Relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine fetal distress

BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that timely interventions can be implemented to safeguard the health and safety of the fetus.AIM To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.METHODS Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups(n=50 each),according to the presence or absence of intrauterine distress.The ultrasound hemodynamic parameters of the uterine artery(UtA),fetal middle cerebral artery(MCA),and umbilical artery(UmA)were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.RESULTS Comparison of ultrasonic hemodynamic parameters,resistance index(RI),pulsatility index(PI),and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity(S/D),revealed higher values of fetal MCA,PI,and S/D of UmA in pregnant women with UtA compared to controls(P<0.05),while there was no difference between the two groups in terms of RI(P<0.05)The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group(66.7%)than in the control group(90.0%),and neonatal weight(2675.5±27.6 g)was lower than in the control group(3117.5±31.2 g).Further,cesarean section rate was higher in the observation group(70.0%)than in the control group(11.7%),and preterm labor rate was higher in the observation group(40.0%)than in the control group(10.0%).The incidence of fetal distress,neonatal growth restriction and neonatal asphyxia were also higher in the observation group(all P<0.05).CONCLUSION Fetal MCA,UmA,and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy,which suggests that clinical attention should be paid to them,and monitoring should be strengthened to provide guidance for clinical intervention.

Case Report: Surgical Correction of Transposition of the Great Arteries with Aortopulmonary Window

Introduction:Transposition of the great arteries(TGA)with aortopulmonary window is a rare type of congenital heart disease with limited experience.We reported a neonate aged 25 days receiving the arterial switch operation and assisted with extracorporeal membrane oxygenation.Conclusion:TGA with aortopulmonary window can be safely correctly with the arterial switch operation.

High Prevalence of Anatomical Variations and Anomalies of the Coronary Arteries Detected by CT Angiography in Symptomatic Patients

Objective:Coronary artery anatomical variations and anomalies are an important topic due to their potential clinical manifestations.This study aims to investigate the prevalence of coronary artery anatomical variations and anomalies in symptomatic patients with coronary computed tomography angiography(CCTA).Methods:This is a retrospective study that included all symptomatic patients who had CCTA in a tertiary care hospital in Saudi Arabia during a period of seven years.Results:The total number of included patients was 507(60%males)with a mean age of 57.4 years.Approximately 41%had luminal stenoses,averaging 49.7%.The total num-ber of patients with coronary anatomical variations(CAV)and coronary artery anomalies(CAA)was 217(43%).CAV prevalence was 26%,which included 14%non-right coronary dominance,5%short left main coronary artery(LMCA),and 7%division variations(trifurcation and quadrifurcarion)of the LMCA.The prevalence of CAA was 29%,which included 5%origin anomalies,22%myocardial bridge,and 2%course anomalies.Conclusions:A high prevalence of coronary artery anatomic variations and anomalies in symptomatic patients is reported in this study.Systematic reviews,meta-analyses,reporting guidelines,and unified definitions and classifications of cor-onary variations and anomalies are lacking in the literature,presenting potential opportunities for future research and publications.

A 63-Year-Old Male with D-Transposition of the Great Arteries Who Had an Early Form of the Arterial Switch Operation

We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data that support our conclusion.He had a diagnostic cardiac catheterization which demonstrated severe pulmonary hypertension responsive to epoprostenol and oxygen.Our case may represent one example of the experimental surgical work done prior to Dr.Adibe Jatene’s description of thefirst successful arterial switch performed in 1975.

Simultaneous Compression of the Celiac Trunk, Superior Mesenteric Artery, and Renal Arteries by the Median Arcuate Ligament: About One Case

Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insertion of the diaphragmatic crura or an abnormally high origin of the celiac trunk from the aorta can cause compression of the celiac artery. Usually, patients with MALS are asymptomatic. Computed tomography (CT) angiography of the abdomen is the main imaging modality to confirm the diagnosis. The coexistence of celiac trunk and superior mesenteric artery compression by the median arcuate ligament is rarely described in the literature. To our knowledge, until now, a simultaneous combination of three abdominal vascular compressions by the median arcuate ligament has never been described. From this case, we report a simultaneous compression of the celiac trunk, superior mesenteric artery, and renal arteries by the median arcuate ligament.

Caudate lobe-sparing subtotal hepatectomy as treatment for extensive intrahepatic arterioportal fistula

Intrahepatic arterioportal fistulas(APFs)are abnormal hepatic artery and portal vein(PV)communications that develop as a result of congenital malformation,trauma,ruptured hepatic aneurysm,cirrhosis,tumor-related changes,biopsy,chemotherapy or iatrogenic causes[1,2].The most common symptoms are gastrointestinal bleeding and ascites secondary to portal hypertension;other symptoms include abdominal pain,pyrexia,edema,back pain and jaundice[3].The main goal of therapy is to decrease the portal pressure with variceal bleeding being the absolute indi-cation for surgical management.Transarterial embolization(TAE)should be the first choice to treat APFs,while resection,portocaval shunt and even transplantation may cure APFs in the case of TAE failure[4].In previous reports,caudate lobe-sparing subtotal hep-atectomy(CLSSH)has been applied for the treatment of primary hepatolithiasis and hepatocellular carcinoma[5,6].As far as we know,this is the first report describing CLSSH as treatment for an extensive intrahepatic APF,which involved segments 2 to 8,with corresponding hypertrophy of the caudate lobe.

船舶用AH32钢常温抗拉强度测量结果不确定度评定

开展船舶用AH32钢抗拉强度测量结果的不确定度评定,对规范试验过程和合理使用抗拉强度数据具有重要意义,也可为其他船舶用钢抗拉强度不确定度分析提供参考。对船舶用AH32钢的拉伸试验测量结果不确定度进行评定及分析,依据GB/T 228.1—2021相关要求开展拉伸试验及不确定度评价,合理地确定相关不确定度来源,对材料性能做出适当评价具有可操作性。在某些质量可靠性高的不确定度分析中,引入拉伸速率不确定度,识别不确定度分量的影响程度,可以使不确定度评价具有规范性和针对性。

小球藻及光照耦合作用下AH32船板钢的腐蚀行为

利用自主搭建的模拟动态海水实验装置,研究小球藻及光照耦合作用下AH32船板钢的腐蚀行为。实验结果表明,无藻条件下,光照对AH32钢在海水中的腐蚀行为影响较小。有藻+黑暗条件下,试样表面生成团聚的片状FePO4,在一定程度上阻挡腐蚀介质与基体的接触。有藻+光照环境下,AH32钢的自腐蚀电位最高,腐蚀电流密度最低,为2.1×10^(-5)A/cm^(2),基体表面生成相对稳定的双层氧化膜,有效阻止腐蚀性介质对基体的侵蚀,提高了AH32钢的耐蚀性能及服役寿命。

基于等离子体视觉和光谱特征的AH36钢激光焊接熔深熔宽预测研究

针对AH36船用钢不同激光功率和焊接速度的激光焊接,通过高速摄像提取焊接过程等离子体的图像,同时采集了光谱信息,最终建立GA-BP(Genetic Algorithm-Back propagation)神经网络以预测焊缝的质量即熔深和熔宽,并与常用的回归分析方法和未经优化的BP神经网络预测效果相比较。结果表明,焊缝熔深和熔宽均随激光功率的增大而增大,随焊速提高而降低;等离子体面积、高度、灰度以及电子密度均随激光功率增大呈增大趋势。当采用仅考虑焊接工艺参数的回归模型进行预测时,熔深预测相对误差18.2%,熔宽预测相对误差12.1%。而采用引入焊接过程等离子体特征的BP神经网络,虽然精度提高,但由于随机性存在导致相对误差变化较大,进一步采用GA算法进行全局求解能力优化后,熔深预测相对误差降低至7.23%,熔宽预测相对误差降低至5.79%,模型稳定性也明显改善。综合考虑工艺参数和等离子体特征建立的神经网络模型能够更准确预测AH36钢激光焊接焊缝形貌,为焊接工艺规划和质量预测提供参考。

Accessory renal arteries-a source of hypertension:A case report

BACKGROUND Secondary hypertension is a relatively rare condition most commonly caused by renovascular disease due to atherosclerotic vascular disease or fibromuscular dysplasia.Although accessory renal arteries are frequent,to date,only six cases of secondary hypertension determined by their existence have been reported.CASE SUMMARY We describe a case of a 39-year-old female who came to the emergency department with an urgent hypertensive crisis and hypertensive encephalopathy.Despite normal renal arteries,the computed tomography angiography revealed an inferior polar artery with 50%stenosis of its diameter.Conservative treatment with amlodipine,indapamide and perindopril was adopted,leading to blood pressure control within one month.CONCLUSION To the best of our knowledge,there are controversies regarding accessory renal arteries as a potential etiology for secondary hypertension,but the seven similar cases already described,along with the current case,could reinforce the necessity of more studies concerning this subject.

An Anatomical and Radiological Study of Origins of the Arteries Forming the Celiac Trunk: Clinical and Embryological Implications

The blood supply to the most of abdominal organs is provided by the branches of CT. The SMA supply caecum, ascends colon, all of the small bowels except the upper part of duodenum. Knowledge of variable anatomy of celiac axis and SMA may be useful in planning and executing radiological interventions such as celiacography and chemoembolization of hepatic and pancreatic tumors. In this study, the uncommon or low percentage cases of CT and SMA are presented in the light of clinical and embryological information. The celiac axises of a total of 30 adult corpses were examined. Dissections of abdominal region were performed in detail according to Cunningham’s manual. Angiographic images of 100 consecutive adult patients who underwent celiac MDCT angiography were evaluated. During autopsies, an incomplete celiac trunk or bifurcation of celiac trunk associated with the hepatomesenteric and gastrosplenic trunks (0.7%) and a celiacomesenteric trunk associated with high origin superior mesenteric artery and gastrosplenic trunk were detected (0.7%). During MDCT angiography, a case of total absence of celiac trunk associated with a hepatosplenomesenteric trunk (0.7%) and also a case of total absence of celiac trunk alone were observed (0.7%). The persistence or unusual development of ventral splanchnic arteries (VSAs) or ventral longitudinal anastomosis may result in variations or the unusual trunks related to celiac axis and SMA. The anomalous trunks of the CT may be result of either the persistence of some parts of the VSAs or ventral longitudinal anastomose that normally disappear or disappearance of parts that normally persist. The prevalence of unusual trunks of celiac axis and SMA in this study is quite low in literature. These abnormal vessels pose problems for surgeons and radiologists. Such vascular anomalies may cause clinical complications following surgical and radiological procedures such as resection of tumor of the pancreatic head, lymphadenectomy, coeliacography, aortic replacement with reimplantation of the trunk and coembolization of pancreatic and liver tumors.

Hepatic arterial infusion chemotherapy with anti-angiogenesis agents and immune checkpoint inhibitors for unresectable hepatocellular carcinoma and meta-analysis

BACKGROUND Hepatic arterial infusion chemotherapy(HAIC)has been proven to be an ideal choice for treating unresectable hepatocellular carcinoma(uHCC).HAIC-based treatment showed great potential for treating uHCC.However,large-scale studies on HAIC-based treatments and meta-analyses of first-line treatments for uHCC are lacking.AIM To investigate better first-line treatment options for uHCC and to assess the safety and efficacy of HAIC combined with angiogenesis inhibitors,programmed cell death of protein 1(PD-1)and its ligand(PD-L1)blockers(triple therapy)under real-world conditions.METHODS Several electronic databases were searched to identify eligible randomized controlled trials for this meta-analysis.Study-level pooled analyses of hazard ratios(HRs)and odds ratios(ORs)were performed.This was a retrospective single-center study involving 442 patients with uHCC who received triple therapy or angiogenesis inhibitors plus PD-1/PD-L1 blockades(AIPB)at Sun Yat-sen University Cancer Center from January 2018 to April 2023.Propensity score matching(PSM)was performed to balance the bias between the groups.The Kaplan-Meier method and cox regression were used to analyse the survival data,and the log-rank test was used to compare the suvival time between the groups.RESULTS A total of 13 randomized controlled trials were included.HAIC alone and in combination with sorafenib were found to be effective treatments(P values for ORs:HAIC,0.95;for HRs:HAIC+sorafenib,0.04).After PSM,176 HCC patients were included in the analysis.The triple therapy group(n=88)had a longer median overall survival than the AIPB group(n=88)(31.6 months vs 14.6 months,P<0.001)and a greater incidence of adverse events(94.3%vs 75.4%,P<0.001).CONCLUSION This meta-analysis suggests that HAIC-based treatments are likely to be the best choice for uHCC.Our findings confirm that triple therapy is more effective for uHCC patients than AIPB.

Prognostic value of ultrasound in early arterial complications post liver transplant

Liver transplantation is the primary therapeutic intervention for end-stage liver disease.However,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.The clinical manifestations associated with early arterial complications following liver transplantation are often non-specific.Without timely intervention,these complications can result in graft fai-lure or patient mortality.Therefore,early diagnosis and the formulation of an op-timal treatment plan are imperative.Ultrasound examination remains the pre-dominant imaging modality for detecting complications post liver transplan-tation.This article comprehensively reviews common causes and clinical present-ations of early hepatic artery complications in the post-transplantation period and delineates abnormal sonographic findings for accurate diagnosis of these con-ditions.Overall,ultrasound offers the advantages of convenience,safety,effect-iveness,and non-invasiveness.It enables real-time,dynamic,and precise evalua-tion,making it the preferred diagnostic method for post-liver transplantation assessments.INTRODUCTION Liver transplantation stands as the primary therapeutic approach for end-stage liver disease.Continuous advancements in surgical techniques and the application of novel immunosuppressive agents contribute to ongoing improvements in the success rate and overall survival in patients undergoing liver transplantation procedures.Despite these advan-cements,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.During the early stages following liver transplantation(within the first 30 d),proper hepatic artery function is crucial for hepatic arterial blood flow.During later stages,collateral circulation,including arteries such as the phrenic artery,right gastric artery,and gastroduodenal artery,becomes important for maintaining hepatic blood supply.It is now understood that the establishment of effective collateral circulation is pivotal for determining the prognosis of hepatic artery complic-ations.The clinical manifestations of these complications are closely linked to factors such as timing,severity,and the specific type of onset.Insufficient hepatic arterial blood flow can lead to abnormal liver function,hepatic infarction,and the formation of hepatic abscesses.Additionally,since the hepatic artery is the sole blood supply to the biliary tract,hepatic artery-related ischemia may result in biliary stricture,obstruction,and the formation of bile ducts.Ultrasound examination remains the primary imaging modality for diagnosing complications post liver transplantation.This article comprehensively reviews common causes and clinical presentations of early hepatic artery complications in the post-transplantation period and outlines abnormal sonographic findings for accurately diagnosing these conditions.NORMAL HEPATIC ARTERY During the intraoperative phase,an ultrasound examination is typically conducted to evaluate the hepatic artery anas-tomosis.The normal internal diameter of the hepatic artery typically ranges from 2 to 5 mm.Two strong echo points are typically identified near the anastomosis.To assess blood flow dynamics,peak systolic velocity,end-diastolic velocity,and resistance index are measured at the donor and recipient sides of the anastomosis following angle correction.Anastomotic stenosis presence and severity can be evaluated by comparing the velocity at the anastomotic site with that at the recipient side.Postoperatively,direct visualization of the anastomosis site through gray ultrasound scans is often challenging.The surgical approach has a significant impact on the proper hepatic artery’s position,resulting in a lower overall success rate of continuous visualization.Color Doppler ultrasound is primarily employed to trace the artery’s path,and spectral measurements are taken at the brightest position of the Color Doppler blood flow signal,primarily used to identify the presence of high-speed turbulence.Hepatic artery spectrum examination plays a crucial role,as a favorable arterial spectral waveform and appropriate hepatic artery flow velocity typically indicate a successful anastomosis,even in cases where the hepatic artery anastomosis cannot be directly visualized by ultrasound.The hepatic artery runs alongside the portal vein,often selected as a reference due to its larger inner diameter.A normal hepatic artery spectrum displays a regular pulsation pattern with a rapid rise in systole and a slow decline in diastole.Parameters for assessing hepatic artery resistance include a resistance index between 0.5 to 0.8 and an artery systolic acceleration of less than 80 ms.Instantaneous increases in the resistance index(RI>0.8)often occur within 2 d after surgery,followed by a subsequent return to normal hepatic arterial parameters.It has been established that the maximum blood flow velocity during systole in the hepatic artery should not exceed 200 cm/s[1].

Increased Risk of Arterial Stiffness in Rhumatoid Arthritis Patients in a Sub-Saharan African Setting

Background: Analysis of arterial stiffness (AS) is a good marker of early arterial disease and an important determinant of cardiovascular risk, independent of other traditional cardiovascular risk factors. Carotid-femoral pulse wave velocity (CfPWV) is the gold standard to evaluate arterial stiffness. There is evidence that patients with rheumatoid arthritis (RA) have a higher arterial stiffness than their age-matched healthy counterparts and thus have higher cardiovascular (CV) risk. However, data on arterial stiffness in African rheumatoid arthritis patients is scarce. Objectives: To determine the patterns of arterial stiffness in rheumatoid arthritis patients in a sub-Saharan African setting, using CfPWV and Augmentation index (AIx). Method: We conducted a case-control study, at the Douala general hospital over four months (February to May 2018) on 63 subjects among which 31 RA patients matched for age and sex with 32 healthy subjects. AIx and CfPWV were determined non-invasively by radial pulse wave analysis and carotid femoral wave analysis respectively, using a sphygmocor Atcor device (SphygmoCor, PWV Medical, Sydney, Australia). Results: The mean age of RA patients was 47 ± 14 years with most of them being females (n = 26, 83.9%). CfPWV was significantly higher in RA patients compared to the control group (mean: 8.85 ± 2.1 vs 7.45 ± 1.38;p ≤ 0.01) as well as was AIx (Median: 33 [26 - 43] vs 26 [20 - 31];p = 0.01). RA (OR: 6.105;95% CI: 1.52 - 24.54;p 1.34;95% CI: 1.14 - 5.17;p = 0.05), elevated CRP levels (OR: 4.01;95% CI: 1.16 - 13.68;p = 0.03) and Hypertension (OR: 5.75;95% CI: 1.24 -11.60;p Conclusion: Arterial stiffness, a well-recognized marker of cardiovascular risk is increased among patients suffering from rheumatoid arthritis when compared to a healthy control group.

FCAW焊接修复对AH36/2205不锈钢复合板接头性能的影响

由于减少了贵重合金元素的使用,AH36/2205不锈钢金属复合板在应用中有着巨大的经济效益。复层和基层金属间的物理、化学性质存在差异,焊接质量不稳定,因此焊接修复不可避免。为了研究焊接修复对于焊接接头性能的影响,针对14 mm+2 mm的AH36/2205不锈钢金属复合板,采用药芯焊丝气体保护焊(FCAW)进行1~3次焊接修复模拟试验。结果表明:AH36/2205不锈钢金属复合板不适合采用FCAW进行焊接修复,1次修复试板的点蚀率达到了167.7 mdd。随着修复次数的增加,不锈钢复合板接头的力学性能及耐晶间腐蚀性能良好,而点蚀率增加,接头的耐点蚀性能下降。

Transcatheter arterial chemoembolization combined with PD-1 inhibitors and Lenvatinib for hepatocellular carcinoma with portal vein tumor thrombus

BACKGROUND Hepatocellular carcinoma(HCC)patients complicated with portal vein tumor thrombus(PVTT)exhibit poor prognoses and treatment responses.AIM To investigate efficacies and safety of the combination of PD-1 inhibitor,transcatheter arterial chemoembolization(TACE)and Lenvatinib in HCC subjects comorbid with PVTT.METHODS From January 2019 to December 2020,HCC patients with PVTT types Ⅰ-Ⅳ were retrospectively enrolled at Beijing Ditan Hospital.They were distributed to either the PTL or TACE/Lenvatinib(TL)group.The median progression-free survival(mPFS)was set as the primary endpoint,while parameters like median overall survival,objective response rate,disease control rate(DCR),and toxicity level served as secondary endpoints.RESULTS Forty-one eligible patients were finally recruited for this study and divided into the PTL(n=18)and TL(n=23)groups.For a median follow-up of 21.8 months,the DCRs were 88.9%and 60.9%in the PTL and TL groups(P=0.046),res-pectively.Moreover,mPFS indicated significant improvement(HR=0.25;P<0.001)in PTL-treated patients(5.4 months)compared to TL-treated(2.7 months)patients.There were no treatment-related deaths or differences in adverse events in either group.CONCLUSION A triplet regimen of PTL was safe and well-tolerated as well as exhibited favorable efficacy over the TL regimen for advanced-stage HCC patients with PVTT types Ⅰ-Ⅳ.

Protective Effects of Different Hypothermal Preservation Solutions on Structure and Function of Isolated Rat Arteries

Objective:With the increasing application of vascular reconstruction in surgical procedures,allogeneic vessels are becoming more popular in clinical practice due to their abundant sources,precise diameter matching,improved histocompatibility,and higher long-term patency rate.This study aimed to investigate the protective effect of various preservation solutions on the function and structure of the isolated rat abdominal aorta preserved under hypothermal conditions.Methods:The study utilized a total of 150 Sprague-Dawley(SD)rats,with 144 rats allocated to the experimental groups and 6 rats allocated to the control groups.The abdominal aorta of the rats was chosen as the subject of our research.The aorta in the experimental groups were randomly assigned to 4 groups:University of Wisconsin(UW)solution group,histidine-tryptophan-ketoglutarate(HTK)solution group,normal saline(NS)group,and sodium lactate Ringer's solution(RS)group.Samples were subjected to examination after preservation periods of 1 day,3 days,5 days,7 days,14 days,30 days,and 90 days.Evaluation of vascular physiological function involved detecting and assessing vasoconstriction ability and measuring cell viability through the MTT test.Evaluation of the vascular wall structure involved tension tolerance tests and pathological staining.Results:The pathogen-positive rate in the HTK group and NS group at 1 month was 16.7%.Regarding the vascular skeleton structure,both the UW group and HTK group exhibited intact structures after 2 weeks of preservation,with slightly edematous collagen and elastic fibers,which was significantly better than that of the NS group and RS group.In terms of cell activity and contractile function,all preservation groups showed similar effects within 2 weeks.However,after 2 weeks,the UW group showed the most favorable preservation effect(P<0.05).In terms of vascular tension,different groups exhibited similar effects within 1 week.However,after 2 weeks,the UW group showed the best preservation effect(P<0.05).Conclusion:All 4 types of preservation solution had a preservation effect on the structure and function of isolated blood vessels during short-term hypothermal preservation.However,after 2-week preservation,the UW solution was found to be the most suitable solution for the preservation of blood vessels.

《2023 AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠状动脉疾病患者管理指南》要点解读

近期,美国心脏协会(American Heart Association,AHA)、美国心脏病学会(American College of Cardiology,ACC)等六大学会联合发布了《2023 AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠状动脉疾病患者管理指南》,该指南强调了“以患者为中心,以团队为基础”的总体管理理念和重视生活方式改善对慢性冠状动脉疾病患者预后的影响,并对主要心血管不良事件风险评估及新型药物推荐等作出了新的阐述,指南内容的更新对于指导我国临床医生为慢性冠状动脉疾病患者提供高质量管理具有重要指导意义。

Haemoglobin Measurement from Eye Anterior Ciliary Arteries through Borescope Camera

Nowadays,smartphones are used as self-health monitoring devices for humans.Self-health monitoring devices help clinicians with big data for accurate diagnosis and guidance for treatment through repetitive measurement.Repetitive measurement of haemoglobin requires for pregnant women,pediatric,pulmonary hypertension and obstetric patients.Noninvasive haemoglobin measurement through conjunctiva leads to inaccurate measurement.The inaccuracy is due to a decrease in the density of goblet cells and acinar units in Meibomian glands in the human eye as age increases.Furthermore,conjunctivitis is a disease in the eye due to inflammation or infection at the conjunctiva.Conjunctivitis is in the form of lines in the eyelid and covers the white part of the eyeball.Moreover,small blood vessels in eye regions of conjunctiva inflammations are not visible to the human eye or standard camera.This paper proposes smartphone-based hae-moglobin(SBH)measurement through a borescope camera from anterior ciliary arteries of the eye for the above problem.The proposed SBH method acquires images from the anterior ciliary arteries region of the eye through a smartphone attached with a high megapixel borescope camera.The anterior ciliary arteries are projected through transverse dyadic wavelet transform(TDyWT)and applied with delta segmentation to obtain blood cells from the ciliary arteries of the eye.Furthermore,the Gaussian regression algorithm measures haemoglobin(Hb)with more accuracy based on the person,eye arteries,red pixel statistical parameters obtained from the left and right eye,age,and weight.Furthermore,the experimen-tal result of the proposed SBH method has an accuracy of 96%in haemoglobin measurement.

Diabetic neuropathy results in vasomotor dysfunction of medium sized peripheral arteries

BACKGROUND The effect of the sympathetic nervous system on peripheral arteries causes vasoconstriction when smooth muscle cells in the walls of blood vessels contract,which leads to narrowing of arteries and reduction of the blood flow.AIM To compare sympathetic vasomotor activation of the brachial arteries in healthy subjects and patients with painful diabetic neuropathy;and therefore,to assess whether there is significant vasomotor dysfunction of medium sized arteries in diabetic neuropathy.METHODS The study included 41 diabetic neuropathy patients and 41 healthy controls.Baseline diameter and flow rate of the brachial arteries were measured.Then,using a bipolar stimulus electrode,a 10 mA,1 Hz electrical stimulus was administered to the median nerve at the wrist level for 5 s.The brachial artery diameter and blood flow rate were re-measured after stimulation.RESULTS In the control group,the median flow rate was 70.0 mL/min prior to stimulation and 35.0 mL/min after stimulation,with a statistically significant decrease(P<0.001),which is consistent with sympathetic nervous system functioning(vasoconstriction).In the diabetic neuropathy group,median flow rate before the stimulation was 35.0 mL/min.After stimulation,the median flow rate was 77.0 mL/min;thus,no significant decrease in the flow rate was detected.In the control group,the median brachial artery diameter,which was 3.6 mm prior to stimulation,decreased to 3.4 mm after stimulation,and this decrease was also statistically significant(P=0.046).In the diabetic neuropathy group,the median brachial artery diameter increased from 3.4 mm to 3.6 mm following nerve stimulation.Once again,no narrowing was observed.CONCLUSION Our research suggests that diabetic neuropathy results in significant vasomotor dysfunction of medium sized peripheral arteries.Physiological vasoconstriction in response to sympathetic activation is impaired in diabetic neuropathy.