Early screening is an important means to reduce breast cancer mortality. In order to solve the problem of low breast cancer screening rates caused by limited medical resources in remote and impoverished areas, this paper designs a breast cancer screening system aided with portable ultrasound Clarius. The system automatically segments the tumor area of the B-ultrasound image on the mobile terminal and uses the ultrasound radio frequency data on the cloud server to automatically classify the benign and malignant tumors. Experimental results in this study show that the accuracy of breast tumor segmentation reaches 98%, and the accuracy of benign and malignant classification reaches 82%, and the system is accurate and reliable. The system is easy to set up and operate, which is convenient for patients in remote and poor areas to carry out early breast cancer screening. It is beneficial to objectively diagnose disease, and it is the first time for the domestic breast cancer auxiliary screening system on the mobile terminal.
Objective To study the mechanism of high intensity focused ultrasound (HIFU) and discuss its clinical significance in the treatment of mid-late stage liver cancer. Methods The patients with mid-late stage liver cancer were treated with HIFU. The changes of photography, pathology and immunology after operation were evaluated. Results It was shown that the results of the photographic, pathologic and immunologic examinations changed during the treatment of the patients with HIFU. Conclusion HIFU is effective and safe for the treatment of mid-late stage liver cancer.
Objective To discuss the relationship between the changes of hepatic blood flow detected by usingspectral Doppler ultrasound and serum TNF- α and IL-1 β levels after liver ischemia/reperfusion （I/R） of rat. Methods The hepatic ischemia 15 min and reperfusion models were established by using pringle method. The hepatic blood flow of hepatic artery and portal vein at 1， 6， and 24 hours after liver I/R were detected by using spectral Doppler ultrasound， the total blood flow volume （FV） was calculated， and the serum TNF- α and IL-1 β levels at each time point were detected. The correlation between the TNF-α， IL-1 β， and FV were analyzed. Results The FV at 1 hour and 6 hours after reperfusion in I/R group were less than those in sham operation （SO） group 〔（52.08±11.88） mL/min vs. （85.32±29.85） mL/min and （44.69±8.75）mL/min vs. （81.41±28.67） mL/min， P＜0.05〕. The FV at 24 hours after operation or reperfusion of 2 groups was no significant differences （P＞0.05）. The serum content of TNF-α at 1 hour after reperfusion in I/R group was higher than that in SO group 〔（310.52±39.83）pg/mL vs. （240.74±31.65）pg/mL， P＜0.05〕. The serum contents of TNF-α at 6 and 24 hours after operation or reperfusion of 2 groups were no significant differences （P＞0.05）. The serum contents of IL-1β at 1 hour and 6 hours in I/R group were higher than those in SO group 〔（38.08±3.73） pg/mLvs. （22.03±0.79） pg/mL and （27.44±6.11） pg/mL vs. （21.78±0.71） pg/mL， P＜0.05〕. The serum content of IL-1β at 24 hours after operation or reperfusion of 2 groups was no significant differences （P＞0.05）. There was a negative correlation between the FV and TNF-α or IL-1β （r=-0.43， P＜0.05；r=-0.46， P＜0.05）. Conclusions Spectral Doppler ultrasound can observe the changes of hepatic blood flow and evaluate the hepatic microcirculation indirectly. The hepatic blood flow after liver I/R decreases and it may be related to over expression of TNF-α and IL-1β.
With the development of medical diagnosis and treatment technology, ultrasound examination has been widely used in clinical practice, but it also faces certain safety hazards. If the ultrasound probe is not effectively disinfected after use, it may be contaminated by pathogenic bacteria transmitted from blood, mucous membranes, genital or rectal secretions, thus becoming a carrier for the transmission of pathogenic bacteria among patients. In addition, the frequent use of ultrasound probe and coupling agent is also an important factor affecting the occurrence of hospital infections. Multiple studies at home and abroad have shown that incomplete cleaning and disinfection of medical ultrasound probe can lead to hospital infection incidents, thereby affecting patient safety and medical quality. Exploring effective disinfection methods and disinfection effects of ultrasound probe is of great significance for hospital infection prevention and control. Therefore, this article provides a review of research related to disinfection of medical ultrasound probe.
ObjectiveTo investigate the effect of pulmonary ultrasound on pulmonary complications in ultra-fast-track anesthesia for congenital heart disease surgery.MethodsIn 2019, 60 patients with congenital heart diseases underwent ultra-fast-track anesthesia in Shenzhen Children's Hospital, including 34 males and 26 females with the age ranging from 1 month to 6 years. They were randomly divided into a normal group (group N, n=30) and a lung ultrasound optimization group (group L, n=30). Both groups were used the same anesthesia method and anesthetic compatibility. The group N was anesthetized by ultra-fast-track, the tracheal tube was removed after operation and then the patients were sent to the cardiac intensive care unit (CCU). After operation in the group L, according to the contrast of pre- and post-operational lung ultrasonic examination results, for the patients with fusion of B line, atelectasis and pulmonary bronchus inflating sign which caused the increase of lung ultrasound score (LUS), targeted optimization treatment was performed, including sputum suction in the tracheal tube, bronchoscopy alveolar lavage, manual lung inflation suction, ultrasound-guided lung recruitment and other optimization treatments, and then the patients were extubated after lung ultrasound assessment and sent to CCU. The occurrence of pulmonary complications, LUS, oxygenation index (OI), extubation time, etc were compared between the two groups.ResultsCompared with the induction of anesthesia and 1 hour after extubation of the two groups, the incidence of pulmonary complications in the group L (18 patients, 60.0%) was lower than that in the group N (26 patients, 86.7%, χ2= 4.17, P=0.040) and the rate of patients with LUS score reduction was higher in the group L (15 patients, 50.0%) than that in the group N (7 patients, 23.3%, χ2=4.59, P=0.032). The correlation analysis between the LUS and OI value of all patients at each time point showed a good negative correlation (P<0.05). Extubation time in the group L was longer than that in the group N (18.70±5.42 min vs. 13.47±4.73 min, P=0.001).ConclusionUltra-fast-track anesthesia for congenital heart disease can be optimized by pulmonary ultrasound examination before extubation, which can significantly reduce postoperative pulmonary complications, improve postoperative lung imaging performance, and help patients recover after surgery, and has clinical application value.
bjectiveTo evaluate the efficacy and limits of high intensity focused ultrasound (HIFU) in tumor treatment. MethodsThe references about the application of HIFU in tumor treatment in recent years were reviewed.ResultsHIFU caused localized hyperthermia at predictable depth in a few seconds to make the tumor tissue coagulative necrosis without injuring surrounding tissue. HIFU treatment had the advantages of low morbidity, noninvasiveness, avoidance of systemic side effects, and repeatitiveness. However, the utilization of HIFU sometimes could be limited by some factors such as imaging technique, organ movement, incomplete tissue destruction, etc.ConclusionHIFU is a promising noninvasive therapy for tumor treatment, though there are lots of problems to be further studied.
Objective To evaluate the diagnostic value of conventional ultrasound, ultrasound elastography and their combination in benign and malignant breast nodules using meta-analysis. Methods The English databases (EMBASE, PubMed, Cochrane Library) and Chinese databases (China Biomedical Literature Database, China HowNet, VIP, Wanfang Database) were searched to collect the Chinese and English literatures about the diagnostic value of conventional ultrasound and elastography in differentiating the benign and malignant breast lesions up to April 20, 2021, the reviewers strictly followed the inclusion and exclusion criteria to screen the literature, extract the data and conduct quality assessment. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and 95%CI were calculated by using meta-DiSc1.4 software for heterogeneity analysis and data combining analysis. The forest map and receiver operating characteristic (ROC) curve was drew, and the area under the ROC curve was calculated. StataSE14.0 software was used to draw deek funnel plot to evaluate publication bias, and Fagan’s nomogram was used to evaluate the clinical utility of each test method. Results A final selection of 42 articles involving 6 009 nodules in 5 118 patients was included. The sensitivity for conventional ultrasound, elastosonography and two techniques combination was 0.80 [95%CI (0.79, 0.82)], 0.87 [95%CI (0.86, 0.89)] and 0.93 [95%CI (0.91, 0.94)], respectively; with specificity of 0.75 [95%CI (0.73, 0.76)], 0.85 [95%CI (0.84, 0.86)] and 0.94 [95%CI (0.93, 0.95)]. The summery area under curve was 0.86, 0.94 and 0.98, respectively. There were significant differences in the diagnostic efficiency among the three groups（all P<0.05）. The Deek’s funnel plot showed no significant publication bias (all P>0.05). The pre-testprobability of conventional ultrasound, elastosonography and two techniques combination were both 20%, and the post-testprobability were 49%, 66%, and 82%, respectively. Conclusions The accuracy of elastography in distinguishing benign from malignant breast nodule is relatively high, while the accuracy of benign and malignant nodules in conventional ultrasound is generally acceptable. However, the accuracy of the combination of the two is higher, which is worthy of clinical application.
Objective To explore the application value of shear wave elastography (SWE) combined with diaphragmatic thickening fraction (DTF) and rapid shallow breathing index (RSBI) in predicting the results of weaning of patients with mechanical ventilation. Methods Fifty-two patients with severe illness who were hospitalized in this hospital from January 2022 to September 2022 were treated with mechanical ventilation. After meeting the conditions for weaning, they underwent spontaneous breathing test, and the diaphragm function of patients was evaluated by measuring DTF using ultrasound technology and shear modulus (SM) using SWE technology. According to the weaning results, they were divided into weaning success group and weaning failure group, The differences of mechanical ventilation time, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, respiratory rate, RSBI, oxygenation index, DTF, SM and other parameters between the two groups were compared. Multivariate logistic regression was used to analyze the factors affecting the withdrawal results. The receiver operator characteristic (ROC) curve was used to evaluate the predictive value of potential influencing factors on the withdrawal results. Results There were 39 cases of successful withdrawal and 13 cases of failure. There were significant differences in mechanical ventilation time, respiratory rate, RSBI, DTF and SM between the successful weaning group and the failure group (P<0.05). Through multivariate logistic regression analysis, RSBI [area under the ROC curve (AUC)=0.771, 95% confidence interval (CI) 0.589 - 0.953], DTF (AUC=0.806, 95%CI 0.661 - 0.951), SM (AUC=0.838, 95%CI 0.695 - 0.981) were independent factors that affected the results of withdrawal. The single parameter AUC was smaller than the combined index with RSBI≤70.48 times·min–1L–1, DTF≥30.0%, SM≥10.0 kPa as the cutoff value (AUC=0.937, 95%CI 0.714 - 1.0, diagnostic sensitivity, specificity and accuracy were 94.9%, 84.6% and 92.3% respectively). Conclusions SWE technology provides a new quantitative index for evaluating diaphragm function by evaluating diaphragm stiffness. Diaphragm stiffness combined with DTF and RSBI can better predict the successful withdrawal in patients with mechanical ventilation.
Abstract： Objective To introduce the new procedure of endobronchial ultrasoundguided transbronchial needle aspiration (EBUSTBNA) for staging lung cancer and diagnosing thoracic diseases, in order to determine its value in the evaluation of thoracic diseases. Methods We retrospectively reviewed the data of all patients examined with EBUSTBNA our institution between September 2009 and May 2010. Among the patients, there were 75 males and 31 females with an average age of 62.3 years old. Based on their primary indication, we divided all the 106 patients into three categories. (1) There were 76 patients with known or bly suspected lung cancer. Enlarged mediastinal lymph nodes on radiographic examination of the chest (≥1.0 cm) were detected in all the patients. (2) There were 22 patients with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin. (3) There were 8 patients with pulmonary mass located close to the central airways. Results (1) 76 patients underwent EBUSTBNA for known or bly suspected lung cancer. Among them, 58 patients were confirmed to have mediastinal lymph nodes metastasis on EBUSTBNA. Sixteen in the 18 patients with negative EBUSTBNA underwent thoracoscopy or thoracotomy for pulmonary resection and mediastinal lymph node dissection. Postoperative pathology confirmed that 12 patients did not have metastatic nodes, 2 patients had metastatic nodes and 2 other patients had benign lesions within the lung. The diagnostic sensitivity, specificity and accuracy of EBUSTBNA for the mediastinal staging of lung cancer were 96.66%(58/60), 100.00%(12/12) and 97.22%(70/72), respectively. (2) 22 patients underwent EBUSTBNA for the evaluation of mediastinal adenopathy or mass in the absence of any identifiable pulmonary lesion. Among them, 7 had malignancy, 13 had benign diseases on EBUSTBNA and the sensitivity of EBUSTBNA in distinguishing malignant mediastinal diseases was 87.50% (7/8). (3) 8 patients with pulmonary mass located close to the central airways were accessed by EBUSTBNA. Definite diagnosis was achieved in 7 patients, and lung cancer was detected in 6 patients. The sensitivity and the diagnostic accuracy of EBUSTBNA for the diagnosis of unknown pulmonary mass was 85.71%(6/7) and 87.50%(7/8), respectively. All the procedures were uneventful, and there were no complications. Conclusion EBUSTBNA is a highly effective and safe procedure. We believe that EBUSTBNA should be used routinely in the diagnosis and staging of thoracic diseases.
The temperature during the brain tumor therapy using high-intensity focused ultrasound (HIFU) should be controlled strictly. This research aimed at realizing uniform temperature distribution in the focal region by adjusting driving signals of phased array transducer. The three-dimensional simulation model imitating craniotomy HIFU brain tumor treatment was established based on an 82-element transducer and the computed tomography (CT) data of a volunteer's head was used to calculate and modulate the temperature distributions using the finite difference in time domain (FDTD) method. Two signals which focus at two preset targets with a certain distance were superimposed to emit each transducer element. Then the temperature distribution was modulated by changing the triggering time delay and amplitudes of the two signals. The results showed that when the distance between the two targets was within a certain range, a focal region with uniform temperature distribution could be created. And also the volume of focal region formed by one irradiation could be adjusted. The simulation results would provide theoretical method and reference for HIFU applying in clinical brain tumor treatment safely and effectively.