Riedel thyroiditis is a benign disease, which is often self-limited. Examinations, such as CT and histologic diagnosis can distinguish it from malignant neoplasms and hashimoto's thyroiditis. Riedel thyroiditis is an uncommon form of chronic thyroiditis in which the thyroid gland is replaced by fibrous tissue. It can be cured by surgery and medicine.
Chronic Disease ; Diagnosis, Differential ; Hashimoto Disease ; diagnosis ; Humans ; Thyroiditis ; diagnosis

The tutor-subsidizing system is the inevitable outcome of the graduate education development.It can also solve various antinomy appearing in the graduate education.But now there still exist some problems such as the course difference which makes it hard to carry out fair performance,distorted relation between teachers and students,the predicament of some edge courses and washing out of tutors and so on.

Based on the research standpoint of internal needs,innovative research and management practice,the paper revealed and deeply discussed the 20 drivers behind the full play of medical doctor students' innovative behavior through the use of the method of questionnaire,expert in-depth interviews.

Thirty patients with ulcerative rectitis were treated by lavement of balsalazide sodium solution combined with Xileisan (test group).The results were compared with those treated by salazosulfapyridine (SASP) suppository (control Ⅰ group, n = 25 ) and those treated by lavement of prednisolone and tinidazole (control Ⅱ group, n =28).The complete remission rate and effective rate were 67% (20/30)and 90% (27/30), 36% (9/25) and 60% (15/25), 68% (19/28) and 86% (24/28) for test group, control Ⅰ group and control Ⅱ group, respectively.The efficacy of test group and control Ⅱ group was better than that of control Ⅰ group (P ＜ 0.05).The least side effects occurred in test group ( P ＜0.05).The recurrence rates of 3 groups were 20% (4/20), 2/9 and 5/19, respectively.Lavement of balsalazide sodium solution combined with Xileisan is effective for ulcerative rectitis with less side effects.

Objective To study the characteristic and manifestations in the middle aged and elderly peoplewith discoid meniscus injury and the outcome of the arthroscopic surgery. Methods Twenty-nine patients with discoid meniscus injury were treated by the arthroscopic surgery from January 2009 to May 2013. According to the injury of discoid meniscus in operation, 6 cases (6 knees , 20.69%) underwent meniscal plasty, 16 cases (16 knees, 55.17%) underwent subtotal meniscectomy, and 7 cases (7 knees, 24.14%) underwent meniscectomy. The Ikeuchi and Lysholm evaluation system was used to assess knee joint function and compared. Results All the postoperative patients were followed up for 12-18 months, and the average was 14 months. According to Ikeuchi knee rating, 5 cases were excellent, 17 cases were good, 4 cases were fair, 4 cases were poor and the rate of excellent and good was 75.86%. Lysholm scores 3, 6 and 12 months after operation were (65.76 ± 5.35), (70.27 ± 4.73) and (77.81 ± 6.24) scores, and before operation was (55.47 ± 3.63) scores. Three, 6 and 12 months after operation, Lysholm scores were significantly higher than those before operation (P<0.05). Conclusions The middle aged and elderly people discoid meniscus injury has its own characteristics compared with adolescent patients in symptoms, signs, and treatments. Arthroscopic surgery is an effective treatment for discoid meniscus with minimal.

Objective To discuss some expectation on reform of classroom teaching method for eight-year program medical education, in order to provide a basis for the evaluation and reform of classroom teaching method. Methods Investigation that mainly included expectation on reform of classroom teaching method, classroom teaching method of most expected application, and ex-pected value of classroom teaching method was investigated and analyzed with self-made question-naire, to total 78 medical students (22 of Grade 2008, 20 of Grade 2009, 20 of Grade 2010, 16 of Grade 2011) of eight-year program who had completed the stage before medical education in the uni-versity, and related 32 teachers. Software of SPSS 20.0 was used to make statistical analysis. Results In the survey, 55.8% students and 78.1% teachers hoped to reform the current classroom teaching methods (χ2=4.782,P=0.029). 61%students and 90.6% teachers expected comprehensive application of diverse method(χ2=15.464,P=0.017), including instruction combined with writing on blackboard, teaching by multimedia, PBL, inversion-type class, independent learning, a lot of questions for exami-nation, and so on. The value expectation (>60%) of classroom teaching method was multivariate, in-cluding to stimulate students' interest in learning, to cultivate ability of finding and solving problems, conducive to understanding of knowledge and memory, conducive to comprehension and memory of knowledge, conducive to cultivation of learning method, able to improve ability of creativity and criti-cal thinking, conducive to strengthening interaction and communication of teachers and students, to improve the subject consciousness of student in classroom, helpful to cultivate the spirit of teamwork, to improve the efficiency of teaching, and able to make full use of information technology. Conclusions For the diversified value demand and the highly expectation on reform of current classroom teaching method, more attention should be paid to evaluation and guidance on reform of classroom teaching method for eight-year program medical education.

Objective To investigate the effect of pidotimod granules combined with Yupingfeng granules in the treatment of children with recurrent respiratory infection.Methods A total of 124 patients in the treatment of children′s immunologic function with recurrent respiratory infection were taken into this research.124 patients were divided into OBG(63 patients)group and COG(61 patients)group according to random number table and treated with pidotimod granules and Yupingfeng granules.Statistics of children′s treatment in the two groups were collected and analyzed after research.Results In OBG group,there were 33 excellent cases,28 effective cases,2 void cases,and the treatment efficiency was 96.83%,which were better than those in COG group(χ2 =8.796,9.054,8.931,9.135, all P <0.05).In OBG group,the extinction time of fever,moist rale,expectoration and chest pain were significantly shorter than those in COG group(t =8.562,9.025,8.747,8.637,all P <0.05).The differences between the two groups after treatment in IMF were statistically significant (all P <0.05 ).Conclusion Pidotimod granules and Yupingfeng granules has perfect effect in the treatment of children′s immunologic function with recurrent respiratory infection,which is worthy of promotion.

Objective:To investigate the clinical diagnosis and treatment of idiopathic subglottic stenosis.Methods:From May 2012 to January 2014,four patients with idiopathic subglottic stenosis admitted in the Department of Otolaryngology,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China were selected for review.Results:All the four patients with idiopathic subglottic stenosis were resolved after the resection of the pathological tissues and subsequent hormone treatment.Conclusions:The confirmed diagnosis of idiopathic subglottic stenosis mainly relied on the medical history and pathological examination.Favorable treatment effects might be obtained by combining surgical resection and hormone treatment.

This paper reviewed the basic concepts of creativity and systematic perspective on creativity and systematically analyzed the connotation of creativity in doctoral candidates,thus summarizing the advantages of the development of creativity in doctoral candidates:physiological function,intellectual quality,non-intellectual quality and professional innovation that may help to unleash creativity,knowledgeable,dedicated,and innovative supervisors and a correspondingly suitable environment,which is of great importance to the researches on unleashing the creativity in doctoral candidates and creating innovative results.

Objective:To evaluate the positive rate of the bronchodilation test (BDT) in asthmatic children with normal forced expiratory volume in 1 second (FEV 1), forced vital capacity (FVC) and FEV 1/FVC, so as to improve the recognition of the importance of the BDT test in asthmatic children with normal FEV 1, FVC and FEV 1/FVC. Methods:Children aged 5-14 who were diagnosed with asthma in the outpatient clinic of Shandong Provincial Hospital Affiliated to Shandong University from September 2018 to August 2019 and willing to receive pulmonary function and BDT examinations were enrolled.Data of pulmonary function of children with normal FEV 1, FVC and FEV 1/FVC were collected to analyze the rate of positive BDT results and the status of small airway function. Results:A total of 1 631 asthmatic children with normal FEV 1, FVC and FEV 1/FVC were enrolled in this study, including 1 414 children with normal pulmonary function and 217 children with small airway dysfunction.Fifteen minutes after the bronchodilator was inhaled, 127 children (87 males and 40 females) showed positive BDT results, accounting for 7.8%.Among these children, 62 cases (28.6%) with co-existing small airway dysfunction showed positive BDT results.The improvement rate of FEV 1 was 8.0% to 11.9% in 132 cases (8.1%). The FEV 1 before bronchodilator inhalation accounted for (98.5±10.3)% of the predicted value.Fifteen minutes after terbutaline sulfate inhalation, the improvement rate was 13.5% (12.5%, 16.2%). The improvement rates of forced expiratory flow at 50% of FVC exhaled (FEF 50, r=-0.339, P<0.01), forced expiratory flow at 75% of forced vital capacity exhaled (FEF 75, r=-0.400, P<0.01), maximum mid-expiratory flow(MMEF, r=-0.375, P<0.01) were negatively correlated with their baseline values.The improvement rate of FEV 1 was not associated with its baseline value ( r=-0.128, P=0.153), but negatively correlated with the baseline value of MMEF ( r=-0.231, P<0.01). Conclusions:BDT results are positive in some asthmatic children with normal FEV 1, FVC and FEV 1/FVC.It is recommended that BDT testing should be conducted as much as possible in the diagnosis and follow-up of children with typical or atypical asthma.In this way, the diagnosis can be confirmed and the current optimal results can be obtained.Meanwhile, small airway function testing is helpful for comprehensive assessment of asthma and its control level.