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Ultrasound-guided peripheral nerve block is widely used in clinical practice because of its high accuracy and safety. Residents must pass formal training to master this technique. However, residents are not familiar with the related anatomical structure of nerve block, and lack of basic ultrasonic knowledge, operation skills, simulation training, understanding of the corresponding complications, the optimal concentration and dose of local anesthetic drugs. In order to solve the above problems, we have taken measures such as basic theoretical knowledge learning, application of anatomy and ultrasound software, simulation training and grading training so that residents in standardized training of anesthesiology could fully grasp the clinical application of ultrasound-guided peripheral nerve block techniques.
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Objective To investigate the effect of ultrasound-guided quadratus lumborum block (QLB) on postoperative analgesia after caesarean section.Methods Sixty parturientsscheduled for cesarean section, aged 20-40 years, ASA physical status Ⅰ orⅡ, were randomly divided into 2 groups (n = 30 each) using a random number table:QLB group (group Q) and control group (group C).Parturients in group Q received bilateral QLB with the use of 20 ml 0.33％ ropivacaine per side after surgery, while QLB was not done in group C.Both groups received patient-controlled intravenous analgesia (PCIA) after surgery which contains 800 mg tramadol, 40 mg nefopam and 80 ml normal saline.The accumulative consumption of tramadol, the score of numerical rating scale (NRS) for pain at rest and on movement and the bruggrmann comfort scale (BCS) score were recorded at 4, 8, 12, 24, 48 hafter operation.The cutaneous sensory block area was determined in group Q at 4, 8, 12, 24, 48 hafter operation.The patient′s satisfaction with postoperative analgesia and adverse reactions were also recorded.Results The consumption of tramadol in group Q was significantly decreased compared with that in group C (P<0.05) at 4, 8, 12, 24, 48 hafter surgery.NRS for pain at rest at all times, NRS for pain when cough at 12, 24 hafter surgery and NRS for pain when turning over at 4, 48 hafter surgery were significantly lower, while the BCS score was higher in group Q than that in group C (P<0.05).Quadratus lumborum block affected T7-L1 dermatomes at 4, 8, 12 hafter surgery and T8-L1 dermatomes at 24 hafter surgery.The analgesic plane of quadratus lumborum block disappeared at 48 hours after operation.The patient's satisfaction with postoperative analgesia was higher in group Q compared with that in group C (P<0.05).The incidence of postoperative nausea, vomiting and dizziness was similar between the two groups.Conclusion Ultrasound-guided quadratus lumborum block can remarkably reduce the consumption of tramadol after caesarean section, lower the postoperative pain score, improve the patient′s comfort and satisfaction.
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Radiomics is a flourishing field for capturing deep potential information of images, which can assess lesion characteristics quantitatively and detect unknown imaging message more detailed than visual sight. In recent years, radiomics has been gradually applied to the study of histopathological grading, tumor staging prediction, differential diagnosis, the rapeutic efficacy and prognosis evaluation of gastric cancer. The research progresses of radiomics in gastric cancer were reviewed in this article.
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Objective To investigate the effect of miR-30a on human osteosarcoma cell 143B in migration,invasion andcellviability.Methods 143BcellswereinfectedortransfectedwithrecombinantadenovirusmiR-30a(Ad-miR30a) and miR-30a inhibitor respectively .Wound healing assay was performed to detect the cell healing ability ( P<0.05 ) .Cell migration and invasion ability were determined by Transwell assay ( P<0.05 ) .The cell viability was analyzed by MTT assay ( P<0.01 ) .Real-time quantitative PCR was performed to analyze the expression of RUNX2 mRNA level and confirmed the adenovirus miR-30a expressed in 143B cells.The expression of RUNX2 was analyzed by Western blot .miR-30a target to RUNX2 was verified by luciferase reported gene assay .Results The ability of migration and invasion was suppressed in osteosarcoma cell 143B by overexpression miR-30a,and the cell viability also decreased .After the endogenous miR-30 a being inhibited , the cell motility and invasion enhanced and the cell viability was promoted .The RUNX2 protein decreased after overexpression miR-30 a as compared with controlgroup.TheluciferaseactivityofRUNX2decreasedbyaddingmiR-30a.Conclusions 143Bcellmigration, invasion and viability were suppressed by miR-30a,and this process is potentially achieved via suppressing RUNX 2 protein expression .
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Objective To investigate the relationship between glutathione S-transferases P1(GSTP1)Ile105Val and glutathione S-transferases M1(GSTM1)single nucleotide polymorphisms(SNP) and the sensitivity to chemotherapy among patients with ad-vanced non-small cell lung cancer(NSCLC) .Methods We used gene sequencing analysis to determine the SNP of GSTP1 Ile105Val and PCR analysis to GSTM1 in DNA from peripheral lymphocytes of NSCLC patients .Totally 89 patients with NSCLC were trea-ted with platinum-based chemotherapy ,and clinical response was evaluated after 2 cycles .The association between GSTP1 Ile105Val and GSTM1 SNP and chemosensitivity were analyzed .Results The overall response rate was 29 .2% .Chemotherapy re-sponse did not show statistically significant differences between the wild genotypes and the variant genotypes for the GSTP1 Ile105Val and GSTM1 gene(P>0 .05) .Conclusion The polymorphisms of GSTP1 Ile105Val and GSTM1 may be not associated with sensitivity to chemotherapy in NSCLC patients .
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Tracheal intubation is an important part in clinical teaching of anesthesiology,it is also the basic skill that each anesthesiologist must master.The distinctive feature of visual technology is intuitive visual,meaning operation process and anatomical structure can be seen directly and clearly.Our department tried to teach tracheal intubation with visual technology.Teachers firstly demonstrated standard incubation with video laryngoscope and explained the related basic theoretical knowledge.Then students practiced the intubation in models until becoming skilled,finally students can practice in real patients.The teaching effect of the modified method was better compared with that of traditional method.
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Anesthesia related skills training is an important component of standardized residency training plan.Attention should be paid to the clinical thinking ability,preoperative assessment capacity,sterile concepts and technologies,cardiopulmonary brain recovery skills and teamwork ability cultivation during the rotation of resident physieians and resident surgeons,and comprehensive and scientific examination system should be established
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Objective:The purpose of this study is to evaluate the clinical efficacy of remifentanil combined with proopofol in the course of anesthesia induction and analepsia. Methods: 90 ASAⅠ～Ⅱpatients excision of tumor of the ovary and salphingectomy undergoing gynaecologic laparoscopy were randomly divided into two groups:R group (propofol and vemifentanil n=45) and F group (propofol and fentanil n=45).MAP and HR were observed at the time of anesthesia induction tracheal intubation;the time of spontaneuusly breathing,awakeness,extubation,orientation force and the time of PACU were record;we view the patient of conscious state,cognition functional and the degree of pain;and observe the side effects of nausea and vomitting,intraoperative awareness and degree of patients'satisfaction. Result:There was no significant diference in decrease of two group of MAP in the course of anesthesia. The rate of cardiovascular response to tracheal intubation in F group is higher than that in R group, and hemobynamics was stabler. There was significantly diference in the time of spontaneously breathing,awakeness and extubation. At the time instant extubation and departing PACU were shorter, VAS after extubation 1h in R group was higher than that in F group. There was no significant diference in incidence rate of postoperative nausea and vomitting. Conclusion: Awake qualily of intravenous anesthesia with Propofol and remifentanil was better than that with Propofol and fentanil in excision of tumor of the ovary and salpingectomy undergoing gynaecologic laparoscopy. As half life of remifentanil was short, patients felt pain soon after operation and pestoperative analgesia should be performed promptly.
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Objective:To investigate the anesthetic management of thymectomy for the patients with myasthenia gravis.Methods:Sixty-two patients with myasthenia gravis who underwent thymectomy in our hospital from 1984 to 2003 were retrospectively studied.Of these patients,21 cases received peroral endotracheal intubation and 41 cases pernasal intubation.Intravenous-inhalation combined anesthesia was taken during operation.All of 62 patients with endobronchial tube were transferred to ICU and received mechanical ventilation.Results:Twenty-one patients with perora endotracheal intubation were extubated at 4h-6h after operation.Of these 21 patients,five cases had to be intubated again because of repeated occurrence of myasthenia crisis.Forty-one patients with pernasal intubation did not extubated until mechanical ventilation for 6 hrs to 5 days,and none needed for intubation again,pernasal intubation cases were significantly different with peroral endotracheal intubation cases.The statistics have no difference betwen the trachea incisioned and the dead cases.Conclusion:In anesthetic management of thymectomy for the patients with myasthenia gravis,pernasal endotracheal intubation is convenient for prolonged mechanical ventilation,it can effectively prevent the occurrence of postoperative myasthenia crisis.The perioperative safety precautions,intravenous-inhalation combined anesthesia during operation and strengthening management of respriratory tract are very important.
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Objective:To summarize the experiences of perianesthesia management of pheochromocytoma treated with esmolol.Methods:HR,SBP,DBP,MAP,CVP of 28 patients with pheochromocytoma treated with esmolol during anesthesia induction and operation were analysed.Results:Hemodynamics of the patients during operation were kept steady,and the differences were not significant compared with the basic data.Conclusion:Esmolol is safe and effective when applied in pheochromocytoma resection for the cardiovascular effects can be prevented and hemodynamics can be kept steady.
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Objective:To compare the cardiovascular responses to orotracheal intubation with GlideScope videolaryngoscope and with normol laryngoscope in hypertensive patients. Methods:84 hypertensive patients aged 50~70 years,blood pressure controlled,ASA physical status Ⅰ~Ⅱ,scheduled for selected non-heart surgery under general anesthesia reguiring orotracheal intubation were randomly allocated to either GlideScope videolaryngoscope (G,n=42)or normol laryngoscope (N,n=42)group. The following data were recorded and analyzed:glottic exposure time,tracheal intubation time,blood pressure(BP)and heart rate(HR)before and after anesthetic induction,at intubation and thereafter at 1 minute interval for 5 minuts. The rate pressure produc(tRPP)at each measuring time point was calculated. Results:There was no significant difference in the glottic exposure time between the two groups,but the intubation time in G group were significantly longer than that in N group.Compared with base value preinduction,BP,HR,and RPP were significantly decreased in both groups. Glottic exposure and tracheal intubation caused significant increases in BP,HR,and RPP as compared with postinduction values. The index at glottic exposure in group N were higher than that in group G. There was no significant difference in BP,HR,and RPP at other time points between two groups. Conclusion:There was no significant difference in cardiovascular responses to orotracheal intubation between GlideScope videolaryngoscope and normol laryngoscope groups. Under clinical depth of anesthesia,myocardial ischemia did not occur during orotracheal intubation with either laryngoscope in hypertensive patients.
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0.05),and that in group 3 or group 4 was obviously shorter than in group 1(P