Complicated changes occur in hemodynamics of hepatic artery and vein, and portal vein under various kinds of pathologic status hepatic blood supply. This because of distinct double article reviews the clinical applica...Complicated changes occur in hemodynamics of hepatic artery and vein, and portal vein under various kinds of pathologic status hepatic blood supply. This because of distinct double article reviews the clinical application of hepatic computed tomography perfusion in some liver diseases.展开更多
AIM： To evaluate treatment safety and hemodynamic changes during a single 6-h treatment with the PrometheusTM liver assist system in a randomized, controlled study. METHODS： Twenty-four patients were randomized to e...AIM： To evaluate treatment safety and hemodynamic changes during a single 6-h treatment with the PrometheusTM liver assist system in a randomized, controlled study. METHODS： Twenty-four patients were randomized to either the study group or to one of two control groups： Fractionated Plasma Separation Adsorption and Dialysis, PrometheusTM system （Study group; n = 8）; Molecular Adsorbent Recirculation System （MARS）TM （Control group 1, n = 8）; or hemodialysis （Control group 2; n = 8）. All patients included in the study had decompensated cirrhosis at the time of the inclusion into the study. Circulatory changes were monitored with a Swan-Ganz catheter and bilirubin and creatinine were monitored as measures of protein-bound and water-soluble toxins. RESULTS： Systemic hemodynamics did not differ between treatment and control groups apart from an increase in arterial pressure in the MARS group （P = 0.008）. No adverse effects were observed in any of the groups. Creatinine levels significantly decreased in the MARS group （P = 0.03） and hemodialysis group （P = 0.04）. Platelet count deceased in the Prometheus group （P = 0.04）.CONCLUSION： Extra-corporal liver support with Prometheus is proven to be safe in patients with endstage liver disease but does not exert the beneficial effects on arterial pressure as seen in the MARS group,展开更多
Objectives: During visual stimulation, the elevated metabolism rate will coupl e with increase of blood flow velocity(BFV) in posterior cerebral artery(PCA). T his study with TCD was aimed to investigate whether the c...Objectives: During visual stimulation, the elevated metabolism rate will coupl e with increase of blood flow velocity(BFV) in posterior cerebral artery(PCA). T his study with TCD was aimed to investigate whether the coupling might change ac cording to the different vasoneuronal conditions. Methods: Ninety-nine voluntee r s including 24 hypertension(HT) patients and 2 patients suffering from both HT a nd diabetes mellitus(DM) were enrolled in this trial. BFV and pulse indexes(PI) in P2 segments of PCA on both sides were monitored during visual stimulation. Re sults: In all subjects, Mean BFV increased and PI went down in response to visua l stimulation. The percentages of changes (ΔV and ΔP) of both mean BFV and PI we re larger in young group(<55 years old) than in old one(≥55 years old). There w a s significant positive correlation between ΔV and ΔP. Multivariated re gression a nalysis did not show HT and DM, but age related to ΔV(ΔP). We did not find signi ficant difference of ΔV(ΔP) between left and right sides. Conclusions: Blood flo w velocity in PCA P2 segment increased due to decreased cerebrovascular resistan ce during visual stimulation and the response weakened with aging of the patient .展开更多
Pollution of environment, connected with intensive industry and, as a result, declination of health of nation is one of the biggest problems of modem age. The purpose of research was the studying of influence of hydra...Pollution of environment, connected with intensive industry and, as a result, declination of health of nation is one of the biggest problems of modem age. The purpose of research was the studying of influence of hydrazine derivatives on redistribution of plasma protein between blood and lymph and change of hemodynamic poisoned by 1, l-nitrozodimethylamine. parameter caused by this. There were some changes in organism展开更多
Objective: To study changes and rules of the left ventricular functions in rabbits with myocardial contusion through parallel functional analysis by using echocardiography combined with cardiac catheter intervention. ...Objective: To study changes and rules of the left ventricular functions in rabbits with myocardial contusion through parallel functional analysis by using echocardiography combined with cardiac catheter intervention. Methods: Thirty healthy rabbits were selected and impacted to make moderate or severe myocardial contusion by BIM II biomedical impact machine. The changes of hemodynamics and cardiac systolic and diastolic functions were respectively observed before injury and 1, 4, 8 and 24 hours after injury. Results: After myocardial contusion, the heart rate, systolic pressure, diastolic pressure and mean arterial pressure of rabbits decreased remarkably at 1 4 hours. The left ventricular end systolic pressure (LVESP), the maximum increasing rate of the left intraventricular pressure (+dp/dtmax), isovolumic pressure (IP) and the maximum systolic velocity of the left ventricle (Vmax) also decreased markedly. And then these parameters recovered to the level of preinjury at 8 24 hours. The left ventricular end diastolic pressure (LVEDP), the rate of the left intraventricular pressure (-dp/dtmax) and the decreasing time constant of the left intraventricular pressure (T) increased remarkably 1 hour after myocardial contusion, and did not decrease until 8 hours after myocardial contusion. Detection by echocardiography showed that ejection fraction of the left ventricle markedly decreased at 24 hours after myocardial contusion, while the systolic volume decreased obviously as early as 1 hour after myocardial contusion, at 4 8 hours it recovered a little and again decreased at 24 hours. The end systolic volume and end diastolic volume increased after myocardial contusion, but statistical significance was only seen at 8 hours after myocardial contusion.Conclusions: Cardiac functions of the left and right ventricles are markedly injured after myocardial contusion with disorders of the left ventricle diastolic function and of the right ventricle systolic function as the dominant injury. While the systolic function of the left ventricle can recover. Echocardiography shows clinical importance in detection of early injuries of cardiac functions.展开更多
Objective： The intoxications caused by 2,4-dinitrophenol （2,4-DNP）, even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and ex...Objective： The intoxications caused by 2,4-dinitrophenol （2,4-DNP）, even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion （HP） in the treatment of patients with acute 2,4-DNP poisoning. Methods We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP （n=5） and intensive HP （n=9） groups. Ultra high performance liquid chromatography/ tandem mass spectroscopy （UPLC-MS/MS） was used to detect the 2,4-DNP concentration in plasma in this study. Results： The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations （C1） of survivors ranged from 0.25 to 41.88 pg/ml （mean （12.56＋13.93） pg/ml）. A positive correlation existed between initial plasma 2,4-DNP concentration （C1） and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day （R3）, the 3rd to 7th day （R3-7）, and the 1st to 7th day （RT）, were only （53.03±14.04）%, （55.25±10.50）%, and （78.29±10.22）%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R3, R3-7, and R7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance （P〈0.05）. Simultaneously, the elimination half-life （tl/2） of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance （P〈0.05）. Conclusions： The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison.展开更多
基金Supported by Shanghai Leading Academic Discipline Project, No. S30203Shanghai Jiaotong University School of Medicine Leading Academic Discipline Project
文摘Complicated changes occur in hemodynamics of hepatic artery and vein, and portal vein under various kinds of pathologic status hepatic blood supply. This because of distinct double article reviews the clinical application of hepatic computed tomography perfusion in some liver diseases.
基金The NOVO Nordic Foundation, Savvrksejer Jeppe & Ovita Mindelegat, Fabricant Vilhelm Pedersen & Wifes Mindelegat, A.P. Moller Scientific Foundation, the Danish Medical Association Research Fund and the Laerdal Foundation for Acute Medicine, and by an unrestricted grant from the Fresenius Medical Care GmBH
文摘AIM： To evaluate treatment safety and hemodynamic changes during a single 6-h treatment with the PrometheusTM liver assist system in a randomized, controlled study. METHODS： Twenty-four patients were randomized to either the study group or to one of two control groups： Fractionated Plasma Separation Adsorption and Dialysis, PrometheusTM system （Study group; n = 8）; Molecular Adsorbent Recirculation System （MARS）TM （Control group 1, n = 8）; or hemodialysis （Control group 2; n = 8）. All patients included in the study had decompensated cirrhosis at the time of the inclusion into the study. Circulatory changes were monitored with a Swan-Ganz catheter and bilirubin and creatinine were monitored as measures of protein-bound and water-soluble toxins. RESULTS： Systemic hemodynamics did not differ between treatment and control groups apart from an increase in arterial pressure in the MARS group （P = 0.008）. No adverse effects were observed in any of the groups. Creatinine levels significantly decreased in the MARS group （P = 0.03） and hemodialysis group （P = 0.04）. Platelet count deceased in the Prometheus group （P = 0.04）.CONCLUSION： Extra-corporal liver support with Prometheus is proven to be safe in patients with endstage liver disease but does not exert the beneficial effects on arterial pressure as seen in the MARS group,
文摘Objectives: During visual stimulation, the elevated metabolism rate will coupl e with increase of blood flow velocity(BFV) in posterior cerebral artery(PCA). T his study with TCD was aimed to investigate whether the coupling might change ac cording to the different vasoneuronal conditions. Methods: Ninety-nine voluntee r s including 24 hypertension(HT) patients and 2 patients suffering from both HT a nd diabetes mellitus(DM) were enrolled in this trial. BFV and pulse indexes(PI) in P2 segments of PCA on both sides were monitored during visual stimulation. Re sults: In all subjects, Mean BFV increased and PI went down in response to visua l stimulation. The percentages of changes (ΔV and ΔP) of both mean BFV and PI we re larger in young group(<55 years old) than in old one(≥55 years old). There w a s significant positive correlation between ΔV and ΔP. Multivariated re gression a nalysis did not show HT and DM, but age related to ΔV(ΔP). We did not find signi ficant difference of ΔV(ΔP) between left and right sides. Conclusions: Blood flo w velocity in PCA P2 segment increased due to decreased cerebrovascular resistan ce during visual stimulation and the response weakened with aging of the patient .
文摘Pollution of environment, connected with intensive industry and, as a result, declination of health of nation is one of the biggest problems of modem age. The purpose of research was the studying of influence of hydrazine derivatives on redistribution of plasma protein between blood and lymph and change of hemodynamic poisoned by 1, l-nitrozodimethylamine. parameter caused by this. There were some changes in organism
文摘Objective: To study changes and rules of the left ventricular functions in rabbits with myocardial contusion through parallel functional analysis by using echocardiography combined with cardiac catheter intervention. Methods: Thirty healthy rabbits were selected and impacted to make moderate or severe myocardial contusion by BIM II biomedical impact machine. The changes of hemodynamics and cardiac systolic and diastolic functions were respectively observed before injury and 1, 4, 8 and 24 hours after injury. Results: After myocardial contusion, the heart rate, systolic pressure, diastolic pressure and mean arterial pressure of rabbits decreased remarkably at 1 4 hours. The left ventricular end systolic pressure (LVESP), the maximum increasing rate of the left intraventricular pressure (+dp/dtmax), isovolumic pressure (IP) and the maximum systolic velocity of the left ventricle (Vmax) also decreased markedly. And then these parameters recovered to the level of preinjury at 8 24 hours. The left ventricular end diastolic pressure (LVEDP), the rate of the left intraventricular pressure (-dp/dtmax) and the decreasing time constant of the left intraventricular pressure (T) increased remarkably 1 hour after myocardial contusion, and did not decrease until 8 hours after myocardial contusion. Detection by echocardiography showed that ejection fraction of the left ventricle markedly decreased at 24 hours after myocardial contusion, while the systolic volume decreased obviously as early as 1 hour after myocardial contusion, at 4 8 hours it recovered a little and again decreased at 24 hours. The end systolic volume and end diastolic volume increased after myocardial contusion, but statistical significance was only seen at 8 hours after myocardial contusion.Conclusions: Cardiac functions of the left and right ventricles are markedly injured after myocardial contusion with disorders of the left ventricle diastolic function and of the right ventricle systolic function as the dominant injury. While the systolic function of the left ventricle can recover. Echocardiography shows clinical importance in detection of early injuries of cardiac functions.
文摘Objective： The intoxications caused by 2,4-dinitrophenol （2,4-DNP）, even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion （HP） in the treatment of patients with acute 2,4-DNP poisoning. Methods We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP （n=5） and intensive HP （n=9） groups. Ultra high performance liquid chromatography/ tandem mass spectroscopy （UPLC-MS/MS） was used to detect the 2,4-DNP concentration in plasma in this study. Results： The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations （C1） of survivors ranged from 0.25 to 41.88 pg/ml （mean （12.56＋13.93） pg/ml）. A positive correlation existed between initial plasma 2,4-DNP concentration （C1） and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day （R3）, the 3rd to 7th day （R3-7）, and the 1st to 7th day （RT）, were only （53.03±14.04）%, （55.25±10.50）%, and （78.29±10.22）%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R3, R3-7, and R7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance （P〈0.05）. Simultaneously, the elimination half-life （tl/2） of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance （P〈0.05）. Conclusions： The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison.
