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Objective Respectively applying the treatment of biventricular pacing and right ventricular septal pacing in atrioventricular block,to compare the heart function influence of two kinds of pacing mode on pacemaker dependent patients, to provide evidence for the physiological pacing mode selection?Methods Enrolled 20 patients from January 2012 to March 2013 who should be placed in pacemakers, their primary disease was the second degree,high or third degree atrioventricular block,giving them three chamber pacemaker ( right atrial + biventricular ) each?Randomly divided into right ventricular septum pacing group ( group A, n=10) and biventricular pacing group( group B,n=10)?Twelve months later,each group crossed into the each other group and continued following?up for 12 months?After 24 months to obtain all the data to do the statistical analysis,including patients'6 min walking distance(6MWD),the Minnesota Heart Failure Quality of life score (MLHFQ),plasma N?terminal pro brain natriuretic peptide precursor(NT?proBNP),left ventricular ejection ejection fraction(LVEF),left ventricular diastolic end diastolic diameter(LVEDD),left ventricular contraction end diastolic diameter(LVESD),left ventricular twelve segmental 14W time standard deviation(Ts?12SD),left ventricular twelve segmental 14W time maximum delay(Ts?dif),the paced QRS qrsd?Results Compared with group B,the 6MWD and LVEF of 12,24 months after treatment of group A were significantly increased( ( 242?58 ±37?56) m vs?(347?42±36?59) m vs?(340?67±24?99) m;(39?97±5?84)% vs?(57?92±10?01)% vs?(60?50±10?06)%;P0?05)?Conclusion Compared with the right septal pacing,biventricular pacing is of no significant advantages on the effect of cardiac function for patients with pacemaker dependent.
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Objective To investigate the wall shear stress(WSS) in the common carotid artery of type 2 diabetes mellitus(DM) patients,and analyzed the spatial distribution of WSS by using quantitative visualization of blood flow shear stress analysis software.Methods Eighteen male type 2 DM subjects were enrolled as DM group and 18 age-matched healthy subjects were selected as control group.None of the participants was hypertensive,hyperlipidemic or a cigarette smoker.Intimal-medial thickness (IMT),number and size of plaques in the common carotid artery were evaluated by high-resolution echo-Doppler.Color Doppler flow images of common carotid arteries in the two groups were extracted from DICOM files.WSS in the common carotid arteries was calculated by shear stress visualization quantitative analysis software,and the corresponding spatial distribution maps of WSS were designed.Results WSS of the common carotid arteries in the control group were ranged from 4 to 14 dyne/cm2.WSS of the common carotid arteries in the DM group were ranged from 2 to 8 dyne/cm2.Compared to mean WSS value [(6.96 ± 1.17)dyne/cm2] of common carotid arteries in the control group,mean WSS value [(3.14 ± 0.79)dyne/cm2] of common carotid arteries in the DM group was significantly lower (t =9.380,P =0.000).Six diabetic participants had a plaque in one carotid artery and no lesions in the contralateral carotid.Among these subjects,mean WSS was significantly lower in the side with lesion (t =7.324,P =0.000).Therefore,IMT of common carotid arteries in participants was significantly inversely related to WSS (r =-0.76,P <0.01).Conclusions The common carotid arteries of DM patients are more prone to atherosclerosis which is associated with reduction of WSS.The hemodynamic profile might represent an additional factor contributing to the increased prevalence and severity of carotid atherosclerosis in diabetic patients compared with general population.
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Objective To measure wall shear stress (WSS) in common carotid arteries of normal subjects and patients with intima-media thickening and analyze the spatial distribution of low wall shear stress by quantitative analysis of blood flow shear stress visualization software.Methods Color Doppler flow images of common carotid arteries in normal subjects (control group) and patients with intima-media thickening (study group) were extracted from DICOM files.Two-dimensional distribution images of WSS,three-dimensional distribution images of WSS and the value of WSS in the common carotid arteries were obtained by this new algorithm.Then,the data and images of WSS were analyzed.Results WSS in the common carotid arteries of the control group were ranged from 4 to14 dyn/cm2.WSS in the common carotid arteries of the study group were ranged from 2 to 6 dyn/cm2.Compared to mean WSS values [(6.91 ±1.20) dyn/cm2] in common carotid arteries of the control group,mean WSS values [(2.87 ± 0.59)dyn/cm2] in common carotid arteries of the study group was significantly lower (t =17.828,P =0.000).Conclusions Low WSS areas have been emerged in local common carotid arteries in the patients with intima-media thickening.The reduction of WSS caused by local hemodynamic change might be related to common carotid artery intima media thickening.
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Objective To evaluate the effects of clinical center-based health management on quality of life (QOL) of patients with asthma. Methods A total of 642 patients who had received standard antiasthma treatment over 3 years in our clinical center from September 2005 up to now were randomly assigned to the good compliance group ( group A, n = 326 ) and bad compliance group ( group B, n = 316 ). A questionnaire was used to estimate the awareness about asthma,medical therapy and disease control. Levels of QOL were compared at 6 months and 1 and 3 years after health education. Results In group A,uncontrolled,partly controlled, and completely controlled asthma were found in 21%, 47%, and 32% participants, respectively. Significant difference of QOL was shown between the 2 groups after the intervention ( P < 0. 05 ). At 6 months, forced expiratory volume in one second ( FEV1 ), percentage of predicted FEV1 ( FEV1 % pre) ,and peak expiratory flow rate ( PEF)were significantly improved in group A ( all P <0. 05 ),although acute attack and hospitalization were largely reduced. In comparison with baseline,6 months and 1 year,self-reported QOL, limitation of motion, stimulus avoidance and response, and disease concerns were significantly changed at 3 years. Conclusions Clinic center-based health management could benefit disease control and QOL of patients with asthma.
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To assess the curative effects of different reduction techniques on the dislocation of cricoarytenoid joint caused by intubation, indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized for the closed reduction of the displaced arytenoid under local anesthesia. 23 patients who underwent the reduction for dislocated arytenoid under IL or DL from January 1991 to June 2001 were reviewed. The data were collected on the duration of the laryngeal injury, times of receiving reduction, side-effects after the treatment and the period for voice to return to normal. The relationship between the duration of the laryngeal lesion and the period of the voice rehabilitation was examined. 13 patients received the reduction under IL and 10 patients under DL. Except the times of the reduction, which showed significant difference, no differences were found between IL group and DL group in the course and the period of voice rehabilitation, as well as sore throat after the manipulation. The patients' voice recovery was positively related to their course of disease in both IL and DL group. It is concluded that the recovery of normal voice is obviously affected by the duration of arytenoid dislocation. The reduction under IL is as effective as under DL in the treatment of arytenoid dislocation. Reduction by DL is better suit the patients with long time course of disease.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cartilagem Aritenoide , Ferimentos e Lesões , Intubação Intratraqueal , Luxações Articulares , Diagnóstico , Terapêutica , Cartilagens Laríngeas , Ferimentos e Lesões , Laringoscópios , Laringoscopia , MétodosRESUMO
To assess the curative effects of different reduction techniques on the dislocation of cricoarytenoid joint caused by intubation, indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized for the closed reduction of the displaced arytenoid under local anesthesia. 23 patients who underwent the reduction for dislocated arytenoid under IL or DL from January 1991 to June 2001 were reviewed. The data were collected on the duration of the laryngeal injury, times of receiving reduction, side-effects after the treatment and the period for voice to return to normal. The relationship between the duration of the laryngeal lesion and the period of the voice rehabilitation was examined. 13 patients received the reduction under IL and 10 patients under DL. Except the times of the reduction, which showed significant difference, no differences were found between IL group and DL group in the course and the period of voice rehabilitation, as well as sore throat after the manipulation. The patients' voice recovery was positively related to their course of disease in both IL and DL group. It is concluded that the recovery of normal voice is obviously affected by the duration of arytenoid dislocation. The reduction under IL is as effective as under DL in the treatment of arytenoid dislocation. Reduction by DL is better suit the patients with long time course of disease.