Objective. To investigate the diagnosis and etiological analysis of GERD by gastric filling ultrasound and GerdQ scale. Methods. The clinical data of 100 suspected GERD patients were selected for retrospective analysis. The selection time was from June 2016 to June 2019. According to the gold standard (endoscopy) results, they were divided into the gastroesophageal reflux group (positive, n = 62) and the nongastroesophageal reflux group (negative, n = 38); both gastric filling ultrasound and GerdQ scale examination were performed to compare the positive predictive value and negative predictive value, evaluate the abdominal esophageal length, His angle, and GerdQ scale score, and analyze the AUC value, sensitivity, specificity, and Youden index of His angle, length of abdominal esophagus, combined ultrasound parameters, and GerdQ scale in the diagnosis of GERD. Results. 100 patients with suspected GERD were diagnosed as GERD by endoscopy; in a total of 62 cases, the percentage was 62.00%. Among them, 28 cases were caused by the abnormal structure and function of the antireflux barrier, accounting for 45.16%, 18 cases were caused by the reduction of acid clearance of the esophagus, accounting for 29.03%, and 16 cases were caused by the weakening of the esophageal mucosal barrier, accounting for 25.81%. After ultrasound detection, the positive predictive value was 88.71% and the negative predictive value was 81.58%; after the GerdQ scale was tested, the positive predictive value was 71.43% and the negative predictive value was 54.05%. The length of the abdominal esophagus in the gastroesophageal reflux group was lower than that of the nongastroesophageal reflux group, while the scores of His angle and GerdQ scale were higher than those in the gastroesophageal reflux group ( P < 0.05 ). ROC curve analysis showed that the AUC values of His angle, length of abdominal esophagus, combined ultrasound parameters, and GerdQ scale to diagnose GERD were 0.957, 0.861, 0.996, and 0.931 ( P < 0.05 ), their sensitivity was 93.5%, 98.40%, 98.40%, and 90.30%, and the specificity was 92.10%, 63.20%, 100.00%, and 92.10%, respectively. Conclusion. Both gastric filling ultrasound and GerdQ scale have a certain application value in the diagnosis of GERD, but the former has a higher accuracy rate, and it is more common for gastroesophageal reflux caused by abnormal structure and function of antireflux barrier in etiological analysis.

Real-time monitoring of high intensity focused ultrasound (HIFU) focal region is a key problem in clinical treatment of focused ultrasound. At present, the change of strong echo in B-ultrasound image is often used in clinical practice to monitor tissue damage in the focal area. However, the strong echo in B-ultrasound image is mostly related to cavitation and boiling bubbles in the focal area, which cannot monitor the treatment status accurately or in real time. In the HIFU treatment, the focal area tissue will be accompanied by changes in temperature, cavitation, boiling, and tissue characteristics. The acoustic load on the surface of the transducer is also constantly changing. To solve this problem, a real-time detection platform of transducer voltage and current is built in this work, which can sense the change of focal area tissue state by measuring the electrical parameters of the transducer. The experimental results show that the stability of the phase difference of the transducer driving signal will be different (the fluctuation amplitude will be different) when different media are placed on the surface of the transducer to change the acoustic load on the surface of the transducer. The fluctuation amplitude of the phase difference of the driving signal will be larger than that in the water when the iron plate is placed in in the focal plane. However, the phase fluctuation amplitude will be much smaller than that in the water where the beef liver is placed. This shows that different acoustic loads can cause the electrical parameters of the transducer to change. The isolated bovine liver tissue is used as the HIFU irradiation object, and the results of the phase difference change are compared with the results of the isolated bovine liver tissue damage. The experimental results show that the phase of the transducer voltage and current will change from relatively stable to large fluctuations during the HIFU irradiation. At this time, obvious damage can be seen in the focal region when the irradiation is stopped, and the grayscale of B-ultrasound image has no significant change. In addition, when the cavitation occurs in the focal region, the fluctuation amplitude and range will turn larger. The damage area of the lower focal area under the monitoring method is smaller than that under B-ultrasonic monitoring, and the overinput of radiation dose can be avoided. This method can provide a new research scheme and means for HIFU focal area tissue damage monitoring.

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