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Background: This study aimed to assess the predictive value of endometrial blood flow branches on pregnancy outcomes after hormone replacement therapy-frozen embryo transfer (HRT-FET). Methods: This prospective observational study involved 292 reproductive-aged women who underwent endometrial receptivity assessment in a tertiary care academic medical center in southwest China using power Doppler ultrasonography during HRT-FET. Three-dimensional power Doppler ultrasound was performed on the day of endometrial transformation and the day before embryo transfer. The endometrial blood flow branches of the endometrial and subendometrial regions were compared in the non-pregnant and pregnant groups at the two time points mentioned above. Results: The endometrial blood flow branches were higher in pregnant patients than in non-pregnant patients on the day of endometrial transformation (P = 0.009) and the day before embryo transfer (P = 0.001). Changes in endometrial blood flow pattern and endometrial blood flow branches at the two time points did not differ among the pregnancy outcome samples. After adjusting for age, antral follicles, and embryos transferred, the endometrial blood flow branches on the day before embryo transfer was the independent factor influencing the chance of clinical pregnancy, with an odds ratio of 3.001 (95% confidence interval: 1.448 − 6.219, P = 0.003). Conclusions: Endometrial blood flow perfusion during the peri-transplantation period of the HRT-FET cycle is a good indicator of pregnancy outcomes, suggesting that valuation of endometrial branches via power Doppler ultrasound is a simple and effective approach for achieving indicator measurements. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the safety and efficacy of salvianolate injection in preventing deep vein thrombosis (DVT) following total hip replacement. Methods: A total of 114 patients who underwent total hip replacement at Department of Trauma, Fengfeng General Hospital of North China Medical and Health Group, Handan City, China from March 2019 to March 2022 were enrolled. Patients were randomly divided into study group (n = 57) and control group (n = 57). The control group received conventional treatment (low molecular weight heparin) while the study group was administered salvianolate injection combined with conventional treatment. Incidence of deep vein thrombosis (DVT) at 7 and 14 days after surgery, platelet function indices, including platelet count, glycoprotein IIb/IIIa (GP IIb/IIIa), and CD62P, coagulation function indices (prothrombin time (PT), fibrinogen (FIB) and D-dimer), and hemodynamics indices, viz, peak blood flow velocity (Vp) and average velocity (Va) were investigated and compared. Results: Incidence of DVT was 1.75 % (1/57) at 7 days and 5.26 % (3/57) at 14 days in the study group, and 5.26 % (3/57) at 7 days and 17.54 % (10/57) at 14 days in control group. Incidence of DVT in the study group was significantly reduced compared to control group 14 days after surgery (p < 0.05). Also, the study group had significantly lower visual analog scale (VAS) scores at 7 days and 1 month after surgery compared to control group (p < 0.05). Platelet count, GPIIb/IIIa, and CD62P in the study group were significantly lower than in control group (p < 0.05). Conclusion: Salvianolate injection significantly prevents DVT after total hip replacement, improves hemodynamics, and coagulation function, and thus contributes to recovery of hip function. Further clinical trials are, however, required to validate these findings. [ABSTRACT FROM AUTHOR]

Objective: General anesthesia (GA) can decrease cerebral flow velocities and predispose patients to cerebral hyperperfusion syndrome (CHS) and other perioperative adverse events after carotid endarterectomy (CEA). The aim of this study was to investigate whether decreased pre-operative flow velocity is associated with an increased risk of CHS and perioperative cerebral infarct, and to further identify risk factors if there is any. Methods: We retrospectively evaluated 920 consecutive patients who received CEA from 2010 to 2020 at a major academic hospital in China. Middle cerebral artery (MCA) blood flow velocities were measured before and after induction of the GA by transcranial Doppler (TCD). Patients were classified into two groups: the NORMAL group if flow velocity decreased < 30% and the LOW group if flow velocity decreased ≥30%. The ultrasonographic diagnostic criterion of CHS was defined as the 100% increase in flow velocity by TCD from the baseline to post-CEA. The occurrence of CHS, perioperative cerebral infarction was compared between the two groups. Results: 399 (43.4%) were classified as LOW measurement, and 521 (56.6%) patients were classified as NORMAL measurement. In the LOW group, there were more patients with diabetes, fewer patients with ipsilateral ICA severe stenosis and the opening of anterior/posterior communicating artery. Although the occurrence of CHS per ultrasonography criteria was higher in the LOW group (21.3% vs 15.7%, P = 0.03), the occurrence of CHS per clinical criteria (3.2%, vs 2.1%, P = 0.28) or the perioperative cerebral infarct between the two groups (5.8% vs 5.0%, P = 0.60) is equivalent. Conclusion: Patients with decreased flow velocities post-GA were more likely to meet the ultrasonography criteria for CHS, but they are not at risk of developing clinical CHS or perioperative cerebral infarct. [ABSTRACT FROM AUTHOR]

Maintenance hemodialysis is the main method for the treatment of end-stage renal disease in China. The K t / V value is the gold standard of hemodialysis adequacy. However, K t / V requires repeated blood drawing and evaluation; it is hard to monitor dialysis adequacy frequently. In order to meet the need for repeated clinical assessments of dialysis adequacy, we want to find a noninvasive way to assess dialysis adequacy. Therefore, we collect some clinically relevant data and develop a machine learning- (ML-) based model to predict dialysis adequacy for clinical hemodialysis patients. We collect 250 patients, including gender, age, ultrafiltration (UF), predialysis body weight (preBW), postdialysis body weights (postBW), blood pressure (BP), heart rate (HR), and blood flow (BF). An efficient graph-based Takagi-Sugeno-Kang Fuzzy System (G-TSK-FS) model is proposed to predict the dialysis adequacy of hemodialysis patients. The root mean square error (RMSE) of our model is 0.1578. The proposed model can be used as a feasible method to predict dialysis adequacy, providing a new way for clinical practice. Our G-TSK-FS model could be used as a feasible method to predict dialysis adequacy, providing a new way for clinical practice. [ABSTRACT FROM AUTHOR]

This review provides a comprehensive update on emerging ROCK inhibitors as an innovative treatment option for lowering intraocular pressure (IOP) in glaucoma and aims to describe the structure, mechanism of action, pharmaceutical characteristics, desirable ocular effects, including side effects for each agent. A literature review was conducted using PubMed, Scopus, clinicaltrials.gov, ARVO journals, Cochrane library and Selleckchem. Databases were searched using "investigational Rho kinase inhibitors," and "glaucoma" as keywords. In addition to this building block strategy, successive fractions were employed to further refine the results. Of the several ROCK inhibitors discovered, only two drugs are currently approved for glaucoma treatment; Netarsudil in the USA and Ripasudil in Japan and China. We identified and reviewed 15 agents currently in laboratory or clinical trials. These agents lower IOP mainly by decreasing outflow resistance through pharmacologic relaxation of the trabecular meshwork (TM) cells and reducing episcleral venous pressure. They have an optimistic safety profile; however, conjunctival hyperemia, conjunctival hemorrhage, pain on instillation, and corneal verticillata are common. Other properties such as neuroprotection (enhancing optic nerve blood flow and promoting axonal regeneration), anti-fibrotic activity, and endothelial cell proliferation may improve the visual prognosis and surgical outcomes in glaucoma. In addition, these agents have the potential to work synergistically with other topical glaucoma medications. [ABSTRACT FROM AUTHOR]

Background: With the ageing of China's population, the incidence and mortality of coronary atherosclerotic heart disease (CAD) is increasing year by year, which brings a heavy burden to the family and society [1]. We aimed to analyse the strategy of coronary artery bypass grafting (CABG) in the right coronary artery and to compare the haemodynamic characteristics of the sequential grafts with those of single grafts and to observe the patency rate of those grafts for 1 week after the operation.Methods: A total of 242 patients (178 men, mean age 62.6 ± 8.8 years) underwent right coronary artery bypass grafting in our hospital from October 2016 to January 2019. The blood flow (Q, ml/min), pulsatility index (PI) and related parameters of the grafts were measured and recorded by TTFM during the CABG. The patency of the grafts was evaluated by coronary computed tomography (CT) for 1 week after the operation.Results: The most common material used for the graft in the right coronary system of CABG is the greater saphenous vein (92.3%), followed by the radial artery (5.5%) and the internal mammary artery (1.9%). The highest frequency target of the right coronary artery is the posterior descending artery (PDA) (47.6%), followed by the right main coronary artery (RCA) (29.1%) and the posterior branch of the left ventricle (PL) (23.3%). The proportion of single grafts was the highest for the right coronary artery in CABG (178 cases, 67.9%), followed by a graft of the PDA-PL (42 cases, 16.0%) and other sequential grafts among the different coronary artery systems (including the system of the left anterior descending artery (LAD) and the left circumflex (LCX)). Whether there were sequential grafts of the PDA-PL or other sequential grafts among the different systems of the coronary artery, the instantaneous flow of a group of sequential grafts was higher than that of a single graft, and the difference had statistical significance (P < 0.01). However, there were no significant differences in the flow between the groups of sequential grafts (P = 0.410). Diastolic flow (DF) in the group of sequential grafts of the right coronary system was better than that in the non-sequential group (P < 0.001), and the difference had statistical significance. There was no significant difference between the DF of the groups of the other system of sequential grafts and that of the right coronary sequential grafts. Coronary artery CT suggested that there were 11 cases of poorly developing grafts or stenosis and occlusion a week after the operation, and those phenomenon mainly occurred in the group with a single graft. There was only one case that was occluded in the group of other systems of sequential grafts, and statistically significant differences existed between the two groups (P < 0.01).Conclusions: In our centre, the most common form of CABG in the right coronary artery system is a non-sequential vein bridge to the PDA. Whether there are sequential grafts of the PDA-PL or other sequential grafts among the different coronary artery systems, the instantaneous flow of a group of sequential grafts is higher than that of a single graft. DF in the group of sequential grafts of the right coronary system was better than that in the non-sequential group. [ABSTRACT FROM AUTHOR]

Background: To report a case of branch retinal artery occlusion (BRAO) secondary to high-altitude exposure and diabetic retinopathy (DR), and to characterize the retinal changes before and after hyperbaric oxygen (HBO) treatment.Case Presentation: We present a case of a 42-year-old man with DR who travelled to Tibet (in China, 3800 m/12467 ft. above mean sea level). The day after the end of his journey, the patient presented with acute, painless visual loss and visual field loss in his left eye. He was then diagnosed with BRAO, which is an acute blockage of blood flow. After HBO treatment, visual acuity and visual field were improved.Conclusions: High-altitude exposure and DR may be considered as relevant risk factors for BRAO. The ophthalmologist should be aware that the BRAO might be a rare presenting sign of high-altitude retinopathy (HAR), particularly in patients with DR. HBO treatment can be considered as a choice for ophthalmologists on treatment against BRAO. [ABSTRACT FROM AUTHOR]

Objective: Yangxue Qingnao granules (YXQNG), which translates to granules that tonify the blood and clear liver heat, are widely available in China for the treatment of Chronic Cerebral Circulation Insufficiency (CCCI). This systematic review aimed to evaluate the effectiveness and safety of YXQNG in treating CCCI. Methods: PubMed, the Cochrane Central Register of Controlled Trials, Embase, the Chinese National Knowledge Infrastructure, and the Wanfang Database were searched from their inception to February 2019. Randomized controlled trials of YXQNG used alone or in combination with other drugs against a placebo, with no intervention or used with other drugs in CCCI patients were identified. The reviewers identified studies, extracted data, and assessed the quality of the evidence, independently and in duplicate. The Cochrane risk of bias assessment tool was used for quality assessment. Results: A total of 31 RCTs and 2,877 patients were selected. The meta‐analysis indicated that the ratio between the combined RR of the total effective rate and the 95% confidential interval (95% CI) was 1.21 (1.17, 1.26). The combined MD of transcranial Doppler (TCD) detecting carotid artery, vertebral artery, and basilar artery blood flows (95% CI), respectively, were 8.84 (5.83, 11.85), 4.72 (3.71, 5.73), and 3.89 (3.03, 4.76). The combined MD of plasma viscosity and fibrinogen, respectively, were −0.35 (−0.40, −0.30) and −0.81 (−1.12, −0.50). Serious adverse effects were not reported in all the included trials. Conclusion: This systematic review revealed that YXQNG could increase cerebral blood flow in patients with CCCI and improve their symptoms, with no serious adverse effects. Since the literature reviewed was affected by factors such as lower quality of the included studies, the systematic evaluation's conclusion is not very reliable. Thus, more rigorously designed trials are needed. [ABSTRACT FROM AUTHOR]

Objective: Hemodynamic changes in response to the hypoxic environment of high altitude are vascular bed-specific. The aim of the present study was to investigate diameter and blood flow changes in conduit vessels in response to hypobaric hypoxia. Methods: Eleven healthy subjects ascending Mount Everest to base camp participated in this study. Vessel diameter and blood velocity for brachial, carotid, common femoral, superficial femoral, and deep femoral arteries were measured by portable Doppler ultrasound. Blood flow was calculated from these values. Measurements were taken at sea level, at increasing altitudes on ascent to base camp (1310 m, 3470 m, 5330 m), and repeated on descent to lower altitude (1310 m). Results: For all vessels except carotids, both vessel diameter and blood flow decreased between sea level and initial ascent to altitude, with subsequent persistence of these decreased values; there was no further significant change with continued ascent to higher altitude. Blood flow for all arteries (except carotids) increased significantly on descent to lower altitude, with an associated nonsignificant increase in velocity and decrease in diameter. Conclusions: This study showed that there is vasoconstriction of limb conduit vessels at altitude, which persists upon descent to lower altitude. Blood flow in these vessels also decreases with initial exposure to high altitude, yet increases when returning to lower altitude, reflecting variations in blood velocity. Carotid arteries responded differently to the stimulus of hypobaria than limb conduit vessels; there was no change in diameter seen on ascent or descent, but there was a progressive decrease in blood flow on ascent, with no change on subsequent descent. [Copyright &y& Elsevier]

River course is the path of carrying river flow and the blood of modern economic and social development. River operation management has attracted great attention from governments and water conservancy circles all over the world. In China, the river operation management mode refers to the combination of two dimensions: The organization method of river operation management and the bearing and use method of river maintenance fund. Based on the practice of China, we used a two-dimensional matrix method to construct a feasible mode set, including 12 modes, according to the various organization methods of river operation management and the bearing and use methods of river maintenance fund over the years in China. We also compared and analyzed the advantages, disadvantages, and applicable conditions of these 12 river operation management modes. In particular, we investigated the main rivers of 19 provinces and municipalities in China, identified the main factors of the river operation management mode, further identified 5 key indexes, and constructed a decision-making index system for the river operation management mode. We used the intuitionistic fuzzy hybrid average (IFHA) and intuitionistic fuzzy weighted average (IFWA) operators to construct a set of river operation management mode selection method based on intuitionistic fuzzy decision-making. A case study was conducted to select the operation management mode for the Heilongjiang section of Songhua River, using the method put forward in this paper. This study can promote water resource management research and prepare for a possible future sustainability emergency. [ABSTRACT FROM AUTHOR]

Background: The stellate ganglion block (SGB) can lead to vasodilation of the head and neck. However, controversy remains concerning the changes in extracerebral blood flow. The objective of this study is to assess the effects of SGB on the blood flow to the neck., Methods: A randomized controlled crossover trial with 38 participants will be conducted. Participants who have primary headaches will be assigned to either group A or B. Patients in group A will receive SGB with 6 ml 1% lidocaine, and after a one-week washout period, they will undergo the second SGB with 6 ml normal saline. In contrast, patients in group B will receive the opposite protocol. Data will be collected at baseline (T0) and at 15 min after the first intervention (T1), 15 min before the second intervention (T2), 15 min after the second intervention (T3) and at a 3-week follow up (T4). T1 is the primary time point for the primary outcome analysis. The primary outcomes include the peak systolic velocity (PSV), the end diastolic velocity (EDV), resistance index (RI) and vessel diameter of the common carotid artery (CCA) and vertebral artery (VA). The secondary outcomes include the rate of ptosis, the rate of conjunctival flushing, and the numerical rating scale (NRS) pain score. Additionally, adverse events (AEs) or serious adverse events (SAEs) will be collected at each assessment point., Discussion: This study will comprehensively investigate the efficacy of SGB in extracerebral blood flow. Our research may also suggest that SGB will be effective in reducing pain in patients with primary headaches., Trial Registration: Chinese Clinical Trial Registry, identifier ChiCTR-IOR-17011536 . Registered on 1 June 2017.