ObjectiveTo compare the effectiveness and safety of one-lung ventilation and small tidal volume two-lung ventilation anesthesia methods in the training of minimally invasive thoracic surgery on experimental pigs.MethodsForty experimental pigs undergoing robotic thoracic surgery were randomly divided into two groups: two-lung ventilation group (n=20) and one-lung ventilation group (n=20). The two-lung ventilation group underwent single-lumen tracheal intubation, utilizing a small tidal volume with a fast respiratory rate combined with carbon dioxide pneumothorax for anesthesia ventilation during the operation. The one-lung ventilation group received one-lung ventilation using a double-lumen bronchial catheter placed under fiberoptic bronchoscopic guidance. The anesthesia implementation indexes from the two groups were compared, including the values of vital signs such as operative heart rate (HR), noninvasive mean blood pressure (MAP), end-tidal carbon dioxide (ETCO₂), and oxygen saturation (SpO₂), as well as the assessment of surgical training performance.Results The intubation success rate for animals in both groups was 100%, with no intraoperative deaths. The intubation completion time was significantly shorter in the two-lung ventilation group compared to the one-lung ventilation group (P < 0.001). Within each group, SpO₂ levels were significantly higher in the two-lung ventilation group at 30 minutes after the start of thoracic surgery (T₁) and at surgery completion (T₃) compared to 60 minutes after the start of surgery (T₂) (P<0.05). ETCO₂, HR, and MAP were significantly higher at T₂ and T₃ compared to T₁ (P<0.05). In the one-lung ventilation group, SpO₂ levels were significantly higher at T₁ and T₃ compared to T₂ (P<0.05), while ETCO₂ levels gradually increasing over time (P<0.05). In the between-group comparisons at the same time points, SpO₂ levels of the two-lung ventilation group were significantly higher than those of the one-lung ventilation group at all time points (T₁, T₂, T₃) (P<0.05).Conclusion Both one-lung ventilation and two-lung ventilation anesthesia methods are effective and safe for use in surgical training, with controllable effects on intraoperative animal vital signs and minimal impact on surgical operation training, meeting the needs of robotic thoracic surgery training. One-lung ventilation provides a better experience during pneumonectomy procedures, while small tidal volume two-lung ventilation is easier to implement and does not require additional equipment purchase, making it a feasible supplemental anesthesia option for thoracoscopic surgery on experimental pigs.

Objective:To explore the efficacy and safety of Rivaroxaban in preventing catheter related thrombosis (CRT) in patients with breast cancer who are undergoing central venous catheter chemotherapy, and provide basis for making standardized prevention and treatment strategies.Methods:In this research, a prospective cohort study was adopted, and breast cancer patients who received central venous catheter chemotherapy in Sanhuan Cancer Hospital during September 2020 to March 2022 were selected as a treatment group to take the rivaroxaban anticoagulation therapy with 10 mg.po.qd for one month. The control group got no preventive anticoagulation therapy. Vascular ultrasound examination was taken to confirm the occurrence of CRT, and a chi-square test was done for comparison the disparity between the groups. Logistic regression was applied to analyze the univariate and multivariate factors for the formation of CRT.Results:In the research, a total of 235 patients were selected, and there were a total of 19 035 days of catheterization with 81 days of catheterization on average. While in the control group, the incidence of CRT was 28.0% (33/118), the incidence of CRT in the treatment group was 20.5% (24/117), the difference was no significant ( P=0.183). Subgroup analysis results showed that the peripherally inserted central catheter (PICC) was performed in 165 cases with the CRT incidence of 18.2% (30/165) and thrombosis was mostly seen around axillary vein, accounting for 63.3%. Subclavian vein catheterization was performed in 63 cases with the CRT incidence of 39.7% (25/63), and thrombosis was mostly seen around subclavian vein, accounting for 88.0% (22/25). Implantable venous access port was implanted in 7 cases around subclavian vein and internal jugular vein with the CRT incidence of 28.6% (2/7). The patients who developed CRT within 30 days after catheterization accounted for 54.4% (31/57), 22.8% (13/57) in a period during 30 days and 60 days) and 22.8% (13/57) in a period during 60 days and 180 days). The diagnosed CRT patients had been treated with rivaroxaban 15 mg.bid.po for 3 months. During the 3 months, 100.0% of the thrombosis waned, 71.9% (41/57) of the thrombosis waned within 30 days, 19.3% (11/57) in a period during 30 and 60days and 8.8% (5/57) in a period during 60 days and 90 days. Univariate and multivariate analysis indicated that the risk of CRT in subclavian vein catheterization was higher than that in PICC, respectively ( OR=2.898, 95% CI:1.386-6.056 P=0.005), and the type of catheterization was an independent factor for the formation of thrombosis. Safety analysis result showed that in the prevention of CRT, rivaroxaban treatment did not induce drug-related bleeding, liver function damage, bone marrow suppression or any other side effects. While CRT diagnosed patients were treated with anticoagulation, they kept the central venous catheter, and the infusion was smooth. These patients all finished the anti-tumor treatment as planned, and no abnormalities like new thrombosis or pulmonary embolism were observed. Conclusions:In the mid-term analysis, the proportion of Rivaroxaban in preventing anticoagulant CRT decreases, but it don't reach statistical significance. The sample size should be further increased for observation. Rivaroxaban is proved effective and very safe in the treatment of CRT, and does not affect the concurrent chemotherapy. Medical personnel should carry out the policy of "early prevention, early detection and early treatment" for CRT so as to improve the patients' quality of life.

Objective:To explore the efficacy and safety of Rivaroxaban in preventing catheter related thrombosis (CRT) in patients with breast cancer who are undergoing central venous catheter chemotherapy, and provide basis for making standardized prevention and treatment strategies.Methods:In this research, a prospective cohort study was adopted, and breast cancer patients who received central venous catheter chemotherapy in Sanhuan Cancer Hospital during September 2020 to March 2022 were selected as a treatment group to take the rivaroxaban anticoagulation therapy with 10 mg.po.qd for one month. The control group got no preventive anticoagulation therapy. Vascular ultrasound examination was taken to confirm the occurrence of CRT, and a chi-square test was done for comparison the disparity between the groups. Logistic regression was applied to analyze the univariate and multivariate factors for the formation of CRT.Results:In the research, a total of 235 patients were selected, and there were a total of 19 035 days of catheterization with 81 days of catheterization on average. While in the control group, the incidence of CRT was 28.0% (33/118), the incidence of CRT in the treatment group was 20.5% (24/117), the difference was no significant ( P=0.183). Subgroup analysis results showed that the peripherally inserted central catheter (PICC) was performed in 165 cases with the CRT incidence of 18.2% (30/165) and thrombosis was mostly seen around axillary vein, accounting for 63.3%. Subclavian vein catheterization was performed in 63 cases with the CRT incidence of 39.7% (25/63), and thrombosis was mostly seen around subclavian vein, accounting for 88.0% (22/25). Implantable venous access port was implanted in 7 cases around subclavian vein and internal jugular vein with the CRT incidence of 28.6% (2/7). The patients who developed CRT within 30 days after catheterization accounted for 54.4% (31/57), 22.8% (13/57) in a period during 30 days and 60 days) and 22.8% (13/57) in a period during 60 days and 180 days). The diagnosed CRT patients had been treated with rivaroxaban 15 mg.bid.po for 3 months. During the 3 months, 100.0% of the thrombosis waned, 71.9% (41/57) of the thrombosis waned within 30 days, 19.3% (11/57) in a period during 30 and 60days and 8.8% (5/57) in a period during 60 days and 90 days. Univariate and multivariate analysis indicated that the risk of CRT in subclavian vein catheterization was higher than that in PICC, respectively ( OR=2.898, 95% CI:1.386-6.056 P=0.005), and the type of catheterization was an independent factor for the formation of thrombosis. Safety analysis result showed that in the prevention of CRT, rivaroxaban treatment did not induce drug-related bleeding, liver function damage, bone marrow suppression or any other side effects. While CRT diagnosed patients were treated with anticoagulation, they kept the central venous catheter, and the infusion was smooth. These patients all finished the anti-tumor treatment as planned, and no abnormalities like new thrombosis or pulmonary embolism were observed. Conclusions:In the mid-term analysis, the proportion of Rivaroxaban in preventing anticoagulant CRT decreases, but it don't reach statistical significance. The sample size should be further increased for observation. Rivaroxaban is proved effective and very safe in the treatment of CRT, and does not affect the concurrent chemotherapy. Medical personnel should carry out the policy of "early prevention, early detection and early treatment" for CRT so as to improve the patients' quality of life.

Objective? To explore the effects of continuous exercise rehabilitation program in heart failure patients. Methods? From March 2017 to March 2018, we selected 170 chronic heart failure patients at Shandong Provincial Third Hospital as subjects by convenience sampling. All of the patients were randomly divided into observation group (n=85) and control group (n=85) according to admission number. Control group carried out routine discharge education. On the basis of that, observation group implemented heart failurecontinuous exercise rehabilitation program for four weeks. We compared the exercise tolerance, fatigue, rehabilitation process and quality of life (QOL) of patients between two groups before and after intervention. Results? A total of 28 days after discharge, the distance of 6 min walk of patients in observation group was longer than that of patients in control group, and the fatigue degree was lower than that of patients in control group;the differences were statistical (P＜0.05). The time of exercise out of bed and hospital stay of observation group was shorter than those in control group with statistical differences (P＜0.05). The total score of QOL and scores of physiological change, sleep status and diet control of patients in observation group were higher than those in control group 28 days after discharge with statistical differences (P＜0.05). Conclusions Application of continuous exercise rehabilitation program for heart failure patients can improve exercise tolerance, accelerate the rehabilitation process and improve their QOL.

Objective:To investigate the protective effects and possible mechanisms of cortex phellodendri water extract and etha -nol extract on the myocardial injury induced by pituitrin and isoproterenol hydrochloride in rats .Methods:SD rats as the experimental animals were randomly divided into the normal control group , model group , compound Danshen tablets group , phellodendron water ex-tract group and phellodendron ethanol extract group .Pituitrin and isopropyl adrenaline hydrochloride were used to establish the myocar-dial injury model in rats.The serum CK, LDH activity, myocardial tissue SOD activity and MDA content were detected and compared . Results:Compared with those in the normal control group , the serum LDH activity , CK activity and MDA content were significantly in-creased , and the SOD activity in cardiac muscle and myocardial tissue was significantly decreased in the pituitrin -established myocardi-al injury model group (P<0.01).In the isopropyl adrenaline hydrochloride-established myocardial injury model group , the MDA con-tent in myocardial tissue was obviously increased , and the SOD activity in myocardial tissue was decreased obviously (P<0.01).The serum LDH activity, CK activity and MDA content were significantly decreased , and the SOD activity in cardiac muscle and myocardial tissue was increased significantly in all drug-taken groups when compared with those in the pituitrin-established myocardial injury model group, and the differences were statistically significant (P<0.05 or P<0.01).The MDA content in myocardial tissue was significant-ly reduced , and the SOD activity was increased significantly in all drug-taken groups when compared with those in the isopropyl adrena-line hydrochloride-established myocardial injury model group , and the differences were statistically significant (P<0.05 or P<0.01). Conclusion:Cortex phellodendri extract has certain protective effect on myocardial injury induced by pituitrin and isopropyl adrenaline hydrochloride in rats .

Objective To investigate the effects of down-regulation of Beclin 1, which is an autophagy regulatory molecule, expression induced by RNA interference on the proliferation and apoptosis in skin fibroblasts of naked mole rat. Methods The expression levels of Beclin 1 were detected after starvation or H2 O2 treatment.The fibroblasts were transi-ently transfected with specific siRNA targeting Beclin 1 and then screened by real-time PCR and Western blot.Cell prolifer-ation and apoptosis were determined using CCK-8 detection kit and flow cytometry ( FCM ) .The expressions of related genes were detected by Western blot.Results The expression of Beclin 1 gene at mRNA and protein levels was signifi-cantly lower in fibroblasts of the naked mole rat.Starvation and H2 O2 treatment induced changes of the Beclin 1 expression. Inhibition of Beclin 1 gene expression can inhibit cell proliferation and induce early and late apoptosis.The protein levels of p53, BAX, Bcl2, LC3B, p-AKT and mTOR were reduced after transient transfection with Beclin 1-siRNA.Conclusions The expression of Beclin 1 in fibroblasts of naked mole rat are changed in response to starvation or H2 O2 stimulation.Inhi-bition of Beclin 1 gene expression can inhibit cell proliferation and induce apoptosis.Therefore, Beclin1 gene may play a regulatory role in autophagy, proliferation and apoptosis in the skin fibroblasts of naked mole rat.

Objective:To study the anti-inflammatory and analgesic effects of different solvent extracts of Folium Pyrrosiae. Meth-ods:Water extract and 75% alcohol extract of Folium Pyrrosiae were obtained. Mouse auricle swelling model induced by xylene was used to observe the anti-inflammation. The analgesic effect was tested by acetic acid writhing test and hot plate test. Results:The eth-anol extract of Folium Pyrrosiae could markedly inhibit the mouse auricle swelling induced by xylene (P<0. 01), and had the ability to inhibit the twisting induced by acetic acid in the mice (P <0. 05). The ethanol extract of Folium Pyrrosiae could increase the threshold of pain in the mice significantly after the 1-hour and 2-hour treatment (P<0. 05). The water extract of Folium Pyrrosiae could inhibit the mouse auricle swelling induced by xylene and the writhing reaction induced by acetic acid (P<0. 05). The water ex-tract of Folium Pyrrosiae could increase the threshold of pain in the mice significantly after the 1-hour treatment (P<0. 05). Conclu-sion:Folium Pyrrosiae has obvious analgesic and anti-inflammatory effects.

Methods and significances of the laboratory opening management for the function experiment teaching center are introduced in this paper. The problems existing in the management of the open Lab and the thinking about the management are communicated with the peers to provide the reference for the opened lab.

Objective To explore the environmental factors change on the plasma endothelin(ET) and nitric oxide(NO) in rabbits exposed to a complex environment:high temperature,hunger,and so on.Methods Ninety China rabbits were randomly divided into myocardial ischemia group,myocardial ischemia and hypoxia and high temperature group,myocardial ischemia and hypoxia group,myocardial ischemia and hunger group,myocardial ischemia and hypoxia and high temperature and hunger group,hunger group,hypoxia group,high temperatures group,control group,ten rabbits in each group.The animal myocardial ischemia was caused by fulgurating the left anterior descending branch artery in the heart.The animal hypoxia was caused by breathing in 8.5% nitrogen oxygen atmosphere(nitrogen content was 91.5%,oxygen content was 8.5%).The animals in the high temperature group were put into a high temperature [(42?2)℃] environment.The animals in the hunger group were treated with fasting and water deprivation for 24 h.Every animal has been taken in above-mentioned experiment environment for 30 min.Blood from jugular veins collected,and the contents of plasma ET and NO were determine.Results Compared with control group,except the hunger group and high temperature group,ET levels in the others six group were significantly increased(P

To discuss the course of implementing tutorial system as well as the effect on medical students,and to point out that implementing teacher system is a kind of pattern of training innovation type of medical talents.