Objective: Thyroid nodules are common clinical thyroid disorders.The purpose of this study was to investigate the diagnostic value of the clinical characteristics and various parameters of malignant thyroid nodules and the sensitive indexes for their differentiation so as to improve the diagnosis of malignant thyroid nodules and avoid unnecessary procedures or operations.Methods: We retrospectively studied 600 cases of thyroid nodules treated by surgery from 2001 to 2008,divided them into a benign and a malignant group according to the pathological results,and analyzed by multivariate logistic regression the correlation between the nature of thyroid nodules and various factors.Results: Of the 600 cases of thyroid nodules,519(83.47%) were benign and 81(16.53%) were malignant.Clinical symptoms and signs,ultrasonography and CT were all useful in indicating malignancy,especially ultrasonography,whose specificity and diagnostic accuracy were 93.3% and 84.2%,respectively.Multivariate logistic regression analysis revealed a higher rate of malignancy in younger patients with solid or hard nodules,or accompanied with calcification or painless adenophyma in the neck.Conclusion: Clinical symptoms and signs,ultrosonography and CT are of significant value in the diagnosis of malignant thyroid nodules.

Objective:To study the integrated information nursing mode of perioperative medical care under the multidisciplinary cooperation of hip fracture in the elderly patients, provide reference for perioperative nursing of elderly hip fracture.Methods:A total of 1 019 patients with hip fracture from May 2018 to May 2019 in Beijing Jishuitan Hospital were randomly selected as the study object, and the non synchronous control was used for the study. From May to December 2018, 527 elderly patients with hip fracture in orthopaedic department of general trauma were taken as the control group, adopting the traditional treatment and nursing mode; from January to May 2019, 492 elderly patients with hip fracture in elderly trauma orthopaedics department were taken as the intervention group. Under the multidisciplinary cooperation, the information-based nursing mode of integrated medical care was implemented, and a multidisciplinary integrated medical care team was established. The information-based platform was used to optimize the clinical nursing path, and standardized, individualized and continuous nursing scheme was developed. The time from visit to hospitalization, the time from hospitalization to operation, hospitalization time, incidence of more than moderate pain, incidence of venous thromboembolism, incidence of stress injury, incidence of delirium and satisfaction of patients and their families at discharge were compared between the two groups.Results:The number of patients in the intervention group was higher than that in the control group within 4 and 24 hours. The rate of operation in 48 h increased from 8.0%(42/527) to 50.0%(246/492), and the rate of operation in 1 week increased from 70.0%(369/527) to 99.0%(487/492). Compared with the control group, the incidence of more than moderate pain in the intervention group decreased from 85.0%(448/527) to 2.0%(10/492), the incidence of venous thromboembolism in the hospital decreased from 12.0%(63/527) to 4.1%(20/492), and the incidence of pressure injury in hip fracture in the elderly decreased from 2.1%(11/527) to 0.2%(1/492); the incidence of delirium in the hospital decreased from 21.1%(111/527) to 8.1%(40/492); the hospital stay was shortened from (13.42 ± 3.36) d to (7.26 ± 2.03) d, and the satisfaction of patients and their families increased from 60.9%(321/527) to 95.9%(472/492). There were statistical significance between the two groups (χ 2 values were 4.157-708.006, t value was -35.119, P<0.05 or 0.01). Conclusions:The information-based nursing mode of integrated medical care under the multidisciplinary cooperation can adapt to the development of hip fracture in the elderly, which is conducive to the accelerated rehabilitation of patients.

Objective:To investigate the clinical effect of linezolid combined with levofloxacin in the intensive treatment of tuberculous meningitis.Methods:Seventy-six patients with tuberculous meningitis who underwent intensive treatment from May 2015 to April 2018 in the Fourth People's Hospital of Taiyuan were included in this study. They were assigned to a control group ( n = 38) and an observation group ( n = 38) according to treatment methods. The control group was given conventional treatment (isoniazid + rifampicin + pyrazinamide + ethambutol). The observation group was given treatment with linezolid combined with levofloxacin based on conventional treatment. All patients were treated for 8 successive weeks. Clinical efficacy was compared between the two groups. Results:Total effective rate and the incidence of complications were 92.11% (35/38) and 5.26% (2/38) respectively in the observation group, and they were 68.42% (26/38) and 23.68% (9/38) respectively in the control group. There were significant differences in total effective rate and the incidence of complications between the two groups ( χ2 = 6.727 and 5.028, both P < 0.05). After treatment, white blood cell count, blood glucose level, and protein level were (30.21 ± 4.16) × 10 6/L, (3.65 ± 0.32) mmol/L and (0.79 ± 0.05) g/L, respectively in the observation group, while they were (54.28 ± 6.42) × 10 6/L, (2.18 ± 0.21) mmol/L, (0.98 ± 0.21) g/L, respectively in the control group. There were significant differences in white blood cell count, blood glucose level and protein level between the two groups ( t = 19.396, 23.675, 4.538, all P < 0.05). There was significant difference in the score of quality of life between the control and observation groups [(187.59 ± 4.11) points vs. (216.94 ± 3.90) points, t = 31.933, P < 0.05]. Conclusion:Linezolid combined with levofloxacin based on conventional treatment exhibits better clinical efficacy with high safety in the intensive treatment of tuberculous meningitis than conventional treatment.

Objective:To analyze and discuss the factors of seizure induced by imipenem/cilastatin.Method: The reports of seizure induced by imipenem/cilastatin from CBMDisc(1971-2006)and CHKD(1994-2006)were re- viewed and analyzed with Excel.Result:28 cases of seizure induced by imipenem/cilastatin were collected,including 20 men and 8 women with the principal primary respiratory infection with an average age of 66.5.Seizure occurred as early as 10 min.after the medication,and occurred latest in the fourth day of the medication.22 cases showed grand mal seizure and 6,partial seizure with a duration ranging from 20s to 30min and with a frequency of eight seizures.18 cases discontin- ued the administration,and 8 cases took lower daily dosage,in which some were given antiepileptic drugs or other adjunc- tive therapy,and 2 cases were not treated at all.All the cases recovered and were discharged from hospital except one who died from his circulation failure and respiration failure.The cause-effect relations of the relevance evaluation of seizures e- yoked by imipenem/cilastatin were as follows:1 sure case,26 probable cases,and 1 possible case.Conclusion:Seizure can be induced by imipenem/cilastatin,Owhich should be rationally used.More attention should be paid in clinic so as to ensure a safe medication.

The lipoprotein-associated phospholipase A2 (Lp-PLA2), a subtype of the phospholipase A2 superfamily, is produced primarily by macrophages and lymphocytes. Lp-PLA2specifically hydrolyzes oxidized phospholipids on oxidized low-density lipoprotein particles,resulting in production of lysophosphatidylcholine and oxidized fatty acids. Lp-PLA2 is expressed in atherosclerotic plaques and in macrophages within a fibrous cap of unstable plaque.Studies haw shown that the plasma Lp-PLA2 activity increases significantly in patients with ischemic stroke, and Lp-PLA2 may become an independent risk factor for predicting ischemic cerebrovascular events. The selective Lp-PLA2 inhibitor can reduce the inflammatory response,enhance the stability of plaques, and inhibit the formation of atherosclerotic plaques, and may become a new class of drugs for preventing the formation of atherosclerotic plaques.

Mechanical ventilation plays an important role in the treatment of preterm infants,especially respiratory problems.With improvement in both antenatal and neonatal care and therapeutic strategies,premature babies are surviving more than ever.However,the incidence of bronchpulmonary dysplasia remains high which affects the clihical outcomes of premature infants.Non-invasive respiratory support techniques have been used in attempts to decrease lung injury and the complications of preterm infants.This review will focus on various ventilation modalities for managing preterm infants with respiratory failure and lung protective ventilation strategies to minimize lung injury in preterm infants.

Objective To investigate the clinical characteristics of imflamatroy bowel disease (IBD) and the risk factors in developing eoloreetal cancers. Methods Five hundred and thirteen patients with IBD were consecutive collected from Jan. 1996 to Oct. 2007. The history database of these patients was established. The items including demography features, morbidity, diagnosis, the related risk factors, the treatment and outcomes were analyzed. Results Two hundred and forty two out of 513 patients were ulcerative colitis (UC). Of which 4 patients (1.65%) developed cancer and 4 (1.650%) were confirmed with precancer. But none of the 271 patients with Crohn's disease (CD) de-veloped cancer. The Logistic regression analysis showed that weight loss, complications and relapse might be the potential risk factors of the cancer. Conclusions In clinical, the probability that develope to cancer in patients with UC is higher than that in patients with CD. The main risk factors are frequent relapse, weight lost and complications.

Thyroid fine needle aspiration biopsy, ultrasonographically guided thyroid fine needle puncture and the common cytologic pathological characterstics of various thyroid diseases are reviewed, and the clinical application is discussed.

The article reviews primary, secondary and tertiary prevention strategy of thyroid diseases and its possible effect.

Objective To study the clinical value of fat-suppression(FS)sequence and dynamic contrast-enhanced MRI in judging the nature of breast neoplasm.Methods Sixty patients with breast neoplasm(including malignant lesions in 40 cases and benign lesions in 20 cases)proved by histopathology were reviewed.All patients were undergone FS sequence and 30 cases underwent dynamic contrast-enhanced MRI examinations,time-signal curves were acquired.Results 22 malignant lesions in 20 cases and 46 benign lesions in 40 cases were found by FS.Dynamic contrast-enhanced MRI showed 18 malignant and 20 benign lesions.The malignant lesions had visible contrast-enhancement of administration of Gd-DTPA.Type Ⅲ curve was showed in 16 lesions(malignant in 14 and benign in 2),type Ⅱ in 5(malignant in 3 and benign in 2)and type Ⅰ in 17(malignant in 1 and benign in 16).There was significant difference between benign and malignant tumors on the type of time-signal curve(P