In patients with typical symptoms of venous insufficiency of the lower extremities, ultrasound can monitor a widening of the diameter of the vein, a slowing of the blood flow, a failure of the venous valves to converge in the midline, and a continuous reflux of the blood flow at the valves for a certain period of time visible during deep inspiration or even calm breathing. However, the severity of the disease is assessed by the following indicators: 1) duration of reflux; 2) number of reflux segments and total reflux time; 3) reflux index; 4) venous internal diameter and mean flow velocity of the lower limbs. The regurgitation time at the first valve of the femoral vein is generally referred to the standard of 0.5s as the physiological regurgitation time, and most scholars believe that the more severe the degree of deep venous insufficiency, the longer the regurgitation time, and if it is greater than 0.5s it will produce symptoms of insufficiency. The clinical fact so far is that there is still a debate on the specific value and application value of the regurgitation time threshold, an important parameter for judging the presence or absence of deep venous reflux in the lower extremities. Due to the limitations of a single venous valve regurgitation time in determining the degree of venous insufficiency, researchers have further proposed more complex parameters such as the number of regurgitant segments and total regurgitant time, as well as the regurgitant index. The results of these parameters are used to assess the susceptibility to ulceration and to determine the criteria for venous reflux. This is undoubtedly more comprehensive and objective, but in practice some objective factors exist that affect the results. For example, in the measurement of reflux time parameters, the method of lack of effect is good for proximal veins, while the squeeze distal limb test is more effective for superficial femoral and N veins. The lack of method is simple and easy to perform, and the results depend on how well the patient understands and cooperates with the physician’s instructions, while the squeeze distal limb method requires the cooperation of an assistant, and the site of squeeze should vary from segment to segment. Different methods have a great impact on the measurement of reflux parameters and are clinically complex. Therefore, for the patient, a result of deep venous valve insufficiency cannot be given only to the patient, but further studies are needed to assess the actual symptoms of the patient. Reasons for choosing the upright position in varicose veins clinics: The upright position is the closest to the physiological state, especially for superficial veins of the lower extremities. Although the patient is easy to work with in the lying position, the veins often empty and lesions are easily missed. In contrast, the superficial dilated veins can be easily detected in the upright position, and the professional surgeon himself can effectively determine the root cause of the disease, understand the detailed blood flow direction and lesion distribution, make precise incision design, reduce blind incision, less incision, less postoperative pain, less chance of incision infection, and precise incision design will also greatly help to reduce the recurrence rate. This treatment method of standing ultrasound is the international mainstream and one of the significant differences of varicose vein treatment process in different regions of China.