Evaluation of autogenous arteriovenous fistula insufficiency by ultrasound monitoring of brachial artery resistance index / 中华超声影像学杂志

Objective:To evaluate the autogenous arteriovenous fistula(AVF) insufficiency by ultrasound monitoring of brachial artery resistance index(RI).Methods:The brachial artery RI and blood flow volume(FV) data of 828 patients who underwent color-Doppler ultrasound detection after AVF in the General Hospital of Western Theater Command from January 2019 to June 2021 were retrospectively analyzed. The patients were grouped according to the adequacy of clinical dialysis, including 668 patients in the group with normal AVF function and 160 patients in the group with insufficient AVF function. The general information and ultrasonic measurement parameters were compared between the two groups. The correlation between brachial artery FV and RI was analyzed. The evaluation of brachial artery flow RI for AVF insufficiency was analyzed by ROC curve.Results:There were statistically significant differences between the two groups in brachial artery RI and FV(both P<0.001). The results of Pearson correlation analysis showed that brachial artery FV was negatively correlated to RI ( r=-0.657, P<0.001). The area under ROC curve for assessing AVF function by brachial artery RI was 0.970, with 95% CI was 0.955-0.986, the optimal cut-off value was 0.665, and the sensitivity and specificity were 0.888 and 0.955, respectively. Conclusions:Brachial artery RI in patients with AVF insufficiency is significantly higher than that in patients with normal AVF function. The optimal cutoff value of brachial artery RI can be used as an evaluation parameter for rapid screening of AVF function.

Normative Data of Infant Pulmonary Function Testing: A Prospective Birth Cohort Study from India

Objective: To develop a normal reference range of Infantpulmonary function test (IPFT) indices for Indian children.Design: Prospective birth cohort study.Setting: Division of Pediatric Pulmonology of a tertiary-careinstitute in India from August 2012 to March 2017.Participants: All neonates born at the institute during the studyperiod were screened for eligibility.Measurement: IPFT at baseline and every 6-month until 36-months of age.Main Outcome Measure(s): Tidal breathing flow-volume loop(TBFVL), Rapid thoracoabdominal compression (RTC), andRaised volume RTC (RVRTC) indices at baseline and follow-up.Results: 310 newborns were enrolled in the cohort; 281 of them(169 male) had completed 36-months of follow-up at the end ofthe study period. There was no influence of gender on thebaseline IPFT indices. Tidal volume per unit body weight (VT/kg)significantly increased from baseline to 36 months of age(P<0.001) while the peak ratio (tPTEF/tE) initially decreased in first18-months of age (P<0.001), after that returned to the baselinevalue by 36 months of age. RTC indices did not changesignificantly from baseline values. In RVRTC, the ratio of forcedexpiratory volume in 0.5s to forced vital capacity (FEV0.5/FVC)was significantly decreased from baseline to 36 months of age(P=0.002).Conclusions: Normal values for various IPFT indices for TBFVL,RTC, and RVRTC from neonates to the age of 36-month areprovided. These data may be used as normative data for healthyneonates and children of Indian origin

A Study of Normal Female Uroflowmetry for Development of Flow Volume Nomogram in an Indian Population

Introduction: Uroflowmetry is a common urological toolto diagnose bladder outlet obstruction in males but it is notappropriate to use the same for females as female uroflowmetrynomograms are not universally acceptable. By conducting thisstudy we aim to create a nomogram for our population andcompare our findings with other investigators. Study aimed toestablish maximum flowrate and average flowrate in womenand develop its NomogramMaterial and Methods: A total of 445 patients meetinginclusion criteria were enrolled and uroflowmetry performed.Peak flow rate (Qmax), average flow rate (Qave),time topeak flow rate (TQmax),voided volume(VV), post voidresidue(PVR) and total voiding time (TVV) were recorded.Corrected Qmax, Corrected Qave and Body Mass Index (BMIwere calculated. statistical analysis was done.Result: Both peak flow rate and average flow rate correlatespositively with voided volume while they correlates negativelywith age and BMI. Both corrected Qmax and corrected Qavewere not having significant negative correlation with age andBMI. Multivariate regression analysis revealed only voidedvolume to significantly affect PFR independently. Univariatelinear regression analysis revealed that only voided volumeaffects the Average flow rate.Conclusion: This study gives a reference value of peak andaverage flow rates of normal women in the form of confidencelimit to help clinicians diagnose poor flow rates taking intoaccount voided volumes (flow–volume nomograms) as wellas age (corrected flow–age nomogram).

Clinical value of measurement of cerebral blood flow volume by color Doppler flow imaging in patients with cerebral infarction / 新乡医学院学报

Objective To explore the clinical value of measurement of cerebral blood flow volume by color Doppler flow imaging in patients with cerebral infarction.Methods One hundred and thirty six patients with cerebral infarction in Central Hospital of Zhumadian City from February 2015 to February 2017 were selected as CI group,and 40 non-CI patients in the corresponding time period were chosen as control group.The end diastolic flow velocity,systolic peak systolic velocity,resistance index,and mean flow velocity of the vertebral artery and internal carotid arteries of all the patients were detected by color Doppler flow imaging,and anterior and posterior circulation and total cerebral blood flow were calculated.At the same time,through the color Doppler flow imaging results of the CI group,the patients were divided into anterior circulation blood-supply infarction (anterior circulation group,101 cases) and posterior circulation blood-supply infarction(posterior circulation group,35 cases) according to the blood-supply scope.The patients in the anterior circulation group were divided into cortical branches group (32 cases),perforating branche group (55 cases) and watershed group (14 cases) according to the feeding artery,while the patients in the posterior circulation group were divided into distal infarction group (15 cases),mid-range infarction group (12 cases) and proximal infarction group (8 cases).The cerebral blood flow volume were compared among the groups.Results The end diastolic flow velocity of vertebral artery in the CI group was significantly lower than that in the control group,and the resistance index was significantly higher than that in the control group (P ＜ 0.05).The carotid intravascular diameter and the end diastolic flow velocity in the CI group was significantly lower than those in the control group,and the resistance index was significantly higher than that in the control group (P ＜ 0.05).There was no significant difference in the vertebral artery diameter,the peak velocity of internal carotid artery and vertebral artery between the CI group and the control group(P ＞0.05).The right vertebral artery blood flow,the left and right internal carotid artery blood flow,cerebral blood flow of the anterior circulation and the total cerebral blood flow in the CI group were significantly lower than those in the control group,and cerebral blood flow of the posterior circulation was significantly higher than that in the control group (P ＜ 0.05).The cerebral blood flow of the anterior circulation in the anterior circulation group was lower than that in the posterior circulation group(P ＜0.05),while the cerebral blood flow of the posterior circulation was significantly higher than that in the posterior circulation group(P ＜0.05).There was no significant difference in the total cerebral blood flow between the anterior circulation group and the posterior circulation group(P ＞ 0.05).There was no significant difference in the cerebral blood flow of anterior circulation and posterior circulation,the total cerebral blood flow among the cortical branches group,the perforating branche group and the watershed group(P ＞ 0.05).Also there was no significant difference in the cerebral blood flow of anterior circulation and posterior circulation,the total cerebral blood flow among the distal infarction group,the mid-range infarction group and the proximal infarction group(P ＞0.05).Conclusion The hemodynamics indexes and cerebral blood flow of vertebral artery and internal carotid are well analyzed and evaluated by color Doppler flow imaging,and the color Doppler has a certain clinical values on the diagnosis for CI.

Hemodynamic analysis of radiation-induced damage in common carotid arteries by using color Doppler ultrasonography

PURPOSE: The aim of this study was to assess vascular changes and blood flow abnormalities in the common carotid arteries of patients with head and neck cancers after external radiotherapy, using color Doppler ultrasonography. METHODS: We studied 24 patients treated with external radiotherapy for various head and neck cancers. In order to study the acute effects of irradiation on common carotid blood flow and arterial diameter changes, color Doppler ultrasonography parameters such as peak systolic velocity, end diastolic velocity, mean velocity, systolic-to-diastolic velocity (S/D) ratio, pulsatility index (PI), resistive index (RI), and instantaneous diameter changes were evaluated before and after external radiotherapy. Additionally, the blood volume flow (VF) values in the peak systolic and end diastolic phases, as well as mean velocity, were evaluated throughout three cardiac cycles using B-mode ultrasonic image processing. RESULTS: The findings showed significant changes in the S/D ratio, PI, and RI of the common carotid arteries before and after external radiotherapy (P < 0.05). Moreover, a significant decrease in artery diameter and blood VF was observed after radiotherapy relative to the pretreatment values. A significant correlation was found between the blood VF values estimated using ultrasonic measurements and mathematical methods throughout three cardiac cycles. CONCLUSION: The hemodynamic parameters of the common carotid arteries changed during radiotherapy. These arterial changes may lead to late adverse effects of radiotherapy, such as ischemic strokes and ischemic attacks.

Hemodinámica funcional: ¿Qué significa "ser respondedor"? / Functional hemodynamics: "Be responsive, what does this mean"?

The conventional analysis and approach to the physiology of the fluid responsiveness has traditionally been focused mainly on the physiology of heart-lung interactions, and on reviews of the technical, methodological, and epidemiological aspects of the dynamic parameters, which are translated into simple algorithms to assess fluid responsiveness and to guide fluid therapy.However, fundamental features of the dynamics of the peripheral circulation, heart-vasculature interaction, and blood volume distribution, are overlooked and sometimes not accounted for, motivating misconceptions about the cardiovascular system's response to fluid administration and fluid management, such as equating fluid loading with cardiac preload, a predictable interpretation whenever Starling's ventricular function curve is analyzed in isolation. This paper reexamines fluid responsiveness' rationale offering a broadened perspective on the circulatory phenomena involved in the physiological interaction between BV, cardiac preload and output, and stroke volume variation. Finally, implications relevant in physiological and clinical terms are discussed.

El análisis convencional y abordaje actual de la fisiología de la "respuesta a fluidos" (RF) ha estado focalizada principalmente sobre la fisiología de la interacción cardiopulmonar, y sobre aspectos técnicos, metodológicos y, epidemiológicos de los parámetros dinámicos, los cuales son traducidos en algoritmos simplificados para evaluar la RF y guiar la fluidoterapia. Sin embargo, aspectos fundamentales de la dinámica de la circulación periférica, el acoplamiento entre el corazón y la vasculatura, y la distribución del volumen sanguíneo son frecuentemente omitidos, motivando mal interpretaciones sobre la respuesta del sistema cardiovascular a la administración de fluidos, tal como equiparar la carga de fluidos con la precarga ventricular, una consecuencia predecible al interpretar la curva de función ventricular (Starling) de forma aislada. Así, esta revisión reexamina la rationale de la RF, ofreciendo una perspectiva ampliada sobre aquellos fenómenos circulatorios implicados en la interacción entre el volumen sanguíneo, la precarga ventricular, el gasto cardíaco y la variación del volumen sistólico. Finalmente, se analizarán las implicancias prácticas y conceptuales.

The relationship between volumetric capnography and the severity of chronic obstructive pulmonary disease / 中华老年医学杂志

Objective To explore the correlation between volumetric capnography(VCap)and traditional pulmonary function in chronic obstructive pulmonary disease(COPD),so as to assess whether VCap can be used as alternative indicators for the evaluation of COPD severity when some of the elderly COPD patients do not accomplish the traditional pulmonary function tests.Methods 960 patients admitted to Fujian Geriatric Hospital from June 2008 to June 2015 and undergoing pulmonary function tests were included in the study.They were divided into 2 groups of the COPD group(640 cases)and the control group(320 cases).The pulmonary function of COPD group was divided into 4 subgroups(Ⅰ~Ⅳ).All persons received tests of traditional pulmonary function and VCap.The correlations between VCap and traditional pulmonary function indexes and between VCap and COPD severity were observed.Results The differences in Vm25-50/VT,Vm50-75/VT,dC/dV3,SR23 of VCap between the 4 subgroups(COPDⅠ~COPDⅣ)and control group were statistically significant(all P0.05).The difference in CO2 max between the COPD Ⅲ group(severe or more severe group)and control group was statistically significant(t=6.91 and 4.65,all P0.555,P<0.05).The specificity of Vm25-50/VT of VCap for the diagnosis of COPD was best,but its sensitivity was poor than other indexes of VCap.The indexes with both high sensitivity and high specificity were Vm50-75/VT and dC/dV3.Conclusions When the patients with COPD manifest the mild airflow limited,Vm25-50/VT,Vm50-75/VT,dC/dV3 and SR23 of VCap are gradually increased with abnormal VCap figures when the illness progressed.The CO2max of VCap might be one of the indexes for assessing the severity of severe or more severe COPD.

Tidal breathing analysis as a tool for asthma diagnosis in children aged six months to five years

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> The diagnosis of asthma is difficult to establish using spirometry in children below 5 years old. Tidal breathing analysis (TBA) can provide useful information about lung function in infants and young children, as it is effort-independent. </p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> To determine if baseline and post-bronchodilator ratios of the time and volume until peak expiratory flow to the total expiratory time and volume, (tPEF/tE and V PEF/V E) can distinguish asthmatics from normal children.</p><p style="text-align: justify;"><strong>METHODS:</strong> This is a cross-sectional study wherein 146 children ages 6 months to 5 years old completed TBA before and 15 minutes after administration of 250?g of salbutamol via nebulization. Children 3 years old and below who did not cooperate were given sedation with oral diphenhydramine (1mg/kg/dose). The tPEF/tE and VPEF/VE were compared between the controls and asthmatics.</p><p style="text-align: justify;"><strong>RESULTS:</strong> In children below 2 years old, the baseline tPEF/tE of asthmatics and non-asthmatics were 29.6  ± 13.8and 22.0 ± 6.6. The area under the curve (AUC) was 0.649 attPEF/tEof 32.250, with a sensitivity and specificity of 50% and 97%. The baseline VPEF/VE of asthmatics and non-asthmatics were 32.7 ±12.4 and 26.0 ± 4.9.AUC was 0.661 at VPEF/VEof34.500, with a sensitivity and specificity of 50% and 97%.In subjects 2 to 5 years old, the baseline tPEF/tE of asthmatics and non-asthmatics were 35.3 ± 14.7 and 35.0 ± 13.1. The baseline VPEF/VE were 37.0 ± 12.3 and 36.7 ± 10.7. After salbutamol nebulization, the tPEF/tE of asthmatics and non-asthmatics in all ages were 30.9±13.7 and 27.9± 10.8. The VPEF/VE were 34.1± 11.4 and 30.9± 9.0.</p><p style="text-align: justify;"><strong>CONCLUSION</strong>: Baseline tPEF/tE and VPEF/VE can distinguish asthmatics from non-asthmatics in children below 2 years old. However, baseline tPEF/tE and VPEF/VE in children 2 to 5 years old and post-bronchodilator tPEF/tE and VPEF/VE in all ages could not distinguish asthmatics from non-asthmatics after nebulization with 250?g of salbutamol.</p>

Analysis of respiratory flow pattern during tidal breathing in seated healthy adults and stable ;chronic obstructive pulmonary disease patients / 中国医师进修杂志

Objective To observe the characteristics of respiratory airflow in healthy adults and stable chronic obstructive pulmonary disease (COPD) patients by analysis of analyzing tidal breathing flow-volume curves (TBFV). Methods Fifteen stable moderate COPD patients (COPD group) and 15 healthy cases without smoking(healthy control group)were enrolled into the study. No bronchodilators were used in patients of COPD group 8 h before test. Pulmonary function test and TBFV in seated position were measured, and the pressure of oral cavity was monitored concomitantly. Results The levels of percentage of vital capacity (VC%), percentage of forced expiratory volume in the first second (FEV 1)/forced vital capacity (FVC) and percentage of maximum mid-expiratory flow (MMEF%) in COPD group were significantly lower than those in healthy control group (P0.05). The levels of tidal expiratory flow at 50%of the remaining tidal volume/PTEF (TEF50/PTEF) and tidal expiratory flow at 25%of the remaining tidal volume/PTEF (TEF25/PTEF) in healthy control group were significantly higher than those in COPD group:0.54 ± 0.13 vs. 0.40 ± 0.12, 0.28 ± 0.13 vs. 0.20 ± 0.06, P<0.01 or<0.05. No differences were found in peak inspiratory pressure (PI max) and peak expiratory pressure (PE max) between two groups. Conclusions The degree of airflow limitation and the effect of bronchodilator in critical patients could be evaluated by analysis of TBFV parameters. The measurement of TBFV is simple and don′t need special technique. It is worth of promoting.

Accuracy of maximal expiratory flow-volume curve curvilinearity and fractional exhaled nitric oxide for detection of children with atopic asthma / 소아과

PURPOSE: Airway pathology in children with atopic asthma can be reflected by the concave shape of the maximal expiratory flow-volume (MEFV) curve and high fractional exhaled nitric oxide (FeNO) values. We evaluated the capacity of the curvilinearity of the MEFV curve, FeNO, and their combination to distinguish subjects with atopic asthma from healthy individuals. METHODS: FeNO and angle β, which characterizes the general configuration of the MEFV curve, were determined in 119 steroid-naïve individuals with atopic asthma aged 8 to 16 years, and in 92 age-matched healthy controls. Receiver operating characteristic (ROC) curve analyses were performed to determine the cutoff points of FeNO and angle β that provided the best combination of sensitivity and specificity for asthma detection. RESULTS: Asthmatic patients had a significantly smaller angle β and higher FeNO compared with healthy controls (both, P<0.001). For asthma detection, the best cutoff values of angle β and FeNO were observed at 189.3° and 22 parts per billion, respectively. The area under the ROC curve for the combination of angle β and FeNO improved to 0.91 (95% confidence interval [CI], 0.87–0.95) from 0.80 (95% CI, 0.75–0.86; P<0.001) for angle β alone and 0.86 (95% CI, 0.82–0.91; P=0.002) for FeNO alone. In addition, the combination enhanced sensitivity with no significant decrease in specificity. CONCLUSION: These data suggest that the combined use of the curvilinearity of the MEFV curve and FeNO is a useful tool to differentiate between children with and without atopic asthma.

Evaluación de flujos y volúmenes dinámicos en pacientes con compromiso muscular respiratorio / Dynamic flows and volumes evaluation in patients with respiratory muscle impairment

Spirometry measures the forced expiratory volumes and flows. In patients with neuromuscular disease, these are altered since there is some respiratory muscle involvement. The usefulness of this test is based on the interpretation of the shape of the flow / volume loop and values of spirometric variables. In patients with neuromuscular disease, Forced Vital Capacity is the most used especially for its prognosis value.

La espirometría mide volúmenes y flujos espiratorios forzados. En los pacientes con enfermedad neuromuscular (ENM) estos se ven alterados debido al compromiso muscular respiratorio. La utilidad de este examen se basa en la interpretación de la forma de la curva flujo/volumen y los valores de las variables espirométricas. En los pacientes con ENM la Capacidad Vital Forzada es la más utilizada ya que otorga valor pronóstico.

Changes in the Flow-Volume Curve According to the Degree of Stenosis in Patients With Unilateral Main Bronchial Stenosis

OBJECTIVES: The shape of the flow-volume (F-V) curve is known to change to showing a prominent plateau as stenosis progresses in patients with tracheal stenosis. However, no study has evaluated changes in the F-V curve according to the degree of bronchial stenosis in patients with unilateral main bronchial stenosis. METHODS: We performed an analysis of F-V curves in 29 patients with unilateral bronchial stenosis with the aid of a graphic digitizer between January 2005 and December 2011. RESULTS: The primary diseases causing unilateral main bronchial stenosis were endobronchial tuberculosis (86%), followed by benign bronchial tumor (10%), and carcinoid (3%). All unilateral main bronchial stenoses were classified into one of five grades (I, 90% to near-complete obstruction without ipsilateral lung collapse). A monophasic F-V curve was observed in patients with grade I stenosis and biphasic curves were observed for grade II-IV stenosis. Both monophasic (81%) and biphasic shapes (18%) were observed in grade V stenosis. After standardization of the biphasic shape of the F-V curve, the breakpoints of the biphasic curve moved in the direction of high volume (x-axis) and low flow (y-axis) according to the progression of stenosis. CONCLUSION: In unilateral bronchial stenosis, a biphasic F-V curve appeared when bronchial stenosis was >25% and disappeared when obstruction was near complete. In addition, the breakpoint moved in the direction of high volume and low flow with the progression of stenosis.

Fisiología de la curva flujo/volumen espirométrica / Flow-volume curve: its physiological basis

We describe physiological basis to explain flow/volume curve obtained by forced spirometry. The main factors involved are alveolar and intraluminal airway pressure and transthoracic pressure, whose interrelationship determines dynamic airway compression. Lung and thoracic elastic recoil pressure and lung volumes also participate.

Se describen las bases fisiológicas de la curva flujo/volumen obtenida mediante espirometría forzada. Los principales factores involucrados son la presión alveolar y de la vía aérea y la presión transtorácica, cuyo balance determina la compresión dinámica de la vía aérea. Además intervienen la presión de retracción elástica pulmonar y de la caja torácica y los volúmenes pulmonares.

Contribution of flow-volume curves to the detection of central airway obstruction / Contribuicao da curva de fluxo-volume na deteccao de obstrucao da via aerea central

OBJECTIVE: To assess the sensitivity and specificity of flow-volume curves in detecting central airway obstruction (CAO), and to determine whether their quantitative and qualitative criteria are associated with the location, type and degree of obstruction. METHODS: Over a four-month period, we consecutively evaluated patients with bronchoscopy indicated. Over a one-week period, all patients underwent clinical evaluation, flow-volume curve, bronchoscopy, and completed a dyspnea scale. Four reviewers, blinded to quantitative and clinical data, and bronchoscopy results, classified the morphology of the curves. A fifth reviewer determined the morphological criteria, as well as the quantitative criteria. RESULTS: We studied 82 patients, 36 (44%) of whom had CAO. The sensitivity and specificity of the flow-volume curves in detecting CAO were, respectively, 88.9% and 91.3% (quantitative criteria) and 30.6% and 93.5% (qualitative criteria). The most prevalent quantitative criteria in our sample were FEF50%/FIF50% ≥ 1, in 83% of patients, and FEV1/PEF ≥ 8 mL . L–1 . min–1, in 36%, both being associated with the type, location, and degree of obstruction (p < 0.05). There was concordance among the reviewers as to the presence of CAO. There is a relationship between the degree of obstruction and dyspnea. CONCLUSIONS: The quantitative criteria should always be calculated for flow-volume curves in order to detect CAO, because of the low sensitivity of the qualitative criteria. Both FEF50%/FIF50% ≥ 1 and FEV1/PEF ≥ 8 mL . L–1 . min–1 were associated with the location, type and degree of obstruction. .

OBJETIVO: Verificar a sensibilidade e especificidade das curvas de fluxo-volume na detecção de obstrução da via aérea central (OVAC), e se os critérios qualitativos e quantitativos da curva se relacionam com a localização, o tipo e o grau de obstrução. MÉTODOS: Durante quatro meses foram selecionados, consecutivamente, indivíduos com indicação para broncoscopia. Todos efetuaram avaliação clínica, preenchimento de escala de dispneia, curva de fluxo-volume e broncoscopia num intervalo de uma semana. Quatro revisores classificaram a morfologia da curva sem conhecimento dos dados quantitativos, clínicos e broncoscopicos. Um quinto revisor averiguou os critérios morfológicos e quantitativos. RESULTADOS: Foram incluídos 82 doentes, 36 (44%) com OVAC. A sensibilidade e especificidade da curva de fluxo-volume na detecção de OVAC foram, respectivamente, de 88,9% e 91,3% (critérios quantitativos) e de 30,6% e 93,5% (critérios qualitativos). Os critérios quantitativos mais frequentes na amostra foram o FEF50%/FIF50% ≥ 1 em 83% e o VEF1/PFE ≥ 8 mL . L–1 . min–1 em 36% dos doentes, e ambos se relacionaram com o tipo, a localização e o grau de obstrução (p < 0,05). Houve concordância dos revisores quanto à existência ou não de OVAC. Existe relação entre o grau de obstrução e o de dispneia. CONCLUSÕES: Os critérios quantitativos devem ser sempre calculados nas curvas de fluxo-volume de forma a detectar OVAC, dado a baixa sensibilidade dos critérios qualitativos. Os critérios FEF50%/FIF50% ...

Association of arteriovenous fistula blood blow dynamics with inflammation and its effect on cardiovascular diseases in maintenance hemodialysis patients / 中华肾脏病杂志

Objective To examine the association of arteriovenous fistula (AVF) blood flow (Qa) dynamics with inflammation state and its effect on cardiovascular diseases (CVD) in maintenance hemodialysis (MHD) patients.Methods Thirty MHD patients with AVF and twelve healthy people were enrolled in the study.Qa and cardiac output (CO) were measured by Transonic Hemodialysis Monitor HD 02.In MHD patients,pre-dialysis blood samples were taken before Qa monitoring.High-sensitivity C-reactive protein (hsCRP) was measured by immunoturbidimetry (Kyoma,Japan).Inflammatory factors IL-2,IL-6,IL-10,TNF were measured by Cytometric Bead Array (BDTM).Cardiovascular diseases morbidity was monitored prospectively within nineteen months follow-up period.Results There were no significant differences in age and sex between MHD patients and healthy people.The serum IL-6,IL-10,TNF and hsCRP were significantly higher in MHD patients than those in healthy controls [2.38 (1.86-4.69) vs 1.14 (0.27-1.18) ng/L,P＜0.01; 1.47 (1.19-2.10) vs 1.04 (0.00-1.23) ng/L,P＜0.01; 1.33 (1.05-1.56) vs 0.54 (0.00-1.24) ng/L,P＜0.05; 4.90 (1.58-7.45) vs 1.50 (0.63-1.90) mg/L,P=0.01].During the follow-up period,6 patients (20.0％) developed at least one episode of cardiovascular event.Qa,serum IL-6 and hsCRP levels were significantly higher in patients with CVD as compared to those without CVD [(1120±192) vs (893±189) ml/min,P＜0.05; 4.86 (2.96-7.85) vs 2.20 (1.80-3.10) ng/L,P＜ 0.01;11.75 (3.83-31.53) vs 4.45 (1.05-6.68) mg/L,P＜0.05].Binary Logistic regression analysis demonstrated that serum IL-6 was an independent and stronger risk factor for CVD morbidity [HR=1.943,95％CI (1.110-3.402),P=0.02].Spearman rank correlation analysis and liner regression analysis showed that Qa was positively correlated with serum IL-6 (β=0.492,P＜0.01).Path analysis suggested that Qa contributed to CVD mortality via the increase of serum IL-6.Conclusions AVF blood flow monitoring is important for MHD patients.IL-6 is an independent risk factor of CVD in MHD patients.AVF blood flow increases cardiovascular diseases morbidity in MHD patients via its promotion of IL-6 production.

Dynamic change and correlation of ventilative function pulmonary mechanics with cardiac function in the term infants / 中国小儿急救医学

Objective To investigate the dynamic change and correlation of the pulmonary ventilative function, mechanic and cardiac function in the term infants. Methods Twenty hundred term infants were divided into A 、B 、C and D groups by age which was 0 ～ 24 h, ～ 72 h, ～ 1 w and 28 d respectively. The lung ventilative and mechanical function were measured respectively by using techniques of tidal breathing flow-volume loop(TBFVL)and the single occlusion. The Master screen Paed-lung function devices of Germanic JAEGER Co. was be used in this study. The parameter of pulmonary function including minute volume(MV) ,tidal volume (TV), respiratory system compliance(Crs) and respiratory system resistance (Rrs). The cardiac function were measured by using SonoSite 180 PLUS color Doppler ultrasonic diagnostic apparatus. The main parameter of cardiac function including cardiac output(CO) and stroke volume(SV). Results The TV of A, B ,C and D group were 20. 2 ± 3.78,21. 1 ± 3.71,22. 3 ± 4. 48 and 23. 9 ±4.90 (ml)respectively, the TV of C and D group were higher than that of A group, and the TV of D group was higher than that of B group (P ＜ 0. 05).There were no significantly difference of Crs, Rrs among A, B, C and D group(P ＞ 0. 05). The CO of A,B,C and D group were 0.93 ±0. 23,0.93 ±0.23,1.02 ±0.21 and 1.08 ±0.27 (L/min) ,the CO of D group was higher than that of A and B groups (P ＜ 0. 05). The CO was negative correlation with Rrs (r = - 0. 16,P ＜ 0. 05) and positive correlation with MV、 TV、 Crs (r was 0. 50、 0. 54、0. 13 respectively, P ＜ 0. 05).Conclusion The lung ventilative function is mature gradually with increasing age. The cardiac output has been obviously improved for postnatal 1 week in the term infants. The pulmonary ventilative function and mechanic parameter are important effective factors of cardiac function.

Padrões ventilatórios na espirometria em pacientes adolescentes e adultos com fibrose cística / Respiratory patterns in spirometric tests of adolescents and adults with cystic fibrosis

OBJETIVO: Avaliar os padrões dos distúrbios ventilatórios observados na espirometria em pacientes com fibrose cística (FC) e suas relações com a gravidade funcional e com o comportamento dos fluxos máximos expiratórios a baixos volumes. MÉTODOS: Estudo transversal e retrospectivo, incluindo pacientes adolescentes e adultos com FC. Todos os pacientes foram submetidos à espirometria. Os pacientes foram classificados como tendo função ventilatória preservada, distúrbio ventilatório obstrutivo (DVO), DVO com CVF reduzida, sugestivo de distúrbio ventilatório restritivo (DVR) ou distúrbio ventilatório combinado (DVC). Os fluxos máximos expiratórios a baixos volumes foram avaliados utilizando-se FEF25-75 por cento, FEF75 por centoe FEF75 por cento/CVF. O grupo controle incluiu 65 indivíduos normais, também submetidos à espirometria. RESULTADOS: Foram incluídos 65 pacientes no grupo de estudo: 8 (12,3 por cento) com função pulmonar preservada, 18 (27,7 por cento) com DVO, 24 (36,9 por cento) com DVO com CVF reduzida, 5 (7,7 por cento) com padrão sugestivo de DVR e 10 (15,4 por cento) com DVC. O VEF1 foi significativamente menor nos grupos DVO com CVF reduzida e DVC, comparados com os outros grupos (p < 0,001). Nos pacientes com função ventilatória preservada, FEF25-75 por cento e FEF75 por cento foram significativamente reduzidos em 1 paciente, assim como FEF75 por cento/CVF em 2 pacientes. CONCLUSÕES: O padrão ventilatório estava alterado em 88 por cento dos pacientes com FC. O distúrbio mais frequente foi DVO com CVF reduzida. Houve maior prejuízo funcional nos pacientes com DVO e CVF reduzida e com DVC. Os fluxos expiratórios máximos a baixos volumes foram alterados em uma pequena percentagem de pacientes com função pulmonar preservada.

OBJECTIVE: To evaluate spirometric patterns of respiratory disorders and their relationship with functional severity and maximal expiratory flows at low lung volumes in patients with cystic fibrosis (CF). METHODS: A retrospective cross-sectional study including adolescents and adults with CF. All of the patients were submitted to spirometry. Patients were classified as having preserved respiratory function, obstructive lung disease (OLD), OLD with reduced FVC, presumptive restrictive lung disease (RLD) or mixed obstructive and restrictive lung disease (MORLD). Maximal expiratory flows at low lung volumes were assessed using FEF25-75 percent, FEF75 percent and FEF75 percent/FVC. We included 65 normal subjects, also submitted to spirometry, as a control group. RESULTS: The study group included 65 patients: 8 (12.3 percent) with preserved lung function; 18 (27.7 percent) with OLD; 24 (36.9 percent) with OLD and reduced FVC; 5 (7.7 percent) with presumptive RLD; and 10 (15.4 percent) with MORLD. The FEV1 was significantly lower in the OLD with reduced FVC group and the MORLD group than in the other groups (p < 0.001). In the patients with preserved respiratory function, FEF25-75 percent and FEF75 percent were significantly reduced in 1 patient, as was FEF75 percent/FVC in 2 patients. CONCLUSIONS: The respiratory pattern was impaired in 88 percent of the patients with CF. The most common pattern was OLD with reduced FVC. The degree of functional impairment was greater in the OLD with reduced FVC group and in the MORLD group than in the other groups. Maximal expiratory flows at low lung volumes were impaired in a low percentage of patients with preserved respiratory function.

Effect of nerve growth factor in promoting survival of super-length random flap / 中国综合临床

Objective To study the effect of nerve growth factor(NGF)in survival of super-length random flap.Methods The experiment employed the animal model of random flap in Wistar's rat back,applied 66.7 μg NGF locally in trial group's flap at the first day after operation with auto-control.The survival proportion,skin temperature and survival rate of random flap were observed,and the blood flow,the blood flow velocity,the blood flow volume change of random flap were measured by the laser and photic-conduct fiber means in differ time.Results The survival proportion(7.12±1.54)cm2 and survival rate(92±5)%of random flap of trial group was obviously higher(P＜0.05)than those in control group[(5.23±0.19)cm2,(69±5)%]after pedicle division.The blood flow,the blood flow velocity,the blood flow volume and skin temperature in the midge and at the end of random flap in the trial group were obviously higher than those in control group 1 day after operation(P＜0.05),and the blood flow velocity in the pedicle of random flap in the trial group was increased markedly(P＜0.05).The blood flow volume and skin temperature in the pedicle of random flap in the trial group were higher than those in control group 3 days after operation(P＜0.05).The survival of randomflapinthetrial groupwere very significantly increased than those in control group 7 days after operation(P＜0.01).Conclusion NGF can increase flap's blood flow,blood flow velocity and blood flow volume,enhancing survival of the big-proportioned and super-length random flap.

The Correlation of Duplex Doppler Ultrasonographic Retrograde Venous Flow Volume and Testicular Volume Difference in Patients with Adolescent Varicocele / 대한남성과학회지

PURPOSE: The aim of this study is to assess effects of testicular volume difference and retrograde venous flow of pampiniform plexus measured by Duplex Doppler Ultrasonograpy (DDU) in patients with adolescent varicocele. MATERIALS AND METHODS: Physical examinations and DDU were performed to assess varicocele in fifty five patients with left sided adolescent varicocele. During both normal respiration and the Valsalva's maneuver, the maximum venous diameter (MVD), maximal velocity of reflux and the peak retrograde flow volume (RFV) was measured by DDU. The percentage testicular volume difference (%) between the right and left testicle was calculated as (right testicular volume-left testicular volume)x100/right testicular volume and divided into 3 group; below 10%, 10~20%, >20%. Grade of varicocele, MVD and peak RFV were analyzed as possible determinants of testicular hypotrophy in adolescent varicocele. RESULTS: A total of 55 patients (mean age 17.8 years, range 12 to 20) were included in this study. Of these, physical examination reviewed that 7 (12.7%), 18 (32.7%), 30 (54.6%) patients had grade I, II or III varicoceles on the left side respectively. The mean MVD was significantly higher according to grade of varicocele. The mean maximal velocity of reflux was significantly higher in the patients grade II and III than grade I, but was not significant between grade II and III. The mean peak RFV was significantly higher according to grade of varicocele. RFV was the only significant parameter of predictive value for percentage testicular volume difference. CONCLUSIONS: Patients with peak RFV >35ml minutes showed significant reduction of testicular volume. Measurement of RFV is recommended as predictive tools for assessing the percentage testicular volume difference in patients with adolescent varicocele.

Diagnostic Value of Nebulized Bronchodilator Test with Tidal Breathing Analysis for Infants with Asthma / 实用儿科临床杂志

Objective To evaluate the effect of nebulized bronchodilator on the change of tidal breathing in infants with asthma.This may provide some objective evidence for clinical diagnosis.Methods One hundred and five infants with asthma and 26 cases with pneumonia were involved for the study.Tidal breathing flow-volume was obtained before and 10-15 minutes after nebulized bronchodilator was given.Accor-ding to the basic lung function results,59 cases as a mild group [the ratio of time taken to reach peak expiratory flow to total expiratory time(TPTEF/Te) ≥15%],and 46 cases of the infant asthma as a severe group(TPTEF/Te0.05).Moreover,in severe group,expect for RR and expiratory time(Te),the other indices significantly increased after administration of nebulized bronchodilator(P