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简介：AbstractObjective:This article aimed to compare the peripheral blood flow intensity (BFI) in the maternal right and left kidney in uncomplicated third trimester pregnancies and to study possible associations between parenchymal BFI in the kidneys and maternal, labor and new-born characteristics.Methods:We conducted a prospective cohort study in third trimester pregnancies at Trondheim University Hospital, Norway, from January to April 2018. The BFI in the maternal kidneys was examined with color Doppler ultrasound and the peripheral BFI was calculated using the Pixel Flux-method which is a method based on pixel wise calculation of color in an image. Velocity was coded by the color bar in the ultrasound device. The peripheral BFI was calculated as the product of velocity and area encoded by all colored pixels divided by all pixels within the cortical layer by a software examining the color in each pixel of a standardized region of interest of the renal parenchyma in video-clips through a complete heart cycle. BFI (cm/s) was thus calculated as follows:The primary outcome measure was peripheral BFI in the renal cortex. We also examined associations between BFI in the entire cortex with maternal age, body mass index, blood pressure, pH in the umbilical artery, Apgar score after 5 minutes and birthweight.Results:In all, 51 pregnant women were included in the study, but 17 were excluded, mainly due to movement artifacts from the pulsating aorta, leaving 34 women in the final study population. We found significantly lower BFI in the cortex of the left kidney compared with the right kidney, 0.37 cm/s versus 0.69 cm/s, respectively (P = 0.04). Dividing into regions, the BFI was significantly lower in the proximal 25% of the left renal cortex compared to the corresponding right side (P= 0.01), and in the proximal 50% cortex (P= 0.02), but the differences were not significantly different in the distal 25% (P= 0.06) or in the distal 50% (P= 0.20) of the renal cortex.We observed a significant negative correlation between peripheral BFI in the left kidney and both systolic blood pressure (r = -0.38; P= 0.03) and diastolic blood pressure (r= -0.36; P= 0.04), and no significant correlations between BFI with maternal age, body mass index, blood pressure, pH in the umbilical artery, Apgar score after 5 minutes and birthweight in the left kidney (P > 0.05). We did not observe any significant correlations between BFI in the right kidney and maternal or new-born characteristics (P > 0.05).Conclusion:The BFI in the left renal cortex was lower compared with the right renal cortex, and BFI in the left renal cortex was negatively correlated with blood pressure, but not significantly correlated with maternal age, body mass index or newborn characteristics. We did not observe any significant correlations between BFI in the right kidney and maternal or new-born characteristics.

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简介：Ultrasonicbiophysicistsandphysicianshavecontinuouslyexhibitedgreatinterestinstudyingtheultrasonicpropertiesofblood.Itisshownthatcompressibilityofredcellappearstobeinverselypropor-tionalwithitshemoglobincontent.Amongultrasonicattenuationproducedbyredcellstructurelevelinblood,absorptionofredcellplayspredominantrole,viscousrelativemotionlossaccountsforlessthan15%,andcellscatteringcontributionisnegligible.Thecoagulationprocessofbloodisaccompaniedbysignificantchangeofsoundparameters.Themarkedadvantagehasbeenfoundintestofbloodcoagula-tionprocessbyusingultrasonictechniquethanthetraditionalviscousmethod.Bloodcoagulationcausessoundattenuation,soundbackscatteringandnonlinearityparameterB/Atoincrease,buttheattenuationfrequencydependencehardlychanges.Allofthesefindingsareofanimportantrealisticsignifi-cancefordevelopingultrasonicmedicine.

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简介：AbstractShark attacks are rare unique pathological processes. Some of them represent devastating injuries with a high morbidity and significant mortality. Related published articles are limited. The increased human interaction within the environment of sharks is the cause of rising incidence of such attacks. This study reported a case of level 4 shark injuries (shark-induced trauma scale) in a 33-year-old male patient, who presented with an extensive injury of the right lower limb with the characteristic features of shark bite. At admission the patient was in a state of shock with profuse bleeding that was controlled by tourniquet. The patient was resuscitated according to the advanced trauma life support. Clinical examination showed hard signs of vascular injury with absent pedal pulse, associated neurological deficits and severance at the knee joint. Prompt vascular intervention after resuscitation was performed to manage the major vascular injuries, together with proper washout and debridement of all the necrotic tissues under strong antibiotic coverage to prevent infection. After that, the patient underwent sequenced plastic, orthopedic, and neurological interventions. Strict follow-up was conducted, which showed that the patient was saved and achieved a functioning limb. This study aims to highlight the management of level 4 shark injuries, which are considered serious and challenging with a high fatality rate and a great risk of amputation due to the associated major vascular injuries. Immediate well organized management plan is crucial. Prompt resuscitation and surgical intervention by a highly-skilled medical team are required to improve the chance of patient survival and limb salvage.

简介：Itisveryimportanttomaintainthelevelofmeanarterialpressure(MAP).TheMAPcontrolisappliedinmanyclinicalsituations,includinglimitingbleedingduringcardiacsurgeryandpromotinghealingforpatient'spost-surgery.Thispaperpresentsafuzzycontroller-basedmultiple-modeladaptivecontrolsystemforpostoperativebloodpressuremanagement.Multiple-modeladaptivecontrol(MMAC)algorithmisusedtoidentifythepatientmodel,anditisafeasiblesystemidentificationmethodeveninthepresenceoflargenoise.Fuzzycontrol(FC)methodisusedtodesigncontrollerbank.Eachfuzzycontrollerinthecontrollerbankisinfactanonlinearproportional-integral(PI)controller,whoseproportionalgainandintegralgainareadjustedcontinuouslyaccordingtoerrorandrateofchangeoferroroftheplantoutput,resultinginbetterdynamicandstablecontrolperformancethantheregularPIcontroller,especiallywhenanonlinearprocessisinvolved.Fordemonstration,anonlinear,pulsatile-flowpatientmodelisusedforsimulation,andtheresultsshowthattheadaptivecontrolsystemcaneffectivelyhandlethechangesinpatient'sdynamicsandprovidesatisfactoryperformanceinregulationofbloodpressureofhypertensionpatients.

简介：Thispaperpresentsthedevelopmentofthebloodflowsimulationintwodimensionsovertherealgeometryofthefemoralartery.TheNavier-Stokesequationsaresolvedusingthefiniteelementmethod,toobtainthedistributionsofthebloodpressureandflowvelocityinmultipleinstantsoftimeanddifferentplacesofthefemoralarteryandthusdeterminethecurrentconditionofthebloodvessels.Thevelocityfieldshowsalaminarbehavior,where,thevelocityishigherinthecenterofthearteryanddecreasesasthebloodflowapproachesarterywalls.Inspiteofallarteryandbloodflowpropertiesnotbeingconsidered,thevaluesofpressureandvelocityobtainedarewithinthenormalranges.Finallythemodelisusedtoverifyifthereexistirregularitiesinthebloodflowinbothhealthysubjectsandsickpatients.

简介：Onthebasisofthemedicalandmechanicalanalysisandexplanationsinthispaperthevisco-elasticsimplysupportedbeammodelisproposedtotreatthedisplacementwaveofthebloodvessels.Therelationshipsbetweenthedisplacementwaveandbloodvesselelasticityaswellastheviscousdissipationofthebloodandbloodvesselareobtained.ThecorrespondingrelationsofsuchkindsofpulsesinthetraditionalChinesemedicineassmoothpulse,surfacepulseanddeeppulsetothedisplacementwavesofbloodvesselsarealsofound.Thecomputationalresultsareingoodagreementwiththoseacquiredintheexperimentswithultrasonicwave.

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简介：Thereexistmanymethodstomeasurebloodspeed,allofwhichhavesomeseriousshortcomings.Asfiberischaracterisedbytinydiameter,andlowlostratioofpowerandflexibility,itissuitableformeasuringbloodspeed.Itisprovedthatthespeedometerhashighspaceresolvingpower,hightimeresolvingpower,andoutstandingcapabilityofapproachingtarget,etc.

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简介：Efficacyofacupuncturetherapyvariesinpatientswithsimilarailments.Thepresentstudywasundertakentosearchforamarkerforbetterefficacyofacupuncturetherapy.Thestudywasmadein224patientsincludingosteoarthritis141(62.94%),polyarthritis23(10.26%),Bursitis&synovitis15(6.69%)andothers45(20.08%).ABObloodgroupsweretestedforeachpatient.ItappearsthatpatientsbelongingtogroupABandBrespondedwelltoacupuncturetherapyinproportionatelymorenumber.Goodresultwasachievedin47.82%casesingroupABand46.04%casesingroupB,whereaspatientsofgroupAandOshowedgoodresultin27.65%and26.15%casesrespectively.ApparentlyitmaybeconcludedthatpatientsofAB&Bbloodgroupswouldrespondcomparativelywelltoacupuncturetherapy.

简介：AbstractAmbulatory blood pressure monitoring (ABPM) has become indispensable in the current management of hypertension. ABPM is particularly useful in the accurate diagnosis of hypertension. Its diagnostic thresholds had been recently established based on hard clinical outcomes. Cross-classification of patients according to office and ambulatory blood pressure identifies white-coat, masked, and sustained hypertension. ABPM is also useful in cardiovascular (CV) risk assessment. It provides information on daytime and nighttime blood pressure and circadian rhythm, particularly nighttime blood pressure dipping. Nighttime blood pressure is predictive of CV risk independent of office and daytime blood pressure. Isolated nocturnal hypertension is a special form of masked hypertension, with normal daytime but elevated nocturnal blood pressure. It also helps in the evaluation of blood pressure fluctuation and variation, such as morning blood pressure surge and reading-to-reading blood pressure variability. ABPM may derive several other indexes, such as ambulatory blood pressure index and salt sensitivity index, which may be useful in CV evaluations.

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简介：AbstractBackground:Obstetric hemorrhage is a major cause of maternal death during cesarean delivery. The objective of this retrospective observational study was to evaluate the efficacy and safety of intra-operative cell salvage (IOCS) in cesarean section.Methods:We included a total of 361 patients diagnosed with central placenta previa who underwent cesarean section from May 2016 to December 2018. In this study, 196 patients received autologous transfusion using IOCS (IOCS group) and 165 patients accepted allogeneic blood transfusion (ABT group). Propensity score matched analysis was performed to balance differences in the baseline variables between the IOCS group and ABT group. Patients in the IOCS group were matched 1:1 to patients in the ABT group.Results:After propensity score matching, 137 pairs of cases between the two groups were successfully matched and no significant differences in baseline characteristics were found between the IOCS group and ABT group. Patients in the IOCS group were associated with significantly shorter length of hospital stay, compared with ABT group (8.9 ± 4.1 days vs. 10.3 ± 5.2 days, t= -2.506, P = 0.013). The postoperative length of hospital stay was 5.3 ± 1.4 days for patients in the IOCS group and 6.6 ± 3.6 days for those in the ABT group (t = -4.056, P < 0.001). The post-operative hemoglobin level in the IOCS group and ABT group was 101.3 ± 15.4 and 96.3 ± 16.6 g/L, respectively, which were significantly different (t= 2.615, P= 0.009). Allogeneic red blood cell transfusion was significantly lower at 0 unit (range: 0–11.5 units) in the IOCS group when compared with 2 units (range: 1–20 units) in the ABT group (P < 0.001).Conclusions:This retrospective observational study using propensity score matched analysis suggested that IOCS was associated with shorter length of postoperative hospital stay and higher post-operative hemoglobin levels during cesarean delivery.