Objective To study etiology screening role of transrectal ultrasonography in male obstructive azoospermia infertility.Methods The clinical data of 328 cases who suspected of being obstructed sperm disease were retrospectively analyzed.TRUS detection was conducted,at the same time,the sperm amount,sperm and semen pH,pure berries quantitative,neutral sugar alpha glycosidase enzymes quantitative,elastic hard protease were tested.Results In 328 cases with male obstructed no sperm,by TRUS detection results,216 cases (65.8％) could find the causes,ejaculatory duct expansion,seminal vesicle gland lesions,prostate midline cyst were the top three causes respectively;112 patients(34.2％) had no obvious abnormal ultrasonic testing.Sperm was not seen in semen of obstructive azoospermia patients and semen pH ＜ 7,pure berries sugar quantitative and quantitative value neutral alpha glycosidase enzymes were very low,hard elastic protease was low.Conclusion The main causes of obstructive azoospermia were ejaculatory duct expansion,seminal vesicle gland lesions,prostate midline cyst,sperm TRUS detection used for diagnosis of high sensitivity,and easy to operate,noninvasive,and combined with seminal plasma biochemical examination,the diagnostic effect is much better.

Objective To study the effect of small doses of remifentanil in preventing cardiovascular responses to extubation in the operation of obstructive sleep apnea hypoventilation syndrome (OSAHS) . Methods Eighty patients with snoring under general anesthesia were selected. The patients were randomly divided into treatment group and control group with 40 cases in each group. The two groups used the same induction anaesthetics, and sevoflurane and remifentanil were used in both groups for anesthesia maintainance. The control group discontinued all anesthetics at the end of surgery; The treatment group stopped sevoflurane alone, and decreased and continued the infusion of remifentanil until extubation. The changes of heart rate, systolic blood pressure, diastolic blood pressure and oxygen saturation before anesthesia (t1) , extubation (t2) , 5 min after extubation (t3) , 10 min after extubation (t4) and 15 min after extubation (t5) were recorded. Recovery indexesand adverse reactions of anesthesia were recorded. Results The heart rate, systolic blood pressure, diastolic blood pressure were significantly increased at t2, t3, t4 and t5 in the two groups (P< 0.05) . SpO2 in all time intervals after extubation was slightly decreased, but the difference was not statistically significant (P> 0.05) .No significant differences were found between the two groups in the recovery time of spontaneous respiration, extubation time and the time returning to the ward (P > 0. 05) . The incidence of adverse reactions was significantly lower in the treatment group (7.5％) than in the control group (30.0％) (P< 0.05) . Conclusion Small doses of remifentanil can effectively prevent the cardiovascular responses during extubation in OSAHS operations, reduce the adverse reactions and increase the safety of extubation.