Objective To compare the efficacy of sevoflurane inhalation and remifentanil-propofol anesthesia in patients undergoing total gastrectomy. Methods Forty ASA class Ⅰ or Ⅱ patients with gastric cancer were divided into sevoflurane inhalation anesthesia (group S) and remifentanil-propofol intravenous anesthesia(group P), with 20 cases each. Perioperative hemodynamic veriables, bispectral index (BIS) values and end-tidal concentration of sevoflurane were continuously monitored. The time of recovery from anesthesia and adverse reactions of anesthesia were recorded as well. Results Compared with those before anesthesia, BP and HR were significantly decreased (P< 0. 05). The depth of anesthesia in both groups was maintained well with BIS in 45-60 and vital signs were stable during operation. The recovery from anesthesia was quicker in group P than that in group S. The incidences of restlessness and couphing were obviously lower in group P than those in group S (P<0.05). Conclusion Either sevoflurane inhalation or remifentanil-propofol intravenous anesthesia can be used safely in total gastrectomy.

Objective To evaluate the surgical procedures and both oncological and functional outcome in patients with bone tumors of the shoulder girdle.Methods Seventy-one patients including 61.pts with malignant tumor and 10 pts with giant cell tumors of the shoulder girdle treated in our department from July 1998 to July 2006 were studied retrospectively.According to the location,there were 15 pts with scapula tumor and 56 pts with proximal humeral tumor.Forty-two male pts and 29 female pts were included in this study with an average age of 36.5 years old ranging from 11.to 62 years old.Surgical procedures:forequarter amputation in 10 pts;Scapulectomy in 3 pts;Scapulectomy and artificial scapular replacement in 3pts;partial scapulectomy and proximal humerus resection with prosthetic reconstruction in 8 pts;proximal humerus resection and prosthesis replacement in 47 pts.Results Due to adequate soft tissue was preserved,the mean functional score was 28 for the pts with giant cell tumor according to MSTS functional scoring system,compared with the functional score 23 for the pts with malignant tumor because the deltoid muscle insertion was resected in the latter group.Among the thirty-seven patients with osteosarcoma,local recurrence occurred in four cases(10.8%),lung metastasis in five and bone metastasis in two.The seven patients died of disease.One patient iagnosed of malignancy in giant cell tumor died after distal metastasis.thtee patients with Ewing sarcoma died of the disease.No recurrence Wag observed in both five humeral chondrosarcoma and five scapular chondrosarcoma.Conclusion Tumot resection and proximal humeral prostbesis replacement is the optimal method for the sarcoma of shoulder girdle in term of preservation of elbow and hand function.Preservation of abductor insertion is necessary for good abduction function.The metastatic rate of proximal humeral osteosarcoma was lower than that of lower extremities.also the prognosis of oncological outcome.Intra-articular and extra-atticular tumor resection produced similar local recurrence rate in the present study,which suggested intra-articular resection may be an altemafive procedure.

OBJECTIVE: To investigate the pharmacokinetics of zolpidem tartrate tablet in Han healthy volunteers. METHODS: 10 Han health volunteers were given 10 mg zolpidem tartrate tablet via p.o. The plasma concentrations were determined by HPLC-fluorescence method and the pharmacokinetic parameters were calculated by DAS 2.0.1 software. RESULTS: The plasma concentration-time curve of zolpidem tartrate is fitted to one-compartment model with a first order absorption. The main pharmacokinetic parameters were as follows: tmax(0.9?0.5)h,Cmax(190.8?70.6)?g?L-1, t1/2(2.2?0.6)h,Vd/F(0.938?0.256)L?kg-1, CL/F (18.09?10.22)L?h-1, AUC0～12(624.9?190.8) ?g?h?L-1, AUC0～∞(650.1?208.4)?g?h?L-1. CONCLUSION: The pharmacokinetic parameters of zolpidem tartrate in healthy volunlteers are concordant with that stated in literature reports, which can be the basis of pharmacokinetic study in people of different nationalities.

In order to explore the effect of flipped classroom in theoretical teaching of biochemistry,lipids metabolism was selected to carry out four stages flipped classroom.The teaching effect of flipped classroom was evaluated by test and questionnaire survey of students.The results indicated that most undergraduate students could accept novel teaching method.However,the consciousness and the ability of students' independent learning need to be further improved.It also takes time for the students to adapt to the transition from traditional teaching to flipped c1assroom.In summary,the specificity of Biochemistry may limit the carrying out of flipped classroom to some extent.Therefore,which kind of teaching method is adopted depends on the biochemistry theoretical content.Our work may provide some references for further application of flipped classroom in biochemistry teaching.

Object To establish an analysis method for determ in ation of irone in Iris tectorum Maxim. f. alba Makino. Methods The three isomers of irone were quantitatively analyz ed by GC-MS. Irone in I. tectorum extract was determinated by GC. Results The three isomers of irone, ?, ?, ?- irone were s p eculated according to the MS splitting decomposition law. Irone contents in the extract were 687, 238 ?g/g (n=6), which h ad much difference. Conclusion The analysis method for irone by GC-MS and GC is hig her efficiency, precise, and the analysis time is acceptable.

SHG was sulfated by chlorosulfonic acid-pyridine method, and six samples which we got were prepared in different reaction conditions. There is a characteristic absorption peak near 260 nm in UV spectra and there are two characteristic absorption peaks near 1240 cm(-1) and 810 cm(-1) in the FT-IR. Degree of sulfation (DS) was calculated by elemental analysis and turbidimetry. Under the same conditions the absorption peaks become strong with the DS increase. The anticoagulant activity of SHG and sulfated modification samples was evaluated by the classic coagulant assays of prothrombin time (PT), activated partial thrombin time (APTT) live enzymes, and plasma thrombin time (TT). Results show that sulfated SHG has a good anticoagulant activity in vitro, and DS increased activity within a certain range.

A new, convenient, and rapid method for kinetic measurement of human fibrinolysis was established. The alteration of absorbance (A) in the process of blood coagulation and lyses was automatically scanned and recorded using a UV2000 spectrophotometer connected to a computer. The parameters of human fibrinolysis kinetics were established. Urokinase at 20 U/mL was the optimal concentration used. There was significant difference in fibrinolysis kinetics and plasma plasminogen concentration between 22 normal subjects and 27 patients with acute myeloblastic leukemia (P<0.05 and <0.01 respectively). The coefficience of variation was (5.24+/-1.51)%. This method could also be used to measure the plasma fibrinogen concentration at the same time. It was concluded that this method was stable and was capable of providing dynamic, direct experimental data and multiparemeters for clinicians. It was also valuable in evaluating the anti-and pro-fibrinolytic capcity of patients' plasmas, allowing for monitoring of therapy, choice of drugs and adjustment of drug concentrations.

Objective To analyze and summarize the clinical characteristics and to evaluate the laboratory tests and therapeutic methods of pancreatic carcinoma,so as to improve the understanding pancreatic carcinoma.MethodsThree hundreds cases of pancreatic carcinoma were collected during 1995—2003 in PUMCH.Results ①The clinical systoms included weight loss(75.3%),abdominal pain(66.3%),anorexia(51.0%),jaundice(50.0%),abdominal distention(44.0%),back pain(18.0%),diarrhea(14.3%) and melena(7.7%).②The sensitivities of tumor markers to diagnose pancreatic cancer were 77.5% of CA19-9,66.0% of CA50,48.3% of CA242 and 29.7% of CEA.If CA19-9 combined with CA50,CA242 and CEA,its sensitivity was increased up to 86.0%.③The titer value of CA19-9 was significantly related with radical operation ratio(P

BACKGROUND:Through a ful investigation of biodegradable scaffolds, we propose a new self-expanding degradable poly-L-lactide coated endotracheal stent based on the design, production, experimental and clinical applications of nickel titanium memory alloy stent. OBJECTIVE:To design a kind of biodegradable endotracheal stent with poly-L-lactide and hydroxyapatite, and to test its mechanical properties, biocompatibility and biodegradation capacity. METHODS:With the technology of computer aided design, the stents were prepared with poly-L-lactide (Mr RESULTS AND CONCLUSION:The average radial supporting force of the tracheal stent was 7.8 kPa, the percentage of stent surface coverage was less than 20%, the stent expansion rate was≥4%, and the stent longitudinal shortening rate was≤9%, which reached the mechanical requirements for degradable endotracheal stents. After 4-16 weeks, there was no significant inflammatory response. The decline in molecular weight changes and weight loss ratio was higher for in vivo degradation than in vitro degradation at different time (P<0.05). These findings indicate that poly-L-lactide/hydroxyapatite composite stents have good mechanical properties, biocompatibility and biodegradability. 150 000) and hydroxyapatite materials, 20 mm to 26 mm in diameter. The mechanical properties were tested using a universal testing machine. These poly-L-lactide/hydroxyapatite stents were implanted into dog models of tracheal stenosis at an appropriate size. The histopathological changes of the tracheas were observed, and biodegradation property was studied via molecular weight changes and weight loss ratio after 4, 8, 12, 16 weeks.

Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P<0.05). While there was no statistically significant difference in the incidence of placental abruption, anemia in pregnant women, or fetal distress among the three groups (P>0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P<0.05). The incidence of the pregnancy complications in the TPOAb (+) treated group was higher than those in the control group, but the differences were not statistically significant (P>0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy. Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P<0.05). While there was no statistically significant difference in the incidence of placental abruption, anemia in pregnant women, or fetal distress among the three groups (P>0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P<0.05). The incidence of the pregnancy complications in the TPOAb (+) treated group was higher than those in the control group, but the differences were not statistically significant (P>0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy.