Objective To compare the clinical value of nerve stimulator-versus ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery.Methods Forty patients,aged 18-60 yr,with body mass index of 18-30 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were randomly assigned into 2 groups (n =20 each) using a random number table:nerve stimulator group (group S) and ultrasound group (group U).Epidural anesthesia was performed with 1.73 ％ carbonated lidocaine in both groups.0.2％ ropivacaine 5 ml/h was infused continuously after surgery to perform femoral nerve block for analgesia.VAS score at rest was assessed at 2,6,24 and 48 h after surgery.At 24 and 48 h after surgery,VAS scores during active and passive movement were assessed.The time for catheter placement near the femoral nerve and development of subcutaneous hematoma at the puncture site,local anesthetic intoxication and nausea and vomiting were recorded.The postoperative requirement for analgesics was also recorded.Results There was no significant difference in the VAS scores and puncture for femoral nerve block-and local anesthetics-related adverse events between the two groups.The time for catheter placement near the femoral nerve was 8.0 ± 1.4 and (6.7 ± 0.9) min in S and U groups,respectively,and the time was significantly longer in group S than in group U.No patients required rescue analgesic after surgery in both groups.Conclusion Nerve stimulator-guided continuous femoral nerve block provides higher clinical value than ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery and it is more suitable for clinical application.

Objective To determine the median effective dose ( ED50 ) of 0?5% ropivacaine for ul?trasound?guided adductor canal saphenous nerve block. Methods Twenty?three patients of both sexes, aged 18-45 yr, weighing 50-85 kg, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective arthroscopic meniscectomy, received an ultrasound?guided adductor canal saphenous nerve block. After successful location, 0?5% ropivacaine was injected. The sensory block of the area in?nervated by the saphenous nerve was assessed by pin?prick test. The dose of ropivacaine was determined by up?and?down technique. The initial dose of ropivacaine was set at 18 ml. Each time the dose increased∕de?creased in the next patient according to whether or not the sensory block of the area innervated by the saphe?nous nerve was complete, and the ratio between the two successive doses was 1 ∶ 1?2. The ED50 and 95%confidence interval of 0?5% ropivacaine for adductor canal saphenous nerve block were calculated by probit analysis. Results The ED50 (95% confidence interval) of 0?5% ropivacaine for ultrasound?guided adduc?tor canal saphenous nerve block was 10?7 ( 8?8-12?2) ml. Conclusion The ED50 of 0?5% ropivacaine for ultrasound?guided adductor canal saphenous nerve block is 10?7 ml.

OBJECTIVETo analyze the changes of patients with type 2 diabetes in different stages in glucagon (GC) and free fatty acid (FFA) in fasting, OGT and L-Arg experiments, and discusses the role of pancreatic alphabeta cells in diabetes pathogenesis by studying the relations among indexes such as glucagon (GC), free fatty acid (FFA) and blood glucose (BG), insulin, insulin homeostasis model (HOMA) and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes.

METHODStudy objects were divided into the T2DM group (45 cases), the IGT group (28 cases) and the NGT group (30 cases) for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose (FBG), insulin (F), glucagon (FGC), free fatty acid (FFA) were detected to calculate HOMA-beta, insulin sensitivity index (ISI) and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUC(BG), AUC(INS) and AUC(GC).

RESULTObvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-beta and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-beta and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-beta, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM > IGR > NGT in AUC(GC) in the OGTT experiment and T2DM > IGR > NGT in in AUC(GC) in the L-Arg experiment, with the significant positive correlation between AUC(GC) and AUC(BG) and significant negative correlation with AUC(INS).

CONCLUSIONGlucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated with blood glucose and HOMA-IR and negatively correlated with INS, HOMA-beta and ISI. The increase in glucagons of T2DM and IGT patients indicated inappropriate secretion of pancreatic alphabeta cells among patients with type 2 diabetes.

Adult ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; Fatty Acids, Nonesterified ; metabolism ; Female ; Glucagon ; blood ; Humans ; Insulin ; secretion ; Islets of Langerhans ; secretion ; Male ; Middle Aged

The major satisfaction of college students will influence their learning interest and motivation, and then influence their learning achievement and future employment. Under the guidance of the concept of the micro system engineering of the education reform, the degree of the major satis-faction of the students in TCM colleges is analyzed by SIMPP method. The results show that students' behavior mode such as their preview situation, teaching adaptation, course satisfaction, students' achievement and their attitude of poor academic performance is closely related to the degree of major satisfaction. Teachers can judge the degree of major satisfaction by following these pattern behaviors;improve the rationality and accuracy of the degree of major satisfaction.

The degree of satisfaction of the curriculum is related not only to the degree of the curriculum but also to the degree of the students' development. With the concept of teaching reform micro system engineering, using the SIMPP analysis of the degree of satisfaction of the curriculum, the relevant factors of the students are studied. The results show that, the learning state, learning objec-tives, and the education level of mother affect the students more easily on the curriculum satisfaction. Research shows, in the present curriculum condition, educators should guide the students to study hard, establish a clear and reasonable learning goal, give the students the introduction and analysis of the curriculum, can effectively improve the students on the curriculum satisfaction, enhance the enthusiasm of the study.

Academic diligence level can not only directly affect the academic performance of students, but also affect the individual's emotional and physical health. In this study, through a question-naire survey of university students, with the method of SIMPP and the concept of the micro system engi-neering in higher education teaching reform, the related factors of diligence and the college students' behavior mode with respect to diligence are systematically analyzed. Analysis shows that, students' diligence level is affected not only by inherent factors such as clear learning objectives, learning state and after-school learning time, but also by the school ethos, the influence factors of the curriculum and parents' re-quirements.

The clear learning objective is one of the important factors to determine the learning effect of college students. In order to analyze the factors affecting the formation process of college stu-dents' learning objectives, to explore the teaching mode that can be helpful for college students' clear learning objective, under the guidance of the concept of the reform of the teaching system, the SIMPP analysis of the students learning objective in the TCM colleges was carried out. Results showed that the related factors that affected student learning objectives included family factors, school principals and students' subjective factors. Teachers' observing students' learning status carefully, their understanding students' background, income and other social factors, mastering the degree of students' learning spe-cific goals and behavior model, and conducting the targeted and effective inventiveness are to help students clear learning objectives. The results provide the technology and method of operation for col-lege teachers to correctly guide different types of students to establish a clear learning objective.

The influence extent of students from teachers is related to the teaching effect , which means whether it can successfully promote the study of students and reach the expected teach-ing goal during the teaching process. To have a good teaching effect, guided by the micro-system en-gineering of teaching reform, we used SIMPP to analyze the related factors of the influence of students extent from teachers during the teaching process in TCM colleges and universities. The result shows that the influence extent from teachers is related to not only teachers themselves but students and their self-condition and family backgrounds as well. Going further in researching these factors and the related behavior patterns of influence extent of students from teachers is helpful to making the teach-ing more effective and more targeted.

Objective To explore the clinical value of transvaginal four-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy)in evaluation of the patency of fallopian tubes. Methods Totally 53 patients underwent SonoVue TVS4D-HyCoSy to observe the tubal patency. Results Among the 106 tubes in 53 patients, TVS 4D-HyCoSy showed 47 unobstructed tubes, 23 obstructed tubes, and 36 partially passable tubes. In unobstructed cases, the fallopian tubes were smooth and regular in morphology, and contrast agents flowed into and dispersed over pelvic cavity rapidly and evenly. In the cases of partially passable tube, fallopian tubes were discontinuous and irregular in morphology, and contrast agents lfowed into and dispersed over pelvic cavity slowly and unevenly. In obstructed cases, there were no or little contrast agents into the fallopian tubes. Compared with the results of laparoscopy, the diagnostic accuracy of TVS 4D-HyCoSy was 94.4%(17/18). Conclusions TVS 4D-HyCoSy is a useful tool in demonstrating the morphological features of fallopian tube, diagnosing intrauterinc adhesion and lesion and assessing the tubal patency.

To propose a formula method of medicated diet based on medicinal property combination patterns in this paper under the context of lack of innovation in medicated diets. By analyzing the property combination patterns of traditional Chinese medicine and commonly used foods recorded in the pharmacopoeia, medicated diet formulae were optimized by using the greedy algorithm, with the property combination patterns of classical formulae based on the syndrome differentiation and treatment. In this paper, the Baihu Rensheng decoction, which is a classical formula for treating lung and stomach heat-derived diabetes, was taken for example in the formula design. As a result, totally 18 medicated diet formulae were developed and proved to be rational in the analysis on traditional Chinese medicines and nutriology. This method expands the way of thinking for personalized diet therapies and provides theoretical basis the industrial development and clinical application of medicated diets.
Animals ; Diabetes Mellitus ; diet therapy ; drug therapy ; metabolism ; Diet ; Diet Therapy ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Humans ; Phytotherapy