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Objective:To study the risk factors, cerebral hemodynamics and clinical outcomes of extremely and very preterm infants with severe intraventricular hemorrhage (IVH).Methods:From January 2019 to December 2019, premature infants with gestational age (GA) <32 w admitted to our hospital were assigned into severe IVH group and non-severe IVH group. Risk factors for severe IVH were analyzed. According to clinical outcomes, severe IVH group was further assigned into improvement subgroup and no-improvement subgroup. Cerebral hemodynamic parameters were compared between the two groups.Results:A total of 346 eligible neonates were enrolled in this study. The incidence of severe IVH was 11.0% (38 cases). The incidences of Grade Ⅲ and Ⅳ IVH were 8.7% (30/346) and 2.3% (8/346), respectively. Multivariate logistic regression analysis showed that CA < 28 w ( OR=4.365, 95% CI 1.055~18.054), 5 min Apgar score ≤7 ( OR=8.749, 95% CI 2.214~36.042), chorioamnionitis ( OR=3.245, 95% CI 1.127～9.344), PaCO 2 fluctuation within 1 h >25 mmHg ( OR=7.728, 95% CI 1.738~80.907) and vasoactive drugs usage ( OR=10.883, 95% CI 3.746~31.621) were the risk factors of severe IVH. 20 cases in severe IVH group were improved at discharge and 12 cases showed no improvement at discharge. Improvement subgroup showed quicker reduction of the middle cerebral artery flow resistance and faster recovery of the mean flow velocity than the no-improvement subgroup. Conclusions:GA <28 w, 5 min Apgar score ≤7, chorioamnionitis, PaCO 2 fluctuation within 1 h >25 mmHg and vasoactive drugs usage are risk factors of severe IVH in extremely and very preterm infants. Cerebral hemodynamic monitoring may provide initial assessment for the clinical outcomes for severe IVH.
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Objective To explore the relationship between blood lipid levels and cerebrovascular hemodynamic indices (CVHI) in a young and middle?aged population, and to identify reference values for early warning of stroke. Method Between June 2015 and June 2016, a total of 6 252 young and middle?aged patients were assessed for cerebrovascular function in The Health Management Center of Affiliated Hospital of Guizhou Medical University. Patients were divided into abnormal and normal blood lipid groups. Differences in CVHI indicators and scores between the groups were determined, and factors influencing CVHI indices were compared using multivariate logistic regression analysis. Results Mean (Vmean), maximum (Vmax), and minimum blood flow velocity (Vmin) and cumulative scores for CVHI indices in the abnormal blood lipid group were significantly lower than in the normal blood lipid group (P<0.001). However, pulse wave velocity, characteristic impedance, peripheral vascular resistance, dynamic resistance, critical pressure, and differences between diastolic blood pressure and critical pressure were greater than those in the normal blood lipid group (P<0.001). Multivariate logistic regression analysis indicated that a high triglyceride level, overweight or obesity, high systolic blood pressure, high diastolic blood pressure, and age were risk factors for low CVHI scores, with odds ratios (95% confidence intervals) of 1.455 (1.195- 1.771), 2.271 (1.782-2.895), 5.967 (4.557-7.815), 4.251 (3.349-5.396), 2.560 (1.993-3.287), and 1.448 (1.189-1.763). Conclusion Abnormal blood lipid levels can lead to abnormal cerebrovascular function in young and middle?aged population; elevated triglyceride level was an independent risk factor for impaired cerebrovascular function.
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Objective To study the effect of different doses of monocrotaline in combination with isopropylarterenol on the hemodynamic resonse, heart index and right heart hypertrophy index in rats.Methods Sixty-four healthy adult SD rats, male:female=1∶1, body weight 200-250 g, were randomly divided into blank control group (n=16) and three model groups (n=16 in each group).The high dose model group (n=16) received i.p.injection of monocrotaline 80 mg/kg once and epinephrine 10 mg/kg once daily for one week.The moderate dose group received i.p. injection of monocrotaline 55 mg/kg once and epinephrine 8 mg/kg once daily for one week.The low dose group received i. p.injection of monocrotaline 30 mg/kg once and epinephrine 3 mg/kg once daily for one week.The rats were fed for 6 weeks, and then pulmonary artery pressure and right ventricular pressure were tested and heart index and right ventricular hypertrophy index were determined.Results Compared with the control group, the mean pulmonary artery pressure and right ventricular systolic blood pressure in the low dose monocrotaline group were not significantly changed, but significantly changed in the moderate dose monocrotaline group ( P<0.05) .The heart index and right ventricular hypertrophy index in the low dose monocrotaline group were not significantly changed, but in the moderate dose monocrotaline group, the heart index was significantly reduced ( P<0.01 ) and the right ventricular hypertrophy index was significantly increased ( P<0.05 ) .Conclusions The use of a single injection of 55 mg/kg monocrotaline in combination with continuous injection of 8 mg/kg isopropylarterenol once daily for one week can ensure the survival rate of rats, and the successful formation of pulmonary artery hypertension, leading to heart weakness.
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Objective:To investigate the value of color doppler flow imaging (CDFI) in the diagnosis of liver cirrhosis upper gastrointestinal bleeding in portal vein hemodynamic changes. Methods: 96 cases of patients with liver cirrhosis were selected who were diagnosed in our hospital, according to the history whether patients had a gastrointestinal bleeding or not. They were divided into bleeding group(45 cases) and no bleeding group(51 cases). At the same time, we chose the hospital physical examination center of 42 cases of healthy volunteers as a control group, using color doppler flow imaging portal venous blood flow mechanics parameters, including diameter, average blood flow velocity and blood flow of portal vein(PV) and splenic vein(SV) and compare the data of the three groups.Results: Compared with control group, the patients with liver cirrhosis, the blood vessel diameter have increased whether bleeding or not. The average blood flow velocity is slower and PVF is larger, and the differences between them are statistically significant(t=3.579,t=3.670,t=4.750,t=3.951,t=6.116,t=5.371;P<0.05). Conclusion: The clinical application of color doppler flow imaging(CDFI) in patients with cirrhosis portal hemodynamic change is not only simple noninvasive, and there is important diagnostic value in the detecting parameters.
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Objective To explore different characteristics of the vertebral artery and basilar artery haemody-namics in different frequencies to provide a theoretical basis for clinical treatment .Methods 90 cases of sudden deaf-ness were induded and according to hearing curve ,the cases were divided into three groups with 30 cases for each while the control group had 30 subjects .All cases were examined by TCD ,the VA ,BA test .Results Compared with group of median and low frequency sudden deafness ,the abnormal blood flow rate were found with decreased hearing(P0 .05) .High frequency hearing loss compared with the con-trol group patients with sudden deafness had a clear abnormal velocity (P<0 .05) ,characterized by high velocity . There was no statistically significant difference in blood flow rate among low and median frequency group ,full-fre-quency group and control group except for Vs of BA in low and median frequency group .Conclusion Vertebral and basilar arterial circulation disorders had present more significance in the incidence of sudden deafness ,evident espe-cially in high and all frequency sudden deafness .Early initiation of TCD examination can understand the change of the vertebral and basilar artery hemodynamics ,providing high clinical application values .
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Objective] To explore the safety and effectiveness of Dexmedetomidine ( Dex) at dif-ferent doses used in laparoscopic partial hepatectomy . [ Methods] A total of 60 patients ( ASA II orⅢmagnitude ) who received elective laparoscopic partial hepatectomy were randomly divided into Group D 1 and Group D2.Group D1 received vein pump injection dose of Dex load 0.2 μg/kg (10 min after injec-tion), and was followed by pump injection of 0.2μg/(kg· h) for 30 min before the end of surgery.Group D2 received vein pump injection dose of Dex load 0.2μg/kg (10 min after injection), and was followed by pump injection of 0.5 μg/( kg· h) for 30 min before the end of surgery .The patients in two groups were both given sevoflurane and propofol to maintain anesthesia in surgery and observed and recorded systolic and diastolic pressure ,heart rate ,oxygen saturation of blood ,postoperative respiratory recovery time , eye-open-ing time, extubation time and the number of agitation before infusion with Dexmedetomidine ( T0 ) , at 10 minutes after infusion of Dexmedetomidine ( T1 ) , endotracheal intubation immediately ( T2 ) , 1 min after endotracheal intubation(T3), and endotracheal tube being drawn immediately (T4). [Results] Com-paring with those at the time of entering the operation room , blood pressure and heart rate in the two groups before and after intubation and at the extubation time were not significantly different (P>0.05).The respi-ratorg recovery time ,eye-opening time and extubation time of group D 2 were longer than those of group D 1 (P<0.05). [Conclusion] With maintained pump infusion of Dex at dose of 0.2 μg/(kg· h),pa-tients undergoing laparoscopic partial hepatectomy have more stable hemodynamics and revive more quickly and completely after operation .
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BACKGROUND: The characterization of normal coronary blood flow dynamics should provide crucial guidelines for the accurate functional assessment of diseased coronary artery. However, the regional characteristics of coronary blood flow dynamics in normal human coronary artery have not been fully evaluated. METHODS: We performed proximal and distal segment velocity measurement of angiographically normal left anterior descending(LAD) and right coronary artery(RCA) in 25 patients(14 males, 12 females, age 50+/-10 yesre) with atypical chest pain. Spectral flow velocity parameters including average peak velocity(APV), average diastolic peak velocity(ADPV), average systolic peak velocity(ASPV), and diastolic-to-systolic velocity ratio(DSVR) were measured using 0.014 inch 15MHz Doppler wire at baseline and intracoronary adenosine-induced maximal hyperemic state. Coronary flow reserve(CFR) was calculated from the ratio of hyperemia to baseline APV. RESULTS: Comparison between LAD with RCA. LAD showed significantly higher APV than RCA at baseline(proximal ; 18+/-6cm/s vs 14+/-4cm/s, p CFR was significantly lower in LAD than in RCA(proximal ; 301+/-0.9 vs 3.8+/-1.0 , p<3001, and distal ; 3.1+/-0.7 vs 3.6+/-0.8, p<.05). Comparison between proximal with distal segment. There was significant reduction in APV and ASPV from proximal to distal segment in RCA, but not in LAD. There was significant increase in DSVR from proximal to distal segment in RCA, but not in LAD. There was no difference in CFR between proximal and distal segment in both coronary arteries. CONCLUSION: We measured coronary blood flow velocities in angiographically normal coronary artery to characterized normal coronary blood flow dynamics and provide the reference values for the assessment of coronary artery disease. Significant regional differences of coronary blood flow velocities should be considered when we assess the diseased coronary artery.
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Feminino , Humanos , Masculino , Velocidade do Fluxo Sanguíneo , Dor no Peito , Doença da Artéria Coronariana , Vasos Coronários , Hiperemia , Valores de ReferênciaRESUMO
In order to observe the pattern of a flow image on multisection MR imaging technique, a flow phantom experiment was preformed using a superconducting high filed 2.0 Tesla MRI scanner. The pattren of the first section images was homogeneous round at all flow velocities until the turbulence forming level. The patterns of the second section images,however,changed into a homogeneous round shape, a ring shape, a target shape, and a small round shape as the velocity increased. When scanned at velocities higher than the trubulence forming level, the images become distored and irregular, and eventually disappeared after the cut-off velocity. The homogeneous round image senn at the lower velocity levels in throught to be due to the overwhelming effects of fully managetized spins influxed into the imaging section during the prior repetition time(TR). Later in the higer velocity levels the effects of the partially saturated spins and fully magnetized spins influxed during the section transit time(TR/slice number) are added, and result in ring, target, and small round patterns in the second section image.