Wrist blood flow signal-based computerized pulse diagnosis using spatial and spectrum features

ABSTRACT Current computerized pulse diagnosis is mainly based on pressure and photoelectric signal. Considering the richness and complication of pulse diagnosis information, it is valuable to explore the feasibility of novel types of signal and to develop appropriate feature representation for diagnosis. In this paper, we present a study on computerized pulse diagnosis based on blood flow velocity signal. First, the blood flow velocity signal is collected using Doppler ultrasound device and preprocessed. Then, by locating the fiducial points, we extract the spatial features of blood flow velocity signal, and further present a Hilbert-Huang transform-based method for spectrum feature extraction. Finally, support vector machine is applied for computerized pulse diagnosis. Experiment results show that the proposed method is effective and promising in distinguishing healthy people from patients with cho- lecystitis or nephritis.

Pulsed arterial spin labeling effectively and dynamically observes changes in cerebral blood flow after mild traumatic brain injury

Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury. At the acute and subacute stages, cerebral blood flow was reduced in the occipital lobe, parietal lobe, central region, subcutaneous region, and frontal lobe. Cerebral blood flow was restored at the chronic stage. At the acute, subacute, and chronic stages, changes in cerebral blood flow were not apparent in the insula. Cerebral blood flow in the temporal lobe and limbic lobe diminished at the acute and subacute stages, but was restored at the chronic stage. These findings suggest that pulsed arterial spin labeling can precisely measure cerebral blood flow in various brain regions, and may play a reference role in evaluating a patient＇s condition and judging prognosis after traumatic brain injury.

Use of a rat model to characterize 35 arterial pulse wave parameters in a comparative study of isoflurane and Zoletil/ xylazine anesthesia and the effect of Acanthopanax senticosus extract

Background : Information obtained from arterial pulse waveforms (APW) can be usefulfor characterizing the cardiovascular system. To achieve this, it is necessary to know thedetailed characteristics of APWs in different states of an organism, which would allowAPW parameters (APW- Ps) to be assigned to particular (patho)physiological conditions.Therefore, our work aimed to characterize 35 APW- Ps in rats under the influence ofisoflurane (ISO) and Zoletil/xylazine (ZO/XY) anesthesia and to study the effect of rootextract from Acanthopanax senticosus (ASRE) in these anesthetic conditions.Methods : The right jugular vein of anesthetized rats was cannulated for the administrationof ASRE and the left carotid artery for the detection of APWs from which 35APW- Ps were evaluated.Results : We obtained data on 35 APW- Ps, which significantly depended on the anesthesia,and thus, they characterized the cardiovascular system under these two conditions.ASRE transiently modulated all 35 APW- Ps, including a transient decrease insystolic and diastolic blood pressure (BP) and heart rate or increases in pulse BP, d P /d t max , and systolic and diastolic areas. Whereas the transient effects of ASRE weresimilar, the extract had prolonged disturbing effects on the cardiovascular system inrats under ZO/XY but not under ISO anesthesia. This negative effect can result fromthe disturbance caused by ZO/XY anesthesia on the cardiovascular system.Conclusions : We characterized 35 APW- Ps of rats under ISO and ZO/XY anesthesiaand found that ASRE contains compounds that can modulate the properties of thecardiovascular system, which significantly depended on the status of the cardiovascularsystem. This should be considered when using ASRE as a nutritional supplementby individuals with cardiovascular problems.

Investigation of blood pulse PPG signal regulation on toe effect of body posture and lower limb height

Objective: To study the regulation of blood pulse volume via photoplethysmography (PPG) signal detected from toe, while the lower limb is passively raised in different height positions. Methods: Use a modified non-invasive PPG technique to detect the blood pulse signal on toe with infrared (IR) photo sensor. A protocol consisting of two postures, i.e., supine and 45° reclining, was designed to conduct laboratory trial in this study. During the period of performing the protocol of these postures, the lower limb was passively raised from the heights of 10 cm to 60 cm randomly and individually with sponge blocks underneath the foot. Results: In the supine posture, the higher the foot was passively raised, the more the blood PPG signal decreased. In the 45° reclining posture, the blood PPG signal increased at the beginning and then decreased in the foot height position from 10 cm to 60 cm. In both postures the normalized AC signal changes significantly while the normalized DC signal changes little. Conclusion: The toe PPG signals can obviously indicate the regulated blood volume change with the designated postural procedures due to the heart level position.

Arterial pulse impact on blood flow

Numerous pathophysiologic observations in humans and animals led to the formulation of the response-to-injury hypothesis of atherosclerosis, which proposed that endothelial denu- dation by the blood flow was the first step in atherosclerosis. At present it is impossible to describe hemodynamics only by the Navier-Stokes or Oldroyd-B equations because in the large arteries blood flow is unsteady, with the flow separation and waveform propagation of the thyxotropic mass. The purpose of this paper is to study the impact of the arterial pulse wave on the blood flow and initial factors of atherosclerosis. In 12 healthy men (25-39 years of age) peak velocity, mean velocity, mean flow and net flow in the aorta have been investigated by МR angiography. Initial velocity was registered after 43msec of the ECG-R wave, and it differed from zero at all sites of the aorta, although net flow was equal to zero. Womersley’s number from the ascending to the thoracic aorta decreased from 12.5 ±1.5 to 7.3 ±1.2;flow modified from inertio-elastic to viscous. In the aortic arch in protodiastole blood flow separated into the opposite directed streams resulting in wave superposition with the high net flow. At the isthmus area separated waves interferences and reflects to anterograde direction. Here flow acceleration in protodiastole is 6 times higher than in systole. Pulse waves move on artery walls fifteen or more times more rapidly than the blood flow. Pulse oscillation increases strain rate to the contiguous vessel wall flow layers. At the sites with the flow wave negative interference vessel pulse oscillation attenuates and at the boundary reflection flow wave can shift the vessel wall.

Effect of music on blood pressure, pulse rate and respiratory rate of asymptomatic individuals: A randomized controlled trial

A slight reduction of blood pressure and heart rate can reduce the risk of developing cardiovascular disease. Maintenance of the respiratory rate within the normal range has also being identified as crucial for a healthy heart. Use of Indian and western music have been considered among many preventive programmes for long time in order to risk reduction associated with cardio vascular diseases. Therefore the aim of this study is to describe the effect of Indian classical music on systolic and diastolic blood pressure, pulse rate and respiratory rate in asymptomatic individuals aged 45 to 65 years. Methodology: A community based randomized intervention study was conducted in 252 asymptomatic individuals. The study group (n = 127) listened to a music based on Indian classical system (entire track of 22 minutes). The control group (n = 125) was kept silent for a similar time period. Systolic and diastolic blood pressure, pulse rate and respiratory rate of each study participant were monitored before and after the intervention. Results: Statistically significant reduction in systolic blood pressure (8.53 mmHg), diastolic blood pressure (5.8 mmHg), pulse rate (5.16 breaths per minute) and respiratory rate (2.55 per minute) were observed in the study group after listening to the music (p < 0.01). In the control group, changes observed during the period of intervention were not significant (p > 0.05). The reduction was independent of gender, age, education level, practicing a mind relaxation technique and preferred type of music of the participant. Conclusions: Listening to Indian classical music for about 22 minutes significantly reduced systolic and diastolic blood pressure, pulse rate and respiratory rate of asymptomatic individuals. Hence, music may have a potential benefit in cardio vascular disease preventive programmes.

Noninvasive method for determining blood pressure and contours of arterial and volume pulses

A noninvasive method for monitoring blood pressure, based on the principles established by Riva-Rocci and Korotkoff (K), is described;it furnishes, after a single compression-deflation cycle of the arm-encircling cuff, values of sys-tolic and diastolic blood pressures as well as the contours of the brachial arterial pulse and the corresponding volume pulse. K-sounds are detected by a single microphone situated in the cubital fossa, and the time-varying cuff pressure P(t) is read by a piezoresistive pressure sensor. The behavior of P(t) during deflation is resolved into two parts, P(t)=p(t)+b(t);p is a train of posi-tive going pulses (arising from arterial pulsa-tions), whereas b is a slowly changing baseline. Noise pulses in the microphone output are re-jected by using the observation that the first few K-sounds are emitted when p is close to a maxi-mum, and the last few when dp/dt is close to a maximum. The performance of the instrument is illustrated by showing how it copes with ambi-ent noise and involuntary manual perturbations of P, and by presenting contours of various pulses.

Detrimental Effect of Electromagnetic Pulse Exposure on Permeability of In Vitro Blood-brain-barrier Model

Objective To study the effect of electromagnetic pulse （EMP） exposure on permeability of in vitro blood-brain-barrier （BBB） model. Methods An in vitro BBB model, established by co-culturing brain microvascular endothelial cells （BMVEC） and astroglial cells （AC） isolated from rat brain, was exposed to EMP at 100 kV/m and 400 kV/m, respectively. Permeability of the model was assayed by measuring the transendothelial electrical resistance （TEER） and the horseradish peroxidase （HRP） transmission at different time points. Levels of BBB tight junction-related proteins were measured at O, 1, 2, 4, 8, 12, 16, 20, 24 h after EMP exposure by Western blotting. Results The TEER level was lower in BBB model group than in control group at 12 h after EMP, exposure which returned to its normal level at 24 h. The 24 h recovery process was triphasic and biphasic respectively after EMP exposure at 100 kV/m and 400 kV/m. Following exposure to 400 kV/m EMP, the HRP permeability increased at 1-12 h and returned to its normal level at 24 h. Western blotting showed that the claudin-5 and ZO-1 protein levels were changed after EMP exposure. Conclusion EMP exposure at 100 kV/m and 400 kV/m can increase the permeability of in vitro BBB model and BBB tight junction-related proteins such as ZO-1 and claudin-5 may change EMP-induced BBB permeability.

Effect of Electromagnetic Pulse Exposure on Permeability of Blood-testicle Barrier in Mice

Objective To study the effect of electromagnetic pulse （EMP） exposure on the permeability of blood-testicle barrier （BTB） in mice. Methods Adult male BALB/c mice were exposed to EMP at 200 kV/m for 200 pulses with 2 seconds interval. The mice were injected with 2% Evans Blue solution through caudal vein at different time points after exposure, and the permeability of BTB was monitored using a fluorescence microscope. The testis sample for the transmission electron microscopy was prepared at 2 h after EMP exposure. The permeability of BTB in mice was observed by using Evans Blue tracer and lanthanum nitrate tracer. Results After exposure, cloudy Evans Blue was found in the testicle convoluted seminiferous tubule of mice. Lanthanum nitrate was observed not only between testicle spermatogonia near seminiferous tubule wall and sertoli cells, but also between sertoli cells and primary spermatocyte or secondary spermatocyte. In contrast, lanthanum nitrate in control group was only found in the testicle sertoli cells between seminiferous tubule and near seminifdrous tubule wall. Conclusion EMP exposure could increase the permeability of BTB in the mice.

Mechanism of Magnetic Pulse Wave Signal for Blood Pressure Measurement

Continuous non-invasive blood pressure (BP) measurement can be realized by using pulse transit time (PTT) based on electrocardiogram (ECG) and pulse wave signal. Modulated magnetic signature of blood (MMSB) is a promising approach to obtain PTT. The origin of MMSB is critical to establish the relationship between MMSB and BP. In this paper, two possible origins of MMSB, blood disturbance mechanism and angular variation mechanism, are analyzed and verified through three control experi-ments under different conditions. The influence of blood velocity alteration and blood volume alteration on magnetic field is investigated though blood flow simulation sys-tem. It is found that MMSB comes mainly from the periodic blood flow while the per-turbation caused by angular variation between sensitive axis of the magnetic sensor and geomagnetic field can be neglected. As to blood disturbance mechanism, the change of blood volume plays a decisive role while the effect of blood velocity altera-tion is negligible.

INFLUENCES OF TWO CARIES REMOVAL METHODS ON BLOOD PRESSURE AND PULSE IN CHILDREN

Objective To compare the effect of chemomechanical caries removal （CMCR） to traditional drilling （TD） on blood pressure and pulse in children. Methods Of all 105 subjects, 53 were randomly assigned to CMCR group; 52, to TD group. For each subject, the systolic pressure （SP）, diastolic pressure （DP） and pulse （ P ） were measured at five time-point： pre-treatment, initiation of carious removal, the end of carious removal, the end of the cavity restoration, and the end of the dental care. They were recorded as To, T1 , T2, T3, and TE, respectively. The difference of SP, DP, and P within each group were analyzed. Results Of all 105 subjects, 14 were administered local anesthesia. Since local anesthesia may be a confounding factor for changes in blood pressure and pulse, only the data of the other 91 subjects that local anesthesia were not administered were analyzed. Regarding the SP, DP, and P for TD, the difference between TO and T1 was significant （ P = 0. 013, 0. 015, 0. 012 respectively）, while not significant between T1 and T2, T2 and T3, T3 and TE（ P 〉0. 05）. Regarding the SP, DP, and P for CMCR, the differences were not significant between every two consecutive time-points （ P 〉 0. 05）. The differences of the SP, DP, and P between CMCR and TD were not significant for time-points T0, T3 and Te （p 〉 0. 05 ）, while significant for T1 and T2 （ P 〈 0. 05 ）. Conclusion In general, CMCR induces less increase of blood pressure and pulse in children compared to traditional drilling （TD）. It may be inferred that CMCR is less distressing than TD.

Changes in pulse pressure × heart rate, hs-CRP, and arterial stiffness progression in the Chinese general population: a cohort study involving 3978 employees of the Kailuan Company

Background Pulse wave velocity(PWV) is a marker of arterial stiffness, which represents sub-clinical atherosclerosis. Pulsatile stress and high-sensitivity C-reactive protein(hs-CRP) are associated with arteriosclerosis. However, there is no prospective data confirming whether changes in pulsatile stress and inflammatory markers affect the progression of arterial stiffness. The aim of this study was to investigate the relationships over time between the effects of changes in pulsatile stress and hs-CRP, and arterial stiffness progression during a 2-year follow-up. Methods We performed a longitudinal study involving 3978 participants. All participants underwent a physical examination in 2010–2011 and 2012–2013, during which we measured participants’ hs-CRP levels, brachial–ankle pulse wave velocity(ba PWV), and pulsatile stress. Results Baseline hs-CRP was correlated with ba PWV(r = 0.18, P = 0.000);however the correlation was weaker than that with systolic blood pressure(r = 0.65), pulsatile stress(r = 0.57), and rate-pressure product(r = 0.58). Multiple linear regression analysis demonstrated that changes in pulsatile stress, mean arterial pressure, and low-density lipoprotein-C(LDL-C) were positively correlated with changes in ba PWV, with correlation coefficients of 0.27, 0.25, and 0.07, respectively, but not with changes in hs-CRP. Moreover, each 100-a U increase in pulsatile stress, 1 mm Hg increase in mean blood pressure, and 1 mmol/L increase in LDL-C was associated with a 3 cm/s, 4.78 cm/s, and 17.37 cm/s increase in ba PWV, respectively. Conclusions Pulsatile stress increases are associated with arterial stiffness progression, but that changes in hs-CRP had no effect on arterial stiffness progression. Hs-CRP may simply be a marker of inflammation in arterial stiffness and has no association with arterial stiffness progression.

ANALYSE OF PULSE WAVE PROPAGATION IN ARTERIES

Based upon the blood vessel of being regarded as the elasticity tube, and that the tissue restricts the blood vessel wall, the rule of pulse wave propagation in blood vessel was studied. The viscosity of blood, the elastic modulus of blood vessel, the radius of tube that influenced the pulse wave propagation were analyzed. Comparing the result that considered the viscosity of blood with another result that did not consider the viscosity of blood, we finally discover that the viscosity of blood that influences the pulse wave propagation can not be neglected; and with the accretion of the elastic modulus the speed of propagation augments and the press value of blood stream heightens; when diameter of blood vessel reduces, the press of blood stream also heightens and the speed of pulse wave also augments. These results will contribute to making use of the information of pulse wave to analyse and auxiliarily diagnose some causes of human disease.

AN ANALYSIS MODEL OF PULSATILE BLOOD FLOW IN ARTERIES

Blood flow in artery was treated as the flow under equilibrium state (the steady flow under mean pressure)combined with the periodically small pulsatile flow.Using vascular strain energy function advanced by Fung,the vascular stress_strain relationship under equilibrium state was analyzed and the circumferential and axial elastic moduli were deduced that are expressed while the arterial strains around the equilibrium state are relatively small, so that the equations of vessel wall motion under the pulsatile pressure could be established here.Through solving both the vessel equations and the linear Navier_Stokes equations,the analytic expressions of the blood flow velocities and the vascular displacements were obtained.The influence of the difference between vascular circumferential and axial elasticities on pulsatile blood flow and vascular motion was discussed in details.

Machine Learning for Detecting Blood Transfusion Needs Using Biosignals

Adequate oxygen in red blood cells carrying through the body to the heart and brain is important to maintain life.For those patients requiring blood,blood transfusion is a common procedure in which donated blood or blood components are given through an intravenous line.However,detecting the need for blood transfusion is time-consuming and sometimes not easily diagnosed,such as internal bleeding.This study considered physiological signals such as electrocardiogram(ECG),photoplethysmogram(PPG),blood pressure,oxygen saturation(SpO2),and respiration,and proposed the machine learning model to detect the need for blood transfusion accurately.For the model,this study extracted 14 features from the physiological signals and used an ensemble approach combining extreme gradient boosting and random forest.The model was evaluated by a stratified five-fold crossvalidation:the detection accuracy and area under the receiver operating characteristics were 92.7%and 0.977,respectively.

从中医脉学的发展谈“系统辨证脉学”

系统辨证脉学是现代创新脉学的典型代表,通过对中医脉学溯源,梳理从传统脉学到现代脉学的发展脉络,总结系统辨证脉学的理论体系。系统辨证脉学具有系统性和辨证性两大基本特点。从脉体、脉壁、脉搏波和血流四个方面,将25对脉象要素进行归类,形成系统辨证脉学的整体架构。手指感觉系统开发和诊查区域是其特色技术要点。从脉象要素到层次到系统形成明晰的思维过程,进而构建出脉治相应的辨证诊疗模式。系统辨证脉学丰富了中医脉学的体系内涵,为实现多学科汇通及中医药现代化起到了极大的促进作用。

基于多频脉冲采样的血流速度估计方法

传统双模超声技术相较于新兴技术更具实现可穿戴化的潜力。在进行脉冲多普勒血流速度估计时,双模超声需同时发射B模式脉冲进行成像定位,这要求B模式脉冲和多普勒脉冲共享采样时间。采用基于单频多普勒脉冲的稀疏间隔发射方式可以解决这一问题,但常见的稀疏发射排布方式(如嵌套发射、互质发射等)存在采样时间窗较长的缺点,特别是在血流速度变化明显的情况下存在时间分辨率不足的问题。此外,长时间窗包含了较多的血流速度分量,容易由于稀疏采样引起伪影,从而影响血流速度估计的准确性。因此,文中提出了一种基于多频脉冲采样的新型血流速度估计方法。首先,构建了多频脉冲采样的回波模型,并对该模型进行推导,证明了在频率衰减平稳假设下,该数学模型等价于单频多普勒脉冲稀疏发射方式,即多频脉冲采样可以通过较短的时间窗实现类似于基于单频脉冲采样模式的长时间窗的性能,从而提高血流速度谱的时间分辨率和估计精度;然后,提出了两种可用于多频脉冲采样模式的血流速度谱的构建方法,分别为复杂度较低的BMUSIC算法和伪影抑制效果较佳的VMUSIC算法。基于FieldⅡ仿真数据和人体实测数据的实验结果表明:相较于单频多普勒脉冲稀疏发射方式,文中方法不仅可以采用较短的时间窗提升血流速度谱的时间分辨率,还可以获得连续、清晰、精度较高且伪影抑制效果较佳的血流速度估计结果;在人体实测数据实验中,由于实验条件所限,文中方法无法实现非整数倍频,未能充分展现VMUSIC算法的性能优势。

基于BiLRCN和注意力机制的脉搏波血压测量

为了提高无创血压测量的精度,提出了基于双向长期递归卷积网络(Bidirectional Long-term Recurrent Convolutional Network,BiLRCN)和注意力机制的脉搏波血压测量方法。通过2个卷积神经网络(Convolutional Neural Network,CNN)层提取出光电容积脉搏信号的高维度特征,将其作为双向长短期记忆(Bidirectional Long Short-Term Memory,BiLSTM)网络的输入,通过BiLSTM提取输入序列前后向的特征信息进行预测;根据注意力机制自动分配权重的特征,给予重要时刻脉搏特征数据较大的权重,并通过2个全连接层得到血压的测量值。将所提出的方法与CNN、长短期记忆(Long Short-Term Memory,LSTM)网络、BiLSTM网络、长期递归卷积神经网络(Long-term Recurrent Convolutional Network,LRCN)方法进行了收敛速度和血压测量的对比实验。实验结果表明,所提出的方法较LRCN均方误差降低了21.63%,平均绝对误差降低了67.5%,确定性相关系数提高了0.42%。所提出的方法的收敛速度更快、血压测量精度更高。

可穿戴人体无创血压测量技术

针对传统的连续无创血压测量设备结构复杂、体积大、不宜穿戴、限制患者运动等问题,设计一种可穿戴设备对人体血压进行实时无创测量。通过硬件设备同步获取心电-脉搏波信号,设计信号处理算法,提取特征点用于后续血压估计。应用MIMIC数据中心电-脉搏-血压信号计算脉搏波传导时间及射血前期,并利用最小二乘法进行线性回归分析,构建血压测量模型,实现个性化血压检测算法。实验验证结果表明:采用该技术检测人体血压时,误差的标准差在±8 mmHg(1 mmHg≈133 Pa)范围内,平均绝对误差小于5 mmHg,满足AAMI国际血压计准确性评价标准的要求。