Objective:To explore the curative effect and safety of unilateral radical thyroidectomy via axillary approach endoscope without air insufflation.Methods:The clinical data of 80 patients with unilateral thyroid cancer in Huaibei People's Hospital in Anhui Province from June 2017 to June 2019 were retrospectively analyzed. The patients were divided into the control group (40 cases) and the observation group (40 cases) according to the surgical method. The observation group was treated with unilateral radical thyroidectomy via axillary approach endoscope without air insufflation, and the control group was treated with open surgery plan. The dissection number of lymph nodes in the central area, the time of flap separation and cavity establishment, the total operation time, the drainage volume and the days of hospital stay in patients of two groups were recorded, and the postoperative complications were evaluated and recorded. The neck and chest pain of patients were investigated with visual analogue scoring method (VAS) at 3 days, 1 month and 3 months after surgery. The white blood cell count (WBC), interleukin 6 (IL-6) and C-reactive protein (CRP) levels were measured before and 24 hours after treatment. The cosmetic satisfaction of the patients was investigated at 3 months after surgery.Results:The time of flap separation and cavity construction, total operation time, drainage volume and hospitalization days in the observation group were (34.27±4.38) min, (130.75±12.28) min, (143.49±15.48) ml, and (7.21±1.95) days, and they were (12.43±1.83) min, (90.38±8.65) min, (87.48±12.11) ml, and (5.48±1.32) days in the control group, and the differences between the two groups were statistically significant ( t values were 29.098, 17.002, 18.024, and 3.576, all P < 0.01). The VAS score of chest pain in the observation group was higher than that in the control group at 3 days after surgery ( P < 0.05); the CRP and WBC levels in the observation group were lower than those in the control group at 24 hours after treatment (both P < 0.05). The cosmetic satisfaction rating grade in the observation group was 6 cases of grade Ⅰ, 31 cases of grade Ⅱ, 2 cases of grade Ⅲ and 1 case of grade Ⅳ, and there were 1 case of grade Ⅰ, 10 cases of grade Ⅱ, 24 cases of grade Ⅲ and 5 cases of grade Ⅳ in the control group, the cosmetic satisfaction of the observation group was better than that of the control group ( P < 0.05). There was no significant difference in the incidence of postoperative wound infection, temporary recurrent laryngeal nerve paralysis and subcutaneous hematoma between the two groups (all P > 0.05). Conclusion:The radical thyroidectomy via axillary approach endoscope without air insufflation has good therapeutic and cosmetic effects, and it can effectively reduce the inflammatory response in patients.

Objective:To investigate the correlation relationship between self-esteem and imposter phenomenon among nurses,and to provide reference for optimizing nurse team.Methods:A total of 836 nurses were selected from February to March 2023 in the Yongzhou Central Hospital of Hunan Province and the People′s Hospital of Longhua, Shenzhen. A cross-sectional survey was conducted on nurses using the General Data Questionnaire, Impostor Phenomenon Scale and Self-Esteem Scale.Results:The imposter phenomenon score of nurses was (48.97 ± 12.58) points and the self-esteem score was (28.93 ± 3.86) points. The total score of self-esteem was negatively correlated with the total score of imposter phenomenon ( r= -0.433, P<0.01). Multivariate linear regression analysis showed that with the increase of self-esteem score, the score of imposter phenomenon decreased ( B=-1.402, P<0.01). Self-esteem was an important factor affecting the imposter phenomenon among clinical nurses, accounting for 18.9% of the total variation. Conclusions:The self-esteem and imposter phenomenon of clinical nurses are both at a moderate level, the improvement of self-esteem is beneficial to decreased their imposter phenomenon.

Objective: To discuss the effect of high-density fat-binding SVF-GEL in female facial lipofilling. Methods: This is a retrospective study including 32 female patients, received facial fat transplantation during June 2017 to June 2018 in Yichun College. Each patient underwent high-density fat-binding SVF-GEL transplantation for facial surgery. Patients′satisfaction with the surgery and the rate of secondary surgery was evaluated. Fat was harvested from the inner thigh, centrifuged at 1200 g for 3 min, and the liquid was removed. The upper 2/3 part is prepared for SVF-GEL, for further used in delicate lipofilling in eyelid, tear groove and nasolabial groove. The lower 1/3 high density fat was used for volume restoration, such as forehead, temporal area and cheek. Results: All patients had significant improvements in facial contours with mild swelling and short recovery time. The satisfaction rate was 68.8%(22/32), and the second operation rate was 15.6%(5/32). Conclusions High-density fat-binding SVF-GEL transplantation can achieve good results in correcting facial volume loss.

Objective To analyze the prevalence and genetic characteristics of influenza A(H3N2) viruses in the city of Xiangyang in 2022-2023, and to provide a scientific basis for predicting the epidemic and mutation of influenza virus. Methods Throat swab specimens of the influenza like cases were collected from national influenza monitoring sentinel hospitals in Xiangyang every week. RNA was extracted from the specimens for influenza diagnosing using real-time RT-PCR．Viruses were isolated from H3N2 positive specimens, and HA and NA genes were amplified and sequenced．3D modeling analyses were conducted. Results The gene phylogenetic tree showed that the H3N2 isolates in 2022-2023 belonged to 3C.2a1b.2a1 and 3C.2a1b.2a2 branches, respectively. The A(H3N2) influenza virus strains all had amino acid point mutation sites on important antigenic determinants of HA protein. The epitope mutations of the 2022 A(H3N2) strain mainly occurred in regions B, C, and D. The epitope mutations of the A(H3N2) strain in 2023 mainly occurred in regions C and D. Different glycosylation sites of HA gene were found in 2022-2023 strains. No variation was found in key amino acid sites associated with neuraminidase inhibitor resistance. The difference of overall structure was not obvious in the three-dimensional simulation structure diagram. Conclusion The A(H3N2) influenza strains isolated in this study have shown antigenic drift, especially the mutation of HA, which may affect the protective effect of the vaccine on the local population and lead to influenza epidemic. The variations of HA and NA suggest that close attention should be paid to the epidemic and genetic variation of H3N2 subtype influenza virus, to provide a scientific basis for the selection of influenza virus vaccine strains and the prevention and control of influenza.