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Purpose: To compare the effect of etomidate versus propofol infusion on hemodynamic profiles, spontaneous breathing, and corneal reflex during the induction of anesthesia., Methods: Adult patients (n=80) were randomized to receive etomidate (Group E, n=40) or propofol (Group P, n=40) infusion during anesthesia induction. Throughout induction, mean blood pressure and heart rate were monitored. Time to loss of consciousness (LOC), bispectral index (BIS), existence of spontaneous breathing, and corneal reflex at LOC were recorded., Results: Fewer changes in hemodynamic profile occurred in Group E compared with Group P during induction of anesthesia. The mean time to LOC was shorter with etomidate than propofol (129.5 s vs 189.5 s, P <0.0001). BIS was lower in Group E compared with Group P at LOC (46.3 vs 52.9, P =0.0141). More patients exhibited spontaneous breathing in Group E compared with Group P at LOC (80% vs 17.5%, P <0.0001). Similarly, more patients maintained corneal reflex in Group E compared with Group P (34 patients vs 4 patients, P <0.0001). The incidence of etomidate-induced myoclonus was 17.5%., Conclusion: Compared with propofol infusion, etomidate infusion during anesthesia induction had fewer effects on the hemodynamic profile of patients. Among patients who received etomidate, the BIS value was lower at LOC, and more patients displayed spontaneous breathing and corneal reflex., Trial Registry Number: China Clinical Research Information Service, ChiCTR-IOR-17011050., Competing Interests: The authors report no conflicts of interest in this work.

By computerized static posturography with sway frequency analysis, subclinical effects of lead on postural balance was examined in 29 female workers (lead workers) employed at a glass factory for 3-17 (mean 7.9) years in Beijing, China, in relation to brainstem function assessed by brainstem auditory evoked potential (BAEP). Their blood lead concentrations ranged from 26 to 79 (mean 55.7) microg/dl; ages were 21-30 (mean 28) years. Control subjects, aged 22-29 (mean 27.0) years, were 14 healthy female workers at a textile factory located in the same district. With eyes closed, power of the sway of high (2-4 Hz) and low (1 Hz or less) frequencies in lead workers was significantly larger than that in controls; with eyes open, their power of the sway of low frequency was significantly larger (p<0.05). The multiple regression analysis showed that the power of high frequency sway with eyes closed and of low and high frequencies with eyes open were significantly related to blood lead concentrations in lead workers (p<0.05). On the other hand, no significant differences in BAEP latencies between lead workers and controls were observed. The low frequency sway with eyes open was significantly correlated with the high frequency sway with eyes closed in the lead workers. The pattern of changes in postural balance suggested that the anterior cerebellar lobe, vestibulo-cerebellar and spinocerebellar afferent systems were affected asymptomatically in female lead workers; the sway of vestibulo-cerebellar and anterior cerebellar lobe types were simultaneously affected by lead. It appears that a computerized static posturography with sway frequency analysis is useful technique for assessment of subclinical lead neurotoxicity.

Auditory brainstem electric response (ABR) and somatosensory evoked potential (SEP) of 21 subjects (41 ears) among villagers in a rare earth element (REE) area in Gan County, Jiangxi, China, were studied. No difference in ABR between the subjects from the REE area and the control group was noted. However, the conduction detected by SEP from the median nerve to the thalamus (P15) was shortened (P < 0.05), especially to the first-grade primary somatosensory responsive region (S1) (P < 0.01) and the amplitude of S1 decreased (P < 0.05), indicating that REE was difficult to accumulate in the brainstem, but it was susceptible to cerebral cortex, thus causing sub-clinical damage. This condition was confirmed in the animal experiment. It was suggested that the toxicity through long-term intake of small doses of REE might not be negligible, and the hazard of REE environments should be investigated.