Objective:To investigate the clinical outcome after surgery and first 131I treatment in patients with moderate-risk papillary thyroid cancer (PTC), and analyze the relevant factors that affect the therapeutic effect. Methods:From January 2018 to April 2019, 135 patients (48 males, 87 females; age (42.7±11.1) years) with moderate-risk PTC in the Second Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. According to the 2015 American Thyroid Association (ATA) guidelines, patients were divided into excellent response (ER) group, inderteriminate response (IDR) group, biochemical incomplete response (BIR) group and structural incomplete response (SIR) group, of which IDR, BIR, SIR were collectively referred to as the non-ER group. χ2 test and Mann-Whitney U test were used to compare the general clinical features between the ER and non-ER groups, and then multivariate logistic regression analysis was performed. The predicted value of pre-ablation stimulated thyroglobulin (ps-Tg) to ER was assessed by ROC curve analysis. Results:The treatment responses of 94 patients were ER, and those of 41 were non-ER. The differences in tumor size (0.80(0.50, 1.10) vs 1.00(0.55, 1.50) cm; U=1 491.50, P=0.036), the number of metastatic lymph nodes (3(2, 5) vs 4(2, 12); U=1 422.00, P=0.015), metastatic lymph node size (0.50(0.30, 0.65) vs 0.50(0.30, 1.45) cm; U=1 396.50, P=0.013), metastatic lymph node involvement rate (50%(30%, 70%) vs 60%(50%, 85%); U=1 441.50, P=0.024), metastatic lymph node location (central/lateral: 76/18 vs 24/17; χ2=7.40, P=0.007) and ps-Tg level (2.1(0.8, 5.3) vs 14.0(3.2, 35.2) μg/L; U=680.00, P<0.001) were statistically significant between the ER and non-ER groups. Multivariate logistic regression analysis showed that ps-Tg (odds ratio ( OR)=1.200, 95% CI: 1.107-1.302, P<0.001) was an independent factor influencing ER. The cut-off value of ps-Tg for predicting ER was 7.38 μg/L, with the sensitivity and specificity of 68.3%(28/41) and 87.2%(82/94) respectively. Conclusion:Moderate-risk PTC patients with smaller tumor size, fewer metastatic lymph nodes, lower metastatic lymph node involvement rate, metastatic lymph nodes in central area, smaller metastatic lymph node size, and ps-Tg<7.38 μg/L have better therapeutic effect after initial 131I treatment.

Objective: To explore the application and effect of blended BOPPPS teaching mode in medical nursing teaching. Methods: A total of 80 nursing undergraduates of Grade 2014 in Hubei Medical University were divided randomly into teaching reform class and control class, with 40 students in each class. From February 2017 to July 2017, BOPPPS teaching was implemented in the teaching reform class, while traditional teaching was conducted in the control class. At the end of the experiment, Students in the two classes had questionnaire on the satisfaction of the teaching design, tests for self-learning ability and medical nursing level. SPSS 20.0 software was used for statistical analysis. Enumeration data between two classes were compared by chi-square test, while measurement data were compared by t test. Results: ①The number of students who were satisfied in the teaching reform class was 34 (85.0%), which was significantly higher than that of the control class (29, 72.5%). The difference has statistical significance. ② The self-learning dimensions and total score of the teaching reform class were (53.1±5.1), (52.4±4.8), (52.2±4.7), (51.9±4.7), (51.2±4.9) and (260.8±24.2), respectively, which were significantly higher than (48.6±4.3),(49.9±4.3), (49.7±4.1), (47.6±4.0), (47.1±3.9), and (242.9±20.6) of the control class. The differences were statistically significant (average P<0.05 or 0.01). ③The total scores (minutes) for regular assessments, theoretical examinations, and internal medicine education in the reform class were (26.1±2.3), (55.4±5.2), and (81.5±7.5) respectively, which was obviously higher than that(23.7±1.9), (52.6±4.6), (76.3±6.5) of the control class. The differences were statistically significant (average P<0.05 or 0.01). Conclusions The blended BOPPPS teaching focuses on the students, pays close attention to the students' attentiveness, participatory learning and goal achievement. This teaching model can improve students' satisfaction, self-learning ability and medical nursing study in a large extent.