Objective:To correlate diaphragmatic ultrasound parameters and pulmonary function in patients with chronic obstructive pulmonary disease (COPD) and its clinical value in the diagnosis of COPD.Methods:Eighty patients with COPD who received treatment in The First People's Hospital of Huzhou from January 2019 to June 2020 and 80 healthy subjects who concurrently received health examination were included in this study. Pulmonary function index, diaphragmatic ultrasonic parameters and activity endurance index were compared between COPD group and healthy control group. Diaphragmatic ultrasound parameters in COPD patients were correlated with pulmonary function index and activity endurance index.Results:The forced expiratory volume in 1 second/forced vital capacity (FEV 1/FVC) ratio in the COPD group was significantly lower than that in the healthy control group [(56.27 ± 8.98)% vs. (87.42 ± 6.29)%, t = 14.583, P < 0.05]. The residual volume/total lung capacity (RV/TLC) ratio in the COPD group was significantly higher than that in the healthy control group [(54.81 ± 6.95) % vs. (27.59 ± 3.92) %, t = 17.904, P < 0.05]. The walking distance in 6-minute walking test (6MWT) in the COPD group was significantly shorter than that in the healthy control group [(502.36 ± 82.41) m vs. (824.59 ± 63.37) m, t = 11.726, P < 0.05]. The diaphragm mobility using quite breathing (DM QB), the diaphragm mobility using deep breathing (DM DB), and diaphragmatic thickening fractions (TF) in the COPD group were (1.71 ± 0.45) mm, (4.03 ± 0.81) m and (117.56 ± 24.83) %, respectively, which were significantly lower than those in the healthy control groups [(2.24 ± 0.30) mm, (5.36 ± 0.62 ) mm, (159.60 ± 22.35)%, t = 4.736-7.592, all P < 0.05]. DM QB, DM DB and TF in patients with COPD were positively correlated with FEV 1/FVC and 6MWT distance ( r = 0.705-0.819, all P < 0.05), but they were negatively correlated with residual volume/total lung capacity (RV/TLC) ratio ( r = -0.774 to -0.847, all P < 0.05). Conclusions:DM QB, DM DB and TF decrease in COPD patients, and their values are correlated with pulmonary function and activity tolerance index. Ultrasound examination of diaphragmatic morphological change is of certain clinical value for the diagnosis and evaluation of COPD.

ObjectiveTo investigate the changes of the serum level of insulin-like growth factor-1 (IGF-1) and lipid as well as their correlation in aged patients with ischemic cerebrovascular diseases(ICVD).MethodsSerum level of IGF-1, Lipoprotein(a) [LP(a)], total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were detected in 130 cases of aged ICVD, as well as in 43 cases of healthy aged control.ResultsIGF-1 level in aged ICVD group was remarkably lower than that in control(P<0.05), and the levels of LP(a),TC, TG and LDL-C in aged ICVD group were significantly higher than that in control (P<0.05). The serum IGF-1 level in TIA patients with infarction was mower than those without infarction (P<0.05). In aged ICVD group, the serum IGF-1 level was negatively correlated with LP(a),TC, TG and LDL-C level (P<0.01). ConclusionIGF-1 decreased in the patients of aged ICVD, which shows a close relationship about the disorder of lipid metabolism, and may play a certain role in the course of occurrence and development of aged ICVD.

Objective: To analyze the association of thrombocytosis with the prognosis of patients with gastric cancer.Methods: The clinical materials of 782 patients with gastric cancer who underwent initial surgery in our hospital between January 1995 and December 1999 were retrospectively analyzed.Kaplan- Meier and Log-Rank test were used to analyze the data.Prognostic factors were analyzed by multivariate Cox proportional hazards model.Results: Thrombocytosis oc-curred in 11.4% (87/782) patients.The platelet level was not significantly different among patients of different gender, tumor stage, and histological differentiation (P>0.05).However, a significant difference was observed in the platelet level among patients with different age and surgical approach (P<0.05).The 1-, 3-, and 5-year survival rates were 75.0%, 40.1% and 28.9% in patients without thrombocytosis and 52.8%, 16.9%, and 13.5% in patients with thrombocytosis (P=0.002).Univari-ate analysis showed that histological differentiation, pathological stage, surgical approach and thrombocytosis significantly affected the survival of patients.While age and gender had no significant impact on patient survival.Multivariate analysis showed that pathological stage, surgical approach, and thrombocytosis were independent prognostic factors for gastric can-cer.The relative risk of death of patients with thrombocytosis was elevated by 1.454 times (RR=1.454, 95% CI: 1.135～1.861, P=0.005).Conclusion: Thrombocytosis is an independent prognostic indicator for the survival of initially treated pa-tients with gastric cancer.

Objective To explore the value of contrast-enhanced ultrasound (CEUS) and intraluminal contrast in the differential diagnosis of postmenopausal endometrial benign and malignant lesions.Methods The ultrasound data of 90 patients with postmenopausal endometrial lesions diagnosed in our hospital between March 2016 and March 2018 were retrospectively analyzed.According to pathological findings,they were divided into benign group (55 cases) and malignant group (35 cases).The endometrial thickness of endovascular contrast,rise time (RT),time to peak (TTP),base intensity (BI),and peak intensity (PI) of CEUS in two groups were compared.Receiver operating characteristic curves (ROC) were used to compare the efficacy of different ultrasound parameters in benign and malignant endometrial by using pathology diagnosis as "gold standard".Results The endometrial thickness and PI were significantly higher in the malignant group than those in the benign group (P ＜ 0.05),while the RT and TTP were significantly lower than benign group (P ＜ 0.05),with no statistical difference in BI (P ＞ 0.05).The ROC curve showed that PI has the highest area under curve (AUC) in the differential diagnosis of benign and malignant endometrial lesions (AUC =0.983),followed by RT and TTP (AUC =0.889,0.872),and intimal thickness (AUC =0.766).AUC of PI was significantly higher than RT,TTP and intimal thickness (P ＜ 0.05),and the best cut-off point for PI ≥20.23 dB.The sensitivity of PI,RT,and TTP in differentiating benign and malignant endometrial lesions was significantly higher than that in intimal thickness (P ＜ 0.05),whereas the specificity and positive likelihood ratio (+ LR) of PI were significantly higher than those of RT,TTP,and intimal thickness (P ＜ 0.05).Conclusions Compared with intracavitary ultrasound,CEUS has better diagnostic value in differentiating benign and malignant endometrial tumors.Among them,the diagnostic sensitivity and specificity of PI≥20.23 dB are higher.

Objective:To observe the clinical effect of pelvic floor ultrasound in the diagnosis and rehabilitation training of postpartum stress urinary incontinence(SUI).Methods:From May 2017 to May 2019, 200 SUI patients and 200 healthy pregnant women in the same period admitted to the First People's Hospital of Huzhou were selected in this study.All the subjects were tested by perineum and pelvic floor ultrasound, and the patients with SUI were instructed to carry out pelvic floor muscle rehabilitation training, the level of rehabilitation training effect was evaluated, and to statistically analyze the difference of pelvic floor ultrasound parameters between the patients with SUI and the healthy women, and the patients with different levels of efficacy.Results:The results of pelvic floor ultrasound in SUI patients were significantly higher than those in healthy women( t=6.536-14.925, all P<0.05). The rate of urinary leakage in SUI patients [88.50%(177/200)] was significantly higher than that in healthy women [10.50%(21/200)](χ 2=243.384, P<0.05). The total effective rate of rehabilitation training was 79.50%(159/200). The bladder neck moving distance, urethra rotation angle, posterior angle of bladder urethra in resting state and posterior angle of bladder urethra in Valsalva state in SUI patients with ineffective rehabilitation training were significantly higher than those in SUI patients with general effective rehabilitation training( t=4.662-12.537, all P<0.05). The formation rate of urethra infundibulum in SUI patients with ineffective rehabilitation training [70.73%(29/41)] was significantly higher than that in SUI patients with effective rehabilitation training [19.50%(31/159)](χ 2=40.744, P<0.05). Conclusion:The rehabilitation training of discoid muscles can effectively relieve the related clinical symptoms of postnatal SUI patients.The detection of pelvic ultrasound has a certain clinical value in the diagnosis of postpartum SUI and evaluation of rehabilitation training effect.

Objective:To investigate the clinical efficacy of qualitative and staging diagnosis of rectal tumors with dual contrast-enhanced ultrasonography and interventional biopsy.Methods:A total of 300 patients with rectal tumors who received treatment in The First People's Hospital of Huzhou from December 2019 to March 2022 were included in this study. All patients underwent dual contrast-enhanced ultrasonography and interventional biopsy followed by focus resection. Taking the postoperative histopathological test results as the gold standard, the efficacy of dual contrast-enhanced ultrasonography and interventional biopsy in the localization, qualitative analysis, and staging of rectal tumors was analyzed.Results:The compliance rate of dual contrast-enhanced ultrasonography and interventional biopsy in the localization of rectal tumors was 100%. The sensitivity, specificity, and accuracy of the dual contrast-enhanced ultrasonography and interventional biopsy for qualitative diagnosis of rectal tumors were 94.8%, 97.8%, and 96.7%, respectively. The Kappa value used for assessing agreement in the qualitative diagnosis of rectal tumors between dual contrast-enhanced ultrasonography and interventional biopsy and postoperative tissue pathological examination results was 0.947. The area under the curve plotted for qualitative diagnosis of rectal tumors was 0.974. The sensitivity, specificity, and sensitivity of dual contrast-enhanced ultrasonography and interventional biopsy for diagnosis of stage I-III rectal cancer were 94.1%-97.8%. The Kappa values used for assessing agreement in staging diagnosis of stage I-III rectal cancer between dual contrast-enhanced ultrasonography and interventional biopsy and postoperative tissue pathological examination results were 0.923, 0.912, and 0.927, respectively. The areas under the curve plotted for staging diagnosis of rectal cancer were 0.961, 0.955, and 0.970, respectively.Conclusion:Dual contrast-enhanced ultrasonography and interventional biopsy have a high efficacy in the localization, qualitative diagnosis, and staging diagnosis of rectal tumors.