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The formative assessment system has been applied to the internship education for the clinical anesthesia with the aim to improve students' initiative and to evaluate their outcomes more compre-hensively. The students' performance in the shift exchange, case discussion, raising question, solving question at the time points of after the preclinical train, one month and 3 months into the anesthesia internship, and after the completion of internship, and their capability in preoperative patient assessment, condition report, clinical practice, review writing have been evaluated to determine the educational quality and to instruct the improvement of educational approach. Assess process takes into account both the individuality and the gen-eral character of the students and feedbacks the evaluation result to improve the practice teaching The im-plementation of the evaluation can promote students' autonomous learning and comprehensively evaluate students' practice process.
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Objective To evaluate the effect of ultrasound-guided arterial catheterization in internships of anesthesiology.Methods Sixty students were randomly divided into ultrasound-guided teaching group(n=30,3 male) and traditional teaching group (n=30,4 male).In the two groups,the ultrasound-guided arterial catheterization technology and artery catheterization technique were adopted respectively for teaching.The success rate of arterial catheterization was compared between the two groups after 2 months internships and when finishing internships of anesthesiology.The questionnaire was investigated in ultrasoundguided teaching group after finished internships of anesthesiology.Results The success rate of arterial catheterization in ultrasound-guided teaching group was extremely higher than in traditional teaching group after 2 months internships of anesthesiology (52 ± 8)％ vs.(38 ± 10)％,(x2=7.746,P=0.005).After finishing internships of anesthesiology,the success rate of arterial catheteri-zation was (67±7)％ in ultrasound-guided teaching group and (59 ± 9)％ in traditional teaching group (x2=5.531,P=0.036).And all students thought ultrasound-guided arterial catheters teaching was helpful to them and could improve their learning interest.Conclusion Ultrasound-guided arterial catheterization is beneficial to the internship teaching of undergraduate of anesthesiology,which can help them to master the arterial catheterization technique better,and improve the success rate of arterial catheterization and their learning interest.
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Objective To explore the more effective measures for the prevention of deep vein thrombosis (DVT ) by comparing the different efficacy between the multimodal strategy and liberal measures .Methods From July 2011 to June 2013 ,medical records of 289 patients who had accepted total knee replacement (TKR) were collected .Patients were divided into two groups according to whether exploring to the multimodal strategy or liberal measures after TKR .The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,intermittent pneumatic compression ,and postoperative continues femoral nerve block analgesia .Patients in group A were treated during July 2011 to June 2012 ,and accepted liberal measures for the prevention of DVT .Patients in group B were treated after June 2012 ,and accepted multimodal strategy .The data of each group were collected for statistical analysis on the following aspects :DVT occurrence rate ,DVT distribution ,age ,gender ,body mass index ,disease ,operation duration ,volume of blood loss and transfusion during operation phase ,drainage volume after TKR .Results The DVT occurrence rate of patients in group B were significantly lower than that of patients in group A (P0 .05) .Conclusion The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,postoperative low molecular weight heparin ,and postoperative continues femoral nerve block analgesia is more effective than liberal measures for the prevention of DVT .
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Objective To evaluate the role of prostaglandin E2 (EP) receptors in H9c2 cardiomyocyte hypertrophy induced by prostaglandin E2 (PGE2).Methods Primary cultured H9c2 cardiomyocytes were seeded in culture flasks (3 ml/flask) or in 24-well plate (1 ml/hole) or 6-well plate (2 ml/hole) with density of 4 × 104/ml.The cells were randomly divided into 4 groups (n=24 each): control group (group C),PGE2 group,AH6809 (EP1 and EP2 receptor antagonist) group (group A) and GW627368X (EP4 receptor antagonist) group (group G).The cells were continuously cultured for 48 h.PGE2 (final concentration 1 μmol/L) was added to the culture medium in PGE2 group.PGE2 (final concentration 1 μmol/L) and A H6809 (final concentration 10 μmol/L) were added to the culture medium in group A.PGE2 (final concentration 1 μmol/L) and GW627368X (final concentration 10 μmol/L) were added to the culture medium.The cells were then cultured for 48 h in groups PGE2,A and G.Then the cell morphology was observed by using fluorescent microscope.The cell diameter was measured by using the Image J medical image analysis system.Total protein content in the cells was measured with BCA method.The expression of atrial natriuretic peptide (ANP) mRNA and brain natriuretic peptide (BNP) mRNA in the cytoplasm was determined using RT-PCR.Results Compared with group C,the total protein in the cells and cell diameter were significantly increased,and the expression of ANP mRNA and BNP mRNA in the cytoplasm was up-regulated in groups PGE2,A and G (P ＜ 0.05).Compared with group PGE2,the total protein in the cells and cell diameter were significantly decreased,and the expression of ANP mRNA and BNP mRNA in the cytoplasm was downregulated in group G (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group A (P ＞ 0.05).Conclusion EP4 receptor mediates H9c2 cardiomyocyte hypertrophy induced by PGE2 and the effect is not related to EP1 and EP2.
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Objective To investigate the effect of propofol anesthesia on the expression of β-secretase 1 (BACE1) and content of anyloid beta protein 1-42 (Aβ1-42) in the neonatal rat hippocampus.Methods Ninety Sprague-Dawley rats,aged 7 days,weighing 12-16 g,were randomly divided into 3 groups ( n =30 each):control group (group C),single dose of propofol anesthesia group (group SP),and repeated doses of propofol anesthesia group (group RP).Group C received intraperitoneal normal saline 7.5 ml/kg once a day for 7 consecutive days.Group SP received normal saline 7.5 ml/kg once a day for 6 consecutive days and propofol 75 mg/kg on 7th day.Group RP received propofol 75 mg/kg once a day for 7 consecutive days.Six rats in each group were chosen at 15 min after the end of injection on 7th day and blood samples were taken from the left ventricle for determination of the blood glucose level and for blood gas analysis.Eight animals in each group were sacrificed on 1st,3rd and 7th day after the end of injection on 7th day to determine the expression of BACE1 (using Western blot) and content of Aβ1-42 in the hippocampus (by ELISA).Results Compared with groups C and SP,the expression of BACE1 was up-regulated and the content of Aβ1-42 was significantly increased at each time point in group RP ( P ＜ 0.01 ).There was no significant difference in the expression of BACE1 and content of Aβ1-42 at each time point between groups C and SP ( P ＞ 0.05).Conclusion Repeated doses of propofol up-regulate the expression of BACE1 and increase the content of Aβ1-42 in neonatal rat hippocampus,which may be one of the mechanisms by which propofol leads to long-term cognitive dysfunction.Single dose of propofol does not have the effect.
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It is the intent of this study to simulate the performance of trans-esophageal aortic blood oxygen saturation (SeO2) monitoring by using trans-esophageal echocardiography (TEE) probe to provide an evidence for proper positioning of placing SeO2 sensor. 25 selected cardiac surgical patients were involved. After anesthesia was induced and trachea was intubated, the multiplane TEE probe was inserted into the esophagus, and the depths from the fore-tooth to the location for detecting aorta were recorded when the distances between TEE probe and aorta anterior wall were shorter than 0.5 cm, 1 cm, and longer than 1 cm, respectively. The o'clock directions of TEE probe were also recorded. The multiplane TEE probe, with its one-use pediatric SpO2 sensor attached, was inserted, and its anterior structure was examined when trans-esophagus oximetry detected high quality SpO2 signals. The results showed the beginning position of detecting aortic SpO2 signal in esophagus was mid esophagus (24.8 +/- 4.4 cm from the fore-teeth), the moving range was 5-10 cm downward, the deepest depth of detecting descending aorta was 41.4 +/- 4.7 cm from the fore-tooth, and the direction was left-posterior. And photoplethymography (PPG) wave's form was changed when SpO2 probe's anterior structure was different.