The check methods of thyroid nodules include palpation,serum thyroid hormone and high-frequency ultrasound.When the diagnosis is difficult,fine-needle aspiration (FNA) is carried to differentiate benign and malignant nodules.In clinical practice,approximately 20％ of FNA-derived cytology reports can not meet the standard of benign or malignant.Some specific molecular biomarkers are applied to the derivative detection of FNA,which achieve considerable progress and improve the preoperative diagnostic rate.

ObjectiveTo Investigate the influencing fators of somatoform disorder and combidity with depressive-anxiety disorders in general hospital patients.MethodsA multi-center,hospital-based cross-sectional study was conducted.A total of 2044 subjects were screened by using general questionnaire,self-made investing scale related somatoform disorder,hospital anxiety and depression scale(HADS) and general health condition survey.Hamilton anxiety scale (HAMA),hamilton depression scale (HAMD),mini international neuropsychiatric interview (MINI)was used to evaluate by psychiatrists for the subjects who scored≥ 9on HADS.Results 16.24％ of all the patients with stamic have been diagnosed and confirmed with depression and anxiety.Possible causes for depression and anxiety included family depression history(P＜ 0.001,OR=83.481 ),past incidence of the disease (P =0.012,OR =4.758),weak ability in handling it (P ＜ 0.001,OR =3.790),bad health condition(P ＜ 0.0001,OR =5.283 ),aggravation of disease(P ＜ 0.001,OR =2.840),bad martial condition (P =0.009,OR =1.805 ),multiple intercurrent diseases (P =0.001,OR =2.051 ),and dissatisfaction of the salary(P ＜0.001,0R=2.362) and tiredness of working(P=0.0054,OR=3.136).ConclusionThe risk factor of somatic patients with the depression and anxiety include family depression history,past incidence of the disease,weak ability in handling it,bad health condition,aggravation of disease,bad martial condition,multiple intercurrent diseases,and dissatisfaction of the salary and tiredness of working.

Objective To evaluate the effect of perioperative administration of Ambroxol combined with Ipratropium on elderly lung cancer patients undergoing thoracoscopic surgery.Methods 82 lung cancer patients aged ≥70 years who were scheduled for thoracoscopic lung resection were randomly assigned into 2 groups:the observation group(n=42) and the control group(n=40).Patients in the observation group were treated with 90 mg Ambroxol(mucosolvan) by intravenous drip and Ipratropium(atrovent) by atomizing inhalation,while patients in the control group were treated with an equal volume of 0.9％ sodium chloride solution.Pulmonary function and changes of arterial blood gases at admission,before surgery and 5 days after surgery,incidences of postoperative atelectasis and pulmonary infection,the rate of return to the intensive care unit(ICU),and the length of postoperative hospital stay were compared between the 2 groups.Results Compared with the control group,the percent predicted forced expiratory volume in 1 second (FEV1％),the ratio of forced expiratory volume in 1 second to forced vital capacity(FEV1/FVC％),the percent predicted maximum ventilation volume per minute (MVV％),and the arterial oxygen pressure (PaO2) were increased in the observation group before surgery [(87.0±8.2)％ vs.(80.6±7.6) ％,(90.4±6.4)％ vs.(81.4±7.0)％,(87.1±5.6)％ vs.(74.6±6.9) ％,(86.6±6.2) mmHg vs.(81.7±6.9)mmHg,t=2.477,2.588,2.937,3.405,respectively,allP＜0.05].TheFEV1％,FEV1/FVC％,MVV％ and PaO2 were higher in the observation group than in the control group 5 days after treatment [(76.4±9.2) ％ vs.(67.3±10.2) ％,(74.7±9.1) ％ vs.(63.0±11.2) ％,(69.5±9.2)％ vs.(60.1±9.2) ％,(79.5±11.5) mmHg vs.(70.1±11.8) mmHg,t 2.583,2.987,2.778,2.666,respectively,all P＜0.05].The incidences of postoperative atelectasis,pulmonary infection and the length of postoperative hospital stay were lower or less in the observation group than in the controlgroup[7.1％ vs.25.0％,11.90％ vs.32.50％,(8.5±1.8) days vs.(12.1±2.6) days,x2=4.897,5.072,2.351,respectively,all P＜0.05].No significant difference in the rate of return to ICU was found between the two groups(P＞0.05).Conclusions The combination of perioperative Ambroxol and Ipratropium can effectively improve lung function by improving ventilation and gas exchange function,reduce postoperative pulmonary complications and shorten the length of postoperative hospital stay in lung cancer patients aged 70 years and over.

Objective To investigate the application of left transthoracic small incisions in combination with tubular gastrectomy for radical esophageal cancer surgery in elderly patients.Methods Clinical data of 83 patients with carcinoma in the middle or lower third of the esophagus aged ≥ 70 years who had undergone radical surgery at our hospital from January 2012 to September 2014 were collected.Patients were divided into two groups:the tubular gastrectomy group (n=38) which had undergone radical surgery through left transthoracic small incisions in combination with tubular gastrectomy and the stomach group (n =45) which had been treated with esophagectomy through conventional left posterolateral incisions and esophageal reconstruction with the remnant stomach.Clinical outcomes were compared between the two groups.Results Compared with the stomach group,operative blood loss [(204.3±75.4) ml vs.(258.4±80.2) ml,t=2.720,P＜0.05],chest drainage on the first and second postoperative day [(201.7±82.6) ml vs.(320.5±78.1) ml,(150.8±83.0) ml vs.(244.6 ± 81.2) ml,t =3.221 and 3.189,respectively,each P＜0.05],pain scores on the third postoperative day [(3.73 ± 1.02) vs.(0.24 ± 1.15),t =2.858,P ＜ 0.05],incidence of arrhythmia (13.2％ vs.33.3％,x2 =4.585,P＜0.05),pulmonary complications (18.4％ vs.46.7％,x2=7.353,P＜0.05) and incidences of gastroesophageal reflux and gastric emptying disorders (23.7％ vs.55.6％,0.0％ vs 11.1％,x2 =8.654 and 4.493,both P＜0.05) were less or lower in the tubular gastrectomy group.The two groups had no significant difference in operation time,length of hospital stay,anastomotic leakage,anastomotic stenosis or 1-year survival rate (each P ＞0.05).Conclusions Radical surgery with small incisions through the left chest combined with tubular gastrectomy shows highly favorable clinical outcomes in elderly patients with middle or lower esophageal cancer,and can significantly reduce surgical trauma,decrease postoperative complications,improve the quality of life,and help patients recover after surgery.

Objective:To evaluate the efficacy of task-oriented training for rehabilitation of stroke patients with hemiplegia in the community.Methods:Eighty stroke patients with hemiplegia receiving rehabilitation in Shanghai Babsongyuan Subdistrict Community Health Service Center from January 2017 to December 2019 were enrolled in the study. According to the rehabilitation methods, the patients were divided into the observation group (42 cases) and the control group (38 cases). Both groups were given routine Bobath technique and motor relearning method for 3 months; on this basis the observation group was given additional task-oriented training. The Brunnstrum stage was used to evaluate the limb function, Bobath balance scale was used to evaluate the sitting and standing balance function, and modified Barthel Index (MBI) was used to evaluate the activities of daily living.Results:The Brunnstrum stage of upper limbs, hands and lower limbs, Bobath sitting and standing balance function classification and MBI score of the two groups were significantly improved after treatment (the observation group: Uc=5.037, 4.567, 5.228, 2.538, 6.508, t=36.215, P<0.05; the control group: Uc=2.483, 2.311, 2.335, 2.200, 4.102, t=29.260, P<0.05). While the Brunnstrum stage of upper limb, hand and lower limb, Bobath sitting and standing balance function grade of observation group were significantly better than those of control group, MBI score was significantly higher than that of control group ( Uc=2.592, 2.243, 2.897, 2.018, 2.825, t=8.375, P<0.05). Conclusion:Bobath technique and motor relearning method combined with task-oriented training can significantly enhance the recovery of limb motor function and the improvement of activities of daily living of stroke patients.

To date,measuring the neural activity of speech processing in adults and children after cochlear implantation has been a great challenge because conventional neuroimaging techniques are limited by the magnetic properties of cochlear implants.Functional near-infrared spectroscopy(fNIRS)is a non-invasive imaging technique for neuroimaging the brain compatible with implanted devices and unaffected by electrical artifacts.fNIRS is suitable for measuring the neural activity of speech processing in adult and pediatric cochlear implant recipients and can better identify and interpret cortical responses.The purpose of this paper is to summarize the use of fNIRS as a tool to measure the neural activation level of speech processing in cochlear implant recipients for different types of speech stimuli,and thus to provide a clinical and objective basis for the assessment of auditory speech rehabilitation and the development of rehabilitation programs for implant recipients.

Objective To establish a predictive model using multiple layer perceptron (MLP) for short-term outcome after subacute ischemic stroke.Methods From January, 2019 to September, 2021, 60 readmission-inpatients in Department of Rehabilitation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were collected the clinical features of first admission (less than 30 days after attack), and the outcomes were assessed with modified Rankin Scale (MRS) three months after the first admission. The risk factors were screened with single factor analysis, and the short-term outcome predictive models were established with multi-factor Logistic regression and MLP. The predictive accuracy of both models was calculated, and the predictive effects were compared with Receiver Operating Characteristic (ROC) curve.Results For multi-factor Logistic regression, the predictive accuracy was 73.3%, and the area under ROC curve was 0.851. For MLP, the predictive accuracy was 88.9%, and the area under the ROC curve was 0.930.Conclusion The prediction of short-term outcome after subacute ischemic stroke can be done with MLP model.