Comparative study for predictability of type 1 gastric variceal rebleeding after endoscopic variceal ligation:High-frequency intraluminal ultrasound study

BACKGROUND The efficacy of endoscopic ultrasonography for the follow-up of gastric varices treated with endoscopic variceal ligation(EVL)has not been established.AIM To evaluate the diagnostic correlation of esophagogastroduodenoscopy(EGD)and high-frequency intraluminal ultrasound(HFIUS)for type 1 gastric varices(GOV1)after EVL and to identify the predictability for rebleeding of EGD and HFIUS.METHODS In liver cirrhosis patients with GOV1,we performed endoscopic follow-up using EGD and HFIUS synchronously after EVL for hemorrhage from GOV1.Endoscopic grading and red color signs were analyzed using EGD,and the largest variceal cross-sectional areas were measured using HFIUS.In addition,1-year follow-up was performed.Variceal rebleeding was defined as the presence of hematemesis,hematochezia,or melena without other evidence of bleeding on endoscopic follow-up.RESULTS In 26 patients with GOV1,variceal cross-sectional areas on HFIUS of GOV1 was poorly correlated with EGD grading of GOV1(r=0.36).In 17 patients who completed the 1-year follow-up,variceal cross-sectional areas on HFIUS was a good predictor of subsequent rebleeding,whereas EGD grading was not a predictor of subsequent rebleeding.CONCLUSION HFIUS measurement is more predictive of GOV1 rebleeding than EGD grading,so HFIUS measurement may be necessary for endoscopic follow-up after EVL in patients with GOV1.

Efficacy evaluation of high-frequency ultrasound in the treatment of diabetic peripheral neuropathy with α-lipoic acid combined with traditional Chinese medicine package treatment

Objective:To use high-frequency ultrasound to evaluate the efficacy ofα-lipoic acid combined with traditional Chinese medicine in the treatment of diabetic peripheral neuropathy(DPN),so as to provide a basis for clinical medication and evaluation of therapeutic effect.Methods:From December 2018 to December 2019,110 patients with DPN who met the inclusion and exclusion criteria were divided into observation group and control group according to different treatment plans.The control group was treated withα-lipoic acid,and the observation group was treated withα-lipoic acid combined with traditional Chinese medicine encapsulation treatment,and used high-frequency ultrasound,nerve conduction velocity and serological examination to comprehensively evaluate the effectiveness of the two treatment methods.Results:The mean amplitude of glycemic excursions(MAGE)value of the observation group and the control group after treatment was significantly lower than before treatment(P<0.05);After treatment,the SCV of the ulnar nerve,median nerve,and common peroneal nerve in the two groups was significantly faster than before treatment(P<0.05).Similar to SCV,the MCV of the three nerves measured after treatment in the two groups was significantly faster than before treatment(P<0.05).Compared between the groups after treatment,the three kinds of nerve SCV and MCV in the observation group were significantly faster than those in the control group(P<0.05).The cross-sectional area(CSA)value of the ulnar nerve,median nerve and common peroneal nerve in the observation group after treatment was significantly lower than before treatment(P<0.05).Compared with the control group after treatment,the three nerves CSA in the observation group was significantly lower than that in the control group(P<0.05).Abnormal ultrasound performance:The proportion of abnormal ultrasound performances of the ulnar nerve,median nerve,and common peroneal nerve in the observation group after treatment was significantly lower than before treatment(P<0.05).The composition ratio of internal echo reduction and ambiguity in the observation group after three nerve treatments was significantly lower than that in the control group after treatment(P<0.05).In the correlation analysis,the three kinds of nerve CSA before and after treatment were negatively correlated with SCV and amplitude(P<0.05),and positively correlated with latency(P<0.05).Conclusion:The combination ofα-lipoic acid and Chinese medicine encapsulation technology has a good effect on the treatment and repair of DPN nerve damage,and can be routinely applied in clinical treatment.High-frequency ultrasound can intuitively observe changes in peripheral nerves and can be used to evaluate the prognosis of DPN.

Application Value of High-Frequency Ultrasound and Contrast-Enhanced Ultrasound in Patients with Knee Osteoarthritis with Different TCM Syndromes

Objective: To explore the application value of high-frequency ultrasound and contrast-enhanced ultrasound in different syndrome types of knee osteoarthritis, and to provide more imaging evidence for clinical diagnosis and treatment. Method: Sixty patients with KOA were selected according to TCM classification, which were mainly divided into Qi stagnation and blood stasis type and cold-dampness blockage type. All knee joints were routinely examined by high frequency ultrasound, and those with synovial hyperplasia were examined by contrast-enhanced ultrasound. High frequency ultrasound is the examination of synovium, cartilage and collateral ligament of knee joint based on two-dimensional ultrasound. Contrast-enhanced ultrasound (CEUS) refers to the contrast examination of synovium in knee joint patients with synovial hyperplasia. Result: Among them, the suprapatellar sac effusion and synovial thickening of Qi stagnation and blood stasis type were more obvious than those of cold-dampness arthralgia type (P < 0.05), and the degree of wear of the intercondylar cartilage of cold-dampness arthralgia type was more obvious than that of Qi stagnation. The blood stasis type is heavier and the meniscus bulge is higher (P < 0.05). The radiography of synovial hyperplasia showed that the area under the curve of Qi stagnation and blood stasis type was higher than that of cold dampness arthralgia type (P < 0.05), and the peak time was significantly shorter than that of cold dampness arthralgia type. There was no statistical difference in effective peak gradient and onset time of type (P > 0.05). Conclusion: To a certain extent, the high-frequency ultrasound and contrast-enhanced ultrasound performance of knee osteoarthritis can be used as a dialectical reference for different TCM syndrome types.

Development of a High-frequency Ultrasound System for High-speed Image Scanning

High-frequency image technique has been widely applied in medical diagnosis recently. For high voltage protection, high speed stage and trigger control circuitry are difficult to implement a high-frequency ultrasound imaging system. In this study, we utilized a linear servo with high noise tolerance and a novel multi-depth expression method to overcome those issues in developed high-speed image system. B-mode image of the chicken phantom by 25 MHz transducer shows the resolution of lateral and axial resolutions are up to 123 μm and 59 μm respectively. In addition, the experiment demonstrates that the axial resolution and depth of field (DOF) can be improved by time gain compensation(TGC) and multi-depth method. The results indicate that the proposed system could achieve over 24 fps for 1 mm scan distance and 100 lines per frame. In the future, the developed system is potential for other clinical applications such as ophthalmology and dermatology.

Relations among High-frequency Magnetic Properties and Frequency in Nanocrystalline Fe_(72.5)Cu_1Nb_2V_2Si_(13.5)B_9 Alloy

High-frequency magnetic properties, such as core loss, coercivity and amplitude permeabilityof a newly-developed nanocrystalline Fe72.5Cu1Nb2V2Si13.5B9 alloy in the wide ranges of f =20-103 kHz, Bm = 0.01~0.6 T and Bmf = 10~40 (T.kHz) have been measured. A largeamount of experimental data have been fitted by a computer, thus obtaining several expressionsrepresenting the influence of frequency on high-frequency magnetic properties, that are useful inpractical applications.

Analysis of High-Frequency Ultrasound in the differential Diagnosis of Lumps in Foot and Hand

Objective:To investigate the ultrasonogram characteristics of common lumps in hand and foot,pursuing for greater understanding of hand and foot lumps.Methods:65 cases of ultrasonographic characteristics of lumps in hand and foot were retrospectively analyzed,including the location,size,shape,boundary,internal echo and posterior echo,surrounding relationship and blood flow.Results:Among 65 cases,there were 26 cases of tendon sheath cyst,16 cases of tenosynovitis giant cell tumor,10 cases of hemangioma,4 cases of tendon sheath fibroma,3 cases of epidermoid cyst,2 cases of Schwannoma,2 cases of fibrolipoma,1 case of angiolipoma and 1 case of neurofibroma.The preoperative and postoperative pathological diagnoses of 45 cases,accounting for 69.23%,were consistent,3 cases(4.62%)were misdiagnosed,which included that 2 cases of tenosynovitis giant cell tumor were misdiagnosed as tendon sheath cyst,1 case of neurofibroma as epidermoid cyst,and the preoperative diagnosis of the rest 17 cases(26.15%)were indefinite.Conclusion:The high-frequency ultrasound can diagnose properties of lumps in foot and hand well,providing diagnosis basis for further treatment in clinic.

B超引导下髋关节囊周神经丛阻滞与腹股沟上髂筋膜间隙阻滞在股骨颈骨折患者中的应用效果对比

目的探讨B超引导下髋关节囊周神经丛阻滞(PNGB)与腹股沟上髂筋膜间隙阻滞(S-FICB)在股骨颈骨折(FNF)患者中的应用效果。方法选取2021年9月至2022年9月在漯河医学高等专科学校第二附属医院就诊的80例行全髋节置换术治疗的FNF患者为研究对象,根据随机数表法分为S-FICB组与PNGB组,每组40例。S-FICB组行S-FICB阻滞,PNGB组行PNGB阻滞。记录患者阻滞前(T_(0))和阻滞后5 min(T_(1))、10 min(T_(2))、15 min(T_(3))时的心率。记录患者T_(0)、T_(3)及阻滞后30 min(T_(4))、2 h(T_(5))、6 h(T_(6))、12 h(T_(7))、24 h(T_(8))静息、抬髋15°时的数字评定量表(NRS)评分。记录患者超声成像时间、穿刺操作时间、超声成像清晰度评分、首次下床活动时间、住院时间、术后并发症发生情况。结果两组T_(0)~T_(3)时的心率组间、时间和交互作用无统计学意义(P>0.05)。两组静息时T_(0)、T_(3)~T_(8)时NRS评分的组间、时间和交互作用有统计学意义(P<0.05),PNGB组静息时T_(0)、T_(3)~T_(8)时NRS评分均低于S-FICB组(P<0.05)。两组抬髋15°时T_(0)、T_(3)~T_(8)的NRS评分的组间、时间和交互作用有统计学意义(P<0.05),且PNGB组抬髋15°时T_(0)、T_(3)~T_(8)的NRS评分均低于S-FICB组(P<0.05)。PNGB组超声成像时间短于S-FICB组(P<0.05);术后,PNGB组首次下床活动时间短于S-FICB组(P<0.05);两组均未见神经阻滞相关并发症。结论S-FICB和PNGB应用于FNF患者中,均有较好的镇痛效果,对心率无明显影响,但PNGB在缓解术后疼痛,缩短超声成像时间,促进术后恢复方面效果更佳。

Diagnostics in inflammatory bowel disease: Ultrasound

Diagnosis of chronic inflammatory bowel diseases (IBD) is based on a combination of clinical symptoms, laboratory tests and imaging data. Imaging of the morphological characteristics of IBD includes the assessment of mucosal alterations, transmural involvement and extraintestinal manifestations. No single imaging technique serves as a diagnostic gold standard to encompass all disease manifestations. Ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) allow cross-sectional imaging of the transmural alterations and extraintestinal manifestations. While in the USA the technique of choice is CT, in Europe the focus is more on MRI and ultrasound (US). Most patients with chronic IBD are diagnosed at a young age. After baseline diagnosis many of these young patients have to undergo repetitive imaging procedures during the variable clinical course of the disease, characterized by alternate periods of remission and active disease, and in monitoring the response to treatment. US has the advantage of being noninvasive, less costly, and easily repeatable, and thus can be very useful in following up patients with IBD. In addition, rising concern about radiation exposure in young adults indicates the demand for radiation-sparing techniques like US and MRI. This article focuses on the current clinical practice of US in IBD, describing the current technologies used in transabdominal intestinal US and the characteristic sonographic findings in Crohn′s disease and ulcerative colitis.

Endoscopic ultrasound using ultrasound probes for the diagnosis of early esophageal and gastric cancers

Endoscopic ultrasound (EUS) devices were first designed and manufactured more than 30 years ago, and since then investigators have reported EUS is effective for determining both the staging and the depth of invasion of esophageal and gastric cancers. We review the present status, the methods, and the findings of EUS when used to diagnose and stage early esophageal and gastric cancer. EUS using high-frequency ultrasound probes is more accurate than conventional EUS for the evaluation of the depth of invasion of superficial esophageal carcinoma. The rates of accurate evaluation of the depth of invasion by EUS using high-frequency ultrasound probes were 70%-88% for intramucosal cancer, and 83%-94% for submucosal invasive cancer. But the sensitivity of EUS using high-frequency ultrasound probes for the diagnosis of submucosal invasive cancer was relatively low, making it difficult to confirm minute submucosal invasion. The accuracy of EUS using high-frequency ultrasound probes for early gastric tumor classification can be up to 80% compared with 63% for conventional EUS, although the accuracy of EUS using high-frequency ultrasound probes relatively decreases for those patients with depressed-type lesions, undifferentiated cancer, concomitant ulceration, expanded indications, type 0-I?lesions, and lesions located in the upper-third of the stomach. A 92% overall accuracy rate was achieved when both the endoscopic appearance and the findings from EUS using high-frequency ultrasound probes were considered together for tumor classification. Although EUS using high-frequency ultrasound probes has limitations, it has a high depth of invasion accuracy and is a useful procedure to distinguish lesions in the esophagus and stomach that are indicated for endoscopic resection.

浸润式B超引导下的A超分段式声速测量在致密型白内障眼轴测量中的准确性

目的:观察浸润式B超引导下的A超分段式声速测量在致密型白内障眼轴测量中的准确性。方法:前瞻性研究。选取成都爱尔眼科医院2020-08/2022-08致密型白内障患者86例90眼,男61例59眼,女25例31眼,平均年龄66.49±14.55岁。术前分别采用接触式A超,浸润式B超引导下A超分段式声速测量法与IOL Master 700测量眼轴(AL)、前房深度(ACD)(含角膜厚度)、角膜曲率(K)、晶状体厚度(LT)、中央角膜厚度(CCT)、白到白角膜直径(WTW)。术后1 wk,使用IOL Master 700的无晶状体眼模式复测眼轴长度。分析三种设备测量眼轴的一致性与相关性。结果:术前接触式A超与浸润式B超引导下A超分段式声速测量眼轴为23.40(22.63,23.89)、23.70(23.04,24.25)mm,术后1 wk IOL Master 700测量眼轴为23.72(23.01,24.27)mm。接触式A超与浸润式B超引导下A超分段式声速测量法、术后IOL Master 700测量眼轴差异均有统计学意义(P=0.018),而浸润式B超引导下A超分段式声速测量法与术后IOL Master 700测量眼轴差异无统计学意义(P=0.991)。通过Bland-Altman分析,浸润式B超引导下A超分段式声速测量法与IOL Master 700测量眼轴有很好的一致性(P=0.0809)。术前浸润式B超引导下A超分段式声速测量法与术后IOL Master 700眼轴正相关(r s=0.992,P<0.0001),术前接触式A超与术后IOL Master 700眼轴正相关(r s=0.989,P<0.0001)。结论:对于致密型白内障,浸润式B超引导下A超分段式声速测量比接触式A超更接近术后IOL Master 700眼轴测量数据,具有良好的相关性和一致性。

Clinical Value of Transperineal 3D Volume Ultrasound Combined with 2D High Frequency Ultrasound in Anal Fistula

Objective: To explore the clinical diagnostic value of transperineal volume ultrasound combined with two-dimensional high-frequency ultrasound for anal fistula. Methods: A total of 52 patients with anal fistula admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from December 2017 to July 2018 were selected. They were all undergoing transperineal 3D volume ultrasound combined with 2D high-frequency ultrasound examination, and the diagnosis results were analyzed. The results of ultrasonography and surgical pathology were compared. Results: Among 52 patients, 3D volume ultrasound combined with 2D high-frequency ultrasound were used to diagnose 32 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 5 cases of supra-sphincter type, and 1 case of extra-sphincter type. T supervisor classification accuracy rate is 90%. The detection rate of branch pipes was 92%, and the compliance rate of internal fistula was 95%. Two-dimensional high-frequency ultrasound was used to diagnose 34 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 4 cases of supra-sphincter type, and 0 cases of extra-sphincter type. The detection rate of branch canals was 42%, and the accuracy of type classification was 90%. The coincidence rate was 95%. There was a statistically significant difference in the detection rate of the anal fistula branch and the coincidence rate of the internal fistula between the two methods (both P Conclusion: 1) The overall coincidence rate of three-dimensional volumetric ultrasound combined with two-dimensional high-frequency ultrasound in the diagnosis of anal fistula is high;2) Three-dimensional volumetric ultrasound technology has great application prospects in infants and anal fistulas.

B超引导下塞丁格技术置入中长管在神经外科患者中的应用效果

目的探讨B超引导下塞丁格技术置入中长管在神经外科患者中的应用效果。方法选取2022年2月~2023年2月于张家港市第一人民医院收治的104例神经外科静脉治疗患者为研究对象,采用随机数表法将其分为对照组和观察组,每组各52例,对照组行传统盲穿下塞丁格技术PICC置管,观察组行B超引导下塞丁格技术置入中长导管,比较两组置管成功率、置管情况(置管安全性及非计划拔管率)、患者置管疼痛程度(VAS)和置管部位舒适度(GCQ)、置管期间相关并发症发生率(穿刺点渗血、导管移位脱出、静脉炎和导管堵塞)及满意度。结果观察组一次置管成功率高于对照组,差异有统计学意义(P<0.05);观察组置管安全性高于对照组(P<0.05),差异有统计学意义,观察组非计划拔管率低于对照组,差异有统计学意义(P<0.05);观察组疼痛程度评分低于对照组,差异有统计学意义(P<0.05),观察组舒适度高于对照组,差异有统计学意义(P<0.05);置管期间,观察组穿刺点渗血、导管移位或脱出、静脉炎、导管堵塞的总并发症发生率(3.84%vs 15.37%)低于对照组,差异有统计学意义(P<0.05);观察组的满意度(94.23%vs 75.00%)高于对照组,差异有统计学意义(P<0.05)。结论B超引导下塞丁格技术导入中长导管应用于神经外科患者静脉治疗,可有效提高一次性置管成功率,保障置管的安全度,提高患者的舒适度,降低患者置管的疼痛程度,减少相关并发生症发生风险,具有较好应用价值。

Treatment of hepatic cysts by B-ultrasound-guided radiofrequency ablation

BACKGROUND: The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effect and reduced suffering. This report describes the effects and reliability of RFA in the treatment of 29 patients with hepatic cysts. METHODS: B-ultrasound-guided REA was used to treat hepatic mono-cyst or multi-cysts of 29 patients (63 tumors). Ablative efficiency and complications were assessed by imaging and clinical symptoms. RESULTS: The tumors were abated completely in 34 cysts with a diameter <5 cm and no recurrence was seen after 3 months. In 21 cysts with a diameter of 5-10 cm, tumor volume was decreased by over 70%, then reduction and fiberosis were found. In 8 cysts with a diameter greater than 10 cm, tumor volume was decreased by more than 60%, and in 2 cysts it was increased more slightly than that at I month after REA. In subsequent follow-up (6 and 12 months after REA), tumors <10 cm in diameter were fully ablated. No significant discomfort and complications were found in any patient. CONCLUSION: RFA for the treatment of hepatic cysts is safe, and free from complications.

Problem analysis and solutions of the B-ultrasound-guided peripherally inserted central catheter process

Objective： The purpose of this study was to address the issues that occur during the B-ultrasound guided peripherally inserted central catheter（PICC） process and to give a summary of the effective management to these issues accordingly.Methods： The information was collected retrospectively on all of the 1950 PICCs inserted during the 2-year period from July 2013 to July 2015. PICC catheter insertion was performed using the Seldinger approach and was delivered from the basilic vein to the superior vena cava in a B-ultrasound guided manner. Moreover, the point raised during the PICC process would be treated immediately.Results： All of the PICCs were inserted successfully. The problems encountered are shown in the inserted central catheter（PICC） process, such as failures of venipuncture, the problem of inserting guide wire, the catheter was dif？cult to be delivered etc.Conclusions： The B-ultrasound guided approach enhanced the average success regarding the PICC insertion, particularly for the subset with a poor condition in the elbow super？cial vein. Due to the items that emerged in the PICC process, the effective prevention prior to surgery and treatment during the operation would be necessary.

Analysis of B-ultrasound and contrast-enhanced ultrasound characteristics of different hepatic neuroendocrine neoplasm

BACKGROUND Hepatic neuroendocrine neoplasm(hNEN) is a highly heterogeneous tumor. The exact identification of the source and malignant degree of hNEN is important.However, there is a lack of information regarding diagnosis of hNEN with imaging. In addition, no studies have compared the imaging between hNEN and hepatocellular carcinoma(HCC) and among different sources and malignant degrees of hNEN.AIM To compare the ultrasound characteristics between hNEN and HCC and among different sources and malignant degrees of hNEN.METHODS A total of 55 patients with hNEN were recruited and defined as the hNEN group.Among them, 35 cases of hNET were defined as the hNET group. Twenty cases of hepatic neuroendocrine carcinoma(hNEC) were defined as the hNEC group.Among the 55 lesions, 29 were transferred from the pancreas, 20 were from the gastrointestinal tract, and six were from other sites. In total, 55 patients with HCC were recruited and defined as the HCC group. The characteristic differences of Bmode ultrasound and contrast-enhanced ultrasound(CEUS) between hNEN and HCC and among different sources and malignant degrees of hNEN were compared.RESULTS In the hNEN group, the proportions of multiple liver lesions, unclear borders,and high echo lesions were higher than those in the HCC group. The proportions of non-uniform echo and peripheral acoustic halo were lower than those in the HCC group(P < 0.05). The washout to iso-enhancement time and washout to hypo-enhancement time were lower than those in the HCC group(P < 0.05). The characteristics of B-ultrasound and CEUS among different sources of hNEN were similar, and the differences were not statistically significant(P > 0.05). B-mode ultrasound characteristics of hNET and hNEC were similar. The proportions of low enhancement at portal venous phase, non-uniform enhancement forms, and combined tumor vasculature in the hNEC group were larger than those in the hNEN group(P < 0.05).CONCLUSION Compared with HCC, hNEN showed multiple intrahepatic lesions, uniform high echo, uniform high enhancement at arterial phase, and rapid washout. Low enhancement at portal venous phase, overall non-uniform enhancement form,and the proportion of combined tumor vasculature in hNEC were larger than those in hNET.

B-scan ultrasound and cytology of the vitreous in primary central nervous system lymphoma with vitreoretinal involvement

AIM: To evaluate the diagnostic value of B-scan ultrasound and explore the cytological characteristics of patients with vitreoretinal lymphoma(VRL) and primary central nervous system lymphoma(PCNSL).METHODS: The clinical data and pathologic specimens from patients with VRL diagnosed at the North Huashan Hospital from 2016 to 2017 were retrospectively reviewed. The patients were diagnosed by slit lamp ophthalmoscopy, B-scan ultrasound, cytology of the vitreous, which was obtained by vitrectomy, and cytokine measurements of interleukin(IL)-10 and IL-6.RESULTS: Twenty-six eyes(19.4%) out of 134 eyes of 67 patients(47 men and 20 women) with PCNSL were diagnosed with VRL by B-scan ultrasound, and 14 eyes(10.4%) were diagnosed by slit lamp ophthalmoscopy. Twenty-four eyes(17.9%) of 17 patients were confirmed as having VRL with cytology. No difference in the association between intracranial lesion location and ocular involvement was found. VRL patients had higher levels of vitreous IL-10 and IL-10/IL-6 when compared with macular hole cases, but the difference was not statistically significant.CONCLUSION: A total of 25.4% of the PCNSL patients had VRL, B-scan ultrasound examination had characteristic features and is recommended over slit lamp ophthalmoscopy for the screening diagnosis of PCNSL with intraocular involvement. Moreover, the cytological and immunohistochemical analyses performed after 25-gauge diagnostic vitrectomy were accurate diagnostic techniques.

Effect of Chinese herbal compound on liver fibrosis in rabbits with schistosomiasis by B-ultrasound

Objective: To explore the value of B-ultrasound on the evaluation of the effects of traditional Chinese medicine compound of Radix astragali , Salvia miltiorrhiza and Angelica sinensis , and TCM + praziquantel on liver fibrosis in rabbits with schistosomiasis. Methods: The hepatic fibrosis model in rabbits with schistosomiasis was established. The experimental animals (24 rabbits) were randomly divided into four groups (group A, B, C and D, n =6). Group A (control group) was only treated by praziquantel; Group B was treated by mixture of Radix astragali and Salvia miltiorrhiza + praziquantel; Group C was treated by mixture of Radix astragali and Angelica sinensis + praziquantel; Group D was treated by mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis + praziquantel. Then B-ultrasonogram was used to evaluate the effects. Results: Each group showed certain curative effect on liver fibrosis in rabbits with schistosomiasis. The efficacy of group B, C and D was better than group A, and that of group D was the best. The differences in long diameter, thickness diameter, transverse diameter and portal vein inner diameter of liver before and after treatment were statistically significant ( P <0.05). The liver function indexes and liver fibrosis indexes were significantly improved after treatment ( P <0.05). Conclusions: The mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis combined with Western medicine treatment can obviously improve the efficacy on liver fibrosis of schistosomiasis.

The Observation on Risk of Ventilator Failure Weaning by Ultrasound bedside Monitoring of Inferior Vena Cava and Lung B Line

Objective: This study was designed to investigate risk of ventilator weaning by ultrasound bedside monitoring of the width of inferior vena cava (IVC) and the number of lung B-lines (B-lines). Methods: This study was conducted on 106 patients from January 2019 to January 2020 who had mechanical ventilation for more than 48 hours in an emergency care unit. They were clinically stable and had the criteria for weaning from the ventilator. Before Spontaneous Breathing Test (SBT) and 30 min or 120 min after SBT, the width of IVC and the number of B-lines in patients were monitored via bedside ultrasound. There were 87 cases of successful weaning as a control group and 19 cases of ventilator failure weaning as a study group. Changes of the width of IVC and the number of B-lines were compared in the different stages of SBT. Results: A total of 106 patients were included in this study. There were 87 cases of ventilator successful weaning and 19 cases failure weaning. The weaning success rate was 82.08%. The width of IVC and the number of B-lines in the study group were higher than those in the control group in same stage of SBT, the difference was statistically significant (P < 0.05), and which increased significantly with time. There was no significant difference in the width of IVC and the number of B-lines on the different stage of SBT in the control group (P > 0.05), and significant difference in the study group. Conclusion: The width of IVC and the number of B-lines monitored by bedside ultrasound can assess the risk of ventilator weaning, it may be caused by cardiopulmonary interaction.

A Drug-induced Hepatitis Patient with a Manifestation of Liver Occupying Lesions on Ultrasound B:Case Report and Literature Review

Drug-induced liver injury(DILI)is defined as injury to the liver caused by exposure to a drug or some drugs.The number of cases suffering from DILI has been increased.There are few clinical features specifically associated with DILI.The recognition and diagnosis of DILI is difficult.In this report,we have described a DILI case caused by herbal remedies.

Preliminary Application of High-Frequency Ultrasound in the Differentiation of Pemphigus and Bullous Pemphigoid:An Observational Study

Objective:Ultrasonography is a diagnostic imaging technique used to visualize subcutaneous body structures for identification of possible pathologies.In this study,we aimed to explore the clinical significance of high-frequency ultrasound in differentiating the location of blisters between pemphigus and bullous pemphigoid.Methods:Eighteen patients were recruited in Department of Dermatology,Zhongda Hospital from 2020 to 2021 and divided into a pemphigus group(n=8)and a bullous pemphigoid group(n=10)according to the diagnostic criteria for each.Ultrasonographic images were collected using a 50-MHz high-frequency ultrasound system.The indexes of ultrasonic evaluation were the layer(epidermis or dermis),size,shape,internal echo,and boundary of the blister.Categorical variables are expressed as n(%),and differences were compared using Fisher’s exact test.Results:The ultrasonographic images in the pemphigus group showed an intraepidermal semi-arc or irregular anechoic or hypoechoic areas.The inferior borders were situated above the characteristic thin linear hyperechoic bands of the epidermis.A linear hypoechoic band was present at the dermoepidermal junction in some cases.In the ultrasonographic images of the bullous pemphigoid group,the linear hyperechoic bands of the epidermis were continuous and intact.An oval fluid anechoic area(subepidermal blister)was present immediately below the bands.The location of the blisters in the ultrasonographic images was significantly different between the 2 groups(P<0.001).Conclusion:High-frequency ultrasound can be used as an auxiliary means to differentiate the location of blisters between pemphigus and bullous pemphigoid.