Objective To compare the accuracy of bispectral index (BIS),Narcotrend index (NI),index of consciousness (IoC) versus auditory evoked potential index (AAI) in monitoring the depth of sedation induced by propofol.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 41-64 yr,with body mass index 20-30 kg/m2,scheduled for elective surgeries under general anesthesia,were enrolled in the study.Propofol was given by target-controlled infusion (TCI) with the initial target effect-site concentration (Ce) of 0.8 μg/ml using Marsh pharmacokinetic model,and then the Ce of propofol was increased by 0.1 μg/ml,and OAA/S was performed.Before TCI of propofol,the values of BIS,NI,IoC and AAI were recorded,and at the same time the value of OAA/S score was 5.During TCI of propofol,when OAA/S score reached 4,3,2 and 1 in turn,the Ce of propofol was recorded,the sequence for determination of the values of BIS,NI,IoC and AAI was determined using a random number table,and the values were then recorded for 5 s after the values were stable and then averaged.The parameters for vital signs were maintained within the normal range.Pearson correlation of BIS,NI,IoC and AAI values with Ce of propofol was analyzed.Results The correlation coefficients of BIS,NI,IoC and AAI values with the Ce of propofol were rBIs-Ce =-0.829,rSI-Ce =-0.886,rloC-Ce =-0.881 and rAAI-Ce =-0.791,respectively.There was no significant difference between rBIS-Ce,rNI-Ce,rIoC-Ce and rAAI-Ce.Conclusion There are no significant differences in the accuracy of BIS,NI,IoC or AAI in monitoring the depth of sedation induced by propofol in middle-aged patients with non-noxious stimuli.

Objective The different distribution and clinical significance of mean platelet volume (MPV) in the healthy normoglycemic and impaired fasting glucose (IFG) individuals were discussed.Methods The 499 individuals including 184 male and 315 female,who had undergone health checks in Tianjin Huanhu Hospital during May and July 2012 were studied retrospectively.Average age is forty-five ( thirty-five to eighty).Subjects were categorized into four groups according to fasting plasma glucose ( FPG) levels:G1 (3.89 mmol/L≤FPG<5 mmol/L, n=125),G2(5 mmol/L≤FPG <5.5 mmol/L, n=121), G3(5.5 mmol/L≤FPG<6.1 mmol/L, n=142), and G4(6.1 mmol/L≤FPG<7 mmol/L, n=111).G1, G2, and G3 are defined as normal FPG groups and G 4 is defined as IFG group.Eighty-nine cases in the same age patients with type II diabetes mellitus group ( G5 ) were observed at the same time.Results The MPV increased with the increasing FPG levels in the following order:G1(8.62 ±0.77) fl, G2 (8.85 ±0.80) fl, G3(8.90 ±0.69) fl,G4(9.14 ±0.78) fl and G5(12.03 ±1.42) fl.MPV[(12.03 ±1.42) fl] of type Ⅱdiabetes mellitus group(G5) was higher than that in the IFG group (G4)[(9.14 ±0.78) fl] and normal FPG groups[G1(8.62 ±0.77) fl,G2(8.85 ±0.80) fl,G3(8.90 ±0.69) fl] (F=12.773,P<0.01);MPV of the IFG group [ ( 9.14 ±0.78 ) fl ] was significantly higher than that in normal FPG groups [ G1 (8.62 ±0.77) fl,G2(8.85 ±0.80) fl,G3(8.90 ±0.69) fl] (F=12.773,P<0.01 for G4 vs.G1 and G2, P<0.05 for G4 vs.G3) ;MPV in the high-normal glucose group (G3) [(8.90 ±0.69) fl] was obviously higher than that in the low-normal glucose group (G1) [(8.62 ±0.77) fl] (F=12.773,P<0.05);MPV was positively associated with FPG in normal FPG groups ,IFG group and type Ⅱ diabetes mellitus group (G1-3:r=0.22, P<0.05;G4:r=0.26, P<0.01;G5:r=0.29, P<0.01).Conclusions Significant difference of MPV was observed in population of different FPG levels.Especially, MPV in IFG group was evidently higher than that in normal FPG group and was positively associated with FPG levels.

Objective:To assess type C behavior in patients with oral lichen planus (OLP) in order to provide basis for clinical prevention,treatment and psychological intervention of OLP.Methods:Type C behavior scale was used on 85 OLP patients and 85 control patients,who were in accordance with the inclusion criteria,in order to investigate their type C behavior.The scale included 9 items:anxiety,depression,anger,anger toward inside (anger-in),anger toward outside (anger-out),reasoning,domination,optimism,and social support.Scores of the 9 items between OLP patients and control group were calculated under the instruction of the scale and were statistically analyzed,and OLP group was further stratified statistically by sex,reticulate-erosive-ulcerative (REU) pathological type and course of diseases,and the scores of each group were analyzed and compared.Results:Among the 85 OLP patients,there were more females,more non-erosive lesion type,and the most common site for OLP was the buccal mucosa.The scores of the type-C behavior questionnaire for anxiety,depression,anger and optimism were respectively 43.01 ± 7.47,44.02 ± 7.61,21.56 ± 5.26,22.15 ± 4.00 among the OLP patients and were 37.94 ±8.70,39.58 ±7.35,18.12 ±5.39,24.05 ±3.23 among control group,with significant differences (P ＜ 0.05 for all) between the two groups.The female OLP patients had higher anxiety,depression,anger scores (43.21 ± 6.97,44.29 ± 7.54,21.64 ± 5.09) and lower reasoning,domination,optimism scores (39.12 ±5.66,16.29 ±3.95,22.05 ±4.12) with significant differences (P ＜0.05 for all) compared with those of the female controls.The scores between male patients and male controls showed no significant difference.The patients with erosive lesions had higher anger score (22.94 ± 5.26) than that of the patients without erosive lesions (20.60 ± 5.03),with a significant difference (P ＜ 0.05).With the development of the disease,the tendency of anxiety and depression of the patients were more obvious,while optimism scores remained declining.The patients suffering more than 3 years of OLP had higher anger-toward-outside scores (17.36 ± 3.35) than the patients suffering less than 3 years of OLP (15.19±3.99),with a significant difference (P ＜0.05).Conclusion:OLP patients showed an obvious type C behavior characteristic,especially in anxiety,depression,anger and low optimism.This research provides the C behavior characteristic of OLP for further psychological consultation or intervention during OLP treatment.

Objective To access the effectiveness of withdrawing iodized salt on correcting the iodine excess in the population living in high iodine areas.Methods Before withdrawing iodized salt,2 twons were selected from each of 5 cities with water-borne iodine excess areas in Hebei province.All the selected towns were divided into 7 groups according to their iodine content in drinking water.Two villages wereselected from each group where urine samples of children aged 8 to 10 years old were collected to investigate the change of urinary iodine content of these children before and after withdrawing iodized salt.The urinary iodine content was determined using the method for determination of ammonium persulfate digestion arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Correlation between children's urinary iodine and drinking water iodine was analyzed.Results Before and after withdrawing iodized salt,744 and 771 urine samples were collected from the examined children aged 8-10 years respectively.The overall median urinary iodine content (MUIC) of the examined children after withdrawing iodized salt (350.1 μg/L) decreased significantly than that of before withdrawing iodized salt (460.8 μg/L,U =3 127.8,P ＜ 0.05).After withdrawing iodized salt,the MUIC of the children decreased significantly in 8 of 12 villages (P ＜ 0.05).Before and after withdrawing iodized salt,the percentage of urine samples with iodine content above 300 μg/L was 76.7％ (571/744),58.5％ (451/771) respectively,with significant statistical difference (x2 =57.7,P ＜ 0.05).After withdrawing iodized salt,Children's MUIC also decreased significantly across gender and age (boys:558.5,351.6 μg/L,U =960,P ＜ 0.05; girls:522.9,355.5 μg/L,U =698,P ＜ 0.05; 8 years old:536.0,295.5 μg/L,U =529.5,P ＜ 0.01; 9 years old:386.2,323.2 μg/L,U =753.5,P ＜ 0.01; 10 years old:525.5,368.8 μg/L,U =521.5,P ＜ 0.05).The children's MUIC correlated positively with the median water iodine contert (MWIC) in the villages where they lived (r =0.951,P ＜ 0.01).Analyzed by linear regression,approximately 89％ of the variability in MUIC was associated with variability in MWIC.Conclusions Withdrawing iodized salt could only correct the iodine excess caused by consuming iodized salt in the population living in the areas with MWIC below 100 μg/L.In the areas with water iodine above 100 μg/L,intervention should be focused on seeking water with proper iodine content.

Objective To investigate the infection characteristics and drug resistance of methicillin resistant Staphylococcus aureus after liver transplantation.Methods Retrospectively analyzed the clinical data of 170 patients who underwent liver transplantation in Beijing Chaoyang Hospital,Capital Medical University between January 2011 and April 2016.The incidence,pathogenic characteristics,distribution and drug resistance of methicillin resistant Staphylococcus aureus were analyzed.Results In this research,the methicillin resistant Staphylococcus aureus infection occurred in 23 cases after liver transplantation,and the incidence rate was 13.53％ (23/170).There were 27 strains of pathogens had been isolated,and 74.07％ (20/27) of pathogens were isolated from peritoneal drainage fluid.The most common methicillin resistant Staphylococcus aureus were Staphylococcus haemolyticus,Staphylococcus epidermidis and Staphylococcus hominis,accounting for 29.63％ (8/27),22.22％ (6/27) and 14.81％ (4/27).Drug sensitivity results indicated that the methicillin resistant Staphylococcus aureus were completely resistant to Penicillin,Oxacillin and Methicillin antibiotics.And the pathogens were extensively drug-resistant to Ciprofloxacin,Levofloxacin and Moxifloxacin,the resistance rates were 63％ (15/24),63％ (15/24) and 58％ (14/24).But the pathogens were sensitive to Teicoplanin,Vancomycin and Linezolid,and there have not been detected drug-resistant bacteria.Conclusions The infection of methicillin resistant Staphylococcus aureus is one of the most common pathogens after liver transplantation.Routine prophylactic antibiotics are not useful for the treatment,however,Teicoplanin,Vancomycin and Linezolid can be used as the first choice of treatment.

Objective To assess the efficacy of urethroplasty by using the mucosa of diverticulum as the distal urethral for the recurrence of urethral stricture.Methods We reviewed our experience about 6 cases from Jan.2007 to Oct.2012,including 5 hypospadias and 1 epispadias.The mean age of the patients was 28 ± 16 (12-45)month,range 12 to 45 months.The patients presenting urethral diverticulum should last for 6 months after urethroplasty,which should last for 6 months.The preoperative mean urinary flow rate was 5.1 ± 1.4 (range 3.1 to 7.3) ml/s.All the patients took the retrograde urethrography and cystoscopy to confirm the position and length of urethrostenosis.The positions of urethrostenosis were at the penis coronary in 5 cases and glans penis in 1 case.The mean length of stricture was 13.3 ±4.2(range 8.8 to 20.5) mm.The mean length of diverticulum was 37.5 ± 15.3 (range 21.8 to 55.2) mm.All patients received the urethral reconstruction by using the pedicel diverticulum mucosa.After resecting the stenosis urethra and exposed the whole diverticulum,we opened the diverticulum laterally and halved it.One was used for tabularized urethroplasty in situ,the other was flipped to the distal urethral as pedicel flap to remedy the defect of the urethral.Results Totally 6 cases received the procedure.The mean operating time was 133 ± 48 (range 84 to 192) min.Postoperatively,urethral catheter was remained 2 weeks.All the patients can urinate smoothly after removing the catheter.The postoperative mean urinary flow rate was 10o 9 ± 3.3 (range 6.3 to 15.9) ml/s.The mean follow-up time was 2.2 yrs(range 1 to 4 years).At the end point of follow-up,all patients had not experienced a recurrent diverticulum or stricture at the anastomotic site.Urethrocutaneous fistula in the coronary glan was reported in 2 patients,which were finally cured after 2nd repair.No complication was found in other 4 patients.Conclusions Urethroplasty by flipping the mucosa of diverticulum takes full advantage of urinary mucosa that already existing,which can be very useful in those patients who are lack of foreskin.This approach can also reduce the patient's pain by completing the urethroplasty in situ and avoiding staging operation.But up till now,it can only be applied to the urethral diverticulum secondary to urethrostenosis.It also demands flip flap skilled.And the long-term effects and complications still remain to be seen.

Objective The aim of this study is to analyze the relationship between the development of audito‐ry and speech in infants with hearing loss after hearing aid fitting and discuss the development of speech with the a‐bility of auditory in infants with different degree of hearing loss and different stage of evaluation after hearing aid fit‐ting .Methods A total of 32 infants (17 boys and 15 girls) with prelingual hearing loss participated in this study . The age at hearing aid fitting ranged from 3 to 34 months with a mean of 15 .6 months .According to their hearing level ,all infants in this study were divided into three groups :group of profound hearing loss(16) ,group of severe hearing loss(11) ,group of moderate hearing loss(5) .CAP and SIR were used to evaluate their abilities of auditory and speech at pre -fitting ,1 ,3 ,6 ,9 and 12 months after hearing aid fitting respectively .A linear and regression a‐nalysis was done in the statistic procedure .Results There was a significant correlation between the scores of CAP and SIR for the three groups respectively .The correlation from low to high followed by the group of profound hear‐ing loss (R=0 .656 ,P=0 .000<0 .05) ,group of severe hearing loss (R=0 .758 ,P=0 .000<0 .05) ,group of mod‐erate hearing loss (R=0 .849 ,P=0 .000<0 .05) .There was also a significant correlation between the scores of CAP and SIR for the different evaluating stages respectively .The correlation from low to high followed by pre -fitting (R=0 .559 ,P=0 .000<0 .05) ,1 month after hearing aid fitting (R=0 .575 ,P=0 .000<0 .05) ,3 months after hearing aid fitting (R=0 .726 ,P=0 .000<0 .05) ,6 months after hearing aid fitting (R=0 .823 ,P=0 .000<0 .05) , 9 months after hearing aid fitting (R=0 .838 ,P=0 .000<0 .05) ,12 months after hearing aid fitting (R=0 .855 ,P=0 .000<0 .05) .Conclusion The development of auditory ability is closely related to speech ability which increases with the improvement of auditory ability .The less the infants have the hearing loss and the longer the infants use the hearing aids ,the higher the auditory ability is related to speech ability in infants after hearing aid fitting .

The effect of realgar nanoparticles (NPs) on endogenous small molecules in rat kidney was analyzed by mass spectrometry-based metabolomics.The relationship between the changes of metabolites and the nephrotoxicity of realgar NPs was also discussed to provide a basis for the further toxicity study and the clinical application of realgar NPs.SD rats were randomly divided into seven groups,including control group,three doses (40,200,1 000 mg/kg) of relegar and realgar NPs groups,respectly.After 28 days of continuous intragastric administration,all rats were sacrificed and their serum and kidney samples were collected.The toxic effect of realgar NPs on kidney tissues were examined by biochemical analysis and histopathologic examination,which revealed a dosedependent nephrotoxicity induced by realgar NPs.The LC-MS and GC-MS analysis were performed for the subsequent metabolomics study.A series of 32 metabolites were found to be altered significandy in the kindey of realgar NPs treated rats,and might serve as potential nephrotoxicity biomarkers.The results of metabolic pathway analysis indicated that the nephrotoxicity of realgar NPs might be associated with the disorders of the amino acids and phosphatidic acid metabolism.

Objective To analyze the changes of splenic volume and blood flow detected by ultrasonography in men having been migra-ted in high-altitude area for 10 years and to explore the relationship between the splenic blood flow and volume. Methods Men migrating to high-altitude area for 10 years,male indigenous Tibetan and healthy men from planitia with 55 cases in each were involved. Ultrasonography was performed to measure the length,width and thickness of spleen to calculate the volume,and color Doppler flow imaging was applied to measure the diameter of splenic artery and the mean flow velocity to calculate the blood flow volume. The differences among groups were com-pared and the relationship between the blood flow and the volume was analyzed. Results The blood flow and the volume of spleen in men migrating to high-altitude area were higher than those in male indigenous Tibetan and healthy men from planitia (P<0. 01),and the blood flow was positively correlated with the splenic volume (r=0. 828,P<0. 01). Conclusion The splenic volume and blood flow are increased in men when have been migrated in high-altitude area for 10 years and ultrasonography is of great importance in detecting the pathophysiologic changes in high-altitude area in our country.

Objective To study the relationship between the development of auditory and speech in children with hearing loss after hearing aid fitting and discuss the development of speech with the ability of auditory in children at different stages of evaluation, with different degrees of hearing loss and different ages respectively.Methods A total of 19 children (14 boys and 5 girls) with hearing loss participated in this study.The age at hearing aid fitting ranged from 3 to 8 years old with a mean of 5.42±1.86 years old.According to their hearing levels, the children in this study were divided into two groups: the moderate hearing loss group (n=10) and the severe group (n=9).According to their ages at hearing aid fitting, all children in this study were divided into two groups: the less than or equal to six years old (n=11) and greater than six years old (n=8).MAIS and MUSS were used to evaluate their abilities of auditory and speech at pre-fitting, 1, 3, 6, 9 and 12 months after hearing aids were worn respectively.A linear and regression analysis was done in the statistic procedure.Results There was a significant correlation between the scores of MAIS and MUSS (R=0.774,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for the different evaluating stages respectively.The correlations were pre-fitting (R=0.710,P<0.05), 1 month after hearing aid fitting (R=0.774,P<0.05), 3 months after hearing aid fitting (R=0.814,P<0.05), 6 months after hearing aid fitting (R=0.819,P<0.05), 9 months after hearing aid fitting (R=0.707,P<0.05), 12 months after hearing aid fitting (R=0.649,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for MAIS (items 3~6) (Sound awareness) and MAIS (items 7~10) (Sound understanding).The correlations for MAIS (items 3~6) were (R=0.768,P<0.05), and for MAIS (items 7~10) (Sound understanding) (R=0.794,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different group of ages.The correlations for the group of <6years old were (R=0.808,P<0.05), and for the group of the ≥6 years old (R=0.775,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different groups of hearing loss levels.The correlation for the group of moderate hearing loss was (R=0.771,P<0.05), and the group of severe hearing loss (R=0.787,P<0.05).Conclusion The development of auditory ability is closely related to the speech ability.The speech abilities increase with the improvement of auditory abilities.The less severe the hearing loss is, the longer the use of hearing aids, the younger the children are, the better the speech ability improved with auditory ability development after hearing aid fitting.