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Objective:To explore the level of arterial stiffness and its influencing factors in prediabetic population.Methods:From June 2021 to June 2022, 207 prediabetes patients were prospectively and randomly recruited from the physical examination center and outpatient clinic of Tangdu Hospital of Air Force Military Medical University to be the prediabetic group and 130 healthy volunteers at the same time with the same gender and age as the healthy controls. The carotid-femoral pulse wave velocity (PWV), brachial-radial PWV, and femoral-ankle PWV were measured by an automatic ultrasonic arterial stiffness measurement technology. The common carotid artery wall intima-media thickness (IMT) and left heart function were routinely evaluated. A questionnaire was designed to investigate the subjects′ smoking, drinking, diet, staying up late, exercise and other living habits. Comparison between groups and multivariate linear regression analysis were used to analyze the relevant data.Results:The carotid-femoral PWV and common carotid artery wall IMT in prediabetic group were significantly higher than those in healthy controls [(7.10±2.00)m/s vs (6.26±1.14)m/s, (0.57±0.11)mm vs (0.51±0.08)mm; both P<0.001], but there were no significant differences in the brachial-radial PWV and femoral-ankle PWV between the two groups (both P>0.05). Multivariate linear regression analysis showed that prediabetes was an independent influencing factor in carotid-femoral PWV after adjusting for confounding factors ( P<0.001), in addition, age ( P<0.001), diastolic blood pressure ( P<0.001), staying up late ( P=0.011) and low density lipoprotein cholesterol ( P=0.022) were also the independent influencing factors of carotid-femoral PWV. Conclusions:Compared with healthy people, the stiffness of aorta is significantly increased in prediabetic people, but there is no significant change in the stiffness of peripheral arteries. Prediabetes, age, diastolic blood pressure, staying up late and low density lipoprotein cholesterol are independent influencing factors of carotid-femoral PWV.
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Objective@#To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR).@*Methods@#Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis.@*Results@#The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05) . During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO2) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030].@*Conclusions@#IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.
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Objective To discuss the value of contrast-enhanced ultrasound and color Doppler in diagnosing esoph-ageal varices( EV) among patients suffering from portal hypertension. Methods The control group consisted of twenty nine patients without EV. Sixty patients with EV diagnosed by endoscopy were divided into two groups equal in number according to grade of EV. One being mild,the other was moderate to severe. All patients underwent color Doppler flow imaging and contrast-enhanced ultrasound, and the dynamic angiography data were collected. Time-in-tensity curves were drawn by software. The quantitative parameters including arrival time of hepatic artery ( HAAT) ,hepatic vein ( HVAT) and portal vein ( PVAT) ,damping index ( DI) of hepatic vein and portal vein ve-locity( PVV) were compared. Results The difference of PV-HV, PV-HA, PVV, DI showed statistically signifi-cant among the three groups(F=72.63,14.97,6.71,13.74,P<0.01). A comparison of the control and moderate to severe group among the above four parameters was statistically significant (P<0.01). PV-HV, PV-HA, DI in moderate to severe group showed statistically significant compared with mild group (P<0.01),however there exis-ted no significant difference grouping PVV between the two groups. Mild group contrasted to the control group,the differences of PV-HA were statistically significant (P<0.01), whereas PV-HV, DI, PVV displayed no significant difference. Conclusion Contrast-enhanced ultrasound and color Doppler are helpful in diagnosing EV,which is ex-pected to become a new noninvasive method.
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ObjectiveTo study the clinical value of minimally invasive treatment of the doppler-guided hemorrhoid artery ligation with lauromacrogal sclerosis injection in treatment of hemorrhoids.MethodsA retrospective analysis was made on treatment of 32 cases with hemorrhoids using doppler-guided hemorrhoid artery ligation combined with lauromacrogal sclerosis injection.ResultsAccording to the branch of the Chinese Medical Association by the Surgery the clinical diagnosis and Treatment Guidelines of Hemorrhoids (draft),the Ⅰ degree hemorrhoid was found in 1 case,Ⅱ degree hemorrhoids in 18 cases,Ⅲ degree hemorrhoids in 13 cases.Recovery was found in 32 cases.The longest follow-up time was 30 weeks.No relapse was found. ConclusionsDoppler-guided hemorrhoid artery ligation combined with lauromacrogal case sclerosis injection is a low aggressive minimally invasive method to treat hemorrhoid and has small trauma,definite effect,less pain,fewer complications,and short course and other advantages,but the longterm outcome needs further observation.
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Objective To investigate the incidence and the risk factors of the vascular disease in lower limbs of patients with type 2 diabetes(T2DM).Methods To retrospectively analyze 318 cases with T2DM patients.All the patients were checked on both lower limbs by color ultrasonic Doppler.The differences of ordinary and biochemical indicators between PVD group and non-PVD group were compared.Results There were 67.2％ (205/318) patients who had vascular disease in lower limbs with type 2 diabetes.Age,course of disease,HbAlC,TC,TG,SBP,DBP and BMI in PVD group were significantly higher than those in non-PVD group( P ＜ 0.01 ).Conclusion There was higher incidence of the vascular disease in lower limbs of patients with type 2 diabetes.And the independent risk factors were hypertension,hyperglycemia,hyperlipemia.It could help to prevent the development of lower limb blood vessel pathological changes in DM patients by controlling the levels of blood pressure,lipid and blood sugar strictly.
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Objective To detect and analyze thyroid tumor by two-dimensional sonogram and Doppler parameter, and evaluate the value of high-frequency ultrasound in diagnosing thyroid benign and malignant tumors. Methods The ultrasonic images of 104 thyroid tumor from 80 patients with typical features were collected. Thyroid tumor was classified into benign and malignant nodules, based on the shape, border, or the rear wall echo, echo attenuation loss, internal echo, and microcalcifications in two-dimensional sonogram and systolic blood peak velocity (Vmax) and resistant index (RI) in Doppler examination. The expected results of high frequency ultrasound were compared with pathological results on consistency and error rate. Results Prediction of benign tumor by high frequency ultrasound was 66, and pathology 61, consistency rate of the two was 92.4%. Prediction of malignant lesions was 38, and pathological examination 32, consistency rate of the two was 84.2%. The total coincidence rate was 89.4%(93/104) and the error rate was 11.6%( 11/104). Conclusions The typical features of thyroid tumor on high-frequency ultrasound are helpful in diagnosis of benign or malignant nodules, which is valuable in guiding clinical treatment.
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Ultrasonic imaging diagnostic technique is one of the most widely used imaging diagnostic techniques,whose fast development has greatly raised the level of clinical diagnosis.The development of ultrasonic imaging diagnostic technique is mainly introduced and various kinds of ultrasonic imaging diagnostic techniques are mentioned including A-mode,M-mode and B-mode ultrasonic diagnostic techniques,Doppler imaging technique,3D imaging technique and harmonic imaging technique.
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Objectives To disscuss the changes of structure and hemodynamics of vertebral artery in patients with cervical spondylopathy.Methods Study the changes of structure,systolic flow rate peak value(MAX),diastolic phase flow rate (MIN),diameter(D) upon vertebral artery by Doppler , s ultrasonic diagnosis apparatus with 7.5MHz in 29 patients with cervical spondylopathy and 28 healthy subjects.Results The arcuation of vertebral artery in patients with cervical spondylopathy distinctly increase.D?MAX?MIN have significantly difference (P
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Venous air embolism(VAE) can occur by the entry of air into open veins, being facilitated if the operative field is above the level of the heart. Among the many diagnostic methods, precordial ultrasonic Doppler is currently the more sensitive. Thus we have attempted to define the incidence of VAE using this device. 103 ASA physical status 1 or 2 parturients undergoing Cesarean section with general anesthesia in 73 parturients and epidural anesthesia in 30 parturients were studied with the ultrasonic Doppler transducer placed parasternally over the 4th right intercostal space. Total incidence of venous emboli was 31%(32/103) during surgery. In some parturients, embolism occurred more than once during operation and leaded to total 45 episodes of venous emboli. The incidence of venous emboli was 26%(19/73 ) during general anesthesia and 43.3%(13/30 ) during epidural anesthesia. No statistical difference existed in the incidence of venous emboli detected related to the type of anesthesia. Among the 45 episodes of venous emboli, 19 episodes(42.2%) were detected during repair of the hysterotomy. As even small air bubbles in the circulation are potentially harmful especially in patent foramen ovale and emboli events may occur at risk cases involving profound hypovolemia, abruptio placenta, or placenta previa, clinically insignificant venous air emboli, although low, is still worrisome. Thus above the cases, the use of additional precordial Doppler monitoring may be considered during cesarean section to detect VAE promptly, efficiently.
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Femenino , Embarazo , Anestesia , Anestesia Epidural , Anestesia General , Cesárea , Embolia , Embolia Aérea , Foramen Oval Permeable , Corazón , Hipovolemia , Histerotomía , Incidencia , Placenta , Placenta Previa , Transductores , Ultrasonido , VenasRESUMEN
The effects of the gravitational potential energy change (GPEC) and the thermal stress on finger microvascular responses were studied by laser Doppler and ultrasonic Doppler flowmetry. Seven healthy male subjects, aged 21 to 31 yrs, participated in the experiment after giving their informed consent. The hand was moved upward (about 60 cm) or downward (about 55 cm) from the heart level to change the vascular transmural pressure of the finger (GPEC) . Sensors of laser Doppler and ultrasonic Doppler flowmeters were attached to the lateral side of the first finger and the skin surface over the radial artery, respectively. Experimental room temperature was maintained at 24°C. Laser Doppler flow (LDF) was decreased at an elevated and lowered arm position. The pulsatile component of LDF, evaluated by the difference between systolic and diastolic LDF, increased when the arm was elevated, but it showed no significant changes when the arm was lowered. Mean blood velocity (MBV) and diastolic blood velocity (DBV) of radial artery decreased when the arm was elevated, whereas the pulsatile blood velocity (PBV), evaluated by the difference between systolic blood velocity (SBV) and DBV, were increased. At the lowered arm position, SBV and PBV decreased significantly, but DBV showed no significant changes. The thermal stress (43°C, 10 min) increased the PBV when the arm was elevated, but the PBV diminished the decreasing rate when the arm was lowered.<BR>These results suggest that the measurements used may be useful for the analysis of arteriolar compliance and microvascular response to the change of transmural pressure pro-duced by the gravitational potential energy change.