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Objective:To discuss the effects of biofeedback dialysis mode of blood volume monitoring on cardiac function in the maintenance hemodialysis (MHD) patients with intra-dialytic hypotension (IDH).Methods:40 patients who underwent maintenance hemodialysis in Suzhou Hospital Affiliated to Nanjing Medical University from September 2018 to December 2020 and had IDH for many times were selected. They were divided into standard dialysis (SHD) group and biofeedback dialysis mode of blood volume monitoring (BVM) group, with 20 cases in each group. In the first 12 weeks of the first stage, the patients in both groups were treated with standard dialysis, and in the second 12 weeks, they were treated with maintenance hemodialysis according to standard dialysis and biofeedback dialysis mode of blood volume monitoring. The incidence of IDH and the changes of blood pressure before and after dialysis, body weight, ultrafiltration volume, B-type brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPW), inlet ventricular septal defect (IVSD), mitral valve flow spectrum E/A value (E/A) and left ventricular mass index (LVMI) were observed.Results:(1) In the second stage of treatment, the number of IDH requiring nursing intervention in BVM group was significantly lower than that in SHD group ( P<0.05). (2) The difference of blood pressure change in BVM group during the second stage of treatment was significantly lower than that in the first stage and SHD group ( P<0.05). (3) In the second stage of treatment, the ultrafiltration volume of patients in BVM group was significantly higher than that in the first stage, and the BNP and body weight were significantly lower than that in the first stage (all P<0.05). However, the body weight, BNP and ultrafiltration volume of patients in SHD group had no significan change in the two stages of treatment (all P>0.05). (4) After treatment, the LVID, LVPW, IVSD and LVMI in BVM group were significantly lower than those before treatment, and LVEF and E/A were significantly higher than those before treatment (all P<0.05). However, there was no significant change in echocardiographic indexes in SHD group before and after treatment (all P>0.05). Conclusions:The biofeedback dialysis mode of blood volume monitoring can significantly reduce the occurrence of IDH, and this dialysis mode can effectively improve the cardiac function of MHD patients with hypotension.
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Recently,patients with Parkinson's disease are suffering from gastrointestinal diseases before the diagnosis.Both clinical and neuropathological evidences have indicated that Parkinson's disease is often accompanied with gastrointestinal symptoms.The hypoxia-related plateau environment shows that gastrointestinal microenvironment is closely related with gastrointestinal disorders.The hypoxia,low temperature and strong radiation on intestinal flora are three important environmental factors.The hypoxia environment may be related to the changed gastrointestinal microenvironment.In this article,we summarized the latest progress in the correlation between gastrointestinal microenvironment and Parkinson's disease in hypoxia situations.
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Purpose Full-term fetal weight is closely related to the choice of delivery mode and perinatal mortality rate.Our aim is to explore the feasibility of magnetic resource image (MRI) with three-dimensional reconstruction and volume measurement in estimating fetal weight and its accuracy compared to ultrasound (US) examination.Materials and Methods Analyzed the MRI volume measurement of 61 fetuses delivered within 7 days after M RI and ultrasound examination in our hospital between November 2013 and March 2016 using MRI three-dimensional reconstruction.The fetal weight estimated by MRI was calculated by the equation developed by Baker et al and the US estimation of fetal weight was performed according to Haldlock et al,the MRI and US estimation of fetal weight were compared.Results 60 fetuses were included and qualified MRI three-dimensional reconstruction models,one was excluded because of frequent movement.The MRI estimation of fetal weight and the birth weight correlated significantly (r=0.927,P＜0.05).The MRI estimation of fetal weight had a lower percentage of random error than US (3.4％ vs 5.0％,P＞0.05),as well as mean absolute error [(172+ 114) g vs (227± 171) g,P＜0.05],but a higher percentage of relative error ≤ 10％ than US (95.0％ vs 78.3％,P＜0.05),with an underestimation in 90.0％ fetuses compared with birth-weight.Concision Full-term fetal weight estimation by using MRI with three-dimensional reconstruction and volume measurement is feasible and more accurate than ultrasound,but lower than the actual weight.This method can be applied in estimating fetal weight in the case of ultrasound examination limited.
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Nowadays, drug-induced liver injury (DILI) is attracting more and more attention during clinical medication and drug research and development. This article introduces the characteristics of DILI in the elderly from the aspects of epidemiology, predisposing factors, clinical features, common drugs inducing DILI, and prognosis, and points out that the health education for the elderly should be enhanced and the elderly should be instructed to use drugs rationally. When adverse events occur, treatment should be given in time and treatment regimen should be adjusted.
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Objective Comparison of the levator ani muscles in three-dimensional (3D) MRI-based models in women with and without pelvic organ prolapse at rest to analyze the morphological characteristics of levator ani muscles in women with POP. Methods Twenty-five women with POP and 22 women with normal pelvic support were selected from Nanfang Hospital of Southern Medical University. Axial, sagittal, and coronal T2-weighted pelvic magnetic resonance scans were obtained with the women in the supine position.The 3D models were reconstructed from the source images. Morphological changes was compared within the two groups of levator ani muscles, and the 3D models were measured to determine the levator ani muscle volume (LVOL), levator plate angle (LPA), levator hiatus width (LH-W) and length (LH-L), distance between symphysis and levator sling muscle (LSG). Results There were no puborectalis avulsions in control, in POP, 3 cases of avulsions just in left, 3 cases of avulsions just in right, 7 cases in bilateral. The shape of iliococcygeus were all dome-shaped in control, 11 cases were U-shaped and 14 cases were dome-shaped in POP. The shape of levator hiatus were 7 cases of U-shape, 12 cases of V-shape, 3 cases of irregular in control; 5 cases of U-shape, 4 cases of V-shape, 16 cases of irregular in POP. POP versus control: LH-L: (68.0 ± 8.9) versus (61.6 ± 7.2) mm (P0.05). Conclusions It is possible to assess the morphologic changes of levator ani by using 3D MRI models objectively, our 3D data demonstrate larger in LVOL, LPA, LH-W, LH-L, LSG, and the changes in shape. It is helpful to diagnose and assess the specific situation of patients POP in clinic.