Objective To discuss differentiated thyroid carcinoma (DTC)postoperative lymph node metas-tasis and clinical use and the effect of 131 I treatment.Methods to185 patients with lymph node metastasis of DTC were selected by random sampling method.The standard 131 I treatment was administrated,ultrasound,CT and Tg chan-ges and imaging characteristics of 131 I treatment were evaluated the clinical curative effect was determined.Results Imaging changes:the whole group of patients,153 patients (82.7%)were effective.153 patients with effective treat-ment,105 cases examined LMDTC completely eliminate (56.8%),48 cases examination revealed narrowing (25.9%).Mere lymph node metastasis after treatment was better than that of patients with viscera metastasis,imaging examination results were statistically significant differences (χ2 =2.57,P =0.02).After treatment,imaging examina-tion result in patients with smaller lymph node was superior to that in the patients with relatively large diameter lymph nodes (P >0.05).Tg level changes:there was a significant reduction in the Tg 97 cases of 185 patients (51.1%), and general decline in 54 patients (29.2%).Tg improvement effect of patients with mere lymphatic metastasis after treatment was better than other viscera metastasis in patients with statistically significant differences (χ2 =3.41,P =0.01).Lymph node Tg improved after treatment in patients with small diameter,which was better than that with other viscera metastasis patients with statistically significant differences(χ2 =6.34,P =0.02).Conclusion Comprehensive curative effect of 131 I treatment of lymph node metastasis postoperatively in patients with DTC is distinct,and is worth popularizing in clinical use of DTC.

Objective To investigate the clinical pathological features of IgA nephropathy with nephrotic syndrome and risk factors for impairment of renal pathology.Methods 121 cases of IgA nephropathy with nephrotic syndrome were selected,all patients had been diagnosed with biopsy.The clinical pathological features wer analyzed, they were divided into two groups according to different kidney disease.The minor pathological changes which Leeˊs classification grade Ⅰ and grade Ⅱ patients belong to group A,with a total of 36 cases,while Leeˊs pathology heavier grade for grade Ⅲ,Ⅳ and Ⅴ grade level in patients belonging to group B,with a total of 85 cases.Clinical character-istics and clinical laboratory indicators of two groups were compared,and risk factors for renal pathological damage were analyzed in multivariate analysis.Results The average duration of group B was significantly longer than the average duration of group A,the difference was statistically significant (t =12.74,P <0.05).Mean arterial pressure of group B was significantly high than that of group A,the difference was statistically significant (t =5.31,P <0.05).Patients with hypertension,urinary erythrocytes with full vision and renal failureof group B were significantly more than those in group A,the differences were statistically significant (χ2 =14.29,9.74,8.26,all P <0.05).Total cholesterol and 24 h urinary protein excretion of group B were significantly lower than those in group A,the differences were statistically significant (t1 =8.75,t2 =6.73,all P <0.05).Serum albumin and hemoglobin levels of group B were significantly higher in group A,the differences were statistically significant (t3 =7.42,t4 =9.15,all P <0.05). Multivariate Logistic regression analysis showed,in IgA nephropathy with nephrotic syndrome,hemoglobin was a protective factor,the mean arterial pressure,24h urinary protein of red blood cells and microscopic urine >5.0 ×107 /Lwere dangerous aggravating factors.Conclusion Hemoglobin protective factors for IgA nephropathy with nephrotic syndrome,the mean arterial pressure,24h urinary protein excretion and urine red blood cells are their risk aggravating factors,they can make a more accurate judgment of the patientˊs condition.

Objective To study the clinical efficacy and effects on CRP levels of ambroxol in treatment of pulmonary infections.Methods 68 patients with pulmonary infection were selected and divided into the observation group(n =34)and control group by using the random number table method(n =34).The observation group was treated with ammonia bromine atomization inhalation treatment,while the control group was treated with alpha chymo-trypsin atomization inhalation therapy.The clinical effect and duration of symptoms and signs disappeared of the two groups were compared,and serum CRP level changes in the two groups before and after treatment were also compared. Results After treatment,the clinical total effective rate was 91.2% of the observation group.And the total effective rate was 70.6% in control group,the comparison between the two groups had statistically significant difference (χ2 =4.316,P <0.05).Compared with the control group,the observation group patients symptoms disappear time(3.1 ± 0.5)d,pulmonary symptoms disappear time(4.1 ±1.7)d,body temperature returned to normal time(4.1 ±1.6)d and hospital stay(8.4 ±2.8)d were significantly shortened,the differences were statistically significant (t =2.879, 2.918,3.025,3.972,all P <0.05 ).The serum CRP levels in patients of the observation group was (22.45 ± 9.27)mg/L,which of the control group was (33.45 ±14.67 )mg/L,both were significantly lower than before treatment,the difference was statistically significant (t =6.314,5.126,all P <0.05).The lower degree of serum CRP level in the observation group was obviously better than tha in the control group,the difference was statistically significant (t =6.263,P <0.05).Conclusion The ambroxol can achieve significant clinical effect on treatment of pulmonary infections,which can significantly shorten the patientˊs symptoms and lung signs disappear time and length of hospital stay,etc.It can reduce the serum CRP level,and is worth popularization and application in clinic.

Objective To investigate the changes of serum and pleural effusion inflammatory indexes in chil-dren with mycoplasma pneumoniae complicated with pleural effusion.Methods Enzyme linked immunosorbent assay (ELISA)double antibody sandwich method was used in the three of pleural effusion group,mycoplasma pneumonia group,control group and other groups to detect serum and pleural effusion human interleukin 6 (IL -6).human inter-leukin 2 (IL -2)and TNF -(human tumor necrosis factor alpha)etc.Inflammation index levels were detected and compared.Results The group of patients with mycoplasma pneumonia mycoplasma pneumonia patients was (9.93 ± 1.05)pg/mL for the IL -6 level,IL -2 levels for (4.93 ±0.55)μg/mL,(1.45 ±0.17)ng/mL for the TNF alpha level,which were significantly higher than those of the control group,the IL -2 was significantly lower than that of the control group,with statistically significant difference (t =6.25,5.88,4.63,5.95,3.69,5.95,all P <0.05).Compa-ring pleural effusion group and mycoplasma pneumonia group,we found serum IL -6,TNF alpha levels of pleural effu-sion group were significantly higher than that of mycoplasma pneumonia group,while IL -2 was lower than that in group mycoplasma pneumonia,with statistically significant difference (t =4.02,3.06,3.06 and 2.88,all P <0.05). The levels of serum IL -6,IL -2 and TNF -in the serum of patients with different effusion levels were significantly different from the other two groups (all P <0.05).Pleural effusion IL -6 and TNF level of pleural effusion group and mycoplasma pneumonia patients was significantly higher than those of the control group and IL -2 were significantly lower than that of the control group,the difference had statistical significance (t =5.69,3.69,602,4.11,2.94,3.67, all P <0.05).Pleural effusion pleural effusion IL -6 and TNF levels were significantly higher than those in the myco-plasma pneumonia group and IL -2 were significantly lower than that in mycoplasma pneumonia group,the difference had statistical significance (t =3.58,4.13,3.21,all P <0.05).The inflammatory indexes of patients with different effusion volume could be found in the pleural effusion,in patients with a large number of pleural effusion,the IL -2, IL -6 and TNF -levels compared with the other two groups showed significantly different (t =6.11、5.44、4.82,all P <0.05).Conclusion IL -6,IL -2 and TNF alpha in the occurrence and development of mycoplasma pneumoniae pneumonia play an important role.Suffering from mycoplasma pneumonia in patients with pleural effusion,whoseTNF-and IL -6 inflammatory index and serum indexes are abnormal,is of certain clinical practical value for clinical diagnosis,treatment and prognosis,as the indicator of the development and prognosis of pneumonia and pleural effusion.

Objective To observe the clinical effects of estradiol valerate and drospirenone applying in missed abortion and curettage before and after operation.Methods 160 patients with missed abortion parallel curet-tage were chosen,who were randomly divided into the observation group and control group by the number table meth-od.Two groups of patients were oral misoprostol 400 g before uterine curettage 1 h,and then were treated with ultra-sonic curettage after filling the bladder and postoperative routine use of antibiotics for 3 D.3 D before the curettage, observation group were treated with oral estradiol valerate 4 mg for 3 D,2times a day..After curettage of the day, drospirenone orally was given for 1 tablet every night,used in conjunction a cycle for 3weeks.The control group before and after curettage were given without estradiol valerate and drospirenone.Operation time,bleeding volume,postopera-tive bleeding time and bleeding volume,the time of the first menstrual cycle,endometrial repair and postoperative complications were observed in the two groups.Results In the control group,operation time,intraoperative bleeding volume,for the first time the resumption of menstruation tide time,endometrial thickness,postoperative complication rate were (6.05 ±0.49)min,(50.88 ±9.18)mL,(36.51 ±1.95)d,(4.08 ±0.56)mm and 15.0%;the data of the observation group were (4.46 ±0.45)min,(35.63 ±8.24)mL,of (29.28 ±1.57)d,(6.11 ±0.76)mm and 3.8%.The operation time,intraoperative bleeding volume,for the first time the resumption of menstruation tide time, endometrial thickness,postoperative complication rate differences of the two groups were statistically significant(t =-11.264,-16.643,-24.93,19.151,χ2 =5.959,all P <0.05).Conclusion Giving estradiol valerate and flexor buspirone before and after missed abortion and curettage,can effectively improve the short -term and long -term complications of uterine curettage,and improve the clinical efficacy of dilatation and curettage.

Objective To investigate the effect of lead aVR on recent prognosis in patients with non -ST -elevation acutecoronary syndrome(NSTE -ACS).Methods 195 patients with NSTE -ACS were divided into ST segment elevation in lead aVR group(n =54 cases)and non -ST segment elevation in lead aVR group(n =141 ) according to ST segment elevation in lead on admission;clinical data,laboratory index and coronary artery lesion were recorded,and major adverse cardiac (MACE)in hospitalization time were also recorded.Results Compared with non -ST segment elevation in the lead aVR group,the heart rate of ST segment elevation in the lead aVR group was faster[(85.4 ±12.0)beats per minute vs.(79.3 ±13.2)beats per minute,t =2.959,P <0.05],systolic blood pressure and diastolic blood pressure were higher[(145.0 ±20.3)mmHg vs.(136.0 ±19.4)mmHg,t =2.874,P <0.05];NT -proBNP[(743.9 ±125.8)pg/mL vs.(416.4 ±95.3)pg/mL,t =19.625,P <0.05],cTnI[(3.4 ± 1.0)ng/mL vs.(1.2 ±0.4)ng/mL,t =21.994,P <0.05],CK -MB[(31.5 ±9.8)ng/mL vs.(19.8 ±6.5)ng/mL, t =9.682,P <0.05]were higher (P <0.05);LVEF were lower[(50.1 ±5.2)% vs.(53.8 ±5.7)%,t =4.153, P <0.05];the rate and amplitude of low ST segment in outside lead aVR also was higher[(9.5 ±3.8)mm vs. (7.4 ±2.8)mm,t =4.224,P <0.05];the rate of left main and three -vessel disease in ST segment elevation in lead aVR group were higher (P <0.05).Compared with non -MECE group,proportion of ST segment elevation in lead AVR on admission was higher (P <0.05).Logistic regression analysis showed that heart rate(OR =1.472),NT -proBNP(OR =1.732),cTnI(OR =1.893),left main coronary artery(OR =2.478)and three -vessel disease (OR =2.310)were risk for ST segment elevation in lead AVR(P <0.05).Logistic regression analysis also showed that ST segment elevation in lead AVR were risk for MACE(OR =1.474).Conclusion ST segment elevation in lead AVR has close relationship with large area of myocardial ischemia,and patients prognosis is poorer,which may be independ-ent risk factor for the recent outcomes of patients with NSTE -ACS.Early record of the change in the case of aVR lead ECG ST segment NSTE -ACS patients is of important value in evaluation of the condition and prognosis.

Objective To observe the clinical efficacy of sishen pills plus trimebutine maleic acid tablets and bifid triple viable bacteria on treating ulcerative colitis.Methods 100 cases were randomly divided into two groups,with 50 cases for each group,the treatment group was given sishen pills plus trimebutine maleic tablets and bifid triple viable bacteria,the control group was treated with sishen pills.The clinical effect of the two groups were observed.Results The efficiency of the treatment group was 80%,which of the control group was 36%,there was statistically significant difference between the two groups (χ2 =8.16,P <0.05).Conclusion The efficacy of sishen pills plus trimebutine maleic tablets and bifid triple viable bacteria was better than that of sishen pills only.

Objective To explore the effect of dexmedetomidine(DEX)for blood pressure,heart rate(HR) and SpO2 levels during anesthesia inquiry in elderly hypertensive(HBP)patients.Methods 96 cases with HBP accepted surgery were selected,and were randomly divided into the observation group and the control group,each group in 48 cases,The patients in the observation group continuous pumped into the 4μg/mL of DEX during surgery, while the control group continuous pumped into 0.9% sodium chloride solution during surgery.Heart rate(HR),sys-tolic blood pressure(SBP),diastolic blood pressure(DBP),pulse oxygen saturation(SpO2 )of the two groups after room entrance(T0),after DEX infusion(T1),before intubation(T2),after 2min intubation(T3)and 10 min(T4)after intubation were recorded and compared,extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time and the incidence of adverse reactions in two groups were recorded.Results The difference of HR SBP,DBP and SpO2 at T0 and T4 between the two groups was not statistically significant(all P >0.05);HR, SBP and DBP were significantly lower in the observation group than those in the control group at T1,T2,T3(all P <0.05).There were no significant changes of SpO2 in the patientˊs after the room entrance;extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time in the observation group were significantly lower than those in the control group(t =8.874,9.073,8.573,all P <0.05).The adverse reactions rate in the observation group was 4.2%,which in the control group was 6.3%,the difference was not statistically significant(P >0.05). Conclusion Continuous pumped DEX has a significant sedative effect in elderly HBP patients during surgery,and does not produce respiratory depression,can help elderly patients with HBP smoothly pass the perioperative period.

Objective To analyze the clinicopathological features of diffuse large B -cell lymphoma(DL-BCL)and its relationship with prognosis.Methods The clinical data of 64 cases of DLBCL patients were retrospec-tively analyzed,and relationship between the clinical pathological features and efficacy were also analyzed.Results There were 25 cases of patients with extranodal infiltration,accounting for 39.06%.There were 26 cases of anemia in patients with newly diagnosed,accounting for 40.63%.Molecular/immune typing results showed,GCB(biochemistry center B cell -like)patients with 19 cases,accounted for 29.69%.45 patients with non -GCB,accounted for 70.31%.ECOG performance status indicators,hemoglobin levels and B symptoms were statistically significant in the two groups(χ2 =6.218,6.100,5.042,all P <0.05).Serum LDH level,large lesions were statistically significant difference(χ2 =10.005,9.227,all P <0.05).Extranodal infiltration,peripheral blood lymphocyte counts,T cell infil-tration,Ki67 and Bcl -6 and other indicators of the difference were not statistical significant (all P >0.05 ). Conclusion Uygur patients with DLBCL mainly are GCB subtype,ECOG score,hemoglobin level,B symptoms,LDH levels and large lesions can affect the prognosis.

Objective To discuss the relationship between the incidence of lymph node metastasis and tumor size in patients with non small cell lung cancer,and to provide evidence for clinical operation and follow -up treat-ment.Methods 180 patients with non small cell lung cancer who were hospitalized and recieived Lobectomy opera-tion were selected,the clinical data of patients and resection of tumor size,lymph node metastasis were retrospectively analyzed,and then the relationship between the lymph node metastasis and tumor volume was investigated.Results 180 cases of patients with lymph node metastasis rate was 37.20%,in which hilar lymph node metastasis rate was 11.02 percent and mediastinal lymph node metastasis rate was 10.95%.Lung lymph node metastasis rates in lymph node metastasis,hilar and mediastinal lymph node metastasis of T1a were 13.21%,15.09% and 13.21%;those of T1b period were 38.09%,35.71% and 28.57%;of T2a period were 44.44%,37.78% and 31.11%;of T2b period were 64.26%,57.14% and 53.57%;and those of T3 period were 58.33%,66.67% and41.67%.Lymph node metastasis,hilar and mediastinal lymph node metastasis in lung lymph nodes transfer rate with patients of T1a had significantly differences compared with patients of T1b,T2a,T2b and T3 stage.(χ2 =5.363,6.175,4.372,8.778, 5.363,9.631,7.936,9.631,20.463,7.521,6.175,4.387,all P <0.05).Hilar lymph node metastasis and lung metastases of T1b and T2b had a significant difference (χ2 =12.353,4.585,all P <0.05).Conclusion For non -small cell lung cancer,tumor size is positively correlated with lymph node metastasis and the greater the tumor size, the greater the likelihood of lymph node metastasis.