Objective To study the change rules with age in morphologic properties of common carotid artery,and to discuss its aging process after kidney transplantation.Methods Thirty-one patients with end stage renal disease (ESRD) supported by hemodialysis,31 kidney transplant recipients (KTR) and 84 control subjects were offered an ultrasound of carotid artery.The carotid intima media thickness (CIMT) and common carotid artery diameter (CCAD) of right carotid arteries were measured by ultrasonic frequency tracking.The tends for slope of CIMT and CCAD with age were analyzed by linear regression analysis.Results Compared with KTR group and control group,ESRD group had significantly thicker CIMT and wider CCAD,but there was no significant difference between KTR group and control group.The linear regression showed the development of CIMT were positively associated with age (P＜0.05).Compared with KTR group and ESRD group respectively,the slope of CIMT with age (unstandardized coefficients b) in control group was greater (Z=1.417,P =0.006;Z =2.223,P＜0.001).There was no significant difference between KTR group and ESRD group (Z =1.038,P =0.723).The development of CCAD were also positively associated with age (P＜0.05).Compared with control group,the slope of CCAD with age in ESRD group was less (Z =1.677,P =0.002).Conclusions After successful kidney transplantation,some morphologic properties of carotid artery are improved and resume the normal aging process.

Objective To analyze the relation between carotid intima-media thickness (IMT) and the shear rate (SR),and to explore the effect of SR on IMT in the patients with end-stage renal disease (ESRD)and the kidney transplant recipients (KTR).Methods From March 2014 to December 2015,31 KTR and 31 patients with ESRD supported by hemodialysis and 84 control subjects underwent an carotid ultrasound in Shanghai General Hospital affiliated to Shanghai Jiaotong University.Bilateral carotid IMT and SR were measured.The differences of IMT and SR in three groups were compared by single factor analysis of variance.SNK-q test was used to compare the two groups.The correlation between SR and bilateral IMT was analyzed by linear regression analysis in healthy control group,ESRD group and KTR group.Results On the right,in ESRD,KTR and control group,the IMTs were (561.9± 147.7) μm,(480.5±90.3) μtm and (529.7±131.80) μtm respectively.Compared with KTR and control group,the IMT on right was thickest in ESRD,but there was no significant difference between KTR and control group in right IMT.On the left,the IMTs were (517.5± 164.7) μm,(506.7± 126.3) μm and (467.0± 106.4) μm in control group,ESRD and KTR,respectively.Among groups,there was no significant difference.On the right,the SRs were (134.01 ±56.4) s-1,(133.4±43.7) s-1 and (175.8±68.3) s-1 in ESRD,KTR and control group,respectively.In ESRD and KTR groups,the SR of the right carotid artery was less than that of the control group,and had significant difference (q=3.133,P=0.002;q=3.470,P ＜ 0.001).There was no significant difference in right SR between ESRD and KTR.On the left,the SRs were (146.3±55.9) s-1,(138.5±43.8) s-1 and (154.7±60.8) s-1 in ESRD,KTR and control group,respectively,and had no significant difference.There was linear negative correlation between SR and IMT in healthy control group,ESRD group and KTR group,respectively (right:r=-0.384,-0.082,-0.454;left:r=-0.572,0.223,-0.276,all P ＜ 0.05).Conclusions The IMT was thickened in ESRD group,but got thinning after successful kidney transplantation.The SR played a vital role in this alteration of IMT.

Objective To observe the correlation between CEUS quantitative parameters of carotid plaques and leukocytes in patients with acute ischemic stroke.Methods Sixty-two patients with large artery atherosclerosis stroke (LAAS group) confirmed by CT or MRI were enrolled,while 54 patients in the same period of hospitalization,age and gender-matched,no history of cardiovascular events with atherosclerosis were taken as control group.The correlation between CEUS quantitative parameters of carotid plaques and leukocytes in two groups were compared.Multiple linear regression model was built and the risk factors of CEUS quantitative parameters were analyzed.Results The total leukocytes count,neutrophils count and neutrophil/lymphocyte ratio in LAAS group were higher,while the lymphocytes count was lower than those in control group (all P＜0.05).CEUS parameters,including timeqntensity curve (TIC) peak (TIC-P),mean (TIC-M),fitting curve (FC) peak (FC-P),sharpness (FC-S) and area under the curve (FC-AUC) of carotid plaques were higher than those in control group (all P＜0.05),while neutrophils count and neutrophil/lymphocyte ratio were positively correlated with FC-AUC (r=0.298 and 0.739,respectively;all P＜0.05).Total leukocytes count was independent risk factor of TIC-P,and neutrophil/lymphocyte ratio was independent risk factor of FC-AUC (all P＜0.05).Conclusion CEUS quantitative parameters of carotid plaques related to leukocytes count.Increased leukocytes or neutrophil/ lymphocyte ratio might rise vulnerability of plaques.

Objective To detecte the neovascularizations in carotid plaques using contrast-enhanced ultrasound (CEUS) and explore the relationship between the neovascularizations and the peripheral leukocytes in the patients with acute cerebral infarction. Methods Sixty-two patients with large artery atherosclerosis cerebral infarction were selected as cerebral infarction group;and 54 age-and gender-matched patients with atherosclerosis and without cerebral cerebrovascular events were recruited control group.The dominant carotid artery plaques were performed by CEUS,the peak of time-intensity curve(TIC-P) and the mean of time-intensity curve (TIC-M) were measured by off-line quantitative analysis.The peak (FC-P), time to peak (FC-TP),sharpness (FC-S) and under the curve area (FC-AUC) were obtained from fitting curves of time-intensity. The correlations between parameters of contrast-enhanced ultrasound and leukocyte counts were analyzed by Pearson correlation analysis. Results ①In the cerebral infarction group, the total leukocytes and neutrophils were higher than those in the control group,while the number of lymphocytes was lower than that of the control group(all P <0.05). ②In the cerebral infarction group,the TIC-P and TIC-M values were greater than those in the control group ( P < 0.05).Compared with the control group,the FC-P,FC-S and FC-AUC values in the cerebral infarction group were increased (all P <0.05). ③There was a negative correlation between PIG-P,TIC-M of FC-P and lymphocytes( r = -0.291,-0.263 and -0.270;all P <0.05).FC-S and FC-AUC were positively correlated with neutrophils ( r =0.261,0.298;all P < 0.05). Conclusions Carotid plaque neovascularizations is related to peripheral leukocyte count.CEUS help us know more the vulnerability of plaque.

Objective To detect the viscoelasticity of carotid artery in healthy volunteers using ultrasonic shear wave dispersion ( SWD ) technique ,and explore the feasibility and influencing factors for SWD parameters . Methods Forty‐five healthy volunteers were recruited and divided into elder group ( ≥50 years old) and younger group ( ＜50 years old) according to the age . T he carotid arteries were examined by SWD at systole ,axial elastic modulus ( SWER ) and viscous index ( SWDR ) were obtained . T he pulse wave velocity ( PWV ) ,a carotid artery circumferential elastic parameter was obtained and considered as the reference indicator . T he difference of SWE R ,SWDR and PWV were compared between two groups ; and the correlation between them were analyzed by Pearson analysis ,respectively . Results ① Compared with the younger group ,the carotid PWV increased ,w hile SWE R and SWDR decreased in the elder group ( all P ＜0 .05) . ②In all subjects ,SWER was negatively correlated with PWV ( r ＝ －0 .256 , P ＜ 0 .05 ) . In the elder group ,SWER was negatively correlated with systolic blood pressure ( r ＝ －0 .357 , P ＜ 0 .05 ) ,and SWDR was negatively correlated with PWV ( r ＝ －0 .393 , P ＜0 .05 ) . In the younger group ,SWDR was positively correlated with systolic blood pressure ( r ＝0 .366 , P ＜0 .05) . Conclusions Compared with the elder group ,the carotid viscoelasticity was higher in young people ,and it is correlated with PWV . SWD can evaluate carotid viscoelasticity ,and contribute to better understanding of its tissue characteristics .

Objective:To investigate gender differences in arterial velocity pulse index(AVI), which is an indicator of vascular stiffness, across various age groups.Additionally, the study will also examine the risk factors associated with AVI.Methods:This cross-sectional study enrolled 4311 patients with an average age of 57.8±12.8 years at Jiading Branch of Shanghai First People's Hospital between August 2020 and September 2021.Patients were divided into three groups based on age: young(<45 years old, n=755), middle-aged(45-59 years old, n=1260), and elderly(≥60 years old, n=2 296). The AVI of the subject was obtained using the cuff oscillation wave method.The subject's AVI was acquired using the cuff oscillation wave.High AVI, indicating arteriosclerosis, was defined as AVI≥33.The subjects were then divided into two groups: the high AVI group(122 cases)and the normal AVI group(4 189 cases).Results:The ankle-brachial index(AVI)was found to be 12.8±3.7, 17.5±5.7, and 19.8±6.5 in the young, middle-aged, and elderly groups, respectively.The study revealed that AVI increased with age( Ftrend=767.819, P<0.01). Additionally, the incidence of high AVI in middle-aged women was found to be(2.8% or 20/722), which was higher than that in men 0.9%(5/538)in the same age group.This difference was statistically significant( χ2=5.371, P<0.05). The results of the multivariate logistic regression analysis indicate that being overweight, having a higher height, and a pulse rate greater than 80 BPM are protective factors in preventing a high incidence of AVI.The odds ratios( OR)with 95% confidence intervals( CI)for these factors were 0.468(0.317-0.690), 0.926(0.895-0.958), and 0.143(1.026-2.432), respectively, all with a P-value less than 0.01.On the other hand, old age, systolic blood pressure of 140 mmHg or higher, and diastolic blood pressure of 90 mmHg or higher were identified as risk factors for AVI.The ORs with 95% CIs for these factors were 2.119(1.322-3.396), 6.652(4.136-10.699), and 1.580(1.026-2.432), respectively, all with a P- value less than 0.05l. Conclusions:Arterial stiffness, as measured by the ankle-brachial index(ABI), tends to increase with age.In middle-aged subjects, women have a higher incidence of high ABI than men.Independent risk factors for high ABI include age and increased blood pressure, while factors such as overweight and height may affect the measured value of ABI.

Objeetive To investigate tear film lipid layer thickness (LLT) and its association with clinical symptom and sign in different types of dry eye patients.Methods A serial case-observational study was carried out.Three hundred and six eyes of 306 dry eye patients were included in Beijing Tongren Hospital from April to August 2016.Ocular surface disease index (OSDI) questionnaire,eyelid slit lamp examination,the measurement of tear film lipid thickness (LLT),tear film break-up time (TBUT),Schirmer Ⅰ test (S Ⅰ t) and the infrared meibomian photography were performed on the patients.The 157 patients with OSDI ＞12 and eyelid score ≥2 served as the MGD group;53 patients with OSDI ＞12 and S Ⅰ t value ＜ 5 mm/5 minutes served as ADDE group;96 patients with OSDI＞12,eyelid score ≥2 and S Ⅰ t value ＜ 5 mm/5 minutes served as MGD/ADDE group.Tear film LLT was detected with LipiView(R) ocular surface interferometer and the association of LLT with clinical characteristics of the patients was analyzed.This study protocol was approved by Ethic Committee of Beijing Tongren Hospital and written informed consent was obtained from each patient prior to any relative medical examination.Results Tear film LLT of the participants was normally distributed with the average was (60.41±18.57)nm.LLT in the MGD group,ADDE group,MGD/ADDE group were (57.04 ± 18.26),(63.52 ± 18.44) and (60.56 ± 18.71) nm,respectively,with a significant difference among the three groups (F =2.347,P =0.035),and the LLT value was significantly lower in the MGD group than that in the ADDE group (t =2.077,P =0.039).The LLT value showed negative correlations with the severity of dry eye symptom,S Ⅰ t and meibomian gland loss rate (r=-0.201,P=0.003;r=-0.146,P=0.005;r=-0.156,P=0.046).OSDI score was significantly correlated with LLT only in the MGD group (r =-0.285,P =0.000).No significant correlation was seen between LLT and S I t in all the groups (all at P＞0.05).In the MGD/ADDE group and MGD group,the correlation between LLT and meibomian gland loss rate was significantly greater than the overall correlation (r=-0.335,-0.248,-0.156).The dry eye symptoms in OSDI questionnaire like foreign body sensation,eye pain,discomfort when watching TV or computer showed significant correlations with LLT (r =-0.243,-0.205,-0.223,-0.258,all at P ＜0.05).Conclusions The tear LLT is appeared to be varied in different types of dry eye.The LLT is thinner in the dry eyes with MGD and thicker in the dry eyes with ADDE.There are association between tear LLT and foreign body sensation,eye pain,discomfort when watching TV or computer.

OBJECTIVE: To compare the parental acceptance of dental treatment under general anesthesia and deep sedation in children and assess the changes in postoperative oral health-related quality of life and treatment efficacy. METHODS: The parents of 131 children undergoing dental treatment in the Department of Stomatology of Sichuan Provincial People's Hospital from January, 2022 to June, 2022 were surveyed using a questionnaire of children's advanced oral behavior management, and 83 children receiving general anesthesia or deep sedation for dental treatment between January, 2018 and December, 2021 were also investigated for changes in quality of life after the treatment using a questionnaire. The treatment efficacy was assessed at the 1-year follow-up visit in 149 children who received dental treatment under general anesthesia or deep sedation during the same period. RESULTS: The survey of perantal acceptance showed that 62.6% of the parents preferred deep sedation, 29.01% preferred general anesthesia, and 8.4% preferred compulsory treatment. Dental treatments under general anesthesia and deep sedation both significantly improved oral health-related quality of life of the children. While dental surgeries under general anesthesia resulted in the most significant improvement of pain symptoms, deep sedation was associated with both obvious relief of the children's pain symptoms and reduction of the parents' pressure level. No significant difference was found in the efficacy of treatments under general anesthesia and deep sedation at the 1-year follow-up. CONCLUSION Dental treatment in children under deep sedation has the highest parental acceptance, followed by treatment under general anesthesia, and the acceptance of compulsory treatment is the lowest. The treatments under general anesthesia and deep sedation significantly improve the quality of life of the children and their parents and both have good treatment efficacy.
Humans ; Child ; Quality of Life ; Deep Sedation ; Child Behavior ; Treatment Outcome ; Anesthesia, General ; Parents ; Pain ; Dental Care ; Dental Caries

Objective: To detect the viscoelasticity of carotid artery in healthy volunteers using ultrasonic shear wave dispersion (SWD) technique, and explore the feasibility and influencing factors for SWD parameters. Methods: Forty-five healthy volunteers were recruited and divided into elder group (≥50 years old) and younger group (<50 years old) according to the age. The carotid arteries were examined by SWD at systole, axial elastic modulus (SWE_R) and viscous index (SWD_R) were obtained. The pulse wave velocity (PWV), a carotid artery circumferential elastic parameter was obtained and considered as the reference indicator. The difference of SWE_R, SWD_R and PWV were compared between two groups; and the correlation between them were analyzed by Pearson analysis, respectively. Results: ①Compared with the younger group, the carotid PWV increased, while SWE_R and SWD_R decreased in the elder group(all P<0.05). ②In all subjects, SWE_R was negatively correlated with PWV (r=-0.256, P<0.05). In the elder group, SWE_R was negatively correlated with systolic blood pressure (r=-0.357, P<0.05), and SWD_R was negatively correlated with PWV (r=-0.393, P<0.05). In the younger group, SWD_R was positively correlated with systolic blood pressure (r=0.366, P<0.05). Conclusions Compared with the elder group, the carotid viscoelasticity was higher in young people, and it is correlated with PWV. SWD can evaluate carotid viscoelasticity, and contribute to better understanding of its tissue characteristics.