ABSTRACT
Purpose To evaluate the myocardial perfusion in diabetes mellitus (DM) rats with insulin intervention at different times by myocardial contrast echocardiography (MCE) so as to explore the value of MCE in evaluating the treatment of diabetic cardiomyopathy (DCM).Materials and Methods In this prospective study,90 rats were randomly divided into normal control (NC) group,DM group and insulin intervention (INS) group,with 30 rats in each group.After the DM models were established,the INS group was then divided into three subgroups of A,B and C treated with insulin intervention at 0,4 and 8 weeks respectively and further treated continuously for 12 weeks.The NC and DM groups were also randomly divided into three subgroups and fed synchronously just as the INS group but without insulin intervention.At the end of 12,16 and 20 weeks after modeling,the rats in each subgroup were examined by MCE.The changes of myocardial blood volume (A),blood velocity (β) and blood flow (A×β) were analyzed,and the myocardial tissues were also collected for pathological examination.Results A,β and A×β were increased in INS group compared with DM group (P＜0.05).Compared with NC group,the values of INS group including A×β in A subgroup,A and A×β in B subgroup,A,β and A×β in C subgroup were decreased (all P＜0.05).In INS group,there was no difference in the three values of myocardial blood between A and B subgroup (P＞0.05),but A and A×β were lower in C subgroup than those in A subgroup (P＜0.05).On pathology,the thickness of capillary basement membrane of INS group improved compared with DM group;the capillary density of INS group increased compared with DM group,but there was significant difference only inA subgroup (P＜0.05).Conclusion Early insulin intervention can improve myocardial microvascular structure and increase myocardial blood flow.MCE can be used to evaluate the myocardial microcirculation of DCM rats sensitively and accurately,which can be used as an important method for early diagnosis and dynamic monitoring of DCM with clinical significance.
ABSTRACT
Objective To evaluate the role of lung ultrasound in the diagnosis of neonatal pneumonia.Methods From April to October 2015, 100 neonates admitted to the Neonatal Department of Xi′an Children′s Hospital underwent lung ultrasound, using the 12 regions method. All intercostal spaces of the upper and lower parts of the anterior, lateral, and posterior regions of the left and right lung were examined. Arterial blood gas analysis parameters of each case were recorded at the same time, including arterial partial pressure of oxygen (PO2), arterial partial pressure of carbon dioxide (PCO2), pH value and oxygen saturation (SO2). A skilled sonographer analyzed the ultrasound images before being aware of the patient′s clinical condition. According to the ifndings, the patients were classiifed into 2 groups: neonatal pneumonia group and non-pneumonia group. All the patients with neonatal pneumonia underwent lung ultrasound score (LUS), and the correlation between LUS and PO2, PCO2, pH value and SO2 was analyzed.Results A ifnal diagnosis of neonatal pneumonia was conifrmed in 62/100 patients. The ultrasonographic manifestations of neonatal pneumonia were as follows: rocket sign (33/62 patients, 53%), ground-glass sign (35/62 patients, 56%) , waterfall sign (31/62 patients, 50%), white lung (8/62 patients, 13%), subpleural lung consolidation (35/62 patients, 56%), pleural line abnormalities (26/62 patients, 41%), pleural effusion (7/62 patients, 11%), atelectasis (3/62 patients, 4%) , and pneumothorax (1/62 patients, 1%). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of lung ultrasound in the diagnosis of neonatal pneumonia was 96.77%, 86.84%, 93.00% of 92.30%, of 94.28%, respectively. The correlation coefficients between LUS and PO2, PCO2, pH value, SO2 were-0.82, 0.64,-0.58,-0.74,P<0.05, respectively.ConclusionLung ultrasound is a reliable tool for diagnosing neonatal pneumonia with high sensitivity, with high practical value in assisting clinicians to carry out appropriate treatment in combination with LUS.