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.

Study of the Bearing Capacity at the Variable Cross-Section of A Riser- Surface Casing Composite Pile

Reducing the cost of offshore platform construction is an urgent issue for marginal oilfield development.The offshore oil well structure includes a riser and a surface casing.The riser,surface casing and oil well cement can be considered special variable cross-section piles.Replacing or partially replacing the steel pipe pile foundation with a variable cross-section pile to provide the required bearing capacity for an offshore oil platform can reduce the cost of foundation construction and improve the economic efficiency of production.In this paper,the finite element analysis method is used to investigate the variable cross-section bearing mode of composite piles composed of a riser and a surface casing in saturated clay under a vertical load.The calculation formula of the bearing capacity at the variable section is derived based on the theory of spherical cavity expansion,the influencing factors of the bearing capacity coefficient N_(c) are revealed,and the calculation method of N_(c) is proposed.By comparing the calculation results with the results of the centrifuge test,the accuracy and applicability of the calculation method are verified.The results show that the riser composite pile has a rigid core in the soil under the variable cross-section,which increases the bearing capacity at the variable cross-section.

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.

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.

软土地区基坑前排倾斜双排桩支护现场试验及工作机理

基坑倾斜桩支护大幅提高了无支撑支护结构的适用深度,具有造价低、施工便捷、绿色低碳、变形控制好等特点,然而目前研究多集中在单排倾斜桩,对前排倾斜双排桩支护的试验、理论与应用的研究均较少。针对前排倾斜双排桩支护基坑开展了现场试验,同时采用有限元方法分别从前排斜桩、桩顶连梁及桩间土体作用3个方面深入探究了前排倾斜双排桩支护的工作机理,进一步分析了直斜桩长度和排距对前排倾斜双排桩支护结构受力变形性能的影响。结果表明,相比传统竖直双排桩,前排倾斜双排桩支护结构的支护性能显著提升,前排斜桩主要发挥“斜撑”作用,连梁主要起到将直斜桩及冠梁连接成一个空间刚架的作用,桩间土体能够提高桩土摩阻力,进而有效减小前排倾斜双排桩变形。研究成果有助于前排倾斜双排桩的推广和应用。

不同溶洞处治措施对桩基承载特性的影响研究

为探究不同溶洞处治措施对岩溶发育区桩基承载特性的影响,通过有限元软件建立溶洞-桩-岩土体耦合作用模型,对比分析溶洞高度变化情况下,2种不同的溶洞处治措施(回填法和钢护筒跟进法)对桩基承载特性的影响。结果表明:随着溶洞高度增加,2种处治措施下桩基竖向承载力都呈降低趋势;溶洞高度小于10 m时,不同处治措施对桩基竖向承载力影响可忽略,溶洞高度大于10 m则需考虑处治措施对桩基竖向承载力的影响;在回填法处治的溶洞范围内,桩身轴力降幅较大,桩侧摩阻力增加显著,在钢护筒跟进法处治的溶洞中桩身轴力与桩侧摩阻力则基本不变;与钢护筒跟进法相比,回填法更有利于发挥桩侧摩阻力;溶洞高度增加时,2种处治措施下桩侧摩阻力比重均逐渐减小,桩端阻力比重逐渐增大,达到桩基极限承载力时,回填法处治后的溶洞较钢护筒跟进法桩端阻力占整体比例更小。

黄土地区洞桩法地铁车站边桩和中柱的受力变形机理

[目的]为了确保黄土地区洞桩法车站施工过程中重要竖向承重构件的稳定性,需要对施工过程中边桩和中柱的受力变形机理进行研究,并对最不利受力阶段边桩和中柱提出变形控制措施。[方法]以西安地铁2号线何家营站为研究背景,通过数值模拟与现场监测的方法,对施工过程中边桩的水平位移、钢筋内力、水平土压力及中柱应变展开研究。[结果及结论]扣拱施作以及站厅层和站台层土体开挖是边桩水平位移最不利的三个阶段,在这些关键阶段施工时,应在结构内部架设钢支撑并适当加固已扰动的地层;在桩梁和扣拱施作中,边桩主筋承受轴向压力,而在站内剩余土方施工阶段,边桩背土侧的钢筋由轴向压力逐渐转化为轴向拉力,且随着边桩埋深的增大,钢筋的轴向拉压力增长变缓;在扣拱初期支护施作中,土压力在边桩埋深6.6 m处达到最大值34.5 kPa,且随着边桩埋置深度增大,边桩的桩侧压力增长速率显著,因此车站内侧的土方开挖是控制边桩迎土侧土压力大小的关键阶段,必要时对桩后土体进行注浆加固有利于提高桩基的承载力;中跨扣拱施工时,中柱的应变呈现出先减小、后增大的趋势。

软土地区轨道交通桥梁下方灌注桩小净距施工影响

[目的]我国沿海软土地区灌注桩与运营轨道交通桥梁、桥墩间小净距的施工影响正成为制约城市轨道交通规划与建设的又一瓶颈因素,因此有必要研究小净距钻孔灌注桩施工对周围地层和桥墩的变形影响。[方法]以浙江某城市道路桩板结构形式下穿轨道交通桥梁在建工程为例,通过设计土体侧向变形监测试验和搭建既有桥梁、桥墩的位移智能监测系统,分析了深厚软土区地层与测斜孔的协同变形特性,以及钻孔灌注桩施工对周围地层及桥墩变形的影响规律。[结果及结论]为使测斜孔与地层具有较好的协同变形,软土区测斜孔施工后应稳定停留6 d;淤泥层对施工加载、卸载过程的敏感性较高,由施工引发的软土地层变形量最大;在施工条件下,桥墩3个方向的变形幅值约为未施工的2~3倍;成孔开挖和混凝土浇筑工序对桥墩深度方向的扰动影响较显著,因此已运营轨道交通桥梁下部施工的监测重点应为竖向位移。

岩溶区PST管桩复合地基的工程应用

经对某场地高层建筑地基素填土厚度大、下伏基岩岩溶发育、以多层串珠状溶洞为主的地层条件研究,提出一种PST管桩刚性复合地基。采用试验和监测等方法来指导复合地基处理设计与施工,根据场地试桩数据来验证设计的合理性。施工完成后,采用静载荷试验对复合地基进行质量验收检测,并连续进行沉降监测。结果表明:岩溶区PST管桩复合地基是一种处理高层建筑地基很可行的方法,处理后可以满足高层建筑物对地基强度、变形及稳定性的要求。

生态库区超厚硬岩条件下大直径长桩桩基施工关键技术

针对生态库区超厚硬岩条件桥梁大直径长桩相对复杂的施工环境,常规施工工艺易造成环境污染、硬岩地层钻进速度慢、维护费用高。为了保护环境也方便施工,提出一种桩基新型施工技术,通过潜孔锤和旋挖钻结合,高效快速完成桩基施工且绿色环保。依托工程实例,对相关施工工艺进行详细阐述。

某高速公路深厚软基路桥过渡段跳车病害处治研究

结合某在役高速公路路堤深厚软基桥头跳车实测累计沉降量40.60 cm病害处治工程,开展室内土工试验、理论计算及GEO5模型计算分析。结果表明:15年内的累计剩余沉降量均超规范中桥头路基容许工后剩余沉降量不大于10.00 cm要求;提出“CFG桩+路面重铺”等处治方案,进行检算校核,计算得剩余总沉降量9.76cm,表明处治设计方案较为可靠。结合工点需保通及基底存在前期已施工CFG桩特点,制定通车条件下的施工顺序及工艺,确保方案可行。

岩溶区桩基承载特性研究综述

在岩溶区进行桩基施工时,应尽可能地避开溶洞,但不可避开的情况也普遍存在,因此岩溶区桩基承载特性研究是桩基发展过程中必须要面对的问题。从理论研究、物理实验、数值模拟3个方面对岩溶区桩基承载特性研究现状进行了分析,得到如下结论:现有承载力计算公式存在影响因素考虑不全的情况,后续理论研究应考虑多因素协同影响下单桩极限承载力计算公式推导。物理模型试验的变量较为单一,试验过程中常常忽略水对桩基承载特性的影响,后续研究应当重点考虑地下水及多因素的协同作用。原位实验开展较少,检测获得数据准确性有待提高,后续应开展更多的原位实验、现场破坏实验以获得更全面的桩基承载特性实验数据。数值模拟研究中溶洞模型的建立大多采用长方体、正方体、椭球体、球体等标准尺寸,这与实际地层溶洞三维几何尺寸不符,真实的溶洞几何模型的建立是未来重点的发展方向。

大面积堆载对临近桩基力学性能的影响

码头堆场的地基通常较为软弱,当在堆场附近有重要的建(构)筑物时,为保证建筑物结构安全,须评估大面积堆载对临近基桩力学性能的影响,包含基桩位移和桩身内力,但现行规范对此未作规定。本文利用经典Boussinesq应力位移解为基础,推导出计算任意荷载作用下土体位移和应力的方法,自编相应的计算程序,并利用土体的位移和应力间接计算桩身的变形和内力。以某煤棚项目为例,采用上述方法计算煤堆荷载作用下桩顶位移和桩身内力,结果表明基桩的最大侧移满足规范要求,桩身轴力和弯矩较大,桩身强度验算需考虑上述荷载产生的桩身内力。采用本计算方法可以方便计算任何荷载下基桩的位移和内力,计算较准确,可为类似的项目提供参考。

PHC管桩在岩溶地区的设计及工程应用

岩溶地区以其独特的地质情况,对工程建设带来了巨大的挑战。为了提高岩溶地区基础工程建设的效果,本文结合大沥御府项目,分析和总结了该地区的岩溶特性,提出了PHC管桩在岩溶地区的设计及工程应用,文中提供了岩溶地质中PHC管桩应用的经验和试验结果,同时也取得了良好的工程及经济效果,为岩溶地区的基础工程建设提供了较好的借鉴意义。

黄土地区地铁车站洞桩法对地层的影响研究

为研究黄土地区富水砂层地铁车站洞桩法对地表沉降及拱顶沉降的影响因素,依托西安市丰禾路地铁车站项目,对导洞的加固范围、开挖错距及开挖顺序进行数值模拟,结果显示:加固范围对该地区富水厚砂层地铁车站地表沉降及拱顶沉降影响较大,随着加固范围的增大,地层沉降逐渐减小;导洞开挖顺序对该地区地层沉降有一定影响,选择先边后中的开挖顺序产生的地表沉降及拱顶沉降更小;导洞的开挖错距对该地区地层沉降的影响不大,随着开挖错距的增大,地层沉降逐渐增大,但变化程度较小。根据结果进一步验证了该地区地铁车站洞桩法施工安排的合理性,即选择1.5m导洞加固范围,10m的开挖错距及先边后中的开挖顺序。

双堆堆积影响酱香型白酒发酵的机理研究

通过在酱香型白酒第六轮次高温堆积过程中,将两组堆子分别进行大堆和双堆堆积发酵,考察比表面积增大在酿造过程中对酱香型白酒的影响。结果表明,与单独大堆堆积相比,双堆堆积的方式提升了酱香型白酒基酒的质量。根据酒醅分析结果,双堆堆积方式由于具有更大的比表面积,更能富集环境中的微生物,从而改变了酒醅微生物多样性,提升了芽孢杆菌属(Bacillus)、克罗彭斯特菌属(Kroppenstedtia)、枝芽孢杆菌属(Virgibacillus)等对于酱酒生产具有积极影响的菌属的相对丰度。基酒分析表明,具有更大比表面积的双堆堆积能够全方位提高基酒中的酯类、醇类、酸类、醛类、酮类、四甲基吡嗪等物质的含量,其四甲基吡嗪含量达到1.82μg/mL,而大堆对照组中未检出。最终使得双堆组基酒酱香、焦香风味突出,酒体醇厚。

西藏自治区超高海拔牧区光伏支架桩基础的施工质量控制研究

西藏自治区超高海拔牧区的气候环境、地质条件、环保要求等与内地的不同,因此在此类地区建设光伏电站时,光伏支架桩基础施工时需要考虑的因素,以及设备、材料等的选择也存在很大差异。以西藏山南曲松罗布沙850 MW牧光互补光伏发电项目中光伏支架桩基础的施工为例,对西藏自治区超高海拔牧区光伏支架桩基础的施工质量控制开展研究。首先结合项目所在地的地质条件和环保要求,选择出最合适的桩基础类型;其次对光伏场区内3种施工设备的施工效率、经济性、稳定性、环保性进行了比较;最后通过严格落实施工工艺及采用钢丝绳定位的方式确保了桩基础的施工质量。研究结果表明:此类地区的光伏支架桩基础采用“以螺旋钢桩基础为主、微孔灌注桩基础为辅”的方案,能同时满足环境保护、施工效率和力学性能的要求;为确保施工进度,施工设备可选择240型普通挖改钻机;介绍的螺旋钢桩基础和微孔灌注桩基础的施工工艺及施工质量控制措施效率高、效果明显,能确保桩基础施工后的力学性能满足设计要求。研究结果为其他同类型光伏发电项目桩基础的施工提供了可借鉴的经验。