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Table of Content

    23 September 2022, Volume 40 Issue 5
    Content
    2022, 40(5):  0-0. 
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    Review and Articles
    Study on an Internal Ultrasound Therapy Method Based on the Chirp-coded Excitation
    CHEN Beiyi, NING Chuanlong, ZHANG Rui, HUANG Wenchang, XU Jie, SHAO Weiwei, CUI Yaoyao
    2022, 40(5):  997-1003.  DOI: 10.7517/issn.1674-0475.220338
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    Ultrasound ablation is a method of treating cancer and other diseases which has received a lot of attention. The paper put forward an internal ultrasound therapy method based on Chirp-coded excitation which was studied in order to expand the therapeutic area and to reduce treatment duration. The self-made experimental platform and driving system were used in phantom experiments. The results of polyacrylamide (PAA) phantom experiments showed that, compared with constant-frequency excitation, Chirp-coded excitation can expand the effective treatment area of single ablation. On the basis of ensuring the range of ablation, the overall treatment duration can be effectively reduced.
    Acetylene Functionalized Photo-curable Acrylic Pressure Sensitive Adhesives
    YAN Hongyu, ZHANG Zhengyuan, WANG Yuechuan
    2022, 40(5):  1004-1009.  DOI: 10.7517/issn.1674-0475.220601
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    Photocuring is an effective way to achieve solvent-free and high-performance acrylate pressure-sensitive adhesives. With ethynyl cyclohexyl acrylate (ECA) as the alkyne functional monomer and using its photopolymerization characteristics, solvent-free and gel-free syrup and their final acrylate pressure-sensitive adhesive are prepared in two steps by photocuring the syrup prepared by bulk photopolymerization. With the increase of ECA addition (0~3 mol%), the molecular weights of the polymers containing the retained acetylene groups in the precursors decreased from 55.59×104 Da to 14.12×104 Da and molecular weight distribution slightly increased. Comparative studies have shown that acetylene groups improve the dynamic and static shear properties of the photocured pressure-sensitive adhesives, but have no or minimal effect on the peeling and tack forces. The acetylene group participates in photocuring, which increases the cohesion strength of the pressure-sensitive adhesive and will be a new means for pressure-sensitive adhesives modification.
    Research Progress in the Application of Ultrasound-targeted Microbubble Destruction Technology in Myocardial Infarction
    LU Xiangxiang, LIU Yan, HUANG Zhaohe
    2022, 40(5):  1010-1014.  DOI: 10.7517/issn.1674-0475.220404
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    Ultrasound-targeted microbubble destruction (UTMD) technology is a novel physical property-targeted gene delivery system, which is a hot research field in the treatment of myocardial infarction. This review introduced the structure, function and development of microbubbles, and discussed the application principle of UTMD technology and the application status of UTMD technology in myocardial infarction. The possible mechanisms of UTMD in the treatment of myocardial infarction were analyzed from the perspectives of promoting angiogenesis, promoting homing of transplanted cells, promoting the regeneration of infarcted myocardium, reducing myocardial cell apoptosis, inhibiting oxidative stress and improving myocardial microenvironment. On this basis, the advantages and disadvantages of UTMD technology were discussed. This review will summarize the research status of UTMD technology, so as to provide theoretical support for the later research and development of this technology.
    Difference Analysis of Different Imaging Methods in the Diagnosis of Breast Cancer
    JI Yufang, ZHOU Jian, XU Weihua, XU Min, ZHU Feng
    2022, 40(5):  1015-1018.  DOI: 10.7517/issn.1674-0475.220331
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    Measured the shear wave velocity (SWV) in this paper by virtual touch tissue quantification (VTQ), and then compared the value of SWV, X-ray and color Doppler ultrasound in the diagnosis of breast cancer. 85 patients with breast lesions with breast masses were selected as the research objects. All patients received X-ray, ordinary color Doppler ultrasound, VTQ and surgical pathological biopsy. Taking the pathological results as the gold standard, and the patients with breast cancer were set as the breast cancer group (52 cases), and the patients with benign breast masses were set as the benign group (33 cases). Compared the blood flow resistance index (RI), SWV value and blood flow display rate of the two groups, and analyzed the efficacy of different imaging methods in the diagnosis of breast cancer. The RI, SWV and blood flow display rates in the breast cancer group were higher than those in the benign group (P<0.05). The imaging diagnosis results showed that the sensitivity and specificity of X-ray in the diagnosis of breast cancer were 32.69% and 45.45%, respectively. The sensitivity and specificity of ordinary color Doppler ultrasound in the diagnosis of breast cancer were 69.23% and 69.70%, respectively. The sensitivity and specificity of SWV in the diagnosis of breast cancer were 82.69% and 75.76%, respectively. The AUC of breast cancer diagnosed by SWV, conventional color ultrasound and X-ray were 0.801, 0.687 and 0.453, respectively. Compared with X-ray, common color ultrasound and other imaging methods, the SWV has the highest efficiency in diagnosing breast cancer, and SWV value can evaluate the hardness of lesions, making up for the deficiency of common ultrasound.
    Changes of VOCAL Parameters and Hcy Levels in Patients with Gestational Hypertension
    WANG Lingling, GUO Zhiguo, LU Limin, LI Shuang, REN Chunli, CAO Xiuyan, XIE Shoujun, ZHENG Huachuan
    2022, 40(5):  1019-1023.  DOI: 10.7517/issn.1674-0475.220516
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    This paper investigated the changes of computer-assisted analysis of virtual organs (VOCAL) parameters and homocysteine (Hcy) levels in patients with gestational hypertension (PIH). 121 patients with gestational hypertension (PIH) were selected as the study group, and another 92 normal pregnant women in the same period were included as the control group. Both the two groups underwent VOCAL examination, and detected the Hcy expression by fully automated biochemical analyzer. The results showed that vascularity index(VI),flow index(FI), and vascularization flow index(VFI)in the study group were all lower than those in the control group, serum Hcy levels were higher than in the control group. FI, VI, VFI were negatively correlated with Hcy, and the AUC of combined diagnosis of PIH with FI, VI, VFI, and Hcy was better than that of single diagnosis (P<0.05). The incidence of adverse pregnancy outcome was higher in patients with low expression of VOCAL parameters than in those with high expression. The incidence of adverse pregnancy outcomes was lower in patients with high expression of Hcy than in patients with low expression, and both VOCAL parameters and Hcy were both factors influencing adverse pregnancy outcomes in patients with PIH (P<0.05). It can be seen that patients with PIH have abnormal expression of VOCAL parameters and Hcy, which has guiding significance for the diagnosis and treatment of the disease.
    Study of Colorectal Cancer CT Image Classification Based on 3D Convolutional Network
    LYU Gang, YING Mingliang
    2022, 40(5):  1024-1028.  DOI: 10.7517/issn.1674-0475.220522
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    Colorectal cancer (CRC) is among the top three tumors in the world. At present, screening CRC in CT images still needs to be done manually by radiologists, which is a time-consuming and laborious repetitive work. This paper investigated a method which extracted 3D features on abdominal CT images based on 3D convolutional network, then estimated whether there were CRC lesions through CT images. This paper collected a colorectal cancer CT image dataset with 348 samples and designed three 3D convolution networks with different structures, and performed a normal/abnormal binary classification experiments on the acquired abdominal CT images. The best performance model in this paper was a 3D convolution networks with three improved residual modules. The average accuracy of normal/abnormal binary classification experiment was 96.2%, and the AUC was 0.989, which was 2.2% and 2.9% higher than the baseline model. The experiment results showed that the 3D convolutional networks with have outstanding performance in the CRC normal/abnormal classification task, it also has good generalization ability and only under CT-level weak-labeled data, it is helpful to clinical application.
    Prediction Analysis of Conventional Ultrasound Indexes Combined with HD Live Technology in Monochorionic Twin Pregnancy
    ZENG Xiumei, LIANG Yuanhao, LIN Yangyang, ZHANG Qian, WANG Xia, ZHU Hexiang, GUO Hongmei
    2022, 40(5):  1029-1033.  DOI: 10.7517/issn.1674-0475.220524
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    This paper investigated the predictive value of conventional ultrasound indices combined with HD live technique in monochorionic (MC) twin pregnancy. Both conventional ultrasound examinations were performed in early pregnancy to obtain fetal conventional ultrasound indices[nuchal translucency layer (NT) thickness, crown-rump length (CRL)], and HD live technique to obtain ductus venosus (DV) spectral abnormalities and fetal cord abnormalities. The results showed that among 208 cases (416 fetuses) MC twin pregnancies, the fetal abnormality rate was 33.67% in MC double amniotic sac twin pregnancies and 58.33% in MC single amniotic sac twin pregnancies. The fetal abnormal group had higher inter-twin NT difference, CRL difference, DV spectrum abnormality rate and fetal umbilical cord abnormality rate in early pregnancy than the fetal normal group (P<0.05). In the early pregnancy the differences of NT, CRL, DV spectrum abnormalities and fetal umbilical cord abnormalities between twins were significantly associated with the occurrence of fetal abnormalities in MC twin pregnancy (P<0.05). The area under the curve (AUC) of NT differences, CRL differences, DV spectrum abnormalities and fetal umbilical cord abnormalities between twins in early pregnancy predicted the occurrence of fetal abnormalities in MC twin pregnancy alone were greater than 0.7, and the combined predicted AUC was the largest (0.922). The anatomical relationship of the HD live technique for examining MC twin pregnancies showed stereoscopic visualization, and it has good application value for predicting fetal anomalies in MC twin pregnancies when combined with conventional ultrasound indices.
    The Guiding Value of Prenatal Echocardiography in the Delivery Mode of Fetuses with Restricted Foramen Ovale Flow
    CHEN Ying, BAO Liwei
    2022, 40(5):  1034-1038.  DOI: 10.7517/issn.1674-0475.220514
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    This paper investigated the value of prenatal echocardiography in guiding the delivery mode of fetuses with restricted flow in the simple foramen ovale. 105 fetuses with restricted flow through the foramen ovale alone were selected and followed up until delivery. They were divided into early-onset group (n=30, gestational week <37 weeks) and late-onset group (n=75, gestational week ≥ 37 weeks) according to the gestational week of delivery. Compared the velocity of flow through the foramen ovale, size of the foramen ovale valve, inversion or disappearance of the A wave of the venous duct, abnormal morphology of the arterial duct, cardiothoracic ratio, and right atrium/left atrium (RA/LA), right ventricle/left ventricle (RV/LV), and degree of tricuspid regurgitation. The results showed that the degree of cardiothoracic ratio, RA/LA, RV/LV, and tricuspid regurgitation were higher in the early-onset group than in the late-onset group (P<0.05). The cardiothoracic ratio, RA/LA, RV/LV, and severe tricuspid regurgitation were all associated with early cesarean delivery (P<0.05). The area under the curve of the working characteristics of subjects with RA/LA, RV/LV, cardiothoracic ratio, and severe tricuspid regurgitation predicting early cesarean delivery was 0.764, 0.757, 0.792, and 0.550, respectively, and the AUC for the combination of these upper parameters to predict early cesarean delivery was 0.929. It is evident that the combination of prenatal echocardiography to detect RA/LA, RV/LV, cardiothoracic ratio, and severe tricuspid regurgitation has important value in guiding the mode of delivery.
    Application of TDI Combined with Serum miR-34a in the Diagnosis of Children CHD Complicated with PAH
    XU Shanshan, CAO Xianying, ZHOU Bin
    2022, 40(5):  1039-1044.  DOI: 10.7517/issn.1674-0475.220407
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    This study explored the diagnostic value of Tissue Doppler Imaging (TDI) combined with serum microRNA-34a (miR-34a) in the diagnosis of children congenital heart disease (CHD) complicated with pulmonary arterial hypertension (PAH). According to the occurrence of PAH, all 112 CHD children were divided into CHD group and CHD+PAH group and all of them underwent TDI examination. The TDI-Tei and TDI-Z of the two groups were measured respectively, and the serum miR-34a level of the children was detected by qRT-PCR test. The results showed that the TDI-Tei of the CHD group was significantly lower than that of the CHD+PAH group(P<0.001), the TDI-Z of the CHD group was significantly higher than that of the CHD+PAH group(P<0.001), the relative expression of serum miR-34a in CHD group was significantly lower than that in CHD+PAH group(P<0.001). Correlation analysis showed that TDI-Tei was negatively correlated with TDI-Z (r=-0.325, P<0.01), TDI-Tei was positively correlated with serum miR-34a (r=0.260, P<0.01), TDI-Z was negatively correlated with serum miR-34a (r=-0.386, P<0.01). The AUC and the sensitivity of TDI-Tei, TDI-Z and serum miR-34a combined diagnosis of CHD complicated with PAH were higher than those of single diagnosis. In conclusion, TDI combined with serum miR-34a has higher value in the diagnosis of CHD complicated with PAH, and was worthy of clinical promotion.
    Value Analysis of Ultrasound Combined with VEGFA in Diagnosis of Biliary Atresia
    WU Jingjing, QIN Xin, CHEN Die, HAN Xiao, ZHAO Yanyan, ZHANG Boyang, QIN Wen
    2022, 40(5):  1045-1050.  DOI: 10.7517/issn.1674-0475.220504
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    In order to investigate the value of ultrasound combined with vascular endothelial growth factor A (VEGFA) in the diagnosis of biliary atresia (BA), this study examined 108 patients with cholestasis suspected of BA by ultrasonography, and obtained the long diameter of the gallbladder, the thickness of the hilar fibrous mass and the liver stiffness. Serum VEGFA of patients with cholestasis and healthy subjects was detected by ELISA. The results showed that the long diameter of gallbladder in BA patients was lower than that in non-BA patients, while the thickness of hepatic hilar fibrous mass and liver stiffness were higher than those in non-BA patients (P<0.001). Serum VEGFA levels in BA and non-BA patients were higher than those in healthy people, while BA patients had higher serum VEGFA levels than non-BA patients (P<0.001). The combined AUC (0.948) and specificity (98.25%) of the three ultrasound parameters for the diagnosis of BA were higher than those for the diagnosis alone. The AUC, sensitivity and specificity of serum VEGFA for diagnosing BA were 0.850, 78.43% and 77.19%,respectively. The AUC, sensitivity and specificity of ultrasound parameters combined with serum VEGFA in the diagnosis of BA were 0.978, 98.04% and 89.47%,respectively. The sensitivity of ultrasound parameters combined with serum VEGFA in the diagnosis of BA are higher than those of single diagnosis and combined diagnosis of ultrasound parameters, and the specificity is second only to the combined diagnosis of ultrasound parameters. This diagnostic method has high clinical application value.
    Application Effect of Fine-needle Aspiration of Modified Small-needle Knife Guided by Ultrasound in the Treatment of Carpal Tunnel Syndrome
    FENG Yan, QIN Xin, XING Ruilin, TIAN Xinrui, GAO Xiaoping
    2022, 40(5):  1051-1055.  DOI: 10.7517/issn.1674-0475.220336
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    This study investigated the effect of lidocaine + trisineacetonide + VitB12 suspension injection combined with fine-needle aspiration under ultrasound and modified small needle knife in the treatment of patients with carpal tunnel syndrome. 60 patients with carpal tunnel syndrome were selected as the research objects, and divided them into the study group and the control group with 30 cases in each group by random number table method. The patients in the study group were treated with lidocaine + trisineacetonide + VitB12 suspension injection combined with fine-needle aspiration under ultrasound and modified small needle knife, and the control group was treated with lidocaine + trisineacetonide + VitB12 suspension injection combined with traditional small needle knife. The visual analog pain scale (VAS) scores after 1 course, 2 courses and 3 courses of treatment were lower than those in the control group (P<0.05). After treatment, the symptom severity scale score and functional status scale score of the patients in the study group were lower than those in the control group, and the difference was statistically significant (P<0.05). The median nerve sensory conduction velocity in the study group was faster than that in the control group (P<0.05), the motor terminal latency of the study group was shorter than that of the control group (P<0.05). After 3 courses of treatment, the overall therapeutic effect of the study group was better than that of the control group (P<0.05). Lidocaine + trisineacetonide + VitB12 suspension injection combined with fine needle aspiration under ultrasound and modified small needle knife in the treatment of carpal tunnel syndrome can effectively improve the clinical symptoms of patients and improve the clinical treatment effect.
    Effect of MSCT Combined with ERCP on Postoperative Infection in Patients with Duodenal Diverticulum Complicated with Gallstones
    LU Meng, CUI Leilei, JIANG Lijie, KANG Jie
    2022, 40(5):  1056-1061.  DOI: 10.7517/issn.1674-0475.220518
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    This study investigated the effect of multilayer spiral CT (MSCT)-based, endoscopic retrograde cholangiopancreatography (ERCP) observation on postoperative infection control in patients with duodenal diverticulum combined with gallstones. 210 patients with duodenal diverticulum combined with gallstones were selected and randomly divided into study group and control group with 105 cases in each group. The control group performed ERCP endoscopic lithotripsy, and the study group performed MSCT and ERCP-based endoscopic lithotripsy. The results showed that the success rate of ERCP cannulation in the study group was higher than those in the control group, and the operation time, nasobiliary drainage time and postoperative hospitalization time were shorter than those in the control group (P<0.05). The serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), blood glucose (Glu), cortisol (Cor) levels at 1 d and 3 d after surgery were lower than those before surgery in both groups, but they were all lower in the study group than in the control group (P<0.05). The serum CD3+ and CD4+ levels at 1 d and 3 d after surgery were lower than those before surgery in both groups, but they were all higher in the study group than in the control group (P<0.05). The serum CD8+ levels at 1 d after surgery were lower than those before surgery in both groups (P<0.05). The incidence of incisional infection, biliary tract infection and recurrence rate at 6 months and 1 year after surgery in the study group were lower than in the control group (P<0.05). It can be seen that endoscopic lithotripsy based on MSCT and ERCP observation can reduce the incidence of postoperative infection and effectively reduce postoperative recurrence in patients with duodenal diverticulum combined with gallstones.
    Application of Finkler Ultrasound Score Combined with LMTK2 Gene in the Diagnosis of Epithelial Ovarian Cancer
    FAN Fangyu, PU Yingmei, ZHOU Zhuyu, XIN Yanfen, XIA Jizhu
    2022, 40(5):  1062-1066.  DOI: 10.7517/issn.1674-0475.220605
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    This paper investigated the value of Finkler ultrasound score combined with lemur tyrosine kinase 2 (LMTK2) gene in the diagnosis of epithelial ovarian cancer (EOC). In this study, 112 patients with EOC (EOC group) and 76 patients with benign epithelial tumor of ovary (benign group) underwent ultrasonography and Finkler ultrasound score, and detected the serum LMTK2 levels by RT-PCR. The results showed that the Finkler ultrasound score and the relative expression of serum LMTK2 mRNA in the EOC group were significantly higher than those in the benign group (P<0.001). There was a significant positive correlation between the Finkler ultrasound score and the relative expression of serum LMTK2 mRNA (r=0.563, P<0.001). When the Finkler ultrasound score was >5, the area under curve (AUC) of the diagnosis of EOC was 0.964. When the relative expression of serum LMTK2 mRNA was >0.415, the AUC of diagnosing EOC was 0.907. The AUC (0.986) and sensitivity (94.64%) of Finkler ultrasound score combined with serum LMTK2 in the diagnosis of EOC were higher than those of single diagnosis. The Finkler ultrasound score and the relative expression of serum LMTK2 mRNA in stage Ⅲ-Ⅳ group were significantly higher than those in stage Ⅰ-Ⅱ group (P<0.05). The AUCs of Finkler ultrasound score, serum LMTK2 and their combined diagnosis of stage Ⅲ-Ⅳ were 0.643, 0.850, and 0.851, respectively. This study showed that in the early diagnosis of EOC, compared with the single diagnosis, the Finkler ultrasound score combined with serum LMTK2 could effectively improve the diagnostic sensitivity, and the diagnostic value of serum LMTK2 for pathological staging could be higher than the Finkler ultrasound score.
    Correlation Analysis between RI and VCSS Score in Patients with Great Saphenous Varicose Veins Complicated with Deep Femoral Popliteal Venous Reflux
    DU Jianqing, WANG Li, WU Zhongyin, LI Ronghua, ZHANG Hong
    2022, 40(5):  1067-1071.  DOI: 10.7517/issn.1674-0475.220333
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    This paper investigated the correlation between color Doppler ultrasonography-based deep venous reflux index (RI) and venous clinical severity score (VCSS) in patients with great saphenous varicose veins complicated with deep femoral popliteal venous reflux. 150 patients with great saphenous varicose veins combined with deep femoral popliteal venous reflux were selected as the research group, and 60 patients with great saphenous varices without deep femoral popliteal venous reflux during the same period were selected as the study group. All patients underwent color Doppler ultrasonography. The results showed that the reflux time, reflux speed and RI in the study group were higher than those in the control group (P<0.05). The AUC of the reflux time, reflux speed and RI in the diagnosis of deep femoral popliteal venous reflux in patients with saphenous varices were 0.820, 0.749, 0.832, respectively. The AUC of combined diagnosis was 0.875. The reflux time, reflux velocity and RI were still significantly correlated with saphenous varices combined with deep femoral popliteal regurgitation (P<0.05). The RI and VCSS scores of patients with venous reflux were positively correlated with the degree of venous reflux (r=0.912, 0.806, P<0.05). The RI were positively correlated with VCSS scores of patients with great saphenous varices combined with deep femoral popliteal venous reflux (r=0.738, P<0.05). Deep vein RI based on color Doppler ultrasonography is positively correlated with VCSS score in patients with great saphenous varicose veins complicated with deep femoral popliteal venous reflux, which can assist clinical assessment of patients' condition, and the reflux time, reflux velocity and RI has a certain value helpful in the diagnosis of great saphenous varices combined with deep femoral popliteal venous reflux.
    Effect of Tirofiban on ACI Stent Thrombectomy and CT Perfusion Imaging in Cerebral Perfusion Abnormal Area
    WANG Zheng, JIANG Hongmei
    2022, 40(5):  1072-1076.  DOI: 10.7517/issn.1674-0475.220319
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    This study observed the effect of tirofiban on the antiplatelet function and CT perfusion imaging (CTPI) results of patients with acute cerebral infarction (ACI) stent thrombus removal. 100 patients with ACI were randomly divided into two groups according to the admission order. The control group was treated with stent thrombectomy, and the observation group was treated with tirofiban combined with stent thrombectomy. Compared the vascular recanalization and adverse events between the two groups. The changes of CTPI results, apoptotic molecules[Caspase-3, apoptotic protein (Bax)] and platelet function indexes (platelet adhesion rate and platelet aggregation rate) were detected. There were 40 cases in the observation group with TICI grades 2b and 3, and the vascular recanalization rate was 80.00%, while in the control group, there were 31 cases in the TICI grades 2b and 3 (the vascular recanalization rate was 62.00%). The vascular recanalization rate was higher than in the control group (P<0.05). Compared with pre-therapy the relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV) in cerebral perfusion abnormal areas in the two groups were both increased (P<0.05), while the relative mean transmit time (rMTT) and relative time to peak (rTTP) were both decreased. After treatment, rCBF and rCBV in cerebral perfusion abnormal areas in the observation group were higher than those in the control group, and rMTT and rTTP were lower than those in the control group (P<0.05). The Caspase-3, Bax, platelet adhesion rate and platelet aggregation rate in the two groups were decreased than those before treatment in the same group (P<0.05). After treatment, the apoptosis molecules and platelet function indexes in the observation group were lower than those in the control group (P<0.05). The incidence of adverse events in the observation group was 4.00%, which was lower than 16.00% in the control group (P<0.05). Tirofiban can improve the cerebral hemodynamics in the cerebral perfusion abnormal area of patients with ACI stent thrombectomy with good antiplatelet function and low incidence of adverse events.
    Application of 1.5T MR Dynamic Enhanced Image Features and Parameters in the Diagnosis of Breast Cancer
    CHENG Yu, ZHANG Yayun, LI Mengshuang
    2022, 40(5):  1077-1082.  DOI: 10.7517/issn.1674-0475.220115
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    This paper explored the application value of 1.5T magnetic resonance dynamic enhanced image features and parameters in the diagnosis of breast cancer. 100 patients with breast cancer were selected as the observation group, and 60 patients with benign breast tumors treated in the same period were selected as the control group. All patients underwent magnetic resonance dynamic enhanced examination. The results showed, compared with the control group that there were statistically significant differences on the lesion morphology, edge, internal enhancement and ring enhancement in the observation group (P<0.05). In the observation group the Kep and Ktrans were higher than those in the control group (P<0.05). The AUC of Kep, Ktrans combined diagnosis was 0.861, which was higher than the single diagnostic value of each index. The lesion morphology, edge, internal enhancement and ring enhancement in patients with poor prognosis were compared with those in patients with good prognosis (P<0.05). Kep and Ktrans of patients with poor prognosis were higher than those with good prognosis (P<0.05). The lesion morphology, edge, internal enhancement, annular enhancement, Kep, Ktrans were independently correlated with the prognosis of breast cancer patients (P<0.05). 1.5T MRI dynamic enhancement image features of breast cancer patients are mainly irregular in shape, edge burr, internal inhomogeneous enhancement and annular enhancement, and the quantitative parameters Kep and Ktrans are at high levels, which could be clinically enhanced by MRI dynamic enhancement imaging features and parameters to diagnose breast cancer and predict prognosis.
    Application of Echocardiography Combined with Serum miR-26b-5p in the Diagnosis of Acute Myocardial Infarction
    QIN Jizhou, JIN Yan, LUO Zhaojun
    2022, 40(5):  1083-1087.  DOI: 10.7517/issn.1674-0475.220321
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    This paper discussed the diagnostic value of echocardiography combined with serum microRNA-26b-5p (miR-26b-5p) in acute myocardial infarction (AMI). 115 patients with AMI (observation group) and 80 patients with old myocardial infarction were selected as the control group, the echocardiographic parameters and serum miR-26b-5p of the two groups were analyzed. The left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVEDs), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and myocardial work index (Tei) in the observation group were higher than those in the control group (P<0.05), while the left ventricular ejection fraction (LVEF), E/A and miR-26b-5p were significantly lower than those in the control group (P<0.05). There were significant differences in LVEF and serum miR-26b-5p levels in patients with different degrees of coronary stenosis (P<0.05). The serum miR-26b-5p was negatively correlated with Gensini score (r=-0.503, P<0.05). The sensitivity and negative predictive value of echocardiography combined with serum miR-26b-5p in the diagnosis of AMI were significantly higher than that of echocardiography alone (P<0.05). Follow-up results showed that LVEDs and LVESV in patients with major adverse cardiovascular events (MACE) were significantly higher than those without MACE (P<0.05), and LVEF and miR-26b-5p were significantly lower than those without MACE (P<0.05). The areas under the ROC curve of LVEDs, LVEF, miR-26b-5p and combined prediction of MACE were 0.753, 0.732, 0.701 and 0.915, respectively, P<0.05. The serum level of miR-26b-5p is decreased in patients with acute myocardial infarction, miR-26b-5p combined with echocardiographic parameters has a good application value in differential diagnosis of AMI and prediction of MACE.
    Correlation between the Dynamic Contrast-Enhanced MRI Time-signal Intensity Curve and the Biological Behavior of Tumor Cells in Breast Cancer Patients
    YE Dongliang, CHENG Shide, FAN Gaojie, ZHENG Xiaomei
    2022, 40(5):  1088-1092.  DOI: 10.7517/issn.1674-0475.220318
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    This study explored the correlation between the dynamic enhanced MRI time-signal intensity curve and the biological behavior of tumor cells in breast cancer patients. 60 patients with breast cancer were selected as the observation group, and 60 patients admitted to the same period with benign breast lesions were selected as the control group. All patients underwent dynamic enhanced MRI examination. The results showed that the maximum concentration of contrast agent (Max Cone), area under time-signal intensity curve (AUC), time-signal intensity curve maximum slope (Max Slop), rate constant (Kep), transport constant (Ktrans), plasma volume fraction (Vp) in the observation group were higher than those in the control group, while the time to peak (TTP) was lower than that in the control group (P<0.05). The AUC of Ktrans, Kep, Vp, TTP, Max Cone, Max Slop and (time-signal intensity curve) AUC in the combined diagnosis of breast cancer were 0.913. The mRNA expression levels of CXCL1, Notch1, Gab2 and FOXF1 in observation group were higher than those in the control group, while the expressions of ATG2B and ATG4D were lower than the control group (P<0.05). The dynamic contrast-enhanced MRI time-signal intensity curve parameters of Ktrans, Kep, Vp, Max Cone, Max Slop, AUC was positively correlated with the mRNA expression of CXCL1, Notch1, Gab2, FOXF1, while negatively correlated with ATG2B, ATG4D mRNA expression (P<0.05). TTP was negatively correlated with CXCL1, Notch1, Gab2, FOXF1 mRNA expression, and was positively correlated with ATG2B, ATG4D mRNA expression (P<0.05). The parameter changes of dynamic enhanced MRI time-signal intensity curve in breast cancer patients are closely related to the biological behavior of tumor cells.
    Application of MRI ADC Histogram in Diagnosis of Endometrial Cancer and Assessment of Tumor Infiltrating
    HE Ying, LIU Xiaojuan, WANG Jing, CHANG Jianmiao
    2022, 40(5):  1093-1097.  DOI: 10.7517/issn.1674-0475.220302
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    This study investigated the value of apparent diffusion coefficient (ADC) histogram of magnetic resonance imaging (MRI) in the diagnosis of endometrial cancer and the degree of tumor invasion. 98 patients with endometrial cancer were selected as the case group, and 100 patients with uterine submucosal fibroids were selected as the control group. Both the two groups of patients underwent MRI examination, and then drew and compared the ADC histogram of the interesting region in MRI. 98 patients with endometrial cancer were stratified according to the degree of tumor infiltrating. The average value of ADC, ADC 10th, ADC 25th, ADC 50th, ADC 75th and ADC 95th in the case group were significantly lower than those in the control group (P<0.05). The AUC of ADC 10th in the differential diagnosis of endometrial cancer and uterine submucosal fibroids was 0.762, and the AUC of ADC 25th in the differential diagnosis of endometrial cancer and uterine submucosal fibroids was 0.842. Among 98 patients with endometrial cancer, 58 patients had myometrial infiltration depth<1/2 myometrium, and 40 patients had myometrial infiltration depth ≥ 1/2 myometrium. The mean value of ADC, measured value of ADC 10th, ADC 25th and ADC 50th in patients with myometrial infiltration depth<1/2 were significantly higher than those in patients with depth ≥ 1/2 (P<0.05). The sensitivity of ADC 10th in differential diagnosis of endometrial carcer with different depth of myometrial invasion was 90.17%, the specificity was 72.80%, and the AUC value was 0.856. MRI ADC histogram parameters are of great value in the differential diagnosis of endometrial cancer and uterine submucosal fibroids. It has a great significance to analyze the depth of invasion of endometrial cancer by MRI ADC histogram before operation.
    Application of Magnetic Resonance-transrectal Ultrasound Puncture Combined with Large Pathological Section in the Diagnosis of Prostate Cancer
    GUAN Yiman, LI Pei, FANG Qinmao
    2022, 40(5):  1098-1102.  DOI: 10.7517/issn.1674-0475.220126
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    Analyzed the advantages of MRI-transrectal ultrasound targeted puncture combined with large prostate pathological slices for accurate diagnosis of prostate cancer. 125 patients with suspected prostate cancer were selected as research objects in the study. According to the puncture method they were divided into 60 cases in the control group and 65 cases in the study group. The control group underwent conventional systematic puncture guided by transrectal ultrasound, and the study group underwent magnetic resonance-transrectal ultrasound puncture combined with conventional system puncture, the patients in the research group underwent magnetic resonance-transrectal ultrasound targeted puncture, a total of 50 patients were diagnosed as prostate cancer, and underwent radical resection of prostate cancer. Then the pathological specimens of 25 patients were collected, and made into large slices, and the other 25 cases were made into regular slices. Compared with the control group, the total number of puncture needles and the number of positive needles for prostate cancer in the study group were lower (P<0.05), the number of patients with positive puncture was higher (P<0.05), the incidence of complications after puncture was lower (P<0.05). Compared with the conventional section group, the incidence of nerve involvement and capsule involvement in the pathological large section group was higher (P<0.05). In the comparison of pathological T staging between the two groups, the number of pT ≥ 3 cases detected in the large pathological section group was higher (P<0.05). Magnetic resonance-transrectal ultrasonography combined with prostate pathological large slices has a higher diagnostic value for prostate cancer.
    Application of Ultrasound Quantitative Analysis Technology in Predicting the Risk of Esophagogastric Varices Bleeding
    LIU Wei, WANG He, CHU Xiaoyan, XU Lili, WANG Aimin
    2022, 40(5):  1103-1107.  DOI: 10.7517/issn.1674-0475.220304
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    This paper investigated the value of ultrasound quantitative analysis technology in predicting the bleeding risk of esophageal gastric varices (EGV). 127 patients with cirrhotic portal hypertension were selected as the research objects. After 3 months of follow-up, 2 patients lost contact. According to the presence or absence of EGV bleeding all patients were divided into the occurrence group (60 cases) and the non-occurrence group (65 cases). The severity of EGV severity, Child liver function classification, liver shear wave velocity (LSWV), portal vein diameter (PV), spleen shear wave velocity (SSWV), and spleen index (SI) were compared between the two groups, and the data were statistically analyzed. The results showed that the LSWV, PV, SSWV, and SI in the occurrence group were higher than those in the non-occurrence group (P<0.05). LSWV, PV, SSWV, and SI were positively correlated with EGV severity and Child liver function grade (P<0.05). The combined predictor expression with LSWV (X1), PV (X2), SSWV (X3), SI (X4) as covariates was:Logit(P)=-3.757+2.003×X1+1.989×X2+1.473×X3+1.981×X4, and its AUC for predicting EGV bleeding risk was 0.873 and greater than the original covariates, the predictive sensitivity was 78.33%, and the specificity was 81.54%. It can be seen that the detection of LSWV, PV, SSWV, and SI by ultrasonic quantitative analysis technology could be used as a plan to predict the risk of EGV bleeding, and it can play a certain guiding role in clinical preventive intervention and surgical method.
    The Relationship Between X-ray, MRI Lumbar Spine Parameters and Prognosis in Patients with Lumbar Spinal Stenosis
    LI Lingyu, LIU Xuanwen
    2022, 40(5):  1108-1112.  DOI: 10.7517/issn.1674-0475.220305
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    This study investigated the relationship between X-ray sagittal lumbar spine and magnetic resonance imaging (MRI) lumbar spine parameters with the course of lumbar spinal stenosis (LSS) and postoperative fast recovery nursing prognosis. 85 patients with lumbar spinal stenosis were selected, according to the course of disease, the patients were divided into group A (course of disease > 10 years) and group B (course of disease ≤ 10 years), the differences of X-ray and MRI parameters between the two groups were compared. The spine pelvis vertical axis (SVA), thoracic kyphosis angle (TK), thoracolumbar junction angle (TLJA), pelvic inclination angle (PT), pelvic incidence angle-thoracic lordosis angle (PL-LL), thoracic lordosis angle (LL), spinal canal area, dural sac area, spinal canal area/vertebral body area, dural sac area/spinal canal area, sagittal diameter of lateral recess, sagittal diameter of intervertebral foramen and intervertebral foramen area in group A and group B were statistically significant (P<0.05). The X-ray, MRI parameter in patients with ineffective and effective treatment were statistically significant (P<0.05). The X-ray and MRI parameters of lumbar spine in patients with lumbar spinal stenosis are related to the course of disease and the curative effect of postoperative rapid rehabilitation nursing, which is worthy of further study.
    Application of MRI Combined with hs-CRP and HMGB1 in Diagnosis of Cerebral Infarction
    TAN Meng, ZHANG Ying, CHEN Lei
    2022, 40(5):  1113-1117.  DOI: 10.7517/issn.1674-0475.220131
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    This study explored the correlation between MRI and high-sensitivity C-reactive protein (hs-CRP), high mobility group protein B1 (HMGB1) and its diagnostic value in patients with cerebral infarction. 120 patients with suspected cerebral infarction were selected. 70 patients with finally diagnosed cerebral infarction were selected as the observation group, and the other 50 as the control group. MRI was performed to observe lumen area (LA), total vessel area (TVA) and tube wall area (WA). hs-CRP was detected by immunorate nephelometry, and HMGB1 was detected by enzyme-linked immunosorbent assay (ELISA). The results showed that compared with the control group, the levels of LA and TVA were lower in the study group, and the levels of WA, hs-CRP and HMGB1 were higher (P<0.05). LA and TVA were both negatively correlated with hs-CRP, HMGB1 and the degree of disease (P<0.05), while WA was positively correlated with hs-CRP, HMGB1 and the degree of disease (P<0.05). The AUC of LA combined with WA, TVA in the diagnosis of cerebral infarction was 0.839 (P<0.05). MRI has a certain correlation with hs-CRP, HMGB1 and the severity of the disease and has a diagnostic value for cerebral infarction.
    Imaging Evaluation and Efficacy Analysis of High Flow Humidified Oxygen Therapy in Elderly Patients with Pulmonary Infections
    WANG Guoyu, BA Chunhe, WANG Haoyu, CAO Junjie
    2022, 40(5):  1118-1122.  DOI: 10.7517/issn.1674-0475.220308
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    This paper discussed the imaging evaluation of elderly pulmonary infection and the efficacy of high-flow humidification oxygen therapy. 96 patients with lung infection were selected as study subjects and divided into conventional oxygen therapy and high-flow humidification oxygen therapy with 48 cases in each group. The levels of inflammation-related factors and blood gas indexes in the two groups were tested, and the pulmonary CT imaging and clinical efficacy of the two groups were compared. After treatment, the levels of leukocyte count, neutrophil percentage, PCT, CRP, IL-1, IL-6, IL-8, TNF-α and PaCO2 decreased, and the high-flow humidified oxygen therapy group was lower than the conventional oxygen therapy group. After treating the SaO2 and PaO2 increased and higher than the high-flow humidified oxygen therapy group (P<0.05). The proportion of pleural effusion, nodules, grid, line pattern, and ground glass in the high-flow humidification oxygen therapy group after treatment was lower than the conventional oxygen therapy group (P<0.05). The high flow humidified oxygen effective rate was higher than the conventional oxygen treatment group (P<0.05). To sum up, high flow humidification oxygen therapy has good treatment effect on elderly patients with pulmonary infection, and pulmonary CT imaging can provide some reference for early diagnosis and efficacy evaluation of patients with lung infection, and has certain clinical promotion value.
    Predictive Analysis of High-frequency Pulmonary Ultrasound Score for Prognosis of Neonatal Respiratory Distress Syndrome
    GUO Jiankang, ZHANG Bin, LIANG You
    2022, 40(5):  1123-1127.  DOI: 10.7517/issn.1674-0475.220313
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    The purpose of this study was to investigate the prognostic value of high frequency pulmonary ultrasound score in neonatal respiratory distress syndrome. Ninety-one newborns with respiratory distress syndrome (observation group) and 80 newborns with non pulmonary diseases (control group) were selected. Result display, the differences of ultrasonic signs, pulmonary ultrasonic score and blood gas oxygenation index and so on between the two groups were analyzed. The proportion of consolidation of lung and pleural line abnormal ultrasonic signs, pulmonary ultrasound score:the observation group was higher than that in the control group (P<0.05). The blood gas oxygenation index:the observation group was lower than that of the control group (P<0.05). Ultrasound score was negatively correlated with blood gas oxygenation index and neonatal critical case score (P<0.05). The ROC curve of pulmonary ultrasound score in predicting the death was 0.872, P<0.05. Pulmonary ultrasound score is correlated with the severity and prognosis of neonatal respiratory distress syndrome, and it has certain application value in predicting the prognosis.
    Diagnostic Evaluation of Bedside Color Doppler Ultrasound Combined with Coagulation-fibrinolysis Markers in ICU Patients with Lower Extremity DVT
    JIAO Qingfeng, LU Meili, PAN Yingchun, HE Yuanling, YANG Xiaofan
    2022, 40(5):  1128-1132.  DOI: 10.7517/issn.1674-0475.220317
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    This study investigated the value of bedside color Doppler ultrasound and coagulation-fibrinolysis markers examination in diagnosing intensive care unit (ICU) patients complicated with lower extremity deep vein thrombosis and the effect of cluster nursing intervention measures. 164 patients with deep vein thrombosis in the lower extremities who were highly suspected of being treated in the ICU were selected as the research subjects. According to whether patients complicated with deep vein thrombosis (DVT) diagnosed by ultrasound venous angiography, they were divided into 94 cases in the DVT group and 70 cases in the non-DVT group, and all patients received bedside color Doppler ultrasound and coagulation-fibrinolysis index examination. The patients in the DVT group were randomly divided into the intervention group and the control group with 47 cases in each group, at the same time both groups were treated with thrombolysis and/or anticoagulation, and the intervention group was also given bundled interventions. The results showed that the values of fibrinogen (Fib), D-dimer (D-D), platelet aggregation rate (PAgT) and thrombin-antithrombin III complex (TAT) in the DVT group were all higher than those in the non-DVT group (P<0.05). In 94 patients with DVT, the overall coincidence rates of ultrasound diagnosis of DVT and ultrasound angiography was 77.66%. The sensitivity of ultrasound in diagnosing DVT was 77.66% and the specificity was 78.57%. After 5 and 7 days of treatment, the limb circumferences of the patients in the intervention group 15 cm above the patella and 10 cm below the patella were smaller than those in the control group (P<0.05). The bedside color Doppler ultrasound and coagulation-fibrinolysis markers examination are of certain value in detecting ICU patients complicated with lower extremity deep vein thrombosis. Combining cluster intervention on the basis of thrombolysis in DVT patients can achieve thrombolysis effect as soon as possible, and relieve the clinical symptoms of patients.
    Study of DECT Myocardial Perfusion Imaging Combined with Serum ANXA1 in the Diagnosis of Myocardial Infarction
    LUO Wei, ZHANG Jing, LI Qian
    2022, 40(5):  1133-1137.  DOI: 10.7517/issn.1674-0475.220320
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    This study investigated the value of dual-source dual-energy CT (DECT) myocardial perfusion imaging combined with serum annexin A1 (ANXA1) in the diagnosis of myocardial infarction. 100 patients with suspected myocardial infarction who underwent DECT myocardial perfusion were selected. All patients were examined with a German Siemens large-pitch dual-source dual-energy CT scanner, and the serum ANXA1 level was detected by an enzyme-linked immunosorbent (ELISA) kit. The coronary angiography and clinical data were used as the gold standard, 55 cases were diagnosed as myocardial infarction and 45 cases as non-myocardial infarction. The sensitivity and specificity of DECT for the diagnosis of myocardial infarction were 92.73% and 88.89%, respectively. The level of serum ANXA1 in patients with myocardial infarction was significantly lower than that in patients without myocardial infarction (t=6.582,P<0.001). The sensitivity and specificity of serum ANXA1 for the diagnosis of myocardial infarction were 92.73% and 68.89%, respectively. With the combined diagnosis based on serum ANXA1 level ≤ 1.92 ng/mL as a positive index or a positive DECT diagnosis result, the sensitivity and specificity of DECT combined with serum ANXA1 for the diagnosis of myocardial infarction were 99.47% and 61.24%, respectively. DECT combined with serum ANXA1 can effectively improve the diagnostic sensitivity of myocardial infarction, also could reduce the missed diagnosis rate, and has a high potential clinical value.
    Study of Ultrasound Combined with Serum OPN and IL-1β in the Diagnosis of Breast Cancer Bone Metastasis
    SONG Jun, LIU Xiang
    2022, 40(5):  1138-1142.  DOI: 10.7517/issn.1674-0475.220324
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    This study investigated the diagnostic value of ultrasound (US) combined with serum osteopontin (OPN) and interleukin-1β (IL-1β) in breast cancer bone metastasis. 60 breast cancer patients were examined by US, and the serum OPN and IL-1β levels were measured by enzyme-linked immunosorbent assay (ELISA). The results showed that the sensitivity of US in diagnosing bone metastases was 82.35% and the specificity was 80.77%. Compared with patients without bone metastases, the serum OPN and IL-1β levels in patients with bone metastases were significantly higher (P<0.001). Compared with patients in the US negative group, the levels of serum OPN and IL-1β in the US positive group were significantly increased (P<0.001). The serum OPN and IL-1β levels gradually increased with the increase of US grade (P<0.05). The sensitivity and specificity of OPN were 52.94% and 96.15% in the diagnosis of bone metastases, respectively. The sensitivity of IL-1β in diagnosing bone metastasis was 82.35% and the specificity was 84.62%. The sensitivity of OPN combined with IL-1β in the diagnosis of bone metastasis was 79.41%, and the specificity was 80.77%. US, OPN and IL-1β all play different roles in the diagnosis of breast cancer bone metastases, among which US and IL-1β have a higher sensitivity and OPN has a higher specificity, and the combination is more conducive to the early diagnosis of breast cancer bone metastases.
    Evaluation of DCE-MRI Parameters for Postoperative Femoral Head Necrosis in Patients with Femoral Neck Fractures
    YANG Junzhong, HU Hao, LI Jiabin, LI Liang, HUANG Pan
    2022, 40(5):  1143-1147.  DOI: 10.7517/issn.1674-0475.220326
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    This study investigated the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluating the blood supply of the femoral head in patients with femoral neck fracture and its relationship with postoperative complications of femoral head necrosis. A retrospective study of 52 patients with femoral neck fractures was selected, and the patients were grouped according to whether they had femoral head necrosis within 12 months after surgery. Among them, 130 cases without femoral head necrosis were classified as non-necrosis group, and 22 cases with femoral head necrosis were classified as necrosis group. All patients underwent DCE-MRI before surgery, 5 days after surgery, and 3 months after surgery. The peak time of the same region of interest (ROI) in the upper outer and inner upper quadrant of the affected side in the necrosis group was higher than that in the non-necrosis group at 5 days and 3 months after operation (P<0.05). Increased age, preoperative traction, Garden classification type IV, and prolonged peak time of upper outer quadrant or upper inner quadrant 5 days after operation were independent risk factors for postoperative femoral head necrosis in patients with femoral neck fracture (P<0.05). Postoperative professional rehabilitation was a protective factor for patients with femoral head necrosis (P<0.05). DCE-MRI has a certain value in evaluating the occurrence of femoral head necrosis after surgery, and it has a guiding significance for early clinical diagnosis and timely intervention measures.
    Diagnostic Analysis of Pelvic Floor Dysfunction Diseases in Different Stages of Pregnancies by Three-dimensional Ultrasonography
    CHEN Yu, ZHANG Chunye, WANG Weijing, GENG Xuna, SUN Congxin, ZHAO Wei, WANG Pin
    2022, 40(5):  1148-1152.  DOI: 10.7517/issn.1674-0475.220327
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    This study investigated the value of three-dimensional ultrasonography in the diagnosis of female pelvic floor dysfunction (PFD) during pregnancy and postpartum and the changes in pelvic floor structure. 134 pregnant women who underwent the whole process of prenatal examination were selected as the research objects, and all underwent three-dimensional pelvic floor ultrasound examination. The parameters differences of three-dimensional pelvic floor ultrasound in different pregnancy periods were analyzed, and at the same time the differences of three-dimensional pelvic floor ultrasound parameters between pregnant women with and without pelvic floor dysfunction diseases were compared. Under rest, contraction and Valsalva maneuver after 42 days postpartum, the anterior and posterior diameter, left and right diameter, area, posterior bladder angle, urethral rotation angle and bladder neck movement were significantly higher than those in the early and late pregnancy (P<0.05). There were significant differences in maternal age, history of constipation, prenatal urinary incontinence and family history of pelvic floor dysfunction between women with and without pelvic floor dysfunction (P<0.05). With the advancement of pregnancy, the parameters such as the diameter of maternal anal lift muscle and other crack are constantly increasing, especially the occurrence of pelvic floor dysfunction diseases, and the value of three-dimensional ultrasound diagnosis of PFD is high.
    Effect of MSCT Scanning Dose Reduction on the Diagnosis of Craniocerebral Combined with Facial Trauma
    TAO Xiaofei, MA Wencan, DING Zhichao, LI Yaxin, HAN Fusheng, TANG Yang
    2022, 40(5):  1153-1157.  DOI: 10.7517/issn.1674-0475.220334
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    This paper investigated the effect of reduced dose of multislice spiral CT (MSCT) on the diagnosis of craniocerebral combined with facial trauma. Selected 180 patients with craniocerebral combined with facial trauma and divided into group A, group B and group C, with 60 cases in each group. Group A was given tube current 220 mA and 200 mA MSCT scanning, group B was given tube current 220 mA and 180 mA MSCT scanning, and group C was given tube current 220 mA and 160 mA MSCT scanning. Analyzed the detection, image quality and radiation dose of craniofacial fractures in each group. CT dose index volume (CTDIVOI), dose length product (DLP) and effective radiation dose (ED) in group A under 200 mA, 180 mA in group B and 160 mA in group C were significantly lower than those in under 220 mA in group A, B and C (P<0.05). The CTDIVOI, DLP and ED in group C with tube current of 160 mA were significantly lower than those in group A with tube current of 200 mA and group B with tube current of 180 mA (P<0.05). In the diagnosis of craniocerebral combined with facial trauma, appropriately reducing the MSCT scanning dose will not affect the diagnosis and image quality, and will help to reduce the radiation harm to patients.
    Effect of Yibuweibao Decoction Combined with Ziwu Liuzhu Acupuncture on Treating Chronic Gastritis
    HAO Jie, HUANG Yunman, HUO Yongli, LI Bolin, SUN Runxue, YIN Lu, CHEN Xian
    2022, 40(5):  1158-1163.  DOI: 10.7517/issn.1674-0475.220405
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    This study investigated the effect of Yibuweibao Decoction combined with Ziwu Liuzhu acupuncture on gastroscopic indexes of patients with chronic gastritis. Selected 136 patients with chronic gastritis and divided them into the control group (routine western medicine) and acupuncture drug combination group (plus Yibuweibao Decoction combined with Ziwu Liuzhu acupuncture) according simple random method with principle of 1:1. Pepsinogen subsets, inflammatory factors were compared between the two groups, and the difference of traditional Chinese medicine(TCM)symptom score, quality of life score, the curative effect and safety were observed. After treatment, the total effective rate in the acupuncture drug combination group was significantly higher than that in the control group (P<0.05). The TCM symptoms in the acupuncture and medicine combination group were significantly lower than those in the control group, and the score of quality of life was significantly higher than those of the control group (P<0.05). Pepsinogen II (PGII), Soluble Interleukin-2 Receptor (sIL-2R), Chemokine-1 (MCP-1) and Tumor Necrosis Factor-α (TNF-α) after treatment in the two groups were both lower than before treatment, the PepsinogenⅠ (PGⅠ) and PGⅠ/PGⅡ were higher than before treatment, and the improvement of pepsinogen subsets and inflammatory factors in the acupuncture drug combination group were significantly better than those in the control group (P<0.05). The improvement of gastroscopic symptoms in the acupuncture drug combination group was significantly better than that in the control group (P<0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Yibuweibao decoction combined with Ziwu Liuzhu acupuncture in the treatment of chronic gastritis can regulate the expression of pepsinogen subsets and inflammatory factors, and also can improve the performance of the symptoms under gastroscopy, and has high safety.
    Therapeutic Effect of Rivaroxaban Combined with Urokinase on LEDVT Treatment and Its Effects on Ultrasound Parameters
    WANG Jia, LI Xiaotian, SONG Hao
    2022, 40(5):  1164-1168.  DOI: 10.7517/issn.1674-0475.220406
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    This paper analyzed the therapeutic effect and ultrasound assessment of rivaroxaban combined with urokinase for thrombolysis in patients with lower extremity deep venous thrombosis (LEDVT). Selected 100 patients with LEDVT as research subjects, according to the method of random number table they were divided into the control group with 50 cases and the study group with 50 cases. The control group was treated with urokinase, and the study group was treated with rivaroxaban + urokinase to detect and compare the inflammatory cytokines, coagulation function indicators, ultrasound parameters level and clinical efficacy of the two groups. After treatment, The levels of Interleukin-18 (IL-18), C reactive protein (CRP), interleukin-6 (IL-6), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), prothrombin time (PT), peak systolic velocity (PSV) and end diastolic velocity (EDV) were reduced, and the study group was lower than the control group. The RI levels of the two groups were increased after treatment, in addition, the study group was higher than the control group (P<0.05). Compared with the ineffective patients in research group, the effective patients have lower levels of PSV, EDV and higher level of RI were lower (P<0.05). The treatment response rate in research group was significantly higher than the control group (P<0.05). In conclusion, it could be seen that the inflammatory factors decreased and coagulation function improved for deep vein thrombosis after rivaroxaban and urokinase combined treatment, and the ultrasound parameters changed significantly after combined treatment. All these suggested that ultrasound could be used to evaluate thrombolysis effect in patients with LEDVT.
    Fungal Ball Sinusitis: CT Characteristics and Relationship with Serum BMP-2 and EGF
    ZHAO Xingquan, ZHONG Qu, GAO Lijun, GU Shanshan, LI Jia, CHEN Qian
    2022, 40(5):  1169-1173.  DOI: 10.7517/issn.1674-0475.220408
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    This study investigated the CT image characteristics of fungal glomus sinusitis and its relationship with the expression of serum bone morphogenetic protein-2 (BMP-2) and epidermal growth factor (EGF). 106 patients with fungal glomus sinusitis were selected as the observation group, and 100 healthy people were selected as the control group. All patients underwent the CT examination, and examined the serum BMP-2 and EGF expression levels. The proportion of nasal septum deviation, moderate and severe deviation, high deviation in the observation group were higher than those in the control group (P<0.05), the proportions of turbinate gasification, uncinate process deviation, uncinate process hypertrophy and Haller's air chamber in the observation group were higher than those in the control group (P<0.05). Serum BMP-2 and EGF in the observation group were significantly higher than those in the control group (P<0.05). The levels of serum BMP-2 and EGF in patients with nasal septum deviation and middle turbinate gasification in the observation group were higher (P<0.05). The incidence of structural variation such as deviation of nasal septum and gasification of middle turbinate increased in patients with fungal sinusitis, and the levels of serum BMP-2 and EGF were related to deviation of nasal septum and gasification of middle turbinate.
    Effects of Bendamustine Combined with Ixazomib on sVCAM-1, β2-MG and Ultrasound Parameters in MM Patients
    LIU Min, YU Zhuojun, LIANG Yan, HUANG Zhiping, TANG Yuanyan
    2022, 40(5):  1174-1178.  DOI: 10.7517/issn.1674-0475.220409
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    This paper exploreed the value of bendamustine combined with ixazomib for sVCAM-1 and β2-MG in patients with multiple myeloma (MM). Selected 100 multiple myeloma patients as research subjects, and divided them into the control group with 50 patients and 50 patients in the study group randomly. Both the two groups were given symptomatic treatment, the control group received dexamethasone plus bendamustine, and the study group gave dexamethasone plus bendamustine plus ixazomib. Before and after treatment, the patients in both groups were examined by ultrasound, the sVCAM-1 and β2-MG levels were tested as well. After treatment, the sVCAM-1, β2-MG, cortical IBS, medulla IBS, interlobe artery RI levels decreased, and the study group was lower than the control group. The kidney volume, kidney length, interlobe artery PSV levels increased, and the study group was higher than the control group (P<0.05). Compared with the ineffective patients in the study group, the effective patients had higher levels of kidney volume, kidney length, and interlobar artery PSV, while lower cortical IBS, medulla IBS, and interlobar artery RI levels (P<0.05). The effective rate of treatment in the study group was significantly higher than that in the control group (P<0.05). To sum up, the levels of sVCAM-1 and β2-MG in patients with multiple myeloma decreased after bendamustine combined with ixazomib treatment, and the clinical efficacy was satisfactory, and the ultrasound parameters changed significantly after the combined treatment, which suggested that ultrasound can be used for evaluation of clinical efficacy in patients with multiple myeloma.
    Effects of Continuous bedside Hemofiltration on Kidney Elasticity and Renal Blood Flow Spectrum in Patients with Cardiorenal Syndrome
    XUE Qianlong, YANG Lipeng, WANG Hui, WANG Jia, HE Ying
    2022, 40(5):  1179-1183.  DOI: 10.7517/issn.1674-0475.220502
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    This study observed the effects of continuous bedside hemofiltration on kidney elasticity, renal blood flow spectrum and left ventricular myocardial function in patients with cardiorenal syndrome. Selected 104 patients with cardiorenal syndrome as the research objects, and divided them into two groups by simple random method. The control group was given basic treatment, and the observation group was given continuous bedside hemofiltration treatment on the basis of the control group. Three-dimensional ultrasonography of the kidney was used to detect the Young's modulus (YM) of the middle renal cortex, and the hemodynamics of bilateral renal arteries parameters, and using three-dimensional speckle tracking technology (3D-STE) to examine the changes of left ventricular myocardial function parameters. The results showed that the YM, resistance index (RI) data of renal hemodynamic parameters in the two groups after treatment were lower than those before treatment. The bilateral renal artery diameter (D), renal blood flow (V) and echocardiography data except for the overall area strain were higher than those before treatment, and the data of YM and renal hemodynamic parameters in the observation group were significantly better than those in the control group (P<0.05). It shows that continuous bedside hemofiltration can improve kidney elasticity and renal blood flow spectrum in patients with cardiorenal syndrome, but has little effect on left ventricular myocardial function.
    MSCT Image Characteristics and Risk Factors of In-hospital Death after Endovascular Repair of Acute Stanford Type B Aortic Dissection
    SHENG Guofang, CAO Yanfang, LUO Chunying, HU Haijuan
    2022, 40(5):  1184-1189.  DOI: 10.7517/issn.1674-0475.220503
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    This paper investigated the relationship between in-hospital death after endovascular repair of acute Stanford type B aortic dissection and neutrophil/lymphocyte ratio (NLR), mean platelet volume/platelet ratio (MPR), vasoactive-inotropic score (VIS). Selected 198 patients with acute Stanford type B aortic dissection, and analyzed the differences in clinical data and multi-slice spiral CT (MSCT) image characteristics between in-hospital death and non-death patients. The results showed that age, NLR, MPR, VIS score and the percentage of the false lumen area at the tracheal bifurcation to the total area aortic lumen area of dead patients were significantly higher than those in non-dead patients (P<0.05). Age, NLR, MPR, VIS score and the percentage of percentage of the false lumen area at the tracheal bifurcation to the total area aortic lumen area were the influencing factors of in-hospital death (P>0.05). The area under the ROC curve of the five combined with the prediction of hospital death was 0.801, P<0.05. NLR, MPR, VIS scores and the percentage of percentage of the false lumen area at the tracheal bifurcation to the total area aortic lumen area are significantly increased in patients who died in hospital after endovascular repair of Stanford type B aortic dissection, which has certain application value in predicting prognosis.
    Ultrasound Parameter Changes of Autonomic Nerve Injury and Arterial Compliance in Patients with SAHS
    WANG Gang, XU Qi, GU Li, XIONG Jing, YANG Jie, XIA Jianguo
    2022, 40(5):  1190-1194.  DOI: 10.7517/issn.1674-0475.220509
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    This article discussed the changes of autonomic nerve injury, arterial compliance ultrasound parameters and their clinical significance in patients with obstructive sleep apnea hypopnea syndrome (SAHS). 140 SAHS patients were selected as the SAHS group, and 70 volunteers without SAHS-related symptoms were selected as the control group. The cardiac function parameters, aortic structure and function parameters, carotid pulse wave propagation speed(PWV1), descending aortic pulse wave velocity(PWV2) of the two groups of subjects were measured by ultrasound, and the Holter parameters changes were detected by electrocardiograph. The measured values of carotid pulse wave velocity (PWV1) and descending aortic pulse wave velocity (PWV2) in the SAHS group were significantly higher than those in the control group (P<0.05). The measured value of total power, very low frequency, and deceleration force (DC) were lower than that of the control group and the difference was significantly (P<0.05). The measured value of the heart rate acceleration force (AC) of the SAHS group was higher than that of the control group (P<0.05). The measured value of sleep-related apnea-hypopnea index(AHI) for SAHS patients was significantly positively correlated with PWV1, PWV2, AC (P<0.05), and the AHI measurement value in SAHS patients was significantly negatively correlated with DC (P<0.05). Patients with SAHS may have autonomic nerve damage and reduced arterial compliance, which are closely related to the severity of sleep apnea.
    Analysis of HFNC Therapeutic Effect and CT Parameters Changes in Elderly COPD Patients Complicated with Respiratory Failure
    LIANG Jinpai, ZHAO Hongling, ZHANG Bing, LIU Shuhong, XIAO Cuijun, YAN Xixin, CHAI Shukun, LIU Li
    2022, 40(5):  1195-1199.  DOI: 10.7517/issn.1674-0475.220513
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    This study investigated the changes and effects of CT quantitative parameters in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure before and after nasal high flow humidification oxygen inhalation (HFNC). 200 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with mild respiratory failure were randomly divided into two groups with 100 cases in each group. All patients were received non-invasive ventilation, and on the basis the patients in the treatment group were treated with HFNC, and the patients in the control group were treated with low flow oxygen therapy. The blood gas parameters, maximum abnormal end inspiratory volume (Cvin), maximum abnormal end expiratory volume (Cvex), lung volume, lung transverse diameter and other CT quantitative parameters of the two groups were compared before and after treatment, and the treatment effects of the two groups were compared. After 72 hours of treatment, the PaO2, PaO2/FiO2 and SaO2 values in the treatment group were higher than those in the control group, and the PaCO2 values in the treatment group were lower than those in the control group, the differences were statistically significant (P<0.05). After treatment, the measured values of Cvin, Cvex, lung transverse diameter, LAA%-950insp, LAA%-856exp in the treatment group were lower than those in the control group (P<0.05). After treatment, the CAT score and mMRC score of the treatment group were lower than those of the control group (P<0.05). After one week of treatment, the effective rate of the treatment group was higher than that of the control group (P<0.05). The effect of transnasal HFNC on COPD patients complicated with respiratory failure is significant. CT lung scan can effectively observe the changes of lung function before and after transnasal HFNC treatment, which is of great significance for evaluating the clinical treatment effect.
    Correlation Analysis of Ultrasound SWV Value, Serum APRI and the Degree of Liver Fibrosis in Children with Biliary Atresia
    ZHANG Jieyuan, PU Siyu
    2022, 40(5):  1200-1204.  DOI: 10.7517/issn.1674-0475.220521
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    This study investigated the clinical value of liver shear wave velocity (SWV) and serum aspartate aminotransferase (AST) to platelet ratio index (APRI) in the diagnosis of liver fibrosis in children with biliary atresia (BA). 102 children with BA were selected as the BA group, and 50 healthy infants of the same age were selected as the control group. Both groups received ultrasound examination and laboratory index detection, and they were grouped and compared according to the degree of liver fibrosis. The value of SWV and APRI values in diagnosing BA was analyzed, and the relationship between SWV and APRI values and liver fibrosis indexes was analyzed. The aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL) and APRI indexes of the children in the BA group were higher than those in the control group. The platelet (PLT) value of the children in the BA group was lower than that in the control group (P<0.05). The measured values of laminin (LN), hyaluronic acid (HA), type Ⅲ procollagen (PCⅢ) and type Ⅳ collagen (Ⅳ-Col) in the BA group were higher than those in the control group (P<0.05). The liver fibrosis score and SWV value of the children in the BA group were higher than those of the control group (P<0.05). The SWV value of children in BA group was positively correlated with LN, HA, PCⅢ, Ⅳ-Col and liver fibrosis score (P<0.05). APRI value was positively correlated with liver fibrosis score (P<0.05). The SWV value and APRI value of children in BA group with fibrosis grade ≥ F2 were higher than those of children with P<0.05). The AUC values of SWV value and APRI value in differential diagnosis of obvious liver fibrosis in children with BA were 0.980 and 0.858 respectively. SWV value and APRI value have certain value in diagnosing liver fibrosis and the severity of fibrosis in children with BA, and are correlated with liver fibrosis indicators.
    Application of Abdominal CT Scan in Diagnosis and Prognosis Prediction of Acute Pancreatitis
    WANG Zhen, LI Wenhua
    2022, 40(5):  1205-1210.  DOI: 10.7517/issn.1674-0475.220526
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    This paper investigated the application of abdominal CT scan in the diagnosis and prognosis prediction of acute pancreatitis. The clinical data of 164 patients with acute pancreatitis were retrospectively analyzed. The abdominal CT imaging features of acute pancreatitis were analyzed and the complications and death were used as the prognostic criteria. Logistic regression analysis was used to identify the risk factors of complications and death in patients with acute pancreatitis. Bahhazar-CTSI scoring system was used to grade the patients' condition, and the incidence of complications and mortality of patients with different CTSI scores were compared. The relationship between severity of acute pancreatitis and complications and death were analyzed. In 164 cases of acute pancreatitis patients, the incidence rate was 51.83%, the mortality rate was 7.32%. The complications and death of patients with acute pancreatitis were related to fatty liver, invasion of bare area of stomach, invasion of adrenal gland, effusion of suprahepatic space and invasion of perirenal space (P<0.05). The severe fatty liver, gastric bare area invasion, adrenal gland invasion, suprahepatic space effusion and perirenal space invasion were risk factors for complications in patients with acute pancreatitis (P<0.05), and gastric bare area invasion, adrenal gland invasion and suprahepatic space effusion were risk factors for death in patients with acute pancreatitis (P<0.05). Bahhazar-CTSI score was positively correlated with the incidence of complications and mortality in patients with acute pancreatitis (r=0.657, 0.688, P<0.05). Abdominal CT imaging of acute pancreatitis has characteristic signs, which can clearly show the degree of pancreatic lesions and the involvement of surrounding tissues and organs, which has high predictive value for the diagnosis and prognosis of acute pancreatitis.
    Comparative Study of ICG Fluorescence Staining and Modified Swelling Collapse Method in Thoracoscopic Segmental Lung Resection
    ZHENG Fade, GUO Xiaotong
    2022, 40(5):  1211-1214.  DOI: 10.7517/issn.1674-0475.220529
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    This paper explored the comparative analysis of Indocyanine Green (ICG) fluorescence staining and modified inflation-deflation method in thoracoscopic pulmonary segmentectomy. Selected 75 patients with lung cancer who received thoracoscopic pulmonary segmentectomy, then randomly divided them into the control group with 35 cases and the study group with 40 cases according to the digital table method. The control group used the modified inflation-deflation method and the study group used the Indocyanine Green (ICG) fluorescence staining method. Compared the efficacy, operation-related indicators of the two groups, and detected the conventional lung ventilation function test. Compared with the control group, the drainage time, chest drainage flow, hospital stay, peak expiratory flow (PEF), forced expiratory volume in one second (FEV1) and forced expiratory volume (FVC) of patients in the study group were all decreased (P<0.05). Patients in study group had earlier formation time of intersegment plane and shorter operation time than those in the control group (P<0.05). The overall incidence of complications in the control group (25.71%) was higher than that in the study group (7.50%), and the difference was statistically significant (P<0.05). Both the ICG fluorescence staining method and the modified inflation-deflation method can affect the lung function of patients during thoracoscopic pulmonary segmentectomy, while the ICG fluorescence staining method has less impact on the lung function, and the incidence of complications is also lower, which can be highly accurate identify the junction line between segments, with high security.
    Application of Ultrasound Imaging Technology Combined with Dezocine and Dexmedetomidine in Radical Mastectomy of Breast Cancer
    MIU Fan, YUAN Luning, GAO Xiaoli, LI Baizhen, WANG Kexin
    2022, 40(5):  1215-1220.  DOI: 10.7517/issn.1674-0475.220508
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    This paper investigated the value of ultrasound imaging techniques combined with dezocine and dexmedetomidine in radical mastectomy of breast cancer. 126 patients with radical breast cancer were selected as research subjects, and they were divided into two groups with 63 cases in each group using random number table method. Both the two groups were treated with erector spinae block by ultrasound imaging, 5 mg of dezocine was administered intravenously in the dezocine group, and in the combined group the dosage of dezocine was the same as that in the dezocine group, and then 0.5 μg/kg of dexmedetomidine was administered intravenously, followed by 0.3 μg/(kg·h) of dexmedetomidine pumped continuously. Cardiac monitors were applied to detect hemodynamic indexes, visual analog scoring (VAS) and Ramsay sedation scoring were used to evaluate the degree of analgesia and sedation, and enzyme-linked immunosorbent assay was used to determine the inflammatory stress indexes, while thequality of recovery and adverse effects were compared. The results showed the mean arterial pressure (MAP) and heart rate (HR) at T1, T2, T3 and T4 in the combined group were lower than those in the dezocine group, and the fluctuations were less than those in the dezocine group (P<0.05). The VAS and Ramsay scores at 3 h, 6 h, 12 h, 24 h and 48 h after surgery in the combined group were lower than those in the dezocine group (P<0.05). The serum tumor necrosis factor-alpha (TNA-α), interleukin-10 (IL-10) in the combined group was lower than those in the dezocine group at 3 d after surgery, while the expression of NK cells was higher than that in the dezocine group (P<0.05). The number of attempted compressions and effective compressions by the automatic intravenous analgesia pump (PCIA) in the combined group was less than that in the dezocine group at 48h after surgery (P<0.05). The comparison of the incidence of adverse reactions between the two groups, there was no statistically significant (P>0.05). Ultrasound imaging technology combined with dezocine and dexmedetomidine was applied to patients undergoing radical breast cancer surgery to achieve satisfactory sedative and analgesic effects, stabilize hemodynamics, improve the quality of early postoperative recovery, and have less effect on inflammatory stress with high safety.
    Study of Pulmonary CTPA Combined with D-dimer in the Diagnosis of Emergency Pulmonary Embolism
    LI Yong, ZHOU Yi, YANG Dichun, DUAN Longyu
    2022, 40(5):  1221-1225.  DOI: 10.7517/issn.1674-0475.210514
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    The purpose of this study was to investigate the value of CT pulmonary angiography (CTPA) combined with D-dimer in the diagnosis of emergency pulmonary embolism. 108 patients with suspected pulmonary embolism were selected, the CTPA and D-dimer were examined, the level of serum D-dimer in patients with pulmonary embolism was significantly higher than that in patients without pulmonary embolism (P<0.05). The area under the ROC curve of D-dimer in predicting pulmonary embolism was 0.921 (P<0.05). The detection rate of CTPA pulmonary embolism in patients with D-dimer ≥ 2.50 μg/mL was significantly higher than that in patients with D-dimer < 2.50 μg/mL (P<0.05). In the indirect signs of CPTA, the proportion of irregular consolidation, atelectasis and inferior vena cava reflux of pulmonary embolism patients were higher than those of non pulmonary embolism patients (P<0.05), D-dimer was positively correlated with CT pulmonary embolism index (CTI%) (r=0.684, P<0.05). CTPA combined with D-dimer detection has good application value in the diagnosis of emergency pulmonary embolism, especially in patients with D-dimer level ≥ 2.50 μg/mL, the detection rate of CTPA pulmonary embolism is high.
    Correlation between Carotid Plaque Characteristics and Serum Hcy, Cys-C, ApoA1 and UA in Patients with Ischemic Stroke Complicated with T2DM Assessed by CTA
    JIN Zhaowei, MA Feilong, ZHANG Dandan, CAO Hongwei
    2022, 40(5):  1226-1230.  DOI: 10.7517/issn.1674-0475.220623
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    This study investigated the relationship between carotid artery plaque characteristics and serum homocysteine (Hcy), cystatin C (Cys-C), apolipoprotein A1 (ApoA1) and uric acid (UA) levels in patients with ischemic stroke complicated with type 2 diabetes mellitus (T2DM) assessed by carotid CT angiography (CTA). 130 ischemic stroke patients with T2DM were selected as the case group, and 65 patients with pure T2DM were selected as the control group. The serum Hcy, Cys-C, ApoA1 and UA levels of the two groups were detected and compared. The case group underwent CTA examination, and the differences of the above indicators in patients with different carotid artery stenosis degrees and plaque characteristics were analyzed. The serum Hcy, Cys-C and UA levels in the case group were significantly higher than those in the control group, and the ApoA1 level in the case group was lower than that in the control group (P<0.05). The serum levels of Hcy, Cys-C and UA in the unstable plaque group were significantly higher than those in the stable plaque group, and the ApoA1 level in the unstable plaque group was lower than that in the stable plaque group (P<0.05). Serum UA levels in patients with severe stenosis were significantly higher than those in patients with mild-to-moderate stenosis, and ApoA1 levels in patients with severe stenosis were lower than those in patients with mild-to-moderate stenosis (P<0.05). CTA assessment can accurately assess the characteristics of carotid artery stenosis and plaque in patients with ischemic stroke complicated with T2DM, at the same time, the changes of Hcy, Cys-C, ApoA1 and UA levels are correlated with plaque characteristics and the degree of carotid artery stenosis.
    Application of PENG-assisted Spinal Anesthesia under Ultrasound in Elderly Patients with THA Surgery
    SONG Qingying, ZHONG Penggui
    2022, 40(5):  1231-1235.  DOI: 10.7517/issn.1674-0475.220325
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    This study investigated the application value of peripheral hip nerve block (PENG) under ultrasound to assist spinal anesthesia in elderly total hip arthroplasty (THA). 180 patients over 60 years old were to undergo THA surgery under general anesthesia were selected as the research objects, and a randomized trial was conducted, of which 90 patients were selected as the research group (anesthesia method:PENG+spinal anesthesia), and the other 90 patients were selected as the control group (anesthesia method:spinal anesthesia). The operation time of spinal anesthesia, the onset time of anesthesia and the recovery time of spontaneous breathing of the patients in the research group were all lower than those in the control group (P<0.05). The mean artery pressure (MAP) value of the research group at the time of skin incision and 30 min after surgery was higher than that of the control group, the MAP value of the study group at 10 min after surgery was lower than that of the control group(P<0.05). The heart rate(HR) value of the study group was lower than that of the control group at 10 min after surgery, while at the time of skin incision the HR value was higher than that of the control group (P<0.05). The prothrombin time (PT) and activeated partial thromboplasting time (APTT) values of the study group were both higher than those of the control group 10 min after the operation, and the fibrinogen (FIB), substance P and cortisol (Cor) were lower than those of the control group (P<0.05). The overall satisfaction of anesthesia effect in study group was higher than that in control group, and the complication rate was lower than that in control group (P<0.05). Compared with the simple use of spinal anesthesia, the use of PENG-assisted spinal anesthesia under ultrasound in elderly THA patients has a more satisfactory anesthesia effect, and has less impact on the patient's hemodynamics, coagulation function and stress response.
    Evaluation of DEG Combined with Heart Rate Deceleration Force and Short-term Blood Pressure Variability on the Risk of Sudden Death in SAHS Patients
    LIANG Lingdi, ZENG Yanling, ZHANG Tiantian, WANG Dongdong
    2022, 40(5):  1236-1240.  DOI: 10.7517/issn.1674-0475.220402
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    This paper aimed to investigate the value of dynamic electrocardiogram (DEG) combined with heart rate deceleration force and short-term blood pressure variability in the risk assessment of sudden death in patients with sleep apnea hypopnea syndrome (SAHS). 92 patients with suspected SAHS were selected, and the finally diagnosed 47 patients with SAHS were set as observation group, and the remaining 45 patients were control group. All patients underwent DEG examination and short-term blood pressure variation detection. The results showed that the standard deviation of normal R-R intervals (SDNN), mean of the standard deviation of normal R-R intervals (SDANN), the root mean square of the difference (rMSSD), and the heart rate deceleration force (DC) were negatively correlated with the severity of the disease (P<0.05). The heart rate (HR), 24 h mean systolic blood pressure variability (24 h SBPV) were positively correlated with disease severity (P<0.05). Compared with SDNN, SDANN, rMSSD, HR, DC, and 24 h SBPV single assessment, the combination of six assessments was more valuable in assessing the risk of sudden death in SAHS patients (P<0.05). It shows that the risk of sudden death in SAHS patients can be evaluated by DEG combined with heart rate deceleration force and short-term blood pressure variability, and the evaluation value is high.
    Application of Multi-b Value DWI and T2*mapping Imaging Cartilage Quantitative Analysis Technology in Diagnosis of KOA
    SUN Weiwei, HUANG Bufa, LI Lei
    2022, 40(5):  1241-1246.  DOI: 10.7517/issn.1674-0475.220520
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    This paper investigated the value of 3.0T MRI multi-b-value magnetic resonance diffusion-eighted imaging (DWI) and T2*mapping imaging cartilage quantitative analysis techniques in knee osteoarthritis (KOA). 60 patients (92 knees) with KOA were selected as the observation group, and another 60 patients (90 knees) with healthy physical examination at the same period were selected as the control group, and all of them underwent multi-b-value DWI and T2*mapping sequence scanning to obtain articular cartilage slow diffusion coefficient (SlowADC value), fast diffusion coefficient (FastADC value), and T2* value. The results showed in the observation group the articular cartilage medial and lateral SlowADC, FastADC and T2* values were higher than in the control group (P<0.05). The articular cartilage medial and lateral SlowADC, FastADC and T2* values were positively correlated with the occurrence and extent of KOA (P<0.05). The AUC of combined diagnosis of articular cartilage medial and lateral SlowADC, FastADC and T2* values for KOA was 0.900, and the AUC of combined assessment of the extent for KOA was 0.881. Multi-b-value DWI and T2*mapping imaging cartilage quantitative analysis techniques can evaluate KOA cartilage damage early and distinguish different periods of KOA, which are of great value for early diagnosis and condition assessment of KOA.
    The Efficacy Evaluation of Arthroscopic Rotator Cuff Repair by Magnetic Resonance T2 mapping Imaging
    PEI Xufeng, HUANG Fang, CHEN Yue
    2022, 40(5):  1247-1252.  DOI: 10.7517/issn.1674-0475.220201
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    This paper explored the efficacy value of magnetic resonance T2 mapping imaging in arthroscopic rotator cuff repair. 72 gymnasts with rotator cuff injury underwent arthroscopic rotator cuff repair were selected, and underwent routine MR sequence and T2 mapping sequence examination of the shoulder joint before and 6 months after surgery. And then divided them into excellent group (n=52) and poor group (n=20) according 6 months postoperative effect. The results showed that the proportion of low-grade MRI in the excellent group was higher than in the poor group, and the T2 values of the supraspinatus tendon in the middle, medial and lateral sides of the supraspinatus tendon before and 6 months after surgery were lower than those in the poor group. The constant-murley score (CMS), university shoulder score (UCLA) was higher than that of the poor group (P<0.05). The T2 values of the middle, medial and lateral supraspinatus tendon were negatively correlated with the CMS and UCLA scores before and 6 months after surgery (P<0.05). T2 values of the supraspinatus tendon before and 6 months after surgery were significantly correlated with the curative effect (P<0.05). The middle, medial and lateral T2 values of the supraspinatus tendon at 6 months after surgery were combined to evaluate the postoperative curative effect. The poor area under the curve (AUC) was the largest at 0.887. Magnetic resonance T2 mapping imaging has a high value in evaluating the efficacy of arthroscopic rotator cuff repair.
    Application of MSCT Combined with Serum Immune Inflammatory Factors in the Diagnosis of Fracture Nonunion
    LIU Lufeng, WANG Meng
    2022, 40(5):  1253-1257.  DOI: 10.7517/issn.1674-0475.220528
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    This paper investigated the multilayer spiral CT imaging (MSCT) in the diagnosis of fractures after knee injury and its correlation with serum immune inflammatory factor levels. 82 gymnasts with suspected post-knee injury fractures were selected for the study, and all patients underwent X-ray, MSCT examination, and serum immune inflammatory factor testing. Compared the differences of quantitative parameters of MSCT[bone mineral density (BMD), cross-sectional moment of inertia mechanical strength index (BSICSMI), cross-sectional area mechanical strength index (BSICSA)] and the serum immune inflammatory factors[tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β] between fracture healed and non-healed patients, and analyzed the correlation between the quantitative parameters of MSCT and serum immune inflammatory factors, and evaluated the value of MSCT quantitative parameters and serum immune inflammatory factors in evaluating fracture non-union. The concordance Kappa value between the type of fracture and surgical outcome after the diagnosis of knee injury by MSCT was 0.901, and the compliance rate was 92.68%. BMD, BSICSA, and BSICSMI in patients with fracture healing were higher than in patients with fracture non-union, and serum TNF-α, IL-6, and IL-1β levels were lower than those in patients with unhealed fractures (P<0.05). After knee injury the BMD, BSICSA, and BSICSMI were negatively correlated with serum TNF-α, IL-6, and IL-1β levels in patients with fractures (P<0.05). The AUC of the combined assessment of quantitative parameters of MSCT and serum immune inflammatory factors for fracture nonunion was 0.908, and was better than evaluating each indicator individually. The effectiveness of MSCT in diagnosing fracture after knee injury was higher, and the quantitative CT parameters were correlated with serum immune inflammatory factors, so MSCT combined with serum immune inflammatory factors could effectively diagnose fracture nonunion.
    Predictive Study of MRI on Spinal Cord Function Postoperative Recovery in Patients with CSCIWORA
    MA Shunjiang, TANG Zhongwen
    2022, 40(5):  1258-1263.  DOI: 10.7517/issn.1674-0475.220510
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    This study investigated the efficacy of magnetic resonance imaging (MRI) in predicting the postoperative recovery of spinal cord function in patients with spinal cord injury without radiological abnormalities (CSCIWORA). 139 patients with CSCIWORA caused by sports falls were selected as the research subjects, and they were divided into good group (n=103) and non-good group (n=36) according to the recovery situation of spinal cord function after surgery. The general data and MRI test results of the two groups were compared, and the data Statistical analysis was performed. The results showed that the time from injury to surgery was longer in the non-good group than in the good group, and the ASIA classification of spinal cord injury was more severe than in the good group (P<0.05). The patients in non-good group with spinal cord injury MRI type edema + hemorrhage and anterior cervical MRI high signal were more than the good group, and the signal length of spinal cord injury was higher than in the good group, while the effective cervical canal rate was lower than in the good group (P<0.05). Time from injury to operation, American Spinal Injury Association (ASIA) classification of spinal cord injury, MRI type of spinal cord injury, cervical MRI prevertebral hyperintensity, signal length of spinal cord injury, and effective cervical spinal canal rate were all correlated with the improvement rate of the Japanese Orthopaedic Association (JOA) score (P<0.05). The AUC of spinal cord injury signal length was the largest among single MRI parameters, but it was still lower than the AUC of all MRI parameters combined (0.922). It can be seen that the type of spinal cord injury MRI, cervical MRI prevertebral high signal, spinal cord injury signal length and effective cervical canal rate are related to the recovery of spinal cord function in patients with CSCIWORA after surgery. MRI technique can reliably predict the regression of spinal cord function after surgery.
    The Correlation between Cardiac Function Index and Uterine Artery Blood Flow in Preeclampsia Pregnant Women
    CUI Xiaojuan, ZHOU Ling, LU Xinming, JIAN Huiqiu, LI Pinghua
    2022, 40(5):  1264-1268.  DOI: 10.7517/issn.1674-0475.210113
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    The relationship between cardiac index (CI), uterine artery pulsatility index (UtA-PI) and resistance index (UtA-RI) in preeclampsia pregnant women and the value of combined prediction of placental abruption was investigated. One-hundred and fifty cases of preeclampsia pregnant women were selected as the observation group, and 100 healthy pregnant women were selected as the control group. The heart, uterine artery UtA-PI, UtA-RI and S/D of pregnant women were examined by color Doppler ultrasound. The left ventricular ejection fraction (LVEF) of the observation group was lower than that of the control group (P<0.05), while the CI was higher than that of the control group (P<0.05). The UtA-PI, UtA-RI and S/D of the observation group were significantly higher than those of the control group (P< 0.05). CI in observation group was positively correlated with UtA-PI and UtA-RI (P<0.05). The area under ROC curve of CI, UtA-PI and UtA-RI combined prediction of placental abruption was 0.960, which was significantly higher than that of single test. The CI, UtA-PI and UtA-RI of preeclampsia pregnant women are related to the severity of disease and placental abruption, and there is a positive correlation among them. The combined prediction of placental abruption has certain application value.
    Correlation between CTP Whole-Cerebral Perfusion Imaging Parameters and Hcy and Its Diagnostic Value for Ischemic Stroke
    WU Binbin, YU Yongqiang
    2022, 40(5):  1269-1273.  DOI: 10.7517/issn.1674-0475.220307
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    This paper investigated the correlation between cerebral perfusion imaging parameters of CTP and homocysteine (Hcy) and its diagnostic value in ischemic stroke. 156 patients with suspected ischemic stroke were selected, 80 patients with confirmed ischemic stroke were selected as the study group, and 76 patients with non-ischemic stroke as the control group. All patients underwent CTP whole- cerebral perfusion imaging examination, and Hcy expression level was detected by enzyme-linked immunoassay (ELISA). The results showed that compared with the control group, the parameters of cerebral blood flow (CBF), cerebral blood volume (CBV) in the study group were decreased, while the parameters of mean transit time (MTT) and time to peak (TTP) were increased (P<0.05). In study group the CBF and CBV parameters were decreased, MTT, TTP parameters and Hcy expression levels were increased in severe patients compared with mild and moderate patients in the study group (P<0.05). Compared with the single diagnosis of CBF, CBV, MTT and TTP, the combined diagnosis of the four items had higher diagnostic value for ischemic stroke, the AUC was 0.876 (P<0.05). CTP whole-cerebral perfusion imaging has high application value in the diagnosis of ischemic stroke patients and is related to the Hcy index of patients, which can be used for the diagnosis of ischemic stroke.
    Application of T1WI Signal Intensity of Globus Pallidus Combined with MRS Image in the Diagnosis of Neonatal HB
    KANG Zhilei, DU Naiyi, LIU Zhaoyan, LI Yang, JIANG Lijie
    2022, 40(5):  1274-1279.  DOI: 10.7517/issn.1674-0475.220330
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    This paper investigated the differential diagnostic value of globus pallidus T1-weighted image (T1WI) signal intensity combined with magnetic resonance spectroscopy (MRS) images for neonatal hyperbilirubinemia (HB) condition, and the correlation analysis with serum bilirubin (TsB) and transcutaneous bilirubin (TcB). 132 neonates with HB were selected, and according to the serum TsB level they were divided into mild, moderate and severe groups. Among them there were 42 cases of children with concomitant acute bilirubin encephalopathy, and 47 healthy neonates at the same time were selected as the control group. All neonates were performed magnetic resonance examination to obtain globus pallidus T1WI signal intensity and MRS image related indexes[N-ethylphthalate aspartate (NAA)/creatine complex (Cr), choline complex (Cho)/Cr, Cho/NAA]. The results showed that the T1WI signal intensity of the left and right globus pallidus, Cho/Cr, Cho/NAA in the severe group > moderate group > mild group > control group, and the NAA/Cr in the severe group < moderate group < mild group < control group (P<0.05). The T1WI signal intensity of the left and right globus pallidus in children with HB were negatively correlated with NAA/Cr and positively correlated with Cho/Cr and Cho/NAA (P<0.05). The area under the curve (AUC) of left globus pallidus T1WI signal intensity, right globus pallidus T1WI signal intensity, NAA/Cr, Cho/Cr, Cho/NAA combined diagnosis of neonatal HB was 0.901. The signal intensity of left and right globus pallidus T1WI, Cho/Cr, Cho/NAA were higher in children with concomitant acute bilirubin encephalopathy after treatment were higher than those of the control group, and the NAA/Cr were lower than those of the control group (P<0.05). It can be seen that the T1WI signal intensity of the globus pallidus combined with MRS images has high sensitivity and specificity in the diagnosis of HB in newborns, and the early detection can assist in the clinical prevention and treatment measures.
    Diagnostic Effect of MRI Combined with Multislice Spiral CT in Avascular Necrosis of Femoral Head
    DU Nana, ZHANG Lu, CHEN Mingmei
    2022, 40(5):  1280-1283.  DOI: 10.7517/issn.1674-0475.220501
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    This study explored the diagnostic effect and imaging characteristics of magnetic resonance imaging (MRI) combined with multislice spiral CT in avascular necrosis of femoral head. 96 patients with avascular necrosis of femoral head were selected as research subjects. All patients were diagnosed by MRI and multislice spiral CT. The imaging features of each stage and the diagnostic effect of different diagnostic methods on the stage of avascular necrosis of femoral head were compared. The results showed that compared with single MRI and multislice spiral CT, the diagnostic accuracy of MRI combined multislice spiral CT was higher, and the difference was statistically significant (P<0.05). Compared with single MRI and multislice spiral CT, the diagnostic accuracy of MRI combined multislice spiral CT in stage I was higher, and the difference was statistically significant (P<0.05). Compared with multislice spiral CT, the diagnostic accuracy of MRI was higher in stage I, and the difference was statistically significant (P<0.05). MRI combined with multislice spiral CT can effectively improve the diagnostic accuracy of avascular necrosis of femoral head, and improve the diagnostic accuracy of stage I.
    Difference Analysis of Spectral CT Parameters between Hepatic Hemangioma and Different Hepatocellular Carcinoma Lesions
    BAO Le, WANG Youbin, LI Pengfei, CHEN Long, LIANG Shuang, JIANG Bo
    2022, 40(5):  1284-1288.  DOI: 10.7517/issn.1674-0475.220328
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    This study investigated the characteristics and significance of spectral CT parameters of residual lesions and early new lesions after intervention for advanced liver cancer. 100 patients with primary liver cancer (liver cancer group) were selected, and 50 patients with hepatic hemangioma were selected as the control group (liver hemangioma group), and the patients with primary liver cancer were treated with percutaneous hepatic arterial chemoembolization (TACE). The differences of energy spectrum CT parameters between the two groups before operation were analyzed, the differences of energy spectrum CT parameters of residual and recurrent lesions and no residual or recurrent lesions in liver cancer group were analyzed. The venous standardized iodine concentration (VNIC), arterial standardized iodine concentration (ANIC), standardized iodine concentration ratio (ICratio), arterial curve slope and venous curve slope in liver cancer group were significantly higher than those in patients with hepatic hemangioma (P<0.05). VNIC, ANIC, ICratio, arterial phase curve slope and venous phase curve slope of recurrent lesions were significantly higher than those of residual lesions, no residual or recurrent lesions (P<0.05). There are significant differences in the energy spectrum CT parameters between hepatic hemangioma and liver cancer, and it has a certain application value in the diagnosis of postoperative recurrence of primary liver cancer patients.
    Effect of Photodynamic Therapy under Ultrasound Combined with Sinus Incision and Drainage in the Treatment of Hidradenitis Suppurativa
    YI Qin, CHEN Hongyan, LIU Jiayan, MEI Rong, YANG Lifeng, HAN Chenglong, LI Erlong, ZHAO Wenbin
    2022, 40(5):  1289-1293.  DOI: 10.7517/issn.1674-0475.220512
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    This paper investigated the effect of ultrasonic photodynamic therapy combined with sinus incision and drainage on purulent sweat adenitis. Selected 80 patients with purulent sweat adenitis randomly divided into test group and control group, with 40 cases in each group. The test group underwent ultrasound-guided photodynamic therapy and drainage, and the control group underwent simple sinus incision and drainage treatment. Observed the patients' visual analogue scale (VAS) scale, peripheral blood white blood cell (WBC), hypersensitive C response protein(hs-CRP) before and after treatment. Scored the patients' wound healing and swelling degree, and then analyzed the efficacy of the two groups. The results showed that the VAS score of test group was lower than that of control group at 3 d and 1 week after operation (P<0.05). In test group, WBC at 3 d and serum hs-CRP at 3 d and 1 week after operation were lower than those in control group (P<0.05). The wound healing and swelling scores at 3 d and 1 week after operation were lower than that in control group (P<0.05). The overall treatment effect of patients in test group was better than those in control group. Ultrasonic photodynamic therapy combined with sinus incision and drainage for suppurative sweat adenitis can significantly reduce the postoperative pain feeling and promote the early healing of the wound.
    Diagnostic Analysis of MRI Double Oblique Coronal Scanning and CT on Shoulder Impingement Syndrome Caused by Swimming
    PAN Yangyang, DONG Chunxue
    2022, 40(5):  1294-1298.  DOI: 10.7517/issn.1674-0475.220624
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    This study comparatively analyzed the value of magnetic resonance imaging (MRI) double oblique coronal scanning and CT in the evaluation of shoulder impingement syndrome (SIS). 63 SIS patients with swimming exercise were selected as the observation group, and 60 patients with simple rotator cuff injury were selected as the control group, the diagnostic value of MRI double oblique coronal position and CT for SIS were analyzed. The sensitivity, accuracy and negative predictive value of MRI in the diagnosis of SIS were significantly higher than those of CT (P<0.05). The acromial angle in the observation group was significantly higher than that in the control group (P<0.05), the angle of acromioclavicular joint and subacromial space were significantly lower than those in the control group (P<0.05). The areas under the ROC curve of acromion angle, acromioclavicular joint angle and subacromial space in the diagnosis of SIS were 0.909, 0.705 and 0.702, respectively. Compared with CT, MRI double oblique coronal scan has higher diagnostic value in swimming SIS.
    SMI Evaluation of IPN Formation and Risk Factors for ACI in Carotid Plaques
    WANG Wenfeng, CHANG Ye, MOU Rongji
    2022, 40(5):  1299-1303.  DOI: 10.7517/issn.1674-0475.220401
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    This study investigated the value of ultramicroscopic flow imaging (SMI) in evaluating the formation of neovascularization (IPN) in carotid atherosclerotic plaques and in predicting the occurrence of acute cerebral infarction (ACI). 60 patients with ACI with carotid atherosclerotic plaque were set as the ACI group and 60 patients with carotid plaque without ACI set as the control group. Both of the two groups underwent SMI, ultrasound angiography (CEUS) examination, and compared the grading of neovascularization in the carotid plaque detected by SMI and CEUS in the two groups, and the multivariate Logistic model was used to analyze the relationship between the formation of IPN in the plaque and the occurrence of ACI. A total of 120 carotid plaques were detected in 60 ACI patients. The consistency test value of SMI and CEUS in diagnosing IPN formation in carotid plaques was Kappa=0.723, P=0.000. A total of 127 carotid plaques were detected in the control group, and the concordance Kappa value of SMI and CEUS in diagnosing IPN formation in carotid plaques was 0.537, P=0.000. The serum TG, LDL-C elevation, concomitant diabetes mellitus, concomitant hypertension, and IPN formation in carotid plaques were the independent risk factors for ACI patients (P<0.05). SMI is highly consistent with CEUS in evaluating carotid atherosclerotic plaque IPN formation, and carotid plaque IPN formation is highly correlated with the occurrence of ACI in patients.
    Analysis of Carotid Plaque Characteristics on Superb Micro-vascular Imaging in Patients with Ischemic Stroke
    MA Lifeng, WEN Dehui, YUAN Guili, LIU Hongqiang, ZHANG Liwei, XU Le, WANG Yicheng
    2022, 40(5):  1304-1307.  DOI: 10.7517/issn.1674-0475.220506
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    This paper analyzed the relationship between superb micro-vascular imaging (SMI) carotid artery plaque characteristics and the incidence of ischemic stroke. Selected 96 patients with carotid artery plaque as research subjects, there were 76 patients occurred ischemic stroke during follow-up and set as the study group, and the remaining 20 patients without ischemic stroke were the control group. Both the two groups underwent SMI to obtain carotid plaque characteristics. Compared with the control group, the plaque thickness, plaque length, calcification degree, lipid degree were higher and the level of fiber degree were lower in the study group (P<0.05). With the increase of plaque thickness, plaque length, plaque calcification degree, lipid degree, and the decrease of fiber degree, the patients' incidence of ischemic stroke increased, and those with plaque thickness> 4 mm, plaque length> 20 mm, plaque calcification degree>20%, lipid degree>20%, and fiber degree <50% had the highest incidence of ischemic stroke. The diagnostic accuracy of SMI for ischemic stroke was 97.37% (P>0.05). In conclusion, the plaque characteristics of SMI are closely related to the incidence of ischemic stroke, and the SMI has a high value in the diagnosis of ischemic stroke.
    Study of High Frequency Ultrasound Elastography Combined with Anti-TG and Anti-TPO in the Diagnosis of Benign and Malignant Thyroid Nodules
    QI Yantao, LIU Huiming, LI Hongyu, CHAI Jixin, ZHANG Liuyang, LI Bo, AO Yazhou
    2022, 40(5):  1308-1312.  DOI: 10.7517/issn.1674-0475.220525
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    This study analyzed the diagnostic value of high-frequency ultrasound elastography combined with anti-thyroglobulin antibody (Anti-TG) and anti-thyroid peroxidase (Anti-TPO) in the diagnosis of benign and malignant thyroid nodules. 55 patients with suspected thyroid nodules were selected as the research objects. According to pathological examination results, they were divided into the benign group with 30 cases and a malignant group with 25 cases. The levels of Anti-TG and Anti-TPO were detected by automatic chemiluminescence analyzer, and the correlation between high-frequency ultrasound elastography and Anti-TG and Anti-TPO was analyzed by Pearson correlation. Compared with benign patients, malignant patients had higher diastolic blood flow velocity (D), resistance index (RI) and pulsatility index (PI) (P<0.05). Compared with benign patients, Anti-TG and Anti-TPO were increased in malignant patients (P<0.05). D, RI and PI parameters were positively correlated with the expression levels of Anti-TG and Anti-TPO. Compared with the single diagnosis of D, RI and PI, the combination of the three items has higher diagnostic value for malignant thyroid nodules (P<0.001). High-frequency ultrasound elastography has high diagnostic value in patients with benign and malignant thyroid nodules, and is correlated with the patient's Anti-TG and Anti-TPO indicators, which can be used for the diagnosis of benign and malignant thyroid nodules.
    Application of Right Heart Contrast Echocardiography Combined with Transesophageal Ultrasound in the Diagnosis of Cryptogenic Stroke in Young and Middle-aged People
    JIN Hong, XIA Zongbao
    2022, 40(5):  1313-1316.  DOI: 10.7517/issn.1674-0475.220309
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    This study explored the application value of right heart contrast echocardiography combined with transesophageal ultrasound in the diagnosis of cryptic stroke in young and middle-aged patients. 240 young patients with suspected cryptic stroke were selected as the research objects. All patients were examined by right heart contrast echocardiography and transesophageal ultrasound to determine whether there was a right-to-left shunt. Then measured the size of the shunt, and graded it according to the shunt flow. The detection rate of right heart contrast echocardiography combined with transesophageal ultrasound was significantly higher than that of right heart contrast echocardiography and transesophageal ultrasound alone (P<0.05). The sensitivity, accuracy and specificity of right heart contrast echocardiography combined with transesophageal ultrasound in the diagnosis of cryptic stroke in young and middle-aged patients were 91.61%, 87.08% and 80.41%, respectively. The right heart contrast echocardiography combined with transesophageal ultrasound examination can effectively improve the diagnostic sensitivity and accuracy of cryptic stroke screening in young and middle-aged people.
    Diagnosis Analysis of Renal Injury in Children with Sepsis by Bedside Ultrasonography, BUN and D-D
    GUO Xiaoli, TANG Aihua, SHI Hui, ZHU Yan
    2022, 40(5):  1317-1321.  DOI: 10.7517/issn.1674-0475.220607
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    This paper aimed to explore the correlation between bedside ultrasonography, blood urea nitrogen (BUN) and D-dimer (D-D) in the diagnosis analysis of renal injury in children with sepsis. 60 children with suspected sepsis complicated with renal injury were selected as the research objects,and they were divided into renal injury (40 cases) and non-renal injury (20 cases). According to the level of 24 h urinary albumin excretion rate the renal injury group were divided into the severe renal injury group (n=22) and the moderate renal injury group (n=18). All children underwent bedside ultrasonography, BUN and D-D levels test. Compared with the non-kidney injury group, the inspiratory collapse rate of the inferior vena cava in the renal injury group were decreased, and the inner diameter of the inferior vena cava and the ventricular end-diastolic diameter (LVIDd) were higher (P<0.05). Compared with patients with mild renal injury, the inspiratory collapse rate of the inferior vena cava were lower in patients with moderate renal injury, and the inner diameter of the inferior vena cava and the level of LVIDd were higher (P<0.05). Compared with the children in the mild renal injury group, the BUN and D-D levels of the children in the moderate renal injury group were increased (P<0.05). The inner diameter of the inferior vena cava and LVIDd were positively correlated with the BUN and D-D levels. The inspiratory collapse rate of the inferior vena cava was negatively correlated with the levels of BUN and D-D (P<0.05). The area under the ROC curve (AUC) of bedside ultrasound combined with BUN and D-D monitoring in the diagnosis of sepsis complicated with renal injury were higher than those of single detection (P<0.05). Bedside ultrasound combined with BUN and D-D monitoring can improve the diagnostic accuracy and sensitivity of renal injury in children with sepsis.