Relationship between sonographically measured median nerve cross-sectional area and presence of peripheral neuropathy in diabetic subjects

BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.

Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang,China

High-resolution ultrasonography was used to analyze the nerve cross-sectional area （CSA） of the median nerve at 7 sites： the wrist crease, pisiform bone, hamate bone, 6 cm proximal to the tip of the wrist crease, proximal forearm （where the nerve enters the pronator teres muscle）, 4 cm proximal to the tip of the medial epicondyle, and mid-humerus （mid-point between elbow crease and axilla） in 200 healthy volunteers from Guiyang, China. Results showed similar CSA values between the left and right sides, but the CSA 6 cm proximal to the tip of the wrist crease, proximal forearm, 4 cm proximal to tip of the medial epicondyle, and mid-humerus in males was greater than that of females. Moreover, CSA values at the wrist crease, pisiform bone, and hamate bone were greater in the middle-aged and old groups when compared to the young group, and correlated with body mass and height. Thus, reference values of median nerve CSA of the upper limbs can facilitate the analysis of abnormal nerve conditions.

Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

BACKGROUND Acromioclavicular joint(ACJ)space narrowing has been considered to be an important diagnostic image parameter of ACJ osteoarthritis(ACJO).However,the morphology of the ACJ space is irregular because of osteophyte formation,subchondral irregularity,capsular distention,sclerosis,and erosion.Therefore,we created the ACJ cross-sectional area(ACJCSA)as a new diagnostic image parameter to assess the irregular morphologic changes of the ACJ.AIM To hypothesize that the ACJCSA is a new diagnostic image parameter for ACJO.METHODS ACJ samples were obtained from 35 patients with ACJO and 30 healthy individuals who underwent shoulder magnetic resonance(S-MR)imaging that revealed no evidence of ACJO.Oblique coronal,T2-weighted,fat-suppressed SMR images were acquired at the ACJ level from the two groups.We measured the ACJCSA and the ACJ space width(ACJSW)at the ACJ on the S-MR images using our imaging analysis program.The ACJCSA was measured as the cross-sectional area of the ACJ.The ACJSW was measured as the narrowest point between the acromion and the clavicle.RESULTS The average ACJCSA was 39.88±10.60 mm;in the normal group and 18.80±5.13 mm;in the ACJO group.The mean ACJSW was 3.51±0.58 mm in the normal group and 2.02±0.48 mm in the ACJO group.ACJO individuals had significantly lower ACJCSA and ACJSW than the healthy individuals.Receiver operating characteristic curve analyses demonstrated that the most suitable ACJCSA cutoff score was 26.14 mm^(2),with 91.4%sensitivity and 90.0%specificity.CONCLUSION The optimal ACJSW cutoff score was 2.37 mm,with 88.6%sensitivity and 96.7%specificity.Even though both the ACJCSA and ACJSW were significantly associated with ACJO,the ACJCSA was a more sensitive diagnostic image parameter.

Correlation between current and cross-sectional area of parallel fixed-movable dual electrodes in ESC

Electroslag casting with parallel fixed-movable dual electrodes is a new method for achieving better quality of castings in complex mold cavities.In this work,a mathematical model,y=kx^2+(k+1)x,was established to describe the ideal correlation between the current ratio(y)and the cross-sectional area ratio(x)of the dual electrodes,where k is the filling ratio.Investigation was conducted on the electroslag casting process with dual electrodes of various cross-sectional areas,but at a constant k value.The experimental results indicated that the ideal correlation was obtained at the stable casting stage,and the fitting results were consistent with the experimental results at certain k values.The experimental findings show that better castings can be obtained when the current ratio is greater than 1.536 and the cross-sectional area ratio is greater than 0.5.

Pore-Throat Combination Types and Gas-Water Relative Permeability Responses of Tight Gas Sandstone Reservoirs in the Zizhou Area of East Ordos Basin, China

With the aim of better understanding the tight gas reservoirs in the Zizhou area of east Ordos Basin,a total of 222 samples were collected from 50 wells for a series of experiments.In this study,three pore-throat combination types in sandstones were revealed and confirmed to play a controlling role in the distribution of throat size and the characteristics of gas-water relative permeability.The type-I sandstones are dominated by intercrystalline micropores connected by cluster throats,of which the distribution curves of throat size are narrow and have a strong single peak(peak ratio>30%).The pores in the type-II sandstones dominantly consist of secondary dissolution pores and intercrystalline micropores,and throats mainly occur as slice-shaped throats along cleavages between rigid grain margins and cluster throats in clay cement.The distribution curves of throat size for the type-II sandstones show a bimodal distribution with a substantial low-value region between the peaks(peak ratio<15%).Primary intergranular pores and secondary intergranular pores are mainly found in type-III samples,which are connected by various throats.The throat size distribution curves of type-III sandstones show a nearly normal distribution with low kurtosis(peak ratio<10%),and the micro-scale throat radii(>0.5μm)constitute a large proportion.From type-I to type-III sandstones,the irreducible water saturation(Swo)decreased;furthermore,the slope of the curves of Krw/Krg in two-phase saturation zone decreased and the two-phase saturation zone increased,indicating that the gas relative flow ability increased.Variations of the permeability exist in sandstones with different porethroat combination types,which indicate the type-III sandstones are better reservoirs,followed by type-II sandstones and type-I sandstones.As an important factor affecting the reservoir quality,the pore-throat combination type in sandstones is the cumulative expression of lithology and diagenetic modifications with strong heterogeneity.

Pore-throat Structure of Tight Sandstone in Yanchang Formation of Huangling Mining Area Based on Scanning Electron Microscopy and Mercury Porosimmetry

Based on scanning electron microscopy and mercury porosimmetry,a large number of experimental data of pores and pore throats of tight sandstone reservoirs are obtained,and the characteristics of pore types,capillary pressure curves and quantitative parameters of pore throats of Yanchang Formation in Huangling mining area are studied.The results show that the main reservoir space types of Yanchang Formation sandstone are primary intergranular pores and feldspar dissolution pores.The pore-throat structure is medium-small pore and thin-small throat type,and the sorting is good to medium.The mercury porosimmetry curve shows a slightly coarse-thin skew.Combining the morphological characteristics of the mercury porosimmetry capillary pressure curve and the quantitative parameter characteristics of pore throats,the Yanchang Formation s micro pore structure is divided into types I,II,III,and IV.Tight oil reservoirs with type I and II pore structure characteristics are favorable.This study has reference significance for the later evaluation of tight sandstone reservoirs in Huangling mining area.

Simulation Study of Solid Rocket Motor C/C Throat Liner Ablation Based on Two Regions

Based on the ablation micro-morphological characteristics, thermo-chemical ablation mechanism, and mechanical stripping mechanism, a dual-region solid rocket motor C/C throat liner ablation model and physical model are established. The ablation program was written and the experimental data of 70 lb BATES engine platform was used for model validation. The relative errors between the simulation calculation results and the experimental results were −6.83% - 10.20%. The ablation program was applied to study the effects of combustion chamber temperature, pressure, oxidation component concentration, throat particle concentration and particle scouring angle on the nozzle throat liner, which provides a reference for the design of the nozzle throat liner and the estimation of solid rocket motor ablation.

Exposed Cross-section of the Archaean Lower Crustin the Shanxi-Hebei-Inner Mongolia Border Region:Problems and Prospects

The Archaean lower crust represented by granulite facies rocks, which is rare in China, is found to be exposed in the Shanxi-Hebei-Inner Mongolia border region. Studies of the regional structure and deformation and metamorphism of the region indicate that there occurred at least two phases of deformation and metamorphism in the region. Early-phase nearly E-W-directed deformational structure is well preserved in the Zhangjiakou-Xuanhua area. Observations of the features of the geological structure from north to south (in the Hengshan metamorphic terrain) have revealed a possible exposed cross-section through the Archaean lower crust. The structure was superimposed by a NE-SW-trending high-temperature ductile shear zone in the Datong area in the late phase, thus reworking the Archaean sequence.

Characteristics of parametamorphic rock reservoirs in Pingxi area, Qaidam Basin, NW China

Based on core, thin-section, scanning electron microscopy(SEM) and well logging data, the characteristics of the parametamorphic rock reservoirs in the Pingxi area were analyzed by means of whole rock X-ray diffraction and micron CT scanning. The parametamorphic rock reservoirs mainly had three types of rocks: slate, crystalline limestone and calc-schist; the original rocks were Ordovician-Silurian marine clastic and carbonate rocks. The three types of parametamorphic rock reservoirs developed three types and six sub-types of reservoir space. The first type of reservoir space was fractures, including structural, weathered and dissolution fractures; the second type was dissolved porosities, including dissolved pores and caves; the third type was nano-sized intercrystalline porosities. The three types of parametamorphic rock reservoirs were different widely in the quantity, volume and radius of pore-throats, and were strongly affected by the type and development degree of fractures. The parametamorphic rock reservoirs were formed by metamorphism, weathering, structural fragmentation and dissolution. Metamorphism reformed the parametamorphic rock reservoirs significantly, breaking the traditional constraint of finding weathering crust at top. The parametamorphic rock reservoirs experienced five formation stages, and their distribution was controlled by rock type, metamorphic degree, ancient geomorphology, and weathering intensity.

Optimal Minimum Number of CT Slices Required to Measure Cross Sectional Areas of Small Pulmonary Vessels

The cross-sectional area (CSA) of small pulmonary vessels can be quantified by CT, which is a reliable method of evaluating vascular alterations in such vessels. However, the optimal number of slices required for accurate quantitation remains unknown. We evaluated relationships among all slices at 10-mm interval and all slices at 3-cm interval, 6-cm interval, and 3-slices and found the closest correlation (0.939) between all slices at 10-mm intervals and 3-cm intervals. Thus, all slices at 3-cm intervals are suitable for accurately measuring CSA.

航空导向器三维测点处理与喉道面积精确计算

导向器是航空发动机的重要部件,喉道面积作为其关键参数直接影响发动机动力性能。针对导向器喉道面积现有测量方法效率低、喉道面积估计不准的问题,提出了导向器三维测点处理与喉道面积精确计算的新方法,并在多联叶片导向器样件上开展了该方法与三坐标测量计算方法的对比实验。实验结果表明,所提方法得到的喉道面积更精确,且多次测量计算结果具有较高的一致性。

车辆段不同区域上盖建筑振动测试分析

为研究地铁列车在车辆段不同区域引起的上盖建筑振动问题,对广州某车辆段试车线,咽喉区及其上盖建筑进行现场振动测试,分析车辆段各区域车致振动特性及传递规律。分析结果表明,轨旁源强振动的主频随车速增加而增大,咽喉区15 km/h、试车线40和60 km/h工况的主频分别为31.5、40和50 Hz,试车线源强的振动能量要大于咽喉区。由于梁和楼板的阻抗作用,振动总能量在向上传播的过程中逐渐衰减,不同传递路径对不同频段振动的衰减作用不尽相同。建筑物内振动主频主要受楼板固有频率影响较大,主要集中在40~50 Hz范围。

ATC车辆基地咽喉区通过能力计算方法研究

车辆基地发车能力逐渐成为提高早高峰正线运营水平的瓶颈,部分城市开始探索建设自动化列车控制(automatic train control,ATC)车辆基地,针对ATC车辆基地收发车能力计算复杂,现有收发车能力计算方法难以应用的弊端,研究了ATC车辆基地咽喉区通过能力的计算方法。首先,在ATC灭灯模式下,通过比较得到不同列车发车顺序下的最小列车总发车时间;其次,计算得到ATC车辆基地的最大咽喉区通过能力;最后以广州萝岗车辆基地为案例,进行ATC灭灯模式下咽喉区通过能力计算模型有效性的验证研究。研究结果表明:ATC灭灯模式、ATC点灯模式、列调结合模式和列车进路模式下咽喉区通过能力分别为28、17、13、11列/h;ATC灭灯模式较其他3种模式有更大的发车能力,能更好地满足早高峰正线的运营需求。研究结果可以为评估车辆基地设计方案提供参考。

基于内收缩比可调的二元TBCC进气道风洞试验及起动特性分析

为拓宽进气道工作马赫数范围,结合型面变几何技术并充分利用迟滞回路效应的优势,基于外压缩面/喉道高度协同调节的二元TBCC进气道模型,采用数值模拟与风洞试验结合的方法,研究了马赫数为4.0的通流状态下进气道内收缩比(即改变喉道高度)增减对起动特性的影响。结果表明:当进气道处于不起动状态时,降低内收缩比使进气道肩部分离包被吞入继而实现再起动;结合纹影和沿程静压分布等分析,进气道入口波系在各内收缩比下与设计值相符,但内流通道的CFD结果与试验结果存在相对误差ε,且起动状态下的εq比不起动状态下的εb约低1.5%(ε_(q)<2.7%,ε_(b)<4.2%),表明采用的数值计算方法对于前体激波的预测较为准确,而对于不起动进气道内流静压预测存在误差;获取此类变几何进气道的迟滞回路特性,当内收缩比≤1.79时,进气道正常起动,当内收缩比≥2.54时,进气道不能正常起动,当1.79<内收缩比<2.54时,进气道的起动特性由初始状态和内收缩比的增减趋势共同决定。

Modeling Blood Flow in Veins of Uniform Properties (Giraffe Jugular Vein)

This paper models the giraffe’s jugular veins as a uniform collapsible tube from a rigid skull. The equations governing one-dimensional steady flow through such a tube for various conditions have been developed. The effects of inertial and inclination angles that have not been discussed previously have been included. It has been shown that different flows for a uniform tube (vein) are possible. However, this flow matches that of a jugular vein which is supercritical, and the steady solution has been given by the balance between the driving forces of gravity and the viscous resistance to the flow at the right atrium of the heart must be sub-critical for a fixed right-atrium pressure which means that an elastic jump is required to return the flow to sub-critical from the supercritical flow upstream this type of relationship gives rise to flow limitation at the same time given any right atrium fixed pressure there exists a maximum flow rate which when exceeded the boundary conditions of the flow do not hold boundary conditions at the right atrium are not satisfied hence making the steady flow impossible this mechanism of flow limitation is slightly different from the other one in that causes airways through forced expiration from the observation made it is clearly shown that there is an intravascular pressure difference with a change in height.

地铁场站咽喉区上盖建筑结构振动测试

为研究地铁运行对上盖建筑的振动影响,以福州市某轨道交通线地铁场站咽喉区上盖建筑为测试对象,采用现场测试的方法,对地铁场站咽喉区上盖建筑楼板中央和剪力墙脚处的振动响应特征进行分析,并基于烦恼度模型对其舒适度作出评价。研究结果表明:随着楼层数的增加,楼板跨中铅垂向振动逐渐衰减,而第四层为振动放大层,其楼板及剪力墙脚的振动加速度有效值均被放大;楼板铅垂向振幅峰值的优势频率为40~70 Hz,剪力墙脚铅垂向振幅峰值集中在10 Hz附近,随着楼层数的增加呈现先衰减后放大的趋势,而水平垂轨向振幅与楼层数正相关,振幅峰值集中在0~20 Hz和40~60 Hz;楼板振动加速度级VAL在1~50 Hz随频率增加而增大,在50~80 Hz随频率增加而逐渐降低,且第一层VAL超出一级限值,各铅垂向Z振级VLZ整体上随楼层数的增加而减小;地铁运营状态下,地铁场站咽喉区上盖物业居住者在第一层卧室中可能会产生“轻度烦恼”的生活体验。研究成果可为地铁场站上盖建筑结构的减振设计提供参考。

带上盖物业开发的地铁车辆基地咽喉区限界设计软件研发

地铁车辆基地具有占地面积大、建筑密度较小、用地强度低的特点,对其进行上盖物业开发能够充分挖掘用地价值、提高土地使用效率,因此我国相关项目逐渐增多。为解决带上盖物业开发的地铁车辆基地咽喉区建筑限界轮廓绘制复杂、繁琐、易错漏等问题,基于AutoCAD软件二次开发技术,研发带上盖物业开发的地铁车辆基地咽喉区限界设计软件。首先在阐述软件设计技术路线的基础上,确定道岔、直线地段、曲线地段建筑限界轮廓以及警冲标设置位置的计算原则与方法;然后,对软件各功能模块及其流程进行介绍;最后,以某地铁车辆停车场为例,对软件的应用效果进行分析,以验证其有效性和准确性,结果表明,该软件运行稳定、高效,速度比人工绘制平均提高约96%,准确率可达100%。

基于目标间隔时间的高速铁路客站设计分析

列车间隔时间是衡量铁路运输能力的重要指标,以压缩间隔时间、提高高峰小时服务频率为目标,通过编制标准图集,并利用牵引计算软件仿真,系统分析咽喉区长度、侧向通过速度及工程设置对间隔时间的影响;到达间隔时间是限制接发车能力的关键,与咽喉区长度呈线性关系;侧向通过速度在低于80 km/h时对间隔时间影响显著;工程设置对咽喉区长度的展长系数为1.17~1.21。道岔选型、站外纵坡优化、进站前速度控制是压缩间隔时间的有效措施;咽喉区采用18号道岔较12号道岔可压缩到达间隔时间约30 s;车站纵坡宜按照“凸形坡”设计,采用20‰坡度、10 km坡段长时,可压缩到达间隔时间46.9 s;对于350 km/h高铁,进站前采用200 km/h限速可压缩到达间隔时间87.2 s,实现高铁系统能力的最大均衡。车站到发线数量与咽喉区长度应与目标间隔时间相匹配;在采用速度控制时,高速铁路客站可实现4 min到达间隔,尽端式车站到发线数量可按不超过8条设计,贯通式车站可按不超过15条设计;当不采用速度控制时,高速铁路客站可实现5 min到达间隔,尽端式车站到发线数量可按不超过6条设计,贯通式车站可按不超过12条设计。

铁路专用线50 kg/m钢轨9号单开道岔顺向连接研究

铁路专用线作为我国铁路网不可或缺的组成部分,对铁路货运“提质增量”具有重要作用。站场设计是铁路专用线规划建设、运输组织及安全生产的核心,是铁路专用线运量与运能匹配的关键。针对当前铁路专用线规范对站场咽喉区道岔间夹直线的要求,文章分析了当前在用的50 kg/m钢轨9号单开道岔(图号:CZ2209)的道岔结构及特点,介绍了道岔前端及末端岔枕的排列方式及道岔间的顺向连接方式,提出了将新建车站道岔间插入直线段的合理长度由6.25 m增加至8.00 m,困难条件下采用6.25 m的解决方法,既有站改造情况下道岔间插入直线段采用6.25 m的解决措施;并分析了实际设计工作和施工应用效果,旨在为日后铁路专用线站场咽喉区设计和现场施工提供参考。