Teaching ward round is an important guarantee to improve the training quality. The purpose and content of anesthesiology teaching ward round are different from clinical surgical teaching ward round, and it has its own characteristics. According to the rule of perioperative medicine, we can complete the teaching ward round with small plate and multi-segment teaching mode on the clinical anesthesia management related issues of various surgical patients involved in anesthesia major or sub specialty. In this paper, the methods of anesthesiology teaching ward round, including the formulation of teaching plan, teacher arrangement, preparation before ward round, ward round process and teaching methods, quality control, and teaching experiences were briefly introduced.

Objective To investigate the preventive effect of low molecular weight heparin or tranexamic acid in the rabbits with hypercoagulation induced by impact injury and intravenous infusion of the endotoxin. Methods Combination of impact injury and endotoxin was created by strike on rabbit chest with type BIM-Ⅱ biological impact machine and injection of endotoxin via vein.Thirty-two male New Zealand rabbits were divided into four groups in a completely random design as follows:impact injury combined with endotoxin without treatment group(control group),treatment with low molecular weight heparin(L group),treatment with tranexamic acid(TA group),and treatment with low molecular weight heparin and tranexamie acid(L+TA group).The changes of interleukin-1β(IL-1β)and interleukin-6(IL-6)were observed by using the enzyme-linked immunosorbent assay;changes of antithrombin-Ⅲ(AT-Ⅲ)activity,tissue factor(TF)and tissue factor pathway inhibitors(TFPI)were detected by the chromogenic substrate method chromozym P:the content of fibrinogen was observed by coagulation analyzer.The lung and kidney were removed from the experimental animals at 24 hours post impact injury forhistopathologic observation. Results In the control group,the activity of AT-Ⅲ was decreased obviously.while the content of fibrinogen and the activity of TF and TFPl were increased,with formation of the thrombosis in the kidney after injection of PLS.Compared with control group,the activity of TF and the content of IL-1β and IL-6 were reduced but the TFPI was increased in the L group,which resulted in a decrease of TF/TFPI ratio.with decrease of formation of the micro-thrombosis in the organs.The content of IL-1β and IL-6 in the TA group were reduced,which was still higher than that in tIle L group.In the TA group.the activity of IF and TFPI Was lower than that in the L group and control group,with higher TF/TFPI ratio than the L group.The frequency of thrombosis increased in pulmonary artery and other important organs.The content of IL-1β and IL-6 in the L+TA group wag lower than that in the L group.In the L+TA group.the activity ofTF was lower than that inthe L group and control group,but the activity of TFPI was higher than that in the L group and control group.with lower TF/TFPI ratio than the L group.There found no increase of thrombus in the pulmonary arterial and other important organs. Conclusions Besides anticoagulation function,the low molecular weight heparin can inhibit the inflanunation reaction,reduce the release of TF and attenuate the coagulation reaction.On the basis of treatment with low molecular weight heparin,application of the tranexamic acid will not lead to the formation of thrombus,but the only use of the tranexamic acid would have the contrary results.The rtsults of the study provide a theoretical and experimental basis for clinical diagnosis and prevention of hypercoagulation induced by injury and infection.

In order to better match the teaching hours of clinical anesthesiology with the teaching content of modem anesthesia, the teachers must take full advantage of various supplementary teaching methods in the limited teaching hours to help enhance the students' enthusiasm in active learning, help the students concentrate on the crucial points and apply their knowledge and ultimately improve the teaching quality.

Objective To analyze the anesthetic methods and surgical procedures in the treatment of inpatients in N 2 People' s Hospital of Deyang after Wenchuan earthquake. Methods More than 900 patients were sorted for injury triage, among whom 83 patients received emergency surgery within 72 hours after earthquake, and 21 received surgery after 72 hours. After 10 days of the earthquake, the hospitalized patients needing further surgery have been transferred to hospitals in safe regions. Of all patients, 89 (85.58%) were with injuries of extremities, 11 (10.6%) with cerebral trauma, 3 with thoracic injury, and 1 (1.0%) with abdominal trauma. Perioperative noninvasive blood pressure, electrocardiogram, pulse and oxygen saturation were detected during the surgery. All patients were cured except that one patient with traumatic flail chest died 12 hours after the surgery. Results Of all patients undergone surgeries, 35 patients (33.7%) received combined spinal-epidural anesthesia (CSEA), 33 (31.7%) received nerve plexus block (NPB), 5 (4.8%) had CSEA plus NPB, 28 were under general anesthesia (GA) [17 (16.3%) were intubated and 11(10.6%) were non-intubated] and 3 (2.8%) received monitored anesthesia care (MAC). The average ratios of operation time to time for patients stayed in operation room were (51.29±12.38)% in GA group, (53.24±11.39)% in NPB group, (58.43±9.26)% in CSEA group and (77.15±9.27)% in CSEA plus NPB group. There was a significant difference between CSEA + NPB group and the other three groups (P<0.01), and there was no significant difference among GA group, NPB group and CSEA group (P > 0.05). Conclusions During the initial period of rescue, the most common type of injuries are fractures. CSEA plus NPB is encouraged to use as they have the advantages of shorter operation time, higher operation throughput, safety and faster convalescence of the victims.

Objective To study the influence and mechanism of seawater immersion on endothelial cell injury sustained by burn firearm combined injury to improve the early therapeutic efficacy. Methods The dogs with burn firearm combined injury were randomly divided into two groups: immersion group and control group. In immersion group, the dogs were immersed in seawater for 4 hours, then taken out from seawater. Blood samples were collected from central vein at 4 h, 7 h, 10 h, 20 h and 28 h following wound for the detection of changes of the circulating endothelial cells (CEC) and von Willebrand Factor (vWF). The same procedures except immersion were performed in the control group. Results The levels of CEC and vWF elevated at 4 h and 7 h following wound in control group( P

0 01) in the two groups were significantly different Conclusion After CPR in non hemorrhagic CA, quick infusion of polyglucose and sodium chloride solution is beneficial to the recovery of erythrocyte rheological parameters before CPR

Objective To assess the changes of coagulation and fibinolysis in patients undergoing thoracotomy. Methods Forty patients undergoing thoracotomy were enrolled into this trial. The venous blood were collected for normal coagulable function test at the following time points: before surgery, at 3 h after the beginning of surgery, at 1 d and 3 d after surgery. Results PT, APTT levels had no obvious change. Compared with before and during surgery, FG levels decreased obviously at 1 d and 3 d after surgery. TEG showed the value of R and K increased during and after surgery and value of MA decreased during and 1 d after surgery, but they had no significance in statistics. CI decreased significantly during and after surgery as compared with before surgery(P

Objective To investigate whether preemptive intrathecal administration of CRH has an antinociceptive efficacy on inflammatory pain model rats. Methods The antinociceptive efficacy of preemptive intrathecal administration of CRH was evaluated by the flinch-licking time and the tail flicking latency in formalin-subjected pain model rats. The c-fos gene expression in spinal cord dorsal horn was analyzed by immunohistochemical technique and computer image technique. Results Comparing with NS control group, preemptive intrathecal administration of 0.5 ?g CRH could markedly inhibit the phase Ⅱpain reaction and meanwhile decrease c-fos gene expression by 25.02% in the superficial lamella of spinal cord dorsal horn of the model rats. The antinociceptive efficacy could be counteracted by preemptive intraperitoneal injection of CP-154526 (the specific antibody of CRHR1, 10 mg/kg). Conclusion CRH could significantly inhibit pain reaction and spinal cord c-fos gene expression, and thereby preemptive intrathecal administration of CRH will contribute to the antinociceptive efficacy because of its potency of inhibiting hyperalgesia.

Objective To study the coagulation of patients with lung cancer or esophagus cancer in thoracotomy during perioperative period.Methods Variables [reaction time(R),clotting time(K),? angle,maximum amplitude(MA)]detected by thrombelastography were measured in 10 cases of lung cancer and 10 cases of upper or median esophagus cancer before anesthesia(T0),at the end of 1 h after operation beginning(T1)and 30 min after operation(T2).The control group consisted of 10 healthy volunteers.Results In lung cancer group and esophagus cancer group,R was shorter than control group(P

Objective To investigate the effect of ondansetron on the development of neuropathic pain in rats following chronic constriction injury (CCI) on sciatic nerve. Methods This research consisted of 3 parts. ①A single bolus of ondansetron was given intraperitoneally 2 h before nerve injury; ②A single bolus of ondansetron was given intraperitoneally on the 7th day after nerve injury; ③Continuous administration of ondansetron was given daily for 35 d; In each part, male SD rats were randomly divided into ondansetron group (0.5, 2, 8 mg/kg), saline group and sham operated group. The paw withdrawal response to thermal stimulation was tested throughout the 35 d following nerve injury. Results Ondansetron administration before nerve injury had no effect on thermal pain threshold in rats of experimental neuropathic pain. ondansetron administration on the 7th day after nerve injury attenuated the descending of thermal pain threshold but did not alter its descending trend in subsequent time period. Daily administration of ondansetron for 35 d attenuated and further delayed the descending of thermal pain threshold significantly in a dose-dependent manner. Conclusion Continuous administration of ondansetron can prevent or at least delay the descending of thermal pain threshold of rats with experimental neuropathic pain after constriction injury.