before each assessment. Results In rTMS treatment group, the UPDRS total scores, UPDRSⅠ-Ⅲ, the mean times of grooved pegboard and 10m turned back test were significantly decreased 10 days after treatment compared with pre-treatment (all (P)0.05), and PDQ scores significantly decreased 3 months after treatment. In sham treatment group, there was no difference of each index between pre- and post-sham treatment.Conclusion Low frequency rTMS may improve the symptoms of the patients with PD and raise their quality of life.

Objective To study the effect of hypothyroidism on oxidative stress status in developing rat brain and to further explore the mechanism of impaired brain development caused by hypothyroidism. Methods Perinatal hypothyroidism was induced by administering propylthiouracil(PTU) solution to the dams by gavage.The oxidative stress indexes were measured in brain homogenate of normal and hypothyroid pups which were sacrificed on the 21st d after birth. Results As compared to the control,the following indexes were found to be increased in the hypothyroid group: protein carbonyl contents,thiobarbital acid reactive substances,reduced glutathione,total antioxidative capacity,activities of superoxide dismutase and glutathione peroxidase(P0.05). Conclusion Hypothyroidism during rat brain development may cause oxidative stress,which may be related to the brain damage caused by hypothyroidism.

Objective To evaluate the effect of infiltration anesthesia at Calot's triangle on postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.Methods One hundred and forty patients,aged 18-64 yr,with 18 kg/m2 ≤ body mass index ≤ 31 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,were randomly divided into 2 groups (n =70 each):control group (group A) and infiltration anesthesia at Calot's triangle group (group B).In group B,1％ ropivacaine 10 ml was injected into Calot's triangle before dissection of the gallbladder,while the equal volume of normal saline was injected into Calot's triangle in group A.The patients in both groups received patient-controlled intravenous analgesia (PCIA) for 48 h starting from 10 min before the end of surgery.The VAS score was maintained below 4 during PCIA.When VAS score ≥ 4,lasting for more than 30 min,tramadol 1.5 mg/kg was injected intravenously.The consumption of physic liquor for PCIA,and requirement for tramadol were recorded.The incidence of puncture-related damage to Calot's triangle and local anesthetic intoxication and adverse effects such as nausea and vomiting within 48 h after surgery were also recorded.The first postoperative flatus time was recorded.Results Compared with group A,the consumption of physic liquor for PCIA,requirement for tramadol,and consumption of tramadol were significantly reduced,and no significant change was found in the incidence of nausea and vomiting and the first postoperative flatus time in group B.No puncture-related damage to Calot's triangle occurred in A and B groups.There was no local anesthetic intoxication in group B.Conclusion Infiltration anesthesia at Calot's triangle can optimize postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.

Adenocarcinoma, Clear Cell ; pathology ; Aged ; Female ; Humans ; Kidney Neoplasms ; pathology ; Paranasal Sinus Neoplasms ; secondary

Objective To evaluate the role of cerebrospinal fluid-contacting nuclei (CSF-CN) in maintenance of chronic itch in rats.Methods Forty-two adult male Sprague-Dawley rats,aged 3 months,weighing 240-280 g,were used in the study.The experiment was performed in two parts.Part Ⅰ Forty-two Sprague-Dawley rats were randomly divided into 3 groups (n =14 each):control group (C group),acetone group (A group) and oxazolone group (O group).0.5％ oxazolone 15 μl was applied to the neck and back of rats in group O,while the equal volume of normal saline and acetone was applied in groups C and A,respectively.Application of the drug mentioned above was repeated on day 7,9,13,16,17,18,21 and 23 after the first stimulation in each rat in each group.Scratching behaviors were oberserved within 30 min after each stimulaiton.Six rats in each group were chosen and sacrificed after the last application of oxazolone,and the brains were obtained for determination of c-Fos expression in CSF-CN.Part Ⅱ Twenty-four rats were randomly divided into 3 groups (n =8 each):control group (C1 group),chronic itch group (group CI),and chronic itch + lesion group (CI + KA group).Chronic itch was induced by repeated application of oxazolone as previously described in CI and CI + KA groups.The chemical lesion of CSF-CN was performed at 6 h after 8th application of the drug.Then the scratching behaviors were observed within 30 min after 9th application of the drug.Results Part Ⅰ Compared with C group,the scratching behaviors were increased significantly at T4-8 in A group,and at T1-8 in O group (P ＜ 0.05),and the expression of c-Fos was up-regulated in O and A groups (P ＜ 0.05).Compared with A group,the scratching behaviors were increased significantly at T1-8 and the expression of c-Fos was up-regulated in O group (P ＜ 0.05).Part Ⅱ Compared with C1 group,the scratching behaviors were significantly increased in CI and CI + KA groups (P ＜ 0.05).The scratching behaviors were significantly reduced in CI + KA group compared with CI group (P ＜ 0.05).Conclusion CSF-CN is involved in the maintenance of chronic itch in rats.

Objective To explore the relative factors of aggressive behaviors in inpatients with schizophrenic.Methods 178 cases of continuously admitted schizophrenic patients were divided into attack group and non aggressive group according to the aggressive behavior of preadmission.Single factor analysis and multi factor regression analysis was applied to two groups in situation(such as age,gender,education level,course of disease,past aggressive behaviors and so on),Brief Psychiatric Rating Scale (BPRS) and Eysenck Personality Questionnaire (EPQ).Results By single factor analysis,attack group had significantly longer course of disease(7.73±6.67) than non aggressive group (5.22 ± 5.47,t =2.631,P＜ 0.01).The score of hostile suspicious factor in BPRS (13.73 ± 3.098) in attack group was significantly higher than that in nonaggressive group(11.47±3.93) (t=4.063,P＜ 0.01),but anxiety factor (7.18± 3.583) was significantly lower than that in nonaggressive group (8.70 ± 3.89) (t=2.679,P＜0.01).The score of E scale of EPQ(11.99±4.340) in attack group was significantly higher than that in nonaggressive group(10.67±4.293) (t=1.990,P＜0.01).Attack group's proportion of patients of previous attacks (71.1％) was significantly higher than that in non aggressive group (16.0％),(x2 =39.082,P＜ 0.01).(2) Logistic analysis showed that hostile suspicious factor in BPRS and past aggressive behaviors entered the regression equation.Condusions Aggressive behavior in schizophrenic patients occurs mainly with psychiatric symptoms and the past history of aggressive behavior.The patients should be treated actively to control the symptoms and prevent the disease recurrence.

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.

Adolescent ; Endoscopy ; Ethmoid Sinus ; Frontal Sinus ; surgery ; Humans ; Male ; Osteoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; surgery