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.

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.

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.

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.

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.

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.

BACKGROUND: Most animal experiments of transgene are derived from mice; therefore, it is necessary to establish a focal cerebral ischemiareperfusion model and significant to prevent and cure ischemic cerebrovascular diseases.OBJECTIVE: To establish a convenient and reliable model with middle cerebral artery occlusion reperfusion (MCAO/R) in mice.DESIGN: Randomized controlled animal study.SETTING: Institute of Cerebrovascular disease, Affiliated Hospital of Medical College of Qingdao University.MATERIALS: Twenty healthy BALB/c mice, of both genders, weighing 25-30 g, of SPF grade, were divided into sham operation group (n=5), ischemia group (n=10) and 22-hour reperfusion group (n=5) on the basis of digital table. In addition, according to digital table, 130 healthy male Kunming mice were divided into sham operation group (n=10), 24-hour ischemia group (n=30), 2-hour ischemia/22-hour, 46-hour and 70-hour reperfusion groups with 30 in each group; meanwhile, 30 female mice were divided into sham operation group, 24-hour ischemia group and 2-hour ischemia/22-hour reperfusion group with 10 in each group. All Kunming mice were weighing 25-30 g and of SPF grade.METHODS: The experiment was carried out in the Institute of Cerebrovascular Disease, Affiliated Hospital of Medical College of Qingdao University from July 2005 to March 2006. The 6-0 suture with silica gel covered at an end was sent from the left external carotid artery (ECA) into internal carotid artery (ICA) till arriving at the initiation of middle cerebral artery (MCA) to block the blood stream in it, then drawing the suture from ICA 2 hours after occlusion to accomplish reperfusion. Mice were cut off their heads in sham operation group at 24 hours after operation, in ischemia group at 24 hours after blocking blood stream and in reperfusion group at 24, 48 and 72 hours after operation. Reliability of models was evaluated with neurology score and tetrazolium chloride stain. Longa standard scores: neurology score ≥ 1 point was regarded as successful models;coronal sections of brain tissue were stained with tetrazolium chloride, and the white region was regarded as infarcted volume.MAIN OUTCOME MEASURES: Neurology score and infarcted volume after staining of triphenyltetrazolium chloride in brain tissue.RESULTS: All mice were involved in the final analysis. ① Successful rate was 20% of BALB/c mice, 66.7%-73.3% of male Kunming mice and 40%-50% of female Kunming mice. ② Brain sections of BALB/c mice in sham operation group were orange at both sides of cortex and infarction focus was not observed. A big infarcted volume was observed on brain sections of mice in ischemia group, and infarcted volume counted for 50%-70% as homonymy hemisphere on optochiasmatic coronal sections. The condition of Kunming mice was similar to that of BALB/c mice, but infarcted volume counted for 40%-65%. In addition, condition in ischemiareperfusion group was similar to that in ischemia group. A big infarcted volume was observed on brain sections, and infarcted volume counted for 50%-75% as homonymy hemisphere on optochiasmatic coronal sections.The condition of Kunming mice was similar to that of BALB/c mice, but infarcted volume counted for 40%-65%.CONCLUSION: The model with MCAO/R in mice characterizes by relatively smaller trauma, and the ischemic region is stable; therefore, it can be used to accurate timing control of ischemia/reperfusion. This model is an ideal one for researching pathophysiological changes, prognosis and therapy in cerebrovascular disease.

Objective To review the long-term oncologic and functional outcomes of surgical treatment for pelvic chondrosarcoma at a single institution to further delineate surgical strategy of resection and function reconstruction.Methods All of 165 patients with pelvic chondrosarcoma that had been surgically treated between July 2000 and Dec 2013 were reviewed retrospectively.There were 102 male and 63 female patients who had a mean age of 43.5 (range,13 to 75) years.The resection type included Type T 16,type Ⅱ 18,type Ⅲ 11,type Ⅰ+Ⅱ 19,type Ⅱ+Ⅲ 63,type Ⅰ+Ⅳ 15,type Ⅰ+Ⅱ+Ⅲ 10 and type Ⅰ+Ⅱ+Ⅳ 13 cases.The pathology diagnosis was grade Ⅰ in 15,grade Ⅱ in 88,grade Ⅲ in 20,dedifferentiated in 28,mesenchymal in 12 and clear cell chondrosarcoma in 2 patients.Nine cases were secondary lesion following multiple exostoses.114 patients received no previous treatment while others were referred due to recurrent tumor.En bloc resection was achieved in 142 patients and intralesional resection in 23 cases.Twelve patients had a hemipelvectomy to achieve local tumor control,whereas 153 patients underwent a limb-salvage procedure.Spinal screw-rod system was used to reconstruct anterior pelvic ring after ilium resection.Modular hemipelvic endoprosthesis was utilized to reconstruct periacetabular defect after tumor resection while no reconstruction was performed after ischium and pubis resection.Results The median duration of follow-up was 54.1 (range,l0 to 159) months.147 (89.1％) patients were alive at the final follow-up,seven of which were alive with tumor.The estimated 5-year survival was 81.5％.Thirty-three patients (20％) had local recurrence,and twenty (12.1％) had lung metastasis.Recurrent case,sacroiliac joint involvement and intralesional resction were three risk factors for postoperative recurrence.Patients who received type Ⅱ+Ⅲ resection and reconstruction had a mean functional score of 23 according to MSTS 93.The mean MSTS 93 for patients with type Ⅰ+Ⅱ and type Ⅰ+Ⅱ+Ⅳ resection and reconstruction was 18.The wound complication rate was 15.8％.Two aseptic loosening and 2 pubic connection plate breakage were observed in hemipelvic endoprosthesis reconstruction.Conclusion Tumor grade correlates with overall or disease-free survival.For low-grade chondrosarcoma,adequate surgical margin can provide long-term local control while for high-grade cases,distant metastasis is the main case of treatment failure.Adequate surgical margin can be achieved in cases with acetabulum involved.However,aggressive surgical resection of pelvic chondrosarcoma still remains as a challenge for orthopaedic oncologists when the tumor invades the iliosacral joint,which necessitates careful preoperative plan and skilled surgical techniques.

Objective To evaluate the value of intraduetal ultrasonography (IDUS) in diagnosing biliary and pancreatic disorders. Methods The findings by endoscopic retrograde cholangiopancreatography (ERCP) and IDUS from 19 patients with suspected biliary and pancreatic disorders from July 2006 to August 2007 in our hospital were analyzed retrospectively. Results Of the 19 patients, 17 had obstructive jaundice (including 6 eases of cholangiocarcinoma, 2 pancreatic adenocareinoma, 2 gallbladder carcinoma, 2 chole-docholithiasis with bile duct stricture, 2 autoimmune pancreatitis, 1 papillary adenocarcinoma, 1 papillary adenoma, and 1 sclerosing cholangitis) and 2 intraduetal papillary mueinous tumor (IPMT). The diagnosis was confirmed by surgery and pathological findings in 11 patients. The diagnostic accuracy of ERCP and IDUS was 73. 7% (14/19) and 84. 2% (16/19), respectively, and that of ERCP combined with IDUS was 89. 5% (17/19). The sensitivity and specificity of ERCP to differentiate benign bile duct strictures from ma-lignant ones were 100. 0% (11/11) and 83.3% (5/6), respectively; and those of IDUS were 100. 0%(11/11) and 100. 0% (6/6), respectively. The sensitivity and specificity of ERCP in diagnosing cholan-gioeareinoma were 83.3% (5/6) and 60% (3/5), respectively; and those of IDUS were 100. 0% (6/6) and 40. 0% (2/5), respectively. Conclusion Combination of ERCP with IDUS can improve the diagnostic accuracy of pancreaticobiliary disorders. Additionally, IDUS shows higher sensitivity and specificity in differ-entiation between benign and malignant bile duct strictures, but it is still difficult to identify the etiologic factors of malignant bile duet strictures by IDUS.