E/e' Ratio and Diastolic Function Between Deep Vein Catheterization and Internal Fistula Treatment in Patients with Chronic Kidney Disease.

Objective: To examine the relationship between diastolic function and the ratio of early diastolic mitral inflow to early diastolic mitral annular velocity (E/e') in patients with chronic renal disease who had deep vein catheterization and internal fistula. Methods: The clinical data of 50 uremia patients treated at The Affiliated Dongyang Hospital of Wenzhou Medical University from January 2020 to January 2022 were retrospectively analyzed. To assess the differences in E/e' ratio and patients' diastolic function between the two groups, they were split into two teams according to the various therapy modalities: the internal fistula team (n = 42) and the deep vein catheterization team (n = 8). Results: After treatment, the left ventricular end-diastolic diameter (LVd), E peak, a peak and E/A value, the volume and area of four chambers of the left ventricle (LV), the volume and area of two chambers of LV in both groups were significantly lower than those before treatment (P < .001). After treatment, the LVd left ventricular end-systolic diameter (LVs), the four-chamber volume of LV, and the two-chamber volume and area of LV in patients with internal fistula were significantly lower than those in patients with deep vein catheterization (P < .001). After treatment, E peak, A peak and E/A value, e' interventricular septum, E/e' value of interventricular septum, e' lateral wall, and E of lateral wall in patients with internal fistula group. Conclusion: Both deep vein catheterization and internal fistula treatment can improve the diastolic function and reduce the pulmonary pressure of uremic patients to a certain extent, but internal fistula treatment is better than deep vein catheterization in reducing LVd, LVs, LV four-chamber volume, LV two-chamber volume and area, and the effects of both in improving the E/e ratio of patients are not obvious.

Lung Ultrasound for the Diagnosis of Neonatal Respiratory Distress Syndrome: A Meta-analysis.

Chest radiography is the primary imaging modality used for the assessment of neonatal respiratory distress syndrome (NRDS) in newborns. However, excessively exposing a growing neonate to harmful ionizing radiation may have long-term consequences. Some studies have shown that lung ultrasound (LUS) is helpful in the diagnosis of NRDS. A comprehensive search was carried out using PubMed, Embase, and the Cochrane Library to identify studies in which newborns with clinically suspected NRDS were assessed by LUS. Two investigators independently screened the literature and extracted the data. Any discrepancies were resolved via discussion with the senior author. Study quality was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool, and pooled sensitivity and specificity of various LUS findings for diagnosing NRDS were determined. Summary receiver operating characteristic curve was used to assess the overall performance of LUS. Ten studies with a total of 887 neonates were included in this meta-analysis. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for the diagnosis of NRDS using LUS were 0.92 (95% confidence interval [CI], 0.89-0.94), 0.95 (95% CI, 0.93-0.97), 20.23 (95% CI, 8.54-47.92), 0.07 (95% CI, 0.03-0.14), and 455.30 (95% CI, 153.01-1354.79), respectively. Furthermore, the summary receiver operating characteristic area under the curve was calculated to be 0.9888. The main LUS characteristics of NRDS include bilateral white lung, pleural line abnormalities, and lung consolidation. In summary, LUS is a highly valuable diagnostic technology that complements chest radiography in the diagnosis and follow-up monitoring of NRDS.

Identification of differentially expressed genes in Budd­Chiari syndrome by RNA­sequencing.

Budd­Chiari syndrome (BCS) is an uncommon disease characterized by the occlusion or obstruction of hepatic venous outflow. The mechanism of BCS is still unclear and there are no accurate and effective diagnostic or therapeutic tools. In the present study, blood samples from BCS patients and healthy controls were used for RNA­sequencing. The differentially expressed genes (DEGs) in BCS patients compared with healthy controls were identified. Gene Ontology (GO) enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway analysis and Protein­Protein Interaction (PPI) networks construction were performed for DEGs. A total of 405 DEGs including 317 upregulated and 88 downregulated DEGs were identified. The cytosol was the most significantly enriched GO term and the proteasome was also identified as significant enriched pathway. According to the PPI network of 30 DEGs (18 upregulated and 12 downregulated DEGs), synuclein α, tubulin ß­2A class IIa and zinc finger protein Gfi­1b (GFIIB) were the three most significant hub proteins. In conclusion, several DEGs including secreted protein acidic and cysteine rich, lipocalin­2, GFI1B and proteasome­associated DEGs may be associated with the pathological process of BCS. These results can provide novel clues for the pathogenesis and provide novel diagnostic and therapeutic strategies for BCS.