OBJECTIVE: To explore the pathological changes of lower extremity arteries of patients with metabolic syndrome. METHODS: Fifty patients with metabolic syndrome (MS) and 30 normal volunteers were included in this study. The inner diameters, peak systolic velocities and intima-media thicknesses of the lower extremity arteries, and the sizes and numbers of the plaques in the lower extremity arteries were obtained with color Doppler ultrasound (CDU). RESULTS: In the fifty MS patients, the intima-media thicknesses of forty-one were thicker than 1.1 mm and thirty-three had plaques which had brought stenosis in different degrees. The intima-media thicknesses of the common femoral, popliteal and posterior tibial arteries in the MS patients were significantly thicker than those in the normal volunteers (P<0.01 or P<0.05), and a greater number of plaques in the lower extremity arteries were observed in the patients, as compared with the normal volunteers (P<0.01). CONCLUSION: Various pathological changes had taken place in the lower extremity arteries of the MS patients. The sites and degrees of the lower extremity arterial diseases in MS patients can be definitely detected with CDU.

Objective: To explore the correlation between the parameters of eTRACKING detection of femoral artery and the syndrome types of traditional Chinese medicine (TCM) in type 2 diabetic patients so as to provide clinical evidence for early prevention and treatment of diabetic lower extremity arterial disease. Methods: A total of 147 cases of type 2 diabetic patients were included. Basic data and TCM clinical information were collected, and eTRACKING detection of common femoral arteries was performed. Differentiation of symptoms and signs for classification of TCM syndromes was performed in all patients. The correlations between TCM syndrome and pressure-strain elastic modulus (Ep), stiffness parameter beta, arterial compliance (AC), pulse wave velocity beta (PWVbeta), and augmentation index (AI) in common femoral arteries were observed. Results: In the patients with deficiency of both yin and yang, the Ep value was higher than that in the patients with deficiency of both qi and yin, the stiffness parameter beta was higher than that in the other three syndrome types (deficiency of both qi and yin, excessive heat due to yin deficiency, accumulation of damp-beat in spleen), the AC value was lower than that in the patients with excessive heat due to yin deficiency, the PWVbeta value was higher than that in the patients with excessive heat due to yin deficiency and deficiency of both qi and yin, and the AI value was higher than that in the patients with excessive heat due to yin deficiency. The stiffness parameter beta in the patients with deficiency of both qi and yin was higher than that in the patients with accumulation of damp-heat in spleen. In the patients with blood stasis, the Ep value was higher and the AC value was lower than that in the patients without blood stasis. Conclusion: The decrease of elasticity in lower extremities can be detected by eTRACKING. This study reveals that type 2 diabetic patients with deficiency of both yin and yang, accumulation of damp-heat in spleen and blood stasis have more severe lower extremity arteriosclerosis. In eTRACKING parameters, stiffness parameter beta, AC and PWVbeta may become the objective indexes in evaluating early diabetic lower extremity arteriosclerosis.

Objective To explore the generalization and application of R-W1 through the phase analysis of Wave intensity technique.Methods The phases of R-W1 of 66 healthy adults were detected by Aloka Prosound α10 color Doppler uhrasound.Results There were all statistical significances in the time difference of R-W1 in left and right common carotid arteries and right brachial artery(P＜0.01),in the pressure wave conductive time in left and right common carotid arteries(P＜0.05),in right brachial artery and both sides of common carotid arteries(P＜0.01).There were no statistical significances in the time from the starting point to the culminate point of W1 in left and right common carotid arteries.There were statistical significances in the time from the starting point to the culminate point of W1 in right brachial artery and both sides of common carotid arteries(P＜0.05).Conclusions"R-W1 almost equals to pre-ejection period"as reported by literatures actually involves three phases which respectively are isovolumetric contraction time of left ventricle,pressure wave conductive time and time from the starting point to the culminate point of W1.The factor of pressure wave conductive time should be considered when evaluating diseases in clinic.The pre-ejection time should be the time from the culminate point of R wave in ECG to the starting point of W1 and the time from the starting point to the culminate point of W1 should not be involved in.

Objective To make certain about the phase of time from the culminated point of instantaneous accelerating wave intensity (W1) to that of instantaneous decelerating wave intensity (W2) wave intensity(WI) technique. Methods The ejection time of the curve of Doppler rate of flow in aortic opens and W1～W2 of common carotid arteries of both sides were detected in 66 healthy adults by Prosound α10 color Doppler ultrasound and the data were contrasted and analyzed. Results There were no statistical significances in the standardized value difference of ejection time of aorta and of time from starting point of W1 to culminated point of W2 in common carotid arteries of both sides (P>0.05). And there were all statistical significances in the standardized value difference of ejection time of aorta and of time in other groups (P<0. 001). Conclusions The ejection time is the time from starting point of W1 to culminated point of W2. The beginning of cardiac ejection should be the starting point of W1 curve,and the culminated point of W2 is the terminal time of ejection.

Objective To evalute the clinical application of the new technique of instantaneous wave intensity(WI) through the correlative analysis of instantaneous acceleration wave intensity(W1) and Tei index. Methods The correlation of the intensity of W1 (the apogee of W1) and Tei index of 66 healthy adults were analyzed by Prosound a10 color Doppler ultrasonograph. Results There were positive correlations in pressure and caliber between the common carotid arteries of both sides in 66 cases of healthy adults (P <0.01). There were negative correlations respectively between the pressure of W1 of left and right common carotid arteries and Tei index (P <0.05),and there were the same in caliber (P <0.01), mean pressure (P <0.05) and mean caliber (P <0.01). Conclusions W1 is negatively correlated with Tei index and can be an index in judging the systolic function.

Objective: To investigate the current basic situation of ultrasound machines of ultrasound departments in Shanghai medical institutions, and to provide the basis for making management policy in order to promote medical quality. Methods: Questionnaire surveys about ultrasound machines and service ability including producing countries of ultrasound machines, the number of ultrasound machines, using years of ultrasound machines, yearly workload and the yearly number of patients that each ultrasound machine accepted were made in 2013 and 2018, respectively. Statistical results were compared between the two surveys. Results: Compared with 2013, the share of imported ultrasound machines declined in 2018 (82% vs 91%). Compared with 2013, the number of ultrasound machines in Shanghai medical institutions had increased by 31% in 2018 (2 123 vs 1 617). The occupancy rate of ultrasound machines in tertiary hospitals was the highest (tertiary hospitals 40%, secondary hospitals 25%, primary grade hospitals 20%, and private hospitals 15%). Compared with 2013, the proportion of ultrasound machines that have been used for more than 10 years increased (9% vs 4%), the yearly workload of ultrasound examination had increased by 46% (19.82 million person-time vs 13.59 million person-time). Tertiary hospitals bored the highest proportion of the workload (tertiary hospitals 51%, secondary hospitals 35%, primary grade hospitals 4%, and private hospitals 10%). Currently, the number of ultrasound machines per 10, 000 people in Shanghai was 1.14. The yearly number of patients that each ultrasound machine accepted had increased by 11% (9300 person-time vs 8400 person-time in 2018). Conclusions The scale of ultrasound departments in Shanghai medical institutions has been developing. Brand localization of ultrasound machines is improving. However, the renewal ability of ultrasound machines still needs to be improved. The workload of ultrasound department is getting heavier. Hierarchical diagnosis and treatment is unbalanced.