Therapeutic Effect of Canagliflozin on Nephrotic Syndrome and Its Ultrasonic Evaluation / 中山大学学报(医学科学版)

ObjectiveTo investigate the therapeutic effect of antidiabetic drug canagliflozin （CGLZ） on adriamycin-induced nephrotic syndrome （NS） in rats， and the evaluation of contrast-enhanced ultrasound （CEUS） combined with color Doppler flow imaging （CDFI） during the treatment. MethodsA total of 56 male SD rats were randomly divided into normal group （NG）， model group （MG）， prednisone （PAT） group （PG）， low-dose single CGLZ group （LSCG）， high-dose single CGLZ group （HSCG）， low-dose CGLZ + PAT group （LUCG） and high-dose CGLZ + PAT group （HUCG）， with 8 rats in each group. The NS model in rats was induced by injecting adriamycin twice into the tail vein， and then the NS rats were treated by intragastric administration daily for 6 weeks with reference of PAT. Twenty-four hour urine total protein （24 h-UTP） was assessed one day before the start of oral administration and at the end of 2， 4 and 6 weeks after oral administration， respectively. CDFI and CEUS were performed on the right renal artery at the end of 6 weeks after oral administration， and the blood of abdominal aorta was taken for serological test the next day. ResultsCompared with those detection index of NG rats， the 24-hour UTP of MG rats increased （P＜0.01）， the serum ALB decreased and TG， TC， LDL increased （P＜0.01）， and CDFI shows that RRCT was thinner （P＜0.01） and the renal artery blood flow indicators RA-PI， RA-RI， RA-S/D all increased （P＜0.05）， and CEUS image shows that the TIC curve parameters TTP， AT， AUC all increased and DPI decrease in MG rats （P＜0.01）. After drug treatment， compared with those detection index of MG rats， 24 h-UTP decrease in LSCG after 2 weeks （P＜0.01）， and decrease significantly in all drug groups after 6 weeks （P＜0.01）； the serological test results show that the serum ALB in all CGLZ groups increased （P＜0.05）， TG decrease in LSCG （P＜0.01）， TC and LDL also decrease in LUCG after 6 weeks （P＜0.05）； CDFI shows that the RRCT thinning degree in all CGLZ is reduced （P＜0.01）， and the RA-PI in LSCG， RA-RI in PG， and RA-S/D in PG， LSCG， HSCG and LUCG rats all decreased （P＜0.05）； CEUS shows that the TTP， AT and AUC of renal TIC curve in drug treatment groups all decreased （P＜0.01）， and the DPI in PG， HSCG， LUCG and HUCG rats increased （P＜0.01）. ConclusionsCGLZ has the effect of treating NS， and the small dose is the best. CEUS combined with CDFI can be used to evaluate the renal morphology and hemodynamic changes of NS model rats before and after drug treatment， which is helpful to guide clinical application.

Analysis of imaging characteristics of papulopustular rosacea by high-frequency ultrasound combined with color Doppler flow imaging / 中华皮肤科杂志

Objective:To investigate imaging characteristics of papulopustular rosacea (PPR) by high-frequency ultrasound combined with color Doppler flow imaging.Methods:From August 2021 to August 2022, 30 patients with PPR were enrolled from the Department of Dermatology, the First Affiliated Hospital of Baotou Medical College in the Inner Mongolia Autonomous Region, and 30 healthy volunteers served as controls. The 22-MHz high-frequency ultrasound combined with color Doppler blood flow imaging was performed to measure the skin thickness, echo and blood flow parameters at the cheek, and the ultrasound results were compared between the two groups. Comparisons between groups were conducted by using t test or chi-square test. The diagnostic value was analyzed using the area under the curve (AUC) in the receiver operating characteristic (ROC) curve. Results:In the case group, there were 12 males and 18 females, and their ages ranged from 22 to 65 years (42.3 ± 12.8 years) ; in the control group, there were 10 males and 20 females, and their ages ranged from 24 to 62 years (41.0 ± 8.4 years) . The epidermal and dermal thicknesses at the cheek were significantly higher in the case group (132.64 ± 12.29 μm, 1 812.29 ± 85.52 μm, respectively) than in the control group (104.34 ± 14.45 μm, 1 671.77 ± 146.55 μm, respectively, both P < 0.05) . High-frequency ultrasound images showed that the case group was mainly characterized by irregular hypoechoic areas in the cheek dermis (80%) , while banded moderately echoic areas were common in the cheek dermis in the control group (90%) ; subepidermal low-echogenic bands and dermal irregular hypoechoic areas were more likely to appear in the case group than in the control group (93.33% vs. 43.33%, 80% vs. 10%, respectively, both P < 0.001) . Compared with the control group, the case group showed a significantly increased proportion of patients with abundant blood flow signals (93.3% vs. 10%, P < 0.05) , and significantly increased blood vessel diameters (1.60 ± 0.42 mm vs. 0.95 ± 0.32 mm, P < 0.05) ; there was no significant difference in peak systolic blood flow velocity and vascular resistance index between the two groups (both P > 0.05) . The AUC of high-frequency ultrasound combined with color Doppler flow imaging quantitative parameters (including epidermal thicknesses, dermal thicknesses, and blood vessel diameters) was 0.989 (95% CI: 0.970 - 1.000) for the diagnosis of PPR, and the sensitivity and specificity were both 96.7%, which were higher than those of single parameter-based diagnostic model. Conclusion:High-frequency ultrasound combined with color Doppler flow imaging can help improve the accuracy of the diagnosis of PPR, by accurately and non-invasively measuring skin thickness and blood flow parameters.

Value of multiparametric ultrasonography in the differential diagnosis of benign and malignant testicular lesions / 中华超声影像学杂志

Objective:To explore the value of multiparametric ultrasonography consisting of gray-scale ultrasound(US), color Doppler flow imaging (CDFI), real-time strain elastography(RTE), and contrast-enhanced ultrasound(CEUS) in the differential diagnosis of testicular lesions.Methods:Forty patients (40 lesions) detected by ultrasonography examination at the Ultrasound Medical Center of Lanzhou University Second Hospital from June 2020 to June 2022 were retrospectively analyzed, and further the CDFI, CEUS and RTE were performed. The presence of vascularization in the lesion was determined by CDFI and CEUS, avascular lesions were defined as benign, vascularization lesions were defined as malignant. The lesion tissue elasticity was assessed by real-time strain elastography, tissue stiffness was encoded as red(soft), green(intermediate), and blue(hard), and the hard lesions were defined as malignant, soft lesions were defined as benign. All lesions were subjected to pathological histologic examination after surgical resection or puncture biopsy as a reference standard. The correct classification rate, sensitivity, specificity and likelihood ratio of the multiparametric ultrasonography imaging for the diagnosis of benign and malignant testicular lesions were analyzed by ROC.Results:Of 40 testicular lesions, 24 (60.0%) were benign and 16 (40.0%) were malignant. The sensitivity of CDFI, CEUS and RTE in the diagnosis of testicular lesions was 0.875, 1.000 and 1.000, and the specificity was 0.833, 0.750 and 0.708, respectively. The correct classification rate was 85.0%, 85.0% and 82.5%, and the positive likelihood ratio was 5.24, 4.00 and 4.42, respectively. AUC was 0.781, 0.802, 0.771, respectively. By combining RTE and CDFI, a sensitivity of 1.000 and specificity of 0.875 and correct classification rate of 92.8% and positive likelihood ratio of 8.00 and AUC of 0.915 ( P<0.001) were achieved in differentiating testicular lesions. And combining RTE and CEUS, achieved sensitivity of 1.000 and specificity of 0.917 and correct classification rate of 95.0% and positive likelihood ratio of 12.0 and AUC of 0.958( P<0.001). Conclusions:Multiparametric US is of great value in the differential diagnosis of benign and malignant testicular lesions.

Ocular echobiometry and resistivity Index of external ophthalmic artery in agoutis (Dasyprocta prymnolopha)

Veterinary Ophthalmology provides complementary information for the diagnosis of ocular pathologies. Studies in wild species are essential. Among the diagnostic techniques in ophthalmology, two-dimensional ultrasonography stands out. The agouti is a rodent belonging to the Dasyproctidae family that has been widely used as an experimental model. For these animals, sight is one of the crucial senses for their survival. The aim of this study was to evaluate the effectiveness of the two-dimensional ocular ultrasound technique to obtain anatomical measurements and the external ophthalmic artery resistivity index, presumably normal in the species Dasyprocta prymnolopha. Forty eye bulbs of 20 adult rodents of the species were evaluated by ultrasonography. In these animals, B-mode echobiometry was performed using the transpalpebral approach and the hemodynamic study of the external ophthalmic artery using the color Doppler technique. All examinations were initiated by the left eye bulb and all measurements were performed by only one examiner. The collected data related to echobiometry were analyzed using Bioest 5.0 for Windows. Initially, normality was tested using the Shapiro-Wilk test for each parameter, then the paired t-test was performed, comparing right and left eyes, and a significance level of 5% (P < 0.05) was adopted. Based on the methodology used, the following values were obtained for the right and left eyeballs, respectively: anterior chamber thickness - mean of 1.28 ± 0.3 mm and 1.22 ± 0.1 mm; lens thickness - 8.27 ± 0.9 mm and 8.11 ± 0.9 mm; vitreous chamber thickness - 5.35 ± 0.48 mm and 5.30 ± 0.47 mm and axial length - 12.7 ± 0.9 mm and 13 ± 0.68 mm. The mean external ophthalmic artery resistivity values were 0.4305 ± 0.0390 and 0.4258 ± 0.0387 (right and left eye, respectively), characterizing a low resistance. There was no statistical difference between the right and left eyeballs in any of the studied parameters. The use of the convex transducer was feasible, promoting adequate contact with the ocular surface and images of satisfactory quality for obtaining measurements, similar to what was observed in studies evaluating the ocular biometry of primates and dogs. The anterior chamber thickness values in this experiment did not differ statistically between the antimers, as well as observed for dogs. The data obtained for lens thickness did not differ statistically for antimers, like those obtained for other rodent species evaluated with the same methodology. The mean values of vitreous chamber thickness were like those observed in chinchillas but correspond to about half of that obtained for capybaras. In this study, the external ophthalmic artery was characterized in all animals, but obtaining the spectral tracing was difficult due to its fine caliber. In wild animals, and especially in wild rodents, there are few data reporting the resistivity of the ophthalmic artery, and there is a lack of studies, which can be explained by the behavioral characteristics of defense and by the high susceptibility to stress in capture, since the performing the technique requires, as in other procedures, the use of chemical containment. (AU)

Analysis of ultrasonic features of melanocytoma of optic disc / 中华超声影像学杂志

Objective:To investigate the ultrasonic features, contrast-enhanced ultrasound findings and long-term follow-up results of melanocytoma of the optic disc(MCOD).Methods:The data of 35 patients (35 eyes, 35 lesions) diagnosed with MCOD in Beijing Tongren Ophthalmic Center, Beijing Tongren Hospital from September 2012 to October 2020 were retrospectively analyzed. The B-mode ultrasonography and color Doppler flow imaging (CDFI) were performed on them. The size, morphology, internal echo and secondary changes of the lesions were analyzed. Contrast-enhanced ultrasound was performed on 13 patients. At the same time, 9 patients were followed up for long-term observation.Results:Six lesions (17.1%) showed hemispherical high echo, and 29 lesions (82.9%) showed limited uplift high echo. The largest base diameter of the lesions was (4.0±0.8)mm, average height was(1.9±0.4)mm. Internal echo characteristics: 8 lesions (22.9%) showed uniform echo and 27 lesions (77.1%) showed uneven echo.Lesion boundary: 35 lesions (100%) showed clear lesion boundary. Fifheen lesions (42.9%) showed secondary vitreous opacity. CDFI: blood flow signals could be detected inside the lesions in 19 lesions(54.3%), and not in 16 lesions(45.7%). Contrast-enhanced ultrasound showed 11 of the 13 lesions (84.6%) were completely filled with contrast agent.Conclusions:MCOD has certain ultrasonographic characteristics, which can provide a reliable basis for clinical diagnosis and differential diagnosis. There is no significant change in tumor size after long-term follow-up.

Comparison of right and left common carotid arteries of horses and mules by two-dimensional ultrasound and Doppler flow / Comparação das artérias carótidas comuns direita e esquerda dos gêneros de equinos e muares por ultrassonografia bidimensional e Dopplerfluxométrico

In ultrasonography, the bi-dimensional mode (B-mode) allows the morphological and morphometric evaluation of several types of organs and tissues, while the Doppler mode allows the hemodynamic evaluation. In humans, the Doppler evaluation is routinely used in the assessment of important arteries and veins, such as the carotid arteries and jugular veins, with significant differences between genres and sides. However, in veterinary medicine, this diagnostic method is not yet well established in the evaluation of the carotid arteries, with only few reports in domestic horses. This study aims to compare the right and left common carotid arteries of domestic horses and mules using bi-dimensional and Doppler ultrasound evaluation. The common carotid arteries from 10 domestic horses (five males and five females) and 10 mules (five males and five females) were evaluated. The following variables were measured at three different portions (cranial, middle and caudal): diameter, intima-media thickness (IMT), resistivity index (RI), pulsatility index (PI), peak of systolic velocity (pSV) and final diastolic velocity (fDV). No significant differences were observed in the bi-dimensional variables (diameter and IMT) between the common carotid arteries of horses and mules, regardless of gender (p>0.05). In Doppler mode, there were no significant differences between carotid values in male and female horses (p> 0.05). In the mules, it was only possible to observe differences between the RI and PI values (p<0.05), being higher on the left side (0.81 and 2.04 respectively), and the fDV (p<0.05) higher, on the right side (14.35) in males. As for females, there was only in fDV (p<0.05), with the upper right side (23.16). Diameters and IMT do not differ between sides in horses and mules in B-mode ultrasound. Spectral Doppler in horses does not differ between sides, regardless of gender. As for mules, males differ in RI, PI and fDV between sides, while females differ only in fDV.(AU)

Na ultrassonografia, o modo bidimensional (modo B) permite a avaliação morfológica e morfométrica de vários tipos de órgãos e tecidos, enquanto o modo Doppler permite a avaliação hemodinâmica. Em humanos, a avaliação com Doppler é usada rotineiramente na avaliação de artérias e veias importantes, como as artérias carótidas e veias jugulares, com diferenças significativas entre gêneros e lados. No entanto, em medicina veterinária, este método diagnóstico ainda não está bem estabelecido na avaliação das artérias carótidas, com apenas poucos relatos em equinos domésticos. Este estudo tem como objetivo comparar as artérias carótidas comuns direita e esquerda de equinos e mulas domésticos, utilizando a avaliação bidimensional (modo B) e por ultrassonografia Doppler espectral. Avaliaram-se as artérias carótidas comuns de 10 equinos domésticos (cinco machos e cinco fêmeas) e 10 mulas (cinco machos e cinco fêmeas). As seguintes variáveis foram medidas em três porções diferentes (cranial, médio e caudal): diâmetro, espessura íntima-média (IMT), índice de resistividade (RI), índice de pulsatilidade (PI), pico de velocidade sistólica (pSV) e velocidade diastólica final (fDV). Não foram observadas diferenças significativas nas variáveis bidimensionais (diâmetro e IMT) entre as artérias carótidas comuns de cavalos e muares, independentemente do gênero (p>0,05). No modo Doppler, não houve diferenças significativas entre os valores para carótidas em equinos machos e fêmeas (p>0,05). Nos muares, só foi possível observar diferenças entre os valores de RI e PI (p<0,05), sendo maiores no lado esquerdo (0,81 e 2,04 respectivamente), e o fDV (p<0,05) superior no lado direito (14,35) nos machos. Quanto as fêmeas, houve apenas no fDV (p<0,05), sendo o lado direito superior (23,16). Os diâmetros e IMT não diferem entre os lados em equinos e muares na ultrassonografia modo B. Já o Doppler espectral nos equinos não difere entre os lados, independentemente do gênero. Quanto aos muares, os machos diferenciam no IR, IP e fDV entre os lados, enquanto as fêmeas apenas para fDV.(AU)

Validez diagnóstica del índice de pulsatilidad y velocidad media de la arteria uterina en preeclampsia y restricción del crecimiento intrauterino / Diagnostic validity of the uterine artery pulsatility index and mean velocity in preeclampsia and intrauterine growth retardation

Objective: To assess the diagnostic validity of the Doppler uterine artery pulsatility index (PI) and mean velocity (MnV) in preeclampsia (PE) and intrauterine growth restriction (IUGR). Design: Analytical cross-sectional study performed at the Hospital III Honorio Delgado in Arequipa, Peru, from May 2014 to April 2015. The group of cases consisted of 78 pregnant women with PE of early onset (< 34 weeks), late onset (≥ 34 weeks), IUGR and IUGR with PE, and the control group included 100 pregnant women 20 to 40 weeks gestation, with singleton pregnancies and no complications. PI and MnV of the uterine arteries, averages and diagnostic validity tests were calculated with Doppler ultrasound. MnV sensitivity and specificity were 76.2 and 96.9 respectively in IUGR, and 42.4 and 96.9 respectively in late onset PE. IP sensitivity and specificity were 28.6 and 92.2 respectively in IUGR, and 30.3 and 92.2 respectively in late onset PE. Conclusion: In this study of the uterine artery, Doppler mean velocity had higher sensitivity and specificity than pulsatility index for late onset PE and IUGR.

Objetivo. Valorar la validez diagnóstica del índice de pulsatilidad (IP) y velocidad media (VM) de la arteria uterina en la preeclampsia (PE) y la restricción del crecimiento intrauterino (RCIU). Diseño. Estudio transversal analítico realizado en el Hospital III Honorio Delgado de Arequipa, Perú, desde mayo 2014 hasta abril 2015. El grupo de casos lo constituyeron 78 gestantes con PE de inicio precoz (< 34 semanas), PE de inicio tardío (≥ 34 semanas), RCIU y RCIU con PE, y el grupo control estuvo formado por 100 gestantes sin complicaciones, con embarazo único de 20 a 40 semanas. Se realizó ecografía Doppler de las arterias uterinas, calculándose el IP y VM de las arterias uterinas, promedios y pruebas de validez diagnóstica en PE y RCIU. Resultados. La VM en la RCIU tuvo sensibilidad y especificidad de 76,2 y 96,9, respectivamente, y en la PE de inicio tardío, la sensibilidad y especificidad fueron 42,4 y 96,9, respectivamente. El IP en RCIU tuvo sensibilidad y especificidad de 28,6 y 92,2, respectivamente, y en PE de inicio tardío, la sensibilidad y especificidad fueron 30,3 y 92,2, respectivamente. Conclusiones. En el presente estudio de Doppler de la arteria uterina, la medición de la velocidad media tuvo más sensibilidad y especificidad que el índice de pulsatilidad, en la PE de inicio tardío y la RCIU.

Protective Effect of Dandeng Tongnao Capsule (DDTN) on Cerebral Ischemia Reperfusion Rats / 中国药学杂志

OBJECTIVE: To observe the protective effects of Dandeng Tongnao capsule (DDTN) on cerebral ischemia reperfusion injury in rat and explore its mechanism so as to reevaluation the clinical efficacy of DDTN. METHODS: Middle cerebral artery occlusion (MCAO) model in rats was established using filament method and reperfusion was processed with filament removed 2 h later. Therefore, the MCAO models were established to observe the effect of DDTN-L group (0.21 g•kg-1) and DDTN-H group (0.84 g•kg-1) on infract volume via TTC staining. Regional cerebral blood flow(rCBF) of corpus striatum of the side of cerebral infraction was measured by using laser doppler flow (LDF). Pathological changes of neuron in hippocampuses were observed via hematoxylin and eosin (HE) staining and transmission electron microscopy (TEM).The changes of amino acid in cerebral ischemia were detected by microdialysis system. The level of Ca2+ was evaluated by flow cytometer (FCM). RESULTS: The results showed that the cerebral blood flow increased and infract volume reduced at 7, 14 d in DDTN group. Analysis of HE staining and TEM scan suggested that DDTN (0.21, 0.84 g•kg-1) remarkably alleviated neuronal injury of hippocampal CA1 area during I/R. The contents of Ca2+ and excitatory amino acids were significantly decreased in DDTN group. CONCLUSION: DDTN could prevent cerebral injury of MCAO rats via decreasing the intracellular Ca2+ concentration, and inhibiting the release of excitatory amino acids.

Study on the diagnostic value of superb microvascular imaging ,advanced dynamic flow and color Doppler flow imaging in breast microcarcinoma and their correlation with pathological microvessel density / 中华超声影像学杂志

Objective To investigate the diagnostic value of superb microvascular imaging ( SM I ) , advanced dynamic flow ( ADF ) and color Doppler flow imaging ( CDFI) in breast microcarcinoma ,and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density ( M VD ) . Methods A total of 85 patients ( 87 lesions ) with BI‐RADS 4 and the maximum diameter≤1 cm were selected ,of which ,46 lesions were benign ( benign group) and 41 lesions were malignant( malignant group) . All the patients and the corresponding lesions were examined by SM I , ADF and CDFI . Blood flow grading was performed on the images using Adler grade of blood flow ,and the difference of blood flow among the 3 methods was compared . T he expression level of M VD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques . Results T he areas under the ROC curve( AUR) of CDFI ,ADF and SM I were 0 .694 ,0 .705 and 0 .776 respectively based on the gold standard with pathological diagnosis . T he sensitivity ,specificity , positive predictive value ,negative predictive value ,and accuracy of CDFI were 78 .0% ,54 .3% ,60 .4% , 73 .5% ,and 65 .5% , respectively ; those of ADF were 75 .6% , 60 .9% , 63 .3% , 73 .7% and 67 .8% , respectively ; and those of SM I were 78 .0% ,69 .6% ,69 .6% ,78 .0% and 73 .6% ,respectively . T he Adler grades of CDFI , ADF and SM I were positively correlated with M VD ( P ＜ 0 .05 ) , w hich the highest correlation coefficient between SM I and M VD ( r ＝0 .430 , P ＜0 .001 ) . Conclusions SM I is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma , and has the highest correlation coefficient among those 3 detection techniques with tumor pathological M VD ,which indicates that SM I may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients .

Study on the diagnostic value of superb microvascular imaging, advanced dynamic flow and color Doppler flow imaging in breast microcarcinoma and their correlation with pathological microvessel density / 中华超声影像学杂志

Objective@#To investigate the diagnostic value of superb microvascular imaging(SMI), advanced dynamic flow(ADF) and color Doppler flow imaging(CDFI) in breast microcarcinoma, and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density(MVD).@*Methods@#A total of 85 patients(87 lesions) with BI-RADS 4 and the maximum diameter≤1 cm were selected, of which, 46 lesions were benign(benign group) and 41 lesions were malignant(malignant group). All the patients and the corresponding lesions were examined by SMI, ADF and CDFI. Blood flow grading was performed on the images using Adler grade of blood flow, and the difference of blood flow among the 3 methods was compared. The expression level of MVD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques.@*Results@#The areas under the ROC curve(AUR) of CDFI, ADF and SMI were 0.694, 0.705 and 0.776 respectively based on the gold standard with pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CDFI were 78.0%, 54.3%, 60.4%, 73.5%, and 65.5%, respectively; those of ADF were 75.6%, 60.9%, 63.3%, 73.7% and 67.8%, respectively; and those of SMI were 78.0%, 69.6%, 69.6%, 78.0% and 73.6%, respectively. The Adler grades of CDFI, ADF and SMI were positively correlated with MVD(P<0.05), which the highest correlation coefficient between SMI and MVD (r=0.430, P<0.001).@*Conclusions@#SMI is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma, and has the highest correlation coefficient among those 3 detection techniques with tumor pathological MVD, which indicates that SMI may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients.

The value of combination of micro-flow imaging and color Doppler flow imaging in the detection of vascular in hepatic tumors / 中华超声影像学杂志

Objective To evaluate the value in the diagnosis of focal nodular hyperplasia( FNH) by combining micro-flow imaging ( MFI) and color Doppler flow imaging ( CDFI) . Methods A total of 32 patients with 32 FNH lesions were enrolled in this study . Each patient underwent CDFI ,MFI ,and contrast-enhanced ultrasonography ( CEUS ) examinations . The differences in the grade and characteristic distribution of blood flow in FNH were compared between CDFI and MFI . The results were further compared with CEUS . Results There was a significant difference between MFI and CDFI in detecting the blood flow in FNH . Twenty-six cases (81 .3％ ) were detected with blood flow of grade Ⅱ and Ⅲ by MFI , however , 18 cases ( 56 .3％ ) were detected of grade Ⅱ and Ⅲ by CDFI ( P = 0 .000) . A total of 12 (37 .5％ ) lesions were correctly showed spoke-wheel arterial flow peculiar by CDFI ,whereas the number increased to 23(71 .9％ ) in combination with MFI( P = 0 .013) . Conclusions In combination with MFI , CDFI can reveal more blood flow and detect more sensitively in FNH ,which helps to diagnose FNH . To a certain degree ,it can be applied to reduce the use of CEUS .

Vascular ultrasound assessment of internal carotid artery dissection and vertebral artery dissection and the difference analysis of lumen recanalization / 中国脑血管病杂志

Objectives To diagnose and test cervical artery dissection (CAD) during the follow-up by color Doppler flow imaging (CDFI) and to analyze and compare the differences of internal carotid artery dissection ( ICAD) and stenosis degree of vertebral artery dissection ( VAD) , and lumen recanalization. Methods From January 2016 to December 2018 , a total of 136 consecutive patients (160 dissecting vessels) with CAD of intramural hematoma type diagnosed by CDFI and confirmed by high-resolution MRI and/or CT angiography in Xuanwu Hospital .Capital Medical University were enrolled retrospectively. They were divided into ICAD group (n =66, with 75 ICADs) and VAD group (n =70,with 85 VADs).The gender, age,risk factors,cerebral ischemic symptoms, and CDFI manifestations were compared in the patients between the two groups. They were followed up at 3,6, and 12 months after onset. The patients with CAD were reexamined, and the difference of recanalization rate between the two groups was compared. Results There was a statistically significant difference in the mean age and proportion of hypertension between the ICAD group and the VAD group (both P 0. 05); there was significant difference in the degree of vascular stenosis (P 0. 05) between the VAG group and the ICAD group. Conclusions ICAD was different from VAD in the degree of lumen stenosis and the rate of lumen recanalization at different follow-up time. CDFI had good test and follow-up re-examination values for CAD.

Hemodynamic study on the relationship between the internal carotid artery subtotal occlusion and cerebral ischemia / 中国脑血管病杂志

Objective To investigate the differences of intra- and extracranial hemodynamics between internal carotid artery subtotal occlusion (ICASO) and internal carotid artery servere stenosis (1CASS) through ultrasonography assessment,and to explore the hemodynamic mechanism of ICASO with ischemic stroke. Methods From July 2013 to January 2019,a total of 483 consecutive patients with ICASO (60 cases, the subtotal occlusion group) and ICASS(423 cases, the servere stenosis group) were retrospectively recruited. Recorded data of the two groups included the clinical symptoms, vascular internal diameter of the distal internal carotid artery (DICA) in the extracranial segment, and both DICA and middle cerebral artery (MCA) parameters containing average blood flow velocity, vascular resistance index and vascular pulse index. The types of intracranial collateral circulation opening and the characteristics of plaques after carotid endarterectomy were also recorded and compared between the two groups. Results The internal diameter of DICA in subtotal occlusion group was significantly thinner than that servere stenosis group (2. 5 ±0. 8 mm vs. 3. 9 ± 0. 9 mm, t = 10. 849, P 0. 05). Compared with the servere stenosis group, the subtotal occlusion group had higher opening rate of intracranial collateral circulation (all P <0. 01), but lower mean blood flow velocity and the pulse index of affected MCA(48 ± 16 cm/s vs. 61 ± 19 cm/s,P < 0. 01;0. 66 ± 0. 09 vs. 0. 73 ±0. 14,P <0. 01; respectively). Conclusions Vulnerable plaques and low perfusion from intra- and extracranial artery in ICASO patients may be the main pathogenesis of increased risk of ischemic stroke. Comprehensive evaluation of ICASO by ultrasonography could provide an objective basis for the individualized treatment selection in clinic.

Total nasal reconstruction based on three-dimensional technology combined with hemodynamics monitoring after operation / 中华整形外科杂志

Objective@#The purpose is to explore the method and clinical effects of total nasal reconstruction with the assistance of three-dimensional (3D) scanning, 3D printing and monitoring the blood circulation after operation.@*Methods@#3D scanning: Artex Eva 3D scanner was used to record the nose data of 500 volunteers from Xuzhou Medical University and its affiliated hospital from September 2016 to February 2017. A nose database of normal individuals was established, of which male was 138 and female was 362. In addition, 3D facial scanning was performed in patients wish to total nasal reconstruction. 3D printing: The individualized nasal structure was designed, with the assistant of patients′facial characteristics, combined with the normal nose database and the opinion of the patients. Anactual nose model was used as guidance during the operation. Postoperative monitoring: The blood flow and the retraction rate of forehead flap after surgery were measured using Laser Doppler Flowmeter and Geomagic Qualify software. The blood flow values, the temperature and the surface area of the flap were recorded and analyzed.@*Results@#The nasal database of normal people in the Huaihai region successfully established. Overall, the width of the nose takes up a quarter of the width of the faces, and the length is 1/3 of the distance from the hairline to the chin. From February 2017 to June 2018, 7 cases underwent total nasal reconstruction operations were performed by this procedure. The nasal models were all successfully printed out, as the guide of flap taken during the operation. The mean operation time of the cases was (2.45±0.75) h, and the follow-up time was 5-15 months, with an average of 12.5 months. After the operations, the retraction rate of the forehead flap were (21.8±2.72)% in one month, and (29.1±1.82)% in six months. All patients are satisfied with the nasal appearance.@*Conclusions@#Nasal reconstruction with forehead flap based on 3D scanning and 3D printing, provides objective targets for nasal fine-structure in a noninvasive way. The postoperative monitoring of the blood flow promotes the successful completion of the total nose reconstruction.

Multi-variated analysis of differential diagnosis in ultrasonography of idiopathic granulomatous mastitis and invasive ductal carcinoma / 中华肿瘤杂志

Objective@#To evaluate the differential diagnosis of idiopathic granulomatous mastitis (IGM) and invasive ductal carcinoma.@*Methods@#The ultrasonographic data of 37 IGM patients and 50 cases of IDC were analyzed retrospectively. The shape, growth direction, margin, internal echo, posterior echo, calcification, Adler blood flow classification, PSV(peak sestolic velocity), RI (resistance index)and elasticity scores were analyzed by χ2 test and independent sample t test. The optimal cutoff values of age, PSV and RI were calculated by receiver operating characteristic (ROC) curve. Logistic regression analysis was used to calculate the odds ratio (OR) of ultrasonic variates in the diagnosis of both diseases.@*Results@#There were no significant differences in the shape, margin, internal echo and blood flow grading between the two groups. The age, lesion growth direction, posterior echo, calcification, PSV, RI and elasticity were statistically different. The cut-of value of Age, PSV and RI were 38.5 years old, 13.20 cm/s, and 0.655. Logistic regression multi-variated analysis revealed that elastic score (OR=9.806) had the best value of the differential diagnosis, as well as calcification (OR=6.937), posterior echo decay (OR=4.613), RI (OR=3.257), lesion growth orientation (OR=3.198), and PSV (OR=1.202). Lesion shape, margin, internal echo, and Adler blood flow classification did not help in differential diagnosis.@*Conclusion@#Ultrasound multi-parameter analysis has high value in IGM and IDC differential diagnosis.

The effects of carotid artery stenting on ophthalmic artery blood flow in ischemic ophthalmopathy patients / 中华眼底病杂志

Objective To observe the effects of carotid artery stenting (CAS) on ophthalmic artery blood flow in patients with ischemic ophthalmopathy (IOP).Methods A prospective case-control study.Sixty IOP patients (60 eyes) who met inclusive criteria for CAS were enrolled in this study.There was 50％ stenosis of internal carotid artery on one side at least confirmed by color doppler flow imaging (CDFI).Among 60 eyes,there were 3 eyes with central retinal artery occlusion,15 eyes with retinal vein occlusion,37 eyes with ischemic optic neuropathy,5 eyes with ocular ischemia syndrome.The patients were randomly divided into CAS group (32 eyes of 32 patients) and medicine therapy group (28 eyes of 28 patients).The difference of age (t=1.804) and sex (x2=1.975) between two groups was not significant (P＞0.05).The examinations of fundus fluorescein angiography (FFA),CDFI and digital substraction angiography (DSA) were performed before,1 week and 6 months after treatment.The following parameters were recorded:arm-retinal circulation time (A-Rct),peak systolic velocity (PSV),end-diastolic velocity (EDV),and resistance index (RI) in the ophthalmic artery (OA) and central retinal artery (CRA),and the best corrected visual acuity (BCVA).Results There was no significant differences in A-Rct (t=1.354) and BCVA (t=0.376) between the two groups before treatment (P＞0.05).Also,there was no significant differences in PSV (t=-0.294,-2.446),EDV (t=0.141,-0.305),and RI (t=-0.222,-0.694) of OA and CRA between the two groups before treatment before treatment (P＞0.05).Compared with the medicine therapy group,the lower A-Rct was found in the CAS group at different time points after the treatment.The difference was significant on 1 week after treatment (t=-3.205,P＜0.05),but not on 6 months after treatment (t=1.345,P＞0.05).The BCVA of eyes in the two groups were increasing with the extending of time of therapy.Compared with the medicine therapy group,the better BCVA was found in the CAS group at different time points after the treatment (t=0.800,1.527;P＜0.05).Compared with the medicine therapy group,the higher PSV,EDV and lower RI of OA and CRA were found in the CAS group at different time points after the treatment.(P＜0.05).Conclusion Compared with conventional medicine therapy,CAS shows earlier effects in improving ocular hemodynamics for IOP patients with carotid artery stenosis,which benefits visual function improvement of the patients.

Preliminary analysis of diagnostic efficiency of vascular morphology distribution in breast tumor by superb microvascular imaging / 中华超声影像学杂志

Objective To compare the differences of superb microvascular imaging ( SMI) and color Doppler flow imaging ( CDFI) in the diagnosis of breast tumor microvessels and explore the value of microvascular morphological features in the detection of benign and malignant tumors . Methods SM I and CDFI were performed in 105 patients ( 105 breast tumors) in the breast surgery in our hospital . The morphological characteristics of the microvessels of the breast tumor were observed . Their values in the diagnosis of the benign and malignant of the tumor were compared with the pathological results . Results There were statistically differences in differentiation of microvascular morphologic types of benign and malignant breast tumors between SMI and CDFI ( P ＝ 0 .021 ,0 .042) . The type of diagnosing benign tumors was no blood vessel ,linear and treelike . The type of diagnosing malignant tumors was root hair-like and crab claw-like . The susceptibility ,specificity and accuracy of SMI and CDFI in diagnosing breast tumors were 85 .36% ,93 .75% ,90 .47% and 63 .41% ,90 .47% ,81 .90% . The area of the two ROC curves were 0 .896 and 0 .786 . The results of the Z test show that the diagnostic efficacies of the two methods were statistically significant( Z ＝2 .265 , P ＝0 .037) .Conclusions SMI is more effective than CDFI in detecting low velocity microvessels in breast tumors . Its morphological typing is of clinical significance in the diagnosis of benign and malignant tumors .

The anomalies of choroidal and retinal blood flow in cone-rod dystrophy / 眼科新进展

Objective To study the alteration of blood flow indexes of ophthalmic artery (OA),central retinal artery (CRA) and posterior ciliary artery (PCA) of the patients with cone-rod dystrophy (CRD).Methods The color doppler flow imaging was used in 50 CRD patients (100 eyes,CRD group) and 90 controls (180 eyes,control group) to measure the peak systolic velocity (PSV),end diastolic velocity (EDV),timeaveraged maximum velocity (TAMV),pulsatility index (PI) and resistance index (RI)in OA,CRA and PCA,respectively,and the data was obtained and analyzed statistically by one-sample t test to compare the alteration of these parameters between the CRD group and control group.Results The TAMV of OA was (14.29 ±3.88)cm · s-1 in CRD group and (12.44 ± 3.64) cm · s-1 in the control group,and the difference was statistically significant (P ＜0.05);meanwhile,the PI was 1.75 ±0.42 in CRD group and 2.02 ±0.71 in the control group,and the difference was statistically significant (P ＜0.05).Moreover,the PSV,EDV,TAMV and PI,RI of CRA was (4.60 ± 1.29) cm · s-1,(1.61 ±0.41)cm · s-1,(2.59 ±0.67)cm · s-1 and 1.11 ±0.31,0.63 ±0.10 in CRD group,respectively,and (10.82 ± 2.97) cm · s-1,(3.28 ± 1.11) cm · s-1,(5.50 ± 2.06)cm · s-1 and 1.48 ±0.49,0.71 ±0.08,in the control group,accordingly,and the differences were statistically significant (all P ＜ 0.05).Furthermore,the PSV,EDV,TAMV and PI,RI of PCA was (7.36 ± 2.18) cm · s-1,(2.28 ± 0.82) cm · s-1,(3.99 ± 1.22)cm · s-1 and 1.28 ± 0.37,0.68 ± 0.09 in CRD group,respectively,and (11.61 ± 3.41)cm · s-1,(3.34±1.25)cm · s-1,(5.83 ±1.91)cm · s-1 and 1.49 ±0.43,0.70 ±0.09 in the control group,accordingly,and the differences were statistically significant (all P ＜0.05).Conclusion Hemodynamic unusual alterations of OA,CRA and PCA in CRD patients suggest there is the correlation between the ocular blood supply and the pathological process of CRD,which remains to be observed further.

Clinical value of measurement of cerebral blood flow volume by color Doppler flow imaging in patients with cerebral infarction / 新乡医学院学报

Objective To explore the clinical value of measurement of cerebral blood flow volume by color Doppler flow imaging in patients with cerebral infarction.Methods One hundred and thirty six patients with cerebral infarction in Central Hospital of Zhumadian City from February 2015 to February 2017 were selected as CI group,and 40 non-CI patients in the corresponding time period were chosen as control group.The end diastolic flow velocity,systolic peak systolic velocity,resistance index,and mean flow velocity of the vertebral artery and internal carotid arteries of all the patients were detected by color Doppler flow imaging,and anterior and posterior circulation and total cerebral blood flow were calculated.At the same time,through the color Doppler flow imaging results of the CI group,the patients were divided into anterior circulation blood-supply infarction (anterior circulation group,101 cases) and posterior circulation blood-supply infarction(posterior circulation group,35 cases) according to the blood-supply scope.The patients in the anterior circulation group were divided into cortical branches group (32 cases),perforating branche group (55 cases) and watershed group (14 cases) according to the feeding artery,while the patients in the posterior circulation group were divided into distal infarction group (15 cases),mid-range infarction group (12 cases) and proximal infarction group (8 cases).The cerebral blood flow volume were compared among the groups.Results The end diastolic flow velocity of vertebral artery in the CI group was significantly lower than that in the control group,and the resistance index was significantly higher than that in the control group (P ＜ 0.05).The carotid intravascular diameter and the end diastolic flow velocity in the CI group was significantly lower than those in the control group,and the resistance index was significantly higher than that in the control group (P ＜ 0.05).There was no significant difference in the vertebral artery diameter,the peak velocity of internal carotid artery and vertebral artery between the CI group and the control group(P ＞0.05).The right vertebral artery blood flow,the left and right internal carotid artery blood flow,cerebral blood flow of the anterior circulation and the total cerebral blood flow in the CI group were significantly lower than those in the control group,and cerebral blood flow of the posterior circulation was significantly higher than that in the control group (P ＜ 0.05).The cerebral blood flow of the anterior circulation in the anterior circulation group was lower than that in the posterior circulation group(P ＜0.05),while the cerebral blood flow of the posterior circulation was significantly higher than that in the posterior circulation group(P ＜0.05).There was no significant difference in the total cerebral blood flow between the anterior circulation group and the posterior circulation group(P ＞ 0.05).There was no significant difference in the cerebral blood flow of anterior circulation and posterior circulation,the total cerebral blood flow among the cortical branches group,the perforating branche group and the watershed group(P ＞ 0.05).Also there was no significant difference in the cerebral blood flow of anterior circulation and posterior circulation,the total cerebral blood flow among the distal infarction group,the mid-range infarction group and the proximal infarction group(P ＞0.05).Conclusion The hemodynamics indexes and cerebral blood flow of vertebral artery and internal carotid are well analyzed and evaluated by color Doppler flow imaging,and the color Doppler has a certain clinical values on the diagnosis for CI.

Descending Aorta Blood Flow Characteristics before the Development of Necrotizing Enterocolitis in Preterm Neonates

PURPOSE: To investigate the hemodynamic risk factors for necrotizing enterocolitis (NEC), we analyzed the characteristics of descending aorta (DA) blood flow in preterm neonates, who later developed NEC. METHODS: This was an observational case-control study on 53 preterm neonates at a tertiary referral center. Clinical and echocardiographic data were collected from 23 preterm neonates with NEC (NEC group), and compared with those of 30 preterm neonates without NEC (control group). Echocardiography was done at a median (interquartile range) of 5 (3–9) days after birth and 2 (1–2.5) days before the diagnosis of NEC. RESULTS: Basic clinical characteristics including gestational age, birth weight, Apgar score, breast feeding status, use of umbilical catheters, and mode of invasive ventilator care were similar between the groups. Compared with the control group, the lowest diastolic velocity of DA was significantly decreased, whereas the diastolic reverse flow and the ratio of diastolic reverse to systolic forward flows were significantly increased in the NEC group. In addition, the resistive index (RI) of DA was significantly increased in the NEC group and showed a positive association with the development of NEC. Multivariate logistic regression analysis showed that increasing RI of DA was an independent risk factor for the development of NEC (P=0.008). CONCLUSION: Significant changes in DA flow characteristics including decreased diastolic velocity and increased diastolic reverse flow along with increased peripheral vascular resistance were observed before the development of NEC in preterm neonates. These findings may help clinicians stratify in advance neonates at a risk of developing NEC and may help improve outcomes in these neonates.