ABSTRACT
Objective:To establish a competing risk model to predict the cumulative hazard risk probability of the outcomes (unhealed or hyperthyroidism recurrence) of Graves disease (GD) treated with 131I. Methods:From January 2020 to May 2021, 61 GD patients (13 males, 48 females; age (46.0±13.8) years) who received 131I treatment in Zhangzhou Affiliated Hospital of Fujian Medical University were enrolled. The outcomes of treatment were recovery, unhealed or hyperthyroidism recurrence (event 1), and hypothyroidism (event 2). Follow-up was started 1 month after 131I treatment and ended 1 year later. It was terminated in the following conditions: one of the two events occurred; no event occurred after 1 year of follow-up; the research deadline was up. The Fine-Gray test was used to analyze the factors related to event 1, and then the competitive risk model was established. Results:Thirty-nine patients had hypothyroidism, 17 patients were unhealed or had hyperthyroidism recurrence, 2 patients lost follow-up, and 3 patients had normal thyroid function after 1 year follow-up. Multivariate analysis showed that effective half-life (hazard ratio ( HR)=1.74, 95% CI: 1.10-2.75, β=0.55, P=0.019) and thyroid volume ( HR=1.12, 95% CI: 1.07-1.17, β=1.12, P<0.001) were risk factors for event 1, while the elasticity of thyroid was a protective factor ( HR=0.17, 95% CI: 0.06-0.54, β=-1.76, P=0.003). The C index of the nomogram constructed based on the multi-factor competitive risk model was 0.784(95% CI: 0.633-0.935). Conclusions:Thyroid volume, elastic value, and effective half-life are associated with treatment outcomes of 131I. The competitive risk model can predict the therapeutic outcomes of GD patients treated with 131I.
ABSTRACT
Objective:To explore ultrasonographic diagnostic characteristics of ovarian epithelial tumors and establish prediction models.Methods:The ultrasonographic images of 427 cases from multicenter with ovarian epithelial tumors confirmed by pathology from January 2015 to July 2019 were retrospectively analyzed according to the International Ovarian Tumor Analysis (IOTA). Ultrasonographic signs with distinguishing significance were obtained through univariate analysis and included into multivariate Logistic regression analysis to obtain important ultrasonagraphic indicators for distinguishing borderline, benign and malignant ovarian tumors, and to establish prediction models.Results:The microcystic pattern of papillary projections and solid components was the diagnostic characteristic between borderline and benign, malignant ovarian epithelial tumors( OR value 10.97 and 19.22, respectively). Irregular morphology, septa thickness, solid lesions, rich blood supply and ascites were diagnostic characteristics between benign and malignant tumors, with the irregular morphology having the highest value. Irregular morphology, large papillary, septa thickness and rich blood supply could be used to identify borderline and malignant tumors. At the same time, irregular morphology was the valuable sign to distinguish borderline and benign tumors. In this study, the total coincidence rate of the proposed model was 72.4%, among which the predicted coincidence rate of the borderline model was 57.2%, 78.6% for benign, and 80.7% for malignant. Conclusions:The microcystic pattern of papillary projections and solid components are the specific sonographic characteristics of borderline ovarian tumors. Irregularity, solid lesions, rich blood supply and ascites have important value in differentiating ovarian epithelial tumors. The prediction models of benign, malignant and borderline ovarian tumors in this study have higher diagnostic efficacy.
ABSTRACT
OBJECTIVES@#To explore the application of random forest algorithm in screening the risk factors and predictive values for postpartum depression.@*METHODS@#We recruited the participants from a tertiary hospital between June 2017 and June 2018 in Changsha City, and followed up from pregnancy up to 4-6 weeks postpartum.Demographic economics, psychosocial, biological, obstetric, and other factors were assessed at first trimesters with self-designed obstetric information questionnaire and the Chinese version of Edinburgh Postnatal Depression Scale (EPDS). During 4-6 weeks after delivery, the Chinese version of EPDS was used to score depression and self-designed questionnaire to collect data of delivery and postpartum. The data of subjects were randomly divided into the training data set and the verification data set according to the ratio of 3꞉1. The training data set was used to establish the random forest model of postpartum depression, and the verification data set was used to verify the predictive effects via the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and AUC index.@*RESULTS@#A total of 406 participants were in final analysis. Among them, 150 of whom had EPDS score ≥9, and the incidence of postpartum depression was 36.9%. The predictive effects of random forest model in the verification data set were at accuracy of 80.10%, sensitivity of 61.40%, specificity of 89.10%, positive predictive value of 73.00%, negative predictive value of 82.80%, and AUC index of 0.833. The top 10 predictive influential factors that screening by the variable importance measure in random forest model was antenatal depression, economic worries after delivery, work worries after delivery, free triiodothyronine in first trimesters, high-density lipoprotein in third trimester, venting temper to infants, total serum cholesterol and serum triglyceride in first trimester, hematocrit and serum triglyceride in third trimester.@*CONCLUSIONS@#Random forest has a great advantage in risk prediction for postpartum depression. Through comprehensive evaluation mechanism, it can identify the important influential factors for postpartum depression from complex multi-factors and conduct quantitative analysis, which is of great significance to identify the key factors for postpartum depression and carry out timely and effective intervention.
Subject(s)
Female , Humans , Pregnancy , Depression, Postpartum/epidemiology , Postpartum Period , Pregnancy Trimester, Third , Psychiatric Status Rating Scales , Risk Factors , Sensitivity and SpecificityABSTRACT
Objective To evaluate the efficacy of the combination of gynecologic imaging reporting and data system (GI-RADS) uhrasonographic stratification and 3D contrast-enhanced ultrasonography (3D-CEUS) in identifying malignant lesions from benign ovarian masses.Methods Both of 2D ultrasound (2D-US) and 3D-CEUS were performed on 102 patients with ovarian masses.The perfusion characteristics of ovarian masses were observed with 3D-CEUS,and the 2D-US features of ovarian masses were analyzed based on GI-RADS.Simple and multiple Logistic regression analysis were used to investigate whether the independent risk predictors in differential diagnosis of benign and malignant ovarian could be confirmed.In addition,ROC curves were drawn.The diagnostic efficacy of GI-RADS combined with 3D-CEUS scoring system was evaluated and compared with that of only GI-RADS.Results Simple and multiple Logistic regression analysis confirmed that there were 8 independent predictors of malignant masses,including large papillary projections (≥7 mm),separated or wall thickness ≥3 mm,central blood flow,the proportion of solid part ≥50％,combination of ascites,high level enhancement,uneven distribution of contrast media in enhanced solid part and the vascular with characteristics as dense,tortuous and anfractuous.When using 4 points as the cut-off,the area under the curve (AUC) of GI-RADS combined with 3D-CEUS scoring system in identifying malignant ovarian masses was 0.969,higher than that of only GI-RADS (0.839;Z=1.64,P=0.029).Furthermore,the scoring system showed higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy (all P＜0.001).Conclusion The combination of GI-RADS with 3D-CEUS can be more effective to distinguish malignant lesions from benign ovarian masses.
ABSTRACT
Objective To select the ultrasonic appearances which effect the benign and malignant of thyroid lesions,and to explore the establishment and applications of supersonic evaluation system for thyroid imaging reporting and data system (TI-RADS) classification.Methods The ultrasound images of 1 080 thyroid nodule cases were retrospectively analyzed by Logistic equation,and the ultrasonic appearances were screened to identify benign and malignant of thyroid lesions.All appearances were obtained weights.The TI-RADS classification analysis software was assigned,which was used to analyze 332 patients with thyroid diseases and to verify the diagnostic performance of the TI-RADS classification system.Results Five ultrasonic features were selected into the regression model,including aspect ratio (odds ratio [OR]=3.61),margins (OR=3.83),composition (OR=11.46),echogenicity (OR=14.12),microcalcification foci (OR =48.82).Using objective evaluation system for TI-RADS classification in ultrasound in diagnosing 332 cases,the area under the ROC curve was 0.91 (P＜0.05).Conclusion Relatively the weight and formation of malignant indicators should be more concern than the number of ultrasonic malignant thyroid lesions indicators.The objective evaluation system for TI-RADS classification in ultrasound has relatively high diagnosis capability which established by the methods of Logistic equation.
ABSTRACT
Objective To evaluate the diagnostic value of virtual touch imaging quantification (VTIQ) technique in the differential diagnosis between benign and malignant breast lesions.Methods From September to December 2015, the imaging data of 115 breast lesions in 100 patients confirmed by pathology on conventional ultrasound (2DUS) and VTIQ were retrospectively analyzed. The breast nodules were examined by 2DUS firstly and then the lesions were classified by breast imaging reporting and data system (BI-RADS). The maximum, minimum and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. According to the pathology results, receiver operating characteristic (ROC) curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. And the diagnosis efficiency was compared between 2DUS and VTIQ.Results There were 38 malignant nodules and 77 benign nodules in 115 breast nodules. BI-RADS grading≥4b level was set as the malignant nodules and grading≤ 4a level as the benign nodules. The SWVmax, SWVmin, and SWVmean on VTIQ of benign and malignant breast nodules were (5.11±1.61) m/s, (2.90±0.86) m/s, (3.73±1.02) m/s, and (7.22±0.94) m/s, (4.33±1.31) m/s, (5.73±1.11) m/s. There were significant differences between malignant and benign breast nodules in SWVmax, SWVmin, and SWVmean on VTIQ (t=-7.442,-7.047,-9.356, allP<0.001). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnose malignant lesion conducted by 2DUS were 89.5％, 85.7％, 87.0％, 0.63 and 0.84, respectively. The cut-off value of VTIQ mean was 4.34 m/s. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the diagnosis of malignant lesion conducted by VTIQ were 89.5％, 85.7％, 87.0％, 0.76 and 0.95, respectively. The diagnosis efficiency of VTIQ was better than 2DUS.Conclusion The study proved that the VTIQ SWVmean is the best parameter for differential diagnosis and VTIQ plays an important role in differential diagnosis of breast nodules.
ABSTRACT
OBJECTIVE:To make proposals to improve narcotics and psychotropic substances(NPS)control in China. METH-ODS:NPS control system of international organizations,the United States,Britain and China were compared in terms of concept, classification,regulatory basis and agency,etc. The suggestions and reference were put forward. RESULTS & CONCLUSIONS:NPS of international organizations,the United States,Britain and China are drug types included in relevant categories,besides ana-leptics,precursor chemicals and other drugs are included in control catalogue by the United States and Britain. NPS are divided in-toⅠ-Ⅳcategories by international organizations,Ⅰ-Ⅴcategories by the United States,A,B,C categories and temporary catego-ry by Britain,and narcotics,first and second class psychotropic substances by China. NPS control basis of the United States,Brit-ain and China are Controlled Substances Act,Misuse of Drugs Act and Regulations on Narcotics and Psychotropic Drugs Control, respectively;major regulation organizations are Controlled Substances Enforcement Administration,Advisory Committee on Drug Abuse subordinated to Ministry of Interior,Special Drug Section under China Food and Drug Administration,respectively;there al-so are differences in the functions of control organization and cooperative units. Considering about the problems of NPS control in China,it is suggested to improve laws and regulations system,establish independent system,extend abuse surveillance network and encourage chronic non-cancer pain therapy.
ABSTRACT
OBJECTIVE:To study the development and status quo of international narcotics and psychotropic substances (NPS)control,and to provide evidence for NPS control in China. METHODS:The development and status quo of NPS control by international organization were summarized and studied through retrieving and collecting literatures,reports and policies about NPS from domestic and foreign databases,news reports and international website. RESULTS & CONCLUSIONS:International narcot-ics control dated back to opium trade with China in 19th century. International narcotics control system was established preliminarily by Shanghai conference and Haiya conference. The end of World War Ⅰ,the establishment of the League of Nations and the sign-ing of a number of international treaties promoted the development of internal control system. Through World War Ⅱ,the establish-ment of the United Nations and the change of international control organization,a number of international treaties were integrated into Single Convention on Narcotic Drugs in the early 1960s,which was used as the foundation of narcotics control system all round the world. In 1970s,the adoption of Convention on Psychotropic Substances meant psychotropic substances were included in the scope of internal control. In 1980s,the signing of United Nations Convention against Illicit Traffic in Narcotic Drugs and Psy-chotropic Substances marked the establishment of three conventions system of international NPS control. At present,internal NPS control is based on three conventions system and NPS list by Commission on Narcotic Drugs,International Narcotics Control Board and United Nations International Drug Control Program. The vast majority of countries are parties to that. International control orga-nizations and listed control have a great influence on NPS control all round the world.
ABSTRACT
OBJECTIVE:To study the development and status quo of controlled substances control in the United States,and to provide evidence for narcotics and psychotropic substances (NPS) control in China. METHODS:The development and status quo of controlled substances control by the United States were summarized and studies through retrieving and collecting literatures,re-ports and policies about NPS from domestic and foreign databases,news reports and international website. RESULTS & CONCLU-SIONS:The United States'control for controlled substances dated back to Harrison Narcotics Tax Act in 1914,and the United States is the first nation to control narcotics addiction through the form of tax law after International Opium Convention is executed. Thereafter,the United States gradually extend the range by including cannabis,heroin and psychotropic substances into control range of Narcotics Drugs Import and Export Act,Heroin Act,Marijuana Tax Act,revising and developing comprehensive act Con-trolled Substances Act,and establishing comprehensive law enforcement agency Controlled Substances Enforcement Administration affiliated to Ministry of Justice by Nixon'sWar on Drugsplan.
ABSTRACT
OBJECTIVE:To study the development and status quo of controlled drugs control in Britain,and to provide evi-dence for narcotics and psychotropic substances(NPS)control in China. METHODS:The development and status quo of NPS con-trol by Britain were summarized and studied through retrieving and collecting literatures,reports and policies about NPS from do-mestic and foreign databases,news reports and international website. RESULTS & CONCLUSIONS:British control for controlled drugs dated back to Pharmacy Act in 1868,and Britain was the first country to control drugs by legislations. A unique British sys-tem of narcotics control was established and improved after issued Rolleston Report and two pieces of Brain Report in Britain. Final-ly,the British system of narcotics control was established,which combined public health prevention with judicial redress. At pres-ent,controlled drugs are classified and controlled by Advisory Committee on Drug Abuse,Serious Organised Crime Agency and National Drug Abuse Treatment Agency subordinated to Ministry of Interior,based on Misuse of Drugs Act.
ABSTRACT
OBJECTIVE:To study the development and status quo of narcotics and psychotropic substances (NPS) in China since 1949,and to provide evidence for perfection of NPS control work in China. METHODS:The development and status quo of controlled substances control by China since 1949 were summarized and analyzed through retrieving and collecting literatures,re-ports and policies about NPS from domestic and foreign databases,news reports and related website. RESULTS & CONCLU-SIONS:Chinese narcotics and psychotropic substances control dated back to the release of Interim Regulations on Narcotics Con-trol in 1950 and Regulations on Narcotics Control,Drug Administration Law and other regulations have been issued. It had experi-enced the progress from no legal basis to having laws to follow and from executive-leading to legalization. Narcotics and psychotro-pic substances were gradually unified in systematic control,and the level of regulations rised from department rules to administra-tion regulation. At present,with Regulations on Narcotics and Psychotropic Drugs Control (2005) as regulatory basis and cata-logue of narcotics and psychotropic substances(2013)as object,China Food and Drug Administration are in charge of the national regulation,cooperating with health department,agricultural department,traffic department and other departments.
ABSTRACT
Purpose It is still undetermined about the application of regular ultrasound (US) combined with ultrasonic elastography (UE) in diagnosing superficial lymph nodes disease.Therefore our aim is to evaluate the value of US combined with UE in diagnosing superficial lymph nodes disease.Materials and Methods The ultrasonography and pathological data of 214 patients (with 266 superficial lymph nodes) were analyzed retrospectively.The US and UE data were compared with the pathologic results.Results The elastic classification of reactive hyperplastic and lymphomatous lymph nodes were no greater than grade 3,respectively;that of malignant metastatic lymph nodes was greater than grade 4.The accuracy of UE or US+UE was higher in diagnosing reactive hyperplastic lymph nodes and metastatic lymph nodes' nature compared with US (P＜0.05).The sensitivity and accuracy of US+UE in diagnosing malignant superficial lymph nodes were higher than those of US (90.13％ vs.72.37％;86.09％ vs.68.05％,P＜0.05).Compared with UE alone,those of US+UE were also higher (90.13％ vs.77.63％;86.09％ vs.72.56％,P＜0.05).Conclusion The accuracy of differential diagnosis of benign or malignant superficial lymph nodes can be improved by US+UE method.
ABSTRACT
Objective To investigate the intermediate and long-term efficacy of endoscopic submucosal dissection (ESD) for early esophageal cancer(EEC).Methods A total of 56 patients with EEC underwent ESD at Jiangsu Province People's Hospital between April 2010 and June 2015.Among the 56 cases,there were 39 cases of intramucosal cancer,17 cases of submucosal cancer.Intravascular cancer embolus was found in 2 patients.The en bloc and complete resection rates,the residual,local tumor recurrence and new occurrence rates of EEC after ESD were evaluated.The average follow-up time was 24.4 months,ranging from 1 to 62 months.Results The en bloc and complete resection rates were 92.9％(52) and 87.5％ (49),respectively.Four patients were treated by additional esophagectomy.The cases of residual lesions,local tumor recurrence,new occurrence and second primary extra-esophageal cancer (gastric cancer) was 1 (1.8％),2 (3.6％),2 (3.6％) and 2 (3.6％),respectively.No additional surgical operations were performed in the 7 patients or no recurrence was found,and there was no death during the follow-up period.Conclusion ESD has the advantage of high complete resection rate,low residual and local tumor recurrence rate in treatment of EEC,and the intermediate and long-term outcomes are satisfactory.
ABSTRACT
Objective To evaluate the application value of three‐dimensional ultrasonography OmniView technology in diagnosis of fetal cleft lip/palate . Methods Three‐dimensional volume data was acquired from 100 normal singleton fetuses and 18 cleft lip/palate fetuses ,and was analysed by OmniView technology . Two‐dimensional ultrasonography and three‐dimensional OmniView technology were compared in the displaying rate of different planes of the lip and palate and the diagnosis accordance rate of cleft lip/palate.Results ①ThedisplayingrateofthelipandpalateofOmniViewtechnologywashigherthanthatof two‐dimensional ultrasonography ( the displaying rates were 64% -88% and 30% -65% ,respectively , P 0 .05) . Conclusions Three‐dimentional ultrasonography OmniView technology can improve the displaying rate of the hard and soft palate .The application of this technology in the fetuses who has a high risk of cleft palate may be beneficial to the diagnosis of cleft palate .
ABSTRACT
Objective To compare surgical gastrojejunostomy and endoscopic stenting in palliation of malignant gastric outlet obstruction.Methods This retrospective study investigated patients treated for malignant gastric outlet obstruction from January 2007 to January 2014 in the first affiliated hospital of Nanjing Medical University.Endoscopic stenting was placed in 29 patients and surgical gastrojejunostomy was performed in 42 patients.The outcomes assessed included diet scores,time to diet,length of hospital stay,treatments fees and complications.Results Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome with significant higher GOOSS score compared with that before treatment (P ＜0.05),but score improves faster in stenting group.Clinical success for endoscopic stenting and surgical gastrojejunostomy was 96.6％ and 92.9％ respectively,and technical success was 100％ for both of them.Endoscopic stenting group was found to have lower early complication rate(3.4％ VS 23.8％,P ＜0.05),higher late complication rate(24.1％ VS 6.9％,P ＜0.05),less time to diet,hospital stay and treatment fees(all P value ＜ 0.05)than surgical gastrojejunostomy group.The major complication after endoscopic stenting is re-obstruction while it is infection and leak of anastomotic site for surgical group.There were no significant differences in complication between two groups (27.6％ VS 11.9％,P ＞ 0.05).Conclusion Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome effectively and safely,but endoscopic stenting improves GOOSS scores more rapid with less time to diet,less early complication rate and easy-dealing late complications,also it needs less hospital stay and fees.It's a better choice for patients with less survival expectation.
ABSTRACT
Objective To search one ultrasonic method which could evaluate gastric emptying function accurately.Methods The gastric emptying time of 74 normal volunteers were measured by radioisotope scanning and different ultrasonic methods which including gastric antrum area,gastric antrum volume and whole gastric cylinder method.Results The gastric emptying time measured by whole gastric cylinder method related best with those measured by radioisotope scanning (r =0.79).The gastric emptying time was no significant difference between the cylinder method and radionuclide scanning (P ＞0.05).Compared with radionuclide scanning,those measured by gastric antrum area and gastric antrum volume had significant differences.Conclusions The whole gastric cylinder method can accurately reflect the gastric emptying function.
ABSTRACT
Objective To evaluate blood flow structure within left ventricle,quantify the variation of the flow at infarct segments,and assess the impact of myocardial infarction.Methods Twenty-eight patients with chronic myocardial infarction(CMI)and 30 healthy controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by vector flow mapping(VFM).Timeflow(T-F)curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile were analyzed by DSA-RSI program.Results Ventricular ejction peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower in CMI group at infarct segment than normal control group,the time duration from bottom to peak was relatively longer in CMI group.Normal velocity profile,parallel velocity profile,vector profile,flow profile at peak S and E were lower in CMI group than normal group.Conclusions The velocity of CMI group was lower and the time to peak was longer than that of control group.VFM is a new noninvasive and clinically useful parameter for the evaluation of regional left ventricular segment flow dynamics.
ABSTRACT
ObjectiveTo evaluate the therapeutic effect of endoscopic full-thickness resection (EFTR) for gastric stromal tumors.MethodsA total of 33 patients with gastric stromal tumor orgination from deep muscularis propria layer received EFTR from January 2010 to July 2011.The effectiveness and safety of EFTR were compared with those of other 34 patients with gastric stromal tumor origination from muscularis propria layer who underwent endoscopic submucosal dissection (ESD).ResultsExcept in 2 patients with lesions larger than 3.0 × 3.0 cm,EFTR was successful in others 31 patients,who recovered well and had no recurrence during the follow-up within 12 months.There were no significant differences in resection rate,incidence of complications,body temperature,white blood cell counts or recovery time between 2 procedures (P ＞ 0.05 ).However,the number of clips used in EFTR ( 7.0 ± 3.5 vs.4.9 ± 3.1,P =0.013 ) and postoperative fasting days (3.4 ± 1.5 vs.2.0 ± 1.0,P =0.001 ) were significantly higher than those of ESD procedures.ConclusionEFTR is effective and safe for gastric stromal tumors with no higher risk than ESD,but it is more complex technically.EFTR can be used as an expanding method of ESD in endoscopic treatment of gastric stromal tumors.
ABSTRACT
Objective Through investigation and analysis of nursing services and needs for community home visiting in Yinchuan city in order to improve the quality of nursing service. Methods Using cluster sampling method to collect 300 residents from five community for questionnaire investigation in Yinchuan city.Questionnaire included general situation and evaluation standard of home care patients and service quality satisfaction questionnaire of home care. Results The residents had different degree of nursing needs and differences existed in satisfaction degree with different project of community home visiting. Conclusions Community home visiting need is high,and further improvement of nursing service quality for community home visiting is needed in Yinchuan city.
ABSTRACT
Objective To investigate the effect of different frequencies of endoscopic ultrasonography (EUS) on diagnosis of duodenal submucesal lesions. Methods A total of 210 elevated duodenal lesions detected by routine endoscopy in 201 patients were examined by EUS at different frequencies according to lesion features and image clarity. Endoscopic resection was applied in 27 lesions with informed consents,and pathological findings were compared with the results of EUS. Results The accuracy of EUS was 81.4% (22/27). Ultrasound of low frequency was superior in displaying overview of lesion and was more suitable for lesions larger than 1.5 cm in diameter or lesions of hyperecho. On the other hand,ultrasound of high frequency was more reliable to reveal minute structures and could be employed in scanning lesions smaller than 1.5 cm in diameter. Combination of different frequencies of ultrasound could provide more details in larger lesions. Conclusion Application of appropriate frequency or combined frequencies of ultrasound in examination of elevated duodenal lesions is beneficial to achieve more accurate diagnosis.