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Objective:To explore the value of layer-specific strain technique in evaluating the changes of left ventricular myocardial systolic function in patients with aortic stenosis(AS).Methods:From January 2019 to March 2022, 90 AS patients with left ventricular ejection fraction (LVEF) ≥ 50% in Hunan Provincial People's Hospital were selected, including 30 mild AS patients, 30 moderate AS patients, and 30 severe AS patients. In addition, 30 health examinees in the same period were selected as the control group. The normal echocardiographic parameters of the control group and the AS groups with different degrees were compared. The global systolic peak longitudinal strain (GLS) and global circumferential strain (GCS) of the left ventricular three-layer myocardium were measured by the layer-specific strain technique, and the correlation between the strain parameters and the peak systolic velocity (Vmax) of the aortic valve was analyzed.Results:The levels of interventricular septal depth (IVSD), left ventricular posterior wall depth (LVPWD), mean pressure gradient (MPG), and Vmax in mild, moderate and severe AS group were higher than those in the control group (all P<0.05); the GLS of each layer of left ventricle in mild, moderate and severe AS group was lower than those in control group (all P<0.05); the GCS of each layer of left ventricle in moderate and severe AS group was lower than those in control group (all P<0.05). The GLS of left ventricular endocardium in moderate AS group was lower than those in mild AS group (all P<0.05); the GLS and GCS of left ventricular layers in severe AS group were lower than those in mild and moderate AS group (all P<0.05). In AS group, GLS and GCS in endocardium, middle layer and epicardium were negatively correlated with Vmax ( r=-0.716, -0.660, -0.669, P<0.001; r=-0.669, -0.686, -0.598, P<0.001). Conclusions:The layer-specific strain can reflect the changes of left ventricular myocardial function in patients with AS, and has certain application value.
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Objective To observe the effect of different fluid resuscitation strategies on respiratory mechanics and oxygena-tion in the patients with septic shock .Methods The treatment data in 125 patients with septic shock in ICU of this hospital were retrospectively investigated and analyzed .The patients were divided into the restriction fluid resuscitation group (n=58) and open fluid resuscitation (n=67) according to fluid resuscitation results .The changes of respiratory mechanics (static lung compliance ,in-spiratory resistance) and oxygenation before and after resuscitation were compared between the two groups .Meanwhile the hemo-dynamics and vasoactive drugs application were recorded in the two groups .Results The hemodynamic indicators had no statistical difference between the two groups .The use amounts and use time of vasoactive drugs in the open fluid resuscitation group were less than those in the restriction fluid resuscitation group (P<0 .01);the airway resistance in the two groups had no obvious change be-tween before and after resuscitation ,the lung compliance and oxygenation in the restriction fluid resuscitation group were superior to those in the open fluid resuscitation group (P<0 .01) .With the fluid resuscitation amount increase ,the lung compliance in the re-striction fluid resuscitation group and open fluid resuscitation group were progressively poorer ,which was especially obvious in the open fluid resuscitation group(P<0 .01);the amount of fluid resuscitation was negatively correlated with the lung compliance and oxygenation (R= -0 .783、-0 .860 ,P<0 .01) .Conclusion In treating septic shock ,although the open resuscitation strategy has smaller dose and use time of vasoactive drugs ,but the lung compliance and oxygenation are affected ,while the restriction fluid re-suscitation strategy is in contrast .
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Objective To study the effect of inhalation combined salmeterol plus fluticasone propionate in treatment of asthma in children between 4 ～ 5 years old.Methods Seventy-four children (age range,4 ～ 5 years) were enrolled for our study,they were randomly divided into 2 groups (one group inhaled combined salmeterol plus fluticasone,37 children;the other group inhaled fluticasone,37 children).Comparative studies of clinical efficacy,quantified symptom score,and regular follow-up observations were conducted at the interval of one week,one month,three months.Results In the first week and first month during the treatment,there were no difference between salmeterol plus fluticasone group and fluticasone group (P ＞ 0.05).In the third month during the treatment,the daytime ratings(0.16 ± 0.09 vs 0.32 ± 0.11,P ＜ 0.05) and night ratings(0.04 ± 0.01 vs 0.14 ±0.00,P ＜0.05) of salmeterol plus fluticasone group were significantly better than those of fluticasone group.After three months,more children in salmeterol plus fluticasone group were responsive to the decreased dose of the drug than those of fluticasone group (x2 =4.57,P ＜ 0.05).Conclusion In the follow-up of exacerbatious,treatment with combined salmeterol and fluticasone propionate was as efficient as that of fluticasone in alleviating symptoms.During remission of asthma,combined salmeterol and fluticasone propionate was probably better than fluticasone for control of symptoms.
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Objective To study the clinical application and its impact factors of tidal flow - volume measurement in infants with bronchiolitis and pneumonia. Methods Thirty infants with bronchiolitis and thirty infants with pneumonia were studied. Tidal breathing flow- volume loops were obtained after the patients were sedated. The tidal volume per kilogram(VT/kg) ,the fraction of tidal volume ex-heled at peak tidal expiratory flow (PTEF) to total tidal volume (VPTEF/VE), and the fraction of exhaled time at PTEF to total expirato-ry time (TPTEF/TE) were measured. Results VT/kg was not significant different between the bronehiolitis group and the pneumonia group. VPTEF/VE and TPTEF/TE were lower in the bronehiolitis group than those in the pneumonia group. Conclusion The measure-ment of tidal breathing flow - volume loops is a good technology, which would be helpful to evaluate airway obstruction in wheezing in-fants. The impact factors should be controlled during the measurement. Otherwise, the results would be affected.