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Accurate assessment of hemodynamic status is crucial for volume management. Venous congestion caused by volume overload can cause organ damage and poor prognosis. Traditional critical ultrasound, including inferior vena cava ultrasound, echocardiography, and lung ultrasound, is widely used in volume management. However, it is unable to evaluate the organ blood flow. The blood flow pattern of abdominal vein changes dynamically with venous congestion, which is an index for evaluating the blood flow of hepatic vein, portal vein and internal renal vein by Doppler ultrasound. This article reviews the acquisition and grading standards of abdominal venous blood flow patterns, their application and limitations in volume management, with a view to providing help for early clinical identification of terminal organ congestion, implementation of fluid negative balance intervention and individualized volume management.
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BACKGROUND:With the increase of aging degree, chronic wounds are increasing. There is few method to cure chronic wounds at present, and vacuum sealing drainage has been applied to the clinic. OBJECTIVE:To investigate the effect of vacuum sealing drainage on the expression of nerve growth factor and the change of microvascular number in the human chronic wounds, and to study the mechanism of accelerating chronic wound healing. METHODS:Ten patients with chronic wounds were included in this study, including one case of soft tissue defect of chest, one case of osteomyelitis with bone exposure, one case of large area skin defect after amputation stump, two cases of wound infection after skin avulsion injury, two cases of shinbone osteomyelitis, and three cases of postoperative wound infection. The skin around the wounds and granulation tissue within the wounds were col ected before vacuum sealing drainage treatment and at 7, 14 days after vacuum sealing drainage treatment. The nerve growth factor expressions and the microvascular number in the wounds were measured by the immunohistochemical technology. The wound healing was also observed. RESULTS AND CONCLUSION:The nerve growth factor expressions in fibroblasts and vascular endothelial cel s at 7 and 14 days after vacuum sealing drainage treatment were significantly higher than that before treatment (P<0.001). The microvascular number was also increased after vacuum sealing drainage treatment compared with pre-treatment (P<0.05-0.01). The vacuum sealing drainage treatment reduced necrotic tissue and purulent secretion within the wounds, as wel as swel ing around the wounds. Simultaneously, granulation tissue gradual y became fine granules, bright red, and bleeding easily, thus it is suitable for promoting wound healing.
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Objective To explore the significance of combined detection of urinary podocalyxin (PCX), nephrin and mono-cyte chemoattractant protein-1(MCP-1) for diabetic nephropathy in newly diagnosed type 2 diabetic patients.Methods A total of 132 newly diagnosed type 2 diabetes mellitus (T2DM) patients and 36 healthy subjects were recruited .The concentrations of urinary PCX (UPCX), nephrin (UNephrin) and MCP-1(UMCP-1) were measured with enzyme-linked immunosorbent assay (ELISA), and urina-ry UAE ( UAlb) concentration was measured with turbidimetric immunoassay method .All the results were shown by dividing the urine creatinine ( UCR) concentration in the same sample .The comparisons among UAlb/UCR, UPCX/UCR, UNephrin/UCR, and UMCP-1/UCR among groups were investigated .The correlation among UAlb/UCR, UPCX/UCR, UNephrin/UCR and UMCP-1/UCR was in-vestigated in T2DM patients.The comparison among positive rate of UMCP-1/UCR, UNephrin/UCR, UPCX/UCR and UAlb/UCR was investigated in T2DM patients.Results The levels of UPCX/UCR and UMCP-1/UCR were significantly higher in diabetes melli-tus(DM) group (37.37 ±22.83 and 47.19 ±29.98, respectively) than in healthy subjects (9.59 ±2.28 and 9.98 ±3.63, respec-tively) ( P <0.05 ) .The levels of UAlb/UCR、UPCX/UCR and UMCP-1/UCR were significantly higher in diabetic nephropathy (DN) group (90.39 ±59.35, 72.11 ±58.88, and 104.82 ±82.77, respectively) than in DM group (17.50 ±9.49, 37.37 ± 22.83 , and 47.19 ±29.98 , respectively ) and in healthy subjects ( 8.93 ±3.81 , 9.59 ±2.28 , and 9.98 ±3.63 , respectively ) ( P<0.05).The level of UNephrin/UCR was significantly higher in DN group (83.60 ±61.61) than in DM group (38.74 ±35.27) ( P <0.05).The levels of UPCX/UCR, UMCP-1/UCR, and UNephrin/UCR were positively correlated with UAlb/UCR ( r =0.619, 0.568, and 0.535, respectively) ( P <0.05) in T2DM patients.The level of UPCX/UCR was positively correlated with the levels of UMCP-1/UCR and UNephrin/UCR ( r =0.799 and 0.718 , respectively ) ( P <0.05 ) .The level of UNephrin/UCR was positively correlated with the level of UMCP-1/UCR ( r =0.635 P <0.05) in T2DM patients.The positive rate of UMCP-1/UCR, UNephrin/UCR, and UPCX/UCR was significantly higher than that of UAlb/UCR(χ2 =9.818, 6.673, and 5.395, respectively, P <0.05)in T2DM patients.Conclusions The combined detection of urinary PCX , Nephrin and MCP-1 is very important for the early renal dam-age in newly diagnosed type 2 diabetic patients .
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Objectives:To explore the optimal method of spiral CT angiography and MPVR in the detection of intracranial aneurysms. Methods:Eleven patients with clinical suspicion of intracranial aneurysms underwent spiral CT angiography, then postprocessed with MPVR. Results:,Five anterior communicating aneurysms,1 posterior communicating aneurysm and 1 base aneurysm were found with MPVR. Conclusions: Lesions at the circle of Willis, the main trunk of the carotid and the vertebrobasilar arteries, including their branches could be visualized perfectly with MPVR by optimizing the thickness, center, angle of rotation and window level, by which more intracranial aneurysms could be found.
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This paper introduces the theory and the main circuit of MRI gradients high-power amplifier,especially the operation principles of its power modules and pulse-width modulators,which is helpful for maintenance of the amplifier.
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This paper introduces the operational principle and circuit blocks of rotating anode controller. The control-driven process and the design of the detection unit are analyzed.