Objective To compare the inhibitory effects of Butorphanol and Dezocine on Etomidate-induced myoclo?nus. Methods A total of 150 patients with ASA physical statusⅠorⅡ, aged 40-65 yr, with body mass index (BMI) of 20-25 kg/m2, scheduled for elective operations under general anesthesia, were included in this study. Patients were randomly al?located into three groups (A, B and C) with 50 patients in each group. Group A was given intravenous Butorphanol 15 μg/kg for 30 s, group B was given Dezocine 0.1 mg/kg and group C was given equal volume of saline. After 2 min, etomidate 0.3 mg/kg was administrated to three groups. The occurrence and severity of myoclonus were recorded for 2 min after administration of Etomidate. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and Bispectral index (BIS) were recorded at the time points before induction (T0), 2 min after the experimental drug treatment (T1), and 2 min after Etomi?date treatment (T2). At the same time, the concentration of serum potassium was determined at T0 and 5 min after endotrache?al intubation (T3) respectively. Results The positive incidences of myoclonus were 12%in group A, 22%in group B and 74%in group C, respectively. Compared with group C, the positive incidence rates of myoclonus and myoclonus scales were significantly lower in group A and group B (P<0.05), but no significant difference between group A and group B (P>0.05). Compared with T0, there was no significant difference in the potassium concentration between patients without myoclonus (grade 0) and patients with myoclonus (grade 1 and grade 2) at T3 (P>0.05). There was a significant increase in potassium concentration in patients with grade 3 (P<0.05). There were no significant differences in MAP, HR, SpO2 and BIS values at T0, T1 and T2 between three groups of patients (P>0.05). Conclusion Pre-treatment of Butorphanol (15μg/kg) or Dezocine (0.1 mg/kg) can reduce the Etomidate-induced myoclonus. At the same time, both therapies show no different effects on cir?culation and respiration system.

Objective To investigate the effects of soy bean isoflavone(SI)on the expression of VEGF,nitric oxide synthase(NOS)subtype,endothelial NOS(eNOS)and inducible NOS(iNOS)mRNA in ovaries during perimenopause period in rats.Methods A rat model of perimenopause was reproduced by enforced ageing.42 female Wistar rats of 12 months old were randomly divided into five groups:aging model group,low,middle,high doses of SI groups,and nilestriol(NI)group.10 female rats of 3 months old served as control group.The animals in low(50mg/kg),middle(158mg/kg)and high(500mg/kg)dosage of SI groups,and in NI group(0.158mg/kg)were gavaged with corresponding drugs for 8 weeks.The expressions of VEGF and NOS mRNA in ovaries were detected by RT-PCR.The total NOS activity in serum and ovaries was detected by chromatometry.Results Compared with control group,the expressions of VEGF mRNA in ovaries of perimenopause rats increased significantly(P

Objective To compare butorphanol or midazolam alone and combination of the two drugs in preventing etomidate-induced myoclonus during anesthesia induction.Methods One hundred sixty patients, aged 40-64 yr, with body mass index of 20-25 kg/m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective operations under general anesthesia, were randomly allocated into 4 groups with 40 patients in each group: control group (group C), butorphanol group (group B) , midazolam group (group M) , and butorphanol combined with midazolam group (group BM).Before induction of anesthesia, butorphanol 15.0 μg/kg, midazolam 50 μg/kg, and butorphanol 7.5 μg/kg combined with midazolam 25 μg/kg were injected intravenously over 30 s in B, M and BM groups, respectively.The equal volume of normal saline was given in group C.And 2 min later, etomidate 0.3 mg/kg was injected intravenously over 1 min.The occurrence of myoclonus was recorded within 2 min after administration of etomidate, and the severity of myoclonus was assessed.Results Compared with group C, the incidence and severity of myoclonus were significantly decreased in B, M and BM groups (P＜0.05).Compared with B and M groups, the incidence and severity of myoclonus were significantly decreased in group BM (P＜0.05).There was no significant difference in the incidence and severity of myoclonus between group B and group M (P ＞ 0.05).Conclusion Butorphanol or midazolam alone produces similar efficacy in preventing etomidate-induced myoclonus during anesthesia induction, and the combination of the two drugs provides better efficacy than either alone in the patients.

Objective To evaluate development of gastro-esophageal reflux (GER) during laparoscopic surgery in lateral jack-knife position under general anesthesia through comparing with reverse Trendelenburg/ Trendelenburg position in the patients lying supine.Methods Ninety patients of both sexes,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,scheduled for elective laparoscopic surgery under general anesthesia,were randomly divided into 3 groups (n =30 each):lateral jack-knife position group (group L),Trendelenburg position group (group T) and reverse Trendelenburg position group (group Tre).Anesthesia was induced with midazolam,sufentanil,propofol and cisatracurium besylate and maintained with propofol and remifentanil given by target-controlled infusion.A pH-sensitive probe was inserted through nose into the lower esophagus and pH value was continuously recorded until 1 min after extubation.GER was defined as pH value ≤ 4 lasting for ≥ 1 min in the lower esophagus during surgery.The development of GER during surgery and the lowest pH value in the lower esophagus when GER developed were recorded.Results Compared with group Tre,the incidence of GER (27％) and total number of times GER had occurred were significantly increased in group L,and no significant changes were found in the indices mentioned above in L and T groups.When GER developed,the lowest pH value in the lower esophagus was 2.1 ± 1.3,2.6 ± 1.2 and 3.5 in L,T and Tre groups,respectively.Conclusion The incidence of GER is 27 ％ during laparoscopic surgery when the patients are in lateral jack-knife position and it is higher than that obtained with reverse Trendelenburg position in the patients lying supine.

Objective To study the Mandarin long-term average speech spectrum (LTASS),the effects of gender,language and region material on LTASS were explored.This research would provide reference for clinical and academic use of Mandarin LTASS.Methods One hundred and sixty subjects from eight major dialectic regions of China,aging 16~30 (average 22.3±3.3),were asked to read two materials (storybook,newspaper)in Manda-rin at a steady speed and conversational level inside a standard soundproof booth.Ten males and ten females were in each dialectic region.A microphone (B&K 4192)was used to monitor each subject's speech which was analyzed with a real-time spectrum analyzer to obtain the long-term spectrum (B&K PULSE 3560C).Results Different Man-darin LTASS spectra were obtained based on gender,material and regions.The spectra were tested with profile a-nalysis.Language material had no significant effects on the Mandarin LTASS (F =2.52,P =0.11 ).There was, however,significant gender difference (F =116.39,P =0.00).Males had spoken with intensity levels higher than females at 100 Hz to 200 Hz.There was also a dialectic difference in the Mandarin LTASS (F =1.29,P =0.02). Speakers from Guangdong had the lowest intensity levels compared to those from other regions.Conclusion Genders and regions are factors that need to be considered when LTASS is used for clinical purpose and academic study.

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil inhibiting responses to insertion of laryngeal mask airway (LMA) when combined with propofol in the elderly patients.Methods ASA physical status Ⅰ or Ⅱ patients,aged 66-75 yr,with body mass index of 19-30 kg/m2,scheduled for elective transurethral resection of prostate under general anesthesia,were included in this study.Anesthesia was induced with propofol given by target-controlled infusion.The initial target effect-site concentration (Ce) of propofol was 1 μg/ml,and the Ce was increased by 0.5 μg/ml every 1 min until it was increased to 2 μg/ml and maintained at this level for 5 min.Sufentanil was simultaneously administered by target-controlled infusion.The target Ce of sufentanil was 0.3 ng/ml in the first patient.The concentration of sufentanil was determined using the modified Dixon's up-and-down method.After the patients lost consciousness,LMA was inserted after the target effect-site and plasma concentrations were balanced.The insertion response was defined as positive when MAP and HR increased by 20％ of the baseline value within 5 min after insertion of LMA.The Ce of sufentanil was increased/decreased in the next patient if the insertion response was positive or negative.The ratio between the two successive concentrations was 1.2.The EC50 and 95 ％ confidence interval of sufentanil blunting responses to insertion of LMA was calculated using Probit analysis.Results When combined with propofol,the EC50 (95％ confidence interval) of sufentanil blunting responses to insertion of LMA was 0.160 (0.130-0.188) ng/ml.Conclusion The EC50 of sufentanil inhibiting responses to insertion of LMA is 0.160 ng/ml when combined with propofol in the elderly patients.

Objective To study the serum levels of melatonin,tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) in multiple sclerosis (MS) patients and the correlation with disability.Methods Forty patients with multiple sclerosis were collected as MS group and 30 healthy participants were collected as control group.Serum levels of melatonin and cytokines,including IFN-γ and TNF-,were detected in all participants by the enzyme-linked immunosorbent assay (ELISA) method;disability status of patients with MS was evaluated by EDSS scale.The relevant analysis between serum melatonin,TNF-α,IFN-γ levels and EDSS score in patients with MS was conducted.Results The concentration of serum melatonin in MS group was significantly lower than control group (P＜0.01).TNF-α levels were higher than control group (P＜0.05) and the difference was statistically significant between MS patients and control group.Among MS group and control group,no significant correlation with the serum levels of IFN-γ was seen.The serum melatonin level was inversely correlated with EDSS score in MS patients (r =-0.76,P＜0.01),and positively correlated with TNF-α (r =0.83,P＜0.01) and as compared to IFN-γ,no significant correlation was found (r =0.17,P＞0.05).Conclusion The decrease of melatonin and increase of TNF-α can be a factor in the inflammatory reaction in patients with MS,and is closely related with dysfunction occurring in multiple sclerosis.Serum melatonin and TNF-α can be used as laboratory indicators to monitor clinical curative effect and evaluate prognosis of MS.

BACKGROUND: Benign prostatic hyperplasia is a common disease of older males. Although the etiology remains unclear, the factors of life style and habits may have an effect on the disease.OBJECTIVE:To examine the association of cigarette smoking and body mass index with the risk of clinical benign prostatic hyperplasia.DESIGN: A hospital-based case-control study SETTINGS:Department of Epidemiology and Statistics, Public Health School,Tongji Medical College, Huazhong University of Science and Technology; Department of Preventive Medicine, Liaoning Medical College.PARTICIPANTS：Totally 343 males with benign prostatic hyperplasia of 50-82 years old (patient group),who were surgically treated between May 2004 and May 2006,were selected from the Department of Urinary Surgery of the First Affiliated Hospital and Third Affiliated Hospital of Liaoning Medical College (former Jinzhou Railway Central Hospital),Jinzhou Central Hospital and Jinzhou Second People's Hospital．Inclusive criteria：① males above 50 years old；intemational prostatic symptom score(IPSS)＞7；②Digital recta examination (DRE) after miction indicated prostate grade Ⅰ(transverse diameter＞3 cm); ③prostatic volume≥30 g;④maximum unnary flow rate＜15 mL／s；Meanwhile，361 inpatients with diseases irrelative to the risk factors of benign prostatic hyperplasia,prostatic cancer and prostatitis were selected trom the above hospitals as the control group,they were 50-82 years of age with an average of 65 years old．Informed contents were obtained from all the enrolled subjects．METHODS：All the patients and controls were interviewed using an anonymous questionnaire．All participants were asked to report whether they had smoked 20 packs of cigarettes or more in their lifetimes and,if yes,they were smokers,on the contrary they were non-smokers．Based on usual number of cigarettes reported in the questionnaire, men were categorized as 1-10，11-20，21-30 and ＞30 cigarettes per day．Based on duration of smoking,the participants were funher classified as never smoke，1-19,20-29 and ≥30 years．Body mass index(BMI)was assessed from measured body mass and body height，and che standards of BMI in adults in China was 18．5-23．9 for normal,24．0-27．9 for overweight and ≥28．0 for obesity)，then the participants were further classified as BMI＜18．4，18．5-23．9,24．0-27．9 and ≥28．0 subgroups respectively．Years of education(＜7,7-11,and≥12) and occupation(worker,peasant, Intellectual and others) were also investigated．The results of the investigation were input into computer to establish database，the odds ratios (OR) and the 95％ confidence interval(CI)in relation to the various measures were estimated using unconditional multiple logistic regression models, including number of cigarettes smoked per day，BMI,years smoked，years of education,occupation．MAIN OUTCOME MEASURES：Relationships of number of cigarettes smoked per day,years smoked．BMI,years of education and occupation with benign prostatic hyperplasia．RESULTS：Totally 343 cases in the patient group and 361 cases in the control group were involved in the analysis of results．①Patients smoked≥30 cigarettes per day had an elevated risk of benign prostatic hypertrophy as compared with the non-smokers(OR=1．32，95％ CI:0．92-2．58，P＜0．01)．②The risks of benign prostatic hypertrophy in overweight and obesity were significantly increased as compared with non-smokers(OR=1.68,95％ CI: 1．32-3．67；OR=2．35，95％CI:1．83-4．16)，③Manual worker (peasant) was negatively correlated with the risk of benign prostatic hyperplasia (χ2=6．62，P＜0．01)．CONCLUSION:Smoking 30 cigarettes per day was positively related to benign prostatic hyperplasia.For male who were both overweight(BMI 24.0-27.9)and obesity(BMI≥28.0)，smoking was significantly associated the increased risk of surgically treated benign prostatic hyperplasia.

Objective To compare the effects of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC) operation. Methods Sixty patients of both sexes , aged 18-65 yr , weighing 46-85 kg , scheduled for LC operation , were randomly divided into 2 groups (n = 30). Patient-controlled intravenous analgesia (PCIA) pump (oxycodone hydrochloride injection 20 mg or sufentanil 100 μg with physiological saline to 100 ml ) was used for postoperative analgesia five minutes before the end of operation. The first dose and bolus dose were both 5 ml , background infusion was 2 ml/h,lockout interval was 5 minute. The NRS score of rest and during movement at 1 ,6 and 24 h after operation,total oxycodone or sufentanil consumption in 24 h, requirement for rescue analgesic, the level of patient′s satisfaction , the adverse events were recorded. Results There was no significant difference in the NRS scores at rest and during movement , total oxycodone or sufentanil consumption in 24 h and postoperative nausea and vomiting (PONV) between the two groups. The patient’s satisfaction were significantly higher (P < 0.05), and the incidence of dizziness were significantly lower (P = 0.026) in group Q than in group S. Both groups were no requirement for rescue analgesic , no sleepiness , no itch , no retention of urine and other adverse reaction. Conclusion PCIA with oxycodone hydrochloride injection is safe and effective in reducing pain after LC operation, however the incidence of dizziness is lower and the level of patient’s satisfaction is higher with oxycodone hydrochloride than with sufentanil.

Objective To evaluate the role of conventional and functional MR in the diagnosis of orbital mucosa-associated lymphoid tissue lymphoma (MALToma).Methods Twenty-two patients with pathologically confirmed orbital MALToma were enrolled in our study.The number,location,morphology,involvement of surrounding structure and imaging features were evaluated.Apparent diffusion coefficient (ADC) values derived from diffusion weighted imaging and time-intensity curve (TIC)pattern derived from dynamic contrast enhanced MRI were assessed. Results Orbital MALToma occurred unilaterally in 1 7 cases and bilaterally in 5 cases.Anterior orbit preseptal region was involved most frequently (20 cases),followed by intraconal(19 cases),extraxonal (17 cases)and lacrimal fossa (12 cases)regions.Most cases showed as homogeneously iso-intensity on both T1 and T2 weighted images.Mean ADC value of the lesions was (0.61 ± 0.08)× 10 -3 mm2/s.A washout-type TIC pattern was observed in 1 5 cases,while plateau pattern was found in 7 cases.Conclusion Conventional MRI can assist in describing the extent,while the functional MRI can quantitatively reflect the histo-pathological features of orbital MALToma.Combination of conventional and functional MRI can help the diagnosis of orbital MALToma.