Objective:To introduce the application of 3D printing technology in standardized residency training of percutaneous precise biopsy.Methods:Twenty-two residents were randomly divided into innovative teaching group and traditional teaching group, with 11 ones in each group. Residents in both groups received standardized training of percutaneous biopsy procedure. Innovative teaching group was given 3D printing template combined with guided operation, while traditional teaching group used bare hand operation. The time spent in biopsy, the times of needle adjustment, the frequency of CT scanning during operation, the positive rate of material sampling and the incidence of complications were compared between the two groups.Results:During the percutaneous lung biopsy, two groups of physicians performed the procedure. There was no significant difference between the two groups in operation time [(22.34±3.12) vs. (23.56±4.21)] and the positive rate of sampling (72.73% vs. 90.91%) ( P> 0.05), but there were significant differences in the times of adjusting biopsy needle during operation [(2.11±0.67) vs. (1.02±0.93)], the frequency of intraoperative CT scanning [(4.35±0.76) vs. (3.12±0.84)] and the incidence of complications (54.55% vs. 27.27%) ( P< 0.05). In percutaneous peritoneal organ biopsy, there was no significant difference among the two groups in the operation time [(16.25±2.89) vs. (15.12±2.59)], the number of CT scans [(3.45±0.79) vs. (2.98±0.23)] and the positive rate (78.57% vs. 88.24%) ( P> 0.05), but there were significant differences in times of intraoperative biopsy needle adjustments [(2.43±0.43) vs. (1.84±0.89)] and the incidence of complications (35.71% vs. 5.88%) ( P< 0.05). Conclusion:The application of 3D printing technology combined with the teaching of three-dimensional guided stent can make percutaneous biopsy technique stylized and standardized. It is of great significance to standardize the operation for improving the quality of medical treatment, and it is worth popularizing in clinical teaching.

Objective:To explore the effect of ultrasound-guided nerve block combined with dexmedetomidine (DEX) on postoperative oxidative stress in patients with hip fracture and diabetes.Methods:From March 2017 to December 2019, 78 patients with diabetes who underwent hip fracture surgery were enrolled and divided into two groups by random number table method, with 39 cases in each group. After the operation, the control group was treated with ultrasound-guided femoral nerve combined with lateral femoral cutaneous nerve block with 0.375% ropivacaine, and the study group was treated with ultrasound-guided femoral nerve combined with lateral femoral cutaneous nerve block with 0.375% ropivacaine and DEX 0.5 μg/kg. Patients in both groups were received patient controlling intravenous analgesia (PCIA) after the operation, and visual analogue scoring (VAS) was used to evaluate the resting pain score of the patients at 4 h (T 1), 8 h (T 2), 16 h (T 3), 24 h (T 4), 36 h (T 5) and 48 h after operation (T 6). The levels of serum superoxide dismutase (SOD), malondialdehyde (MDA), 8-hydroxydeoxyuridine (8-OHdG), at T 1 and T 6 were compared between the two groups. The management system of continuous glucose monitoring system (CGMS) was used to calculate the mean amplitude of glycemic excursions(MAGE), largest amplitude of glycemic excursions (LAGE), absolute means of daily differences (MODD) of the patients during 48 h after operation, and the correlation between the blood glucose fluctuation indicators and the oxidative stress of the study group were compared. Results:The scores of VAS in the study group at T 1-T 6 were lower than those in the control group , the difference were statistically significant ( P<0.05). At T 6, the level of serum SOD in the study group was higher than that in the control group: (79.58 ± 13.55) kU/L vs. (64.16 ± 11.95) kU/L; the level of serum MDA and 8-OhdG in the study group were higher than those in the control group: (4.36 ± 0.81) μmol/L vs. (5.64 ± 0.94) μmol/L, (1.06 ± 0.19) μg/L vs.(1.42 ± 0.22) μg/L, the differences were statistically significant ( P<0.05). The levels of MAGE, LAGE, MODD in the study group were lower than those in the control group: (2.42 ± 0.47) mmol/L vs. (5.19 ± 0.96) mmol/L, (3.47 ± 0.64) mmol/L vs. (7.61 ± 1.32) mmol/L, (1.21 ± 0.27) mmol/L vs. (2.74 ± 0.46) mmol/L, the differences were statistically significant ( P<0.05). The correlation analysis showed that the blood glucose fluctuation indicators MAGE, LAGE and MODD of the study group were negatively correlated with SOD, and were positively correlated with MDA, 8-OHdG ( P<0.05). Conclusions:The use of ultrasound-guided nerve block combined with dexmedetomidine (DEX) for patients with hip fracture and diabetes can improve the analgesic effect, reduce oxidative stress of the patients, and improve the blood glucose fluctuation indicators.