To explore the value of ultrasound strain elastography (SUE) combined with magnetic resonance diffusion-weighted imaging (MRI-DWI) guided targeted puncture in the diagnosis of prostate lesions.

Patients with suspected prostate space-occupying lesions who were treated at Huizhou Central People's Hospital from May 2019 to May 2022 were prospectively collected as the research subjects. Rectal ultrasound, SUE, and MRI-DWI were performed before puncture, and the suspicious areas were recorded. All patients underwent transrectal systematic prostate puncture under the guidance of rectal ultrasound, and targeted puncture of suspicious lesions under the guidance of SUE combined with MRI-DWI. The imaging characteristics were recorded. Taking the pathological results as the "gold standard", the positive detection rates by systematic puncture and targeted puncture were compared. The receiver operating characteristic (ROC) curve of apparent diffusion coefficient (ADC) was plotted to analyze the value of ADC in diagnosing prostate lesions. The Gleason scores of the two puncture biopsy schemes were compared.

A total of 105 patients with suspected prostate space-occupying lesions were included in this study, of which two withdrew from the study due to their own psychological reasons. Finally, 103 patients were included in this study. All 103 patients were successfully punctured and sampled for examination, among which 66 (64.08%) were pathologically diagnosed with prostate cancer (all were adenocarcinoma). There were 37 cases of benign prostatic hyperplasia, accounting for 35.92% (37/103), of which two were accompanied by intraepithelial neoplasia. A total of 59 patients were diagnosed with malignant lesions, including 55 cases by MRI-DWI and 57 cases by SUE. In patients with malignant lesions, MRI-DWI examination (T2WI) showed that the lesions had nodular low signal, DWI showed high signal, ADC map showed that the ADC value was low, and SUE examination can find a blue area with increased hardness. The malignant lesion detection rate by systematic puncture was 48.54%, and that of SUE combined with MRI-DWI targeted guided puncture was 57.28%; there was no statistical significant difference between them (P>0.05). A total of 1181 needles were used in systematic puncture, of which 379 achieved a pathological diagnosis of malignant lesions, with a single needle detection rate of 32.09%. A total of 218 needles were punctured under the guidance of SUE and MRI-DWI, and 136 needles achieved a pathological diagnosis of malignant lesions, with a single needle detection rate of 62.38%. The single needle detection rate by targeted guidance puncture was significantly higher than that by systematic puncture (P<0.05). The ADC value in malignant lesions was (1.18±0.17) mm²/s, while in benign lesions it was (1.42±0.23) mm²/s; the ADC value in malignant lesions was lower than that in benign lesions (t=6.303, P<0.001). The area under the curve (AUC) of ADC for diagnosis of benign and malignant prostatic lesions was 0.816 (95%CI: 0.718-0.914). The sensitivity and specificity of evaluating benign and malignant prostatic lesions using an ADC value of 1.34 mm²/s as the cutoff point were 83.33% and 67.57%, respectively. There was no statistical significant difference in Gleason scores between the two puncture schemes (P>0.05).

Compared with systematic puncture, SUE combined with MRI-DWI guided targeted puncture can obtain a similar detection rate of prostate malignant lesions with less puncture needles and a higher positive rate of puncture.

To evaluate the safety and effectiveness of ultrasound-guided percutaneous nephrolithotomy without artificial hydronephrosis.

The clinical data of 395 patients who underwent percutaneous nephrolithotomy at the Department of Urology Affiliated Hospital of Jining Medical University from January 2019 to December 2021 were retrospectively analyzed. The patients were divided into three groups (no hydronephrosis, mild hydronephrosis, and moderate/severe hydronephrosis) according to the degree of preoperative CT hydronephrosis assessed by preoperative CT, and each group was further divided into either an artificial hydronephrosis group or a no artificial hydronephrosis group according to the surgical method used. The differences in the one-time puncture success rate, operation time, intraoperative bleeding, one-stage calculus clearance rate, the incidence of postoperative fever, and postoperative hospital stay were compared between the artificial hydronephrosis group and the no artificial hydronephrosis group.

There was no significant difference in general data between the two groups (P＞0.05). For patients without hydronephrosis, operative time [(54.8, 95.5) min vs (5.0, 60.0) min, P＜0.01], intraoperative blood loss [(10, 25) ml vs (5, 20) ml, P＜0.01], and postoperative hospital stay [(3.0, 5.0) d vs (2.0, 4.0) d, P＜0.01] differed significant between the artificial hydronephrosis group and the no artificial hydronephrosis group. For patients with mild hydronephrosis, operative time [(65.0, 115.8) min vs (25.0, 40.0) min, P＜0.01], intraoperative blood loss [(20, 50) ml vs (5, 20) ml, P＜0.01], and postoperative hospital stay [(3.0, 6.0) d vs (2.0, 4.0) d, P＜0.01] also differed significantly between the artificial hydronephrosis group and the no artificial hydronephrosis group. For patients with moderate/severe hydronephrosis, operative time [(60.0, 111.0) min vs (25.0, 60.0) min, P＜0.01], intraoperative blood loss [(10, 30) ml vs (5, 20) ml, P＜0.01], and postoperative hospital stay [(3.0, 5.0) d vs (2.0, 4.0) d, P＜0.01] still differed significantly between the artificial hydronephrosis group and the no artificial hydronephrosis group. There was no significant difference in the one-needle puncture success rate, one-stage calculus clearance rate, and the incidence of postoperative fever between the two groups (P＞0.05).

Ultrasound-guided percutaneous nephrolithotomy without artificial hydronephrosis is safe and effective for the treatment of kidney stones with different degrees of hydronephrosis, which can shorten operation time and accelerate postoperative recovery.

To screen key genes (Hub genes), pathways, and drug candidates related to myocardial ischemia-reperfusion injury (MIRI) in rats by bioinformatics analysis based on the gene expression omnibus (GEO) database.

The rat GSE122020 dataset was downloaded from the GEO database and differentially expressed genes (DEGs) were screened using the GEO2R online tool. Pathophysiological processes and potential signaling pathways involved in MIRI-related DEGs were investigated by Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. The MIRI-related DEGs protein-protein interaction (PPI) network was constructed using databases such as STRING, and the key genes in the PPI network were screened and visualized using Cytoscape software. Potential drug candidates for key genes were screened using the Enrichr database.

A total of 377 differential genes were screened, of which 109 were up-regulated and 268 down-regulated. KEGG pathway enrichment analysis showed that the up-regulated 109 genes were enriched in six pathways including the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway, while the 268 down-regulated genes were enriched in 58 pathways including the tumor necrosis factor (TNF) signaling pathway. Combined analysis based on the STRING and Gene MANIA databases and Cytoscape software resulted in the identification of 20 key DEGs, of which 4 were up-regulated and 16 down-reglated. For the 4 up-regulated genes, 55 potential drugs including nicotinic acid and quercetin were predicted based on the DSigDB database in the Enrichr database, while for the 16 down-regulated genes, 92 potential drugs including 3,3'-diindolylmethane and potassium dichromate were predicted.

Through bioinformatics methods, the pathogenic genes of MIRI can be effectively discovered, which provides new ideas and entry points for further exploring the molecular mechanism and therapeutic targets for MIRI.

To investigate the relationship of umbilical artery ultrasonography parameters, neutrophil to lymphocyte ratio (NLR), and soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PLGF) ratio with adverse pregnancy outcomes in patients with pregnancy induced hypertension syndrome (PIH).

A total of 100 PIH patients who gave birth in the Fifth Affiliated Hospital of Guangzhou Medical University from April 2020 to April 2021 were selected as an observation group, and 100 healthy pregnant women in the same period were selected as a control group. Umbilical artery ultrasound and NLR and sFlt-1/PLGF ratio in the late pregnancy were compared between the two groups, and adverse pregnancy outcomes were recorded.

The pulse index (PI), resistance index (RI), and systolic/diastolic velocity ratio (S/D) in the observation group were significantly higher than those in the control group (P＜0.05). The percentage of subjects with an abnormal S/D was higher in the observation group than in the control group (33.00% vs 9.00%, P＜0.05). NLR and sFlt-1/PLGF ratio in the observation group were significantly higher than those in the control group (P＜0.05). The percentages of subjects with premature delivery, fetal distress, low birth weight infants, and Apgar <7 points at 1 min in the observation group were significantly higher than those in the control group (P＜0.05). Pearson correlation analysis showed that abnormal PI, RI, S/D, NLR, and sFlt-1/PLGF ratio were positively correlated with adverse pregnancy outcome in PIH patients (r=0.511, 0.495, 0.524, 0.533, and 0.606, respectively, P＜0.01). The a rea under the ROC curve (AUC) values of PI, RI, S/D, NLR, and sFlt-1/PLGF ratio for predicting adverse pregnancy outcomes in PIH patients were 0.833 [95% confidence interval (CI): 0.786~0.904], 0.814 (95%CI: 0.754~0.877), 0.864 (95%CI: 0.773~0.924), 0.820 (95%CI: 0.754~0.854), and 0.870 (95%CI: 0.763~0.892), respectively; the sensitivities were 74.11%, 72.19%, 76.32%, 70.25%, and 78.52%, and the specificities were 72.18%, 84.37%, 87.65%, 80.33%, and 82.51%, respectively. The AUC of umbilical artery ultrasound parameters combined with NLR and sFlt-1/PLGF ratio in predicting adverse pregnancy outcomes in PIH patients was 0.940 (95%CI: 0.825~0.984), with a sensitivity of 88.56% and specificity of 97.41%.

The proportion of patients with abnormal PI, RI, S/D, and umbilical artery ultrasound parameters in PIH pregnant women is significantly higher than that of healthy pregnant women. Umbilical artery ultrasound combined with NLR and sFlt-1/PLGF ratio has appreciated predictive value for adverse pregnancy outcomes of PIH.

To measure the bone mineral density of infants and toddlers aged 0-3 in Shijingshan district of Beijing.

A total of 6297 infants and toddlers aged 0-3 years who received physical examination at Peking University Shougang Hospital from January 2015 to February 2020 were selected, of whom there were 3306 boys and 2991 girls. Bone mineral density was measured by quantitative ultrasound. The results were then analyzed statistically.

The mean Z value of bone mineral density in 6297 infants and toddlers was -0.99; the mild deficiency rate was 14.2% (911/6297), moderate deficiency rate was 11.6% (750/6297), severe deficiency rate was 19.9% (1268/6297), and the total deficiency rate was 46.5% (2929/6297). The bone mineral density of girls was significantly lower than that of boys. The deficiency rate of girls was 56.9% (1702/2991), which was significantly higher than that of boys (37.1%, 1227/3306). The mild deficiency, moderate deficiency and severe deficiency rates of girls were also all higher than those of boys. The bone mineral density was the lowest in the 4-6 months group, followed by 0-3 months. After 6 months of age, the bone mineral density increased gradually with age. The deficiency rate was the highest too in the 4-6 months group.

There is a high rate of low bone mineral density in infants and toddlers aged 0-3 years in Shijingshan district of Beijing, which is related to gender and age.

Myocardial ischemia-reperfusion injury (MIRI) is one of the key causes of myocardial injury, secondary to cardiovascular diseases, which is mostly present in coronary heart disease and during the perioperative period of cardiac surgery. MIRI elicits oxidative stress, inflammatory activity, and cell apoptosis, with a high incidence and mortality rate. The current treatments for MIRI include medicines and physical therapy, but with unsatisfactory effects. As a small molecule non-toxic reducing gas, hydrogen has a clear protective effect against cell ischemia-reperfusion, and has therefore become a promising treatment for MIRI. This paper reviews the mechanism of hydrogen for the treatment of MIRI and the preliminary prospect of its clinical application in the future.

To assess the clinical diagnostic value of real-time contrast-enhanced ultrasound (CEUS) quantitative analysis in hepatic focal lesions initially discovered in physical examination.

Eighty-seven patients with hepatic focal lesions initially discovered by conventional color Doppler ultrasound in the physical examination at the Fourth People's Hospital of Haikou City from January 2018 to January 2021 were selected to undergo real-time CEUS examination. The results of real-time CEUS and conventional color Doppler ultrasound were analyzed based on the puncture pathology results. The time-intensity curve (TIC) was used to quantitatively analyze the real-time CEUS characteristics of the lesions and to compare the CEUS characteristics of different lesions.

A total of 101 lesions were detected in 87 patients, including 74 cases with a single lesion and 13 cases with multiple lesions. Pathological examination confirmed 57 lesions in 47 cases with benign lesions, including 21 cases of nodular hyperplasia (26 lesions), 9 cases of hepatic hemangioma (9 lesions), 3 cases of cirrhosis nodules (4 lesions), 4 cases of local inflammatory lesions (4 lesions), and 10 cases of focal fat defect (10 lesions). There were 40 cases (44 lesions) of malignant lesions, including 16 cases (18 lesions) of primary hepatocellular carcinoma, 11 cases (12 lesions) of metastatic liver cancer, and 13 cases (14 lesions) of cholangiocellular liver cancer. The diagnostic coincidence rate of color Doppler ultrasonography with the puncture pathology results for the 57 lesions in the 47 cases with benign lesions was 77.19%, and that of real-time CEUS for benign lesions was 100%; the difference was statistically significant between the two modalities (χ²=12.503, P=0.01). The diagnostic coincidence rate of color Doppler ultrasonography with puncture pathology results for the 44 malignant lesions was 61.36%, while that of real-time CEUS was 93.18%; the difference was statistically significant between the two modalities (χ²=10.935, P=0.001). The rise time, time to peak, and time to time to half value in the TIC curve were significantly later in patients with benign lesions than in those with malignant lesions (P＜0.05), while the peak intensity was significantly lower in patients with benign lesions than in those with malignant lesions (P＜0.05). The proportion of patients with blood flow Alder grade 0 and grade Ⅰ was higher in patients with benign hepatic focal lesions, while the proportion of patients with blood flow Alder grade Ⅱ and grade Ⅲ was higher in patients with malignant hepatic focal lesions; the differences between the two groups were statistically significant (P＜0.05).

Real-time CEUS can quantitatively identify benign and malignant liver lesions by assessing internal blood perfusion of hepatic focal lesions, contrast enhancement pattern, and TIC curve parameters, and can be used as an effective means for clinically determining the hepatic focal lesions detected by color Doppler ultrasound in physical examination.

Ultrasound elastography is a new technique that can objectively evaluate the elasticity of body tissues. It has been widely used in the assessment of elasticity of the liver, kidney, breast, thyroid, and prostate. In recent years, the continuous development of pulmonary ultrasound technology has made it be widely used in the diagnosis and evaluation of critical care illness patients due to its advantages of non-invasiveness, cheapness, non-radiation, and repeatability. Lung ultrasound elastography has shown high sensitivity and specificity in the diagnosis of some lung diseases (such as tumors, lung interstitial diseases, and pulmonary edema). In particular, the ultrasonic surface wave elastography technology developed by Zhang et al from Mayo Clinic has expanded a new field for the diagnosis of lung diseases. This review summarizes the application of lung ultrasound elastography in lung diseases and discusses its application prospects.

To investigate the significance of sentinel lymph node (SLN) biopsy (SLNB) using contrast-enhanced ultrasonography (CEUS) combined with blue dye in neoadjuvant-treated human epidermal growth factor receptor 2 (HER2)-positive or triple-negative breast cancer with initially biopsy-proven nodal metastasis.

From June 2020 to April 2022, HER2-positive or triple negative breast cancer patients with baseline stage cT1~3N1M0 and negative axillary status after neoadjuvant therapy were prospectively included at Sichuan Cancer Hospital. All the patients received SLNB and subsequent axillary lymph node dissection. SLNB was conducted using CEUS combined with blue dye. Using the final pathological results as the golden standard, the detection rate, sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and false negative rate (FNR) of the combination method were calculated.

Twenty-nine patients were included, with a median age of 51 years (range, 28-64 years); 24 cases were HER2 positive and 5 were triple-negative. The overall rate of axillary pathological complete response was 72.4% (21/29). The detection rate of the combination method was 96.6% (28/29). Twenty-eight patients underwent SLNB successfully using the combination method. Compared with the pathological diagnosis, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and FNR of the combination method were 100% (7/7), 100% (21/21), 100% (7/7), 100% (21/21), 100% (28/28), and 0% (0/7), respectively.

The combination of CEUS with blue dye for SLNB has a meaningful detection rate and FNR in neoadjuvant-treated HER2-positive or triple-negative breast cancer with initial nodal involvement.

To assess the diagnostic value of ultrasound-guided percutaneous lung biopsy and identify the risk factors for the development of complications, so as to improve the success rate of puncture and reduce the development of complications.

A retrospective analysis was performed on 106 patients who underwent ultrasound-guided percutaneous lung biopsy at the Ultrasound Interventional Therapy Center, University of Chinese Academy of Sciences Ningbo Huamei Hospital from July 2019 to July 2021. By comparing the biopsy results and pathological results, the diagnostic accuracy of ultrasound guided percutaneous lung puncture was assessed, and the risk factors for the development of complications were identified by logistic regression analysis.

Among the 106 cases included, biopsy pathology suggested malignant lesions in 84 cases (79.2%) and benign lesions in 20 (18.9%); there was also one isolated fibroma (0.9%) and one thymoma (0.9%). Among the 106 cases, 32 (30.2%) had complications, including 17 cases (16.0%) with hemorrhage and 15 (14.2%) with pneumothorax. Logistic regression analysis showed that gender, lesion located in the upper middle lung, and emphysema were significant independent risk factors for bleeding (P＜0.05). Gender, age, puncture frequency, puncture position, emphysema, and pneumothorax had no significant impact on the development of complications (P＞0.05).

Ultrasound-guided percutaneous lung biopsy is a safe and effective biopsy technique. Gender, puncture position, and emphysema are important factors affecting the development of complications.

Ultrasound (US)-guided fine needle aspiration is an accurate method for the diagnosis of benign and malignant thyroid nodules. Given the lack of cheap and high-fidelity simulation models, most domestic residents do not practice enough on the models. This study attempted to provide a cost-effective viable and high-fidelity simulation model for training radiology residents in ultrasound-guided thyroid fine-needle aspiration.

A high-fidelity simulation model was made by using konjac, gelatin, cornstarch, tubes (small-sized and medium-sized) and several fish oil capsules. Twenty ultrasound residents participated in the training of thyroid fine needle puncture using our self-made model, and filled in a questionnaire before and after the training.

The anatomical and ultrasonographic images of the thyroid glands obtained using our simulation model were extremely close to real-world ones. All participants found that the training session was valuable. There was a statistically significant improvement in all surveyed aspects (statistically significant increases in both professional knowledge and technical confidence of residents, and a statistically significant decrease in the residents' anxiety degree related to performing thyroid biopsy).

The konjac-gelatin simulation model is a cost-effective, high-fidelity phantom for training residents in ultrasound-guided fine needle thyroid nodule targeting punctures.

Cesarean scar pregnancy (CSP) is a special type of ectopic pregnancy and one of the serious long-term complication of cesarean section. The incidence of CSP has increased in recent years due to the increasing use of cesarean delivery and childbearing policy. Serious complications of CSP include placenta accreta, massive hemorrhage, and uterine rupture. Early diagnosis and reasonable treatment are particularly important for women who are suspected of having CSP. Contrast-enhanced ultrasound (CEUS) play an important role in the diagnosis and differential diagnosis of CSP. In this paper, we systematically review the progress of CEUS in the diagnosis and differential diagnosis of CSP.

To grade anismus by echodefecography (EDF) based on standard anismus grading by anorectal manometry (ARM), and analyze the correlation between the grade of anismus and the clinical symptoms of constipation.

Ninety-seven patients diagnosed with anismus were collected from December 2018 to December 2021 at the Anorectal Treatment Center of The Second Affiliated Hospital of Nanjing University of Chinese Medicine. After providing informed consent, the patients underwent ARM, chronic constipation severity scale (CSS) evaluation, and EDF. First, the patient showing abnormal contractions on anorectal manometry were scored on the CSS scale, and then EDF was performed. Anismus was then graded by EDF. On this basis, Logistic regression analysis was conducted for the anismus grade of patients and their constipation symptoms.

The following regression equation was obtained by linear regression analysis: y=0.586x-1.191 (P＜0.05). According to the CSS, anismus was graded by EDF as follows: mild, 1°＜ɑ≤5°; moderate, 5°＜ɑ≤10°; severe, 10°＜ɑ≤16°. Logistic regression analysis demonstrated that there was no significant correlation between anismus grade and patients' self-defecation, defecation frequency, anal pendant expansion, or abdominal (distension) pain (P＞0.05). However, anismus grade had a strong correlation with symptoms such as sense of bowel movement, defecation obstruction, and sense of defecation failure (P＜0.05).

Anismus grade evaluated by EDF is associated with clinical symptoms of anismus, such as bowel movement, defecation obstruction, and sense of defecation failure, which suggests that EDF is an effective method to diagnose anismus. The sample size of this study was small, so further larger-sample multi-center study is needed to determine its value.

To investigate the specificity and sensitivity of cardiac color Doppler ultrasound in the clinical diagnosis of patients with chronic heart failure.

A total of 212 patients with chronic heart failure were randomly selected at our hospital from March 2019 to March 2021. All patients underwent cardiac color Doppler ultrasound and coronary angiography. Data including left ventricular diastolic diameter, left atrial diameter, left ventricular ejection fraction, E peak/Ea peak, and adverse reactions after diagnosis were recorded. The results of cardiac color Doppler ultrasound and coronary angiography were compared to calculate the accuracy, specificity, and sensitivity of cardiac color Doppler ultrasound in the diagnosis of chronic heart failure.

The accuracy, specificity, and sensitivity of cardiac color Doppler ultrasound in the diagnosis of chronic heart failure were 93.40%, 71.43%, and 95.61%, respectively. The negative predictive value was 35.71% and the positive predictive value was 98.99%.

Color Doppler echocardiography has unique advantages in evaluating patients with chronic heart failure. It is simple, effective, and noninvasive, and has good sensitivity and specificity.

To investigate the application of bedside ultrasound in type I mellitus diabetes patients after simultaneous pancreas-kidney transplantation (SPK), and to discuss the strategies, reference parameters, and postoperative complications of ultrasound scanning.

From July 2009 to June 2020, the hemodynamic parameters, vascular reconstruction procedures, and complications of six patients with type I mellitus diabetes were retrospectively analyzed.

Among the six patients, four developed pancreatic renal immune rejection, in which the resistance index (RI) of the internal pancreatic artery was 0.74~0.87, and peak systolic velocity (PSV) was 87~90 cm/s; the RI of the other two patients was 0.69 and 0.72, respectively. In the four patients with pancreatic renal immune rejection, complications occurred in both pancreas and kidney grafts. One patient underwent end to side anastomosis between the donor's portal vein and the recipient's external iliac vein, and the other five patients underwent end to side anastomosis between the donor's portal vein and the recipient's inferior vena cava. All the six patients underwent Y-shaped vascular anastomosis, and the renal artery of the donor kidney was the same as that of the donor kidney. The internal iliac artery was anastomosed, the abdominal aorta sleeve (including celiac trunk and superior mesenteric artery) of the donor was anastomosed with the external iliac artery of the donor, and the common iliac artery of the donor was anastomosed with the external iliac artery of the recipient end to side.

Bedside ultrasound has great clinical value in the evaluation of organ function after SPK. The reconstruction of blood vessels is the key point of scanning. The diagnostic strategies of ultrasound doctors need to be closely combined with the specific procedure of surgery.