Application of Team Situational Simulation Education and Teaching Mode in Clinical Pharmacy Teaching / 中国药房

OBJECTIVE：To explore th e applicatio n of team situatio nal simulation education and teaching mode in clinical pharmacy teaching. METHODS ：A total of 60 clinical pharmacy interns were selected as the research objects ，and course disease was type 2 diabetes mellitus. Thirty interns were randomly selected as control group ，using traditional teaching mode ；other 30 interns were selected as trial group ，which carried out team situational simulation education and teaching mode. The teaching effects were evaluated by using the satisfaction of interns to the two modes ，the comprehensive score of graduation examination and the self-evaluation of learning effect. RESULTS ：Compared with traditional teaching mode ，team situational simulation education and teaching mode was conducive to stimulate the learning interest of interns ，improve their interpersonal communication ability ， cultivate teamwork spirit ，improve the awareness of humanistic care ，and cultivate the professional attitude of clinical pharmacists （P＜0.05）. Compared with control group ，the comprehensive score of trial group was dominantly increased （P＜0.001），and the scores of professional quality ，humanistic care and communication skills in the trial group were significantly higher than control group（P＜0.01）. In terms of self-evaluation of learning effect ，except for the pathogenesis of type 2 diabetes and the commonly used treatment regimens ，the self-evaluation scores of the other items in trial group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Team situational simulation education and teaching mode is superior to traditional teaching mode for clinical pharmacy teaching.

Synthesis reduction of central neurotransmitter 5-hydroxytryptamine by branched chain amino acid and associated antagonists improves postoperative fatigue syndrome / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To observe the change of postoperative fatigue in rats after the effect of branched chain amino acid(BCAA) and associated antagonists on central neurotransmitter 5-HT metabolic pathway, and to investigate the role of 5-HT in the development of postoperative fatigue syndrome(POFS).</p><p><b>METHODS</b>Fifty SD rats were randomly divided into sham operation group(C group, n=10), model group(M group, n=10), L-type amino acid transporter inhibitor group(L group, n=10), 5-HT uptake inhibitor group(F group, n=10) and branched chain amino acids(B group, n=10). The rats in the C group and the M group were injected with normal saline, while other three groups were respectively injected with BCH, fluoxetine, BCAA(val:leucine:isoleucine=5:3:2), on preoperative 1 h, postoperative day 1, 2, 3, 4. The rats, except for those in the C group, underwent resection of 70% of the middle small intestine with end-to-end anastomosis. General status of the rats was observed before and after surgery. Morris water maze test, including the hidden platform test and search space test (detecting the learning ability of rats) and tail suspension test (detecting physical endurance of rats) were used to evaluate the degree of POFS from postoperative day 1 to day 7. Concentration of tryptophan(TRP), 5-HT, 5-hydroxyindoleacetic acid (5-HIAA) in different position of brain(hippocampus, striatum, hypothalamus) of rats were measured by high performance liquid chromatography(HPLC) at postoperative day 8.</p><p><b>RESULTS</b>As compared to the M group, other four groups showed better general condition and less fatigue. In the hidden platform test, M group showed the least time of crossing platform as compared to other four groups(all P<0.05). Meanwhile, M group and B group performed the longer incubation period than C group and L group(all P<0.05). In search space test, M group and B group showed less time of crossing platform, but there were no significant differences among the groups(all P>0.05). In tail suspension test, M group and F group showed lower score of physical strength than L group and B group(all P<0.05). Levels of TRP in the L, F, B groups were lower compared to the M group(all P<0.01) in brain tissue. The least concentration of striatum 5-HT was found in the C group but there were no significant differences among the M, L, F and B groups. Level of 5-HIAA in the M group, only in hypothalamus, was higher than that in the F group(P<0.05), but no significant differences between the M group and the L and B groups were found.</p><p><b>CONCLUSION</b>BCAA and associated antagonists (BCH, fluoxetine) can improve POFS by reducing the absorption of TRP that results in decreased synthesis of central 5-HT.</p>

"Effect of perioperative use of fish oil on ""post-operative fatigue"" of rat" / 中华临床营养杂志

ObjectiveTo investigate the effect of perioperative use of fish oil on post-operative fatigue(POF) of rat.MethodsAfter one week's preoperative behavior training,12 rats presented poor behavior were excluded from 60 healthy adult male SD rats as the normal controls of serum parameters.The remaining 48 rats were randomly divided into model group and fish oil treatment group by random number table.The fish oil treatment group received 10 days' (3 days before surgery and 7 days after surgery) intraperitoneal injection of fish oil [2 ml/( kg · d) ],and the model group with saline.On the 1st,3rd,5th,and 7th post-operative day,rats were assessed by Morris water-maze and tail suspension test.Serum levels of interleukin ( IL)-1β,IL-6,tumor necrosis factor-α (TNF-α),superoxide dismutase (SOD),and glutathione peroxidase (GSH-PX) were measured.ResultsSerum parameters:on the 1st and 3rd post-operative day,the IL-6 level in the fish oil treatment group [ (66.22 ±8.80),(56.03 ± 1.19) pg/ml] was significantly lower than in model group [ (83.30 ± 10.69),(82.72 ± 24.27) pg/ml ] (P =0.034,P =0.038 ) ; on the 1 st,3rd,5th,and 7th post-operative day,the TNF-α level in the fish oil treatment group [ ( 104.36 ±5.02),(84.49 ±7.81 ),(64.47 ±2.89),(39.29 ±2.52)pg/ml ] was significantly lower than in model group [ ( 120.01 ± 14.99 ),( 119.68 ± 8.84),(75.29 ± 2.58 ),(41.96±1.65) pg/ml] (P=0.014,P=0.003,P=0.000,P=0.004); onthe1st,3rd,5th,and 7th postoperative day,the IL-1β level [(155.11 ±9.08),(79.39±5.86),(57.26±16.07),(35.42±1.53) pg/ml]was significantly lower than model group [ (204.87±30.61),(198.82±54.83),(152.12±29.06),(64.35 ± 2.70) pg/ml ] ( P =0.024,P =0.002,P =0.000,P =0.000) ; on the 5th postoperative day,SOD ( 1.08±0.08) μmol/L was significantly higher than model group (0.71±0.06) μmoL/L (P=0.000) ; on the 5th and 7th postoperative day,GSH-PX [ (31.21 ± 1.30), (30.78 ± 1.83) μmol/L] was significantly higher than model group [ (25.03 ±1.74),(27.57±3.57) μ mol/L](P=0.000,P=0.036).Behavior:in tail suspension test,on the 1st and 3rd postoperative day,value of struggle in fish oil treatment group [ (6620 ± 1390),(7011 ± 1472) mv · s] was significantly higher than in model group [ (4739 ± 1040),(4344 ± 1130) mv · s](P=0.048,P=0.043); cumulative fixed time [ (118.42±10.05), (101.02±8.68) s] and single rest time [ (55.39±7.70),(56.60±5.88) s] was lower thanin modelgroup [ (135.08+12.44),(131.02±9.24) s; (65.73±3.78),(64.93±3.25) s] (P=0.042,P=0.012,P=0.043,and P=0.042).In Morris water-maze,on the 3rd and 5th postoperative day,escape latent period of fish oil treatment group [ (48.263 ±1.815),(44.955±2.567) s] was lower than model group [ (51.543±1.990),(49.956±2.888) s] (P=0.035,P=0.035) ; on the 1st,3rd,5th,and 7th postoperative day,the cross platform number (1.04±0.25,1.95±0.49,2.42 ±0.41,3.21 ±0.53) was significantly higher than in model group (0.58 ±0.26,1.20±0.33,1.50±0.39,2.17±0.68) (P=0.002,P=0.003,P=0.018,P=0.035).ConclusionPerioperative use of fish oil can reduce postoperative inflammatory response,enhance antioxidant defense capability,and mitigate post-operative fatigue.