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.

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.

空白区探矿权准入的法律规制

文章通过从法律层面解读探矿权的“申请在先”并将其与竞争性出让进行比较,探析“申请在先”具备的优势和可能的问题,以及“协议出让”在空白区的适用,提出空白区探矿权准入法律规制的建议:准入方式方面“申请在先”须限定于战略性紧缺矿产,空白区战略性非紧缺矿产适用“协议出让”;准入程序方面引入听证和集体会审制度;准入主体资质方面纳入对探矿权申请人司法品行的要求。

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.

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.

Mulching broad ridges with a woven polypropylene fabric increases the growth and yield of young pear trees ‘Yuluxiang' in the North China Plain

Unlike traditional ridging, mulching broad ridges with a woven polypropylene fabric (WPF) can reduce soil evaporation during the drought season and avoid long saturation time in the root zone of pear trees during the rainy season. In this study, field experiments were conducted from 2017 to 2020 in a pear orchard in the North China Plain to investigate the effects of mulching broad ridges (0.3 m in height and 2 m in width) with WPF on soil temperature and moisture, nitrogen leaching, vegetative and reproductive growth of young pear trees(Pyrus bretschneideri Rehd.‘Yuluxiang’). The experiments involved two treatments, namely, control (traditional no-ridge planting without mulching) and mulching broad ridges with WPF (RM treatment). The results showed that the RM treatment increased soil moisture and temperature and decreased nitrogen leaching, resulting in vigorous growth of the young pear trees. Moreover, the RM treatment increased the tree trunk cross-sectional area and height of the young pear trees by 37%and 8%in 2020, respectively. The nitrate nitrogen content at the soil layer depth of 0-30 cm was significantly higher in the RM than that in control. Furthermore, the RM treatment significantly increased the fruit yield due to larger tree size. In addition, compared with control, significantly higher fruit soluble solid content of RM treatment was detected in 2020. High precipitation (423 mm) occurred during fruit enlargement stage in 2020, RM treatment decreased the rainfall infiltration in the ridge and the soil moisture in root region, resulting in the improvement of fruit quality, compared with control.Therefore, mulching broad ridges with WPF can be implemented to increase soil moisture during drought season, soil temperature, and nitrate nitrogen content, thereby improving the growth and fruit yield of young pear trees. Additionally, it can reduce soil moisture in the root zone during the rainy season and improve the fruit quality of the trees. Finally, it can reduce nitrate nitrogen leaching, thereby reducing environmental pollution.

Eff ects of early standardized enteral nutrition on preventing acute muscle loss in the acute exacerbation of chronic obstructive pulmonary disease patients with mechanical ventilation

BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with invasive mechanical ventilation(MV).METHODS:A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang.The conventional EN group(stage Ⅰ)and early standardized EN group(stage Ⅱ)included 46 and 51 patients,respectively.ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed.RESULTS:On day 7,the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group,while the plasma GDF-15 levels were significantly lower than those in the conventional EN group(ESMcsa:28.426±6.130 cm^(2) vs.25.205±6.127 cm^(2);GDF-15:1661.608±558.820 pg/mL vs.2541.000±634.845 pg/mL;all P<0.001).The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40%and 73.90%,respectively(P=0.406).CONCLUSION:ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels,both of which indicated acute muscular atrophy and skeletal muscle dysfunction.Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness(ICU-AW)in AECOPD patients.

某液压缸筒含芯棒旋锻轴向残余应力研究

以某含芯棒旋锻液压缸筒为研究对象,对不同尺寸下旋锻过程中的轴向残余应力分布进行仿真,绘制产品沿径向方向的轴向残余应力,分析不同尺寸毛坯对轴向残余应力影响。研究发现,随着毛坯外径和毛坯厚度增加,其轴向残余应力无论是压应力还是拉应力都呈递增趋势,但并未对任一类尺寸表现出更敏感的变化趋势。进一步通过相同截面积毛坯仿真发现,轴向残余应力具有高度相似性,证明毛坯截面积为影响轴向残余应力分布的关键因素。

宁懋石室、墓志相关问题研究

宁懋墓志与石室是美术史上的重要作品。墓主名非“懋”,有学者认为是“想”,笔者认为有可能是“惁”。其五世祖应是济阴石匠,西晋末因中原战乱而迁西凉。至北魏初,宁氏之父兴被迁往平城。墓主生前以家传石工手艺服务皇室,后娶妻荥阳郑氏遗姬。宁懋及妻殁后,其二子获得精美石室葬具一座随葬父母之墓,并凿去石室正壁中央原有画像,留下坑洼不平的空白区域。

提高聚氨酯复合模冲切合格率的研究

基于某聚氨酯模具结构与冲裁原理分析,结合模具设计及制造过程理论计算,提出影响聚氨酯模具正常落料的3种因素,即挤入深度、压套与聚氨酯接触面积、聚氨酯硬度,并采取了相应的优化措施。通过对容框设计计算后,将压套倒角宽度尺寸由初始的2.5 mm加宽至5.0 mm,得出了聚氨酯模具冲裁超薄不锈钢零件的压套倒角宽度尺寸为5.0mm时冲裁效果更好的结论。

关于弧形类缩口件坯料计算模型

在设定金属材料塑性变形前后面积相等的前提下,利用几何关系和初等数学基本知识,导出了圆弧形缩口坯料计算的传统公式,指出了其存在理论依据粗浅、局限而导致精度不高的问题。进而,针对缩口件的典型形状,利用高等数学中的曲线积分方法,推导并提出了建立在金属塑性成形原理中体积不变条件下,能直接反映材料厚度及变化影响的弧形类缩口坯料计算新公式模型。并用算例进行对比分析,验证了新公式的较精确性与实用性。

基于热传导模型位场网格数据补空方法研究

基于热传导模型研究位场网格化数据补空方法,将网格数据空白区域的补空过程类比于热传导过程,实现位场网格中的已知有效信息向数据缺损区域传递,逐步填补数据空白区域。理论模型试验表明基于热传导模型补空精度高,效果明显,在边缘衔接处等值线光滑连续,能够清晰、真实、准确的反映异常梯度走向和趋势变化特征;实际航空重力资料进一步验证了该方法的可行性和实用性,补空效果更符合实测航空重力区域变化规律,最大限度的反映出区域内地质信息,丰富了位场异常信息,提高了位场数据处理和转换的精度,具有实际意义。

锥形类缩口件坯料计算公式

利用金属材料塑形变形前后面积相等假设条件,经过从几何关系与数学上的考量,导出了锥形缩口坯料计算的两个传统公式;用算例进行对比计算与分析,并综合归纳,给出了建立在金属塑形成形原理中体积不变等条件下锥形类缩口坯料计算的两个新公式。

基于钻孔测斜及水力冲孔融合的瓦斯三角空白区治理技术

以主焦煤矿2303工作面底板巷为研究对象,针对打钻过程中出现的钻孔偏移现象,以解决煤层瓦斯三角空白区的瓦斯治理工作为目标,从设计角度进行理论分析,并采用YZG9.6矿用随钻测震轨迹仪对钻孔的偏移情况进行观测,对出现瓦斯治理空白带的区域进行补打钻孔,检测补打水力冲孔的偏移轨迹以及瓦斯抽采浓度情况,验证了钻孔测斜与水力冲孔技术结合治理瓦斯三角空白区的有效性,增强了水力冲孔技术在主焦煤矿瓦斯治理工作中的利用率。

浅层地震反射波法在追索地下人防工程中的应用

对于许多规模小、深度浅的地下人防工程．用地震反射波法查明它们在地下的分布和大小。在江西临川市某区，我们采用浅层地震反射波法，根据当地的场地条件、物性差异和干扰情况等，合理布置测线，选择恰当的激发和接收方式，进行适当的资料处理，得到了清晰的地震时间剖面。根据时间剖面上反映出来的反射空白区，较好地推断出了该区地下人防工程的分布位置和防空洞的深度、宽度等。为该区一高层建筑的基础设计提供了依据。

注浆法在煤矿采空区地基处理中的应用

介绍了利用注浆法进行地基处理的原理及作用,结合工程实践,从使用材料、施工工艺、工程质量控制、竣工检测结果等方面对建筑工程采用注浆法对采空区进行地基处理作一介绍,以提高采空区承载力,节约土地资源。