RESUMO
OBJECTIVE: To observe the multi-slice spiral CT angiography (MSCTA) imaging features of arteriovenous fistula dysfunction in patients undergoing maintenance hemodialysis and analyze the significance of the imaging examination. METHODS: Altogether 90 patients with end-stage renal disease treated by maintenance hemodialysis in General Hospital of China Resources & Wisco from June 2020 to February 2023 were divided into a normal function group (n=68) and a dysfunction group (n=22) according to the function of autogenous arteriovenous fistula. The clinical data of the two groups were recorded. The MSCTA was performed in each patient, and the manifestations of arteriovenous fistula dysfunction were analyzed. Additionally, the vascular access stenosis, vascular access lumen stenosis, arteriovenous diameter, blood flow, and hemodynamic indices were tested, and the value of MSCTA in predicting arteriovenous fistula function was analyzed by Logistic regression. RESULTS: The degree of vascular access stenosis and vascular access lumen stenosis in the normal group were less than those in the dysfunctional group (P<0.05). The arteriovenous diameter, blood flow, blood flow velocity at anastomotic vein end, dialysis adequacy (spKt/V), and von Willebrand factor (vWF) function in the normal group were larger than those in the dysfunction group, and the radial artery shear force was lower than in the dysfunction group, with statistical significance (P<0.05). Among the arteriovenous fistula dysfunction, there were 3 patients with anastomotic + outflow vein stenosis, 4 patients with outflow vein stenosis, 9 patients with inflow artery + anastomosis + outflow vein stenosis, and 6 patients with superior vena cava stenosis. Logistic regression analysis showed that slow blood flow velocity at the venous end of anastomosis and high shear force of radial artery were influencing factors of arteriovenous fistula dysfunction, and the area under ROC curve of blood flow velocity at the venous end of anastomosis plus shear force of radial artery was 0.93, with a sensitivity of 0.87 and a specificity of 0.85. CONCLUSION: MSCTA can be used to evaluate the dysfunction of autologous arteriovenous fistula in patients undergoing maintenance hemodialysis, and provide important reference information for the formulation of the next best clinical treatment plan.
RESUMO
Nitrogen modified reduced graphene oxide (N-RGO) was prepared by a hydrothermal method. The nitrogen modification enhanced its adsorption and catalysis ability. For an initial bisphenol concentration of 0.385 mmol L(-1), the adsorption capacity of N-RGO was evaluated as 1.56 and 1.43 mmol g(-1) for bisphenol A (BPA) and 1.43 mmol g(-1) for bisphenol F (BPF), respectively, both of which were about 1.75 times that (0.90 and 0.84 mmol g(-1)) on N-free RGO. N-RGO could activate persulfate, producing strong oxidizing sulfate radicals. The apparent degradation rate constant of BPA on N-RGO was 0.71 min(-1), being about 700 times that (0.001 min(-1)) on N-free RGO. In mixtures of various phenols, the degradation rate constant of each phenol was linearly increased with its adsorption capacity. A simultaneous use of N-RGO and persulfate yielded fast and efficient removal of bisphenols. The use of N-RGO (120 mg L(-1)) and persulfate (0.6 mmol L(-1)) almost completely removed the added bisphenols (0.385 mmol L(-1)) at pH 6.6 within 17 min. A mechanism study indicated that the adsorption enriched the pollutant, and the catalytically generated sulfate radicals rapidly degrade the adsorbed pollutant, accelerating in turn the adsorption of residual pollutant.