Anatomical basis of transition from eleven to twelve meridians in Han dynasty

Bisoma five element acupuncture

Chinese classical formulas, firstly recorded in Shanghan Zabing Lun by Zhang Zhongjing in the Han dynasty, have been widely used by traditional Chinese medicine physicians for thousands of years due to its good compatibility, strict structures, significant clinical efficacy and less adverse effects. Ephedra associated prescriptions, widely used in the treatment of skin diseases, are famous representative prescriptions in Chinese classical formulas. The commonly used Ephedra associated prescriptions include Mahuang Lianqiao Chixiaodou decoction, Maxing Shigan decoction, Maxing Yigan decoction, Mahuang decoction, Mahuang Jiazhu decoction, Guizhi Mahuang Geban decoction, and Guizhi Eryue Biyi decoction. Skin allergy is an allergic reaction, manifested as erythema, papules, and itching. It has been identified that Guizhi Mahuang Geban decoction (1/2 Guizhi decoction + 1/2 Mahuang decoction) is effective in dispersing wind and cold, relieving exterior syndrome and dredging the collaterals, so it can be used to treat skin allergy caused by pathogenic wind-cold. Guizhi Eryue Biyi decoction (1/4 Guizhi decoction + 1/8 Yuebi decoction) is effective in dispersing wind and cold, relieving exterior syndrome and clearing heat, so it is mainly used for the syndrome of wind-cold tightening superficies and heat transformed from wind-cold. Additionally, Mahuang Lianqiao Chixiaodou decoction can relieve exterior syndrome, clear heat and remove dampness, mainly for the dampness and heat depression in the muscle surface. It is found that Guizhi Mahuang Geban decoction and Guizhi Eryue Biyi decoction have certain efficacy for skin allergies, while Mahuang Lianqiao Chixiaodou decoction has significant efficacy for urticaria, acute and chronic eczema, etc. It has been identified that if the conditions of Ephedra associated prescriptions are well mastered by traditional Chinese medicine physicians, they could be widely applied to treat exogenous diseases and miscellaneous diseases.

We review the Finapres technology, embodied in several TNO-prototypes and in the Ohmeda 2300 and 2300e Finapres NIBP. Finapres is an acronym for FINger Arterial PRESsure, the device delivers a continuous finger arterial pressure waveform. Many papers report on the accuracy of the device in comparison with intra-arterial or with noninvasive but intermittent blood pressure measurements. We compiled the results of 43 such papers and found systolic, diastolic and mean accuracies, in this order, ranging from -48 to 30 mmHg, from -20 to 18 mmHg, and from -13 to 25 mmHg. Weighted for the number of subjects included pooled accuracies were -0.8 (SD 11.9), -1.6 (8.3) and -1.6 (7.6) mmHg respectively. Subdividing the pooled group according to criteria such as reference blood pressure, place of application, and prototype or commercial device we found no significant differences in mean differences or SD. Measurement at the finger allows uninterrupted recordings of long duration. The transmission of the pressure pulse along the arm arteries, however, causes distortion of the pulse waveform and depression of the mean blood pressure level. These effects can be reduced by appropriate filtering, and upper arm 'return-to-flow' calibration to bring accuracy and precision within AAMI limits. For the assessment of beat-to-beat changes in blood pressure and assessment of blood pressure variability Finapres proved a reliable alternative for invasive measurements when mean and diastolic pressures are concerned. Differences in systolic pressure are larger and reach statistical significance but are not of clinical relevance. Finger arteries are affected by contraction and dilatation in relation to psychological and physical (heat, cold, blood loss, orthostasis) stress. Effects of these phenomena are reduced by the built-in Physiocal algorithm. However, full smooth muscle contraction should be avoided in the awake patient by comforting the patient, and covering the hand. Arterial state can be monitored by observing the behaviour of the Physiocal algorithm. We conclude that Finapres accuracy and precision usually suffice for reliable tracking of changes in blood pressure. Diagnostic accuracy may be achieved with future application of corrective measures.

Joanna Grant, A Chinese physician: Wang Ji and the ‘Stone Mountain medical case histories’, Needham Research Institute Series, London and New York, RoutledgeCurzon, 2003, pp. xi, 209, illus., £55.00 (hardback 0-415-29758-3) - Volume 48 Issue 3

Ionizable lipid-containing lipid nanoparticles (LNPs) are regarded as promising nonviral vectors for gene therapy delivery systems. Rationale design of the ionizable lipid structure based on initial screening of ionizable lipid molecule libraries combined with systematic comparison and analysis on the physical chemical parameters related to delivery efficiency greatly accelerated the discovery of novel LNP candidates for delivering various nucleic acid therapeutics like mRNAs (mRNAs). Based on the copper-catalyzed azide-alkyne click reaction, which is highly efficient and biocompatible, we were able to obtain the lipid molecule library containing a common triazole moiety between different lipid tails and various substituents as hydrophilic head groups. Herein, we systematically investigated the change of pKa values of different ionizable lipid molecules with different substituents as head groups in the click-based lipid library, mapping the pKa value change to different steps in the process of the LNP assembly and mRNA delivery. Systematic analyses on the data including the pKa value of the ionized lipids and the encapsulation and delivery efficiency of mRNA in LNPs with these ionized lipids provided the possibility of rational design on the head and tail structure for the triazole containing ionized lipids to realize highly efficient delivery of different mRNAs.

ObjectiveKnowledge regarding arterial variations is important during surgeries, intra-arterial injections, venipuncture and imaging of the upper limb. Our objective was to document brachial artery variations. MethodsWe studied 54 upper limb specimens during routine dissection. The anterior compartment of the arm, cubital fossa and the forearm were dissected and the pathway and the distribution of the brachial artery and its branches were documented. ResultsVariations of the brachial artery anatomy were noted in 3 specimens (5%). Unilateral high bifurcation of brachial artery was noted in two specimens on the left side. In one of these, bifurcation was directly from the axillary artery at the axilla just proximal to the formation of the median nerve. Here the brachial artery divided into its terminal radial and ulnar branches. In the other specimen, the brachial artery bifurcated into radial and ulnar arteries at the level of the mid humerus. In the other specimen, the brachial artery was seen to trifurcate into radial, ulnar and common interosseus arteries at the level of the neck of the radius. ConclusionsHigh brachial artery bifurcation and trifurcation of the brachial artery in the upper arm was noted in this study. Reporting of such variations in different populations is important for the practicing clinician during diagnostic and surgical procedures.

As a part of the systematic analysis of parameters involved in electrical epidural spinal cord stimulation therapy, distribution of paresthesiae in accordance with the position of contacts, as related to midline and vertebral level of contacts, was investigated. A preliminary analysis performed for 266 combinations having contacts implanted in the midcervical and low-thoracic vertebral levels showed that the topographical spread of the paresthesiae did not always cover the classical dermatomes. Significant paresthesiae spread was found as follows: C4-midline, unipolar combinations; the hand, forearm and upperarm, bipolar combinations; the hand, forearm; C4-lateral, unipolar combinations: the anterior shoulder, forearm, upper arm and hand, bipolar combinations: the hand, forearm and upper arm; T10-midline, unipolar combinations: the anterior and posterior of thigh, leg, knee, ankle and foot, bipolar combinations: the anterior and posterior thigh, leg, knee and foot; T10-lateral, unipolar combinations: the abdomen, anterior leg, knee and anterior thigh, bipolar combinations: the anterior thigh, anterior leg, knee and foot. This preliminary analysis suggests that more detailed studies would be worthwhile in the investigation of sensory responses to electrical stimulation of the spinal cord with epidural electrodes. Findings from such investigations could also be useful to extend our present anatomical knowledge of central and peripheral sensory neural structures.

This study investigated changes in blood flow in the conduit artery, superficial vein, and deep vein of the upper arm during increase in internal temperature due to leg cycling. Additionally, we sought to demonstrate the contributions of blood velocity and vessel diameter on blood flow responses. Fourteen subjects performed supine cycling exercise at 60-69% maximal oxygen uptake for 30 min at an ambient temperature of 28 degrees C and relative humidity of 50%. Blood velocity and diameter in the brachial artery, basilic vein (superficial vein), and brachial vein (deep vein) were measured using ultrasound Doppler, and blood flow was calculated. Blood flow in the artery and superficial vein increased linearly with rising oesophageal temperature (DeltaT (oes)) after DeltaT (oes) was about 0.3 degrees C (within threshold), as well as cutaneous vascular conductance on the forearm. Changes in blood velocity in these vessels were similar to those in blood flow. Conversely, the brachial artery and superficial vein diameter did not affect the blood flow response. Blood flow variables in the deep vein did not change remarkably with rising DeltaT (oes). These results suggest that blood flow response, by an increase in velocity, in the conduit artery with rising DeltaT (oes) during exercise is similar to that in the superficial vein, but not deep vein. Also, it is indicated that these increases in blood flow relate to the increase in skin blood flow on the forearm with the rise in body temperature during exercise.

Accurate displacement measurement is essential for structural health monitoring (SHM). With the rapid development of computer vision, video-based techniques have become attractive for non-contact displacement sensing. Among these approaches, subpixel displacement measurement algorithms can achieve high-precision even under low-resolution video conditions, thereby showing considerable potential for engineering applications. Although various subpixel displacement measurement algorithms have been developed, their performance differs considerably, highlighting the urgent need for systematic comparison and analysis. This study conducts a comparative analysis of four subpixel displacement measurement methods. First, the computational principles of the algorithms are systematically analyzed, and computer-simulated vibration videos are employed to evaluate measurement accuracy and computational efficiency under different video resolution conditions. Subsequently, laboratory experiments are performed to investigate the influence of measurement distance on accuracy. Finally, the robustness of each method against measurement noise is examined by comparing their accuracy under various signal-to-noise ratio conditions. The results demonstrate that subpixel algorithms can significantly enhance the accuracy of vision-based displacement measurement, with different methods exhibiting variations in efficiency, accuracy, and robustness. These findings provide new insights into the trade-offs between accuracy, efficiency, and noise tolerance, offering practical guidelines for selecting appropriate algorithms in vision-based structural displacement monitoring.

Study question To investigate CFTR and ADGRG2 gene variants in patients with idiopathic obstructive azoospermia and identify semen parameters associated with these variants to guide genetic testing. Summary answer Fructose serves as an independent predictor of CFTR and ADGRG2 variants, indicating its potential role in guiding genetic testing for idiopathic obstructive azoospermia. What is known already Previous studies have identified four key semen parameters—ejaculate volume, pH, α-glucosidase, and fructose levels—that are significantly reduced in patients with two CFTR variants. Among these parameters, the diagnostic efficacy for detecting mutations was highest for pH (81.4%) and fructose (81.8%), with cutoff values of 7.4 for pH and 2 mmol/ejaculate for fructose. However, the OA patients in these studies exhibited a wide range of phenotypes, including congenital absence of the vas deferens (CAVD), idiopathic obstruction, cryptorchidism, varicocele, epididymitis, and pelvic trauma, which may limit the ability to specifically evaluate the predictive efficacy for idiopathic obstructive azoospermia. Study design, size, duration Study Design: A cross-sectional study was conducted to thoroughly analyze the targeted population. Sample Size: The study included 76 Chinese patients diagnosed with idiopathic obstructive azoospermia, providing a solid foundation for the research findings. Study Duration: The research was conducted from 2022 to 2023, with systematic data collection and analysis. Participants/materials, setting, methods Seventy-six patients with idiopathic obstructive azoospermia were classified into three groups according to their variant status: Group I included patients with at least two CFTR variants or a hemizygous ADGRG2 variant; Group II comprised patients with one CFTR variant and no ADGRG2 variants; Group III consisted of patients lacking both CFTR and ADGRG2 variants. Associations between genotypes and clinical parameters were evaluated using univariate and multivariate logistic regression to identify potential biomarkers. Main results and the role of chance Of the 76 patients, 36 (47.37%) carried one or more CFTR or ADGRG2 variants, characterized by significantly lower semen volume, fructose levels, and pH. Twenty distinct variants were identified, including three novel variants: c.1851A>T and c.2426C>T in CFTR, and c.1105G>A in ADGRG2. The most common variant was c.1210-12T[5] (5T) (18.42%), followed by c.1666A>G (4.61%) and c.4056G>C (3.95%). Group I patients had significantly lower ejaculate volume, pH, and fructose levels compared to Groups II and III. The combined AUC for fructose, age, pH, and volume was 0.979, with fructose alone achieving an AUC of 0.952. Diagnostic efficacy for variant detection was highest (88.1%) at a fructose cutoff of 0.923 mmol/ejaculate, with a sensitivity of 0.958, specificity of 0.923, PPV of 0.895, and NPV of 0.877. Fructose was identified as an independent predictor of CFTR and ADGRG2 variants, highlighting its potential utility in guiding genetic testing and clinical decision-making in idiopathic obstructive azoospermia patients. Limitations, reasons for caution First, although the nomogram was well-calibrated, our study’s sample size was limited. Second, the retrospective design may have introduced biases. Future research should use a prospective clinical study design. Integrating this model into clinical practice could enhance patient outcomes. Wider implications of the findings To date, no non-invasive semen parameter-based indicators exist for predicting genetic variations in idiopathic obstructive azoospermia. Our findings recommend CFTR and ADGRG2 testing for patients with fructose levels below 0.591 μmol per ejaculate. Trial registration number No

Computer simulation of blood flow in the human arm

The phase-locked loop (PLL)-based grid-following inverters have been widely used as the interface between renewable energy resources (e.g., wind and solar power) and the utility grid. In addition to the basic PLL and inner current control loop that are responsible for tracking the phase angle of the point of common coupling (PCC) voltage and regulating the current injection according to the estimated phase angle, respectively, these grid-following inverters are commonly also equipped with outer power and voltage control loops. Some examples are outer active power/dc-link voltage control loops and outer reactive power/PCC voltage control loops, which provide the <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$dq$ </tex-math></inline-formula> -axis current references for the inner current control loop. However, the existing literature generally focuses on specific outer control modes within a specific small-signal modeling framework, e.g., state-space or admittance modeling framework. In addition, different research groups usually repeatedly derive these small-signal models without a systematic modeling and analysis procedure. Furthermore, the systematic and comprehensive comparative modal and admittance analysis of these outer control modes is still missing in the literature. To avoid reinventing the wheel, provide the small-signal stability analysis community with handy both state-space and admittance models, and investigate the effects of various outer control loops on the small-signal models, this article presents a comprehensive and systematic small-signal modeling, analysis, and comparison framework of the PLL-based grid-following inverters, where the state-space and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$dq$ </tex-math></inline-formula> -domain admittance models of eleven control modes are derived step by step in a completely followable style. All of these derived small-signal models are verified by the time-domain step responses and frequency-domain <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$dq$ </tex-math></inline-formula> -domain admittance measurement. The insights into the effects of these outer control modes on the poles and residues of the <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$dq$ </tex-math></inline-formula> -domain admittance model are also explored, which help to understand how these outer control modes contribute to the <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$dq$ </tex-math></inline-formula> -domain admittance shaping.

In the past, different training scenarios have been developed and implemented on robotic research platforms, but no systematic analysis and comparison have been done so far. This paper deals with the comparison of an isokinematic (motion with constant velocity) and an isotonic (motion against constant weight) training algorithm. Both algorithms are designed for a robotic research platform consisting of a 3D force plate and a high payload industrial robot, which allows leg extension training with arbitrary six-dimensional motion trajectories. In the isokinematic as well as the isotonic training algorithm, individual paths are defined i n C artesian s pace by sufficient s upport p oses. I n t he i sotonic t raining s cenario, the trajectory is adapted to the measured force as the robot should only move along the trajectory as long as the force applied by the user exceeds a minimum threshold. In the isotonic training scenario however, the robot’s acceleration is a function of the force applied by the user. To validate these findings, a simulative experiment with a simple linear trajectory is performed. For this purpose, the same force path is applied in both training scenarios. The results illustrate that the algorithms differ in the force dependent trajectory adaption.

Although several studies have suggested that anti-inflammatory strategies reduce secondary infarct growth in animal stroke models, clinical studies have not yet demonstrated a clear benefit of immune modulation in patients. Potential reasons include systematic differences of post-ischemic neuroinflammation between humans and rodents. We here performed a systematic review and meta-analysis to summarize and compare the spatial and temporal distribution of immune cell infiltration in human and rodent stroke. Data on spatiotemporal distribution of immune cells (T cells, macrophages, and neutrophils) and infarct volume were extracted. Data from all rodent studies were pooled by means of a random-effect meta-analysis. Overall, 20 human and 188 rodent stroke studies were included in our analyses. In both patients and rodents, the infiltration of macrophages and neutrophils preceded the lymphocytic influx. Macrophages and neutrophils were the predominant immune cells within 72 h after infarction. Although highly heterogeneously across studies, the temporal profile of the poststroke immune response was comparable between patients and rodents. In rodent stroke, the extent of the immune cell infiltration depended on the duration and location of vessel occlusion and on the species. The density of infiltrating immune cells correlated with the infarct volume. In summary, we provide the first systematic analysis and comparison of human and rodent post-ischemic neuroinflammation. Our data suggest that the inflammatory response in rodent stroke models is comparable to that in patients with stroke. However, the overall heterogeneity of the post-ischemic immune response might contribute to the translational failure in stroke research.

Various types of titania nanostructures are synthesized with a polymer‐templated sol–gel method based on the amphiphilic diblock copolymer polystyrene‐b‐polyethylene oxide (PS‐b‐PEO) in combination with selective incorporation of the titania precursor titanium tetraisopropoxide. Custom tailoring of different types of titania morphologies is realized by changing the phase separation behavior of the PS‐b‐PEO template. Particularly, application of solvents from different categories is found to have a major impact upon the phase separation behavior of PS‐b‐PEO and the final titania film morphology. The amount of available hydrochloric acid catalyst during the gelation process is seen as an additional key factor to induce controllable morphological changes. Scanning electron microscopy and grazing incidence small angle X‐ray scattering measurements are carried out to study the surface and inner structure of porous titania films. Systematic analysis and comparison of different characterization results allow attributing the following three factors to the respectively formed titania nanostructure: the surface energy between PS blocks and surrounding solvent, the aggregation behavior of the titania nanoparticles, and the block‐specific selectivity of the used solvent. For all synthesized titania thin films, an anatase‐type crystallization is confirmed through X‐ray powder diffraction.