Objective:To explore the influence of Passy-Muir speaking valve(PMV)on diaphragm function by using ultra-sound in stroke patients with tracheotomy and to evaluate the application value of improving respiratory func-tion by using ultrasonography parameters of diaphragm in PMV therapy.Method:Ninety stroke patients with tracheotomy meeting the inclusion criteria were randomly divided into PMV group(n=45)and control group(n=45).The control group received traditional respiratory therapy.The PMV group underwent PMV therapy based on traditional respiratory therapy.The procedure was 60min/day,6days/week for 2 weeks.The scores of Borg scale,end-expiratory diaphragm thickness(EDT),end-inspiration diaphragm thick-ness(IDT),diaphragm thickening fraction(DTF)and diaphragm mobility were assessed before and after treatment.The correlation of the scores of Borg scale and diaphragm ultrasonographic parameters were analyzed.Result:After two weeks of treatment,significant improvements were observed within both groups:Borg scores decreased(P<0.05),while EDT,IDT,DTF,and diaphragm mobility increased(P<0.05).Compared with control group,FMV group had significantly greater improvement on the scores of Borg(P<0.05),EDT(P<0.05),IDT(P<0.05),DTF(P<0.05)and diaphragm mobility(P<0.05).In the PMV group,post-treatment Borg scores were significantly negatively correlated with EDT(r=﹣0.962,P<0.01)、IDT(r=﹣0.948,P<0.01)、DTF(r=﹣0.972,P<0.01)and diaphragm mobility(r=﹣0.960,P<0.01).Conclusion:PMV can improve respiratory function,increase the mobility of diaphragm and improve pulmonary function in stroke tracheotomy patients.Diaphragm ultrasonographic parameters can predict the degree of dys-pnea to provide the following rehabilitation with ultrasonography evidence.

Objective:To explore the influence of Passy-Muir speaking valve(PMV)on diaphragm function by using ultra-sound in stroke patients with tracheotomy and to evaluate the application value of improving respiratory func-tion by using ultrasonography parameters of diaphragm in PMV therapy.Method:Ninety stroke patients with tracheotomy meeting the inclusion criteria were randomly divided into PMV group(n=45)and control group(n=45).The control group received traditional respiratory therapy.The PMV group underwent PMV therapy based on traditional respiratory therapy.The procedure was 60min/day,6days/week for 2 weeks.The scores of Borg scale,end-expiratory diaphragm thickness(EDT),end-inspiration diaphragm thick-ness(IDT),diaphragm thickening fraction(DTF)and diaphragm mobility were assessed before and after treatment.The correlation of the scores of Borg scale and diaphragm ultrasonographic parameters were analyzed.Result:After two weeks of treatment,significant improvements were observed within both groups:Borg scores decreased(P<0.05),while EDT,IDT,DTF,and diaphragm mobility increased(P<0.05).Compared with control group,FMV group had significantly greater improvement on the scores of Borg(P<0.05),EDT(P<0.05),IDT(P<0.05),DTF(P<0.05)and diaphragm mobility(P<0.05).In the PMV group,post-treatment Borg scores were significantly negatively correlated with EDT(r=﹣0.962,P<0.01)、IDT(r=﹣0.948,P<0.01)、DTF(r=﹣0.972,P<0.01)and diaphragm mobility(r=﹣0.960,P<0.01).Conclusion:PMV can improve respiratory function,increase the mobility of diaphragm and improve pulmonary function in stroke tracheotomy patients.Diaphragm ultrasonographic parameters can predict the degree of dys-pnea to provide the following rehabilitation with ultrasonography evidence.

Vitamin D is classic metabolism regulator of the calcium and phosphorus. Type 2 diabetes is main charac-terized by insulin resistance and beta cell function impairment, which causes insulin secretion defects and synthesis ab-normality. In recent years, studies found close relationship between vitamin D and type 2 diabetes; Many basic re-searches and animal experiments show that vitamin D can improve insulin resistance, protect islet beta cells and have immune regulation effects in the development of type 2 diabetes Diseases. Vitamin D can regulate and control islet function by inhibiting islet beta cell apoptosis, promoting the secretion of pancreatic beta cells and weakening the se-cretion of islet alpha cell. This paper reviewed the research progress in recent years on the correlation between vitamin D and islets function.

Objective To investigate the clinical application of CT perfusion imaging in assessing the hemodynamic changes in patients with small hepatocellular carcinoma (<5 cm) before and after transcatheter arterial chemoembolization (TACE). Methods Twelve patients with small hepatocellular carcinoma were enrolled in this study. CT perfusion imaging of the liver was performed 1 - 2 days before and 3 - 4 weeks after TACE. By using the perfusion parameters the hemodynamics of the preoperative and postoperative tumor tissue, the hemodynamics of the preoperative tumor tissue and the normal tissue, and the hemodynamics of the postoperative active tumor tissue and the normal tissue were determined , and the results were compared between each other. Results Before TACE, the blood flow (BF), hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP) and permeability of surface (PS) in the tumor tissue were significantly higher than those in the normal tissue (P < 0.01), while after TACE all the perfusion parameters except blood volume (BV) were significantly decreased in the tumor tissue (P < 0.01). After TACE, BF, PS, HAF and HAP in the activity tumor tissue were increased more than those in the normal tissue (P < 0.05). Conclusion CT perfusion imaging is of great clinical value in diagnosing < 5 cm hepatocellular carcinoma , in evaluating the hemodynamic changes after TACE and in demonstrating the activity of the residual tumor tissue.