Objective: To examine the effects of midazolam-induced sedation on heart rate variability (HRV). Method:Fifteen ASA Ⅰ- Ⅱ adult patients,undergoing elective surgery under lumbar epidural anesthesia were randomly selected. An intravenous bolus dose of midazolam(1.5mg) was administered every 3-5 minutes until patients' sedation levels assessed by observers assessment of alertness sedation(OAA/S) scale had scores of 1. Spectral analysis of HRV was performed at different OAA/S scores and at 3min,5min and 10min following OAA/S score of 1. Result:All frequency components of HRV were significantly reduced as patients' OAA/S scores decreased,especially low frequency (LF) and total power. Midazolam decreased normalized unit power of LF from 33.5%?8.9% to 16.65?9.6% and increased normalized unit power of high frequency(HF) from 11.7%?4.2% to 20.5%?26.5%. LF/HF ratio also reduced. Conclusion:Midazolam shiftes the balance of autonomic nervous activity toward the parasympathotonic.

Objective: To analyse correlation of bispectral index,spectral edge frequency of electroencephalogram with midazolam-induced sedation. Method: 30ASA grade Ⅰ-Ⅱ adult patients, undergoing elective surgery under regional anesthesia were randomly devided into three groups according to intravenous bolus doses of midazolam,i, e. group Ⅰ:0.05mg?kg~(-1),group Ⅱ:0.1mg?kg~(-1),group Ⅲ:0.2mg?kg~(-1). After an intravenous bolus dose of mida zolam was administered,both bispectral index (BIS), 95% spectral edge freguency (SEF) of electroencephalogram were monitored and their correlation with midazolam induced sedation was analysed. Result: Both BIS and 95% SEF-correlated with midazolam-induced sedation significantly (r= 0.86,0.73, P

ObjectiveTo investigate the clinical appli cation of ultrasound in Peyronie disease. MethodsSixty-nine patients with Peyronie disease were examined by conventional ultrasound, and compared with pathology. ResultsUltrasonographic imaging showed the size and morphological of Peyronie plague,and located the position of the plagues.The ultrasound figures of plagues directly related to pathological components and case history,and they were roughly divided into twe types:hypoechoic type and hyperechoic type.ConclusionsUltrasound examination is the best and reliable method in choice for Peyronie plagues and evaluation of the therapeutic effects.

Objective To investigate the mechanisms of Mal gene down regulated in human esophageal cancer. Methods We amplified the 5′regulatory region of Mal gene in normal placenta tissue and human esophageal cancer cell lines EC9706、EC8712、EC109 by optimization the PCR methods, cloned and sequenced the PCR products and compare the sequence. Results Human esophageal cancer cell lines EC9706、EC8712、EC109 all have the 654 th of 5′regulatory region of Mal gene T to C changes, corresponding codon changed from TCC to CCC, and the amino acid which it codes changed from serine to proline; EC9706 also has the 657 th of 5′regulatory region of Mal gene T to C changes, corresponding codon changed from TGC to CGC, the amino acid which it codes changed from cysteine to arginine; EC8712 has the 139 th of 5′regulatory region of Mal gene A to G changed, corresponding codon changed from GGA to GGG, the amino acid which it codes remains glycine. Conclusion Our results suggested there are may point mutation in 5′ region of Mal gene in human esophageal cancer.

Objective To study the status of cystatin B gene expression in human esophageal cancer. Methods Expression of cystatin B gene was detected by RT PCR in 41 pairs of human esophageal cancer tissues, matched adjacent normal mucosa, human esophageal cancer cell line EC9706 and human lung cancer cell line GLC82. Results cystatin B gene expression was down regulated in 82.9% (34/41) of human esophageal cancer tissues while expressed at high level in all matched adjacent normal esophageal mucosa, and was significantly corelated to lymph node metastasis ( P

Purpose To investigate the effects of different concentration of ketamine on Ca2 transsarcolemmalinflux induced by KCl in isolated rat ventricular myocytes. Methods Freshly isolated rat ventricular nyoeyteswere loaded with Fluo-3AM, a Ca2 + indicator. The effects of different concentration ketamine( 1 × 10- s, 1 × 10- 4,1 × 10-3 mmol/L) on the change of intracellular Ca2+ concentration induced by KCl were investigated. ResultsLow concentration ketamine(1 × 10-5 mrnol/L) did not change Ca2+ transsarcolemmal influx. Although mediumeoncentration ketamine( 1 × 10-4 rmol/L) made the influx slower, the eventual peak concentration of intracellularCa2+ had no difference from that of the control group. The high concentration ketamine (1 × 10-3 mmol/L) inhibited Ca2-1 influx,intracellular Ca2+ fluorescent intensity decreased about 13.2% (P＜0.05). ConclusionsKetamine inhibits Ca2 + trranssarcolemmal influx in isolated rat ventricular myocytes dosedependently, which may inpart explain its negative inotropic effect.

Objective To investigate the clinical efficacy of covered self-expanding metal stent in the treatment of malignant esophageal stricture.Methods The clinical data of 512 patients accepted stent were retrospectively analyzed,which included patients' profiles,relief of dysphagia,incidence of complications and survival period.The data were analyzed by t test.Results A total of 596 stents were placed in 512 patients.There was significant difference in mean dysphagia score between before and after stent placement (grade 3.4±0.6 vs grade 1.1±0.8,t=54.09,P＜0.01).After the placement,the overall incidence of complications was 14.5％ (74/512),of which there were 21 cases of severe retrosternal pain (4.1％),16 cases of bleeding (3.1 ％),29 cases of stent displacement (5.7％),six cases of food impaction (1.2％),two cases of fistula without completely blocked (0.4％).The survival period of 238 patients with complete follow-up ranged from 30 to 1445 days,the mean time was 218.9 days.Conclusion Endoscopic covered self-expanding metal stent placement may effectively relieve dysphagia symptoms in patients with malignant esophageal stricture.

Objective To investigate the value of narrow band imaging (NBI) and lugol chromo-endoscopy (LCE) in the diagnosis of advanced esophageal carcinoma.Methods The clinical data of 162 patients with advanced esophageal carcinoma who received NBI and LCE at the Cancer Hospital of Peking University from November 2010 to May 2012 were retrospectively analyzed.Esophageal mucosa was first examined using white light imaging (WLI),and then followed by NBI and LCE,and the lengths of the lesions were recorded.Biopsy histology was obtained in all abnormal mucosa which were detected by NBI or LCE.Difference in the length of lesions detected by the NBI/LCE and WLI was calculated.Surgical approach and method of anastomosis were recorded for patients who received surgical treatment,and the final treatment method was recorded for patients who did not receive surgical treatment.Difference in the treatment methods was compared before and after endoscopy.Results The length of the lesions detected by the 3 methods was identical in 121 patients,different in 41 patients.The difference ranged between 1 and 3 cm was observed in 22 patients,＞3 cm and ≤5 cm in 8 patients,＞5 cm and ≤10 cm in 7 patients,＞ 10 cm in 4 patients.Of the patients in the above mentioned 4 categories,there were 1,2,2,4 patients in each category received neo-adjuvant therapy,and the rest patients received operation.Superficial cancer contiguous to the primary lesion was found in 41 patients,including squamous cell carcinoma in 31 patients,carcinoma-in-situ in 3 patients and severe dysplasia in 7 patients.Of the 153 patients who received surgery,the surgical plan for 12 patients was modified.Intrathoracic anastomosis was changed to cervical anastomosis in 2 patients,anastomosis under the aortic arch was changed to anastomosis above the aortic arch in 3 patients,trans-abdominal operation was changed to thoraco-abdominal operation in 7 patients.Conclusions The combination of NBI and LCE is more accurate to evaluate the extent of lesions of advanced esophageal carcinoma,and is useful to decide the treatment protocol.Pathological examination of the adjacent abnormal mucosa should be carried out for patients whose lesion length was inconsistent under different observation methods.

ObjectiveTo investigate the association of HLA-Cw alleles with inflammatory bowel disease(IBD), so as to identify IBD susceptibility gene.MethodsThe HLA-Cw genotype were analyzed in 100 patients with ulcerative colitis (UC), 73 patients with Crohn's disease (CD) and 106 randomly ethnically matched healthy controls by sequence specific primer polymerase chain (PCR-SSP).Results HLA-Cw * 07 gene phenotype frequencies increased in patients with UC (0.430) compared with that in healthy controls (0.226), P = 0.002; while HLA-Cw * 12 gene phenotype frequencies increased in patients with CD (0.356) compared with that in healthy controls (0.123), P = 0.000.ConclusionHLA-Cw * 07 allele and HLA-Cw * 12 allele may be strongly associated with the susceptibility of UC and CD, respectively.

Objective To investigate the gene polymorphism of inhibitory killer cell immunoglobulin- like receptor (iKIR) in patients with inflammatory bowel disease (IBD) and whether the iKIR gene polymorphisms were associated with IBD.Methods Peripheral blood DNA samples were isolated from 100 patients with ulcerative colitis (UC),52 patients with Crohn's disease (CD) and 106 randomly ethnically matched healthy controls.The iKIR gene polymorphisms were analyzed by sequence specific primer polymerase chain reproduction (PCR-SSP).Phenotypic frequency and gene frequency of iKIR gene were calculated,and differences were compared between IBD patients and healthy controls.Results iKIR genes (including KIR2DL1,KIR2DL2,KIR2DL3,KIR2DL4,KIR2DL5,KIR3DL1,KIR3DL2, KIR3DL3) were found to be present in all subjects at different levels.Interestingly,phenotypic frequencies of KIR2DL1 and KIR2DL3 were significantly lower in UC patients than those in healthy controls (P = 0.001),while phenotypic frequencies of KIR2DL2,KIR2DL4,KIR2DL5,KIR3DL1, KIR3DL2 and KIR3DL3 were no difference between UC patients and healthy controls (P>0.05).The phenotype frequency of KIR2DL1 was significantly decreased in CD patients compared with healthy controls (P = 0.007),while phenotypic frequencies of other iKIR were observed to be no significant change between CD patients and healthy controls (P>0.05 ).Conclusions The KIR2DL1 and KIR2DL3 gene phenotype frequencies are decreased in UC patients,which suggests that these gene polymorphisms are associated with the susceptibility of UC,and the polymorphism of KIR2DL1 gene is involved in the susceptibility of CD.