Objective To investigate effects of cerebral isehemic preconditioning on neurological function,in- farct volume,and the expression of caspase-3 in brain issue after brain ischemia again,and to investigate the brain protection mechanism produced by cerebral ischemia preconditioning.Methods 48 healthy male Sprague-Dawley (SD)rats(weighted 200～250g)were randomly divided into 2 groups:ischemia group(n=24),ischemia precondi- tioning group(namely preconditioning group,n=24).Each group was divided into 4 subgroups according to 6h,1d, 2d,4d after ischemia again.Results At the same point of time after ischemia,neurological deficit in preconditioning group was much less than that in ischemia group,the difference was significant(P

Acupuncture Therapy ; Adolescent ; Craniocerebral Trauma ; complications ; Humans ; Male ; Optic Nerve Injuries ; etiology ; physiopathology ; therapy ; Vision, Ocular

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.

This paper is discussed about course system construction of Microbiology, teaching method, in- struction means and experimental teaching mode. Teaching practice indicated that reform the pattern of Mi- crobiology educational mode can stimulate students’ interest in studying the course, cultivate their inde- pendent ability to solve questions, develop their creative thinking. It is an important way to train high-caliber talents.

OBJECTIVETo observe the impacts of different frequencies of electroacupuncture (EA) on post-operative cognitive function and the change in serum S-100beta protein under the compound anesthesia of acupuncture and drugs.

METHODSOne hundred and twenty-four patients of abdominal operation at selective time were randomized into a routine drug anesthesia group (group A, 24 cases), a meridian point 2 Hz group (group B, 26 cases), a me ridian point 2 Hz/100 Hz group (group C, 25 cases), a meridian point 100 Hz group (group D, 24 cases) and a transcutaneous acupoint electric stimulation 2 Hz/100 Hz group (group E, 25 cases). In group A, the endotrachea-lgeneral anesthesia was applied. In the rest groups, the acupuncture anesthesia was induced for 30 min before the endotracheal general anesthesia, at Baihui (GV 20), Yintang (GV 29) and Neiguan (PC 6), with G6805-2 electric acupuncture apparatus used. In group B, the continuous wave and 2Hz in frequency were selected. In group C, the disperse-dense wave and 2 Hz/100 Hz in frequency were selected. In group D, the continuous wave and 100 Hz in frequency were selected. In group E, the disperse-dense wave and 2 Hz/100 Hz in frequency were selected, and the electrode pads were stick on the acupoints and connected with the electric stimulation till the end of operation. Mini-mental state examination (MMSE) was adopted to evaluate and record the changes in cognitive function 1 day before operation and on the 3rd day after operation. The conditions of post-operative cognitive dysfunction (POCD) in the patients and the changes in serum S-100beta protein were monitored before and at the end of operation.

RESULTSThe incidence rate of POCD on the 3rd day after operation was 41.7% (10/24) in group A. The incidence rates of POCD were 26.9% (7/26), 16.0% (4/25), 33.3% (8/24) and 16.0% (4/25) in group B, C, D and E separately. Compared with group A, the incidence rate of PCOD in group B, C, D and E were reduced (all P<0.05), the incidence rate in group C and E were lower than that in groups B and D (all P<0.05). At the end of operation, the level of serumS-100beta protein was (0.186 +/- 0.027) microg/L in group A, the levels were (0.165 +/- 0. 028) microg/L, (0.166 +/- 0.027) microg/L, (0.163 +/- 0.025) microg/L and (0.164 +/- 0.025) microg/L in group B, C, D and E separately. The levels of serum S-100beta protein in group B, C, D and E were lower than that in group A separately (all P<0.05).

CONCLUSIONThe general anesthesia assisted with EA at different frequencies reduces the incidence of cognitive dysfunctionand, decreases the level of serum S-100beta protein after intestinal cancer resection. The effects of the meridian point electric stimulation at 2 Hz/100 Hz and the transcutaneous electric stimulation at 2 Hz/100 Hz are the best. Hence, these two approaches of anesthesia deserve to be recommended practically.

Abdomen ; surgery ; Acupuncture Analgesia ; Aged ; Aged, 80 and over ; Anesthesia, General ; Cognition ; drug effects ; Electroacupuncture ; Female ; Humans ; Male ; Postoperative Period

OBJECTIVETo explore the effect of acupuncture-anesthetic composite anesthesia (AACA) on the incidence of postoperative cognitive dysfunction (POCD) and changes of TNF-alpha, IL-1beta, and IL-6 in elderly patients.

METHODSTotally 83 patients undergoing surgical resection of gastrointestinal tumor were randomly assigned to the simple anesthesia group (A group, 41 cases) and the AACA group (B group, 42 cases). Patients in Group A received endotracheal general anesthesia. Those in Group B were induced by acupuncture anesthesia for 30 min by needling at Baihui (DU20), Neiguan (PC6), Zusanli (ST36). The electro-acupuncture (EA) apparatus was connected after arrival of qi, with the wave pattern of density 2/100 Hz. The stimulus intensity was set by patients' tolerance, with the peak current of 5 mA. Then the endotracheal general anesthesia was performed and the EA lasted till the end of the surgery. The cognitive function of all patients was assessed before operation and at day 3 after operation using mini-mental state examination (MMSE). POCD was confirmed if with one or more decreased stand- ard. The peripheral venous blood was collected before anesthesia induction (TO), immediately at the end of surgery (T1), 24 h after operation (T2), and 48 h after operation (T3), and serum concentrations of IL-1beta, IL-6, and TNF-alpha were correspondingly measured using ELISA.

RESULTSThe postoperative anesthesia awakening time was shorter in Group B than in Group A [(20.37 +/- 6.09) min vs (29.24 +/- 7.48) min, P < 0.05]. The remifentanil dose used during the operation was less in Group B than in Group A (P < 0.05). The incidence of POCD at day 3 was lower in Group B than in Group A [10/41 (23.8%) vs 15/42 (36.5%), P < 0.05]. The concentrations of IL-1beta, IL-6, and TNF-alpha at T1-T3 were higher than those at TO in the two groups (P < 0.05). The increment of TNF-alpha and IL-1beta was less in Group B than in Group A (P < 0.05). CONCLUSION AACA could reduce the incidence of POCD and inhibit postoperative release of TNF-alpha, IL-1beta, and IL-6 in elderly patients undergoing colorectal cancer resection.

Acupuncture Analgesia ; Aged ; Cognition Disorders ; etiology ; prevention & control ; Gastrointestinal Neoplasms ; surgery ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Postoperative Complications ; prevention & control ; Tumor Necrosis Factor-alpha ; blood

Objective To evaluate the specificity,sensitivity and accuracy of miniature probe combined with radial scanning endoscopic ultrasonography(EUS)in preoperative TN staging of rectal cancer,and to assess its value in the choice of therapeutic strategy.Methods A total of 60 patients with rectal cancer received EUS assessment before surgery.Diagnosis was made according to TNM standard and compared with those of MRI and postoperative pathological examination.The reference value of EUS for therapy selection was studied.Results According to EUS staging,there were 4 cases of TI,18 T2,30 T3 and 8 T4,among which 7 cases were over-staged and 4 others were under-staged.MRI staging showed 1 case of T1,18 T2,30 T3 and 10 T4,among which 14 were over-staged and 3 others were under-staged.The total accuracy of EUS in T staging and N staging was 81.67%(49/60)and 78.33%,respectively,with the sensitivity and specificity at 71.43%and 91.03%,respectively.Accuracy of MRI for T staging and N staging were 71.67%(43/60)and 83.33%,respectively,with the sensitivity and specificity as 85.71%and 86.96%.Conclusion EUS with combination of miniature probe and radial scanning is effective in preoperative TN staging of rectal cancer with easy manipulation and less pain.

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.

Objective:To study the mechanisms of immune suppression mediated by Gr-1+CDllb+ myeloid derived suppressor cells (Gr-1~+CDllb~+MDSC)from tumor-bearing mice.Methods:Gr-1~+CDllb~+MDSC recruited into spleen and bone marrow of tumor-bearing mice were purified by Percoll,and suppression mediated by MDSC on T cell proliferation from spleen of naive mice was detected by flow cytometry with CSFE and FTTC-anti CD3 staining,and NO,ROS,IL-10 and TGF-β in the supematant of MDSC were detected by Griess and ELISA.Results:There were much more Gr-1~+CDllb~+MDSCs in spleen and bone marrow from tumor-bearing mouse than those of naive mouse,and suppression on T cell proliferation mediated by MDSC from tumor beating mouse was significantly increased,and there were much more NO,ROS,IL-10 and TGF-βin the supematant of these MDSC than that from naive mouse.Conclusion:MDSC from tumor-bearing mice secreted hish level of NO,ROS,IL-10 and TGF-βto induce immune suppression,and inhibite the proliferation of T cells.

Objective To observe the effect of liver disease special-purpose enteral nutrition preparation on protein metabolism and liver function in children with liver injury.Methods Sixty cases of severe ill with liver injury in hospital,with mean age of (7.8?6.3) years old.All patients were randomly divided into experimental group (n=30) and control group(n=30).The experimental group was treated by adding the liver disease special-purpose enteral nutrition preparation homogenized diet and control group was treated by adding entire protein entire nutrition type enteral nutrition preparation.All patients in both 2 groups were nasally fed with intestinal nutrition,which contained 418-628 kJ/(kg?d).One day before nutritional support and 14 days after nutritional support,the liver function,total serum protein,albumin,hemoglobin were recorded.SPSS 11.5 software was used to analyze the data.Results The baseline indicators were similar before nutritional supports.Fourteen days after nutritional support,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were all significantly lower in experimental group than in control group(Pa