ABSTRACT
Objective To learn the quality of life for people with disabilities in Hangzhou City, and to provide the basisfor targeted interventions. Methods Using the health survey list (SF-36) and the self-compiled population learningvolume, 350 disabled people were investigated face to face in Xiaoshan, Jiande and Fuyang District of Hangzhou City,and the quality of life of different disabled people with demographic characteristics were compared. Results A total of 335disabled people were investigated. The SF-36 score of the 335 disabled people was (62.36±18.40) . Compared with thehealthy people, the scores were lower in the survey of 335 people with disabilities(P<0.001) . The scores of the maledisabled in VT, MH, and PF were lower than the female. In terms of PF, RP, BP, scores of people above 48 years oldwere lower than people under the age of 48 years old, and in terms of mental health, scores of people above 48 years oldwere higher than people under the age of 48 years old. Score in physiological function of the physical disabled people waslower than other types of disabled people(MD=-19.447, -18.509, -19.792, P<0.008) . In terms of PF, score ofgrade 2 disabled people was lower than grade 1 and 4 disabled people (MD=-17.925, -18.162, P <0.008) .Conclusion The quality of life of disabled people in Hangzhou is low, which is affected by gender, age, and disabilitytype and disability grade.
ABSTRACT
<p><b>BACKGROUND</b>Right ventricular function plays an important role in the hemodynamic derangement during off-pump coronary artery bypass (OPCAB) surgery. Pressure-volume loops have been shown to provide load-independent information of cardiac function. Therefore, the aim of this study was to investigate the feasibility of construction of right ventricular pressure-volume loops with pressure and volume data measured by a volumetric pulmonary artery catheter (PAC) and to evaluate right ventricular systolic and diastolic function by end-systolic elastance (E(ES)) and end-diastolic stiffness (E(ED)) in OPCAB surgery.</p><p><b>METHODS</b>Twenty-eight patients who underwent OPCAB surgery were included. After anesthesia induction, a volumetric PAC was placed via the right internal jugular vein. Data were recorded at: anesthesia steady-state before skin incision (T1); 5 minutes after the stabilizer device was placed for anastomosis on the heart's anterior wall (T2), lateral wall (T3), posterior wall (T4), respectively; after sternal closure (T5). Three sets of data were collected at each time point: first, hemodynamic variables were measured; second, right ventricular E(ES) and E(ED) were calculated; third, right ventricular pressure-volume loops were constructed with pressure and volume data measured from end-diastole point, end-isovolumic systole point, peak-ejection point, end-systole point and end-isovolumic diastole point.</p><p><b>RESULTS</b>Right ventricular pressure-volume loops generally shifted to the left during OPCAB surgery. Especially, the end-diastolic point shifted upward and to the left at T2-T5 compared with that at T1. Decrease in right ventricular ejection fraction, stroke volume index and end-diastolic volume index occurred (P < 0.05) at T4 compared with values at T1. Pulmonary vascular resistance index at T4 increased relatively compared with that at T2 and T3. The change of E(ES) was not statistically significant during operation. Right atrial pressure increased only during coronary anastomoses (T2-T4, P < 0.05), whereas E(ED) increased throughout OPCAB surgery (P < 0.05).</p><p><b>CONCLUSIONS</b>Right ventricular pressure-volume loops can be constructed using a volumetric PAC. Right ventricular systolic dysfunction occurred during anastomoses on the heart's posterior wall not due to impaired myocardial contractility but as a result of reduced preload and a relative increase in afterload. Right ventricular diastolic function was impaired throughout OPCAB surgery.</p>