Thyroid nodule has an increasing prevalence during pregnancy,which might caused by the change of internal environment.The research regarding the potential factors of thyroid nodule in pregnancy and approach for the pregnant with thyroid nodule is ongoing.So what's reviewed here is about the specialties of thyroid nodule in pregnancy and the strategies for them.

The combination of TCM and WM has developed for more than 50 years,with fruitful achievements from drug study to talents training.However,it also encountered several problems on the way of development.In the course of the practice of the combination of TCM and WM,we find that for the real combination of TCM and WM,we must base on the fully understanding the theories,respective lacks and the aim of the combination of TCM and WM,moreover,the combination is not to make TCM become WM,but the combination on the level of theory.

Objective To observe the clinical curative effect of stomach dampness decoction combined with quadruple therapy in the treatment of Hp related peptic ulcer.Methods 80 cases of Hp related peptic ulcer were randomly divided into control group and treatment group,40 cases in each group.The control group was treated with quadruple therapy(oral amoxicillin capsule,left ofloxacin tablets,pantoprazole enteric coated tablets,citric acid bis-muth potassium granule),the treatment group was given stomach dampness soup on the basis of the control group.The treatment course was 14 days,1 month after anti Hp therapy,assessed HP eradication rate of the two groups.Results The Hp eradication rate of the treatment group was 95% which was higher than 80% of the control group,the differ-ence was statistically significant(χ2 =4.114,P <0.05).Conclusion Hewei huashi decoction combined with quad-ruple therapy in treating Hp -related petic ulcer has better Hp eradication rate and drug safety than the quadruple therapy.

Objective To investigate the distribution and susceptibility of carbapenem resistant citrobacter freundii for rational antimicrobial therapy.Methods The C.freumdii were collected between January 2011 and December 2014 from inpatients.The minimum inhibitory concentration (MIC) were detected by an automated analyzer (VITEK 2) to analyze the characteristic of tested bacteria.Results (1) Of the 21 strains of carbapenemresistant citrobacter freundii,95％ were collected from urine,among which most of the strains were isolated from the Department of Transplantology (66.7％) and Urology (19％);(2) Antimicrobials Susceptibility test showed that Citmbacter freund were highly resistant to Cephalosporins and relevant beta-lactamase inhibitors.Even carbapenem were highly resistant.Imipenem had a resistance rate of 90％ (95％ confidence interval:70 to 99),Meropenem 85.7％ (95％ confidence interval:64 to 97),The drug resistance rate to Amikacin was only 4.8％,followed by Nitrofuran toin (10.5％) and Fosfomycin (15％).Conclusions Carbapenem resistant citrobacter freundii,which often causes urinary tract infection in our hospital,was characterized by multi-drug resistant (MDR).Monitoring of the Citrobaeter freundii should be strengthened to control the prevalence of drug resistance.

Objective: To evaluate the effect of early preoperative mobilization on the rehabilitation of the elderly patients with hip fractures after operation. Methods: The clinical data of 16 elderly patients with hip fractures between February 2017 and April 2018 who met the selection criteria was retrospectively analyzed. There were 8 males and 8 females, with an average age of 80.3 years (range, 69-90 years). There were 8 cases of intertrochanteric fracture and 8 cases of femoral neck fracture. The preoperative American Society of Anesthesiologists (ASA) scored 2.94±0.43. There were 3 cases of cardiovascular and cerebrovascular diseases, 6 cases of essential hypertension, 5 cases of respiratory diseases, 3 cases of diabetes, and 2 cases of other system diseases. The time from injury to admission was 4 hours to 14 days with an average of 39.5 hours. On the day of admission or on the first day after admission, the patient started to exercise on the floor underwent analgesia treatment. And the patients were treated with closed reduction (9 cases) or artificial hip arthroplasty (7 cases). The time from admission to operation was 4 to 25 days, with an average of 7.4 days. At the time of admission, after the first ground movement before operation, on the second day after operation, and at last follow-up, the Barthel Index was used to assess the patients' self-care ability, and Barthel effectiveness (BE) was calculated. The complications were observed and recorded during follow-up. Results: All 16 patients underwent operation successfully. The hospital stay was 8 to 24 days, with an average of 14.1 days. All patients were followed up 2.5-16.0 months with an average of 6.5 months. One patient developed postoperative pulmonary infection; the remaining patients had no surgical-related complications. No patient died during the follow-up. The Barthel Index scored 30.63±5.56 at admission, 53.13±9.50 after the first ground movement before operation, 60.63±6.09 on the second day after operation, and 96.25±4.84 at last follow-up. There were significant differences in Barthel Index scores between different time points ( P<0.05). The BE was 0.23±0.06 after the first ground movement before operation, 0.30±0.04 on the second day after operation, and 0.66±0.06 at last follow-up. There were significant differences in BE between different time points ( P<0.05). Conclusion: For elderly patients with hip fractures who have long waiting time before operation, early preoperative mobilization has a positive impact on patients' activities of daily living.

The study of protein-surface interactions represents one of the most important topics in the field of biomaterials.It is believed that blood cells do not actually contact the biomaterial surface directly,but rather interact with the molecular structure of the adsorbed protein layer.Therefore,protein plays a key role in regulation and induction of cells.It provides ideas for biomaterials designing that exploring the molecular mechanism of controlling protein adsorption and regulating cell response.This paper reviews the research progress of the interactions of protein and surfaces,and prospects the future research direction.

Objective:To investigate the treatment failure sites, risk factors, and survival rates of patients with persistent or recur-rent squamous cell carcinoma (SCC) of the cervix within one year after concurrent chemoradiotherapy (CCRT). Methods:Clinical data of 30 patients with persistent or recurrent SCC of the cervix within one year after CCRT between June 2006 and June 2011 were ana-lyzed retrospectively. These data were compared with those of another 35 SCC cases without recurrence after complete remission. These 35 patients were treated homeochronously (from 2006 to 2011) and randomized in the control group. Results:Among the 30 pa-tients, 25 exhibited distant metastases;14 of these 25 patients were observed within six months after CCRT. Univariate analysis showed a higher incidence of pelvic or para-aortic lymphadenectasis and SCC-ag>10 ng/mL in the group with persistent or recurrent disease be-fore treatment (P<0.01). Multivariate analysis by logistic regression revealed that the pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag>10 ng/mL were found as the independent risk factors. Palliative chemotherapy ranked as the first method used to treat patients. The two-year survival rate was 21.7%, and the median survival time was 17 months. Conclusion:Patients with persistent or recurrent SCC of the cervix after CCRT possibly exhibited a high rate of distant metastasis with poor prognosis. The pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag>10 ng/mL were found as the independent risk factors of per-sistent or recurrent SCC within one year after CCRT.

Objective To analyze the therapeutic effects of different meth ods in operative treatment of intertrochanteric fractures of femur. Methods 106 cases were treated with operation and their average age was 72 year old. 39 case s of them were treated with external fixation, 3 cases with steeliness, 13 cases with Metanghin nail, 45 cases with DHS, and 6 cases with proximal femoral nail( PFN). Results The therapeutic effects of the dynamic hip screw(DHS) and PFN trea tment were the best among these methods. The excellent and good rates of DHS, PF N, external fixation, steeliness, and Metanghin were 100%, 87.2%, 33.3%, 69. 2%, respectively. Conclusion For the intertrochanteric fracture of lemur,DHS or PFN is recommendable to the patients who can tolerate an operation, whereas uni lateral external fixation is preferable to those who cannot or will not receive an operation.

Objective To compare the contents of astragaloside Ⅳ and polysaccharides in radix astragali with different growth years, providing reference for the better harvest time of radix astragali. Methods HPLC-ELSD was used to determine the content of astragaloside Ⅳ. A Hypersil-Keystone C18 column was used with the mobile phase consisting of acetonitrile-water (33∶67). The flow rate was set at 1.0 mL/min. The parameters of drift tube and gas flow rate of the detector were set at 105 ℃ and 2.7 L/min respectively. Phenol-sulfuric method was employed to determine the content of polysaccharides, and the detection wavelength was set at 490 nm. Results The linear range of astragaloside Ⅳ was within 1.25-6.28 μg. The average recovery was 97.28%, with RSD=1.42%. The linear range of polysaccharides was 10-100 μg. The average recovery was 99.02%, with RSD=0.94%. The content of astragaloside Ⅳ in radix astragali cultivated for more than 1 year was higher than the standard in Chinese Pharmacopoeia, and radix astragali cultivated for 3 years showed the highest content. The content of polysaccharides in radix astragali cultivated for more than 3 years was the highest, and radix astragali cultivated for 2 years was slightly lower. Conclusion The better harvest time for radix astragali is at least two years of growth, which is judged from the content of astragaloside Ⅳ and polysaccharides.