OBJECTIVE:To investigate the effects of etomidate combined with propofol on painless gastrointestinal endoscopy and cognitive function of elderly patients. METHODS:Totally 90 elderly patients with painless gastrointestinal endoscopy were ran-domly divided into propofol group(30 cases),etomidate group(30 cases)and combination group(30 cases). Propofol group was given Fentanyl injection 1 μg/kg+Propofol injection 1.5 mg/kg;etomidate group was given Fentanyl injection 1 μg/kg+Etomidate injection 0.3 mg/kg;combination group was given Fentanyl injection 1 μg/kg+Propofol injection 1 mg/kg+Etomidate injection 0.15 mg/kg. The levels of SBP,DBP,HR,MAP and SpO2 at different time points,examination time,anesthesia induction time,recov-ery time and recovery time of orientation were observed in 3 groups. NCSE and MMSE score at different time points,the occur-rence of ADR were also observed in 3 groups. RESULTS:During examination,SBP,DBP,MAP and SpO2 of propofol group were significantly lower than before anesthesia,after examination and those of combination group,with statistical significance(P<0.05);but there was no statistical significance in above indexes of propofol group between during examination and before anesthesia (P>0.05). The recovery time and recovery time of orientation in combination group were significantly shorter than propofol group and etomidate group,with statistical significance(P<0.05),but there was no statistical significance in above indexes between etomidate group and propofol group(P>0.05). The proportion of patients'memory ability,computing ability,orientation ability passing examination in combination group were significantly higher than propofol group,with statistical significance(P<0.05). There was no statistical significance in above indexes between combination group and etomidate group,between etomidate group and propofol group(P>0.05). There was no statistical significance in MMSE score of combination group at different time points (P>0.05);MMSE score of propofol group 15,30 min after anesthesia and that of etomidate group 15 min after anesthesia were significantly lower before anesthesia and combination group,with statistical significance(P<0.05). There was no statistical signifi-cance in MMSE score of propofol group 1 h after anesthesia,etomidate group 30 min and 1 h after anesthesia,compared to before anesthesia(P>0.05). The incidence of apnea,hypotension and injection pain in combination group and etomidate group were low-er than propofol group,the motor response,myoclonus,nausea and vomiting in combination group and propofol group were lower than etomidate group,the tachycardia ease in combination group was lower than propofol group,with statistical significance(P<0.05). CONCLUSIONS:Etomidate combined with propofol anesthesia shows good therapeutic efficacy for painless gastrointestinal endoscopy of elderly patient,can reduce cognitive dysfunction and shortens recovery time,but doesn't increase the occurrence of ADR.

This study aims to analyze and improve Howland current source circuit and to study the constant current source of alternating current with high output impedance and high stability. A simulation study was carried out on the constant-current characteristics of Howland current source from two aspects of resistance match value and the selection of Op amp parameters, and then the output impedance was analyzed. The simulation experiment showed that when it was with the best matched resistance, the constant-current characteristics of Howland current source was better. Op amp parameters could affect the constant-current characteristics of Howland current source. In Howland current source circuit, the current source after parameter optimization had better output impedance and load capacity. The results showed that there was the best matched resistance in the selection by Howland current source. The Op amp with large broadband, high slew rate and open loop gain, and wide range of power supply voltage is more suitable for the bioelectrical impedance detection circuit.
Electric Impedance ; Electric Power Supplies ; Electricity

0.05). Cross-reactivity was seen in 1 case of clonorchiasis sinensis by both the methods. Conclusion Microwave ELISA has the advantages of high sensitivity, specificity and rapidity.

Objective To investigate the prevalence of BPPV in patients with Meniere’s Disease(MD),and to investigate the diagnostic and predictive values of VEMP in patients with MD and BPPV.Methods A total of 1 1 6 patients previously diagnosed MD were followed up through telephone about their BPPV-like attacks.We recorded the detailed history of BPPV-like attacks,and provided them with complete Dix-Hallpike and roll tests if patients were on their BPPV-like attacks.Results In all,4 patients'histories supported BPPV,and 4 patients were found with BPPV.The prevalence of BPPV in patients with MD was 3 .4%(4/1 1 6 ).Meniere's symptoms preceded the on-set of BPPV in 8 patients.In 4 confirmed BPPV patients with Meniere's disease,BPPV was limited to the same ear as the MD in 2 cases,and 1 had contralateral BPPV,and 1 was uncertain.Six histories supported or confirmed BP-PVpatients with high abnormal oVEMP rates (5/6).Four in this 5 (80%)had abnormal oVEMP of the same MD ear.The single repositioning procedures can improve vertigo and eliminated positional nystagmus in cases of BPPV associated with MD.Conclusion In the present study,the prevalence of BPPV in patients with MD was 3 .45%.De-tailed medical histories combined with Dix-Hallpike and roll tests and VEMP tests can identify BPPV in patients with MD.

OBJECTIVE: To analyze the abnormal conditions of the affected ear and the contralateral ear of patients with unilateral Meniere's disease and the prevalence of bilateral abnormalities among these unilateral Meniere disease population, providing reference for the clinical treatment strategies for Meniére disease. METHOD: A retrospective analysis of 106 Meni6re disease cases was performed, the abnormal incidence of the affected ears, the contralateral ears and the bilateral abnormalities were calculated, and the disease characteristics were analyzed. RESULT: The bilateral ears abnormal incidence of unilateral Meniére disease was 35. 85% (38/106); the cochlear symptoms of the contralateral ears often occurred 2. 25 years later of the symptoms of Meni6re disease; contralateral cochlear symptoms included at least two symptoms of tinnitus, deafness and ear fullness; 39. 47%(15/38) patients with bilateral abnormalities would appear binaural hearing impairment. CONCLUSION This study showed that about one-third of unilateral Meniére diseases have binaural symptoms, among which about one-third would occur bilateral hearing loss. Therefore, it is necessary to consider the course of disease and the symptoms of the contralateral ear before taking damage or destructive method for treating Meniére's disease clinically.
Cochlea ; physiopathology ; Deafness ; Ear ; abnormalities ; Hearing Loss, Bilateral ; epidemiology ; Humans ; Incidence ; Meniere Disease ; epidemiology ; Prevalence ; Retrospective Studies ; Tinnitus

Objective To investigate the association between PARK16 gene polymorphism and Parkinson's disease(PD)susceptibility in Chinese Han population.and to analyze its single-nucleotide polymorphism(SNP)genotypes,frequencies and odds ratios(OR)of different genotypes.Methods The association between two SNP loci in PARK16 gene(Rs947211,Rs823128)and PD susceptibility was investigated by TaqMan quantitative polymerase chain reaction(PCR)in 226 PD patients and 362 healthy controls.Allele and genotype frequencies were calculated by the Chi-square test,and the clinical data were also analyzed.Results Three genotypes of Rs947211(GG,AG and AA)account for 34.1%(77/226),46.0%(104/226),19.9%(45/226)in the PD group,and 23.8%(86/362),53.0%(192/362),23.2%(84/362)in the control group,respectively.There was significant difference between two groups (P<0.05).Setting the GG genotype as the reference,OR values of AG and AA genotype were 0.57(95%CI0.38-0.85,P=0.006)and 0.55(95%CI 0.34-0.85,P=0.015),while the OR value for exposure to the A allele(AA+AG)was 0.56(95%CI0.38-0.82,P=0.003).Genotypes of Iate-onset PD were also significantly different from the controls(OR valne of AG=0.46,95%CI 0.27-0.78,P=0.004:OR value of AA=0.35.95%CI 0.18-0.68,P=0.002).And there was no diffefence in clinical features among the 3 genotypes. The frequency of Rs823128, another locus, in PD group was not significantly different from the control group( AA genotype as the reference, OR value of AG was 1. 12, 95% CI 0. 75-1.68, P = 0.568; OR value of GG was 0.99, 95% CI 0.35-2.76, P = 0.994). Conclusion Polymorphism of PARK 16 locus Rs947211 is associated with PD patients in Chinese Han population.

Objective To evaluate the inter-observer variability of static breast sonogram final assessment among observers with different breast imaging experience, using the first edition of the Breast Imaging Reporting and Data System(BI-RADS) for ultrasound. Methods Thirty patients with 30 breast lesions were included who underwent beast lesions resection operation. A pathological diagnosis was available for all 30 lesions:16 (53%) malignant and 14 (47%) benign. Twelve radiologists independently reviewed two sonograms of each lesion, and assigned a final BI-RADS assessment category. Inter-observer variability was measured using kappa statistic. Positive predictive value(PPV) and negative predictive value (NPV) for final assessment were also calculated. Results As for the experienced observers,kappa values of categories 3,4 and 5 were 0.72,0.28 and 0.60,NPV of category 3 was 93% ,PPV of category 5 was 97% ,all of which decreased as the breast imaging experience reduced. PPVs of categories 4a,4b and 4c were 56 % ,88% and 69%, respectively. Conclusions Using BI-RADS final assessment, radiologists with sufficient breast imaging experience can provide accurate and consistent assessment for breast ultrasonography,but the agreement of diagnosis decreased as the breast imaging experience reduced. The clinical feasibility of 4a,4b and 4c subcategories is uncertain.

Objective To study the import way of schistosomiasis and the vector snail in Three Gorges Reservoir areas (TGR), so as to provide the reference for the surveillance, early warning of schistosomiasis.Methods A total of 256 movement population in Badong County and Zigui County and 1584 immigrants from TGR to the endemic area of Hubei Province were investigated by questionnaire, and screened by means of IHA and COPT. The farm cattle were surveyed in Badong County and Zigui County. Production of paper mills, the source of papermaking raw material, flowers and trees in gardens were investigated for snail survey. At the same time, current situation of immigrants in TGR was investigated. Social data (statistic yearbook, etc) and policy data of development of TGR were collected. Results No farm cattle from endemic area of schistosomiasis was found. In Hubei reach of TGR, the movenment population were mainly from the endemic area of schistosomiasis in Hubei Province. The positive rate of both IHA and COPY was 0 57%(1/175); the positive rate of both IHA in emigrants from TGR was 1 01%(12/1186). No Oncomelania snail was found in the introduced flowers and trees in garden. In paper mills, no reed from the endemic area of schistosomiasis was found. Migrants′ living and sanitary condition were improved after moving,but the production was not well arranged. Orange industry, travel industry, animal husbandry and fishery should be developed preferentially in the future. Conclusion Migrants from TGR to the endemic area of schistosomiasis and the movement population will be the mainly infection source. The problem on cattle as the infection source should be paid attention. It can't be excluded that snail will enter TGR together with the raw material for paper mills or flowers and trees. To develop orange industry will be good for the control of schistosomiasis; but the development of animal husbandry, fishery and travel industry will increase the risk of import of the infection source and snails to TGR.

Objective To systematically review the effect of donor ischaemic preconditioning in liver transplantation.Methods Databases including the Cochrane Library,PubMed,EMbase,CNKI,VIP and WanFang database were searched up to June 2016 for studies which involved donor ischaemic preconditioning (IPC) in liver transplantation.The data retrieved included 1-year mortality,incidence of Primary Graft Non-Functioning (PGNF),intensive therapy unit (ICU) hospitalization and liver function tests which were used to evaluate the treatment outcomes.The data were analyzed using both the fixed-effect and the random-effects models.For categorical outcomes,risk ratio (RR) with 95％ confidence intervals (CI) were calculated.For continuous outcomes,the mean difference (MD) with 95％ CI were calculated.The metaanalysis was performed using Review Manager 5.2 software.Results Six clinical studies with 322 patients were qualified for this meta-analysis.There were no significant differences in the 1-year mortality (OR =0.51,95％ CI 0.24 ～ 1.05,P ＞ 0.05),PGNF (OR =0.33,95％ CI 0.08 ～ 1.40,P ＞ 0.05) and ICU hospitalization (OR =-0.17,95 ％ CI-2.72 ～ 2.38,P ＞ 0.05) between the donor ischaemic preconditioning and the control groups.There were also no significant differences in the transaminase and bilirubin levels on postoperative day 1,3 and 7 between the two groups.Conclusion There is currently not enough evidence in evidenced based medicine to recommend the routine use of ischaemic preconditioning in donor liver retrieval.

OBJECTIVE: To investigate the result of vestibular evoked myogenic potentials (VEMP) of primary benign paroxysmal positional vertigo(BPPV)and to identify the characteristics in VEMP examination of the primary BPPV and to observe the relevance of patients with primary BPPV and abnormal VEMP with hearing loss. METHOD: Patients with primary BPPV were tested with pure tone audiometry, videonystagmograph and VEMPs test. We analyzed the difference in the two groups with normal hearing and hearing loss, discussed the etiology and pathogenesis. RESULT: Primary BPPV comprised 23.0% with hearing lost, 77.0% hearing normal. The results of oVEMP were abnormal in 79. 7% (59/74) of the cases; and the results of cVEMP were abnormal in 66. 2% (49/74) of the cases; oVEMP and cVEMP differences to the diagnosis of primary BPPV (P<0. 05); oVEMP and cVEMP differences to the diagnosis primary BPPV with hearing lost (P<0. 05). CONCLUSION oVEMP detection positive rate of primary BPPV is higher than cVEMP,which may be due to otolithic particles falling from the utricle; positive rate of cVEMP in primary BPPV with hearing loss is higher than that of oVEMP, which may related to the cochlear and sacculus occured in the same embryonic tissue structure.
Audiometry, Pure-Tone ; Benign Paroxysmal Positional Vertigo ; physiopathology ; Cochlea ; Hearing Loss ; etiology ; Hearing Tests ; Humans ; Otolithic Membrane ; Saccule and Utricle ; Vestibular Evoked Myogenic Potentials