笔者想感谢谁参加了我们的研究中，我们已经评估使用FMD测试内皮功能的众多学科和病人。

注:以下FMD过程中中西医血管和运动生理学（LIVEP）的血管实验室评估研究常规进行。所有的程序遵循赫尔辛基宣言的原则和乔治亚大学校务由机构审查委员会的批准。所有的参与者被告知的目标和获得参与该技术可能的风险的书面同意之前， 图1说明了应考虑肱动脉口蹄疫超声评估的基本要素的概要总结。 1.除准备（在抵达前） <ol><li>确认参与者从实践锻炼（≥12小时），咖啡因（≥12小时），吸烟或二手烟暴露（≥12小时），补充维生素（&gt; 72小时）和任何药物（≥4小时半衰期弃权药，为1大的非甾体抗炎剂y和3天阿司匹林）。 </li><li>确保参与者空腹条件下或只在测试消耗低脂肪膳食4之前。 </li><li>当测试绝经前妇女，因此建议在月经周期的月经期来进行口蹄疫协议来限制内源性雌激素和孕酮8,32,33的影响。 </li></ol> 2.除准备（抵达时） <ol><li>测量收购前，验证对象是在仰卧位休息在一个安静，温度控制（22°C至24°C）的房间约20分钟，使血流动力学稳定状态。 </li><li>在标准肢体附加3导联心电图导致II位置。使用美国标准仪器，将白/负极铅只是右肩锁骨下方。黑/双极性导线连接附近的肩膀锁骨左侧下方，连接红色/正极引线下面在胸部的横向基部左侧胸肌。 </li><li>延长受试者的臂横向在约80℃肩外展的并固定前臂远端在真空包装枕头的测定（ 图2）期间保持臂的精确位置。 </li><li>放置前臂箍立即远端肱骨内上髁，并确保没有正在触摸的压脉袋，包括下表（ 图2）。 </li></ol> 3.测量基线<ol><li>映射肱动脉的超声: <ol><li>同时用手握住探头，横截面的位置，并开始扫描上臂的内侧开始在二头肌的插入和近侧进行。 </li><li>内B模式（灰度），确定肱动脉和侧支血管，并使用彩色流量（CF）方式，以帮助确认动脉的位置。解释颜色和搏动仔细考虑换能器的方向，以确保动脉，而不是静脉评估。 注意:对于面向头探头指示灯，红色意味着流向换能器（动脉血流），而蓝色表示流走（静脉血流）。 </li></ol></li><li>肱动脉鉴别: <ol><li>发现肱动脉后，旋转探头90°纵向扫描臂。获得2至10厘米肘窝上面之间的图像。 </li><li>确定解剖标志，如静脉和在同一主题的多个评估筋膜（ 图3）。 </li></ol></li><li>固定探头: <ol><li>固定探头的立体探头支架。确认探针被适当地固定，以避免过度的运动。与固定在支架上的探头，确保图像是作为手动得到无支架的图像一样好。 </li></ol></li><li>优化Resolutio图像的N: <ol><li>与固定探头优化使用时间增益控制图像（TGC的）。 注:获得从腔和血管壁之间的前部和后部内膜接口清亮的B模式图像时，一个最佳的图像实现。 </li><li>有技术人员手动调节增益，联络点，动态范围，和谐波，以获得内皮的远近壁的清晰定义的图像。 </li></ol></li><li>多普勒模式: <ol><li>继B-模式采集，进行双工在脉冲多普勒模式扫描。 </li><li>使用脚跟由摇摆传感器上的一端比其它调节肱动脉图像，将获得的60°声波作用的角度与支架内的探针趾方法。 </li></ol></li><li>基线采集: <ol><li>获取标识与该动脉的内膜清晰内膜壁内皮层的满意的B模式图像。 ENS该多普勒信号出现锐利和清晰的声音，没有围巾URE。 </li><li>通过冻结和解冻图像重置超声波电影圈。按F1键开始在图像处理软件记录数据。为至少30秒记录的基准数据。分析平均直径和血流速度为30秒，以表示基线值。注:不同的超声波及软件调校可能需要不同的顺序，以获得所需的操作。 </li></ol></li></ol> 4.血管闭塞测量<ol><li>前臂闭塞: <ol><li>迅速膨胀前臂闭塞袖口，使用压缩空气，至超收缩压（250毫米汞柱）5分钟以诱导动脉闭塞。 </li><li> 4分钟和前臂闭塞30秒后，开始采集数据。 注:闭塞测量将通过闭塞的最后30秒来表示。 </li></ol></li></ol> 5.反应性充血（邮政袖口释放）测量<ol&gt; <li>继续从预发布袖口数据采集: <ol><li>袖带放气5分钟。 </li><li>保持以下袖带释放记录两分钟。 </li></ol></li><li>下面的帖子发布袖口录制2分钟，停止并保存录音。最高5秒平均在整个2分钟闭塞后收集期间的时间间隔将被用来代表峰充血直径。 </li></ol> 6.结果分析:边缘检测和跟踪墙<ol><li>由于口蹄疫分析的复杂性，根据制造商的说明使用的边缘检测和壁跟踪软件整个口蹄疫测试更高的再现性。 注意:此离线分析是操作者较少地依赖比手动评估，因此提高了口蹄疫数据4,34-36的准确性。此外，这种离线分析系统也允许与ECG终了舒张动脉的识别同步直径，避免了4个直径的脉冲相关的变化失真。应当指出的是，虽然使用心电图被认可，以减少脉动变化，它也可以没有心电图gaiting 37执行口蹄疫协议。虽然不建议，如果边缘计算机辅助分析是不可用的，直径和速度的仔细的手工评估应收集36。 </li><li>对于血管直径的评价，这是必要的目视检查每个帧确定沿B模式图像38超声波卡钳的最佳位置。 注意:不管数据分析方法的，建议的第20秒反应性充血和每5秒对剩余阻塞后周期4期间，收集直径和速度数据每4秒。 </li></ol>

作者什么都没有透露。

在1989年20引入，口蹄疫测试已被广泛用于在人中作为内皮功能的非侵入性的措施。口蹄疫不仅被证明是预测未来的血管相关疾病的风险19,52,53，降低FMD值已经显示与心血管损伤24,25,54强烈相关。虽然也有其他的技术来评估血管内皮功能，既侵入（冠状动脉造影）和非侵入性（静脉体积描记术和手指体积描记法），口蹄疫一直是最广泛使用的，由于它的非侵入性和外周动脉功...

心血管疾病是全世界发病率和死亡率的首要原因。血管内皮功能障碍表示朝向多种血管相关疾病的发展1的初始阶段。因此，血管内皮功能的人类的准确评估是一个重要的技术，可以帮助理解多种心血管病症的病因，以改善治疗和预防疾病的疗效的最终目标。 内皮内皮是细胞单层该合成众多血管活性物质，诸如一氧化氮（NO），前列环素，内皮素，内皮细胞生长因子，白细胞介素，和纤溶酶原抑制剂2。这些因素有助于内皮的功能来调节血液的流动性，血管张力，血小板聚集，血浆成分和血管壁INFL的渗透性ammation 2-4。此外，没有在促进血管扩张和维持内皮完整性的关键抗动脉粥样硬化的作用。通过控制输送氧气到组织和它们的代谢需求3,5-之间的平衡NO调节血管张力和直径。有多个内源性，外源性，和机械刺激因子诱导内皮NO合酶（eNOS），它从NO合成的L-精氨酸6,7。最显着的机械刺激是剪切应力。壁剪切应力与eNOS更大激活，导致NO的产生和随后的平滑肌松弛4。出于这个原因中的NO生物利用度的减少通常被用作内皮功能障碍8的量度。 内皮功能障碍血管扩张和血管收缩因子之间的失衡导致内皮机能障碍2。此外，relea炎症介质和改变的局部剪切力本身可以提高内皮衍生的活性氧（ROS）的合成。这种上调在氧化还原不仅信令 ​​修改内皮的完整性，并降低NO 9的合成，它可以脱开的eNOS导致直接生产的额外自由基。最终，这改善中的NO生物利用度促进血管收缩，血管硬度，降低动脉扩张4。 内皮功能障碍的程度已与若干疾病，如其中包括高血压10，动脉粥样硬化11，缺血性中风12，糖尿病13，先兆子痫14或肾脏疾病15的严重程度有关。因此，有广阔的兴趣，不仅评估随时间的血管内皮功能的变化，也下列的治疗性干预。不同的方法已被用于在冠状动脉和外周环流19内皮功能都侵入（心导管和静脉闭塞容积描记3,16）和非侵入性（流动介导的扩张，桡动脉张力计和脉冲轮廓分析4,17,18）的临床评估。 血流介导的舒张流动介导的舒张（FMD）是血管内皮功能的非侵入性的，超声评价，并已与血管的健康问题的发展密切相关。公司自1989年成立以来20，口蹄疫已被广泛用作可靠， 体内方法评估人类19,21,22主要是NO介导的血管内皮功能。事实上，肱动脉FMD试验已经与其他微创技术23和众多调查相关的所描述的口蹄疫和心血管损伤24,25这样INDIVI之间存在很强的负相关关系偶与更多的血管病变具有更低的FMD 25。因此，这些数据强调的预后信息，这种技术可提供，因为它涉及到未来心血管疾病中的无症状受试者26-30。 在口蹄疫检测，肱动脉的直径在基线和前臂的停循环上映后连续测量。在袖口发布，诱导反应性充血促进介导的NO释放和后续血管舒张19,31在剪切应力的增加。口蹄疫被表示为压脉袋的释放在基线直径（FMD％）相比，按照动脉直径增加的百分比。 尽管在此技术的日益临床利益，口蹄疫测试是一种生理评估，因此，几个变量需要，以便在人体中进行的血管内皮功能的精确评估被考虑。这是rticle描述的标准化协议和推荐的方法来最小化的技术和生物问题，以帮助改善口蹄疫测试的准确性，再现性和解释。

<table>
	<tbody>
		<tr>
			<td>Doppler ultrasound</td>
			<td>GE Medical Systems&#160;</td>
			<td>Logiq 7</td>
			<td>Essential to include Duplex mode for simultaneous acquisition of B-mode and Doppler</td>
		</tr>
		<tr>
			<td>Electrocardiographic (ECG) gating&#160;</td>
			<td>Accusync Medical Research</td>
			<td>Accusync 72</td>
			<td></td>
		</tr>
		<tr>
			<td>12-MHz Linear array transducer&#160;</td>
			<td>GE Medical Systems</td>
			<td>11L-D</td>
			<td>A high-resolution linear array probe is essential</td>
		</tr>
		<tr>
			<td>Forearm occlusion cuff&#160;</td>
			<td>D.E. Hokanson</td>
			<td>SC5</td>
			<td>5 x 84 cm</td>
		</tr>
		<tr>
			<td>Ultrasound transmission gel&#160;</td>
			<td>Parker</td>
			<td>01-08</td>
			<td></td>
		</tr>
		<tr>
			<td>Rapid cuff inflator</td>
			<td>D.E. Hokanson</td>
			<td>E-20 AG101</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterotactic-probe holder</td>
			<td>Flexabar&#160;</td>
			<td>18047</td>
			<td>Magnetic base fine adjustor</td>
		</tr>
		<tr>
			<td>Edge detection analysis software</td>
			<td>Medical Imaging Applications</td>
			<td>Brachial Analyzer 5</td>
			<td></td>
		</tr>
	</tbody>
</table>

ultrasound assessment of endothelial function: a technical guideline of the flow-mediated dilation test

心血管疾病是死亡的主要原因和残疾的主要病因全世界。血管内皮功能障碍是一种病理状况，其特征主要由中断在血管舒张和血管收缩的物质之间的平衡，并提出在动脉粥样硬化的心血管疾病的发展中发挥重要的作用。因此，血管内皮功能在人类一个准确的评估，是一个重要的工具，可以帮助人们更好地理解多心为中心的病症的病因。 在过去的25年里，许多方式方法已被开发，以提供内皮功能的评估在人中。在1989年推出的口蹄疫测试采用了前臂闭塞和随后的反应性充血，促进一氧化氮的产生和肱动脉血管舒张。现在口蹄疫测试是使用最广泛的，非侵入性，ULTR在人类和内皮功能asonic评估已经与未来心血管事件相关联。 虽然口蹄疫测试可能有临床应用，它是继承了需要考虑的几个混杂因素生理评估。本文介绍了确定口蹄疫包括推荐的方法，以帮助减少生理和技术问题，提高了评价的精度和可重复性的标准化协议。

从明显健康的队列组的基线特征在表1中呈现在综合血管和运动生理学（LIVEP）的实验室进行的口蹄疫测试的最常见的变量在表2中，以下的变量被认为是主要的口蹄疫参数在公布的FMD教程4和准则36分析。 基线和峰值直径下列适当的驯化阶段?...

Watch this Scientific Journal Video about Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test at JoVE.com

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

血管内皮功能的超声评估:血流介导的舒张试验的技术指导原则

The flow mediated dilation (FMD) test is the most commonly utilized, non-invasive, ultrasound assessment of endothelial function in humans. Although the FMD test has been related with the prediction of future cardiovascular disease and events, it is a physiological assessment with many inherent confounding factors that need to be considered.

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a ...

ultrasound-assessment-endothelial-function-technical-guideline-flow

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

17.3K 次观看.  Georgia Regents University. The flow mediated dilation (FMD) test is the most commonly utilized, non-invasive, ultrasound assessment of endothelial function in humans. Although the FMD test has been related with the prediction of future cardiovascular disease and events, it is a physiological assessment with many inherent confounding factors that need to be considered. 

视频: Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Assessing Endothelial Vasodilator Function with the Endo-PAT 2000

The endothelium is a delicate monolayer of cells that lines all blood vessels, and which comprises the systemic and lymphatic capillaries. By virtue of the panoply of paracrine factors that it secretes, the endothelium regulates the contractile and proliferative state of the underlying vascular smooth muscle, as well as the interaction of the vessel wall with circulating blood elements. Because of its central role in mediating vessel tone and growth, its position as gateway to circulating immune cells, and its local regulation of hemostasis and coagulation, the the properly functioning endothelium is the key to cardiovascular health. Conversely, the earliest disorder in most vascular diseases is endothelial dysfunction.
In the arterial circulation, the healthy endothelium generally exerts a vasodilator influence on the vascular smooth muscle. There are a number of methods to assess endothelial vasodilator function. The Endo-PAT 2000 is a new device that is used to assess endothelial vasodilator function in a rapid and non-invasive fashion. Unlike the commonly used technique of duplex ultra-sonography to assess flow-mediated vasodilation, it is totally non-operator-dependent, and the equipment is an order of magnitude less expensive. The device records endothelium-mediated changes in the digital pulse waveform known as the PAT ( peripheral Arterial Tone) signal, measured with a pair of novel modified plethysmographic probes situated on the finger index of each hand. Endothelium-mediated changes in the PAT signal are elicited by creating a downstream hyperemic response. Hyperemia is induced by occluding blood flow through the brachial artery for 5 minutes using an inflatable cuff on one hand. The response to reactive hyperemia is calculated automatically by the system. A PAT ratio is created using the post and pre occlusion values. These values are normalized to measurements from the contra-lateral arm, which serves as control for non-endothelial dependent systemic effects. Most notably, this normalization controls for fluctuations in sympathetic nerve outflow that may induce changes in peripheral arterial tone that are superimposed on the hyperemic response.
In this video we demonstrate how to use the Endo-PAT 2000 to perform a clinically relevant assessment of endothelial vasodilator function.

A noninvasive procedure to assess endothelial function is demonstrated using the Endo-PAT 2000.

评估与远藤的PAT 2000内皮血管舒张功能

The endothelium is a delicate monolayer of cells that lines all blood vessels, and which comprises the systemic and lymphatic capillaries. By virtue of ...

科研

医学

Non-invasive Assessment of Microvascular and Endothelial Function

The authors have utilized capillaroscopy and forearm blood flow techniques to investigate the role of microvascular dysfunction in pathogenesis of cardiovascular disease. Capillaroscopy is a non-invasive, relatively inexpensive methodology for directly visualizing the microcirculation. Percent capillary recruitment is assessed by dividing the increase in capillary density induced by postocclusive reactive hyperemia (postocclusive reactive hyperemia capillary density minus baseline capillary density), by the maximal capillary density (observed during passive venous occlusion). Percent perfused capillaries represents the proportion of all capillaries present that are perfused (functionally active), and is calculated by dividing postocclusive reactive hyperemia capillary density by the maximal capillary density. Both percent capillary recruitment and percent perfused capillaries reflect the number of functional capillaries. The forearm blood flow (FBF) technique provides accepted non-invasive measures of endothelial function: The ratio FBFmax/FBFbase is computed as an estimate of vasodilation, by dividing the mean of the four FBFmax values by the mean of the four FBFbase values. Forearm vascular resistance at maximal vasodilation (FVRmax) is calculated as the mean arterial pressure (MAP) divided by FBFmax. Both the capillaroscopy and forearm techniques are readily acceptable to patients and can be learned quickly.
The microvascular and endothelial function measures obtained using the methodologies described in this paper may have future utility in clinical patient cardiovascular risk-reduction strategies. As we have published reports demonstrating that microvascular and endothelial dysfunction are found in initial stages of hypertension including prehypertension, microvascular and endothelial function measures may eventually aid in early identification, risk-stratification and prevention of end-stage vascular pathology, with its potentially fatal consequences.

Capillaroscopy is a non-invasive, relatively inexpensive methodology for directly visualizing the microcirculation. The forearm blood flow technique provides accepted non-invasive measures of endothelial function.

非侵入性的评估微血管和内皮功能

The authors have utilized capillaroscopy and forearm blood flow techniques to investigate the role of microvascular dysfunction in pathogenesis of ...

Technical Aspects of the Mouse Aortocaval Fistula

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta and inferior vena cava (IVC) are exposed. The proximal infrarenal aorta and the distal aorta are dissected for clamp placement and needle puncture, respectively. Special attention is paid to avoid dissection between the aorta and the IVC. After clamping the aorta, a 25 G needle is used to puncture both walls of the aorta into the IVC. The surrounding connective tissue is used for hemostatic compression. Successful creation of the AVF will show pulsatile arterial blood flow in the IVC. Further confirmation of successful AVF can be achieved by post-operative Doppler ultrasound.

The goal is to produce an arteriovenous fistula that is simple and reproducible. This method does not use sutures or glue adhesive. Therefore the samples can be used with the least amount of foreign materials for analysis.

在的鼠标Aortocaval瘘的技术方面

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta ...

A Novel Application of Musculoskeletal Ultrasound Imaging

Ultrasound is an attractive modality for imaging muscle and tendon motion during dynamic tasks and can provide a complementary methodological approach for biomechanical studies in a clinical or laboratory setting. Towards this goal, methods for quantification of muscle kinematics from ultrasound imagery are being developed based on image processing. The temporal resolution of these methods is typically not sufficient for highly dynamic tasks, such as drop-landing. We propose a new approach that utilizes a Doppler method for quantifying muscle kinematics. We have developed a novel vector tissue Doppler imaging (vTDI) technique that can be used to measure musculoskeletal contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities using ultrasound. The goal of this preliminary study was to investigate the repeatability and potential applicability of the vTDI technique in measuring musculoskeletal velocities during a drop-landing task, in healthy subjects. The vTDI measurements can be performed concurrently with other biomechanical techniques, such as 3D motion capture for joint kinematics and kinetics, electromyography for timing of muscle activation and force plates for ground reaction force. Integration of these complementary techniques could lead to a better understanding of dynamic muscle function and dysfunction underlying the pathogenesis and pathophysiology of musculoskeletal disorders.

We describe a new ultrasound-based vector tissue Doppler imaging technique to measure muscle contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities. This approach provides complementary measurements of dynamic muscle function and could lead to a better understanding of mechanisms underlying musculoskeletal disorders.

肌肉骨骼超声成像的一种新应用

Ultrasound is an attractive modality for imaging muscle and tendon  motion during dynamic tasks and can provide a complementary methodological  approach ...

Diagnostic Ultrasound Imaging of Mouse Diaphragm Function

Function analysis of rodent respiratory skeletal muscles, particularly the diaphragm, is commonly performed by isolating muscle strips using invasive surgical procedures. Although this is an effective method of assessing in vitro diaphragm activity, it involves non-survival surgery. The application of non-invasive ultrasound imaging as an in vivo procedure is beneficial since it not only reduces the number of animals sacrificed, but is also suitable for monitoring disease progression in live mice. Thus, our ultrasound imaging method may likely assist in the development of novel therapies that alleviate muscle injury induced by various respiratory diseases. Particularly, in clinical diagnoses of obstructive lung diseases, ultrasound imaging has the potential to be used in conjunction with other standard tests to detect the early onset of diaphragm muscle fatigue. In the current protocol, we describe how to accurately evaluate diaphragm contractility in a mouse model using a diagnostic ultrasound imaging technique.

Diagnostic ultrasound imaging has proven to be effective in diagnosing various respiratory diseases in human and animal subjects. We demonstrate a comprehensive ultrasound protocol utilized by Dr. Zuo's lab to analyze diaphragm kinetics specifically in mouse models. This is also a non-invasive research technique which can provide quantitative information on mouse respiratory muscle function.

小鼠膈肌功能诊断超声成像

Function analysis of rodent respiratory skeletal muscles, particularly the diaphragm, is commonly performed by isolating muscle strips using invasive ...

Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research

The vascular endothelium is a monolayer of cells that cover the interior of blood vessels and provide both structural and functional roles. The endothelium acts as a barrier, preventing leukocyte adhesion and aggregation, as well as controlling permeability to plasma components. Functionally, the endothelium affects vessel tone.
Endothelial dysfunction is an imbalance between the chemical species which regulate vessel tone, thombroresistance, cellular proliferation and mitosis. It is the first step in atherosclerosis and is associated with coronary artery disease, peripheral artery disease, heart failure, hypertension, and hyperlipidemia.
The first demonstration of endothelial dysfunction involved direct infusion of acetylcholine and quantitative coronary angiography. Acetylcholine binds to muscarinic receptors on the endothelial cell surface, leading to an increase of intracellular calcium and increased nitric oxide (NO) production. In subjects with an intact endothelium, vasodilation was observed while subjects with endothelial damage experienced paradoxical vasoconstriction.
There exists a non-invasive, in vivo method for measuring endothelial function in peripheral arteries using high-resolution B-mode ultrasound. The endothelial function of peripheral arteries is closely related to coronary artery function. This technique measures the percent diameter change in the brachial artery during a period of reactive hyperemia following limb ischemia.
This technique, known as endothelium-dependent, flow-mediated vasodilation (FMD) has value in clinical research settings. However, a number of physiological and technical issues can affect the accuracy of the results and appropriate guidelines for the technique have been published. Despite the guidelines, FMD remains heavily operator dependent and presents a steep learning curve. This article presents a standardized method for measuring FMD in the brachial artery on the upper arm and offers suggestions to reduce intra-operator variability.

Endothelial dysfunction is associated with numerous disease states and is predictive of adverse cardiovascular events in humans. Flow-mediated vasodilation (FMD) is a non-invasive ultrasound method of evaluating endothelial function. Methodological choices and operator experience may affect results. A systematic approach to FMD in human studies is discussed here.

肱动脉的临床研究超声评价血管内皮依赖性血流介导的血管舒张功能

The vascular endothelium is a monolayer of cells that cover the interior of blood vessels and provide both structural and functional roles. The ...

Ultrasound Assessment of Flow-Mediated Dilation of the Brachial and Superficial Femoral Arteries in Rats

Arterial vasodilation to increases in wall shear rate is indicative of vascular endothelial function. In humans, the non-invasive measurement of endothelial function can be achieved by employing the flow-mediated dilation technique, typically performed in the brachial or superficial femoral artery. Briefly, a blood pressure cuff placed distal to an ultrasound probe is inflated to a suprasystolic pressure, which results in limb ischemia. After 5 min of occlusion the cuff is deflated, resulting in reactive hyperemia and increases in wall shear rate that signal vasodilatory molecules to be released from the endothelium eliciting vasodilation. Despite the thousands of studies performing flow-mediated dilation in humans, surprisingly, no studies have performed this technique non-invasively in living rats. Considering the recent shift in focus to translational research, the establishment of guidelines for non-invasive measurement of flow-mediated dilation in rats and other rodents would be extremely valuable. In the following article, a protocol is presented for the non-invasive measurement of flow-mediated dilation in brachial and superficial femoral arteries of rats, as those sites are most commonly measured in humans.

Non-invasive assessment of endothelial function in humans can be determined by the flow-mediated dilation technique. Although thousands of studies have used this technique, no study has performed this technique non-invasively in rats. The following article describes non-invasive measurement of flow-mediated dilation in the brachial and superficial femoral arteries of rats.

肱血流介导的扩张和大鼠股浅动脉超声评估

Arterial vasodilation to increases in wall shear rate is indicative of vascular endothelial function. In humans, the non-invasive measurement of ...

A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program.
Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation.
51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p&#60;0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t&#60;1.66, all p&#62;0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t&#60;1.64, all p&#62;0.11).
Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training.

This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.

以基于技术的日常功能技能为目标的计算机化功能技能评估和培训计划

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a ...

A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible

Valid comparisons of postoperative accuracy results in computer-assisted reconstruction of the mandible are difficult due to heterogeneity in imaging modalities, mandibular defect classification, and evaluation methodologies between studies. This guideline uses a step-by-step approach guiding the process of imaging, classification of mandibular defects and volume assessment of three-dimensional (3D) models, after which a legitimized quantitative accuracy evaluation method can be performed between the postoperative clinical situation and the preoperative virtual plan. The condyles and the vertical and horizontal corners of the mandible are used as bony landmarks to define virtual lines in the computer-assisted surgery (CAS) software. Between these lines the axial, coronal, and both sagittal mandibular angles are calculated on both pre- and postoperative 3D models of the (neo)mandible and subsequently the deviations are calculated. By superimposing the postoperative 3D model to the preoperative virtually planned 3D model, which is fixed to the XYZ axis, the deviation between pre- and postoperative virtually planned dental implant positions can be calculated. This protocol continues and specifies an earlier publication of this evaluation guideline.

Here, we propose a practical, feasible and reproducible evaluation guideline for computer-assisted reconstruction of the mandible in order to create uniformity between studies regarding postoperative accuracy evaluation. This protocol continues and specifies an earlier publication of this evaluation guideline.

可读机辅助重建术后评估指南

Valid comparisons of postoperative accuracy results in computer-assisted reconstruction of the mandible are difficult due to heterogeneity in imaging ...

A Non-Invasive Method for Generating the Cyclic Loading-Induced Intra-Articular Cartilage Lesion Model of the Rat Knee

The pathophysiology of primary osteoarthritis (OA) remains unclear. However, a specific subclassification of OA in relatively younger age groups is likely correlated with a history of articular cartilage damage and ligament avulsion. Surgical animal models of OA of the knee play an important role in understanding the onset and progression of post-traumatic OA and aid in the development of novel therapies for this disease. However, non-surgical models have been recently considered to avoid traumatic inflammation that could affect the evaluation of the intervention. 
In this study, an intra-articular cartilage lesion rat model induced by in vivo cyclic compressive loading was developed, which allowed researchers to (1) determine the optimal magnitude, speed, and duration of load that could cause focal cartilage damage; (2) assess post-traumatic spatiotemporal pathological changes in chondrocyte vitality; and (3) evaluate the histological expression of destructive or protective molecules that are involved in the adaptation and repair mechanisms against joint compressive loads. This report describes the experimental protocol for this novel cartilage lesion in a rat model.

Here, we present the cyclic loading-induced intra-articular cartilage lesion model of the rat knee, generated by 60 cyclic compressions over 20 N, resulting in damage to the femoral condylar cartilage in rats.

一种生成周期负荷诱导的大鼠膝关节内软骨病变模型的非侵入性方法

The pathophysiology of primary osteoarthritis (OA) remains unclear. However, a specific subclassification of OA in relatively younger age groups is likely ...