The hemodynamics changes of the common carotid arteries in 10 SD rats were measured with a color doppler flowmetry in an attempt to define the changes resulting from end-to-end anastomosis. The left common carotid arteries were divided and followed by end-to-end anastomosis. The systolic mean peak velocities in the left arteries were measured at the proximal, distal and anastomotic sites and in the right intact arteries as well at 6, 12, 24, 48, 72 and 120 hours after repair. The percentage of area reduction at anastomosis was calculated from these data. The results indicated that the systolic mean peak velocity at the anastomotic sites was significantly increased as compared to the velocity at the proximal, distal and contralateral sites (P lt; 0.05). The velocity at the distal sites was significantly lower than that from the proximal and contralateral sites (P lt; 0.05), the mean percentage of the reduction was 33.18% and 33.33%, respectively. From 6 hours to 120 hours after anastomosis of arteries there was various degree of narrowing at the site of anastomosis. The mean per cent of stenosis was 42.48%. It was concluded that from 6 to 120 hours after end-to-end anastomosis of the small arteries, the velocity at the anastomotic site was increased as compared to the velocities at pre- and post-anastomotic sites. The increase of velocity at the site of anatomosis was caused by stenosis at the anastomosis.
ObjectiveTo investigate impact of splenectomy plus pericardial devascularization on liver hemodynamics and liver function for liver cirrhosis patients with portal hypertension. MethodsThe internal diameter, maximum velocity, minimum velocity, mean velocity, and flow volume of portal vein and hepatic artery of 42 cases of liver cirrhosis with portal hypertension were measured by Doppler ultrasonic instrument on day 1 before operation and on day 7 after operation. The free portal pressures at different phases (after open abdomen, after splenic artery ligation, after splenectomy, and after devasculanrization) were read from the disposable pressure sensor. Twenty-four healthy people through physical examination were selected as control. Results① The free portal pressure of liver cirrhosis patients with portal hypertension was decreased from (29.12±1.40) mm Hg after open abdomen to (22.71±1.21) mm Hg after splenic artery ligation, and further decreased to (21.32±1.12) mm Hg after splenectomy, but increased to (22.42±1.15) mm Hg after devasculanrization, the difference was statisticly different (all P < 0.01). ② Compared with the healthy people, for the liver cirrhosis patients with portal hypertension, the internal diameter, maximum velocity, minimum velocity, and flow volume of portal vein were significantly enlarged (all P < 0.01), which of hepatic artery were significantly reduced (all P < 0.01) on day 1 before operation; On day 7 after operation, the internal diameter of portal vein was significantly reduced (P < 0.01), the maximum velocity, minimum velocity, and mean velocity of portal vein were significantly enlarged (all P < 0.01), but the internal diameter of hepatic artery was significantly reduced (P < 0.01), the maximum velocity, minimum velocity, mean velocity, and flow volume of hepatic artery were significantly enlarged (all P < 0.01). For the liver cirrhosis patients with portal hypertension, compared with the values on day 1 before operation, the internal diameter and the flow volume of portal vein were significantly reduced (all P < 0.01) on day 7 after operation; the internal diameter, maximum velocity, minimum velocity, mean velocity, and flow volume of hepatic artery were significantly enlarged (all P < 0.01) on day 7 after operation. ③ The Child-Pugh classification of liver function between before and after surgery had no significant difference (χ2=1.050, P > 0.05). ④ No death and no hepatic encephalopathy occurred, no thrombosis of splenic vein or portal vein was observed on day 7 after surgery. Conclusionsplenectomy plus pericardial devascularization could decrease portal vein pressure and reduce blood flow of portal vein, while increase blood flow of hepatic artery, it doesn't affect liver function.
目的 分析彩色多普勒超声对肝硬化患者门静脉血流改变的评价作用。 方法 选择2010年1月－2011年4月收治的50例肝硬化患者作为观察组，其中代偿期患者27例，失代偿期患者23例；同时设置健康对照组50名，比较两组的门静脉内径（Dpv）、门静脉平均血流速度（Vpv）、门静脉血流量（Qpv）。 结果 观察组患者的Dpv增宽，Vpv减慢，Qpv减少，与对照组比较，差异均有统计学意义（P＜0.05）；且失代偿期患者的改变更为明显，与代偿期患者间差异有统计学意义（P＜0.05）。 结论 彩色多普勒超声检查门静脉血流改变可以对肝硬化患者进行初步确诊。
To visualize and quantify the hemodynamics in the aortic arch in normal individuals, we used velocity distribution, retrograde flow, vortex formation, and mean energy loss (mEL) at different cardiac cycles in our study. We performed Vector flow mapping (VFM) analysis by using echocardiography in 87 healthy volunteers. The results showed that ① in different sections of the aortic arch, a skewed peak flow velocity (Vp) always appeared in the period of rapid ejection but in different distribution. The systolic flow in the entire aortic arch rose rapidly from near-zero at the point of iso-volumetric contraction to the peak velocity at the period of rapid ejection, and then decreased gradually; ② In the period of iso-volumetric relaxation, retrograde flow and vortex were observed in all subjects in the inner wall of the entire aortic arch; and ③ The change rule of mEL in the entire aortic arch was similar to that of flow velocity. VFM can provide insights into the intra-aortic arch flow patterns, and offer essential fundamentals about flow features associated with common aortic diseases.
OBJECTIVE: To investigate the hemodynamic changes of the end-to-end anastomosed arteries with nitinol clips. METHODS: Fifteen New Zealand rabbits were divided into anastomosis clip group, suture group and control group randomly. The carotid arteries were resected and end-to-end anastomosis were carried out with nitinol clips in anastomosis clip group and with traditional suture in suture group. The carotid arteries remained undamaged in control group. On the days of 3, 9, 21 and 30 postoperatively, mean blood velocity (Vm), pulsatility index (PI) and resistance index (RI) of anastomosed arteries were determined by Ultrasonography Doppler. RESULTS: On the days of 8 and 9 postoperatively, there were no significant differences of VM, PI and RI between two experimental groups (P gt; 0.05). On the days of 20 and 30 postoperatively, the differences of Vm and RI were significant (Vm: P lt; 0.01, P lt; 0.05: RI: P lt; 0.01, P lt; 0.05). The hemodynamic restoration of the anastomosis clip group was better than that of the suture group. CONCLUSION: The hemodynamics of arteries anastomosed with nitinol clips is better than that with traditional suture. This technique has practical value clinically.
Ｈｅｍｏｄｙｎａｍｉｃ ｃｈａｎｇｅｓ ｏｆ ｓｙｓｔｅｍｉｃ ａｎｄ ｐｏｒｔａｌ ｖｅｉｎ ｆｌｏｗ ａｎｄ ｒｅｇｕｌａｔｉｏｎ ｏｆ ｉｎｄｏｍｅｔｈａｃｉｎ ｈａｖｅ ｂｅｅｎ ｓｔｕｄｉｅｄ ｉｎ ７３ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ（ｇｒｏｕｐ Ａ）ａｎｄ ３９ ｃａｓｅｓ ｗｉｔｈ ｓｉｍｐｌｅ ｇａｌｌｂｌａｄｄｅｒ ｓｔｏｎｅｓ（ｇｕｏｕｐ Ｂ）．Ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ ｗａｓ ｓｕｂｇｒｏｕｐｅｄ ｉｎｔｏ ｇｒｏｕｐ Ａ１（ｎｏｉｎｄｏｍｅｔｈａｃｉｎ ａｄｍｉｎｉｓｔｒａｔｉｏｎ），ｇｒｏｕｐ Ａ２（ｐｒｅｏｐｅｒａｔｉｖｅ ａｄｍｉｎｉｓｔｒａｔｉｏｎ ｏｆ ｉｎｄｏｍｅｔｈａｃｉｎ），ｇｒｏｕｐ Ａ３（ｐｏｓｔｏｐｅｒａｔｉｖｅ ａｄｍｉｎｉｓｔｒａｔｉｏｎ ｏｆ ｉｎｄｏｍｅｔｈａｃｉｎ），ａｎｄ ｇｒｏｕｐ Ａ６（ｓｅｎｉｌｅ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ）．Ｏｆ ｔｈｅｍ ｇｒｏｕｐ Ａ１ ｗａｓ ｓｕｂｇｒｏｕｐｅｄ ｉｎｔｏ ｇｒｏｕｐ Ａ４（ｍａｌｉｇｎａｎｔ ｏｂｓｔｒｕｃｔｉｏｎ）ａｎｄ ｇｒｏｕｐ Ａ５（ｂｅｎｉｇｎ ｏｂｓｔｒｕｃｔｉｏｎ）ａｇａｉｎ．Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈａｔ ｔｈｅ ｓｔｒｏｋｅ ｖｏｌｕｍ（ＳＶ），ｃａｒｄｉａｃ ｏｕｔｐｕｔ（ＣＯ）ａｎｄ ｃａｒｄｉａｃ ｉｎｄｅｘ （ＣＩ）ｗｅｒｅ ｈｉｇｈｅｒ ｉｎ ｅａｃｈ ｇｒｏｕｐ ｏｆ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ ｔｈａｎ ｔｈｏｓｅ ｉｎ ｇｒｏｕｐ Ｂ（Ｐ＜０．０１），ａｎｄ ｔｈｅ ｍｅａｎ ａｒｔｅｒｙ ｐｒｅｓｓｕｒｅ （ＭＡＰ），ｓｔｒｏｋｅ ｖｅｓｓｅｌ ｒｅｓｉｓｔａｎｃｅ （ＳＶＲ）ａｎｄ ｐｏｒｔａｌ ｖｅｉｎ ｂｌｏｏｄ ｆｌｏｗ（ＰＶＦ）ｗｅｒｅ ｌｏｗｅｒ ｉｎ ｅａｃｈ ｇｒｏｕｐ ｏｆ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ ｔｈａｎ ｔｈｏｓｅ ｉｎ ｇｒｏｕｐ Ｂ（Ｐ＜０．０１）．Ｔｈｅ ＭＡＰ，ＳＶＲ ａｎｄ ＰＶＦ ｉｎ ｇｒｏｕｐ Ａ２ ａｎｄ ｇｒｏｕｐ Ａ３ ｓｈｏｗｅｄ ｂｅｔｔｅｒ ｉｍｐｒｏｖｅｍｅｎｔ ｔｈａｎ ｔｈｏｓｅ ｉｎ ｏｔｈｅｒ ｓｕｂｇｒｏｕｐｓ，ｂｕｔ ａｓ ｃｏｍｐａｒｅｄ ｗｉｔｈ ｇｒｏｕｐ Ｂ ｔｈｅｒｅ ｗｅｒｅ ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅｓ （Ｐ＜０．０１）．Ｔｈｅ ａｕｔｈｏｒｓ ｃｏｎｓｉｄｅｒ ｔｈａｔ ｉｎｄｏｍｅｔｈａｃｉｎ ｃａｎ ｉｍｐｒｏｖｅ ｔｈｅ ｃｉｒｃｕｌａｔｉｏｎ ｆｕｎｃｔｉｏｎ，ＰＶＦ ａｎｄ ｌｉｖｅｒ ｆｕｎｃｔｉｏｎ ｉｎ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｏｂｓｔｒｕｃｔｉｖｅ ｊａｕｎｄｉｃｅ．
ObjectiveTo evaluate the effect of positive end-expiratory pressure (PEEP) on respiratory function and hemodynamics in acute lung injury (ALI) with intra-abdominal hypertension (IAH). MethodsSix pigs were anesthetized and received mechanical ventilation (MV). Volume controlled ventilation was set with tidal volumn(VT) of 8 mL/kg,respiratory rate(RR) of 16 bpm,inspired oxygen concentration (FiO2) of 0.40,and PEEP of 5 cm H2O. ALI was induced by repeated lung lavage with diluted hydrochloric acid (pH<2.5) until PaO2/FiO2 declined to 150 mm Hg or less to established ALI model. Intra-abdominal hypertension was induced by an nitrogen inflator to reach intra-abdominal pressure of 20 mm Hg. Respiratory parameters and hemodynamics were continuously recorded at different PEEP levels(5,10,15,and 20 cm H2O). Every level was maintained for one hour. ResultsPaO2/FiO2 in PEEP5,10,15 and 20 were 90±11,102±10,172±23 and 200±34 mm Hg respectively. PaO2/FiO2 in PEEP15 and 20 were significantly higher than those in PEEP5 and 10 (P<0.05). Chest wall compliance (Ccw) in PEEP5,15 and 20 were 26±3,76±15 and 85±14 mL/cm H2O respectively. Ccw in PEEP15 and 20 were significantly higher than those in PEEP5 (P<0.05). There was no significant difference in lung compliance (CL) in different PEEP levels (P>0.05). Plateau pressure(Pplat) in PEEP5,10,15 and 20 were 30±3,31±2,36±2 and 38±4 cm H2O respectively. Pplat in PEEP15 and 20 were significantly higher than those in PEEP5 and 10 (P<0.05). There was no significant difference in Pplat between PEEP15 and 20 (P>0.05). Heart rate (HR) in PEEP5,15 and 20 were 113±17,147±30,and 160±30 beat/min respectively. HR in PEEP15 and 20 were significantly higher than those in PEEP5 (P<0.05). There was no significant difference in HR between PEEP15 and 20 (P>0.05).Cardiac index (CI) in PEEP5 and 20 were 4.5±0.6 and 3.5±0.6 L·min-1·m-2 respectively. CI in PEEP20 was significantly lower than that in PEEP5 (P<0.05). There was no significant difference in CI in PEEP5,10 or 15(P>0.05). Central venous pressure(CVP) in PEEP5,15 and 20 were 12±2,17±2,and 18±3 mm Hg respectively. CVP in PEEP15 and 20 were significantly higher than those in PEEP5 (P<0.05). There was no significant difference in CVP between PEEP15 and 20 (P>0.05). There were no significant differences in MAP,SVRI,ITBVI,GEDI,PVPI,or EVLWI between different PEEP levels. ConclusionConcomitant ALI and IAH can induce great impairments in respiratory physiology. When PEEP is gradually increased,oxygenation and the respiratory function are improved without significant secondary hemodynamic disturbances.
Hematopoietic stem cells (HSCs) are tissue specific stem cells that replenish all mature blood lineages during the lifetime of an individual. Hematopoietic cell clusters in the aorta of vertebrate embryos play a pivotal role in the formation of the adult blood system. Recently, people have learned a lot about the embryonic HSCs on their development and homing. During their differentiation, HSCs are regulated by the transcription factors, such as Runx1 and Notch signaling pathway, etc. MicroRNAs also regulate the self-renewal and differentiation of hematopoietic stem/progenitor cells on the post-transcriptional levels. Since the onset of circulation, the formation of HSCs and their differentiation into blood cells, especially red blood cells, are regulated by the hemodynamic forces. It would be of great significance if we could treat hematologic diseases with induced HSCs in vitro on the basis of fully understanding of hemotopoietic stem cell development. This review is focused on the advances in the research of HSCs' development and regulation.
Objective To introduce the clinical significance and pathophysiologic aspects of the circulatory and cardiac complications in terminal stage cirrhosis. Methods Recently relevant literatures were reviewed and summarized. Results Haemodynamic changes in cirrhosis arose on the basis of combined humoral and nervous dysregulation, with abnormalities in cardiovascular regulation, volume distribution and cardiac performance. Conclusion Comprehending the mechanisms of cardiovascular complications will contribute a lot for the treatment of terminal stage cirrhosis.